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Dr. Luis Villar is highly regarded for his expertise in

Dr. Villar is a Fellow of the American College of Surgeons, a member of the American Society of Plastic and Reconstructive Surgeons, and certified by the American Board of Plastic Surgery. Dr Villar has been in private practice in Stuart, FL since 1982.
Dr.
Asked By: rnholly
ANSWER
Botox and Xeomin are identical in dose, onset and duration, but these all vary with individual patients. We presented a study at the Boston Plastic Surgery Meeting in which ten women had Xeomin injected into the right forehead and Botox on the left with a space in the middle. Identical dose and injection technique. The women were videotaped pre injection and during injection. They then sent selfie video of their forehead daily for the first two weeks and weekly there after until the effects wore off.3 responded in 24 hrs, 3 in 48 hrs. and all by 72 hours. Whatever the onset, both sides were 100% identical as documented by split screen video. The interesting finding was that EVERY patient responded differently with 9 lasting between 3 to 4 months, but one outlier lasted 7 1/2 months!No matter what the duration, both sides were the same onset and duration. Xeomin was 100% identical to Botox in onset and duration. This means that all previous research using a different product in different patients and comparing them, were fundamentally flawed.10 t0 12 units per site, forehead, frown lines, and divided 5/5 on crows feet suffices in most patients and can be individually customized. 20, 30 units per site is usually overkill and a waste of neurotoxin. Theoretically as muscles atrophy, less neurotoxin would be needed, but don't compare yourself to others.
Asked By: Sensible7242
ANSWER
Without a hands on examination you cannot get sound advice, but as a general rule, those are big implants. You are wise to worry they may be too big and unnatural. Some patients prefer breasts that appear stuck to their chest and bulge out in a bra. The classical breast has a slope on the upper pole. We call that classy but juicy which most people consider full C small D though there is no such thing as a true cup size. If you buy ten bras, one might be a D, another a B, another a C on you. Breast size is really an aesthetic judgment based on body size, shape, and posture.
Asked By: realgirl2131
ANSWER
The fetus is formed by two neural tubes side by side, like two hot dogs. These develop independently with variations. Thus everyone is asymmetric left and right, down the middle. Eyes, ears, nostrils, hands, breasts, etc. Asymmetry can be minimal or dramatic as in the case of your breasts.Strategy for reconstruction takes into account that the right breast is the limiting breast. It has a limit to how big it can be made with implants. It cannot be enlarged to match the left breast. Therefore, it is prudent to enlarge it to its maximum cosmetically pleasing size. Then the left breast can be reduced to match it as best possible with or without an implant as necessary. This can be done in one sitting, but I prefer to reconstruct the limiting breast first and allow it to heal and stabilize before matching the opposite in a secondary procedure because the final position and shape of the right breast can vary with healing and a better match may be possible. Implants over the muscle are prudent in this shape of breast to get a splaying effect to widen the base, and better cleavage without a jumping deformity.
Asked By: terryjo73
ANSWER
Bad advice is common on this question and opinions vary. But a common sense approach based on wound healing will decrease complications.When an incision is made, the wound is held together with sutures clotting blood and serum. Little buds grow from the blood vessels and attempt to cross the incision line to contact buds from the other side. At around day five and six the buds attach and try to reestablish circulation. A loose net of collagen III forms to loosely bind the wound. Activity causing shearing forces can tear the buds apart and the wound can be pulled open at this point.At week two, collagen I starts to form, which gives the repair strength. Tensile strength develops on a curve, first rapid and then slows down. At two weeks, tensile strength is at 10% and the greatest amount of wound dehiscence occurs at this time.At three weeks it is about 20% and at three months reaches maximal tensile strength, which is only 80% of the original strength before injury. At three weeks you cannot pull the wound apart.The collagen formed is like spaghetti in a bowl with all the strands tangled. The scar tissue is thick and lacks mobility. A long term process of maturation the occurs in which the collagen is absorbed and remodeled over time until the fibers become parallel light spaghetti in the box and ross links form that allow the fibers to slide along each other. This is why a mature wound has softer supple feel and slides again. This may take 6 to 12 months. The capillaries feeding the wound healing usually resorb at this point and the redness goes away indicating maturity.So when can you return to full activity? Well, at three weeks you can safely resume full activity. We advise secretaril work at one week, excercise at three weeks when we start massage and burning the surgical bra. You can push your luck at two weeks, but the healing curve dictates 3 to be safe.
Asked By: db1190
ANSWER
Yes, you can have implants removed while breast feeding under local anesthesia. There should be little or no need for pain medication with simple removal.Performing a capsulectomy at the same time would require general or heavy sedation anesthesia, but more importantly may make you vulnerable to a fistula to the milk ducts with filling of the pocket with milk. This is very rare but has occurred. Capsules do not have to be removed unless implants are being replaced with new ones for capsular contracture, or implants are being permanently removed that had textured surfaces. Do not have a mastopexy until you have stopped breast feeding and the breasts have atrophied and stabilized. If you are two staging removal and having a delayed mastopexy, then removal of the capsule will facilitate revascularization from the chest wall to the central breast. Every little bit helps.
Asked By: Naturalbound12
ANSWER
Since you have saline implants, there is an easy way to see what you will be left with after removal. In the office, your surgeon can insert a needle and remove the saline untill the implant is deflated. You will be able to determine if you will be happy without a lift. The breast will actually shrink a little, like a pregnant belly after delivery, so give it a week and then decide. If you decide on a lift, you will have the benefit of improved blood supply and less distance and tension on the nipple areola complex.
Asked By: angiefsm
ANSWER
The basic concept is that the breast shapes the implant unless the implant is so rubbery and solid that it cannot be molded by the breast tissue forces. Thus, soft mobile natural gel implants we commonly use in the USA fold and mold within the pocket, Shaped implants may influence extremely thin breast tissue, but patients with increasing amounts of breast tissue will notice increasingly less difference between a shaped implant and others. Placing implants over the muscle can improve cleavage, and different profiles can benefit certain patients, but the better shape the breast preoperatively, the better post operatively. European "gummy bears" and implants with a solid core insert can be of benefit in breast reconstruction, but are less desireable in cosmetic augmentation. The only sure way to determine the best option for a particular patient, is to use sizers at surgery and the surgeon looks at which one looks best. Every patient is different and one size dose NOT fit all. Pick your surgeon carefully.
Asked By: Lyzzie16
ANSWER
Dr. Leonard Rubin wrote about the anatomy of smiles some forty years ago. There are extensive variations. Sometimes the chin deforms when associated muscles contract. These can be adressed with Botox/Xeomin, but there is no set protocol. Surgical experts in facial anatomy can visualize the underlying anatomy by observation and palpation and then experiment with dose and location. It is always best to be conservative wait a few days to see the effect and touch up as needed until a pattern of treatment is customized for that patient for future treatments. There is great variation. Misplaced injections can result in crooked smiles and drooling. unfortunately, the majority of injectors in this country are not expert in the anatomy and chemistry of Neurotoxins. Fortunately damage is usually not permanent. Since the early 90s, when I first experimented with Botox, no nurse or technichian is permitted to inject Botox or Fillers into any of my patients.
Asked By: Lily1983xx
ANSWER
You do not appear to have loose sagging skin. It appears you may have a tight platysma band which can be ascertained on physical examination. Botox or surgical release of the bands may be appropriate. Thermage or Ultherapy will likely be disappointing.
Asked By: mls325
ANSWER
A saline implant is a silicone shell filled with saline. If the saline is removed, is there any downside to leaving it in place? It is the exact same bag but crumpled up. Does it have any different properties inflated or deflated? Probably not, but who knows for sure.Will it interfere with mammograms? We know a mammogram does not see through a filled implant. Therefore is the mammogram improved if the shell is contracted and out of the way of most of the breast? We know an implant can become infected by bacteremia (bacteria in blood stream) from another infected site. But is the risk any different whether the shell is inflated with saline or collapsed?As a general rule, if an implant (foreign body) is serving no purpose, then it is prudent to remove it. However, is this mandatory? Is it time sensitive? Is it "dangerous" to leave it in? Probably not, but who knows for sure. Fortunately it is usually easy to remove these implants under local in the office. if you cannot afford the time or money to do this now, the saline can be removed through a percutaneous needle to alleviate your discomfort, and you can have the implant shell removed some day in the future when it is more affordable.
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Dr. Luis Villar is highly regarded for his expertise in