Kevin Brenner, M.D.
Board Certified Plastic & Reconstructive Surgeon in Beverly Hills
FAQs from Dr. Brenner’s Blog at Real Self
Q: Hernia repair right after c-section?
I am pregnant with my 3rd child, which will be a repeat c-section. I already had 2 c-sections with my other two children before. I have developed Crohn’s and had surgery to remove 2 feet of small intestine back in 2002. Then within a year, I developed an umbilical hernia which has just gotten worse and worse (no insurance).
Now, my ob-gyn has referred me to general surgery to see if they will repair the hernia when I have my c-section. I am very fearful that the bigger I get with this pregnancy, the worse it’s going to be. I am all for it, but what do you think? Is it a good idea? Do you have any suggestions? Thank you so much.
Asked by giniageorge on RealSelf.com
A: Elective surgery and hernia repair
I see many women who develop umbilical hernias around the time of their pregnancy. Umbilical hernias can get larger during pregnancy as the abodmen enlarges, but they rarely pose a problem. The abdominal tissues get very swollen and are not entirely normal immediately after delivery. For that reason alone, I feel that repair of the hernia should be done about 4-6 months after the C-section (not at the same time), once you are down to your normal weight. If you have your hernia repaired at the time of C-section, you run a higher risk of the hernia recurring.
Q: Will I have visible scars from a tummy tuck?
I imagine that you have them hidden below your underpants but is this true? can i wear a bikini after tummy tuck?
Asked by Heidi on RealSelf.com
A: Tummy tuck scars
Los Angeles moms tend to be extremely conscious of these incisions. When I perform my Mommy Makeovers, I intentionally keep the scar as low as possible so that my patients can wear their lingerie, bikinis and “hip-hugger” blue jeans. The real “tip-off” that someone had a tummy tuck is usually the belly button. I believe that many plastic surgeons don’t know what looks good when it comes time to inset the belly button during a tummy tuck. For this reason, I developed a new technique for sewing in the belly button which reduces the amount of visible scar tissue.
Q: Duration of hospital stay post-Tummy Tuck?
I’m thinking of having a Tummy Tuck, and I was wondering, how long would I have to stay in the hospital after the procedure?
Asked by diedelee on RealSelf.com
A: Safety is most important with Tummy Tuck!
Hospitals are for sick people, not patients recovering from cosmetic surgery. Safety is very important, so I send all of my tummy tuck patients to an outpatient, nurse-supervised recovery retreat for a minimum of one night.
Q: What is an open roof deformity?
Hello all, what is a roof deformity? I think I may have this problem pretty severely. I’ve read that seemingly quite a few problems can cause this, such as improper bone re-setting, shaving too much cartialge, etc.
What does this deformity usually look like? How would it be corrected depending on the problem? And also, generally what is going on with the cartilage/bone when a open roof occurs? Does it get worse with time? Thank yall very much!!!
Asked by CSmitty on RealSelf.com
A: The Open Roof Deformity can be fixed
An “Open Roof Deformity” can occur after a rhinoplasty if the surgeon reduces the bone and cartilage along the bridge and inadequately repairs the defect. It can usually be repaired in one of several ways:
1) Re-breaking the bones.
2) Placement of new cartilage grafts (called Spreader Grafts).
3) Camouflage with other types of nasal grafts (Fascia and Diced Cartilage).
These are common strategies that I use in revision (aka secondary) rhinoplasty operations.
Q: What to do for insurance coverage for tummy tuck and breast reduction?
I have spreaded since I had my daughter 3 years ago. I am a size D and my breasts get in the way. I also need a tummy tuck because my fat on my stomach gets stuck in the zipper of my pants. I have Amerigroup Medicaid insurance and I live in Maryland. I called to ask if they cover tummy tuck and breast reduction, and they said that it isn’t. I have no hope but to cut it myself because I am so depressed. Ever since I had her my self-esteem went down..I need help, these surgeries will make me feel so much better. Any idea on how I can get these procedures covered?
Asked by Kim20099 on RealSelf.com
A: Insurance will pay for some operations
Kim,
Many insurance plans will pay for certain operations for body contouring when medically necessary, such as:
1) BREAST REDUCTION
2) PANNICULECTOMY (removal of excess abdominal skin)
3) HERNIA REPAIR
Most PPO, and POS plans and even Medicare will cover some of these operations. However, every insurance company has different requirements before they will cover them. You should check with your insurance company and even consider upgrading to a different insurance company or insurance plan.
Q: Breast implant removal: does it require breast lift surgery?
i want to remove my breast implants. too big. if i do this will i most likely need a breast lift? is my skin stretched permanently as a result of implants?
Asked by UB44 on RealSelf.com
A: Every breast implant removal patient is different
Whether you need a lift after removal of breast implants depends on several things:
1) Amount of BREAST TISSUE you had before your augmentation.
2) Degree of SAGGING of your breasts.
3) Number of STRETCH MARKS within your breast skin.
4) Position of your NIPPLE & AREOLA in relation to the lower breast fold.
Q: Silicone Breast Implant removal and replacement cost?
How much does a silicone Breast implant removal and replacement usually cost? I had the original implants put in 23 years ago. I would like them removed and replaced with the memory Silicone implants.
Asked by Vickster on RealSelf.com
A: Removal and replacement of Silicone Breast Implants
Removal of silicone breast implants can be covered by your medical insurance in certain situations. I work with many insurance companies in cases such as removal of ruptured silicone implants, or removal of painful or distorted implants as a result of severe capsular contracture. If your silicone implants are 23 years old, the likilihood that they may be ruptured or leaking is very high. In these situations, insurance companies will pay for for the removal and you would only be responsible for the cost of replacement with new implants should you desire.
Q: Sagging breasts: How to perk things up
after babies and i guess aging :( my breasts sag more than i’d like. is breast lift or plastic surgery my only option for getting them perked up again?
Asked by Saggy S. on RealSelf.com
A: Breast Lift with or without an implant
Breast shapes and sizes vary between patients. “Sagging” for one patient may actually only be loss of breast volume. True sagging, where the skin is stretched out and the nipple sits too low, usually requires some sort of breast lift. Loss of volume is usually best treated with an implant. Commonly, both operations need to be performed at the same time.
Q: When is a body lift covered by insurance?
I understand that most of the time, body lift surgery isn’t covered by medical insurance, but in certain cases it is. What are the normal criteria for having a body lift paid for by insurance?
Asked by Randy on RealSelf.com
A: Some portions of the bodylift procedure may be covered
Insurance companies will likely not pay for your entire bodylift outright. Although it is usually a cosmetic operation, some portions of the procedure that need to be done as a component of, or concurrently with, the bodylift may be covered benefits under your insurance plan. Examples of medically indicated procedures are:
1) Panniculectomy.
2) Abdominal Hernia Repair.
3) Repair of disfiguring scarring from trauma or previous surgery.
Q: 360cc Breast Implants to get C cups?
I’m scheduled for Breast Augmentation surgery in a week. I’m 5’1″ and 100 lbs, currently a large A cup / small B as my surgeon calls it, and I want to be a full C cup.
He’s thinking about a size 300cc saline moderate profile implant filled to about 360cc. First off, is that too much of overfilling? And second, is that too big of an implant for me to achieve my desired results?
Asked by robbie12 on RealSelf.com
A: Don’t get stuck on an absolute bra cup size
I never guarantee a cup or bra size to my patients because bra cup sizes vary between bra manufacturers. Further, the cup size is not important; what matters is that your new size actually fits your frame. Saline implants do have a fill range, as dictated by the implant companies, which is usually between 50 and 75 cc over the volume listed on the implant. As long as the final volume is within this pre-determined range, the implant is not overfilled. 360 cc may be within range for a 300 cc implant, but this really depends on the actual implant. However, a 360 cc implants sounds like it may be a bit too big for your frame.
Q: Should I massage my breasts after breast implant surgery?
Asked by Anonymous on RealSelf.com
A: Breast massage after augmentation is helpful
I have found that self-breast massage is beneficial after breast augmentation because:
1) Massaging your implants will help to counteract scar formation, keeping breast capsules softer.
2) Massaging your implants will help to facilitate descent of the implant after surgery; particularly when placed below the pectoralis muscle.
3) Massaging your implants will force you as a patient to become familiar with the size, shape and consistency of your breasts after augmentation. This is extremely important so that you, as a patient, will be immediately aware of any change that may occur with your breasts (i.e. such as capsular contracture).
Q: How is Breast Implant replacement surgery done?
I have textured silicone implants in a subglandular placement and want to replace them with smooth silicone implants under the muscle.
Will the new implants be placed in at the time of removal of the textured ones? Or will it have to be done in two separate procedures so I can heal from the first surgery first. I hate to have to walk around with deflated boobs for months.
Asked by Vero on RealSelf.com
A: Removal, Replacement & Repositioning: One Operation
Removal of your textured implants and replacement with smooth silicone implants in a new pocket should usually be done in one operation. However, if you have very little native breast tissue and require an extensive total removal of the breast capsule (capsulectomy), then it may be necessary to wait in between the removal and the replacement.
Q: What is the average “life” of a breast implant?
What is the procedure for replacing implants? I have had my saline implants for over 15 yrs. How long is the expected time period before you need to replace them? Is the procedure more painful or difficult than the original implant? I have a lot of rippling, even though I went under the muscle. My bags are textured, I believe. I also think that they may have loss some of their initial volume. Can you describe the average “life” of an implant, the replacement procedure and any new advancements in the last year or two? Thank you
Asked by beauty advice on RealSelf.com
A: New advances in breast implants
I agree I with some of the advice from the other surgeons; the average life span of a saline implant is about 10-15 years. However, if your implant has lost volume, it is leaking and should be replaced no matter its age.
The most recent advance in breast implant technology is a new device called “Ideal Implant” which is currently going through and FDA trial. It is a saline implant which was designed with an internal baffling system with the intent of decreasing implant rippling as well as internal movement of the saline. The manufacturer describes it as a HYBRID implant, because it is filled with saline only, but has a look and feel that is closer to a silicone implant than any saline implant that I have ever seen. So far, all of my patients that have them in are very pleased.
Q: How can I get rid of loose sagging skin after pregnancy?
will a mommy makeover take care of all the loose skin from pregnancy?
Asked by dsteingard on RealSelf.com
A: Mommy Makeover is the answer to sagging or loose skin after pregnancy
An abdominoplasty, or tummy tuck, will remove the extra skin, fat and stretch marks from your abdomen while tightening the abdominal muscles at the same time. For breasts that have lost volume and sag after breast feeding, a breast augmentation along with a breast lift will restore the breast to its correct position and pre-pregnancy volume. Some women retain adequate breast size after breast feeding and only experience sagging of the tissues along with stretching of the breast skin. These patients are excellent candidates for breast lift (mastopexy) alone.
Q: Is Brow Lift the only option for deflated eyelids?
One year ago, I had fat removed from the upper eyelid. Now, the skin has deflatted and my eyes look like they have excess skin. My doctor said a Brow lift would correct this but I want to know if I can do anything else.
Asked by kristall on RealSelf.com
A: Brow lift may help your upper eyelids
If your eyebrow position is too low and is causing the skin of your upper lids to bunch up, then a brow lift is a good solution. If your brow position is normal, then a better option would be to have some skin removed from your upper lids.
Q: Preventing eye ptosis from Botox?
I keep hearing more and more cases of eyelid ptosis or “droopy” or closed eye from Botox. Is there a way to decrease the chances of this happening? Does it happen as often with Dysport as well?
Asked by KGB on RealSelf.com
A: Selecting your Botox injector carefully can help prevent problems
It is important to distinguish between Eyelid ptosis and Eyebrow ptosis.
Eyelid ptosis occurs when the eyelid excursion (ability to open and close) is diminished and the upper eyelid begins to cover the pupil, interfering with the upper visual field.
Eyebrow ptosis is when the eyebrow position is too low, and falls below the bony rim of the eye socket. This can make a patient appear as though the eyelid cannot open, when in fact there is nothing wrong with the eyelid muscles.
Both conditions can occur in patients who have had botox injections. The best way to prevent either of these from happening is:
1) Have a doctor inject you who is very familiar with the pertinent anatomy of the face.
2) Do not rub any area for 24-48 hours after injection. Doing so can cause the botox to migrate.
3) Avoid excessive exercise for 24 hours after injection.
Dysport works in the same manner as botox and can therefore exacerbate both of these conditions as well.
Q: Does breast lifting alone leave suture marks and scars?
Asked by Farnie on RealSelf.com
A: Breast Lift scars, yes. Suture marks, no!
The purpose for a breast lift is to elevate the nipple back up to the proper position. Doing so requires that a certain amount of skin be removed, in conjunction with reshaping of the breast tissue. The only way to remove excess skin, is to make an incision and actually cut it out. Anytime that an incision is made in the skin, a scar will result. The amount of scarring that result is in directly related to the amount of excess skin that exists. Suture marks only occur when skin sutures are left in too long. Suture marks can be prevented by using absorbable sutures in the deeper tissues, and by removing and skin sutures within the first week after surgery.
Q: Possible to get larger breast implants without fake look?
I was a 34A (if not less) before my Breast Augmentation 2 years ago. I got 320CC cohesive gel implants that brought me to a 34C (not full). I now wish I could have gone larger! I want to be a 34D (full). I am now considering the same implant with 550 CCs. Is that too big for me? I do not want the fake look, just a larger size of what I am now. I look very, very natural now and would not like to destroy that. Is it possible to go larger without obtaining a fake look? I am 5’4 and 135 lbs.
Asked by queenbm on RealSelf.com
A: Decide what you want before changing your breast implants
It sounds like you are not quite sure about what you want exactly. A size 34C breast sounds like it is in good proportion for your height and weight. If you would like your breasts larger, then by all means have it done. But realize that an additional 230 cc on each side will be a very big change for you.
Q: Mini tummy tuck less painful than a full tummy tuck?
Is a mini tummy tuck less painful than a full, regular tummy tuck?
Asked by maria on RealSelf.com
A: It all depends on whether the muscle needs tightening.
Most of the discomfort from a tummy tuck relates to the tightening (aka plication) of the abdominal muscles. Usually with a mini-tummy tuck, the muscle is only tightened below the belly button versus a full tummy tuck, which tightens the muscle from the rib cage to the pubic bone. However, both can be painful.
Q: Breast reduction recommended if overweight?
there is some hestitation on my part to get breast reduction. would a good candidate for breast reduction surgery be overweight?
Asked by Im44 on RealSelf.com
A: Losing weight will make your breast reduction operation easier
Losing weight prior to surgery will make the entire process easier for you. In particular, the anesthetic-related co-morbidities (i.e. complications) are usually less frequent in patients you are closer to their ideal weight. When you lose weight, you will also lose volume in your breasts. However, simply losing weight does not guarantee that your breasts will get smaller, so you will still likely need a breast reduction.
Q: Breast reconstruction for infected breasts?
I have had breast infections due to Gamella bacteria first, then had a bilateral periductal fistula on both breast 3 times, then contracted HA MRSA. I underwent surgery for that. I still have infection but my breasts look terrible now. They are scarred from the many procedures, and the right nipple is actually at an angle now instead of horizontal.
I was wondering if there’s any type of corrective surgery that would be helpful for my situation. We are still treating an infection, although unknown. The last culture was ” normal skin flora”. Thank you for your time.
Asked by avasmom on RealSelf.com
A: Breast reconstruction with your own soft tissue
Sometimes when breast tissue becomes severely scarred, the best option is to remove the extensively damaged tissue. This does not mean you will require removal of the entire breast, but possibly a portion of it. Replacement with your own tissue by means of a flap (using the Latissimus Dorsi or Rectus Abdominus muscles) will bring new soft and pliable tissue with a healthy blood supply.
Q: Is it possible to have normal looking breasts after explant surgery?
I have had saline breast implants for 8 years and am scared of the aesthetic outcome should I have them removed. I am 29 years old, I have very little breast tissue and stretch marks on my breasts from having a baby. I have constant aches and pains in my left breast. I have considered get revision surgery, but what I really want is them to be taken out. I have been researching this for a year now and would really like some advice (especially when it comes to finding the right surgeon to remove them).
Asked by Jai on RealSelf.com
A: Breast shape after explantation
If you are planning on having your implants removed permanently, you may need to have the following done:
1) Implant removal;
2) Capsule removal;
3) Breast lift.
Without examining you, it is difficult to say which of these you will require. Some patients will require all three. Some patients can avoid a mastopexy (breast lift) by allowing their surgeon to remove the implants and capsules and wait. In certain situations, the skin envelope may tighten up over time. However, be prepared to possible need a second operation to lift the breast back to an aesthetically pleasing position.
Q: Breast implant removal – Will my breasts sag if I decide to explant?
What if you decided to explant? Will your breasts sag?
Asked by xklorx on RealSelf.com
A: Factors to consider before explanting
The most important factors that will determine if you will require a lift after explant are:
1) SIZE of your current implants.
2) Amount of BREAST TISSUE that you had before.
3) TIME interval since your augmentation.
4) Degree of BREAST SAGGING that has occurred since your augmentation.
5) POSITION OF YOUR NIPPLE in relation to the lower breast fold.
Q: Breast augmentation redo?
I had a breast augmentation 4 years ago after the birth of my second child. Thanks to weight gain, breast feeding and weight loss. I went from a B cup to a D cup. However, because of the weight of the implants and aging, the breasts are no longer high and create a clevage; they hang to my waist and look sad:)
I am thinking about getting to a size C cup and making them perkier. They feel to heavy, and the bra straps dig into my shoulders despite fitting every three months. Any words of advice?
Asked by Grace Ely on RealSelf.com
A: Downsize your implants and lift the breast tissue
I have not even seen your photos, and I can tell that you will need:
1) removal of your current implants;
2) replacement with smaller implants; and
3) Breast lifting, most likely a full lift, but depends on your degree of sagging.
Q: Unusual approach to gynecomastia?
I am a 32 year old male who had Liposuction of breasts about a year ago. Also, my surgeon chose to address the gynecomastia through incisions below and medial to my nipples. Is this an unusual approach?
Asked by asbestos on RealSelf.com
A: Liposuction incision placement less important than the result.
The choice of site for incisions for liposuction of gynecomastia really depends on the extent of breast tissue that exists. Truth is, that the contour that you have afte surgery is probably more important than the exact location of the incisions. Occasionally I will make additional access incisions during liposuction of gynecomastia if I think it will allow me to obtain a better final contour.
Q: Flying after Breast implants revision
How long until I can take a 2 1/2 hour flight after breast augmentation revision? I am traveling to Florida to have my breasts re-done and wondering when it is safe for me to take the 2 1/2 hour flight back home.
Asked by Chanel7 on RealSelf.com
A: Traveling after breast implant revision surgery
I care for many patients from out of state, so this is a very common question in my practice. I do like to have frequent contact with my patients during the first week after surgery, so that I can manage their sutures and dressings and deal with any problems that might occur. Although it rarely occurs, the most common early complication after breast surgery is bleeding. When it happens, it usually occurs within the first 24-48 hours after surgery (although it can occur later). Traveling itself, for short durations, is relatively safe after surgery. Make sure that you stay in close contact with your surgeon after surgery and that you have the ability to travel back to your surgeon should a problem develop.
Q: Breast reduction after pregancy
hi i’m a 21-year-old-mother who gave birth over 14-months ago,my problem is that i always had an a-cup breast and during my pregnancy my breast changed to a c-cup and stayed that way. i never felt back pain until my pregnancy and now a year later its still there. hypothetically i drew the conclusion it’s my breast after reviewing diffrent stories. because my back,neck and sholders are hurting and my breast is so heavy. do you think my insurance company would cover it even though i’m not a d-cup? (i included a pic) thanks in advance dana321
A: Insurance will pay for true breast reductions
Your symptoms of back, neck and shoulder pain are quite typical. Most insurance companies will pay for breast reduction that needs to be done for medical reasons. However, each company’s criteria are a bit different, so be sure to check with your insurance provider beforehand.
Q: Navel area tightening procedure?
I am very athletic and I maintain a healthy, low-calorie diet. My body fat is low, but lately I’ve noticed that the skin surrounding my navel is a bit loose. I have a flat and tight stomach and I can even see abs, and I haven’t had children, so I don’t think a Tummy Tuck is suitable for me. Also, I really don’t want a scar. Is there a minor procedure for tightening the skin around the navel?
Asked by random36 on RealSelf.com
A: It all depends on the degree of skin laxity
For minor skin laxity, you could try the Accent device, which is a RFA (Radio Frquency Ablation) laser. More severe laxity will likely require some open surgical contouring procedure.
Q: Body lift – How long do results last?
How long does the “lift” from body lift surgery last? I am 35, and I want to get a body lift, but I may wait if the results won’t last well into my 40s or 50s.
Asked by Deedee from Buena Vista, CA on RealSelf.com
A: Body Lift results can depend on your weight maintenance
Removing the skin and fat that remains after massive weight loss with a body lift is permanent. That is why you should have surgery once you reach your ideal, stable weight. Should you continue to lose weight after surgery, you may develop some new laxity and require a “touch-up” procedure years later.
Q: Reduce saline breast implant volume without surgery?
Is it possible to reduce approximately 70 cc from saline breast implants without having surgery (for example, with a very small needle)? Would it continue to leak afterward? Thank you.
Asked by tyler on RealSelf.com
A: Reducing saline implant volume without surgery?
It is only possible to adjust saline implant volumes without surgery if you happen to have the type of implant that has a special port. These implants are very rare, and in fact I do not use them. However, saline volume can be adjusted with a very minor procedure which; sometimes even using local anesthesia.
Q: Waiting period for Breast Reduction or Lift after weight loss?
I have recently lost 46 lbs and have about 15 more to go. My breast size has not decreased significantly, only from a DDD cup to a DD cup. How long after my weight loss is complete should I wait to have a breast reduction or breast lift? Thank you.
Asked by Sweetgirl1 on RealSelf.com
A: Breast size can vary with weight loss
A woman’s breast size will change during weight gain and weight loss. However, the amount of change is unpredictable. Ideally, breast lift and reduction should be performed once you have reached a steady weight for at least three months; even if it is not your ideal weight.
Q: Waiting period for Breast Reduction or Lift after weight loss?
I have recently lost 46 lbs and have about 15 more to go. My breast size has not decreased significantly, only from a DDD cup to a DD cup. How long after my weight loss is complete should I wait to have a breast reduction or breast lift? Thank you.
Asked by Sweetgirl1 on RealSelf.com
A: Breast size can vary with weight loss
A woman’s breast size will change during weight gain and weight loss. However, the amount of change is unpredictable. Ideally, breast lift and reduction should be performed once you have reached a steady weight for at least three months; even if it is not your ideal weight.
Q: Are silicone breast implants safe?
need to know before i’d consider silicone implants
Asked by Jasmin on RealSelf.com
A: Silicone is safe, but consider a hybrid implant
Saline and Silicone are both safe implants. However, the FDA is currently investigating the newest “hybrid” implant on the market. This IDEAL IMPLANT, is a baffled saline implant which was designed to look and feel more like a silicone implant, but without the silicone. You should check to see if there is a plastic surgeon investigator near you.
Q: How do I choose the best breast implant for me?
i dont know whether to go big or medium, saline breast implants or silicone breast implants, under or over muscle. help!
Asked by H. K., NYC, NY on RealSelf.com
A: Saline, silicone, or hybrid breast implants
Choosing the correct implant size is truly a matter of a patient’s personal choice. Although I tend to be conservative with breast augmentation size, ultimately what matters most is whether the patient is happy with the final size. As far as implant type is concerned, there are both advantages and disadvantages to either type of implant. An excellent compromise is the Ideal Implant, which is a baffled saline “Hybrid” implant. It has the look and feel of silicone, without the risk of silent rupture.
Q: Uneven nipples after breast augmentation and lift
I recently had breast lift and implants (200 cc, 1 cup size bigger, age 26 no kids) 2 weeks ago, and my nipples look like something out of a child’s coloring book. They’re completely uneven, choppy, and not at all near perfectly circular. Will these eventually fix themselves? I also thought the breasts would be higher. Does this look like a well executed lift?
Asked by ajonesca on RealSelf.com
A: Every woman’s breasts are asymmetrical to some degree
Small asymmetries are common. Every patient has two different breasts before surgery. As a result, they usually tend to heal a bit differently. Breast implants also will settle or drop over the first month or two once implanted. Occasionally, they descend at different rates. Be patient, most likely this discrepancy will even itself out.
Q: Lose weight before breast implant revision?
I have gained 80 lbs since having my 800 cc breast implants. Back then I was a double D. I just want them removed until I lose weight and then will get a more reasonable size. Would you recommend I lose weight first? They are really causing me issues due to their size.
Asked by JenniferOC on RealSelf.com
A: Simply downsizing breast implants may be the way to go
800 cc implants are indeed large for the average breast augmentation patient. However, if you have had them in for a while, your breast skin most likely has stretched to accomodate the implants. If you remove them, you may be left with very saggy breasts. Consider downsizing them first.
Q: Inverted nipple a sign of breast cancer?
my left breast nipple is dented. i’ve been ok with it, yet i saw a story in the news that it could be a sign of breast cancer. so now i am really scared! what’s the cause of inverted nipples and is it something i need to get checked out right away?
Asked by FloridaG on RealSelf.com
A: Inverted nipples are worth investigating
New changes in your breast that cause your nipple to become inverted are worth investigating with your doctor. Especially if it is associated with nipple discharge or with a new bump in your breast. Talk with your doctor, get an exam by your doctor and consider a mammogram if you have not done so already. However, an inverted nipple can be a normal variant, particularly if you have had it for a long time.
Q: Risk of getting keloid scars from breast lift?
I am interested in breast lift surgery. I’m wondering, will I have a high chance of having keloid scars on my breasts, seeing that both my C-sections had thick, bumpy scars?
Asked by condos01 on RealSelf.com
A: Scars can vary, even on the same person
Although there is always a risk of developing thick scars after any operation, the chance with a breast lift is very low. How a scar heals often depends on the location on the body as well as the technique to close the skin. It is possible to develop a thick scar on your abdomen and heal an incision on your breast normally. There is no way to know for sure if you will develop hypertrophic (thick) scars or keloids. However, African-American, Hispanic and Asian skin types tend to have a higher risk.
Q: Tummy tuck surgery – where will I have scars? How big are they?
Asked by Anonymous on RealSelf.com
A: Tummy tuck incisions kept low
Incisions for tummy tucks are essential; it is the only way to remove the excess skin that inevitably exists. I keep the transverse (horizontal) incision very low, just above the pubic hair line, so that my patients can easily hide them with a standard bikini. I also take great care re-creating the belly-button incision, so that only half of it is visible.
Q: Will insurance allow breast reduction from F to D cup?
I have always been large breasted and have always wanted a reduction. In the past 2 years, I have given birth to two children and breastfed. My youngest is now a year old and my breast have not returned to “normal” size. I am still wearing my maternity, size F bras. My back and neck hurt all day long. As I said earlier, I have always been large breasted. Will insurance allow me to be a size D, or must you go really small? Am I a good candidate for insurance to cover my breast reduction? I am 33 years old, 5’7″, and 165 lbs.
Asked by GarrisonJ on RealSelf.com
A: Medical insurance coverage varies between plans
Although you appear to be an excellent candidate for breast reduction, whether your insurance will pay for it depends entirely on your plan. Insurance coverage varies between companies, and even between different plans in the same company. Generally, however, most plans will cover breast reduction if the following criteria exist:
1) Back pain (from breasts being too big)
2) Bra strap grooving on the shoulders.
3) Rash in the lower breast fold that does not respond to medical treatment.
4) Your surgeon believes that a minimum amount of tissue can be removed (usually 500 gms per side, sometime less)
Q: Can tummy tuck scar be lowered to the pubic area?
I had a full tummy tuck five years ago. I would like my scar to be lowered well into my pubic area (at least two inches lower) I have extra skin now from two pregnancies after the surgery. Would this be possible? Will the belly button be re-done? Would it be considered a scar revision or a tummy tuck redo? Thank you!
Asked by questforperfection on RealSelf.com
A: Re-doing your tummy tuck
From your photo, it does appear that you have some addtional laxity to your abdominal wall skin. This can be improved, but will require re-opening all of your incisions. Since you have had two pregnancies since your original tummy tuck, most likely the muscles will also require re-tightening. Your incision can be lowered into the pubic area, but you will almost certainly also need to have an additional incision in the midline to relocate the belly button to the correct position.
Q: How much weight to lose before Tummy Tuck?
Hi. I am interested in having a Tummy Tuck done and I want to know how much height to lose before having the surgery. I am 5’7″ and currently weigh 210 lbs.
Asked by sunshine3 on RealSelf.com
A: Sometimes staging your operation works best
I have found that many overweight patients have difficulty exercising because their extra abdominal fat and skin either gets in the way or makes them self conscious. In select patients, removing the skin with a tummy tuck increases their confidence and frequently stimulates them to start heading for the gym to lose the remaining weight. However, if you go on to lose a significant amout of additional weight, you may likely need a second operation to adjust your contour.
Q: When does swelling after breast augmentation begin to subside?
I had 325cc silicone breast implants 5 days ago. I am 5’1 and 102 pounds. I was hoping to be a C cup, but I am fitting into a D bra. Is this because of the swelling? If so, when will the swelling begin to go down? When will I know exactly what bra size I will wear?
Asked by kcali on RealSelf.com
A: Bra cup sizes vary
It is important to remember that bra cup sizes vary between different bra manufacturers. What fits 34C in Cosabella, may be too tight or a bit loose in a comparable Victoria Secret bra. The swelling will go down, but it usually takes at least one month…and frequently longer. I recommend that my patients wear a snug fitting sports bra for the first four weeks after surgery to provide both compression and support. In the mean time, have a few different size bras available.
Q: Vertical skin bunching after Tummy tuck
I’m 3 days post Tummy tuck. Will this vertical bunching up of my skin after Tummy tuck go away? Doctor said it happened because he had to pull muscles together so tight due to severe separation of muscles.
Asked by TATA3 on RealSelf.com
A: Vertical bunching after Tummy Tuck will likely need revision
If this bunching does not completely flatten out over the next few months (I suspect that it will not), you will probably require revision of your tummy tuck. Your surgeon is correct about the bunching resulting from the underlying muscle tightening. Although that was likely corrected very well, the overlying skin and fat is not laying correctly and will likely need to be re-draped, or possible converted to a “Fleur-de-lis” pattern for your incision, which would result in an long vertical incision.
Q: Surgery to correct puffy areolas?
I’m a 20 year old female, no kids. And I was considering puffy areola reduction. My areola is a little bit wider then a quarter in diameter. Everything else with the breast is fine, size and shape. But I have a puffy areola and so in the relaxed state there is no nipple just areola.
I know it’s a simple incision and quick healing process, but will having a puffy areola be a problem for breast feeding if I get pregnant in the future? And I haven’t been able to find any before and after pictures of puffy areola treatment, where can I find some? And is this surgery by itself costly?
Asked by surfergrlchick on RealSelf.com
A: Correcting large areola
There is a great variation between every patient in terms of breast, areola and nipple sizes. Despite this variation, some patients simply have an areola that is too large for their breast and simply is unpleasing aesthetically. There are operations designed to reduce or change the size of the areola; they are similar to the techniques that we use to do a Periareolar Mastopexy (Breast lift using an incision only around the areola).
Q: Lumpy area and dark stitch marks after Lipo
I have lumpy area and dark stitch marks after Liposuction. What can I do about this? Preferrably NOT a second Lipo.
Asked by Ivana on RealSelf.com
A: Tips to improve the look of you liposuction scars
All scars take at least a full year to fully heal, fade and mature. Sun exposure during this first year can lead to permanent color change…in particular darkening of the scars known as hyperpigmentation. To help lighten the scars, you may try:
1) Bleaching with HYDROQUINONE CREAM
2) Laser treatments with IPL (Intensed Pulsed Light) or FOTOFACIAL laser.
For thick scars: Careful injection with a steroid liquid (i.e Kenalog) is effective.
For irregularities in your fat after liposuction: Accent RFA non-surgical treatments.
Q: Possible have nipple implants for more realistic appearance?
I had my nipples replaced with skin from my inner leg. They have very little fat and look like mounds. They are shaped like nipples but they don’t look real. I think I found the answer in round, pearl-like beads that people put in the forehead or strange areas. I have breast implants under the muscle. I can’t find anyone who will do this. Tattoo parlors the only people who understand. Is this procedure even possible? I don’t want to die with mounds. Is there anyone who can help me?
Asked by andreasadat on RealSelf.com
A: More realistic Breast Reconstruction
The most difficult part of recreating a natural appearing breast after reconstruction for cancer is frequently the creation of a realistic nipple.There are devices that can be placed behind reconstructed nipples to help give them more structure. However, I have found that reconstruction with a patient’s own tissue has less risk, lower incidence of incorrect positioning and a reduced incidence of infection.
Q: Body lift or thigh lift for stretch marks on calves, hips, and thighs?
I gained 33 lbs with one pregnancy and 28 lbs with the other. I’m 30 years old, and feel as though my lower body looks 60! I know there is nothing permanent for stretch marks and cellulite removal. I had 6 Fraxel treatments on my legs and there was some improvement. I want to wear shorts again. I would like to get rid of the stretch marks on my hips and calves. Is this possible with a lower body lift or thigh lift? I understand I will have another scar, but its better than many. I have olive skin and always scar lighter than my skin tone.
Asked by mary649 on RealSelf.com
A: Getting rid of stretch marks
Stretch marks are particularly troublesome to many of my patients who are new moms. Depending on the severity of the stretch marks and their locations, sometimes a surgical procedure to remove the damaged skin (i.e abdominoplasty or lower body lift) is a more effective choice. For my patients who have scars that are not amenable to surgical removal, I have had very good success with a combination laser treatment with the Pixel Fractionated Erbium Laser and Skin Tightening Laser. Cellulite can also be addressed with non-surgical Accent RFA laser treatments.
Q: Duration of hospital stay post-Tummy Tuck?
I’m thinking of having a Tummy Tuck, and I was wondering, how long would I have to stay in the hospital after the procedure?
Asked by diedelee on RealSelf.com
A: Safety is most important with Tummy Tuck!
Hospitals are for sick people, not patients recovering from cosmetic surgery. Safety is very important, so I send all of my tummy tuck patients to an outpatient, nurse-supervised recovery retreat for a minimum of one night
Q: What are the pros and cons of a thigh or lower body lift ?
After liposuction, my thighs are just loose bags.
A: Patients with excess hanging skin are excellent candidates for body contouring
Excess skin laxity following liposuction is very common. It usually indicates that your skin integrity was inadequate to “shrink wrap” down after liposuction. Patients with this issue are excellent candidates for open body contouring procedures. This can include tummy tuck, lower body lift, brachioplasty and thigh lift. If you have a significant amount of excess skin that hangs down, surgical removal probably is your best option
Q: Will pregnacy but not breastfeeding ruin my breast reduction surgery?
results?
A: Hormonal changes in pregnancy…
The hormonal changes that your body endurs during pregnancy is usually the cause of the majority of breast deformity. The 40 week gestational period not only allows a woman’s body to accommodate a growing baby, but it also prepares it to care for the baby following delivery. I believe that the changes that the female breast incur in preparation for breast-feeding (lactation) are what ultimately cause the underlying damage to the breast tissues
Q: Can crow’s feet be merely softened with Botox?
I’m a 52 yr old male. I hoped to have my crow’s feet subtly softened but not eliminated. After my first Botox injections the crow’s feet are completely gone. Can less Botox be given next time to leave some of the lines? Is this hard to do? Is this an uncommon request?
A: Absolutely, crow’s feet can be softened with Botox
In my practice, I see so many patients from other injectors who look completely frozen. Botox can easily be used to soften lines and not eliminate them once the dose is appropriately adjusted. I think that conservatism is key when injecting Botox.
Q: Will my insurance pay for breast lift?
A: Occasionally insurance will cover breast lift
There are a few circumstances in which insurance companies will pay for a mastopexy. This most commonly occurs when patients have rashes of the skin in the fold below the breast. Although you need to try treating these rashes with medications first, mastopexy may be covered if that fails. The other situation would be for patients that have breast cancer in one breast and require a breast lift of the other breast in order to achieve symmetry and fit into a bra normally.
Q: How many units of Botox is needed for entire eye area?
I have been considering botox for my eye area. I have crows feet and other tiny lines around that area. I wondered how many units would be needed?
A: Conservative approach works well for Botox
When injecting Botox, I tend to be more conservative that most physicians. I find that a “frozen” look appears very unnatural. Specifically for the lateral orbicularis muscle fibers (“Crow’s Feet”), I find that 6 small injections on each side works well. This amounts to about 8 units per side which is equivalent to 0.6 ml of solution. Obviously, more Botox will be needed for the glabella area and forehead.
Q: Is Lipoma removal on the mouth area possible?
I have a Lipoma in my mouth on the back side of my lip. How would you suggest getting rid of that ?
A: Lip Lesions not usually Lipomas
I have removed many lesions from the lip (both on the lip and within the lip). It is indeed rare to have a true lipoma in this location, although it is possible. Other non-cancerous tumors can grow there. However, you should definitely have it removed so that it can be evaluated for any pathology.
Q: Is it possible to remove Botox from unwanted areas?
The doctor injected more Botox in a chin more than the other. Is it possible to remove the extra Botox, and in this case what shall I do?
A: Need to wait for the Botox to wear off
Once injected, Botox cannot be removed. This is why judicious placement is so crucial. However, be patient…it will wear off in about four months time.
Q: How long does eyelid droop after Botox last?
had botox treatment and 3rd day after noticed right eyelid droop. Droop has become progressively worse now 1 wk post and using lipodine drops without much improvement. MD is certified and has done procedure many years without this outcome. Had botox in the past twice no side effects. How long does this eyelid droop last and is there any other treatment that may help? thanks in advance for any answers or suggestions
A: It really depends on the amount that leeched into your eyelid muscle…
Eyelid droop after Botox injections is indeed rare, but can happen if the Botox spreads from the site of injection into the levator muscle of your eyelid. The important thing to remember is that it will get better. This usually improves over about a month’s time, but should definitely be better at four months when the Botox effect wears off. Be patient.
Q: Deep, funny wrinkles after Botox
I received Botox a week ago. The second day I developed huge, deep, funny-looking wrinkles starting at the corner of my eyes and extending down the cheek. Can you suggest any makeup to cover this up? Is getting more Botox a good or bad idea? My doctor said he could give me more next week. Thanks!
A: Botox injections require skill and good judgement
Although minor asymmetries are fairly common after injecting Botox, major or strange looking wrinkles (like what you have mentioned) is frequently due to improper placement. Many inexperienced injectors can commonly overinject Botox, which can lead to weird facial expressions. Sometimes (depending on the location) additional smaller injections of Botox will work to counterbalance such wrinkles.
Q: Risk of hypertrophic scars from earlobe surgery?
I want an earlobe repair or reduction surgery. However, I have a hypertrophic scar on my shoulder for the past 3 years. I don’t know how I got it. It’s 1.5 cm long. No surgery or injury that I can remember. I am 30 years old. I am scared of keloid formation once I carry out an earlobe reduction surgery. How scared should I realistically be?
A: Everyone heals differently
It is possible to develop keloid on your earlobes after reduction or repair; however it is not inevitable. Should you start seeing keloids develop, the key is to start treatment early. Steroid injections, pressure therapy and even radiation therapy can all be effective.
Q: Numbness after breast implant exchange
I had my breast implants exchanged (and 4th degree contraction scars removed) 6 weeks ago and I have total numbness over 75-80% of both breasts. The new implants are 325 cc silicone and are larger than the original. My first surgery was 31 years ago.
What is causing this numbness and is there anything that I can do to enhance recovery of the nerves? If the feeling does not return, is there anything that can be done?
A: Sensation frequently returns
Loss of sensation after major breast surgery can happen, albeit infrequently. The good news is that most of the time, loss of sensation to the nipple is temporary and usually due to swelling from surgery. Give it some time to recover before you get defeated.
Q: Aesthetic result after breast implant removal?
I had a silent breast implant rupture (no encapsulation). My breasts are both soft and jiggly. The implants are 10 years old, mushy, and soft, and I have at least a B cup of my own tissue (sub-dermal implants). They are not droopy. Will I be deformed after having my breast implants removed? I’m very scared, my aesthetic result is important to me. What will I look like after explantation? What should I expect? Will I need a breast lift? Will all my own tissue be removed, leaving me with concave “puppy dog ears”?
A: Removal and Replacement is advised for Ruptured Gel Implants
If your gel implants are ruptured, they need to be removed. This will changed the appearance of your breasts. Depending on the degree of tissue sag and contour, you have three choices:
1) Remove the implants alone
2) Remove the implants and replace them
3) Remove the implants and have a breast lift.
Your best bet is to discuss these options with your plastic surgeon
Q: Botox party: are they safe?
I’m interested in knowing more about the true risk of Botox parties. Are the risks all that significant that you need a doctor on-hand? Afterall, Botox does wear off
A: Botox parties can be safe if done right
Botox parties do not have to have a negative stigma. I regularly hold Botox parties in my office and in The Roxpsa medispa at the Roxbury Clinic and Surgery Center. When performed safely, with approved medical techniques and appropriate informed consent, Botox parties can be very safe.
That being said, you must still be cautious and suspicious when Botox parties are conducted by non-trained individuals. These are still medical procedures and must always be supervised by a knowledgeable physician.
Q: Lipoma removal – would surgery require an overnight hospital stay?
I have a lipoma on the back of my neck and am planning on having it removed. Can I leave the hospital the same day as the surgery or would I have to stay overnight?
A: Lipomas on the back of the neck a common location
I have removed many lipomas from the back of the neck and it is almost always a straightforward procedure. I have never had a patient who required admission to a hospital for this.
Q: Is lower body lift the only option?
I am 25 years old. I gained about 45lbs during pregnancy. I was left with tons of stretch marks and loose skin. I went for a consultation with a surgeon in my area, and he told me that he could not perform a Tummy Tuck, and I would need a full lower body lift.
He said a regular Tummy Tuck would leave me with “dog ears” over my hips because I stretched so far onto my sides. Recently, I decided that major surgery just is not an option for me. My question is, do you think I could benefit at all from any laser treatments or liposuction?
A: Liposuction alone will not give you a satisfactory result
With the degree of skin laxity and stretch marks that you have, I am afraid that liposuction alone will not give you the result that you are looking for. While I cannot tell if you will require a lower bodylift from the one photo posted, the odds of you needing at least an abdominoplasty are fairly high.
Stretch marks are actual disruptions in the integrity of the dermis portion of your skin. While you may be able to obtain some improvement with laser treatments, if you have liposuction alone the skin will not contract well enough.
Q: Can I replace saline implants with silicone implants through my armpits?
I had my saline breast implants 15 years ago. Can I replace it with silicone implants go through my armpits?
I had a consultation with my Dr. He said the only way he can replace silicone implants is go through the nipple area. Because he has to remove the capsule.
A: Direct approach usually best
A direct approach utilizing an incision around the nipple or in the fold below is a much technically easier and safer way to remove a breast capsule. Although it can be done from the armpit, it is technically more difficult and will likely take a longer time under anesthesia. As far as placing a silicone implant through an armpit incision is concerned, I find that the incision required to do so is unacceptably long.
Q: Leg lipoma hurts, should it be removed?
this problem has been going on for about a year.i have already been seen by a surgeon, and he says that it is not necessary, but he is not the one who has to deal with the pain. i want to get it removed but i do not want to be put to sleep. could it be removed while i am awake? meaning could they just numb the area?
A: If lipoma is getting bigger, have it taken out
If this lipoma is getting bigger, have it taken out. Removing the lipoma will likely make the pain subside, but not always. However, it should be removed in order to determine a pathological diagnosis.
Q: Is my lipoma from whiplash?
I was the driver in a car that was rear-ended on May 30. On June 8, I noticed a lump on my right upper back, ER initially diagnosed as muscle knot. MRI and doctor later diagnosed lipoma. On June 17, I developed swelling in my neck (kind of the nape of my neck, between the scapula and clavicle) that seems more noticeable when I pull my shoulders back, about size of small golf ball. The dorsal subcutaneous lipoma is 6.1 cm x 6.8 x 3.6. Swelling on neck did not show on MRI. ER visit on June 17 said maybe lymph node, nurse practitioner on June 20 didn’t know what it was, didn’t think lymph node said ask surgeon to check. I am scheduled to see surgeon about next step on July 9. Would like to hear any thoughts/opinions. Thank you.
A: Trauma does not cause lipomas
In all likelihood, you probably did not realize that the lipoma was there until you were involved in the motor vehicle collision. Occasionally, traumatic hematoma can cause fat necrosis as a result of the pressure exerted on the tissue, but this is rare. Blunt trauma, however, does not cause lipomas to grow.
Q: What are my Lipoma treatment options?
I might have a lipoma and I am just curious about what kind of lipoma treatments exist. Is surgery the only option for lipoma removal or do people with lipomas have other options?
A: Lipoma removal
Lipomas are usually removed because of a change in characteristic (i.e increase in size), compression of a critical structure (i.e. compresses a nerve) or for aesthetic reasons (i.e. don’t like how it looks). Frequently, they can be excised easily. Liposuction of lipomas is possible, but increases the chance that they will regrow since they are not removed completely. In rare situations, a mass that is suspected to be a lipoma turns out being a malignant (cancerous) mass. This is why any suspected lipoma should be biopsied and assessed microscopically by a pathologist.
Q: Is lipoma removal like liposuction?
My dad is going to have surgery to remove two lipomas from his flanks/lower back area. I think a lipoma is some kind of fat deposit, so I’m wondering is lipoma removal anything like liposuction? Is it a cosmetic procedure like liposuction, i.e. not covered by insurance?
A: Contour defects from lipoma removal
Proper excision of a lipoma does neccesitate an incision in the skin. Very large lipomas will leave a large indentation in the surrounding tissue once the lipoma is removed. For this reason, it is important to have this done by a plastic surgeon who is familiar with and able to properly perform reconstruction of the deeper tissues. Although liposuction is possible for removing lipomas, it is only used in rare situations. Additionally, liposuction will not completely remove the lipoma and therefore will increase the chance of the lesion re-growing.
Q: Can broken zygoma bone be fixed?
I had a zygoma bone broken 3 years ago. It has been left spun under and in on the arch and part of my eye socket at about 5 millimitres. Is this something that can be corrected? I’m interesred in my own bone not an implant and I hate the way it look. Thank you.
A: Facial bone malpostion can be fixed without implants
We see many patients with old facial injuries. I have recently corrected several old deformities that have failed correction with injections, and facial implants. I use a technique that involves your own rib cartilage and other tissues in your body.
Q: Can broken zygoma bone be fixed?
I had a zygoma bone broken 3 years ago. It has been left spun under and in on the arch and part of my eye socket at about 5 millimitres. Is this something that can be corrected? I’m interesred in my own bone not an implant and I hate the way it look. Thank you.
A: Facial bone malpostion can be fixed without implants
We see many patients with old facial injuries. I have recently corrected several old deformities that have failed correction with injections, and facial implants. I use a technique that involves your own rib cartilage and other tissues in your body.
Q: Collagen injections for facial scars?
Can collagen injections work on facial scars such as chicken pox scars? The old pock marks really bother me.
A: You may need a combination of procedures for facial scars
I see many patients with acne scarring, which is a similar process to chicken pox scarring. Pixel laser resurfacing works very well to smooth out these scars. I also use scar subscission, and injection of filler materials for the deepest scars. A new topical collagen treatment (Purigenex) also works well to help smooth out scars without injections.
Q: Permanent suture and metal plates in my nose causing irritation?
In order to safeguard the stability of my nose, a permanent suture and two tiny metal plates were used to hold my nasal septum in place. This procedure took place during my fourth and latest rhinoplasty which is now 5 years ago, after which I have had recurring nasal swelling problems. I asked my question as a way for me to find out if I can eliminate “the permanent suture + metal plates” from the list of “suspects” behind my nasal dilemma. Thanks ever so much for your informed help!!
A: Recurrent swelling with foreign material in place may signal an infection
It is unusual, but not unheard of, for permanent sutures and metal plates to be placed during rhinoplasty. I suspect that you may have a serious issue with your nose if metal plates were required. If you are continuing to have problems with the plates, it may mean that you have a subclinical infection occurring. You should go back to your plastic surgeon for an evaluation; you may need some sort of imaging procedure such as a CT-scan of your nose and facial bones. If the plates are indeed infected, they should be removed and you should be reconstructed with your own tissues. This may require rib grafting.
Q: How can I treat discoloration around my tummy tuck scar?
i had a tummy tuck 3 years ago, now i have a scar and reddish to purple skin all around the scar. How can I treat the discoloration around the scar? I can see the thin line that my surgeon told me I would have, it is very small and almost invisible, the problem is the red purple skin across the scar.
Would a laser treatment work best? I used contractubex, and it helped a bit but the purple is still there so I’d like to go with laser or whatever treatment is needed to remove the scar/purple skin?
A: Discoloration is often treatable with lasers
Depending on the exact color of your scars, they may be easily treatable with lasers. Talk to your surgeon to find out which laser will work best. Lasers work by being absorbed into tissue at a particular wavelength of light, so only certain lasers work for each particular color being treated.
Q: Does a reconstructed breast feel different?
What kind of sensation can be expected to return to the newly reconstructed area following breast reconstruction surgery?
A: The skin will maintain some sensation after breast reconstruction
When a breast is removed during a mastectomy, the main sensory nerve supply is removed along with the nipple and areola. The remaining skin will still have some sensation, but not to the same degree as before the mastectomy. Although breast reconstruction is great at recreating the shape of a breast, the sensory nerve supply cannot be reestablished.
Q: Is a lipoma a tumor?
Is a lipoma a tumor? I just found out I might have a couple lipomas and I don’t know if should be worried by this… can cancer cause lipomas?
A: A tumor is simply a growth of cells
There are two general types of tumors: benign and malignant. Benign tumors are non-cancerous. Malignant tumors are cancerous. All malignant tumors need to be evaluated and treated, in some fashion. Most benign tumors are usually removed simply because of the concern that they may be or become malignant.
Q: Do I have to get Lipomas surgically removed?
I have three lipomas and I am debating what to do about them. Do I have to have them removed? Is there any danger if I decide not to have the lipoma removal procedure? Are there any alternatives to surgery that will get rid of my lipomas? Thanks
A: All concerning lumps should be evaluated by your surgeon
Lipomas are benign fatty tumors and usually to not require removal. Many people have them removed for aesthetic reasons. Others have them removed because of fear that the lipoma may in fact be something more serious. There are other tumors that can masquerade as lipomas, so if you are concerned you should have your surgeon evaluate it under a direct exam.
Q: Options for breast reconstruction implants or tissue fillers?
I have breast cancer, and will undergo mastectomy, but my insurance will not approve the use of Alloderm for the reconstruction because they say its investigational. If this is the case, what are my other options?
A: Alloderm is changing Implant-based Breast Reconstruction
The use of Alloderm and other dermal matrices is really changing the results that are possible with implant-based reconstruction. Although some insurance companies will deny coverage for use of this product, there are cases in which its cost is covered. You should work with your plastic surgeon to appeal the decision by your insurance company. As Alloderm use is becoming more common, reimbursement will likely also become more common.
Q: Lower body lift with incision under buttocks?
Is there anyone out there willing to do lower body lifts with an incision *under* the buttocks?
I tried it with an incision in the belt line, skin undermined, etc, but excess butt and thigh skin was not addressed. I know it’s not an ‘accepted’ technique but I also know the lower the incision to the problem area the more effective the result, and I can’t live like this anymore.
Already underwent lower body lift with belt-lipectomy scar line and thigh undermining — no improvement to butt/thigh area, so why won’t any surgeons try this other approach?
A: Lower Buttock Contouring
An incision at the bottom of the buttocks (in the fold) can frequently be used for contouring of hanging skin at the lower portion of the buttocks. However, this does not truly constitute a lower body lift, as it does not lift the lower body skin.
Q: Mastectomy, breast reconstruction with tummy tuck?
I’m a BRCA positive 40 year-old in excellent health, normal weight. I’m having a prophylactic mastectomy with immediate, “one-step” reconstruction (using Alloderm and silicone implants).
Could I have a tummy tuck at the same time? I have lumpy results from a previous abdominal liposcution and a nasty appendectomy scar I’d love to be rid of!
A: Safety is most important
Although it would be possible to have a tummy tuck at the same time as your mastectomies and implant reconstruction, it sounds like too much surgery in one setting. The good news is that, even patients who have excellent immediate reconstruction will require some type of minor secondary breast revision surgery about 6-12 months
Q: Mastectomy and breast reconstruction – Can the procedures be combined?
My mom gets really painful cysts in her breasts constantly. It’s not cancer, but she is tired of having tons of biopsies and plans to have a mastectomy later this year. From what I recall when my grandmother (my dad’s mom) had a mastectomy due to breast cancer, she had to wait some time before having the breast reconstruction. But I was wondering if there is any way the two procedures could be done in succession, during the same surgery session, in cases like this where there is no breast cancer involved.
A: Talk to a Plastic Surgeon before having a mastectomy
Immediate reconstruction following mastectomy offers many great advantages. Particulaly in cases of prophylactic mastectomy, immediate reconstruction should be considered. This is why it is so important to consult with a plastic surgeon prior to having the breast removed. Reconstructed breasts can have a great aesthetic outcome, especially when skin-sparing and nipple-sparring techniques are used.
Q: How to lift breast naturally
I have sagging boobs and want to know what treatment is available. I don’t want to do cosmetic surgery.
A: Surgical options most effective for breast enlargement
Breast surgery that consists of either a lift, augmentation or both are really your only options currently. There have been products marketed as “breast enhancing pills,” but they do not work. Further, the so-called “Bo-tox Breast Lift” is not a viable option.
Q: Breast reduction surgery after pregnancy?
How long after giving birth should I wait before I can undergo breast reduction surgery?
A: Need to wait for breast reduction after pregnancy
It takes about 10 months for pregnancy to change your body…and it takes about 10 months for your body to recover afterwards. So wait; there’s no rush. You also need to factor in your breast-feeding schedule. It is common to continue to produce breast milk up until six months after you stop breast-feeding. I recommend that my patients wait six months after completing breast-feeding before they have any elective breast surgery.
Q: Acne scar removal – what approach works?
I am still trying to figure out what is the right laser and/or treatments for me. I have had acne for 2 decades and now want to get rid of the deep scars and wrinkles.
A: Pixel laser works great for acne scarring
I have treated many patients’ acne scarring with Pixel laser resurfacing. Pixel is a fractionated Erbium laser that can aggressively improve the indentations that result from old bouts of cystic acne.
Q: Five days smoke free before Body Lift?
I am having torsoplasty (body lift) in five days and just stopped smoking today. Will five days smoke-free prior to surgery aid in my recovery as long as I continue not to smoke afterwards?
A: Need to completely stop smoking prior to surgery
For major body contouring operations, my patients need to be completely off all tobacco products for a minimum of one month prior to surgery.
For heavy smokers, I recommend a longer smoke-free period. It is also essential that patients stay off of tobacco products until they are completely recovered and all incisions have healed.
Smoking can not only increase the risk of wound healing problems, but will also lead to a higher likelihood of lung-related problems.
Q: What types of breast implants are available in the US?
The last I knew, saline breast implants were my only option since silicone breast implants were banned. I did hear of some new type of implant that is being used in some Asian countries, but I’m not sure if it’s available here. Does anybody know what options I have for types/materials of breast implants that are FDA approved?
A: Saline, Silicone, and Ideal Implant available in the US
In addition to the FDA approved standard saline and silicone breast implants, there is currently a third choice. Ideal Implant is a new modification of the standard saline implant that was designed to look and feel more like silicone. It is a baffled saline implant, with internal implant shells that serve to limit internal saline movement. They also provide structure to the implant which may reduce visible rippling.
The implants are currently available only in a limitied FDA trial. I am one of the investigators in this trial.
Q: Is the Ideal Breast Implant really ideal?
i saw a tweet that said the doctors TV show would talk about Ideal Implant, the newest hybrid breast implant on the market. i looked at the Ideal Implant web site and saw they are doing a study with 500 women augmented with the implants. Do any doctors have knowledge about the study and whether women are seeing really good results? Is the implant truly ideal or are their downsides?
A: Information about Ideal breast implant
Ideal Implant is not a description, but rather is the name of the company that produces a new hybrid saline breast implant that is undergoing an FDA trail. I am one of the few investigators across the country, and am also the surgeon who presented this implant on “The Doctors” television show. I have had great success with this implant
Q: How to get rid of sagging skin after gastric bypass and weight loss?
I had gastric bypass and my skin sags now. Where it folds (abdomen, thighs, arms), I get infections and painful rashses, and I’m looking for ways to stop this.
What type of treatment or surgery is available to get rid of all the extra skin? Could the sagging skin be fixed all at once or would it require me to have lots of things done over a long time?
A: Safety first with post-bariatric body contouring
These types of complaints are very common following massive weight loss. While it is possible to perform multiple operations during one setting, it must be done safely. You need to choose a surgeon who has good, safe judgement in order to minimize your surgical risk. Factors that need to be considered are: your overall health, ability to heal, length of time under anesthesia, and your ability to recover from the operations.
Q: Worried about belly button after mini tummy tuck
I just had my mini TT about 2 wks ago. All went fine. The pain was less than during a c-section. I’m worried about the way the belly button looks. It looks like a line with two folds around it. My doc said to start packing it which I’m doing but once I remove the gauze and tape, it folds back into a line. I can’t see how the skin will spread apart but I’m still hopeful. Is this the normal healing process for the belly button because the pictures that I’ve seen show very tight skin around the navel. Will time fix this???
A: Belly button insets differ
Frequently the belly button is not relocated during a mini-tummy tuck; rather some of the skin below it is removed and the belly button itself becomes stretched. During a full tummy tuck, an incision is made around the belly button and it actually gets relocated. The surgeon has much more control of the ultimate shape during this inset process and the “slit-like” appearance is rare.
Q: Procedures to tighten loose skin from massive weight loss?
I’m a male 23 years old. I was 300 lbs. and now I’m 185 lbs. The problem is I have excess skin just above the penis area and around my stomach. Is there any exercise I can do to get rid of it? I work out a lot. What procedures are available to get rid of this? It’s really upsetting me. Please can you help and tell me how I can tighten this area? Thank you!
A: Body Lift
Most patients who lose over 100 pounds will require some type of lower body contouring procedure in order to treat the redundant skin. Although a tummy tuck can improve the situation, frequently the skin laxity extends around to the back necessitating a lower body lift (also known as a belt lipectomy).
Q: How safe is breast reduction?
I would like to get breast reduction but im so nervous about the whole surgery because there has been so many deaths or complications during or after the procedure. I’m also afraid of going under general anesthesia, but I need that surgery so bad. How safe is this procedure, and how can I make sure I won’t get all those complications?
A: Breast reduction is very safe in the right hands
Breast reduction surgery itself is very safe when performed by a well trained, board certified plastic surgeon, on a healthy patient, and in a safe, clean and certified surgical facility. Today, anesthesia is extremely safe when performed by anesthesia professionals in a facility that has all the necessary safety measures in place. If you truly are in need of breast reduction, try to not let your fear stand in the way between you and an excellent result.
Q: How much does breast explantation cost?
I am now 63 and am beginning to realize that no other woman my age has such full and perky breasts as I do. I am beginning to feel self-conscious and expect that as I grow older, this will become more of a problem for me. I want to know if breast explantation is an option, what could be done to ensure my breasts would become much smaller and how much this would cost.
A: Will you need a lift after explantation?
Removing existing breast implants is easy to do and relatively inexpensive. The real question is: what will your breasts look like afterward? Most patients will require a breast lift following explantation, which is another procedure and an additional cost.
Q: Does Pixel laser treat broken capillaries?
Will Pixel treatment remove the appearance of broken capilaries?
A: Pixel is for skin resurfacing
Lasers are specialized beams of light that work by being absorbed by the various different types of pigment in our tissues. Pixel erbium laser light is preferentially absorbed by the collagen within the skin. A different type of laser, such as V-beam or Versapulse, would be more effective for small spider veins.
Q: Has anyone had success with the harmony pixel laser?
A: Success with Pixel Laser
I commonly use the Pixel laser for treatment of three common conditions with excellent success:
1) Sun Damage
2) Fine lines (around the mouth and eyes)
3) Acne scarring.
Q: Does the Pixel laser work on sun damage?
I have a lot of brown spots and freckles from sun damage and I was wondering what laser would best to get rid of them. Is the Pixel laser a good treatment for this problem?
A: Pixel skin resurfacing for sun damaged skin
The Pixel fractionated erbium laser is the most effective treatment for extensive sun damage on your face, neck and hands. It is an excellent tool for resurfacing your skin, and my patients who have it done heal very quickly.
Q: What is a lipoma?
What exactly is lipoma? Should I be worried if I have one?
A: 3 reasons to remove lipomas
Although lipomas are benign (non-cancerous) growths, there are three common reasons to have them removed:
1) To have a pathologist analyze the tissue to make sure it isn’t a cancerous growth.
2) The lipoma to pressing on another structure (i.e. a nerve) which is causing pain or numbness.
3) The lipoma is in an obvious area and does not look good cosmetically.
Q: Excess flab on sides after Breast Reduction
I had Breast Reduction around five years ago, followed by a lot of complicatons (which were fixed by another doctor). Now, I’m concerned about the excess flab on my sides from the surgery. It’s really bothersome if i don’t put a bra on, or if I wear certian kinds of bra. Are there any procedures for fixing this? If so, is it possible for such procedures to be covered by insurance?
A: Liposuction commonly needed with breast reduction
Liposuction of the outer chest wall is a common need for breast reduction patients. Although this area certainly contributes to the overall shape and look of the breasts, it is not actually breast tissue. Therefore, this is considered cosmetic in nature most insurance companies usually will not pay for it.
Q: Breast implants and pregnancy
what can i expect should i go with breast implants and then get pregnant? does the pregnancy cause the breast swelling to become abnormally painful? do stretch marks appear more often?
A: Pregnancy after Breast Augmentation
Since so many of my patients who have breast augmentation are in their 20′s and 30′s, it is very common for them to become pregnant afterwards. Most patients will return to their pre-pregnancy breast size once they are done breast-feeding. Occasionally, patients will lose some volume once they have finished breast-feeding but for the most part they remain happy with their size.
Q: After breast reduction will my breasts remain full?
I am due to get a breast reduction in a short while, I am just waiting for my insurance company’s approval, which my doctor said will not be a problem due to the size of my breasts.
My concern is that right now my breasts are very full and I love that part about them… Is there a way that they can be reduced to a smaller size and remain full?
A: Fullness after breast reduction guaranteed
Given the appearance of your breasts pre-operatively, you are almost certain to maintain fullness after your reduction. However, the amount of fullness will depend on the technique used to reduce the breasts. I find that use of a superior or supero-medial pedicle technique (where the blood supply to the nipple is maintained on a superior or supero-medially based portion of the breast) tends to maintain more fullness in the upper portion of the breasts.
Q: How to achieve ideal weight before Tummy Tuck?
I have tried for several years to loose the weight for a Tummy Tuck, I can loose 5 to 10 lbs, but then it comes right back. I am genetically predisposed to having “dunlop disease”.
My mother, her mother and aunts all have this. I am a size 18 to 20 depending on the day. I exercise everyday and no change. What can I do to get to my ideal weight before I have the procedure done, or do I have to? Help!
A: Weight Reduction with Nutrition
At this point, your best bet for sustainable weight reduction would be to consult with a nutritionist to help get you on a diet plan that works for you. Although it would be great for you to be at your ideal weight before you have a tummy tuck, for most patients that is not practical.
Q: Breast implant size to achieve full D cup?
I’m having round smooth saline breast implants placed in 2 weeks and am confused on size. I am 5’4″ 130 lbs and currently have 36 B breast. I was 36 C prior to children. My shoulders are wide at 18″ and breast diameter 14 cm. I want to go to a full D cup and thought 450 cc would accomplish it (under the muscle). I liked the 400 cc sizers. My doctor said he may have to use 500cc and I’m concerned that it will be too large and weigh my breasts down too much. I currently do not need a lift. On the other hand, I don’t want to go too small and be unhappy.
A: Implant size depends on desires and chest dimensions
For your given measurements, I think that about 400-450 cc would accomplish your goals. However, with a wider breast diameter of 14cm, you may need to go with a slightly larger, lower (moderate) profile implant.
Q: Does breast lift require augmentation afterwards?
I want to get a breast lift. In my first consultation with a cosmetic surgeon he said my breast may lose 15% of volume because of skin removed. Does this mean most women get breast implants at the same time as a lift, or is this a path to greater complications?
A: 15% reduction in breast size with a lift is unlikely
It is true that you will lose a small amount of breast tissue with the average breast lift, but only about a “shot glass size” amount. A breast lift mostly reduces skin, not the breast tissue. If you are happy with the size of your breasts when you have a bra on, then you should not get implants; just have a lift. If you think your breasts are too small, even in a bra, then you should consider adding implants.
Q: Combination nose job and chin?
I severely dislike my nose and chin, they aren’t very feminine to me. I would prefer a smaller chin and my nose is relatively round and bulbous. I already have a deviated septum, and the shape of my nose just makes me dislike it even more. How much would those two procedures cost? And what do you suggest?
A: Combo nose job and chin
From this photo, it appears as though you have a bulbous-type nasal tip. This certainly can be fixed with a cosmetic rhinoplasty. If your septum is deviated and is causing problems with your nasal breathing, then repair is indicated and may be covered by your health insurance.
It is very common for people to have cosmetic refinement of their nose at the same time as repair of the internal nasal airway. The cost for this operation truly depends on what needs to be done, and whether or not you have a problem with your airway that needs to be fixed. As far as your chin is concerned, I would need to see a full set of facial photos in order to make a determination. Your best bet is to come in for a full in-office consultation with direct evaluation of your internal airway.
Q: Risk of scarring from a breast lift with a history of keloids?
I am interested in having a breast lift. Currently I’m a 34DD, and happy with the fullness and amount of breast tissue that I have. I don’t feel that I’d need an implant but I’m unhappy with the my chest’s “droopy” look when I remove my bra. If I undergo this procedure, what are the risks of serious scarring or keloid development? I’ve had a history of keloids on my ear that were successfully removed with steroids and surgery as well a hyperthropic scar on my knee. Would this affect my chances? If so, what can be done to minimize it? Also, what would be the average costs of these procedures in major cities such as NYC or LA?
A: Higher risk for keloids
Certainly, if you have a history of keloids on other areas of your body, you are at higher risk than the general population to develop them on your breasts following a breast lift. However, higher risk does not mean that you will develop them for sure. You should discuss this with the surgeon that you choose, so that you can determine if injection of a dilute steroid into your incisions at the initial operation may be beneficial. At the hospital that work with, we also have a low dose radiation protocol for treatment of keloids in patients who have required revision of severe keloids.
Q: Are my breasts considered “tuberous”?
Are my breasts are considered “tuberous breasts”? This how my breasts developed as a teen. I’m now 20 years old and my breasts never been super perky. I’m a virgin and I never had children or lost any dramatic amount of weight. My areloas and nipples always been big, but my breasts remain small. I never had any upper fullness and the bottom of my breasts never filled out. Most of my teens, my breasts has been a crooked like v-shape. So are my breasts are tuberous?
A: Tuberous Breast Deformity
Tuberous Breast Deformity, also known as Constricted Breast Deformity, occurs when the lower pole of a breast does not fully develop. There is great variablity in how it presents, but in general the lower pole of the breast is short and underdeveloped with a lower breast fold that is higher than normal. As a result, as the breast develops it herniates through a fibrous band internally which leads to a small, sometimes pendulous breast with an abnormally large areola. From what you describe, you may very well have some form of this deformity.
Q: Breast lift – how long do results last?
I am almost done with nursing my twins babies (halleluia!). It has taken quite a toll and I would like to get a breast lift, but I am wondering how long the surgery would be effective. I’m not planning to, but what if I had another baby? Would the breast lift hold up? If I didn’t have any more kids, how many years could I expect the effect of the breast lift to last?
A: Duration of breast lift
Breast lifting is a great operation because it permanently gets rid of the extra sagging skin that women tend to develop on their breasts. Although the change is permanent (with great results ten years out), your breasts will continue to age even after surgery. During pregnancy and lactation, women’s breasts do enlarge quite a bit to accommodate milk production. This process can stretch out the skin again, even if you have had a mastopexy previously. For this reason, it is usually best to wait until you are done with child rearing.
Q: Is breast reduction surgery like liposuction?
I want breast reduction surgery and I am wondering how it all works. Do they just do liposuction to remove the extra fat in your breasts?
A: Liposuction and Breast Reduction are complimentary to each other
Because breasts are composed of both fatty and fibrous tissue, liposuction alone is rarely very effective. Most women who need their breasts reduced (due to excessively large size) also have excess breast skin. Surgical removal of this excess tissue is almost always required to some extent. Liposuction works well in concert with breast reduction, to help contour the outer chest wall and areas near the armpits.
Q: Products that can get rid of forehead wrinkles?
I am 27 years old and I have wrinkles on my forehead that I don’t like. Is there any over the counter products to cover or remove them?
A: Eliminating Forehead Lines
There are many wonderful over the counter skin care products. However, none of them will diminish the action of the forehead (frontalis) muscle that causes horizontal lines. The best non-surgical option is Botox or Dysport. The best surgical option would be a brow lift or endoscopic brow lift, if you are a good candidate.
Q: Doing research about breast implants
What should i include in my research process for breast augmentation?
A: 10 Point Checklist for Breast Augmentation
1) Is your surgeon a Board-Certified Plastic Surgeon?
2) Does your surgeon operate in a facility that has been appropriately accredited by either AAAAAF, AAAHC, JCAHO, or Medicare?
3) What type of implant is right for you: saline, silicone or hybrid saline?
4) Do you want the implants placed above or below the chest wall muscle?
5) What incision will work best for you: around the nipple or in the fold below?
6) Do you need a breast lift at the same time?
7) Do you know what complications can occur during and after surgery?
8) What type of follow-up will be required after the operation?
9) Have you been appropriately screened for breast cancer prior to surgery?
10) What type of post-operative care will you need?
Q: Weight lifting help breast shape?
can you reshape your own breasts through weight lifting vs. getting plastic surgery?
A: Weight Lifting great, but does not replace surgery
Weight lifting is great to help build and define upper body tone. It will also aid you in losing total body fat, which may include reduction of fat within the breasts. However, weight lifting will not increase breast size, nor will it correct sagging breast skin.
Q: Breast lift without implants?
I’m happy with the size of my breasts, but they could definitely be perkier. Can I get a breast lift without implants?
A: Perfect Breast Lift Candidate
The ideal breast lift (mastopexy) candidate is a patient who is happy with her amount of breast tissue when wearing a bra, but unhappy with the amount of sagging that occurs when her bra is taken off.
Q: Breast augmentation recovery
Considering enhancing my breasts through surgery. My biggest worries are about breast augmentation recovery. What can I expect? How much time off work does breast implant recovery require? Will I be able to take care of my 2 children afterwards? When do scars really begin to fade? The more you can tell me the better!
A: Healing your breast augmentation
After breast augmentation can expect, with some variation:
1) Discomfort from the muscle dissection for about the first 3-5 days.
2) Swelling, and maybe some mild bruising, for about the first 2 weeks.
3) No heavy lifting with arms (including lifting kids) for the first month.
4) To start light aerobic activity after 2 weeks.
5) To be back to full activity after the first month.
6) Scars will be thickest around 2-3 weeks after surgery.
7) Scars will be about 80% healed and matured 2 months after surgery.
8) Scars will be fully matured and faded 1 year after surgery.
Q: Recommendations of surgeons in vegas that will do a breast lift
and silicone augmentation for around 8000?
A: Breast lift and augmentation
I frequently do simultaneous breast augmentation and breast lift as a major component of my “Mommy Makeovers,” however I am not aware of the best surgeons in Las Vegas. If you are flying in from Oregon, however, you will likely have better luck and more selection of Board-Certified Plastic Surgeons in Los Angeles; and the flight is about the same. My office routinely coordinates patients from all over the country, so feel free to call us if you need any assistance.
Q: Repairing reccurring incisional hernia with Tummy Tuck?
I have a reccurring incisional hernia repair with mesh and severed right lower quadrant stomach muscle can this be repaired and a tummy tuck performed?
A surgeon severed some stomach muscle 4 years ago during abdominal surgery and I know suffer back pain from the pull the reoccurring hernia causes. I was operated on 3 years ago and had a mesh inserted – but the hernia is completely back.
A: Simultaneous Hernia Repair and Tummy Tuck
Most abdominal wall (or “ventral”) hernias can be repaired at the same time as a tummy tuck. It all depends on the size and extent of the hernia. Because a tummy tuck operation by design exposes all the anterior abdominal muscles, it actually makes it an easier approach to fix these hernias. Since you already have reccurrence after a mesh repair, you may be a candidate for an abdominal wall “components separation” operation. I would recommend that you first talk to your primary care doctor and have him or her order a CT scan of your abdomen. That way you will be armed with all the information you need when you go to meet with a board-certified plastic surgeon. Please don’t try to cut corners on this one!
Q: Sagging breasts: How to perk things up
after babies and i guess aging :( my breasts sag more than i’d like. is breast lift or plastic surgery my only option for getting them perked up again?
A: Breast Lift with or without an implant
Breast shapes and sizes vary between patients. “Sagging” for one patient may actually only be loss of breast volume. True sagging, where the skin is stretched out and the nipple sits too low, usually requires some sort of breast lift. Loss of volume is usually best treated with an implant. Commonly, both operations need to be performed at the same time.
Q: When is a body lift covered by insurance?
I understand that most of the time, body lift surgery isn’t covered by medical insurance, but in certain cases it is. What are the normal criteria for having a body lift paid for by insurance?
A: Some portions of the bodylift procedure may be covered
Insurance companies will likely not pay for your entire bodylift outright. Although it is usually a cosmetic operation, some portions of the procedure that need to be done as a component of, or concurrently with, the bodylift may be covered benefits under your insurance plan. Examples of medically indicated procedures are:
1) Panniculectomy.
2) Abdominal Hernia Repair.
3) Repair of disfiguring scarring from trauma or previous surgery.
Q: Should I massage my breasts after breast implant surgery?
A: Breast massage after augmentation is helpful
I have found that self-breast massage is beneficial after breast augmentation because:
1) Massaging your implants will help to counteract scar formation, keeping breast capsules softer.
2) Massaging your implants will help to facilitate descent of the implant after surgery; particularly when placed below the pectoralis muscle.
3) Massaging your implants will force you as a patient to become familiar with the size, shape and consistency of your breasts after augmentation. This is extremely important so that you, as a patient, will be immediately aware of any change that may occur with your breasts (i.e. such as capsular contracture).
Q: How is Breast Implant replacement surgery done?
I have textured silicone implants in a subglandular placement and want to replace them with smooth silicone implants under the muscle.
Will the new implants be placed in at the time of removal of the textured ones? Or will it have to be done in two separate procedures so I can heal from the first surgery first. I hate to have to walk around with deflated boobs for months.
A: Removal, Replacement & Repositioning: One Operation
Removal of your textured implants and replacement with smooth silicone implants in a new pocket should usually be done in one operation. However, if you have very little native breast tissue and require an extensive total removal of the breast capsule (capsulectomy), then it may be necessary to wait in between the removal and the replacement.
Q: What is the average “life” of a breast implant?
What is the procedure for replacing implants? I have had my saline implants for over 15 yrs. How long is the expected time period before you need to replace them? Is the procedure more painful or difficult than the original implant? I have a lot of rippling, even though I went under the muscle. My bags are textured, I believe. I also think that they may have loss some of their initial volume. Can you describe the average “life” of an implant, the replacement procedure and any new advancements in the last year or two? Thank you
A: New advances in breast implants
I agree I with some of the advice from the other surgeons; the average life span of a saline implant is about 10-15 years. However, if your implant has lost volume, it is leaking and should be replaced no matter its age.
The most recent advance in breast implant technology is a new device called “Ideal Implant” which is currently going through and FDA trial. It is a saline implant which was designed with an internal baffling system with the intent of decreasing implant rippling as well as internal movement of the saline. The manufacturer describes it as a HYBRID implant, because it is filled with saline only, but has a look and feel that is closer to a silicone implant than any saline implant that I have ever seen. So far, all of my patients that have them in are very pleased.
Q: How can I get rid of loose sagging skin after pregnancy?
will a mommy makeover take care of all the loose skin from pregnancy?
A: Mommy Makeover is the answer to sagging or loose skin after pregnancy
An abdominoplasty, or tummy tuck, will remove the extra skin, fat and stretch marks from your abdomen while tightening the abdominal muscles at the same time. For breasts that have lost volume and sag after breast feeding, a breast augmentation along with a breast lift will restore the breast to its correct position and pre-pregnancy volume. Some women retain adequate breast size after breast feeding and only experience sagging of the tissues along with stretching of the breast skin. These patients are excellent candidates for breast lift (mastopexy) alone.
Q: Is Brow Lift the only option for deflated eyelids?
One year ago, I had fat removed from the upper eyelid. Now, the skin has deflatted and my eyes look like they have excess skin. My doctor said a Brow lift would correct this but I want to know if I can do anything else.
A: Brow lift may help your upper eyelids
If your eyebrow position is too low and is causing the skin of your upper lids to bunch up, then a brow lift is a good solution. If your brow position is normal, then a better option would be to have some skin removed from your upper lids.
Q: Preventing eye ptosis from Botox?
I keep hearing more and more cases of eyelid ptosis or “droopy” or closed eye from Botox. Is there a way to decrease the chances of this happening? Does it happen as often with Dysport as well?
A: Selecting your Botox injector carefully can help prevent problems
It is important to distinguish between Eyelid ptosis and Eyebrow ptosis.
Eyelid ptosis occurs when the eyelid excursion (ability to open and close) is diminished and the upper eyelid begins to cover the pupil, interfering with the upper visual field.
Eyebrow ptosis is when the eyebrow position is too low, and falls below the bony rim of the eye socket. This can make a patient appear as though the eyelid cannot open, when in fact there is nothing wrong with the eyelid muscles.
Both conditions can occur in patients who have had botox injections. The best way to prevent either of these from happening is:
1) Have a doctor inject you who is very familiar with the pertinent anatomy of the face.
2) Do not rub any area for 24-48 hours after injection. Doing so can cause the botox to migrate.
3) Avoid excessive exercise for 24 hours after injection.
Dysport works in the same manner as botox and can therefore exacerbate both of these conditions as well.
Q: Does breast lifting alone leave suture marks and scars?
A: Breast Lift scars, yes. Suture marks, no!
The purpose for a breast lift is to elevate the nipple back up to the proper position. Doing so requires that a certain amount of skin be removed, in conjunction with reshaping of the breast tissue. The only way to remove excess skin, is to make an incision and actually cut it out. Anytime that an incision is made in the skin, a scar will result. The amount of scarring that result is in directly related to the amount of excess skin that exists. Suture marks only occur when skin sutures are left in too long. Suture marks can be prevented by using absorbable sutures in the deeper tissues, and by removing and skin sutures within the first week after surgery.
Q: Possible to get larger breast implants without fake look?
I was a 34A (if not less) before my Breast Augmentation 2 years ago. I got 320CC cohesive gel implants that brought me to a 34C (not full). I now wish I could have gone larger! I want to be a 34D (full). I am now considering the same implant with 550 CCs. Is that too big for me? I do not want the fake look, just a larger size of what I am now. I look very, very natural now and would not like to destroy that. Is it possible to go larger without obtaining a fake look? I am 5’4 and 135 lbs.
A: Decide what you want before changing your breast implants
It sounds like you are not quite sure about what you want exactly. A size 34C breast sounds like it is in good proportion for your height and weight. If you would like your breasts larger, then by all means have it done. But realize that an additional 230 cc on each side will be a very big change for you.
Q: Mini tummy tuck less painful than a full tummy tuck?
Is a mini tummy tuck less painful than a full, regular tummy tuck?
A: It all depends on whether the muscle needs tightening.
Most of the discomfort from a tummy tuck relates to the tightening (aka plication) of the abdominal muscles. Usually with a mini-tummy tuck, the muscle is only tightened below the belly button versus a full tummy tuck, which tightens the muscle.
Q: Breast reduction recommended if overweight?
there is some hestitation on my part to get breast reduction. would a good candidate for breast reduction surgery be overweight?
A: Losing weight will make your breast reduction operation easier
Losing weight prior to surgery will make the entire process easier for you. In particular, the anesthetic-related co-morbidities (i.e. complications) are usually less frequent in patients you are closer to their ideal weight. When you lose weight, you will also lose volume in your breasts. However, simply losing weight does not guarantee that your breasts will get smaller, so you will still likely need a breast reduction.
Q: Breast reconstruction for infected breasts?
I have had breast infections due to Gamella bacteria first, then had a bilateral periductal fistula on both breast 3 times, then contracted HA MRSA. I underwent surgery for that. I still have infection but my breasts look terrible now. They are scarred from the many procedures, and the right nipple is actually at an angle now instead of horizontal.
I was wondering if there’s any type of corrective surgery that would be helpful for my situation. We are still treating an infection, although unknown. The last culture was ” normal skin flora”. Thank you for your time.
A: Breast reconstruction with your own soft tissue
Sometimes when breast tissue becomes severely scarred, the best option is to remove the extensively damaged tissue. This does not mean you will require removal of the entire breast, but possibly a portion of it. Replacement with your own tissue by means of a flap (using the Latissimus Dorsi or Rectus Abdominus muscles) will bring new soft and pliable tissue with a healthy blood supply.
Q: Is it possible to have normal looking breasts after explant surgery?
I have had saline breast implants for 8 years and am scared of the aesthetic outcome should I have them removed. I am 29 years old, I have very little breast tissue and stretch marks on my breasts from having a baby. I have constant aches and pains in my left breast. I have considered get revision surgery, but what I really want is them to be taken out. I have been researching this for a year now and would really like some advice (especially when it comes to finding the right surgeon to remove them).
A: Breast shape after explantation
If you are planning on having your implants removed permanently, you may need to have the following done:
1) Implant removal;
2) Capsule removal;
3) Breast lift.
Without examining you, it is difficult to say which of these you will require. Some patients will require all three. Some patients can avoid a mastopexy (breast lift) by allowing their surgeon to remove the implants and capsules and wait. In certain situations, the skin envelope may tighten up over time. However, be prepared to possible need a second operation to lift the breast back to an aesthetically pleasing position.
Q: Breast implant removal – Will my breasts sag if I decide to explant?
What if you decided to explant? Will your breasts sag?
A: Factors to consider before explanting
The most important factors that will determine if you will require a lift after explant are:
1) SIZE of your current implants.
2) Amount of BREAST TISSUE that you had before.
3) TIME interval since your augmentation.
4) Degree of BREAST SAGGING that has occurred since your augmentation.
5) POSITION OF YOUR NIPPLE in relation to the lower breast fold.
Q: Breast augmentation redo due to weight gain, breast feeding
I had a breast augmentation 4 years ago after the birth of my second child. Thanks to weight gain, breast feeding and weight loss. I went from a B cup to a D cup. However, because of the weight of the implants and aging, the breasts are no longer high and create a clevage; they hang to my waist and look sad:) I am thinking about getting to a size C cup and making them perkier. They feel to heavy, and the bra straps dig into my shoulders despite fitting every three months. Any words of advice?
A: Downsize your implants and lift the breast tissue
I have not even seen your photos, and I can tell that you will need:
1) removal of your current implants;
2) replacement with smaller implants; and
3) Breast lifting, most likely a full lift, but depends on your degree of sagging.
Q: Unusual approach to gynecomastia?
I am a 32 year old male who had Liposuction of breasts about a year ago. Also, my surgeon chose to address the gynecomastia through incisions below and medial to my nipples. Is this an unusual approach?
A: Liposuction incision placement less important than the result.
The choice of site for incisions for liposuction of gynecomastia really depends on the extent of breast tissue that exists. Truth is, that the contour that you have afte surgery is probably more important than the exact location of the incisions. Occasionally I will make additional access incisions during liposuction of gynecomastia if I think it will allow me to obtain a better final contour.
Q: Flying after Breast implants revision
How long until I can take a 2 1/2 hour flight after breast augmentation revision? I am traveling to Florida to have my breasts re-done and wondering when it is safe for me to take the 2 1/2 hour flight back home.
A: Traveling after breast implant revision surgery
I care for many patients from out of state, so this is a very common question in my practice. I do like to have frequent contact with my patients during the first week after surgery, so that I can manage their sutures and dressings and deal with any problems that might occur. Although it rarely occurs, the most common early complication after breast surgery is bleeding. When it happens, it usually occurs within the first 24-48 hours after surgery (although it can occur later). Traveling itself, for short durations, is relatively safe after surgery. Make sure that you stay in close contact with your surgeon after surgery and that you have the ability to travel back to your surgeon should a problem develop.
Q: Breast reduction after pregancy
hi i’m a 21-year-old-mother who gave birth over 14-months ago,my problem is that i always had an a-cup breast and during my pregnancy my breast changed to a c-cup and stayed that way. i never felt back pain until my pregnancy and now a year later its still there. hypothetically i drew the conclusion it’s my breast after reviewing diffrent stories. because my back,neck and sholders are hurting and my breast is so heavy. do you think my insurance company would cover it even though i’m not a d-cup? (i included a pic) thanks in advance dana321
A: Insurance will pay for true breast reductions
Your symptoms of back, neck and shoulder pain are quite typical. Most insurance companies will pay for breast reduction that needs to be done for medical reasons. However, each company’s criteria are a bit different, so be sure to check with your insurance provider beforehand.
Q: Body lift – How long do results last?
How long does the “lift” from body lift surgery last? I am 35, and I want to get a body lift, but I may wait if the results won’t last well into my 40s or 50s.
A: Body Lift results can depend on your weight maintenance
Removing the skin and fat that remains after massive weight loss with a body lift is permanent. That is why you should have surgery once you reach your ideal, stable weight. Should you continue to lose weight after surgery, you may develop some new laxity and require a “touch-up” procedure years later.
Q: Waiting period for Breast Reduction or Lift after weight loss?
I have recently lost 46 lbs and have about 15 more to go. My breast size has not decreased significantly, only from a DDD cup to a DD cup. How long after my weight loss is complete should I wait to have a breast reduction or breast lift? Thank you.
A: Breast size can vary with weight loss
A woman’s breast size will change during weight gain and weight loss. However, the amount of change is unpredictable. Ideally, breast lift and reduction should be performed once you have reached a steady weight for at least three months; even if it is not your ideal weight.
Q: Are silicone breast implants safe?
need to know before i’d consider silicone implants
A: Silicone is safe, but consider a hybrid implant
Saline and Silicone are both safe implants. However, the FDA is currently investigating the newest “hybrid” implant on the market. This IDEAL IMPLANT, is a baffled saline implant which was designed to look and feel more like a silicone implant
Q: How do I choose the best breast implant for me?
i dont know whether to go big or medium, saline breast implants or silicone breast implants, under or over muscle. help!
A: Saline, silicone, or hybrid breast implants
Choosing the correct implant size is truly a matter of a patient’s personal choice. Although I tend to be conservative with breast augmentation size, ultimately what matters most is whether the patient is happy with the final size. As far as implant type is concerned, there are both advantages and disadvantages to either type of implant. An excellent compromise is the Ideal Implant, which is a baffled saline “Hybrid” implant. It has the look and feel of silicone, without the risk of silent rupture.
Q: Uneven nipples after breast augmentation and lift
I recently had breast lift and implants (200 cc, 1 cup size bigger, age 26 no kids) 2 weeks ago, and my nipples look like something out of a child’s coloring book. They’re completely uneven, choppy, and not at all near perfectly circular. Will these eventually fix themselves? I also thought the breasts would be higher. Does this look like a well executed lift?
A: Every woman’s breasts are asymmetrical to some degree
Small asymmetries are common. Every patient has two different breasts before surgery. As a result, they usually tend to heal a bit differently. Breast implants also will settle or drop over the first month or two once implanted. Occasionally, they descend at different rates. Be patient, most likely this discrepancy will even itself out.
Q: Lose weight before breast implant revision?
I have gained 80 lbs since having my 800 cc breast implants. Back then I was a double D. I just want them removed until I lose weight and then will get a more reasonable size. Would you recommend I lose weight first? They are really causing me issues due to their size.
A: Simply downsizing breast implants may be the way to go
800 cc implants are indeed large for the average breast augmentation patient. However, if you have had them in for a while, your breast skin most likely has stretched to accomodate the implants
Q: Inverted nipple a sign of breast cancer?
my left breast nipple is dented. i’ve been ok with it, yet i saw a story in the news that it could be a sign of breast cancer. so now i am really scared! what’s the cause of inverted nipples and is it something i need to get checked out right away?
A: Inverted nipples are worth investigating
New changes in your breast that cause your nipple to become inverted are worth investigating with your doctor. Especially if it is associated with nipple discharge or with a new bump in your breast. Talk with your doctor, get an exam by your doctor and consider a mammogram if you have not done so already. However, an inverted nipple can be a normal variant, particularly if you have had it for a long time.
Q: Risk of getting keloid scars from breast lift?
I am interested in breast lift surgery. I’m wondering, will I have a high chance of having keloid scars on my breasts, seeing that both my C-sections had thick, bumpy scars?
A: Scars can vary, even on the same person
Although there is always a risk of developing thick scars after any operation, the chance with a breast lift is very low. How a scar heals often depends on the location on the body as well as the technique to close the skin. It is possible to develop a thick scar on your abdomen and heal an incision on your breast normally. There is no way to know for sure if you will develop hypertrophic (thick) scars or keloids. However, African-American, Hispanic and Asian skin types tend to have a higher risk.
Q: Tummy tuck surgery – where will I have scars? How big are they?
A: Tummy tuck incisions kept low
Incisions for tummy tucks are essential; it is the only way to remove the excess skin that inevitably exists. I keep the transverse (horizontal) incision very low, just above the pubic hair line, so that my patients can easily hide them with a standard bikini. I also take great care re-creating the belly-button incision, so that only half of it is visible.
Q: How much weight to lose before Tummy Tuck?
Hi. I am interested in having a Tummy Tuck done and I want to know how much height to lose before having the surgery. I am 5’7″ and currently weigh 210 lbs.
A: Sometimes staging your operation works best
I have found that many overweight patients have difficulty exercising because their extra abdominal fat and skin either gets in the way or makes them self conscious. In select patients, removing the skin with a tummy tuck increases their confidence and frequently stimulates them to start heading for the gym to lose the remaining weight. However, if you go on to lose a significant amout of additional weight, you may likely need a second operation to adjust your contour.
Q: When does swelling after breast augmentation begin to subside?
I had 325cc silicone breast implants 5 days ago. I am 5’1 and 102 pounds. I was hoping to be a C cup, but I am fitting into a D bra. Is this because of the swelling? If so, when will the swelling begin to go down? When will I know exactly what bra size I will wear?
A: Bra cup sizes vary
It is important to remember that bra cup sizes vary between different bra manufacturers. What fits 34C in Cosabella, may be too tight or a bit loose in a comparable Victoria Secret bra. The swelling will go down, but it usually takes at least one month…and frequently longer. I recommend that my patients wear a snug fitting sports bra for the first four weeks after surgery to provide both compression and support. In the mean time, have a few different size bras available.
Q: Body lift or thigh lift for stretch marks on calves, hips, and thighs?
I gained 33 lbs with one pregnancy and 28 lbs with the other. I’m 30 years old, and feel as though my lower body looks 60! I know there is nothing permanent for stretch marks and cellulite removal. I had 6 Fraxel treatments on my legs and there was some improvement. I want to wear shorts again. I would like to get rid of the stretch marks on my hips and calves. Is this possible with a lower body lift or thigh lift? I understand I will have another scar, but its better than many. I have olive skin and always scar lighter than my skin tone.
A: Getting rid of stretch marks
Stretch marks are particularly troublesome to many of my patients who are new moms. Depending on the severity of the stretch marks and their locations, sometimes a surgical procedure to remove the damaged skin (i.e abdominoplasty or lower body lift) is a more effective choice. For my patients who have scars that are not amenable to surgical removal, I have had very good success with a combination laser treatment with the Pixel Fractionated Erbium Laser and Skin Tightening Laser. Cellulite can also be addressed with non-surgical Accent RFA laser treatments.
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