James F. Boynton, MD, FACS

In general, no I would not recommend a "skin only" facelift in someone in their 20s.  I don't favor "skin only" facelifts.  The deep layer of the face known as the SMAS has to be lifted and supported in any version of a facelift that I do so as to take tension off the skin. If only the skin is tightened then the tension will be on the skin only and cause scar widening. Also the skin does not have the "power" to maintain any sort of result over time.  It will simply re "loosen" quickly over time.  If you only seek a few millimeters of face-lifting, then I would recommend meeting with one or several board certified plastic or facial plastic surgeons to discuss in consultation.  Energy-based devices may be an option for you as well.  Good luck!

Thank you for your question.  I agree with my colleagues.  I think a "mini facelift" or "cheek lift/jowl lift" will help you.  It will improve the shape of the lower face and jawline region immensely.  Energy devices cannot lift the jowl as well as surgery.  This can be done with a well-concealed facelift incision.  Sometimes, removal of the buccal fat pad through a small incision inside the cheek can be helpful and accentuate the lower cheek shape and lessen the "chubbiness" that bothers you as well.  I hope this helps!

Everyone ages differently and some patients will come to need another lift several times in their lives.  Sometimes this can be as soon as 10 years and sometimes that is even sooner. It all depends on the techniques that are performed as well as the genetics, sun-damage exposure and aging patterns of the patient. Many patients in the 40s opt for a "mini lift" or possibly a "short scar facelift" depending on their anatomy.  This can be a excellent first option but there is no way to eradicate aging and recurrent laxity.  I tend to recommend a more conservative approach and re-lifting at 10 years - if it's necessary  - in my opinion is always better than over-correction, over-tightening and facial distortion from doing too "aggressive" of a facelift which is something we all recognize when we see it.  I hope this helps!

Thank you for your question.  In reviewing your photos, I would recommend starting with neurotoxin (i.e. Botox). This can treat the "platysmal bands" that are bothering you and can do quite a nice job in most cases. There are a number of neurotoxins available (Botox, Dysport, Xeomin, and now Jeuveau).  I would recommend starting with this and seeing how much improvement you get. The next step may be neck lift which could range from a less invasive neck lift such as Neck - Ellevate or ICLED or even a suture suspension neck lift with percutaneous division of the plastysmal bands. A formal platysmaplasty may also be necessary.  I would visit with one or several board-certified plastic surgeons in your area to discuss your options.  Good luck!

Thank you for your question.  I agree that it is fine to remove one and then the other drain.  This is very typical based on the amount and color of the drainage over time.  Based on your description of differential swelling on one side, I would recommend contacting your plastic surgeon to be examined for that.  Sometimes this can be caused by a build up of fluid (called a seroma).  Compression garments can help manage but many times they need to be aspirated if that is indeed what is going on.  The only way to tell if that is present is an in-office physical exam by your plastic surgeon.  I would ask your plastic surgeon about this.  Good luck !

Thank you for your question. I agree that the "yellow skin" you are seeing 3 weeks after your tummy tuck procedure is likely resolving bruising which can be normal for that time period of healing after surgery.  I would make an appointment to discuss your concerns with your plastic surgeon.  Sometimes there can be more going on than can be gleaned from a photograph and it is important to get an in person exam to make sure everything is healing properly and there are no fluid collections in that area that sometimes require attention. Good luck!

Thank you for your question.  I also agree that it is not possible for you to achieve your desired outcome without a lift.  I would recommend breast augmentation and lift but not together, as two separate procedures.  I do think ultimately you will want both.  Decide what is more important to you now - added volume or "up lift".  You can do either one first depending on what bothers you most.  Augmentation alone, even with a bigger implant will not give you the desired look that you are seeking.  The nipple will still look lower after augmentation until you come back and do the lift.  It is ok to come back and decide on a lift later.  It also allows the breast skin to relax and puts less tension on the breast lift incisions than when it is done together. I would visit with one or several board certified plastic surgeons in your area that specialize in aesthetic breast surgery.  Good luck!

Thanks for your question.  I agree, you do not have tuberous breasts.  In reviewing your pictures, you have ptosis (more on the right than the left) as well as some significant asymmetry in breast size which is very normal and common.  My recommendation would be to try to achieve the best breast enhancement and breast symmetry which I would do in two procedures.  I would do "differential breast augmentation" which means two different size silicone gel breast implants, followed by a breast lift.  I do think you will need a breast lift, but I think it is safer to "stage" it and do it 3 - 6 months after the breast augmentation.  The smaller left breast would require the larger implant; however, the skin can only stretch so much with expansion and that will limit your selection on the left.  The smaller implant will have to go on the right breast, which is the breast that for sure needs the breast lift.  The left breast may not need a breast lift.  I typically wait until 3 months after breast augmentation and then at that time would do a breast lift both sides.  I would discuss your concerns will one or several board certified plastic surgeons in your area that specialize in aesthetic breast surgery.  Good luck!

Thank you for your question.  I agree with my colleagues that it is impossible to tell if anything was harmed by your slight lift with your cat without photos and examination in person; however, if anything "tore" or "pulled free" or you had a hematoma, you would have symptoms such as severe pain, swelling, and even bruising.  If you are not in increasing pain and based on the 5 lbs of your cat which is usually a normal weight to be able to lift after surgery in most cases, you are probably fine.  I would still recommend notifying your plastic surgeon and making an appointment to allay your concerns and fears and let he or she check you in person to make sure everything is ok.  I hope that is helpful.  I hope you do great!

Thank you for your question.  Yes, it is very normal to still have some muscle spasms at 2 weeks after subpectoral breast augmentation (under the muscle).  I think it is important to discuss your concerns with your plastic surgeon, since he or she knows your anatomy best.  In my practice, I recommend valium which I think is excellent for relieving muscle spasms and tightness, especially at night.  I have also found, in my experience, sometimes the recovery can take slightly longer with textured implants compared to smooth round implants.  Heat and frequent showering can also be helpful.  Again, it is important to discuss your symptoms with your plastic surgeon so that he or she can give you the best management plan. Good luck!