Doctor Q&A

Thanks so much for your questions,
A 255 cc implant is very commonly used for patients who want to return to a pre-baby size or move from an A/small B to a full B or very small C, especially when placed properly (often under the muscle or dual plane). It fills the upper pole without creating heaviness, side spill, or that “implants first” look. It also tends to age better and feel more proportional over time.

Suggesting 325 cc doesn’t mean it’s “wrong,” but that size often lands close...

In my opinion, both 320 cc and 340 cc Motiva demi implants will give you more volume than 245 cc, but 320 cc is more likely to keep you in a natural range that fits your goal of wearing bralettes (small) and keeping your xs/s shirt size. The difference between 320 cc and 340 cc is relatively small, but it can be noticeable on a petite frame.

Since your priority is fuller without looking “too large”, 320 cc tends to be more predictable for that sweet spot between enhanced and natural. A car...

A “normal“ sternal notch to nipple distance is 18 to 22 cm. If your sternal notch to nipple distance is 15 cm, it means that your breasts sit higher up on your chest. This impacts the choice of your breast implant size because as implants get larger, they also get wider/taller and the top of larger implants will appear to be closer and closer to your clavicle if the implant is positioned correctly behind your nipple. You should have a detailed discussion about what implants would fit bes...

The most likely reason the implants have dropped in position is the placement in the subglandular position. When implants are put on top of the muscle and fascia, the weight of the implant is supported only by the breast tissue and skin. 285cc is not a “large” implant, but it seems that it was more weight than your breast tissue is able to support on its own. With the stretching of the tissue, the implants gradually drop in position. The space between the implants could be due to the sam...

Thanks for your question. The best thing to do is to schedule an appointment with your plastic surgeon and explain what happened along with your symptoms. He/She can examine you and may order some imaging to determine if you have a rupture. You may have just pulled a muscle, but an exam by your plastic surgeon is warranted.

Best of luck!
Port City Plastic Surgery

The abdominal scar is not keloid or hypertrophic. The primary problem is the abdominal fat above the scar. I would suggest liposuction of the abdomen with a possible scar revision. The umbilicus needs to be revised. You should see another plastic surgeon in your area for another opinion.

Your photos suggest a mini tummy tuck or liposuction alone would be inadequate. A more standard tummy appears indicated. This can be confirmed during a consultation with a board-certified plastic surgeon.

Your concerns are valid.

In my opinion, the procedure needed to achieve your desired results is a full tummy tuck. Based on the amount and pattern of your skin excess, a short-scar approach may not remove all of the loose skin and could leave residual unevenness. A full abdominoplasty allows for more complete skin tightening and a smoother, more balanced contour.

Whenever you’re ready:
Let’s make it better.

Warmly,
Dr. Luis Mejía, MD
Board-Certified Plastic Surgeon
CECILIP – Domini...

Hi, thanks for your question! A full tummy tuck will remove the stretch marks below your belly button. Depending on the surgeon, your incision will most likely be at the same point as your C-section scar or a little bit below it. If there are remaining stretch marks, their appearance can be reduced with Fraxel CO2 Laser.

Hello and how are you. I always recommend patients do at least ten to twenty lymphatic drainage massages after their procedures. We recommend that these massages be done by a massage therapist that specializes in lymphatic drainage. If you do them by yourself, it may harm your results and you may heal improperly. Lymphatic drainage massages are absolutely necessary. Another reason these massages are important is protecting your invest in your body to maximize your results.

Thanks so much for your question,
Yes, in general, it is better to do a brow lift before a hair transplant or hairline-lowering procedure. A brow lift changes the position of the brows and the forehead skin, and in some techniques it can subtly affect the hairline position or tension. If you did the hair transplant first and then lifted the brow later, you could end up distorting the transplanted grafts or shifting the hairline in an unpredictable way. Doing the brow lift (and...

Thanks so much for your question,

Based on what you’ve shared, yes , you can be a candidate for a BBL, but it would likely be shape-focused BBL rather than a high-volume one. At 5’2” and 120 lbs, you’re on the leaner side, which changes how a BBL is approached, not whether it’s possible.

Having large flanks and a lower abdominal pooch is actually important here, because those are excellent donor areas. In shorter patients, even modest fat in the flanks and lower back can yield enough vo...

Thanks so much for your inquire,

A tummy tuck removes skin and tightens muscle; it does not remove the deep fat that is typically harvested for a BBL. The fat used for a BBL comes from areas like the flanks, upper and lower back, waist, and belly, not from the skin that’s excised during a TT. So the fear that “if I do TT first, I won’t have fat for a BBL later” is usually overstated.

Doing a BBL first can leave you with a rounder butt but a still-loose abdomen, and when a tummy tuck is...

Hello, Thanks so much for your inquire,
Liposuction alone is rarely ideal for an apron belly. Removing fat without tightening skin can actually make the fold more noticeable. That’s why many women in your situation are good candidates for a mini tummy tuck. A mini tuck targets the lower abdomen only, removes excess skin below the belly button, and can include a small amount of muscle tightening if needed. It avoids the more extensive dissection of a full tummy tuck and has a shorter r...

Thanks so much for your inquire,
What you’re calling “chicken butt” typically happens when fat was removed from the lower gluteal pole or infragluteal fold, something that unfortunately was more common years ago before modern gluteal anatomy and aesthetics were better understood.

Lower buttock contour irregularities can often be improved, but the correction has to be conservative and very strategic. The goal isn’t augmentation ,it’s restoring continuity, support, and smoothness to the lo...

Usually at least 6 mm of lower lateral cartilage should be left after cephalic trim. Removing too much can lead to deformities after some time. We often leave more to keep good support of the sidewall of the nose. The key is to straighten the lateral crus, which created a less bulbous, more defined tip. Correcting an over resection involves using cartilage grafts to reestablish the lateral cartilage to the proper size. Be sure you see a rhinoplasty expert for consultation.

Straightening the frontal view of a nose is often not very predictable. However, when we have the opportunity to change the overall size or shape of the nose, that helps a lot in working on asymmetries. For example, (caveat: my assessment is based on these few small photos, but here goes anyway) if you love your nose exactly as it is, and just want it symmetric from the front, I'd probably advise against trying, because the attempt is more likely to change one asymmetry for another, or make...

A rhinoplasty only uncommonly would change the length of the philtrum, and the surgeon should be able to tell you, based on your photos, whether you have the kind of nose where that might happen. But it's rare-ish. If, however, your tip is so droopy that it covers part of your philtrum, and if the surgery is successful at elevating your tip, then you may be able to *see* more of the philtrum after surgery, even if the length of the philtrum didn't change. Get it? I think it'd be really rare...

Hello and thank you for your question. Based on your photographs, the best way to fix this is with a surgical revision. Support with cartilage grafts needs to be established and noninvasive ways such as thread lift or Botox would never work for this. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D...

Just like all other people, your face is a symmetrical.
Your right side has more cheek projection, and the left side has less projection and is wider(assuming you didn’t take the pictures using a mirror)Because each side of the face is different this has a significant impact on how the nose is perceived.
To me, your nose looks just fine and I don’t think you should have any operation on it based on the pictures included.
Best,
Mats Hagstrom MD

A March surgery date can absolutely be realistic, but it depends on a few key factors. If you have your consultation in December or January, and there are no medical issues, March is typically achievable depending on the surgeon’s availability, financing approval, and completion of pre-operative requirements.
As far as recovery and time off work, this varies by procedure and the physical demands of your job. For mommy makeovers that include a tummy tuck, I generally recommend 2 weeks off f...

If your primary concern is loose, sagging abdominal skin, the most definitive solution is a tummy tuck. A tummy tuck physically removes excess skin and tightens the abdominal wall, which is why it is the best option for the “lumpy” appearance you notice when bending over. Stretch marks alone don’t drive this decision; it’s the skin laxity, and that cannot be corrected with non-surgical treatments.
From a contour standpoint, I would typically recommend a tummy tuck with lipo 360 and BBL, co...

Based on your history, goals, and current anatomy, you have both surgical and non-surgical options, but it’s important to be upfront about what will and will not realistically achieve the changes you’re looking for.
You’ve had under-the-muscle silicone implants for 15 years, three pregnancies, and breastfeeding, which commonly leads to skin laxity and loss of upper-pole fullness, even when implant volume is still acceptable. Non-surgical treatments cannot tighten breast skin or restore upper...

I routinely combine breast surgery with a tummy tuck and liposuction, including 360 liposuction, in healthy patients. That combination is generally safe when planned carefully and allows for one recovery period.
I do not recommend combining a tummy tuck with a thigh lift in the same surgery. The incisions for a tummy tuck and a thigh lift sit very close to one another in the groin and hip crease. Performing both at once increases tension on the skin, reduces blood supply to the area, and...

Congratulations on your weight loss. Losing over 100 pounds is a major accomplishment, and what you’re experiencing with excess skin is very common after that kind of transformation.
For the midsection, based on your photos, most patients in this situation benefit more from a belt lipectomy (also called a 360 tummy tuck) rather than a standard tummy tuck alone. A traditional tummy tuck primarily addresses loose skin and muscle laxity in the front of the abdomen. After massive weight loss, e...

Breasts are seldom perfectly symmetric. The symmetry can generally be improved as a part of a breast reduction.

Hello and thank you for this question. This is a topic I’m asked about during every consultation I do for both breast reduction and breast augmentation. There is an area of fat right under the armpits that plagues women of all shapes and sizes. It’s very simple to treat with liposuction during your procedure. It’s not typically covered by insurance but the cost, time and recovery are often minimal and can be done at the same time as your reduction or performed later under local anest...

Yes, it is absolutely possible in many cases to keep your current implants and still perform a breast reduction — but it must be done with the right technique and for the right reason.This situation is actually a classic indication for a Push-Up Lift–style reduction.How breasts get “too big” with implantsOver time, breasts can enlarge due to:Weight changesHormonal factorsPregnancySkin and tissue stretchIn these cases, the excess volume is usually your own breast tissue, not the impla...

Being told that a free nipple graft (FNG) is “required” to go from a G cup to a D cup is common — but it is not always true, even for large reductions.With modern tissue-preserving reduction techniques, it is often possible to achieve:Significant size reductionGood upper-pole fullnessNipple sensation preservationViable nipple–areola complex— without a free nipple graft.Why surgeons recommend free nipple graftsFNG is usually suggested when surgeons are concerned about:Nipple blood...

Unfortunately, breastfeeding is not possible after a free nipple graft. During a free nipple graft, the nipple-areola complex is completely detached from the breast and then reapplied in its new position, similar to a skin graft. This process transects the milk ducts, which subsequently scar and do not reconnect. As a result, patients are unable to breastfeed following this procedure.
If preserving the ability to breastfeed is important to you, it may be worth seeking additional...

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Yes — you can have a natural-looking result with implants alone, and in your situation the best way to do that is with a Preservé (tissue-preserving) augmentation approach.A Preservé augmentation focuses on:Preserving your natural breast tissue, ligaments, and footprintAvoiding unnecessary skin or nipple surgeryCorrecting asymmetry through precise pocket control, not lifting scarsWhy Preservé works well for small, asymmetrical breastsIf your breasts are small, not sagging, and ni...

Based on the findings, this is not simply small breasts — it is most consistent with an advanced (moderate–severe) tuberous breast deformity.Why this is tuberous (and more advanced)Your description includes several classic and significant signs:Large, soft, puffy areolae relative to breast sizeAreola positioned very low on the breast moundLittle to no under-breast (“underboob”) tissueMarked lack of upper-pole fullness and cleavageWide-set breasts with asymmetryBreast tissue displ...

Based on your height, weight, age, post-pregnancy changes, and current 34B with mild droop, it’s important to be very honest about expectations.Augmentation alone (dual plane with a 265–300 cc implant) can add volume, but it will not reliably correct droop or create upper-pole fullness in a natural way at 52. An implant can fill the breast, but it does not reposition breast tissue or the nipple. This is why many patients feel “bigger but still droopy” after implant-only surgery.For your go...

The older 83% vs 17% breastfeeding numbers are outdated and oversimplified. Current evidence and clinical experience show that both under-the-muscle (UTM) and over-the-muscle (OTM) implants can allow successful breastfeeding. What matters more than the implant plane is surgical technique—specifically preserving milk ducts, nerves, and blood supply, and choosing incisions that avoid ductal injury.OTM implants can theoretically increase pressure on the ducts in some patients, especially...

Hello and how are you. I always recommend patients do at least ten to twenty lymphatic drainage massages after their procedures. We recommend that these massages be done by a massage therapist that specializes in lymphatic drainage. If you do them by yourself, it may harm your results and you may heal improperly. Lymphatic drainage massages are absolutely necessary. Another reason these massages are important is protecting your invest in your body to maximize your results.

Hello and thank you for your question Given your weight, height, and history of 2 pregnancies it might be better to consider an abdominoplasty with liposuction for maximum aesthetic results. This procedure would remove excess skin, fat and stretch marks, while repairing muscle that can be stretched due to multiple pregnancies. Your best bet is to see a plastic surgeon and have him examine you and then detail the pros and cons of liposuction vs a liposuction with tummytuck. Good luck!

Hello and thank you for your question. It sounds as though you would simply need fat removal fromThe pubic area with liposuction. This can be done through a single small incision. This procedure can be done under local anesthesia while you’re awake and comfortable. Healing is very rapid and most people have swelling for 3-6 weeks post op.

Hello and thank you for your question. Upon reviewing your photos, it appears as if you have fat deposits as well as some loose skin. A combination of liposuction and skin removal from your inner thigh will help improve the appearance of this. The procedure usually takes about 3 hours, incision are generally placed either in the groin or inside of the thigh to help hide them. There are several options to address your buttock including adding volume to lift it or also doing a skin excision to...

Hello there,
Hey, thanks for the photo!
Good news: that color change isn't permanent skin damage. It looks like it's vascular- and nerve-related, probably from the liposuction being a bit too intense. The fact that it gets worse in the cold but better with heat and massage supports this. Since it's only been 7 months, it's still healing, not the final result.
Vbeam usually doesn't help much with this kind of thing, and paying extra for Vbeam Perfecta probably won't change that. Usually, this...

Hello, it looks as if the contour of your upper eyelids is slightly off-center on each side. This may be due to the ptosis sutures being placed too far outward instead of right above the pupillary center. Can consider a revision to help correct this contour. Please visit an oculofacial plastic surgeon for best results.

Based on your photos, your brows are in a reasonable position, so you would benefit from upper lid surgery by itself. If the brows start to droop in the future, then a browlift would be performed. Be sure to see a facial specialist for consultation.

You have hooding of your upper eyelids laterally which will not be adequately corrected with upper blepharoplasty alone. In these cases I combine upper blepharoplasty with a lateral browlift which I routinely perform under local anesthesia with light oral sedation as an office procedure with long lasting natural results that do not change eyelid shape or raise the brow unnaturally. Doing a browlift alone will not correct the eyelid excess without elevating the brow to an unnaturally high...

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are...

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are...

It really is best to do both at the same time. It makes absolutely no sense to break them up as you need to do them together to get a good result. A facelift includes doing the neck. You need to address them both so that the extra skin can be removed properly and the face and neck compliment one another.. Doing them separately would prolong the number of days of your recovery as well. Hope this helps.

All the Best,

Dr. Jabs

Thank you for your query. You may benefit from non surgical procedures. I would recommend radio-frequency based skin tightening along with autologous fat grafting. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Hi there! I recommend a face lift to help reposition your SMAS. Different surgeons tend to have different definitions of what a "mini" face lift is, but ultimately you should be certain that your surgeon is accessing and lifting your SMAS, which is what I would consider a face lift- nothing "mini" about it!

Hi there. I do not think you would benefit greatly from a face lift, and your fat pad descent is not as pronounced as your volume loss, so even a minimally invasive option like the so called "pony tail" or endoscopic lift would not be of great benefit. However, a small volume of autologous fat grafting, Renuva, or HA filler could look very nice.

Looking at you to post photos I am not sure what you mean by vertical lines?? An appearance I might recommend the Endo laser, full face and lower eyelid treatment under local anesthesia or IV sedation local anesthesia. But I also might recommend a mini face neck lift with muscle multiplication with the Endo laser?? Best of virtual console with expect fee fees to range from $5000-$15,000 depending on what surgical options you decide to use again best of virtual consult with.