Question
Answer Header & Date
Answer Snippet
Which procedure has the most long term results, tummy tuck, or liposuction?
Lipo vs. TT
Apr 11, 2017
Liposuction is a very different procedure from a tummy tuck. It would be best for you to get seen and evaluated by a board certified plastic surgeon to determine what is best for you.
In liposuction, fat is removed from underneath the skin but the skin remains untouched. There is some shrinkage of the skin with the removal of fat as well. Overall, the fat cells in our body does not change but the size of each fat cell does change. Once fat cells are removed, they do not multiply and so they…
Fat cell transfer, lipo, and other breasts augmentation. Do I seem like an ideal candidate?
Breast Augmentation with Fat Grafting
Apr 3, 2016
Thank you for your question. The best way to think about a breast is to break it down to it’s components of volume as well as envelope. In general, the breast tissue and fat make up the volume while the envelope is made of skin. Breast augmentation is a procedure that changes the volume of a breast but doesn’t necessarily effect the envelope in which the implant or tissue is placed. As such, women who have “ptosis” or a droop to their breasts benefit occasionally from a lift at the same time…
Do I wear a compression bra after fat grafting or not?
Compression after Fat Grafting
Apr 3, 2016
Thank you for your question. Fat grafting is currently an imprecise science that does not have objective data to support a particular practice. What we do know is that small fat deposits must be made in a vascular bed for there to be support of the fat to ensure long term viability. As such, a constrictive garment can cause a decrease in blood flow to the area, therefore, most plastic surgeons do not recommend a compression garment. At the same time, comfortable and supportive garments can…
I have asymmetrical breasts and wanted to know if it is possible to transfer fat from one breast int
Breast Asymmetry fixed with Fat Transfer
Apr 3, 2016
Thank you for your question. It is hard to answer your question without a physical exam and a consultation. The best way to think about a breast is to break it up into volume as well as envelope. Breast asymmetries often are attributed to both volume discrepancies as well as skin discrepancies. Therefore, treatment by changing the volume alone generally does not treat the discrepancy. Additionally, fat transfer generally occurs from another area of the body (generally abdomen/thighs) to…
Why is breast reduction non cosmetic?
Breast Reduction Surgery
Mar 29, 2016
Reduction mammoplasty is a procedure to breast a more proportional appearance and alleviate physical discomfort caused by large, heavy pendulous breasts. Reduction mammoplasty can correct symptoms from excessively heavy breasts causing an inability to do certain exercise, causing back, shoulder and neck pain, poor posture, and bra-strap shoulder indentations. Sometimes large breasts can rest on the chest wall causing chafing or rashes under the breasts. The reason some refer to reduction…
Noticeable size difference between breasts 3 weeks after a breast reduction. Can that be fixed? (Pho
Breast Asymmetry after Reduction
Mar 29, 2016
Thank you for your question and photo. I can see from the picture where you concern would be coming from and, based on the picture, there does seem to be some asymmetry. However, also based on the picture and time frame you provided, it does seem as though this is relatively early after your procedure. At only three weeks after surgery, you are still in what is considered to be the healing process. Over the next three months your breasts will continue to heal and change in size and shape. …
Am I a good candidate for a breast reduction?
Breast Reduction Candidacy
Mar 29, 2016
Thank you for your question and photos. I am sorry to hear about the challenges you have faced due to the size and weight of your breasts. Based on your pictures and questions, you would likely be a candidate for breast reduction surgery. Keep in mind a few things prior to this. The first is that you must ensure you don’t have any underlying malignancy prior to this. This especially applies to patients who have a strong family history of breast cancer or are beyond 35 years old. These…
Will I be able to get a breast reduction?
Breast Reduction vs. Mastopexy
Mar 29, 2016
Thank you for your question. Breast reduction/Reduction mammoplasty surgery is performed in a similar fashion as a mastopexy procedure. Various insurance companies have different requirements that help them separate out what is cosmetic vs. reconstructive/necessary and therefore covered by them. I would contact your insurance company to determine what their specific criteria are. Some companies have a weight that has to be resected while others use a scale based on the patient’s BMI while…
Will Breasts Sag if I Decide to Explant?
Explantation and Breast Size
Mar 29, 2016
Thank you for your question. Augmented breasts can be thought of as a component of three different components: 1. Breast skin, 2. Breast parenchyma/soft tissue, 3. Breast implant. After breast implants are removed, the breast loses the third component and is only composed of number 1 and number 2. The amount of skin excess is a ratio of the volume lost (basically 2/(2+3)). The larger the implant, the larger the volume loss and the more sagging expected. Sag therefore will depend on the…
Explant – what size would I be, roughly?
Explantation and Breast Size
Mar 29, 2016
Thank you for your question. Estimating size after removal of implants is difficult to do without palpation. Remember that the placement of implants stretches the skin envelope so the breast will sit slightly lower on the chest than it did previously. This effect combined with aging, pregnancy and breast parenchyma changes often requires a lift at the same time as removal of the implant to obtain shape and symmetry of the breasts again. A board certified plastic surgeon who specializes in…
Can Under the Muscle Implants Be Moved to Over?
Animation Deformity after Augmentation
Mar 29, 2016
Thank you for your question. Animation deformity is a common complaint amongst women who have had sub-pectoral breast augmentation or reconstruction. The simple answer to your question is that it is possible to move the implants from a sub-pectoral plane to a sub-glandular plane. Another alternative would be to release all the fibers of the pec insertion below to minimize the function of the pectoral muscles. However, both of these potential solutions also have consequences. Having implants…
How Long Before Incision from Breast Augmentation Heals?
Incision Healing after Breast Augmentation
Mar 29, 2016
Thank you for your question. Implant extrusion is very rare after primary breast augmentation. Incisions are usually closed in multiple layers of sutures and there are several layers between the skin and the implant. Unless you’ve had previous surgery, radiation therapy or have a connective tissue disorder, implants should not extrude. Remember that suture is just a fancy name for string and that the strength of the skin for the first six weeks is dependent upon just that. As the scar…
My breasts are too close together. What is the best way to fix them?
Symmastia/Close Breasts
Mar 29, 2016
Thank you for your question. Symmastia or breasts that are spaced too closely together is a result of over dissection of the pocket medially. This can happen over time or during the operation if the skin and subcutaneous tissue is dissected too much over the central portion of the chest. The result is tenting of the skin centrally which can appear as though the implants are touching or a true connection between one side of the chest wall and the other. Treatment depends on where the implants…
Is it necessary to take a full week of antibiotics post BA?
Antibiotics and Implants
Mar 29, 2016
Thank you for your question. Most plastic surgeons prescribe antibiotics after placing a foreign body in a patient such as a breast implant. Generally treatment duration with antibiotics lasts 5-14 days depending on surgeon preference. There are tremendous side effects that can occur with antibiotics that range from GI upset to devastating systemic reactions that can lead to hospitalization or death. That being said, most plastic surgeons believe that by minimizing the bio-burden on or…
Hard big lumps in both breast. Can steroids heal big hard lumps after fat transfer breast augmentati
Hard lumps after fat transfer for augmentation
Mar 16, 2016
Thank you for your question. I would revisit a breast surgeon and see your plastic surgeon to evaluate your areas of concern. Breast lumps initially should always be taken seriously and evaluated by physical exam and imaging to ensure underlying malignancy is ruled out. If evaluated as a cyst or fat necrosis, this can be a more reassuring diagnosis related to your previous surgery. Treatment of this requires either direct excision or liposuction of the area depending on the size and type of…