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Pedro Vieira, MD

Board Certified Plastic Surgeon
579A Cranbury Rd., Ste. 202, East Brunswick, New Jersey
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47 Questions Answered
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QUESTIONS ANSWERED

0.8ML of juvederm in lips and two weeks later it's gone. Is this normal? (Photo)

Asked By:AnonymousANSWERS (1)
I must respectfully disagree with your assessment.  Your photo at two weeks does show an increase in lip volume.  The reason why the lip volume was so dramatically different immediately following filler placement was due to swelling from the injections.  0.8mL is a fair amount of filler for the upper lip alone.  If 0.8mL was used for both upper and lower lips, it may be that you just need a bit more.  Juvaderm filler does not disappear that soon.  I would recommend waiting at least one month before considering additional filler.  It may be that all you need is half a syringe to achieve the lip volume you desire.  Hope that helps you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

I'm 3 days post juvederm and I don't like the fake looking result. What can I do? (Photo)

Asked By:AnonymousANSWERS (1)
Best advice I can give you is...wait!  Lips often undergo a lot of swelling post filler injection.  At three days, you're not past the peak swelling phase yet.  You'll need to wait at least two to three weeks before seeing the final result.  In the meantime, it might be a good idea to visit the physician who injected you, just to make sure there is nothing seriously wrong that needs to be addressed.  Sometimes, lumps and malpositioned filler can be massaged away.  Best wishes.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Can I have my own tissue reconstruction if expander now in place?

Asked By:AnonymousANSWERS (1)
Great question and good for you for being proactive in the decision making process.  The simple answer is, yes, in general it is possible to undergo autologous or own tissue breast reconstruction after initial placement and fill of a tissue expander implant.  In fact, most breast reconstruction surgeons, when planning own tissue breast reconstruction, prefer to complete the tissue transfer part of the reconstruction after the radiation.  That's so the newly reconstructed tissue is not subjected to radiation injury.  However, there are many considerations that go in to determining what type of own tissue reconstruction you're a candidate for or even whether your a good candidate at all.  That can only be decided upon by an individualized evaluation of your case by a breast reconstruction surgeon with experience in all types of tissue transfer procedures.  Stay curious and expectant of only the best for yourself.  Take care.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

2 weeks post op. Just removed the surgical tape. Is this normal or does it look infected? Belly button and incision (Photo)

Asked By:AnonymousANSWERS (1)
Of course it is impossible to tell solely from a picture what's going on, but this is what I see.  The belly button incision has a bit of crusting and scabbing, which is very common.  This will usually resolve with time, washing the area and dressing changes.  In my opinion, it's best to apply some type of ointment to the belly button along with the dressing in order to speed up the healing process.  But please check with your surgeon.  The central part of the transverse incision appears to have suffered a very small bit of skin injury or loss from the procedure.  This is unfortunately not uncommon.  It's no big deal, but will also take a little time and care to heal.  That wound may need a bit of debridement or clean up in the office.  But eventually it should heal fine and leave you with a good result.  Best wishes.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Do you think I need a nose job? (photos)

Asked By:AnonymousANSWERS (1)
Whether or not you need a nose job is purely a function of preference, unless you are experiencing some sort of breathing difficulty.  There are all sorts of aesthetic ideals defining nasal size and shape.  These will vary based on gender and racial/ethnic identity.  But, they are just guidelines.  Ultimately, you and your chosen surgeon need to consider what actually "fits" your face.  Humans are like snowflakes...everyone's different.  Hence, not everyone's nose needs to look the same.  Having said all that, the one objective detail I can glean from your photos is that your nasal tip is just slightly bulbous.  But it does not appear "way too big" for your face. : ).  I advise you to seek some consultations with reputable plastic surgeons in order to get some reasonable opinions.  I also advise you not to opt for to drastic a reduction in nasal size (if you decide on surgery) because very small noses don't breathe as well.  Best of luck to you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Question about swelling and pain after Liposuction.

Asked By:AnonymousANSWERS (1)
Those are very good questions you should get satisfactory answers to before considering liposuction.  Yes, it is generally true the majority of bruising and swelling goes away by two to three weeks after liposuction.  That is if the patient complies with the recommendations about compression garment usage and avoidance of medications which increase peri-operative bleeding risk.  It does take months (maybe 6 months) before all swelling has resolved and the final result becomes apparent.  That is also true in many other cosmetic surgery procedures.  But it is more so the case with liposuction because fatty tissue just doesn't deal with swelling as well as other tissues in the body.  By two to three months after surgery you can expect to have little to no pain.  Your surgeon may ask that you wear some sort of compression garment for months after the procedure.  However, after a period of two to three weeks it's usually fine to remove the garment for activities such as bathing and having relations with your partner.  Best of luck to you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Neck/chin/jawline lipo an option? Double chin and undefined jawline.

Asked By:AnonymousANSWERS (1)
Many people out there share your frustration, because the "double chin" area is really difficult modify with diet and exercise alone.  Without the benefit of additional photos or an in-person exam of your facial features, please take this advice as a general guideline. It is possible liposuction of your neck and "double chin" area alone would get you that desired look.  Neck liposuction is a pretty straight forward procedure that can many times be done with local anesthesia.  Fees will vary based upon location.  You may also benefit from a chin implant or genioplasty (moving chin bone) in order to optimally improve your chin/neck profile.  Alternatively, there are newer non invasive treatments that could help you melt away some of that double chin without the need for surgery.  Hope that didn't confuse things for you.  Best thing to do is see a few qualified plastic surgeons and learn as much as you can about your options before making a decision.  Best of luck to you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

What kind of a CT needed to locate old scarred seroma sacs? (photos)

Asked By:AnonymousANSWERS (1)
If you had a CT scan done without IV (intravenous) contrast it is very possible for scar tissue or small seromas to not show up on the images very well.  In which case I would recommend repeating the CT scan with IV contrast.  If your scan was done with IV contrast  but shows no significant findings, then I would recommend seeing the reconstructive surgeon first before going through any other studies.  Best of luck to you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

1 week post op, the entire left breast it is extremely tight and painful. Any suggestions?

Asked By:AnonymousANSWERS (1)
Sorry about your discomfort.  It is very likely you developed some bleeding after surgery which led to a trapped hematoma.  There are a couple of other possibilities to explain your symptoms.  But, hematoma needs to be considered first because early drainage of a trapped hematoma will alleviate your symptoms and avoid later problems.  I would contact your surgeon about what you're experiencing as soon as possible.  Best of luck to you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Surgeon estimated four hours for an otoplasty procedure?

Asked By:AnonymousANSWERS (1)
Take it from a surgeon who takes his time to do most all procedures.  Patient's don't usually get upset the procedure took a bit longer than average when the results are great.  Your surgeon may have budgeted 4 hours taking into consideration your specific anatomy and his particular surgical plan.  I will however suggest you inquire about the possibility of having the procedure done with local anesthetic only or local with sedation.  It is very easy to perform nerve blocks for otoplasty.  Sure, local injection hurts a bit.  But once the local sets in the procedure is pain free for the patient.  It is also a matter of surgeon preference.  Best wishes for you.
provider-Pedro Vieira, MD-photo

Pedro Vieira, MD

Board Certified Plastic Surgeon

Pedro Vieira, MD reviews

Pedro Vieira, MD

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