Simeon Wall, Jr, MD, FACS

You have a gorgeous face with very nice features. Your nose has an overall beautiful appearance from what I can see, so if you seek out a change to it, I would proceed cautiously and make sure you find a highly experienced rhinoplasty surgeon who can give you an honest opinion of what he/she can do to help. Subtle changes like the ones you would want require an expert touch.  Make sure you are on the same page with what the surgeon can accomplish. Vectra 3D imaging is really helpful for all of our rhinoplasty patients in this regard, and it would be highly recommended for you to see simulations beforehand and discuss them with your surgeon. Good luck!

After literally decades of potions, gimmicks, and other disappointments, patients finally have something for cellulite to be excited about.This is very new and is only being released to 4 plastic surgery practices (at first) for post approval study, but we finally have something for cellulite that works.Cellfina is an FDA approved minimally-invasive, in-office, one-time treatment for cellulite of the buttocks and thighs.The practices that have Cellfina right now are Jeff Kenkel in Dallas, Haideh Himmand in New York, Julius Few in Chicago, and us in Shreveport.There are a few dermatology practices with Cellfina as well.Cellfina has a 94% satisfaction rate at 1 year, and 96% satisfaction rate at 2 years (data from the Cellfina pivotal study), which has us very excited.The first few patients we've done have been coming back in and they look fantastic so far.You can learn more about Cellfina by doing a search for it above, in the RealSelf search bar.Thanks for your question!

Hi. It sounds like you may be a great candidate for liposuction. If you’ve had children and your skin or muscles are a little loose, you may be a better candidate for more than just liposuction, and would need to be evaluated for an abdominoplasty as well. If not, and you’re healthy and fit, and at a stable weight, your young skin should "snap back" well after lipo. You're also right to be concerned about some of the more common problems that can arise after liposuction. The problems you've mentioned can happen when too much or not enough fat is removed or the fat is removed unevenly. Heat generating forms of liposuction can kill blood vessels and other tissues, and cause internal and external scarring and dermal adhesions. Some patients simply heal poorly due to skin quality or other factors. It's essential that you find a highly qualified liposuction surgeon, and that he or she chooses the best liposuction technique for you. I use a body contouring process called SAFELipo that takes extra steps to ensure a smooth, even, dramatic result. Step 1 utilizes a specialized cannula or probe to gently separate the fat from surrounding tissues and partially dissolve & liquefy it. This allows the fat to be more easily removed during the next step, aspiration. I use gentle suction and a smaller, less aggressive cannula to remove the emulsified fat. There is little to no bleeding and minimal trauma to the skin, blood vessels, or support structures in the area. Lastly, the fat equalization step sculpts the remaining fat to create a smooth, even, thin layer below the skin, without the visible indentations or lumpiness that you're worried about. Although it involves a little more work and finesse on the surgeon's part, the SAFELipo process allows for the removal of a maximum amount of fat without the contour irregularities that can occur with liposuction.Whatever method you choose, I wish you the best of luck!

You may be tempted to try one of the laser, ultrasound, or radiofrequency-assisted liposuction platforms based on the promise of improved skin tightening. However, there is no evidence that thermal liposuction creates better results. In fact, in my experience, the heat from these devices can actually cause problems like scarring, dermal adhesions, and burns. I do not recommend thermal liposuction for the chin or anywhere else on the body. Traditional liposuction has proven quite effective on the neck and chin area, although the surgeon must be very careful not to treat the area maximally for fear of creating a contour deformity, otherwise known as a divot, wavy area, or rippled skin. A different option is SAFELipo, which is great for delicate areas like the chin. It uses a 3-step process that is extremely precise, allowing for maximal fat removal while causing minimal bruising, bleeding and swelling. In the first step, the special cannula or probe gently breaks apart fat and separates it from the surrounding tissues without disrupting the blood vessels. This creates mechanically emulsified fat that is now ready to be removed easily. The second step is the aspiration or suctioning of the ‘liquefied’ fat. Since the fat has already been separated and emulsified, the surgeon can use a much smaller, gentler cannula to remove it. The third and final step is the fat equalization step, which smooths out the remaining thin layer of fat by creating ‘local’ fat grafts that prevent the skin from scarring down unevenly. This creates a very smooth, firm result with excellent skin retraction. I've performed thousands of SAFELipo procedures, and I've found that patients experience fewer adverse effects, a shorter, more comfortable recovery, and superior results. Consult with a board-certified surgeon and make sure that you're very comfortable with his or her credentials, their actual before and afters, and their recommendations. Good luck!

Good question. Different surgeons will have different opinions as to the best liposuction technique, but as others here have said, the most important factor is the skill of the surgeon. That said, I advise against thermal liposuction techniques – laser, radiofrequency, ultrasound – because I think they pose more risks of complications. While the heat energy does liquefy fat cells, it also damages and destroys other important cells around them. I've performed countless revision liposuction procedures on people who had previously undergone thermal liposuction which produced dermal adhesions, scarring, and an uneven, indented surface appearance. My preferred method is SAFELipo, which is ideal for your situation. The 3 steps in SAFELipo – separation, aspiration, and fat equalization – allow for maximum fat removal from the abdomen while creating firm, smooth results. Because the procedure is unique, allowing for removal of mechanically emulsified fat without killing the fat cells with heat, the harvested fat has the best chance of survival for use in your fat transfer to the butt and thighs. As far as the areas NOT treated with liposuction, it's a myth that you'll gain weight there after having liposuction, unless you’re actually gaining weight. First of all, your surgeon will advise you to maintain a healthy weight so that you can preserve your results. However, should you gain weight, it will be distributed among all the fat cells in your body, not concentrated in one spot like your chin. You will still have fat cells in your abdomen, just not as many. Good luck!

You seem to have a pretty good basic understanding of the procedure, but I can fill in the details. SAFELipo is a 3-step body contouring process that has been adopted by plastic surgeons all over the U.S. and internationally. The separation step uses some specially designed ‘exploded’ probes, or in some cases, a basket cannula to gently break up the fat and detach it from surrounding tissues without causing damage to the blood vessels that support the area. There is no heat generated, so there is no risk of thermal injuries like scar tissue, dermal adhesions, and even burns that can result from thermal liposuction methods. With SAFELipo, the tissue around the separated fat is left in a healthy, intact state. The aspiration step removes the mechanically emulsified fat using a smaller type of cannula that won’t rip or tear blood vessels. This allows for removal of all of the targeted fat, and the surgeon doesn't have to use a lot of manual force like with other liposuction methods, which is another reason there is minimal bruising and bleeding with SAFELipo. The fat equalization step combines aspects of fat shifting and fat grafting to smooth the remaining layer of fat for visibly stunning results. In the past, one of the biggest challenges of liposuction was how to remove ALL of the unwanted fat in an area without creating a dented, lumpy or wavy surface in the treated area. This process has answered that challenge, and creates the dramatic yet smooth results patients and doctors are looking for. Board-certified plastic surgeons undergo special training in order to become a SAFELipo provider. I train surgeons around the world in this method, and the number of doctors offering the process continues to grow. If you're considering the procedure, the SAFELipo website offers a doctor locator to help you find a provider in your area. Good luck!

Thanks for your question; it's one that a lot of people have because there are so many options now for liposuction patients. First of all, I think you were wise to avoid laser liposuction. In my experience, liposuction techniques that use heat, like laser, radiofrequency and ultrasonic energy, can cause a lot of problems. The same heat that liquefies the fat also causes damage to the tissues surrounding the fat, not only killing the fat cells, but killing other very important types of cells as well. This thermal injury causes intense inflammation, subsequently causing even more cells to die and more scar tissue to form in the targeted areas. This scar tissue causes the formation of dermal adhesions which ultimately result in contour deformities such as indentations or ripples. I think that traditional liposuction can be fine, as long as you don’t try to go too thin, and at a minimum, it’s performed by a board-certified plastic surgeon with plenty of experience. Power-assisted liposuction is considered by many to be quite a bit easier on the patient and surgeon, and it’s a tried-and-true form of liposuction, with most surgeons feeling like they achieve very good results with it. I developed a comprehensive body contouring method called SAFELipo that many doctors around the world have adopted. It uses a 3-step process of fat separation, aspiration, and equalization that combines the benefits of liposuction, fat shifting and fat grafting. This process approach allows some unique advantages in shaping all parts of the body, breasts, and face. The very careful, unique separation step allows for removal of the maximum volume of fat while preserving healthy tissue and optimal blood supply to the area. The final equalization step ensures a smooth, thin layer of remaining fat for visibly smoother and more thorough results. These steps also allow for treatment of adjacent areas that may not need liposuction, but do need skin tightening. Because of the dramatic, smooth, sculpted results surgeons achieve, as well as the very low rate of complications and bruising, and shortened recovery with SAFELipo, I believe it to be the best liposuction method. I recommend you consult with a board-certified plastic surgeon who specializes in body contouring and can show plenty of his or her own before and after pictures of the exact procedure you’re looking to have done. He or she can give you guidance tailored to your specific physical characteristics and goals. Good luck!

It sounds like you may be a candidate for a lift with some reduction on one side to match the smaller breast, but you may also be a good candidate for a liposuction-only approach utilizing SAFELipo, which can be done through tiny access incisions.  SAFELipo usually creates a significant amount of skin tightening in addition to removing the excess breast and fatty tissue.  Sometimes the skin tightening can be significant enough to avoid performing a lift procedure.  It also depends on the breast tissue you have.  Denser breast tissue can't be treated as well as breast tissue with more fat in it.  You would need to see a plastic surgeon who offers and is familiar with these procedures, and he or she can help you figure out what will work best for your specific needs.

Great question.  You have probably heard that many plastic surgeons have all our surgery patients stop any estrogen-containing medicines or devices at least two weeks before and two weeks after surgery in order to decrease the already small chance of forming a blood clot (VTE, DVT, PE).  This includes most oral contraceptives and most hormone replacement therapy, but does not include the progesterone-only implantable birth control devices like nexplanon.  Progesterone-only devices should not significantly increase the chances of forming a blood clot after surgery like the estrogen-containing medicines can, so we let our patients keep these devices.  Make sure to let your plastic surgeon know about any and all medicines and supplements you are taking or have in your system so you can have the highest chances of having a great outcome.

As several other PS's have stated below, there is no expiration date on breast implants. In the past, when previous generations of implants had higher rupture or leakage rates, a good rule of thumb was to at least have your implants re-evaluated at 10 years. I still think that's a good idea, especially if you haven't seen your plastic surgeon in many years. I like to see my breast implant patients every two years just to keep track of them and make sure they are not developing any problems. The real issue is that it's not usually the implant that will cause us to reoperate, but rather the aging of the patient, life changes (babies), weight fluctuations, loss of skin elasticity (sagging skin), and other things that just go along with getting older. Some patients just hold up better than others for a variety of reasons, and in these cases, there's no reason to replace breast implants just because of a certain time limit. Hope this helps!