Doctor Q&A

So much depends on your surgeon and anesthesiologist.
Typically I schedule 2 1/2 hours for an augment with mastopexy going under the muscle. As an aside I don't like doing an above muscle augment because I feel they sag quicker requiring another operation. Saline implants add time to the case becasue they must be filled.
Anesthesia has such a low risk today due to advanced monitoring techniques I wouldn't worry about the time it takes.
If an implant ruptures you will notice it very quickly...

Hello, thank you for asking this question and attaching your photos.
What you’re seeing is due to very thin tissue coverage now that your implants are above the muscle. This makes rippling and dents visible and it won’t improve on its own. The solution is to increase coverage over the implant. This is usually done by changing to a more cohesive silicone implant, moving the implant back under the muscle if possible, and or adding fat grafting to thicken the tissue. Even small amounts of fat...

Great question — and you’re thinking about exactly the right details.Short answerIn your situation, an internal bra is usually NOT necessary.Why Motiva Preserve changes the equationThe Motiva Preserve technique is specifically designed to:Preserve the native ligaments, fascia, and IMF integrityMinimize internal dissectionAvoid weakening the natural support structures of the breastBecause those internal supports are kept intact, the breast is already doing the job that an “internal bra...

Thanks for your question!
Eighteen is not too young to schedule a consultation for a breast augmentation. It's great that you have a supportive parent. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Unfortunately, no laser or microneedling will help the scar. I would suggest a series of steroid injections to see if this helps. If this doesn't work, a scar revision is your only option.

Hello, that is a great question and thank you for asking. Yes, a thinner person can get a BBL, but the result will be subtle, not dramatic. At your height and weight, there is usually limited fat available, so the goal is shape and contour rather than major volume.
This is often called a skinny BBL, and it works best when expectations are realistic and fat is carefully harvested from areas like the abdomen, flanks or thighs.
A consultation is needed to confirm how much fat is available and...

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...

Dear Nice18501,

it is hard to tell for sure without an examination. Generally speaking, you can get fat transfer only to specific areas. 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

Thank you for sharing your concerns. Buttock asymmetry and sagging are prevalent and are usually caused by uneven fat distribution, skin laxity, and natural body anatomy.

Exercise can improve muscle tone, but it cannot fully correct sagging skin or significant asymmetry. Weight loss may help in some cases; however, if there is already looseness, it can sometimes make sagging more noticeable.

In these situations, a customized surgical approach gives the best results. Depending on your...

Hello, thanks for your photos.
In your case, fillers are not a good solution. The split and irregularity you’re seeing in the nasal bones is structural. Fillers cannot fix bone asymmetry, they can only camouflage it by adding volume, which would make the nose look wider and heavier. They also require repeat treatments and carry higher risk in the nose.
In my opinion a rhinoplasty would address everything in one procedure: smoothing and straightening the nasal bones, refining the bulky and d...

This is a very insightful question, and it’s thoughtful that you’re stepping back to understand what may truly be driving your concerns before making any decisions. It's of course difficult to give a full answer without additional photos (a profile view for example), or more ideally, an in-person examination, but here are some thoughts that I hope will help:
In someone with a thinner face, changes related to facial aging—such as volume loss, soft-tissue descent, and shifts in pro...

Ultimately, only you can decide whether surgery feels worth it, and that decision often comes down to how much this concern affects you. Is it something you notice and think about frequently, or only occasionally? If addressing it would provide a meaningful boost in confidence, that’s an important consideration.

When performed thoughtfully and conservatively by an experienced surgeon, removing a dorsal hump can absolutely be done in a way that looks natural and balanced—especially in som...

Hello.
Nipple piercings don’t affect nipple health during surgery, but they must be removed before the operation to reduce infection risk. You don’t need to remove them far in advance, just a few days before surgery is enough.
They can usually be re-pierced after healing but make sure to consult your surgeon first.
Andaç Aykan, MD, Assoc. Prof.

Thank you for your pictures and questions. You seem to be a very good candidate for a breast reduction. Be sure to see a Board-Certified PS for your consultation and surgery.

Dear Shakiishd

Great question, and easily managed.

All of our breast patients (implant, lift reduction) who have piercings remove the piercing the day before and thoroughly clean the nipples with Hibilclens (unless allergic).

On the day of surgery we sterilize the piercing and put the in place before the patient wakes up. This has been a fool proof method of keeping the piercings so that they don't close up.

Best of Luck,
Dr. Jim Romanelli

Hello, thanks for your photos.
Yes, based on your photos and age you can have implants without a lift. You have mild sagging, but not enough to require a lift right now. An implant alone will improve upper pole fullness (especially with high profile/round implants) and overall shape, though it won’t raise the nipple position. Round implants are usually the better choice for long term shape and simplicity. A lift can always be considered later as you age if needed.
Choosing a moderate size i...

Intuitive852736,
Based on the photographs you have shared, your tattoo location is at the lower edge of your stream overlying your xiphoid process and then extending onto your upper abdomen. The most commonly used incisions for breast implant placement, infra areolar and infra mammary are both well above your tattoo. I do not think implants will affect your tattoo.
Dr Stein

When doing an augmentation we want the implant to be centered on the nipple. This will give the most natural look. You have excellent shape to start. Remember that measurents of chest width are never exact. The human body moves and is not symmpetric R to L. For example your nipple height is different on each side. Totally normal. The most important consideration is volume. Did you like the look with a 350 cc sizer in a bra? (Sizers typically come in 50 cc increments). I would definitely not...

You have Grade II breast ptosis and need a lift to allow alignment between the implant and breast. You'd also benefit from an areola reduction. Most surgeons would prefer general anesthesia for this procedure.

Pioneering742783,
Before any procedure, surgical or noninvasive, your doctor will assess your history of blood clotting disorder and decide how to proceed. If in fact its determined that you are not appropriate for a tummy tuck, but could undergo a less invasive surgery, liposuction with J-Plasma® (also called Renuvion®) is a technique we use to remove unwanted fat while also helping tighten the overlying skin. Traditional liposuction is excellent for contouring, but it doesn’t tighten ski...

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...

Hello, thanks for adding your photo.
From what’s visible, you have moderate lower-face and neck laxity, with the neck contributing significantly to the tired appearance. Your skin quality is still reasonable, but the face and neck are clearly aging together, not independently.
Doing the procedures in stages is possible, but there are trade-offs. If staged, the neck lift should be done first, as it would give the most noticeable improvement with less attention from others. The face lift can b...

Based on what you’ve shared, I do feel you would ultimately be an excellent candidate for a deep plane face and neck lift; however, it’s important to move forward with that type of procedure only when you feel both emotionally and financially ready.

In the meantime, there are meaningful, non-surgical and minimally invasive options that can provide improvement without undergoing procedures that offer limited benefit. Rather than a unilateral blepharoplasty, I would be more inclined to rec...

You seem to have acquired a horizontal line above the right upper lip and you may 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. This takes 1 hour to perform under local anesthesia and costs $4,000.

Best Wishes,

Gary Horndeski, M.D.