I was extremely happy and impressed with Dr. Fernandez! His reply was very well thought and he explained his ideas perfectly. This is further proof that I have found the perfect Dr.
This is reply:
Thanks for contacting us.
First of all, let me apologize for the delayed answer. I seriously do my best to answer as much emails as I can, but as you'll read below, I take my time to really observe and see every detail in the photos, so I can make this evaluation as objective as possible. Truth is that, between emails, surgeries, seeing patients, and just having a little time to simply live, this is as fast as I can reply (we get about 50+ per day). Many patients complain about it, but if I can't reply the way I want to and say everything I believe that needs to be said, I prefer not answering at all.
I will proceed to do your evaluation and then your husband's, area by area so it is as understandable as possible:
- Breasts: when it comes to your breasts, you are a very good candidate for a breast lift. The question here would be: with or without implants, as the results are very different on both surgeries. They both enhance the breasts, but one will give you a very natural look (without implants) and depends solely on your breast tissue, so depending on how it behaves, that will determine the consistency and firmness of your breasts. With an implant (you have the con of a foreign body), but I control the outcome much more because the implants will not change, and the firmness and upper pole fullness will stay. Don't misunderstand me when I say firmness or upper pole fullness, they would still be a very natural outcome, so don't think I am talking about fake looking breasts). What I normally do with my patients is that I ask for a sort of awkward task: search for nude breasts on the web and send me photos of the ones you consider ideal. The point is not to try and imitate them, but to understand what format and volume you like, this way I make sure we're on the same page.
- Abdomen: Now, you clearly have a very good indication for a tummy tuck (and I think we'd both agree is the area that needs work the most), and your case is very good for this surgery, because you have a severe skin excess and moderate fat accumulation. There is some evident muscle separation seen in your abdominal region. The tummy tuck not only eliminates fat and skin, but it defines the waist line more, giving the patient a curvier body because of the "corset" effect created by the abdominal rectus muscle. Another good point on your favor is the fact that you have enough skin to have a very low positioned scar, meaning, this surgery should allow you to use a very low bikini bottom or panties if you feel like it. Regarding your stretch marks, most would go out, but only below the level of the belly button.
- Body: Liposuction could greatly improve your body silhouette by eliminating the unwanted fat from unwanted areas. In your case, the areas that mostly call my attention are abdomen, back (upper and lower) and flanks (love handles). The main point with lipo in your case would be to make your torso look longer, which makes your overall body frame look more elegant. You're one of those cases that could greatly benefit from an important liposuction, so you have to make sure your blood levels are high (specially your hemo). If you have anemia, you cannot (and should not) have this surgery, as you may put your life at risk. Also, only by doing Liposuction in the lower back and flanks, the transition from lower back to your butt is accentuated or pronounced, creating a visual effect as if your butt has been lifted and defined.
Regarding your husband:
- Abdomen: I am very transparent, and I say things very direct so please don't take this the wrong way, I am just doing this in your husband's best interest. He is not a good candidate for a tummy tuck (you'll find plenty of surgeons that will say he is, but trust me he is not), and I will show you how you can prove this: touch his abdominal area and you'll see is much harder than yours. This is because, most of his abdominal projection is due to visceral fat (which is the fat around the inner organs and intestines) and not parietal fat (which is the one between the skin and the abdominal muscle, like yours and it is treated with plastic surgery). A good point on his behalf is that, visceral fat is burned much easily than parietal fat, only by having a better lifestyle (eating healthier, avoiding or reducing alcohol intake, exercising, etc). He can have liposuction the the very little abdominal parietal fat that he has and for the love handles and back. That fat is hard to get rid of and liposuction treats that very well. Also, his under chin fat can be treated with liposuction. Bottom line: he can have liposuction for the mentioned areas, but a tummy tuck is not indicated, which means that even with liposuction his abdomen will not be flat, and it's very important that he understands that.
Karel, my assistant will send you your quotes (usually less than 24 hours) for you:
1) Breast Lift (with implants) + Tummy Tuck + General Liposuction
2) Breast Lift (without implants) + Tummy Tuck + General Liposuction
and for your husband:
- Body Liposuction (including under chin)
Take good care of yourself,
Dr. Luis A. Fernandez Goico