Marc DuPéré, MD

Thank you for your question.  Nutrients and vitamins important too hair health include vitamin A, B (biotin and B5), C, D, E, fish oils, zinc and iron; all of those are often present in a healthy diet.  They will help in strengthening your current hair.To stimulate growth of living hair follicules, one must stimulate the blood flow; think of a hair as a plant that needs water. Minoxidil daily works in many individuals and regular PRP (platelet rich plasma) and/or nanofat grafting/injections, along with light therapy, have been showed to also contribute to hair growth and hair health.Hope this helps!Kind regards,Dr. Marc DuPéré, aesthetic plastic surgeon

Thank you for your questions.Experience is for sure important and so is the technique, the technology, safety and the artistry for a natural result.In Ontario, Canada, safety has been improved by requiring accreditation of the clinic as to maximize standards of sterilization and infection control.  We do believe this is a positive requirement for our patients.Having access to the latest technology is also important.  The latest in FUE has been quite important in my practice as to enhance the quality of our results and minimize stigmata of hair harvesting.Plastic surgeons are known for their manual dexterity and also their artistry.  We have also been trained in all types of hair restoration technique, surgical and non-surgical.  Many Canadians chose a plastic surgeons today for their hair restoration procedures.I also strongly believe in PRP, nano fat grafting, low level laser and LED technology for hair thinning and for maintenance of native and grafted hair.I hope this helps!Kind regards,Dr. Marc DuPéré, Aesthetic plastic surgeon

Thank you for your question and pictures.  It is unlikely to be caused by a TCA peel (or laser).  Superficial lines are often "sleep lines".  Deep linear vertical dents are usually caused by blood vessels or rarely a manifestation of linear scleroderma (called "coup de sabre sign", usually bigger and slightly more central over the forehead).Treatment is dermal fillers or fat grafting.Hope this helps!Kindest regards,Dr. Marc DuPéré, Toronto aesthetic plastic surgeon

Thank you for your question and pictures.Yes fillers are great products to fill in the mid-forehead depression and is a much easier alternative to fat grafting (poor survival rate in forehead) and custom-made forehead implant (I do all 3 procedures in my practice).  The filler must be inserted over the bone and the CANNULA technique is mandatory for optimal safety.  Using needle injection technique there has a high risk of injecting inadvertently in the blood vessels and causing serious soft tissue damage.  Cannula (I use 25g) is much much safer.Get an experienced plastic surgeon to do this.Hope this helps and thanks again for raising this great application of fillers here on realself!Kind regards, Dr. Marc DuPéré, aesthetic plastic surgeon

Thank you for your questions and pictures.  I do see the small pointy earlobe on your second picture; it is a mild "pixie" ear, as we call it and a tell-tale sign of a facelift.  It is fixable with re-elevating the posterior skin flaps and a small component in front of the earlobe.I know you prefer the first incision YET we all try to hug the incision right into the creases so for me, the first incision is wrong too.It is very important, when doing a facelift and neck lift to do a SMAS AND a skin lift.  The SMAS refers to the muscle layers below the skin.  Once can pull HARD on the muscles BUT NOT HARD on the skin.  Since the skin is attached to the muscles, pulling on the muscles will bring the skin along.  Relying too much on the skin lift leads to unusual horizontal lines on the cheeks and/or temples (the so-called "windswept" facelift and/or one get thick scars and/or the earlobes gets pull down, as in your case.  I trained in Toronto, Paris, Los Angeles, NYC and Brazil.  I've learned to fix the muscles under the chin (so an anterior platysmaplasty is very important in most people) and then anchoring this neck "sling (SMAS) to 3 strong anchors; pulling hard on the muscles will not give you any tell-tale signs of a facelift.  Then one tailors the skin exactly to the underlying ear contours so NO tension on the skin.Hope this helps!Kind regards,Dr. Marc DuPéré,

Thank you for your questions.Injectables such as Juvederm Volume, Restylane Volume or Sculptra can be used but the amount required is large and therefore so is the associated fees.  The results are also not long-lasting, although patients do form some collagen to the fillers and provide them with some longer effects.  It is not uncommon for patients to pay 30000 to 50000 Can$ (Canadian dollars) for one augmentation (one sculptra augmentation is done in 3 stages).Advantages four injectables are that it is a simple procedure done in-office (yet should be done in a sterile fashion and by professionals as complications do occur when not done by certified plastic surgeons, as you may have read in the press).  There are also no real downtime.Buttock implants do exist and can be quite successful if you follow your plastic surgeon rigid rules post-op for the first 4-6 weeks to minimize complications.Many patients in my practice do not have enough fat and are not interested in implants so they do chose the injectable alternative.  Yet I am versed in all 3 techniques and will guide them in their search for the best options.Hope this helps!Kind regards,Dr. Marc DuPéré, aesthetic plastic surgeon.

Thank you for all the pictures and question, very helpful.Very large areola may lead to some residual areolar tissue in the final scar after a reduction and/or breast lift, as your doctor told you and as you understand it.6-12 months post surgery, it is often possible to revised the scar and remove a bit more tissue to make the scars better.Hope this helps!Kind regards,Dr. Marc DuPéré, aesthetic plastic surgeon

Thank you.  It is hard to know based on pictures but this is very unusual and considering you have breast implants, I would suggest you visit sooner than later your plastic surgeon.  Could be a reaction to some sutures as it looks like granulation tissue, could be a pyogenic granuloma, could also be scarring.Best to visit your plastic surgeon.Kind regards,Dr. DuPéré, aesthetic plastic surgeon.

Thank you for your question.It is likely a seroma, despite the use of drains and despite using the rule of 25-30cc or less per day for 2 consecutive day.It may resolve.  If not, it should be drained otherwise, it can heal with excessive internal organizational tissues (ie scar) and may distort the final outcome.Aspirating (draining) the seroma is a simple procedure yet you may need to do it a few times, 1-2 per week.I would continue to wear your compression garment.Finding someone around you willing to help may or may not be easy as many surgeons will recommend you to see your original surgeon and this demonstrate one of the issues with medical tourism.  But it is likely you can find a local plastic surgeon willing to help you for a fee.Hope this helps.Kind regards,Dr. Marc DuPéré, aesthetic plastic surgeon

Thank you for your question.An in-office examination is always better.  Getting 2-3 opinions never hurts either.I use excellent sizers (better than bag of rice of water) and a mirror, and a sport's bra patient brings of the desired volume, to determine if the volume is looking natural and to your liking.  As for the cleavage, we then determine the implants slightly wider to reach closer to midline (without causing a symmastia, a kind of "unibrow" of the breasts) and then we chose the projection depending on the desired volume, the skin laxity and the breast fullness.I truly feel the sizers, used with a sports bra the patient bring of the size they are wishing for, make a huge difference as very patients now wish they had gone smaller or bigger.  Hope this helps!Kind regards,Dr. Marc DuPéré, aesthetic plastic surgeon