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Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon
3974 Springfield Rd., Glen Allen, Virginia
4.4 | 35 Reviews
723 Questions Answered
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QUESTIONS ANSWERED

My lower blepharoplasty incision split after day 4. Doc restitched on day 5 and it came apart. Am I stuck like this? (Photo)

Asked By:AnonymousANSWERS (1)
at,

It is quite unusual to see a lower lid incision open for any reason, but even though it looks scary today,
the thin skin of the lower eyelid is very forgiving, and once the swelling resolves, it is unusual to see
much scarring form.  I suspect this will turn out ok, but be patient.  If scar revision is needed it should
wait until the skin is totally healed, and the scar is mature and soft to limit inflammation.
I hope that this helps.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

How can you minimize the risk of symmastia? (photos)

Asked By:AnonymousANSWERS (1)
Beth,

Simply stated, in submuscular augmentation if the pectoralis muscles are not released (cut) medially to "enhance cleavage" symmastia will not occur.  I have reconstructed many referred cases of symmastia, but I have never seen it occur without surgical cutting of the medial muscle origins along the sternum, or aggressive release of the lower pole muscle origins extending up along the lower sternum where the implants can bottom-out and then migrate medially causing complex symmastia/bottoming-out.  I hope that this helps.  Information concerning symmastia prevention and treatment is found at the link and related gallery that follows:
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

Is this the right result? (Photo)

Asked By:AnonymousANSWERS (1)
eukk,

You have an excellent result from your surgery, and comparison to starting point is always important in determining how successful the procedure has been. Nonetheless, tissues that have sagged to the extent that they have required mastopexy are not going to change their tendency to future sag after the surgery, and you now also need to support the weight of the additional implants. This is especially true if the implants are large or if they are placed over the muscle, where they have no intrinsic support.  Implants are usually added at the time of mastopexy, because without implants the upper pole fullness that is gained will be quickly lost as the soft tissues stretch again.  Also the closer your implants are to the surface, that is the less tissue overlying to hide them. the more you will be able to feel them.  That issue cannot be judged by photos.  In summary, mastopexy with implants will restore a more youthful shape , and will add volume, but will not provide you with new tissues or "cure" their tendency to sag again to some extent.  I hope this helps.  Information concerning mastopexy with implants follows below.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

One of my breasts came down/drop. I'm wondering why this happened ?

Asked By:AnonymousANSWERS (1)
kellanns,

Pre-op and post-op comparison photos would help here, but late descent of implants is often due to inadequate internal support, particularly if implants are over the muscle, or if they are unsupported because of lower pole muscle release, when placed under the muscle. In either instance the lower pole of the implant is unsupported, except by the skin, and the weight of the implant can lead to skin stretch on one or both sides as time passes in a situation like this. This is particularly true with larger implants that place more demand on whatever support tissues remain.  For this reason, I do not place any implants in the subglandular position, and I always leave the lower pole muscle support intact when I place implants via the axillary approach, or by any other route. I find this to be the commonest cause of late bottoming out situations that require repair.  You should discuss this with your surgeon and seek their advice.  I hope this helps.  Bottoming-out is discussed at the link that follows:
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

How to get rid of an infection around a gummy bear implant after reconstruction from mastectomy?

Asked By:AnonymousANSWERS (1)
Justmealisa,

Unfortunately risks are higher with reconstructive situations, and infection around an implant is one of those risks, though usually it is associated with implant exposure.  A study of the outcome of implant infections that were treated with antibiotics alone was printed in June 1979 in the Plastic and Reconstructive Surgery Journal by the late Eugene Courtiss from MA, and the findings are still pertinent.  The finding was that even if the implant could be salvaged by antibiotic treatment of implant pocket infection, and that did not succeed often, the result was uniformly development of capsule contracture as a sequela to the infection.  Thus in most such instances, where there is evidence of infection surrounding a breast implant, the implant must be removed to allow the area to sterilize.  Resolution of the process will not prevent later insertion of a new implant, with tissue expansion, if necessary.  I am sorry to hear you are having this problem, and I hope that this information helps.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

Any Doctors out there perform insertion of drains or sclerotherapy for prologned breast seroma after augmentation?

Asked By:AnonymousANSWERS (1)
Elib,


Chronic seroma around an implant, or one that comes and goes, almost always indicates a low grade bacterial contamination, usually with Staph. epidermidis (common skin Staph.) which can be quite hard to identify on culture, and often produces relatively few white blood cells in the seroma fluid. Other sources of inflammation can also cause this, but are less likely in this scenario.  As the body tends to try to ward off such bacterial colonization, the process may wax and wane, but will not resolve. Draining will limit accumulation, but only lead to a chronic draining communication to the seroma cavity around the implant, and potential infection with other bacteria.  Sclerosis will just produce a capsule contracture, and so is not a viable approach, either. In a situation like this the least effective approach is likely to be excision of he capsule and removal of the implant for an interval. Some surgeons will try to replace the implant at the same time, but that runs the risk of recurrence in my view.  This is not a very common problem, so you will find varying opinions, so try to find a surgeon who has experience with the process.  I hope this helps.


provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

I am 3 months post revision from 335 cc saline overs to 500 cc HP silicone unders. Have they bottomed out? (photos)

Asked By:AnonymousANSWERS (1)
SSB,


In lateral view, your implants do appear to be low relative to nipple position, but that is accentuated by having your arms raised, and thus needs to be assessed with arms at side and someone else taking the photos.  Your post-op frontal photo does not appear to show bottoming-out, but the arms up photos do show what could be bottoming-out, and clearly you have had internal muscle release, as evidenced by the flexion deformities that you show in animation, so you are at risk for bottoming-out in the future. Repair of bottoming-out is technically demanding, and with severe muscle retraction often requires use of acellular dermal grafts or mesh placement to bridge the gap between the cut muscle and the position of the muscle origins on the ribs and low sternum that appear to have been sacrificed.  This generally requires special expertise and experience, and is why I simply do not cut these muscle origins during submuscular primary placement or submuscular transfer during revision of subglandular implants.  I hope that this helps.  Fairly extensive data regarding bottoming-out correction is found at the link below, and the related gallery and case links on that page.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

I had a breast reduction and lift almost 10 years ago. I have bad scares / keloids that are thick and ugly. Any suggestion?

Asked By:AnonymousANSWERS (1)
Dena,


Scarring is greatly influenced by genetics, but stresses on the skin and circulation during and after a large soft tissue flap-type procedure, such as breast reduction, can also impact scarring in a way that will not be as likely if a scar revision is done as the scope of the procedure and the stresses on the tissues and circulation are not as great. This is particularly true if you had areas of wound healing delay, skin separation, or suture extrusion that may have occurred with the original procedure, as all of those issues may occur with breast reduction.  You should see a Plastic Surgeon to discuss options in this regard.  Discussion of skin scarring and definition of hypertrophic (thick) scarring versus Keloid (genetically determined pathologic scarring) is discussed at the bottom of the page linked below.  I hope that this helps.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

Mentor Saline implants: What style and size should I consider to help me get as close to the wish picture as possible? (Photo)

Asked By:AnonymousANSWERS (1)
Negrura,

Your photos show that you will need a lift to correct your breast geometry, as well as implants to add volume, as your starting point shape is not suitable for augmentation alone. Remember, addition of implants only increases the volume of the breasts but will not change fundamental starting point geometry and the relationship of nipple position to fold and breast base position.  That said, you should plan to lose as much of your weight as possible so that you are as near to your target weight as possible when you proceed because the final volume outcome will be a summation of the implant volume and the existing breast volume, and that is how the geometry of the lift is determined at surgery.  If you go on and lose weight after the surgery, you are likely also going to lose breast volume, and the skin will become looser and the lift will stretch out sooner.  Realize also that mastopexy will not "cure" the tendency of your tissues to sag, and eventual loosening of the skin to some extent after mastopexy is almost inevitable, though not always to the extent that re-tightening of the skin is necessary.  I hope that this helps.  Information regarding mastopexy with implants is found at the link that follows:
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

Not happy with breast augmentation result, did something go wrong? (Photo)

Asked By:AnonymousANSWERS (1)
sfj,

It is particularly difficult to assess issues of symmetry, either before or after surgery, and particularly in comparison unless standardized and unclothed frontal and side views are used. This means photos taken by someone else, with your arms at the sides, eliminating distortion due to arm position and camera position, particularly if you take the photo yourself into a mirror.  That said, you are still early in your post-op course, and the breast on the left in the photos (your left if that is a bounced reversed photo) may still settle more and round out at the bottom to match the right breast.  Revision is sometimes needed, but start with good photos to assess actual symmetry.  I hope that this helps.
provider-Thomas M. DeWire Sr., MD (retired)-photo

Thomas M. DeWire Sr., MD (retired)

Plastic Surgeon

4.4 | 35 reviews

Thomas M. DeWire Sr., MD (retired) reviews

Thomas M. DeWire Sr., MD (retired)

RATING DETAILS

4.4
35 reviews

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Thomas M. DeWire Sr., MD (retired)
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10 Results
Breast Augmentation

chenoaspirit

who is he referring his pts to?

Who is he referring his patients to? He did my breast augment MANY years ago and they now are making me sick with an autoimmune disorder. He did an amazing job, I love them, they still look great but I did not know they need to be replaced after a length of time. I need them OUT and replaced, but I just learned he retired. I dont know where to go. He is the only one I trusted and he was the I expected to do this. I dont know where to go!!! I wish he had sent a letter to all patients, I know that would be work, but I feel abandoned.

$250Botox
PersimmonFrost

PersimmonFrost

47 Years Old ~ Botox Between Brows... - Richmond, VA

I decided to try Botox in 2013 for the touted asthetic effects and absolutely loved it ~ the added benefit that I did NOT expect was the elimination of my tension headaches! HUGE bonus! I get Botox between the brows about every 9 month - 12 months and am very happy with both the smoothing asthetic results and the elimination of any tension headaches. I have RA and recieve chemotherapy for my condition ~ RA can cause headaches because it affects the neck joints (as well as the internal organs and overall body joints - it is an autoimmune disease that has no cure). I would highly recommend Botox to anyone who is a headache/migraine sufferer and/or would like the smoothing skin benefits of Botox. Botox usually lasts about 9 months for me, but can last as little as 3 months for some - depends on one's individual metabolism - everyone is different. Procedure is painless - just a few mild needle pinches in the brow muscles and it takes about 5 minutes tops to do (if not less). One may also opt for injections in the upper forehead muscles and around the eyes - I've been told that the "around the eyes" injections provide and "eye lift" effect. My doctor is very versed in his practice and will advise me if I need any in a particular area - genetics play a very large role in how one's skin ages. So far, he said that between the brows, if anything, is enough for me - plus it's ridding me of my tension headaches. The cost depends on how many areas are done at one time and what region one resides in. I would guesstimate that Botox can cost anywhere between $250.00 ~ $1000.00, depending on how many areas that the client wants injected. One can be beautiful at ANY age, with or without makeup - just take care of your skin and don't forget the sunblock. Try to purchase makeup with sunscreen already in it - protecting the skin from sun helps tremendously in maintaining smooth skin. I'm headed to 50 years old and I'm doing my best to age gracefully ???? Much love! Updated on 20 May 2016: It's almost 4 months now and the Botox between my brows is still going strong - very happy with the smoothing effects and the lack of tension headaches. It tends to last quite a while for me - some it lasts for 3 months and others it can last up to 8/9 months. I will continue using Botox until I feel that I need a facelift :) Updated on 20 May 2016: Forgot picture ;) Updated on 6 Jun 2016: Recieved Botox between the brows in March 2016 and the effects are still showing - very happy with the results as well as the relief of tension headaches :) Possibly in August I will need another treatment, we will see how long this one lasts :) much love! (47.5 yrs old) Don't forget to use that sunblock this summer! xoxo

$5,900Breast Augmentation

cclark38936

23 Years Old, No Kids, Saline Implants - Glen Allen, VA

I got boob implants because I had been talking about getting them forever and once I was able to I did. It has increased my self esteem and confidence and it has helped me with my modeling career. I got the saline implants which are not harmful to your body if one erupts since it is made out of salt water, it will just dissolve. The most painful part of the procedure is after its done. My breasts were extremely tender and sore to the touch and any movement I made for about 4 weeks. Also you have to remember to continuously massage each implants so they do not get stiff or form to the side of your chest.

$5,800Breast Implants
Sharen54

Sharen54

47 Years Old and Saline Breast Implants. Wish I Had Done This Sooner! - Glen Allen, VA

I'm an incredibly cautious person by nature. I will study something to death before I jump in. Health first; everything else will fall into place. And although raised to believe real beauty comes from within, I struggled with weight and overall body image since having my boys via C-section in 1979 and 1983, respectively. I think I must have researched breast augmentation for about 10 years before I got the nerve (and money) to actually get it scheduled and do it. I researched plastic surgeons specializing in breast augmentation in Virginia for about five years (told you I study something to death...), and the name of Thomas DeWire, Sr., M.D. of Advanced Art of Cosmetic Surgery kept coming up. Women from all over the Country were recommending him. So I made an appointment. Loved his office and his staff. And I found him to be very knowledgeable. A bit cocky as well. Sometimes he comes across as a bit brusque....especially if you mention vitamins, supplements or holistic medicine. He pretty much poo-poos whatever you have to say on the subject. But, whatever. He's an awesome doctor. He initially had me take off my top and he took pictures with a camera connected to a computer. He was able to show me exactly what he could do given my unique physiology. I tell you, you just don't realize how asymmetric your body is until you see it up on a screen with a doctor telling you all about it. In my case, my left breast is larger than my right. This is how it was naturally, before augmentation. I was under the mistaken assumption that a doctor could somehow "even it up" using the saline implants. Nope. They have to work within your unique structure. Not sure if this is the same with silicone. In any event, I decided on an axillary approach (through the armpit). You can't even see my scars, they are so tiny. I liked the fact that the implant is positioned behind the muscle, like you have an added "support bra" thing going on. It also makes mammograms easier. Following surgery, I felt like there was a truck on my chest. But, Dr. DeWire had prescribed adequate pain medication, so I was good. I had bruising for several weeks, and it takes some time (a couple of months) for your breasts to drop and settle into proper position. I had some initial numbness, but this went away. I was taught to massage them daily, and I followed Dr. DeWire's instructions to the letter on this. I did not want to end up with capsular contracture! Knock on wood, my implants are now 7 years old, and I have not had any adverse effects from them. I absolutely love them, still. Eventually, of course, they will need to be replaced. I like the safety aspect of saline....but I probably would prefer the more natural look that silicone implants would give me. Perhaps by that time, I will have studied (to death) the pros and cons of silicone, and the choice will be easy.

$10,800Facelift

Happy Face1

Facelift/Brow Lift/Upper Lid Blepharoplasty - Richmond, VA

Prior to selecting Dr. DeWire as my cosmetic surgeon I consulted with several doctors in Virginia to discuss my expectations and receive their recommended treatment plans. I am seven days post surgery and so pleased with my choice of physician and the early results. Dr. DeWire is a terrific, experienced, highly skilled, board certified plastic surgeon. He is an excellent communicator and runs a very professional office. Both Dr. DeWire and his staff are very accommodating and focused on me, the patient. Dr. DeWire was very thorough and candid during my initial consultation. He did not try to "sell" me additional services. He described the choices of procedures and took the time to show me computer graphics of potential outcomes. I called the office several times prior to the procedure with follow up questions and his staff and/or Dr. DeWire responded promptly. The practice is very accommodating. I am so pleased with how natural the outcome looks just one week post op. The swelling has been minimal, bruising far less than I expected, and overall result excellent. Dr. DeWire clearly described the stages of healing post op. The pain was also minimal. The instructions pre and post op were very clear and I followed them exactly. Dr DeWire assured me if I needed to get in touch with him post op I could reach him. Other than the scheduled follow up visits I did not need to speak with Dr. DeWire. Dr DeWire interacted with me and my husband on the day of surgery pre and post op. He did not delegate this to his nurses. Although I was nervous he put me at ease. It was great to have the procedure in his surgical suite. I was not dealing with an impersonal hospital. I was seen the day after surgery, five days and seven days post op. Almost immediately after I arrived in the examining room for my follow up visits the doctor arrived. His bed side manner was exceptional. He did not rush me. I had a list of questions each time and he was very thorough in his responses. I highly recommend Dr. DeWire. My experience has been exceptional. The early results definitely exceed my expectations and I had high expectations. Again I enthusiastically recommend Dr. DeWire.

$5,900Breast Implants

madisonpicardat

26 Year Old Breast Implants - Glen Allen, VA

Knowing a few friends that had had the same procedure and their comments about it made me want to go along with having my breast done. I had been thinking about doing this for years and it was now or never. I was terrified of getting just an IV so I had to take a deep breath and suck it up. It was well worth it. The only cons I had were my parents that were completely against it. Now that they see the end result and how everything was handled and how happy I am with my appearance they are happy too.

$5,900Breast Augmentation

fitgal1229

Second Augmentation to Go Bigger - Richmond, VA

This was my augmentation revision to go bigger. I was very pleased with my initial augmentation, but decided after four years I wanted to go bigger. Best experience ever with both procedures and absolutely no complications! Dr. DeWire is very professional and performs all of his procedures in his OR suite in his office! Updated on 26 May 2015: Updated on 26 May 2015: Before and after photos and review of breast augmentation revision. Initial augmentation was great, just wanted to go bigger! Updated on 26 May 2015: You will first have a consultation where he will take photos from many angles allowing him to show you some options for sizing on the computer. He will go over in great detail the different types of implants with the pros and cons. After deciding what's best for you, you will then schedule your surgery date. I waited only 3 weeks to get in for surgery mostly due to my work schedule. Surgery is in the morning and has gone smoothly for me both times. You will follow up the next morning then again in about 5-6 days for suture removal. He used the axilla approach on me so very minimal scarring because he put the incision in my natural folds. He will provide you with pre-op instructions via email and post-op instructions the day of surgery. Very detailed instructions that are easy to follow!

$6,000Breast Implants

mlfrye

Middle-aged Happy Momma - Glen Allen, VA

I am a 39 year old mother of 3, and I did this procedure to feel better about the way I look and to get more lift and fullness to my chest. Dr. Thomas DeWire listened to everything I wanted and gave me exactly that. He took the time to listen to my concerns and talked with me for quite a while to get an understanding of what I wanted as well helping me to understand everything. He was honest and told me the things that he could do and couldn't do. I am very happy with my experience and the way everything turned out. I will definitely go back for anything else and will be referring everyone I can to Dr. DeWire. Updated on 15 Sep 2015:

$8,100Tummy Tuck
Kwilton

Kwilton

30-years Old, 3 Kids, Diastasis Recti, Much Needed Tummy Tuck! - Richmond, VA

I am on Post-Op Day 3 from Full Abdominoplasty with Diastasis Recti repair. I had my first child when I was 18 & my stomach was never the same. I had my third child 5 months ago & decided to have a tummy tuck done. I went into this expecting to be in a lot of pain & I honestly have felt great! I was up & walking the day of my surgery & have had minimal pain. I am taking Percocet when needed, 800mg of Motrin round the clock, & an antibiotic four times a day. It hasn't been bad at all. I'm sleeping in a chair with pillows behind me & propping my feet up. I have 2 drains that I cannot wait to have taken out! All in all, I feel great! Updated on 7 Feb 2015: Today was the first day that I did not wake up feeling stiff/sore. I did my dressing changes first thing this morning & it looks better & better everyday. The only complaint I have at this point is lower back pain & abdominal itching! I know it's all part of the healing process but I wish I could scratch my stomach! I took my antibiotic this morning & haven't needed anything for pain so it's been a great day so far! I go to see my doctor for my first post-op appointment in 2 days & I cannot wait! I'm hoping he will pull 1 if not both drains! Here's hoping! Updated on 8 Feb 2015: Feeling good today! I gave my baby a bath for the first time last night & even though I had to take my time & take frequent breaks, I got through it just fine. I'm doing my daily dressing changes & am still taking Motrin for any discomfort that I may have. I'm standing up straight & am feeling great. I cannot wait to go back to my doctor tomorrow & hopefully have the drains pulled! Hopefully! Updated on 9 Feb 2015: Saw my PS today for my first post-op appointment! He removed the steri-strips & pulled the drains out! And boy did that hurt! He grabbed both of those babies & yanked them out at the same time! Ouch! But it was over quickly & I think that was his goal! So happy their out. I need to take it easy for the next 5 days to prevent fluid build-up. He found 4 places right about the incision that are nectrotic. He said that he skin will peel off in those areas. Kind of bummed to see necrotic tissue. I read up on it & they say the healing time will be longer in those areas & it could affect the scar so time will tell how it turns out. I'll post a picture up close so you can see the necrotic areas. I actually felt better having the steri-strips on but I'm hoping in a few days, I'll feel better about having them gone. My PS said that I need to wear my binder for another 5 days. He said I can start sleeping in my bed again so I may try that tonight. I go back for another check-up next Monday! Hope everyone else is healing nicely! Updated on 11 Feb 2015: Feeling great! Getting around fine. Still having back pain & I'm not sure why. I'm standing straight & walking straight so I'm a little confused by that. Incision is looking better everyday! Still doing my dressing changes everyday & I haven't taken any Motrin in days. My PS told me "no twisting" so I'm trying to be various when I am moving around. I still have some bruising & swelling on the bottom of my tummy but it's getting a little better with each day! Updated on 11 Feb 2015: Updated on 17 Feb 2015: I'm 2 weeks post-op today! I feel great! I feel about 85% back to normal. I'm standing completely straight (my back thanks me), & lifting my children fine. I'm back to caring for them 100%. I saw my PS yesterday & he said I look great! I can resume light exercise next week. He wants to see me in 4 weeks & he's going to take pictures of me to compare "before & after". I can't wait! I haven't taken anything for pain in over a week. I'm sleeping without my binder & on my sides comfortably! All in all, this has been a great experience & I'd do it again in a heartbeat! Worth every $$$. I have my self confidence back & I haven't had that in years! So thankful! I'll post my 2 week pictures that I took this AM. Hope everyone else is healing nicely! Good luck to those who are about to have their surgery! Updated on 24 Feb 2015: Feeling fantastic! Almost back to normal. Still some soreness in the tummy but not bad at all. I can't wait to start exercising again! Here are some pictures that I took this AM! Hope everyone is healing beautifully!

$9,499Breast Implant Revision
silomi

silomi

38 Year Old, 5 Kids, Breast Implant Revision - Richmond, VA

Having nursed 4 kids for a year each, I had lost a lot of volume and could hardly fit into an A sized cup bra. So in 2012 I saw Dr. DeWire for a saline breast augmentation, at which time we thought we were done with having any more kids. He did such an amazing job that as a result we got pregnant with our 5th child, whom I also nursed for a little under a year. I did develop mastitis, which I did with most of our kids. The mastitis caused a local inflammatory response and thus triggered capsule formation in my right breast. Of course, after nursing our 5th my nipples also dropped and I had some skin sagging so I went and got a revision on Jan. 28th, 2015 with a Benelli mastopexy. I couldn't be happier with Dr. DeWire's work, professionalism and bedside manners!!!! I feel like a million bucks!!!! Updated on 1 Oct 2021: I'm still super happy with my saline implants and augmentation! Had mentor implants in 2014 and augmentation. Size I think was about 400 mL each. Nipples were also repaired after 5 breastfed babies! Pictures are from about a year after.