FAQs

Breast Augmentation Q&A

Q: What gives the normal breast its shape?

A: Breast shape is determined by several elements; these include the size and shape of the skin envelope, amount of fat and breast tissue. These elements are influenced by hormones and gravity. The shape is also include by the shape of the chest wall and the overlying pectoral muscles. The breast is a changes with time and gravity. It is influenced by weight change, menstrual period, pregnancy, lactation and menopause. At his San Diego office, Dr. Jaibaji will asset you in deterring the implant that fits your body.

Q: What type of silicone is in breast implants?

A:Silicone is made of silicone dioxide which is a combination of semi metallic material and oxygen. Processing of silicone converts it to a long chain known as silicone. Silicone can be in the form of liquid, gel or more firmer substance. Silicone is found in many household items. Dr. Jaibaji, At his San Diego office uses highly cohesive silicone implants made by Mentor and Allergan for breast enhancement.

Q: Is it safe to have silicone implants?

A: Over the past three decades silicone safety and effects on humans has been studied extensively. The studies showed no correlation between silicone and any major disease. This was the conclusion of the Institute of Medicine.

Q: How long before I need to change the breast implants?

A: Generally speaking breast implants need to be replaced around ten years after placement. But, after ten years if the implants are intact and there is no capsular contracture, no surgery is needed. It is best if you consult with your plastic surgery to address that issue.Breast augmentation is not a one time procedure. Change in the breast or the implant will prompt a revision surgery. These include breast ptosis, implant malpositon, capsular contracture, or infection.

During you consultation with Dr. Jaibaji, San Diego board certified plastic surgeon, he will explain to you the natural history of breast implant and the timing of replacement.

Q: What are the different shapes of breast implants?

A: Implants can be divided into moderate profile, hight profile and ultrahigh profile. Different manufacturer have different implant shape and sizes.

Implants can also be round or sharped ( tear drop). The surface of the implant can be smooth or textured. At Dr. Jaibaji’s San Diego office the different implants shape and texture is addressed during the initial consultation.

Q: Am I eligible for saline breast implants?

A: It is best if you consult with your plastic surgeon about the eligibility for breast augmentation. I general, if you are a healthy person over the age of 18 you are eligible for breast augmentation.  Dr. Jaibaji, Board certified San Diego plastic and reconstructive surgeon, will determine if you are eligible for saline implants.

Q: Am I eligible for silicone breast implants?

A: Silicone breast implants are usually used in patients 22 years and older for breast augmentation. It is also used in breast reconstruction following mastectomy. At San Diego plastic surgery office Dr. Jaibaji will address you eligibility for silicone breast implant.

In patients with congenital deformity of the breast silicone implants can be used before the age of 22.

Q: Who is not a candidate for breast implants?

A: Breast implants should be avoided in women who have active infection or have cancer. The implants are not performed on patient who is on therapy for cancer such as chemotherapy or radiation. In San Diego, a consultation with Dr. Jaibaji, MD will discuss with his clients the appropriate candidate for breast augmentation.

Q: Is there an increased risk of breast cancer with implants?

A: Most studies have shown no correlation between silicone breast implants and breast cancer. BIA-ALCL has been associated with certain implants. Dr. Jaibaji will discuss this issue during the consutation

Q: Do breast implants interfere with mammogram?

A: Generally speaking, breast implants do not interfere with mammograms. The imaging techniques can detect early breast cancer in the presence of breast implants. Implant placement above or below the muscle does not interfere with mammogram. Information are available at Dr. Jaibaji’s San Diego office on the brast implants and mammography.

Q: What are the effects of radiation therapy on breast implants?

A: Radiation therapy to the breast will result in increase likelihood the development of capsular contracture of the breast. In can also cause necrosis of the skin and extrusion of the implant.

Q: Can I become allergic to silicone?

A: Alllergy to silocne is rare. However, if a person knows that they allergic to it, then she should not have breast implants. This apply to both saline and silicone implants.

Q: Am I a candidate for breast augmentation if I am over 50 years?

A: If you are in good health and looking to have breast enhancement there is no reason why you should not have breast implants. During you consultation with Dr. Jaibaji, San Diego plastic and reconstructive surgeon, the issue of age and breast enhancement will be addressed.

Q: Will the breast shape change with weight fluctuations?

A: Yes. the breast has fatty tissue that responds to weight changes.  Weight gain will result in breast enlargement and vise versa.

Q: Will breast implant surgery affect nipple sensation?

A: Breast augmentation can affect nipple sensation. Most patient will experience no change or temporary change in nipple sensation. Some patients will experience increase in nipple sensitivity. Another small number of patients may have temporary or permanent decrease in nipple sensation. These changes can affect one or both nipples. Dr. Jaibaji, San Diego plastic surgeon will address the issue of nipple sensation at the time of your consultation.

Q: Will my breasts be soft and move like normal breasts?

A: The aim of breast augmentation is to give the breast a natural look and feel. Silicone implants have the advantage of giving a more natural feel to the breast. The natural feel of the implants can change with capsular contracture or implant malposition.

Q: Do breast implants cause stretch marks on breasts?

A:Not always. The larger the implant placed in a small pocket can result in excessive skin stretching and formation of stretch marks.

Q: Should I stop smoking before surgery?

Yes you should. In my practice I advise my patients to stop smoking three to six weeks before the surgery and for four weeks after. It is advisable if they stop smoking for good. Smoking can increase the risk if tissue necrosis.and affect the healing process. If you are a smoker, D. Jaibaji, board certified plastic surgeon in San Diego will advise you to stop smoking about three to six week before surgery.

Q: When can I go back to work and resume exercise?

A: Returning to work after breast augmentation depends on your job. Office workers can usually resume work after about one week from surgery. Those who are involved in a more manual occupations will need to wait for about six weeks before returning to full duty. You can discuss your work with Dr. Jaibaji, San Diego plastic and reconstructive surgeon.

Q: When can I sunbathe or go tanning if I have breast implants?

A:It is generally advisable not to do excessive sunbathing or tanning due to the increase risk of skin cancer. The scars on the breast can heal less favorably with excessive sun exposure and tanning. I do not thinks spray tanning can affect the healing.

Q: When can I fly after breast implants?

A:There may be some expansion and contraction of the implant shell with pressure changes.

Q: How long after breast implant surgery I can wear an underwire bra?

A: Generally speaking, I advise my patients to wear underwire bra six to eight weeks after surgery. Before that they can only wear sports bra. I also advise patients to start massaging the breast three weeks after surgery and continue for six months. This will help in reducing the risk of getting capsular contracture.

Q: Will pregnancy affect my breast implant or breast shape?

A: Yes. pregnancy will affect the shape of the breast and can affect the overall breast shape after pregnancy.

Q: Will I be able to breast feed after breast augmentation?

A: Breast implants can affect you ability to breast feed.

Q: What is capsular contracture or implant hardening and scarring?

A: It is a natural reaction to any device placed in the body to form scar tissue around the breast implant surface creating a capsule.

The scar tissue or capsule that normally forms around the implant may tighten and put pressure on the implant and is called capsular contracture. Infection, hematoma, and seroma predispose to capsular contracture. It is also more common with over-the-muscle placement. Symptoms range from firmness and mild discomfort to pain, distortion, palpability of the implant, and/or displacement of the implant.

In cases where pain and/or firmness is severe, additional surgery is needed. This surgery ranges from removal of the implant capsule tissue to removal and possibly replacement of the implant itself. Capsular contracture may happen again after these additional surgeries.

Q: How do I know if an implant is ruptured?

A: Saline implant rupture is easy to detect because the affected breast will look significantly smaller than the other side. Small saline leaks can sometimes be difficult to detect.

Silicone implant rupture can be more difficult to detect. Patient may experience increasing pain and deformity of the breast. Mammogram, Ultrasound and MRI are useful tools to detect silicone implant rupture.

Ruptured implants will require implant removal. The may involve removing the capsule.

Q: What are the risks of silicone breast implants?|

A: Concern over the association of breast implants to the development of autoimmune or connective tissue diseases, such as lupus, scleroderma, or rheumatoid arthritis, was raised because of cases reported in the literature with small numbers of women with implants.

After review of several large epidemiological studies of women with and without implants, the results indicate that these diseases are no more common in women with implants than those without implants.

In addition, published studies indicated that breast cancer is no more common in women with implants that those without implants.

Q: What size breast implant should I choose?

A: Here are some guidelines that help in selecting the breast implant size. The patient must consider several factors when deciding which size of implant to choose. During the consultation, Dr. Jaibaji, board certified plastic surgeon in San Diego,  will assist you with that decision.

The breast implant size depends on what the patient desires and what the breast can accommodate. In general, the larger the implant, the less natural the look.

The shape of the breast is a combination of implant size and bra type. Dr. Jaibaji , at his San Diego office will need to know the desired cup size and it would be helpful for the patient to bring pictures of models.

Also, bring pictures of breast shapes that you do not like. During the consultation, Dr. Jaibaji, San Diego bard certified plastic surgeon, will show you before and after pictures that will help you make a decision.

In different women, the breast shape will look different even if the same size implant was used. There are certain things to consider that will determine the final shape. These are: original breast volume, breast base diameter, shape of the chest wall, tissue stretch, history of pregnancy, and the height of the patient.

Each cup size is about 150 cc. In other words, if a patient has an A cup and wants to be a full C, then a 400-500 cc implant is required. That does not mean the breast can accommodate that size implant.

Dr. Jaibaji, San Diego Board certified plastic surgeon,  will be able to decide that during the consultation. Projection is another option patients need to consider. If more projection is desired, then a high profile implant is chosen.

In many occasions Dr. Jaibaji, San Diego Board certified plastic Surgeon, overfills the implant up to the manufacture’s recommendation. The aim is not only to make the implant firmer, but more importantly, to avoid wrinkling of the implant, also known as rippling. The rippling can be visible and seen in the upper and lateral part of the breast.

Cleavage is the medial distance between the breasts. The cleavage improves after augmentation. However, if the distance between the breasts remains wide, then the bra can adjust the cleavage and improve the shape.

Breast Lift Q&A

Q: Do I need breast lift?

A: Thank you for the question. You are only three weeks post breast augmentation and there is still some swelling that will take time to subside. Your question is best answered when all the swelling subsides and the implants settle. Usually you want to wait about six months after the surgery. The picture you provided is somewhat limited and does not allow for full evaluation of the breast. Best wishes.

Q: Can I get breast lift without implants?

Thank you for the question and the photos. You can have breast lift without an implant. The type of lift you need will depend on the examination findings. In general, breast lift involves removing tissue to reshape the breast. This will make the breasts smaller.

My advice for you is to consult a board certified plastic surgeon. During the consultation you can articulate your goal and discuss all the treatment options. Best wishes.

Q: When is it safe to fly after breast lift?

Thank you for the question. It is best if you address this question with your plastic surgeon. In general, you should be able to travel if you have no post operative complication. Keep in mind that traveling is a significant activity and may involve carrying bags etc. Best wishes

Q: Should I get a mammogram before breast lift?

Thank you for the question. Mammogram is indicated before breast surgery if there is a mass in the breast and , in general, in patients over the age of 35. If your breast is normal on examination, you do not need a mammogram. Also, at your age, dime to the density of the breast tissue, ultrasound is mor effective than mammogram. Best wishes.

Q: What is the cost of breast lift and what is the recovery like?

Thank you for the questions. The cost of surgery depends on your location, type of lift and whether implants are needed. The is usually no hospital stay. The return to work will depend on the type of surgery, the nature of your work and your recovery. All these questions are best addressed during a plastic surgery consultation and after evaluating your goals. Best wishes.

Q: How long does it take for the scars to settle after breast lift?

Thank you for the question and the photos. Your surgery results are really good. It will take up to 18 months for the scars to settle and it will take up six months for the breast to settle. My advice for you is to be patient , follow you plastic surgeon instructions and from your photos I do not think you need any liposuction. Best wishes.

Breast Lift with Augmentation Before and After Photos

General Breast Procedures Q&A

Q: Breast asymmetry and do I have tuberous breasts?

A: Thank you for the questions and the photos. You do not have tubular breast. Your breast asymmetry can be improved with breast augmentation. your left breast ahas a more tear drop shape and the right side is more rounded. Even after a well performed breast augmentation you will still see some asymmetry. I recommend you see a board certified plastic surgeon for in person consultation. Best wishes.

Q: Do I have tubular breast?

A: Thank you for the question and the photos. Tubular breast is a spectrum of shapes that range form mild constriction of the inferior pole of the breast to severe constriction of the breast base with herniation of the breast tissue into the nipple areola complex. From your photos you do have tubular breast. The good news is there is treatment. The type of treatment depends on what you want to achieve. In general patient usually require periareolar mastopexy ( donut lift) and breast augmentation. My advice for you is to get a consult with a board certified plastic surgeon to address your concerns and formulate a treatment plan. Best wishes.

Q: How to fix the nipple?

A: Thank you for the question and the photos. What you have is a tuberous breast. Tuberous breast is a spectrum of various shapes that range from mild to severe. In your case, to fix the nipple you will need periareolar lift, even if you don’t want to change the implants or the pocket. My advice for you is to get a consultation with a board certified plastic surgeon to address you goals and your options. I wish you all the best.

Q: Implant pocket, under the muscle or under the breast?

A: Thank you for the question. In general, submuscular pocket has several advantages, it reduced the risk of capsular contracture and less rippling. the looks depends on several factors, including the size of the implant, the breast shape before augmentation and presence of ptosis. I prefer submuscular augmentation for all my patients.

You need to see a board certified plastic surgeon for a consultation. during the consultation all your questions should be addressed. You need to see before and after photos and preferably take pictures with you of what you want to look. Best wishes

Q: Best combo procedure for poor breast skin quality, is it augmentation, reduction or lift?

A: Thank you for your question and the photos. From the pictures you provided it clearly shows that you have more skin than actual breast tissue. You want to go down to C cup. In this case breast lift (anchor) lift would achieve several objectives. It would remove the excess skin, reshape and reposition the areola and reduce the breast size. You will have, however, upper pole flattening. If you wan to improve the upper pole fullness you will need an implant. Implants under the muscle should not affect the pectoral strength or function.

What you need is a consultation with a board certified plastic surgeon. During the consultation your hopes and desires will be addressed. You need to see before and after photos and you and your surgeon can decide to the surgery in one or two stages. I wish you all the best.

Q: Type of breast lift after augmentation for sagging breast?

A: Thank you for your question and photos. Your five months photos does show difference between the two breasts. A lift will give you more symmetry. The type of lift you need depends on the examination findings. You may need an anchor lift to achieve symmetry.

My advice for you is to wait for 2-3 more months to allow the implants to settle and then you can have the surgery.

Q: How to correction of breast asymmetry?

A: Thank you the question. It is difficult to answer your question without photos. In general, when there is significant asymmetry, there several option to correct it. In your case, you will need an implant in the B cup breast. The question is what is the shape of the breasts, does the D cup breast needs a lift, is the asymmetry in the areola etc. all theses questions need to addressed before giving you an accurate answer.

My advice for you is to see a board certified plastic surgeon. Look at their before and after photos. Convert clearly what you want to your surgeon. Good luck.

Q: Augmentation +/- lift for lasting results?

A: Thank for your question and the photos. The decision on whether you need a lift or not depends on severe factors; elasticity of the skin, breast measurement and the shape you desire. That’s why in person consultation would give you a better answer to your questions. You need to photos of patient who had augmentation with and without lift, convey what you want very clearly to your plastic surgeon and then make a decision.

Q: Hematoma or seroma after mastopexy?

A: From the history and the photo you provided, it is most likely to have a hematoma. The right person to confirm that is your plastic surgeon. I suggest you contact him and if there is more collection, then it has to be evacuated.

Q: Red/ green discharge 1 week after breast augmentation/lift?

A: Your concern about the discharge is a valid one and You should take it seriously. My best advice for you is to contact your plastic surgeon and discuss it with him. It is even better if you arrange to see him for direct evaluation of the breast. I wish you all the best.

Q: Breast asymmetry surgery, what is the best way to correct it?

A: Thank you of the question and the photos, your situation is not uncommon and you have several options. Any surgery whether its reduction/lift with or without implant will aim to achieve more symmetry. The question is how you want your breasts to look. You can address that question by taking photos to the consultation, look at before and after photos from the surgeons portfolio and then make your decision. It is very important for you own satisfaction after surgery to convey your concerns to the plastic surgeon very clearly.

Q: Can I have implants without a lift?

A: Thank you for your question. From the information you provided and the photos I think you will need a lift. The left breast areola is lower, both breast have excess skin from pregnancy and weight loss. Doing implant only procedure will give some volume but not the shape you want.

Q: What is the recovery time after sub glandular breast augmentation?

A: Generally speaking recovery after sub glandular augmentation is straightforward. I advise my patients to wear a sports bra for about 6 weeks. Return to work in about in about 6-7 day depending on their occupation and recovery. Return to full activity after 6-8 weeks. I also advise you to follow up with your plastic surgeon and follow his/her instructions. Each surgeon has their own post operative regiment and you have to adhere to the instructions of your surgeon.

Q: Breast is very soft and high, what is causing that?

A: Thank you for the question. In general it can take up to six months before the implant finally settle. I think you have to address your concern with your plastic surgeon. You also have to follow his/her post operative instructions.

Q: Benelli lift and breast augmentation.Can I go from a B to a DD cup?

A: Thank you for your question. The decision on the size and shape of breast implant is a very important part of your consultation. It also a mutual decision in which you should bot agree on. In my practice, if a patient desire a larger implant, the best approaches to use a breast sizer during the surgery and the appropriate implant can be placed based on that the breast pocket can accommodate. Based on the information you provided you may benefit from a second consultation.

Q: Want more fullness after breast augmentation

A: Generally speaking, it is too early to determine the final shape of the breast. It usually takes up six months before the implants settles and the swelling subsides. During that period the breast shape will continue to improve. I suggest to wait, follow all your post operative instructions and appointments.

Q: Electric shock sensation after breast augmentation

A: The muscle distortion you describe may be related to animation ferocity as a result of sub muscular placement of the implant or partial separation of the lower fibers of origin of the pectorals major muscle. As for the electric shock sensation, it may be related to nerve injury. It is best for you if you address your concerns with your plastic surgeon.

Q: Checking up post op results

A: Thank you for the question and the photos. Generally speaking, it takes 4-6 months for the implants to settle. During that period one side may look bigger or higher or different than the other side. I think you are doing fine. Follow your post operative instruction and communicate any question to your plastic surgeon.

Q: Discoloration of the areola after breast augmentation.

A: Most likely what you have is post operative bruising. But still check with your plastic surgeon.

Q: Rippling after augmentation

A: It is not uncommon after pregnancy and breast feeding that the breast become much thinner due to atrophy of the bread tissue. If there is an implant, it be more easy to feel it and some times there is rippling. There are, however, different ways to address it. You need to see a plastic surgeon, get examined and determine what procedure is appropriate for you.

Q: Chest pain 8 day post augmentation.

A: Just reading your note, I think you need to contact your plastic surgeon or primary care physician. Although pain is normal after breast augmentation. in the first few days, pain that does not improve along with difficulty to take deep breath is a concern.

Q: Chronic pain in right breast around scar area.

A: Thank you for your question. Surgical scars can be very sensitive for long periods. This may be related to nerve injure, or underlying costochondritis which is inflammation of the costal cartilage. Messaging, silicone sheets, and anti-inflammatory medication may help.

The key to you treatment is establishing the cause of pain. You will need to address your concerns with your plastic surgeon and follow his/her instructions.

Q: Breast type and augmentation, do I have tuberous breast?

A: Thank you for the question. It is not easy to determine from the the photo if you have tuberous breast. Tuberous breast, however, is a spectrum of deformity ranging from very mild to severely contracted breast and herniation of the breast tissue into the nipple areola complex.

As for augmentation and type of lift, The photos show ptosis and for that you may need more than a donut lift such as vertical or anchor lift. The best way to address you questions and concerns is through a consultation with a board certified plastic surgeon. Look at before and after photos

Q: Scar s after breast augmentation

A: Thank you for the question. Usually after 2 years scars mature and any residual scaring after that is likely to be permanent. After five years you have options but the results are limited. Non surgical option may help such as scar products or even laser therapy.you may see some improvement, but I doubt it will be significant. Surgical scar revision may help, but you are replacing a scar with another one.

I would advise you to see a dermatologist and get their advice.

Q: Model looking for breast implants, what size?

A: Thank you for your question. The first step is to find a board certified plastic surgeon, you can get the information from the American Society of Plastic Surgeons website. Get a consultation. More than one if necessary. During the consultation, look for the before and after photos, take photos with you of what you want to look like. Try and decide, what shape, size and type of implants. The plastic surgeon will advise you about what can be achieved.

Q: Indentation after breast augmentation

A: Thank you for your question and the picture. I do agree with you that you have good results. The indentation you mention is difficult to see and probably not that significant to warrant anything done about it. In the photo the left breast appears higher than the right and this may be in part to using your left hand to take the photo. The peeling may be related to skin stretching and subsiding swelling.

Q: Uneven breast surgery, what is the best implant size?

A: Thank you for your question and the photos. Asymmetry like the one you have is not uncommon. You have several options. Lift on the left breast and reduction on the right to achieve symmetry. You can have the lift/reduction and breast augmentation at the same time.

I do not think simple breast augmentation with the implants you mentioned will give you the shape and results for are looking for. A consultation with a board certified plastic surgeon who has experience in dealing with these cases is what you need.

Q: Revision implant surgery for snoopy breasts

A: Thank you for your question and the pictures. You have high riding implants, ptosis and breast asymmetry. Also from the pictures you may have medial malposition . I think you are a good candidate for vertical breast lift, internal suturing to correct the malposition and augmentation.

Having said that; there is no replacement to complete examination of the breast by a board certified plastic surgeon.

Q: Timing of corrective surgery after breast augmentation

A: It is not uncommon patient after breast augmentation surgery to feel they should have gone bigger or smaller. It is best during the recovery period is wait until all the swelling has gone and the implant settle. After about 6 months one can evaluate the breast and decide if additional or revision surgery is needed. That period also give the patient the time needed to adjust to the new situation. You may find that you may not want anything done.

Q: One implant moves more than the other

A: It is not uncommon after breast augmentation to have one implant settles before the other. You are only seven week out of surgery and the implants still has more time to settle. You need to follow the post operative instructions very carefully and contact your plastic surgeon if you have any concerns.

Q: Tuberous breast fix

A: Thank you for your question and photos. I think you have good results from you surgery. The left breast still has a wide areola and herniation of the breast tissue under the nipple areola complex. If you were happy with the outcome of the right side, then I think you should continue your treatment. You also have address your concerns with your plastic very clearly.

Q: Blisters on nipples after augmentation

A: Thank you for your question. From the information you provided it would difficult to determine the exact cause of the blistering three months post augmentation mammoplasty without full history and examination, especially when you had MRSA infection. It is best for you if you address your concerns with your plastic surgeon and keep a close follow up with him/her.

Q: Suture remove following breast augmentation

A: Each plastic surgeon has his/her own technique of wound closer and postoperative care. You have to follow your surgeons instruction on wound care and the timing of suture removal.

Q: Are my breast tuberous?

A: Thank you for your question. Tuberous breast is characterized by contraction of the base of the breast preventing it from in horizontal or vertical axes. There is also herniation of the breast tissue toward the areola nipple complex. There are several treatment options. You could have periareolar lift and reshaping of the breast tissue to achieve a more appealing shape. You do not need a TRAM flap for that. What you need, however, is a consultation with a board certified plastic surgeon. Direct examination, seeing before and after photos and discussing your treatment portion and desires all will help you reach the right surgery.

Q: How many times should you see your plastic surgeon before breast augmentation surgery?

A: Thank you for your question. There is really no hard answer. Generally speaking, the initial consultation is usually the longest. Thats when complete history and examination is performed. The surgical option are discussed with the patients, before and after photos are presented and all questions answered. This takes up to an hour. Ultimately it is not the length of the consultation, but the quality of information provided and that’s what matters.

Q: Severe Asymmetry before and after BA

A: Like you said it is still six weeks since surgery. It may take up 6 months before the breast swelling settles and sometimes longer than that. During that time you have to be patient and discuss your concerns with your plastic surgeon.

Q: Treatment of stretch marks following breast augmentation

A: There is no effective treatment for stretch marks in the market. There many products in the form of creams, and devices that claim to remove the or eliminate stitch marks. Non of the wok.

Q: Bottoming out after breast augmentation

A: From the photos you provided, the left breast implant does appear to be more displaced inferiorly. This may have resulted from over dissection of the pocket on the left side. It can be fixed with internal suturing of the capsule. But, I think you should give it few more months before you make that decision.

Q:Should I have gone bigger with my breast augmentation?

A: From the information you provided I think you will get a moderate C cup. At this point my advise for you is to be patient. Wait for the swelling to subside and for the implants to settle. After about 6-8 weeks from surgery you can check the bra that fits you. You will find that you have lots of choices.

Q: Breast augmentation and post op instructions

A: Thank you for your question. The reason why there are specific instructions for each surgical procedure is to avoid complication. The complication after breast augmentation can be bleeding, capsular contracture and implant malposition. Remember prevention is the best cure.

Q: Decisions before breast reduction surgery

A: I think you still have time to talk to your plastic surgeon about what size you want to be. It is really hard to give an accurate size after breast reduction surgery but, good communication with your plastic surgeon and reviewing before and after photos will help you and you surgeon to reach a common ground.

Q: Right sided sternal pain 18 months after breast augmentation, what are the causes?

A: There are several causes of pain following breast augmentation. Cosotochondritis is one of them. The pain may also be related to muscle trauma, muscle spam etc. Also it may not be related to the implant. You need to con act your plastic surgeon to address this issue.

Q: How to reduce the risk of capsular contracture?

A: This is a very unfortunate situation. There are several several techniques that try to prevent it from happening. Washing the implant and pocket with triple antibiotic solution during surgery, wearing breast band, breast massages are all used to prevent it from happening. Other method such as the use of anti-inflammatory or anti asthma medication have to be discussed with your plastic surgery. As for Strattice, there reports that show it is useful in preventing recurrence of contracture.

Q: Breast augmentation in the Summer

A: You can have breast augmentation whenever you are prepared to have it done. You have make sure you have enough time to recover before you resume your normal activities or travel.

Q: Do I need breast lift?

A: The photos you provided show breast asymmetry and large areola. Since you have lost significant weight, I think you have, in addition, significant skin laxity. To perform implant only surgery would require a large implant that not only cosmetically be unpleasing , but will increase your ptosis and may bring other symptoms such as shoulder and back pain. I think what you need is a breast lift and implant.

Q: Bottoming out and revision surgery

A: The photos you have taken do show a double bubble appearance on the right and ptosis on the left. A before pics would have been helpful. Either way, you will need to wait for several more months for the implants to settle and the final shape is determined. Then one can decide on the next step. I think you will need a revisionary surgery.

Q: firm high breast implant

A: You are three months out from your surgery. The left breast is still higher and firmer. I wonder if you had breast asymmetry before surgery. Either way, I think your plastic surgeon is giving you the right advice. message, compression and time will help. It may take up six months and sometimes longer for the breasts to settle.

Q: Augmentation +/- lift

A: From the photos you provided I think you need a breast lift. An implant would give you some nipple elevation but it is no replacement for lift in you case. The type of lift will depend on what the surgeon find on examination and measurements of the breast.

Q: Treatment of tuberous breast

A: Before going into the treatment of tuberous breast, let me give you some information about it. Tuberous breast have several features; a contracted skin envelop both horizontally and vertically, a constricted breast base, a reduction in the volume of the breast parenchyma, abnormal elevation of inframammary fold, peudoherniation of the breast parenchyma into the areola, areola hypertrophy.

The treatment, as you mentioned is surgery. It involve periareolar mastopexy (lift) and implant placement. The presence of supernumerary nipple under the left breast should not affect the surgery or the results.

Q: Change in breast shape after saline breast augmentation

A: After breast augmentation surgery, it takes 4-6 months and sometimes linger for the implants to settle. In your case you are still three weeks post op. Messaging the breast is important not only it allows the implants to settle but also reduce the risk of capsule contracture. It is important to communicate your concurs with your plastic surgeon so that he/she can address them.

Q: Breast augmentation and shoulder surgery can both be done at the same time?

A: It is not uncommon the patient requests two surgeries to be performed at the same time. Plastic surgeons commonly combine procedure in one surgery. In your case, things are a bit different. The recovery process of shoulder surgery is a lot different than recovery process of breast augmentation and may conflict with each other. Hence, I would not advise to do them both at the same time.

Q: Question about breast augmentation

A: Thank you for your question. Without proper examination it would be difficult to answer your question. It is good that you are loosing your baby wight. I suggest you consult with a board certified plastic surgeon in your area.

Q: Implant size and breast augmentation in muscular women

A: You have a good question. The implant choice depends on several factors, most importantly` is what you breast can accommodate based on breast measurement. It also depends on what you desire. The decision to choose an implant before surgery should be done after full examination and evaluating what you want and seeing before and after photos.

Q: Fluid filled lumps under the scar after breast implant surgery, what causes it?

A: I think sofa you have done all the right things. It could be a cyst, but in some occasions, in patients with saline implant they can feel the fill port of the implant under the skin. Since it is on both side and under the scar, then may be one of the causes for lump feel. You do not have to remove the implants for that. I agree with repeating the exam, mammogram and ultrasound in 6 months.

Q: I have PIP implants, should I have them removed?

A: The recommendation is to have these implants removed because of the high incidence of rupture. I recommend you see you plastic surgeon to address that particular situation.

Q: Chicken pox and breast augmentation

A: I think you need to contact your plastic surgeon and address that issue with him. It may help to an advice from infectious disease physician as well to reach an answer to your situation.

Q: I am unhappy with size after breast augmentation; Will they get bigger?

A: In general the breasts are swollen in the first 3-4 weeks after surgery and then the swelling will start to fade. The breast will then look smaller. What you need is a staged procedure. You have a very good first stage, which is lift and augmentation. The second stage would be to go with bigger implants after about 6 months.

Q: Insurance coverage for breast asymmetry surgery

A: It depends to a large extent on insurance criteria. The insurance company will look for medical necessity. If you your PCP can prove that the procedure is medically necessary and correcting it would improve you medical condition, then you stand a better chance of getting approved. If it was determined by your insurance company that the procedure is cosmetic; they will deny coverage. I hope that is helpful.

Q: drainage following breast augmentation

A: There is a high chance that you have breast infection. You need to logout, call your doctor and ask to see him.

Q: Scarring around the areola following breast augmentation; does it need revision surgery?

A: There is a difference in scarring between the two breasts because of different surgery. The scar on the left is red and slightly raid which means it is still active and healing has not completed. In general, any scaring after two years from surgery is likely to be permanent. So I would give some more time before considering scar revision.

Q: What will be my cup size with 350 cc breast implant?

A: The relationship between the cup size and implant size is not straightforward. In general, each 150 cc will take you one cup size higher. But, even with that, it depends on the bra shape and manufacturer. The best way to address it is to address that issue in detail during your consultation and seeing before and after photos of patient with similar breast size and body habits. It is also helpful if you bring to the consultations sample photos of what you would like.

Q: Question on bottoming out surgery, how much does it cost?

A: Before you move to cost, timing and recovery, you need an accurate diagnosis. From the photo you provided it is difficult to you all the information for your questions. In general, if you hove bottoming out, then surgery will cost more, the surgery is more complicated that just placing implants and has to performed by a plastic surgeon who is familiar with this type of surgery.

Q: Weight loss and breast shape

A: Your weight and height are ideal, if you do the math your body mass index is 20.5. Losing more wight in the range of 10 pounds would probably not change much in terms of breast shape, but you may notice that difference in size given your height and weight. I applause you for staying healthy and your desire to be healthier.

Q: Breast type and appropriate surgery, do I have tuberous breast?

A: Although you gave a detailed description of your breast; a photo and clinical examination would be the appropriate way to address your concerns and decide on type of surgery. In general, tuberous breast comes in different varieties, mild or some tuberous feature to a very constricted breast base and wide areola. You need to see a board certified plastic surgeon and see before and after photos of patients with similar features and then you and your surgeon can arrive to an appropriate treatment plan.

Q: Concerns about breast shape and size post breast augmentation

A: Thank you for your questions. It seems from your note that you had breast asymmetry that required two different size implants. If you are concerned about hematoma in the left breast, then you should contact your plastic surgeon. Regarding the asymmetry and difference in the feel, it is too early to judge the outcome. Commonly after breast augmentation one breast looks bigger, higher and more painful than the opposite. If this is the case then you need to give it some time. It really help you a lot if you address your concerns with your plastic surgeon. Close communication will alleviate your concerns.

Q: Unsatisfied with breast augmentation

A: It is really hard to give a correct answer without a proper examination and reviewing you before photos. In general asymmetry is the norm, in both the shape and size of the breasts. You already had two surgeries within a one year period and I think you need to communicate you expectations with for plastic surgeon.

Q: Breast implants and breast feeding

A: Breast implants and breast feeding questions are very common. Mainly because many women undergo breast augmentation at child bearing age. To answer your questions: yes it is fine to have breast augmentation before having children. Most women who were able to breast feed before breast augmentation will be able to do that after augmentation. You definitely can not get implants during pregnancy. nursing should not make a difference in the size of implant you choose. The size of the implants depends on what your body can accommodate and what you desire. You need a consultation with a plastic surgeon to address all these questions. you can also visit my website for more information.

Q: Breast augmentation

A: Thank you for your questions. Based on the information you provided and the photo, I think you are a good candidate for breast augmentation. I agree with the size and type of implant you mentioned, however, an accurate examination is essential to address this particular part of the procedure. I prefer under the muscle placement for several reasons.; the risk of rippling and capsular contracture are lower when the implants are placed under the muscle.

Here are some helpful tips for your procedure:

Here are some guidelines that help selecting the breast implant size. Patient must consider several factors when deciding which size implant to choose. Dr. Jaibaji, during the consultation, will assist you in making that decision. The implant size depends on what the patient desire and what the breast can accommodate. In general, the larger the implant, the less natural the look.

The shape of the breast is a combination of implant size and bra type. Tell Dr. Jaibaji what cup size you desire, it would be very helpful if you can bring pictures of models. Also bring pictures of breast shapes that you do not like. The use of rice bags, different size breast implants during the consultation may help but is by no means accurate. During the consultation Dr. Jaibaji will show you before and after pictures that would help you make a decision.

In different women the breast shape will look different even if the same size implant was used. There are certain things to consider that will determine the final shape; these are: original breast volume, breast base diameter, shape of the chest wall, tissue stretch, history of pregnancy, height of the patient.

Each cup is about 150 cc. in other words, if a patient had A cup and wants to be full C, 400- 500 cc implant is required. That does not mean the breast can accommodate that size implant. Dr. Jaibaji will be able to decide that during the consultation. Projection is another thing patients need to consider. The more projection is desired a high profile implant is chosen.
Overfilling the implant; in many occasions the plastic surgeon overfills the implant up to manufactures recommendation. The aim is not only to make the implant firmer, but more importantly, to avoid wrinkling of the implant, also known as rippling. The rippling can be visible and seen in the upper and lateral part of the breast.

Cleavage is the medial distance between the breasts. The cleavage improves after augmentation. However, if the distance between the breasts remains wide, then the bra can adjust the cleavage and improves the shape.

Q: Should the implant placed under the muscle or under the gland?

A: Implant placement under the muscle carries several advantages, it reduces the risk of rippling, reduce the risk of capsular contracture and mammogram is easier to interpret when the implants are under the muscle. For that, i agree with most of the comments made her. The issue of whether you need a lift of not has to be addressed with your plastic surgeon. The physical examination and seeing before and after photos of patient with similar situation is advisable. It is also advisable to show your plastic surgeon photos of what you think is good results for you. This will help you and your surgeon in arriving at the right procedure for you. Good luck

Q: Best breast implant surgeon

A: The starting point would be to search for a board certified plastic surgeon. That is certified by the American Board of Plastic Surgery. Then you can check their website and look at their before and after photos. Go for several consultations, it is helpful if you could take photos of what you want to look like. Ask questions. Go with the surgeon you feel comfortable with and who does lots of breast work.

Q: Underwire bra and breast surgery

A: I agree with comments made for this question. In general, when it comes to breast surgery, there is no “one fits all”. each case is dealt with on own merits. The experienced plastic surgeon will give the appropriate advice on the type and duration of after surgery care.

Q: Breast augmentation and double bubble

A: The majority of women have breast asymmetry and they are good candidates for breast augmentation. I think you are a good candidate for that procedure. Your nipples are in normal position, from the pictures you provided. The risk of double bubble deformity is really low if done appropriately. You will need to address your concerns with an experienced plastic surgeon, bring photos of what you like to look, this will convey significant information to your plastic surgeon. The concerns that you mentioned including how to correct the asymmetry can be discussed during the consultation.

Q: Return to pre pregnancy breast size and can I have implants that lifts the breast without making it larger?

A: Any time you place a breast implant the breast will be larger, doing breast lift alone, however, will make the breast smaller. It seems to me you need beast augmentation and lift at the same time. You need a consultation with a plastic surgeon and see before and after photos and have a discussion on what you desire and what can be achieved. It is also desirable to bring photos of what you want to look like. Only then you will have the right answer to your questions.

Q: Augmentation only or should I get lift and Augmentation?

A: I agree with the comments made. However, you have to see photos of patients with and without lift. Since you are concerned about the scars, I suggest you go with an augmentation only. But, you will need a larger implant to fill the skin envelope. I prefer the periareolar incision and submuscular placement of the implant. If you agree to have a lift, than the type of lift will depend on how big of an implant you want. The bigger the implant the less skin needed to be taken out. I am not in favor of a donut lift in your case as it may flatten the areola and looks un natural. Good Luck

Q: Top five questions to ask a breast surgeon.

A: I agree with all the above comments. What you are looking for is experience and appropriate certification. It is vital that you inform your plastic surgeon about your expectations and see before and after pictures of patient with similar anatomy to you.

Q: lift or no lift with breast augmentation?

A: You have a borderline situation. You could have augmentation only, with implants placed under the muscle. This may be all that you need. If you desire more symmetry, then a lift with an augmentation is the answer. A donut lift on the left and vertical on the right may all you need. You have to discuss you concerns with your plastic surgeon and see photos of patient without lift and those who have lift. This would make you decision much easier.

Q: Can I get breast implants without a lift?

A: I think you do need a lift and implants to achieve the shape that you desire. The question is what type of lift and what size implant. From the photos you provided, I think a full lift is what you need. The concern over the scaring and keloid formation is a valid one. Every skin type is susceptible to hypertorphic scarring and keloid formation. This is one of the risks of any surgery.

Q: Procedure best for you

A: In order to answer your question with some accuracy, you need to submit photos. Having said that, it seems that you think mastopexy scars are horrible, and that is a concern. Especially if you do need one. I think you need to communicate your concerns and expectations to your plastic surgeon and go from there. Good luck

Q: Should I get 500 cc implants or less and do I need a lift?

A: Both procedures will work for you, implant with lift and without lift. If you consider only an augmentation, then a large implant is needed to fill the excess skin envelope. That may result in a large and ptotic breasts and you may be happy with that. If you desire more symmetry and less droopiness, then a lift is needed along with an implant. The implant will definitely be smaller than 500cc.

You need to communicate with your plastic surgeon your expectations, you also need to review pictures of patients who had augmentation and lift and simply just augmentation, this would make your decision much easier. Another advice, do not rush into surgery if you are not sure about the type of procedure you need. Good luck.

Q: Would my insurance cover tubular breast surgery since it is considered a congenital anomaly?

A: Anomaly is not a deformity. Although there are different grades of tubular breast, the correction procedure is not covered by insurance companies. But, to satisfy your curiosity, try contacting your insurance company and see what they say. Personally, I have not seen a case of tubular breast covered by any insurance company. It is a cosmetic procedure and your local plastic surgeon will advise you on the type of surgery and cost. Good luck

Q: I want to be Full C/D, will 400 cc implant be adequate?

A: This is common question and should be addressed at the time of your consultation. You can use implant sizers under the bra that would simulate the post operative results to a certain extent. I suggest you talk to your doctor prior to surgery.

Q: Menstrual cycle and breast surgery, should I get it before or after the cycle?

A: Hi Dina, It really does not matter. And like the previous answer, you should not be pregnant prior to surgery. I usually ask for pregnancy test before surgery.

Q: Options for tubular breast

A: Regarding the type of surgery, i would recommend augmentation with silicone gel breast implants placed under the muscle and vertical breast lift. This would prevent the areolar stretching after surgery. The size of the implant is determined at the time of your consultation and is based on your breast and chest wall measurements. in general the bigger the implant the more likely you will have unnatural look.

As for breastfeeding about fifty to sixty percent of women will be able to breast feed after surgery.

Q: Breast lift and tuberous breasts

A: The easy answer to your condition is breast lift, this would reduce the size of the areola and give you a better shape. Whenever you do a lift the breast will be smaller. If that is fine with you then you only need a lift. If you desire an increase in breast size or maintaining the same size then I would recommend adding an implant to the lift. Good luck

Q: Red heads and bad scars; is there an association?

Thank you for the question. Generally speaking scars can take up to 18 months to settle. One to find out about how you scar is to look at an old scar in your body. People differ in the way the scars heal but most will have favorable scars. You should discuss with your plastic surgeon how to take care of your wounds and scars postoperatively. Post op scar managements is important to optimize your healing and usually ensures better outcome. Best wishes.

Q: I have breast asymmetry after lift and augmentation, is going to get better?

Thank you for the question and the photos. Although there is a noticeable difference between the left and right side, it is still too early to determine the final outcome. The results at this point is altered by swelling and it will take six to eight months for the implants to settle and the swelling to subside. At that point you can discuss your concerns with your plastic surgeon for a possible revision surgery. My advice for you is to address your concerns with your plastic surgeon and follow up with him/her. Best wishes.

Q: Square bottom breast and asymmetry after breast lift and augmentation?

Thank you for the question and the photos. It is too early to determine the shape of the breast and the outcome of the surgery. My advice for you is to wait for 6-8 months before deciding on doing any revision surgery. During TNT time you need to address your concerns with your plastic surgeon and follow all the post operative instructions. Best wishes.

Q: What procedure is best for me; Lift, Augmentation or both?

Thank you your questions and the photo. Each procedure has its indications. Looking at the photo, your nipples are low and you will require a lift. Just breast augmentation without a lift is not advisable. If you get a lift only, the shape of the breast will improve. However, the breasts will be smaller. So if you want to maintain the current cup size, you will need augmentation and lift.

The best way to address your concerns is with in person consultation with a board certified plastic surgeon. You have to be very clear about your hopes and desires. During the consultation you need to see before and after photos of each procedure. Best wishes.

Q: Is it possible to have Benelli lift without permanent suture?

Thank you for the question. Doing Benelli lift without permanent suture runs the risk of areolar stretching and flattening. My advice for you is to communicate your questions with your plastic surgeon.

Q: I am considering cohesive gel implants, where should I start?

A: Thank you for the questions. Your questions and hopes and desires are best addressed with in person consultation with a board certified plastic surgeon. During the consultation your goals, are discussed, the type of surgery including possible complication and risks are also addressed. I wish you all the best.

Q: I have had breast augmentation five years ago and now I am having breast pain. What is causing that?

A: Thank you for thew question. It is difficult to determine the cause of unilateral breast pain and swelling without proper history and physical. There are several reasons why this could happen and speculations is not in your best interest. My advice for you is to contact your plastic surgeon. You may also contact your PCP for an appointment if you can not see your plastic surgeon. Best wishes.

Q: I had breast augmentation and now I am concerned about the implant feel and look.

A: Thank you for the question. It is difficult to address your concerns without in person exam. I think you need to discuss your concerns with your plastic surgeon. However, in general, if there was breast asymmetry before surgery, you may notice a difference in the look and feel of the breast. The more the asymmetry in shape and size , the more likely you will see the difference after surgery. Best wishes.

Q: When can I fly after breast enlargement?

A: Thank you for the question. Generally speaking you can fly after few days following breast augmentation. Your surgeon will determine Kane best time to fly back based on yours urgency and recovery. Best wishes.k

Q: I want to get saline implants, what size implant should I get to go for full D?

A: Thank you very much for the question. The best way to address your question is through in person consultation. I would not do you any good giving you an answer online. The decision on implant size depends on multiple factors; breast shape and size, skin elasticity and what you desire. The other thing here is there is little correlation between cup size and implants size.

You need to see a board certified plastic surgeon and address these questions during the consultation. It will be helpful to you if you take photos of what you want to look and check the surgeons before and after photos. Good luck

Q: Localized swelling after breast augmentation

A: Thank you for your question. I agree with your surgeon. it is too early to determine the outcome of the shape of the breast. I think you need to wait 4 to 6 monthsperceive time for the implants to settle. In the meantime you need to follow up with your plastic surgeon and follow all the post operative instructions . good luck t

Q: Nipple pointing downward after hard massaging?

A: Thank you for the question. Unfortunately it would not be helpful to give an answer online. You need to communicate your concern with your plastic surgeon. Make sure you see him/her in office and follow their advice.

Q: Pecs contracting following breast augmentation

A: Thank you for your question. What you are feeling is normal. You may also notice the implant moves when the pec contracts. This is called animation deformity and is related to the sub muscular placement of the implants. As long as the breast is soft and the feel is the same in both breast you should not worry about it. I also advise you to communicate your concern with your plastic surgeon.

Q: I had symastia repair and I wonder what would be the recovery process?

A: Thank you for your question. It would not be in your best interest to give an advice online. You need to communicate with your plastic surgeon. Follow all the post operative instructions. Also you need to keep your appointments. He/she will be the best person to answer that question.

Q: ID card shows different type of implant

A: Thank you for the question. The ID card comes with the implant box. When the implants are placed in the breast, the cards are marked for the site, left or right. In your case I do not want to speculate what could have happened. Talk to your plastic surgeon. Good luck

Q: Is breast tightening after physical activity normal 23 days post BA?

A: Thank you for the question, It is not uncommon in to have breast pain and slightly more swelling on the side of the dominant hand. However, I still think that you should address that question with your plastic surgeon. Also make sure you follow all the post operative instructions regarding activity, massage act.

Q: I have had breast augmentation and am not happy with the results. The breasts are still small. What should I do?

A: Thank you for your question. It is not uncommon that patients can feel differently about the size of the breast right after surgery. My advice for you is be patient, communicate your concerns with your plastic follow all the post operative instruction. Overtime, when the breast implant settle, after six months you can reevaluate the size and shape with your plastic surgeon.

Q: What size breast implant should I get?

A: From your note, it seem that you have searched for answer really well, but the main question of what size implant remains unresolved. The best way to address that question with in person consultation. Prepare your questions, take photos with you, check before after photos mainly of patient with similar body habitus. The plastic surgeon should be able to help you with that decision.

Q: Breast asymmetry 3 weeks after augmentation

A: The photos you provide does show a more settled left breast implant. However, they still have more time to settle. In general, in the first six week it is not unusual to have one implant higher. Implants may take up to six months to settle. My advice for you is to follow up with your plastic surgeon. Address your concerns with him/her and follow the post operative instructions.

Q: Excess skin shrinkage

A: Thank you for your question. Unfortunately without picture and more importantly in person exam it would difficult to decided on what you need. My understanding is you are one month out of mastopexy and implant reduction and subsequent hematoma. The best thing for you is to discuss your concerns with your plastic surgeon.

Q: Breast implant dropping after 6 months

A: Generally speaking, the breast will continue to change even after six months. But, how much it will drop is a matter time. It is very common after augmentation, to have one implant higher, firmer and probably more painful than the other. And with time these symptoms and sign tend to settle and the patient fells better and happier. From your pictures, I see good results. Even the asymmetry that you mention is not taking much from the overall shape. You could still massage it if it was firmer than the other side.

Q: Implant diameter and upper pole fullness

A: There is no doubt that the bigger the implant, the wider the implant the more upper pole fullness. However, the choice of the implant is not solely based on implant base diameter. Breast measurements, breast shape and how you want to look are all important. You need to discuss your surgery outcome with your plastic surgeon. It is helpful if you take photos with you, look at a his/her photo gallery. This will ensure your satisfaction after surgery.

Q: If I get 500 cc implant, what would be my cup size?

A: The choice of implant for breast augmentation is an important part of the consultation process with your plastic surgeon. What make it difficult is the lack of correlation between the cup size and implant size. This is related to several factors including how much breast tissue you have, different bra manufacturers and different shapes of bras.

To make the decision easier, talk to your plastic surgeon, show him/ her picture of what you want to look like and review therefore and after gallery in their office for patient who have close body frame and breast shape to you. This will ensure mutual understanding of your expectations and gives you more satisfaction after surgery.

Q: Family planing and plastic surgery

A: From you question it seems to me you are seriously considering having children give all the circumstances. Doing cosmetic surgery will definitely delay that goal. You could always, once your family is complete, go back and get breast augmentation and tummy tuck. So my advice would to wait on surgery.

Q: Swollen left breast 11 weeks post breast enhancement.

A: I think you should take your concern seriously and discuss it with your plastic surgeon. There are several causes for breast swelling after surgery. Keep a close follow up with him/ her and adhere to all post operative instructions given to you.

Q: Left implant is hard 3 weeks after implant exchange

A: Thank you for your question. The left photo does show that the left breast pocket is smaller than the right. There are several reasons for that, but you did not mention if there was asymmetry, was capsulectomy performed and was the same implants used. You need to address your concern with your plastic surgeon and follow his/her instructions. Messaging the breast,using the compression band and sports bra will help in keeping both breast soft.

Q: Should I get HP ( high profile) saline implant. my breast base is 11 cm wide?

A: It is difficult to answer your question without proper examination. The process of selecting breast implant size is based on many factors. What you desire, breast size and shape, skin elasticity, degree of ptosis if any, and you body frame. The discussion of breast implant size and shape is an important part of your consultation with your plastic surgeon.

Q: Do I need a lift and if I need one, what type of lift?

A: From the photos you provided, it seem to me that you would benefit from a lift. The type of lift is a vertical one. But, this answer is no replacement for proper examination and consultation.

Q: Bra strap after breast augmentation

A: It is not too late to wear the strap and it will help the implants settle. You need to find from you plastic surgeon how long he wants you use it and what other instructions you need to have such breast massage information.

Q: compression band for high implant

A: The implants will continue to settle and change beyond four month. I agree with your doctor that a compression band will help. This is in addition to messaging and sports bra. Pharmacologic ways to reduce the risk of capsular contracture have debatable advantage and may have some side effects. You need to discuss that with your plastic surgeon. Good luck

Q: choices?

A: When it comes to breast augmentation, you will have several choices on implant size and shape. What I find helpful for patients in their decision making process is to show before and after pictures of patient with breast shape close them. It will defiantly help you if you do that.

Q: I am four day post breast augmentation, what would be my cup size?

A: Four days after surgery is too early to tell what cup size you will be. But, in general, if you were a B cup and had 339 cc implant then that will most likely get you to a C cup. I suggest you wait for about 6 – 8 weeks and then decide.

Q: Imagination Vs Reality

A: Although it may be possible for you to get what you want in one or two surgeries, I advise to see the results of patient who had similar procedure and look at complications. They may make you change your mind.

Q: The right breast implant feels really hard. I had both breast implants replaced four weeks ago. Why is this happening?

A: Thank you for the question. The best advice iI can give is for you to follow up with your plastic surgeon. It would not be in your best interest to give advice online without proper knowledge of your history and direct examination of the breasts.

Q: Exchange of implants from saline to silicone; is the surgery complicated?

A: Thank you for the question. Exchange of implants is a relatively straightforward procedure. If you have had the saline implants for 18 years and you have some capsular contracture, or require and additional procedure to improve the implant pocket then the procedure is more complicated. Complicated procedures is best done by a plastic surgeon who has experience in revision breast surgery. You have to determine your hopes and desires and address it clearly with your plastic surgeon. Best wishes.

Q: Breast asymmetry after revision surgery; should I get a wider implant for the left breast and a smaller implant for the right?

A: Thank you for the question and photos. It is too early to do any surgery now. You need to wait about six months before deciding on doing anything. Most likely after the swelling subsides the shape and symmetry will improve. My advice for you is to relate your concerns with you plastic surgeon and follow all his/her instructions. Best wishes.

Q: Problems after second breast augmentation

A: Thank you for the question. I think you need to follow your surgeon’s advice. It is difficult and not advisable to give you an answer online. Your surgeon is in the best position to answer that question and advise you about the treatment. Best wishes.

Q: I see rippling and bottoming out two weeks after breast augmentation?

A: Thank you for the question and the pictures. You are only two weeks out from surgery and it is too early to determine the results. My advice for you is to communicate your concern with your plastic surgeon and take his/her advice. It is not uncommon for patients to be concerned the first few weeks after surgery and that period right after surgery can be emotionally challenging. Waiting for six months is a good advice. Best wishes

Q: Are my implants bottoming out

A: Thank you for the question and the photos. The pictures do show bottoming out. However, not sure what you are concerned about. If you want the bottoming out corrected, then this can be done with internal sutures ( capsulloraphy). The same size implants or smaller implant can be used. You need to discuss your concerns with your plastic surgeon. Best wishes.

Q: Change of implants form D/DD to C cup, can it be done in one surgery; can I breast feed after augmentation?

A: Thank you for the questions. Lets answer your questions, 1- you can have it done in one surgery. 2- you can breast feed as long as you want. 3- it is best if you wait 6 months. Best wishes.

Q: Breast revision surgery for implants I had for ten years. I also some sagging? What are my options?

A: Thank you for the question. It would be difficult to give a good answer without seeing you. But, in general, there are different way to address your situation. If you want to go smaller, you may need a lift. The type of lift will depend on the amount of excess skin and the size of the implant.

My advice for you is to see a plastic surgeon who has experience in revision breast surgery. You may want to get more than one consultation. Check before and photos. And it is very important that your are clear about what you want and take pictures with you what you want to have. Best wishes.

Q: Will implant replacements bring back the look I had before having my baby?

A: Thank you for the question and the the photos. It is difficult to determine what procedure you need from the photo provided. What you need is in person consultation to determine what is best for you. In general, you could get a biggest implant to get a firmer breast, you can get silicone implant, you may lose the sensation in the other nipple especially if capsule tommy or lift is performed. As for recovery, it will depend on what procedure you get. And in general, exchange of implant recovery is usually easier than the initial surgery.

Q: Implant replacement after capsulectomy, is it required?

A: Thank you for the question and the photo. In general, it is recommended to change the implant if you are having capsulectomy. In many cases, however, the same implant can can be used if the implant is not defective and there is no deflation or sign of infection. It is best if you discuss that with your plastic surgeon and he/she can give you your option. Good luck

Q: Surgery time for implant exchange. Is it longer or shorter?

A: Thank you for your question. The surgery time depends on what is being done. If it was simply just taking one set out and putting another one in then the surgery time should be shorter than the initial one. If you need more done like capsulectomy, change of pocket, internal sutures then the surgery time is longer.

My advice for you is to address your questions with your plastic surgeon.

Q: PIP Implants keep dropping, why is that?

A: Thank you for the question. What you are describing is implant malposition. The right breast has lateral and inferior malposition. During the implant replacements surgery, capsulectomy may have been performed and that has affected the breast pocket.

My advice for you is to wait for 4-6 months and the reevaluate the breast. I also advise you to communicate your concerns with your plastic surgeon. Repair of the malposition is usually performed with internal suturing technique. Good luck.

Q: Asymmetry following implant revision, should anything different be done?

A: Thank you for the question and the photos. You are three weeks out from surgery and the shape and feel of both breast will change over the next three to six months. So my advice you now is wait, follow all the post operative instructions and address your concerns with your plastic surgeon.

Looking at the left photo, it does show bottoming out of the right breast implant. You have to wait few more months. Repair of bottoming out can be done with internal suture. Good luck.

Q: Size of breast implant, currently 36 B, is 500cc to 600cc too big for my frame?

A: Thank you for the question and the photos. The choice of implant for breast augmentation is a very important decision and should be determined carefully before surgery to avoid dissatisfaction. The choice implant depends on multiple factors, your breast measurements, skin elasticity, what you want etc. All this is determined during the consultation. It also helpful if you take photos with you and review before and after photos before the consultation. Good luck.

Q: Bottoming out left breast or simply just dropped before the right breast?

A: Thank you for the question and the photos. Your right breast has bottomed out. The good news is there is a way to fix it. You need to have internal sutures to repair the capsule inferiorly and correct the breast shape. I think you should wait for few more months and then have it repaired.

Q: Fold in areola and muscle distortion when flexing my arm?

A: Thank you for the question and the photos. You have animation deformity of the right breast. What happens is the capsule is attached the inferior edge of the muscle and to the areola, so every time the muscle moves it will pull on the areola creating a noticeable crease. So what are your option, messaging the breast may soften the scar and reduce the deformity. The most definitive answer is to transfer the implant from sub muscular to sub glandular position. This will eliminate this deformity.

Q: Beast message after revision surgery, when should I start doing it? 

A: Thank you for your question. I don’t think its too late, but your surgeon should be able to tell whether you need it or not.

Q: Fluid buildup in breast, what can I do to help it heal?

A: Thank you for your question. It is difficult to answer your question without examining you and get a more detailed history. You need to address your concerns with your plastic surgeon. Follow his/her instructions. Was the tissue removed sent for pathological evaluation?

Q: Mastopexy and breast reduction, can I go back to D cup from FF?

A: The answer to you question is yes. You can go smaller, but the there no exact correlation between the size of the implants and bra size. Each bra can measure differently depending on the manufacturer and bra shape. You have to communicate your objective to your plastic surgeon before surgery. See before and after photos of patients who went smaller.

Q: Increase implant size from 400cc pip under the muscle to 600cc under the muscle, will I see a difference?

A: Thank you for your question. It is good that you are replacing your PIP implants. As for the 600 cc implant , you will definitely see a difference. But you have to be convinced before surgery that this is the size you want.

Q: Nipple is low following drainage of hematoma, will it get higher?

A: Thank you for your question. It is too early to determine the outcome of right breast or both breast. It usually takes up to six months for the implants to settle and sometimes longer. You need to keep your follow up appointments with your plastic surgeon and follow all the post operative instruction.

Q: Rippling with silicone implants, I had them replaced four months ago and now I see rippling, will this go away?

A:Rippling can occur with both saline and silicone implants. You do not mention in your note whether the implant were placed above or below the muscle, how big the implants and the status of breast skin. You need to address your concerns with your plastic surgeon. Rippling in general is more common in patients who had their implants placed over the muscle and in patients with thin skin envelope. Although it is often quoted that silicone implants cause less rippling but, I have seen it in both.

Q: Third implant revision, i am looking to have higher cleavage and perkier breast?

A: Thank you for your question. Unfortunately without pictures and more importantly in person evaluation it would be difficult to answer your question. You need to see a board certified plastic surgeon who has interest in breast revision surgery, address your concerns and how you want your breasts to look and go from there.

Q: Infection and revision, will infection come back after my breast implant revision?

A: Thank you for your question. When it comes to breast implants and infection, you need to keep close follow up with your plastic surgeon. Follow his/her advice. Whether the infection will come back is a question of time. Giving you a prices answer her would be difficult and may not help your case.

Q: Implant exchange to 350 cc, I am looking for an expert.

A: There is no doubt that revision surgery is more complex and more demanding. It also carries its own risks, including asymmetry and internal suture failure. But, It can be done and in your situation, from the photos you provided, I think you will need internal suturing and possible revision of the mastopexy to remove the excess skin.

All this is no replacement to office consultation and examining the breast. I wish you all the best.

Q: Reducing implant pocket size and risks of surgery?

A: Generally speaking, revision surgery is more complex than primary augmentation. Not only the surgery is different but also the post operative recovery and instruction are different. The outcome of surgery depends on several factors; how you conveyed what you wanted to the surge , your expectations and the experience of the surgeon.A consultation with a board certified plastic surgeon and addressing all the above issues is important for satisfactory outcome.

Q: Implant exchange, I am looking for a second opinion?

A: When it comes to revision surgery on the breast, online consultation will not help you. There are several things to consider prior to determining what surgery is appropriate. My advice for you is to see a board certified plastic surgeon. During the consultation address your concerns and take photos with you. Rview the surgeons before and after photos then discuss the surgical plan. I hope this helps.

Q: Revision implant surgery for more cleavage, is it possible to make the implants closer together?

A:Thank you for your question and the photo. It would probably be inappropriate to give an answer in this forum without fully examining you. The final shape of the breast after implant placement depends on many factors. It is the interaction of breast snap, size, implant shape and size and your desires will determine the final outcome. For your best interest, I advise you see a board certified plastic surgeon for a consultation and a clear discussion of what you want and what can be achieved.

Q: Surgery for ruptured silicone implant, how do you treat extracapsular rupture and how is leaked silicone material removed?

A: Thank you for your question. Regarding your question on the incision site; the surgeon can use the same periareolar incision to do the explantation. Once the capsule is reached, it should be dissected out and sent for histopathology. Any residual silicone gel or granuloma can be excised and again sent for histopathology. The pocket is then irrigated with saline. A new implant can be placed. You will need a drain placed during surgery, since capsulectomy increase the risk of bleeding after surgery. I hope this is helpful.

Q: Exchange of implants and lift

A: Thank you for your question. Without examining you it is difficult to decide if going to 650-700cc gel implants would be appropriate. The decision depends on several factors; skin elasticity, degree of ptosis and hence type of lift and what can your breasts accommodate. It is vital that you convey what you want to have with your plastic surgeon, It is also very helpful if you take photo of what you expect.

Q: Causes of hard breast following revision surgery. I just had them revised two weeks ago.

A: Thank you for your question. it is still too early to judge the outcome of your revision. But, in general, following breast revision for capsular contractors, the breasts feel very soft and patients usually feel much better. There may be other causes of early hardening of the breast such a blood clot in the left breast.You may want to communicate your concerns with your plastic surgeon and get has advice. Good luck

Q: High riding implants, is there a revision surgery for this problem?

A: I think revision using a periareolar approach would be helpful. I agree with the other comments that the implants seems a bit too big for you. Having said that, lowering the fold along with capsulectomy will allow the implant to drop and you may be able to keep the same implants.

Breast Reduction

Q: Am I Able to Get Breast Reduction?

A: Thank you for the question. The candidate for breast reduction is a patient with large breast with daily physical ( shoulder, neck, back pain) and psychological affects. You are 13 years old and have no such symptoms.

Q: Should I get liposuction or Breast reduction surgery?

A: Generally speaking liposuction is used as an adjunct to breast reduction and not a replacement. Now there are cases of liposuction of the breast without reduction, but it is applied to a very limited situations. There are two problems with liposuction. The first is it is difficult to predict the results especially when large reduction is needed. The excess skin (envelop) may not retract. The second is the inability to send the removed aspirate for pathological examination.

Q: is there a way to make the areola look natural after breast reduction procedure?

A.Thank you for the question. Any time the skin is cut there will be a scar. Some patients heal with less scarring than other. The problem is it is hard to predict how good or bad the scar will be. The scar and shape of the areola is a trade off of the procedure. You will get the areola lifted,excess breast tissue remove and an improvement in shape. Best wishes

Q: What should I do the night before breast reduction surgery?

A: Thank you for the question. Each plastic surgeon has his/her instructions for preparation for surgery. My advice for you is to address these questions with you plastic surgeon. Best wishes.

Q: Breast reduction technique and nipple placement?

A: Thank you for the question. There are different breast reduction technique and I agree with you that some can result in bottoming out. As for the areola, it is usually reduced in size during surgery and lifted to a higher level. What you need to determine is what you want be after surgery. Cup size is not the most accurate way to describe the amount of breast tissue need to be removed. It is the close discussion between you and your plastic surgeon and checking the before and after photos will help you and your surgeon to determine how much tissue to remove. I wish you all the best.

Q: How to find a Plastic surgeon in Canada?

A: Thank you for the question and the photo. Selecting your surgeon is the first step toward having a satisfactory results. In Canada, you can search the Canadian Society for Plastic Surgeons to find a board certified surgeon. During you consultation you want to be very clear about your hopes and what you want to achieve. Check the surgeon’s before and after photos. Best wishes.

Q: how do you prevent infection after breast reduction procedure?

A: Thank you for the question. Generally speaking, the risk of infection after breast reduction is low. Like any surgical procedure, prepping the skin, giving antibiotics before surgery and after surgery, proper wound care should prevent infection. Selecting a board certified plastic surgeon for your procedure and having the surgery done in an accredited facility would ensure the appropriate care is provided. Best wishes.

Q: Before and after picture for breast reduction cases

A: Thank you for the question. No is the answer to your question. But, the reason for having before and after pictures is to help patients make a decision on the surgery and they become better informed about their procedure. Seeing where the scars are going to be, the different shapes of the breast etc. will allow a better understanding of the procedure to the patient. It is best if these photos are from the surgeon’s own photo gallery. And I do advise my patient to check the before and after gallery on my website.

Q: Pain pump and breast reduction

A: Thank you for the question. Generally speaking, pain pumps are not used for breast reduction. They can be used for breast augmentation. Following breast reduction surgery, the pain is usually controlled with tablets. You can find information on pain pump online or ask your plastic surgeon.

Q: How small should I go for a reduction surgery. I am 5’1, 118 Lbs and a size 32 G?

A:Thank you for the questions. Your questions can be addressed with a plastic surgery consultation. During the consultation, your hopes and desires and concerns are evaluated. The treatment options are given to you. That includes the type of breast reduction and the amount of breast tissue to be removed. The surgery, the outcome of surgery and complications are all addressed during the consultations. You should ask to see for before and after photos. It is also helpful if you take photos with you.

After the consultation, your surgeon will submit request to the insurance company. Best wishes.
Best wishes

Q: Insurance coverage for periareolar reduction

A:Thank you for the question. Although tuberous breast is described as a form of breast deformity it is usually not covered by insurance companies. Generally speaking, insurance companies will look for medical necessity to approve a procedure. This could be in the form of back problems, mobility problems, recurrent infections, or breathing difficulty. ” Emotionally crippling” is not one of their criteria.

Your surgeon can submit a request to your insurance company and see the outcome. If it is denied, they will advise you in writing for the denial reason.

Q: I am 41 years, 155# 4’11 34G/H, Hips 45″ waist 32; should I go D or C?

A: Thank you for the questions and the photos. Your questions are best addressed directly with your plastic surgeon before surgery. In general, the more breast tissue removed the smaller the cup size, and better outcome in terms of your back pain. The surgery has some tradeoffs. less tissue removed may maintain better body balance in terms of shape but you may continue to have back problems.

I think you have valid concerns and you need to address these concerns in detail with your plastic surgeon.

Q: What is a good estimate of my cup size after removing 500 gm?

A:Thank you for the question and the photos. Generally speaking, it is difficult to determine the exact cup size after breast reduction surgery. Your surgeon should be able to give you an idea based on how much breast tissue removed. It is also important to address with your surgeon your concerns before surgery.

Q: Benefits of breast reduction for a teen?

A:Thank you for the question. Your symptoms and concerns indicate that you would benefit from breast reduction. Your first step is to get a consultation with a board certified plastic surgeon. During the consultation your concerns and goals will be evaluated. Breast reduction will help in improving self esteem and improve your symptoms of shoulder, neck and back pain. The type of breast reduction, post operative outcome should be discussed in detail during your consultation. I wish you all the best.

Q: will my insurance cover breast reduction surgery?

I am 5’3″ 136 lbs, 34DD.A:Thank you for the question. Breast reduction is indicated in patients with symptoms similar to the ones you described and having breast hypertrophy. The decision is usually made after taking complete history and doing physical exam. Without examination, it would be difficult to give you an answer.

Q: Open wound after breast reduction

A: Thank you for the question. There is no one way to address your wounds. Your plastic surgeon is the best person to advise you about the treatment options. It is treated conservatively with dressing changes it will take 6-8 weeks to heal completely.

Q: 2nd appointment for breast reduction

A: Thank you for the question. The second consultation is an opportunity for you to address all the questions that you mentioned. You have to be very clear with your plastic surgeon about what you want to achieve. Also during that consultation, the surgeon will go over the surgery with you in more detail. Best wishes.

Q: Timing of breast reduction

A: Thank you for the question. Based on the information you provided. I think you are a good candidate for breast reduction surgery. The timing of surgery will depend on your symptoms. Having shoulder, neck or back pain!, self esteem usually improved after reduction. As for insurance coverage, your procedure has to be authorized by your insurance. You have to make sure that breast reduction is a procedure covered by your policy. Best wishes.

Q: Breast reduction from G cup to B cup, 18 years old, 5’3″ and 130 lbs. bra size 30G.

A: Thank you for the question. Breast reduction surgery will help you with all your symptoms both physical and will improve your self esteem. The question of what cup size you can get is usually addressed during a consultation. During the consultation your breast measurements and type of surgery will be determined and your plastic surgeon will determine how much breast tissue can be removed. Best wishes.

Q: Deep bruising after breast reduction, I am three weeks post surgery.

A: Thank you for the question and the photos. You do need to get in touch with your plastic surgery for in person exam. The pictures show bruising, but it os only with examination the possibility of hematoma ( blood clot) can be ruled out. Best wishes.

Q: Breast reduction for a 14 year old?

A: Thank you for the question. I think you need a consultation with a plastic surgeon to address your concerns. Breast hypertrophy can cause the symptoms you describe and the treatment is breast reduction. The surgery will have positive physical and psychological impact.

Q: Breast reduction and insurance

A: Thank you for the question. The insurance company should be able to answer your question. You should first check if the breast reduction procedure is a covered procedure under your policy. If it is then the next step is to see a plastic surgeon for a consultation and submit a request for authorization for surgery. I hope this helps.

Q: Breast reduction from DD to B

A: Thank you for the question and congratulation on your weight loss. I think you are a good candidate for breast reduction. There is, however, a difference between breast reduction surgery and tummy tuck. You could go down to full B/ small C. There is however, some correlation between the bra cup size and the actual breast size. Different bars will fit you differently based on shape of the bra and manufacturer.

You need to see a board certified plastic surgeon. Take to the consultation photos of what you want to look, check your plastic surgeon before and after photos and then make your decision. I wish you all the best

Q: Bra after breast reduction, what is is the best option?

A: Thank you for the question. Generally speaking, any sports bra that is comfortable to wear is good to use when you go back to work. There is nothing special here except they should not have any under wires. You can get the sports bra from any local store.

It is also helpful if you check with your plastic surgeon about his /her post operative recovery protocol. Best wishes.

Q: What would be the cup size after removing 628 gm from each side?

A: Thank you for the question. It is difficult to tell you exactly what will be your cups size for several reasons,; thou have to wait initially for all the swelling to subside. This may take 6 months and sometimes longer. the bar cup size is not an accurate reflection of the breast size. There are different bar manufacturers and different bra designs will fit you differently. Best wishes

Q: Smoking and breast reduction

A: Thank you for the question. Smoking does affect any surgery. Skin healing may be affected, there is a higher risk of wound complications and also it can increase the anesthetic complications. Passive smoking is also a risk to health and surgery. Therefore, smoking one cigaret is too many.

Ii usually advise my patient to stop smoking about 6 weeks before surgery and to refrain from smoking is.x weeks after. Best wishes.

Q: Amount of breast tissue removed and insurance payment

A: Thank you for the question. It is really hard to tell what the insurance company will do. They may pay the claim and sometimes they will deny it. Therefore, it is the experience of the surgeon that you and the insurance company are relying on when the procedure is approved. Good luck.

Q: insurance and breast reduction

A: Thank you for the question. I think you need address that question with your insurance company. Depending on your insurance, you also want to know if the surgeons your are consulting with are in network or not.

Q: Breast reduction without surgery

A: Thank you for the question and the photos. Your photos especially the lateral view show a good reduction and much smaller breast. Since you are only five months from surgery , there is a room for more swelling to go and a reduction in the size of the breast. As for the shoulder , neck and back pain it usually improves a lot after surgery but there be a small percentage of patients who will still have symptoms .

So my advice for you is to wait for another six to eight months and then re evaluate your surgery.

Q: Breast reduction and pregnancy

A: Thank you for the question and the photo. From the information you provided I think you are a good candidate for breast reduction. After delivery and breast feeding your breast will continue to change. You may want to wait for 6 months after pregnancy before considering surgery and longer if you plan to beast feed. This would give time for the breast to return to pure pregnancy size. I wish you all the best.

Q: Breast reduction for a 15 year old

A: I think she is a candidate for breast reduction surgery. Not only surgery will improve her pain, but also will improve her posture. The best avenue for her is the insurance route. She needs to see a board certified plastic surgeon for a consultation. After complete evaluation, her information is sent to the insurance company for authorization. If the surgery is approved then she can have it done.

Q: Breast reduction in Malaysia, what to expect and what is the recovery process?

A:Thank you for the question. You can check with your primary care doctor for a plastic surgeon in Malaysia. The exact pre and postoperative care depends on the type of reduction and your surgeon will explain all that to you. You are asking the right questions, but with out in person exam it would be difficult to give exact answers online. Good luck.

Q: Insurance coverage for breast reduction

A: Thank you for the question. This is a common question. If you have insurance and you are symptomatic; i.e. have neck, back and shoulder pain and you have documentation by your primary care physician, then I think you should try the insurance route. The plastic surgeon will submit all the information along with his examination findings. The insurance may approve the surgery or reject it. If the surgery was denied they will tell why it was denied.

If you decide to pay for it, then you have to find a board certified plastic surgeon, this can be from the American Society of Plastic Surgery directory. Get a consultation, look at before and after photos and determine what you want.

Q: Breast hypertrophy after reduction?

A: Thank you for your question. Generally speaking the two most common causes of breast hyperthyroid after reduction are weight gain and hormonal imbalance. I suggest you follow up with your plastic surgeon for evaluation.

Q: Breast size after reduction with removal of 500 cc from 36 H cup?

A: Thank you for the question. I think you are an excellent candidate for breast reduction. The breast size does not always correlate with the bra size. Hence it would be difficult to comment on breast size after reduction and removal of 500 gm. Your plastic surgeon can give a rough idea on how the breast shape will be. My advice for you is to get a consultation with a board certified plastic surgeon. Convey clearly what you want and check their before and after photos. Good luck.

Q: Breast reduction candidate? Can I go from G to C?

A: Thank you for the question. I think you are an excellent candidate for breast reduction. It is possible to go from G to C cup. But keep in mind that breast size does not always correlate with the bra size.

My advice for you is to get a consultation with a board certified plastic surgeon. Convey clearly what you want and check their before and after photos. Good luck.

Q: Infection after breast reduction

A: Thank you for the question. I think you need to contact your plastic surgeon for advice. Answering the question on this forum will not be the best approach for your situation. Good luck.

Q: Approach for breast reduction surgery

A: Thank you for the question. These are common questions when it comes to breast reduction surgery. If you have insurance and you are symptomatic; i.e. have neck, back and shoulder pain and you have documentation by your primary care physician, then I think you should try the insurance route. The plastic surgeon will submit all the information along with his examination findings. The insurance may approve the surgery or reject it. If the surgery was denied they will tell why it was denied.

If you decide to pay for it, then you have to find a board certified plastic surgeon, this can be from the American Society of Plastic Surgery directory. Get a consultation, look at before and after photos and determine what you want. I hope that helps you.

Q: Weight loss and breast shape; will it sag?

A: The breast is very changeable organ. It changes with weight, in pregnancy and lactation, and with the effect of time and gravity. There is no double that losing 25 lbs will affect the breast shape. But will it sag significantly, I think you will know after losing the weight. It is really good that you are losing weight and trying to achieve a healthy life style. Congratulations on your effort.

Q: Complication of breast reduction and congenital heart disease

A: Thank you for the question. Generally speaking, when a patient has a medical condition and requires breast reduction surgery, the procedure is coordinated between the plastic surgeon, and your cardiologist. All the risks of surgery must be address and explained to you in detail. After that you and your family will have to decide if is worth it taking the risk. I wish you all the best.

Q: Suture too tight to remove

A: Thank you for the question. Is is unlikely that the suture can cause damage. but sometimes they can be the source of infection. Not sure why you have not seen your plastic surgeon about that.

Q: Itching under left nipple area 15 years after breast reduction. I have also lost nipple sensation in the left side after the surgery.

A:Thank you your question. I would be difficult to give you a precise answer without complete history and examination. I suggest you see your primary care physician or a plastic surgery to address that particular issue. Good luck

Q: Questions post breast reduction, 3 weeks post op, 32HH to 32 DD?

A: Thank you for your question. It is too early to determine the outcome of your sugary. It takes four to six months before the swelling subsides and the breasts take their final shape. As for sensation, again it is too early to determine if this is permanent. I advise you you address your concerns with your plastic surgeon and keep your appointments. Also follow all the post operative instruction.

Q: Breast reduction for breast pain, 5’2 130 lbs, 36 DDD?

A: Thank you for the question and the photos. Breast reduction is a very rewarding procedure. When its done for neck and back pain it will improve your symptoms and reduce or eliminate the pain.

As for breast pain; it would difficult to say if the surgery will reduce that pain since some breast tissue will remain.
My advice for you is to contact a board certified plastic surgeon and get consultation.

Q: Candidate for breast reduction?

A: Thank you for the question and the photos. I think you are a good candidate for reduction based on the information you provided. Breast reduction is a very rewarding procedure and does reduce or eliminate neck pain.

There are different ways to do breast reduction, vertical scar (Lollipop) reduction may be suitable for you and that will eliminate the need for the inframammary scar.

Q: Breast reduction pain and Unevenness after 2 months of breast reduction

A: Thank you for the question. After breast surgery it may take up six months before the swelling subsided and some times longer. So the unevenness you may want to wait longer. As for the pain, my advice for you is to address it with your plastic surgeon.

Q: Vitamine E Vs Mederma for post op scars?

A: This is a very common question and usually it is your surgeon who will recommend the best scar treatment for you. I recommend scar guard for my patients. It has Vitamin E, steroid an silicone. It is applied once daily. good luck

Q: Treatment of open wound after breast reduction?

A: Wound breakdown after breast reduction is not uncommon and usually heals well. Most of these wounds heal within 3-6 weeks. However, it is your surgeon who will direct the treatment of this wound. You need to address your concurs with him/her and follow all the instructions. As for the lumps, most likely they are fat necrosis and they usually disappear.

Q: Black nipple after breast reduction should I be concerned?

A: Yes you should be concerned. You need to see your plastic surgeon to examine the breast and determine the cause of discoloration.

Q: Breast discoloration 34 years after reduction

A: Thank you for the question. It would be difficult to give you an answer without in person consultation. It is very unusual complaints and not sure if it could be related to your beast reduction. My advice for you is to see a plastic surgeon in your area.

Q: I have a saggy breast from weight loss, is reduction possible?

A: Congratulation on the wight loss. It is possible to go down much smaller after reduction from F/G cup. You have to know that the breast size does not always match the cups size. There are different bra manufacturers and shapes and they cup size fit differently for each person. You have to address your desire with your plastic surgeon. Check before and after photos.

Q: Amount of tissue to remove in breast reduction?

A: Thank you for the question. It would be difficult to give a good answer online. The right way to address this situation is to communicate your concerns with your plastic surgeon. Show picture of what you want your daughter to be. Check his/her before and after photos. Get a third consultation if you are still concerned. Then decide.

Q: will my breasts shrink after reduction surgery?

A: Thank for the question. The swelling after breast reduction will be more pronounced in the first 3-4 weeks and then it will start yo go down. It usually takes up to 6 months for the swelling to resolve. What you have now is a swollen breast and that most likely will get smaller. What you want to do is address your concern with your plastic surgeon, be patient over the next few months. Follow all your post operative instructions and keep you appointments with your plastic surgeon.

Q: I have an Open wound after breast reduction

A: Thank you for your question. Wound healing problems are not uncommon after breast reduction. Most commonly the occur at the T junction( below the nipple close to the fold). This could be due reaction to tape or suture exposure. All these wounds will heal and the scar is usually very good. You do however, ned to address this issue with your plastic surgeon and he/she will tell you how to deal with it.

Q: I had breast reduction about 10 days ago and they are uneven, hard and painful.

A: One breast is larger, more painful and feel as it will explode; all are signs of internal beed. Contact your plastic surgeon.

Q: Sit-ups after breast reduction and lift?

A: Thank you for your question. This question is best addressed with your surgeon. He/she usually have their own criteria for post operative care including starting sit-ups based on your surgery and recovery.

Q: Breast reduction after breast feeding, when can I get it?

A: I think you are a good candid for breast reduction surgery, but you have to time it right. Since you are breast feeding now, I would not advise you to get it. You will have to wait at least three months after you stop breast feeding before considering surgery. This will allow time for all the changes to the breast from pregnancy and lactation to go back to prepregnancy state.

Q: Breast reduction questions

A: You are a candidate for breast reduction. From your description, the surgery will help you a lot. Sp what is breast reduction; breast reduction removes excess breast fat, glandular tissue and skin to achieve a breast size in proportion with your body and to alleviate the discomfort associated with overly large breasts. Breast reduction surgery reduces the amount of skin, fat, and tissue in the breast, producing a more proportionate breast, and increasing feelings of self-confidence.
Breast reduction surgery is performed using an anchor-shaped incision made around the areola, along the natural crease under the breast, and vertically in between. After the incision is made, the surgeon, removes excess fat, tissue, and skin from the lower breast area. Next, the nipple and areola are moved to a higher and more natural position. The remaining skin is tightened and sutured in its new place, resulting in a more proportionately sized and pleasingly shaped breast. The entire process takes a few hours and can be combined with breast lift surgery for better results.

Q: Treatment of keloid scars after breast reduction?

A: Thank you for your question. There is a difference between keloid and hypertrophic scarring. But going back to your question; I would advise to follow what your plastic surgeon recommends. There is always a chance of recurrence even with multi modality therapy.

Q: How to reduce swelling after breast reduction?

A: Thank you for your question. It takes several months for the swelling to go down. In your case where you had two hematomas on the right side; this will even take longer for the swelling to subside. You do not mention in your question whether these hematomas were evacuated.

Q: Breast reduction post op question

A: It seems to me you’r doing fine. That spot on the areola most likely will get better over time. It takes about 2-3 weeks for the bruising to subside and up to six months for the swelling to go down and the breasts to settle.

Q: Breast reduction and breast size, would the removal of 500 cc leave me with nothing?

A: From the photos you provided, I agree with your plastic surgeon that removing 500 cc would leave with very little breast tissue. What you need is a breast lift. The lift differs from reduction. In breast lift the nipple and areola are reposition in higher position without taking too much breast tissue. Even with a lift your breast will be smaller than now, but not as much as removing 500 cc. You also have preaxillary fat and you may benefit from liposuction of the fat pad.

Q: Breast reduction and dietary supplements

A: Thats is a good question and it is good that are akin about dietary supplants before surgery. You need address this particular question to your plastic surgeon. You have to know how long before surgery you should stop the supplements and when to start afterward. The question of the exercise should also be discussed with your surgeon before surgery. Good luck

Q: Breast shape after reduction surgery, does it improve with time?

A: Thank you for your question. Breast shape varies significantly between women. Even in the same person the shape and size varies. If you are having a bilateral breast reduction, you need to communicate your expectations to your plastic surgeon before surgery. There are different types of breast reduction surgery. You need to see before and after photos patient who have similar or close breast shape and body frame to you.

Q: Diastasis recti after implants 620 cc and lift. How did I get it?

A: Thank you for your question. Without photos and physical examination it is difficult to give an answer to your question. You had multiple procedures done to the breasts and whether your current complaint is related to your surgery or not is difficult to tell. You need to communicate with your plastic surgeon who the above procedure for advice and treatment.

Q: I still have swelling six months following breast reduction, will it go away?

A:Thank you for your question. There is still a room for the swelling to go down in the next few months. but I think you had still have beast hypertrophy despite your surgery. You have to give it more time to settle. The swelling does take longer to settle when there is a complication such as infection or hematoma.

Q: Can the breast increase to larger size overtime after breast reduction?

A:The breast can increase in size following breast reduction. Causes, weight gain, pregnancy and lactation, and when reduction is performed at a young age when the breast are not matured. On the anther hand the great could get smaller with weight reduction, post menopause.

Q: Breast reduction and smoking?

A: What matters most at this point is you address this particular question with your plastic surgeon. Hoping that someone would say it will be fine, in this forum is not the right approach.

Rhinoplasty Q&A

Q: Do I need to have a Perfect Nose?

A: Thank you for the question. Your point is valid. The surgery can be tailored to what you want provided it can be achieved. You have set your goal and that is very important when it come to patient satisfaction. During your consultation, the plastic surgeon should give you all your options, but it does not mean you have change every aspect of the nose. Clear goals and achievable results will make assure your satisfaction.

Q: How to correct polly beak deformity?

A: Thank you for the question. The first step is to search for the aplastic surgeon in your area. The American Society of Plastic Surgery is a good starting point. After reviewing several websites, get a consultations. During the consultation, your goals, hopes and objectives should addressed and a treatment plan is formulated. The cost of nasal surgery depends on what is being done and  your location. Best wishes.

Q: Possible nasal tip refinement and chin implant? Am I a good candidate for that procedure?

A: Thank you for the question and the photo. It would not be in your best interest to comment on your case without in person exam and full set of photos. On line consultation, especially for a delicate situation like your can be misleading. My advice for you is to get a consult with a board certified plastic surgeon in your area hat has interest in facial surgery. A note on chin implants; although it is considered a straight forward/ simple procedure it can have several drawback if not done properly. Best wishes.

Q: Nose job 1 month ago, Concerned about the height and the tip shape?

A: Thank you for the question. It is too early to determine the outcome of your nose surgery. It usually takes 8-10 months before the swelling subsides completely. Over the nest few months with will notice changes to your nose as the swelling starts to go down. During that time you need to keep close contact with your plastic surgeon and address all your concerns directly with him/ her. Best wishes

Q: What changes I need to make on my nose?

A: Thank you for the question and the photos. The hump at the bridge of the nose, the tip rotation and the tip itself needs to be addressed. Now, thats from looking at your photos and reading your note. However, this is not a formal consultation. Ultimately, you need be seen in  a consultation, the face and nose are evaluated. Your hopes and desires are addressed and you see before and after photos. It would also be helpful if you could take pictures of your desired looks with you to the consultation. Best wishes.

Q: Revision nose surgery, is it safe?

A: Thank you for the question. It is safe to have a revision nose surgery. The nose can be straightened to the center again. In your case is has been several years since your first surgery and now the scar tissue and swelling from the surgery has subsided. You need to have your nose evaluated and the appropriate procedure planned.  Best wishes

Q: Can you fix my crooked nose?

A: Thank you for the question and the photos. You will benefit from septorhinoplasty. This would correct the septal and boney deformity. I agree with you, your profile view looks good and not be changed.

You need to consult with a board certified plastic surgeon to address your concerns. Be very clear about your goals and hopes. Take pictures with you of what you hope to look and check your surgeons before and after photo gallery. Best wishes.

Q: Do I need rhinoplasty?

A: The decision to have a rhinoplasty. Is primarily yours. You need to identify what you are concerned about and determine your goal and then ask if it could be done. Rhinoplasty is a procedure  that encompass several techniques and is tailored to each patients needs. If the patient can not determine what they need, they shouldn’t get a  rhinoplasty. Best wishes

Q: nose shape after nose implant removal

A: Thank you for the question. I think you need to discuss your concerns with your plastic surgeon. I wouldn’t be in your best interest if you are give an answer online without proper examination. You are only 20 days out from surgery and your plastic surgeon should be able to answer that question.Best wishes.

Q: Altered Photos for rhinoplasty consult.

A: Thank you for the question and the photos. Yes it is helpful to bring those photos to your consultation. It will the plastic surgeon an idea of what you expect and what can be achieved. Good luck

Q: Fillers after rhinoplasty to correct nose?

A: Thank you for the question and the photos. The photos are not clear to the exact deformity. But, generally speaking, there is a role for fillers in nasal deformity. It should be applied after the swelling from surgery has resolved. I am not sure if botox can correct nasal deformity.

Q: Correction of nasal rotation with rib graft

A: Thank you for the question and the photos. Although the photo is limited but, what your plastic surgeon described is appropriate. The question is, is the results will match the photo you presented. It is good that you brought it up, but you have to have realistic expectations.

Q: Anxiety 14 weeks post rhinoplasty

A: Thank you for the question. There is no reason why you can’t use these skin products on your nose. You should be able to wear glasses. It is also advisable that you run these questions by your plastic surgeon.

Q: Nose implant to raise bridge, am I a candidate for that procedure?

A: Thank you for the question and the photos. It is difficult to address your question without better photos and more important, in person exam. To answer your question about implant for nose bridge; the best way to elevate the bridge is with your own cartilage. It gives better results and the complications are lower.

Q: Surgical procedure to get a Shorter nose?

A: Thank you for your question and the photos. Your frontal view photos are limited. To get a shorter nose and a softer look, you need dorsal (bridge) reduction. This would rotate the tip upward and give you a shorter and smaller nose. The actual tip from the photos looks fine. The boney sidewall is difficult to evaluate. In person consultation is the best way to address your concerns and plan surgical treatment.

Q: Advice about nose shape and surgery

A: Thank you for the question and photos. Generally speaking when it comes to nose evaluation and surgery you have to be seen in person. You also want to be more clear and specific about your concerns. I advise to see a board certified plastic surgeon in your area.

Q: Crooked columella after rhinoplasty and nasal deviation to one side?

A: Thank you for the question. It is too early to determine the shape and the results of your surgery since you are only two weeks out. It takes months for the swelling to subside. During that period you will see some asymmetry. My advice for you is to address your concern with your plastic surgeon and follow all the post operative instruction and keep your appointments.

Q: Bump on one side of nose, will it go away?

A: Thank you for the question. The bump on the left side could be due swelling and scarring. You are still five months out from surgery and my advice for you is to wait for another 5-6 months. I also advice you communicate your concerns with your plastic surgeon and keep your appointment.

Q: Exercise after tip platy, is it safe two weeks after rhinoplasty?

A: Thank you for the question. In general you need about three to four week weeks before you can start light exercise such as cardio on a treadmill and 6 week before any contact sports. But, still contact your plastic surgeon.

Q: Defined expectation for rhinoplasty

A: Thank you for your question. It is really good that you bring up a photo of what you wish to look. It would be more useful for you if you could see a plastic surgeon for in person consultation. Your nose and facial features can be evaluated and the appropriate surgery is determined. The photo you brought shows us your goals and this is a good first step in rhinoplastic surgery.

Q: Thinner bridge with changing the tip, is it possible?

A: Thank you for the question. It is possible to do surgery on the nose bridge without changing the tip. Having said that, you need to have in person consultation with a board certified plastic surgeon. Keep in mind that revision surgery on the nose is more complex than primary rhinoplasty.

Q: Kenalog shots post rhinoplasty

A: Thank you for your question. It would be difficult to answer your question without seeing you in person or seeing photos. You need to address your concern with your plastic surgeon.

Q: Questions about rhinoplasty, my nose is too small and the nostrils are big after rhinoplasty. will this improve?

A: Thank you for your questions and the photos. I will joint the other surgeons in this forum and say you should wait. Your results so far are good. It is important also to address your concerns to your plastic surgeon.

Q: Post rhinoplasty head trauma

A: Thank you your question. From your description, it is unlikely that your nose was involved in the injury. Usually patients can tell if something happened to the nose. Pay your plastic surgeon a visit and take his/her advice.

Q: Care credit and surgery payments, is it worth it?

A: Thank you for your question. Care Credit is a financing company. Once your application is approved you can have the surgery and then make monthly payment. It is good if you do not want to pay for the entire surgery in one payment. They have different plan options and interest rated. You should pick the plan that fits your budget/monthly payment. The decision to go with financing or not is entirely a personal one.

Q: Tip asymmetry following rhinoplasty

A: Thank you for your questions. As the swelling started to go down you will notice some asymmetry a the tip. This can be corrected with a revision procedure; but you will have to wait for another 6-8 months to allow all the swelling and the scar tissue to settle before contemplating the next step.

Q: Removing tip graft and columella strut after rhinoplasty?

A: Thank you for your question. You are only 5 months out from surgery and I advise you to wait for another six to eight months before doing anything. The nose will continue to s=change over a period of one year and even longer. During that time the scars will settle and the swelling will decrease. After that it would appropriate to determine if removal of the cartilage graft is appropriate and would improve the shape of the nose.

Q: How long for the swelling to go down after rhinoplasty?

A: Thank you for your question. Usually it takes months for the swelling to go down and up to a year. During that time your nose will continue to change. So I would advise you wait and convey your questions to your plastic surgeon. He/ she will want you to have the results you want.

Q: Kenalog injections following rhinoplasty?

A: In general kenalog can cause fat atrophy, skin atrophy and discoloration at the injection site. The question for you is why was kenalog injected after rhinoplasty?.

Q: Nasal deviation one year after rhinoplasty?

A: Thank you for your questions and the pictures. I agree with you there is some deviation. But overall outcome from the photos you provided looks good. If you still want to correct the deformity, you will need cartilage grafts placed along the septum. For more accurate diagnosis of the deformity clinical exam is needed.

Q: Rhinoplasty swelling, when will it resolve?

A: Thank you for your questions. The best answer would be to wait until a year has passed after surgery. This will allow for the swelling and scarring to resolve before you consider your next surgery. I agree with you there is a dorsal hump that may require revision.

Q: Nasal change from glasses

A: Thank you for your question and the picture. It is hard to imagine that wearing glasses can deform the nasal bone ever if they were heavier than the previous ones. What might have happened is skin change ( thinner)f from the heavier glasses.  You could go back to your previous glasses and see if the boney edges go away.

Q: Tip rhinoplasty for bulbous tip?

A: Thank you for your question and the pictures. Many patient when they request rhinoplasty they are concerned about one  or two problems with their nose. But, after full nasal examination by a plastic surgeon, you may fine that you need more than tip rhinoplasty to achieve harmony in your nasal appearance. I suggest you consult with a board certified plastic surgeon who has interest in rhinoplasty. Good luck.

Q: Treatment of dorsal hump with just rasping?

A: It would be difficult to give you an exact answer with examination and photos. In general, with a small hump removal can be done with rasping and that may all you need. In a larger hump, open roof deformity will happen and will need bilateral osteotomy and possible spreader grafts. It so only with proper examination the appropriate procedure is determined.

Q: What should I do to my nose?

A: It is good that you can identify your problems in such a detail. The answer to your questions is yes. All is possible in one surgery and you may to have the nasal bones broken if you develop what is called open roof during surgery. Good luck

Q: Nose surgery and Breast augmentation?

A: The two procedures can be combined. Regarding the specifics of each procedure, you need to consult with your plastic surgeon.  Address all your concerns with him/her. Check before and after photos for both procedures. It is also helpful if you take photos with of people who you want your nose , breast to look like. As for the cost, it varies for each region and surgeon.

Q: Treatment of crooked nose

A: The photo you provided does not help, but your description is good. It appears to me that you have two problems, a functional problem which is you’re breathing and a cosmetic problem which a crooked nose. Both can be fixed. You need see a board certified plastic surgeon who can address this kind of cases.

Q: Treatment of alar asymmetry, flared uneven nostrils.

A: Thank you for your question, your right ala is slightly higher than the left. This may be related right alar retraction related to difference in shape and size of the lateral crura of lower lateral cartilage. Another cause is hanging columella that is more pronounced on the right than on the left side. You need to be seen by a board certified plastic surgeon with special interest in rhinoplasty surgery. Detailed history and exam will lead you to the correct answer to your question.

Q: question about reduction rhinoplasty with tip enhancement?

A: It is good that you have done some background search and you are asking the right questions. You need to see a board certified plastic surgeon with interest in rhinoplasty. See before and after results and the surgeon will tell you exactly what you need. You have the right approach to your surgery.

Q: Rhinoplasty Surgeon credentials

A: I agree with the comments made in this forum. Board certification in plastic/ facial plastic surgery. Lots of rhinoplasty experience and see their results. The before and after and ask for references from previous patients.

Q: how many revisions can one patient get?

A: When it comes to surgery, and a genera rule, one visit to the OR should be the rule. Therefore, choosing the right surgeon is important. Occasionally a second procedure is required when it comes to rhinoplasty.

Q: puffy nose one month after surgery

A: Nose swelling after rhinoplasty is the norm and takes longer than one month to resolve. You should however, see gradual improvement overtime. You need to communicate your concerns with your plastic surgeon.

Q: nose job with a 65 year old surgeon?

A: It is good that you searched your plastic surgeon very well. but, it is not age that matter; experience, results, testimonials from his patients and how you felt about the whole consultation.

Q: can I get sedation for my rhinoplasty or it has to be general anesthesia?

A: It really depends on multiple factors, what your surgeon, anesthesiologist are comfortable with and the trent in the facility. The type and duration of nose work is also a factor. So the the answer to your question is yes, it can be done either way, but it is your surgeon who wil decide what is appropriate.

Q: what do you suggest for nose refinement?

A: From your comments, It seems to me that you have a defined objectives for how you want your nose to look. In order to get the right answer and the right surgery, you need to be evaluated by a plastic surgeon. Sending photos does help here in this forum, but the ultimately you to see a plastic surgeon.

Q: The healing of stair step incision

A: Usually the incision heal well and the scar is not visible. This may take two – three months to achieve. Using Medarma, scar-guard or other scar products may help. You are only three weeks out and your concern is valid. But, give it more time and you will see a significant improvement. If this is your only concern after rhinoplasty then I think you had a good surgery.

Q: I am nine days out of my surgery and my nose looks very long?

A: It is too early to judge the results of rhinoplasty. I suggest you discuss your concerns with your surgeon. Your nose is still swollen and swelling is usually more and takes longer to resolve after open rhinoplasty.

Q: Nasal Injury and how to fix it?

A: The description you provided gives the impression of nasal septal injury and consequent nasal deformity, Looking at your before and after picture, it is difficult to determine the degree of nasal deformity.  I suggest you get a consultation with a board certified plastic surgeon.

Q: My nose is too big and masculine looking for my face?

A: Your nose does appear in some disproportion to your facial features making it a focal point. From the photos you provided your eyes, lips, chin and checks are in proportion to your face. Regarding your nose, the tip is slightly wide and under rotated. It is difficult to see the bridge clearly from those photos, but I do not see a significant hump. I suggest you see a board certified plastic surgeon to evaluate your nose and provide you with the appropriate surgery.

Q: Rhinoplasty for asymmetric nose in Asian?

A: My preference for nasal bridge elevation is diced cartilage wrapped in fascia. It is your own tissue and can be moulded easily even one week after surgery and there is minimal risk if infection, displacement or the need for revision surgery. As for your nasal deviation, I think you need to be seen by a plastic surgeon to address that particular issue and correct it at the time of surgery. Good luck.

Q: Rhinoplasty at age 16, is it too young?

A: Your age and your concerns are appropriate. I suggest you see your  local plastic surgeon and discuss your concerns. Good luck

Q: Rhinoplasty and crohn’s disease

A: There is no doubt that being on immunosuppressive therapy and having another surgery may increase the risk of surgical complication. Your plastic surgeon should be able to coordinate with your gastroentrologist to do what is best for you.  Patient  on Imuran can go through surgical procedures with no complication.

Q: Changes in upper lip after alar base reduction?

A: Alar base reduction results is decrease in horizontal width of the nose and has no effect upper lip length.

Q: I had rhinoplasty and I do not like my nose.

A: Yes it is possible to get a good rhinoplasty in a situation like yours. The surgery is called septorhinoplasty which is a combination of septal remodeling and correction of bony pyramid deformity. You may require cartilage grafts that is harvested from the septum, ears or rib cartilage. This would address the shape of the nose and should also address the breathing problem if you have it

Q: Is it safe to have nose job in India?

A: You are taking to much effort for a procedure that is widely done in the US. If money is the issue, choose a closer country with a good health care and you can travel back and forth if needed!.

Q: Can septoplasty complicate rhinoplasty?

A: It is very unusual that a prior septoplasty performed to correct breathing problem to affect the outcome of a rhinoplasty. Having said that, the cause of your breathing problem must be addressed prior and during the rhinoplasty. You may have internal valve weakness that is causing the breathing problem. This can be corrected by spreader grafts placed at the time of rhinoplasty. You have to look at rhinoplasty as a combination of a aesthetic procedure and a functional procedure ( breathing). If both are addressed the chances of having post operative problems is very limited. Good luck

Q: Hanging columella can be corrected?

A: You can attach the cartilage of the columella to the membranous septum and that may correct the problem. It is a surgical procedure. My question to you is have you had a nose job done before and if not is there another thing you are concerned about with you nose. I think you need to see a plastic surgeon for a consultation so that a full evaluation of you nose and face can be done and the appropriate procedure performed.

Q: Will septoplasty correct external nasal deformity?

A: Septoplasty and turbinate surgery is performed to correct breathing problem. I am unaware that it can correct external nasal deformity. In general, to correct a nasal deformity a septorhinoplasty is needed. This can be done as a single procedure.

Q: Is revision always needed following rhinoplasty and septoplasty?

A: In general rhinoplasty revision rate is low at 10-15%. The results are long lasting. Some people do need touch ups. You need to understand that during the consultation. Also you need to ask your plastic surgeon about the cost if revision is needed.

Q: Which has the fastest healing time alar base reduction or rhinoplasty?

A: Alar base reduction can create a scar that may take long time to settle. Rhinoplasty is is reshaping the nose, in which alar base reduction can be part of. There is nothing to compare here. you may want to be more detailed about your concerns so you could get a more objective answer.

Q: Scar revision vs rhinoplasty, will my insurance cover the procedure?

A: Two completely different procedures. The first one is a reconstructive procedure and can be covered by insurance. On the other hand,  rhinoplasty is cosmetic procedure and is not covered by insurance.

Q: Do I need more than surgery for my nose?

A: Many rhinoplasty procedures that are performed include all what you described, dorsal hump reduction, tip reduction and changing the size of the nostril. It would be helpful if you discuss exactly what you are looking for in terms of shape with your plastic surgeon. It also helpful if you can show pictures of other people whom you like your nose to look alike.

The results of surgery depends on many factors including, but not limited to, type of your skin, size of the hump and whether you have breathing problems prior to surgery. Significant changes on the nose can give an operated look nose and you may have breathing problems. All these issues have to be addressed during your consultation so that you can be satisfied with the outcome.

Q: Rhinoplasty for short and wide nose?

A: The pictures you presented are good and you concerns can be addressed with open rhinoplasty. For the bridge; elevating it with a diced cartilage graft will not only improve the shape but will also improve the length. For the tip; a tipplasty with cartilage suturing techniques will improve the width and the height. As for the nasal tip depression during smiling; a release of the muscle the pulls the tip downward will correct this problem.  I hope this is helpful.

Scar revision Q&A

Q: Acar revision face for a nose and upper lip scar that is uneven?

A: Thank you for the question and the photo. Unfortunately it is difficult to evaluate your photo. But generally speaking, scars take more than two months to settle. You need to communicate your concerns with your plastic surgeon. But for now my advice for you is to wait for at 12- 18 months before doing anything. Best wishes.

Q: Ear piercing and keloids

A: Thank you for the question. Unfortunately, no one can tell if you would get another keloid or not, but, there is high likelihood that you will. You mentioned tattoo “and have no problems”. There is no mention on which area of the body. Generally speaking, keloid tend to have predilection to certain areas. The ear is one of them.

Q: Lip revision for a 10 year old

A: Thank you for the question. Generally speaking, since she has symptoms related to puffiness of the lip she can have revision surgery. She need a consultation with a plastic surgeon to evaluate her condition and get the appropriate procedure.

Q: Treatment of scar above the belly button

A: Thank you for the question and the photo. Scar revision is not a bad option in your case. Excising the scar as a vertical ellips and closing it will result in a longitudinal midline scar. The procedure can be done under local anesthesia in the office. Best wishes.Q: How Do I Remove An Old Indented Forehead Scar?

Q: Old scar on forehead, how to treat?

A: Thank you for the question. Unfortunately without photos it would be difficult to answer your question.I suggest you see a plastic surgeon or a dermatologist for a consultation.Update your answer

Q: Scar treatment on face from a necrotic wound?

A: Thank you for the question. There is really no hard answer. Non surgical treatments ranging from silicon sheets to laser may improve the scar. I think giving it more time would help. It usually takes up 18-20 months before scars settle. Surgical treatments are aimed at converting that scar from an oval irregular shape to a straight line along the fold.

Q: Do I have Keloid or hypertrophic scarring?

A:Thank you for the question and the photos. The photos are not clear in showing the lesion. Generally speaking, keloid scars tend to grow beyond the actual scar. Whereas hypertrophic scarring tend to stay within the scar boundary. The treatment is somewhat different and the outcome is also different. You need to see a plastic surgeon or dermatologist in your area to address this problem.

Q: How to treat keloid on my shoulder after scar removal?

A: Thank you for the question. Generally speaking, scars around joint don’t heel well due to joint mobility. Your scar is still 6 months post revision. I agree with the use of silicon pads. Steroid injections may help. but ultimately you will have to wait longer for the scar to stabilize. And anything after two years is likely to be permanent.

Q: Treatment of linear scar?

A:Thank you for your question. From plastic surgery perspective, you have a scar that runs across the nasolabial fold in the left commisure. One way to address the scar is to do Z platy and reorient the scar along the nasolabial fold. This would produce a more anatomically aligned scar.

Q: Scar revision around the knee and over the tibia and insurance coverage?

A: Thank you for the question, I would be difficult to say if scar revision would help without photos and more importantly seeing you in person. In general, scar removal or revision creates another scar. I suggest you get a consultation with a board certified plastic surgeon to address your concern.

Earlobe surgery Q&AQ: Cost of removal of Keloid on the earlobe?

A: Thank you for the question and the photo. Removal of the keloid include combination therapy; Surgery, steroid and possibly radiation therapy. Even with all that recurrence can happen. The recurrence rate is lowest with surgery and radiation therapy. The cost of surgery depends on your location. you need to see a board certified plastic surgeon to address your concern and get an estimate for the procedure. Best wishes.

Q: Earlobe asymmetry after surgery?

A: Thank you for the question and the photos. It is too early to determine the outcome of your surgery. You photos show you still have sutures in place; add to that some swelling it will definitely give you a distorted look. My advice for you is to give it two to three months before judging the outcome. Best wishes.

Q: Is there a tissue disorder causing the ear to rip out?

A: Thank you for the question. I would be helpful if you could give more information on the tissue disorder that is causing the problem. This would allow us to give a better and more definitive answer. In general, earlobe repair is an office procedure performed under local anesthesia. I wish you all the best.

Q: Swelling of earlobes seven days after ear reduction surgery, when will I see the final outcome?

A: Thank you for the question. Most likely you have swelling of the earlobe and this usually resolve by itself. The only concern here is that the swelling started a week after surgery and not sure if there is wound infection. I suggest you contact your plastic surgeon for advice.

Q: Cost of closing ear piercings

A: Thank you for the question. The average cost is $600-$1200. It depends whether its one side or both. The procedure is performed in the office under local anesthesia. The results are usually very good. Patient satisfaction is very high.

Q: Cost of ear lobe repair stretched with gauges at one inch?

A: Thank you for your question. The cost of surgery depends on the geographic location of the practice and experience of the surgeon. The procedure is done in the office and requires local anesthesia. The results are usually excellent. What you need to do is contact your local plastic surgeons, check their results and go with the one you feel comfortable with.

Q: Piercing a torn earlobe without repairing it?

A: Thank for the question. The answer is yes. you can pierce it above the torn part. This could be a problem in the future; you may not like the way it looks and be self conscious about it, or the second piercing may teat and you end up with one big tear or two small tears. Enough said.

Q: Uneven areolar diameter; how can I fix it?

A: Thank you for the question, areolar reduction can be performed to match the other side. You need a consultation with a plastic surgeon.

Q: Ear lobe stretching

A: Thank you for the question. It may go back since it is only partial injury to the earlobe and only happened the day before. By now four months after the incident, if the earlobe is still stretched, it can can be repaired. The repair is performed in the office under local anesthesia. The results are usually very satisfactory.

Q: Scar following earlobe reduction, how to minimize it?

A: Thank you for your question and the before and after photos. I think you have very good results from your surgery. The earlobe looks natural. The scar is minimal, some redness which is inline with the scar age. My advice is wait,the scar will improve over the next 6- 8 months and would not recommend scar revision.

Q: Cost of repairing earlobe

A: The cost depends on whether is one or both side and how much repairs needs to done. In my office it cost about $500-$900. The procedure is done in the office. Local anesthesia is usually used. The results are usually very dramatic and patient satisfaction is very high. No ear piercing for two months after the repair.

Q: Setting back earlobes for prominent earlobes?

A: Thank you for the question. Without photos and more importantly in person evaluation it would be difficult to answer your question. Otoplasty usually sets back the whole ear and is done through a incision at the back of the ear. You need to see a board certified plastic surgeon for evaluation of your ears and possible redo surgery.

Q: Cost of earlobe repair following stretching with size 5/8 Gauges?

A: The average cost is $600-$1200. It depends whether its one side or both. The procedure is performed in the office under local anesthesia. The results are usually very good. Patient satisfaction is very high.

Q: Recurrent inflammation following ear repiercing

A: Thank you for your question. What you describe is most likely an inclusion cyst within the earlobe that keeps getting infected. This may also explain the hardened substance inside the earlobe.

I suggest you see board certified plastic surgeon to address your concern. If there is a cyst, then it has to be excised to prevent further infection.

Q: Recurrence of keloid.

A: The keloid that you have is treated with mutimodality therapy. I usually perform surgical excision of the keloid within its margins (intralesional) followed by steroid injections. Most patients will require 2-3 injections six weeks apart. Compression therapy is also used There is still about 30-40% chance of recurrence.
If the keloid comes back again then you will need excision and radiation treatment. The recurrence following this treatment is lower.

Q: Cost to fix earlobe surgery

A: Thank for your question. The cost of surgery depends on the geographic location of the practice and experience of the surgeon. In general it cost $500-$1000 in my practice to fix it.

Q: Cost of earlobe repair

A: The cost of the procedure depends if it is one side or both and an the experience and location of the practice. You have to call an office and find out how much they charge. The procedure is done in the office under local anesthesia. In my practice the range is $500-1000.

Q: Curved up earlobe

A: There are procedures to correct earlobe deformity. You could place a picture or see a plastic surgeon for a consultation and possible in office correction.

Q: Uneven stretched earlobe.

A: Thank you for you questions and photos. From your description, your earlobe are so stretched and more likely going to split if you continue expanding them. Unfortunately there is no procedure to even them out. But, there is a procedure to correct split earlobe.

Q: Repair of stretched earlobe near Torrence, CA?

A: Thank you for your question, repair of stretched earlobe is usually done in the office and under local anesthesia. The results are usually excellent and patient satisfaction is high.

Q: Repair of split earlobe

A: The simple answer to your question is yes. It can be repaired. The repair can be done in office under local anesthesia. Stretching it even after few months from repair carries the risk of re rupture, however.

Q: Problem with earlobe

A: Thank you for your question. The photos you provided do not show the problem very clearly. You may have a keloid scar at the rim of the run of the earlobe. My advise would be to consult your local plastic surgeon.

Q: Surgery will bring it back to normal

A: This is a common question. The holes will shrink to a certain degree but never completely close. Surgery is your best option if you would like to have a closed hole. The procedure is an office procedure performed under local anesthesia. Good luck.

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