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I’m Dr. Michael Burgdorf, a board-certified plastic surgeon and founder of Music City Plastic Surgery in Brentwood, Tennessee, serving the Nashville area. My practice focuses on breast and body surgery, including mommy makeovers, breast augmentation and lifts,
Asked By: Straightforward964438
ANSWER
At 23, your age alone does not make you too young for a tummy tuck. The more important questions are whether you are healthy, at a stable weight, have the anatomy that would benefit from the procedure, and whether you are comfortable with the scars, recovery, and potential risks. If you are planning pregnancies in the near future, that is also something I would take into consideration because pregnancy can change the result. I would, however, be very cautious about traveling internationally for a major operation such as a tummy tuck. This is not because excellent surgeons cannot be found outside the United States. My concern is what happens if you develop a problem after surgery. A tummy tuck is a significant operation. Complications such as bleeding, infection, delayed wound healing, fluid collections, blood clots, or other issues can require examination and sometimes additional treatment. Having your surgeon nearby and having a clear, established postoperative care plan is extremely important. Flying long distances soon after surgery also adds another consideration when we are already focused on minimizing the risk of blood clots. If you were my patient, I would encourage you to choose a board-certified plastic surgeon whose credentials you can verify, who operates in an appropriately accredited facility, and who will personally be available to care for you throughout your recovery—not simply someone whose photographs look impressive online. During your consultation, ask who will provide your anesthesia, where the surgery will be performed, what safety protocols are in place, how complications are handled, who you contact after hours, and who will care for you if something happens several days or weeks after surgery. Most importantly, do not let price or the excitement of traveling determine where you have a major surgical procedure. You should feel completely confident in your surgeon, your facility, and your postoperative care before moving forward. If you are already very anxious about the possibility of something going wrong, I would not dismiss that feeling. Take your time, have more than one consultation, and choose the situation where you feel safest and best cared for. In my practice, I would not recommend traveling overseas for a tummy tuck when excellent surgical care and, importantly, ongoing postoperative care can be arranged closer to home.
Asked By: Pqna
ANSWER
Based on your photos and the concerns you describe, I do think you would be a good candidate to consider a full tummy tuck. Being slim does not mean a tummy tuck is unnecessary. In patients like you, the goal is often not major tissue removal, but improving lower abdominal skin laxity, tightening the abdominal contour, and creating a smoother, more refined result. I would also assess your abdominal wall carefully during a physical examination. You do not have to have been pregnant to have laxity or separation of the rectus muscles. If your examination confirms that the abdominal wall would benefit from plication, I believe that could provide a meaningful improvement in the flatness and shape of your abdomen. The short vertical scar your surgeon discussed can sometimes be necessary in thinner patients who do not have enough excess skin to bring the original belly-button opening all the way down to the horizontal incision. In that situation, a small vertical scar may be preferable to compromising the position or appearance of the belly button. A mini tummy tuck or skin-only approach can work well in very selected patients, but those procedures are more limited and may not give the same degree of improvement if there is laxity involving more of the abdomen. From your photos, I think a tummy tuck is certainly worth considering, and if an in-person examination confirms abdominal wall laxity, adding rectus plication could further improve your contour. The key is choosing the operation that addresses the entire problem rather than limiting the procedure simply to avoid a small additional scar.
Asked By: Flower43
ANSWER
Based on what you are describing, I would lean toward a full tummy tuck rather than a reverse tummy tuck or an umbilical float. The reason is that the issue does not sound limited to one small area of skin laxity. When there is meaningful upper abdominal laxity as well as lower abdominal skin excess, a full abdominoplasty generally gives the surgeon much better control over the entire abdominal contour. It also allows the belly button to be repositioned appropriately rather than potentially leaving it too low or creating an unnatural relationship between the upper and lower abdomen. An umbilical float can be useful in very selected patients, but it has limitations, particularly when the upper abdominal skin needs significant tightening. A reverse tummy tuck also addresses a different pattern of laxity and is not usually the best choice when the problem involves the abdomen more globally. The fact that you have already spent a significant amount on noninvasive treatments without meaningful improvement is also important. Noninvasive treatments simply cannot remove excess skin or correct significant laxity the way surgery can. From your description, I would recommend focusing on the procedure that will address the entire problem rather than trying to force a more limited operation. In my opinion, a full tummy tuck would likely give you the most complete and predictable correction, assuming your examination confirms the degree and distribution of skin laxity.
Asked By: helenexo
ANSWER
At 11 months after surgery, most of the swelling and settling should be complete, so a persistent difference in implant position and breast shape is worth having evaluated. From what you are describing, it sounds like one implant may be sitting lower than the other, which can make the nipple appear relatively higher and can also change the overall shape of the breast. A more square appearance can sometimes be related to the implant pocket, implant position, scar tissue, or differences in the surrounding breast tissue. Whether you need a revision depends on the degree of asymmetry, whether the implant position is stable, and how much it bothers you cosmetically. If the implant has truly dropped too low, revision surgery may involve adjusting or reinforcing the implant pocket to restore a more balanced position. I would recommend an in-person examination with your surgeon or a board-certified plastic surgeon experienced in breast revision surgery. At this stage, if the asymmetry is significant and persistent, it is reasonable to discuss revision options rather than simply waiting for further settling.
Asked By: mainemom
ANSWER
Based on your photos and the changes you are describing, I do think you would benefit from an in-person evaluation for revision surgery. At 11 years out from your original augmentation and lift, the increased upper-pole fullness, the developing indentation, and the overall change in breast shape suggest that it may be time to address both the implants and the supporting breast tissues. From your photos, a likely approach would be a breast implant exchange combined with another breast lift. Since you are also interested in going smaller, that can often be incorporated into the revision plan to create a lighter, more natural result. Depending on the quality of your tissues and what is found during your examination, I would also consider whether additional internal support, such as GalaFLEX, may be helpful. This can act as an internal support scaffold in selected patients and may help provide additional reinforcement after a lift and implant exchange. The indentation you are noticing should also be examined directly so we can determine whether it is related to the implant pocket, scar tissue, tissue thinning, or another contour issue. At 57, your age alone would not prevent you from being a good candidate. Your overall health, tissue quality, and surgical goals are much more important. Based on what I can see, I do think this is the right time to have a revision consultation and discuss an implant exchange, lift, and whether internal support would be beneficial in your case.
Asked By: Tluna
ANSWER
That is an excellent question, especially given your history of one implant not settling properly. At this point, I would not recommend adding BPC-157, TB-500, or injectable GHK-Cu to your postoperative regimen unless your operating surgeon specifically recommends and supervises their use. There is currently very limited human clinical evidence showing that these peptides improve healing after breast implant surgery, and BPC-157 and TB-500 are not FDA-approved treatments for postoperative healing. The FDA has also noted limited safety information for injectable GHK-Cu. Your concern about capsule formation is understandable. However, we do not have good clinical evidence showing that these peptides would cause the breast capsule to mature “too quickly,” nor do we have evidence proving they are safe or beneficial in preventing implant malposition. With a revision—particularly when you are downsizing from 350cc to 255cc—the surgical plan, pocket control, existing scar tissue, implant selection, and your postoperative restrictions are going to be much more important in determining how the implant settles. I would discuss any supplements, peptides, or injectable products with your plastic surgeon before surgery and follow their postoperative protocol closely. In revision breast surgery, predictable healing is generally preferable to experimenting with therapies whose effects on capsule formation have not been well studied.
Asked By: hema2
ANSWER
Yes, you may still be a candidate for a Mommy Makeover after your hip and knee replacements. In fact, it is generally best to complete the joint replacement surgeries first and allow yourself to fully recover before considering elective body-contouring surgery. The most important factors will be your mobility, overall health, ability to walk comfortably after surgery, and clearance from your orthopedic surgeon and primary care physician. Good mobility is especially important after a Mommy Makeover because walking soon after surgery helps reduce the risk of blood clots. Once your joint replacements are healed, you are moving well, and your doctors feel you are medically stable, a board-certified plastic surgeon can evaluate you and help determine the safest timing for your Mommy Makeover. Your dream does not necessarily have to go away — it may simply need to happen in the right order.
Asked By: Fabulous172494
ANSWER
I’m sorry you’ve been dealing with this. What you’re describing can occur after aggressive liposuction, particularly when scar tissue or fibrosis develops beneath the skin. This can sometimes create firmness, lumps, tethering, or visible indentations. The best treatment really depends on how much of the irregularity is caused by scar tissue, loss of fat volume, skin adherence, or a combination of these factors. In some cases, improvement may involve carefully releasing the scar tissue and restoring volume with fat grafting. In other situations, additional liposuction may actually make the contour irregularity worse, so I would be cautious about removing more fat without a thorough evaluation. Because you’ve already had two procedures and have been told the tissue is quite firm, I would recommend an in-person consultation with a board-certified plastic surgeon who has experience treating secondary liposuction deformities and contour irregularities. An examination of the skin, underlying scar tissue, and remaining fat would be necessary to determine what options are likely to give you the best improvement. Revision cases like this can often be improved, but the goal should be improvement rather than expecting perfectly smooth tissue after significant fibrosis.
Asked By: jack711
ANSWER
A breast lift with augmentation can be one of the most challenging procedures (both for the patient to undergo and for the surgeon to achieve the desired results). There are many factors at play that may effect the results. Initial stretchability of the skin (having children can impact this, but so can fluctuations in weight and/or initial shape of the breasts), size of the implant, how tight skin is pulled effecting tension on the scars, amount of breast tissue, etc. It does appear that the implants are holding in a nice position, but that the skin has stretched past the bottom of the implants. This "residual droop" is one of the most difficult components to anticipate. Since this is a push/pull operation ( implants "pushing" out, while the breast lift "pulls" the tissue back in), there is a fine line to walk to get the perfect results. One newer component that might be helpful could include the use of Galatea scaffold that can strengthen the lower aspect of the tissue as this scaffold is reabsorbed and broken down by the body into carbon dioxide and water. It has allowed the expected "residual droop" to be more regulated and controlled with more consistent results. Hope that helps
Asked By: Elena001
ANSWER
There are many factors to help determine the prefect breast size. One is the type of breast implant. The anatomically shaped or more form stable implants can be a nice option for very thin women, like yourself, who desire breast augmentation. These type of implants may mitigate the risks of showing the implants or looking too obvious. I encourage you to visit a board certified plastic surgeon who has extensive experience with breast augmentation surgery. Good luck.
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Dr. Michael Burgdorf is highly praised for his expertise in plastic surgery procedures such as , , , and . Patients highlight his professionalism, attentiveness, and ability to deliver natural-looking results. Many express gratitude for his supportive staff and the positive impact of his procedures on their self-esteem and quality of life.
