Armando Soto, MD, FACS

Hi there, Without examining you in person, and having the benefit of a careful conversation with you to discuss your history, lifestyle, and most importantly your goals, it would be very difficult or impossible to advise you responsibly. Having said that, I deliver that because you have had those 4 babies, it is unlikely you are going to be pleased with your appearance were you to proceed with liposuction at this point, and muscle repair will be necessary. Good luck!

Hi there,Unfortunately, only your surgeon can responsibly answer this question for you, because it will depend on details only they understand. These would include how your original surgery was done and exactly what is planned at this time.Your best bet is to ask your surgeon this question.Good luck!

Hi there,As respectfully as I can, I would say to you that it isn't a good idea for you to "crowdsource" your plastic surgery experience. I love Realself- and obviously participate here- it is an amazing resource for patients like yourself to learn about what we do, how we do it, and what you might experience along your journey to your "real self". But I think many patients go astray when they use this platform (or others) INSTEAD of communicating with their doctor or his office. If you've already chosen a surgeon you like and that you trust, and you did so for all the right reasons (Board Certification, beautiful examples of their work, reviews, etc...), then you should ask your surgeon this question.The reason they are the only person alive who can answer this question for you is because the real question you are asking is, "Am I going to achieve my goals with the procedure I have already planned?"... And obviously only he/she can answer that.I think you appear to be an excellent candidate for breast enhancement- but only your surgeon knows exactly what they are planning and whether or not it is likely to give you the shape shown in the photos you submitted.I hope that makes sense- good luck!

Hi there,You appear to have very small breasts with some asymmetry and a constricted lower pole (or tubular) deformity. This could be dramatically improved through a relatively minor procedure, which would also allow reduction of your areolas.Visit an excellent surgeon in your area who can show you many examples of their excellent work and discuss your options and goals.Good luck!

Hi there,You do appear ago show a minor case of gynecomastia in your photos, but I would hasten to say that this could only be determined for sure on exam.Find a qualified and Board Certified Plastic Surgeon in your area and pay them a visit. There are many good options for management that don't necessarily involve surgery or scars, although depending on your exam this may be necessary.Good luck!

Hi there,As with any other myth or legend that persists over time is that after liposuction or a tummy tuck, patients will experience an increase in fat collections in areas not operated on as a result of the procedures performed. People sometimes say- after their tummy tuck or liposuction- that their butt or other areas of their body got bigger.The truth of the matter is that when liposuction or a tummy tuck is performed, there are a certain number of fat cells removed, and that humans do not (except in the most extreme of circumstances) create more fat cells in the course of life. When we gain weight or lose weight, the fat cells we have get bigger or smaller by collecting or releasing fat (triglycerides) from themselves. So after surgery, there are simply fewer fat cells in the areas treated that can get bigger. But fat cells in areas not treated can still get bigger...So imagine a situation where after liposuction on their belly, someone realizes how good they look and feels like their dresses and pants are loose... Sometimes in these situations, they start to enjoy their new body a little too much... and they eat, and become more careless with their lifestyle in general. When this happens, the fat cells that are still present take up fat. Their butt, thighs, arms, and any other areas not treated, will collect fat disproportionately. And so the myth persists.There is no reason that you should believe a tummy tuck will cause this as long as you maintain your healthy weight and lifestyle after surgery.Good luck!

Hi there,I never think it's a good idea to communicate your goals, or judge your outcome based on bra size... If you hate your breasts, but the letter on the bra is what you wanted it to be are you going to be happy?With breast reduction (indeed with all plastic surgery), I think the best way to approach it is to prioritize your safety and happiness at all times. Communicate carefully with your surgeon about your goals for breast appearance and size (small, good proportion to my body, still a bit busty but smaller than now), and understand that there is no way that any surgeon could possibly guarantee any particular outcome to you. Make sure they can show you many examples of excellent work.

Hi there,If I had to make a decision based solely on your photos, I would say a tummy tuck is your best bet. Mini tummy tuck is, IMO, a bad operation. Find a surgeon you like who can show you examples of excellent work and visit for a consultation.

Hi there,Based solely on the photos you've submitted, I definitely believe you will need a breast lift in order to achieve a young and attractive shape, regardless of your goals for size. This need not be upsetting, however, if you choose the right surgeon and are able to see many (not one or two) photos of his/her work showing excellent outcomes after these procedures. They do exist. Also, be sure you ask to see what they look like right after surgery AND many motnhs later. There are many who can make things look good on the OR table, but the result a few months later is not so pretty. The good news is that you can have beautiful breasts- but you will need a breast lift to get there.Good luck!

Hi there, These imperfections visible in your photos seem amenable to an easy correction under local anesthesia, depending on your preferences, and those of your surgeon. I would return to them (your original surgeon) and review this with them. I'm sure that they want you to be happy, and returning to the original surgeon makes it most likely that the final outcome (both in appearance and in your experience) as well as your costs are as favorable as possible (your original surgeon will have an interest in making this better for you- a new surgeon will likely want to charge you full price).  Sometimes patients feel uncomfortable returning to their surgeon to "complain"- but you shouldn't see it this way (and neither should they). Think of it more like you are returning to visit an old friend and talk about how this doesn't look the way you want (understanding that guarantees of outcome are never possible in plastic surgery), and to learn about your options. Approach it in a positive and respectful way, and I think you're likely to get what you want with minimum expense and trauma. Remember that the doctor-patient relationship is at the core of all good health care and its maintenance is the responsibility of both parties. Having said that, if your surgeon rebuffs you or refuses to consider your concerns or offer options for improvement that are acceptable to you, then I would consider visiting another surgeon for an opinion.  I hope that's helpful. Good luck.