Inland Empire Plastic Surgeons

Are my Areola Incision Scars Healing Well? (photo)

I am an African American 8 months post op (breast aug) and I am very worried about how my scars are healing. They often appear bright pink or red. Also I can feel the scars over my shirt this worries me that they aren’t healing flat enough. I have not used anything to aid in the healing of the scars and wonder if I should use some of the suggested silicone strips, scar cream or vitamin E.

If you have a thick scar 8 months after a breast augmentation it still may go down and soften.  If it does not cortisone is an option but it may blanche the scar and make it more visible, also it may thin it out too much as well.  This would make the scar indented instead of raised.  Silicone gel sheeting is the only proven treatment other than cortisone injection which has been shown to improve scar thickness.  If  the color of the scar does not improve surgical revision is a good option.

Dev Wali, MD

Los Angeles Plastic Surgeon

Options To Correct a Crooked Mouth? (photo)

Hi I noticed that my mouth seems crooked a few months ago - it's really obvious in pictures but noone has ever pointed it to me. When i smile it looks more even for some reason. What can be the reasons and what is a possible treatment for that? Thanks!

You have a subtle problem that appears fairly "real."  That is to say that the right side of your mouth at rest is is pulled more than the left, which is shifting your philtrum (central part of your upper lip).  The problem fortunately seems to disappear with aggressive smiling.  You are most likely habitually activating the right corner of your mouth at rest, but you may not be aware of it.  Sometimes, this sort of appearance may be due to facial weakness on one side as one might get when recovering from Bell's palsy (or temporary paralysis of the facial nerve).  However, it sounds like this has been a lifelong problem.  To correct the habit of shifting your mouth to the right, you may want to consider biofeedback therapy with a trained therapist who specializes in facial weakness or paralysis.  Alternatively, very careful administration of Botox or Dysport on the overactive right side of your face may balance your closed lip posture in repose.  If this problem is truly bothersome, then I would suggest seeing a board-certified plastic surgeon with expertise in facial paralysis for a more accurate recommendation.

Andre Panossian, MD

Los Angeles Plastic Surgeon

Can I Get Large Implants to Avoid Lift? (photo)

Hi, I'm wanting to end up in the 34f range. Ive breast fed 2 children so I'm pretty saggy/deflated/very sad looking. Is there a way to avoid the lift using a large implant or does that not matter? Also is it customary for the surgeon to place the implants first then do the lift? I think I'm just paranoid my nipples will end up in some strange position. thanks!

Using a large implant to treat sagging breasts does not usually work.  One way to check for yourself is to see where the bottom of your breast attaches to the chest wall.  if the breast or if the nipple hang below this point then most likely you will need a lift.  This is mainly because the implant usually cannot be placed below the fold of the breast.  So, if you simply put an implant and do not do a lift then the drooping tissue will likely be hanging lower than where the implant is on the chest. 

Dev Wali, MD

Los Angeles Plastic Surgeon