Doctor Q&A

If your nipples were symmetric prior to surgery, then there is a good chance the symmetry can be improved by adjusting the implants. If you have photos of symmetric nipples prior to surgery, seek a consultation with a board-certified plastic surgeon and bring your photos with you at the time of the visit.

Grade 1 is a normal capsule. The breast appears and feels normally soft. Grade 2 the breast appears normal and is slightly firmer than a grade 1 breast and not often noticeable to the average person. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Hello,
Thank you for the question. This can be fixed with simple scar revision.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Optimal surgical plan is always best determined based on a physical exam and your unique measurements. However, based on the degree of ptosis you have, a small volume augmentation is unlikely to give a result that you are pleased with. If you are hoping for a low-moderate volume augmentation, than a lift may also very likely be needed to fully address your concerns. I would recommend finding a well-qualified plastic surgeon who can discuss the roll of combination procedures that will more...

In patients aiming to transition from a B cup to a natural-looking C cup who have wide-set and lower-positioned breasts, selecting a round implant in an appropriate size and profile based on breast base measurements can enhance upper pole fullness and contribute to a visually narrower cleavage, though final decisions should always be made after an in-person examination and precise measurements.

It is unlikely that you can cause any damage to the muscle repair after 15 months. A follow-up visit to your surgeon would be suggested for conformation.

A standard tummy tuck will remove a large portion of the tattoo, but it is unlikely to remove all. Discuss this with your surgeon during a consultation. He or she can mark out the anticipated tissue resection and provide a good estimate of what would be excised.

Congratulations on your tummy tuck! I know it's hard to be patient but you are still early in your recovery and can expect changes ahead as swelling resolves and healing continues. Continue to follow the instructions from your surgeon. If a revision is needed it won't be known for several months.

There are many medication alternatives to manage pain after a tummy tuck. Narcotic based pain medication is typically only needed for the first few days to a week. Some don't need it at all. Speak with your surgeon about your preference for medications. Together you can determine what is best for you.

There are different types of tummy tucks with different lengths of incisions. Each patient is evaluated to determine the best incision for them. The goal is always to keep them low so that they can be hidden beneath undergarments and swimsuits. The shortest incisions are with the mini tummy tuck. The standard tuck is about hip to hip. The extended tummy tuck goes further around the hips and the circumferential tummy tuck goes all the way around the body. Any existing c-section scar...

Body contouring procedures have become increasingly popular and can help men and women recontour their body in adulthood. If you have stubborn areas of fatty accumulation that are more resistant to diet and exercise, you may be a candidate for body sculpting liposuction performed at Kare Plastic Surgery in Santa Monica. Liposuction remains one of the most popular procedures in cosmetic surgery and allows patients to slim and toned their waist line, back, arms, and legs using this minimally...

Thanks so much for your question,
Yes, in general, it is better to do a brow lift before a hair transplant or hairline-lowering procedure. A brow lift changes the position of the brows and the forehead skin, and in some techniques it can subtly affect the hairline position or tension. If you did the hair transplant first and then lifted the brow later, you could end up distorting the transplanted grafts or shifting the hairline in an unpredictable way. Doing the brow lift (and...

Thanks so much for your question,

Based on what you’ve shared, yes , you can be a candidate for a BBL, but it would likely be shape-focused BBL rather than a high-volume one. At 5’2” and 120 lbs, you’re on the leaner side, which changes how a BBL is approached, not whether it’s possible.

Having large flanks and a lower abdominal pooch is actually important here, because those are excellent donor areas. In shorter patients, even modest fat in the flanks and lower back can yield enough vo...

Thanks so much for your inquire,

A tummy tuck removes skin and tightens muscle; it does not remove the deep fat that is typically harvested for a BBL. The fat used for a BBL comes from areas like the flanks, upper and lower back, waist, and belly, not from the skin that’s excised during a TT. So the fear that “if I do TT first, I won’t have fat for a BBL later” is usually overstated.

Doing a BBL first can leave you with a rounder butt but a still-loose abdomen, and when a tummy tuck is...

Hello, Thanks so much for your inquire,
Liposuction alone is rarely ideal for an apron belly. Removing fat without tightening skin can actually make the fold more noticeable. That’s why many women in your situation are good candidates for a mini tummy tuck. A mini tuck targets the lower abdomen only, removes excess skin below the belly button, and can include a small amount of muscle tightening if needed. It avoids the more extensive dissection of a full tummy tuck and has a shorter r...

Based on these photos you are a very good candidate for a rhinoplasty; a hump reduction and columella shortening should be part of this surgery. In person consultation with a board certified plastic surgeon with expertise in rhinoplasty as well as 3D simulation may give you better idea what to expect. Good luck.

Hello! Thank you for your question.
As far as I can understand from your question rhinoplasty surgery is a comprehensive procedure and should be approached as such. For this reason, rhinoplasty would be the most suitable method we can recommend for you.
It would be better face to face consultation.
Best Regards!

Hello! Thank you for your question.
As far as I can understand from your question if you can send photos of your face from the front and side profiles at 95-degree angles, it will be possible to make a more accurate assessment.
It would be better face to face consultation.
Best Regards!

Hello! Thank you for your question.
As far as I can understand your question non-invasive methods will not provide permanent and accurate results. We never recommend having filler procedures done on your nose. Instead, I recommend revision surgery as the most permanent and safe method for you.
It would be better face to face consultation.
Best Regards!

To correct the crooked caudal septum I would just trim back the cartilage that is sticking out of the nostril. No grafts needed. Although I think you would benefit from a full rhinoplasty if you just want the lower septum trimmed that would be quite simple to do although many surgeons make it more complicated than it needs to be. The diagram you show makes it too complicated. I trim back the lower septum in almost every rhinoplasty a perform and it can be done with way the closed technique

A March surgery date can absolutely be realistic, but it depends on a few key factors. If you have your consultation in December or January, and there are no medical issues, March is typically achievable depending on the surgeon’s availability, financing approval, and completion of pre-operative requirements.
As far as recovery and time off work, this varies by procedure and the physical demands of your job. For mommy makeovers that include a tummy tuck, I generally recommend 2 weeks off f...

If your primary concern is loose, sagging abdominal skin, the most definitive solution is a tummy tuck. A tummy tuck physically removes excess skin and tightens the abdominal wall, which is why it is the best option for the “lumpy” appearance you notice when bending over. Stretch marks alone don’t drive this decision; it’s the skin laxity, and that cannot be corrected with non-surgical treatments.
From a contour standpoint, I would typically recommend a tummy tuck with lipo 360 and BBL, co...

Based on your history, goals, and current anatomy, you have both surgical and non-surgical options, but it’s important to be upfront about what will and will not realistically achieve the changes you’re looking for.
You’ve had under-the-muscle silicone implants for 15 years, three pregnancies, and breastfeeding, which commonly leads to skin laxity and loss of upper-pole fullness, even when implant volume is still acceptable. Non-surgical treatments cannot tighten breast skin or restore upper...

I routinely combine breast surgery with a tummy tuck and liposuction, including 360 liposuction, in healthy patients. That combination is generally safe when planned carefully and allows for one recovery period.
I do not recommend combining a tummy tuck with a thigh lift in the same surgery. The incisions for a tummy tuck and a thigh lift sit very close to one another in the groin and hip crease. Performing both at once increases tension on the skin, reduces blood supply to the area, and...

Congratulations on your weight loss. Losing over 100 pounds is a major accomplishment, and what you’re experiencing with excess skin is very common after that kind of transformation.
For the midsection, based on your photos, most patients in this situation benefit more from a belt lipectomy (also called a 360 tummy tuck) rather than a standard tummy tuck alone. A traditional tummy tuck primarily addresses loose skin and muscle laxity in the front of the abdomen. After massive weight loss, e...

Breasts are seldom perfectly symmetric. The symmetry can generally be improved as a part of a breast reduction.

Hello and thank you for this question. This is a topic I’m asked about during every consultation I do for both breast reduction and breast augmentation. There is an area of fat right under the armpits that plagues women of all shapes and sizes. It’s very simple to treat with liposuction during your procedure. It’s not typically covered by insurance but the cost, time and recovery are often minimal and can be done at the same time as your reduction or performed later under local anest...

Yes, it is absolutely possible in many cases to keep your current implants and still perform a breast reduction — but it must be done with the right technique and for the right reason.This situation is actually a classic indication for a Push-Up Lift–style reduction.How breasts get “too big” with implantsOver time, breasts can enlarge due to:Weight changesHormonal factorsPregnancySkin and tissue stretchIn these cases, the excess volume is usually your own breast tissue, not the impla...

Being told that a free nipple graft (FNG) is “required” to go from a G cup to a D cup is common — but it is not always true, even for large reductions.With modern tissue-preserving reduction techniques, it is often possible to achieve:Significant size reductionGood upper-pole fullnessNipple sensation preservationViable nipple–areola complex— without a free nipple graft.Why surgeons recommend free nipple graftsFNG is usually suggested when surgeons are concerned about:Nipple blood...

Unfortunately, breastfeeding is not possible after a free nipple graft. During a free nipple graft, the nipple-areola complex is completely detached from the breast and then reapplied in its new position, similar to a skin graft. This process transects the milk ducts, which subsequently scar and do not reconnect. As a result, patients are unable to breastfeed following this procedure.
If preserving the ability to breastfeed is important to you, it may be worth seeking additional...

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we...

Swelling after front thigh and knee liposuction often lasts a bit longer than outer thigh areas. While a significant amount of swelling usually improves within 6–8 weeks, residual swelling—especially around the knees—can take 3–6 months to fully settle. Recovery timelines vary by individual, and your previous healing experience is helpful but not a guarantee for identical recovery this time.

Based on the photos, the areas you’re concerned about appear to be a combination of flank fat and hip contour rather than true “hip dips” alone. Flank or limited Lipo 360 can help reduce width and improve the waist-to-hip transition, while fat transfer to the hip area may be considered if the goal is a rounder silhouette. Which option is most appropriate depends on fat distribution, skin quality, and your overall proportions, so this should be decided after an in-person consultation.

Yes, targeted liposuction to address asymmetry in a single flank is technically possible. In cases like yours, where one side holds more fat than the other, selective contouring can be considered rather than full bilateral liposuction.
However, because skin elasticity appears limited, there is a risk of residual looseness or unevenness after fat removal. The goal in these situations is usually subtle improvement and better balance, not perfect symmetry.
Whether you are a good candidate, and...

Liposuction is a great tool to help sculpt and enhance curves. Be aware that the surgeon must respect your anatomy so it is important to discuss your goals for surgery and to learn what you can expect in terms of results. Visit with a board certified plastic surgeon near you for an evaluation and to learn more.

You have enough ski. Laxity around the mouth, jowl and neck that your only truly good option is a lower facelift. It is also more cost effective over the long turn because a skillfully performed deep oak r facelift with last 19-15 year predictably. fillers or fat by themselves , if added in enough volume to fil out the relaxed skin will not look entirely natural. Smaller volumes will look fine but not give much benefit.

Thank you for your question. I would consider the face and the neck as one aesthetic unit. The face and neck belong together. Anatomically, the tissue layers of the face transition into the neck. It only makes sense while performing a deep plane face lift to address the neck as well. The most beautiful results are obtained when both is combined usually with some ancillary procedures of the face, to address all the aging processess - like the eyes, volume loss, upper lip ptosis, brow...

You appear to be a great candidate for a deep plane facelift and neck lift, especially given your concerns about nasolabial folds, midface sagging, and heaviness along the jawline. This technique lifts the deeper facial layers rather than just the skin, providing a more natural and long-lasting result.
I often combine this with fat grafting to restore volume in the cheeks and around the mouth, which helps smooth folds and balance the facial contour.
While your photos are helpful for an...

Thank you for your query. You may benefit from non surgical procedures. I would recommend radio-frequency based skin tightening along with autologous fat grafting. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Looking at you to post photos I am not sure what you mean by vertical lines?? An appearance I might recommend the Endo laser, full face and lower eyelid treatment under local anesthesia or IV sedation local anesthesia. But I also might recommend a mini face neck lift with muscle multiplication with the Endo laser?? Best of virtual console with expect fee fees to range from $5000-$15,000 depending on what surgical options you decide to use again best of virtual consult with.

I think you need a lift but if you just want more volume an implant would accomplish that. Fat transfer is often disappointing. You can’t achieve much volume increase with fat transfer

In my practice, I always evaluate each patient individually. In some cases, placing implants alone can achieve a full and balanced look, while in others, the degree of sagging makes adding a lift the better option.
If the breast tissue isn’t very droopy and the skin quality is good, I usually prefer to start with implants only. Some mild sagging over time is expected, but since you don’t mind that and are open to a lift in the future, this approach is reasonable.
However, going for the lar...

The size recommendation may be able to achieve your goals. However, due to the shape asymmetry you may need to consider a lift on one or both breasts (depending on whether your nipples are located at or below your breast fold.) This would give you the fullness that you’re looking for.

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Yes — you can have a natural-looking result with implants alone, and in your situation the best way to do that is with a Preservé (tissue-preserving) augmentation approach.A Preservé augmentation focuses on:Preserving your natural breast tissue, ligaments, and footprintAvoiding unnecessary skin or nipple surgeryCorrecting asymmetry through precise pocket control, not lifting scarsWhy Preservé works well for small, asymmetrical breastsIf your breasts are small, not sagging, and ni...

Hi there, hope all is well. Based on the photos alone, here are a few observations:
Asymmetric eyebrow position (left lower than the right)
Brow ptosis (overall low eyebrow position)
Excess upper eyelid skin — possibly more on the right than the left
Eyelid ptosis, particularly on the left, is a possibility and should be ruled out
My recommendations would include an in-person evaluation by both an Ophthalmologist and a Plastic Surgeon for a thorough physical exam. Based on those...

Hello, it looks as if the contour of your upper eyelids is slightly off-center on each side. This may be due to the ptosis sutures being placed too far outward instead of right above the pupillary center. Can consider a revision to help correct this contour. Please visit an oculofacial plastic surgeon for best results.

Based on your photos, your brows are in a reasonable position, so you would benefit from upper lid surgery by itself. If the brows start to droop in the future, then a browlift would be performed. Be sure to see a facial specialist for consultation.

From the photos, the primary issue appears to be a deep tear trough caused more by volume deficiency than by true fat protrusion.In cases like this, non-surgical treatments such as PRP/PRF or collagen stimulators generally provide limited improvement and often do not significantly soften a deep tear trough.
A lower blepharoplasty may be appropriate in some patients, particularly if skin laxity or fat herniation is present.However, based on your photos, a conservative approach such as micro...

Based on the photos, under-eye fat repositioning appears to be a reasonable option. However, depending on the actual skin elasticity and tissue condition, a lower blepharoplasty may be more appropriate. The final decision should be made after an in-person examination.