William H. Huffaker, MD (retired)

You need to give yourself more time.  There is always a potential problem when you work on the capsule on one side because that side will tend to be looser. Over time the capsule will likely tighten a little on the left and the right side swelling will disappear allowing the right to drop somewhat.  I would expect them to be more symmetrical in 3-6 months.  If not, a release can be done at that time.

From your photos, you appear to have loose skin as well as a large amount of intra-abdominal fat.  The excess skin can be removed, but there is a limit on how much compression of the intra-abdominal fat you can have  done.  If the muscles are tightened too much and excess pressure is placed upon your intra-abdominal fat, circulation can be restricted in the portal vein and vena cava. Weight loss before surgery will give you a better and safer result.  I hope this answers your question. Good Luck.

From your photos, you appear to have primarily a weakness of your abdominal muscles and not excess skin.  You would benefit from either an endoscopic approach or a small lower incision.  Your muscles will have to be tightened up all the way up to your xyphoid.  Good Luck.

From your photo you appear to have a moderate amount of ptosis (raising your arms lifts your breasts as well).  A crescent lift is actually a nipple-areolar lift.  It really does not lift the bottom of the breast much.  A Circumareolar lift (going all the way around the areola) is similar to the crescent lift but is able to tighten up the breast skin slightly and to reduce the size of the areola.  The vertical (lollipop) lift by removing skin beneath the breast gives much more lift than either a crescent or circumareolar lift.  The anchor lift by removing skin in both the vertical and horizontal directions is used to lift a longer breast which hangs further downward.

I would recommend a vertical lift for you.

If everything goes well, you would probably do ok as an outpatient.  However, I would recommend staying overnight after having those procedures.  I normally keep an iv in overnight for fluid replacement as well as a urinary catheter after a mommy makeover.  I can also administer stronger pain medications while in the hospital.  I always inject Marcaine or Exparel while in the OR to help with the pain afterwards.  As the length of the operation exceeds 4 hours, I prefer to keep the patients overnight.

From your photo, your labia appears to be very normal.  You have nothing to be embarrassed about.  A labiaplasty will tuck your inner lips in and make them appear straighter.  It could easily be performed under a local anesthesia.  Good Luck.

This is a frequent question.  Better symmetry can be achieved with a bilateral approach. Certainly you can do just one side, but from looking at your photo, you will achieve a better result by working on both sides.  Good Luck.

From looking at your photos, a central wedge technique would be best to correct your problem.. A clitoral hood elevation would also probably help, but it is a little difficult to tell from a photo. These can be performed in the office under local anesthesia.

The pigmentation will be improved by the surgery itself. Much of the pigmented tissue will be removed.  The remaining portion will be tucked in and be tighter.  Pigment is difficult to remove with topical agents.Good luck.

Most of the standard information on any cosmetic procedure will be supplied to you  by the office staff along with written information.  The important questions that you DO want to ask are more specificl questions.  

Size and location of the incision

Type of implant and why

Do I need a lift?  What type of lift?

What is your experience?

What is your revision policy?  And follow-up policy?

There should be a lot of discussion on size.  Do you have 3D Imaging?  Bra inserts?

Good luck!

Sometimes there is just a small amount of extra tissue on top of the chest muscle and this can be suctioned easily. Sometimes this extra breast tissue can be larger and more to the side of the chest muscle in the axilla.  This tissue in my experience is easier to excise. I more often than not would also use a small drain in this area.  This tissue is normally more fibrous and is closer to significant vessels and nerves in the axilla.  These structures are less likely to be injured with direct excision than liposuction.  Good Luck!