Doctor Q&A

In the photos, there is noticeable lower-pole fullness and the implants sit relatively low on the chest, but photos alone cannot confirm true bottoming out or whether this is within the expected settling process. The key issue on exam is whether the inframammary fold has dropped, the nipple is riding high on the breast mound, or the implant pocket has stretched.

By this many months after augmentation, most settling has already occurred, so a continued downward change is worth reviewing with...

In the photos, the abdominal midline appears to curve or sit off-center, especially in the image where it is marked. A photo cannot tell how much of that comes from diastasis, a hernia, skin laxity, fat distribution, posture, or the natural position of the abdominal muscles.

A tummy tuck with diastasis repair may improve the abdominal contour and support, and a hernia may be repaired at the same operation when planned appropriately, sometimes with a general surgeon depending on the hernia....

Yes, your goal is technically feasible, although it is less commonly requested than traditional rhinoplasty. Rhinoplasty can be customized to reduce nasal projection, soften the bridge, broaden the tip, and adjust the nostrils to better match your desired appearance while preserving function. If you also have a deviated septum, this can often be corrected during the same procedure. I recommend consulting a rhinoplasty surgeon with experience in individualized, ethnically sensitive nasal...

Thank you for your question and photos.
There is not a specific term for the type of nose you have, but I would describe it as you have already as a slightly wide middle third of the nose. This can be addressed with rhinoplasty, particularly by shaving some of the nasal bone width and performing osteotomies to narrow the bridge. While this is fairly common with rhinoplasty, the question would be whether or not this would justify a full rhinoplasty if you are happy with the rest of your...

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. 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 technique, you could have an outstanding result. I recommend...

Hi, yes you could classify the tip as bulbous. This appearance is due to the size and orientation of the lower lateral cartilages, which form the underlying framework for your nose. Surgery would focus on reshaping the cartilages either through cartilage grafting, reduction, and/or sutures to create a more aesthetic tip. Good luck!

Acid reflux/GERD does not automatically mean you cannot have liposuction and a BBL, but it does need to be taken seriously before general anesthesia. Active reflux, regurgitation, swallowing problems, vomiting, or a hiatal hernia can increase aspiration risk when you are asleep and lying flat.

Tell your plastic surgeon and anesthesiologist exactly what symptoms you have and what medicines you use. They may want your reflux better controlled, may adjust acid-suppression medication, may...

One likely explanation is that the implant has turned or flipped inside the pocket — so the base is now facing the wrong way rather than sitting flat. That can create exactly the kind of odd, uneven look you're describing, with fullness where you don't want it and flatness at the outer bottom.
A second possibility is that the implant has dropped lower in the pocket — this can happen even under the muscle — and if the breast tissue over it isn't very minimal, that descent...

Based on what you've described, it sounds like you may be experiencing symptoms related to excessively large, heavy breasts, including discomfort with physical activity, pain without adequate support, and concerns about breast shape and appearance. These are very common reasons women seek consultation with a plastic surgeon.While maintaining a healthy weight is always beneficial, breast size is influenced not only by body fat but also by breast glandular tissue and genetics. This is why many...

Thank you your inquiry! We would love to sit down with you to discuss your concerns. Removing excess breast volume will help remove the tension and weight on your back and neck as well as help with the other listed concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Manufacturers recommend regular surveillance imaging to diagnose silicone ruptures. Most are silent. There are rarely external signs of rupture. They will look and feel the same. Patients will demonstrate no clinical sign of rupture.

Recommendations are for MRI at 3-5 years post augmentation and then serially at 2-3 year intervals moving forward.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

It is challenging to really assess the situation based on these photos alone. Your measurements (obtained from physical exam) provide clear guidelines if there is need for a lift or not (which is sometimes hard to determine based on photos alone, as is making any official recommendations). You may want to consider doing a lift first and then attempting to place the very large imlant. This is because placing a very large implant at the same time as attempting to reduce the soft tissue...

Thank you for such a thoughtful and well-prepared question, and congratulations on taking this step. Your dilemma, feeling caught between "natural" and "proportional," is one of the most common and legitimate tensions in breast augmentation, and it is even more relevant on a tall, broad frame with a wide chest wall like yours. The key concept to hold onto is that because all three implants share the same base width, they will all "fit" your chest equally; the only variable you are choosing...

Dear NewBootyCutie101,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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...

In the photos, you appear to have an athletic build with localized lower-body fullness and some skin/cellulite-type texture around the thighs and buttock area, rather than a large amount of loose skin. Liposuction can sometimes refine the inner/outer thighs or saddlebag area, but in a lean, muscular patient it has to be conservative because aggressive fat removal can create contour irregularities, dents, or a more uneven look.

Qwo-type treatments are aimed at cellulite dimples, not at...

Permanent sutures, including Gore-Tex, can be used in facelift and brow lift surgery, and many patients do not feel them once healing is complete. In the early healing period, some tightness, pulling, or awareness of the operated area can happen, but a well-placed deep suture is usually not something you should constantly feel inside the body.

That said, no material is perfect. Permanent sutures can rarely be palpable, irritating, infected, or need removal, depending on where they are...

Tired eyes are often addressed by upper blepharoplasty alone or in combination with a brow lift. On examination the eyebrow position is assessed if this is the cause of upper eyelid hooding, this helps determine the best plan for the patient. Lower eyelid fat grafting may be combined with cheek fat grafting to help give support to the lid cheek junction and help soften any hollowing. Bringing older photos to consultation is quite helpful.

Hi Cheerful331303. I am sorry this has been worrying, and I will keep my thoughts general because I have not examined you and your situation is genuinely a specialist one. A few honest principles. Ptosis linked to Horner's syndrome behaves differently from ordinary age-related droop, and eyelid surgery in that setting is less predictable, so early asymmetry does not necessarily mean this is your final result. The lids are also still healing. Swelling, tissue settling and the way the two...

Based on the photos, your concerns appear to be related to under-eye hollowing and midface support rather than excess lower eyelid fat alone. If fillers and fat grafting have not provided satisfactory improvement, further evaluation of your underlying anatomy is appropriate. In carefully selected patients, structural procedures such as infraorbital implants or midface augmentation may be considered. However, these are advanced procedures and should only be recommended after a comprehensive...