James H. Rogers, MD

There are several different technologies available to tighten skin, including radio frequency. None of these, In my opinion, will significantly correct a drooping breast or enlarge one. Some degree of augmentation can be achieved with fat grafting, however this is limited and typically requires several sessions. In my opinion, if significant enhancement is desired , augmentation with silicone or saline filled implants is currently the only reasonable option.

It would be necessary to examine you to determine what would best provide correction of your eyebrows and upper eyelids. From your photo, it appears that you have significant brow ptosis, or drooping, as well as excess upper eyelid tissue. An upper blepharoplasty would be needed to address the problem of the eyelids. While fillers would improve the brows somewhat, it appears that a browlift would be necessary fr significant correction. Consult an experienced surgeon to discuss your options.

There are a number of factors that must be considered when selecting the correct implant size for a given patient. Most of my patients will say that they want natural looking breasts, however each one has a very different idea of what that actually means. We find having patients provide us with pictures of results they would like is most helpful in determining this. The amount of breast tissue present, elasticity of the skin, and width of the chest wall are some of the factors that are used to determine implant size. Costs can vary significantly from region to region. In our area, an augmentation alone costs around 6k and combined with an abdominoplasty around 12-15k.

From your description , I'm  assuming that you had fat harvested from your abdomen to provide graft material for your BBL. If there is still swelling and induration present , I would recommend delaying an abdominoplasty untill this is resolved. Lifting the abdominal wall skin while healing is still occuring could result in problems with wound healing or even skin necrosis. With the combination of procedures you are considering and the lengthy anesthesia time, it is wise to minimize risks as much as possible.

If you feel that your painful breast symtoms are caused by your implants, it is possible that removal may be indicated. However, I would recommend a thorough  breast exam and mammography to rule out other causes first. If your implants are the problem, it is also possible that this may be corrected without removal or with an exchange. It is very difficult to achieve significant volume correction with fat grafting alone, and typically multiple sessins are required. I would recommend consultation with an experienced breast surgeon to determine the cause of your symtoms and what the best treatment option for you would be.

Yes, it is possible to have all three procedures done at one setting. However, a more important question is it safe or wise. A breast lift and abdominoplasty together require a lengthy anesthesia alone, and there is a great deal of wound healing that must occur afterward. Your overall medical status, the condition of your heart , lungs and kidneys must all be evaluated to determine if surgery and anesthesia is safe for you. In our practice, we generally restrict outpatient surgeries to five hours or less to reduce risks. Discuss your plans with your surgeon to determine if they are reasonable

It is difficult to comment on what might be of benefit in your particular case. A BBL is a difficult procedure to achieve consistently good results and is associated with a fairly high complication/dissatisfaction rate. Most likely, you will not be able to correct the problem without surgical intervention .  Liposuction can be selectively done to correct contour irregularities or remove areas of excess. Noninvasive fat removal, such as Coolsculpt may also be an option. Before proceeding with any correction or revisions, consult a surgeon experienced with the procedure who has good results.

It is impossible to answer your question based on the information provided. Many things must be considered when choosing the correct implant for a given patient. These include breast width, the amount of breast tissue and body fat, elasticity of the the tissues, to name just a few . The most important consideration is how you want your breast to look. In my opinion, only your surgeon has the knowledge and experience to make make the correct selection, and it should be their responsibility. In our practice , we have the patient show us how they want their breasts to look, and trust us to provide the correct result. This avoids much of the anxiety patients experience over this issue.

It is certainly possible to experience prolonged swelling after fat grafting in any location, especially the eyelids. Typically , most edema has resolved by three months postop. The problem could be due to excess graft material or scar tissue. A possible treatment for any these causes would be very conservative injections of steroids. This can also be associated with its own complications such as thinning or discoloration of the skin. The eyelids are a very challenging area to provide good results and complications can be difficult to correct. Consult an experienced surgeon to determine the cause of the problem and discuss potential solutions.

Unfortunately, from your photo, it is impossible to accurately answer your question. Adding volume can correct much of the drooping that results after pregnancy . Generally speaking, if the nipples are at or above the breast crease (inframammary fold), implants alone can adequately correct the problem. If the nipples are below this level a lift , or mastopexy will be required with or without implants . The extent of scarring necessary depends on the amount of skin that must be removed. A lollipop scar can be used if there is limited skin resection, however an anchor scar will be necessary if alot of skin is removed. Consult an experienced surgeon to discuss your options.