John Samas, MD, FACS

I understand how frustrating it must be to have spent all of that time doing your research and frustrating a surgeon you felt comfortable with, only to have this come out of nowhere and complicate everything. Now your Surgeon is correct, the MTHFR gene had been "linked" to Breast Implant Illness, it is still not well understood, and neither is Breast Implant Illness itself.
I personally have performed Breast Augmentation on patients with the MTHFR gene and they have had no issue. I believe it is necessary to have a conversation about the data that we do have, so that the patient is able to make the best informed decision.
As to whether you should have the surgery or not, that decision is a personal one and there's no way anyone can predict your specific risk. The one thing I would definitely advise would be to not push the surgeon that already said he would not offer a Breast Augmentation to you, to do it. The last thing you ever want to do is ask a surgeon to do something that they are not comfortable with, even if you are.
I hope this helps, and I wish you luck in your journey.

This is not an uncommon complaint from patients who have had a tummy tuck. If there was noticeable fat in the pubic area before surgery, it will be a lot more visible after surgery because it has been lifted and placed into a more visible location. This is why I either directly thin the area or perform liposuction there, to avoid this problem.
I believe the first step should be if to just have a candid conversation with your surgeon that performed your previous surgery.

First off, great job on your weight loss after having kids. I know from speaking with my patients as well as seeing my wife go through it, how difficult a task that can be. Even more frustrating when you're left with loose skin after.

I think you're a great candidate for a tummy tuck and that it would be the best option for you. It would address the skin laxity as well as tighten any diastasis (muscle spreading) that may have occurred.

In regards to your back pain, constipation, and incontinence, these all are likely related to pelvic floor issues. Going to your gynecologist to ensure there isn't anything surgical that needs to be corrected would be the first step. If not, there are regimens out there for strengthening your pelvic floor and core musculature.

First off, congrats on the weight loss. I know it can be frustrating when you overcome one problem (weight loss), only to be presented with a new one (loose skin). In my experience, the restrictions with a tummy tuck aren't necessarily from the plication (muscle tightening), its from the overall tightening during the surgery. We want to avoid the incision coming apart. The plication definitely contributes to initial discomfort, but that will be gone way before 4 weeks.
In my opinion (without examining you for diastasis (muscle widening), I believe you would be a good candidate from a full tummy tuck, with muscle repair. You've worked hard enough to get here and worked long enough to earn the money for the surgery. Don't short change yourself by trying to cut a last second corner, at a hope of a slightly quicker recovery.

Based on the photos you provided, it seems to me like you are a small D-cup. As to whether you could have / should have gone bigger, that's completely a subjective choice. Of course you could have gone bigger, but it all depends on the conversation between you and your surgeon (which I can't speak to). In regards to Crisalix, having used it at one of my practices, I can tell you that in my experience, it does not always give an accurate representation of what the result will look like.
The most important thing here would be your satisfaction (or lack there of). Forget the "what if", the bottom line is you are not satisfied. You need to have an open and honest dialogue with your surgeon, and together, try to find a way to leave you feeling satisfied.

As the face ages, in addition to the bony structure of the face changing in a manner that gives the appearance of a more "hollowed out" look, the facial fat pads lose volume and begin to sink. Both of these contribute the the look of an aging face, which is where fat transfer can be helpful. I recommend setting up a consult with a plastic surgeon, so that they may analyze if and where you would benefit from a potential fat transfer, or any other procedure. Together, you can come up with a plan that would be in-line with your ultimate aesthetic goal.