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CLAIM YOUR PROFILEWhile it is not possible to answer this question specifically without an examination and discussion I can give you some general information about this issue. The challenge when performing an augmentation and lift together is that each procedure has somewhat different goals and, in some instances, interferes with the success of the other. For example, the goal of the lift is to remove some of the loose breast skin and tighten the breast against the chest. The implant, however, will stretch the skin and expand the breast away from the chest. Therefore, the amount of loose skin that can be removed during the lift needs to be reduced to leave enough skin for the implant. Also, the size of the implant may need to be reduced so that the skin is not so tight that closing the lift incisions becomes impossible. Finally, the lift is trying to elevate the breast and keep it in a lifted position while placement of an implant will add weight to the breast and lead to more drooping over time. The decision as to what approach is best depends on your specific anatomy and the preferences of the surgeon. Seek several consultations with board-certified plastic surgeons to be certain you are well informed about your options.
Board Certified Plastic Surgeon
We do not fully understand what causes capsular contracture. While the likelihood of developing a contracture decreases over time it probably never disappears completely. To the best of our knowledge bacteria play some role in the development of a contracture which is the thickening and tightening of the layer of scar tissue that forms around all implants. While there is a risk of dental work causing bacteria in the blood stream it is quite unlikely and, in fact, the American Dental Association no longer recommends antibiotic prophylaxis for patients with artificial joints. I have seen several patients who have had an apparent late onset of capsular contracture who also had ruptured silicone gel implants. Whether that is causing the contracture or is coincidental is unknown and most patients with ruptures do not have contractures. We are still learning more about this phenomenon and, hopefully, will soon have answers to some of these questions.
Board Certified Plastic Surgeon
I cannot comment specifically about recommendations for you without an examination but I can tell you that I find crescent lifts to be of little value. There is minimal lifting of the breast initially and virtually none longer term. Also, the areola is being stretched and may become excessively large and misshapen. In my experience you either can get by without a lift or, at a minimum, a circular incision around the areola is necessary.
Board Certified Plastic Surgeon
There is no specific optimal weight before having a tummy tuck. Ideally someone would have a BMI in the normal range but this is not a requirement and may not be attainable for many patients. It is best if you are within 5-10 lbs. of your goal weight and your weight has been stable for a few months. In my experience a fluctuation of 5-10 lbs. postop has not been a problem but I would have concern about a large weight change affecting the result of the procedure.
Board Certified Plastic Surgeon
Dog ears are not typical but they are certainly not unusual either. They result from a disparity in length of the upper and lower incisions and the more skin that is removed the greater the likelihood they will occur. This is why it is necessary to taper the amount of skin that is removed as the incision proceeds from the center to the sides. Dog ears can be minimized by closing the incision from the sides toward the center so the "extra skin" can be distributed as the closure proceeds Despite our best efforts, however, sometimes small dog ears persist and can be removed in the office with a local anesthetic.
Board Certified Plastic Surgeon
As I am sure you know, a tummy tuck is not a weight loss procedure. You have done the hard work of losing weight so the goal of the procedure is to reduce the amount of loose skin and give you the improved appearance you want. So it really doesn't matter how much weight is removed and it would be impossible to predict how much it would be without performing an examination.
Board Certified Plastic Surgeon
I believe exparel can be a useful component of a more comprehensive approach to reducing postoperative discomfort. Exparel is a time-released version of a commonly used numbing medication and is thought to be effective for approximately 72 hours. While it is difficult to quantify how much it reduces discomfort as every patient has a different pain tolerance and each procedure is different, it does seem that patients who elect to have the medication experience less discomfort. Exparel is injected while you are asleep so it is painless and eliminates the use of pain pumps which are inconvenient and, in my opinion, less effective. The downsides of exparel are the cost and the risk of its being injected into a blood vessel. You should definitely discuss the pros and cons of exparel with your physician.
Board Certified Plastic Surgeon
A pierced belly button is not a problem when doing a tummy tuck. As for the need to create a new belly button that depends on the extent of the procedure. A mini tummy tuck would not affect the belly button at all. A full tummy tuck, on the other hand, would require separating the belly button from the surrounding skin and then re-inserting it into it's new position after the loose skin has been removed. It's still the same belly button but it will likely have a somewhat different appearance. The final option is the "float procedure" in which the belly button is separated where it attaches to the muscle so there is no external scar but the position of the belly button will be lower on the abdomen. You should discuss these options with your surgeon during your consultation.
Board Certified Plastic Surgeon
A breast lift should not change the size of the breasts. In fact, you may feel your breasts look a little smaller as they are less droopy and are tighter against your chest. Of course if an implant is placed in addition to the lift the breasts will be larger but that is not a requirement and, in some patients, may actually make the lift less effective.
Board Certified Plastic Surgeon
This is an important question and must be addressed to your surgeon. You should not follow the recommendations of someone who is not knowledgeable about your specific situation and has not examined you. The reason we typically recommend a compression garment is to reduce swelling and the likelihood that fluid will accumulate following surgery. The concern about an excessively tight garment, however, is the possibility of constricting the blood supply to the flap and causing a problem with healing. Check with your surgeon to get instructions that are appropriate for you.
Board Certified Plastic Surgeon
If anyone is tired of their old implants & is on the fence about having them removed... do it! I had my implants removed, a reduction/lift and lipo of my back and flanks done 1 year ago today! It may have been the best thing I have done! I went from a G bra to a C! I can be more active now, and I can wear all the cute little stappy sports bras! But j favorite part is wearing just about any kind of top & I don’t have to worry about looking pregnant or fat! It wasn’t horribly painful. The lipo pain is truly what gave me the mos grief.
I am now 2 days out from my surgery and I feel like it was the best idea ever! They are sore, tight and right under my chin but I know they will drop as time goes by. This website helped me pick out what I wanted. The doctor was Dr Kofkoff and I was his last surgery, he is retiring! I remember giving him and the anesthesiologist a high five right before I went into surgery. Updated on 5 Mar 2018: I started developing a rash on my neck, down my arm pits and goes right above my belly button and up the other side. I stopped taking the medicines this morning because all of them say that it can cause a rash. It is really itchy and irritated! I will be calling my dr tomorrow. But, they are still sitting high and feel tighter on my chest today.
I absolutely loved this doctor. He makes you feel very comfortable. I had breast augmentation. My husband and I felt very confident with Dr. Kofkoff doing the surgery. He included my husband in all decisions. Highly recommend.
From my consult to my 6 month follow up (which was today!), Dr. K has been amazing. I had a TT with MR and BR/BL. To me, my breast look fantastic! Before kids I was a full D. After 3 children, which were all nursed, I was up to a J at one point. I would joke to my frienda that i could stick my nipple in my belly button. Lol. My scars have faded nicely and I didn't end up with googly eyed boobs. I was so nervous about that! My stomach has greatly improved. After having the kiddos, it was pretty hideous looking. Dr. Kofkoff worked his magic and I am just floored. I know I'll never fully get my pre-mommy body back, but this new one is working for me :) Dr. K and his office staff are very professional. I love that I was treated as a unique patient, and not as if they were bored bc I was the 10th person that day to walk in and whine about my body. They always thoroughly answer my questions, even if I asked the same one 3 times already. I can easily see how plastic surgery could become addicting...especially when you have a great surgeon.
I was referred to Dr. Kofkoff by a friend who works with several doctors. I had a consult with another doctor before I had talked with her. I am so happy she gave me Dr. Kofkoff's name. What a difference! The entire office is professional and classy. The people in his office are so caring and make you feel very comfortable. Dr. Kofkoff was a constant professional and makes you feel comfortable throughout the entire process. He really listens to your wants and delivers too. I am more than satisfied with my breast augmentation outcome. It is better than I was imagining. I have been considering this surgery for several years and only wish I would have done sooner. I would highly recommend Dr. Kofkoff! I look and feel amazing. I am very thankful to him and his staff for everything. My recovery went well and quick. They are there for you at all times with any questions you have during the process. I am 39 y/o, 128 lbs , 5'6. I went down in size due to breast feeding my 3 children.
My motivation was all the loose skin that I had left over after losing all of my baby weight. Having 3 kids really does take a toll on one's body! I'm an avid runner who averages about 20 miles per week. I was very sick of passing by mirrors during my daily jogs and seeing my stomach poke through my shirt. My breasts were also left saggy after the babies which was a huge problem for me!
Dr. Kofkoff is a surgeon that I would highly recommend to anyone. With all of his qualifications, which I will add are numerous, his years of experience, his excellent reviews and his excellent staff, in my opinion Dr. Kofkoff is the number 1 choice. His staff is excellent, very caring, polite, helpful, and knowledgeable. My main contact with his staff is Teresa. She, I believe is the very best in her field. She handles everything from setting up the appointments, the financial part, fitting, talking to me when I have questions for her, making sure I was totally informed and comfortable with each step of the process to make me feel and look like the person I wanted to be. She also always let me know that if at any time I needed to talk with Dr. Kofkoff he was only a phone call away. My experience started October 2016. I contacted Dr. Kofkoff’s office for my consult. I had researched Dr. Kofkoff for 2 years, his qualifications, his reviews, watched his videos, I viewed other doctors and their same information. No one compared to him. Once I met him, there was no doubt in my mind my decision would be made that day and he would be my surgeon. He took his time, listened to my concerns, my questions, and answered each and every question with concern, patience and confidence. My breast surgery was December 28, 2016. I went with high expectations and of course nervous as anyone would be. Today, 3 weeks out from having my surgery, I could not be any happier with my results. Every expectation was met. The surgery center was excellent; the staff was caring and informative. My implants are under the muscle, smooth high profile silicone 375cc. They offered a time released numbing medicine that would last a few days, I declined that, I was given pain meds and muscle relaxers to ease any pain I might have. I was raising my arms above my head before I left the surgery center. My surgery was on Wednesday morning and early Friday morning, I stopped taking pain meds and muscle relaxers. I had the tightness of course, I had no bruising, some swelling that was expected, and that I kept managed with ice packs that were recommended by Dr. Kofkoff. Dr. Kofkoff contacted me personally a few times at my home to check to make sure I was doing ok. I have my second follow up in 3 weeks. It has been an amazing journey, that has changed the way I look at myself and I would like to thank Dr. Kofkoff for his awesome gift of being the plastic surgeon he is and just for being the person he is.
I have dealt with gynecomastia since 12yrs old. I totally changed my lifestyle at 18 and lost 95pounds in 6 months. I have kept the weight off since. However, my excess skin remained. I always thought if I just hit the gym harder, i could get rid of the sagging chest. However, after 17yrs of the gym and great diet, i had come to the reality that I was stuck with the excess skin. As many of you know, this impacts your entire life. Wearing shirts to the pool, wearing shirts at the beach, hurrying to find a shirt when someone knocks at door. Also, I have a 5 and 4yr old that i never took for swim lessons due to my embarrassment. I didn't even know anything about a procedure to correct this issue until a friend told me about it. I did an internet search and found the word "gynecomastia" and went down a rabbit hole for hours. I went for a consult with Dr. Richard Kofkoff and decided to have the surgery. My procedure was gynecomastia with skin removal. One of the best decisions I ever made. I only wish i had known about this sooner. Unbelievable results. Great doctor. If you're on the fence, get off it now. Your excess skin will not go away with diet and exercise. My life was changed for the better and yours could be too.
My experience was fantastic. I received a breast augmentation approximately 6 weeks ago. I considered the procedure for many years and after meeting with Dr. Kofkoff I decided to finally go through with it. He is extremely polite, knowledgeable, and understanding. My results are better than I ever dreamed of and I would highly recommend him to anyone considering cosmetic surgery!
I spent hours researching and went on consultations with several other doctors and knew Dr. Kofkoff was the right choice for me. He had the best bedside manners, professionalism, and helped me find the best size for my body. It has been a little over a year since my procedure and I couldn't be happier with my results and my entire experience.
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