Doctor Q&A

Based on your description and the photos, it sounds like you may have excess soft tissue or fullness in the intermammary area (the space between the breasts), which can sometimes become more noticeable after a breast augmentation and lift, particularly depending on your anatomy, implant size, skin quality, and how your tissues healed.
The good news is that there are treatment options that can improve this area without creating large visible scars on the chest. In situations like this, I...

I would not recommend an implant without a lift due to the soft tissue/skin laxity. Your surgeon should take tissue based measurements that will guide the decision. It is truly based on mathematics (breast width, skin stretch, vertical excess).

It’s understandable that you’re feeling a bit conflicted, as the "over the muscle" (OTM) versus "under the muscle" debate is one of the most important decisions in breast augmentation, especially when trying to avoid a "double bubble." Your surgeon’s suggestion of an OTM teardrop implant is likely aimed at ensuring the implant moves naturally with your existing breast tissue rather than being held back by the chest muscle, which is a common strategy when there’s a slightly higher breast ...

Dear Tru,
Your age is no obstacle to having a tummy tuck, so if that's what you want, you can do it. You have a lot of stretched out skin, and a tummy tuck will remove it, the muscles will be tightened and aside from some residual stretch marks around the belly button and lower abdomen, you will notice a major improvemeent

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.

Regarding your persistent, localized pain 14 months post-BBL, experiencing severe discomfort while sitting falls outside the expected recovery timeline for standard fat graft integration. This presentation strongly suggests non-standard etiologies such as deep scar tissue contracture, localized nerve compression, or a chronic inflammatory response within the deep soft tissue layers. Given the lack of resolution, a secondary clinical evaluation by an independent plastic surgeon is indicated....

Hi there! Yes, based on your photos, I do think you would be a good candidate for a skinny BBL. This term is typically used for patients who have a smaller amount of fat available for transfer, compared to a traditional BBL.
While there’s always a chance that we may not have as much fat as we’d ideally like, I do think you appear to have enough to achieve a very nice result. The combination of liposuction and fat transfer can create a beautiful, more feminine shape by enhancing your nat...

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...

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...

Swelling after liposuction of the front thighs and knee area can be different from the outer thighs. The knee area is more dependent, moves constantly, and has tighter soft tissue, so swelling may be more noticeable and slower to settle there.
For many patients, the first few weeks are the most swollen. A large amount of the swelling may improve by 6 to 8 weeks, but the knees and lower thigh can still feel puffy, firm, or uneven for several months. The final contour commonly continues to...

Looking at your photo, I do not think you look like someone who necessarily needs a full facelift yet. What I mainly see is early midface descent, under eye hollowing/shadowing, and some softening around the lower face that creates that “tired” appearance.

In your case, a lower blepharoplasty — possibly combined with fat repositioning or conservative fat grafting — would likely make a more noticeable difference than RF microneedling alone.

Sculptra and RF treatments can improve skin qu...

There is usually nothing wrong with doing facial fat transfer after a deep plane facelift, as long as the timing and goals make sense. Many surgeons combine fat grafting with a facelift because lifting and volume restoration treat different parts of facial aging. The facelift repositions sagging tissues, while fat transfer can soften hollows in areas such as the temples, cheeks, under-eyes, or around the mouth.
Adding fat transfer at the same operation can add some bruising, swelling, and...

First, it is important to confirm that all filler has been fully dissolved. In some cases, residual product or tissue reaction after hyaluronidase can still contribute to persistent puffiness or shadowing.
If the filler has been completely resolved and the issue persists, the underlying cause is often related to prominence or displacement of the lower eyelid fat pads.
In these cases, I typically perform a lower blepharoplasty, most commonly using a transconjunctival approach. This means...

You do have a deep set eyes but, very likely, a bilateral eyelid ptosis, droopy eyelids. This needs to be confirmed on the basis of in person evaluation. Correction of ptosis and conservative fat grafting would be my suggestion. Good luck.

Patients frequently complain about some asymmetry of their facial features. No one has exact symmetry and everybody has a small amount of asymmetry. Your upper eyelids do not have any redundant skin that would be treated with an upper blepharoplasty. I believe the small amount of brow asymmetry that you have could be improved with a temporal, hairline brow lift. Your hairline is rather high, but a subcutaneous brow lift with an incision along your hairline should help to correct the small...

I recommend you begin with a lower blepharoplasty with fat transposition to fill out the hollows. After this is done, you can consider if you need a mid facelift.

Best Wishes,

Gary Horndeski, M.D.

Good news — the transconjunctival approach to lower blepharoplasty is actually the better choice for a contact lens wearer, and once healed it shouldn't interfere with your toric (astigmatism) lenses.
Why the transconjunctival incision is contact-lens-friendly:
The incision is made on the inside of the lower lid (the conjunctival surface), not through the outer skin. It's well away from the cornea, where your contact lens actually sits. The cornea and the optical surface of your eye...