Doctor Q&A

With all due respect, recovery time really should be decided by your surgeon and not us. But a general rcommendation would be to take about 3 weeks off of work and then go back to light duty. As a flight attendant, you are obviously very active and so you might want to see if you can shift some of the more active aspects of your role to your co-workers when you return and gradually get back to normal activities.

I'm curious as to how you are getting the Motiva Ergonomix 2 implants since...

In patients with tuberous breasts, I would not make the decision simply between placing the implant over or under the muscle. The breast base, degree of constriction, soft-tissue thickness, nipple position, and lower-pole development all need to be considered.
I also use a subfascial approach in selected patients. The implant remains above the pectoral muscle while being covered by the fascia, which can provide a natural transition while avoiding muscle-related animation deformity.
Regarding...

Thank you for your question. There is no right or wrong answer to your question as both are reasonable options. Over the muscle carries a higher risk of capsular contracture than dual plane placement in most studies, but does have less risk of animation deformity. The other drawback with over the muscle placement is increased palpability of the implant and wrinkling in thin patients. Your concern about weight lifting, specifically shoulder presses and pull ups, is not really an issue in the...

Thank you for your question and photos. First, liposuction 360 means removing fat from all around or circumferentially from the body. Based on these photos, without the advantage of a physical examination, you would get the best results with liposuction 360 degrees and a full abdominoplasty. Lipo 360 is not interchangeable with a tummy tuck procedure. They complement each other to deliver the best body shape based on your muscle and bony anatomy. I would recommend light liposuction of the...

Hi, lymphatic massage is generally optional after a tummy tuck and is not required for every patient. Even when the procedure involves primarily loose skin removal and muscle repair, some degree of postoperative swelling is expected as part of the normal healing process. Gentle lymphatic massage may help with swelling and comfort in some patients, but your body will naturally resolve this swelling over time.

After three C-sections, abdominal fullness can come from diastasis, loose skin, scar tethering, or a combination. If there is true muscle separation, exercise can improve core strength but usually cannot fully close the separation once the fascia is stretched.
A full tummy tuck is usually the most complete option because it can repair diastasis from the upper abdomen to the lower abdomen, remove lower abdominal skin, and improve the C-section scar area. It also allows the belly button to be...

Your photographs are somewhat limited. You would benefit from a rhinoplasty with possibly a cartilage graft to increase the projection of the nose and tip refinement. You may also benefit from a chin implant.

Best Wishes,

Gary Horndeski, M.D.

A closed rhinoplasty technique can accomplish your goals by shaving down the dorsal hump, performing osteotomy in the nasal bones to narrow the bridge line. You may need a small amount of tip work to reduce the bulb as tip, and most likely some thin spreader grafts placed underneath your narrow upper lateral cartilages as well to prevent them from collapsing and more after the hump removal. The osteotomy themselves will narrow your nasal bones with all of the incisions placed on the inside...

Thank you for your question and photos.
In short, yes, you can absolutely decrease the length/projection of the nose. However, there is always a tradeoff when reducing the projection of the nose, as this can sometimes be at the cost of decreased tip definition. Part of what makes a well defined nasal tip is the appropriate amount of tension on the skin, and when the tension is decreased by deprojection, you can lose some of this definition. Your best option is going to be scheduling with a...

At 6 years after rhinoplasty, persistent roundness of the tip is usually not simple swelling alone. It may be due to scar tissue, thicker skin, cartilage shape, loss of tip support, or the way the soft tissue healed after surgery.
Non-surgical treatments cannot truly reduce cartilage or reshape the nasal tip in a reliable way. Steroid injections may help if there is localized scar tissue or thick soft-tissue swelling, but they must be used very carefully because they can cause skin thinning,...

Thank you for your question and photos. You are correct, this is an adhesion and not a volume deficit. Trying to fat graft this area without scar detachment and biostimulator placement will lead to further distortion, since fat transfer will not release the depression. Cellulite can happen too, if the surgeon injects the fat too superficially. All that is treated with the above stated procedure. The scar depression is treated with subcision and placement of biostimulators like Radiesse. This...

These are two major surgeries and should be done separately for reasons such as blood loss, danger of thromboembolism, prolonged recovery, shaping of the abdomen. In patients who may require minimal TT without any undermining, exception can be made. Good luck.

Hello! Thank you for your question.
After pregnancy and significant changes in weight, the abdominal skin and underlying tissues can become lax and may not return completely to their original shape. In these cases, an abdominoplasty combined with liposculpture can be one of the most effective ways to restore abdominal contour and define the waist.
The liposculpture can be used to strategically treat areas such as the back, flanks, waist, and abdomen, creating a more feminine and defined...

I recommend a breast reduction using the Bellesoma. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. This technique is not...

Yes, this would usually be considered a breast reduction, and because you had a mastopexy many years ago, it is also a revision breast surgery. The prior lift matters because the surgeon needs to understand the old scar pattern and likely blood supply to the nipple.
At 69, age alone does not prevent surgery. Your lack of hypertension, heart disease, and diabetes is favorable. The bigger questions are overall fitness for anesthesia, smoking/nicotine status, BMI, medications, skin quality,...

Thank you for your question and photo.
The question will always come down to whether you would need a revision facelift or something less invasive like laser resurfacing. In particular, the finer wrinkles around the mouth will respond better to laser than another lift. The fullness of the neck and jawline will respond better to a lift. Your best option would be scheduling a consult with a plastic surgeon well versed in facial rejuvenation to discuss these options and determine the best...

I agree with your instinct: elective facelift surgery should wait until the reason for the persistently high platelet count is understood.
A platelet count of 587,000 is above normal, and if it has stayed elevated over several months, it needs hematology evaluation. High platelets can be reactive, such as from inflammation, iron deficiency, infection, or recent illness, but they can also come from a bone marrow condition. The treatment and surgical risk depend on the cause.
For facelift...

I can tell you that a deep-plane facelift is exceptionally effective for precisely the concerns you are describing.
Even if you do not have many fine lines or loose surface skin, a facelift is fundamentally a structural procedure, not a skin-tightening one. In your 40s, facial aging is driven by gravity pulling down the deeper muscle and fat layers (the SMAS), which causes:Cheeks: Descending from the high cheekbones, which flattens the midface.Nasolabial Folds: Deepening because the fallen...

Absolutely not. Being 74 does not automatically mean you are too old for a facelift. What matters much more than your age is your overall health, medical history, skin quality and whether you are a good candidate for surgery.
If you are bothered by significant laxity in the lower face, jowls or neck, a properly planned face and neck lift can still provide a very noticeable and natural rejuvenation. In fact, for someone who is healthy and wants a meaningful, long-lasting improvement, surgery...

I recommend you find photos of women’s breasts you consider to be pretty and share those photos with your plastic surgeon. Trust your surgeon with regard to recommendation of Round versus Ergonomix. The “Round” can potentially look slightly less natural. If a natural appearance is important to you, Ergonomix is advisable. I don’t think you have a serious risk of rippling since you appear to have adequate breast tissue to conceal your implant. Best of luck to you.

Clear or yellow nipple discharge years after breast augmentation should be evaluated in person. It may be related to hormonal changes, pregnancy/breastfeeding effects, duct irritation, infection, skin breakdown, or less commonly an implant-related problem.
Because the fluid is increasing and sticking to the bra enough to pull skin from the areola, I would not ignore it. You should see a breast specialist, gynecologist, or plastic surgeon for an exam.
The evaluation may include breast...

Hello Rational322108,
Thank you for your question and photographs. Well done on your weight loss of 30 Kg!
The issue relates to the ability of your upper arm skin to retract after liposuction alone on the basis of skin integrity and elasticity given your skin has stretched with weight gain. Whilst liposuction involves minimal scarring and shorter recovery, brachioplasty surgery to remove the excess skin may be required to remove excess skin if liposuction alone results in loose skin.
My...

We have reviewed your question. Liposuction may be possible with a J-plasma, but you should first be evaluated and cleared by your colorectal specialist. An in-person consultation is recommended.

In your 40s, if you are noticing both sun damage around the eyes and hollowing under the eyes, I would definitely consider a lower blepharoplasty. This can address the under-eye area in a much more direct and long-lasting way than trying to simply camouflage the hollowing with filler.
Depending on your anatomy, the procedure can include repositioning or carefully adding fat to create a smoother transition between the lower eyelid and cheek. If there is any excess or damaged skin, that can...

We have reviewed your photos. Upper blepharoplasty revision may help improve the residual crepey skin. An in-person consultation is recommended to determine the best approach.