Ankur Mehta, MD

Hello and thank you for your question and for posting photos! If I saw a patient similar to your photos in my office, I would recommend a full tummy tuck. Coolsculpting and ABSOLUTE no for you because it wont do anything for the loose skin or the looseness of your abdominal wall. From your photos it doesn't appear that a mini tummy tuck will give you the optimal aesthetic result because you have a significant amount of loose skin and after a mini tummy tuck your belly button will probably look very unnatural and you will still have an abdominal bulge because your muscles cant be tightened with a mini. You MUST BE WARE however!!!! You have a very high belly button so make sure whomever you choose is aware of this, informs you of this and explains what the plan is based on that. I operate on many patients who have been told they will need extra incisions due to their high belly buttons but I have managed to keep their incisions low and haven't had the need for extra incisions. I have attached a before and after of one of my patients that had a mini-tummy tuck from someone else and then came to me. I performed 360 liposuction and full tummy tuck. Notice the incision is low and there are no extra incisions. I hope this helps and wish you the best in your plastic surgery journey. Please make sure you are evaluated by a board certified plastic surgeon! Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for your question. It would be much more helpful to see photos in multiple views to help better answer this question. As stated by my colleagues below, a donut lift is right for only very few patients. Also, not all donut lifts are the same. Therefore, some can easily be done under local but some may be better done under some type of anesthesia for patient comfort. I do all my surgeries under IV sedation which is much safer than general anesthesia and the patients remain extremely comfortable throughout the entire procedure. If you are a B cup and have "mild" sagging you may not even truly need a lift if you are getting an implant. That is really only something that can be discussed after evaluating you in person. I have done many Benelli mastopexies (form of a "donut" lift) successfully but I have picked the right patients to perform them on and have used many different techniques to try and prevent areolar spreading which will happen to some degree on most patients. Please make sure you are being evaluated by a board certified plastic surgeon who truly understands how to perform a "donut" lift and that you have seen many of their before and after photos that are at least 1 year out from surgery! I have attached before and after photos of a patient who had a "donut" lift and augmentation by another plastic surgeon that I had to correct. Her areolas spread VERY wide which is something that can happen with these types of lifts. Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for your question. The simple answer is yes....it is possible to do a donut lift under local anesthesia. As stated by my colleagues below, a donut lift is right for only very few patients. Also, not all donut lifts are the same. Therefore, some can easily be done under local but some may be better done under anesthesia for patient comfort. I do all my surgeries under IV sedation which is much safer than general anesthesia and the patients remain extremely comfortable throughout the entire procedure. Please make sure you are being evaluated by a board certified plastic surgeon who truly understands how to perform a "donut" lift and that you have seen many of their before and after photos that are at least 1 year out from surgery! I have attached before and after photos of a patient who had a "donut" lift and augmentation by another plastic surgeon that I had to correct. Her areolas spread VERY wide which is something that can happen with these types of lifts. Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for posting photos along with your question. From your photos it appears you would be a good candidate for circumferential liposuction to your waist area. This would include at least your hips and flanks (lateral abdomen and lower back). Although liposuction of the hips is important in reducing the waist size, liposuction of the lower back area is what REALLY makes a very big difference in the appearance of the waist. I hope this helps and please make sure you are being evaluated by a board certified plastic surgeon!Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for your question. I can tell you that I have operated on patients with both lupus and RA. I have performed 360 liposuction with tummy tucks, 360 liposuction with tummy tuck and buttock augmentations and breast surgeries on these patients. They went on to heal well with minimal to no complications. I was in close communication with their PCPs and Rheumatologists. It requires open communication between all members of the team to ensure safety and a smooth post operative course. One of the main issues is the medication....Many of the medications can effect wound healing and the ability to naturally clot. You should make sure the plastic surgeon you choose is board certified in plastic surgery, has performed surgery on patients with autoimmune disease and make sure they will be in close communication with your appropriate physicians. Hope this helps and wish you the best of luck in your plastic surgery journey. Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for posting photos along with your question! I seem to have a slightly different stance then some of my colleagues. I agree that 6 weeks is still early on in the healing process but by this time, if I saw implants that hadn't dropped much I would be concerned they won't drop much more. Don't get me wrong, there is a possibility they drop but this far out I cant imagine them dropping as much as they would need to give your breasts a more natural appearance and to drop all the way in the lower pole like they need to. I personally have my patients massage after the 1st week and if I think they are not doing a good job, not massaging as frequently as they need to, or as forceful as they need to I will band them at 2 weeks and then follow them closely to make sure the implants are dropping. The only real reason I can see not to massage early on is if they are textured implants. At this point the only real thing you can do is be patient and follow your plastic surgeons advice or if it doesn't seem right you can get a second opinion. Hope this helps and wishing you the best of luck in your recovery.Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for your question. Fat injection to the infraorbital rim dose improve the hollowed look to the under eyes and in the right hands, done correctly, can have very good results. However, if you have fat to the lower lid, this fat can be draped over the rim to add some volume to that area and fat may not need to be then injected. It is believed that adding fat to the malar area can help with ectropion and decrease the chances of it occurring especially in those who have a negative vector (eyeball protrudes past the cheek bone). There are many other things that can be done to prevent the risk of ectropion both during and after surgery. If you are having a trans conj bleph and skin pinch then your risk of ectropion should theoretically be VERY low to begin with because the middle layer of the eyelid is theoretically not being touched which is one of the HUGE benefits of doing this procedure so as to significantly decrease the risk of ectropion. Hope this helps and wish you the best of luck with your procedure!Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for posting photos along with your question. In your photos I do see what you describe as your concerns. I agree with most of my colleagues that you should definitely go back to your surgeon and get better answers. See what they think the issue is and how long they think it will take to improve. You should take photos maybe every 2-3 weeks to track progress and if you don't see any changes then it is unlikely to suddenly change. If it appears to be improving then it may continue to improve. Your surgeon is the only person who knows exactly how the surgery was performed and maybe they see this commonly after their technique. If fat was injected this could be an excess amount of fat that may take some time to go down. It could potentially be swelling but it looks very localized. It could be from the midface lift if that is where things were suspended but there is no way for us to really know without seeing you in person and knowing exactly how the procedure was done. Hope this helps!Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for posting photos along with your question! From the photos alone it appears that you could undergo an augmentation alone and have a satisfactory result. However, if you wanted the BEST cosmetic result with an augmentation then a lift would probably achieve a better result then augmentation alone. If you are unhappy with your nipple position and want them to sit higher then a lift would also be necessary. You would also have to understand that you may be fine with an augmentation now but will likely need a lift in the near future. Hope this helps and wish you the best of luck in your breast enhancement journey. Please make sure you are evaluated by a board certified plastic surgeon!Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd

Hello and thank you for posting photos along with your question! I have attached a before and after photo of a patient who is not exactly like you but is similar to you. She had liposuction, tummy tuck and hernia repair. She had loose skin, as do you. If she would have had liposuction alone then her loose skin would have gotten worse and likely will yours. She has a loose abdominal wall which made her look like she had fat to the abdomen when she only had minimal fat. It was really just a loose abdominal wall that made her look like she had a "bulge" and it appears you have a loose abdominal wall as well. Liposuction alone would not have fixed the bulge of her abdomen. The tummy tuck allows tightening of the abdominal wall which is the most powerful maneuver to get you a FLAT abdomen and then it also allows tightening of the loose skin. I would likely recommend liposuction plus tummy tuck and then what ever fat was obtained (which you do not have a lot of) could be injected into the buttocks. Hope this helps and please make sure you are being evaluated by a board certified plastic surgeon! Wishing you the best of luck on your journey to smoother flatter abs!!!Ankur Mehta MD Board Certified by The American Board of Plastic Surgery Instagram: @ankurmehtamd