Breast Augmentation

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Deep Plane Facelift

Breast Implant Revision

Breast Lift with Implants

Breast Lift

Hi there, thank you so much for your question, and thank you for taking the time to share you photos. What you are describing and showing is called a "double-bubble deformity". This happens when the structure layer of the bottom crease/fold of the breast was disrupted during surgery. I can appreciate that this causes concern for you, and this can be sometimes challenging to fix. A revision would involve tightening the pocket around the breast implant and then reinforcing the bottom part to the fold to prevent it from dropping. I will typically use an internal mesh in this case to reinforce the area as well. 
As far as capsular contracture is concerned, this is hard to tell from the photo. However, if you feel that one side is becoming a lot more firm than the other side, this could be an early sign of cap con.

I had an augmentation 6 months ago and my implants have dropped considerably. I have pectus excavatum predominantly on my right side. To combat this my doctor chose 345cc on the left and 275 on the right. My nipples were positioned on the higher side pre surgery and I had very little breast tissue. Now that they have dropped or bottomed out, my scars are very visible, my nipples sit very high making it challenging to wear low cut tops, and the implants appear uneven now that they sit below my chest deformity. I also see some noticeable Rippling and have concerns of left side capular contractor. Let me know your thoughts.

My implants have dropped below the crease. Is a revision worthwhile? (Photos)

Hi there, thank you for the question and thank you for sharing your photo. Given your measurements and photo, implant placement at the time of a breast lift would not be a good idea. This is due to several factors: 1. Nipple blood supply, high likelihood of nipple necrosis 2. Issues with controlling the "pocket" to contain the implant in the right position 3. Overall shape of the breast
The best and safest way to manage this would be perform a lift first, allow your body to recover, and then place the implant as a second stage.

Hi I’m 34 years old looking at havjng a breast uplift with implants i have spoken to a surgeon who would do a uplify with implants for me but i have to measure 35cm or less drop from my collar bone to my nipple to reduce the risk of having my blood supply to my nipple as an issue. I am bordering just over the 35cm drop from the sag from my breasts basically what is the % chance of me getting the issue with the blood circulation if I opted to have the implants with the lift due to this? Thanks

Breast uplift & implants - what are the risks of blood circulation issues if breasts are sagging lower than recommend? (Photo)

Hi there, thank you for your question and thanking for sharing your photos. It seems like you are looking for a lifted and fuller breast appearance without getting breast implants. It also sounds like you'd like to go slightly smaller in your bra size, D to a full C. As you mentioned, I think a lift would get you to the desired bra size, and the auto-augmentation can help with a bit of upper-pole fullness. However, even with the internal mesh, you would not be able to get a significant amount of upper pole fullness without implants. The internal mesh mainly does a better job at maintaining the bottom part of the breast and reducing the chance of the breast "bottoming out". You could consider fat transfer to the upper pole, which can provide you with some extra fullness but not as much as an implant would.

It was recommended I get an internal mesh with an anchor breast lift. I agree that I do need and want a breast lift after breastfeeding children. I am trying to determine if I can achieve the results I would like without an implant. Maybe auto augmentation. I was hoping for a lifted and slightly more upper pole fullness or a little more round than the current ski slope I have. I wasn't sure if that was possible without an implant. I am 40. 5'7" and 135lbs. Hoping to maintain a minimum full C (current is 34D and sometimes 34C).

If I get an anchor breast lift with internal mesh, can I achieve slight upper pole fullness without an implant? (Photos)

Hi Lydia, thank you so much for your question and sharing your photo. Breast rejuvenation is a very personal choice, and procedures can depend on your goals. Assessing the position of the nipple on the breast is typically the first thing to look for, so a lift (and potentially a reduction) would be beneficial to reposition the breast and nipple to a more rejuvenated position. A lift or reduction would not address loss of volume at the upper part of the breast/chest. If this is a priority, then implants can be discussed. Other areas to assess include symmetry of the breasts, areola size, and fullness around the breast (like in the outer chest area) that can be contoured with liposuction. An evaluation with a plastic surgeon would be best in terms of understanding your goals and your ideal result. Hope that helps!

Hello! I'd really like my boobs to look good again as they are not where I want them. Docs, I'd like your evaluation and what procedure options. Thank you very much.

What are the best options to make my boobs look good again? (Photo)

Hi there, thank you so much for your question. From your question, it looks like you had a deep plane face and neck lift 1 year ago. The photo that you uploaded depicts a "Cobra-neck appearance". This can happen when the neck muscle (the platysma) was not stitched together and/or when too much deeper tissue/fat was removed in the middle of the neck. 
This can be a challenging condition to address, but it would typically require a revision to stitch the neck muscle together in the middle, sometimes stitching the deeper muscles together (anterior digastric) and sometimes adding fat into that area as well.

i had dp fl/no at 55. im now 56. 5’1, 115lbs, fair skin

Will I need a revision? (Photo)

Hi there, thank you for your question! You are asking about a breast augmentation without a lift or areolar reduction, but you are concerned with the size of your areola. With a breast augmentation, the nipple/areola will typically move upwards slightly, and depending on the implant size, it may also make your areola even larger. It's hard to determine based on the angle the photo was taken, but a lift may be needed to position the breast and nipple in a more ideal position for the implant. If a smaller areola is a priority, then a reduction using an incision around the areola (and potentially a vertical lollipop incision if a small lift is needed) would be necessary.

Hi there! I would love to get an inquire about my actual situation. I have had pregnancy before, and I always had breast smaller and I’m looking forward to get a breast augmentation soon but my main concern is that my areolas are too big. Although I dont mind them at all, I dont want to reduce them but is it still possible to get a breast augmentation without lift or areolas reduction in my case? I just want larger breast with implants and not looking forward to reduce my nipples .

Large areolas - Can I have breast augmentation without a lift or areola reduction?

Hi Milli79, thank you so much for your question. This is a really common question I get in my clinic as patients often want to know what size implant to use to achieve a specific look. The answer is quite complex and as you have mentioned, it depends significantly on your breast width or diameter. The advantage of the Motiva Ergos is that it has a teardrop shape when sitting up to give that natural slope look, whether above or below the muscle. 
It's hard to say without examining or photos what the ideal size would be, as this still depends on how much existing breast tissue you have and whether you would also want to have fat transferred at the same time as the implant augmentation. If 10.5cm is the correct measurement, then yes the ideal implant size would fall in the 215-245cc range. A difference of 15cc is very minor and would not contribute a large amount to the final result (at most quarter to half of a cup size). A good way to see for yourself would be to try some sizers on under a bra to see how you like the fit.

Hello there, I am having some trouble understanding what size would give me the desired outcome. I am 5"3'-5"4' , 118 lb. Pretty lean and athletic, 47 years old, very small breast tissue ..I am A cup. Iwas suggested to go under the muscle, dual plane as my skin is pretty thin (less then 2 cm). Diameter of my breast in around 10,5 cm. I want Motiva ergonomic Demi projection..with that diameter I could go 230 cc or 245 cc. I would like a very natural look, natural slope...don't care about cleavage without a bra. But I would like a small natural C cup...which cc would most likely give me tha outcome without looking augmented?

A cup to small, natural C cup - what CC amount should I choose?

Hi there, thank you so much for your question. I'm sorry that you are dealing with long-term issues related to radio-frequency treatments. This can sometimes occur from thermal injury to the deeper tissue like the fat underneath the skin. As you may have noticed, HA filler does a great job at adding volume, but this is temporary so it will dissolve with time (or sometimes migrate depending on where it's placed). A more permanent intervention would involve either a face lift or fat transfer (grafting). 
I like to think of this as a sausage or water balloon. With age or fat loss (from weight loss or from RF treatment), there is often times more skin (think the sausage lining/balloon rubber) and lack of volume (think sausage filling/water in the balloon). If there is skin excess causing folds or jowls, then a facelift would be needed. Additionally, if there is sagging of the fat or soft tissue under the skin, a face lift can be done to reposition them. If there is loss of that sausage filling, then fat transfer would be beneficial.
That is a high-level understanding of the differences between the two procedures. It's hard to determine based on just the partial photos if a face lift would be needed, but volume loss/atrophy would best be treated with fat transfer to those areas. This can be in the form of microfat and nanofat (this does a great job at improving the texture of the skin and glow through the stem cells processed in the fat).

I am 55 years old and unfortunately experienced significant facial fat loss after undergoing RF treatments a few years ago. This has left me with flat cheeks and visible dents, as well as a pulled or uneven smile caused by a dent above the smile line. In January 2025, I had hyaluronic acid filler placed (½ syringe on each side), which did help, but only to a limited extent. While I did notice some improvement, my cheeks are still quite flat and the dent affecting my smile remains. The filler seem to have now gone. I’m feeling unsure about what treatment options might work best in my situation and would really appreciate advice on how RF-related fat loss and smile distortion can be addressed safely and effectively. Thank you very much for your time and guidance.

Flat cheeks, visible dents and uneven smile following RF treatments - Facelift, Fat graft, cheek lift or filler ? (Photos)

Hi there, thank you for your question! I can definitely understand your concern with regards to choosing a qualified anesthetist. CRNAs as well as anesthesiologists are widely utilized in many office-based surgery suites as well as surgery center and hospital ORs. I have worked with CRNAs who regularly work in cardiac operating rooms doing open heart surgery as well as anesthesiologists just out of training. The best way to address your concern would be to speak with your surgeon to express your concern as well as ask for the experience of the anesthetist. Thorough communication is key to address your concerns!

I have a lower FL amd neck lift scheduled for Jan 7, and just found out my PS uses a CRNA and not a full on anesthesiologist. I’m kind of uneasy about this and wanted to get some expert opinions. The surgery suite is in her office. Thanks!

Is it safe to use a CRNA instead of an anesthesiologist?

Hi there, thank you for asking as this is a great question! Sometimes, significant overhanging skin as well as a large hernia can contribute to lower back pain due to the imbalanced strain on your back. However, minimal loose skin and rectus diastasis do not typically cause back pain. Tightening the diastasis with rectus plication can help with core strength though, but your lower back pain may need to be evaluated by your PCP/physical therapist/back specialist.

I’m 5’6”, 120lbs, workout 5-6 days a week, am toned but have a little loose skin around my belly button due to 3 pregnancies. I have had an umbilical hernia repair that needs to be repaired again, diastasis recti, and have had a partial hysterectomy. I have constant low back pain from “holding in my core” all day, every day. And wondered if a tummy tuck, hernia repair, &amp; muscle repair would help strengthen/tighten my core and give some low back relief?

I have constant low back pain from “holding in my core” all day. Would a TT / muscle repair help with low back pain?

Waylon Zeng, MD

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Plastic surgeons specialize in the full spectrum of cosmetic and reconstructive surgeries for the face, eyes, nose, breasts, and body.

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I don’t usually write reviews, but Aestira absolutely deserves one. From the first visit, everyone made me feel welcome and at ease. Dr. Zeng spent so much time getting to know me and answering every question, which honestly made all the difference. The space itself is calm and welcoming, and the entire team goes out of their way to make you feel cared for. It never felt transactional—more lik...

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