Your skin looks very good. Have you tried a good skin care regimen that includes, A gentle cleanser to help prevent striping the skin Alpha hydroxy acids to help lighten skin spots Peptides to help hydrate the skin Retinol to help prevent collagen breakdown. Start slowly with retinol and retinoic acid products, they may cause redness and irritation if overused. Try to use them only at night as they will make your skin more sensitive to sunlight. Start there, it will help even out the skin and slow further aging of the skin.
If there is nipple loss then the wound needs to be debrided of dead tissue, that is, all dead tissue must be removed. Once the dead tissue is removed then the wound will begin to heal itself. The wound will heal slower if the dead tissue is left in place. Once the wound is healed the scar will be come softer with time. Your doctor may encourage you to massage the area to help soften the wound. Once the scar is soft then reconstruction of the nipple can be performed. Depending on what tissue is left, the nipple can be reconstructed from local laps, that is the skin and fat around that area. The surgeon may elect to take from another part of the body such as the groin area to help rebuild the nipple. If you are smoking I suggest you stop as this will impede blood supply and make future reconstruction more difficult as wound healing is affected. There are many women that have their nipple reconstructed for cancer and the reconstructed nipple looks very similar to their old nipple. I hope this information has helped you.
After their menstrual cycle. I advise my patients to have cosmetic breast surgery right after their menstrual cycle. If you have the breast surgery before then keep in mind you will swell as your breasts become engorged before your menstrual cycle. This will often cause pain and can put more pressure on the incision lines. For this reason, I recommend right after. Most patients feel uncomfortable and embarrassed having to go to the operating room with a sanitary pad on and this is understandable. There have been conflicting reports in regards to breast cancer surgery timing and survival. These reports are not a concern if your breast surgery is cosmetic in nature. I hope I have given you some useful information.
Lipoma of the back does not require drains in all cases. I recommend drains if the lipma is large or if it deeper with in the muscle. Generally I leave these drains in for 48 hours. Going away a a week after surgery is not a good idea. if there is drainage, wound problems or concern of infection then your doctor will not be available. I suggest you have elective surgery performed when there will be adequate follow up.
Basically there are three ways to treat jowlng. I will approach it with the least invasive. The first would be through a radiofrequency non-invasive procedure such as Thermage. The problem at least up until now is there is no way to determine what your response will be do it. The second would be fillers to help camoflauge the jowling. The last would be a lower face lift to help pull the SMAS tighter and get rid of the redundent skin.
