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CLAIM YOUR PROFILEGood luck with your upcoming surgery. There are many ways to determine implant size for patients including trying on sizes in the office, biodimensional planning, photos, etc. One size on one patient does not mean the same size on another because of each patient's baseline anatomy, skin stretchability, and chest width. That being said, 595 is on the larger end of implant sizes. The largest silicone implants come in 750-800 cc depending on profile.
In my practice, I have patients try on sizes in my clinic to give a sense of range while also taking anatomical measurements, looking at photos or a size they desire. In the operating room, I do the "sit up" test where I do different test sizes before committing to the permanent implant to ensure that the look is what my patient and I discussed beforehand. This is one way to determine final implant size.
In the end, it is about trusting your surgeon, which is incredibly humbling.
Board Certified Plastic Surgeon
Great question. There are multiple factors that go into whether or not you or your surgeon want to stage procedures or not. I consider face and neck lift as one procedure because a lower face lift usually includes a neck and the incisions connect depending on your skin laxity. To answer your question, it depends on your anatomy and your surgeon and total procedure time. For some, staging it is a better option; for others all at once is better. It's best to see a board-certified plastic surgeon in-person to help you make this decision. Good luck!
Board Certified Plastic Surgeon
Hi there,
Based on the photos, you look to have some tuberous characteristics but I would not categorize this as severe. There are several options including breast augmentation with (augmentation-mastopexy) or without lift (mastopexy alone) or lift without breast implants. The type of lift you get depends on your anatomy, your expectations, and your aesthetic desires. There are limits to a periareolar lift only (meaning the scar is around the areola only). Some patients may want a certain type of lift but may only be a candidate for a lift with more incisions, such as lollipop or anchor. Because there are different options in this scenario, it is always recommended to consult with a board-certified plastic surgeon to go over this in detail.
Board Certified Plastic Surgeon
Hi - these are great questions that you have and sounds like you are being thoughtful in considering a breast augmentation. There is a lot that goes into the decision of implants versus fat transfer including your anatomy, your goals and aesthetic desires, longevity, etc. I think that these questions are best answered by an in-person consultation with a board-certified plastic surgeon so that they can go over the details of all the options including technique and the risk and benefits of each.
Board Certified Plastic Surgeon
This is not unheard of, and I think your surgeon is being thorough to assess your risk of a bleeding or clotting complication (such as a pulmonary embolism or DVT) after surgery. PT/INR/PTT does not give complete information about bleeding or clotting disorders.
I order bleeding/clotting panels if my patients screen positive for a history of heavy menstrual bleeding, blood clots or clotting in the family history. For example, I order a von willebrand factor panel if my patients report a history of heavy menstrual bleeding as this is one of the most common symptoms of von willebrand's disease.
Factor V Leiden is more common than you would think and increases one's risk of a blood clot after surgery. There is something called the Caprini Score that plastic surgeons use to evaluate clotting risk.
Board Certified Plastic Surgeon
HI Dazzling426515, I am a board-certified plastic surgeon in San Francisco and perform upper and lower blepharoplasty. Based on the photos you have shown, I would say that your healing is on the spectrum of normal. You are still early in your postoperative course and likely have some swelling that will settle. It is difficult to say whether this is true webbing of the inside corners of your eyes (called your inner canthus) based on the photos you have shown and how early this is after surgery. I agree with your doctor, I would not do steroid injections this early as the side effects can be thinning the skin, widening or lightening the scar and impairing wound healing. I usually do not offer a revision or injections before 6 months postoperatively to give the tissues adequate time to heal.
Board Certified Plastic Surgeon
I'll preface this review by saying it took a long, long time for me to feel ok with even wanting the procedure and then an excessive amount of research before I chose Dr. Nguyen. It's a complicated type of surgery and choosing a specialist is the best course of action. I wish I'd had the procedure sooner but at the same time I'm incredibly grateful that the painstaking research led me to Dr. Nguyen and the SF plastic surgery practice. I knew from the previous reviews and pictures that the results were phenomenal, but I felt especially blessed by how kind and invested the entire team has been throughout the process. Dr. Nguyen really took into account my goals. I had heard from other people who have undergone breast surgery that the surgeons often encourage you to go much bigger than you plan. I was honest about my goal to remain on the smaller side for numerous reasons and she listened, respected my choices, and gave an honest explanation as to the benefits of each and the need for a certain level of size in order to correct the nipple. She has been amazing with tailoring the surgery to my goals while also providing very supportive expectation management as to my own anatomy's limitations. I never felt pressured and it truly felt like a team effort the whole time. Aside from wonderful bedside manner and professionalism she and the whole office went above and beyond to help and accommodate me. I traveled from out of town because from what I saw they were the best at this procedure in Northern California. I also couldn't drive myself for a while due to unrelated medical issues so that complicated matters and I had to take a 3-4 hr train sometimes when I couldn't get a ride. They knew that and were so patient and flexible with me in spite of it! Dr. Nguyen was extremely attentive even post-surgery. A week or 2 post surgery I laughed so hard that I thought I popped a stitch and the next day Dr. Nguyen made time to see me to make sure everything was OK, as well as maintaining a very calming presence while I was on the brink of crying/self-flagelation. This included the possibility of needing to do a surgical repair and additional imaging. She helped me to navigate, personally reached out to other providers, and expedited the extra imaging. Good news - it was totally fine - but I felt even better knowing if anything did go wrong there would be immediate support. She's talked me through expectations for the timeline post-surgery which provides great reassurance. Despite the extra-severe restriction in one of my breasts the results have been fantastic and very symmetrical overall, but there is a difference in the "drop" time and she assuaged some of my nerves surrounding this. An item that is probably important but it's such an afterthought to me because it didn't plague me - pain. When Dr. Nguyen said that her patients typically didn't finish the prescription pain medication I thought "well, I'm an absolute baby, so that won't be me." Come to find out I didn't even go through half of the provided amount, it was well enough managed with extra strength tylenol and ice!! Minimal pain, even for me, the aforementioned absolute baby! This whole experience has been very healing in more ways than one. If you're reading this you may also have tuberous breast deformity and it comes with a lot of shame. The energy of the whole practice is very positive and affirming, and it feels like there's so much hope they provide throughout the journey. I know it might seem obvious but I didn't fully realize the improvement in quality of life that would happen as I start to feel more connected to my body rather than trying to ignore it. I'm so grateful to Dr. Nguyen, Dr. Romano, and the front desk staff. I couldn't have imagined how amazing both the process and the results would be. I hope everyone is as blessed in this experience! Side note - while he didn't end up performing my surgery, I spoke to Dr. Romano on the phone when I was first doing the consultation. We only spoke once but when I was in the hallway of the office he greeted me warmly and remembered me, including the particular details of my case! I was so surprised! He told me this was one of his favorite surgeries because the results are so successful and the patients have such an improvement in quality of life. Couldn't have been more true! Also, I deleted the pictures from my phone (not something i wanted anyone to find) but if I can I'll post the images at another time to show the progress!
Dr. Nguyen's evaluation and recommendations regarding my concern of a ruptured breast implant were absolutely invaluable. From the moment I voiced my concerns, Dr. Nguyen's expertise and compassion shone through. She took the time to thoroughly assess the situation, providing me with clear and trustworthy guidance every step of the way. Not only did she demonstrate exceptional skill and knowledge in her field, but she also showed genuine empathy, taking the time to address all of my questions and concerns. I left her clinic feeling reassured and empowered, knowing that I was in the best possible hands. Dr. Nguyen's professionalism and dedication to patient care put me completely at ease, and I wouldn't hesitate to trust her with any future cosmetic concerns or procedures.
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