Doctor Q&A

Revision is really the only way to correct the placement of the implant and give you the aesthetic look you desire. The pec muscle has not been released at all medial, keeping the implants way lateral and high. I would use a small inframammary incision to convert to a dual plane and allow the implants to come farther down and centered where they should be for optimal results.

Hello,
Thank you for the question. It is hard to tell from this photo, but it seems that a small Motiva ergo in the subfascial position will be appropriate and will meet your goals.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Thanks for your question! A crescent lift will be a mistake. You need a full breast lift and then you can consider an implant but have to be comfortable with a fair amount of added volume. I would seek in-person consultations from qualified breast surgeons. Good luck!

Thanks for your question! If you are looking for a very natural look, 220 will be a great option. It is very natural, subtle, ballerina-breast looking. Best of luck!

Based on your postal photo, you do have a large breast, descent or sack, and the only way that this can be corrected is by a reduction lift with a small implant. There will be the anchor looking scar, and if you feel you cannot accept the possibility of this scar then you should not do the surgery. Best of virtual consult with to get a better understanding. Expect fees to arrange from $10,000-$20,000.

Hello,
Thank you for the question. This is a common concern. Experienced surgeons will use appropriate technique as well as post-operative scar care management in order to reduce the incidence of keloid scarring. I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Lymphatic massages do help reduce the amount of swelling that you experience after surgery. I think that the patients who benefit the most from lymphatic massage are those who are undergoing liposuction with their tummy tuck, but those who are getting a tummy tuck alone still get some benefit from it. Every surgeon has their own personal preference on the number of sessions that patients perform and the timeline for when the massages should begin. In the case of a tummy tuck, in addition to...

Congratulations on your significant weight loss - that is no small feat. With the amount of loose skin and degree of skin laxity that appears in the pictures your submitted, I think you are going to get a far superior result with a tummy tuck than with any skin tightening modality that is available. Liposuction is great at removing fat from the body, but it doesn't do much to help the skin contract back down afterwards. Even if you were to add a skin tightening procedure (e.g. Bodytite,...

With a mini tummy tuck, you are correct that it would address some of the excess skin at the lower part of the tummy. And correct, it would not change the scar from your belly button ring. A mini tummy tuck would not remove a lot of the stretch marks that are present. With a mini tummy tuck, you also wouldn’t get much tightening of the abdominal wall muscles.
If you want to remove the stretch marks, remove the scar from the belly button ring, and flatten the tummy as much as possible, then a...

Hello, and thank you for your question. In my opinion, you are definitely a candidate for a tummy tuck (abdominoplasty). It appears you may still have some fat pockets which will hopefully resolve while you continue on your weight loss journey. Otherwise, some liposuction can be done as well. I advise my patents to be at least 20% from their goal weight in order to achieve optimal results from their procedure. Best of luck to you!

Hello,
Thank you for the question.
Best on the shape of your body, I would recommend at least adding small volume of fat to your hip dips and buttock. You will still maintain your athletic look. I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Hello, If you have Undetectable HIV and a good CD4 Count as well as normal Blood Test results and a Normal Cardiologist Evaluation, BBL with Fat from Hips and arm fat transfer is definitely possible. Jaime Caloca Jr., M.D.

I certainly understand the differing opinions that you have received. Their perspective is certainly valid. Based on the photos you submitted, a reasonable but aggressive option that some practices offer is combining the procedures you have described. Doing liposuction 360 with an extended abdominoplasty and BBL as a single procedure is an option at some surgical centers. If you find one where that is possible, I would recommend (as in most cases) to ensure that the facility is JCAHO or Quad...

Dear jaz209,

it depends on the type of injections as some can cause fat atrophy at the injection site. It is best to consult your plastic surgeon and get his opinion.

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

Yes!!! You are a perfect candidate in my opinion. A BBL doesn’t always have to be about size. That said, there will still be a size increase in your case, though maybe not dramatic, it will be noticeable. But that is not a problem! Most importantly, there will also be an improved ratio between your butt, hips and waist making your entire body look better.

So liposuction of your tummy, waist, flanks and back will certainly yield more then enough fat for great results. We can reduce the w...

Thank you for the photos and your question.I frequency see this in my practice. Based on your photos you need a rhinoplasty to refine your nasal tip and increase tip rotation. The overall straightness of your nose is hard to tell from the photos and I would need to see a full frontal view. This is done under general anesthesia or in some cases IV sedation. I recommend an in person consultation with a facial plastic surgeon or plastic surgeon who specializes in rhinoplasty. Best of luck!

Hello and thank you for your question. Based on your photographs, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G....

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good...

Hello and thank you for your question. I think endotracheal intubation with a protected airway is much safer. Of course it is extremely important to have a board-certified anesthesiologist taking care of you the entire time. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good...

Hello,
Thank you for the question.
Once you recover fully from your hip and knee replacement surgeries, and you are back to full activity, it should not affect your mommy makeover surgery.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Combining procedures is common and considered safe but there are limits. Generally it's recommended that surgical time for elective plastic surgery be kept to under six hours of anesthesia time. This is for your safety and to optimize results. For the procedures that you mentioned this shouldn't be an issue as long as you are otherwise a good candidate and are generally healthy. Visit with a board certified plastic surgeon near you to learn more.

I encourage you when you go for your tests to speak to your cardiologist about your interest in a Mommy Makeover. Your surgeon will likely request clearance before proceeding with your scheduled surgery.

It's not uncommon to have your menstrual cycle thrown off a bit by a Mommy Makeover. Everything from the stress of surgery to medications your body is not used to can interrupt your normal cycle. If your cycle doesn't return to normal contact your OB/Gyn.

I encourage you to begin by visiting with your primary care physician to discover the underlying cause for your bradycardia and Vitamin D deficiency. Some people have a slow heart beat related to regular cardio exercise and healthy living. Since your safety is always the priority it may be best to have it assessed first.

A reduction can certainly help asymmetry. I realize that I am not a woman who has been through this, but I have a lot of experience on the other side of things. You are starting from a position of mild asymmetry compared to many women. Removing slightly more tissue from the larger side and ensuring that the markings/measurements are precise, you can achieve a lift and reduction that will position your breasts higher, reduce the weight, and achieve more symmetry with an aesthetically pleasing...

In order to preserve the blood flow to the nipple and areola, surgeons have to the blood vessels intact along a "pedicle." There are a number of different pedicles that can be used to do that, but some of the pedicle have a more robust blood supply than others. I would agree that preserving the blood flow to the nipple-areolar complex, in your case, would be difficult using a superiorly-based pedicle. Using a superiorly-based pedicle and trying to go from a G to a D would be challenging, so...

Enthusiastic484638,
Free nipple grafts are done when the blood flow to the nipple in a breast reduction surgery will be so compromised that your surgeon is worried about the health of the nipple. That happens when too little tissue is left behind to ensure enough blood vessels can be preserved. If your surgeon is worried about having to take away so much tissue to get your breast reduction covered, perhaps you are better served by having a breast lift with a smaller amount of breast tissue...

Fotamat,
Thanks for your question. After extensive scarring, the breast skin around the breast tissue will be quite tight. If you plan on excising the scar, you will eventually need to remove/reduce the breast tissue to allow the skin to close. So yes, you will end up with slightly smaller breasts.
Hope that helps.

It is highly unlikely that any insurance company will pay for breast surgery that is not medically necessary. You can contact your insurance carrier and/or your primary care physician for information regarding qualifying criteria.

Thank you for your inquiry. We would love to sit down with you and discuss your goals. Schedule a consultation with a Board Certified Surgeon.

Thank you for your inquiry. We would love to sit down with you and discuss your goals. The best way is to try on multiple sizes/styles of breast implants with a sports bra during a consultation. Schedule a consultation with a Board Certified Surgeon.

Thanks for your question. Based on your pictures, it seems you would be a good candidate for a breast lift with implants for optimal results. However, an in-person evaluation would be best to determine a tailored plan for your breast enhancement. I suggest scheduling a consult for a proper evaluation. Be sure to always consult with a board certified plastic surgeon. Take care, Dr. Salama, Board Certified Plastic Surgeon.

Tuberous breast is not, technically speaking, a "yes" or "no" question. There can be different points on the continuum. The typical hallmarks include a high, tight fold with "puffy" or distended areola, minimal breast tissue and potentially herniation of the breast tissue through a tightened ring thus the "tuberous" label. It is a congenital deformity which usually manifests at puberty. To what degree it manifests will vary from one patient to the next. Treatment of tuberous breasts varies...

Many patients are in your exact situation - they want fuller breasts with an implant, notice a little breast drop, but don’t want the scars or risks of a breast lift. If your nipple sits at or above the breast fold, we can often achieve a good result with augmentation alone, but it’s important to understand the trade-offs: your nipples may appear slightly lower on the breast, the shape may not be perfectly round, and the implants may sit a bit lower than ideal. Natural asymmetries can als...

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we...

Body contouring procedures have become increasingly popular and can help men and women recontour their body in adulthood. If you have stubborn areas of fatty accumulation that are more resistant to diet and exercise, you may be a candidate for body sculpting liposuction performed at Kare Plastic Surgery in Santa Monica. Liposuction remains one of the most popular procedures in cosmetic surgery and allows patients to slim and toned their waist line, back, arms, and legs using this minimally...

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we...

Body contouring procedures have become increasingly popular and can help men and women recontour their body in adulthood. If you have stubborn areas of fatty accumulation that are more resistant to diet and exercise, you may be a candidate for body sculpting liposuction performed at Kare Plastic Surgery in Santa Monica. Liposuction remains one of the most popular procedures in cosmetic surgery and allows patients to slim and toned their waist line, back, arms, and legs using this minimally...

Body contouring procedures have become increasingly popular and can help men and women recontour their body in adulthood. If you have stubborn areas of fatty accumulation that are more resistant to diet and exercise, you may be a candidate for body sculpting liposuction performed at Kare Plastic Surgery in Santa Monica. Liposuction remains one of the most popular procedures in cosmetic surgery and allows patients to slim and toned their waist line, back, arms, and legs using this minimally...

Great question! It looks like (although hard to tell given no true lateral view) that you might have what is called a negative vector, which is where your cheek is recessed compared to your eye. What would help best in that situation is a small implant to correct that deficiency, +/- bleph depending on what the exam shows for fat/skin excess and correction of the tear trough.

If your concern is primarily excess fat and lower lid bags, and you have little to no excess skin and tight lower lids, you may only require a fat removal/repositioning to achieve the results you want and you could get evaluated any time for that. If you need any skin excised or the lid tightened with a canthoplasty/pexy, I would wait a minimum of 3 months before surgery. You could always present for a consultation and plan around a future surgery date. Remember, it takes time for the...

Blepharoplasty, especially revision cases, really require a detailed exam to determine the best treatment. Your left eye appears to have more skin that needs removed to make that component symmetric, but also you appear to have less volume and a mild “A” frame deformity. I believe you would require some fat grafting to restore some of this volume to achieve symmetry and make a more youthful appearance. Again, a good examination would give more information on what exactly would be req...

Thank you for your inquiry! We would love to sit down with you to discuss your concerns. Blepharoplasty will remove excess skin and fat pads. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Thank you for your inquiry! We would love to sit down with you to discuss your concerns. There are different types of sutures for closure. We use nylons and they are removed at the one week appointment. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals.

Thank you for your inquiry. We would love to sit down with you and discuss your goals. There are options to help with the appearance of skin laxity/creepy skin. Schedule a consultation with a Board Certified Surgeon

At age 55, with visible skin laxity around the mouth and lower face, a deep plane facelift combined with fat grafting would likely provide the most effective and long-lasting results compared to fillers alone. This technique lifts the deeper facial layers while restoring volume in a natural, harmonious way. That said, the current photo angles are limited, and a full assessment can't be made without an in-person consultation and physical examination. This is essential to tailor the approach...

Will Sculptra affect a future facelift? Yes, to some degree it can complicate the surgical dissection but it is generally injected in a relatively deep plane. Will it cause delayed healing? Absolutely not in my experience. I commonly inject Sculptra at the time of a facelift in patients who require additional volume. Watch out for half-truths and over simplifications in your research.

Thank you for your question. Generally speaking a facelift result will "last" about 12 years. If that is your specific concern, a minimally invasive and temporary solution is a combination of Botox to the DAO's and/or a filler to the corners of the mouth. The DAO muscles can be released surgically, preferably when performed along with a facelift procedure. Best to discuss these concerns in a consultation.

The whole concept about noticeable facelift scars is a false argument. Clearly, there are Surgeons who do not understand or practice basic principles of wound tension and produce bad scars. However, the average facelift incision/ scar in my practice is extremely hard to see. I would say the same about the vast majority of my colleagues. The endoscopic facelift is designed for a younger patient who requires little to no skin removal and in which it is debatable about whether there are...