Jocelyn E. Leveque, MD

A good facelift should not alter your facial expressions in any way. While nerve damage can rarely occur with facelift procedures, they are usually temporary. Good results should make you look like a younger more rested version of yourself!

I do not think a breast lift is necessary in this case. In my opinion you have pseudoptosis, which describes a breast in which the nipples themselves are in a proper position but a significant portion of the breast tissue has dropped inferiorly. I have great experience with performing a dual plane dissection in which through an incision in the fold under the breast, dissection is first performed on top of the muscle up to the areola, then the remainder of the dissection of the breast implant pocket is created under the muscle. In this way the implant is 1/2 to 2/3 covered by muscle and the lower portion by breast tissue. By separating the lower portion of the breast from the muscle, the nipple gets a little lift. I would also use a higher profile implant which provides more projection and contributes to a more elevated nipple position. Since you don’t have true ptosis, I don’t feel a breast lift is needed.

You can definitely have a tummy tuck after liposuction. There are increased risks for skin loss if you combine liposuction of the central abdomen with a simultaneous tummy tuck but as long as the tummy tuck is performed at least six months after the liposuction procedure it is totally safe. It is very common to benefit from a tummy tuck after having children since this procedure removes the extra lower abdominal skin and tightens the abdominal wall which has been stretched out from pregnancy. You should have no risk of additional complications because of your previous liposuction and should be able to obtain satisfying results.

Thank you for your question. The ideal placement for breast implants is under the muscle. During your implant exchange your surgeon should be able to place your new, silicone implants under the muscle with no problems. You may even experience less discomfort post op, as your muscle has already been stretched with the saline implants. Best of luck!

Thanks so much for submitting your question and photos. From the pictures, it looks as though the rippling is only seen when you are leaning forward/downward and only in the medial aspect of the breasts. Otherwise, it does look like you have a good result. Fat transfer can help solve the problem of rippling as well as implant placement below the muscle, but do not always work to prevent rippling depending on your body habitus (thin breast tissue, etc). Using a more cohesive style breast implant such as an Inspira SSF or SCF can help prevent rippling. An SSF (soft touch) implant is considered more cohesive than a normal SRF Inspira implant, but still retains its softness - an SCF (cohesive) implant has the most cohesivity and will be most firm but will help most to prevent rippling. I hope this helps answer your question. Best of luck with your recovery and enjoy your new look!

Thanks so much for submitting your question and pictures. From the photos, it does appear you have a hematoma which can be a risk after a large surgery such as an abdominoplasty. Hematomas do typically feel large and firm at first and will begin to breakdown and dissolve over the course of a few weeks. At that point, they can be removed by syringe aspiration. The surgeon may also decide to remove the hematoma surgically. Following up with the operating surgeon would be best in this case. If you are unhappy with the result after the hematoma is dealt with, it may be best to seek a second opinion from another Board Certified Plastic Surgeon. I hope this information helps. Good luck with your recovery!

Thanks so much for your question and before and after pictures. It is not uncommon to see some irregularities after liposuction. You are far enough out post-operatively to go back to your original plastic surgeon to see if a touch-up procedure may be needed to help you reach the surgical outcome you were looking for. If you have gained any weight at all post-operatively, remember that this can also affect your liposuction result.  If for some reason you do not feel comfortable returning to the original physician or they have stopped offering this procedure, I would recommend selecting another Board Certified Plastic Surgeon in your area to consult with. They will be able to do a physical examination to help guide you in your decision. Best of luck!

Thanks so much for your question and submitting your photos. Congratulations on getting to your current weight - you're almost to your goal weight, good job! It is always best to reach your goal weight and maintain this weight prior to any cosmetic procedure such as a mommy makeover. Weight loss after surgery can cause loose skin and an unfavorable long term result. When you are ready to move forward with surgery, make sure to select a Board Certified Plastic Surgeon for consultation. Good luck with your surgical goals!

Thanks for submitting your question and photos. From the photos, it does appear that you mostly have loose skin along the arms. Because of this, you are a better candidate for an arm lift. Due to the loss of elasticity after major weight loss, your skin may not tighten up properly after liposuction and you would be left with even more excess skin. In my practice, I do a fair amount of arm lift procedures. Scarring after the surgery is always a concern for my patients. Most surgeons can place the incisions along the inside of the arm so it is easily hidden from plain sight and under clothing. Use of scar creams or strips as well as avoiding sun exposure after surgery will also help to reduce the appearance of the scars. Make sure that you chose a Board Certified Plastic Surgeon in your area to consult with about this procedure. Best of luck with your search!

Thanks so much for your question. We do a fair amount of medial thigh lifts in my practice, and your question is very common amoung patients. As with any surgery, there will be risks and benefits. The benefit of this surgery, of course, is the loss of excess loose skin on the inner thighs. This procedure can give you a much slimmer looking thigh with less unwanted bulky skin. The risks of this surgery can include healing issues, infection do to the distance from the perineum, scarring and change in appearance to the labia from excess pulling. These issues can all common factors in thigh lift surgery. For all of these reasons, it is best to seek consultation with a Board Certified Plastic Surgeon. After a physical examination, the surgeon should provide you with the best surgical outcome possible for you. I hope this information helps. Best of luck!