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Dr. Sam Gershenbaum is highly regarded for his expertise in various plastic surgery procedures, including

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Dr. Sam Gershenbaum: World renowned, award winning plastic surgeon...because you deserve the best.
Asked By: SheShe19
ANSWER
Thank you for your question. Breast asymmetry is not uncommon. You have a markedly smaller and constricted breast on one side, with some appearance of tuberous deformity and a larger ptotic breast on the other side. A tuberous breast is constricted and has breast tissue protruding into the nipple areolar complex to varying degrees. You do have several choices to make in determining your results. Essentially, you will be enlarging the smaller breast with an implant and likely addressing the apparent mild tuberous deformity and having a breast lift and likely some reduction on the other side. I think it is important to be very conservative with the implant size on the smaller breast for a more natural result. Certainly a consultation with a board certified plastic surgeon who performs these types of surgeries on a routine basis and has many before and after photos to review with you, and that you find pleasing is the best approach. Best wishes. Dr Sam Gershenbaum.
Asked By: my next journey
ANSWER
Ideally, return to your plastic surgeon to review your concerns. If you are not satisfied with the information and response from your surgeon, an in person consultation with a Board Certified Plastic Surgeon would be in your best interest. In this forum, without photos, it is not possible to address your concern. While you are doing your research, send in a photo with your question. Best wishes. Dr Sam Gershenbaum.
Asked By: chynabee90
ANSWER
YES, they are too big for you! They wont fit, and don't do it to yourself ! I am a big believer in striving for "well done", rather than "over done." Call me old fashioned, but I strongly believe that breasts should look like breasts. Choosing what size implant to use will depend on many factors and is best decided during a physical exam and discussion. Photos can help the initial discussion. The appropriate size implants will depend on the width of the breast, the distance from the nipple to the infra-mammary crease, the thickness and elasticity of the skin and subcutaneous tissues. In basic terms the appropriate size implant will depend on what fits. The discussion will depend on one's requests and expectations based on how big versus how natural. The larger the implant is beyond what fits appropriately, the less natural will be the result. The larger the implant extends beyond what fits, the more you will feel the implants and potentially see the outline of the implant or even rippling on the sides. Attempting to place an implant that is too large for the space available, will not only look unsightly, but will significantly increase the chance of any number of complications that will require additional surgeries, risks and expense to repair. Much depends again on measurements and thickness of the skin and subcutaneous issues. Someone who is thin, with small breasts to start, will have a more narrow range of what will fit if they want a natural looking result. Someone who has larger breasts and thicker subcutaneous tissues, meaning more to cover an implant, will have a greater range of sizes to choose. High profile implants can also be used, at times, to give more projection and a larger appearance. Choosing appropriate size implants makes all the difference. In your particular case, my patients would normally receive implants that are in the 200s to 300s maximum, just for your information. Review lots of photos and ensure that your surgeon produces results consistently that are pleasing to you. Understand your measurements and choice of implant size. Choose a Board Certified plastic surgeon that will take the time to review all this with you and help you get those great results ! Best of luck. Dr Sam GershenbaumUPDATE ANSWER
Asked By: christimartin123
ANSWER
Thank you for your question. From your front view in a standing position, it appears as though you have a pleasing result. If you want to keep a natural appearing result, i would not recommend going larger. Not to mention the larger you go, the more stress you put on your tissues, and the increased chance you have of developing more displacement. If you did go a bit larger, I would recommend you not add a larger diameter implant, but increase the projection of the implant, although i don't think it will look as natural. In my opinion, 400cc would be way too large for your frame. With regards to the lateral separation of the implants when supine... it is certainly not uncommon. In reality, any sizable breast without implants will fall to the side to varying degrees. How much an implant will fall to the side, will depend on many factors such as the shape of the rib cage, the size of the implants, the extent of the pocket made by the surgeon, your tissues and capsules thickness and integrity and ability to hold an implant well in position. Some tissues heal with laxity and thin capsules that do no hold an implant as secure as others. Some tissues and capsules have great integrity and heal at a more ideal thickness and consistency and are able to hold the implant in an ideal position. And then, on occasion, there are those who heal with excessive thickness firmness and develop capsular contracture to have the opposite problem. Combine a narrow and oblique rib cage, and tissues that have a tendency to heal with laxity and thin capsules, the implant is sure to fall more lateral even if the surgeon creates a perfect pocket. There are many things the surgeon can control, and there are several unknowns and things a surgeon cannot control and has to use his knowledge, experience and best judgement to provide the best chance for a great outcome. The lateral displacement that you question, can be revised by lateral capsulorrhaphy ( lateral capsule repair ) which may or may not necessitate use of an acellular dermal matrix, such as Strattice, to reinforce the repair. These are all discussions you can have with your plastic surgeon. Best Wishes. Dr Sam Gershenbaum.
Asked By: HN90210
ANSWER
Sorry to hear of you unfavorable outcome. From the limited photo, you have a couple different options. One option is revision liposuction, to include reduction of any high spots and fat shifting or transfer to any overly low spots to improve over all symmetry. If any loose skin is apparent, a mini tummy tuck may be an option along with the above revision. A mini tummy tuck may be an easier decision to make if a C section scar is already present. For those who may not wish to jump into surgery again for a small amount of discrepancy, cool sculpting may be an option. As a word of caution, be aware of immediate post operative photos and results. Actual results are not realized until months after a procedure. Best wishes. Dr Sam Gershenbaum
Asked By: Skylar21
ANSWER
thank you for your question. From the photo at hand, it appears you have a smaller and reasonably positioned breast one one side and a larger and more ptotic breast on the other. You have several opinions and several options. There is not necessarily one right procedure. There are often multiple ways to achieve similar goals. Another choice that was not mentioned could be a liposuction reduction on the larger breast which will reduce size and allow some elevation and you can do some fat augmentation to the smaller breast. Other options include a breast lift on the larger breast and fat transfer or an implant on the smaller side. Another option is simply a breast lift and reduction on the larger side and no surgery on the smaller side. Other options would likely arise in an in person consultation. You have choices. There is not necessarily a right way or wrong way, just a discussion to include your expectations and your understanding of the likely outcomes of each of the procedures. Best wishes. Dr Sam Gershenbaum
Asked By: danielag920
ANSWER
Thank you for your photos and question. Taking down a significant hump of the nasal dorsum without osteotomies (breaking the bones) to close the open space will lead to an overly wide nasal dorsum and an open roof deformity. There are also other issues that may be addressed in a discussion about your revision regarding the nasal tip and nostrils to have better aesthetics and harmony in your final result. This discussion must be made in person with a board certified plastic surgeon or facial plastic surgeon who performs revision rhinoplasty on a routine basis and has many before and after photos that you find pleasing. Best wishes. Dr Sam Gershenbaum.
Asked By: venecccia
ANSWER
Part of the reason, the skin is hanging as low as it does is due to the weight of the remaining fat that is still present. That being said, you have some different choices. Additional liposuction performed adequately and correctly (even circumferential to some degree) will reduce an amount of fat, and allow contraction of some of the skin and some further reduction and improvement of the arm overall. These results will vary depending on the experience of the surgeon. As far as as other skin tightening procedures, along with liposuction alone, I have not been impressed with anything I have seen so far, however, Renuvion by Bovie, may be something worth looking into.To make a more dramatic result and actually have fat reduction and firm skin, a brachioplasty would need to be performed...the trade off being the scar. Ensure you visit with a Board Certified plastic surgeon, who performs these procedures on a routine basis and have many before and after photos that you find appealing. Best wishes. Dr Sam Gershenbaum.
Asked By: withvictoria
ANSWER
Thank you for your question. When there is a mild to moderate asymmetry of the breasts, with a planned mastopexy, you may choose to make the larger breast smaller to match, or the smaller breast larger to match. To make the larger breast smaller, it entails a bit of a reduction of breast tissue while performing the lift. To make the smaller breast larger, this can simply be done with fat grafting/transfer, a procedure also commonly performed. From the appearance of your photos, there does not appear to be a marked amount of asymmetry. It should be a easy matter to resolve and simply a matter of making this decision with your surgeon. With the amount of flaccidity/laxity that you have, you may want to consider Galaflex mesh for your surgery. Galaflex mesh acts as an internal bra during the healing processes and resorbs after a year and a half to two years, leaving a more supportive collagen framework to help reduce the chance of recurrence and stretch-back. Ensure you visit with a Board Certified Plastic Surgeon who performs these procedures on a routine basis and he has many before and after photos that you find appealing. Best wishes. Dr Sam Gershenbaum.
Asked By: Turner44
ANSWER
Thank you for your question. I'm sorry you are disappointed after surgery. I think it is vital for the surgeon to understand the patients goals and expectations and for the patient to fully understand the likely outcome of a particular procedure. For patients who are borderline or who are not sure they wish to have a lift, I have them view photos of patients who are similar and chose to do implants without the lift and the results there of. It is important to have careful discussion of the results of breast augmentation alone when the patient is starting with a low position of the nipple areolar complex. If those types of results are not acceptable to a patient, then they are clearly able to see that they would need a lift in order to achieve their anticipated results. In basic terms, breast implants do not lift the breasts, and essentially make larger what is there. In your case, in my humble opinion, you will not achieve the results you desire and will require a lift. Discuss your desires and concerns with your surgeon so you can come to agreements to achieve your truly desired outcome. Best Wishes. Dr. Sam Gershenbaum
Dr. Sam Gershenbaum is highly regarded for his expertise in various plastic surgery procedures, including