Doctor Q&A

Hello,
Thank you for the question. Based on your photos, subfascial position will likely create a better shape, although an in-person examination is needed to confirm this.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Nipple asymmetry is extremely common. Sometimes there are a number of surgical ways to improve symmetry, but any surgical procedure carries risk. You can consider going to a plastic surgeon to get an in person exam and another opinion, but you should surely consider excepting your asymmetry and enjoying very nice breast augmentation results.

Yes, many patients with a history of a provoked pulmonary embolism (PE) successfully undergo breast augmentation, but careful preoperative planning is essential. The fact that your PE was pregnancy-related, your thrombophilia workup was negative, and you subsequently completed another pregnancy with prophylactic Lovenox without complications are all reassuring factors. Nevertheless, any elective surgery requires individualized risk assessment, ideally with input from your hematologist and...

Some asymmetry of scars, breast shape, and lower pole fullness can improve as swelling settles and scars mature, but not every difference becomes fully symmetric with time. Incisions may not be perfectly identical because surgeons work around anatomy, exposure, implant pocket needs, and tissue tension; however, whether the placement was appropriate can only be judged by examining you and reviewing the operative details.

In the photos, the main visible issue is uneven inframammary scar...

It is difficult to asses whether you are a good candidate for this procedure. The photos are not clear enough to give me enough information to give you an expert opinion. Yes, you can do this now and do your breasts later. I advise seeing your plastic surgeon and discussing this.

Hello,
Thank you for the question. A combination of tummy tuck with liposuction would be the best surgery for you.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

An examination would allow me to give you better idea of whether muscle repair is recommended. No one truly needs muscle repair, but it may depend on your expectations of the results. And there are some patients who simply do not need muscle repair because they have excellent tone and tightness of the muscles to begin with. This is a lucky group because it makes the recovery somewhat easier.

A skinny BBL can be possible in selected patients, but the limiting factor is usually how much usable fat can be safely harvested and how much change you expect. A prior tummy tuck does not automatically rule it out, but it can reduce or change the abdominal donor area because of scar tissue and altered skin/tissue planes. The surgeon would need to examine your abdomen, flanks, back, thighs, skin quality, and scars before saying whether enough fat is available.

In the photos, you appear to...

Evaluating the ideal height of a nasal bridge involves assessing the relationship between your radix—the deepest point of the nasal root and your surrounding facial features, particularly the brow and eyelash line. On a profile view, a structurally balanced nasal bridge typically begins at the level of the upper eyelid crease or deep superior tarsal fold, projecting outward to form a harmonious nasofacially balanced angle with the forehead. My suggestion to determine if augmenting your...

Based on the photos, significant asymmetry is not very noticeable. Everyone naturally has some degree of facial asymmetry, and even with surgery, achieving 100% perfect symmetry is difficult.
Rather than asymmetry, the main concerns appear to be the rounded nasal tip, the widened appearance of the nostrils, and the low starting point of the nasal bridge from an aesthetic standpoint. Especially when smiling, the widening appearance of the nostrils can also be improved. These areas do appear...

It is hard to tell anything from one photo. If the nostrils are only long, it may be possible without sutures because the nostrils become a bit shorter as the projection is lessened. Outside nostril sutures are only needed to reduce nostril flare. Be sure to see a rhinoplasty expert for consultation.

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...

Thank you for your question. It is definitely possible to go from a 36G to around a C cup, especially if your goal is significant relief from heaviness, neck/back pain, and better proportion. The main question is whether it can be done safely while maintaining good blood supply to the nipple and an aesthetically balanced shape. Continuing weight loss before surgery is still a good idea because it can improve healing and help the surgeon better judge your final desired size. Keep in mind that...

Dear YDahl,

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

Two 700 cc implants weigh almost 3 lbs. and the result will be large low breasts. I do not recommend such large implants. If you are already a size 38 C then each 200 cc of implant corresponds to 1 cup size change. 400 cc implants will take you to a DD. I would not recommend anything larger than that. The lift technique I recommend is the Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial...

Hello,
Thank you for the question. Most likely, your surgeon will inspect your capsule and will not remove it (capsulectomy) if it looks normal and unremarkable.
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Given your history of a breast reduction in 2009 and your current framework at 5'8" and 155 lbs, achieving a distinct upper pole fullness and cleavage without looking "too big" is a very common and highly achievable goal, but it requires navigating the unique anatomy of a post-reduction breast. Since your previous reduction likely widened your breast base and removed lower tissue, a moderate-plus profile or high-profile silicone implant would be ideal because they feature a narrower base...

Missing compression over one area for the first 3 days usually would not by itself determine the final skin retraction or overall liposuction result. Compression helps with swelling control, comfort, and fluid management, but final contour depends more on the amount of fat removed, skin quality, healing biology, swelling, and how evenly the area was treated.

In the photo, the main visible issue is mild bruising around the upper back/underarm area, but the image is limited and an exam would...

I’m sorry this happened to you. It’s possible that revising the facelift and separating the skin from the muscle in that area would help. The original
Undermining of the skin may not have been sufficient

While a corner lip lift can be effective for improving the downturned corners of the mouth, it is generally a more localized procedure. In many patients, marionette lines are not caused solely by the position of the mouth corners but also by descent of the deeper facial tissues and loss of support in the lower face.
For this reason, I often prefer a deep plane facelift when appropriate. By releasing and repositioning the deeper facial structures, a deep plane facelift can provide more...

Lactose from milk does not affect skin aging in exactly the same way as a high intake of added sugar. The concern with sugar and aging is mainly related to repeated high blood sugar levels and glycation, which can affect collagen and elastin over time. Lactose is a natural milk sugar, but the overall diet, total sugar load, insulin response, and individual tolerance matter more than lactose alone.

For most people, moderate dairy intake is not a major driver of facial aging. If milk triggers...

Most of the issue in the photo are horizontal lines. Many patients want a surgical option to this but the best is still a neuromodulator such as Botox. Having said that, it does appear as if you have excess folds in between the lines. I would consider a consult with a facial plastic surgeon and see if a trichophytic brow lift would be an option.

It is very difficult to comment and suggest anything based on these limited photos. It appears that you had small cheek bones, malar hypoplasia to start with. This created laxity of lower eyelids, hollowness, sagging and tired looking eyes. There is also possibility that you may have upper eyelid ptosis, droopy eyes, what needs to be checked on the basis of in person exam. Based on these photos I would consider cheek augmentation with implants, lower eyelid tightening and, in the case of...

Based on your photos, the signs of aging appear to be more pronounced in the under-eye area than in other parts of your face. The tear trough hollowing has become deeper and more noticeable over time, and there is significant volume loss throughout the under-eye region.
As we age, the fat and soft tissues beneath the eyes gradually descend. This can create heaviness over the upper nasolabial area while simultaneously causing the under-eye area to appear hollow and sunken.
In cases like...

Thank you for your photos. An upper blepharoplasty with trimming of the medial fat pads of your eyes should help to reduce your medial bulging, as well as trim off and contour the excess skin of your upper eyelids, resulting in a rejuvenated, more alert appearance. Board certified plastic surgeons are an excellent choice to accomplish this. This procedure can usually be done under local anesthesia only, if that is acceptable to you. A single suture, running under the skin, will close each...