Doctor Q&A

Your photos show high, rounded implants with some lateral fullness and medial skin stretch; photos cannot prove the condition of the capsule, but your description of implants moving under the skin is very important. What you describe can be consistent with pocket laxity or lateral displacement, but this has to be confirmed with an in-person exam.

Yes, the lateral and lower pocket can often be tightened with capsulorrhaphy, and many surgeons use long-lasting or permanent sutures for that...

Your photos show lower abdominal skin laxity and a fold/overhang, with some remaining fullness, but a physical exam is needed to judge skin quality, fat thickness, and muscle separation. SmartLipo can remove fat and may give a small amount of skin contraction in selected patients, but it does not remove loose skin, tighten stretched abdominal skin reliably, or repair diastasis from pregnancy or weight change.

Because your weight loss is still ongoing, the best first step is usually to get...

In your photos, the main issue appears to be a lateral/posterolateral buttock hollow rather than simple saddlebags, and you look fairly lean, which limits the amount of fat available for transfer. Glute training can improve muscle tone and projection, but it usually cannot fully fill a structural hollow in the soft tissue envelope.

If you do not want implants, the most common surgical option is conservative fat grafting/BBL, sometimes combined with very selective liposuction around the...

Hello and thank you for your question. Based on your photograph, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip derotation , among other maneuvers. A chin implant can be performed at the same time. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical...

Over-resection (excessive tissue removed) is one of the primary reasons patients undergo revision rhinoplasty. A revision procedure could restore a more natural appearance to your nasal bridge and a conservative de-projection of the tip. The procedure is complicated, so it's important to select a surgeon who is certified in both facial plastic surgery and otolaryngology—ENT with an extensive track record of excellent revision rhinoplasty results. Good luck to you.

Congratulations on the weight loss! An extended abdominoplasty with 360 lipo and fat transfer to the buttocks (BBL) with a bilateral mastopexy (breast lift) with Aveli to treat the buttock cellulite for the first stage. Second stage would be a bilateral brachioplasty (arm lift) with liposuction. Use that fat to transfer to the breasts after the mastopexy. Hope this helps!

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...

Never mind what cc number she gave you. Look at your natural chest width. That number determines the implant.

I would personaly stay away from tear drop implants, they have texture and texture has been seen to cause a type of lymphoma in rare cases.

The closest thing would be a Motiva Ergonomix, which is a round implant that moves with your body.

#StayBeautiful,

@RealDrWorldWide

Hi there,
I think you would have a great result with UTM or OTM, but in your case I may steer you towards under the muscle. Specifically, this is because of the slight indentation on the upper outer aspect of your left side towards your armpit. In my experience, an under the muscle approach does a better job a smoothing out that corner. On your right, I would do a dual-plane augmentation with would potentially help lift your right nipple to match your left, which is just a touch higher. In...

Breasts will undergo natural changes in appearance over time, so it is not unusual for your breasts to look different after 14 years. Having said this, there are at least two conditions that should be investigated. These are capsular contracture and failed/ruptured silicone gel implants. The latter can be evaluated by an MRI or high-resolution ultrasound. A visit to your surgeon or any other board-certified plastic surgeon can determine the presence or absence of a capsular contracture.

Yes, modern “gummy bear” implants (cohesive silicone gel) are still generally considered softer and more natural-feeling than saline implants.
Saline implants are basically a silicone shell filled with saltwater, so they tend to feel more like a water balloon and can have more rippling, especially in thinner patients. Gummy/cohesive silicone implants are filled with a thicker gel that behaves more like natural breast tissue, which is why they typically feel softer, move more naturally, and...

Your photos show a small amount of submental fullness that is most visible with chin flexion or low-angle photos, while the side profile looks fairly clean; an exam is still needed to confirm whether this is fat, skin laxity, anatomy, or simply a normal fold with neck position.

For a small stubborn pocket of fat and good skin tone in someone in her 20s, submental liposuction is often the most precise and predictable option. It can directly remove a small fat pad and usually has faster, more...

The photo shows mild cheek and lower-face soft-tissue laxity with some uneven facial volume, but the picture is limited and a full facial exam would be needed. Because you recently had fat transfer, it is important not to rush into another procedure until swelling and fat survival have stabilized, usually several months.

Your concerns fall into different categories, so one treatment is unlikely to solve all of them. Uneven fat transfer or hollows may need observation first, then very...

Based on your photos, I can see asymmetry in brow position, with a more noticeable lateral brow descent, along with volume loss in the upper eyelid and periocular area. These changes are quite common after significant weight loss.
In this situation, I typically recommend a temporal lift.This procedure specifically elevates the outer part of the brow, creating a more open and refreshed eye appearance while reducing the “tired look.”
In addition, I would perform fat grafting to restore vol...

I completely understand why you are feeling self-conscious about this, but please let me reassure you that having a small pocket of fluid accumulate after your drain was removed is a incredibly common part of the healing process. When a surgical drain is taken out, your body naturally continues to produce fluid in that space, and it can sometimes collect under the skin—a very typical occurrence known as a seroma. At just three weeks post-op, your body is actively working to reabsorb...

Based on your photo, you do appear to have some mild upper eyelid drooping (ptosis), especially with a higher-than-average eyelid crease. This combination is actually pretty common. A ptosis repair could help lift the eyelids to a more open and balanced position, and in many cases it can also soften or lower the appearance of a very high crease. However, ptosis surgery alone may not fully “make the eyes smaller.” What it really does is improve eyelid position and shape so the eyes look mor...

It is completely normal to notice changes in the periocular region as you approach your mid-30s, and it can be incredibly frustrating when your eyes look tired even when you feel perfectly rested. Looking at your photo, you actually have excellent skin quality and strong bony support, meaning an invasive upper or lower blepharoplasty would be premature and counterproductive for your anatomy right now. The heavy, fatigued appearance under your eyes is primarily a shadow caused by a mild...