Pedy Ganchi, MD

Hello, Fat grafting to the labia is a very safe and effective procedure to rejuvenate the labia majora that may be deflated from weight fluctuations or pregnancies. It does not carry the serious risks of fat emboli as with BBL fat grafting, where large veins lying under the gluteal muscle may be penetrated with the cannula. The fat in such cases then may then travel through the veins and into the heart causing serious harm. In labial fat transfer, a very small amount of native fat is harvested typically from the thigh or abdomen and injected safely within the labia. There are no large veins or critical structures in this region as with the buttocks gluteal muscle. Warm regards, Dr Pedy Ganchi Village Plastic Surgery

Hello, I hope you're feeling better now! It is quite normal to have asymmetry of the face and to notice one side as more tight and defined. You appear to have some mild aging and laxity of the face and neck along with loss of mid face volume. There may also be edema or swelling under the eyes (difficult to see in images) that may be a result of your thyroid condition. This is very difficult to treat if present. The best option for facial rejuvenation will depend on your goals. For modest, less invasive improvement, fillers or fat grafting to the mid face will help restore lost volume and create a lifted appearance. If you desire additional correction of the neck laxity and early jowls a secondary facelift with fat grafting is advised. Additionally a steady weight will help avoid fluctuations after such procedures. It's best to visit an experienced, Board Certified Plastic Surgeon for a thorough assessment and determination of your goals in order to offer you the best options. Warm regards, Dr Pedy Ganchi Village Plastic Surgery

Hello, It appears that you have breast ptosis(droop) and would benefit from a breast lift and balancing fat grafting(to smaller side) for symmetry or for added volume on both sides. Your cleavage is a bit widened which can appear to mimic a tubular anatomy. I like to use fat grafting in this region to enhance the cleavage for a softer, balanced appearance if desired. Implants will offer more round, stable volume and upper pole fullness. If you are happy with your size within a supportive bra, a lift alone would be a good option (+/- cleavage fat grafts). I recommend visiting a Board Certified, experienced Plastic Surgeon to better guide you after a thorough exam and discussion of your goals. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, Breast lifts + fat grafting are an effective method of treatment for sagging breasts after implant removal. The degree of augmentation with fat grafting will depend on the amount of donor sites and fat available. Since your implants are of a smaller size, you may be able to approximate the fullness with fat grafting, either with one or two sessions. It is less likely, however to achieve the consistent round, firm upper pole that an implant helps create. Also fat "take" is variable and size can not be guaranteed as with implants. Benefits of FG include no foreign body to maintain, natural feel, no capsular contracture, rupture or rippling risks. There is a minor potential for oil cysts and calcifications. Its best to consult an experienced Plastic Surgeon who routinely performs breast fat grafts and implant augmentations to guide you to your best option. Warm regards, Dr Pedy Ganchi Village Plastic Surgery

Hello, There is no set rule, but generally speaking, it's best to have comfortably healed (back to all activities) from one surgery before undergoing another. Most individuals who stage their procedures in our practice wait at least 3 months after a body procedure and about 6-8 weeks after facial procedures before undergoing anesthesia and secondary surgery. Each surgery and patient has their unique healing timeline and patterns and suitability is best determined on a case by case basis. I agree that combining the two procedures would be too lengthy and risky and staging them is most safe and appropriate. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, Fat grafting or fat transfer to the breasts is an effective and safe alternative to implant breast augmentation in suitable candidates. Generally speaking, smaller framed individuals can expect less gain in breast size as their fat stores are limited (*also excessive fat tansferred into a tight skin envelope will not survive). Staged fat grafting as opposed to a single session can help result in more realistic and predictable volume enhancement in most cases where two cup sizes are desired. As you noted, an expert in liposuction would better guide you during an examination as to your suitability for body contouring so as to avoid risks in harvesting the fat. Best candidates are those with good skin elasticity and who desire reshaping of other areas of the body (a win-win!). Otherwise you risk distortion for the sake of obtaining fat alone. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, A mini tummy tuck can help sculpt the lower abdomen in the region between the belly button and pubis. Excess skin can be removed and the lower muscles tightened if needed. Liposuction contouring is often used to shape the abdomen and waist as needed. In your case, a mini tummy tuck may be appropriate as your upper abdomen seems firm and without laxity or muscle separation. Of course an in person exam would be needed to more accurately guide you and to better understand your expectations. C-section scars are often used to perform the mini tummy tuck and extended as needed. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, The answer is "YES"! Nicotine is a vasoconstrictor, meaning it will narrow the arteries supplying oxygen to the tissues. This can lead to complications in wound healing especially in surgeries requiring elevation of flaps, such as facelifts, breast reductions and tummy tucks. It is crucial to stop using tobacco/nicotine products at least 3-4 weeks prior to surgery and for 4 weeks thereafter. Synthetic cigarettes including vape and e-cigarettes along with nicotine patches and gum are also harmful. Oxygen delivery to tissues is critical to healing and anything that impairs this process will compromise healing. In addition to Nicotine, carbon monoxide is another such harmful substance in tobacco that leads to vasoconstriction. Any surgeon who values patient safety and strives to minimize complications will always decline surgery for patients who have failed to cease tobacco/vape usage. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, A facelift is the gold standard to address jowls, cheek and neck laxity. In your case, liposuction neck contouring would additionally help shape the neck and jawline while the facelift would help restore and lift the tissues. Fillers alone in the marionette and pre-jowl sulcus can help modestly camouflage the hollows and laxity temporarily. They will not provide a lifting effect, nor address the neck. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery

Hello, A facelift is the gold standard for treating jowls and for jawline and neck restoration. Other modalities including fillers, Ultherapy, Radiofrequency and thread lifts can help modestly improve this region when there is a mild degree of aging. At age 66 most individuals would best be served with a facelift and possible fat grafting to restore youthful facial contours. Advanced techniques with SMAS flaps and finesse accessory procedures with lasers and fat grafting can help create beautiful, natural looking, lasting results. Warm regards, Dr. Pedy Ganchi Village Plastic Surgery