Alexander Zuriarrain, MD, FACS

Hello and thank you for submitting your photos. After performing thousands of abdominoplasty procedures and mommy makeovers, I want to say that you have a very nice result. Your breast shape and volume and your scarring are very good. What is happening to your abdomen is absolutely normal after tummy tuck. It does not mean that the surgeon did not try to pull you tight enough it is a situation related to the fragility and weakness of your overall skin. I am impressed that your breasts have not already begun to stretch significantly because that would be the expectation over time. When any patient bends over slightly after surgery there is always going to be some extra skin as we do not walk around hunched over. When you stand straight with proper posture that skin should stretch and not wrinkle at the bottom. Overall what I am seeing with you is a case of a very light skinned Caucasian woman who has very fragile skin with significant stretch marks that is leading to the cosmetic result that you are not satisfied with. After waiting for one year after surgery an attempt could be made to remove further skin to enhance the result. That would be one option for you. Happy to help you along your journey. Alexander Zuriarrain, MD, FACS, FAACSDiplomate, American Board of SurgeryDiplomate, American Board of Plastic SurgeryDiplomate, American Board of Cosmetic SurgeryDiplomate, American Board of Facial Cosmetic Surgery

Hello and thank you for posting your photos. As a surgeon who does a tremendous amount of abdominoplasty surgery and liposuction I would tell you that your result is standard. I do not see anything that is out of the ordinary. Many times there is excess roundness to the abdomen due to what is called visceral fat. I would recommend that you calculate your body mass index and it if it is anywhere above 22 you are carrying excess visceral fat which is causing bulging to your abdomen. There are also gastrointestinal issues that arise as we all age and it would be smart to visit your gastroenterologist. I would first encourage weight loss. You could add liposuction to the entire anterior abdomen, flanks and back to enhance your results further. That would be the best way to obtain further body contouring. Happy to help! Alexander Zuriarrain, MD, FACS, FAACSDiplomate, American Board of SurgeryDiplomate, American Board of Plastic SurgeryDiplomate, American Board of Cosmetic SurgeryDiplomate, American Board of Facial Cosmetic Surgery

Hello and thank you for your question. Based on your photographs I would highly recommend doing a breast lift with your desired augmentation. The reason for that is the degree of sagging to the breast that is currently evident on your photographs. If you were only to do a breast augmentation the rest of the breast would sag on top of the implant and this would create a cosmetic deformity that is not pleasing to the eye. By doing a breast lift at the same time as the augmentation you get better upper breast fullness and much better positioning of the areole. Currently there is too much sagging to recommend a breast augmentation alone. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question. You would benefit from a below muscle procedure as the breast tissue is very thin and placing an implant above the muscle will cause a highly visible implant edge and an inferior cosmetic result. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question. Based on the photographs I would recommend an evaluation with a board-certified plastic surgeon that is going to measure you accurately. Tuberous breast and constricted breast deformity is the same by definition. This is a congenital anomaly produced from birth. I do agree with the diagnosis. This can easily be corrected by performing a breast augmentation above the muscle, scoring the breast gland from the inside to release the contracture bands that caused the tuberosity, reduce the areola circumference and lift the breast. All of this can be done in a single operation and can provide excellent results. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question. Based on your age and photos, I would recommend a procedure that would enhance the upper pole of your breast on both sides with an augmentation. An areola reduction procedure would be of benefit to reduce the size of the areola and improve your overall aesthetics. You do have an asymmetry that would need to be evaluated further in person with measurements during a consultation to decide on the best procedure for you. Overall you have excellent potential to have a fantastic result. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question/photo. Based on your single photo it would suggest that you would be fine with a breast augmentation alone and would not need a breast lift. This of course would need to be verified using measurements in the office during a consultation. I am confident you would have a very natural and pleasing result using only implants and avoiding a breast lift. Hope this helps. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question. It is highly recommended to use smooth implants to avoid concerns of anaplastic large cell lymphoma associated with textured implants. I recommend a round implant as it avoids future issues with cosmetic deformity when the implant rotates. Under the muscle or above the muscle just depends on your anatomy, skin quality, physical activity levels, body habitus, and measurements. All of these things need to be taken into consideration during a consultation. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello and thank you for your question. There are always risks, benefits and alternatives to every surgical procedure. I would highly recommend coming to see a board-certified plastic surgeon for more detailed examination and information. Nonetheless, based on your athletic nature and being into weightlifting I would recommend placing your implants above the muscle. Animation deformity can be a serious problem. I would not recommend teardrop anatomic implants. These implants can shift over time causing a secondary aesthetic deformity requiring another procedure. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Great question!! This is a very common situation where patients have genetically a wide gap between each breast. This is very normal in a certain percentage of the population. If you have a wide gap between your breasts, it will be challenging to bridge that gap without causing a complication known symmastia. You cannot completely get rid of that gap but you can make serious improvements. Another way to make an even better improvement is with fat grafting to the cleavage area which gives a much fuller look and a better result. Subsequent surgeries will not necessarily provide you with improved cleavage so I wouldn't go into the process thinking that a second surgery will make a more significant difference. This would have to be taken on a case-by-case basis. Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained