Doctor Q&A

Implants alone may be possible if you are comfortable with a natural, slightly lower breast shape, but they are less reliable for correcting true lower-pole excess, nipple height differences, or significant left-right asymmetry. The photos show volume asymmetry and more lower-pole laxity on the left, so the key measurement is where each nipple sits compared with the breast fold, not just whether the nipple points downward.

A larger implant can improve upper-pole fullness, but it does not...

Let me answer your main worry first, because it is the most reassuring part: yes, with a dual plane implant you can absolutely keep doing heavy lower-body training and moderate shoulder and back work. The animation and implant-displacement concerns that come with a dual plane are caused specifically by the pectoralis major muscle, and that muscle is strongly activated by direct chest exercises — bench press, chest flys, push-ups, dips. Squats, deadlifts and lower-body work do not...

Thank you for your question! Based on your photos, you appear to have what we call Grade 2 ptosis, meaning the nipple sits at or near the level of the breast fold. This is most noticeable from the side view.

The challenge with adding implants alone is that the implant sits behind the existing breast tissue. When the breast tissue has descended, the implant will also sit lower on the chest, which often does not create the upper fullness or cleavage that many patients are hoping to achieve...

It is very difficult to appreciate you facial balance based on these photos. It appears that conservative full nose rhinoplasty would be a better solution than tip elevation, shaping and rotation? In order to improve profile harmony chin augmentation should be considered. Good luck.

Hello! Thank you for your question.
As far as I can see from your photos It is possible to achieve the look you desire through rhinoplasty, I recommend rhinoplasty procedure for you.
It would be better face to face consultation.
Best Regards!

A tummy tuck may still be possible after an old open cholecystectomy scar, but the scar changes the planning because it can affect blood supply to the upper abdominal skin. The photos show a visible upper abdominal scar with lower abdominal laxity, so this is not automatically non-viable, but it should be assessed by a surgeon who is comfortable modifying the abdominoplasty design when prior scars are present.

Your consultations are worthwhile. The surgeon will check skin mobility, scar...

I would really need and in person exam to give you the best advice. Recovery by 4 weeks should be very well progressed and maybe this should not be the deciding point on whether you get muscle tightening. The tummy tuck will often last a lifetime and a certain amount of extra pain and inconvenience for 5 or 10 days may be worth a better final result. Not everyone needs muscle tightening, but the decision may also be based on your expectations.

Hello. You an ideal candidate for lipo-abdominoplasty or tummy tuck. VASER liposuction helps in removing excess fat and better skin tightening. Tummy tuck will help in achieving the better waistline by removing the excess skin. Also you can consider breast lift in same sitting if the sagging breast are bothering you, that becomes a Mommy-makeover surgery. For any further queries feel free to contact to us.
Thank you.

Regards,
Dr. Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai,...

Thank you for your question! A "skinny BBL" is typically best suited for patients with a BMI between about 20 and 24. Based on the information you provided, your BMI is currently around 19, which means you have very little available fat for transfer.

While you do appear to have some fat in the abdominal area that could be used to improve your waistline and create a flatter contour, there may not be enough fat to produce a noticeable increase in buttock volume.

For that reason, I would...

A prior superficial clot does not automatically rule out a BBL, but it is an important risk factor that must be reviewed before elective surgery. The key details are whether it was truly superficial thrombophlebitis versus a DVT, how recently it occurred, whether it has fully resolved, whether you used blood thinners, and whether you have any clotting disorder or ongoing leg symptoms.

BBL is usually a longer operation with liposuction, positioning, and recovery limits, so your plastic...

First, please do not feel embarrassed — external hemorrhoids are extremely common, your surgical team has seen them countless times, and they are simply a medical detail to plan around, nothing more. The reassuring news is that they should not complicate the surgeries you are planning. A tummy tuck, implant removal, breast lift with fat grafting, and liposuction are all performed in completely different areas of the body from the anal region, so your hemorrhoids will not be in the...

I understand all your concerns. After losing weight, usually I recommend having a lower body lift (circular abdominoplasty), because with that procedure we can reposition in a better way the glutes, the anterior and lateral thighs and lower back. The aesthetic result we can achieve is much better than a standard tummy tuck. We can add liposuction in the back and flanks for a better contour, add fat to the butt and add a breast lift without reduction.
We can do all these procedures in the...

There are many techniques for a breast reduction. I personally have never done a full nipple graft because I think we can lift as much as needed with a specific technique for that.
I would absolutely consider doing a technique that doesn´t involve a full nipple graft.
Every case has to be studied appropriately and decide what technique is best for you.
Feel free to contact us for an evaluation.

Thank you.
Dr. Salvador Medina

Thank you for sharing this so openly. First, please know that what you're describing — physical pain, difficulty exercising, and constant self-consciousness with a 34DDD+ chest — is exactly the situation that breast reduction surgery is designed to treat, and 20 is absolutely an appropriate age to consider it. Once breast development is complete (usually by the late teens) and your size has been stable, there's no medical reason to keep waiting if the symptoms are affecting your...

Hi and thank you for your question. Speaking generally about the process of liposuction, it's used more so to remove adipose tissue. What makes liposuction of the breast difficult and oftentimes not recommended is that breast tissue tends to ne made up of largely fatty adipose tissue. Distinguishing between these 2 different layers is often difficult and can't be done properly using liposuction techniques.
The only time I use liposuction in regards to the breast is if I want to contour out...

Good morning! It’s very common to still have a small amount of milk production even after weaning, especially after breastfeeding for an extended period of time. In most cases, this does not interfere with breast reduction surgery, and I agree with your plastic surgeon’s guidance.
The biggest thing is avoiding frequent checking or expressing the milk, since stimulation can encourage continued production. Residual milk during surgery or early healing is usually manageable and typically res...

What you’re describing—visible “bulging” in parts of the forehead with a nearby dip or indentation—is something we often see when the frontalis muscle is working unevenly or over-contracting in certain zones. It can create a very wavy or textured appearance at rest or during expression, even in younger patients.

In many cases like this, Botox can help—but only if the underlying pattern is truly muscle-driven.

How Botox helps in this situation

Botox works by relaxing specific portions of...

Thank you for reaching out, and I completely understand how frustrating it can be to look tired no matter what you do — under-eye hollowness is one of the most common concerns I see, and it can absolutely be addressed.Just to clarify one thing: a brow lift addresses the forehead and upper eyelid area, so that wouldn't target your concern. What you're describing — the hollowness and shadow under the eyes — falls in the territory of the lower eyelid and tear trough area.At...

The best way to determine if your silcone implant is leaking is an MRI, and in some cases a high-resolution ultrasound can be used by an experienced operator.

If your implants have been in over 8 to 10 years, or of they are older models, or if you have changes in size/shape then I would be suspicious for rupture or leak.

Leaking silicone, especially from older devices, can migrate or move through the tissues and is hard to remove. Always best to be on the safe side and have things...

Thank you for describing this so clearly, and I want to gently encourage you to have this evaluated in person soon — not because I want to alarm you, but because new or increasing nipple discharge always deserves a proper workup. The most reassuring news first: nipple discharge after recent pregnancy and breastfeeding is very often benign and hormonally driven, and your implants under the muscle are usually not the cause of clear or yellowish fluid. Galactorrhea (milk-related...

Yes, breast implants can often help restore volume after a breast reduction, but the relationship between grams removed and implant volume is not a direct one-to-one conversion.
In your case, having approximately 400 grams removed from each breast does not necessarily mean that a 400–425 cc implant will return you to your exact pre-reduction size. Breast tissue is a combination of glandular tissue, fat, and skin, while implants add volume in a different way and create a different shape. F...

The degree of breast sagging is significant enough that a breast lift should be strongly considered.

While it is possible to undergo breast augmentation with implants alone, it is unlikely to provide a substantial lifting effect. It may improve the loss of upper breast fullness to some extent, but using larger implants could result in an unnatural appearance, known as a waterfall deformity.

For this reason, I would recommend undergoing a breast lift (mastopexy) in addition to augmentation.

Hello. For a better projection, upper pole fullness and better cleavage go for round implants. For subtle and tear drop shape choose anatomical. However, there is chance of implant rotation in anatomical implant. Also consider pros and cons before choosing the implants. For any further queries you can reach out to us.
Thank you.

Regards,
Dr. Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai, India
+919833571333

The amount suctioned is usually more than the final amount injected because lipoaspirate contains fluid, oil, blood, and damaged fat cells that are removed during processing. To obtain about 200 cc of usable graft fat, a surgeon may need roughly 300-500 cc or more of aspirate, but the exact number varies with technique, donor-site quality, and how much viable fat is available.

In a thin athletic patient, the limiting factor may not be the math but whether there is a safe donor area that can...

It is difficult to say for sure, but it does appear that you have stretch marks. This indicates that there are issues with skin laxity, which would make a tummy tuck more suitable. Liposuction alone may remove the excess fat, however it would most likely leave you with loose skin which would hide your results.

Hello. I would recommend a 360 Vaser liposuction with Bodytite and tummy tuck for your body morphology to get rid of all the rolls. Just focusing on back rolls without considering tummy will not give you better results.
Thank you.

Regards,
Dr. Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai, India