Gregory Baum, MD

Based on your photos, it looks like you may benefit from some liposuction to thin out the area at the lower abdomen and get that area smoother. It is impossible to know if this was present at the time of your original procedure or due to some possible recent weight gain. I would speak to your original surgeon to see if liposuction may get you the result you desire.

This is a very common question I get from our patients. You will not have more wrinkles as you get older if you start Botox and then stop. Stopping Botox usage does not result in more “damage” than if you never started using it. It typically lasts 3-4 months so if you get it once per year then most of the year your wrinkle muscles will be working normally. I hope this helps.

I would agree with your surgeon that a revision is warranted. I think using Galaflex or Galashape is an excellent idea to help with resetting the fold under your breast back to its proper place. Changing the implant style won’t really affect things much unless you go up in size. Be careful though because the larger the implant, the heavier it is and thus more pressure on the fold under your breast. It’s difficult to tell if your implant is a bit too wide for your chest based on the photos. This would be best evaluated with an in-person consultation. Wish you all the best with your revision surgery. Dr. Baum

I think there are advantages to each type of mesh but Galaflex is certainly the most common at this time because it provides structural support yet it eventually gets absorbed. We hope that your body will form new scar tissue around your implant so that as the Galaflex gets absorbed, the new scar capsules will hold your implants in the correct position. Theoretically, there’s less chance for infection with absorbable mesh. I hope this helps. Best wishes on your revision surgery.

I would think long and hard about traveling abroad for your cosmetic surgery. Like others who have commented on this forum, I have seen plenty of serious, life-threatening complications from people who have travelled to Mexico and the DR for cheap cosmetic procedures. Here in Syracuse, we have seen dead nipples, atypical fungal infections, awful scarring, and procedures frankly just done wrong by practitioners in these locations. Sometimes the “plastic surgeon” is not even a plastic surgeon at all. In short, it’s buyer beware in these situations. Best wishes.

Thanks for your question and photo. Retin-A will increase cell turnover and therefore improve fine lines but will not really effect breast lift/reduction scars. Based on your photo, I think you would benefit from a standard breast lift. This would lift your breasts and reduce the size of your areolae. I hope this helps. Best wishes. Dr. Baum

Thanks for your question and photos. Based on your photos, I think you could probably just do implants but your nipples/areolae would likely be a bit low on the center of the breast implants. This may be of no concern to you but us plastic surgeons like the breast gland and nipples centered perfectly on the breast implants. I think this comes down to how much imperfection you’re willing to accept in order to avoid the scars of a breast lift. Best wishes, Dr. Baum

It’s difficult to say exactly what needs to be done without an exam in person. It would also be very helpful to see your preop photos. Based on the photos you submitted, I would recommend removing your current implants, scoring the lower poles of your breast skin envelopes, placing a mesh called Galaflex, and possibly placing slightly larger implants. Your inframammary creases were disrupted by the first procedure and this is the source of your double-bubble deformity. I hope this is helpful!!

I’m sorry to hear about your unhappiness with the Ideal implants. I think they are an improvement over traditional saline implants but they are still not as soft and natural feeling as silicone implants. I would recommend waiting at least 3 more months to let your current implants settle into their final spot. This may make it easier when/if you decide to swap out your implants. I would continue to follow up with your surgeon so that he/she can continue to give you guidance. Best wishes. 

Based on your photos, I think you need a revision of your breast lift and perhaps slightly larger implants to give you the upper pole fullness you are looking for. Switching the implants to on top of the muscle will likely cause significant bottoming out, less upper pole fullness with time, and an increased risk of recurrent capsular contracture. Best regards.