Carey Campbell, MD

If you are a healthy, non smoker, your age itself is not a contraindication to surgery. However, your BMI is 40 and that is a significant contraindication to surgery and greatly increases your risk of recurrence of the diastasis and complications after surgery. 




Your BMI needs to be closer to 30, if not at 30, before your proceed with Diastasis repair. At your current BMI, you’re intraabdominal contents (intestines, organs, and the surrounding fat) will push against your repair and that pressure can tear your repair apart. Even if you had a surgical repair, your abdomen may still appear round if your BMI is high because your intra-abdominal contents haven’t gotten smaller.




Sounds like you have a great doctor who gave you good advice.

You have a great result and should take a look at a photo of your breasts prior to surgery to see how they probably weren’t symmetrical your whole life. Additionally, since they are symmetrical in some photos and not others, it may be as simple as how you hold the camera differently affects your pectoralis muscle position making your breasts look different. 




And yes it is very typical, if not the norm, to have breast asymmetry that you are born with. There are some asymmetries which can’t be addressed such as difference in how your rib cage is shaped from left to right. Many women have chest wall asymmetries which they don’t appreciate until their implants are put in. 

Additionally the actual volumes of your breasts may be different and when you make your breasts bigger, the asymmetry in volume is more apparent because it was augmented too. That’s why plastic surgeons often say your breasts are “sisters not twins.”

That being said, your implants will also settle into place over the year after your surgery. I think your surgeon is right to tell you to wait a little longer. If it still bothers you at a year, you could consider upsizing one of your implants on the smaller side. However, most Plastic Surgeons generally put the same size implant in both breasts unless the volume difference between the breasts is greater than 50 cc. 

Hope that is helpful to you.




Carey Campbell

The Zygomaticus Major muscle inserts along the deep surface of the Orbicularis Oris muscle below/inferior to the orbit. I have seen a patient whose Botox was injected too medial (closer to the nose) and deeper than just under the skin (where the orbicularis lives). Her Botox did affect the elevation of her lip corners and resulted in a flatter smile.  This happened when attempting to eliminate all of her crows feet, even the low ones. When I treat a patient’s crows feet, I don’t aggressively treat those lower lines as a result. It doesn’t sound like you received too many units and I wouldn’t expect that much diffusion if it really was just at the tail of your brow. I’ve only seen it with low crows feet injection.