Doctor Q&A

Pain that is increasing several months after surgery is something that should be evaluated, especially if it’s now waking you from sleep or becoming more frequent at rest. Occasional shooting pains early in recovery can be normal as nerves heal, but worsening pain at 7 months is not something I would ignore.
There are several possible causes, including nerve-related pain, scar tissue changes, muscle irritation, implant-related issues, or inflammation. While anxiety can understandably make s...

Dear Meb,
If you have good abdominal tone, nothing is sticking out, you are strong and have a good core, maybe have not had children, and just have extra loose skin, and maybe fat, there is no reason to try to close the space between the rectus muscle, and there is unlikely to be much space to close.

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.

In many cases, non-metal retainers such as acrylic or glass may be safer than metal jewelry during surgery, but whether they are allowed depends entirely on your surgeon and anesthesia team.

For procedures like BBL or abdominal etching, surgeons often prefer all piercings to be removed completely because:
— Surgical positioning can create pressure on piercings
— Sterility is important around the operative field
— Swelling and compression garments may irritate the area
— Electro...

A BBL and flank liposuction with buttock filler are not really interchangeable. Liposuction to the flanks can improve the waist-to-hip contour, and fat transfer can add volume using your own tissue, but the safety of a BBL depends heavily on surgeon training, patient selection, and strict injection technique. If you do not have enough donor fat or you cannot follow the recovery restrictions, the result may be limited.

Large-volume buttock filler is a separate decision and I would be...

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

Der Gorgeous,
Your goal to narrow the breast and go smaller can be accomplished with a revision of your breast reduction. You look very good right now and appear to be a B cup, but that doesn't matter, you can go smaller if you want to.
The nipples are pointing high and the nipple to fold distance is excessive, so as part of the revision, while reducing the horizontal width (modestly to avoid an unesthetic loss of lateral curvature), excess skin and breast tissue would be removed as a...

Thank you for submitting the photos. The best way for me to answer that question for my patients is to use the Crisalix app. This makes a 3D image of your chest and breasts. Then you can add specific implants to the images to see if you like it. The app can also demonstrate a mastopexy (lift) as well. Then you can make a confident decision. Hope this helps!

With your anatomy, the most important part is not simply the implant size in cc’s, but choosing the correct implant dimensions for your chest wall, breast footprint, and skin characteristics. In patients with a narrow chest and a mild chest wall deformity such as pectus carinatum (“pigeon chest”), implant width and height become extremely important.

The reason your surgeons are recommending anatomical/teardrop implants is likely because they create a more natural slope and can help camou...

Thank you for your question. Each implant company uses its own naming system based on the relationship between the implant’s base width and projection, so a “moderate” implant from one brand may actually have very similar dimensions to a “moderate plus” from another brand. That is why you cannot compare profiles by name alone. The most important thing is the actual implant measurements, including base width (how wide the implant is), projection (how far it sticks out), and volume (cc). For...

At 44, the structural asymmetry in your submental region is primarily driven by a localized distribution of deep subcutaneous fat coupled with early platysma muscle band laxity, rather than a simple loss of superficial skin elasticity. My suggestion to achieve a clean, symmetrical jawline is targeted neck liposuction combined with a conservative submentoplasty (platysmaplasty) to physically bind and tighten the underlying muscle bands. While non-invasive skin tightening devices or simple...

Fat transfer can sometimes be used to soften contour hollowness or over-resection in the inner thighs, but it is a correction procedure rather than a simple volume add. The result can look natural when the defect is well defined, the skin is healthy, and small amounts of fat are layered carefully. It is less predictable in very thin legs because donor fat may be limited and some of the grafted fat may absorb.

An in-person exam is essential to see whether the issue is true volume loss, skin...

Hello,
The summary (TL;DR): More is usually more in facial aesthetics.
At 42, there are many patients who are in the “in-between” stage — where they are bothered by some features of aging, but may not yet need a full facelift depending on their anatomy and goals.
Sculptra and RF microneedling can absolutely have a role, particularly for skin quality, collagen stimulation, mild volume loss, and crepey skin.
However, these treatments generally produce more subtle and gradual imp...

One of the biggest misconceptions about fillers is the idea that adding filler can truly create a lifting effect. While additional volume may initially give the impression of lifting, in many cases the added weight and volume can actually make sagging appear heavier over time.
To improve sagging, the solution is not simply adding volume, but first considering lifting procedures that address the underlying tissue descent. Considering that you are still 28 years old, a mini lift or thread...

Based on your photos, you are a great candidate for lower face and necklift in the deep plane. This will do a great job of tightening the jawline and neck while maintaining a natural appearance. Be sure to see a facial expert for consultation.

I'm sorry you're dealing with this, persistent under-eye/malar fullness after tear trough filler is a recognized complication that can be frustrating and make people look more tired. It sounds like possible malar edema (swelling in the cheekbone area due to lymphatic issues) or a festoon/malar mound that the filler worsened or highlighted. This often happens because filler can obstruct lymphatic drainage in the thin tissues around the eyes and midface.
At 37, you're not "too young" for...

At 42 and not overweight, this area can come from several different things: a small pocket of submental fat, skin laxity, platysma banding, chin projection, or deeper neck anatomy. In the photos, there appears to be fullness under the chin with some loose neck skin or banding, but an in-person exam is needed to tell how much is fat versus skin and muscle laxity.

Kybella or small-volume liposuction can help when the main issue is fat and the skin still has good recoil. Filler or a chin...

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...

Looking at your photos, the tear trough hollowing appears to be quite significant. Tear troughs develop as the skin under the eyes and the underlying muscle become more adherent over time, causing the crease and hollow to deepen gradually. Because of this, the color of the muscle underneath can also show through more visibly, making the dark circles appear worse.
Your right eye also appears to have more prominent protruding fat above the tear trough area.
In cases like this, we can make an...

Filler should actually be dissolved before the SOOF lift. The filler and the SOOF do not sit in the same plane. Filler is either placed supraperiosteally or just below the skin, while the SOOF compartment sits between the orbicularis oculi and the orbital septum.

When you operate into a cheek already loaded with HA filler, the layers become indistinct. It hides the underlying landmarks and causes problems like contour irregularities and asymmetric vertical lift. You also cannot discern if...

It is completely understandable to worry about how a transconjunctival lower blepharoplasty might impact your highly specialized, gravity-orienting toric contact lenses, but you can feel reassured that this approach should not compromise your ability to wear them. The incision for a transconjunctival blepharoplasty is strategically placed deep within the lower fornix the bottommost fold on the inside of your eyelid which sits well below the lower edge of a standard contact lens and far away...