Eric Swanson, MD

Yes, you are a candidate judging from your photos. A vertical lift is best (not the anchor scar lift). This surgery does not affect the erectility of your nipples. There is no good way to make them more protuberant although grafts have been used and even prosthetics. Be sure your surgeon is experienced, particularly in doing combination procedures. And it is important to know how to be safe doing buttock fat transfer.

Exactly the opposite. In women with a narrow chest, high profile implants are best so you don't have too much "side boob."

It's not unusual to get a little bottoming out. This can be revised by removing more skin and tissue from the crease area under your breast, "cinching" the breast, and producing more lift. Usually there are no additional scars, but rather replacement of your existing scars with new ones in a similar position.

Your best option is a secondary breast lift using the vertical technique. Whether to include skin resection around the nipple/areolas is a judgment call. If you want the best result and the most tightening, then this is recommended. Basically, your old scars are replaced with new ones. You might consider small implants for upper pole volume. Energy based treatments are ineffective and costly. Mesh is unnecessary and not helpful. A vertical lift is best.

You have skin redundancy of the abdomen. The treatment is a tummy tuck, and not a mini-tummy tuck. Of course, an incision is needed within the bikini line.

Usually a bulge in this location is caused by a hernia around the belly button or weakness of the muscles. It is rare to have a seroma persist. You could have it aspirated with a needle under ultrasound guidance. This can be repeated. If it does not resolve, surgery is needed to remove it. One of the disadvantages of going out of country for surgery is not having your surgeon handy to treat problems that come up.

The donut incision sounds like a good idea. Just keep the scar around the areola. However, it does not provide much lift and the scar can heal badly because of excess tension. Your best option is a vertical lift with removal of some tissue from the lower pole. You have to accept a vertical scar. Implants work best for upper pole volume. Better than fat. It's a plus/minus concept. Add volume on top and subtract on the bottom.

Liposuction works well for calves (cankles). However, the surgeon needs to be cautious because there is little room for error. I use a spatula-tipped cannula. Overaggressive or uneven treatment can leave contour deformities that are hard to correct. Incidentally, your calves look pretty good. Many women like a muscular look today. Calves are mainly muscle, so liposuction produces an incremental improvement, but for patients like you that may be enough.

Yes, breast implants will give you the upper pole volume you want. However, you should consider a vertical breast lift to correct the lower pole excess. Must be vertical, not an inverted-T (anchor scar). I see you have had a previous lift. Your surgeon needs to be careful not to elevate your nipples because they are already sitting high. Have you considered facial fat injection? You are a good candidate.

When doing a tummy tuck, the surgeon does not enter the abdominal cavity, so there is no risk of causing adhesions between abdominal organs. This is also true when performing a diastasis rectus repair.