Corey Harkins, MD

Based on your BMI of 38.7, you would be a surgical candidate for our surgical center (BMI under 40), assuming there were no other significant medical comorbidities. I don't recommend a tummy tuck and BBL at the same time as you will be having to sit a lot and place a lot of pressure on your buttocks, thus you will get more resorption of fat, and a less ideal result. Schedule an in-person or virtual consultation with a board-certified plastic surgeon to get more detailed info. Best of luck to you! -Dr. Harkins

Patient's with Factor V Leiden are at an increased risk of DVT/PE (as you are well aware), and staged procedures may be performed safely with a low risk of thromboembolic events. Hematology clearance but be documented, and I would probably recommend Lovenox to be started before surgery (12-24 hours) and up to 3 weeks postoperatively. Best of luck to you! -Dr. Harkins

You would need to have your procedure performed in a hospital setting and have a pre-operative evaluation by anesthesia (along with cardiology clearance which you have already received). From a surgical standpoint, if you were deemed low risk for anesthesia and cardiac complications then I don't see any reason why surgery couldn't be performed. Best of luck. -Dr. Harkins

I remove all of my own drains. While exceedingly rare, there can be sudden bleeding upon drain removal which would require a physician to be ready and available. Also, if there was resistance upon removal, and this was ignored, a portion of the drain can break - and this only comes with experience. More concerning is that follow up is 1 month after surgery? Depending on the surgery, I always see patients within 8 days post-op. Best of luck to you. -Dr. Harkins

It is safe as long as: SCDs are utilized; a DVT risk assessment is performed and anticoagulation is prescribed as indicated (Lovenox, Xarelto, etc); the importance of frequent and early ambulation is explained. Best of luck to you! Dr. Harkins

Your BMI is 41.6, and the criteria for our outpatient surgery center is a BMI less than 40. 240 pounds would put you below that threshold. Insurance would likely cover the breast reduction (the lift is part of the reduction procedure), but they don't cover a tummy tuck. In circumstances where the abdominal pannus hangs to the mid thighs along with documented infections in the fold, insurance will usually cover a panniculectomy. Is is my opinion that proceeding with the tummy tuck and breast lift is too risky to be done in 1 surgery and would recommend 2 stages. Best of luck! -Dr. Harkins

Generally speaking, there is no weight that is too low in order to proceed with a mommy makeover - as long as the BMI is over 17ish and there are no nutritional deficiencies. I personally find that thinner patients often get the best results. Best of luck! -Dr. Harkins

You seem to have done your research. In every circumstance, I would recommend the implant position to be submuscular. However, be aware that the greatest degree of nipple elevation without a lift is achieved with a subglandular plane. It seems to me in the photos you posted that you have a greater degree of pseudoptosis on the breast pictured to the left (which is also the larger breast). I would recommend a moderate plus profile implant somewhere between 400-550cc depending on your base diameter. High profile implants don't settle as nicely in patient's with grade 1 or pseddoptosis. Ultimately, volume tends to be be what we try to match based on your wish pic - and once the base diameter is maxed out with a mod plus, we're obligated to go to high or ultra high profiles. Best of luck to you! -Dr. Harkins

Certainly, a tummy tuck with lipo of the flanks and back would be the best overall option in my opinion. But, considering the circumstances, I would recommend lipo 360 and a lower abdominal scar revision/mini to address the small skin fold. I do not feel there are any non-invasive skin tightening options on the market today - J Plasma, ThermiTight, etc - will give you a better result than lipo of the back. Performing lipo of the posterior truck will fully address your flanks, midback and braline. Best of luck to you! -Dr. Harkins

A tummy tuck will give you the best results as it will tighten the skin and rectus muscles. The skin from the belly button to the pubic hariline is removed, and this will address any skin laxity/folds you currently have (ie above your belly button) while also removing a good percentage of your stretch marks. The muscle tightening (plication) would flatten the abdominal wall like an internal girdle. Take a look at some of the photos I have posted to see what I mean. Best of luck to you - Dr. Harkins