Doctor Q&A

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. I have taken care of 100's of cases similar to yours. I have developed with a technique termed "reductive augmentation" which I published in 2017. It involves perform an internal bra/capsulorrhaphy, reaugmentation with a smaller ultra high-profile implant, removal of inferior pole breast tissue, and revision of your mastopexy/lift. You should be able to...

You could definitely get a good result with either open or closed rhinoplasty. You should be aware that closed rhinoplasty is not done much these days because most surgeons are taught only open rhinoplasty. The most important thing is to select the best rhinoplasty surgeon regardless of whether it is done closed or open.

From your side view photograph, you have a weak chin, which makes your nose look more dominant. I recommend you consider a chin implant. This is done through an intra-oral approach so there are no external scars. After this, you can assess your profile. You may not need a rhinoplasty if the chin is corrected. However, if you want a rhinoplasty then the chin implant and nose can be done together.

Best Wishes,

Gary Horndeski, M.D.

Hello! Thank you for your question.
As far as I can see from your photos It is possible to achieve the look you desire through rhinoplasty, I recommend rhinoplasty procedure for you.
It would be better face to face consultation.
Best Regards!

AlloClae is a newer option being used for gluteal contouring and what some patients refer to as a “non-surgical BBL.” It is a structural adipose filler made from processed donor-derived adipose tissue and is designed to add soft volume and improve contour without traditional liposuction and fat harvesting.

A prior superficial clot does not automatically rule out a BBL, but it is an important risk factor that must be reviewed before elective surgery. The key details are whether it was truly superficial thrombophlebitis versus a DVT, how recently it occurred, whether it has fully resolved, whether you used blood thinners, and whether you have any clotting disorder or ongoing leg symptoms.

BBL is usually a longer operation with liposuction, positioning, and recovery limits, so your plastic...

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 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...

Based on the photo, over-volumization of lower face from past fat graft is the primary problem. Correction of overcorrected fat grafting with liposuction is possible but not always reliable, and results depend heavily on the location, volume, and how long ago the graft was placed.Overtime fat graft integrates with the surrounding tissue and establishes blood supply and settles permanently, as evident by patient's description of dynamic volume with weight gain. Liposuction in these areas...

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

Great quesiton!

You are definitely not alone here. I have seen a good number of patients who underwent a breast reduction in the past and who now want to replace some of the lost volume. In your case, it sounds as if you actually want to replace all of the volume.

To that, while it is usually not as simple as replacing the exact amount of volume removed, your Plastic Surgeon can use sizers to identify which specific volume replacement will help you achieve your goal. I would bring in...

Hi there thank you for your question and for sharing your photos. Congratulations on moving forward with your top surgery! I know this is a big step and it will be very rewarding. From what you are telling me, it seems like you are stuck deciding between 600cc MP vs 750cc HP OTM. With mentor implants, specifically the memory gel, there will be a decent amount of ripping up top when going above the muscle. I will not typically do over the muscle on patients will minimal breast tissue unless...

The larger the implants, the more they will look "fake." If you are wavering between two sizes, the smaller one will always look more natural.

It is difficult to say for sure, but it does appear that you have stretch marks. This indicates that there are issues with skin laxity, which would make a tummy tuck more suitable. Liposuction alone may remove the excess fat, however it would most likely leave you with loose skin which would hide your results.

Hello. I would recommend a 360 Vaser liposuction with Bodytite and tummy tuck for your body morphology to get rid of all the rolls. Just focusing on back rolls without considering tummy will not give you better results.
Thank you.

Regards,
Dr. Sameer Karkhanis,
Centre for Cosmetic Surgery, Mumbai, India

Persistent blue-black discoloration 6 months after liposuction is not usually simple fresh bruising. In the photos, there appears to be patchy dark discoloration across the lower abdomen with some contour firmness, but an exam is needed to tell whether this is hemosiderin staining, post-inflammatory pigmentation, fibrosis/scar tissue, fat necrosis, vascular change, or another skin condition.

Because your own surgeons are unsure and you describe a flat hard area, it would be reasonable to...

While an in-person examination is always necessary for a definitive recommendation, fillers would likely provide only a temporary improvement and may not adequately address the underlying cause of your under-eye concerns.
Based on your photos, you may be a good candidate for a transconjunctival lower blepharoplasty combined with conservative fat grafting. This approach can address both under-eye fullness and volume deficiency while avoiding an external lower eyelid incision. Fat grafting may...

Hi Diligent564279, this is a good question and a common one. The honest answer is that it depends on where the heaviness is really coming from, and that needs an in-person look rather than a photo. Two different things create a hooded upper eye. One is genuine excess eyelid skin, which upper eyelid surgery removes directly. The other is a brow that sits low and pushes skin down onto the lid. If your brow position genuinely does not bother you and the spare skin is sitting on the lid itself,...

Here is what is going on, with three things to fix. The pic shows upper eyelid hooding, a flattened lid-cheek junction that has drooped, and the outer corner being neutral or a bit downturned. That flatness you mentioned is the sinking. I cannot see a lot of ptosis in the pics that covers up the pupil and would mean you need a ptosis correction right off the bat, but a doc can check that in person and see if you need it. In terms of getting rid of hooding, a small and minimal upper...

From your photographs, it appears your eyebrows are below the level of the orbital rim medially. They should be at the level or above the level of the orbital rim. You may have descent of the eyebrows which contributes to the excess skin appearance of the upper eyelids. You may benefit from a browlift and would also benefit from a revision of the upper blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Eyelid and eyeshape asymmetries can be very common, and the good news is there is a lot we can do cosmetically to create more balance between your eyes. An endoscopic brow lift would help address any heaviness sitting over the eyes and lift the brows into a more even position, and when combined with a very subtle upper eyelid blepharoplasty (removing a touch more skin on the left side to match the hooding and shape of the right) the two eyes can look much more balanced together.
The brow...