Cameron S. Francis, MD

Thanks for the question. A lift alone will generally not have long-lasting upper pole fullness or a round appearance. An implant combined with the lift is the best way to ensure roundness and upper fullness in the long-term. The higher the profile of the implant used, the rounder and more superior fullness the breast will have. Based on your desired outcome, I would suggest going this route unless you are opposed to implants. I recommend fat transfer for those patients who are opposed to having implants and want a middle-ground between implants and a lift alone. Even a small implant that is higher profile can greatly enhance upper pole fullness greatly, so I wouldn't worry about ending up too big. I hope this helps.

Thank you for the question. Absolutely, you can. Adding a BBL to a mommy makeover is something that we do routinely at my office. Often, because of the length of the surgery, and especially if the total volume of liposuction is more than 5 liters, I will keep a patient overnight for comfort and observation. I hope this helps.

Thank you for your question. Technically, a breast lift does not actually reduce the total volume of the breast, as no breast tissue is removed. If a significant amount of tissue is removed, that procedure is called a breast reduction. To maximize the volume of your result with a breast lift without placing an implant, your best option is to have fat transfer to the upper poles of the breasts. This is done by liposuctioning another area of the body, processing the harvested fat, and injecting the upper part of the breasts. I hope this helps.

Thanks for the question. I understand your desire to avoid scarring. However, in your case I think you are going to get the best result with a full tummy tuck, and short horizontal scar mastopexy. The good news with the breast lift, is that if your surgeon uses a circumvertical, tailor tack technique you should be able to avoid long horizontal incisions. As an alternative to a tummy tuck you may be able to get away with liposuction of the abdomen if you are willing to accept less than a perfect result, but you would need to see a plastic surgeon in person to evaluate your skin quality to see if you would be a good candidate for this. However, I think you will get your best result with a full tummy tuck, including skin resection and tightening of the rectus muscles. I hope this helps.

Thanks for your question. A breast reduction includes a breast lift. A breast lift is essentially a breast reduction where no tissue is removed. In both cases the breast mound is elevated, along with the nipple. I hope this helps.

Thank you for your question. In terms of the result that can be achieved, there is really no difference between the two approaches. Each has its own pros and cons. The advantages of a periareolar incision is that the scar is very well hidden at the bottom of the areola. The disadvantage for the surgeon is that it is a little more difficult to perform, because the incision is generally smaller. In addition, there is a theoretical disadvantage with periareolar incisions, that there may be an increase in the rate of capsular contracture due to contamination of the implant due to contact with the milk ducts. However, most surgeons now use a Keller Funnel, which is a sort of sterile plastic bag that delivers the implant directly into the pocket without contacting the areolar tissue. This should minimize the increased risk of capsular contracture. I prefer to use a periareolar approach for all my breast augmentations, but I believe patients can get an equally good result using either periareolar of inframammary incisions, regardless of their starting anatomy. I hope this helps.

Thanks for your question. Injection of a long-lasting hyaluronic acid-based filler (I prefer Voluma) along the cheek bones and jaw line can give you the result you are looking for.

Thank you for your question. It appears that your breasts have "bottomed out." If you think of the skin of the breast as a bag that contains the breast tissue, then in bottoming out the lower part of that bag has stretched out from gravity and the breast tissue has all settled low on the chest. The nipple ends up relatively high compared with the sagging breast tissue. This happens commonly over time following breast reduction, especially after pregnancy. There are two options depending on your goal: 1) If you want a very natural look and want to be a little smaller you can have a breast lift with some resection of the bottomed out breast tissue2) If you want more fullness at the top of the breast (a rounder look) you can have a "Reductive Augmentation" where, in addition to the steps above, you have a small implant placed under the muscleMake sure you find a surgeon who understands your goals and can collaboratively make a plan to achieve them.

Thank you for your question. Liposuction can be very effective for improving these back rolls, particularly in young individuals with good skin quality. The reason for this is that young skin with good elasticity is better able to contract after removal of the fat. In addition, the use of a specialized instrument during liposuction (called a "basket cannula") works to break up the tissue bands that cause the the shape of the roll in the first place, smoothing out the contour. Using this technique, you would likely get the result you are looking for without the need for large incisions/scars. I hope this helps.

Thanks for your question. Evaluating for something as subtle as eye asymmetry requires more standardized photos or an in-person consult. In the above photo your head is slightly turned to one side. From what I can see your have lovely, youthful-appearing eyes and wouldn't recommend any surgical correction.