Steven P. Davison, DDS, MD, FACS

Hello, and thank you for your question. The sort answer is, age is just a number. In general, surgical clearances are based off of health history moreso than age. Please visit a board-certified plastic surgeon -- depending on the type of buttocks augmentation you wish to pursue, the time under anesthesia associated with that procedure, and your own personal and family medical history, your plastic surgeon will ask you to get certain pre-operative clearances from other physicians. For healthy individuals within a normal weight range for their height and age, this poses no problem and they can typically get all clearances from a primary care physician. However, if you have a significant history, such as a prior or current history of diabetes, heart problems, or blood clots (DVT/PE/VTE), the pre-operative clearance process becomes more intensive, but not insurmountable by any means (you may need to be checked out by one or two more physicians prior to getting cleared for surgery). These clearances serve as a mechanism to check that the procedure and anesthesia associated with that procedure is as safe as possible for you as a patient. If you have a complex or significant medical history, are on medication, or have a significant family history, it is important to disclose these risk factors to your plastic surgeon so that they can make sure you are appropriately cleared with surgery. Additionally, it is always very important to follow your physician's pre and post-operative instructions to make sure your procedure and recovery go as smoothly as possible. I hope this helps you! 

Hello, and thank you for your question! I certainly can appreciate your concerns regarding sensitivity. Here, there are a number of factors to consider:  1) Labial reduction is certainly possible. However, to get the contour and coloration to match the picture in question, you would likely need a wedge excision technique. The wedge excision maintains the color gradient of the labia minor/majora while still giving an excellent reduction and contour. The look you are going for is certainly achievable with this technique, but this technique is more advanced than a typical tissue amputation technique. You clearly want some labial show, which lends a more natural appearance. I would recommend going to a board certified plastic surgeon in your area and consulting with them to decide on the best course of treatment for you, as pictures can only tell so much.  2) In labiaplasty surgery, clitoral unhooding sets the position for the labial reduction. If you are in fact experiencing increased clitoral sensitivity, I would speak with your plastic surgeon in advance. Sometimes, this sensitivity can be confused with general sensitivity in the area or sensitivity associated with "chaffing." Many patients prefer the aesthetics of clitoral unhooding, so please make sure to discuss this concern in depth with your surgeon. As with any surgery, it is important to note your sensitivities to your surgeon, but especially so with labiaplasty, which is often performed under local anesthetic. If you have concerns about sensitivity, you may wish to have an operation under twilight, or even general, sedation.  I wish you all the best! 

Hello and thank you for your question. I understand that you are concerned about the tip of your nose. It is difficult to appraise cosmetic outcomes by photographs, especially when you are still in the initial stages of surgical recovery. It is promising that your nasal tip looked aesthetically appealing to you on the day of surgery. Before you worry about final results, bear in mind that you are only one week out of surgery. Often, in the first 24-72 hours after surgery, swelling collects in the nose. This is why many physicians put nasal casts on patients post-rhinoplasty, as you had according to the pictures. This swelling can take up to 6 months to one year to fully disappear, depending on the type and extent of the rhinoplasty. The nasal tip is often the last portion of nasal swelling to dissipate post-rhinoplasty. This swelling in the tip of the nose can cause a temporary "bulbous" or "droopy" appearance. As such, I would recommend being patient and waiting for swelling to subside before judging the final results. With a board-certified and well-respected plastic surgeon, I suspect that you will be pleased with your results, which many not be fully apparent for a little while. That being said, I would discuss your concerns with your surgeon in-person, who can give you a better estimate of when you can expect to see the final results. Wishing you all the best in your recovery, Steven Davison, DDS, MD, FACS

Hello and thank you for your questions. I understand that the days following a surgical intervention can produce anxiety about final results. However, I think right now you should focus solely on your recovery -- following all post-operative instructions and ambulating regularly. This will ultimately get you the best results possible.  You are only two days post-op and the swelling from your surgery will not reflect the final results. As the swelling resolves, the placement of the incision lines will likely shift and the skin placement and laxity may very well change. Thigh lift surgery will not yield immediate results; any surgical intervention will introduce swelling and changes to the body that can take months to resolve before the final results are evident. At the sixth month mark, most of the swelling will be resolved and you may begin to speak with your doctor about revisions. However, right now is not an appropriate time to speculate about final results. Your physician is correct on erring on the side of safety -- if skin laxity is still an issue later, more skin can always be taken out. For right now, embrace your smooth recovery and let your body resolve the swelling before making judgments about the final results. 

Thank you for your question. Facial scarring can be incredibly disconcerting, and I think you are well justified in wanted the best result possible. The quality of the photos makes it difficult to evaluate your scar; that being said, photos or not, I would highly recommend you visit a board certified facial plastic surgeon. As a facial plastic surgeon who does many scar revisions and facial reconstructions, I may or may not take a surgical approach depending on the hypertrophy (width), location relative to anatomical features (such as your mouth), and depth of the scarring. If the scar is relatively well-healed, I might recommend localized dermabrasion, which will resurface the skin. This route requires about a week of care for the dermabrated area following the treatment to ensure a good result, and then avoiding UV/wearing sunscreen on a regular basis to avoid discoloration. If the scar has created a divot in the skin, fillers may be appropriate to recreate the contour of your cheek. With fillers, you would need to avoid alcohol, NSAIDs, exercise, and putting your head below your heart for 4-6 hours after injection. Fillers would not be a permanent solution and would require re-injection at designated intervals (most metabolize in 9 to 24 months, depending on which one you use). However, the scar may require a scar revision, which would rearrange the local tissues to avoid any abnormalities or the look of pre-mature aging. I would hesitate to reopen a well-healed scar as it requires more post-operative care (social recovery while you have sutures/surgical dressings, staying out of UV rays, ect.) than the former options. A scar revision, however, may be necessary for a long-term solution. I hope this helps you, and I wish you the best of luck! 

Thank you for your question! The short answer is: based on pictures alone, it is difficult to tell the level of abdominal surgery that will suit you best. I recommend going to a trusted, board-certified plastic surgeon for a consultation. Generally speaking, there are trade-offs in abdominoplasty surgery. The right choice for you depends on your goals, the amount of skin and skin laxity, and the extent of any rectus diastasis. With a mini abdominoplasty, there is generally a shorter scar, no mobilization of the belly button, and a shorter recovery. I say generally because I typically tailor the abdominoplasty surgery to the patient and their needs, rather than sticking to discrete categories. That being said, in a formal abdominoplasty, while there is a longer incision pattern with mobilization of the belly button, also has significant benefits. These are three-fold:  1. The formal abdominoplasty allows for more tightening of the abdominal muscles. Rectus diastasis can often occur in females postpartum. By mobilizing the belly button and using a longer incision above the mons, more muscle-tightening can be achieved.  2. The longer scar of the formal abdominoplasty allows for more skin to be taken out. With liposuction contouring of the abdomen (which is included as part of the Abdominoplasty by many surgeons), the result can yield "hanging skin" especially when there is much skin laxity present. The formal abdominoplasty addresses this moreso than the mini abdominoplasty.  3. The mobilization of the umbilicus in a formal abdominoplasty also allows for more skin to be taken out of the abdomen. Think: you can only move the umbilicus around so much; at a certain point, it will be necessary to free it from the surrounding tissue for the added benefit of excising more skin, especially if there is pre-operative excess skin above the belly button. When done correctly, the peri-umbilical incision can be virtually imperceptible.   Additionally, a thoughtful plastic surgeon will hide the abdominal scar from either procedure below the bikini line. I typically consult with patients to find where the scar will be best hidden, which typically means hiding the scar in an underwear line or using existing scars from a previous abdominal surgery. Make sure to speak with your plastic surgeon about their plans for scar care post-operatively as well if the end-result scarring greatly concerns you. 

Thank you for your question. It is, in fact, a very good one, and a question that I get very often. Fatty tissue deposits around the knee area can be very disheartening, especially for someone who exercises regularly. There are a few options for you.  The first is SculpSure or another non-surgical treatment. SculpSure was designed for areas of stubborn fat and gives excellent results for fatty tissue deposits in localized areas, using laser technology to break down fatty tissue and mobilize it out of the body via your lymphatic system. I have had much success with SculpSure for the inner thighs and knees. SculpSure requires no recovery and results typically can be seen in 6-12 weeks. However, more than one treatment may be required.  The other option is liposuction, which is surgical in nature. This option gets rid of excess fat using a tumescent and cannula technique. This technique is associated with swelling and bruising and will require some measure of downtime from your exercise routine. I often discourage patients from choosing liposuction for the knees as it can be more expensive and can lead to excess skin problems after surgery. That being said, I would highly recommend you see a provider for your concerns as an in-person consultation could yield different recommendations depending on your skin laxity and the amount of fullness above and around the knees. 

Keep in mind that the nose is the central part of the face and you want it to blend in, not become the central focus. It should complement not appear out of shape or proportion for the shape of your face. Most people have asymmetry to their face and if the nose is over corrected and the tipis to small or not reshaped to the correct size it will appear large and not blend in with your other features. It is important that your doctor use similar imaging tools but also give you realisitic expectations. what you have shown may be possible, but only a face-to-face examination/consultation can be the best indicator of what can be achieved.