Doctor Q&A

Thank you for your thoughtful question. I commend you for taking the time to carefully research aesthetic breast procedures in order to determine the approach that will best help you achieve your aesthetic goals.

Based on your photos, it appears you may be a good candidate for a breast augmentation combined with a lift (mastopexy). In patients with breast ptosis or skin laxity, combining these procedures can improve both breast volume and shape while repositioning the nipple-areolar complex...

You should probably go by what your plastic surgeons say. Like most of plastic surgery, it depends what your expectations are and what trade-offs you are ready to make. It is difficult to say without an examination, but I think I would be hesitant to just do an augmentation here without a lift. There is a very high chance that the patient would not ultimately be happy, even if they say they are willing to accept certain trade-offs.

Without an in person exam, and more complete photographs, it is hard to give you any useful advice. I know it is difficult when you get different opinions from different plastic surgeons. It often comes down to having realistic expectations and knowing either approach may be a trade off. Good luck with any upcoming surgery. It seems you could have a very nice result.

Thank you for your photos. I believe you would be best served by weight loss prior to considering your surgeries. A consultation with a plastic surgeon would allow you to understand your expected results before weight loss and the better results which you would likely achieve after weight loss. Prior to considering the surgeries your BMI should be 30 or less to maximize your results and minimize your complications. Your plastic surgeon can discuss this in detail with you. I can’t make a c...

In many cases, patients born with one healthy, well-functioning kidney can still safely undergo procedures such as a tummy tuck, muscle repair, and liposuction. The most important factor is confirming that your kidney function is completely normal before surgery and that you are medically cleared appropriately.

Since you mentioned you have never had issues with high blood pressure, diabetes, or kidney-related complications, that is certainly reassuring. However, a surgery of this magnitude...

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...

Persistent pain after a BBL can sometimes be related to nerve irritation, inflammation, prolonged swelling, compression from scar tissue, or pressure on surrounding structures during healing. In many cases, symptoms improve gradually over time, but ongoing pain should never be ignored, especially if it is severe, worsening, associated with numbness, weakness, burning sensations, or difficulty walking or sitting comfortably.

One of the most important first steps is determining whether this...

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 thoughtful question. I commend you for taking the time to carefully research breast reduction procedures as you explore the options that will best help you achieve your aesthetic goals.

In the vast majority of breast reduction procedures, an areolar reduction is performed as part of the surgery. Because breast reduction involves reshaping the breast and removing excess skin and tissue around the areola, we are typically able to reduce the diameter of the areola at the...

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...

No, The only reason to remove capsule is if it abnormal or pathologic. Your surgeon would have most likely done that at that time if this were the case. Dr. Ted Eisenberg, board certified plastic surgeon and author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa. USA.

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...

At 44, the structural asymmetry in your submental region is primarily driven by a localized distribution of deep subcutaneous fat coupled with early platysma muscle band laxity, rather than a simple loss of superficial skin elasticity. My suggestion to achieve a clean, symmetrical jawline is targeted neck liposuction combined with a conservative submentoplasty (platysmaplasty) to physically bind and tighten the underlying muscle bands. While non-invasive skin tightening devices or simple...

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...

Filler should actually be dissolved before the SOOF lift. The filler and the SOOF do not sit in the same plane. Filler is either placed supraperiosteally or just below the skin, while the SOOF compartment sits between the orbicularis oculi and the orbital septum.

When you operate into a cheek already loaded with HA filler, the layers become indistinct. It hides the underlying landmarks and causes problems like contour irregularities and asymmetric vertical lift. You also cannot discern if...

At 42, your concerns with the under-eye area are driven by a combination of mild lower eyelid fat prolapse (eye bags) and early structural volume loss along the midface and nasolabial regions, which is why temporary injectables like EZ Gel only provided short-term improvement. Looking at your anatomy, my suggestion is a transconjunctival lower blepharoplasty combined with micro-fat repositioning or grafting; this will seamlessly flatten the under-eye bags and fill the tear trough without...