Stefan Mark Szczerba, MD

The results you're hoping for seem subtle... fat graft is a good option to help build fullness in tough areas such as the cleavage. For upper pole fullness fat graft is also a reasonable option- but you have to have reasonable expectations there. Breast implants give much more definition to the upper border of the breast. If you have enough fat to work with, using fat to give the shape adjustment and size adjustments to your "goal photos" seems reasonable. Best Wishes!!

There are 2 distinct issues going on with your eye appearance in opinion: 1. the dark circles 2. aging changes of your lower eyelid. I would tackle this with a cheeklift (aka midface lift) to shorten your lower eyelid bulge area and loosen the ligament that makes the transition into your cheek area so distinct. Then either before or after I would recommend a chemical or laser peel to lighten the color. Fat graft can also help with certain patients as those patients have veins under thin skin that contribute to the dark circle appearance. Best Wishes!!

From the photo you submitted, it certainly seems as though everything is ok- the areola is centered on the breast. The lateral photo really helps assess better the location of areola onto the breast and implant. I hope that helps!!

This is difficult to answer without looking at your "before" pictures and doing an exam to check on implant mobility... however I think the implant on right side is lower in position. The left may have some level of capsular contracture and needs to be lowered and likely replaced. The right implant may need to repositioned and reinforced with a mesh like Galaflex to support the position higher. I hope that helps!!

From what I can see you are good candidate. You need to be measured and fitted in the office though to determine which implants are best for your goals. I have found Motiva good for certain candidates while Mentor and Allergan implants better for others. I don't recommend the tear drop implant because the shell is usually textured. Best Wishes!!

I have many prior patients with darker skin pigments and I have not issues with scarring. The position of your nipple and areola is too low to really consider other options. Periareolar incisions drift down with time and spread too far making the areola too wide to really be a option for anyone that needs their areola /nipple position to rise up to any significant elevated position. There are techniques that skip the vertical incision, however they do leave the breast looking slightly more "boxy" after the breast settles. The vertical incision geometically prevents that boxy look. RF treatments are a really interesting option for small corrections of nipple/areola position. Best Wishes!!

I think most important is getting your joint replacements done so you can make sure you can get up and walk around comfortably while recovering from your Mommy Makeover! Health first on this for numerous reasons! Best Wishes!!

Not sure what is causing that however some surgeons use permanent sutures- I personally do not. Review the operative report with your surgeon to see if that could be the cause. For treatment, consider subcision and discontinous undermining with blunt instrumentation over the right areas. The "sliding browlift" uses this technique for a forehead lift technique that loosens the skin from the underlying muscle. Best Wishes with this issue.

I would do a closed rhinoplasty AND base width/nostril reduction. You have a great nose, but a few refinement tweaks will go a long way!! Best Wishes!!

That may be correct. A lot goes into that decision and you can't take back the scars-so I would take a minute and consider your options. When I am not sure if a breast lift is absolutely needed on someone who is also unsure if they want to risk the scars, I put in the implants and hold for 6-9 months. Dual plane surgery with an internal release of the breast tissue can change a lot of anatomy. Frequently when the implants settle, then the decision is self-evident..... either you can do without it OR the lift is now quite a smaller lift because the breast is different. I hope that helps!!! Best Wishes!!