Doctor Q&A

Thanks for your question! Every surgeon takes different amounts of time in surgery. This would take me about 2 hours. Your breast tissue looks thin, so I would encourage you to consider a gel or silicone implant. If you have a deflation or rupture, you would need to go back under anesthesia either way for replacement. Good luck!

Hi, thank you for sharing your question. It’s difficult to identify significant skin laxity in these photos so recommending a standard tummy tuck may be tough to do without a proper evaluation. Based on the photos alone and your information given, I would consider a mini tummy tuck.

Dear raniung13,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because 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...

Hi, thank you for your question.
No. After 9 years, BBL fat behaves like normal fat and cannot be damaged or destroyed by massage, even very deep pressure. Grafted fat is not more fragile once it has fully healed.
What you’re noticing is more likely temporary inflammation, muscle soreness, skin laxity, or normal changes that became noticeable around the same time.
Sculptra can improve skin firmness and mild fullness, but it does not replace lost fat. Its effects last about 1.5–2 years. Tru...

Hello and thank you for your question! I agree that you have a great frame/underlying shape. In my opinion, lipo 360 and BBL can certain enhance this shape and contour by subtracting the excess fatty tissue from areas like your abdomen, flanks, and lower/mid back, and adding some of this volume will help with the overall contour and projection of the gluteal region. The other important factor to address would be the excess skin. If you are not finished having children, I would ultimately...

Great question and thank you for providing photos!
It is a bit challenging to determine based on photos alone, but the change in shape of the tip can come from a subtle dropping of the tip over tip called tip ptosis. It may be that the firm part is the cartilage in a new, lower position where you can now feel it. It is also possible you may be able to palpate any cartilage grafts if they were placed. As always, I think the best place to start is to let your rhinoplasty surgeon know your...

You seem to be a candidate for rhinoplasty, based on these very limited photos. Whether open or closed, you can expect predictable result in the hands of an experienced surgeon. In person consultation with a board certified plastic surgeon with expertise in rhinoplasty would give you a chance to discuss benefits and shortcomings of open vs closed rhinoplasty in your particular case. Good luck.

Based on your photos, you are a great candidate for rhinoplasty. The bump can be taken down and your tip refined. You shouldn't need diced cartilage for grafting. But septal cartilage can be used to support and refine the nasal tip. And even though the nasal bone will be mostly straight, if the tip is refined and projected properly there will be a small lift/curve at the end, making it cute and feminine. Be sure to see a rhinoplasty expert for consultation.

Hi, thanks for your question. Possible surgical goals could include reducing the dorsal hump and reducing columellar show. The appearance of your nostrils is likely due to a low hanging columella, which can be due to elongation of the nasal septum and/or the positionining of the medial crura of the lower lateral cartilages. These issues be addressed surgically by trimming the nasal septum as necessary and repositioning the medial crura.

First of all, congratulations on your weight loss! Losing 100 pounds is a tremendous accomplishment and a major investment in your health and well being. As a board certified plastic surgeon, the next step is to match your surgical plan to your anatomy and aesthetic goals as safely and efficiently as possible.

From your description, a breast lift, tummy tuck vs lower body lift, and liposuction are all reasonable components of a comprehensive contouring plan after massive weight loss. Given...

Dear Rational46570,

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

It is extremely likely that you will benefit from a breast reduction! Even without seeing any photos, I can say based upon your description that it would be beneficial. I have many breast reduction patients who are in their twenties, and each one was elated with her results. Definitely meet with a board certified plastic surgeon to be evaluated and find out more!

I attached a link to a 20 year patient of mine with very large breasts and asymmetry. She loves her results!

You’re asking a very real and very common question — and your symptoms are absolutely valid, even if insurance criteria don’t always reflect that.At 5’7”, 135 lbs with a 32DDD, your breasts may not sound “large” on paper, but on a petite, athletic frame they can be biomechanically very heavy. Pain with running and limits on activity are legitimate medical concerns.Why insurance is the sticking pointMost insurers use gram-based criteria (often ~500 g per breast) to approve reductions....

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. When considering breast augmentation above or below the muscle, it is the lesser of two evils. Usually, the animation deformity from breast augmentation is minimal, however when you place implants on top of the muscle, the complications are significantly worse - slide down and wrinkling. I have a whole gallery of patient's with long-term changes with...

Yes — at your age, it is absolutely reasonable to have breast implants without a lift, especially if avoiding scars is important to you right now.You’re also thinking about this the right way by accepting that you may choose a lift later in life if your priorities change.Do you really need a lift at 20?In most 20-year-old patients:Skin elasticity is still goodSagging is usually mild or borderlineThe issue is more volume than true droopIf your nipples sit at or above the breast fold, a...

Hello, thank you for your question and photos.
Yes, based on your photos, you do have enough pinchable fat in the flanks for conservative liposuction. In lean, athletic patients, the key is gentle, precise fat removal. When done conservatively by an experienced surgeon, the risk of bumps or irregularities is low. This would be for subtle contouring, not dramatic fat removal.
Best regards,Andaç Aykan, MD, Assoc. Prof.

Skin adhesions, in the anterior neck in particular, can be seen after neck lift surgery relatively frequently. Too aggressive liposuction of the skin and removal of fat tissue over the muscle may create condition which favor skin adhesions. However, it is still something that can not be entirely predicted. You should discuss with your surgeon whether additional liposuction of the skin flap is absolutely necessary . Good luck.

Great question and thank you for providing the photos!
I think you are asking the right questions. While I can certainly appreciate a degree of brow ptosis (heavy brows) and excess skin of the upper eyelid, it is hard to determine which one is the predominant factor causing your issues. I think your best option is to schedule a consultation with a plastic surgeon that specializes in eyelid surgery who can perform a thorough exam to determine which of these factors (brow vs eyelid) is...

YES! There is no reason that you can't have aesthetic surgery in the US. I would recommend planning surgery with plenty of time for recovery prior to traveling internationally.

Young women with smaller cheek bones (malar hypoplasia) frequently present with this type of deformity very early in their life (13-19 years). Surgical correction includes correction of muscle attachment which creates tear trough deformity (via transconjuctival blepharoplasty) and augmentation of cheek bones with implants or fat grafts. In person or teleconference consultation with a board certified plastic surgeons with experience in this procedure is recommended. Good luck.

If you feel that your lids look too long, then there is possibly a way to address this. Fullness of the upper lids is often quite youthful and necessary. We can place fat or a filler back in the area to keep a youthful eye shape while reducing "eyelid show" as you mention.

You have facial asymmetry and would benefit from a rhinoplasty to straighten the nose and correct the uneven nostrils. You would also benefit from an eccentric lip lift. This does 4 things: shortens the distance between your nose and upper lip, increases the mucosa of the upper lip, increases the incisor show and pulls up the corners.

Best Wishes,

Gary Horndeski, M.D.

Hi, thank you for your question and photo.
At 37 years young, with your good skin quality, I think this is more of a volume and support issue rahter than excess skin. A full facelift would be too aggressive and I don't think it's necessary for your face. The most appropriate surgical options are a limited midface lift to reposition tissue and improve asymmetry, or fat transfer to restore volume. A small midface lift can reposition descended tissue and improve asymmetry, and many patients are...

Based on what you’re describing — lower face heaviness, early jowling, loss of jawline definition, and sagging — a deep plane facelift (often combined with a conservative neck lift) is the more appropriate and durable option, even at age 42.Your age does not exclude you from a deep plane lift. In fact, it often makes the result better and more natural.Why surgeons are split in their recommendationsThis is very common and usually reflects philosophy, not confusion.Surgeons r...

Let's summarize:
SMAS lift followed by
-loss of sensation sides of face
-parts of neck (side not mentioned)
-occasional numbness under R eye
-tingles on top of head on R when R eyebrow area touched
-recent diagnosis of Grave's disease and psoriatic arthritis
-no change for months

It is not unusual to have numbness temporarily after a SMAS lift due to skin undermining. This should all come back on both sides of the face.
The occassional numbness should also resolve.
The tingling on top of...