Doctor Q&A

From the limited photo, I can see why the lower-pole shape is the focus, but an exam is needed to judge the breast tissue quality, skin laxity, nipple position, and where the excess or deficient tissue actually sits. A Ryan-type reshaping procedure may be appropriate in some patients when the goal is to change tissue distribution and lower-pole contour, but it is only one possible technique and the result depends heavily on the starting anatomy.

Since you do not want implants and have...

Choosing the right size and profile breast implants for you. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very...

A tummy tuck can tighten the abdominal wall when muscle separation or laxity is present, but it does not reliably stop bloating that appears after eating or drinking. What stands out in the photo is a slim abdomen with limited visible loose skin, although the image is limited and an exam is needed to assess the lower abdominal wall.

A 1-2 cm diastasis is relatively small, and repairing it may improve contour if the lower abdomen is protruding because of muscle laxity. However, swelling that...

Yes. Based on your description and the photos provided, it appears that your primary concern is the amount of tip projection seen on profile view rather than the appearance of the nose from the front. This is a common request, and in many cases it can be addressed with a very conservative rhinoplasty.The goal would not be to create a dramatically different nose, but rather to subtly reduce tip projection while preserving your natural appearance and maintaining harmony with your facial...

A seroma capsule does not always have to be removed 100% for the seroma to resolve, but the remaining space has to collapse and stop producing fluid. In chronic seromas, recurrence can happen because of residual capsule, motion in the area, a persistent dead space, inflammation, or less commonly infection; the right treatment depends on exam and imaging findings, not just the amount of capsule left behind.

If fluid keeps returning 2.5 months after capsule excision, it is reasonable to ask...

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...

Thank you for this important question. Modern silicone implants are filled with a cohesive ("gummy bear") gel, so when the shell tears the gel tends to stay in place rather than spreading. This is why most silicone ruptures are "silent" — they often cause no symptoms at all, and many women have no idea anything has changed. When there are signs, they can include a change in breast shape or size, new firmness, lumps, a different feel to the breast, and sometimes discomfort. The...

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 photos show visible inner-thigh contour depressions and uneven transitions, but an in-person exam is needed to tell how much is true fat deficiency, scar tethering, residual swelling, or skin laxity. When a dent is caused by over-resection or tethered scar, simply removing more fat below the dent can sometimes soften the transition, but it can also make the area look thinner or more irregular if the main problem is volume loss.

Correction usually starts with waiting until healing is...

The best treatment for this would be liposuction. There are no non-surgical treatments for this area.

Best Wishes,

Gary Horndeski, M.D.

Fat that was transferred 30 years ago is usually living tissue mixed with normal cheek fat and scar tissue, so it is not always possible to simply "remove the fat transfer" as one clean layer. A lower facelift can improve jowls, neck, and lower-face laxity, but it may not fully correct excess volume high in the cheeks unless the overfilled area is directly addressed with a separate, carefully planned contouring step.

Kybella is generally not a precise choice for this problem and can be...

Hello, and thank you for sharing your concerns. I understand how distressing it can feel when you notice changes in your face that seem to happen quickly, especially at a young age. Although you mentioned no weight loss, body composition changes can affect our faces, as rapid weight loss can. Both can sometimes lead to facial volume loss and changes in skin support that may make folds and sagging appear more noticeable. At 26, I typically do not recommend a facelift. Facelift surgery is...

Thanks A.G.A. for your question! This is a notoriously tricky situation, and it is completely understandable why you are receiving conflicting advice. Looking at picture, there is a noticeable asymmetry and fullness in the lower face/perioral mound area, which aligns perfectly with what happens when transferred fat behaves like regular body fat—fluctuating and expanding when you gain weight.
Because the transferred fat has integrated into your living tissue over 15 years, managing it r...

Based on the photo, this appears to be a small residual dog ear or standing cone at the lateral aspect of the upper blepharoplasty incision. Fortunately, this is typically one of the more straightforward revision procedures in eyelid surgery.At two years postoperatively, the scar is fully mature, so further spontaneous improvement is unlikely. If the prominence continues to bother you, a minor revision can often flatten the area and improve the contour. In most cases, this involves excising...

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...