Doctor Q&A

The breasts continue to noticeably develop until the early 20s, therefore you may want to wait a few more years before considering breast augmentation. If you have one done too soon, your results may be negatively affected should further development occur.

It appears that you already have a midsection that curves in, giving you an hourglass shape. It would be helpful if you can provide wish pics that illustrate how much more of an hourglass shape you’d like. Rib removal is not recommended. It does appear that there is some bulging in your side photo. It is difficult to see, but if the area of concern is located below your belly button, a mini tummy tuck may be sufficient.

Beausmom20 great question! While it is safe to combine some procedures (i.e. Breast lift w/ implants & Tummy Tuck), it is uncommon that a surgeon will agree to perform all of the surgeries listed in one trip to the OR. This is because the complication rate increases with longer anesthesia time and you're more likely to have wound healing problems. Additionally, it is difficult to recover from surgery on all 4 extremities at the same time.
I would recommend going to a surgeon who discusses...

Hi, thank you for sharing your question. It’s difficult to identify significant skin laxity in these photos so recommending a standard tummy tuck may be tough to do without a proper evaluation. Based on the photos alone and your information given, I would consider a mini tummy tuck.

Dear raniung13,

based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.

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

Hi, thank you for your question.
No. After 9 years, BBL fat behaves like normal fat and cannot be damaged or destroyed by massage, even very deep pressure. Grafted fat is not more fragile once it has fully healed.
What you’re noticing is more likely temporary inflammation, muscle soreness, skin laxity, or normal changes that became noticeable around the same time.
Sculptra can improve skin firmness and mild fullness, but it does not replace lost fat. Its effects last about 1.5–2 years. Tru...

Hello and thank you for your question! I agree that you have a great frame/underlying shape. In my opinion, lipo 360 and BBL can certain enhance this shape and contour by subtracting the excess fatty tissue from areas like your abdomen, flanks, and lower/mid back, and adding some of this volume will help with the overall contour and projection of the gluteal region. The other important factor to address would be the excess skin. If you are not finished having children, I would ultimately...

Great question and thank you for providing photos!
It is a bit challenging to determine based on photos alone, but the change in shape of the tip can come from a subtle dropping of the tip over tip called tip ptosis. It may be that the firm part is the cartilage in a new, lower position where you can now feel it. It is also possible you may be able to palpate any cartilage grafts if they were placed. As always, I think the best place to start is to let your rhinoplasty surgeon know your...

You seem to be a candidate for rhinoplasty, based on these very limited photos. Whether open or closed, you can expect predictable result in the hands of an experienced surgeon. In person consultation with a board certified plastic surgeon with expertise in rhinoplasty would give you a chance to discuss benefits and shortcomings of open vs closed rhinoplasty in your particular case. Good luck.

Based on your photos, you are a great candidate for rhinoplasty. The bump can be taken down and your tip refined. You shouldn't need diced cartilage for grafting. But septal cartilage can be used to support and refine the nasal tip. And even though the nasal bone will be mostly straight, if the tip is refined and projected properly there will be a small lift/curve at the end, making it cute and feminine. Be sure to see a rhinoplasty expert for consultation.

Hi, thanks for your question. Possible surgical goals could include reducing the dorsal hump and reducing columellar show. The appearance of your nostrils is likely due to a low hanging columella, which can be due to elongation of the nasal septum and/or the positionining of the medial crura of the lower lateral cartilages. These issues be addressed surgically by trimming the nasal septum as necessary and repositioning the medial crura.

First of all, congratulations on your weight loss! Losing 100 pounds is a tremendous accomplishment and a major investment in your health and well being. As a board certified plastic surgeon, the next step is to match your surgical plan to your anatomy and aesthetic goals as safely and efficiently as possible.

From your description, a breast lift, tummy tuck vs lower body lift, and liposuction are all reasonable components of a comprehensive contouring plan after massive weight loss. Given...

Dear Rational46570,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.


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

It is extremely likely that you will benefit from a breast reduction! Even without seeing any photos, I can say based upon your description that it would be beneficial. I have many breast reduction patients who are in their twenties, and each one was elated with her results. Definitely meet with a board certified plastic surgeon to be evaluated and find out more!

I attached a link to a 20 year patient of mine with very large breasts and asymmetry. She loves her results!

You’re asking a very real and very common question — and your symptoms are absolutely valid, even if insurance criteria don’t always reflect that.At 5’7”, 135 lbs with a 32DDD, your breasts may not sound “large” on paper, but on a petite, athletic frame they can be biomechanically very heavy. Pain with running and limits on activity are legitimate medical concerns.Why insurance is the sticking pointMost insurers use gram-based criteria (often ~500 g per breast) to approve reductions....

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. When considering breast augmentation above or below the muscle, it is the lesser of two evils. Usually, the animation deformity from breast augmentation is minimal, however when you place implants on top of the muscle, the complications are significantly worse - slide down and wrinkling. I have a whole gallery of patient's with long-term changes with...

Yes — at your age, it is absolutely reasonable to have breast implants without a lift, especially if avoiding scars is important to you right now.You’re also thinking about this the right way by accepting that you may choose a lift later in life if your priorities change.Do you really need a lift at 20?In most 20-year-old patients:Skin elasticity is still goodSagging is usually mild or borderlineThe issue is more volume than true droopIf your nipples sit at or above the breast fold, a...

Hi there, thank you for the question and thank you for sharing your photo. Given your measurements and photo, implant placement at the time of a breast lift would not be a good idea. This is due to several factors:1. Nipple blood supply, high likelihood of nipple necrosis2. Issues with controlling the "pocket" to contain the implant in the right position3. Overall shape of the breast
The best and safest way to manage this would be perform a lift first, allow your body to recover, and then...

Hi, great question to ask.
You do not need to avoid implants because of CrossFit, but you should expect an adjustment period. Under muscle placement is commonly recommended with a lift to reduce future sagging and give better long term support. With a size like 265cc, most patients return to full training without issues once healed. That is the important part.
You will need a proper recovery period (usually 6 to 8 weeks before heavy overhead lifting). After that, most athletes resume...

The appearance of the scars should continue to improve in terms of coloration with ongoing use of scar creams. Unfortunately, the width of the scars is unlikely to improve on its own. You may wish to consider scar revision surgery, in which your surgeon excises the existing scar and redoes the suturing.
The loss of pigmentation in the lower portion of your areola is also unlikely to improve over time. Medical tattooing may be a helpful option to restore color and achieve a more uniform...

When marking for a mastopexy, your surgeon will plan for a vertical and horizontal excision in order to narrow the breast and achieve a rounder outcome. The vertical wedge is typically set outside the borders of the areola in order to avoid moving pigmented tissue onto the vertical scar.

In the case of a widened areola, setting the wedge outside the borders of the areola creates excessive tension as you attempt to narrow the breast while removing the pigment. Thus there is a risk of healing...

Due to the lower nipple placement on the right breast (left in the photo), a lift would be recommended to improve symmetry.

Hello, thank you for your question and photos.
Yes, based on your photos, you do have enough pinchable fat in the flanks for conservative liposuction. In lean, athletic patients, the key is gentle, precise fat removal. When done conservatively by an experienced surgeon, the risk of bumps or irregularities is low. This would be for subtle contouring, not dramatic fat removal.
Best regards,Andaç Aykan, MD, Assoc. Prof.

Skin adhesions, in the anterior neck in particular, can be seen after neck lift surgery relatively frequently. Too aggressive liposuction of the skin and removal of fat tissue over the muscle may create condition which favor skin adhesions. However, it is still something that can not be entirely predicted. You should discuss with your surgeon whether additional liposuction of the skin flap is absolutely necessary . Good luck.

I do not think the answer is filing the upper eyelid with hyaluronic acid fillers or grafted fat. What is going on here is your surgeon made your upper eyelid crease too high, removed too much upper eyelid fold, and surgery damaged the insertion of the tendon that raises the upper eyelid. You have mild upper eyelid ptosis and a compensatory eyebrow elevation. There is a degree of eyelid platform skin crepiness and too much eyelid platform exposure. Stuffing the upper eyelid fold with...

Great question and thank you for providing the photos!
I think you are asking the right questions. While I can certainly appreciate a degree of brow ptosis (heavy brows) and excess skin of the upper eyelid, it is hard to determine which one is the predominant factor causing your issues. I think your best option is to schedule a consultation with a plastic surgeon that specializes in eyelid surgery who can perform a thorough exam to determine which of these factors (brow vs eyelid) is...

YES! There is no reason that you can't have aesthetic surgery in the US. I would recommend planning surgery with plenty of time for recovery prior to traveling internationally.

Young women with smaller cheek bones (malar hypoplasia) frequently present with this type of deformity very early in their life (13-19 years). Surgical correction includes correction of muscle attachment which creates tear trough deformity (via transconjuctival blepharoplasty) and augmentation of cheek bones with implants or fat grafts. In person or teleconference consultation with a board certified plastic surgeons with experience in this procedure is recommended. Good luck.