Doctor Q&A

When you increase implant volume but keep a moderate profile, the implant usually becomes wider. That can work only if your breast base width, soft-tissue coverage, and existing pocket can safely accept that extra width. If a 400 cc moderate implant is too wide for your chest, it may increase the risk of side fullness, implant malposition, rippling, or a less natural shape.

A higher profile implant does not automatically mean an obviously augmented look. It mainly means more projection for...

Your photos show abdominal fullness with some skin laxity, and congratulations on losing 68 pounds. At 5'4" and 200 pounds, your BMI is about 34, which is why some surgeons may decline surgery or ask for more weight loss first. This is not a judgment about your effort or muscle mass; it is mainly about safety and predictability.

A tummy tuck removes loose lower abdominal skin and can repair muscle separation when present, but it is not a weight-loss operation. At a higher BMI, the risks of...

Yes. Based on your description and the photos provided, it appears that your primary concern is the amount of tip projection seen on profile view rather than the appearance of the nose from the front. This is a common request, and in many cases it can be addressed with a very conservative rhinoplasty.The goal would not be to create a dramatically different nose, but rather to subtly reduce tip projection while preserving your natural appearance and maintaining harmony with your facial...

Your photos show a lean, fit frame with what appears to be limited visible donor fat, so the amount of added roundness from a second BBL may be more modest than in someone with more available fat. A second BBL can sometimes improve contour, hip-to-waist transition, and symmetry, but it cannot reliably create a large change if there is not enough safe donor fat to harvest and transfer.

Fat survival varies, and careful aftercare helps but does not control everything. The key questions are how...

First, please do not feel embarrassed — external hemorrhoids are extremely common, your surgical team has seen them countless times, and they are simply a medical detail to plan around, nothing more. The reassuring news is that they should not complicate the surgeries you are planning. A tummy tuck, implant removal, breast lift with fat grafting, and liposuction are all performed in completely different areas of the body from the anal region, so your hemorrhoids will not be in the...

I understand all your concerns. After losing weight, usually I recommend having a lower body lift (circular abdominoplasty), because with that procedure we can reposition in a better way the glutes, the anterior and lateral thighs and lower back. The aesthetic result we can achieve is much better than a standard tummy tuck. We can add liposuction in the back and flanks for a better contour, add fat to the butt and add a breast lift without reduction.
We can do all these procedures in the...

There are many techniques for a breast reduction. I personally have never done a full nipple graft because I think we can lift as much as needed with a specific technique for that.
I would absolutely consider doing a technique that doesn´t involve a full nipple graft.
Every case has to be studied appropriately and decide what technique is best for you.
Feel free to contact us for an evaluation.

Thank you.
Dr. Salvador Medina

Thank you for sharing this so openly. First, please know that what you're describing — physical pain, difficulty exercising, and constant self-consciousness with a 34DDD+ chest — is exactly the situation that breast reduction surgery is designed to treat, and 20 is absolutely an appropriate age to consider it. Once breast development is complete (usually by the late teens) and your size has been stable, there's no medical reason to keep waiting if the symptoms are affecting your...

Hi and thank you for your question. Speaking generally about the process of liposuction, it's used more so to remove adipose tissue. What makes liposuction of the breast difficult and oftentimes not recommended is that breast tissue tends to ne made up of largely fatty adipose tissue. Distinguishing between these 2 different layers is often difficult and can't be done properly using liposuction techniques.
The only time I use liposuction in regards to the breast is if I want to contour out...

Good morning! It’s very common to still have a small amount of milk production even after weaning, especially after breastfeeding for an extended period of time. In most cases, this does not interfere with breast reduction surgery, and I agree with your plastic surgeon’s guidance.
The biggest thing is avoiding frequent checking or expressing the milk, since stimulation can encourage continued production. Residual milk during surgery or early healing is usually manageable and typically res...

Thank you for this important question. Modern silicone implants are filled with a cohesive ("gummy bear") gel, so when the shell tears the gel tends to stay in place rather than spreading. This is why most silicone ruptures are "silent" — they often cause no symptoms at all, and many women have no idea anything has changed. When there are signs, they can include a change in breast shape or size, new firmness, lumps, a different feel to the breast, and sometimes discomfort. The...

Yes, breast implants can often help restore volume after a breast reduction, but the relationship between grams removed and implant volume is not a direct one-to-one conversion.
In your case, having approximately 400 grams removed from each breast does not necessarily mean that a 400–425 cc implant will return you to your exact pre-reduction size. Breast tissue is a combination of glandular tissue, fat, and skin, while implants add volume in a different way and create a different shape. F...

The degree of breast sagging is significant enough that a breast lift should be strongly considered.

While it is possible to undergo breast augmentation with implants alone, it is unlikely to provide a substantial lifting effect. It may improve the loss of upper breast fullness to some extent, but using larger implants could result in an unnatural appearance, known as a waterfall deformity.

For this reason, I would recommend undergoing a breast lift (mastopexy) in addition to augmentation.

Hello. For a better projection, upper pole fullness and better cleavage go for round implants. For subtle and tear drop shape choose anatomical. However, there is chance of implant rotation in anatomical implant. Also consider pros and cons before choosing the implants. For any further queries you can reach out to us.
Thank you.

Regards,
Dr. Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai, India
+919833571333

Because a DIEP flap depends on the abdominal skin, fat, and perforator blood vessels, any liposuction near the abdomen, waist, or flank area should be discussed with your microsurgical breast reconstruction team before it is done. Liposuction of the lower back and sides may not directly enter the DIEP flap itself, but swelling, scarring, contour changes, and changes in available tissue can still affect planning, donor-site closure, and symmetry.

If your reconstruction surgeon feels...

Your photos show mild smile-line/nasolabial fold prominence that becomes more noticeable with expression, without an obvious lower-face or neck sagging pattern. At age 32, this is usually more related to normal facial movement, subtle midface volume loss, skin quality, and facial anatomy than to something a facelift would reliably correct.

A facelift mainly improves jowls, loose lower-face skin, and neck laxity; it is not the best operation for lines that appear mostly when smiling. Options...

Based on the photo, this appears to be a small residual dog ear or standing cone at the lateral aspect of the upper blepharoplasty incision. Fortunately, this is typically one of the more straightforward revision procedures in eyelid surgery.At two years postoperatively, the scar is fully mature, so further spontaneous improvement is unlikely. If the prominence continues to bother you, a minor revision can often flatten the area and improve the contour. In most cases, this involves excising...