Board Certified Plastic Surgeon
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Dr. Karl William Schwarz, MD, affectionately known by his patients as Dr. William, is a highly educated, likable and compassionate plastic surgeon with extensive training and expertise and is the creator of Ogee Lipo®. Originally from Canada, where he complete
Asked By: allibobs
ANSWER
Yes you can but it is not a common procedure to perform because there are not many good candidates for just a liposuction only breast reduction. When we do a breast reduction in a traditional way we will move the nipple and areola to a significantly higher position and this cannot be done with liposuction only so in order to be a candidate for lipo only reduction you would need to have almost no droop to the breast which is not a common finding in women with very large breasts wanting to undergo a breast reduction. I use liposuction for almost all of my breast reductions because that way I can remove the bra fat and the lateral breast fat so the breast will look better and the patient's bras will fit better and no one likes the bra fat that pokes out above and under the bra so patients are very appreciative of lipo here.
Asked By: 30j
ANSWER
I started practice in 2007 and since then I have seen an increase in the number of free nipple grafts (FNG). I am not sure why. When a FNG is done the new nipple tends to be hypo pigmented, flat, insensate, and not look very good. Here is how I approach patients with very large, long breasts. I explain that I will try to perform a breast reduction as I normally do but if I see there is a problem with the blood supply to the Nipple Areolar Complex (NAC) I will convert them to a FNG. So far I have only had to do that once out of hundreds of cases. In my experience the blood supply is fine even in women with very, very long pendulous breasts (40 cm distances) and having a full NAC that has sensation and looks normal is a much better option than a FNG>
Asked By: Vivid4915
ANSWER
I think you are right and it is the position of the strattice and the implant that is causing the nipple asymmetry. At this point I would wait for a full year to see if natural settling will correct the asymmetry as when implants settle they naturally cause a small elevation of the nipple. I would imagine there might still be a mild amount of asymmetry after settling and then you will have to decide if a revision is warranted. My guess is that it won't be needed or rather, your nipples will be close and it would not be worth the risk of opening the implant pocket and risking an infection for a very small amount of nipple asymmetry but wait for a year and then see your surgeon and discuss your options.
Asked By: Plucky358632
ANSWER
The short answer is yes you can go from a G to a C with a breast reduction. I don't think you should even be thinking about a Free Nipple Graft (FNG). FNG's do not give a very good nipple areola complex (flat, uneven pigment) after surgery, and leaves you with a non-functioning (no breast feeding), insensate (no feeling) nipple areolar complex and it is not necessary for you to achieve your goals. A breast reduction will give you a significantly smaller, higher breast. Your breast will be off of your abdomen and have a rounder, fuller shape with a smaller size and you will be able to breast feed and keep your nipple sensation. Weight loss will not play a factor as most likely your breasts are dense and heavy because of the breast tissue and breast tissue is not changed with weight loss.
Asked By: bamagirl66
ANSWER
Your right breast is in good position and looks very nice. I think your disappointment comes from your preparation for surgery and not actually the result. I think Motiva are better implants than Mentor implants however, I don't think using a Motiva implant would have changed your result. Your result was predictable from your preoperative photo as your left breast naturally sits more laterally (towards your side) and when placing an implant we can't move the location of your breast we can only enlarge it. So the real issue was in your preparation and not being told about this and that it couldn't be changed. We simply can't move the breast to a more central location on your chest. Most patient's dissatisfaction after surgery is because their results were not met but if patients go into surgery understanding the limitations of their anatomy and are prepared and understand how their breast location will affect their results then people are prepared and are usually happy after surgery despite the same result.
Asked By: Energetic30552
ANSWER
Your best option is to have a breast lift with implants also known as a mastopexy augmentation and also I would suggest adding some mesh for an internal bra to prevent bottoming out and preserve your results for longer. If a breast has droop then only placing an implant would leave a very unsatisfactory result so in your case the scar would be necessary. One big misconception is patients think an implant by itself will lift the breast and remove the need for a lift but breast implants don't lift the breasts so just an implant in your case would give you the augmented look but your breasts would still be falling off the implant. I have included a video which will help explain it better.
Asked By: s3chac
ANSWER
You are a good candidate for a breast reduction. An implant would be a massive mistake so it is good you are not thinking implant. A breast reduction along with mesh, given your weight loss, would be the best option for you. A breast reduction really is an auto-augmentation unto itself so you would be able to get upper pole fullness and cleavage.
Asked By: Cute542659
ANSWER
You don't have enough skin to be able to perform a tummy tuck, and the amount of skin lax that you have should be able to re-drape after your BBL because your overall skin quality from not having children is good so it would be my expectation that your skin would be fine after having a BBL. In the remote chance that you did have some access skin, it would most likely be at the very bottom of your abdomen and a small little mini tummy tuck could help with that after a BBL.
Asked By: Triciab1986
ANSWER
I think your best option in this situation where you don't have any fat to use is to replace the implants under the muscle but your muscle is probably shortened and retracted so a piece of Strattice could help establish the implant pocket under the muscle and also provide you with more soft tissue which is really what you need. Alloclae is a newer cadaveric fat that is used for people in your situation where they don't have any usable fat of their own. That could be combined with the above procedure as well. The implant size will not really have a significant impact on the rippling alone but I would personally use a round Motiva implant as they are filled to 100% and have less risk of rippling.
Asked By: lauraheaver87
ANSWER
Your best option is to have a full lift (anchor pattern, or also called inverted 'T') along with a breast implant. That will position your nipple at the correct spot, reshape the breast and fill in the breast that has become empty after child bearing. A breast lift will almost always look more natural than a breast augmentation especially if the implant is kept in a normal size range. I have linked a video talking about the different types of breast lifts that may be helpful. I would also consider adding mesh for an internal bra as that will help support the implants as well.
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Dr. Karl William Schwarz is highly praised for his expertise in , , , , and . Patients commend his professionalism, care, and outstanding surgical results. His attentive communication, personalized approach, and thorough explanations have made him a top choice for many seeking plastic surgery.
