Saint Petersburg Doctors

Do I Really Need Mastopexy on Top of Different Size Implants For Asymmetry? (photo)

Hello, i have been to one surgeon who has suggested me to have a breast augmentation with mastopexy on my right breast, because of the position of my nipple, She says if i don't get it done, the assymetry will still be there with two different size implants, and it won't look nice and i won't like the result. i was against the mastopexy (which she plans to do around the aerola) because i am scared of having scars...she suggested 150-200cc but i think i am going for 200-300cc would it be too big?

Your photo demonstrates a good deal of asymmetry on your breasts, with the right side being much fuller than the left side. I do feel that some degree of breast lifting on your right side might be required in order to be approximate symmetry. However, it is possible to undergo breast augmentation only and see what kind of asymmetry persists. It is not completely unrealistic to hope that matching breast size alone could provide you with enough symmetry at the moment that a mastopexy would not be required.   You could always have the mastopexy done at a later date if you did not obtain the symmetry that you desired.

Antonio Gayoso, MD

Saint Petersburg Plastic Surgeon

How Do I Know Which CC's Will Look Ok On My Body? (photo)

I am 5'7 1/2 and weigh 180 pounds. I currently wear a 36B and recently went to a consultation. I tried on 375cc's and thought it may be too big. My doctor said no, and encouraged me to go bigger. I'm unsure what will look good? I ultimately want to be a D but I don't want it to look too extreme. But I also don't want to go through with getting 375 or 400cc's and it turn out to be too small. What do you recommend? Help! I have attached my pic along with two pictures I would like to look like.

Hi there-

Questions like yours are incredibly common and the choice of implant tends to generate an extreme amount of anxiety in patients... I have found the following very helpful:

Take a deep breath and think about the following...

The reason you are pursuing breast augmentation is because you would like to safely achieve a more pleasing breast appearance. Right?

You didn't wake up one day and think, "I really want the letter on my bra to be a D", or "I really want a sack of goo in my chest that has the number 400 on it"...

In other words, in my opinion, because it is a certain appearance that women like yourself are trying to achieve through the surgery, and NOT a letter on their bra or a number on their implants, using those measures to communicate goals or judge outcomes misses the point a bit, is too indirect, and greatly increases the chances of postoperative unhappiness.

After surgery, if the implants you chose are the ones you got, but your breasts look funny, will you be happy? 

Conversely, if your breasts are beautiful after surgery and look very close to what you envisioned for yourself, but the number on them is different than what you thought you were going to get, would you be concerned?

Take a step back from the trees, and look at the forrest- I think you'll agree the best thing you can do (other than choose your surgeon very carefully and based on the appropriate criteria- hint- lowest price is not a good one to use) to maximize your chances of being happy is to very carefully communicate your goals for appearance to your surgeon. Then give him the freedom to do what is necessary to achieve that appearance for you.

Choosing the implant before surgery gives the patient the (false) sense of security and control that (at least before surgery) might make you feel more comfortable about the process, and helps the surgeon absolve themselves of responsibility if the patient is unhappy after surgery (you picked them), but does not (IMHO) lead to a higher percentage of happy patients. In fact, this is (again, IMHO) a large part of the reason that the FDA expressed concerns that up to 10% of breast augmentation patients have a second operation within the first 12 months after surgery- because they are not happy with the size of the implants.

Communicate your appearance. Choose a surgeon carefully and trust their skills and judgment. Follow all instructions carefully.

Armando Soto, MD

Orlando Plastic Surgeon

Can You Get Fat Grafting Done on Your Face After You Have Have Fillers Placed? Can I Get a BBL at the Same Time?

i am a small framed caucasian/asian 40 year old. Can I have fat grafting done on my face if I have had a filler Six months ago (hylaronia, I think that is how to spell it) but it has clearly worn off. I really want to have a Brazilian butt lift and have my crows feet and forehead worked on as well. I have been working on increasing my body fat % which is now 19%. I am wondering if I am a candidate for a BBL with no implants and if I would be able to address my face issues at the same time.

Hi there-

Provided you are a good candidate for your desired improvements, there should be no reason that they cannot be performed as you describe.

If fat is grafted into your face in the same area you previously had filler, and if some of the filler result persists at the time of fat grafting, it is possible that as the remaining filler material goes away your overall outcome is diminished, making it necessary to supplement it (either with more filler or more fat). In this regard it may behoove you to wait until you are confident the filler is gone.

Otherwise there should be no problem.

Armando Soto, MD

Orlando Plastic Surgeon