Imagine Plastic Surgery - Riverside

A: Dear Ms. JenniferjenD-4, Thank you for your story, questions and posted photos. Unfortunately without an exam of your tissues and a complete review of your past medical history …. I can can only comment based your story and a single photo…. however I hope you find my comments helpful. My responses: 1)we all have both internal fat (located n your internal organs and pushing your belly outward) and external fat (on top of your muscles). Internal fat can not be treated by either liposuction or tummy tuck...only weight loss. 2)You did not mention your current height or weight. We often calculate body mass index (BMI) that helps us give you better advice. I recommend that you attain you goal weight prior to surgery. 3)If you have had children you most likely have a separation of the two vertical abdominal muscles (that are not repaired with liposuction). 4)their are three types tummy tucks: a) traditional (muscle repaired from breast bone to pubic bone) b) mini (muscle repaired from umbilicus (tummy button) to pubic bone) c) extended (like traditional tummy tuck but extends around at to hip area all will remove excess fat and skin of the lower abdomen. The remaining skin is stretched tight resulting in smooth abdominal appearance. 5liposuction will remove only external fat but may leave your skin loose and hanging. liposuction will not repair separated muscles 6)both liposuction and tummy tuck are often done together, except in the upper abdomen (May reduce blood flow and cause healing/flap problems at the tummy tuck incision. 7)the types of liposuction are: a)traditional suction asst. Liposuction (SAL) b) ultrasonic asst. liposuction (UAL) c) power asst. liposuction (PAL) d) laser asst. liposuction (LAL) e) water asst liposuction (WAL) are all effective and are secondary to the experience of the Plastic Surgeon 8)non surgical methods to help "shrink skin" after liposuction use RF: a) Vellashape III b) Thermi tight 9)Non surgical (ultrashape) is for minor isolated diet resistant areas. Conclusion: 1) based on limited information and not being able to evaluate you in person I would recommend you reach your goal weight and then have a traditional tummy tuck and liposuction to contour the flank areas. 2) I suggest you make several appointments with different Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery). My best, R. A. Hardesty, MD, FACS Diplomate and Certified by the Am. Bd. of Plastic Surgery Inductee Real Self Hall of Fame wwwimagineplasticsurgery.com 4646 Brockton Ave Riverside, Ca 92506 (951) 686-7600

A: Dear Ms. Knitypixy, Thank you for your story, questions and photos. Nothing substitutes for a personal evaluation and a face to face discussion of your options Unfortunately without a examination I can advise you in general terms, however I hope you will find them helpful. PHYSIOLOGY Breast "sag" or "hang" because the "skin bra" is larger than the breast tissue. Over time the weight of breast tissue can continue to stretch the skin and acts like a "rock in a sock". Some women develop breasts that sag but more often the cycle of expansion and contraction of breast tissue (during pregnancy and/or after weight loss) results in a permanent stretching of the skin. Technically the "viscoelastic elastic" properties of the skin have been irreversibly altered. An analogy is like a pair of panty hose that have lost their elasticity. Unfortunately there are no known reliable non surgical techniques to significantly shrink the skin. BREAST LIFT Mastopexy (breast lift) involves shaping the breast, repositioning the nipple areolar complex (NAC) and when needed reducing the size of the NAC, and by removing excess skin that causes the sag of the breast. The nipple is left connected to the breast tissue. Each of the below techniques involves a progressive removal of excess skin and builds on each other to lift and contour the skin "bra" to the shape of the breast desired. SHAPE Depending on how much excess skin and desired shape the three main types: 1)Peri areolar doughnut shaped scar around NAC. Primary result is elevation of the NAC. Minimal shaping . 2)Vertical lollipop shaped scar. Elevation of the NAC and shaping the breast in a horizontal plane. More shaping 3)Inverted "t" anchor shaped scar. Elevation of the NAC, shaping the breast in both a vertical and horizontal and plane. Most shaping. Depending on your desires, shape and look of the breasts your chosen Plastic Surgeon will decide what type of Mastopexy is required. I request that patients bring in photos of "ideal" or "model" photos to better help me understand what the patients needs, wants and desires are. SIZE Breast size will not significantly change because skin is only resected. SENSATION The nerve to the nipple areolar complex (NAC) is directly under the NAC and is rare to be disturbed by removing the excess breast skin during a mastopexy. The surrounding breast skin may have some short term numbness but usually returns. UPPER UPPER POLE FULLNESS Current mastopexy techniques will not often maintain over the long term the "upper pole" fullness patients desire. A small breast breast implant is placed to can be to create the upper pole contour and will not increase size substantially. SCARS Scaring is always a concern. However there are various postoperative "anti scar" programs to optimize, reduce and treat scars. In my experience if the desired goals of shape of the breasts and positioning/size of the NAC is obtained .... The patients rarely complain about the scars. AREOLAR SIZE The size of the areolae (pigmented area around the nipple) can be not only changed location and size. I recommend that you take a “bottle cap” press firmly over your areolae and choose the diameter you desire SHAPE OF THE BREAST I suggest you you collect several "model", “inspirational” or "goal" photos. This will help determine which procedure is needed/required to reach your goals. RECOMMENDATION Collect your goal photos, determine the diameter size of your areolae and then make a appt. with Plastic Surgeon, who is experienced, who is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery). My best wishes, R. A. Hardesty, MD, FACS Diplomate and Certified by the Am. Bd. of Plastic Surgery Awardee: RealSelf Top 100, Inductee RealSelf Hall of Fame wwwimagineplasticsurgery.com 4646 Brockton Ave Riverside, Ca 92506 (951) 686-7600