Doctor Q&A

Implants can restore volume, but they do not truly lift the nipple or tighten loose skin. In the photos, there appears to be breast deflation with the nipples sitting relatively low on the breast mound, so an in-person exam and measurements are needed to decide whether an implant alone would look balanced.

If the nipple is at or above the breast fold and the skin envelope is not too loose, a well-planned implant may give enough upper fullness for someone who accepts a slightly lower nipple...

Because you are five days from a tummy tuck, the safest answer should come from your surgeon or anesthesia team, who know your blood pressure, heart history, medication list, and anesthesia plan. Sumatriptan is not a blood thinner, and many patients who already use it are allowed to take it near surgery, but it can affect blood vessels and blood pressure and may interact with some medications, so your team should confirm it for you.

Call the office today and ask specifically whether your...

A BBL and flank liposuction with buttock filler are not really interchangeable. Liposuction to the flanks can improve the waist-to-hip contour, and fat transfer can add volume using your own tissue, but the safety of a BBL depends heavily on surgeon training, patient selection, and strict injection technique. If you do not have enough donor fat or you cannot follow the recovery restrictions, the result may be limited.

Large-volume buttock filler is a separate decision and I would be...

Your intuition is correct. From your profile picture, you have a moderate dorsal hump and a slightly drooping tip on your nose, contrasted by a chin set back from your lower lip. Addressing only the nose in a face with a receding chin is a prevalent pitfall in rhinoplasty. While it may appear to minimize your nose, it accentuates the chin recession, resulting in a lower face that appears both shorter and rounder. Many patients subsequently return for chin surgery six months post-rhinoplasty...

My suggestion is that doing part of the nose and leaving the rest untouched isn’t the right approach. If you’re going to do rhinoplasty, you need to consider the whole nose—otherwise you end up with a disproportionate look. The tip and dorsum end up out of proportion.

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.

Thank you for your question. You would most likely benefit from a mommy makeover because, apparently, there is a combination of loose skin, abdominal wall laxity, and stubborn fat that liposuction alone cannot fully correct. A BBL may not be necessary if you already like your butt volume. For your breasts, you would most likely require a breast lift with implants. Regarding the scar, tummy tuck scars can vary a lot depending on healing, tension, genetics, and surgeon technique. Many surgeons...

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!

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

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...

Thank you for submitting the photos. The best way for me to answer that question for my patients is to use the Crisalix app. This makes a 3D image of your chest and breasts. Then you can add specific implants to the images to see if you like it. The app can also demonstrate a mastopexy (lift) as well. Then you can make a confident decision. Hope this helps!

With your anatomy, the most important part is not simply the implant size in cc’s, but choosing the correct implant dimensions for your chest wall, breast footprint, and skin characteristics. In patients with a narrow chest and a mild chest wall deformity such as pectus carinatum (“pigeon chest”), implant width and height become extremely important.

The reason your surgeons are recommending anatomical/teardrop implants is likely because they create a more natural slope and can help camou...

Thank you for your question. Each implant company uses its own naming system based on the relationship between the implant’s base width and projection, so a “moderate” implant from one brand may actually have very similar dimensions to a “moderate plus” from another brand. That is why you cannot compare profiles by name alone. The most important thing is the actual implant measurements, including base width (how wide the implant is), projection (how far it sticks out), and volume (cc). For...

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.

Fat transfer can sometimes be used to soften contour hollowness or over-resection in the inner thighs, but it is a correction procedure rather than a simple volume add. The result can look natural when the defect is well defined, the skin is healthy, and small amounts of fat are layered carefully. It is less predictable in very thin legs because donor fat may be limited and some of the grafted fat may absorb.

An in-person exam is essential to see whether the issue is true volume loss, skin...

I'm sorry you're dealing with this, persistent under-eye/malar fullness after tear trough filler is a recognized complication that can be frustrating and make people look more tired. It sounds like possible malar edema (swelling in the cheekbone area due to lymphatic issues) or a festoon/malar mound that the filler worsened or highlighted. This often happens because filler can obstruct lymphatic drainage in the thin tissues around the eyes and midface.
At 37, you're not "too young" for...

At 42 and not overweight, this area can come from several different things: a small pocket of submental fat, skin laxity, platysma banding, chin projection, or deeper neck anatomy. In the photos, there appears to be fullness under the chin with some loose neck skin or banding, but an in-person exam is needed to tell how much is fat versus skin and muscle laxity.

Kybella or small-volume liposuction can help when the main issue is fat and the skin still has good recoil. Filler or a chin...

From your three close-ups, your eyebrows are low on the orbital rim and the loose skin hangs over your eyelashes, causing that heavy appearance. Your two blepharoplasty procedures removed skin from the lids but did not fix the underlying problem, which is your eyebrow position. The drooping is back because the eyebrows were never raised in the first place. Blepharoplasty surgery feels incomplete because when your eyebrows are low, taking just loose skin off the eyelids creates heavy lashes...

While a SOOF (sub-orbicularis oculi fat) lift can technically be performed with remaining hyaluronic acid filler in place, it is highly recommended to dissolve the product before surgery to ensure maximum precision. Leaving filler intact can distort your true underlying anatomy, making it difficult to judge exactly how much natural tissue needs to be mobilized and vertically repositioned. A SOOF lift primarily provides a beautiful, strictly vertical elevation of the midface fat pads to...

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...

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...