Doctor Q&A

Six months after explant, it is reasonable to start discussing revision options, but the best plan depends on skin quality, scar pattern, nipple position, and how much fullness you want. In the photos, there appears to be loss of upper-pole volume with some loose skin and mild breast descent after implant removal.

If your main goal is fuller breasts, reimplantation is usually the most predictable way to restore volume. A revision lift can improve shape and perkiness, but a lift alone will...

Reaching a healthy BMI of 24.2 takes an immense amount of dedication and you should be incredibly proud of your journey. What you are dealing with is purely structural loose skin and a small amount of residual stubborn fat, which is entirely normal after significant weight loss because skin loses its elasticity over time. Since you mentioned you are uncomfortable with the idea of surgery, I want to reassure you that nothing is "necessary" unless it is causing you physical discomfort like...

A reverse tummy tuck is usually reserved for patients whose main problem is upper abdominal skin excess that cannot be adequately pulled downward from a standard tummy tuck. In the photos, there appears to be loose and creased skin in both the upper and lower abdomen, with the lower fold also visible; photos are helpful, but the final decision depends on how the skin moves during an in-person exam.

If your priority is avoiding an upper scar, it is reasonable to ask whether a full tummy...

Having had hyaluronic-acid body filler dissolved does not automatically rule out BBL, but it makes preoperative evaluation more important. Fillers such as HYAcorp can leave residual product, scar tissue, nodules, or areas of inflammation even after hyaluronidase, and fat grafting should not be done into tissue that is still abnormal or irritated.

Before considering BBL, a surgeon should examine the buttocks and may use ultrasound or MRI to look for residual filler or pockets. Surgery is...

Evaluating the ideal height of a nasal bridge involves assessing the relationship between your radix—the deepest point of the nasal root and your surrounding facial features, particularly the brow and eyelash line. On a profile view, a structurally balanced nasal bridge typically begins at the level of the upper eyelid crease or deep superior tarsal fold, projecting outward to form a harmonious nasofacially balanced angle with the forehead. My suggestion to determine if augmenting your...

Based on the photos, significant asymmetry is not very noticeable. Everyone naturally has some degree of facial asymmetry, and even with surgery, achieving 100% perfect symmetry is difficult.
Rather than asymmetry, the main concerns appear to be the rounded nasal tip, the widened appearance of the nostrils, and the low starting point of the nasal bridge from an aesthetic standpoint. Especially when smiling, the widening appearance of the nostrils can also be improved. These areas do appear...

It is hard to tell anything from one photo. If the nostrils are only long, it may be possible without sutures because the nostrils become a bit shorter as the projection is lessened. Outside nostril sutures are only needed to reduce nostril flare. Be sure to see a rhinoplasty expert for consultation.

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 your thoughtful question. I commend you for taking the time to carefully research breast reduction procedures as you explore the options that will best help you achieve your aesthetic goals.

In the vast majority of breast reduction procedures, an areolar reduction is performed as part of the surgery. Because breast reduction involves reshaping the breast and removing excess skin and tissue around the areola, we are typically able to reduce the diameter of the areola at the...

Thank you for your question. It is definitely possible to go from a 36G to around a C cup, especially if your goal is significant relief from heaviness, neck/back pain, and better proportion. The main question is whether it can be done safely while maintaining good blood supply to the nipple and an aesthetically balanced shape. Continuing weight loss before surgery is still a good idea because it can improve healing and help the surgeon better judge your final desired size. Keep in mind that...

Dear YDahl,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Given your history of a breast reduction in 2009 and your current framework at 5'8" and 155 lbs, achieving a distinct upper pole fullness and cleavage without looking "too big" is a very common and highly achievable goal, but it requires navigating the unique anatomy of a post-reduction breast. Since your previous reduction likely widened your breast base and removed lower tissue, a moderate-plus profile or high-profile silicone implant would be ideal because they feature a narrower base...

180 Mini and 195 Demi are so close that you are not picking size at all, you are picking how much it projects out. Demi literally brings back the fill on top where you said it is lacking. 225 is right where it becomes the obvious augmented look you have said repeatedly you want nothing to do with, and to place 225 into an already 10-centimeter (narrow!) base, no, that will look huge. Stick with low Demi, make it 195s, it refills nicely and looks like yours, that is how narrow you are, there...

Thank you for submitting the photos. The best way for me to answer that question for my patients is to use the Crisalix app. This makes a 3D image of your chest and breasts. Then you can add specific implants to the images to see if you like it. The app can also demonstrate a mastopexy (lift) as well. Then you can make a confident decision. Hope this helps!

Liposuction removes a portion of fat cells from the treated areas, so those exact removed fat cells do not come back. However, the fat cells that remain in the treated and untreated areas can still enlarge with weight gain, which is why contour can change after liposuction. Some areas may gain more noticeably than others depending on your natural weight distribution and how much fat was removed.

In the photo, your waist, lower abdomen, and hip contour are visible, but a photo cannot show...

After a 90 lb weight loss, the best treatment depends on whether the issue is true loose skin, volume loss, or both. In the photos, there appears to be some softening of the lower face and jawline/neck area, but photos cannot show skin elasticity or how much tissue actually needs to be lifted.

Botox will not tighten loose skin, and fillers can help selected volume loss but may make the lower face look heavier if too much is used. Morpheus8 or other energy treatments can give modest...

It is quite common for a standard SMAS facelift and forehead lift to leave the central midface and the corners of the mouth unaddressed, as their lifting vectors primarily target the jawline, cheeks, and upper face. Based on your concerns , effectively lifting a sagging midface and correcting a downturned mouth typically requires a targeted deep-plane midface lift or an endoscopic lifting approach to elevate the malar fat pad vertically, often combined with a corner lip lift or strategic...

Please do not lose hope regarding the concerns you shared as there is definitely potential for improvement through a specialized secondary surgery rather than resignation. Suspected Ehlers-Danlos Syndrome (EDS) radically alters tissue elasticity and wound healing, which directly explains the persistent discoloration and the heavy, flaccid state of your eyelids despite your 2023 procedure. While your scheduled deep plane face, neck, and endoscopic brow lift will beautifully rejuvenate your...

Based on your photos, the signs of aging appear to be more pronounced in the under-eye area than in other parts of your face. The tear trough hollowing has become deeper and more noticeable over time, and there is significant volume loss throughout the under-eye region.
As we age, the fat and soft tissues beneath the eyes gradually descend. This can create heaviness over the upper nasolabial area while simultaneously causing the under-eye area to appear hollow and sunken.
In cases like...

Thank you for your photos. An upper blepharoplasty with trimming of the medial fat pads of your eyes should help to reduce your medial bulging, as well as trim off and contour the excess skin of your upper eyelids, resulting in a rejuvenated, more alert appearance. Board certified plastic surgeons are an excellent choice to accomplish this. This procedure can usually be done under local anesthesia only, if that is acceptable to you. A single suture, running under the skin, will close each...