Toledo Doctors

Squishy Skin on Nose 7 Months After Tipplasty, Is this Likely to Heal/Change?

I had a tipplasty about 7 1/2 months ago where my bulbous tip cartilage was reduced. Now, the skin on the front of my nose is squishy. When I touch it, it looks and feels exactly as if I was poking my cheek. Maybe its excess skin or fluid/tissue under the skin but I'm certain its not the cartilage structure underneath that is moving. Higher up on my nose where the skin rests on the bone is normal. Is this something that will heal/change with more time or is it just the result of the surgery?

7 months after rhinoplasty it is not unusual for the skin to feel a little loose, soft, or squishy. Usually the tip of the nose feels hard for 3-5 months after an open rhinoplasty. Then the skin will feel a little squishy in many patients until about 18 months after surgery. Thanks for your question. 

Steven Goldman, MD

Cleveland Plastic Surgeon

Subglandular Saline Implant Deflation in Doctor's Office, What Happens to Shell Until Removed?

Considering implant deflation in the office. What happens to the shell after saline is removed since my implants are NOT behind my muscle? Will they just lay flat until I decide to have them removed or shrivel up and be noticeable? I wanted to explant but found out I'm pregnant so doctor offered to deflate and then remove after my pregnancy.

Saline implants can be deflated percutaneously (through the skin) just using a needle. The shells can be left in place indefinitely, although they are generally left in place only if there are health or other issues that preclude their removal. Removal of saline or silicone implants can be performed under local anesthesia in the office in appropriate patients, avoiding andsthesia  Thanks for your question. 

Steven Goldman, MD

Cleveland Plastic Surgeon

What Are my Options to Correct Double Bubble? (photo)

I had my surgery on June 24, 2011. I was a 34A and got 520cc silicone implants. However, at the 3 month mark I started to notice something was off. The incision was under the fold and my surgeon promised that it would not be noticeable, and that this was the only way to fit such a large silicone implant along with lowering my crease, so i trusted him. I now have double bubble and my breast stay raised up in the air, always exposing my incisions. Its been 18 months. What are my options?

Your photographs show both a double-bubble deformity and bottoming out. The breast implants appear to have migrated below the original inframammary folds, recruiting abdominal skin onto the breasts and becoming visible below the breasts. In general, repair would involve an inferior capsulorraphy (sutures placed at the bottom of the scar tissue envelope that forms around the breast implants) to raise the pockets. The so-called acellular dermal matrices (like Strattice and Alloderm) are sterilized dermis (skin) from various sources. They may be used in cases such as yours, but I generally feel that they are only needed in more severe cases than yours.

Of course, to determine the specific surgical plan and possible outcomes, you must have a formal consultation with a board certified plastic surgeon familiar with breast revision surgery. Thanks for your question.

Steven Goldman, MD

Cleveland Plastic Surgeon