Daniel Butz, MD

We often say breast are sisters not twins and it’s common to be more critical of these subtle asymmetries after surgery than before. You have a very nice result.

If you haven’t had children and you have minimal muscle separation you could likely have a great result without repairing the muscle. Boxy results are often a result of skipping the liposuction when it would’ve been helpful. Make sure you choose a board certified plastic surgeon who has a lot of results that you like and you trust. Get a couple opinions. Don’t choose the ‘easier’ surgery if it’s not the right one for you. You only want to have one tummy tuck.

I’m sorry to hear you’re not happy with your results. Since they’ve been in for a short period of time it’s likely things will bounce back fairly well. Resetting the fold is important but relatively straightforward. Removal of the capsule will allow the tissue to heal back to the muscle. One benefit of subfascial placement is the muscle wasn’t disrupted and doesn’t need to be repaired. The cleavage will likely return to its baseline shape.

Thanks for your question. It’s relatively common with age and weight fluctuations for the skin to stretch and hang off the implants - this is referred to as a waterfall deformity. Since you have saline implants you could do deflate your implants to get a better sense of what volume you’d have without implants. It can help you make a more informed decision. Both choices are reasonable though - implant removal and lift or just implant replacement and lift. I would not recommend just doing a lift. These implants are quite old and maybe they’ll last another 5-10 years but higher chance of them rupturing sooner than later and then you’d require another surgery. Make sure to see a board certified plastic surgeon and review their implant removal/ lift examples to make sure you’re going to be happy with that result.

Thank you for your question. You don’t have classic tubular breast. They are slight constricted - meaning the distance from your nippler to your crease is short. A breast augmentation is likely your best option for improving shape, volume and cleavage. For optimal cleavage results you may do best with subfascial placement and fat transfer. The fold may need to be lowered to accommodate the implant volume and I routinely reinforce these with internal bra mesh. Hope that’s helpful!

Thanks for your question. There are certainly a lot of ways you could proceed. I think circumferential (ie 360) liposuction will improve your overall contours more than just a tummy tuck. I tend to do liposuction with all tummy tucks - we do spare the central abdomen to avoid compromising blood supply but otherwise you’re more prone to boxier outcomes. This can be done drainless as well. Ultimately go with who you felt most confident with and liked their before and afters the most. And make sure their board certified plastic surgeons. Thanks!

Thank you for your question. Tuberous and constricted breast folds can be confusing. I wouldn't say you have the classic tuberous breast finding buts maybe your fold is a little constricted. Nothing that should make your surgery more difficult. I would likely recommend breast augmentation with mastopexy in a single surgery. Depending on your goals you could consider fat transfer but implants tend to be more reliable. Maybe consider an additional consult and find someone you're fully confident in. Make sure they're board certified in plastic surgeons and they should be able to show you a number of examples that are similar to your situation. Hope that's helpful.

Based on your photos you look like a great candidate. The first step is setting up consults and finding the right surgeon for you. I wouldn’t make timing your number one priority as you want it done safely and to get a great result. Make sure you see a board certified plastic surgeon. It’s not unusual to be scheduled out several months.

We were all residents at some point in our training and these cases are typically well supervised. However, if you’re uneasy or not comfortable with the plan it might be worth getting a second opinion. We can normally do Aug/pexy in one stage. Lipo to those areas added are routinely part of the surgery. So I would consider that extra. Never hurts to get another opinion.

Everyone has different goals. For petite patients like yourself a smallish 200-250 can often provide nice fullness but maintain a natural look. I've found that petite patients that want to be natural are less likely to get "boob greed" and are very happy with their smaller implants. If 300 felt like too much then you should trust that instinct. Maybe trying on a 250 and seeing it that's a nice in between or help narrow the options down would be helpful.