Andrew Bonett, MD

It looks like most of the skin laxity is central in your photos, so keeping the incision shorter than a fully tummy tuck actually might work in your favor here. The real difference is the degree of dissection and how much of a change you hope to see above the belly button. It sounds like your surgeon is suggesting what some of us might call an "extended mini TT." Small contour irregularities are always a risk after liposuction and/or body contouring surgery but from what I can tell this is not a bad plan.

At 4 weeks there will likely be a very thin, immature capsule film starting to form. It is likely so thin at this point that there is no need to worry about removing every last bit of it. It would likely cause more damage than benefit to be aggressive with capsule removal at this point. Also, being only 33 years young, your skin has good elasticity and will likely bounce back pretty nicely. Of course there is a risk it got a little stretched out but unlikely to a significant degree. Good luck!

Hi, good question. This is a pretty common outcome after any reduction or lift and even happens without the significant weight loss you mentioned. A lot of it has to do with the way the skin incisions were designed and how much lift was required during the reduction. There are other variable during the healing process as well, such as swelling and tension differentials at different points around the circle. We try to distribute these forces equally but there are a lot of variable throughout the surgery and healing process. The good news is you actually have a relatively good shape to the areola that can typically be fixed with a small scar revision under local anesthesia in the office. It may be worth the revision, but remember, most natural nipples and areolas are not perfectly round to start with

Hi Nadia_, based on what you are describing and what I can tell from the photos, it is a difficult situation with a couple limiting factors. First, now that the nipple position is asymmetric, it is nearly impossible to attain symmetry without some form of a lift, even if just a small donut-type lift. Secondly, you desire more cleavage but currently have implants under the muscle which can push them away from center and make more cleavage difficult. Lastly, it seems that you are rather fit and don't have much fat elsewhere that would be available for fat transfer to the breast. Sometimes doing a little fat transfer just to the inner and upper breast can help with that last little bit of cleavage. I do agree with the opinion that a transition to subfascial would help improve cleavage and be less detrimental to your weightlifting. However, you need to be careful because the more you push the implants toward the middle, the more the nipple position can be displaced outward. Something has to give in this situation, and it is up to you and your surgeon to discuss these pros and cons and decided what meets most of your needs.

Hi @hema2, the short answer is no! The main issue with doing these things close together are going to be risk of blood clots. Long surgeries such as a mommy makeover can have a slightly higher risk of blood clot formation, especially if you already have more risk factors. One of the biggest preventable risk factors, though, is recent orthopedic surgery. Since these are all elective surgeries, I would just make sure you space everything out to decrease your risk. I would say at least 3 months apart. You also should consider your "down time" for each. Most people don't want to jump into another elective recovery period when they are just getting back to more activity.