Rockville Plastic Surgeons

Would Filler Work For My Nasolabial Folds? Two Derms Said I'm Too Young at 34. (photo)

I am 34 years old and feel like I have deep smile and nasolabial lines. I have 2 personal friends who are dermatologists that perform filler injections. They have both said I am too young and do not need filler. Should I seek another opinion? Would I benefit? Is there a downside to starting these at 34 outside of cost? These lines were not noticeable 5 years ago and they are quite bothersome to me. Thanks.

Injectable fillers would be expected to smooth your nasolabial folds (smile lines).  Other people your age certainly use wrinkle fillers, and studies done on the nasolabial fold have included patients your age. 

There are temporary fillers and permanent ones.  While a permanent filler might sound attractive, no one knows how your face will age around the filler over time since you are young, so I wouldn't advise a permanent filler. 

The temporary fillers are used most frequently and the major downside is the need for repeated injections to maintain the filling (once or twice a year) and the associated costs.  Hope this is helpful.

Janette Alexander, MD

Rockville Plastic Surgeon

What Can I Do to Get The Waist I Had Before Children? I Don't Want a TT, But My Muscles Feel Loose. (photo)

If I get lipo on my back and tummy will i look ok(not saggy)? I have 1 11mo son. I began 140-150 and was 216 when pregnant and down to about 180-185 now, I fluctuate back and forth when bloated. I am not sure the reason my belly feels loose. might have separation in muscles? I definantly would love to avoid a TT.I love my curves and dont want to be super skinny. I wouldnt mind losing 20 lbs because its hard to find jeans however. I just want that tiny waist I had before the baby.

That thank you for your photographs and for your question. 

You're already on the right track by using diet and exercise to help regain your figure.  Unfortunately, as a consequence of childbearing it seems from your photographs that you have significant skin laxity and even significant separation of the abdominal wall muscles.  These muscles separate during pregnancy as the uterus enlarges.

Diet will make you thinner internally which is always good,  but that will not take away the laxity of the abdominal muscles or the loose skin.  In fact, as you do everything correctly and return to your ideal weight you will likely find that the abdominal skin becomes looser.

Never let anyone push you into surgery, but given your photographs, ultimately if you're looking to restore your figure a full tummy tuck with muscle tightening would probably be your best bet.  As you approach your pre pregnancy weight you'll be doing yourself a great service because if you do embark upon tummy tuck a slender patient will generally see a better and more lasting result and also have a safer surgery.

Whether you embark upon tummy tuck or not you may wish to consult with a board certified plastic surgeon simply to learn more about your options.

I hope that this answer helps and I wish you the best.

Adam Tattelbaum, MD

Washington DC Plastic Surgeon

Pubic Area Appears Bigger After Tummy Tuck

I'm now 6 weeks post-Tummy Tuck, and I am pleased with the results. However, I'm bothered that my pubic area appears to be 2-3 centimeters higher/bigger that it was pre-operation. My underwear used to cover the area completely, but now they don't. Is this normal? Will the skin eventually stretch back to its place?

Thank you for your question. 

When I perform a tummy tuck I always try to bring the scar down as low as possible because the pubic skin and pubic mound tend to be elevated by tension from the upper abdominal skin.    I will often take a layer of fat out from under the pubis as well to help it look thinner and to help it line up with the thickness of the upper abdominal skin.

If you have already had your tummy tuck you may wish to discuss liposuction of the pubic area as a next best alternative.

Hope this helps.

Adam Tattelbaum, MD

Washington DC Plastic Surgeon