Suleyman Koken, MD

To create a more V-shaped facial contour, you could consider jawline enhancement, either with dermal fillers or a chin implant, to refine the chin and jaw proportions. For a sharper transition between the chin and the neck, VASER liposuction to the under-chin area can help remove excess fat and improve definition. These procedures can be performed separately or combined, depending on your goals and anatomy.

Best,
Dr. Süleyman Köken

It seems you may have a waterfall deformity, where the breast tissue has descended over the implant, causing sagging. This can be corrected with a breast lift (mastopexy). However, as with any lift procedure, the breasts will become slightly smaller due to the removal of excess tissue.

If you wish to maintain your current size or increase it, the lift can be combined with larger implant replacement during the same surgery.

Best,
Süleyman Köken

From your description and photos, this could be called an "accessory or ectopic breast tissue" rather than a typical lipoma. If it is bothersome, it can be surgically removed through a small incision in the armpit.

This is generally a straightforward procedure that can be done under local anesthesia. The recovery is usually quick, with minimal downtime, and the scar is well hidden in the natural crease of the armpit.

Given that you’ve noticed recent growth and discomfort, it would be a good idea to have it checked again before scheduling removal, just to confirm the diagnosis and plan the best approach.

From your photos, it looks like you still have a good amount of natural breast tissue. Because of this, doing a lift with an implant at the same time could carry a higher risk of developing “waterfall deformity”, where the natural tissue droops over the implant over time.

For that reason, my recommendation would be to first do a lift without an implant or reduction. This will allow the breast tissue to settle and give you a clear idea of the shape and volume after the lift. If you still want more fullness after healing (usually a few months later), an implant can be added at that stage for a safer and more predictable result.

Best,
Dr. Süleyman Köken

Yes, a rhinoplasty can absolutely address all of the concerns you’ve mentioned. Reducing the hump on the bridge, straightening a deviation, and refining a bulbous or square tip to create a smaller, more feminine shape. An upper blepharoplasty to open the eyes and reduce hooding can be performed during the same surgery, provided you are in good overall health. Based on your description, you appear to be a suitable candidate for both procedures, and your desired results are achievable.

Best,
Dr. Süleyman Köken