Doctor Q&A

@mdoyle10 I'm sorry you are struggling with this problem. Unfortunately, it is harder to control the implant pocket after it has stretch/bottomed out. In my opinion, based on your history and photos I would recommend a surgical tack up with an internal mesh for support. Typically when I perform this surgery, I expose your implant perform adjustments to the capsule as needed and anchor the mesh to the ribcage at the location of your desired IMF/bottom of the implant. Then I cover the lower...

Yes, in my experience my patients say they have been satisfied with a traditional approach. You trust your surgeon and are happy with his results on similar patients. Sounds like a trifecta. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Breast augmentation and breast implants put no more demand on a person with HIV than any other elective surgery. All you need is a sufficient T4 cell count to ensure you don't have an elevated risk of infection from the surgery. Having HIV will not affect breast implants, but also just as importantly, vice versa is true as well. Costs for surgery vary, but given today's costs for doing business in LA, expect to pay around $10K for an experienced ABPS certified surgeon to perform the surgery...

From your photos, it appears that you have a moderate degree of asymmetry with the left breast being about 50 cc large than the right. My suggestion would be the following:
1. Find 2-3 inspiration photos of a volumetric look that you are trying to accomplish. Cup size is really meaningless; it is more of a volume relationship that will help guide your surgeon in the right direction.
2. Look for a Board Certified Plastic Surgeon who uses breast implant sizers in the OR. Tissue can be...

In your case, the answer is yes. You appear to have a fair amount of visceral (intra-abdominal) fat which can make it difficult to tighten the abdominal midline during surgery. This fat can also not be addressed by an external liposuction you may have so better to lose it before the procedure.

Otherwise, you are a great candidate for the True Tuck Abdominoplasty procedure:
-Circumferential combination ultrasonic/power-assisted liposuction + Renuvion skin tightening
-Midline rectus...

Your surgeon is correct that prior liposuction can make a tummy tuck more technically challenging. Liposuction can create scar tissue beneath the skin, which may affect how the tissues separate and how smoothly the skin redrapes. It's something experienced plastic surgeons see regularly, but it does require careful planning and meticulous surgical technique.

As for muscle tightening, I wouldn't recommend it unless you actually have a rectus diastasis (separation of the abdominal muscles)....

Congratulations on your weight loss and continued journey. I always separate thigh lifts from abdominoplasty for safety concerns. Your plan to potentially do thighs first is a good plan. I do require (based on recommendations from literature) patients to reach a goal BMI of 32 or lower prior to moving forward with elective surgeries.

A tethered C-section scar can create a shelf because the scar is stuck down to deeper tissue while the skin and fat above it hang over. If the problem is very localized, scar release or scar revision with limited liposuction can sometimes improve it.
However, if there is loose skin across the lower abdomen, abdominal wall laxity, or a wider lower belly fullness, a full tummy tuck may give a more complete and predictable correction. A tummy tuck can remove the old scar area, release the...

Hello and thank you for your question. This will depend on if you are able to obtain medical clearance from your primary physician . I also 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. FACS
Harvard-trained board certified plastic surgeon

The two procedures can be done together, but I prefer to separate them. Rhinoplasty causes post op swelling of the whole area, including the upper lip. I want the incision line of a lip lift to heal as good as possible without the extra swelling of rhinoplasty. A lip lift can easily be done as a local procedure once the swelling goes down and the location of the new nose is noted.

You could either get grafted material placed there through the typical nose incision or through the mouth even.

There are excellent rhinoplasty surgeons both in the United States and internationally, so the most important factor is choosing a surgeon with extensive experience in the specific type of rhinoplasty you need. That said, if you live in the U.S., it's important to consider the practical aspects of traveling abroad. Rhinoplasty requires close follow-up during the first year, and while many postoperative visits can be done virtually, some situations—such as concerns about healing, scar t...

Based on your photos, I think your edited goal is realistic. A well-performed BBL can absolutely add fullness to the lower pole of the buttocks and improve the transition into the gluteal fold, creating a rounder appearance.

The key is that a BBL isn't just about adding volume, t's about strategic fat placement. By carefully shaping both the buttocks and the surrounding areas with liposuction, we can often create a smoother, more projected, and more balanced contour.

That said, the final...

Thank you for your question, If you are in the initial weeks of recovery, severe bruising across your flanks, upper thighs, and beneath your breasts is expected. During 360 liposuction, the cannula disrupts tiny blood vessels in the subcutaneous tissue. Because gravity pulls pooled fluid and blood downward, discoloration frequently migrates beyond the immediate treatment zones into your sides, upper legs, and submammary folds.
Wear your garment as instructed by your surgeon to compress...

Thank you for your question! The fat transferred during a Brazilian Butt Lift behaves like the rest of your body's fat, so when you lose weight with a GLP-1 medication or another weight loss injection, the fat loss is generally distributed throughout your body, including the arms, abdomen, breasts, and buttocks. Since your goal is to lose only the 10 pounds you gained after surgery, I would expect any change to your BBL results to be slight to moderate. Most patients do not experience a...

It's difficult to tell you exactly how small you can be after a breast reduction, since there are so many variables to take into consideration. In general terms, you can be a lot smaller than you are now no matter what technique is used. But if you want to be even smaller than is possible with standard techniques to keep your nipple alive, then the procedure can be done with a free nipple graft which would allow you to be almost as small as you could request. Best advice would be to ask...

Choosing the right size and profile breast implants for you under the muscle for a natural look. I recommend an in person evaluation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see...

Infection after breast surgery is almost always related to the surgical period itself, it is not something that keeps coming back randomly years later. Six months after removal with a healed, calm breast, reimplantation is generally reasonable, and the recurrence risk is low when the new operation is done with strict antibiotic and sterility protocols. The retained capsule is usually harmless, but in a breast with an infection history many surgeons prefer to remove it during reimplantation...

Hello. It is technically possible to perform surgery using implants alone in your current condition. However, in that case, we would need to use implants with a smaller diameter and a higher projection. Even after surgery, your breasts would likely still have a somewhat sagging appearance.

For this reason, I recommend a periareolar mastopexy (donut breast lift) combined with breast implants. This approach can correct the sagging while restoring volume. It also allows us to use implants with...

At two years post-op, the scar is mature enough to consider revision if it is still bothering you. Since it is not raised and the main issue is that it sits too far from the ear, microneedling alone is unlikely to correct the position of the scar.
Laser or microneedling may improve texture or color slightly, but they cannot move the scar closer to the ear. Medical tattooing can help camouflage hypopigmentation, but it also does not solve scar placement.
If there is enough skin laxity and the...

First of all, given your medical history including surgical menopause, treatment with an aromatase inhibitor, and a history of aggressive breast cancer—it is especially important to proceed with caution. Before considering any aesthetic procedure, you should be evaluated in person by an experienced facial plastic surgeon, and, if necessary, your oncologist should also be involved in the treatment planning to ensure that surgery is appropriate for you.
Menopause, significant weight loss, a...

First, congratulations on your weight loss that's a huge accomplishment. Looking at your photos, I think you have a nice foundation to build on, and I understand why you're looking for more balance and smoother contours.

From photos alone, I can't diagnose lipedema, but because you've always had proportionally larger legs, even after significant weight loss, it's certainly something worth evaluating with a surgeon who has experience treating it.

If lipedema isn't the primary issue, I think...

This is always a tricky question to answer without an in-person consult, because a lot depends on your goals and the status of your abdominal skin.
In general, liposuction can reduce overall fullness and enhance contours, but it does not tighten skin on its own. So, if your goal is just to reduce the amount of fat and slightly enhance the shape of the lower abdomen, you could be a great candidate. That being said, many plastic surgeons would recommend combining the liposuction with some...

Thank you for your question, Experiencing skin burns or surface skin breakdown after liposuction is an unexpected complication, but understanding what caused it and how to manage it properly will help protect your skin and minimize scarring., our suggestion is ask your doctor after that what is the next step to take, and if they have a plan for this particular unplaned situation.
Please make sure to share clear pictures of the area with your surgical team so they can guide you on the exact...

Thank you for your question. The best approach depends on the amount of loose skin and the location of the excess fat, which is difficult to determine without photographs or an in-person examination. If the fullness is isolated to the pubic (mons) area, liposuction through one or two small, well-hidden incisions may be all that is needed. If you also have significant lower abdominal skin laxity after weight loss, a tummy tuck may be recommended, as it can tighten the lower abdomen and...

Thank you for your question, Yes, it is worth pursuing a second opinion, provided you target the right sub-specialist and adjust your goal toward modest tissue restoration and eyelid support rather than aggressive skin removal.The fact that one professional turned down your case is actually a positive sign of ethical practice. It indicates they recognized that standard skin excision in your specific situation carries a high risk of pulling the lower eyelid downward.
Dr. Luis Mejia
Let's...

This is not a cosmetic surgery, this is strabismus surgery. It can help but you're not going to find good responses on a plastic surgery website! I would look for a strabismus specialist to discuss this with.

We have reviewed your photo. You may be a suitable candidate for revision blepharoplasty. We recommend an in-person consultation to evaluate your eyelids and determine the most appropriate surgical plan

After reviewing your photos, you may be a candidate for fat grafting or lower eyelid surgery. A detailed consultation is required to determine the most appropriate treatment plan.