Bahram Ghaderi, MD

Liposuction could help reduce the fat underneath your chin. It would create a more defined jawline and slimmer appearance in the neck. The best results are typically seen in patients with good skin elasticity. You should meet with a board certified plastic surgeon to be evaluated and see if liposuction, or a different procedure, would be recommended to help you feel more confident about your chin area.

Implants can help give you fullness in the upper pole area, especially if you don’t currently have any. The amount of fullness you would achieve depends on the amount of breast tissue you already have, skin elasticity, shape of breast, and implant placement. If your breasts have significant sagging or your nipples sit low, the overall shape of your breasts may not be to your liking with just an augmentation. The breast tissue may hang over the implant or the implant may accentuate the sagging. I’d suggest meeting with a board-certified plastic surgeon in person for a consultation. They will evaluate your breast shape and then recommend the best path forward - breast implant without a lift.

Yes, I have many patients that choose to do a tummy tuck at the same time as their tubes being tied. It’s helpful that the two procedures can be combined into 1 surgery so there is only 1 recovery time needed. You will need to coordinate with your board-certified plastic surgeon and OB/GYNE to see if you are a candidate to have both procedures done together. Both surgeons can address if you are in good health and if there are any risks involved having the procedures done at the same time.

Yes, in most cases when the breast implant moves during exercise because of animation deformity, they return back to their usual position once the chest muscle relaxes. Animation deformity happens when the implants are placed under the muscle. When the muscle contracts, it can change the shape of the breasts. Once the muscle relaxes, the implant typically will settle back into their resting position. Wearing a bra will not have any effect on animation deformity other than concealing it. There is an option of having the implants placed above the muscle if animation deformity is a big concern for you. A board certified plastic surgeon can discuss the benefits and risks of implant placement.

Yes, a tummy tuck can just remove excess skin without tightening the abdominal muscles. Not everyone needs muscle repair. If your abdominal muscles aren’t separated where your abdomen looks rounded or bulges forward, you may not need a tummy tuck with abdominal muscle repair. The best way to know is being evaluated by a board certified plastic surgeon. Removing the fat/skin from a tummy tuck does not make the fat go to other areas of the body. That fat/skin is removed permanently. But if you gain weight after surgery, you can gain weight in other areas of the body - as well as your abdomen.

First off, it is great that you are paying attention to the type of certifications your surgeons have. The size of your breast does not determine the skill level of the surgeon. But, there is a difference between a surgeon that is certified by The American Board of Plastic Surgery (ABPS) vs The American Board of Cosmetic Surgery (ABCS). Surgeons that are certified by the ABPS have completed specialized plastic surgery training. Usually 3 years beyond their other surgical training. Typical ABPS certified surgeon has 6-8yrs of training after medical school. They have passed comprehensive exams in both cosmetic and reconstructive procedures. The ABPS is the only board recognized nationally as the standard bearer for appropriate training, credentials and continued education. For a breast reduction, the surgeon that is certified by The American Board of Plastic Surgery would be ideal since that certification reflects extensive training formally in plastic surgery. Of course, meet with a ABPS certified plastic surgeon you feel comfortable with.

Yes, a breast enhancement procedure can often be done at the same time as an arm lift procedure. We do this commonly as with significant weight loss these are common areas of concern for patients. Combining both procedures can help you treat two areas with one surgery and recovery process. When you meet with a board certified plastic surgeon for a consultation, they will be able to evaluate and determine if this combination of procedure would be safe and right for you.

I can understand how overwhelming it can be researching your options for breast augmentation. The Preserve method is a newer approach and there is less known about long term results and side effects. For some patients, “a new method” might be appealing, but for most it does not necessarily provide an advantage. The “traditional” approach to breast augmentation has provided great results, and with more predictability. The recovery is generally quick (2-3 days before going back to work and driving) and with limited discomfort with the established technique. Most patients having breast augmentation may not have enough tissue coverage to have their implants placed above the muscle which then negates the use of the Preserve method (It is exclusively above the muscle placement). Once you have a trusted surgeon, then I would suggest following their recommendations rather than a method that may or may not be beneficial.

There are pros and cons to both above the muscle (sub glandular/ sub fascial) and below the muscle (submuscular) implant placement. Patients that have their implants placed above the muscle are usually concerned about animation deformity which is the implant’s shape being changed due to the chest muscle contracting. Patients that are heavy weightlifters tend to want muscles placed above the muscle so when they perform a heavy chest exercise the implant isn’t impacted. Patients that have the implants placed below the muscle have a more natural look, better mammogram readings, and lesser risk of capsular contracture to form. Ideally you should be evaluated by a reputable board certified plastic surgeon in person so they can recommend which option would be best for you. Be careful of fads that may come and go. Stick to proven methods that have had success for decades. If you have thin tissue, then visible rippling (which will happen more with above the muscle placement) will negatively affect the look you want to achieve.

Yes, the look you are wanting is possible. It may require two surgeries to get the exact look you are wanting. If you are patient, the results are great! The first surgery would be a breast reduction/lift. The reduction would make the breast smaller, reduce sagging, and create a good foundation. After the breast has healed from that procedure, the second one would be putting in a small implant. The implant would give you fullness to the upper-pole as you mentioned. This 2 procedure or staged approach could give you a lifted breast but still having upper pole fullness. A board certified plastic surgeon can help see if you would be a good candidate for this.