Doctor Q&A

Thanks jewells38 for your question! It is completely understandable to feel concerned when you notice new skin changes during your recovery, especially when they appear symmetrical. Even if you feel you aren't massaging roughly, the skin in that area is often thinner and more sensitive post-surgery. Small "stress marks" or localized redness can occur from the repetitive motion in the exact same spot on both sides.
Check for "the four signs of concern": increased heat, swelling, pain, or...

This is very difficult to answer without an examination. For woman with quite a bit of breast tissue, often the best aesthetics can be achieved with a significant reduction and lift and small implant. It seems you could also get a very nice result with just a lift and possible removal of minimal tissue for contouring.

Your blood tests are normal. you can have breast augmentation safely according to this blood test results.

The "Rhinoplasty" itself would not be contraindicated after having implants, nor be a cause of capsular contracture. Bacteria (in general) however and infectious processes are linked to capsular contracture. It is important that you do take antibiotic regimens as prescribed by Dr's overall.

From your photograph, it seems like a tummy tuck is pretty much the only way to remove the extra skin and may be give you a little bit of a waist. An examination by a plastic surgeon would allow you to better understand the expectations of surgery.

Based on your photos and history, you seem to be an ideal candidate for a tummy tuck (full abdominoplasty). This procedure will remove the excess skin, tighten the abdominal wall muscle fascia to improve diastasis recti, and can be combined with liposuction to completely contour the trunk. Seek out a board certified plastic surgeon for consultation.

I recommend a tummy tuck, an extended tummy tuck with a back lift. If a back lift is not performed and the procedure is concluded with only a full tummy tuck, the back rolls will not be corrected. It will be necessary to combine the two procedures.

Some plastic surgeons will repair hernias at the same time as a tummy tuck with diastasis repair. Others will have you get the hernia repaired first (or sometimes they can work together in the OR). I cannot see from the photos if you have enough skin laxity to warrant an abdominoplasty. Your aesthetics are overall very nice. A diastasis repair will help correct some abdominal protuberance.

Prior liposuction can create internal scar tissue and changes in blood supply that sometimes make tummy tuck surgery more technically challenging. This does not mean you are a poor candidate, but it can limit how aggressively tissues can be tightened and may affect how smoothly the skin re-drapes. Experienced plastic surgeons do manage these situations regularly, but it’s important to have realistic expectations about the degree of tightening that can be safely achieved.

Muscle tightening (...

Thanks JerseyM7 for your question! It is completely understandable that you are concerned, especially given that you are seven months post-op and still experiencing pain and a persistent red spot. When redness and pain persist or appear suddenly months later, it usually suggests that something beyond standard post-surgical inflammation is occurring. Sometimes, bacteria or virus or less likely fungus can colonize internal sutures or small remnants of cartilage grafts. This can create a...

Hello and thank you for your question. Laser would not fix that. You would definitely need a revision to fix that. Based on your photographss, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include, nasal tip deprojection, placement of a fascial tip graft to provide smoother tip contour, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified...

In a young, healthy patient, we can combine aesthetic surgeries that do not exceed 8 hours. Breast implant removal, breast lift, and BBL can be combined as long as your health condition permits.

Thank you for your question.
Even if only a limited amount of fat can be transferred during one procedure, you may still see improvement in shape and projection, especially when combined with waist contouring. In some cases, patients choose a second BBL to further enhance volume once additional fat is available.
A detailed evaluation would help determine whether a staged approach would be the most suitable option for your goals.

The technique I recommend is Bellesoma. This will reduce and reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. The weight of the breast is transferred to the underlying pectoralis major muscle resulting in pain relief without excessive reduction. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. No free nipple graft is needed using...

Hi! This is a thoughtful question, and it’s something I hear from patients concerned about long-term effects of Botox on facial structure. Here’s what you should know:

Botox and muscle atrophy – When the frontalis muscle (the one that lifts your eyebrows) is repeatedly treated, it can temporarily weaken or shrink from disuse. This is called disuse atrophy. Over time, if treated aggressively or too frequently, the muscle may appear slightly softer or less prominent.

Effect on the brow ridge...

Even if you have a chin problem, you can have lipolysis, which is a fat-dissolving product, to melt the fat in that area and tighten it with mesotherapy. But of course, I need to see if you have a chin clenching problem. If you do, Botox can be injected into your chin tip, and if you have a receding chin, fillers can be used to bring your chin to its normal position. This will also visually reduce the fat tissue in your chin area, giving you the desired look. The best choice is to examine...

Botox can sometimes be used to subtly relax an upturned nasal tip by targeting the muscle that pulls the tip downward when you smile. Results are temporary and usually subtle, and it won’t change the nose’s underlying structure like surgery can. A consultation with an experienced injector can help determine if this approach makes sense for your anatomy.

Thanks Mariana for your question! It can be incredibly frustrating when your eyes suddenly change, especially at 23.
Based on your photos, your inner eye bulge could be a fat prolapse. For this medial upper eyelid compartment, while you are young, sometimes the septum (the membrane holding fat in place) weakens, allowing fat pads to bulge forward, particularly in the inner corners. This can create a hooded appearance. Your outer bulge could be again fat pad or lacrimal gland. You need to be...

Your eyebrows are asymmetrical, one is higher than the other and the eyebrows are below the level of the orbital rim. You may benefit from a browlift that would help with the upper eyelid skin and avoid blepharoplasty. A browlift can be done either in the hairline or behind it.

Best Wishes,

Gary Horndeski, M.D.

You would need to be evaluated by a doctor beforehand, but in general dark circles under the eyes are one of two things. Either there is protrusion of the fat underneath the eye, which cast a slight shadow underneath it, which makes the skin appear dark, or the skin itself appears darkened. In the second case, where the skin itself is darkened, this may be improved using a prescription strength hydroquinone cream.

Hello H,
Your eyes are perfect just the way they are. If you are bothered by the slight heaviness of your upper eyelids that you have probably had your whole life, then a skin only upper blepharoplasty under local anesthesia in an outpatient office by a blepharoplasty expert surgeon would be the call. Good luck and stay well!!!
Michael A. Persky, MD
Encino, Ca , USA

In my clinic, I allow the patient to decide size based on a "sizer try on" system. Trying on sizers is so important in the decision-making process as you are the only person who knows that is right for you. A 210 or 240cc moderate natrelle implant or 200cc mod plus in mentor might be nice choices for a more natural look if your measurements are indeed 11.5.Good luck!

Thanks for your question!
You should quit smoking 3 weeks prior and 3 weeks post surgery. Smoking can interfere with the healing process & possibly causing an infection. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Your breasts are low on the chest wall and adding just implants would result in large low breasts. You would benefit from a breast lift using Bellesoma. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired...

Thank you for your question and for submitting a picture.
The maximum implant size that can be used safely depends on the measurements your surgeon takes, the tissue quality, overall body frame and your aesthetic goals. The implant must properly fit your anatomy to achieve a safe and proportionate result.
Bearing in mind, that during a breast lift — larger implants create more tension and stretch the skin. This can limit how much pigmented areolar skin can be removed.
Finally, I...

Thank you for your question.
Based on your photo and description, a breast lift combined with implants is likely the best option for you. The lift will address nipple position and breast sagging, while implants will restore volume and shape.
Implants alone often do not correct significant sagging, so combining both provides a more balanced and lasting result.
A consultation can confirm the ideal approach for your goals.
I hope this helps.