Boise Plastic Surgeons

Fat Injection to Fix Atrophic Scar on Face Did Not Work Well, What Can I Do?

I have an unilateral atrophic scar on the face due to trauma years ago.I recently undergone liposuction in the ab area to graft fat for injection into depressed area on face. its been 2 wks post opt-swelling went down alot!but injected fat area are more noticeable now.It looks like the fat was place below instead of into the scar site. the scar look worse now than before.its apparent there is a lump on my face-there is also a shawdow (not bruise) at the scar site now. advice or tx options please

Fat grafting is an excellent procedure and possibly  the best approach to the problem that you had.  The face is very swollen after fat grafting and it is not unexpected to have more edema inferior to the graft site.  Again, this is likely fluid, not fat.  You need to be patient for at least 6 months to know your result.  A second or even third re-grafting in not uncommon.

Mark D. Wigod, MD

Boise Plastic Surgeon

Reconstruction after mastectomy and radiation

I had a right mastectomy in March of this year and was planning on having immediate reconstruction; however, one of the lymph nodes had a tiny bit of cancer in it so they did not do that.  I did have radiation and completed that in June, but did not require chemotherapy.  I am planning on having a TRAM flap and having my left breast reduced and lifted to match the right one (I wanted to be smaller).  Would it be reasonable for me to plan on having this done next March or April?  I have been very diligent about putting Aloe gel on my radiation site, am getting my strength back (even stopped working to speed my recovery) and am working out about 4 times a week (I'm 57).  I want to get this done and move on with my life.  I am VERY self-conscious about going out with the "one breast" and wear big shirts to camoflauge, and only wear the bra & prosthesis when line dancing as it is very uncomfortable. I would appreciate any help you could give me - thank you! Pam Murchison

I have patients wait at least 6 months post radiation therapy before any surgery and I almost always include autologous tissue (tram or latissimus flaps).  Best wishes to you.

Mark D. Wigod, MD

Boise Plastic Surgeon

Translation for a Rhinoplasty Recommendation..."dorsum" & "Suprstip?

Recommendation I received for my rhinoplasty except I don't fully understand... "lower ever so slightly your dorsum to achieve a slight "suprstip" dip"

The dorsum refers to the top ridge of the nose - think the peak of an A frame house.  Most patients and doctors like a smooth dorsum.  The question is, what happens when you get to the tip cartilages?  If there is a clear change in slope between the dorsum and cartilages - think a gentle hockey stick shape - we call this a supra tip break.  You just need to bring in some dorsum to tip transitions that you like to your surgeon to decide what you prefer and if that look is possible for your nose.  Remember, anatomy always beats desire.

Mark D. Wigod, MD

Boise Plastic Surgeon