Tummy Tuck

Breast Reduction

Breast Implants

Liposuction

Breast Lift

Arm Lift

Breast Implant Revision

Facial Feminization Surgery

Breast Augmentation

Petite or Ballerina type breast enhancements are wonderful options for women who prioritize shape over volume. Based on your height/weight I would be surprised to see an 18 cm BWD. Your base width is the width and height of your breast footprint on your chest and is a little narrower than the breast itself considering skin etc. A small enhancement with a Motiva Round gel may be great for you to give fullness while maintaining a soft breast. Please note that the smallest Motiva implants available are 150 cc (Ergonomix gel) and 205 cc (Round gel). I recommend having an examination and consultation with a board certified plastic surgeon familiar with these implants. Best of luck on your journey!

Hi- I'm 5'2" 125pounds and my BWD measured a few times by me and my husband is 18cm. I made sure I did this nipple to nipple, using the right side of a flexible measuring tape. I am concerned that my BWD seems so much larger than other women's. My bra size is a 34AA. I would like to get motiva mini implants so that I can fill out a bra and be a full 34A size. Is this reasonable? Or will I need much larger implants because my chest is so wide? Thank you

BWD of 18, 34AAA - can Motiva mini implants help me achieve a full 34A size?

Hello StarCross77, the short answer to your question is that - Yes - saline implants can slowly lose volume over time related to either a very small defect or a problem with the valve through which the implant is originally filled. 29 years is a great lifetime for saline implants, but they wear out over time. Typical rupture risk is 11% at 10 years, and an additional % each year after that. So at 29 years, you have about 30% risk per year of having a rupture or leak. If the breast feels softer or looks a little smaller, you should definitely have an examination by a Plastic Surgeon to evaluate for rupture. Regardless, I would recommend exchange or removal of those implants so that you can have better control over your exchange process. Exchanges due to rupture tend to require more pocket work and are more complicated than straightforward planned exchanges.

I have had saline breast implants for 29 years. I went to get them checked out about 4 years ago, and the doctor I saw said I shouldn't do anything because they looked good. Well, now I am having an aching feeling in my left boob. It's a little sore. The implant feels a little less firm, but I know with Saline, typically, you know when it has leaked. Can Saline implants have a slow leak? Is it dangerous with the age of the breast implants?

29 year old saline breast implants - Can saline implants have a slow leak?

Mesh comes in several types, but the most common is an absorbable mesh made of out poly-4-hydroxybutyrate (P4HB). This type of material is the same as is used in many absorbable sutures, and will be replaced by your body's scar tissue as it dissolves slowly over the course of 1.5-2 years. This acts as a reinforcement to your soft tissue during the healing period. If your capsule needs to be tightened by over 1 cm in any direction, I do recommend use of mesh to reinforce the repair and prevent a heavy implant from weakening your repair. Some downsides of mesh include risk of visible or palpable wrinkles, extrusion and infection. The use of mesh reinforcement in breast surgery is considered "off label." Ask your surgeon to review the risks and benefits of using mesh with you. As always, I recommend seeking the opinion of a board certified plastic surgeon.

I’m going under again in a few months for a capsulorrhaphy to help lateral displacement while laying down. My plastic surgeon mentioned mesh too but I’m on the fence about mesh. Should I do the mesh as well?

Do I need mesh to help lateral displacement? (Photos)

While you may still see some changes even 9-12 months following a breast augmentation, the asymmetry of the upper pole between the breast does raise some concerns regarding an early capsular contracture on the left. The other possibility is that there was incomplete release of the muscle on the left side, and that is holding the implant in a higher position. The fold is slightly lower on your right side, even in your preoperative photographs, and this may account for the slightly lower position of your implant on the right side. I recommend you have an exam by your plastic surgeon to determine whether there is a mechanical issue before embarking on any other corrective procedures.

37 year old female, 5’ 9” 140lbs, 3 previous pregnancies and breastfed all 3. Had breast augmentation done the end of May so currently coming up on 7 months post op. We decided on 350cc gummy bear silicone, moderate profile, partially under the muscle. Included are images of me before, right after procedure and today. Immediately after I felt the left side was a bit higher but know things heal at different rates and one side can take longer. Well at 7 months I was hoping they would have been more even (did not have asymmetry prior). One side appears too low while the other too high. They are both soft. My concern is about pocket size? Was one created too large which caused the implant to sit lower and also allowed for so much rippling so soon after. What would your recommendation be moving forward to achieve a more symmetrical look?

Breast augmentation unevenness - how can I achieve a more symmetrical look? (Photos)

During breast reduction, the nippl and areola are moved to a higher position in the breast and are kept alive on a mound of breast tissue where the nerves, arteries and veins travel. There are several options of where this mound can be based, and the best option for robust blood flow is the superomedial pedicle. This pedicle limits the amount of breast tissue that can be removed. If your goal is to have a G to D reduction, you may require more tissue removed and an inferiorly-based pedicle to permit this. Because inferiorly based blood flow is not as robust, you may be at risk of requiring a free nipple graft. If your surgeon is concerned at the time of surgery that the blood flow is not sufficient, then your surgeon may convert to FNG. It is reasonable to plan your surgery without FNG, but with such a significant reduction you should be aware that it is a possibility that it would be converted to FNG during your procedure. I recommend that you consult with a board certified plastic surgeon who is comfortable with performing breast reduction via multiple pedicles.

Black female. My surgeon stated a free nipple graft is required if I want to go down to a D cup, from my current G cup.

D cup to G cup - Do I need to have a free nipple graft? (Photo)

Assuming you meet criteria for medical necessity for breast reduction through your insurance carrier, you can expect your insurance to cover only the removal of excess breast tissue. Any additional procedures such as skin or fat removal by direct excision or liposuction will not be covered by insurance. Depending on where the excess fatty tissue is, you may be a great candidate for some lateral chest liposuction to address the stubborn tissue that interferes with your bra band under your arm. Some women have skin excess that extends from the breast towards the back in this area, and that might be contoured with skin removal at the time of breast reduction, but leaves a significantly longer scar. It would be best to mention all of your concerns to your surgeon when you schedule your consultation with a board certified plastic surgeon, that way she can be sure to address each of them.

I am considering getting a breast reduction through my insurance and I was wondering if surgeons usually remove armpit fat as well when doing a breast reduction.

Do surgeons remove armpit fat when doing a Breast Reduction?

Facial feminization is all about softening your look without significantly changing your appearance - my goal would be that you still look like you. Small changes that may help you reach this goal based on your photos can include brow lift/hairline lowering to shorten your forehead, rhinoplasty to refine your nasal tip, and consider jawline contouring to create a more oval shape to your lower face. I do recommend a consultation with a board certified plastic surgeon so that you can have an examination performed. A professional will then be able to measure your facial proportions and make recommendations based on both your goals and exam results.

Good afternoon! What kind of surgery do I need to look like a feminine woman? I always had a very long horse face, masculine jaw and big forehead. I know my nose is big, I know I need rhinoplasty, that one is clear. However when it comes to my long face, I have no idea where to start. I have a couple of fillers already which I thought it would help but apparently it did not. Fillers I have: tear-trough for my very hollow eye, lateral and midface cheekfiller for my already sunken cheek, chin filler because I have slightly recessed chin (this I regret a lot as my face just got even more bigger). I really don’t know what to do, I just know I want to be perceived as someone who is pretty and feminine looking. Thank you for the suggestion in advance! Renata

What procedures do I need to make my face look more feminine? (Photos)

Your aversion to using implants is very understandable. Ultimately your options will depend on your goal for your breasts, however you may consider fat transfer or an off-the-shelf product such as Renuva or Alloclae to build volume in your breast(s). This is a good place to start to then achieve better volume symmetry between the breasts. More volume will help to smooth out the skin and fill the depression created by your prior tissue loss. A lift is possible, and can also help to create more symmetry between the breasts, but I would recommend improving the volume first.

I have had 4 breast surgeries previously. I had PIP implants in 2007-2012. The right one had ruptured and leaked into my breast tissue and is still in my lympnodes. I had them replaced and then had to habe more surgery for capsular contracture. I ended up explanting in 2018. The surgeon said that i had lost muscle due to the muscle not being previously sewn down. So i am deformed from that and lack full function in that pec. Also deformed from breast tissue loss from rupture. Ive breastfed my 2nd child and i want to know what my options are for correction without implants. Can you get a lift when theres not much to lift

How can I fix this without implants? (Photos)

You do appear to be a great candidate for body contouring with liposuction to help define your waist. Liposuction is not a good tool for weight loss or to make you 'skinny,' but it can enhance contours and modify shape when applied correctly. When done properly, liposuction takes away the deeper layer of fatty tissue and leaves the top layer of fat behind to keep your skin smooth. If liposuction is performed to superficially or too close to the skin, then you can see a lumpy bumpy appearance. There is a higher risk of having contour irregularities like this in thinner patients such as yourself, because the fat layers are thinner and your superficial fat layer is not as thick to hide deeper irregularities. Liposuction on thin patients takes longer because smaller cannulas and lower power/suction strengths are used specifically to avoid these types of contour irregularities. Lipo360 is a way to address the entire torso (abdomen, flanks and back) at one time with one recovery period. If patients are considering body contouring of the abdomen and back, I will usually recommend treating this at one time to both optimize recovery time and keep your result cohesive.

Greetings! I have considered lipo for a long time. Ive gone on a few consults. Most say I'm a great candidate; however, one told me she would only do my flanks because I have smooth skin and there is a risk of irregularities, and that she commonly does flanks only for women. I just want to appear a little more curvy (considering my body structure), and look more fit in clothing. The lower downtime is also appealing to me. Is this a good option for me? Is lipo better done 360? Could I add the front at a later point if I wanted? I want to look natural and not uneven. Thank you so much!

I want to look natural and not uneven. Would it make sense to get flanks only liposuction? (Photos)

There are several factors that go into whether a mini or full abdominoplasty skin removal is recommended. The best way to determine which is best for you is to have an examination by a board certified plastic surgeon. This will show where the belly button is relative to aesthetic ideals, how much skin laxity and skin excess there is both above and below the belly button, as well as whether there is muscle separation. Either abdominoplasty technique will replace your c section scar with a longer scar hidden in the bikini line. A mini will remove less skin, and can potentially place your belly button too low. A circumferential abdominoplasty will place a scar around the front and back of your lower torso, and can provide a modest buttocks lift, which can help with mild skin laxity in the buttocks but involves more recovery. I usually will recommend separating the front and back skin removals into separate surgeries because of this. A full abdominoplasty may be the best option based on your photographs, but this does depend on your examination. The benefit of skin removal is that all of the fat that attached to that skin removal can be harvested and used for transfer, in addition to liposuction of the flanks, lower back and upper abdomen at the time of an abdominoplasty.

I am 46 and delivered two kids via c-section. Im fair skinned and my scars fade to pale and dont show real well. I wanted lipo with abdominal etching and skinny BBL. As I have it perimenopause, i have lost by backside. One doctor recommended a tummy tuck, another recommended a mini tummy tuck, another a circular tummy tuck and another said he could do what I want with lipo. Which would you recommend?

Tummy tuck, mini tummy tuck or lipo - Which procedure is more recommended with a skinny BBL? (Photos)

Emily C. Wirtz, MD

Videos

TreatmentPricing

WebLinkBoost

CoverPhotos

WebsiteLink

Highlights

Locations

CovidAnnouncement

RemoveCompetitorAds

Reviews

QuestionAnswer

ImpressionTarget

PersonalStatement

Photos

ContactForm

Instagram

SpecialOffers

ExpertiseModule

Breast Implant Removal

Plastic surgeons specialize in the full spectrum of cosmetic and reconstructive surgeries for the face, eyes, nose, breasts, and body.

Plastic Surgeon

Dr Wirtz is AMAZING!  She’s done 2 procedures on me and I’d go back again! My breast reduction and panniculectomy both had very little pain and recovery was quick.  100% success- results are beyond expectations!  I cannot believe that some of the scars are nearly invisible after just 6 months.  Already sent family to her.   Highly recommend

Results Beyond Expectations

Independent356295

Panniculectomy

22 Answers from Board Certified Plastic Surgeon Emily C. Wirtz, MD See Education, Board Certification, and Treatments Offered.

Meet Emily C. Wirtz, MD, a trusted Board Certified Plastic Surgeon. See 22 expert answers, 35 before-and-after photos, credentials, treatments, and 1 real patient reviews. Book a consultation today!

Plastic and Reconstructive Surgery, University of North Carolina Chapel Hill

Aesthetic Plastic Surgery, H/K/B Charlotte, NC

B.A. Economics Northwestern University, Cum Laude

M.D. Case Western Reserve University

Doctors

Ohio

Cleveland

Meet Emily C. Wirtz, MD, a trusted Board Certified Plastic Surgeon. See 22 expert answers, before-and-after photos, credentials, treatments, and 1 real patient reviews. Book a consultation today!

Emily C. Wirtz, MD

MEET Emily C. Wirtz, MD

Location

Before and After Photos

EMILY C. WIRTZ, MD REVIEWS

RATING DETAILS

WE SEND PRETTY
EMAILS

Emily C. Wirtz, MD

MEET Emily C. Wirtz, MD

Location

EMILY C. WIRTZ, MD REVIEWS

RATING DETAILS

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS