I had a failed breast implant surgery from another surgeon. The breasts devolved capsular contracture and one side traveled upward resulting in one high riding breast and one regular. This made my chest look disfigured. The other surgeon did not follow up with me or care. I went several years with my breasts this way before consulting with Beautologie. I was extremely nervous but after going through a breast implant replacement and having the scar tissue scraped out with Dr. Knoetgen , the breast healed better than expected. There were several follow up appointments to monitor the healing process. Every three months for the next year. My next appointment is soon and if I’m not completely happy or need anything else then Dr. Knoetgen is willing to go back in and do anything else that can help. Overall they look much much better and I am so relieved and happy I didn’t wind up botched. Dr. Knoetgen is really good at what he does. When you go into beautologie, you can see all his awards on the hallway wall including an award for being the most caring/compassionate. The awards are impressive and grateful to have found a surgeon that was knew what to do and how to do it. Scraping scar tissue and replacing implants gone wrong is no easy task. Thank you Dr. Knoetgen! As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.
Dr Knoetgen was a phenomenal surgeon! The whole process of my breast augmentation and tummy tuck was top notch! He listened to what I wanted, and was honest and realistic with me. He didn't try to push me to make certain decisions, but gave me the information to make my own informed decisions. He did an excellent job on my surgery and I couldn't be happier with my results! I have and would continue to refer all of my friends and family to him for anything they might want done. As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.
Amazing experience from start to finish. All the staff made me feel comfortable. Highly recommend Dr. James Knoetgen. He did a phenomenal job. Very clean inside. Surgery recovery wasn’t bad at all!
I have been so excited to post my review for this office. I have to say #1, my coordinator Ginger was the absolutely sweetest and down to earth soul. She truly made me feel at home. Her knowledge was out of this world. Karol was my nurse towards the end for pre-labs and also my post op care. She is freaking amazing and sweet. Love her. The receptionist is by far adorable. She immediately greets you and is super quick with check in. Everyone in the office is perfect. Okay now to the amazing Dr.Knoetgen, I am just so utterly grateful. After losing over 70lbs on my own I had so much skin and no boobs. Lol. My 5 kids took not just milk but it all. From the very beginning before surgery he made me feel so comfortable and not nervous at all. He explained everything well and was superhonest.I had a Mommy Make Over with 450cc saline implants. The morning of surgery was honestly fast. His staff day of surgery was amazing and kind and his anesthesiologist was absolutely amazing and sweet. My recovery went smooth, painless and fast. My scar for tummytuck is low and straight, My belly button looks natural and amazing and boobs are freaking perky and plump. Im so obsessed with the overall experience and look. No complications. No pain. Back to being a nail tech at 3weeks post op.I'm currently 1month post op and feel and look amazing. Skinny and not boxy at all. . Dr.Knoetgen is the G.O.A.T of it all. He's an artist.Book with him you will regret it if you go elsewhere
The best in California!!! If you are far or close just choose Dr.Knoetgen. he is the best. 5 kids later and losing 70+lbs I needed his magic. He snatched me up. The best! pain free and fast recovery. . Updated on 11 Sep 2023: I have been so excited to post my review for this office. I have to say #1, my coordinator Ginger was the absolutely sweetest and down to earth soul. She truly made me feel at home. Her knowledge was out of this world. Karol was my nurse towards the end for pre-labs and also my post op care. She is freaking amazing and sweet. Love her. The receptionist is by far adorable. She immediately greets you and is super quick with check in. Everyone in the office is perfect. Okay now to the amazing Dr.Knoetgen, I am just so utterly grateful. After losing over 70lbs on my own I had so much skin and no boobs. Lol. My 5 kids took not just milk but it all. From the very beginning before surgery he made me feel so comfortable and not nervous at all. He explained everything well and was superhonest. I had a Mommy Make Over with 450cc saline implants. The morning of surgery was honestly fast. His staff day of surgery was amazing and kind and his anesthesiologist was absolutely amazing and sweet. My recovery went smooth, painless and fast. My scar for tummytuck is low and straight, My belly button looks natural and amazing and boobs are freaking perky and plump. Im so obsessed with the overall experience and look. No complications. No pain. Back to being a nail tech at 3weeks post op. I'm currently 1month post op and feel and look amazing. Skinny and not boxy at all. . Dr.Knoetgen is the G.O.A.T of it all. He's an artist. Follow my Instagram for thr pre-surgery and post at @marisachavez4. Book with him you will regret it if you go elsewhere
I had a mommy make over back in October by Dr knoetgen, he is amazing and made my experience so easy, nothing of what I thought it would be base of experiences of people I know who had plastic surgery in the past … my experience was so easy …. Ginger was my coordinator and answer all of my questions she went above and beyond to make me feel comfortable, help me with all the million questions I had… Maribel was my nurse she was so helpful, I was going back and forth with my implants size she let me try the sizers over and over again and told me if I wasn’t sure yet I don’t have to make my decision right away and I can always choose later on on the road since my implants are going to be saline so that make me feel I wasn’t in a rush to choose and want to make the right choice and not to regret it later… My consultation was in the end of July 2022 and my surgery was scheduled for August 30th 2022… the day before surgery I test positive for COVID so my surgery was postpone for October 20th 2022 my dr was making sure I was in good health to proceed with my surgery and my health was good … the only thing that sucks about that it’s that I had to redo all my lab work and pay for it ($460 ) since my insurance won’t cover:/ The day of surgery I was so nervous I don’t know why I thought I was prepared for it since I had 4 previous c sections !! But all the staff at the surgery center were so professional and make me feel comfortable especially my admission nurse and the anesthesiologist he was my favorite!!!! He make sure I was calm and relax, he star a conversation with me while the nurses help me getting into the surgery bed and all I remember is him putting the mask on my face and I was out … when I open my eye again I was in the recovery room looked at my ride (my mom ) receiving instructions …. The staff ask me how I feel and I remember ask how many pounds of skin the dr Take of me ( I know weird :/) and if I could drink my coffee because that morning I didn’t have one lol … My first 2 weeks went by fast no pain at all in my tummy or my liposuction areas only on my breast they hurt until my 1 month , right now I’m 6 week post op and feel no pain at all , my boobs are healing good and getting on their place slowly but surely:) my incisions are looking good except for one of my liposuction hole that one it’s not healing fast enough.! I’m still bloated and just wasn’t for my next appointment I need to ask Dr knoetgen if this still normal? Before getting my surgery I always wonder if the tummy tuck hurts more that a c section and I guess that’s one of the main question a lot of women have and let me tell you tummy tuck it’s nothing in compares with a c section , c section hurts the most well that’s on my opinion, I think the pain pump made I so easy for me I didn’t have any pain in my tummy area … what it hurts the most are the drains and if they stay longer than 10 day ( in my case one was out in 7 days the second one at 2 weeks ) Overall my whole experience is excellent so far :)
I got my mommy makeover September 22, 2021 I have been so excited to get this done and I’m so glad I did. I’m three weeks out and I’m finally starting to feel back to normal. Every recovery is different. I’m so happy w my breast size and my new tummy. I went with high profile 400cc Mentor gummy.
Hoping to provide an honest, thorough review. I had my first consult in nov. 2020 virtually due to COVID. I decided I wanted an in person consult before making my decision. I was asked to pay $100 or put down a deposit, so put down my deposit. Attended in person and respectfully, DR recommended I lose weight prior to procedure. Fast forward a few months and 20 pounds down, ( thanks for the motivation, Dr. K) He agreed I was ready for surgery. I am now 9 days post op and I feel amazing!!!! I had the TT, lipo flanks, lipo mons. I only had one drain that was removed yesterday. THE DRAIN WAS MY ONLY COMPLAINT, BE PREPARED FOR IT! It stings and throbs like crazy. It Kept me up at night. thankfully, I only had one and it was removed fairly early as I really didn’t have a lot of fluid I guess. I think my swelling has substantially subsided as my tummy is quite flat. The side where my drain was is a little lumpy in my opinion, but I think it’s due to not wearing compression garment low enough over drain site due to pain. I’m now wearing it lower and a little tighter and have noticed an improvement. Not flawless like the other side, but I’m monitoring it. My incision is very low, pretty straight so I’m happy about that. I dress pretty modest in public, so no one will ever see my TT scar, however, my belly button is depressing. I was not prepared for the shock I am in over it. I’ve done some research and found that it’s common to look wild initially, so I will give it some time, 9-12 months before I decide if I want a revision. It looks big, stretched out, and just ugly. I try not to look at it. Time heals all things! Staff were great, nurses, scheduling coordinator, and even anesthesiologist was super cool. I REALLY liked Heather as well. Dr. Knoetgen is a very laid back kind of dr who I thought was real easy to talk to. Beautologie was the 4th place I had a consultation with, and I have no regrets at all!!! Will post pics soon and updates.
It was amazing! I was so extremely happy with my results. I have gotten my boobs done here and I tell all my friends to come here for theirs. Love it! Everyone is so nice and they always answered my questions. Thank you!
About a year ago I was asked about my pregnancy for the last time. I haven’t been pregnant for 8.5 years, but I looked it, apparently. Dr Knoetgen gave me his honest and expert recommendation (which is more than I can say of his local competitor) so I trusted him. He even worked with me on price to try to match the competitor, but in the end I was willing to pay a little extra for his care. I started 5’6” and 157 lbs. I am now about 159 pounds. I have only done spin classes for exercise, so I know know I need to focus more on strengthening my core to improve my results. That will be my next step so that I Can gain the most out of this surgery. I hope my pics and recommendation help you with your decision! Updated on 10 Aug 2019: I’ve started working out and again, doing boot camp for the past 8 weeks. Not one person has asked if I’m pregnant. Scar is not much better, but I don’t mind. Clothes fit so much better. I have not lost any weight over this year, in fact I’ve gained a couple pounds but I wear smaller shirts and my pants fit more at my natural waist where they used to sit lower below my belly. And I feel stronger! :)
Great question — and one that comes up often after breast lift with implant surgery. Yes, significant weight loss can affect your breast results, including causing some sagging again. Here's why: 1. Breast Tissue Still Contains Fat Even with implants, your natural breast tissue is still present, and it contains fat. If you lose a noticeable amount of weight, especially body fat, that volume can decrease — leading to looser skin and potentially some drooping over time. 2. Skin Elasticity Plays a Role During a breast lift, excess skin is removed and the breast is reshaped. However, skin elasticity isn't permanently "fixed." Weight fluctuations can stretch the skin again, especially if the weight loss is rapid or substantial. 3. Implants Provide Support — But Not Unlimited Implants can help maintain volume and some degree of shape, but they don’t fully prevent sagging if the surrounding tissue and skin lose tone or shrink after weight loss. What You Can Do: • Maintain a stable weight: Try to be close to your goal weight before surgery when possible. • Use supportive bras: Especially during workouts or weight changes. • Consider skin quality support: Treatments like radiofrequency or microneedling may help maintain skin tone. If you're planning or expecting weight loss, it’s smart to talk with your surgeon — they might recommend timing your procedure or selecting specific implants that will age better with your body changes.
Given your history and symptoms, both muscular and implant-related causes are possible, but based on the timeline and progression, here’s a breakdown of what might be happening: Muscular (Pectoral) Spasm or Strain – Still the Most Likely Cause • Deep tissue massage can irritate or overstimulate the pectoral muscle, especially post-submuscular implant placement. Even though the massage was focused on your back, tension release or pressure around the shoulder blades, traps, or rhomboids can indirectly affect the anterior chest wall and pectoral insertion points. • Combined with intense workouts, your muscle could have entered a prolonged spasm or developed localized inflammation. • The sudden onset of symptoms (pain, swelling, firmness, and high-riding breast) strongly suggests muscle involvement rather than the gradual process of capsular contracture. • Medrol dose pack improvement followed by plateauing once the steroid wore off also supports a muscular or inflammatory etiology rather than true fibrotic capsule development. Early Capsular Contracture – Possible but Less Likely (For Now) • Capsular contracture typically: o Develops more gradually (unless due to hematoma or infection) o Is not usually triggered by massage or activity alone o Doesn’t resolve at all with steroids or muscle relaxants • However, grade 1-2 early contracture can start subtly and mimic muscle tightness, especially if inflammation is involved. • If your breast is: o Progressively firmer o Not relaxing with muscle relaxants o Changing shape or symmetry significantly Then capsular contracture could be evolving, and a follow-up exam or imaging may help clarify Imaging Consideration If symptoms persist past 2–3 weeks or worsen, you might benefit from: • Ultrasound – to check for seroma, hematoma, or thickened capsule. • MRI with contrast – for a more detailed implant and tissue assessment, especially if capsular contracture is suspected. Differential Possibilities to Consider • Localized seroma or fluid collection: May mimic swelling and firmness • Muscle adhesion or nerve entrapment: Especially if discomfort radiates • Minor implant displacement or rotation: Rare with round implants, but can mimic asymmetry or tightness What You Can Do Now 1. Continue avoiding upper body workouts or stretching until symptoms stabilize. 2. Use muscle relaxants and NSAIDs under guidance, even post-Medrol. 3. Apply warm compresses and consider gentle chest wall massage (once cleared). 4. Schedule a re-evaluation with your surgeon if symptoms do not significantly improve in another 1–2 weeks. 5. If there's concern about implant position, consider baseline imaging now rather than waiting. When to Escalate: • Rapid re-hardening or size change • Visible asymmetry or distortion • Fever, redness, or signs of systemic inflammation • No improvement within a reasonable window (2–4 weeks) Yes, a deep tissue massage, especially in combination with workouts, could reasonably trigger a pectoral muscle spasm or strain, even several months post-op. This remains the most likely cause. Capsular contracture is a possibility, but your timeline and partial response to steroids lean more toward muscular inflammation. Ongoing monitoring and possibly imaging are warranted if there's no further improvement.
Yes, loss of sensation – especially in the nipples – is a known risk with breast lift procedures, including the lollipop lift and augmentation with implants. Here’s what you should know: How Common Is It? • Temporary loss of sensation is fairly common after surgery. Many women experience numbness or reduced sensitivity in the nipples and surrounding breast tissue in the weeks or months following surgery. • Permanent loss of sensation is less common, but it does occur. Estimates vary, but permanent nipple sensation loss can occur in about 5-15% of cases depending on factors like: 1. the extent of the lift 2. the surgical technique 3. your anatomy 4. surgeon skill and experience Why It Happens • Nerve pathways to the nipple can be stretched, cut, or disrupted during surgery, especially when the nipple is repositioned (as is done in most lifts). • The lollipop lift preserves more tissue than full anchor lifts, so it tends to have a lower risk of permanent nerve damage, but the risk is not zero. Things that May Increase Risk • Very large or sagging breasts needing a significant lift • Larger implants placed simultaneously • Smoking (impairs healing) • Multiple previous breast surgery Does Sensation Return? • In most cases, sensation gradually returns over a period of weeks to months • Some women report changes in the type of sensation (e.g., tingling, hypersensitivity) during recovery • Full return may take up to a year or longer Minimizing Risk • Choose a board-certified plastic surgeon experienced in breast lifts with augmentation • Follow post-op care instructions closely • Avoid smoking and maintain good circulation to the area If sensation is a high priority for you, definitely bring this up during your consultation – your surgeon can explain their specific technique and what kind of outcomes they usually see regarding nerve preservation and sensation.
I'm glad you’re monitoring your recovery closely — that’s very important after gynecomastia surgery, especially when complications like hematomas occur. What is a hematoma? A hematoma is a collection of blood outside of blood vessels, often caused by bleeding during or after surgery. It's relatively common in gynecomastia procedures and usually occurs within the first 24–48 hours. Healing Timeline for a Hematoma After Gynecomastia Surgery: The timeline can vary depending on • Severity/size of the hematoma • Whether it was evacuated surgically • Use of drains • Your body’s healing capacity General Recovery Outlook 1. Mild hematomas (small and not surgically evacuated): o May resolve on their own in 2–4 weeks, with swelling and bruising gradually subsiding. 2. Moderate to large hematomas (like yours, with fluctuating drain output and likely under close observation): o Healing may take 6–8 weeks or longer. o Continued drainage (as in your right side) indicates your body is still processing excess fluid or minor bleeding. 3. Surgically treated hematomas (if evacuated during or after surgery): o Recovery is usually quicker once the hematoma is drained, though bruising and swelling may persist for several weeks. o Full healing and contour normalization may still take up to 3 months. Drain Output and Concerns As long as: • The output doesn’t continue to increase consistently, • There's no sign of infection (fever, pus, increased redness), • And your surgeon is closely monitoring the situation, ...this can still resolve without further surgery. What You Can Do • Keep your compression garment on as instructed — this helps reduce fluid buildup. • Limit activity (especially chest movements) to avoid worsening the hematoma. • Continue monitoring drain output and share trends with your surgeon. • Follow up if you notice sudden swelling, increasing pain, warmth, or redness. Most hematomas resolve within 4 to 8 weeks, but some may take up to 3 months for full healing, especially if large or initially untreated. If your surgeon continues to monitor you and drain output gradually decreases, you're likely on the right path to recovery.
Undergoing liposuction with an arm lift (also known as brachioplasty) can be a powerful combination for those looking to improve the appearance of the upper arms. Here's a breakdown of the pros and cons of combining these two procedures: Pros of Liposuction with Arm Lift 1. Comprehensive Results o Liposuction removes stubborn fat. o Arm lift tightens and removes excess sagging skin. o Together, they provide more sculpted, toned arms than either procedure alone. 2. One Surgery, One Recovery o Combines both procedures in one surgical session. o Reduces total downtime compared to doing them separately. o Minimizes anesthesia risks and surgical costs. 3. Enhanced Skin Retraction o Liposuction alone can leave loose skin behind. o Adding an arm lift addresses this by removing the excess skin. 4. Improved Confidence o Patients often feel more comfortable in sleeveless clothing and with overall body proportions. 5. Long-Lasting Results o With a healthy lifestyle, results can be maintained for many years. Cons of Liposuction with Arm Lift 1. Scarring o Arm lift incisions typically run from the armpit to the elbow. o Scars are permanent, though they fade and can be hidden in many cases. 2. Longer Recovery o Dual procedure more tissue trauma longer healing time. o Swelling, bruising, and limited arm mobility may last several weeks. 3. Higher Risk of Complications o Combining procedures increases risk for issues like: Infection Seroma (fluid buildup) Poor wound healing or skin necrosis 4. Numbness or Sensory Changes o Temporary or sometimes permanent changes in arm sensation can occur. 5. Cost o More extensive than liposuction or arm lift alone. Ideal Candidate for Combo Procedure: • Significant upper arm fat and loose or sagging skin (often post-weight loss or aging). • Non-smoker in good health with realistic expectations. If you're considering this combo, it’s essential to consult with a board-certified plastic surgeon who can assess your skin quality, fat distribution, and surgical goals.