Debra L. Stafford, MD

Hello,
Abdominoplasty with muscle plication remains the gold standard for tightening the anterior trunk in individuals with loose skin. BodyTite will provide an improvement in tightening the skin but not to the degree of an abdominoplasty and muscle plication but patients often prefer a less invasive option. I am unable to examine you so I cannot access the degree of loose skin present. I am speaking generally. Consultation with a board certified plastic surgeon in which a physical exam can be done will provide you with more information concerning your options.

Debra L Stafford, MD

Hello, it generally takes approximately 8 weeks for facial bones to heal so you should be healed by 6 months. If you have any questions or concerns, you should speak with your surgeon.

Hello. I am able to appreciate a significant improvement although fullness in the lower abdomen is evident based upon the provided photographs.

Was muscle plication (suturing of the rectus abdominis muscle) from the pubis to the xiphoid performed ?

If not, suturing of the muscle would tighten the abdominal wall further. In addition, you may possibly have residual fat in the lower abdomen so additional liposuction could be helpful.

Hello, you appear to have type 2 tubular breasts in which the lower quadrants of the breast did not expand (constricted) with a high inframammary (IMF) fold. The lMF needs to be lowered and the restrictive bands of the IMF released. The posterior portion of the breast gland also must be cut in a chessboard or radial type fashion to allow the breast to expand combined with an implant that would be needed to fill out the deficient lower portion of the breast. You would also benefit from liposuction of the lateral chest walls.

Consult a surgeon certified by the American Board of Surgery for a full examination.

Hello. The chin can be expanded without an implant or filler by the use of osteotomies (cutting of the bone) of the chin or jaw. Depending on what is required, orthodontic work of the teeth may be required.

Sincerely,
Dr Debra Stafford

Hello, Liposuction continues to be the "gold standard" to remove localized fat that is resistant to diet and exercise. Non surgical options can be effective but not to the degree of liposuction.

Hello, two general anesthesias in one month does not pose a serious risk for the majority of healthy patients. However, anesthesia in individuals over the age of 65 or 70 may have lingering effects on the brain for months to years. This phenomenon is a concern in older individuals.

Cognitive function in elderly patients undergoing surgical procedures under general anesthesia can be protected via HBO preconditioning. In general, HBO can only be helpful in your recovery.

In conclusion, healthy non elderly individuals do not have a significant risk undergoing more than a single anesthesia in one month.

Sincerely,
Debra L Stafford, MD

Anatomical implants (teardrop) implants are not "more dangerous" than round implants but there are distinct disadvantages of the anatomical implant over the round implant. The most long term serious risk would be the increased occurrence of a rare type of malignancy "anaplastic large-cell lymphoma" that is more likely to occur in textured implants over smooth implants (anatomical implants are always textured to prevent rotation). Anatomical implants can rotate and cause distortion of the breast and requires very precise dissection of the implant pocket to prevent this potential occurrence. Intense activities can be undertaken with anatomical breast implants as with round implants after full healing has occurred.

Round implants can provide very natural results when placed in the sub pectoral plane in women with varying degrees of breast tissue. Overall, smooth round silicone implants provide excellent and natural results in the majority of patients and is more straightforward surgery.

Sincerely,
Debra Stafford, MD

Hello, the best implant size is decided upon by the patient in consultation with her surgeon. Radiographic studies suggest that a range of 130-150 cc will increase the breast one cup size depending on a narrow or wide bra band width. I however rarely as a plastic surgeon recommend an implant less than 200 cc but would place an implant in the 130-150 cc range if the patient was wanting a very subtle augmentation.

Breast augmentation in athletic women has a high satisfaction rate with the majority maintaining the strength of the pectoral region regardless of pre pectoral or post pectoral placement of implants.
I would prefer the placement of post pectoral implants in athletic women because the post pectoral placement of implants provides a more natural shape and feel.

Sincerely,
Debra Stafford, MD

Hello, I would recommend that the procedure be postponed for 4-6 weeks. Unfortunately, one episode of inhaling tobacco returns an individual back to the starting point. Being free of tobacco during the
4-6 weeks and refraining from tobacco during an equal time period postoperatively will decrease the risk of wound healing complications in addition to decreasing the risks of blood clots, infection and inflammation. The healthy habits you practice are beneficial for recovery but will not negate the detrimental tobacco effects.

Please discuss your concerns with your surgeon.

Sincerely,
Debra Stafford, MD