Baltimore Doctors

What is the Best Implant Position for Tuberous Breast? (photo)

I am 27 yrs old & a 36B. I have 1 son who I nursed. I am very athlethic. My PS says that I have tuberous breast & he will have to give me a mastopexy/augmentation. What is the best placement for the implant? Submuscular or subglandular? He says that the subglandular is better considering my constriction but I have heard that submuscular is the placement of choice when it comes to longevity, future ptosis and rippling/contracture. I want to go up to a full C/small D.

I have to agree with Dr Hochstein on two counts.  
1) It doesn't appear to me that you have a tuberous breast.  You definitely have drooping and at most a very mild component of constriction if any at all. 
2) I never place implants on top of the muscle any more.  I haven't performed Sub Glandular Augmentation in about 10 years.  There are so many benefits to Sub Muscular that it's hard to justify doing subglandular implants at all.  Capsular contractures (tightening of the capsular tissue making the implants feel hard), cancer detection on mammograms, little to no chance of synmastia (implants too close together) and much less chance of bottoming out, etc..... are all better under the muscle!   So, even if there were a slightly better cosmetic outcome with the implants on top of the muscle, I would still recommend under the muscle for the long term outcome.

Daniel P. Markmann, MD

Baltimore Plastic Surgeon

How to Thicken Skin After Rhinoplasty to Avoid Revision? (photo)

So apparently I have thin skin and it is showing imperfections on the tip of my nose. Is there a way to thicken the skin on the nose, I really would like to avoid having a revision if possible.

You should try some HA (hyalurronic acid) fillers, like Restylane or Perlane. Speak to your surgeon about it.

Ronald Schuster, MD

Baltimore Plastic Surgeon

What Can Be Done For My Nose To Be Straight? (photo)

What type of nose do i have? what causes it to be in this shape? What has to be done for it to become straight? Thanks

Your nose is not bad at all. There are a couple of different things that can be done to correct the small little dip in your nose. This is the perfect set up to try a non-surgeical nose correction with fillers. It's safe, relatively inexpensive and will last about a year or so. If you like the result it could be done permanently with a cartilage graft. If you think the "bump" needs to be lowered than you will need surgery. But the bump is not bad and surgery should be very successful. Good luck.

Ronald Schuster, MD

Baltimore Plastic Surgeon