Doctor Q&A

Based on your photos, you appear to have significant volume loss after weight loss with some nipple and skin descent. An implant can restore fullness, but it does not reliably lift the nipple or tighten loose skin. If an implant is placed without a lift, you may still have a low nipple position or a "waterfall" look, where the breast tissue hangs off the implant.

If your goal is simply to refill the breast and you can accept a more natural, slightly lower shape, augmentation alone may be an...

Based on your photos, there appears to be some residual fullness and skin/fat folds in the lower back and flank area, with healing changes around the tummy tuck scar. A 2-liter liposuction volume is not automatically too little; the safe amount depends on your anatomy, blood loss, skin quality, BMI, and the fact that it was combined with a tummy tuck. Being overly aggressive during the same operation can increase the risk of contour problems and blood-supply complications.

If you are still...

Thank you for sharing your photos and goals. Based on what you've described, it sounds like you're looking for a more refined version of your current nose rather than a dramatic change. Procedures such as bridge refinement and nostril narrowing may help achieve a smaller, more balanced appearance while maintaining your natural features and ethnic identity.
The best way to determine what is possible is through an in-person or virtual consultation, where your surgeon can evaluate your anatomy...

Thank you for your question. Based on your photos and description in image_4ebd18.jpg, a cosmetic rhinoplasty can certainly help narrow and soften the overly pronounced sides of your nose. When a patient feels their eyes are close together, a wide nasal bridge can visually draw more attention to the center of the face, and narrowing it can create a more balanced appearance. By performing precise osteotomies, we can safely refine the nasal bones and narrow the upper sidewalls to make the nose...

Such a great question and one that is more nuanced than it might seem! There is no universal measurement for ideal nasal bridge height, but as a general principle, a higher radix (the bony root of the nose where it meets the forehead) tends to have a more masculinizing effect on the face, while a softer, lower radix is generally considered more attractive in female patients. A helpful landmark I use in consultation is the upper lash line. Beyond that starting point, the bridge should be...

Your medial crura is contributing to the fullness of your columella. In the inferior view, your columella is quite wide. You will need repeat surgery. Either the septum or medial crura needs to be thinned and repositioned. Unfortunately, there are no non-surgical options for this.

Best Wishes,

Gary Horndeski, M.D.

Type 1 diabetes does not automatically rule out elective plastic surgery, but it does make preoperative planning more important. Safety depends on how well your blood sugar is controlled, your recent HbA1c, whether you have kidney, heart, circulation, or nerve problems, and the length and type of procedure.

For larger operations such as BBL or liposuction, I would want clearance from your endocrinologist or primary doctor, a clear insulin plan for the day of surgery, and surgery in an...

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

With a low-set breast footprint and a prominent chest wall, I would be careful about simply choosing a larger implant to compensate for the anatomy. In patients like you, the goal is usually improving upper pole fullness and breast shape, not creating significantly larger breasts. Going too wide or too large can actually make the breasts appear lower and heavier over time, which sounds like the opposite of what you want.The difference between medium-height and tall-height anatomical implants...

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half...

Dear nikki021,

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

Hello,
Thank you for the question. It all depends on your goals. Trusting your surgeon is key, because only your surgeon can answer this question.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

You should not assume the recovery will be exactly the same, but a tummy tuck with breast augmentation is still a significant recovery. The tummy tuck portion, especially if muscle repair is needed, usually drives the first 1-2 weeks: tightness, difficulty standing fully upright, drains or compression, and needing help at home are common.

That said, barely being able to walk for months after liposuction is not a typical recovery pattern, so it is worth discussing that experience in detail...

From the photos, the asymmetry appears mild but real around the mouth corner and lower cheek/jawline. It may not be simply "skin or fat growing" over the corner; smile asymmetry can come from a combination of facial muscle pull, volume differences, dental/bite position, skin laxity, and early jowling.

A good in-person exam with a board-certified facial plastic or plastic surgeon is the most important first step, ideally including photos at rest and with animation. Depending on the cause,...

Dar Caring,

Your under-eyes don’t look like a simple “bag removal” problem to me.

I’d first check whether some of the fullness in your cheeks is swelling or normal anatomy because that can affect the under-eye appearance. I’d also evaluate your brow since heavier upper lids can make the eyes look more tired.

For the lower lids, I would lean more toward repositioning what you already have rather than removing a lot of fat. Depending on skin quality, that could mean:

la...

Thank you for your question. Based on your photos and description , it is certainly possible to alter a negative eye tilt to a more positive, upturned one while maintaining the roundness and openness of your eyes. To achieve a brighter "doe eye" look rather than a narrowed "fox eye," we can perform a conservative canthopexy or canthoplasty to elevate and secure the outer corner of the eye slightly higher on the bone. It is important to note that a very precise, gentle technique must be used...

Based on your photos and description in image a second eyelid surgery is not recommended right now because your suspected Ehlers-Danlos Syndrome (EDS) makes your tissues fragile and prone to poor healing. However, your upcoming endoscopic brow lift and deep plane facelift in July should help significantly by lifting the heavy brow tissue that is pushing down on your eyelids. We recommend waiting 6 to 12 months after that surgery to heal completely, and if you still need improvement,...

Yes, a SOOF lift can absolutely be performed under local anesthesia, and it has been done so safely for many years; it really comes down to patient preference and comfort level. In my practice, I perform all lower eyelid blepharoplasties exclusively through a transconjunctival approach, meaning the entire procedure is carried out from the inside of the eyelid with no incision on the skin whatsoever, which in my hands yields better outcomes and meaningfully reduces the risk of lid malposition...