Doctor Q&A

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.

Your intuition is correct. From your profile picture, you have a moderate dorsal hump and a slightly drooping tip on your nose, contrasted by a chin set back from your lower lip. Addressing only the nose in a face with a receding chin is a prevalent pitfall in rhinoplasty. While it may appear to minimize your nose, it accentuates the chin recession, resulting in a lower face that appears both shorter and rounder. Many patients subsequently return for chin surgery six months post-rhinoplasty...

My suggestion is that doing part of the nose and leaving the rest untouched isn’t the right approach. If you’re going to do rhinoplasty, you need to consider the whole nose—otherwise you end up with a disproportionate look. The tip and dorsum end up out of proportion.

In many cases, non-metal retainers such as acrylic or glass may be safer than metal jewelry during surgery, but whether they are allowed depends entirely on your surgeon and anesthesia team.

For procedures like BBL or abdominal etching, surgeons often prefer all piercings to be removed completely because:
— Surgical positioning can create pressure on piercings
— Sterility is important around the operative field
— Swelling and compression garments may irritate the area
— Electro...

A BBL and flank liposuction with buttock filler are not really interchangeable. Liposuction to the flanks can improve the waist-to-hip contour, and fat transfer can add volume using your own tissue, but the safety of a BBL depends heavily on surgeon training, patient selection, and strict injection technique. If you do not have enough donor fat or you cannot follow the recovery restrictions, the result may be limited.

Large-volume buttock filler is a separate decision and I would be...

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

Der Gorgeous,
Your goal to narrow the breast and go smaller can be accomplished with a revision of your breast reduction. You look very good right now and appear to be a B cup, but that doesn't matter, you can go smaller if you want to.
The nipples are pointing high and the nipple to fold distance is excessive, so as part of the revision, while reducing the horizontal width (modestly to avoid an unesthetic loss of lateral curvature), excess skin and breast tissue would be removed as a...

Thank you for your thoughtful question. In many cases, the capsule does not necessarily need to be removed if you are planning to have new implants placed in a different pocket, such as transitioning from a submuscular (under the muscle) to a subglandular/prepectoral (over the muscle) position. However, the best approach depends on several important factors, including the thickness and quality of the remaining capsule, whether there is any capsular contracture, calcification, inflammation,...

CC is your last step, not your first. After you have the tissue reduced, your breast base width is decided and your skin envelope has determined the space left. A person 5'8" 155 lbs would usually have a breast width of 12-13.5 cm and that puts you 300-375 cc implants in most people. Bigger than what fits the envelope creates side splay and stretch marks that you will see after two years. CC alone does not make for a good upper pole fullness or cleavage choice.

A moderate-plus gives you...

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!

With your anatomy, the most important part is not simply the implant size in cc’s, but choosing the correct implant dimensions for your chest wall, breast footprint, and skin characteristics. In patients with a narrow chest and a mild chest wall deformity such as pectus carinatum (“pigeon chest”), implant width and height become extremely important.

The reason your surgeons are recommending anatomical/teardrop implants is likely because they create a more natural slope and can help camou...

Thank you for your question. Each implant company uses its own naming system based on the relationship between the implant’s base width and projection, so a “moderate” implant from one brand may actually have very similar dimensions to a “moderate plus” from another brand. That is why you cannot compare profiles by name alone. The most important thing is the actual implant measurements, including base width (how wide the implant is), projection (how far it sticks out), and volume (cc). For...

At 44, the structural asymmetry in your submental region is primarily driven by a localized distribution of deep subcutaneous fat coupled with early platysma muscle band laxity, rather than a simple loss of superficial skin elasticity. My suggestion to achieve a clean, symmetrical jawline is targeted neck liposuction combined with a conservative submentoplasty (platysmaplasty) to physically bind and tighten the underlying muscle bands. While non-invasive skin tightening devices or simple...

Fat transfer can sometimes be used to soften contour hollowness or over-resection in the inner thighs, but it is a correction procedure rather than a simple volume add. The result can look natural when the defect is well defined, the skin is healthy, and small amounts of fat are layered carefully. It is less predictable in very thin legs because donor fat may be limited and some of the grafted fat may absorb.

An in-person exam is essential to see whether the issue is true volume loss, skin...

Based on your photo, you are at least a good candidate for a minifacelift which will give a much better result than RF microneedling can ever give. Your lower lids can be improved at the same time. Just be sure to see a facial specialist for consultation to get a good exam and go over everything.

I'm sorry you're dealing with this, persistent under-eye/malar fullness after tear trough filler is a recognized complication that can be frustrating and make people look more tired. It sounds like possible malar edema (swelling in the cheekbone area due to lymphatic issues) or a festoon/malar mound that the filler worsened or highlighted. This often happens because filler can obstruct lymphatic drainage in the thin tissues around the eyes and midface.
At 37, you're not "too young" for...

At 42 and not overweight, this area can come from several different things: a small pocket of submental fat, skin laxity, platysma banding, chin projection, or deeper neck anatomy. In the photos, there appears to be fullness under the chin with some loose neck skin or banding, but an in-person exam is needed to tell how much is fat versus skin and muscle laxity.

Kybella or small-volume liposuction can help when the main issue is fat and the skin still has good recoil. Filler or a chin...

For the lower lid area, you have both excess fat bags which can be reduced with blepharoplasty. You also have a tear trough deformity which is nicely treated with fat transfer at the same time. This can be combined with a subperiosteal cheeklift to help the midface at the same time. Be sure to see a facial specialist with pleny of experience with midface lift.

Filler should actually be dissolved before the SOOF lift. The filler and the SOOF do not sit in the same plane. Filler is either placed supraperiosteally or just below the skin, while the SOOF compartment sits between the orbicularis oculi and the orbital septum.

When you operate into a cheek already loaded with HA filler, the layers become indistinct. It hides the underlying landmarks and causes problems like contour irregularities and asymmetric vertical lift. You also cannot discern if...

It is completely understandable to worry about how a transconjunctival lower blepharoplasty might impact your highly specialized, gravity-orienting toric contact lenses, but you can feel reassured that this approach should not compromise your ability to wear them. The incision for a transconjunctival blepharoplasty is strategically placed deep within the lower fornix the bottommost fold on the inside of your eyelid which sits well below the lower edge of a standard contact lens and far away...