Doctor Q&A

Hello,
You bring up good questions. From reviewing your photos and measurements I think you could get the result you want without requiring a breast lift. You rNAC is above your inframammary fold which means it is at an ideal position already. A lift could cause your NAC to be too high and point upwards. You also appear to have good skin quality and not much laxity making a breast lift also much less needed. You have options in regards to going above versus below the muscle pending your...

From your photo, you are slim with very little breast tissue. The right breast sits slightly lower and has a bit more droop than the left, but the difference is small. In this situation I think implants alone can give a good result, and I would not add a periareolar lift, which on such thin tissue tends to widen the areola and flatten the breast. Because your coverage is thin, I would place the implants under the muscle. A slightly different implant volume or a small adjustment of the fold...

You are a great candidate for surgery. It looks like your muscles are flat and the majority of your concerns is the skin and fat. I would recommend liposuction with skin removal and umbilical transposition (much like a tummy tuck skin removal pattern). Muscle tightening can be overkill and risk adverse with increased downtime. You would need umbilical transposition as the skin above the umbilicus needs tightening. This can also be done with local anesthesia, no drains and less down time. See...

Thank you for your photos. A FDL tummy took will remove your present midline scar above your belly button, but it will replace it with a new scar, which is both above your belly button and below your belly button down to the top of your pubic area. It appears you’ve done an excellent job losing weight and a standard abdominoplasty, which fully releases the tethering of the scar above your belly button to allow the upper abdominal skin to be moved lower and tightened, will likely give you a...

Yes, rhinoplasty can significantly improve both overall nose asymmetry and profile irregularities, but setting realistic expectations is crucial for a successful outcome.Fixing Asymmetry: True structural asymmetry—such as a crooked nasal bridge, uneven cartilage, or mismatched nostrils—can be corrected using precise grafting, suturing, and realignment techniques. However, complete 100% facial symmetry is biologically impossible because natural underlying bone and soft tissue...

A tip plasty refines and rotates the tip, but it does not change the bridge, a dorsal hump or the width of the nasal bones. Whether it is enough depends on which of these actually draws the eye in your profile. Femininity of a face rarely comes from one feature alone; the relation between the nose, the lips and the chin matters just as much, and a weak chin can make a normal nose look larger. Before settling on a limited procedure, ask your surgeon to show you on your own photos what a tip...

Elevated factor VIII is a recognised independent risk factor for venous thrombosis, roughly doubling or tripling the baseline risk depending on the level, and combined with a family history it puts you in a higher risk category for surgery. It does not mean a clot is likely; it means the risk is meaningfully above average and needs to be managed, which is exactly what your hematologist is doing with prophylactic anticoagulation. What I want to add as a plastic surgeon is that a lipo 360 with...

It is concerning that your surgeon doesn’t know what’s going on either. Please find another board certified plastic surgeon for a second opinion.

After reviewing your photos and your weight and height it does appear that you do have enough of excess in the abdomen, flanks, upper hips, mid and lower back to harvest enough fat to recued these areas safely and begin to create a more hour glass shape to you body. Your waist will look slimmer just by liposuction. Next, this fat is prepared and then carefully injected into the buttock and hip dips. This will create more fullness of the buttocks and roundness of the outer hips. This will...

Hi! A 7-day interval can generally be sufficient for a 3.5-hour flight after a mommy makeover, provided your recovery is progressing normally and your surgeon has assessed you and confirmed that you are fit to travel.

Because you will be having several procedures at the same time, including abdominoplasty, liposuction and breast reduction, it is particularly important to follow your surgeon’s postoperative instructions closely and attend your follow-up before travelling.

During your r...

Combining a hysterectomy with a tummy tuck is sometimes done in the same surgery -- this is occasionally called a 'mommy makeover with hysterectomy' -- but it requires close coordination between your gynecologic surgeon and your plastic surgeon, since it means a longer combined operation and anesthesia time. Not every patient is a good candidate for combining these, depending on your overall health and the complexity of the hysterectomy. This is a conversation to have with both surgeons...

Hello @chcoer
I understand you want a reduction but want to avoid ending up with a deflates upper pole (which it sometimes happens after reductions)
There are 2 ways of avoiding that. One is using your own breast tissue to redistribute the volume and place the lower pole volume in the upper pole so you have a nice proyection, even after reducing.
The other option is using a small implant for proyection wich can be combined with the reduction.
I prefer using your own breast tissue for this...

The American Board of Plastic Surgery is the certification recognized by the American Board of Medical Specialties and requires completing a full plastic surgery residency, which includes extensive breast surgery training. The American Board of Cosmetic Surgery is not an ABMS member board and its diplomates come from different residencies; your second surgeon also holds American Board of Surgery certification, meaning he trained as a general surgeon and then added cosmetic training. For a...

In some patients (generally older patients when there is more fat in the breast), yes, a breast reduction can be done using only liposuction. Liposuction limits the amount of fat that can be removed but does not address the sagging. A traditional breast reduction would be a better option to address larger amounts of breast tissue/fat removal and help lift the sagging. It would be best to be evaluated by a board certified plastic surgeon to determine what method would be best for you.

From your photos you have a slim, athletic chest with very little breast tissue and no sag, and a round, smooth implant under the muscle is a good choice for you. Textured surfaces are used mainly for implants placed over the muscle, and for anatomical teardrop implants so that they do not rotate. Under the muscle a round smooth implant can be used without any problem, and in a dual plane pocket the muscle flattens the upper pole, so the breast takes on a natural slope when you stand. Unless...

Choosing the right size and profile breast implants for you under the muscle for a natural look. I recommend an in person evaluation with a plastic surgeon to discuss your goals and be measured. 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...

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first...

Hello Iovinac,
Thank you for your question which relates to management of patients prior to elective cosmetic surgery procedures including facelift surgery. My practice is particularly 'risk averse' and much effort is undertaken to optimise patients prior to surgery in order to minimise preventable risk, including working in high acuity facilities with the necessary medical backup.
The risk related to your thrombocytosis or high platelet count is two fold :
1. failure to identify and manage...

It would be very difficult to give you good advice based on these photos. Full face photos or, better, in person evaluation, would be much more appropriate. I would be inclined to suggest periorbital fat grafting but it would be a soft call based on such a limited photo information. Good luck.

There aren't any non surgical options that I am aware of to address your concerns. A consultation with a board certified plastic or oculopastic surgeon would be helpful to discuss surgical options. These would likely include a surgical canthopexy or canthoplasty to improve your canthal angle and slope.

Hi, thank you for sharing your question. Based on your photo, you do appear to have lower eyelid fat prolapse with some tear trough hollowing, which lower blepharoplasty can often address. Since you don't appear to have much excess skin, a transconjunctival approach (incision is behind the lower eyelid) may be an option. Filler is a nonsurgical option that can help camouflage the area, but it doesn't address the underlying fat prolapse the way surgery does. A detailed in-person exam —...

Hi there! Based on the picture provided, I suggest facial and neck liposuction with a submentoplasty to tighten the neck muscles and remove the central fat pad. A possible skin-tightening procedure such as Renuvion. A consultation would help provide a more in-depth analysis; however, I hope this helps!