Vincent N. Zubowicz, MD

Obliquity in the neck can be due to excess fat, excess skin, or laxity of the platysma muscle. In your particular case, without the benefit of and in person physical examination, it looks as though liposuction would give you substantial improvement. This is a simple procedure done in the office with local anesthesia.

You should have no difficulty with the facelift after your abdominoplasty. Provided you've had no complications a facelift is really physiologically not particularly hard on someone. The abdominoplasty is but after three weeks the body should be substantially recovered to be able to heal without difficulty after a facelift.

From the photographs it does not appear that you have constriction of the base of the breast. When that condition exists it is easily treated by breast augmentation with a concurrent mastotomy

The prominence of the top portion of the sternum should be well camouflaged by breast augmentation alone. I don't think fat grafting would be necessary. Should grafting be needed to improve the result, and I don't think it would, this can be performed in the office with tumescent anesthesia and oral sedation.

I certainly would recommend liposuction of the waist. The skin of the abdomen appears to be in good shape and from the photographs it doesn't look as though there is a major diastasis. Under the circumstances liposuction of the waist and abdomen of an by itself may give you a very good result. Physical examination would be necessary to totally substantiate this and your expectations of course our premier importance. However it looks as though you may be one of the occasional patients that gets an excellent result from liposuction alone which can be performed in the office with oral sedation and tumescent anesthesia.

From the photograph it looks as though a trans-oral buccal fat pad reduction would be of aesthetic benefit. This can also be camouflaged with creative use of fillers. In my estimation your faces attractive and if you are considering buccal fat pad reduction purely for prophylaxis against the way things might look in the future I would not recommend the procedure at this time.

From the limited information in the photographs it looks as though your aesthetic expectations are within range of operation. Physical examination is a critical part of assessing the patient so this would be necessary before any stronger reassurances could be offered.

Lowering the dorsal hump of the nose will not increase the width of the nose obviously. Whether or not there would be a perceived increase in width of the base of the nose could be easily sorted out with video imaging.

Depending on the magnitude of the problem, your age, and your expectations of the procedure in your modulator or an office procedure can probably solve the problem. The lateral subcutaneous brow lift can correct minor asymmetries. It would be important to evaluate the function of the frontalis muscle so that it is symmetrical on both right and left sides.

In my practice I almost never see a patient who is a good candidate for a mini abdominoplasty. The most common patient has been pregnant in the entire abdomen can benefit from repair of the fascia as well as removal of surplus fat in skin. True, the incision is longer but if properly executed eschar can be very inconspicuous.