Doctor Q&A

Hello, and thank you for your question. Based on your photos, you appear to have mild volume loss in the upper portion of the breasts following pregnancy and breastfeeding, with what seems to be limited soft tissue coverage. While photographs can provide a general impression, they are not sufficient to determine the ideal implant pocket. Whether an over-the-muscle approach is appropriate depends on factors that can only be evaluated during an examination, including tissue thickness, skin...

Based on the photos, the change in breast shape could be related to implant-related issues such as capsular contracture, implant malposition, or implant rotation. The fullness in the upper pole and developing indentation are not specific for capsular contracture alone. Since you also have a family history of breast cancer, keeping your appointment at the breast clinic is the right step to rule out other causes. A clinical examination and imaging, such as ultrasound or MRI if indicated, will...

Your breasts are not tuberous but widely separated. I recommend breast augmentation using a circumareola approach. This will move the nipple-areola complexes more medially and at the same time implants can be placed.

Best Wishes,

Gary Horndeski, M.D.

Hello Babylifter, Thank you for your question regarding the fact that you are 37 years old, 5'3", approximately 170 pounds, and have had two pregnancies and whether you would do better with a tummy tuck or BodyTite. Thank you for your history and your pictures. First, we should analyze your pictures to determine the best procedures. Three things can go wrong with the abdomen: skin, fat, or muscle. Let's look at each of them individually with you. You have MINIMAL cutis pleonasmus (excess...

Thank you for your photos. You appear to be in excellent shape with minimum skin laxity of your abdomen and a moderate disastasis. The diastasis would need to be sutured together to recreate a flat foundation for your abdomen. If your skin is lax enough, a standard skin resection of your abdomen could be done. If your skin is not sufficiently lax, and scar position is negotiable, moving the abdominoplasty incision upward would allow the umbilical opening created at the time of the incision...

Yes, a Vectra 3D scan performed at another clinic can be useful for consultation and surgical planning, provided the files are compatible with your surgeon's software. However, most surgeons prefer to perform their own 3D imaging because surgical simulations are based on their individual technique and aesthetic goals. While some systems allow limited patient interaction, the final surgical plan and modifications should always be created and reviewed by your surgeon. I recommend discussing...

The indentation is caused by the shape and position of the tip cartilages, so you could undergo just a tip plasty to correct this. Cost varies from place to place but could average around $10,000. Be sure to find a rhinoplasty expert for consultation.

Hello and thank you for your question. Based on your photograph, that your nasal bone at the bone-cartilage junction. It can be fixed if you would like rhinoplasty. 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 technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who...

Your photos suggest you already have reasonable buttock volume, with some natural lateral hip-dip contour visible. From photos alone, this looks more like a question of how much refinement you want rather than whether you need a dramatic BBL. If your goal is only a little more roundness or hip-dip softening, a conservative plan may fit better than a high-volume change.

Transferred fat can decrease. Some of the grafted fat may not survive, and later weight loss can make both your original...

Even though you saw a doctor, it would be best to let your surgeon know so they’re aware of your situation.

Hello and thank you for your question. Upon reviewing your photos, you appear to be an excellent candidate for a breast reduction and lift.
The Nipple-Areola complex is typically reduced and lifted in a very symmetric fashion during this procedure. In my experience, patients are typically able to gain both a customized size to the areola and a reduced nipple as a result of these procedures. Best wishes.
David Shokrian, MD Plastic & Reconstructive Surgeon

Thank you for sharing your photos.
First, I would like to mention that these photos are not ideal for an accurate assessment. If possible, photos taken by someone else from the front, clearly showing both breasts, would allow for a much more reliable evaluation.
Based on the photos you have provided, however, my preliminary impression is that I do not think a free nipple graft would be necessary. I believe that an excellent outcome could likely be achieved using a Wise pattern breast...

Thank you your inquiry! We would love to sit down with you to discuss your concerns. Removing excess breast volume will help remove the tension and weight on your back and neck as well as help with the other listed concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

@Plucky887365 thank you for the question and including photos for review. It allows for custom recommendations.
I frequently get asked about mesh vs no mesh in a primary augmentation and you're right to wonder why some surgeons recommend it and some don't! I primarily perform subfascial augmentations and will recommend mesh for patients who select an implant over 250cc.
While this is a slightly arbitrary cutoff, the benefit of mesh is the long term support for heavier implants.

It is incredibly common to experience a shift in perspective or even regret after a major, life-changing surgery like a breast reduction, especially when your body is adjusting to a brand-new silhouette.

To answer your question directly: No, grams of breast tissue removed and cubic centimeters (cc) of a breast implant do not correlate in a perfect 1:1 ratio.

Probably not exactly, and there is a high chance they might actually make you look larger or more projected than you were before...

Being heterozygous for Factor V Leiden does not necessarily exclude you from liposuction, facial fat transfer, or BBL surgery, but it does place you at an increased risk for blood clots. Important considerations include a detailed personal and family history of clotting events, consultation with a hematologist, careful assessment of the length and extent of surgery, use of compression devices, early postoperative mobilization, and, in some cases, anticoagulation therapy. Because BBL...

Liposuction without a tummy tuck is absolutely an option for the right patient. Liposuction removes fat.
After the fat is gone, your skin needs to retract and conform to your new contour. In patients with good skin tone and elasticity, it does this well, and the result can be excellent. In patients with looser skin, the skin may not retract adequately after fat removal, leaving you with loose or wrinkled skin that obscures the improvement.
From your photo, there does appear to be some skin...

For limited-area liposuction under sedation, a 3-hour flight at 5–7 days postop is generally acceptable and within common practice. The main concerns are swelling and DVT risk, so wear your compression garment, stay hydrated, avoid alcohol, and walk the aisle every 45–60 minutes. If your recovery is uncomplicated at your one-week check, flying should be safe.

At 72, having a well-maintained 2018 lower lift makes you an excellent candidate for secondary rejuvenation. However, rather than an isolated midlift, I strongly advise a High SMAS revision facelift.While your lower lift held up well, the midface naturally deflates and descends over time. A High SMAS approach enters the muscle layer much higher up—above the cheekbone. This allows us to lift the fallen cheek fat pads vertically while simultaneously sweeping away any minor jawline laxity...

You would benefit from a facelift which includes the neck. The nasolabial folds and marionette deformities can be improved by the procedure.

Best Wishes,

Gary Horndeski, M.D.

Thanks sdnatvbb for your question! A consultation with a Board-Certified Plastic Surgeon is necessary to determine the appropriate options for addressing issues after an initial procedure.
One of the options for lifting the midface and corners of the mouth includs Revision Facelift (SMAS) in which a surgeon may choose to repeat or revise a SMAS lift to tighten and reposition tissues that were not sufficiently lifted previously. Another option is Deep Plane Facelift that unlike other...

Based on your photos, you appear to have persistent lower eyelid retraction and recurrent lateral canthal webbing despite revision surgery. These are complex problems that often require structural reconstruction rather than simple scar revision. Treatment may include scar release, spacer grafting, and canthal reconstruction to restore eyelid support and shape. I recommend consulting an experienced oculoplastic surgeon who specializes in complex revision eyelid surgery.

Based on the photos and your history of Bell’s palsy, the asymmetry appears consistent with residual facial nerve weakness affecting the eyelid and brow position. There are surgical options that may improve symmetry, depending on the degree of muscle function and eyelid support. These can include ptosis repair, brow lift, eyelid repositioning, or other facial reanimation procedures. A comprehensive evaluation by an experienced oculoplastic surgeon or facial nerve specialist is recommended t...

Yes you are correct that you are hollow below your fat pad, so fat transfer would work very well. However, you still have some fat herniation (which many younger people do have usually from a genetic reason). The final result will look much better if both procedures are done. Be sure to see a facial expert for consultation.