Debra J. Johnson, MD
Active Member
Debra J. Johnson, MD
Debra J. Johnson, MD, is an ASPS Member plastic surgeon who is board certified by The American Board of Plastic Surgery® and trained specifically in plastic surgery. ASPS members operate only in accredited medical facilities, adhere to a strict code of ethics and fulfill continuing medical education requirements in plastic surgery, including training in patient safety techniques. As your medical partner, Dr. Johnson is dedicated to working with you to achieve your goals.
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Meet Dr. Debra Johnson
Contact
Locations
Sacramento Office
77 Cadillac Drive, Suite 170
Sacramento,
CA
95825
Granite Bay Office
8723 Sierra College Blvd.
The Plastic Surgery Center
Granite Bay,
CA
95746
Languages
- English
- Spanish
Board Certifications
- American Board of Plastic Surgery
Memberships
- American Society of Plastic Surgeons
- American Association of Plastic Surgeons
- American Society of Aesthetic Plastic Surgeons
- California Society of Plastic Surgeons
- American Cleft Palate Association
Hospital Affiliations
- Sutter Community Medical Center
- Mercy General Hospital
More Links
Procedures Performed
Arm Lift
Body Contouring
Body Lift
Botulinum Toxin
Breast Augmentation
Breast Implant Removal
Breast Implant Removal
Breast Implant Revision
Breast Lift
Breast Reduction
Breast Reduction
Brow Lift
Buttock Lift with Augmentation
Chemical Peels, IPL, Fractional CO2 Laser Treatments
Chin Augmentation
Chin Surgery
Cleft Lip and Palate Repair
Cosmetic Surgery
Dermabrasion
Dermal Fillers
Deviated Septum Correction
Ear Surgery
Endoscopic Technique
Eyelid Ptosis Repair
Eyelid Surgery
Facelift
Gender Confirmation Surgery
Hair Transplant
Injectable Fillers
Laser Skin Resurfacing
Lip Augmentation / Enhancement
Liposuction
Male Breast Reduction
Microdermabrasion
Mommy Makeover
Neck Lift
Panniculectomy
Permanent Make-up
Retin-A Treatments
Rhinoplasty
Scar Revision
Skin Cancer Removal
Spider Vein Treatment
Thigh Lift
Tummy Tuck
Ask a Surgeon
Dr. Debra Johnson participates in the ASPS Ask A Surgeon service. View responses to public questions below.
Ejection fraction
Breast AugmentationMember Response:
With your heart history, most plastic surgeons would want a "clearance" from your cardiologist that you are safe to undergo another anesthetic. Usually you need to have a relatively recent EKG that is "normal". Or if abnormal, a stress test or echocardiogram. Your surgeon may ask you to obtain a clearance or have the anesthesiologist look at your EKG and EF and determine if elective surgery is safe for you.
Ejection fraction
Question:
I had a heart attack over 25 years ago. Had a CABG and have been stabile ever since. Had recent open mesh abdominal surgery under a general with no problems. My question is... Is there a minimum ejection fraction to be a candidate for a arm lift or a breast augmentation?
Debra J. Johnson, MD's Response:
With your heart history, most plastic surgeons would want a "clearance" from your cardiologist that you are safe to undergo another anesthetic. Usually you need to have a relatively recent EKG that is "normal". Or if abnormal, a stress test or echocardiogram. Your surgeon may ask you to obtain a clearance or have the anesthesiologist look at your EKG and EF and determine if elective surgery is safe for you.
Small breast augmentation for male
Breast AugmentationMember Response:
If you don't need much volume to make the contours more comfortable for you, one option might be to transfer fat into the breasts (if you have some fat elsewhere in your body that could be donated for transfer). A small breast or pectoral implant would also be a possibility but would carry risks of a tight scar, malposition, and implant failure. Use the Find-a -Surgeon link on this website to find an ASPS member near you. Not all plastic surgeons perform breast fat transfer, so you can ask over the phone before making an appointment. Good luck!
Small breast augmentation for male
Question:
Hi, I am a 36 yo male who had a gynecomastectomy in 2018 and heavily regret the procedure. I am generally mentally and emotionally healthy but the reasons for having the procedure were from a place that wasn’t healthy. I am considering getting a breast augmentation with small implants to return my body to as close to normal as possible. What are realistic possibilities with this?
Debra J. Johnson, MD's Response:
If you don't need much volume to make the contours more comfortable for you, one option might be to transfer fat into the breasts (if you have some fat elsewhere in your body that could be donated for transfer). A small breast or pectoral implant would also be a possibility but would carry risks of a tight scar, malposition, and implant failure. Use the Find-a -Surgeon link on this website to find an ASPS member near you. Not all plastic surgeons perform breast fat transfer, so you can ask over the phone before making an appointment. Good luck!
Breast Lift & Augmentation
Breast LiftMember Response:
For a 36 size bra, you're around 175-200cc/cup size. So 375 is around a 2 cup size increase. If you are a small C, then it might work, but if you're a full C, that volume may be a bit over the top.
Breast Lift & Augmentation
Question:
If I am currently a 36C and am getting a breast lift and augmentation and want to be a full 36D, is 375cc too much? I am 5’4 and weigh 139 lbs.
Debra J. Johnson, MD's Response:
For a 36 size bra, you're around 175-200cc/cup size. So 375 is around a 2 cup size increase. If you are a small C, then it might work, but if you're a full C, that volume may be a bit over the top.
Post Bariatric Body Contouring
Body ContouringMember Response:
You should call your insurance customer service line (usually listed on your insurance card). Tell them you've had weight loss surgery and now have symptoms due to your excess skin. Ask what their requirements are for coverage of post-bariatric surgery to see if you qualify. Ask for the names of plastic surgeons in your insurance network and whether you need a referral from your primary care doctor or not.
Post Bariatric Body Contouring
Question:
If I had WLS, do any providers submit to insurance to cover Post Bariatric Body Contouring surgery?
Debra J. Johnson, MD's Response:
You should call your insurance customer service line (usually listed on your insurance card). Tell them you've had weight loss surgery and now have symptoms due to your excess skin. Ask what their requirements are for coverage of post-bariatric surgery to see if you qualify. Ask for the names of plastic surgeons in your insurance network and whether you need a referral from your primary care doctor or not.
willing to do breast lift surgery but having concerns
Breast LiftMember Response:
A breast lift involves reducing the excess skin envelope of a drooping breast and repositioning the areola. It is impossible to reposition the areola without creating an incision around the areola. A permanent change in sensibility is a risk of this operation, but is relatively low. The vast majority of breast list patients have normal sensation within a few weeks of surgery.
willing to do breast lift surgery but having concerns
Question:
I am willing to have a breast lift surgery but I have two concerns first is regarding the sensations in the Areola area .. how likely am I to lose the sensations in that area after the surgery? Second one is regarding the technique of the Surgery itself.. Is there any way I can get the surgery without having a cut around the Areoula ? I mean I want to avoid cutting around the areola ?
Debra J. Johnson, MD's Response:
A breast lift involves reducing the excess skin envelope of a drooping breast and repositioning the areola. It is impossible to reposition the areola without creating an incision around the areola. A permanent change in sensibility is a risk of this operation, but is relatively low. The vast majority of breast list patients have normal sensation within a few weeks of surgery.
So much anxiety after breast implant removal, capsules left inside
Breast Implant RemovalMember Response:
Capsules form around foreign bodies. When the foreign bodies are removed, the capsules will slowly dissipate. Your risk of BIA-ALCL from your short exposure to Siltex implants is very low. You are more likely to be struck by lightning! Residual capsules can sometimes create pockets of fluid, so you should be on the look out for that and seek attention, but these fluid collections are most often benign. While your risk isn't zero, it's pretty darn close, so I would dial down the anxiety and just take appropriate care of yourself.
So much anxiety after breast implant removal, capsules left inside
Question:
Hey, im having anxiety and I will really appriciate your professional help. Ive had mentor siltex placed under the muscle, I had them removed after 6 months due to capsular contracture that also had a bit of fluid. My surgeon said I had 1&2 degree capsules and he DIDNT REMOVE THEM AT ALL. So Im left with the capsules inside my body now. Can you please tell me what are the risks & bia alcl wise too
Debra J. Johnson, MD's Response:
Capsules form around foreign bodies. When the foreign bodies are removed, the capsules will slowly dissipate. Your risk of BIA-ALCL from your short exposure to Siltex implants is very low. You are more likely to be struck by lightning! Residual capsules can sometimes create pockets of fluid, so you should be on the look out for that and seek attention, but these fluid collections are most often benign. While your risk isn't zero, it's pretty darn close, so I would dial down the anxiety and just take appropriate care of yourself.
What would you recommend to fix asymmetrical lips resulting from previous injury? (photos)
Cosmetic SurgeryMember Response:
It is difficult to know exactly what might work best for you without an examination in person, but options might be: the addition of filler or fat to the smaller side lip to make it as plump as the other side, surgical reduction of the larger side (depending on which side you like best), or if the lip is symmetrically full and doesn't need plumping you could consider tattooing the left side to create a more symmetric lip line. I would consult with a local ASPS plastic surgeon to determine your best options. Good luck!
What would you recommend to fix asymmetrical lips resulting from previous injury? (photos)
Question:
Hi, I have asymmetrical lips resulting from a dog attack when I was a child. My bottom lip had to be sewn back on on one side. Is there any procedure that can fix this? I'm open to anything cost-wise, but would obviously prefer a cheaper option given similar results.
Debra J. Johnson, MD's Response:
It is difficult to know exactly what might work best for you without an examination in person, but options might be: the addition of filler or fat to the smaller side lip to make it as plump as the other side, surgical reduction of the larger side (depending on which side you like best), or if the lip is symmetrically full and doesn't need plumping you could consider tattooing the left side to create a more symmetric lip line. I would consult with a local ASPS plastic surgeon to determine your best options. Good luck!
Explant, lift with tummy tuck safety
Breast Implant RemovalMember Response:
Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.
Explant, lift with tummy tuck safety
Question:
Hello, I would like to enbloc capsulectomy explant, lift and get a tummy tuck. I am 40 years old, pretty healthy..eat very healthy, no smoking, occasional glass of wine, work out..I am a smaller woman (116 lbs 5’3”)..I posted on an explant Facebook site about the surgery and they said a woman died when she combined those surgeries? I’ve been told it’s perfectly safe and I am healthy for it. ???
Debra J. Johnson, MD's Response:
Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.
Explant, lift with tummy tuck safety
Breast Implant RemovalMember Response:
Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.
Explant, lift with tummy tuck safety
Question:
Hello, I would like to enbloc capsulectomy explant, lift and get a tummy tuck. I am 40 years old, pretty healthy..eat very healthy, no smoking, occasional glass of wine, work out..I am a smaller woman (116 lbs 5’3”)..I posted on an explant Facebook site about the surgery and they said a woman died when she combined those surgeries? I’ve been told it’s perfectly safe and I am healthy for it. ???
Debra J. Johnson, MD's Response:
Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.
Can I get a reduction? Please help!
Breast ReductionMember Response:
Your BMI is 38.3, in the high obese range. This excess weight increases your risk of a postoperative complication, such as infection , wound healing delays, or reduced blood supply that can result in skin loss, nipple loss, or fat necrosis (scarring) within the breast tissue. The heavier you are, the more tissue has to be removed to satisfy insurance carriers that the reduction is necessary. At your current weight, many insurers would require removal of over 550 grams of tissue from each breast. Weight loss will reduce the size of your breast, so it is much better to lose weight before embarking on breast reduction. If you lose the weight after a reduction, your breasts will lose fatty volume, become smaller and saggier. Your current weight puts your overall health at risk, so I would encourage you to work to get your BMI below 30, which reduces your surgical risk and is healthier for your heart and back. Talk to your doctor about a medically supervised weight loss program.
Can I get a reduction? Please help!
Question:
I was wondering if I would be able to get a reduction if I’m over weight? I’m 5’2 and 209lbs. I have a DDD and they give me back pain which makes doing physical activity hard and i will also get a rash under and between my breast because they sag. Will I need to drop to a specific weight before I can get the surgery or can I go through with one to help alleviate my back pain to further exercise?
Debra J. Johnson, MD's Response:
Your BMI is 38.3, in the high obese range. This excess weight increases your risk of a postoperative complication, such as infection , wound healing delays, or reduced blood supply that can result in skin loss, nipple loss, or fat necrosis (scarring) within the breast tissue. The heavier you are, the more tissue has to be removed to satisfy insurance carriers that the reduction is necessary. At your current weight, many insurers would require removal of over 550 grams of tissue from each breast. Weight loss will reduce the size of your breast, so it is much better to lose weight before embarking on breast reduction. If you lose the weight after a reduction, your breasts will lose fatty volume, become smaller and saggier. Your current weight puts your overall health at risk, so I would encourage you to work to get your BMI below 30, which reduces your surgical risk and is healthier for your heart and back. Talk to your doctor about a medically supervised weight loss program.
Smoking
Breast ReductionMember Response:
It is never "safe" to smoke. My smoking father died a pulmonary cripple, and my smoking sister died at 60 from lung cancer. You've done something very nice for yourself in having your breast reduction. You should continue that trend by quitting smoking entirely. You've made it 6 weeks, you're over the hump! Keep up the good work!
Smoking
Question:
I had a breast reduction 6 weeks ago to the day. I know smoking is bad i am aware of the risks I have refrained from smoking for 6 weeks but am beyond ready to continue... is it safe now? My surgeon said I have healed very well.
Debra J. Johnson, MD's Response:
It is never "safe" to smoke. My smoking father died a pulmonary cripple, and my smoking sister died at 60 from lung cancer. You've done something very nice for yourself in having your breast reduction. You should continue that trend by quitting smoking entirely. You've made it 6 weeks, you're over the hump! Keep up the good work!
Can this be fixed.
Neck LiftMember Response:
Since it is now over 6 months since your surgery, the results should be fairly settled. If you haven't seen your surgeon since week 6, then I would returnto his office and the two of you can discuss your concerns. Perhaps a touch-up would be suggested. If you aren't satisfied with the results of the discussion with your surgeon, perhaps seeing another ASPS member surgeon for a second opinion would be helpful. Good luck.
Can this be fixed.
Question:
I had a neck lift on 1/2. Initial results were thrilling. But, I noticed a change in wk 4. I called wk 5, and was seen wk 6. I was told it was my 'anatomy' and I had to heal. I went again & expressed concern, told it was my anatomy. I went back b/c this is clearly a fail and was told there is nothing he can do. My skin was smooth and I never had these bands before surgery. Pics in second response.
Debra J. Johnson, MD's Response:
Since it is now over 6 months since your surgery, the results should be fairly settled. If you haven't seen your surgeon since week 6, then I would returnto his office and the two of you can discuss your concerns. Perhaps a touch-up would be suggested. If you aren't satisfied with the results of the discussion with your surgeon, perhaps seeing another ASPS member surgeon for a second opinion would be helpful. Good luck.
Nearly 1 & 1/2 yr post op, last check up prior covid. Will a local surgeon see me bc of this issue i
Breast Implant RevisionMember Response:
You really can't expect someone to see you for free. Would you call a plumber to unplug your toilet and expect not to pay? If you can't see the plastic surgeon who placed your implants (who should be open now, especially for complications!) then call more local plastic surgeons (use the Find-a-Surgeon tool on this website) and ask for an appointment. If you have health insurance, it should cover the cost of seeing a surgeon for this. You could have a seroma (lymph fluid) or a hematoma (blood) around the implant that would need to be drained and tested for infection and possibly breast implant associated lymphoma (if you have textured implants). This could be serious, so don't delay in getting checked out!
Nearly 1 & 1/2 yr post op, last check up prior covid. Will a local surgeon see me bc of this issue i
Question:
The issue is my right breast doubled in size one night both have no feel of implant from the top from rippling & sagging. Left breast not only is noticeably smaller but bc my appts keep getting postponed when I begged to even drive the hour and wait bc it’s bad bad. They’re hot to the touch always, spread out flat when I lay on my side, leftie won’t grow, just squeezed in the middle. I can’t pay
Debra J. Johnson, MD's Response:
You really can't expect someone to see you for free. Would you call a plumber to unplug your toilet and expect not to pay? If you can't see the plastic surgeon who placed your implants (who should be open now, especially for complications!) then call more local plastic surgeons (use the Find-a-Surgeon tool on this website) and ask for an appointment. If you have health insurance, it should cover the cost of seeing a surgeon for this. You could have a seroma (lymph fluid) or a hematoma (blood) around the implant that would need to be drained and tested for infection and possibly breast implant associated lymphoma (if you have textured implants). This could be serious, so don't delay in getting checked out!
Can I receive breast reduction surgery if I have arrhythmia?
Breast ReductionMember Response:
If that is your only medical issue, it would be unlikely to bar you from a breast reduction. If a current EKG shows no abnormality, and your primary care doctor feels you are healthy, you should be able to have surgery. I see you live nearby, so feel free to contact my office for a consultation!
Can I receive breast reduction surgery if I have arrhythmia?
Question:
I (39, F) was diagnosed w/premature ventricular contractions approx. 15 years ago. Cardiologist said it wasn't "the dangerous kind" (quoting him) & treatment was not considered medically necessary, but I opted to begin taking 25mg of Atenolol daily to keep my heartbeat steady. Works great! Would this arrhythmia and/or medication affect my ability to receive a breast reduction surgery?
Debra J. Johnson, MD's Response:
If that is your only medical issue, it would be unlikely to bar you from a breast reduction. If a current EKG shows no abnormality, and your primary care doctor feels you are healthy, you should be able to have surgery. I see you live nearby, so feel free to contact my office for a consultation!
breast reduction at the age of 16.
Breast ReductionMember Response:
Many young women are deserving of a breast reduction. You want to assure that you have stopped growing: height and shoe size haven't changed in the last year, you are at least two years from the date you started your period, and your bra size hasn't changed in a year. You need your parents' permission. Usually health insurance will cover breast reduction for women who are a DD or greater, and they often require a 2-3 cup size reduction to qualify. In younger women, you have to think about what will happen to your breasts in the years to come: most women lose breast volume with pregnancy and breastfeeding, breasts to change size depending on your weight (if you are overweight, you should try and lose weight into the normal range first), reduction may limit your ability to breastfeed. I don't want tol trade your self-consciousness about your large breasts for self-consciousness about having scars. If you understand, and want to proceed, find an ASPS surgeon near you!
breast reduction at the age of 16.
Question:
I just want to know if a 16 year old can have a breast reduction surgery? even if, her doctor said she stopped growing but said to wait until 18 because she’s not ‘’mature” enough and might regret it... even though, the girl has been waiting to get it done due to shoulder pains and sometime back pains.
Debra J. Johnson, MD's Response:
Many young women are deserving of a breast reduction. You want to assure that you have stopped growing: height and shoe size haven't changed in the last year, you are at least two years from the date you started your period, and your bra size hasn't changed in a year. You need your parents' permission. Usually health insurance will cover breast reduction for women who are a DD or greater, and they often require a 2-3 cup size reduction to qualify. In younger women, you have to think about what will happen to your breasts in the years to come: most women lose breast volume with pregnancy and breastfeeding, breasts to change size depending on your weight (if you are overweight, you should try and lose weight into the normal range first), reduction may limit your ability to breastfeed. I don't want tol trade your self-consciousness about your large breasts for self-consciousness about having scars. If you understand, and want to proceed, find an ASPS surgeon near you!
Gynecomastia
Male Breast ReductionMember Response:
It is not uncommon for young men to have a degree of gynecomastia. It usually resolves later in the teen years. But in some it persists and causes embarrassment, anxiety and difficulty camouflaging the excess fullness in clothing. If you have stopped growing (no increase in height or shoe size in the past year) then a plastic surgeon would consider surgery for you. There aren't any hormones or drugs that can diminish breast size that I know of. If your parents are supportive, I would suggest they take you to a plastic surgeon (you can find Israeli International members of ASPS by using the Find-A-Surgeon link on this website).
Gynecomastia
Question:
Hi, I’m 16 years old and I have had gynecomastia for about 3 and a half years and I’m embarrassed of my body and I went to a breast doctor and they said that I have to wait until I’m 18 and didn’t give me any treatments or advice on what to do and I was wondering if testosterone accelerator would reduce gynecomastia in any way?
Debra J. Johnson, MD's Response:
It is not uncommon for young men to have a degree of gynecomastia. It usually resolves later in the teen years. But in some it persists and causes embarrassment, anxiety and difficulty camouflaging the excess fullness in clothing. If you have stopped growing (no increase in height or shoe size in the past year) then a plastic surgeon would consider surgery for you. There aren't any hormones or drugs that can diminish breast size that I know of. If your parents are supportive, I would suggest they take you to a plastic surgeon (you can find Israeli International members of ASPS by using the Find-A-Surgeon link on this website).
Breast Reduction at 16
Breast ReductionMember Response:
Getting your weight into a healthy range is important for your overall health. You should try to improve your diet. Ask your doctor or your school nurse for help with a plan. Find out what your BMI is and work to get it below 30. This helps reduce your risk of complications after surgery. Your breast may also shrink with weight loss, since there is a fair amount of fat in the breasts. Age is another matter. Breast growth starts in younger girls but continues through the teen years often, so you may not yet be through developing. You want to be at least two years out from the age you started your period. In younger women, I worry about three things: you will have scars that may make you self-conscious, you might reduce your ability to breastfeed, and future pregnancy/breastfeeding may shrink your breasts to a size you think is too small. Operating on younger women is fine, as long as you understand the risks.
Breast Reduction at 16
Question:
i am a 40 H at 16 and it is getting very difficult for me now. i am overweight so i try to excerise but the back pain, neck and shoulder pain is too much and getting overwhelming. My doctor says i’m too young and i should lose weight first but the pain i’m going through is too great. what should i do?
Debra J. Johnson, MD's Response:
Getting your weight into a healthy range is important for your overall health. You should try to improve your diet. Ask your doctor or your school nurse for help with a plan. Find out what your BMI is and work to get it below 30. This helps reduce your risk of complications after surgery. Your breast may also shrink with weight loss, since there is a fair amount of fat in the breasts. Age is another matter. Breast growth starts in younger girls but continues through the teen years often, so you may not yet be through developing. You want to be at least two years out from the age you started your period. In younger women, I worry about three things: you will have scars that may make you self-conscious, you might reduce your ability to breastfeed, and future pregnancy/breastfeeding may shrink your breasts to a size you think is too small. Operating on younger women is fine, as long as you understand the risks.
Post-surgery regrets
Breast ReductionMember Response:
The post-surgical appearance of breasts changes as healing completes. Often the lower skin of the breast stretches out, which can tip up the nipples and make them appear higher. Scarring takes 12 months or so to mature, but will continue to face over time. If you are unhappy, I would return to your surgeon to express your concerns. There might be some revisional surgery that could improve the scarring and shape of the breasts. Best of luck.
Post-surgery regrets
Question:
Hello, I had surgery now 13 months ago and was initially thrilled with the results. I am now quite insecure about the scarring as it is much more than I expected and the nipples appear higher than I would have liked. My mother believes I did not wear supportive enough bras post surgery and this is the cause. Is there anything I can do now or is it a case of accepting what I have?
Debra J. Johnson, MD's Response:
The post-surgical appearance of breasts changes as healing completes. Often the lower skin of the breast stretches out, which can tip up the nipples and make them appear higher. Scarring takes 12 months or so to mature, but will continue to face over time. If you are unhappy, I would return to your surgeon to express your concerns. There might be some revisional surgery that could improve the scarring and shape of the breasts. Best of luck.
Saline implant deflation and wait several months?
Breast Implant RevisionMember Response:
Yes, that is a very reasonable plan. Deflating the implants makes them immediately smaller and the breast size more comfortable. You can then assess the size of your natural breasts and be better able to decide if you want to replace the implants and what size. Also the skin will have a chance to shrink a bit (kind of like after having a baby for the tummy skin) so you can decide if you need a breast lift and if so what scars you would end up with. I usually wait 3 months in between deflation and the surgery. Good luck!
Saline implant deflation and wait several months?
Question:
Hi, I've had saline implants for 10+ years and it's time to redo them (too big, uneven height). My surgeon suggests that we deflate and drain them now, let the skin heal/shrink back if possible then do the new breast augmentation in 3-4 months. The goal being that perhaps I'll need less of a breast lift and smaller implants placed if we give it more time to heal. Is this a realistic plan?
Debra J. Johnson, MD's Response:
Yes, that is a very reasonable plan. Deflating the implants makes them immediately smaller and the breast size more comfortable. You can then assess the size of your natural breasts and be better able to decide if you want to replace the implants and what size. Also the skin will have a chance to shrink a bit (kind of like after having a baby for the tummy skin) so you can decide if you need a breast lift and if so what scars you would end up with. I usually wait 3 months in between deflation and the surgery. Good luck!
Is a Breast Lift with loss of 3-4 cup sizes normal?
Breast LiftMember Response:
The postoperative photo looks to be shortly after your surgery, and indeed your surgery was only two weeks ago. A lift does decrease the size of the breasts a bit, since you remove the excess skin and make the remaining breast tissue more compact by elevating it back onto your chest wall. I would wait for healing to complete (2-3 months) and then evaluate the size.
Is a Breast Lift with loss of 3-4 cup sizes normal?
Question:
I had a breast lift on 06/12/20. I was a 38DD and now Im a 38B. Im disappointed with my loss of volume, I would not have had the lift if I knew I would lose my breasts. When I voiced concern about the small size, both times he said I would adjust to the new size. Is this normal to lose 3 full cup sizes? I was a full DD and now barely a B. My husband thinks I was given a reduction and not a lift.
Debra J. Johnson, MD's Response:
The postoperative photo looks to be shortly after your surgery, and indeed your surgery was only two weeks ago. A lift does decrease the size of the breasts a bit, since you remove the excess skin and make the remaining breast tissue more compact by elevating it back onto your chest wall. I would wait for healing to complete (2-3 months) and then evaluate the size.
Removing keloid scar from upper chest
General ReconstructionMember Response:
The photo wasn't attached so I can't be specific. However, upper mid chest is a common site for keloid formation. Keloids are the result of an injury and a genetic tendency. If you remove the current scar and re-close the wound, your chance of getting another keloid (possibly bigger!) is high. You would need to see a well-trained plastic surgeon. That surgeon might recommend injection of steroid into the scar to soften and fade it, silicone sheeting to try and flatten it, or surgical removal. If it is removed, then the options to try and prevent recurrence include injection of steroid at the time of closure, use of immediate silicone sheeting, and possibly immediately post-closure one time radiation treatment. This is a tough problem, and I wish you well.
Removing keloid scar from upper chest
Question:
Hello! Since the childhood I had keloid scar on my upper chest and it make me sad. Can you please tell me, it is possible to remove that scar or make it much smaller? Picture in attach. Thank you for answer!
Debra J. Johnson, MD's Response:
The photo wasn't attached so I can't be specific. However, upper mid chest is a common site for keloid formation. Keloids are the result of an injury and a genetic tendency. If you remove the current scar and re-close the wound, your chance of getting another keloid (possibly bigger!) is high. You would need to see a well-trained plastic surgeon. That surgeon might recommend injection of steroid into the scar to soften and fade it, silicone sheeting to try and flatten it, or surgical removal. If it is removed, then the options to try and prevent recurrence include injection of steroid at the time of closure, use of immediate silicone sheeting, and possibly immediately post-closure one time radiation treatment. This is a tough problem, and I wish you well.
Body Feminization Surgery For A Minor (17)
Cosmetic SurgeryMember Response:
Gender-affirming surgery is a covered benefit in California. Some health plans require a patient to be 18, even though studies have shown the benefit of surgery in adolescents. Your child would need to be following WPATH guidelines: dressing as a female and living as a female for at least one year, on hormone replacement therapy, and been evaluated by a gender mental health specialist who deems her ready to undergo surgery. You can access the Find-a-Surgeon link on this website to locate plastic surgeons near you. Not all plastic surgeons perform gender-affirming surgery, so you'll have to call and inquire. If you have a local gender health clinic, they may be able to provide a good referral.
Body Feminization Surgery For A Minor (17)
Question:
Hi! I'm wondering if it's possible for my son to get body feminization surgery, he's 17 and has been looking to have a more "feminine" image. If there is a surgeon in California willing to do this please let me know! Thank you
Debra J. Johnson, MD's Response:
Gender-affirming surgery is a covered benefit in California. Some health plans require a patient to be 18, even though studies have shown the benefit of surgery in adolescents. Your child would need to be following WPATH guidelines: dressing as a female and living as a female for at least one year, on hormone replacement therapy, and been evaluated by a gender mental health specialist who deems her ready to undergo surgery. You can access the Find-a-Surgeon link on this website to locate plastic surgeons near you. Not all plastic surgeons perform gender-affirming surgery, so you'll have to call and inquire. If you have a local gender health clinic, they may be able to provide a good referral.
Insurance Red Flag
Male Breast ReductionMember Response:
Gynecomastia can be a covered procedure of your health insurance if there is truly overdevelopment of male breast tissue (and not just due to obesity). Providing surgery for insured patients is absolutely not a red flag. It means the surgeon is committed to providing services to the community, even though insurance payments do tend to be less than what a plastic surgeon can demand from privately paying customers. Some plastic surgeons do not participate in insurance plans, and only accept patients who pay for their services with cash. This does not make them "better" surgeons, it just means they don't want to hassle with obtaining authorizations from insurers or having to work at an insurance-approved facility. Other plastic surgeons feel a commitment to serving all patients, whether they pay with their own money, their health insurance, or via Medicare/MedicAid. If you find a plastic surgeon you like who accepts your insurance, got for it!
Insurance Red Flag
Question:
Is it a red flag for a plastic surgeon at a UAB (Birmingham, AL) clinic to accept insurance for gynecomastia surgery? Does it mean that the surgeon might be desperate for patients, etc.? Dr. Lebowitz said this to me and I saw it on Dr. Carini's website. Why do you think this is the case?
Debra J. Johnson, MD's Response:
Gynecomastia can be a covered procedure of your health insurance if there is truly overdevelopment of male breast tissue (and not just due to obesity). Providing surgery for insured patients is absolutely not a red flag. It means the surgeon is committed to providing services to the community, even though insurance payments do tend to be less than what a plastic surgeon can demand from privately paying customers. Some plastic surgeons do not participate in insurance plans, and only accept patients who pay for their services with cash. This does not make them "better" surgeons, it just means they don't want to hassle with obtaining authorizations from insurers or having to work at an insurance-approved facility. Other plastic surgeons feel a commitment to serving all patients, whether they pay with their own money, their health insurance, or via Medicare/MedicAid. If you find a plastic surgeon you like who accepts your insurance, got for it!
Inverted nipple repair breastfeeding problems
General ReconstructionMember Response:
No. If you are unable to breastfeed there is not a surgery to reattach the ducts. The reason your nipple was inverted was because the ducts were foreshortened. To repair the inverted nipple the ducts have to be divided and thus disconnected. I am sorry you are unable to breastfeed, but that is a consequence of having any inverted nipple repair.
Inverted nipple repair breastfeeding problems
Question:
I had inverted nipple repair surgery 10 years ago and wasn’t told that it would affect me being able to breastfeed. Now that I have a baby my body is producing milk but it won’t flow out. Is there a procedure that I can have done to reattach the ducts?
Debra J. Johnson, MD's Response:
No. If you are unable to breastfeed there is not a surgery to reattach the ducts. The reason your nipple was inverted was because the ducts were foreshortened. To repair the inverted nipple the ducts have to be divided and thus disconnected. I am sorry you are unable to breastfeed, but that is a consequence of having any inverted nipple repair.
Incision
Tummy TuckMember Response:
Wound healing difficulties and poor scarring are known risks of any operation. The reasons for it are often unknown, but can stem from poor nutrition, smoking, your body's reaction to suture material, infection, having tension on the wound from standing up straight too fast, or if the surgeon took too much skin or damaged the skin with liposuction. Having a scar revision once the dust has settled will hopefully give you a better scar. It is very generous of your surgeon to offer to do this for free, but there are expenses involved with equipment, sutures, staff time, dressings, etc. that have to be paid for. If you could do this in the office with just local anesthesia, your doctor may be able to charge you less. But if you need sedation and monitoring in an operating room, $1200 is just covering the cost of that.
Incision
Question:
I had a tummy tuck a year ago. My incision opened during recovery and did not heal properly. My doctor said he needed to cut it and restitch the incision. Today I went to my doctor and he said I can have the scar repaired and he wouldn’t charge his fee but I would be responsible for surgery center, $1200. Should I have to pay to have this incision repaired or should it be dr responsibility?
Debra J. Johnson, MD's Response:
Wound healing difficulties and poor scarring are known risks of any operation. The reasons for it are often unknown, but can stem from poor nutrition, smoking, your body's reaction to suture material, infection, having tension on the wound from standing up straight too fast, or if the surgeon took too much skin or damaged the skin with liposuction. Having a scar revision once the dust has settled will hopefully give you a better scar. It is very generous of your surgeon to offer to do this for free, but there are expenses involved with equipment, sutures, staff time, dressings, etc. that have to be paid for. If you could do this in the office with just local anesthesia, your doctor may be able to charge you less. But if you need sedation and monitoring in an operating room, $1200 is just covering the cost of that.
Had tummy tuck 6 years ago and now experiencing discharge from my belly button
Tummy TuckMember Response:
I would make sure your belly button is thoroughly clean. Sometimes debris can get lodged deep in the crevices and can cause drainage. If you have cleaned it well and there is still a discharge, I would see your primary care and ask for a culture to be taken. Also ask for a referral back to your plastic surgeon. Occasionally one of the deep sutures can fester and cause a small opening in the skin with drainage. It might require exploration to remove a suture which is not a huge deal, but should be taken care of. Don't take no for an answer, even if you have to pay a fee to return to your surgeon.
Had tummy tuck 6 years ago and now experiencing discharge from my belly button
Question:
I have read information on your website regarding my issue, so I contacted the plastic surgeon who did the surgery right away. I was told to see my PCP. No explanation, no sense of concern from them. As if they didn't want to be bothered. I have no issue with seeing my PCP, but just wish the plastic surgeon's office had handled with more compassion.
Debra J. Johnson, MD's Response:
I would make sure your belly button is thoroughly clean. Sometimes debris can get lodged deep in the crevices and can cause drainage. If you have cleaned it well and there is still a discharge, I would see your primary care and ask for a culture to be taken. Also ask for a referral back to your plastic surgeon. Occasionally one of the deep sutures can fester and cause a small opening in the skin with drainage. It might require exploration to remove a suture which is not a huge deal, but should be taken care of. Don't take no for an answer, even if you have to pay a fee to return to your surgeon.
I think one of my implants may have ruptured?
Breast AugmentationMember Response:
Your photo shows asymmetry of the implants and the size difference. If you have saline implants, you could have have a failure on the right, with the saline leaking into your tissues and "deflating" the implant. When silicone implants break, there is no absorption of the silicone, so the breasts usually stay the same size, but there can be some shape change. Implants do have a "warranty" and the manufacturer will provide a new free implant. If your implants were placed not too long ago, they will often assist you with OR expenses. You should return to your plastic surgeon for an evaluation. If you need a new surgeon, use our Find-a-Surgeon tool on this website to locate a board-certified ASPS member surgeon near you.
I think one of my implants may have ruptured?
Question:
For the past few weeks I've noticed my left is slightly bigger than my right, and I recently noticed that my right side is a bit smaller than I thought and having a slight amount of pain
Debra J. Johnson, MD's Response:
Your photo shows asymmetry of the implants and the size difference. If you have saline implants, you could have have a failure on the right, with the saline leaking into your tissues and "deflating" the implant. When silicone implants break, there is no absorption of the silicone, so the breasts usually stay the same size, but there can be some shape change. Implants do have a "warranty" and the manufacturer will provide a new free implant. If your implants were placed not too long ago, they will often assist you with OR expenses. You should return to your plastic surgeon for an evaluation. If you need a new surgeon, use our Find-a-Surgeon tool on this website to locate a board-certified ASPS member surgeon near you.
Bbl
Buttock Lift with AugmentationMember Response:
For your overall health, it would be good to lose the weight prior to any elective surgery. Your BMI is currently 32.7, in the obese range. This can increase your risk of complications from surgery. You should work to get your BMI below 30 and be physically fit. For liposuction, the best candidates are patients who are at a stable, healthy weight who want to improve contours. If you gain or lose weight after liposuction, your results can change as you will gain or lose in a different way than before surgery. BBL transfers fat into the buttock to enlarge it. This is the most dangerous operation we perform, with a risk of death calculated at around 1:3000 patients. You definitely want to think long and hard about this, and only have it performed by a board certified ASPS member surgeon skilled at this procedure.
Bbl
Question:
I am 7 month postpartum. My height is 5’2” and I currently weigh 179llbs and 26 years of age mom of 2. I am at my heaviest wt .my Wt was 150 prepregnancy. I want to get lipo 360 with a bbl but wanted to get guidance on either losing weight before getting this type of procedure or any Other advice. All of my weight gain is in my abdominal section and I have major bra bulge.
Debra J. Johnson, MD's Response:
For your overall health, it would be good to lose the weight prior to any elective surgery. Your BMI is currently 32.7, in the obese range. This can increase your risk of complications from surgery. You should work to get your BMI below 30 and be physically fit. For liposuction, the best candidates are patients who are at a stable, healthy weight who want to improve contours. If you gain or lose weight after liposuction, your results can change as you will gain or lose in a different way than before surgery. BBL transfers fat into the buttock to enlarge it. This is the most dangerous operation we perform, with a risk of death calculated at around 1:3000 patients. You definitely want to think long and hard about this, and only have it performed by a board certified ASPS member surgeon skilled at this procedure.
Tuberous Breasts
Breast ReconstructionMember Response:
It is very difficult to offer options without knowing what your breasts look like. There are techniques to improve the appearance of a puffy areola, and fat grafting can be considered to add volume to the lower pole without an implant. Any surgery has risks, such as changing the sense of feeling to the breast or nipple, and creating scar. If possible, I would wait until after your have finished childbearing, since pregnancy often changes the way the breasts in terms of size and shape.
Tuberous Breasts
Question:
I have a mild case of tuberous breasts and I still like the size of my breasts but I’d like have tissue-based surgery without an implant. I was wondering what the cost would be. I have large, puffy areolas and my breasts don’t have much tissue towards the lower poles. Is there any other form of surgery I could have that wouldn’t need such an invasive surgery?
Debra J. Johnson, MD's Response:
It is very difficult to offer options without knowing what your breasts look like. There are techniques to improve the appearance of a puffy areola, and fat grafting can be considered to add volume to the lower pole without an implant. Any surgery has risks, such as changing the sense of feeling to the breast or nipple, and creating scar. If possible, I would wait until after your have finished childbearing, since pregnancy often changes the way the breasts in terms of size and shape.
what should I do
Breast ReconstructionMember Response:
Most women's breasts are different from each other: sizes, nipple position/size, degrees of droopiness. I assume you're an adult. Have you had children? Sometimes insurance will cover if there is a large difference between the two breasts, particularly with neck, back, or shoulder pain. You could have the larger breast reduced to match the smaller, the simplest solution. You could have an implant in the smaller to match the larger, also relatively simple but harder to get insurance companies to pay for an implant in a non-cancer patient. Or you could operate on both breasts to try and get the closest size and shape symmetry. You should discuss this issue with a case manager at your insurance company and convince her of your need for surgery. A squeaky wheel often can get what they need. If they persist in saying the surgery is "cosmetic" then you'll have to save and pay for it yourself.
what should I do
Question:
When I started developing breast only one side developed... This has affected my life in so many ways. My self esteem, things I wear and activities I like to do in the summer that I just try to avoid. I've seen a few doctors and at first thought it would cost about $4500. I got insurance through work and tried to get it covered that way and didn't happen but that Dr. told me about $10,000.
Debra J. Johnson, MD's Response:
Most women's breasts are different from each other: sizes, nipple position/size, degrees of droopiness. I assume you're an adult. Have you had children? Sometimes insurance will cover if there is a large difference between the two breasts, particularly with neck, back, or shoulder pain. You could have the larger breast reduced to match the smaller, the simplest solution. You could have an implant in the smaller to match the larger, also relatively simple but harder to get insurance companies to pay for an implant in a non-cancer patient. Or you could operate on both breasts to try and get the closest size and shape symmetry. You should discuss this issue with a case manager at your insurance company and convince her of your need for surgery. A squeaky wheel often can get what they need. If they persist in saying the surgery is "cosmetic" then you'll have to save and pay for it yourself.
Do i need surgery?
Body ContouringMember Response:
Congratulations on your weight loss! Have you reached your goal weight yet? If you have, and you've been at a stable weight for 4-6 months, then by all means you should consult with an ASPS board-certified plastic surgeon. Exercising your core/abdominal muscles is great too, as people with stronger cores tend to recuperate faster and have less pain than those with weaker abdomens. If you have completed childbearing, and your BMI is less than 30, and your health is otherwise good, you would be a good candidate for an abdominoplasty (tummy tuck). Sometimes health insurance plans will cover the removal of the excess abdominal skin, so you might check with your plan to see if it's covered. Use the Find-a-Surgeon tool on this website to locate an ASPS member surgeon near you.
Do i need surgery?
Question:
I have lost at least 150 pounds i have loose skin and was wondering if i should continue to exercise hard or have surgery
Debra J. Johnson, MD's Response:
Congratulations on your weight loss! Have you reached your goal weight yet? If you have, and you've been at a stable weight for 4-6 months, then by all means you should consult with an ASPS board-certified plastic surgeon. Exercising your core/abdominal muscles is great too, as people with stronger cores tend to recuperate faster and have less pain than those with weaker abdomens. If you have completed childbearing, and your BMI is less than 30, and your health is otherwise good, you would be a good candidate for an abdominoplasty (tummy tuck). Sometimes health insurance plans will cover the removal of the excess abdominal skin, so you might check with your plan to see if it's covered. Use the Find-a-Surgeon tool on this website to locate an ASPS member surgeon near you.
When/if to do a second breast reduction
Breast ReductionMember Response:
I have performed a number of secondary reductions. There is a somewhat higher risk of healing difficulties, due to the fact that the breast tissue contains scar from the original reduction which hampers blood flow. If you have completed childbearing, and your weight is stable and comfortable for you, then considering another reduction is appropriate.
When/if to do a second breast reduction
Question:
Hello, I had a reduction when I was 18 (from a 32I to a 32B). I am now 29 and am up to a 34DDD. I can feel the same issues that led to the first reduction (rashes developing beneath breasts, skin feels stretch and painful, upper back pain, inability to do cardio exercises without intense pain) coming back. Is DDD enough to warrant another reduction? How do I know when to do it again?
Debra J. Johnson, MD's Response:
I have performed a number of secondary reductions. There is a somewhat higher risk of healing difficulties, due to the fact that the breast tissue contains scar from the original reduction which hampers blood flow. If you have completed childbearing, and your weight is stable and comfortable for you, then considering another reduction is appropriate.
Tummy tuck needed?
Tummy TuckMember Response:
I agree with what my colleagues have already written, but would also suggest you lose some weight prior to any surgery. Heavier patients have a higher risk of complications after surgery. Such complications could be open wounds requiring daily dressing changes, fluid collections under the skin, infection, blood clots in the legs and possible pulmonary embolus. Getting your BMI below 30 is an important thing you can do to reduce your risk in surgery. Also, if you are a tobacco user, you would need to quit at least 4 weeks before and after surgery.
Tummy tuck needed?
Question:
Hello! I’m a little nervous to go under the knife. I have had 3 C-Sections and 4 pregnancies which has left my midsection like the photo. I would like to have my flat curvy midsection back. Do I need a Tummy Tuck or will 360 lipo help me get this back? BMI 33. Thank you
Debra J. Johnson, MD's Response:
I agree with what my colleagues have already written, but would also suggest you lose some weight prior to any surgery. Heavier patients have a higher risk of complications after surgery. Such complications could be open wounds requiring daily dressing changes, fluid collections under the skin, infection, blood clots in the legs and possible pulmonary embolus. Getting your BMI below 30 is an important thing you can do to reduce your risk in surgery. Also, if you are a tobacco user, you would need to quit at least 4 weeks before and after surgery.
Itching 10 years After Breast Lift
Breast LiftMember Response:
It's difficult to know if the itching is a result of the breast lift or just bad luck. The fact that it occurred three years out makes me feel like it is less likely due to the surgery. Did you have any numbness of that nipple immediately after the procedure? Usually itching is a histamine reaction, so an antihistamine lotion like benadryl might be helpful. When you scratch an itchy area, the trauma of scratching causes the release of more histamine, so it's a vicious cycle. Do your best to avoid scratching! I have had some luck with using Vitamin B6 (pyridoxine) to reduce fritzy nerve discomfort. It's over the counter. I recommend patients take 100mg daily for 30 days. If it works, then slowly wean off. If it doesn't work, just quit it. Also, make sure you are up to date on mammography screening, just to be on the safe side.
Itching 10 years After Breast Lift
Question:
I had a breast back in 2009. A little over 3 years afterwards I started experiencing severe itching on my right nipple. It drives me crazy. I had dermatologists look at it and tried topical prescription cortisone among other things with no results. My physician thinks it's a damaged nerve and is starting me on Gabapentin since it's worked in other cases with nerve pain. How common is this?
Debra J. Johnson, MD's Response:
It's difficult to know if the itching is a result of the breast lift or just bad luck. The fact that it occurred three years out makes me feel like it is less likely due to the surgery. Did you have any numbness of that nipple immediately after the procedure? Usually itching is a histamine reaction, so an antihistamine lotion like benadryl might be helpful. When you scratch an itchy area, the trauma of scratching causes the release of more histamine, so it's a vicious cycle. Do your best to avoid scratching! I have had some luck with using Vitamin B6 (pyridoxine) to reduce fritzy nerve discomfort. It's over the counter. I recommend patients take 100mg daily for 30 days. If it works, then slowly wean off. If it doesn't work, just quit it. Also, make sure you are up to date on mammography screening, just to be on the safe side.
Asymmetry breasts
Breast AugmentationMember Response:
Most women have asymmetric breasts, but it is usually not noticeable in clothes. How many women have you seen with breast asymmetry? See? We are much more self-critical about our bodies. If you like the size of the smaller breast, then a reduction of the larger breast could give you size symmetry. You would have permanent scarring on the reduced breast. If the smaller breast is too small, you could place a small implant or perform some fat transfer to get it to a D cup, and again a small reduction on the larger breast. Options would depend on your anatomy, your goals, whether or not you've finished childbearing, etc. Consult with a board-certified plastic surgeon to discuss your options. I'm pretty close or there are also plastic surgeons in Folsom you could speak with. Good luck!
Asymmetry breasts
Question:
Hi.. so I’ve been looking into getting breast implants but my concern & most insecurity is the huge difference between my breasts. My right breast is a DD cup & my left is a D or C cup. would i have to get a breast lift as well with this procedure? I would want both of my breasts to be a size D, my breast now aren’t “saggy” but you can definitely see the difference in both. Any recommendations?
Debra J. Johnson, MD's Response:
Most women have asymmetric breasts, but it is usually not noticeable in clothes. How many women have you seen with breast asymmetry? See? We are much more self-critical about our bodies. If you like the size of the smaller breast, then a reduction of the larger breast could give you size symmetry. You would have permanent scarring on the reduced breast. If the smaller breast is too small, you could place a small implant or perform some fat transfer to get it to a D cup, and again a small reduction on the larger breast. Options would depend on your anatomy, your goals, whether or not you've finished childbearing, etc. Consult with a board-certified plastic surgeon to discuss your options. I'm pretty close or there are also plastic surgeons in Folsom you could speak with. Good luck!
Minimum age for upper eyelid surgery?
Eyelid SurgeryMember Response:
There is no minimum age. It just depends on how much your eyelids bug you. Some people are born with pretty hooded lids. But the eyelid skin does tend to stretch out as we age. So if you proceed now, it might be something you would repeat later in life. Personally, I had my upper lids done when I was 39 and now 25 years later they still look fine. As a cosmetic procedure there is no minimum amount of skin excess necessary. But if you want to try and have your health plan cover the cost, then you usually have to have skin hanging down enough that it obscures your vision to a degree. Use out Find-a-Surgeon tool to locate a nearby board-certified plastic surgeon.
Minimum age for upper eyelid surgery?
Question:
Is there a minimum age before which you would consider performing upper eyelid surgery on a patient? How much drooping would need to be present before doing the surgery? Thanks
Debra J. Johnson, MD's Response:
There is no minimum age. It just depends on how much your eyelids bug you. Some people are born with pretty hooded lids. But the eyelid skin does tend to stretch out as we age. So if you proceed now, it might be something you would repeat later in life. Personally, I had my upper lids done when I was 39 and now 25 years later they still look fine. As a cosmetic procedure there is no minimum amount of skin excess necessary. But if you want to try and have your health plan cover the cost, then you usually have to have skin hanging down enough that it obscures your vision to a degree. Use out Find-a-Surgeon tool to locate a nearby board-certified plastic surgeon.
covid-19
Breast ReductionMember Response:
Many plastic surgeons are offering virtual consultations during the pandemic. Use the Find-a-Surgeon tool on this website to locate a board-certified plastic surgeon near you. Use the contact form on the surgeon's website, or telephone the office, to inquire about a virtual consult. Breast reduction is often a covered benefit of health insurance, but most companies require the patient to be a DD or greater. If your breasts are uncomfortable, but not large enough to qualify for your insurer paying for a reduction, you can still have the procedure performed by paying for it yourself. Many plastic surgeons offer financing options for their patients as well.
covid-19
Question:
Is there any chance of receiving a consultation during lockdown, and is getting a reduction good for someone who is 5’0 with 36D’s?
Debra J. Johnson, MD's Response:
Many plastic surgeons are offering virtual consultations during the pandemic. Use the Find-a-Surgeon tool on this website to locate a board-certified plastic surgeon near you. Use the contact form on the surgeon's website, or telephone the office, to inquire about a virtual consult. Breast reduction is often a covered benefit of health insurance, but most companies require the patient to be a DD or greater. If your breasts are uncomfortable, but not large enough to qualify for your insurer paying for a reduction, you can still have the procedure performed by paying for it yourself. Many plastic surgeons offer financing options for their patients as well.
Natural 38h
Breast ReconstructionMember Response:
The breast is a complex organ in which the blood and nerve supply to the skin travels through the breast tissue. When the breast tissue is removed in a mastectomy, the skin then survives on blood that comes randomly from the periphery. The bigger the skin envelope, the bigger the risk that some of the skin may not survive. If women have very large or very droopy breasts, it is often better to reduce the amount of skin with a reduction or breast lift. The largest breast implant is 800cc in silicone, and 960cc in saline. That converts to about a 38 D-DD. If you have excess fat in your abdomen, a plastic surgeon might suggest creating a free flap of that tissue to reconstruct the breast. But, again, the larger the amount of tissue transferred, the higher the risk that some of the tissue might not survive due to blood supply. You should consult with a board-certified plastic surgeon well experienced in breast reconstruction to see what your options could be.
Natural 38h
Question:
Is it possible to get the same size breast with reconstruction
Debra J. Johnson, MD's Response:
The breast is a complex organ in which the blood and nerve supply to the skin travels through the breast tissue. When the breast tissue is removed in a mastectomy, the skin then survives on blood that comes randomly from the periphery. The bigger the skin envelope, the bigger the risk that some of the skin may not survive. If women have very large or very droopy breasts, it is often better to reduce the amount of skin with a reduction or breast lift. The largest breast implant is 800cc in silicone, and 960cc in saline. That converts to about a 38 D-DD. If you have excess fat in your abdomen, a plastic surgeon might suggest creating a free flap of that tissue to reconstruct the breast. But, again, the larger the amount of tissue transferred, the higher the risk that some of the tissue might not survive due to blood supply. You should consult with a board-certified plastic surgeon well experienced in breast reconstruction to see what your options could be.
Going from a small cup to flat chest.
Breast ReductionMember Response:
A breast reduction can be performed on almost any sized breast, but when you remove breast tissue, you reduce the blood supply to the remaining breast. A plastic surgeon has to ensure that there is enough blood supply remaining to keep the tissues alive and healthy, so there is a limit as to how much tissue can be removed. A more important question is why you would want to alter your normal anatomy. Are you a transgender? Is there some other psychological issue that is playing out in your breasts? Plastic surgeons are trained to correct abnormalities due to congenital deformity, trauma, post-pregnancy, or just plain aging. We do not like to change "normal" unless such a change would make you healthier psychosocially. You should fir seek attention from a psychologist or psychiatrist to determine whether this discomfort with your breasts is appropriate. If a mental health doctor supports your desire for breast alteration, then consult with a board-certified plastic surgeon.
Going from a small cup to flat chest.
Question:
I have a reasonably small chest (large b, maybe small c cup), and they’re proportional, and people regularly compliment me on them, but I’m unhappy. Is it possible to get a breast reduction to make them even smaller (or even a flat chest?)? I do not intend to have children or breastfeed, and I am very unhappy with my chest. Is there options for that, or are they too small?
Debra J. Johnson, MD's Response:
A breast reduction can be performed on almost any sized breast, but when you remove breast tissue, you reduce the blood supply to the remaining breast. A plastic surgeon has to ensure that there is enough blood supply remaining to keep the tissues alive and healthy, so there is a limit as to how much tissue can be removed. A more important question is why you would want to alter your normal anatomy. Are you a transgender? Is there some other psychological issue that is playing out in your breasts? Plastic surgeons are trained to correct abnormalities due to congenital deformity, trauma, post-pregnancy, or just plain aging. We do not like to change "normal" unless such a change would make you healthier psychosocially. You should fir seek attention from a psychologist or psychiatrist to determine whether this discomfort with your breasts is appropriate. If a mental health doctor supports your desire for breast alteration, then consult with a board-certified plastic surgeon.
Breast reduction surgery
Breast ReductionMember Response:
A plastic surgeon can evaluate your breasts and determine whether breast reduction is appropriate for you. You would need your parents permission since you are younger than 18. You should be at a healthy weight, which would mean having a BMI in the normal range. If your BMI is higher than 25, then losing some weight prior to surgery would be better for your overall health. You can call the customer service number of your health insurance to inquire if breast reduction is a covered benefit. Breast reduction prior to childbearing can reduce your ability to breastfeed, and pregnancy after a reduction can result in a change in breast size.
Breast reduction surgery
Question:
Hi, I’m a 17 year old female and I wear a 36DD. I weigh about 140 so I’m not necessarily fat, I’ve worked out to try to lose weight in my breasts but it only further proved that exercise and dieting does nothing. I have indentions in my shoulder bones from my bra straps along with back problems. I’m just wondering if insurance would cover a procedure such as mine? (I have passport at the moment)
Debra J. Johnson, MD's Response:
A plastic surgeon can evaluate your breasts and determine whether breast reduction is appropriate for you. You would need your parents permission since you are younger than 18. You should be at a healthy weight, which would mean having a BMI in the normal range. If your BMI is higher than 25, then losing some weight prior to surgery would be better for your overall health. You can call the customer service number of your health insurance to inquire if breast reduction is a covered benefit. Breast reduction prior to childbearing can reduce your ability to breastfeed, and pregnancy after a reduction can result in a change in breast size.
Not sure what I need.... having breast problems?!
Breast LiftMember Response:
I am sorry you have to deal with this congenital problem. Your skin is stretchier than normal, and as yet there is no treatment for that. You are on the right path in trying to get your weight to a good place. Once you have reached your goal weight, you should consult with a board-certified plastic surgeon to discuss breast reduction/lifting. While a lift can take out the excess stretchy skin, if your breasts remain large, their gravitational effect will stretch out the skin faster in the future. It would be wise to downsize to a B-C cup, just so you don't have a much breast tissue weight trying to stretch out the skin again. You shouldn't go braless, except for sleeping, as gravity is definitely not your friend. This is an issue that may dog you your whole life. Your breasts may need to be lifted again. If you have children, your tummy skin will stretch out and you might want a tummy tuck. Good luck!
Not sure what I need.... having breast problems?!
Question:
I’m 17 and have Ehlers-Danlos Syndrome. My skin is very stretchy, I’m overweight and working on losing it, but I have a problem with my breasts sagging and it really lowers my self esteem. They’re big, DDD cups, the skin around them is especially stretchy, and won’t hold them up. The breasts themselves seem fine, and sometimes if I wear a bra the skin seems to temporarily sag less. What can I do?
Debra J. Johnson, MD's Response:
I am sorry you have to deal with this congenital problem. Your skin is stretchier than normal, and as yet there is no treatment for that. You are on the right path in trying to get your weight to a good place. Once you have reached your goal weight, you should consult with a board-certified plastic surgeon to discuss breast reduction/lifting. While a lift can take out the excess stretchy skin, if your breasts remain large, their gravitational effect will stretch out the skin faster in the future. It would be wise to downsize to a B-C cup, just so you don't have a much breast tissue weight trying to stretch out the skin again. You shouldn't go braless, except for sleeping, as gravity is definitely not your friend. This is an issue that may dog you your whole life. Your breasts may need to be lifted again. If you have children, your tummy skin will stretch out and you might want a tummy tuck. Good luck!
Question
Breast ReconstructionMember Response:
If the smaller breast is okay in size, then you could have a reduction on the larger breast to get them close to the same. A reduction will leave scars, but you would be even. If you like the larger breast size, you could consider fat grafting to the smaller breast. Fat grafting is less predictable and might have to done more than once if there is a big size difference. You also have to have a donor area (abdomen, thighs, flanks etc.) where you have some excess fat that could be liposuctioned and transferred to the breast. Use the Find-a-Surgeon link to see board-Certified plastic surgeons near you and schedule a consultation.
Question
Question:
Hi I am 24 years of age , and I have severe differences in my breast . My right breast is bigger than my left Nd I want surgery to fix it but my problem is that I do not want any implants . I just want it fixed naturally without any silicone or saline . . What is the best option for me?
Debra J. Johnson, MD's Response:
If the smaller breast is okay in size, then you could have a reduction on the larger breast to get them close to the same. A reduction will leave scars, but you would be even. If you like the larger breast size, you could consider fat grafting to the smaller breast. Fat grafting is less predictable and might have to done more than once if there is a big size difference. You also have to have a donor area (abdomen, thighs, flanks etc.) where you have some excess fat that could be liposuctioned and transferred to the breast. Use the Find-a-Surgeon link to see board-Certified plastic surgeons near you and schedule a consultation.
Scar revision
General ReconstructionMember Response:
As Dr. Cigna said, it is too soon to consider scar revision for your son. His scars are red because there is extra blood flow as part of the healing process. That redness will disappear with time, usually 6-12 months after the injury. When the redness is gone, the remaining scars will be a little lighter than his natural skin, but will likely not be very noticeable. Massaging in some silicone gel cream once or twice daily can speed the process of scar maturation. If your son is self-conscious about the scars, covering them with a little foundation makeup can camouflage the redness until it disappears.
Scar revision
Question:
I'm inquiring as to the gen'l cost to get my son's scars less noticeable. He's age 16. Had stiches on the 3 middle fingers of left hand + a small one on the hand Each finger scar is approx 1" long, below the knuckle. date of stitches was 12/20/19.
Debra J. Johnson, MD's Response:
As Dr. Cigna said, it is too soon to consider scar revision for your son. His scars are red because there is extra blood flow as part of the healing process. That redness will disappear with time, usually 6-12 months after the injury. When the redness is gone, the remaining scars will be a little lighter than his natural skin, but will likely not be very noticeable. Massaging in some silicone gel cream once or twice daily can speed the process of scar maturation. If your son is self-conscious about the scars, covering them with a little foundation makeup can camouflage the redness until it disappears.
Breast Lift w/out Implants
Breast LiftMember Response:
You can certainly do a lift without implants. As breasts age, the breast tissue tends to settle into the lower half of the breast. So older women tend to lose their cleavage. This is worse in women with sagging breasts. When you remove the excess skin and reposition the nipple in a breast lift, the breast looks much improved, but there still is not a lot of tissue in the upper half. So the upper breast looks a little scooped out. But it also looks very normal. Some women add an implant to provide a little upper pole fullness, but if you don't want implants, that's perfectly fine. If you look at my website, there are some before/after breast lifts without implants.
Breast Lift w/out Implants
Question:
Hello, I have wide-set very saggy breasts that are presently a large A cup. I am considering a breast lift, but I do *not* want implants. I cannot find before and after pictures that fit my situation. What type of result can I expect? Editing to add: I prefer a flat chest to an implant for aesthetic and medical reasons. As I have very little breast tissue, the saggy breasts age me. Thank you.
Debra J. Johnson, MD's Response:
You can certainly do a lift without implants. As breasts age, the breast tissue tends to settle into the lower half of the breast. So older women tend to lose their cleavage. This is worse in women with sagging breasts. When you remove the excess skin and reposition the nipple in a breast lift, the breast looks much improved, but there still is not a lot of tissue in the upper half. So the upper breast looks a little scooped out. But it also looks very normal. Some women add an implant to provide a little upper pole fullness, but if you don't want implants, that's perfectly fine. If you look at my website, there are some before/after breast lifts without implants.
Saline rupture
Breast AugmentationMember Response:
Dr. McCall is correct. When a saline implant breaks, it deflates. It may retain a little bit of fluid, but usually not much. Sometimes as the fluid is absorbed by your body that can cause some discomfort, but it goes away quickly. The saline that your body absorbs is not at all dangerous, you'll just pee-pee it out. While we do like to replace saline implants in a timely manner, now is unfortunately not the time. We will have to wait until it is safe to start performing elective (non-emergency) procedures again. So hang in there! Fortunately, replacement is usually a pretty quick and easy procedure, and you should receive a free implant. If you have a Mentor implant, the company will also help you with the expense of the surgery. You should contact your doctor again and ask them to set you up with an appointment and notify the implant company that you need warranty benefits.
Saline rupture
Question:
I had breast augmentation done 4 years ago recently i realized it hurted and felt different it ruptured!! && with all the virus Stuff, it was too late when i called office they are closed for 2 weeks. I got a hold of his assistant & she said they could not see me and if i felt too bad to go to the emergency room. That made me super upset what should i do? I thought it would be an emergency?
Debra J. Johnson, MD's Response:
Dr. McCall is correct. When a saline implant breaks, it deflates. It may retain a little bit of fluid, but usually not much. Sometimes as the fluid is absorbed by your body that can cause some discomfort, but it goes away quickly. The saline that your body absorbs is not at all dangerous, you'll just pee-pee it out. While we do like to replace saline implants in a timely manner, now is unfortunately not the time. We will have to wait until it is safe to start performing elective (non-emergency) procedures again. So hang in there! Fortunately, replacement is usually a pretty quick and easy procedure, and you should receive a free implant. If you have a Mentor implant, the company will also help you with the expense of the surgery. You should contact your doctor again and ask them to set you up with an appointment and notify the implant company that you need warranty benefits.
Help me please i dont know what to do
LiposuctionMember Response:
Liposuction would not remove an underlying muscle. The muscle could have some swelling or not be working normally because of the injury to the fatty tissue directly above it. That will usually resolve over time. If the muscle was congenitally missing, then you might not have a normal axillary fold, and you probably wouldn't be able use a pec-dec machine or do a push-up. If too much fat is removed, then sometimes the area can appear concave. I would return to your surgeon, or another board-certified plastic surgeon for an evaluation. The results of liposuction usually take 4-6 months to evolve.
Help me please i dont know what to do
Question:
what can make me sure that i dont have part of my pectoralis major in my left chest conginital not removed from doctor by mistake in traditional liposucation because of gynecomastia from 4 months ago. what investigation shoud i do to be sure ? mri ? what the difference will be showed in mri can tell me if i dont have muscle conginital or removed by doctor ? The pic is before liposuction
Debra J. Johnson, MD's Response:
Liposuction would not remove an underlying muscle. The muscle could have some swelling or not be working normally because of the injury to the fatty tissue directly above it. That will usually resolve over time. If the muscle was congenitally missing, then you might not have a normal axillary fold, and you probably wouldn't be able use a pec-dec machine or do a push-up. If too much fat is removed, then sometimes the area can appear concave. I would return to your surgeon, or another board-certified plastic surgeon for an evaluation. The results of liposuction usually take 4-6 months to evolve.
17yo Breast Reduction
Breast ReductionMember Response:
As the other surgeons said, breast reduction is performed on younger symptomatic women. It is usually covered by your health insurance. But since it is considered elective surgery, it is not being performed right now during the Covid-19 crisis. Unless it was a typo, your bra size of 46G indicates that you are seriously overweight. Women with BMIs greater than 30 are at higher risk for complications (wound healing problems, infection, etc.) following reduction. The one thing you can do to reduce your risk of surgical complications is to get your BMI below 30. Weight loss will also reduce the weight of the breasts to a degree.
17yo Breast Reduction
Question:
All my life my breasts have been a constant challenge. In sixth grade I was DD. I am a sophomore now and I am a 46G . At this point I’m tired of feeling constant weight on my shoulders and neck. I’m carrying 16 pounds on my chest and I think it’s time I get a reduction. My question is can I get one as a 17 year old? How much would it cost?
Debra J. Johnson, MD's Response:
As the other surgeons said, breast reduction is performed on younger symptomatic women. It is usually covered by your health insurance. But since it is considered elective surgery, it is not being performed right now during the Covid-19 crisis. Unless it was a typo, your bra size of 46G indicates that you are seriously overweight. Women with BMIs greater than 30 are at higher risk for complications (wound healing problems, infection, etc.) following reduction. The one thing you can do to reduce your risk of surgical complications is to get your BMI below 30. Weight loss will also reduce the weight of the breasts to a degree.
How would breast reduction surgery effect me?
Breast ReductionMember Response:
Large breasts are very uncomfortable. Breast reduction can be performed on younger women. However, breast reduction does leave significant scars: all around the areola, and from 6:00 down to the lower fold (lollipop) at least, and sometimes also a scar all along the lower fold (anchor). These scars are forever. Younger women need to know that your breasts will change with pregnancy, weight fluctuations, and aging, so you may eventually want additional surgery on your breasts. To undergo surgery, you need to be in good health, at a stable weight (BMI less than 30 if possible to reduce risk of complications). You should also be prudent about your desired size. Almost all women with DD or bigger breasts have neck, back, and shoulder pain. Consult with a board-certified plastic surgeon for advice regarding breast reduction.
How would breast reduction surgery effect me?
Question:
Hi, under 18 with 38J cups here. My back is in constant pain. There are rashes under the breast. I can’t run, see my feet, work out like I want, and I feel numbness down my arms sometimes. I also feel my breasts sag. I’m different from the other girls. I think reduction may be right for me but would it leave major scars? Would the breasts turn it out even? I ideally want a cup DDD. Is it possible?
Debra J. Johnson, MD's Response:
Large breasts are very uncomfortable. Breast reduction can be performed on younger women. However, breast reduction does leave significant scars: all around the areola, and from 6:00 down to the lower fold (lollipop) at least, and sometimes also a scar all along the lower fold (anchor). These scars are forever. Younger women need to know that your breasts will change with pregnancy, weight fluctuations, and aging, so you may eventually want additional surgery on your breasts. To undergo surgery, you need to be in good health, at a stable weight (BMI less than 30 if possible to reduce risk of complications). You should also be prudent about your desired size. Almost all women with DD or bigger breasts have neck, back, and shoulder pain. Consult with a board-certified plastic surgeon for advice regarding breast reduction.
Saggy tummy and bellybutton
Tummy TuckMember Response:
Your photo shows the often typical effects after a pregnancy: Loose skin, stretch marks, protrusion of the lower abdomen, a "frowning" bellybutton. It is important prior to considering any surgery to be in the best of health. You need to get your weight where you want it. You need to exercise your abdominal "core" muscles so they are as strong as possible. Most importantly, you need to be sure you are not going to have any more children (since a pregnancy after a tummy tuck will damage your result). A tummy tuck can remove the excess skin and a lot of the stretch marks. It can repair the underlying abdominal wall. Judicious liposuction can improve the contours further. The trade-off is a long lower abdominal scar (within your panty line) and a circular scar around your bellybutton. The recuperation from the surgery takes about 4 weeks. This is a big surgery with real risks, so you need to consult with a board-certified plastic surgeon for more information.
Saggy tummy and bellybutton
Question:
I had my first child a little over a year ago she was 10 pounds 9 ounces so I had to stretch a lot now my belly button sags and so does the lower of my stomach I've tried exercise and dieting nothing helps I'm looking to see what treatment would best work for me
Debra J. Johnson, MD's Response:
Your photo shows the often typical effects after a pregnancy: Loose skin, stretch marks, protrusion of the lower abdomen, a "frowning" bellybutton. It is important prior to considering any surgery to be in the best of health. You need to get your weight where you want it. You need to exercise your abdominal "core" muscles so they are as strong as possible. Most importantly, you need to be sure you are not going to have any more children (since a pregnancy after a tummy tuck will damage your result). A tummy tuck can remove the excess skin and a lot of the stretch marks. It can repair the underlying abdominal wall. Judicious liposuction can improve the contours further. The trade-off is a long lower abdominal scar (within your panty line) and a circular scar around your bellybutton. The recuperation from the surgery takes about 4 weeks. This is a big surgery with real risks, so you need to consult with a board-certified plastic surgeon for more information.
Do I need to be tested for BIA-ALCL?
Breast Implant RevisionMember Response:
Dr. Allen is correct that the most common symptom of BIA-ALCL is breast swelling. However, BIA-ALCL can present with a mass sometimes, so evaluating your breast concerns as soon as possible is important. Seek attention from a Board-certified ASPS member, using the Find-A-Surgeon tool on this website.
Do I need to be tested for BIA-ALCL?
Question:
In 1988 I had Surgitk Polyurethane textured silicone I had burning pain for 12 yrs. in 2003 I found out I had ruptured implants. Removed implants & scar tissue. Replaced with Allergan Bio texted saline implants. Lymph’s & Lymph’s Absolute high since 2014 painful left breast, burning pain in right at times,ultrasound found masses,distortion. In axillaRight 22x14x20mm Left 18x11x15 Do I need testin
Debra J. Johnson, MD's Response:
Dr. Allen is correct that the most common symptom of BIA-ALCL is breast swelling. However, BIA-ALCL can present with a mass sometimes, so evaluating your breast concerns as soon as possible is important. Seek attention from a Board-certified ASPS member, using the Find-A-Surgeon tool on this website.
The first time of nose surgery
Cleft Lip and Palate RepairMember Response:
Usually the nose deformity is also addressed at the time of cleft lip repair. However, some kids, especially those with a complete cleft lip have a significant nasal deformity even after primary repair. These kids may need additional nasal surgery when they are older. Some surgeons like to wait until the child goes through puberty (age 13-15 after the nose has achieved its adult size). Some surgeons will address nose issues earlier, to try and avoid the child being teased by other children. Be sure to consult with a board-certified plastic surgeon soon, and connect with a Cleft Panel (often associated with major hospitals or Universities) where your child can be evaluated in a clinic that has a cleft "team" of plastic surgeons, ENT, dental, orthodontics, social work, speech pathologist, hearing specialist, geneticist, etc. that advocates for the appropriate care of your child.
The first time of nose surgery
Question:
When will cleft lip baby can get her first nose surgery to restore nasal symmetry and nostril? Thank you.
Debra J. Johnson, MD's Response:
Usually the nose deformity is also addressed at the time of cleft lip repair. However, some kids, especially those with a complete cleft lip have a significant nasal deformity even after primary repair. These kids may need additional nasal surgery when they are older. Some surgeons like to wait until the child goes through puberty (age 13-15 after the nose has achieved its adult size). Some surgeons will address nose issues earlier, to try and avoid the child being teased by other children. Be sure to consult with a board-certified plastic surgeon soon, and connect with a Cleft Panel (often associated with major hospitals or Universities) where your child can be evaluated in a clinic that has a cleft "team" of plastic surgeons, ENT, dental, orthodontics, social work, speech pathologist, hearing specialist, geneticist, etc. that advocates for the appropriate care of your child.
Infantile hemangioma involution
Cosmetic SurgeryMember Response:
You certainly have some asymmetry in your upper lip. Removing some of the left upper lip skin to raise the vermilion on that side will leave a scar at the edge of your lip line, so there are tradeoffs to trying to improve your situation. Use our Find-a-surgeon tool to locate an ASPS board-certified plastic surgeon near you. You will need to be examined and offered options for treatment. Since this is a congenital problem, your health insurance should cover the surgery.
Infantile hemangioma involution
Question:
Hello, im 17 years old and i was born with a infantile hemangioma on the left side of my upper lip. After it involuted it left stretch skin over the area and it affected the left side of my vermillion border (its out of place and barely can see it). I wanted to ask you guys who are professionals, if yall can explain to me how does this cosmetic surgery go to improve my look. Thank you
Debra J. Johnson, MD's Response:
You certainly have some asymmetry in your upper lip. Removing some of the left upper lip skin to raise the vermilion on that side will leave a scar at the edge of your lip line, so there are tradeoffs to trying to improve your situation. Use our Find-a-surgeon tool to locate an ASPS board-certified plastic surgeon near you. You will need to be examined and offered options for treatment. Since this is a congenital problem, your health insurance should cover the surgery.
Denver Area - 13 y/o gel implants - both ruptured, one side capsule ruptured as well
Breast Implant RemovalMember Response:
If you have a ruptured capsule, then your problem needs to be cared for as soon as possible, to limit the spread of silicone into your tissues. Performing a capsulectomy and implant material removal is needed. It can usually be combined with a breast lift, with or without replacing the implants. There will be some discomfort, but probably less than the initial procedure. The risk of serious or life-threatening complications is very rare. Use the Find-a-surgeon link on this website to locate an ASPS surgeon near you. My friend, Lisa Hunsicker MD, in Littleton would be well qualified to care for you.
Denver Area - 13 y/o gel implants - both ruptured, one side capsule ruptured as well
Question:
My implants were done in CA prior to our move to CO. I’m terrified to endure this procedure. Augmentation pain was truly excruciating - great surgeon, modern tech, no drains needed. I’m now 53 & May do a lift but not replacing with new implants. PLEASE advise ways to deeply vet a surgeon for the extraction & cleanup now required? We have 4 kids who need their mom.
Debra J. Johnson, MD's Response:
If you have a ruptured capsule, then your problem needs to be cared for as soon as possible, to limit the spread of silicone into your tissues. Performing a capsulectomy and implant material removal is needed. It can usually be combined with a breast lift, with or without replacing the implants. There will be some discomfort, but probably less than the initial procedure. The risk of serious or life-threatening complications is very rare. Use the Find-a-surgeon link on this website to locate an ASPS surgeon near you. My friend, Lisa Hunsicker MD, in Littleton would be well qualified to care for you.
Avoiding latissimus dorsi FLAP on radiated breast
Breast ReconstructionMember Response:
The radiation is the bugaboo here. You've already failed once....infection rate much higher in the face of radiation. If you try to expand this radiated skin, it is likely doomed to fail again. You need to bring in blood supply, thus the recommendation of the latissimus flap. I would listen to your surgeon, it's good advice. A latissimus will nourish the radiated skin and better protect you from infection.
Avoiding latissimus dorsi FLAP on radiated breast
Question:
Double NSM & beautiful pre pec reconstruction, but 1 breast developed an infection so implant was removed. Recon scheduled in 3 mos. This breast was radiated, so PS predicts being flat these 3 mos will cause elasticity loss. Lat Dorsi FLAP with expander is the plan, swap to implant in 6 mos. I prefer expander and no flap. Can I massage to keep skin flexible? Or anything else? I'll try anything!
Debra J. Johnson, MD's Response:
The radiation is the bugaboo here. You've already failed once....infection rate much higher in the face of radiation. If you try to expand this radiated skin, it is likely doomed to fail again. You need to bring in blood supply, thus the recommendation of the latissimus flap. I would listen to your surgeon, it's good advice. A latissimus will nourish the radiated skin and better protect you from infection.
To My skin
PanniculectomyMember Response:
Some insurances in California will cover removal of the excess skin in the lower abdomen after massive weight loss. As Dr. Stone mentioned, the patient usually has to have symptoms related to the overhanging skin, like rashes or red skin or wounds that you can't control with creams and good hygiene. Anthem Blue Cross, for instance, requires patients to have lost over 100 pounds and maintain their current weight for one year. You can call the Customer Service number on the back of your insurance card and explain your situation. They can tell you if panniculectomy is a "covered benefit". Panniculectomy does not include repositioning of the belly button, tightening the abdominal wall, or getting rid of any skin excess above your belly button, but it does get rid of the hanging "apron" of lower abdominal skin. If you want a more "cosmetic" repair, then you may have to pay for an abdominoplasty privately. Consult a plastic surgeon to see what would work best for you.
To My skin
Question:
I had gastric bypass surgery in 2009 and 2 hernia surgeries since. Can my insurance pay for this surgery? I have so much skin hanging from loosing weight from the surgeries
Debra J. Johnson, MD's Response:
Some insurances in California will cover removal of the excess skin in the lower abdomen after massive weight loss. As Dr. Stone mentioned, the patient usually has to have symptoms related to the overhanging skin, like rashes or red skin or wounds that you can't control with creams and good hygiene. Anthem Blue Cross, for instance, requires patients to have lost over 100 pounds and maintain their current weight for one year. You can call the Customer Service number on the back of your insurance card and explain your situation. They can tell you if panniculectomy is a "covered benefit". Panniculectomy does not include repositioning of the belly button, tightening the abdominal wall, or getting rid of any skin excess above your belly button, but it does get rid of the hanging "apron" of lower abdominal skin. If you want a more "cosmetic" repair, then you may have to pay for an abdominoplasty privately. Consult a plastic surgeon to see what would work best for you.
Uneven breast
Breast AugmentationMember Response:
Many women have one breast which is larger than the other. When the size difference is difficult to camouflage or causes distress, then trying to even them out in some way can be considered. You need to decide which breast size you prefer. If you like the B cup breast, then a small reduction on the bigger breast would work. The tradeoff would be some visible scar on the C cup (now B cup) breast. If you like the larger breast size, then placing a small implant, or possibly fat transfer, into the smaller breast to enlarge it would work. Since you are young, any correction now could change with subsequent pregnancies, breast feeding, or weight fluctuations. You would need to be prepared for possible additional surgery in the future.
Uneven breast
Question:
Hi, I'm 24 and I have pretty uneven breast. I'd say one is a B and the other a C. I apologize if I sound ridiculous, but is it possible to have the fat transferred from 1 breast to another? If that is not possible, could an option be just reducing the larger breast ? Any advice would be greatly appreciated and thank you for your time in advance! *I have scoliosis*
Debra J. Johnson, MD's Response:
Many women have one breast which is larger than the other. When the size difference is difficult to camouflage or causes distress, then trying to even them out in some way can be considered. You need to decide which breast size you prefer. If you like the B cup breast, then a small reduction on the bigger breast would work. The tradeoff would be some visible scar on the C cup (now B cup) breast. If you like the larger breast size, then placing a small implant, or possibly fat transfer, into the smaller breast to enlarge it would work. Since you are young, any correction now could change with subsequent pregnancies, breast feeding, or weight fluctuations. You would need to be prepared for possible additional surgery in the future.
Surgery with BMI over 30
Arm LiftMember Response:
With a BMI of 45 you are still considered "morbidly obese" and at a high risk for complications after any surgery. Congratulations on your weight loss, but to have any elective surgery you should get your weight into a healthier range. You will significantly reduce your risk of infection, wound healing problems, blood clots with possible pulmonary embolism, and even death. And your heart and knees will be grateful. I agree with Dr. Dowbak that a medically supervised weight loss program would likely have the best chance of success.
Surgery with BMI over 30
Question:
I had WLS several years ago and have alot of loose skin. I am 41 and like my thicker frame. My current BMI is 45 (5’7” and currently 290 lbs, down from 403 lbs). I do not desire to be smaller than 240 lbs, but in order to be at a BMI under 30, that would put me at 190 lbs, which I feel is too small for me. I just want an arm lift and tummy tuck to remove the skin. Is that possible at my BMI?
Debra J. Johnson, MD's Response:
With a BMI of 45 you are still considered "morbidly obese" and at a high risk for complications after any surgery. Congratulations on your weight loss, but to have any elective surgery you should get your weight into a healthier range. You will significantly reduce your risk of infection, wound healing problems, blood clots with possible pulmonary embolism, and even death. And your heart and knees will be grateful. I agree with Dr. Dowbak that a medically supervised weight loss program would likely have the best chance of success.
36DDD at 21
Breast ReconstructionMember Response:
By age 21, it is likely that your breasts have stopped growing. Many women with DD or greater breasts complain about neck, back, and shoulder pain. If you are happy with your current weight, the consulting with a plastic surgeon about breast reduction is appropriate. If your weight is higher than you'd like, then it is best to try and lose the weight before undergoing a reduction. The tradeoff is scarring on the breast skin, usually around the perimeter of the areola, from the 6:00 position of the areola down to the fold, and then sometimes also in the bottom fold of the breast. In younger women, there is also concern that breast feeding might not be possible after a reduction. Pregnancy and breast feeding can change the size/shape of your breasts, so I warn young women that, depending on what happens in your life after breast reduction, you may require some "maintenance work" in the future. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon nearby.
36DDD at 21
Question:
Since I was 15, I’ve had very large breasts. It has always been difficult but recently it’s been causing me a lot of pain. I’ve had bruised from the weight of my breasts pressing my bras underwire onto them, I’ve also had shoulder pain and lower back pain from them. I’ve never had a surgery, do you think a reduction could be beneficial?
Debra J. Johnson, MD's Response:
By age 21, it is likely that your breasts have stopped growing. Many women with DD or greater breasts complain about neck, back, and shoulder pain. If you are happy with your current weight, the consulting with a plastic surgeon about breast reduction is appropriate. If your weight is higher than you'd like, then it is best to try and lose the weight before undergoing a reduction. The tradeoff is scarring on the breast skin, usually around the perimeter of the areola, from the 6:00 position of the areola down to the fold, and then sometimes also in the bottom fold of the breast. In younger women, there is also concern that breast feeding might not be possible after a reduction. Pregnancy and breast feeding can change the size/shape of your breasts, so I warn young women that, depending on what happens in your life after breast reduction, you may require some "maintenance work" in the future. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon nearby.
Old Implants
Breast AugmentationMember Response:
The left implant has likely deflated and is “flat as a pancake” so difficult to see on a mammogram. You may now notice a size difference between the two breasts. You could have the implant replaced. It might have a lifetime warranty wherein the company would give you a new free replacement. If you don’t want to replace you can have the implants removed fairly easily., although living with the deflated implant shell poses no risk other than occasional discomfort if it ends up folding up on itself and creating a pressure point.
Old Implants
Question:
I have old saline implants. The left implant is not visible in a mammogram, although the right is plainly visible. Should I be concerned about where the left one is? I have to assume the saline leaked out, but where could the capsule be?
Debra J. Johnson, MD's Response:
The left implant has likely deflated and is “flat as a pancake” so difficult to see on a mammogram. You may now notice a size difference between the two breasts. You could have the implant replaced. It might have a lifetime warranty wherein the company would give you a new free replacement. If you don’t want to replace you can have the implants removed fairly easily., although living with the deflated implant shell poses no risk other than occasional discomfort if it ends up folding up on itself and creating a pressure point.
Breast lift or reduction?
Breast LiftMember Response:
If you are happy with your breast volume in a bra, but don't like the sagginess, then a lift would be a good option. If you also think your breasts are too large for your body, then a reduction (which includes a lift) could make the breasts a bit smaller and lifted. If you haven't finished childbearing, then I would wait until after your last child is born/weaned, since your breasts will again be affected by pregnancy and may change volume/become saggy due to the hormones, weight fluctuation, breastfeeding. Remember to wear a supportive bra when you're vertical, particularly if you run/jog/bounce for exercise to "protect your investment" and try to prevent future sagging.
Breast lift or reduction?
Question:
I had a baby about two years ago and my breasts (size D) are sagging. Would a lift or reduction be best?
Debra J. Johnson, MD's Response:
If you are happy with your breast volume in a bra, but don't like the sagginess, then a lift would be a good option. If you also think your breasts are too large for your body, then a reduction (which includes a lift) could make the breasts a bit smaller and lifted. If you haven't finished childbearing, then I would wait until after your last child is born/weaned, since your breasts will again be affected by pregnancy and may change volume/become saggy due to the hormones, weight fluctuation, breastfeeding. Remember to wear a supportive bra when you're vertical, particularly if you run/jog/bounce for exercise to "protect your investment" and try to prevent future sagging.
Implants
Breast LiftMember Response:
It is fine to get a breast lift without implants. Breast lifting reshapes the breast, repositions the nipple, and brings the whole breast mound up higher on your chest again. Sometimes implants are added to give more cleavage, but are not necessary. The trade-off with breast lifting is the scars, which usually end up around the edge of the areola, from the 6:00 position of the areola down to the fold, and sometimes also in the lower fold of the breast. The amount of scarring required depends on the shape of your breasts. Consult with an ASPS member board-certified plastic surgeon in your area (use our Find-A-Surgeon tool) to find out your options.
Implants
Question:
I would like to get This procedure done but I do not desire implants. I want a natural lift , Is That possible? And will This surgery cause Loss in nipple sensation?
Debra J. Johnson, MD's Response:
It is fine to get a breast lift without implants. Breast lifting reshapes the breast, repositions the nipple, and brings the whole breast mound up higher on your chest again. Sometimes implants are added to give more cleavage, but are not necessary. The trade-off with breast lifting is the scars, which usually end up around the edge of the areola, from the 6:00 position of the areola down to the fold, and sometimes also in the lower fold of the breast. The amount of scarring required depends on the shape of your breasts. Consult with an ASPS member board-certified plastic surgeon in your area (use our Find-A-Surgeon tool) to find out your options.
How will my weight affect getting this procedure?
Breast ReductionMember Response:
If weight loss is an achievable goal, please do that first. If you had your breast reduction today and then lost the 55 pounds, your reduced breasts would "deflate" even further and might end up too small. The breasts contain a lot of fat, so weight loss will reduce their volume. When you achieve your weight goal and your breasts are still DDD-E you should qualify for a breast reduction paid for by your health insurance.
How will my weight affect getting this procedure?
Question:
All my life I’ve naturally had very large breasts, but they become a larger issue when I’m heavier. At my ideal weight (160lbs) I’m about a DDD or even an E. At my current weight (215lbs) I am an H (still wearing a G size bra). I would ideally like to have D or DDs in order to be comfortable. I am currently on a diet and plan to lose those 55lbs quite quick. How will this affect me going for a BR?
Debra J. Johnson, MD's Response:
If weight loss is an achievable goal, please do that first. If you had your breast reduction today and then lost the 55 pounds, your reduced breasts would "deflate" even further and might end up too small. The breasts contain a lot of fat, so weight loss will reduce their volume. When you achieve your weight goal and your breasts are still DDD-E you should qualify for a breast reduction paid for by your health insurance.
Insure what to do
Breast Implant RemovalMember Response:
You don't mention why you want to remove your implants. If you are removing them and not replacing them, then you don't really need to know beforehand the size/manufacturer. Your surgeon will be able to give you that information once they are removed. If you are wanting to replace the implants because of failure, then the implants would be under "warranty" and you would qualify to receive a new free implant to replace the failed one(s). We will file a warranty request with both manufacturers in cases like yours, and then once the implant is removed and we know which brand it is, we will return the broken implant(s) to the appropriate company. There is now a National Breast Implant Registry, but it just started two years ago, and not all surgeons participate. This national registry will be a great resource for patients and plastic surgeons in the future.
Insure what to do
Question:
I've seen here that it's recommended to have a history of previous implant procedure for reference. What if it's been 20 yrs since and records are lost and surgeon no longer practicing. How can I obtain a hostory? Is there a registry of my implants when it was done in a national registry? Can a current surgeon be able to still remove my implants without knowing my history?
Debra J. Johnson, MD's Response:
You don't mention why you want to remove your implants. If you are removing them and not replacing them, then you don't really need to know beforehand the size/manufacturer. Your surgeon will be able to give you that information once they are removed. If you are wanting to replace the implants because of failure, then the implants would be under "warranty" and you would qualify to receive a new free implant to replace the failed one(s). We will file a warranty request with both manufacturers in cases like yours, and then once the implant is removed and we know which brand it is, we will return the broken implant(s) to the appropriate company. There is now a National Breast Implant Registry, but it just started two years ago, and not all surgeons participate. This national registry will be a great resource for patients and plastic surgeons in the future.
From teardrop over muscle to High profile under muscle
Breast Implant RevisionMember Response:
If you had a firm breast from a tight capsule, shifting the implant to the submuscular position is the way to try and get you a softer breast (the risk of capsular contraction is much lower if implants are submuscular). If you were switching from textured to smooth implant because of concerns for BIA-ALCL, shifting to submuscular is best since smooth implants stay softer under the muscle than above. That being said, with that switch, you have two wounds, one above and one below the muscle. The breast skin has been stretched out by the implant so in removing the implant, the breast skin is looser and the nipple will drop. With the new implant below the muscle, the muscle is tight and needs time to stretch the muscle and settle into position. There is frequently a short-term mismatch between the two pockets. This is not a "botch". Your breasts need time to adjust, like 4-6 months. Wear a bra to support the breast skin, give it time, and you may not even need a lift.
From teardrop over muscle to High profile under muscle
Question:
URGENT: Hello.Is it normal a surgeon recommend getting a high profile under muscle implant to replace a “teardrop” over muscle implant? This was suggested and performed by my surgeon 3 weeks ago and now I’m left with an empty saggy pocket with my nipple completely below the new implant. COMPLETELY BOTCHED! surgeon now telling me I need a breast lift which he NEVER said before but he insists he did
Debra J. Johnson, MD's Response:
If you had a firm breast from a tight capsule, shifting the implant to the submuscular position is the way to try and get you a softer breast (the risk of capsular contraction is much lower if implants are submuscular). If you were switching from textured to smooth implant because of concerns for BIA-ALCL, shifting to submuscular is best since smooth implants stay softer under the muscle than above. That being said, with that switch, you have two wounds, one above and one below the muscle. The breast skin has been stretched out by the implant so in removing the implant, the breast skin is looser and the nipple will drop. With the new implant below the muscle, the muscle is tight and needs time to stretch the muscle and settle into position. There is frequently a short-term mismatch between the two pockets. This is not a "botch". Your breasts need time to adjust, like 4-6 months. Wear a bra to support the breast skin, give it time, and you may not even need a lift.
Teen surgery
Breast ReductionMember Response:
Large breasts can certainly cause physical symptoms as well as psychological stress. Some girls also have breasts that are abnormally shaped. The biggest concern would be whether your daughter has completed her breast development. This depends on what age she started her periods (breasts usually stop growing about 2 years or so later), whether her weight is stable, and if she has reached her adult height. Operating on younger women carries the risk that they will trade their discomfort about breast size/shape with discomfort about the necessary scars. Their ability to breastfeed may be diminished. And their breasts may be changed by later pregnancy, breastfeeding, weight fluctuations and aging for which they might want further surgery. The best place to start is by consulting with a board certified ASPS member plastic surgeon. Your daughter can be examined and suggestions for treating her concerns can be discussed.
Teen surgery
Question:
My daughter, 16, has 32DD breasts that seem to be extreme tubular breasts. She struggles with her self esteem and confidence from this. She can’t wear anything without a bra tightened all the way. She has pain from the weight and has indents on her shoulders from the bra. Will surgeons preform on her because of the major psychological effects? Would this be considered cosmetic or medical?
Debra J. Johnson, MD's Response:
Large breasts can certainly cause physical symptoms as well as psychological stress. Some girls also have breasts that are abnormally shaped. The biggest concern would be whether your daughter has completed her breast development. This depends on what age she started her periods (breasts usually stop growing about 2 years or so later), whether her weight is stable, and if she has reached her adult height. Operating on younger women carries the risk that they will trade their discomfort about breast size/shape with discomfort about the necessary scars. Their ability to breastfeed may be diminished. And their breasts may be changed by later pregnancy, breastfeeding, weight fluctuations and aging for which they might want further surgery. The best place to start is by consulting with a board certified ASPS member plastic surgeon. Your daughter can be examined and suggestions for treating her concerns can be discussed.
Mirror vs Camera
Cosmetic SurgeryMember Response:
When you look in a mirror, the left side of your face now appears on the right and vice versa. Your image is flipped. When you take a selfie, the left is on the left... That’s why people often “don’t like” the way they look in pictures because it is the opposite of what they see in a mirror. Just a fact of life. If you altered your face to match your mirror image, then when you look in the mirror your face would be “flipped” the opposite direction and would again be disconcerting. We just have to accept that we have natural asymmetries between the two sides of our face (and bodies).
Mirror vs Camera
Question:
I don’t know if this makes sense, but is it possible to get surgery that makes you look like your mirror reflection? Sense the camera and mirror are different
Debra J. Johnson, MD's Response:
When you look in a mirror, the left side of your face now appears on the right and vice versa. Your image is flipped. When you take a selfie, the left is on the left... That’s why people often “don’t like” the way they look in pictures because it is the opposite of what they see in a mirror. Just a fact of life. If you altered your face to match your mirror image, then when you look in the mirror your face would be “flipped” the opposite direction and would again be disconcerting. We just have to accept that we have natural asymmetries between the two sides of our face (and bodies).
Explant
Breast Implant RemovalMember Response:
It seems to me that either the implants were never removed (unlikely, particularly if your wife’s breasts are smaller now than before the surgery), or your wife has seromas (pockets of serious fluid occupying the space where the implants used to be). “Stacked” (double) implants were performed on occasion 25-30 years ago especially in reconstruction patients who needed more volume to match their remaining natural breast than standard implants could achieve. I would ask that the MRI be evaluated by another radiologist well-versed in breast imaging to determine if what is seen is truly an implant or just a fluid collection (seroma).
Explant
Question:
My wife had her implant explanted several months ago. When she went to get MRI the MRI showed that she still had an implant on both sides. The plastic surgeon stated that he removed one and their was probably 2 implants per breast. This doesn't sense since the pre MRI showed only 1 implant per breast. Is it ever normal procedure to put 2 breast implants on top of one another for each breast?
Debra J. Johnson, MD's Response:
It seems to me that either the implants were never removed (unlikely, particularly if your wife’s breasts are smaller now than before the surgery), or your wife has seromas (pockets of serious fluid occupying the space where the implants used to be). “Stacked” (double) implants were performed on occasion 25-30 years ago especially in reconstruction patients who needed more volume to match their remaining natural breast than standard implants could achieve. I would ask that the MRI be evaluated by another radiologist well-versed in breast imaging to determine if what is seen is truly an implant or just a fluid collection (seroma).
Uneven areolas after breast lift
Breast LiftMember Response:
When a plastic surgeon performs a breast lift (or breast reduction) the areolar diameter if often reduced. A "cookie cutter", a round device that draws a perfect circle is used to create the new areolar diameter, with the nipple in the center. This circle is ultimately sutured to the breast skin in a new, higher position. Then the patient heals....and sometimes the healing forces of the skin and breast tissue alter the size or shape of the nipple/areola. Since this asymmetry is bothersome to you, I would return to your plastic surgeon to see if a small revision could be performed. He or she would likely need to reduce the left areola to match the smaller right, and might want to re-center the right nipple to be more centralized, which could reduce the right diameter further. Alternatively, you could have the right areolar tattooed to a larger diameter, matching the left, with the nipple centered. Good luck!
Uneven areolas after breast lift
Question:
Hello, I had a breast lift and augmentation 9 months ago. I am overall satisfied with the outcome, but my areolas bother me a lot. The areolas were reduced in size during the surgery. The left one turned out good, the right one not. The right nipple is not positioned centrally within the areola and the right areola is smaller than the left one. Was this a mistake by the surgeon? Thank you.
Debra J. Johnson, MD's Response:
When a plastic surgeon performs a breast lift (or breast reduction) the areolar diameter if often reduced. A "cookie cutter", a round device that draws a perfect circle is used to create the new areolar diameter, with the nipple in the center. This circle is ultimately sutured to the breast skin in a new, higher position. Then the patient heals....and sometimes the healing forces of the skin and breast tissue alter the size or shape of the nipple/areola. Since this asymmetry is bothersome to you, I would return to your plastic surgeon to see if a small revision could be performed. He or she would likely need to reduce the left areola to match the smaller right, and might want to re-center the right nipple to be more centralized, which could reduce the right diameter further. Alternatively, you could have the right areolar tattooed to a larger diameter, matching the left, with the nipple centered. Good luck!
Treatment for vaginal rejuvenation
Vaginal RejuvenationMember Response:
You are absolutely normal. Your boyfriend is not complaining, so why are you worried? Women might notice some loosening of the vaginal tissues after childbirth, but this rarely necessitates surgery, as sexual satisfaction remains high for both the man and the woman. Exercising your pelvic muscles can help you feel more toned.
Treatment for vaginal rejuvenation
Question:
m a 27 unmarried bt sexually actv. Hv had 2 rltnshp including current. Wth my current partner,v r in a long distance reltnshp so v meet vry rarely it's bn 1yr n v met 5 times fr max 2 days on a gap of 3-4 mnths n had it. My ex hd vry big a v we xtremely actv,so nw i feel vry loose n unconfident,maybe he feels dissatisfied bt he doesn't say, vaginal rejuvenation is best? Or is der any other option?
Debra J. Johnson, MD's Response:
You are absolutely normal. Your boyfriend is not complaining, so why are you worried? Women might notice some loosening of the vaginal tissues after childbirth, but this rarely necessitates surgery, as sexual satisfaction remains high for both the man and the woman. Exercising your pelvic muscles can help you feel more toned.
Earlobe repair
Ear SurgeryMember Response:
Repairing earlobes damaged by earrings requires removing the piercing hole completely and closing the skin back together. After healing for several weeks, the earlobe may be re-pierced. This procedure is usually done in the office with just local anesthesia and takes about 15 minutes. Sutures are removed after one week. In my office it runs $500 and includes the re-piercing, but other plastic surgeons might charge more or less.
Earlobe repair
Question:
What's the procedure for repair to stretched out pierced earring holes and what is the cost?
Debra J. Johnson, MD's Response:
Repairing earlobes damaged by earrings requires removing the piercing hole completely and closing the skin back together. After healing for several weeks, the earlobe may be re-pierced. This procedure is usually done in the office with just local anesthesia and takes about 15 minutes. Sutures are removed after one week. In my office it runs $500 and includes the re-piercing, but other plastic surgeons might charge more or less.
breast augmentation for minors
Breast AugmentationMember Response:
Girls under 18 can be considered for breast augmentation, but a plastic surgeon would want to be sure that a patient has finished her natural development. This usually means waiting at least two years or so after a girl has started her periods, and that she is at a stable weight. She should have no other health issues. She would have to have thought long and hard about this decision and understand both the short and long term risks of breast implants. Her parents would certainly have to be supportive. Women under 22 qualify for saline filled implants. Silicone implants are recommended by the FDA for women 22 and over only. Some girls might have a birth defect, such as Poland Syndrome, which results in maldevelopment of a breast. These patients are considered "reconstructive" and can qualify for silicone implants at younger than 22.
breast augmentation for minors
Question:
Can a minor get a breast augmentation with parental consent?
Debra J. Johnson, MD's Response:
Girls under 18 can be considered for breast augmentation, but a plastic surgeon would want to be sure that a patient has finished her natural development. This usually means waiting at least two years or so after a girl has started her periods, and that she is at a stable weight. She should have no other health issues. She would have to have thought long and hard about this decision and understand both the short and long term risks of breast implants. Her parents would certainly have to be supportive. Women under 22 qualify for saline filled implants. Silicone implants are recommended by the FDA for women 22 and over only. Some girls might have a birth defect, such as Poland Syndrome, which results in maldevelopment of a breast. These patients are considered "reconstructive" and can qualify for silicone implants at younger than 22.
Guess-timate on Size?
Breast AugmentationMember Response:
I'm a little confused by your numbers. A 34B is usually about 350-400 cc in volume. It looks like the implants added were around 350-400 cc in size? If so, that would add about two cup sizes to your wife's bra. However, bras are not very standardized so she could be a full C in one brand and a D in another. Bras are also tricky to find a comfortable fit. Likely better to give her a generous gift certificate to some nice bra shop so she can pick them out herself. Maybe just ask to tag along as her "peanut gallery" in the dressing room! Happy shopping!
Guess-timate on Size?
Question:
My wife recently had breast augmentation: sub-muscular, highly-cohesive silicone gel implants, smooth, round, moderate-plus profile. Her natural breasts were 34B : 136.5 CCs (right) & 158.1 CCs (left). The implants resulted in CCs of: 521.5 (right), 513.1 (left). She is 5'5", 122 lbs. Can anyone guess-timate what her cup size will be? I'd love to surprise her for Christmas with new bras. Thanks!
Debra J. Johnson, MD's Response:
I'm a little confused by your numbers. A 34B is usually about 350-400 cc in volume. It looks like the implants added were around 350-400 cc in size? If so, that would add about two cup sizes to your wife's bra. However, bras are not very standardized so she could be a full C in one brand and a D in another. Bras are also tricky to find a comfortable fit. Likely better to give her a generous gift certificate to some nice bra shop so she can pick them out herself. Maybe just ask to tag along as her "peanut gallery" in the dressing room! Happy shopping!
Could a Panni with lipo shape enough or tummy tuck necessary?
Mommy MakeoverMember Response:
A panniculectomy removes only the extra lower abdominal skin. It doesn't smooth out any of the excess skin above the bellybutton. If you have extra skin in both the upper and lower abdomen, then a tummy tuck would be best. You should consult with a board-certified plastic surgeon who can examine your abdomen, discuss your goals, and come up with an appropriate plan.
Could a Panni with lipo shape enough or tummy tuck necessary?
Question:
I am starting to consider my mommy makeover and I’m wondering if having a Panni with Lipo to help shape could be enough or if a tummy tuck would be necessary? I have had 4 kids (single,twins, single) first 2 deliveries were Ccesarean sections & have the typical C-section pooch & have also lost about 70lbs but feel like muscles are fine, it’s mostly extra skin & last bit of fat. Most likely option?
Debra J. Johnson, MD's Response:
A panniculectomy removes only the extra lower abdominal skin. It doesn't smooth out any of the excess skin above the bellybutton. If you have extra skin in both the upper and lower abdomen, then a tummy tuck would be best. You should consult with a board-certified plastic surgeon who can examine your abdomen, discuss your goals, and come up with an appropriate plan.
Need help with insurance
Breast ReductionMember Response:
You will need to call the Customer Service number on the back of your Blue Cross Blue Shield card and explain your situation. Usually with an HMO you primary care provider has to make the referral to a specialist such as a plastic surgeon. If your HMO is in New Mexico, then you would likely have to return there to receive services, or else change your insurance to a California plan. Customer Service may be able to help you find a primary care in California who can get you to an in-plan plastic surgeon for your breast reduction.
Need help with insurance
Question:
I need help picking a doctor or just a place to start. I have insurance with blue cross blue shield, my policy is in New Mexico. I am currently in California, my policy is HMO so I will be approved with a doctor that accepts blue cross blue shield. But I might need a referral from a primary care giver but I do not have one in California nor will it be covered to get one here in CA.
Debra J. Johnson, MD's Response:
You will need to call the Customer Service number on the back of your Blue Cross Blue Shield card and explain your situation. Usually with an HMO you primary care provider has to make the referral to a specialist such as a plastic surgeon. If your HMO is in New Mexico, then you would likely have to return there to receive services, or else change your insurance to a California plan. Customer Service may be able to help you find a primary care in California who can get you to an in-plan plastic surgeon for your breast reduction.
Eye bags surgery
Eyelid SurgeryMember Response:
Use the Find-a-Surgeon tool on this website for a list of board-certified plastic surgeons in your zip code! All ASPS members are readily capable of seeing you for your “eye bags” and recommending an appropriate procedure.
Eye bags surgery
Question:
Can you please recommend some cosmetic surgeon in the area for zip code 94605 specialized in eye bags surgery?
Debra J. Johnson, MD's Response:
Use the Find-a-Surgeon tool on this website for a list of board-certified plastic surgeons in your zip code! All ASPS members are readily capable of seeing you for your “eye bags” and recommending an appropriate procedure.
Surgery possible for patient who takes warfarin due to AVR?
Male Breast ReductionMember Response:
Certainly many patients on blood thinning agents undergo surgery. Warfarin is usually stopped a few days in advance and low molecular weight heparin (lovenox) is then used during the perioperative period until the warfarin is resumed. The biggest risk is bleeding, leading to excessive bruising or even hematoma (a collection of blood under the skin surface) that might require a return to the OR to wash the blood out. If your husband is otherwise a good candidate for surgery, and his cardiologist is on board, then a board-certified ASPS member surgeon in your area should be comfortable caring for him.
Surgery possible for patient who takes warfarin due to AVR?
Question:
Would any plastic surgeon even consider a male breast reduction for a patient who is on warfarin therapy with a target INR of 1.5-2.0 (mechanical On-X aortic valve replacement due to congenital bicuspid valve), by working with the patient's cardiologist on the appropriate Lovenox bridging plan? My husband is extremely unhappy with his appearance and I want to help him. Thank you.
Debra J. Johnson, MD's Response:
Certainly many patients on blood thinning agents undergo surgery. Warfarin is usually stopped a few days in advance and low molecular weight heparin (lovenox) is then used during the perioperative period until the warfarin is resumed. The biggest risk is bleeding, leading to excessive bruising or even hematoma (a collection of blood under the skin surface) that might require a return to the OR to wash the blood out. If your husband is otherwise a good candidate for surgery, and his cardiologist is on board, then a board-certified ASPS member surgeon in your area should be comfortable caring for him.
Fat grafting in athletes
Breast AugmentationMember Response:
Fat grafting to the breast has been found to be a reasonable option in women who have enough "extra" fat to donate. Fat is often harvested from the abdomen, flanks, and/or thighs. However, in the breast, only about 50% of the injected fat survives. If your bodyfat level is fairly low, then you might not have enough excess fat to make a big difference in your breast size. However, the fat that does survive will stay put and your breast may enlarge or decrease in volume with weight gain or loss.
Fat grafting in athletes
Question:
Hi, What is the long term success of breast augmentation by fat grafting in athletes? Is this procedure recommended for athletes?
Debra J. Johnson, MD's Response:
Fat grafting to the breast has been found to be a reasonable option in women who have enough "extra" fat to donate. Fat is often harvested from the abdomen, flanks, and/or thighs. However, in the breast, only about 50% of the injected fat survives. If your bodyfat level is fairly low, then you might not have enough excess fat to make a big difference in your breast size. However, the fat that does survive will stay put and your breast may enlarge or decrease in volume with weight gain or loss.
After deflation
Breast Implant RevisionMember Response:
If your implants deflate spontaneously, or if you have your doctor puncture the implant with a needle to deflate them, you will know what size your native breasts are. You can then decide whether you want to have the implant shells removed, or have new implants placed. Deflated implant shells are inert, so you can leave them in place, but they can sometimes fold on themselves and create edges that you might feel or might cause discomfort. If you don't mind the way your breasts look after deflation, then simply removing the implant shells using local anesthesia in the office is possible. If you feel your deflated breasts are too droopy, then some kind of breast lift, removing the shells and the surrounding capsule as needed, could be performed.
After deflation
Question:
If I have my saline breast implants deflated, must I have the implants removed?
Debra J. Johnson, MD's Response:
If your implants deflate spontaneously, or if you have your doctor puncture the implant with a needle to deflate them, you will know what size your native breasts are. You can then decide whether you want to have the implant shells removed, or have new implants placed. Deflated implant shells are inert, so you can leave them in place, but they can sometimes fold on themselves and create edges that you might feel or might cause discomfort. If you don't mind the way your breasts look after deflation, then simply removing the implant shells using local anesthesia in the office is possible. If you feel your deflated breasts are too droopy, then some kind of breast lift, removing the shells and the surrounding capsule as needed, could be performed.
Concerned teen needing advice
Gender Confirmation SurgeryMember Response:
Almost every teen has appearance/body concerns. Sometimes those concerns dissipate with time, sometimes not. Removing your breasts is a major surgery, and should performed only after long and hard thought. Have you discussed this with your parents? Certainly having them help you with this decision would be wise. Although you say you are not a transgender, you might find people willing to help you in this decision-making process at a gender health center. They care for trans- and gender-fluid people who have concerns with body image. A plastic surgeon would want you to meet with an experienced mental health professional to discuss your concerns and objectives. Gender health centers would be able to refer you to an appropriate counselor.
Concerned teen needing advice
Question:
I am 16yrs old and is thinking about getting FTM top surgery, I am not transgender I still very much Identify as female, but I wear a binder and want my breasts completely removed, I know I'm a little young for this kind of surgery and is not planning to do it right now but when I'm 19, still I despise my breasts and I don't know if my insecurities are valid or am I being ridiculous about this?
Debra J. Johnson, MD's Response:
Almost every teen has appearance/body concerns. Sometimes those concerns dissipate with time, sometimes not. Removing your breasts is a major surgery, and should performed only after long and hard thought. Have you discussed this with your parents? Certainly having them help you with this decision would be wise. Although you say you are not a transgender, you might find people willing to help you in this decision-making process at a gender health center. They care for trans- and gender-fluid people who have concerns with body image. A plastic surgeon would want you to meet with an experienced mental health professional to discuss your concerns and objectives. Gender health centers would be able to refer you to an appropriate counselor.
Wound defet
Cosmetic SurgeryMember Response:
Many scars ca be improved by careful revision of the scar line and recontouring with fat grafting or tissue transfer. For your particular problem, you would need to consult with a board-certified plastic surgeon to see what your options are. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you. Good luck!
Wound defet
Question:
Can my lower arm near my elbow be fixed from dog bite that's left a bad scar.From the dog bite some of my arm is gone. It's like a big dent in my arm where it makes it look like it's a deformed arm
Debra J. Johnson, MD's Response:
Many scars ca be improved by careful revision of the scar line and recontouring with fat grafting or tissue transfer. For your particular problem, you would need to consult with a board-certified plastic surgeon to see what your options are. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you. Good luck!
Facial mole removal
Cosmetic SurgeryMember Response:
You cannot remove lesions from the skin without creating some kind of scar. The way you scar depends on your skin color (more darkly pigmented people tend to get some browning of their scars) and your genetics (do other people in your family make poor scars?). Shaving off lesions tends to leave a circular scar, while surgically excising them leaves a line scar. Plastic Surgeons are known to be the best surgeons for removal of these lesions, but even we are unable to perform "scarless" surgery.
Facial mole removal
Question:
I am a 55 years old post menopausal female with multiple hair-growing facial moles ranging in sizes from 1/8 to 1/2 inch. I would like them removed without scarring or facial discoloration, distortions, and I do not believe a regular dermatologist should perform the procedure. Who should evaluate me? A cosmetic surgeon or a plastic surgeon? Thank you.
Debra J. Johnson, MD's Response:
You cannot remove lesions from the skin without creating some kind of scar. The way you scar depends on your skin color (more darkly pigmented people tend to get some browning of their scars) and your genetics (do other people in your family make poor scars?). Shaving off lesions tends to leave a circular scar, while surgically excising them leaves a line scar. Plastic Surgeons are known to be the best surgeons for removal of these lesions, but even we are unable to perform "scarless" surgery.
Help! When to remove face stitches on 1 yr old
General ReconstructionMember Response:
So you're looking at basically 5 1/2 days to removal on the 24th, which I think is fine. In fact, since the stitches are "dissolvable" some or all of them may "fall out" before you see your doctor. Enjoy the rest of your time in Maui!
Help! When to remove face stitches on 1 yr old
Question:
My 1 yr old daughter had 6 stitches on her forehead on 9/18 at 4pm. Is removing them on 9/24 at 10am too late? The dr said they were dissolvable and if still there after 7 days get them removed. Everything I’m reading says remove sooner (5 days) to avoid scars. It was a large cut with 6 stitches :( We are on vacation So deciding if we fly home early or go to urgent care in Maui for removal?
Debra J. Johnson, MD's Response:
So you're looking at basically 5 1/2 days to removal on the 24th, which I think is fine. In fact, since the stitches are "dissolvable" some or all of them may "fall out" before you see your doctor. Enjoy the rest of your time in Maui!
Question for 13 month old large forehead cut and scar-time sensitive
Gender Confirmation SurgeryMember Response:
It is often unnecessary to do more than a single layer closure in the face. Deeper sutures are placed to reduce the tension on the skin, and since there is very little tension in the facial skin, surface sutures are the only ones needed. On the face, I remove the surface sutures in around 5 days, to prevent railroad tracking by the suture entry/exit of the skin, and then tape the incision for about 4 weeks, changing weekly or as needed. The scar will be firm and red initially and will slowly soften and face. But that scar maturation will take up to a year, so be patient.
Question for 13 month old large forehead cut and scar-time sensitive
Question:
My daughter is 13 months old. She got 6 stitches on her forehead today from a large cut. ER doc just did one top layer of stitches. Everything I’m reading online suggests we should have done two layers of stitches. Should we go see a plastic surgeon tomorrow. Is there anything they can do? Will her scar be a lot worse?
Debra J. Johnson, MD's Response:
It is often unnecessary to do more than a single layer closure in the face. Deeper sutures are placed to reduce the tension on the skin, and since there is very little tension in the facial skin, surface sutures are the only ones needed. On the face, I remove the surface sutures in around 5 days, to prevent railroad tracking by the suture entry/exit of the skin, and then tape the incision for about 4 weeks, changing weekly or as needed. The scar will be firm and red initially and will slowly soften and face. But that scar maturation will take up to a year, so be patient.
Is this true about surgical liposuction?
LiposuctionMember Response:
I call "bupkus" to this spa. Liposuction permanently removes fat! You need to watch your diet and exercise after liposuction, because if you gain weight it has to go somewhere....and if your primary fat storage areas have been removed by liposuction, the excess weight may appear elsewhere. I always tell a patient: if you weight 130 today and I remove 5 pounds of fat, then your goal is to weight 125 from now on. That's the best way to maximize the longevity of your result. There are a lot of "devices" to reduce fat, like this Strawberry Laser, CoolSculpting, etc. Many of them work to a degree, but are far less predictable than liposuction. And there are some patients who see no change at all, which can be very frustrating to spend good money and get nothing. Consult with a board-certfied plastic surgeon to get the best advice.
Is this true about surgical liposuction?
Question:
A salon selling Strawberry Laser told me the following: Surgery completely removes the fat cells. When you do this, the body knows how many fat cells you’re supposed to have and simply replaces them and not necessarily in the same area. Meaning you will end up with random fat pockets. With our form of lipo, the fat cells are emptied but still remain there so the body doesn’t try to replace them.
Debra J. Johnson, MD's Response:
I call "bupkus" to this spa. Liposuction permanently removes fat! You need to watch your diet and exercise after liposuction, because if you gain weight it has to go somewhere....and if your primary fat storage areas have been removed by liposuction, the excess weight may appear elsewhere. I always tell a patient: if you weight 130 today and I remove 5 pounds of fat, then your goal is to weight 125 from now on. That's the best way to maximize the longevity of your result. There are a lot of "devices" to reduce fat, like this Strawberry Laser, CoolSculpting, etc. Many of them work to a degree, but are far less predictable than liposuction. And there are some patients who see no change at all, which can be very frustrating to spend good money and get nothing. Consult with a board-certfied plastic surgeon to get the best advice.
Cut Across my face
Cosmetic SurgeryMember Response:
Scars on the face take up to a year to mature. During that time they will soften and the redness will fade. During this early phase silicone gel scar cream and or laser treatments might be helpful to speed the maturation. After the scar has matured, there might possibly be something a plastic surgeon could offer to improve the scar, but a scar is forever and can never be completely erased. It would be best to consult with an ASPS member surgeon in your area to get advice on what options might be available to improve your scarring.
Cut Across my face
Question:
I was in an altercation and a man took a razor and cut me and across the face. It was a traumatic experience and I can't stand too look at the scar. What procedures can I have done to fix the scar and roughly how much does the procedures cost ?
Debra J. Johnson, MD's Response:
Scars on the face take up to a year to mature. During that time they will soften and the redness will fade. During this early phase silicone gel scar cream and or laser treatments might be helpful to speed the maturation. After the scar has matured, there might possibly be something a plastic surgeon could offer to improve the scar, but a scar is forever and can never be completely erased. It would be best to consult with an ASPS member surgeon in your area to get advice on what options might be available to improve your scarring.
Swelling breast
Breast ReductionMember Response:
If your breasts are a DD cup or larger, you would likely qualify for breast reduction surgery. Since you are in a MediCal HMO program through Blue Cross, you will need to see your primary care doctor and ask for a referral to a plastic surgeon. If the plastic surgeon you see thinks you are a good candidate for surgery, then he or she will need to send a letter to Blue Cross requesting authorization for the procedure. Once that is obtained you can get a date for surgery. All of this takes a bit of time, so in the meantime get yourself as healthy as possible: eat right, exercise, and keep your breasts as clean and rash-free as possible. Good luck!
Swelling breast
Question:
Hay i have anthem blue cross thru Medi-Cal i been having breast pains lately and swolling and there making my back hurt and the just to heavy for me is there a way my insurance will cover a breast reduction precedure?
Debra J. Johnson, MD's Response:
If your breasts are a DD cup or larger, you would likely qualify for breast reduction surgery. Since you are in a MediCal HMO program through Blue Cross, you will need to see your primary care doctor and ask for a referral to a plastic surgeon. If the plastic surgeon you see thinks you are a good candidate for surgery, then he or she will need to send a letter to Blue Cross requesting authorization for the procedure. Once that is obtained you can get a date for surgery. All of this takes a bit of time, so in the meantime get yourself as healthy as possible: eat right, exercise, and keep your breasts as clean and rash-free as possible. Good luck!
Gynecomastia issue: Tissue removed through incision, still little swollen/puffy on one side. hematom
Breast ReductionMember Response:
Sheesh, King123, it's a little early to be worrying about your results. When gynecomastia surgery is performed the extra breast tissue is removed from under the skin. This is like letting the air out of a balloon. The overlying skin is squishier than normal and takes some time (three to four months!) to tighten up as much as it will. At four days you still have a lot of swelling, and the two sides never behave exactly the same....one will be more swollen, or more bruised, or feel squishier, etc. You need to drink plenty of fluid, eat enough protein to help you heal, take it easy, and wait things out. Nothing happens overnight. You'll look better and better as time goes on. Your doctor will discuss your progress with you at each post-op visit. In 3-4 months if things aren't as you had hoped, then you can discuss with your surgeon what options might be available to improve your result. Here's hoping that by that time you'll be quite pleased with your chest.
Gynecomastia issue: Tissue removed through incision, still little swollen/puffy on one side. hematom
Question:
I had surgery four days ago to remove the glandular tissue from the chest because of which the appearance which was very massive in appearance reduced. The right side seems deflated/small and the left side has swelling and still feels(haven’t taken bandages or drains off) some fat is there. Will some exercise, considering there is some fat layer, give me a flat appearance better than what I had?
Debra J. Johnson, MD's Response:
Sheesh, King123, it's a little early to be worrying about your results. When gynecomastia surgery is performed the extra breast tissue is removed from under the skin. This is like letting the air out of a balloon. The overlying skin is squishier than normal and takes some time (three to four months!) to tighten up as much as it will. At four days you still have a lot of swelling, and the two sides never behave exactly the same....one will be more swollen, or more bruised, or feel squishier, etc. You need to drink plenty of fluid, eat enough protein to help you heal, take it easy, and wait things out. Nothing happens overnight. You'll look better and better as time goes on. Your doctor will discuss your progress with you at each post-op visit. In 3-4 months if things aren't as you had hoped, then you can discuss with your surgeon what options might be available to improve your result. Here's hoping that by that time you'll be quite pleased with your chest.
Age
Breast AugmentationMember Response:
Age is just a number. As long as you are healthy, have a good understanding of the risks and benefits of breast implants, and can make an informed decision you would be a fine candidate for breast augmentation. You would want to be up-to-date on your mammogram. If you have any health issues, you might want to discuss your suitability for elective surgery with your primary care. Use the Find-a-Surgeon tool to locate a board-certified plastic surgeon near you and make a consultation appointment.
Age
Question:
Ism 56 years old. Is it too late in life to get breast implants?
Debra J. Johnson, MD's Response:
Age is just a number. As long as you are healthy, have a good understanding of the risks and benefits of breast implants, and can make an informed decision you would be a fine candidate for breast augmentation. You would want to be up-to-date on your mammogram. If you have any health issues, you might want to discuss your suitability for elective surgery with your primary care. Use the Find-a-Surgeon tool to locate a board-certified plastic surgeon near you and make a consultation appointment.
Reopening of “new” bellybutton 6 years after Abdominoplasty?
Mommy MakeoverMember Response:
It's good to check and make sure there's no infection, as your primary care is doing. You should return to see your plastic surgeon. If that surgeon is no longer available to you, you can use the Find-a-Surgeon tool on this website to locate an ASPS surgeon near you. You could have a small fluid collection (seroma) leaking. It's not dangerous, but might need some attention to stop the leakage.
Reopening of “new” bellybutton 6 years after Abdominoplasty?
Question:
I had an abdominoplasty in 2013. My surgeon created a new belly button, closed my natural one. 6 years later, I now have clear watery fluid turning into crusty yellow discharge coming from inside the “new” bellybutton. My PCP swabbed it to verify it’s not bacterial or fungal, and so far it’s come back as neither. Shes worried it may be slightly open and abdominal fluid is leaking out. Possible?
Debra J. Johnson, MD's Response:
It's good to check and make sure there's no infection, as your primary care is doing. You should return to see your plastic surgeon. If that surgeon is no longer available to you, you can use the Find-a-Surgeon tool on this website to locate an ASPS surgeon near you. You could have a small fluid collection (seroma) leaking. It's not dangerous, but might need some attention to stop the leakage.
Is there an age requirement and does it matter breast size?
Breast ReductionMember Response:
Breast reduction can be performed at any age, as long as you are healthy and your weight is stable. If you are overweight, and would like to lose weight, it is better to do that before you have a breast reduction. Weight loss after reduction might result is some deflation of the breasts, making them smaller than you might like. Younger women do need to think about the fact that you might one day have children and want to breastfeed. Pregnancy and breastfeeding can ultimately change the breasts in both size and shape. If you go ahead with reduction now, you may not be satisfied with the way your breasts are after pregnancy. I always warn younger women that there may be some "maintenance work" in your future. Reduction does reduce your ability to breastfeed by a small percentage, so realize if you are unable to breastfeed that you may have to bottle/formula feed your baby.
Is there an age requirement and does it matter breast size?
Question:
I'm a 38G Cup and I just recently turned 18. I was thinking by the time I'm 20 of going into get breast liposuction reduction surgery. They sag and make it hard for me to get clothes and bras that fit and have always caused back pain and I wouldn't participate in running and stopped doing my favorite sports a long time ago. What do you guys recommend?
Debra J. Johnson, MD's Response:
Breast reduction can be performed at any age, as long as you are healthy and your weight is stable. If you are overweight, and would like to lose weight, it is better to do that before you have a breast reduction. Weight loss after reduction might result is some deflation of the breasts, making them smaller than you might like. Younger women do need to think about the fact that you might one day have children and want to breastfeed. Pregnancy and breastfeeding can ultimately change the breasts in both size and shape. If you go ahead with reduction now, you may not be satisfied with the way your breasts are after pregnancy. I always warn younger women that there may be some "maintenance work" in your future. Reduction does reduce your ability to breastfeed by a small percentage, so realize if you are unable to breastfeed that you may have to bottle/formula feed your baby.
Full Mastopexy & Breast Augmentation
Breast LiftMember Response:
500 cc implants are larger than average. That size implant adds a little over two cups sizes to your bra. The additional implant weight puts even more gravitational effect on your breasts, so that despite the lift, you are stressing your breast skin. Your plastic surgeon likely recommended mesh to try and counteract the additional weight of the implants and prevent future "bottoming out" of the breast skin. Keeping your breasts D-cup or lower is a good preventative to future droopiness of the breasts, and also helps reduce neck, back, and shoulder pain associated with DD+ breasts.
Full Mastopexy & Breast Augmentation
Question:
Hi! I am having a full mastopexy and aug. replacing my saline 420’s with silicone high profile. I weigh 145, athletic, 5’6”. Would a 500cc implant be too large? My doctor also wanted to do galaflex bra but is the bra a gimmick? Is anyone allowed to say the markup on mesh is? I feel like the mesh is a sales technique.
Debra J. Johnson, MD's Response:
500 cc implants are larger than average. That size implant adds a little over two cups sizes to your bra. The additional implant weight puts even more gravitational effect on your breasts, so that despite the lift, you are stressing your breast skin. Your plastic surgeon likely recommended mesh to try and counteract the additional weight of the implants and prevent future "bottoming out" of the breast skin. Keeping your breasts D-cup or lower is a good preventative to future droopiness of the breasts, and also helps reduce neck, back, and shoulder pain associated with DD+ breasts.
Incision not healing
Tummy TuckMember Response:
Delayed healing is the most common risk from a tummy tuck. Keeping the area clean is important. Then cover with some antibiotic ointment and a dry gauze. It can take several weeks to heal completely so don’t lose faith. The resulting scar will be a bit purplish for awhile but in the long run will likely look fine. If it doesn’t, a small scar revision might improve things.
Incision not healing
Question:
So I'm 4 weeks post op for my tummy tuck. Everything seems to have settled well and my incision has healed up nicely...apart from 1 small section on my right hand side. A small hole has not closed up. I've been told numerous times it will close but hasn't. It's not infected as I've taken a course of antibiotics. Neither it is leaking puss. What should I do?
Debra J. Johnson, MD's Response:
Delayed healing is the most common risk from a tummy tuck. Keeping the area clean is important. Then cover with some antibiotic ointment and a dry gauze. It can take several weeks to heal completely so don’t lose faith. The resulting scar will be a bit purplish for awhile but in the long run will likely look fine. If it doesn’t, a small scar revision might improve things.
mastoplexy failure
Breast LiftMember Response:
It is very disappointing to have your breasts sag again after a breast lift. But the very reasons your breasts sagged in the first place are still affecting your breasts now. Often I have patients with very thin skin, and even though you tighten as much as you think is safe, it will "rebound" after breastlift and stretch again. If you have a fair amount of your own breast volume/weight (like a C-cup or bigger) gravity will work against you. Also, you don't mention the type of lift you had, but often the shorter scar lifts (like periareolar or lollipop) leave more weak skin behind that can stretch out after surgery. Hopefully, tightening the skin envelope again will do the trick, but unfortunately no promises can be made. Wearing a good supportive bra, avoiding activities that "bounce" the breasts (like jogging, jump-roping, bouncing on a trampoline, etc) will reduce the stretching. Good luck!
mastoplexy failure
Question:
I had a breast augmentation with lift 14 months ago. I have maintained my weight and used proper support. The right breast required suturing a few weeks because the implant slipped. The placement of both breasts is lower than I had been told, and my surgeon is recommending another lift after only one year. The physician I work with does not believe I have unrealistic expectations. Reasonable?
Debra J. Johnson, MD's Response:
It is very disappointing to have your breasts sag again after a breast lift. But the very reasons your breasts sagged in the first place are still affecting your breasts now. Often I have patients with very thin skin, and even though you tighten as much as you think is safe, it will "rebound" after breastlift and stretch again. If you have a fair amount of your own breast volume/weight (like a C-cup or bigger) gravity will work against you. Also, you don't mention the type of lift you had, but often the shorter scar lifts (like periareolar or lollipop) leave more weak skin behind that can stretch out after surgery. Hopefully, tightening the skin envelope again will do the trick, but unfortunately no promises can be made. Wearing a good supportive bra, avoiding activities that "bounce" the breasts (like jogging, jump-roping, bouncing on a trampoline, etc) will reduce the stretching. Good luck!
FDL and BTL
Tummy TuckMember Response:
Congratulations on your weight loss! Have you reached your goal weight? Most surgeons would want you as close as possible to your goal weight and to have maintained that weight for 3-6 months prior to an abdominoplasty. You can combine a tummy tuck with other procedures but it can increase the risk of complications. You would need to have a gyn surgeon and a plastic surgeon that could work together. Salpingostomy (unblocking of a Fallopian tube) makes me think you might be wanting to get pregnant in the future. Pregnancy after an abdominoplasty would likely stretch out your abdominal skin and worsen your result. It is usually best to finish childbearing before having a tummy tuck.
FDL and BTL
Question:
Let me start off I have lost 150 lbs. I am thinking about having a tummy tuck surgery with an FDL cut. I am also wanting a BTL At the same time. Can this be done?
Debra J. Johnson, MD's Response:
Congratulations on your weight loss! Have you reached your goal weight? Most surgeons would want you as close as possible to your goal weight and to have maintained that weight for 3-6 months prior to an abdominoplasty. You can combine a tummy tuck with other procedures but it can increase the risk of complications. You would need to have a gyn surgeon and a plastic surgeon that could work together. Salpingostomy (unblocking of a Fallopian tube) makes me think you might be wanting to get pregnant in the future. Pregnancy after an abdominoplasty would likely stretch out your abdominal skin and worsen your result. It is usually best to finish childbearing before having a tummy tuck.
How expensive is it?
Breast ReductionMember Response:
You should consult with one of our ASPS member board certified plastic surgeons to see what your options might be. Sometimes gynecomastia is covered under health insurance so you would only be responsible for your co-pay and deductible. If you don't have insurance or it isn't a covered benefit, then many plastic surgeons have their own office operating room where they perform surgery far more economically than in a hospital. You should call customer service for your health insurance to see if gynecomastia surgery is covered, and if it is, ask for a list of plastic surgeons in your plan. Then you will have to google or make a few phone calls to find an in-network board-certified plastic surgeon to care for you (sometimes dermatologists and ENTs are listed under plastic surgery). If it's not covered, use the Find-a-Surgeon tool on this website to locate ASPS member surgeons near you. Good luck!
How expensive is it?
Question:
Hello, I have gynecomastia and I hate it! It is something very embarrassing and I want it gone. My question is what is the typical cost to get rid of it? And do I need to get referred by a doctor in order to get surgery.
Debra J. Johnson, MD's Response:
You should consult with one of our ASPS member board certified plastic surgeons to see what your options might be. Sometimes gynecomastia is covered under health insurance so you would only be responsible for your co-pay and deductible. If you don't have insurance or it isn't a covered benefit, then many plastic surgeons have their own office operating room where they perform surgery far more economically than in a hospital. You should call customer service for your health insurance to see if gynecomastia surgery is covered, and if it is, ask for a list of plastic surgeons in your plan. Then you will have to google or make a few phone calls to find an in-network board-certified plastic surgeon to care for you (sometimes dermatologists and ENTs are listed under plastic surgery). If it's not covered, use the Find-a-Surgeon tool on this website to locate ASPS member surgeons near you. Good luck!
Boob Reduction
Breast ReductionMember Response:
The cost depends often on how long the procedure will take. Is your breast size just a little different so that perhaps just liposuction would correct the asymmetry? Or is the larger breast also very droopy and both skin and breast tissue will need to be removed? What is your age? Have you had children yet? Do you want to try and have your health insurance cover the cost? These are all issues that play into what might be recommended. A standard one-sided breast reduction in my practice in California would run about $4000, although price varies throughout the country. You should consult with a board certified plastic surgeon in your area. Consult the Find-a-Surgeon tool to find qualified ASPS member surgeons near you.
Boob Reduction
Question:
I wanted to know the round about cost for a breast reduction on one Breast. Does the size of the breast matter ?
Debra J. Johnson, MD's Response:
The cost depends often on how long the procedure will take. Is your breast size just a little different so that perhaps just liposuction would correct the asymmetry? Or is the larger breast also very droopy and both skin and breast tissue will need to be removed? What is your age? Have you had children yet? Do you want to try and have your health insurance cover the cost? These are all issues that play into what might be recommended. A standard one-sided breast reduction in my practice in California would run about $4000, although price varies throughout the country. You should consult with a board certified plastic surgeon in your area. Consult the Find-a-Surgeon tool to find qualified ASPS member surgeons near you.
Financing
Tummy TuckMember Response:
There are various ways to finance a medical procedure: you can use a credit card you already have and pay the cost over time, but with a monthly interest payment added in. There are companies that provide short term loans, some at no interest for 6 months to a year, that give you the opportunity to pay the bill off in monthly installments. You need to understand that the longer you take to pay, the more interest you might have tacked on, making the surgery more expensive. Google cosmetic surgery financing and carefully read the offers. Applying before you see a plastic surgeon lets you know if and for how much loan assistance you may qualify, so that you can go ahead a schedule the surgery once you find a plastic surgeon you like.
Financing
Question:
Is there financing for people that has less than perfect credit? I’ll be 50 in October.. I saved for a couple years to get surgery but my son was shot and lived thank God but I had to use it to help him with recovery. This is a dream. I feel deformed.
Debra J. Johnson, MD's Response:
There are various ways to finance a medical procedure: you can use a credit card you already have and pay the cost over time, but with a monthly interest payment added in. There are companies that provide short term loans, some at no interest for 6 months to a year, that give you the opportunity to pay the bill off in monthly installments. You need to understand that the longer you take to pay, the more interest you might have tacked on, making the surgery more expensive. Google cosmetic surgery financing and carefully read the offers. Applying before you see a plastic surgeon lets you know if and for how much loan assistance you may qualify, so that you can go ahead a schedule the surgery once you find a plastic surgeon you like.
Weight
Tummy TuckMember Response:
The best thing you can do to reduce your risk of post-operative complications is to reduce your weight. If you can get to a BMI of less than 30, you will reduce your risk of wound healing problems and blood clots in the legs that could travel to the lungs and cause shortness of breath, palpitations and even death. Your BMI is currently 36.4 which places you in the "obese" range. To get your BMI below 30 you would need to weigh less than 164 pounds. So you need to lose 35 pounds. Talk to your doctor about a medically supervised weight loss program. Or consider Weight Watchers, a proven method of safe weight loss. And good luck!
Weight
Question:
5'2 199 pound do i have to lose weight for a tummy tuck?
Debra J. Johnson, MD's Response:
The best thing you can do to reduce your risk of post-operative complications is to reduce your weight. If you can get to a BMI of less than 30, you will reduce your risk of wound healing problems and blood clots in the legs that could travel to the lungs and cause shortness of breath, palpitations and even death. Your BMI is currently 36.4 which places you in the "obese" range. To get your BMI below 30 you would need to weigh less than 164 pounds. So you need to lose 35 pounds. Talk to your doctor about a medically supervised weight loss program. Or consider Weight Watchers, a proven method of safe weight loss. And good luck!
Tiny breast
Breast AugmentationMember Response:
Fortunately in San Antonio there are several ASPS member surgeons. Use the Find-a-Surgeon tool to locate board certifiedplastic surgeons in your area. Placement of a breast implant or even fat transfer may be options.
Tiny breast
Question:
What is the best brand /type of implant for a 45 year year woman with AAA Breast. Literally just have tiny nipples and not going to have more children?
Debra J. Johnson, MD's Response:
Fortunately in San Antonio there are several ASPS member surgeons. Use the Find-a-Surgeon tool to locate board certifiedplastic surgeons in your area. Placement of a breast implant or even fat transfer may be options.
Age limitation
Tummy TuckMember Response:
Age is not a limitation as long as your general health is good. If you have any health issues, then your plastic surgeon may ask you to get a “medical clearance” from your cardiologist or primary care doctor to assure they believe you could undergo a procedure without difficulty. Consult with an ASPS member surgeon to assess your suitability for surgery.
Age limitation
Question:
Can someone in her mid-70s have a successful tummy tuck, or some kind of face work done?
Debra J. Johnson, MD's Response:
Age is not a limitation as long as your general health is good. If you have any health issues, then your plastic surgeon may ask you to get a “medical clearance” from your cardiologist or primary care doctor to assure they believe you could undergo a procedure without difficulty. Consult with an ASPS member surgeon to assess your suitability for surgery.
Average cost of reduction and lift
Breast ReductionMember Response:
If your wife is unhappy with the size and shape of her breasts, she should consult with an ASPS member surgeon regarding her options. She likely has saline-filled implants, if they were placed in 2004 (silicone was not available at that time for breast enlargement patients). As long as the implants are intact, there is no reason to replace them, unless downsizing the implants is a necessary part of her breast reduction. If she needs a lift and small reduction, then a breast lift alone (removing a smaller amount of breast tissue) might suffice. Your wife should be up to date on her mammogram. If she has a card with the implant size/type on it, take that to her consultation. Unfortunately, pain is not something you can see to pluck out. A good exam by a plastic surgeon may be able to determine if the implant/capsule is a source of her pain. If her pain is in the breast, it may improve with time. Costs vary b/w $5000-10,000 depending on what is needed.
Average cost of reduction and lift
Question:
My wife has implants and occasionally has pain in that area her implants are 14 years old as is telling me they need to be replaced and would like a reduction and lift. What is the average cost for this procedure?
Debra J. Johnson, MD's Response:
If your wife is unhappy with the size and shape of her breasts, she should consult with an ASPS member surgeon regarding her options. She likely has saline-filled implants, if they were placed in 2004 (silicone was not available at that time for breast enlargement patients). As long as the implants are intact, there is no reason to replace them, unless downsizing the implants is a necessary part of her breast reduction. If she needs a lift and small reduction, then a breast lift alone (removing a smaller amount of breast tissue) might suffice. Your wife should be up to date on her mammogram. If she has a card with the implant size/type on it, take that to her consultation. Unfortunately, pain is not something you can see to pluck out. A good exam by a plastic surgeon may be able to determine if the implant/capsule is a source of her pain. If her pain is in the breast, it may improve with time. Costs vary b/w $5000-10,000 depending on what is needed.
Autoimmune disorder
Tummy TuckMember Response:
Having ankylosing spondilitis does not bar you from having a tummy tuck. You would need to talk to your rheumatologist regarding this surgery and receive his or her okay for going through with the procedure. Most plastic surgeons ask you to discontinue your Naproxyn prior to surgery because one of the side effects of NSAIDs is increased bruising and risk of bleeding causing a hematoma (a collection of blood in the wound that might require further surgery). After a tummy tuck, many women have to walk a bit hunched over for a few days, which can result in low back pain. On the positive side, people with autoimmune disorders often end up with better scars than the general population. Consult with an ASPS member surgeon to see if you are a safe candidate for this surgery.
Autoimmune disorder
Question:
I'm considering a tummy tuck but I'm very scared to do so because i have Anklosing Spondylitis . I have not started any biologic yet . I just take naproxen and tizandine . Is someone with an autoimmune disorder a good candidate for surgery / tummy tuck
Debra J. Johnson, MD's Response:
Having ankylosing spondilitis does not bar you from having a tummy tuck. You would need to talk to your rheumatologist regarding this surgery and receive his or her okay for going through with the procedure. Most plastic surgeons ask you to discontinue your Naproxyn prior to surgery because one of the side effects of NSAIDs is increased bruising and risk of bleeding causing a hematoma (a collection of blood in the wound that might require further surgery). After a tummy tuck, many women have to walk a bit hunched over for a few days, which can result in low back pain. On the positive side, people with autoimmune disorders often end up with better scars than the general population. Consult with an ASPS member surgeon to see if you are a safe candidate for this surgery.
vaping after surgery
Breast ReductionMember Response:
Ideally you would discontinue vaping forever, as nicotine addiction is an expensive, unhealthy practice. Nicotine constricts the blood vessels that produce healing, and there is tons of evidence that tobacco products increase healing complications. Nicotine also constricts vessels supplying sensory nerves and thus increases pain after surgery. I would ask your surgeon how long you should lay off vaping, but my best answer is forever.
vaping after surgery
Question:
Hi! I got a breast reduction 4 days ago and I was wondering how long I should wait until I can start vaping again? I know how nicotine is a blood vessel constrictor but so is coffee? just wondering is 2 weeks okay? post op?
Debra J. Johnson, MD's Response:
Ideally you would discontinue vaping forever, as nicotine addiction is an expensive, unhealthy practice. Nicotine constricts the blood vessels that produce healing, and there is tons of evidence that tobacco products increase healing complications. Nicotine also constricts vessels supplying sensory nerves and thus increases pain after surgery. I would ask your surgeon how long you should lay off vaping, but my best answer is forever.
Recovery
Breast ReductionMember Response:
I usually ask patients to avoid vigorous physical activity for two weeks. Off work for 10-14 days, and no alcohol while using pain medication. It usually takes 2-3 months for the last little tweaky feelings to dissipate and to feel 100% again.
Recovery
Question:
How long on average for me to be fully healed and would I be able to enjoy a drink after a month?
Debra J. Johnson, MD's Response:
I usually ask patients to avoid vigorous physical activity for two weeks. Off work for 10-14 days, and no alcohol while using pain medication. It usually takes 2-3 months for the last little tweaky feelings to dissipate and to feel 100% again.
Can I become flat chested?
Breast ReductionMember Response:
When you reduce the breasts the surgeon needs to leave enough blood supply to keep what's left alive. Going "flat" might mean that the nipple/areola would have to be removed and then replaced as a graft. A grafted nipple loses its sensitivity and projection. If you are willing to sacrifice the feeling in the nipple, then going flat is possible. If you want to maintain the sensibility of the nipple, then your surgeon can make you as small as possible, but it may not be completely flat.
Can I become flat chested?
Question:
I have C or D breast and I want to be completely flat chested I don’t want to have no breast so to speak left. Is this possible with breast reduction and if not what is the lowest possible breast size I can go to.
Debra J. Johnson, MD's Response:
When you reduce the breasts the surgeon needs to leave enough blood supply to keep what's left alive. Going "flat" might mean that the nipple/areola would have to be removed and then replaced as a graft. A grafted nipple loses its sensitivity and projection. If you are willing to sacrifice the feeling in the nipple, then going flat is possible. If you want to maintain the sensibility of the nipple, then your surgeon can make you as small as possible, but it may not be completely flat.
Upper back/shoulder/neck pain
Breast ReductionMember Response:
It would be a good idea to consult with an ASPS member plastic surgeon. Many women with larger breasts wear bras that are too small for them, so your 36D might not be correct. If you can hold your breasts up with your hands and feel relief in your back pain, then a reduction would likely improve your symptoms. Usually women with DD or greater will qualify for reduction under their health insurance plan. Use the Find-A-Surgeon tool to locate an ASPS member near you.
Upper back/shoulder/neck pain
Question:
I’ve dealt with upper back pain, particularly shoulder and neck pain for quite some time and this year alone have been to doctor 3 times regarding this. At my last appointment they recommended me to have consultation to see if I would be a candidate for a breast reduction. I don’t feel like my breast are that huge for my body structure but I am curious as to what you think. I’m 5’9 and 36D bust.
Debra J. Johnson, MD's Response:
It would be a good idea to consult with an ASPS member plastic surgeon. Many women with larger breasts wear bras that are too small for them, so your 36D might not be correct. If you can hold your breasts up with your hands and feel relief in your back pain, then a reduction would likely improve your symptoms. Usually women with DD or greater will qualify for reduction under their health insurance plan. Use the Find-A-Surgeon tool to locate an ASPS member near you.
Revision
Breast AugmentationMember Response:
Your implant should have a lifetime product warranty (unless it is a PIP implant). That means the manufacturer will provide a new implant for free. You would have to pay for the surgeon and the operating room fee. Your original surgeon may waive his/her fee. I do this for my own patients. For patients I didn't operate on, I charge $500. The OR is usually only one hour, so not terribly expensive. If your original surgeon is not available, check the Find-A-Surgeon tool for ASPS members near you. Call around and ask what the price might be. USC and UCLA may have "resident's cosmetic clinics" in which a resident (under the supervision of a professor) might offer a reduced cost surgery. You could also consider one of the no or low-interest loans that would allow you to pay off the surgery over 6-12 months. Good luck.
Revision
Question:
Left implant deflated can’t afford revision looking for clinical trial free procedure. Had my saline implants over 20 years.
Debra J. Johnson, MD's Response:
Your implant should have a lifetime product warranty (unless it is a PIP implant). That means the manufacturer will provide a new implant for free. You would have to pay for the surgeon and the operating room fee. Your original surgeon may waive his/her fee. I do this for my own patients. For patients I didn't operate on, I charge $500. The OR is usually only one hour, so not terribly expensive. If your original surgeon is not available, check the Find-A-Surgeon tool for ASPS members near you. Call around and ask what the price might be. USC and UCLA may have "resident's cosmetic clinics" in which a resident (under the supervision of a professor) might offer a reduced cost surgery. You could also consider one of the no or low-interest loans that would allow you to pay off the surgery over 6-12 months. Good luck.
Possible breast reduction
Breast ReductionMember Response:
Large breasts often cause neck, back, and shoulder pain. A lot of women get grooves in their shoulders from heavy bra straps. Some women will get rashy under the breast where is is moist and warm from the skin on skin. If you can lift your breasts up with your hands and immediately feel relief in your neck and shoulders, it is likely you would benefit from breast reduction. The trade off is the surgery and recuperation, as well as the permanent scars on the breasts. If you are overweight and would like to lose weight, it is better to lose it before your breasts are reduced. If you lose weight after a breast reduction, the breasts will lose volume too and can be saggier than you'd like. Good luck!
Possible breast reduction
Question:
I'm considering breast reduction surgery. I've had large breasts since elementary school and even though I was able to do a lot of activities it was always uncomfortable. I'm now 41yrs old and 4'10 and 234lbs, I currently am wearing a 46 ddd. I do get neck back and shoulder pain. I recently had a mammogram and the results are it's mostly fatty tissue. What should I do.
Debra J. Johnson, MD's Response:
Large breasts often cause neck, back, and shoulder pain. A lot of women get grooves in their shoulders from heavy bra straps. Some women will get rashy under the breast where is is moist and warm from the skin on skin. If you can lift your breasts up with your hands and immediately feel relief in your neck and shoulders, it is likely you would benefit from breast reduction. The trade off is the surgery and recuperation, as well as the permanent scars on the breasts. If you are overweight and would like to lose weight, it is better to lose it before your breasts are reduced. If you lose weight after a breast reduction, the breasts will lose volume too and can be saggier than you'd like. Good luck!
Theresa
Tummy TuckMember Response:
Lord knows we should all be at our ideal weight. I always suggest to my patients that if weight loss is an "achievable goal", they should try and achieve it before surgery to give me the opportunity to give them the best results. If you lose weight after an abdominoplasty, you may notice loosening of the skin again which can lessen your result. We do know that complications, such as wound healing difficulties and blood clots in the legs, are greater in heavier patients, so weight loss is the one thing a patient can do to make the surgery safer for themselves.
Theresa
Question:
Do you have to be at an ideal weight for liposuction or tummy tuck?
Debra J. Johnson, MD's Response:
Lord knows we should all be at our ideal weight. I always suggest to my patients that if weight loss is an "achievable goal", they should try and achieve it before surgery to give me the opportunity to give them the best results. If you lose weight after an abdominoplasty, you may notice loosening of the skin again which can lessen your result. We do know that complications, such as wound healing difficulties and blood clots in the legs, are greater in heavier patients, so weight loss is the one thing a patient can do to make the surgery safer for themselves.
Consideration for 2nd Facelift
FaceliftMember Response:
You certainly want a board-certified plastic surgeon who is experienced in facelift surgery. Many of us choose plastic surgery because of the variety of procedures we get to perform. The surgical skills required, and the tricks of the trade if you will, are the same no matter if it is a facelift or a breast lift or a tummy tuck. You could certainly return to your first surgeon, if you were happy with the results. Otherwise, use our Find-A-Surgeon tool to locate an ASPS member surgeon near you.
Consideration for 2nd Facelift
Question:
How would it be to my advantage if I decide to have a second Facelift, to choose a surgeon who does other plastic surgeries (breast implants, lipo, tummy tuck, etc.) vs. a surgeon who only does Facelifts?
Debra J. Johnson, MD's Response:
You certainly want a board-certified plastic surgeon who is experienced in facelift surgery. Many of us choose plastic surgery because of the variety of procedures we get to perform. The surgical skills required, and the tricks of the trade if you will, are the same no matter if it is a facelift or a breast lift or a tummy tuck. You could certainly return to your first surgeon, if you were happy with the results. Otherwise, use our Find-A-Surgeon tool to locate an ASPS member surgeon near you.
Liposuction and transfer to the breast
LiposuctionMember Response:
When you transfer fat it needs to be done in very small increments so that the tiny globules of fat are completely surrounded by living tissue that can then nourish the graft and provide blood supply. The amount of fat you can graft will depend on how thick her native breast tissue is. If she has a fair amount of her own tissue, then there is more space in which to place the fat grafts. If she had very little breast tissue then you won’t be able to graft too much at once. And even under the best conditions only about half the fat survives. So she might require more than one grafting session, separated by 4-6 months between each time.
Liposuction and transfer to the breast
Question:
My Fiancé is getting an explant of her 420cc silicone breast implants. We are going to do liposuction of her mid section and transfer the fat to her breasts. Our question is how much can we safely transfer. She weighs about 145 lbs. we have been to consults with plastic surgeons and cannot get a consistent answer. We are worried about the outcome. Any information would be great.
Debra J. Johnson, MD's Response:
When you transfer fat it needs to be done in very small increments so that the tiny globules of fat are completely surrounded by living tissue that can then nourish the graft and provide blood supply. The amount of fat you can graft will depend on how thick her native breast tissue is. If she has a fair amount of her own tissue, then there is more space in which to place the fat grafts. If she had very little breast tissue then you won’t be able to graft too much at once. And even under the best conditions only about half the fat survives. So she might require more than one grafting session, separated by 4-6 months between each time.
Prepectoral reconstruction and screening
Breast AugmentationMember Response:
Because you are very lean, I would be concerned that you would have visible rippling of the implants in the upper/medial breast, since you likely have thin skin covering an implant. Submuscular placement would provide more camouflage, but you would notice the muscle pulling on the overlying skin and flattening the implant when you tighten your pec muscle. I would consider a highly cohesive gel implant which ripples less, or a baffled saline implant well filled. You could also consider gluteal flaps as an autologous recon option. Recurrent cancer could appear either right under the breast skin or on top of the pec muscle. With an autologous recon or prepectoral implant you can only monitor the breast skin. With subpectoral implants the muscle is right under the skin, so it can be readily monitored as well. Recurrences usually appear within the first 5 years, but only affect 2-4% of patients.
Prepectoral reconstruction and screening
Question:
I have stage 2 Invasive ductal carcinoma. I've had a double mastectomy. My plastic surgeon has recommended prepectoral reconstruction as I'm 53, active, 5'8, 120 lbs, and want to be a 34" B cup. My oncologist is concerned that the only way to do cancer screening is an MRI (will insurance cover this?). What are your thoughts on prepectoral reconstruction and cancer screening?
Debra J. Johnson, MD's Response:
Because you are very lean, I would be concerned that you would have visible rippling of the implants in the upper/medial breast, since you likely have thin skin covering an implant. Submuscular placement would provide more camouflage, but you would notice the muscle pulling on the overlying skin and flattening the implant when you tighten your pec muscle. I would consider a highly cohesive gel implant which ripples less, or a baffled saline implant well filled. You could also consider gluteal flaps as an autologous recon option. Recurrent cancer could appear either right under the breast skin or on top of the pec muscle. With an autologous recon or prepectoral implant you can only monitor the breast skin. With subpectoral implants the muscle is right under the skin, so it can be readily monitored as well. Recurrences usually appear within the first 5 years, but only affect 2-4% of patients.
I just want my confidence back
Breast AugmentationMember Response:
Fat transfer, if appropriate for you, would result in two breast that are more similar (rather than one with an implant and one without). As Dr Culbertson mentioned, you have to have enough fat elsewhere to donate and it sometimes requires more than one treatment. Use the Find-A-Surgeon tool to locate ASPS members near you, then make some calls asking whether the doctor does dat transfer for breast enlargement (not all do). While the consult may not be free, remember you are receiving the doctors expert opinion and their time which is valuable.
I just want my confidence back
Question:
I have been researching for a while but I can't make up my mind on whether it would be better to have a breast augmentation with silicone or a fat transfer. I had 4 kids and one breast is a full C, while the other is maybe a B (or full A). I would like to have a consultation but I haven't seen any that do Pro Bono consults in (or near) SC. I just want my confidence back.
Debra J. Johnson, MD's Response:
Fat transfer, if appropriate for you, would result in two breast that are more similar (rather than one with an implant and one without). As Dr Culbertson mentioned, you have to have enough fat elsewhere to donate and it sometimes requires more than one treatment. Use the Find-A-Surgeon tool to locate ASPS members near you, then make some calls asking whether the doctor does dat transfer for breast enlargement (not all do). While the consult may not be free, remember you are receiving the doctors expert opinion and their time which is valuable.
Ehlers Danlos and breast reduction?
Breast ReductionMember Response:
Large breasts, particularly those that are droopy, are known to cause back, neck, and shoulder pain. Certainly your Ehlers-Danlos could also be contributing. If you can hold your breasts up with your hands, and feel relief of some of your back pain, then a reduction would likely make you feel better. The tradeoff is the surgery, recuperation, and permanent scarring. As long as your primary care doctor feels you are in good enough health to undergo this outpatient surgical procedure, then find a local board-certified plastic surgeon and discuss your options. Use the Find-A-Surgeon tool on this website to find an ASPS member surgeon near you.
Ehlers Danlos and breast reduction?
Question:
I was diagnosed with Ehlers Danlos as a toddler, I am now 42. I also have very large breasts and have been experiencing back pain over the last 6 months. Could either of these be contributors to my back pain? If a reduction would help, would EDS be a containdication for surgery? Thanks for any input. Betsy
Debra J. Johnson, MD's Response:
Large breasts, particularly those that are droopy, are known to cause back, neck, and shoulder pain. Certainly your Ehlers-Danlos could also be contributing. If you can hold your breasts up with your hands, and feel relief of some of your back pain, then a reduction would likely make you feel better. The tradeoff is the surgery, recuperation, and permanent scarring. As long as your primary care doctor feels you are in good enough health to undergo this outpatient surgical procedure, then find a local board-certified plastic surgeon and discuss your options. Use the Find-A-Surgeon tool on this website to find an ASPS member surgeon near you.
Necrosis
Breast ReductionMember Response:
So the good news is that you’re early in the healing process, and still have a fair amount of inflammation going on. That will settle in the coming months and the breast should improve significantly. Although massaging may feel creepy, it is good to do it to help the firm areas “remodel”. Good luck!
Necrosis
Question:
Follow up to my question my original surgery was in December and the emergency surgery on my right breast due to infection, my adipose tissue was showing and loss part of my areola, was in January. The tennis ball in my right breast feels disgusting I hate to touch it. What can be done for the scarring and the tennis ball size necrosis other than massage if anything.
Debra J. Johnson, MD's Response:
So the good news is that you’re early in the healing process, and still have a fair amount of inflammation going on. That will settle in the coming months and the breast should improve significantly. Although massaging may feel creepy, it is good to do it to help the firm areas “remodel”. Good luck!
Necrosis
Breast ReductionMember Response:
When a breast reduction is performed, the breast is taken apart and then put back together after removing tissue and skin. In that process, sometimes there are areas of the skin or tissue that don't end up getting enough blood supply. This can cause loss of skin or scarring within the breast tissue, known as fat necrosis. Infection can compound this problem. You don't say how long it's been since your surgery, but often fat necrosis can improve with time, as inflammation subsides and the scar tissue gets remodeled. Hopefully you will notice the breast getting softer as the months go by. Sometimes, if the firmness does not go away, and particularly if it is painful, the damaged tissue can be removed, but that can cause the breasts to be asymmetric size wise and shape wise. Massage and time are your best friend. Hang in there.
Necrosis
Question:
I had a bad infection 1 month after reduction and had to be re closed. It feels like a tennis ball in that breast due to tissue necrosis per my surgeon. What can I do?
Debra J. Johnson, MD's Response:
When a breast reduction is performed, the breast is taken apart and then put back together after removing tissue and skin. In that process, sometimes there are areas of the skin or tissue that don't end up getting enough blood supply. This can cause loss of skin or scarring within the breast tissue, known as fat necrosis. Infection can compound this problem. You don't say how long it's been since your surgery, but often fat necrosis can improve with time, as inflammation subsides and the scar tissue gets remodeled. Hopefully you will notice the breast getting softer as the months go by. Sometimes, if the firmness does not go away, and particularly if it is painful, the damaged tissue can be removed, but that can cause the breasts to be asymmetric size wise and shape wise. Massage and time are your best friend. Hang in there.
Smoking issues prior to my operation
LiposuctionMember Response:
Best bet is to stop using all nicotine for 3-4 weeks prior to surgery, and then forever thereafter. Nicotine increases wound healing problems, worsens scarring, increases pain. Protect your result, and your health, by quitting now.
Smoking issues prior to my operation
Question:
I had a scar revision for a big wound that was painful now one year half after my operation. For better results we used some liposuction, I could not stop in time for operation . I bought Patches realize that is still harmful . What is my best answer with the best healing and quitting. My operation was all surface except for Lipo . I was too afraid to tell my doctor . I want to quit ..
Debra J. Johnson, MD's Response:
Best bet is to stop using all nicotine for 3-4 weeks prior to surgery, and then forever thereafter. Nicotine increases wound healing problems, worsens scarring, increases pain. Protect your result, and your health, by quitting now.
Mom life
Body ContouringMember Response:
If your goal weight is 160, you need to do the hard work of diet and exercise to try and get as close as you can prior to any surgery. Losing weight after surgery can result in loosening of the skin and a lesser result. Your skin has been stretched out by the weight gain and the pregnancies, so that excess skin will need to be removed, resulting in permanent large scars. Consult with a board certifiedpkastic surgeon to determine your options and best timing of any procedures.
Mom life
Question:
Really want to get back down to 160 the weight I was before my first child in now 255 after my 3rd child I would also like to fix all the flabbiness in my body my arms, my legs, and my chin. Get my butt back to plump instead of flat and my boobs back where they should be. I was wondering a price range for body contouring?
Debra J. Johnson, MD's Response:
If your goal weight is 160, you need to do the hard work of diet and exercise to try and get as close as you can prior to any surgery. Losing weight after surgery can result in loosening of the skin and a lesser result. Your skin has been stretched out by the weight gain and the pregnancies, so that excess skin will need to be removed, resulting in permanent large scars. Consult with a board certifiedpkastic surgeon to determine your options and best timing of any procedures.
Removal
Breast AugmentationMember Response:
You had your breast implants placed for personal reasons and you can have them removed for personal reasons. There is no definitive evidence that removal of breast implants will improve your health. Epidemiologic studies have not shown an increased risk of autoimmune disorders in women with breast implants when compared to women without. You will have loose breast skin after the removal, and may want to consider a breast lift to reduce the excess skin. Consult with an ASPS member surgeon to discuss your options.
Removal
Question:
Breast augmentation almost 23 years ago with a beautiful result Over next several years became hypothyroid, hysterectomy, breast shooting pain, extreme fatigue, loss of exercise due to severe joint pain, pain under arms, depression, suicide attempts, hormone replacementBRVONIGHTSWEATS Ana highly positive and lulus. Used to be beautiful just want implants out. Please help
Debra J. Johnson, MD's Response:
You had your breast implants placed for personal reasons and you can have them removed for personal reasons. There is no definitive evidence that removal of breast implants will improve your health. Epidemiologic studies have not shown an increased risk of autoimmune disorders in women with breast implants when compared to women without. You will have loose breast skin after the removal, and may want to consider a breast lift to reduce the excess skin. Consult with an ASPS member surgeon to discuss your options.
Removal/replace?
Breast AugmentationMember Response:
When a breast implant is placed, your body forms a scar, called the capsule, all the way around the implant, kind of like an envelope around a letter. In some women, that scar will shrink, which balls up the implant and makes it feel firmer than normal. If this firmness persists for several years, the capsule will start to calcify, making it even firmer and like an eggshell. Before operating on breasts, we like to be assured there is no breast cancer, so we will often have a woman get a mammogram pre-operatively if she is due for one. If your mammograms are painful or difficult to read, then an MRI could be considered. An MRI can check the breast tissue for abnormalities, and it can then be dialed to check implant integrity. If your implants are ruptured, your insurance will often pay to have them removed. They won't pay for replacement implants or a breast lift, as that is considered cosmetic. Consult an ASPS member surgeon, use the Find-A-Surgeon tool to locate members nearby.
Removal/replace?
Question:
Five months ago I learned that one of my 32-year old implants is ruptured and calcified. I’ve been told numerous times by my doc that I have very dense breast but had been instructed to have annual mammograms (even upon my concern for rupture). At this time all I want is a reputable board-certified surgeon that would at least remove them. He’s Sending me for another Mam to see if worse. Should I?
Debra J. Johnson, MD's Response:
When a breast implant is placed, your body forms a scar, called the capsule, all the way around the implant, kind of like an envelope around a letter. In some women, that scar will shrink, which balls up the implant and makes it feel firmer than normal. If this firmness persists for several years, the capsule will start to calcify, making it even firmer and like an eggshell. Before operating on breasts, we like to be assured there is no breast cancer, so we will often have a woman get a mammogram pre-operatively if she is due for one. If your mammograms are painful or difficult to read, then an MRI could be considered. An MRI can check the breast tissue for abnormalities, and it can then be dialed to check implant integrity. If your implants are ruptured, your insurance will often pay to have them removed. They won't pay for replacement implants or a breast lift, as that is considered cosmetic. Consult an ASPS member surgeon, use the Find-A-Surgeon tool to locate members nearby.
Adhesions after breast implant removal
Breast ReductionMember Response:
Removal of the breast implants and capsules leaves an empty space. That space has to heal back together and that healing occurs by scar formation. Some scars tighten and can pull at the tissue, creating indentations or skin folds. Think of the woman who had a C-section. The scar in the lower abdomen sticks to the abdominal wall and this can create a “shelf” where the tummy skin folds on itself. The bigger the baby, the more stretched the skin gets, and the larger the fold can be. With implants, the same situation occurs: the breast skin was enlarged by the implant. When the implants is removed there is more skin than is needed, and the scarring can cause folds or wrinkles to appear. Remedies might include a breast lift or fat transfer. Consult with your plastic surgeon regarding options. But be sure to wait at least 6 months after the implant removal, and during that time massage the breasts to try and stretch out any adhesions.
Adhesions after breast implant removal
Question:
What causes adhesions after enbloc-total capsulectemy implant removal if all scar tissue is supposed to be removed? If mastopexy is not performed with explant, does that cause visible adhesions?
Debra J. Johnson, MD's Response:
Removal of the breast implants and capsules leaves an empty space. That space has to heal back together and that healing occurs by scar formation. Some scars tighten and can pull at the tissue, creating indentations or skin folds. Think of the woman who had a C-section. The scar in the lower abdomen sticks to the abdominal wall and this can create a “shelf” where the tummy skin folds on itself. The bigger the baby, the more stretched the skin gets, and the larger the fold can be. With implants, the same situation occurs: the breast skin was enlarged by the implant. When the implants is removed there is more skin than is needed, and the scarring can cause folds or wrinkles to appear. Remedies might include a breast lift or fat transfer. Consult with your plastic surgeon regarding options. But be sure to wait at least 6 months after the implant removal, and during that time massage the breasts to try and stretch out any adhesions.
Breast reduction
Breast ReductionMember Response:
High blood pressure is commonly associated with older age, arteriosclerosis (hardening of the arteries), lack of exercise, and obesity. Since you are a normal weight, your hypertension could be due to these other factors. Genetics plays a big role too. If your parents have high blood pressure, you would be more at risk to develop it too. I have never heard of breast implants causing high BP. But DD breast could give you back, neck, and shoulder pain due to their heaviness. DD patients often request breast reduction for these symptoms. See your doctor to discuss your health and lifestyle to see if there are modifications you might be able to make to get your pressure down and get off the meds. Good luck!
Breast reduction
Question:
I think my breast implants causing my blood pressure to go up. I got my boobs done in 2009 and 7 years later I only gained like 10 lbs and now my blood pressure is elevated. Im currently on bp meds. I did have size C cups prior and went back and got a double d. I’m only 125 and no none in my family takes bo meds. Should I get them out or is it the size for my small frame? Is this a factor?
Debra J. Johnson, MD's Response:
High blood pressure is commonly associated with older age, arteriosclerosis (hardening of the arteries), lack of exercise, and obesity. Since you are a normal weight, your hypertension could be due to these other factors. Genetics plays a big role too. If your parents have high blood pressure, you would be more at risk to develop it too. I have never heard of breast implants causing high BP. But DD breast could give you back, neck, and shoulder pain due to their heaviness. DD patients often request breast reduction for these symptoms. See your doctor to discuss your health and lifestyle to see if there are modifications you might be able to make to get your pressure down and get off the meds. Good luck!
Choosing a surgeon
Mommy MakeoverMember Response:
It is difficult to know who a qualified surgeon is. Unfortunately, any doctor can call themselves a plastic surgeon. But many are not certified by the American Board of Plastic Surgery. All ASPSmembers are Board-Certified plastic surgeons. Use our Find-A-Surgeon tool on this website to locate ASPS members near you. This website also has a blog on choosing your surgeon, and questions to ask to assure safety. You can also check the State Medical Board to see if a doctor has had lawsuits or disciplinary actions. Don’t trust glossy websites, since no one posts bad photos. You need to do your homework. Plastic surgery is real surgery with real risks. Don’t trust your body to someone not as well-trained as an ASPS member surgeon.
Choosing a surgeon
Question:
Hello, I am looking for someone that can do a mommy makeover and I’m having difficulty finding malpractice or issues with those surgeons. I have seen Dr. Camille D. Chavez in Miami her work is amazing but what does her record look like? all i found through media is that someone went to cardiac arrest in 2016 during surgery and died. And not many reviews out there nor recent ones to compare either
Debra J. Johnson, MD's Response:
It is difficult to know who a qualified surgeon is. Unfortunately, any doctor can call themselves a plastic surgeon. But many are not certified by the American Board of Plastic Surgery. All ASPSmembers are Board-Certified plastic surgeons. Use our Find-A-Surgeon tool on this website to locate ASPS members near you. This website also has a blog on choosing your surgeon, and questions to ask to assure safety. You can also check the State Medical Board to see if a doctor has had lawsuits or disciplinary actions. Don’t trust glossy websites, since no one posts bad photos. You need to do your homework. Plastic surgery is real surgery with real risks. Don’t trust your body to someone not as well-trained as an ASPS member surgeon.
North Carolina Medicaid
Breast ReductionMember Response:
You may well qualify under the guidelines of North Carolina MedicAid. You should use the Find-A-Surgeon tool on this website to locate a board certified ASPS member plastic surgeon near you. Understand, however, that your BMI is greater than 35, placing you in the class 2 Obese range. Elective surgery in people with your BMI have much higher risks of infection, wound healing difficulties, and other issues. If you lose weight after a reduction, your breasts will likely deflate due to loss of fatty tissue and will be droopier. Weight loss prior to reduction will be safer and your result will be more long lasting.
North Carolina Medicaid
Question:
I’m 32 5’9 260lbs with very large 38k breast. Can my breast reduction be covered by Medicaid?
Debra J. Johnson, MD's Response:
You may well qualify under the guidelines of North Carolina MedicAid. You should use the Find-A-Surgeon tool on this website to locate a board certified ASPS member plastic surgeon near you. Understand, however, that your BMI is greater than 35, placing you in the class 2 Obese range. Elective surgery in people with your BMI have much higher risks of infection, wound healing difficulties, and other issues. If you lose weight after a reduction, your breasts will likely deflate due to loss of fatty tissue and will be droopier. Weight loss prior to reduction will be safer and your result will be more long lasting.
Revision
Tummy TuckMember Response:
During a tummy tuck, the abdominal wall that has stretched with pregnancy or weight gain is tightened up with sutures from the upper ribcage down to the pubic bone. Occasionally, those sutures can "give way" due to increased intraabdominal pressure like heavy coughing, sneezing, or lifting heavy objects. It can happen to the best of surgeons. If you have gained weight since your surgery, you should try to get your weight down prior to re-operation. Most surgeons will provide a secondary repair at a reduced fee, but they often have no control over anesthesia or operating room fees. I'm sure your surgeon will try to get you the "best deal" possible, as we all want our patients to get to a happy outcome. Good luck!
Revision
Question:
I had a tummy tuck procedure done exactly one year ago. Amazing results. This past week I noticed a bulge above my belly button followed by a sharp pain in my left side and then a VERY swollen abdomen. I followed up with my surgeon and learned that my internal sutures had came out... Do i trust the same doctor to do the revision? Is this common? Should I pay almost as much as I did a year ago?
Debra J. Johnson, MD's Response:
During a tummy tuck, the abdominal wall that has stretched with pregnancy or weight gain is tightened up with sutures from the upper ribcage down to the pubic bone. Occasionally, those sutures can "give way" due to increased intraabdominal pressure like heavy coughing, sneezing, or lifting heavy objects. It can happen to the best of surgeons. If you have gained weight since your surgery, you should try to get your weight down prior to re-operation. Most surgeons will provide a secondary repair at a reduced fee, but they often have no control over anesthesia or operating room fees. I'm sure your surgeon will try to get you the "best deal" possible, as we all want our patients to get to a happy outcome. Good luck!
Back pain
Breast ReductionMember Response:
Usually health insurance will cover breast reductions for women with a bra size of DD or greater. They also usually require removal of breast tissue to drop your breast size down by about two cup sizes. At 150, your weight is a little higher than ideal, so if weight loss is possible, that would be the best place to start. Chiropractic evaluation might be helpful to determine what is causing this recent increase in your back pain. Both breast reduction and breast lifting have been shown to reduce back, neck, and shoulder pain. Unfortunately, breast lifting is considered "cosmetic" by insurers and patients have to pay for it out-of-pocket. See a board-certified plastic surgeon to determine if you might qualify for surgery under your insurance, or what the cost might be if you opted for a lift.
Back pain
Question:
Once I got into highschool, my breasts grew fast. And from that, I have had off and on back pain, but nothing too serious until about a week ago. I began having severe stabbing pains from my mid back, up through my shoulders and I am currently a size 38D and stand at 5'4", 150lbs Would it be better to get a breast reduction, or would a breast lift work about the same?
Debra J. Johnson, MD's Response:
Usually health insurance will cover breast reductions for women with a bra size of DD or greater. They also usually require removal of breast tissue to drop your breast size down by about two cup sizes. At 150, your weight is a little higher than ideal, so if weight loss is possible, that would be the best place to start. Chiropractic evaluation might be helpful to determine what is causing this recent increase in your back pain. Both breast reduction and breast lifting have been shown to reduce back, neck, and shoulder pain. Unfortunately, breast lifting is considered "cosmetic" by insurers and patients have to pay for it out-of-pocket. See a board-certified plastic surgeon to determine if you might qualify for surgery under your insurance, or what the cost might be if you opted for a lift.
Bra indentations
Breast ReductionMember Response:
Disproportionately large breasts often result in neck, back, and shoulder pain. Bra straps can cause grooves in the shoulders and the bra band below your breasts can sometimes dig in and cause discomfort. If you are overweight, and weight loss is possible, then that would be advisable prior to any surgery. Getting fitted at a good bra shop to make sure the bra you are wearing is as comfortable as possible would also be helpful. Sometimes pain at the junction of the ribs and the sternum can be due to "costochondritis" or inflammation of the connection there. Consult with a board-certified plastic surgeon in your area to determine your best options moving forward.
Bra indentations
Question:
I've been told my rib and sternum pain is being caused by my breast. I cant wear any bra without extreme pain at the tip of my sternum and ribs. I had indentations but when I gained weight and switched to sports bras they have disappeared. When I lose weight again will the indentations be visible again? Is bra indentations the only proof for insurance to process procedure?
Debra J. Johnson, MD's Response:
Disproportionately large breasts often result in neck, back, and shoulder pain. Bra straps can cause grooves in the shoulders and the bra band below your breasts can sometimes dig in and cause discomfort. If you are overweight, and weight loss is possible, then that would be advisable prior to any surgery. Getting fitted at a good bra shop to make sure the bra you are wearing is as comfortable as possible would also be helpful. Sometimes pain at the junction of the ribs and the sternum can be due to "costochondritis" or inflammation of the connection there. Consult with a board-certified plastic surgeon in your area to determine your best options moving forward.
ALCL and now to diagnose
Breast AugmentationMember Response:
If your capsule was removed, it would have been evaluated by a pathologist. If any abnormal cells were seen the pathologist would report that. Discuss your concern with your plastic surgeon and ask for a copy of the pathology report. As yet, there have been no cases of BIA-ALCL in patients with smooth breast implants, only textured surface implants.
ALCL and now to diagnose
Question:
I heard Dr. Matarasso on Doctor's Radio and wondering I have/had this cancer. Prophylactic mastectomy in December 2013. Several revisions due to fluid build up on one side only. Some times tied to bacteria infection. November 2018 staph infection. Entire capsule and implant pulled. Will wait at least 9 months to heal. 5 consults and while they mention this I am not sure this was every tested for.
Debra J. Johnson, MD's Response:
If your capsule was removed, it would have been evaluated by a pathologist. If any abnormal cells were seen the pathologist would report that. Discuss your concern with your plastic surgeon and ask for a copy of the pathology report. As yet, there have been no cases of BIA-ALCL in patients with smooth breast implants, only textured surface implants.
Pain killers
Breast ReductionMember Response:
Unless your daughter has had issues with drugs in the past, the small amount of pain medication given for breast reduction shouldn't cause her any problems. You can certainly control the dosing and interval between pills. She might have enough discomfort for something more than plain acetaminophen for the first couple of days. There are things to consider in a 16 year old. You want to make sure she has completed her breast development. The breasts usually stop growing about two years after the period starts, but some girls will gain breast tissue into their early 20s. Her weight should be stable. If she is overweight, she should try to get her BMI 25 or below prior to surgery. Lastly, breast reduction may limit her ability to breastfeed. Ideally, women wait until completing childbearing before undergoing reduction. If your daughter can't wait that long, make sure she understands that implication.
Pain killers
Question:
Hello, my 16 yr old daughter wants to get a breast reduction and we have several consultations scheduled but I’d like to get as many opinions as possible. I am worried about her being prescribed an opioid as a pain killer. Is there a non-addictive pain reliever she can take even if it isn’t quite as effective?
Debra J. Johnson, MD's Response:
Unless your daughter has had issues with drugs in the past, the small amount of pain medication given for breast reduction shouldn't cause her any problems. You can certainly control the dosing and interval between pills. She might have enough discomfort for something more than plain acetaminophen for the first couple of days. There are things to consider in a 16 year old. You want to make sure she has completed her breast development. The breasts usually stop growing about two years after the period starts, but some girls will gain breast tissue into their early 20s. Her weight should be stable. If she is overweight, she should try to get her BMI 25 or below prior to surgery. Lastly, breast reduction may limit her ability to breastfeed. Ideally, women wait until completing childbearing before undergoing reduction. If your daughter can't wait that long, make sure she understands that implication.
Breast Augmentation Healing
Breast AugmentationMember Response:
I think you are likely allergic to the antibiotic ointment. Stop using it. Sometimes using an over-the-counter hydrocortisone 1% cream can clear the rash faster. Check with your plastic surgeon if the rash doesn’t resolve quickly.
Breast Augmentation Healing
Question:
I had my breast redone about 4 weeks ago. Changed saline to Silicone. My breast have no tenderness or swelling. The scabs and stitches are gone however, my breast are still “crusting” around the areola. Sometimes fluid comes through the pores of the areola like sweat. I’ve been cleansing with Hibiclens and putting neosporin around the incision site. Should this still be happening at 4 weeks?
Debra J. Johnson, MD's Response:
I think you are likely allergic to the antibiotic ointment. Stop using it. Sometimes using an over-the-counter hydrocortisone 1% cream can clear the rash faster. Check with your plastic surgeon if the rash doesn’t resolve quickly.
Nose surgery?
Lip Augmentation / EnhancementMember Response:
Nose surgery (Rhinoplasty) is usually delayed until the nose gets to its adult size and shape. In men, this occurs around age 15-16. However, if you have breathing issues due to a deviated septum or some such, surgery can be suggested earlier to reduce your symptoms. If you are under 18, you would need your parents' permission. You should discuss your concerns with your parents and, if they are supportive, seek a consultation with a board-certified plastic surgeon. You can use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you.
Nose surgery?
Question:
Ok so im a 15 year old male (don't plan on getting surgery soon) im wondering if I could get my nose smaller and my lips. If so how old is required?
Debra J. Johnson, MD's Response:
Nose surgery (Rhinoplasty) is usually delayed until the nose gets to its adult size and shape. In men, this occurs around age 15-16. However, if you have breathing issues due to a deviated septum or some such, surgery can be suggested earlier to reduce your symptoms. If you are under 18, you would need your parents' permission. You should discuss your concerns with your parents and, if they are supportive, seek a consultation with a board-certified plastic surgeon. You can use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you.
Choosing size of reduction
Breast ReductionMember Response:
Ideally, you would like to be as close as possible to your desired weight before you embark on breast reduction surgery. The breasts have a fair amount of fat mixed in with the breast tissue, so if you lose weight after a reduction, your breasts will lose fat as well. You may end up with a deflated breast that is too small for your frame. That is perhaps why your surgeon is suggesting a larger size than you desire. Remember, the surgeon has to leave enough tissue behind to support the remaining breast, skin, and nipple with adequate blood supply. Good communication is key. If you are willing to go to a B now, knowing your breasts might shrink with more weight loss, then be firm with your surgeon, and explain that you understand you might end up smaller if you do lose weight after surgery.
Choosing size of reduction
Question:
Age 54, current size 34E/F like to be a B cup but my PS said I'd look better with a C cup to go with my body. Normally I am smaller but not being able to work out I've gained weight. I'm looking to the future of losing that wieght. I've only gained weight do to inactivity because my breast perspire and I get a rash. I don't want my PS choosing my cup size on my current weight.
Debra J. Johnson, MD's Response:
Ideally, you would like to be as close as possible to your desired weight before you embark on breast reduction surgery. The breasts have a fair amount of fat mixed in with the breast tissue, so if you lose weight after a reduction, your breasts will lose fat as well. You may end up with a deflated breast that is too small for your frame. That is perhaps why your surgeon is suggesting a larger size than you desire. Remember, the surgeon has to leave enough tissue behind to support the remaining breast, skin, and nipple with adequate blood supply. Good communication is key. If you are willing to go to a B now, knowing your breasts might shrink with more weight loss, then be firm with your surgeon, and explain that you understand you might end up smaller if you do lose weight after surgery.
Best surgery for me?
Tummy TuckMember Response:
Any surgery you consider would be "elective", meaning you choose to do it to improve yourself. The type of surgery you choose would be based on what you are trying to achieve, and what the general state of your health is. You will need to consult with a board-certified plastic surgeon to determine what might be your options. You weight is a significant risk factor. Women with BMIs over 30 have far greater risk of complications (wound healing difficulties, blood clots in the legs, collections of blood or serum in the operated area, etc) than women who are not obese. The most important thing you can do to reduce your risk of complications is to lose weight prior to surgery.
Best surgery for me?
Question:
I’m 5’3” and 205lbs. I have a bit of a tummy and some extra skin and love handles. What would be the best surgery for me? Tummy tuck and lipo?
Debra J. Johnson, MD's Response:
Any surgery you consider would be "elective", meaning you choose to do it to improve yourself. The type of surgery you choose would be based on what you are trying to achieve, and what the general state of your health is. You will need to consult with a board-certified plastic surgeon to determine what might be your options. You weight is a significant risk factor. Women with BMIs over 30 have far greater risk of complications (wound healing difficulties, blood clots in the legs, collections of blood or serum in the operated area, etc) than women who are not obese. The most important thing you can do to reduce your risk of complications is to lose weight prior to surgery.
Minnesota care
Breast AugmentationMember Response:
I'm assuming by MA you mean MedicAid. Not all plastic surgeons accept MedicAid, and not all plastic surgeons perform gender confirmation surgery. You should look through the Find-A-Surgeon tool on this website to locate ASPS members near you. Then you'll have to call and ask if they accept MedicAid patients and if they do top surgery. If you have a local LGBTQ community group, they might have resources to assist you and information regarding surgeons who have helped their clients. It is likely you would also need a psychological evaluation to determine whether you are "fit" for surgery, as is required of all transgenders.
Minnesota care
Question:
Hi do you guys know who accepts MA insurance i live in saint Paul MN and i was born intersex my father made me in to a man and looking to do breasts and reassignment surgery to please help.
Debra J. Johnson, MD's Response:
I'm assuming by MA you mean MedicAid. Not all plastic surgeons accept MedicAid, and not all plastic surgeons perform gender confirmation surgery. You should look through the Find-A-Surgeon tool on this website to locate ASPS members near you. Then you'll have to call and ask if they accept MedicAid patients and if they do top surgery. If you have a local LGBTQ community group, they might have resources to assist you and information regarding surgeons who have helped their clients. It is likely you would also need a psychological evaluation to determine whether you are "fit" for surgery, as is required of all transgenders.
Tummy tuck and breast reduction
Breast AugmentationMember Response:
Breast reduction is usually a covered benefit, but you'd have to check with your health plan's customer service to make sure. If covered, the woman would need to have disproportionately large breasts (DD or greater) with symptoms of neck, back, and shoulder pain that is unrelieved by conservative treatments (special bras, over-the-counter pain medication, massage, diet and exercise, chiropractic care, etc). Some plans like Kaiser require you to be within 25% of your ideal body weight. As far as abdominoplasty is concerned, it is rarely covered except in those patients who have undergone massive weight loss (greater than 100 pounds) and have symptoms such as skin infections or ulceration. If your loose skin is the result of a pregnancy 35 years ago, and you have no other symptoms, correction would be considered cosmetic and would be on your own dime. Sorry.
Tummy tuck and breast reduction
Question:
Any chance insurance would cover documented breast reduction AND removing extra mid-lower tummy skin that hangs from pregnancy? It's been 35 years.
Debra J. Johnson, MD's Response:
Breast reduction is usually a covered benefit, but you'd have to check with your health plan's customer service to make sure. If covered, the woman would need to have disproportionately large breasts (DD or greater) with symptoms of neck, back, and shoulder pain that is unrelieved by conservative treatments (special bras, over-the-counter pain medication, massage, diet and exercise, chiropractic care, etc). Some plans like Kaiser require you to be within 25% of your ideal body weight. As far as abdominoplasty is concerned, it is rarely covered except in those patients who have undergone massive weight loss (greater than 100 pounds) and have symptoms such as skin infections or ulceration. If your loose skin is the result of a pregnancy 35 years ago, and you have no other symptoms, correction would be considered cosmetic and would be on your own dime. Sorry.
Board Certification
FaceliftMember Response:
The doctor you are researching is certified by the American Board of Otolaryngology (ENT) and has also been certified by the American Board of Facial Plastic and Reconstructive Surgery. This means the doctor has completed a one-year fellowship in facial plastic surgery (taught by ENT surgeons) and passed their examinations. While not an ABMS board, the ABFPS is recognized as an "equivalent" board in the state of California. If you would prefer a board-certified plastic surgeon, use the find-a-surgoen tool on this website to locate an ASPS member surgeon certified by the American Board of Plastic Surgery.
Board Certification
Question:
I conducted a search here for a specific surgeon in my area, & there were no results. Per advice of surgeons in posts here, I went to the American Board of Plastic Surgeons and again, no results. The surgeon's website states that he is double board certified and lists this board: American Board of Facial Plastic and Reconstructive Surgery. Is this a recognized board?
Debra J. Johnson, MD's Response:
The doctor you are researching is certified by the American Board of Otolaryngology (ENT) and has also been certified by the American Board of Facial Plastic and Reconstructive Surgery. This means the doctor has completed a one-year fellowship in facial plastic surgery (taught by ENT surgeons) and passed their examinations. While not an ABMS board, the ABFPS is recognized as an "equivalent" board in the state of California. If you would prefer a board-certified plastic surgeon, use the find-a-surgoen tool on this website to locate an ASPS member surgeon certified by the American Board of Plastic Surgery.
Blue cross blue shield
Breast ReductionMember Response:
Each insurance plan has its own set of “preferred providers”. Even within Blue Cross Blue Shield in Oklahoma, there may be different sub plans with different providers. You should call BC/BS customer service and ask for a listing of plastic surgeons in your plan. Now, not all of them may be Board-Certified plastic surgeons. Some ENT doctors, dermatologists, and others will claim to be plastic surgeons and BC/BS lists them as such. So use the Find-a-Surgeon tool on this website to find ASPS surgeons near you, and then cross-check with your insurance list. If you find some matches, then call the surgeon’s office to verify the doctor is in your plan and that he/she does breast reduction surgery. Ask if you need a referral from your primary care doctor to get an appointment. Good luck!
Blue cross blue shield
Question:
I need a surgeon for my daughter who takes blue cross blue shield insurance for breast reduction surgery. Of course a skilled surgeon and patients happy with their results. IN OKLAHOMA
Debra J. Johnson, MD's Response:
Each insurance plan has its own set of “preferred providers”. Even within Blue Cross Blue Shield in Oklahoma, there may be different sub plans with different providers. You should call BC/BS customer service and ask for a listing of plastic surgeons in your plan. Now, not all of them may be Board-Certified plastic surgeons. Some ENT doctors, dermatologists, and others will claim to be plastic surgeons and BC/BS lists them as such. So use the Find-a-Surgeon tool on this website to find ASPS surgeons near you, and then cross-check with your insurance list. If you find some matches, then call the surgeon’s office to verify the doctor is in your plan and that he/she does breast reduction surgery. Ask if you need a referral from your primary care doctor to get an appointment. Good luck!
Cis Woman Who Had FTM Top Surgery
Gender Confirmation SurgeryMember Response:
If your top surgery was to remove your breast tissue and give you a masculine chest contour, then the majority of your breast tissue is gone. There may be a small amount of breast tissue remaining that would respond to the hormonal changes of pregnancy, perhaps creating some minor fullness during pregnancy. Once you deliver, this remaining breast tissue might create small lumps as it tries to produce milk. However, if you don't/can't breastfeed, the lumps will soon go away. It would be unlikely that you would have a significant enlargement of the breast, or a post-pregnancy change that would require a surgical touch-up.
Cis Woman Who Had FTM Top Surgery
Question:
Hi! I have had FTM top surgery to try to alleviate distress about my chest. I now realize I did not need to transition to male. As a 22 year old, one of my goals is to become a mother if it is possible for me, but I have received mixed responses and confusion about whether breast tissue will return or grow with pregnancy. I do not want that due to the changed shape of my chest. Is that possible?
Debra J. Johnson, MD's Response:
If your top surgery was to remove your breast tissue and give you a masculine chest contour, then the majority of your breast tissue is gone. There may be a small amount of breast tissue remaining that would respond to the hormonal changes of pregnancy, perhaps creating some minor fullness during pregnancy. Once you deliver, this remaining breast tissue might create small lumps as it tries to produce milk. However, if you don't/can't breastfeed, the lumps will soon go away. It would be unlikely that you would have a significant enlargement of the breast, or a post-pregnancy change that would require a surgical touch-up.
What should I expect?
Gender Confirmation SurgeryMember Response:
When transgender patients come in for a consultation, I want to know if they have been following WPATH guidelines: living, working, dressing in their gender; hormone replacement therapy;and psychological evaluation to determine fitness for surgery. I then want to assure the patient is healthy, and has a family/friend support system to assist with recovery. Although there have been articles published regarding the benefit of gender confirming surgery in adolescents, some insurers still require patients to wait until age 18. Also, Medicare will not cover top surgery for MTF patients, as they (mistakenly) feel that estrogen will grow adequate breast tissue. They do cover FTM mastectomy. You should consult with a board-certified plastic surgeon to determine your options, Kadence. Use the Find-A-Surgeon tool to locate an ASPS member near you.
What should I expect?
Question:
I’m a transgender man and I haven’t yet received top surgery but I am looking into it. I read that the surgeon will want to know about my transition progress. What exactly does this mean? Will they want to know about HRT or about the questions I’ve answered in therapy? If it is the latter, what are those questions? Thank you!
Debra J. Johnson, MD's Response:
When transgender patients come in for a consultation, I want to know if they have been following WPATH guidelines: living, working, dressing in their gender; hormone replacement therapy;and psychological evaluation to determine fitness for surgery. I then want to assure the patient is healthy, and has a family/friend support system to assist with recovery. Although there have been articles published regarding the benefit of gender confirming surgery in adolescents, some insurers still require patients to wait until age 18. Also, Medicare will not cover top surgery for MTF patients, as they (mistakenly) feel that estrogen will grow adequate breast tissue. They do cover FTM mastectomy. You should consult with a board-certified plastic surgeon to determine your options, Kadence. Use the Find-A-Surgeon tool to locate an ASPS member near you.
Breast and Bottom
LiposuctionMember Response:
You can certainly transfer fat that has been suctioned out of one area into another area. However, once the fat is suctioned out of the abdomen, it has lost its blood supply and is in the process of dying. When you re-inject it elsewhere (breasts, bottom) it has to redevelop a blood supply in order to survive. Statistically, only about half the transferred fat will survive. For the best results, consult with a board-certified plastic surgeon to determine your best options. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you.
Breast and Bottom
Question:
If possible, would it be easy to spread the tummy fat to the breast and bottom? To much in the stomach area and not enough in the other areas.
Debra J. Johnson, MD's Response:
You can certainly transfer fat that has been suctioned out of one area into another area. However, once the fat is suctioned out of the abdomen, it has lost its blood supply and is in the process of dying. When you re-inject it elsewhere (breasts, bottom) it has to redevelop a blood supply in order to survive. Statistically, only about half the transferred fat will survive. For the best results, consult with a board-certified plastic surgeon to determine your best options. Use the Find-A-Surgeon tool on this website to locate an ASPS member surgeon near you.
Difference in implants
Breast AugmentationMember Response:
The difference between silicone implants is the degree to which the silicone is cross-linked. The more cross-linking the sturdier the silicone. Cohesive gel are like thick molasses. HIghly cohesive gel implants are semi-solid, kind of like jello (or gummy bears!). Saline implants are filled with salt water, which moves quickly. Saline implants tend to be a bit more "feelable" than silicone. The baffled saline implant prevents the water from moving so quickly, so it feels more like a silicone implant. All implants can fail. If a saline implant fails you know it quickly because it deflates. Replacing it is a quick swap-out. Silicone implants need to be "monitored" for failure, using ultrasound or MRI. If a silicone implant fails, you must remove the implant and the surround scar capsule...a much bigger operation. The "safest" implant is saline. The most natural feeling is a cohesive gel silicone. Gummy implants are firmer. Baffled saline is a good option.
Difference in implants
Question:
What are the main differences in silicon implants versus gummy bear implants? I was told the gummy bear implants were filled with the same product the gummy bears are made from. I personally think that information is incorrect. I just want to know which of the two are the better option in terms of safety, and length of use?
Debra J. Johnson, MD's Response:
The difference between silicone implants is the degree to which the silicone is cross-linked. The more cross-linking the sturdier the silicone. Cohesive gel are like thick molasses. HIghly cohesive gel implants are semi-solid, kind of like jello (or gummy bears!). Saline implants are filled with salt water, which moves quickly. Saline implants tend to be a bit more "feelable" than silicone. The baffled saline implant prevents the water from moving so quickly, so it feels more like a silicone implant. All implants can fail. If a saline implant fails you know it quickly because it deflates. Replacing it is a quick swap-out. Silicone implants need to be "monitored" for failure, using ultrasound or MRI. If a silicone implant fails, you must remove the implant and the surround scar capsule...a much bigger operation. The "safest" implant is saline. The most natural feeling is a cohesive gel silicone. Gummy implants are firmer. Baffled saline is a good option.
Gynecomastia Surgery for Minors
Breast ReductionMember Response:
Usually young men are asked to wait to have gynecomastia surgery because sometimes the breast enlargement will disappear with further growth after puberty. If you've noticed no change in the past year and you have not significantly increased your height or weight in that time, then you would likely be a candidate for surgery. You should consult with a board-certified ASPS member in your area to determine your options and the appropriate timing for any surgical procedure.
Gynecomastia Surgery for Minors
Question:
I’m 16 and have had Gynecomastia for about 3 and a half years. It’s not from fat, but it’s the glandular tissue that has created the hard disc underneath. I’ve read that usually if it’s fat it’s best to wait until 18 because it can come back, but since it’s just the glandular tissue it can’t grow back so would a surgeon remove it?
Debra J. Johnson, MD's Response:
Usually young men are asked to wait to have gynecomastia surgery because sometimes the breast enlargement will disappear with further growth after puberty. If you've noticed no change in the past year and you have not significantly increased your height or weight in that time, then you would likely be a candidate for surgery. You should consult with a board-certified ASPS member in your area to determine your options and the appropriate timing for any surgical procedure.
Breast Pain
Breast AugmentationMember Response:
Many women experience breast pain. It can be due to pressure within small cysts in the breast tissue itself, plugged ducts, nerve irritation, etc. You also have an implant that has been placed behind the pectoral muscle. There is a scar-tissue capsule that surrounds the implant. This capsule can sometimes cause pulling at the muscle or the sensory nerves that can cause pain. It is definitely a good idea to get checked out. Depending on your age, you might need a mammogram. You should get your implants imaged with ultrasound or MRI to check their integrity. It would be good to be seen by a plastic surgeon, as your primary MD may have little experience with women with implants. Use the Find-A-Surgeon tool on this website to locate a board-certified ASPS member near you. Increasing your fluids, reducing caffeine intake, and taking Vitamin E can sometimes be helpful for breast pain. Good luck!
Breast Pain
Question:
Hi! I have been having shooting pain in both breast- center focused, behind nipple. I have textured silicon breast implants-under chest muscle. Got them done 5 years ago. The pain comes and goes,never constant. I just had an appt a my pcp to get checked out due to my PS office being permanentlyclosed and to get mri scheduled. Is this a common issue? What could be the cause of the pain? Thank you
Debra J. Johnson, MD's Response:
Many women experience breast pain. It can be due to pressure within small cysts in the breast tissue itself, plugged ducts, nerve irritation, etc. You also have an implant that has been placed behind the pectoral muscle. There is a scar-tissue capsule that surrounds the implant. This capsule can sometimes cause pulling at the muscle or the sensory nerves that can cause pain. It is definitely a good idea to get checked out. Depending on your age, you might need a mammogram. You should get your implants imaged with ultrasound or MRI to check their integrity. It would be good to be seen by a plastic surgeon, as your primary MD may have little experience with women with implants. Use the Find-A-Surgeon tool on this website to locate a board-certified ASPS member near you. Increasing your fluids, reducing caffeine intake, and taking Vitamin E can sometimes be helpful for breast pain. Good luck!
My left breast
Breast ReductionMember Response:
You should see a plastic surgeon to explore your options. You might want to make the bigger breast match the smaller with a breast reduction. Or make the smaller one bigger with a breast implant or fat transfer. You would need to be at a stable weight, and not enlarging in the breasts for the past year or so. And, of course, you would need the support and permission of your parents.
My left breast
Question:
My left breast is visibly bigger than my right and I fear it is a cup size bigger also. This is disturbing me both mentally and physically as in it looks uneven and wrong. I am 17, what do you suggest I should do?
Debra J. Johnson, MD's Response:
You should see a plastic surgeon to explore your options. You might want to make the bigger breast match the smaller with a breast reduction. Or make the smaller one bigger with a breast implant or fat transfer. You would need to be at a stable weight, and not enlarging in the breasts for the past year or so. And, of course, you would need the support and permission of your parents.
Necklift same as mini Facelift?
FaceliftMember Response:
In my practice, a necklift is the lower 2/3s of a facelift. A facelift elevates the lateral brow, cheek, jowls, and neck. A necklift treats just the jowls and neck. The incision runs from the sideburn area, around the nooks and crannies of the ear, and down the posterior hairline. There is often also an incision under the chin to tighten the central neck muscles and remove fat. The surgery requires about 3 hours, and a 10-14 day recuperation. Minilifts are marketed as a quick and easy refresher, with short scars, but unfortunately also a short duration of improvement. A regular neck- or facelift gives longer lasting results and is more cost-effective in the long run. Consult a board-certified plastic surgeon or two (use the Find-A-Surgeon tool here to locate ASPS members in your area) and determine your best options.
Necklift same as mini Facelift?
Question:
Is a necklift the same procedure as a mini facelift? I know I want a necklift, but am told it is the same basic procedure as an S-Flap mini facelift. Is this true or are they two separate procedures? Thanks!
Debra J. Johnson, MD's Response:
In my practice, a necklift is the lower 2/3s of a facelift. A facelift elevates the lateral brow, cheek, jowls, and neck. A necklift treats just the jowls and neck. The incision runs from the sideburn area, around the nooks and crannies of the ear, and down the posterior hairline. There is often also an incision under the chin to tighten the central neck muscles and remove fat. The surgery requires about 3 hours, and a 10-14 day recuperation. Minilifts are marketed as a quick and easy refresher, with short scars, but unfortunately also a short duration of improvement. A regular neck- or facelift gives longer lasting results and is more cost-effective in the long run. Consult a board-certified plastic surgeon or two (use the Find-A-Surgeon tool here to locate ASPS members in your area) and determine your best options.
Breast Reduction at a Young Age
Breast ReductionMember Response:
Ideally, breast reduction is performed after a woman has completed childbearing. Pregnancy and breast feeding can change the volume and shape of the breast. Breast reduction can make it harder for a woman to successfully breastfeed, due to scar tissue within the breast and the rearrangement of the tissues. That being said, some younger women just can't take it, and desire to have their breasts smaller for both physical and emotional reasons. If your breasts have stopped growing, your weight is stable, and your overall health is good, you should be able to have a breast reduction. You will need your parents' consent, since you are not yet an adult. I warn younger women that breasts may change over time, depending on childbearing, breastfeeding, weight, etc. You may in the future desire additional breast surgery, if your breasts have a cosmetic appearance you don't like. Certainly the areolar diameter is reduced with reduction. Inverted nipples can be corrected at the same time.
Breast Reduction at a Young Age
Question:
I am 17 years old and I have had big breast since I was 14. Over the years, my back and neck pain has gotten worse. Not only have I experienced physical pain, but emotional as well. If I were to get a breast reduction would I also be able to have my nipples reconstructed? Or is that a completely different surgery? Does it cost more to get both done and will my insurance pay for it?
Debra J. Johnson, MD's Response:
Ideally, breast reduction is performed after a woman has completed childbearing. Pregnancy and breast feeding can change the volume and shape of the breast. Breast reduction can make it harder for a woman to successfully breastfeed, due to scar tissue within the breast and the rearrangement of the tissues. That being said, some younger women just can't take it, and desire to have their breasts smaller for both physical and emotional reasons. If your breasts have stopped growing, your weight is stable, and your overall health is good, you should be able to have a breast reduction. You will need your parents' consent, since you are not yet an adult. I warn younger women that breasts may change over time, depending on childbearing, breastfeeding, weight, etc. You may in the future desire additional breast surgery, if your breasts have a cosmetic appearance you don't like. Certainly the areolar diameter is reduced with reduction. Inverted nipples can be corrected at the same time.
Consultation costs
Breast AugmentationMember Response:
The cost of a consultation will vary. When you call for an appointment you will be informed of the cost. Some surgeons will deduct the consult fee from the surgical fee is you decide to have the procedure done. Remember, you are paying for the surgeon’s time and expertise in speaking with you, so it’s worth it. Use the Find-a-Surgeon link on this website to locate a board-certified plastic surgeon near you. Call and tell them what you are interested in. You can ask if this is a common procedure performed by that surgeon, and approximate costs. But the surgeon will need to examine you, discuss your options, develop a plan, and only then give you an exact fee.
Consultation costs
Question:
I'm looking for a few good surgeons to have a consultation with, what are usually the cost of them and what should I look for?
Debra J. Johnson, MD's Response:
The cost of a consultation will vary. When you call for an appointment you will be informed of the cost. Some surgeons will deduct the consult fee from the surgical fee is you decide to have the procedure done. Remember, you are paying for the surgeon’s time and expertise in speaking with you, so it’s worth it. Use the Find-a-Surgeon link on this website to locate a board-certified plastic surgeon near you. Call and tell them what you are interested in. You can ask if this is a common procedure performed by that surgeon, and approximate costs. But the surgeon will need to examine you, discuss your options, develop a plan, and only then give you an exact fee.
Weight
Breast ReductionMember Response:
If weight reduction is an achievable goal, then by all means get your weight as close to “ideal” as possible prior to breast reduction. With reduction you remove the excess breast tissue as well as skin so you shape a nice breast. If you lose a significant amount of weight after reduction, you will lose fatty tissue within the breasts and they will “ deflate” to a degree, depending on your age, skin quality, and the amount of weight you lose. Subsequent pregnancy/breastfeeding can also impact the size and shape of the breasts. If you proceed with reduction now and lose weight after, you may need a revisional surgery after to retighten the skin. That second surgery, if needed, would be considered cosmetic and would not be covered by your health insurance.
Weight
Question:
I was wondering if I go ahead and get the reduction, if I plan to workout, will my breasts become saggy? Or will they slim down along with my body? I want to get the reduction then I will be able to work out the way I want to. I wear a 38O !
Debra J. Johnson, MD's Response:
If weight reduction is an achievable goal, then by all means get your weight as close to “ideal” as possible prior to breast reduction. With reduction you remove the excess breast tissue as well as skin so you shape a nice breast. If you lose a significant amount of weight after reduction, you will lose fatty tissue within the breasts and they will “ deflate” to a degree, depending on your age, skin quality, and the amount of weight you lose. Subsequent pregnancy/breastfeeding can also impact the size and shape of the breasts. If you proceed with reduction now and lose weight after, you may need a revisional surgery after to retighten the skin. That second surgery, if needed, would be considered cosmetic and would not be covered by your health insurance.
Surgery Abroad
Mommy MakeoverMember Response:
While having surgery outside of the US might offer a cost advantage, you have to consider that you will not have any post-operative care unless you remain out of the country. If you return home and need care for suture or drain removal, or if you have a complication, you will have to pay additionally for that. If you feel you suffered from some medical negligence, you will have no legal recourse. You are considering major surgery which has the highest risk of DVT/PE (blood clots developing in the legs during surgery, that can then cause blockage in the lung, which can result in death). I don't allow my abdominoplasty patients to fly for 4 weeks after surgery as this increases the risk further! It is always safer to have surgery closer to home, but if you insist on going to Mexico or elsewhere, at least make sure your surgeon is an ASPS International member.
Surgery Abroad
Question:
Hi, I'm looking for a surgeon that could give me a mommy makeover with some extras. Tummy tuck, lipo on abdomen, back, arms, inner thighs, and breast lift. I'm having a hard time choosing a surgeon. There is one in Tijuana that I like but I'm worried about safety and recovery since it wouldn't be performed in the US, I wouldn't have a PS to go to. Thoughts? Advice? Thanks in advance! Amanda
Debra J. Johnson, MD's Response:
While having surgery outside of the US might offer a cost advantage, you have to consider that you will not have any post-operative care unless you remain out of the country. If you return home and need care for suture or drain removal, or if you have a complication, you will have to pay additionally for that. If you feel you suffered from some medical negligence, you will have no legal recourse. You are considering major surgery which has the highest risk of DVT/PE (blood clots developing in the legs during surgery, that can then cause blockage in the lung, which can result in death). I don't allow my abdominoplasty patients to fly for 4 weeks after surgery as this increases the risk further! It is always safer to have surgery closer to home, but if you insist on going to Mexico or elsewhere, at least make sure your surgeon is an ASPS International member.
uneven breast
Breast ReductionMember Response:
Very odd that you noticed this unevenness after a mammogram. Could you have been injured and the swelling is due to bleeding(hematoma), or some such? I would consult with your primary care to make sure there is not something strange going on in the larger breast. If not, then see a board-certified plastic surgeon (use the Find-a-Surgeon tool to locate ASPS members near you) to determine your options.
uneven breast
Question:
Greetings wishing all is well with you, two years ago I went for a mammogram that was painful and left me with my left boob being larger, what can be done with out getting implants, and what would be the estimated price?
Debra J. Johnson, MD's Response:
Very odd that you noticed this unevenness after a mammogram. Could you have been injured and the swelling is due to bleeding(hematoma), or some such? I would consult with your primary care to make sure there is not something strange going on in the larger breast. If not, then see a board-certified plastic surgeon (use the Find-a-Surgeon tool to locate ASPS members near you) to determine your options.
Breast Rupture
Breast AugmentationMember Response:
Dear Timelessmac, Sorry for your bad luck! Many women with saline implants go their whole lives never having to replace them. However, they do run a risk of failure due to the fact that they are slightly underfilled so they'll feel soft, and when you move you can create folds in the implant normally. I liken it to a credit card you bend back and forth, it can eventually crack. I had a patient once whose implant failed after a few years. I replaced it and it failed again in a few months! I replaced it again and the next one failed in 3 years! Crazy. Replacement number3 is holding steady, thank goodness. Fortunately, replacing a saline implant is a pretty quick swap out. Your implants are warrantied, and the company will pay towards the OR since it's been less than 10 years. I highly doubt your surgeon would have refilled a leaking implant; since the replacement implant was free, it makes no sense. You should return to your surgeon, or use the Find-a-Surgeon tool here.
Breast Rupture
Question:
I had B.A. 2 yrs ago & within a yr my left side ruptured. I think it had a slow leak from day 1. I'd of $8,000. So I went back, my surgeon was supposed to replace both while there, since the implant had lifetime warranty. I have a feeling, he just refilled it! It's been 11 mos. & Here I am again! It's been slowly leaking the whole time! Now at this point it' obvious. He said he'd tell me what the
Debra J. Johnson, MD's Response:
Dear Timelessmac, Sorry for your bad luck! Many women with saline implants go their whole lives never having to replace them. However, they do run a risk of failure due to the fact that they are slightly underfilled so they'll feel soft, and when you move you can create folds in the implant normally. I liken it to a credit card you bend back and forth, it can eventually crack. I had a patient once whose implant failed after a few years. I replaced it and it failed again in a few months! I replaced it again and the next one failed in 3 years! Crazy. Replacement number3 is holding steady, thank goodness. Fortunately, replacing a saline implant is a pretty quick swap out. Your implants are warrantied, and the company will pay towards the OR since it's been less than 10 years. I highly doubt your surgeon would have refilled a leaking implant; since the replacement implant was free, it makes no sense. You should return to your surgeon, or use the Find-a-Surgeon tool here.
Surgery cost and payment
Mommy MakeoverMember Response:
Dear Ashburnam, Mommy makeovers are considered cosmetic operations and are never covered by health insurance. The cost depends on what you're trying to achieve. Do your breasts need an implant, a lift, or both. Does your tummy need liposuction, a mini-abdominoplasty, or a full abdominoplasty? Pricing would range from around $10,000 to $20,000+, and also depends on the type of anesthesia you need and the operating room facility your doctor uses. You would benefit from using the Find-A-Surgeon tool on this website to locate a board-certified plastic surgeon near you. An in-person consultation is the best way to discuss your needs and the costs. Many surgeons offer financing so be sure to ask.
Surgery cost and payment
Question:
Im wondering if its possible to have a mommy makeover with out insurance and to just pay completely out of pocket? Is that aloud? Also how much would that even cost fully out of pocket no insurance?
Debra J. Johnson, MD's Response:
Dear Ashburnam, Mommy makeovers are considered cosmetic operations and are never covered by health insurance. The cost depends on what you're trying to achieve. Do your breasts need an implant, a lift, or both. Does your tummy need liposuction, a mini-abdominoplasty, or a full abdominoplasty? Pricing would range from around $10,000 to $20,000+, and also depends on the type of anesthesia you need and the operating room facility your doctor uses. You would benefit from using the Find-A-Surgeon tool on this website to locate a board-certified plastic surgeon near you. An in-person consultation is the best way to discuss your needs and the costs. Many surgeons offer financing so be sure to ask.
If there any kind of age limit or concerns
Body ContouringMember Response:
Suzann, Certainly your general state of health is an important factor. Your weight, specifically your BMI, is also an important consideration. Women with a BMI over 30 have higher complication rates than women below 30. Weight loss is the most important thing you can do to reduce your risk. If you already have a BMI below 30, consult with a board-certified plastic surgeon regarding your abdominal concerns and find out what is possible. If your BMI is above 30, consider a medically supervised weight loss program if you can't do it on your own. If you can follow a home program, Weight Watchers is my favorite system of behavior modification for weight loss.
If there any kind of age limit or concerns
Question:
My stomach is hanging over really bad and has bothered me many years. I am overweight, weight has been up and down, but no matter what, it’s still the same. Have some money now. I’m 63. Would it be more dangerous at this age, and/or not heal as well ?
Debra J. Johnson, MD's Response:
Suzann, Certainly your general state of health is an important factor. Your weight, specifically your BMI, is also an important consideration. Women with a BMI over 30 have higher complication rates than women below 30. Weight loss is the most important thing you can do to reduce your risk. If you already have a BMI below 30, consult with a board-certified plastic surgeon regarding your abdominal concerns and find out what is possible. If your BMI is above 30, consider a medically supervised weight loss program if you can't do it on your own. If you can follow a home program, Weight Watchers is my favorite system of behavior modification for weight loss.
Capsular contracture
Breast AugmentationMember Response:
Several factors affect the development of capsular contracture: low grade bacterial contamination, as mentioned by Dr. Wallach, location of the implant (above the muscle more commonly tightens than below the muscle), type of implant (textured vs. smooth, and saline vs. silicone). Removal of the breast implants and and entire capsule is usually te recommended treatment. Changing the location of the implants can sometimes be helpful. Some surgeons also use acellular dermal matrix as "hammock" to try and break up the new capsule that forms. Some recommend taking a leukotriene inhibitor, like Montelukast, after surgery. A person with capsular contracture still has a higher risk of redeveloping a tight scar after surgery. Discuss with your surgeon the best way to try and reduce your risk and achieve soft breasts after augmentation.
Capsular contracture
Question:
What causes a capsular contracture after breast implants, and what has to be done to reverse the breasts feeling hard?
Debra J. Johnson, MD's Response:
Several factors affect the development of capsular contracture: low grade bacterial contamination, as mentioned by Dr. Wallach, location of the implant (above the muscle more commonly tightens than below the muscle), type of implant (textured vs. smooth, and saline vs. silicone). Removal of the breast implants and and entire capsule is usually te recommended treatment. Changing the location of the implants can sometimes be helpful. Some surgeons also use acellular dermal matrix as "hammock" to try and break up the new capsule that forms. Some recommend taking a leukotriene inhibitor, like Montelukast, after surgery. A person with capsular contracture still has a higher risk of redeveloping a tight scar after surgery. Discuss with your surgeon the best way to try and reduce your risk and achieve soft breasts after augmentation.
Insurance is covering panniculectomy. Can I pay the difference for TT?
Tummy TuckMember Response:
First, you would need to talk to customer relations at your insurance and see if they are amenable to your combining a "cosmetic" procedure to your panniculectomy. Then your plastic surgeon would need to figure out for you what the difference in his/her surgeon's fee would be for the added surgery. Finally, you would be responsible for the additional Operating Room and Anesthesia time. Some surgery centers are so pricey that adding additional cosmetic procedures is too expensive. You need to speak to the surgery center and get a fee quote in writing, so you know up front what you're in for. Sometimes it's less expensive to just pay for the whole abdominoplasty and have it done in the doctor's private operating suite.
Insurance is covering panniculectomy. Can I pay the difference for TT?
Question:
My insurance is covering a panniculectomy due to infections from weight loss after c section 3 years ago. I’ve heard of surgeons billing the insurance company for the panni and then bill the patient for the difference. The surgeon I spoke to does not do that and if I got a tummy tuck it would cost almost $12,000. I’m looking for a surgeon that will do that and I’m willing to travel if necessary.
Debra J. Johnson, MD's Response:
First, you would need to talk to customer relations at your insurance and see if they are amenable to your combining a "cosmetic" procedure to your panniculectomy. Then your plastic surgeon would need to figure out for you what the difference in his/her surgeon's fee would be for the added surgery. Finally, you would be responsible for the additional Operating Room and Anesthesia time. Some surgery centers are so pricey that adding additional cosmetic procedures is too expensive. You need to speak to the surgery center and get a fee quote in writing, so you know up front what you're in for. Sometimes it's less expensive to just pay for the whole abdominoplasty and have it done in the doctor's private operating suite.
Breast Revision Recovery for body builder
Breast AugmentationMember Response:
Body builders present unique difficulties in breast augmentation. Subpectoral augmentation often results in muscular distortion of the breast. Subglandular augmentation runs a higher risk of capsular contracture (a tight scar with firmness) causing an abnormal appearance. Body builders are usually low body fat folks, so there is little subcutaneous fat to camouflage ripples in subglandular breast implants. You rarely have enough fat to consider fat transfer to mitigate the rippling or add more camouflage. Tough situation. Some surgeons have tried to overcome some of these difficulties by using the more highly cohesive implants to reduce rippling, or consideration of a dual-plane technique to reduce the animation deformity. As plastic surgeons, we need to be cognizant of the unique problems encountered in groups such as body builders. Thank you for sharing your story.
Breast Revision Recovery for body builder
Question:
Not a question, but asking you to post: I had submuscular implants in 2009 and began body building in 2014. By 2016, I had severe distortion in my pec area. After a revision in 2018, I was cleared for workouts after 8 weeks; same result. After a successful, beautiful revision in January, my PS stated I should never be doing pec work again. I wish my surgeon had warned me. Please share!
Debra J. Johnson, MD's Response:
Body builders present unique difficulties in breast augmentation. Subpectoral augmentation often results in muscular distortion of the breast. Subglandular augmentation runs a higher risk of capsular contracture (a tight scar with firmness) causing an abnormal appearance. Body builders are usually low body fat folks, so there is little subcutaneous fat to camouflage ripples in subglandular breast implants. You rarely have enough fat to consider fat transfer to mitigate the rippling or add more camouflage. Tough situation. Some surgeons have tried to overcome some of these difficulties by using the more highly cohesive implants to reduce rippling, or consideration of a dual-plane technique to reduce the animation deformity. As plastic surgeons, we need to be cognizant of the unique problems encountered in groups such as body builders. Thank you for sharing your story.
What are the side effects of breast implants
Breast AugmentationMember Response:
Pregnancy can alter the way your breasts look by changing the size and stretching out the skin a bit. It is prudent to wait until after you have completed childbearing before embarking on breast augmentation. If you don't want to wait, just realize that after having children and breastfeeding, your breasts may need some "maintenance work" to look the way you want them to again. Breast augmentation is not a risk-free procedure, but complications are relatively rare. You can read about breast augmentation on this website, and use the find-a-surgeon tool to find an ASPS member surgeon near you to discuss the pros and cons of breast implants in detail.
What are the side effects of breast implants
Question:
Hi Am Makie, I’m 30 with a very small breast,never had a surgery before, but I’m so insecure bout my breast,my husband says he’s not complaining, but I am. I want a C cup just like Rihanna, but I’m scared what is your advice, plus can I breastfeed if I have a breast implant?
Debra J. Johnson, MD's Response:
Pregnancy can alter the way your breasts look by changing the size and stretching out the skin a bit. It is prudent to wait until after you have completed childbearing before embarking on breast augmentation. If you don't want to wait, just realize that after having children and breastfeeding, your breasts may need some "maintenance work" to look the way you want them to again. Breast augmentation is not a risk-free procedure, but complications are relatively rare. You can read about breast augmentation on this website, and use the find-a-surgeon tool to find an ASPS member surgeon near you to discuss the pros and cons of breast implants in detail.
What age should you get a nose job?
RhinoplastyMember Response:
Most surgeons recommend waiting on cosmetic rhinoplasty until your nose reaches adult size. In men, this is usually around age 16-17.
What age should you get a nose job?
Question:
What age should you get a nose job?
Debra J. Johnson, MD's Response:
Most surgeons recommend waiting on cosmetic rhinoplasty until your nose reaches adult size. In men, this is usually around age 16-17.
Previous Internal Injury
Vaginal RejuvenationMember Response:
I would suggest you start with a visit to your gynecologist. You'll need an examination to see if there is an abnormality to your vagina and what options you might have for correcting it. Good luck.
Previous Internal Injury
Question:
When I was young and hitting puberty I was using tampons and pushed one I guess you can say into my vaginal wall/lining. When I went to take it out it was stuck and in the attempt to get it out I stretched the loop on my vagina it was stuck in. This kept happening so I stopped using tampons. Now my partners can feel it and will sometimes get caught on it during intercourse. Can this be removed?
Debra J. Johnson, MD's Response:
I would suggest you start with a visit to your gynecologist. You'll need an examination to see if there is an abnormality to your vagina and what options you might have for correcting it. Good luck.
Ruptured implant
Breast AugmentationMember Response:
You likely had smaller breasts to start with, which was why you got breast implants. The implants then tend to stretch out the breast skin envelope. Even if you hadn't had a contracture/rupture, if you had removed an intact implant your breast would look "empty" because you now have more skin and less breast tissue volume. Contracture puts pressure on the surrounding breast tissue and can thin it. It doesn't "eat" it, but can make it reduce volume-wise, kind of like how the pressure from bra straps creates dents in your shoulders by thinning the fat there. In removing a ruptured implant, as Dr. Culbertson said, sometimes some of the breast tissue contains silicone, and that must be removed. Discuss with your surgeon how your breast might be reconstructed using your own fat or perhaps another implant such as a baffled saline (Ideal is the brand name). Use the Find a Surgeon tool to locate additional ASPS member surgeons near you for a second opinion. Good luck.
Ruptured implant
Question:
I had capsular contracture removal and new implants. The left implant was ruptured. I had to have new left implant removed after 6 months, I have a big hole in my breast there is no breast tissue, I look like I had a mastectomy. The surgeon said it was because my leaked silicon ate my breast tissue! Can the silicon from a ruptured implant destroy breast tissue ie: eat the breast tissue?
Debra J. Johnson, MD's Response:
You likely had smaller breasts to start with, which was why you got breast implants. The implants then tend to stretch out the breast skin envelope. Even if you hadn't had a contracture/rupture, if you had removed an intact implant your breast would look "empty" because you now have more skin and less breast tissue volume. Contracture puts pressure on the surrounding breast tissue and can thin it. It doesn't "eat" it, but can make it reduce volume-wise, kind of like how the pressure from bra straps creates dents in your shoulders by thinning the fat there. In removing a ruptured implant, as Dr. Culbertson said, sometimes some of the breast tissue contains silicone, and that must be removed. Discuss with your surgeon how your breast might be reconstructed using your own fat or perhaps another implant such as a baffled saline (Ideal is the brand name). Use the Find a Surgeon tool to locate additional ASPS member surgeons near you for a second opinion. Good luck.
Risk
Tummy TuckMember Response:
Biggest risk after a tummy tuck is a blood clot (deep venous thrombosis or DVT). Higher risk factors are obesity, tobacco use, hormone use, personal or family history of DVT. BMI less than 30, nonsmoking status are helpful. Drinking plenty of fluids postoperatively and walking frequently are important. Following all your doctor’s instructions will help you get through the process as successfully as possible.
Risk
Question:
Hello, I’m scheduled to have a TT on February 22nd and I’m extremely nervous but excited all at the same time. My question is how likely is it to have major complications and what can I do to prevent them. I’m not concerned about pain or minor risk. Also, I’m worried about going under. I have a irregular heart beat but I always get cleared and last year he cleared me but I’m getting another.
Debra J. Johnson, MD's Response:
Biggest risk after a tummy tuck is a blood clot (deep venous thrombosis or DVT). Higher risk factors are obesity, tobacco use, hormone use, personal or family history of DVT. BMI less than 30, nonsmoking status are helpful. Drinking plenty of fluids postoperatively and walking frequently are important. Following all your doctor’s instructions will help you get through the process as successfully as possible.
Vertical Wrinkles on mid stomach
Tummy TuckMember Response:
Vertical lines on the abdomen can occur after pregnancy or weight loss. Unfortunately, the skin doesn't have the elasticity to tighten up on its own. You can remove excess skin from the sides of your abdomen to smooth the central area. However, you will have scars on the sides, usually from the lateral chest wall to the hip. But for some people that's a reasonable tradeoff.
Vertical Wrinkles on mid stomach
Question:
I'm a very fit, slim woman with vertical lines on my mid stomach. Id like to have the skin pulles to my sides, which would make my stomach very smooth. Is this possible? I do not have lower stomach sagging.
Debra J. Johnson, MD's Response:
Vertical lines on the abdomen can occur after pregnancy or weight loss. Unfortunately, the skin doesn't have the elasticity to tighten up on its own. You can remove excess skin from the sides of your abdomen to smooth the central area. However, you will have scars on the sides, usually from the lateral chest wall to the hip. But for some people that's a reasonable tradeoff.
Inf request
Eyelid SurgeryMember Response:
The plastic surgeries that are covered by health insurance all have to have some functional impairment involved. Breast reduction is covered since patients have significant back, neck and shoulder pain. You tagged eyelid surgery, so sometimes upper eyelid surgery can be covered if the eyelid skin is so heavy and excessive that it hangs down over the lashes and obstructs vision. Panniculectomy, the removal of excessive skin and fat from the abdomen, is sometimes covered in massive weight loss patients since they tend to have trouble with rashes and odor in the skin folds. Cosmetic surgery, where you are improving on a normal appearance and not correcting any medical problem, is not covered by insurance.
Inf request
Question:
Which cosmetics surgeries are cover by insurance?
Debra J. Johnson, MD's Response:
The plastic surgeries that are covered by health insurance all have to have some functional impairment involved. Breast reduction is covered since patients have significant back, neck and shoulder pain. You tagged eyelid surgery, so sometimes upper eyelid surgery can be covered if the eyelid skin is so heavy and excessive that it hangs down over the lashes and obstructs vision. Panniculectomy, the removal of excessive skin and fat from the abdomen, is sometimes covered in massive weight loss patients since they tend to have trouble with rashes and odor in the skin folds. Cosmetic surgery, where you are improving on a normal appearance and not correcting any medical problem, is not covered by insurance.
Hashimoto Hypothyroidism
Mommy MakeoverMember Response:
In a perfect world, you should try and get your weight down under150 (BMI less than 25). That reduces your risk of postoperative complications significantly. Make sure your thyroid function is okay. Then go for it, girl!
Hashimoto Hypothyroidism
Question:
I’m 57, 5’5, 159 and have had 2 c-sections and partial hysterectomy and a completed hysterectomy, all using the same incision scar. I have Hashimoto Hypothyroidism and wonder would this condition prohibits me from getting a mommy makeover that I have wanted for over 12 years. This question’s answer is my start towards getting a mommy makeover. Thank you.
Debra J. Johnson, MD's Response:
In a perfect world, you should try and get your weight down under150 (BMI less than 25). That reduces your risk of postoperative complications significantly. Make sure your thyroid function is okay. Then go for it, girl!
Why can't someone help me at home
Body ContouringMember Response:
Best course would be to contact your insurance company and ask them for a list of plastic surgeons in your network. Your insurer is the one who decides who they contract with. If you have “out of plan” capability, you may have more choices. New York does have rules regarding charges for out of plan providers. Call your insurance customer service, ask to speak to a supervisor, and ask who you can see in your network or if you have out of network benefits. Good luck.
Why can't someone help me at home
Question:
I beat death and weight issues ! After gastric and other weight complications why cant soneone take my insurance to get rid of skin I think it's wrong my full story on Facebook and GoFundMe! To much to say here
Debra J. Johnson, MD's Response:
Best course would be to contact your insurance company and ask them for a list of plastic surgeons in your network. Your insurer is the one who decides who they contract with. If you have “out of plan” capability, you may have more choices. New York does have rules regarding charges for out of plan providers. Call your insurance customer service, ask to speak to a supervisor, and ask who you can see in your network or if you have out of network benefits. Good luck.
Removal of old implants & replacement
Breast AugmentationMember Response:
You should have bilateral capsulectomy and removal of implants. That gets rid of all the old silicone. Depending on how your breasts look and are sizing now, maybe simply replacing the implants, or if your breasts have dropped, a breast lift with or without implants. Use the Find A Surgeon link to locate a board-certified ASPS member surgeon near you to discuss options. Insurance will pay for broken implant removal, although replacement and breastlifting would be considered “cosmetic” and on your dime. As another surgeon said, not an emergency, but should be taken care of in a timely manner. Best of luck.
Removal of old implants & replacement
Question:
Implants are 28 yrs old. Recent mammogram shows leakage on one side yesterday, never showed before. Need advice of next steps as to how soon to remove, replace and by whom.. want the best surgeon experienced in this.
Debra J. Johnson, MD's Response:
You should have bilateral capsulectomy and removal of implants. That gets rid of all the old silicone. Depending on how your breasts look and are sizing now, maybe simply replacing the implants, or if your breasts have dropped, a breast lift with or without implants. Use the Find A Surgeon link to locate a board-certified ASPS member surgeon near you to discuss options. Insurance will pay for broken implant removal, although replacement and breastlifting would be considered “cosmetic” and on your dime. As another surgeon said, not an emergency, but should be taken care of in a timely manner. Best of luck.
Breast reconstruction, gel versus saline
Breast AugmentationMember Response:
After mastectomy, most women have little subcutaneous tissue to camouflage the feel of an implant. Saline implants tend to show more rippling in the upper breast, and scalloping on the outer aspect where there is less muscle coverage. For that reason, many patients prefer silicone. There are both cohesive gel and highly cohesive gel implants. Highly cohesive gel implants have the least rippling, but are a little sturdier feeling. Another option to consider if you want to avoid silicone is the baffled saline implant called Ideal. This implant has two saline chambers with internal walls in each chamber. This construction allows the implant to hold its shape better. There is less rippling and more of a silicone-like feel. The advantage of saline implants is that, in case of a failure, the replacement is a relatively easy swap-out, whereas a failure in a silicone implant requires capsulectomy which is a bigger operation.
Breast reconstruction, gel versus saline
Question:
I would like to know your opinion regarding cohesive gel versus saline implants after tissue expanders are removed . They are posterior to the pectoralis muscle. My pre bilateral mastectomy implants were silicone meme textured implants. I am considering rippling, natural feel/look and of course systemic health. Thank you Kelli
Debra J. Johnson, MD's Response:
After mastectomy, most women have little subcutaneous tissue to camouflage the feel of an implant. Saline implants tend to show more rippling in the upper breast, and scalloping on the outer aspect where there is less muscle coverage. For that reason, many patients prefer silicone. There are both cohesive gel and highly cohesive gel implants. Highly cohesive gel implants have the least rippling, but are a little sturdier feeling. Another option to consider if you want to avoid silicone is the baffled saline implant called Ideal. This implant has two saline chambers with internal walls in each chamber. This construction allows the implant to hold its shape better. There is less rippling and more of a silicone-like feel. The advantage of saline implants is that, in case of a failure, the replacement is a relatively easy swap-out, whereas a failure in a silicone implant requires capsulectomy which is a bigger operation.
Breast lift without implant
Breast LiftMember Response:
Mastopexy (breastlifting) can be performed with or without an implant. Use of an implant can give better upper breast fullness or cleavage. Without an implant you don’t get quite as much oomph to the cleavage, but you do get more youthful/perky-looking breasts. Mastopexy alone saves the extra expense for implants and possible reoperations for implant failure etc.
Breast lift without implant
Question:
I am considering a breast lift. The majority of the information I am finding suggests an implant. Can it be a successful lift surgery without an implant? Thanks!
Debra J. Johnson, MD's Response:
Mastopexy (breastlifting) can be performed with or without an implant. Use of an implant can give better upper breast fullness or cleavage. Without an implant you don’t get quite as much oomph to the cleavage, but you do get more youthful/perky-looking breasts. Mastopexy alone saves the extra expense for implants and possible reoperations for implant failure etc.
Breast Implant Illness
Breast AugmentationMember Response:
Breast Implant Illness is not a disease that can be diagnosed by testing. Some women with breast implants have concerns that various symptoms they have might be related to their implants. There are certainly Facebook groups and chat rooms devoted to Breast Implant Illness although it as yet has not been scientifically proven to exist. Prior studies aimed at whether autoimmune diseases such as scleroderma or lupus could be related to implants showed no increased risk of disease in women with implants versus without. Removal of implants cannot guarantee that symptoms will resolve. However, you chose to have implants placed and you can choose to have them removed, although you have to realize that surgical removal carries some risk of complications and deformity, as well as expense, and may not improve your symptoms. Talk to your plastic surgeon.
Breast Implant Illness
Question:
I have been tested by every doctor I can find and had blood, urine, and heart tests. I have no other medical issues. Yet I am losing hair, have chronic insomnia and chronic breast pain since revision on 19 Sept. I am positive I have Breast Implant Illness and need advice as to how to fix this.
Debra J. Johnson, MD's Response:
Breast Implant Illness is not a disease that can be diagnosed by testing. Some women with breast implants have concerns that various symptoms they have might be related to their implants. There are certainly Facebook groups and chat rooms devoted to Breast Implant Illness although it as yet has not been scientifically proven to exist. Prior studies aimed at whether autoimmune diseases such as scleroderma or lupus could be related to implants showed no increased risk of disease in women with implants versus without. Removal of implants cannot guarantee that symptoms will resolve. However, you chose to have implants placed and you can choose to have them removed, although you have to realize that surgical removal carries some risk of complications and deformity, as well as expense, and may not improve your symptoms. Talk to your plastic surgeon.
Accutane and surgery
Body ContouringMember Response:
Accutane is associated with more aggressive scar formation. The general rule of thumb is to wait at least six months after completion of Accutane therapy before considering any elective surgery.
Accutane and surgery
Question:
I am currently on 30mg accutane daily and wanting to get a labiaplasty at some point. What do cosmetic surgeons think about this drug and surgery? Do I have to stop the medication? For how long? And is there enough study on this? Thank you!
Debra J. Johnson, MD's Response:
Accutane is associated with more aggressive scar formation. The general rule of thumb is to wait at least six months after completion of Accutane therapy before considering any elective surgery.
Ugly jaw/neck definition.
FaceliftMember Response:
In a young person, a lack of an angle to the neck on profile is usually due to genetic fat under the chin. If the projection of your chin on profile view is good, and there is a genetic fat deposit, then liposuction of the fat (or injection of a fat dissolver like Kybella) might do the trick. If your chin lacks projection, then some sort of chin augmentation might be needed. Please use the Find-a-Surgeon link to locate a board-certified plastic surgeon in your area who can examine you in person and offer you options for treatment.
Ugly jaw/neck definition.
Question:
What would be the best procedure for a 24 year old male who's wanted a more defined jawline/chin. I know for a fact this is genetic, my mom has the same profile view as me. From the front my jaw looks good! But, from the side it looks like one slightly curved slope, chin to neck. Instead of a beautiful angle. Thanks in advance for the advice!
Debra J. Johnson, MD's Response:
In a young person, a lack of an angle to the neck on profile is usually due to genetic fat under the chin. If the projection of your chin on profile view is good, and there is a genetic fat deposit, then liposuction of the fat (or injection of a fat dissolver like Kybella) might do the trick. If your chin lacks projection, then some sort of chin augmentation might be needed. Please use the Find-a-Surgeon link to locate a board-certified plastic surgeon in your area who can examine you in person and offer you options for treatment.
No definition in neck
LiposuctionMember Response:
There are definitely options to correct your problem. Lack of definition to the neck/jawline can be due to a small mandible (lower jaw bone), skin laxity, or excess fat in the jowl and/or under the chin. Treatments depend on your specific issues and age. Please use the Find-a-Surgeon tool to locate an ASPS member board-certified plastic surgeon near you to discuss your concerns and get your options.
No definition in neck
Question:
My whole life I have had no definition in my neck/jawline. I always look heavier then I am. I don't know if i need a chin implant, neck lift or liposuction. Just need some advice.
Debra J. Johnson, MD's Response:
There are definitely options to correct your problem. Lack of definition to the neck/jawline can be due to a small mandible (lower jaw bone), skin laxity, or excess fat in the jowl and/or under the chin. Treatments depend on your specific issues and age. Please use the Find-a-Surgeon tool to locate an ASPS member board-certified plastic surgeon near you to discuss your concerns and get your options.
Sad belly button and indent
Tummy TuckMember Response:
If ypur belly button “frowns” that usually means you have excess skin above the belly button. It’s the overhang that make the frown. Contour irregularities in the lower abdomen...too much skin and sometimes fatty excess. Please consult with a board-certified plastic surgeon to learn your options. Tummy tucks aren’t cheap, but they can make a tremendous improvement in abdominal shape.
Sad belly button and indent
Question:
So my frowning belly button isn't rare I've seen this over and over. But i also have an area below it that looks like i was poked and it left a wrinkled indent. How is this fixed? Is it all one procedure? It would be nice if I could attach a photo. Being seen to show it is so embarrassing. I'm also afraid to know the cost.
Debra J. Johnson, MD's Response:
If ypur belly button “frowns” that usually means you have excess skin above the belly button. It’s the overhang that make the frown. Contour irregularities in the lower abdomen...too much skin and sometimes fatty excess. Please consult with a board-certified plastic surgeon to learn your options. Tummy tucks aren’t cheap, but they can make a tremendous improvement in abdominal shape.
To lift or to lift and reduce
Breast LiftMember Response:
While you don't have symptoms related to your large breasts, you might well suffer from neck, back, and shoulder pain in the future due to your large breast size. Simply lifting the breasts will improve their look in the short term, but gravity will likely cause the breasts to droop again due to their heavy weight. It would certainly be better for your overall health, and for the longevity of your surgical result, if you were able to reduce your weight prior to undergoing any breast surgery. Ultimately, making your breasts proportional with the rest of your body will make it easier to find clothing that fits well, as you will not have to "size up" just to fit your breasts. Use the Find-A-Surgeon tool on this website to locate a board-certified plastic surgeon in your area and discuss your goals. Good luck on this journey!
To lift or to lift and reduce
Question:
Hello, I have had sagging but large breast for most of my life. I am currently overweight, but my breast have always been large in spite of my weight. The size does not cause me any discomfort or health issues. I want to keep my breast size, but I need some heavy lifting. So, my question is: At a size 44G, am I able to simply get a lift or will a lift require a reduction?
Debra J. Johnson, MD's Response:
While you don't have symptoms related to your large breasts, you might well suffer from neck, back, and shoulder pain in the future due to your large breast size. Simply lifting the breasts will improve their look in the short term, but gravity will likely cause the breasts to droop again due to their heavy weight. It would certainly be better for your overall health, and for the longevity of your surgical result, if you were able to reduce your weight prior to undergoing any breast surgery. Ultimately, making your breasts proportional with the rest of your body will make it easier to find clothing that fits well, as you will not have to "size up" just to fit your breasts. Use the Find-A-Surgeon tool on this website to locate a board-certified plastic surgeon in your area and discuss your goals. Good luck on this journey!
Tummy tuck
Tummy TuckMember Response:
Many patients like to combine procedures so that they have only one recuperation and can save money by having only one surgery rather than two or three. However, the longer the surgery lasts, the higher the risk of complications. Abdominoplasty plus another procedure has a higher complication rate than abdominoplasty alone. BBL or fat transfer to the buttock is a high risk procedure, with a published death rate of around 1:3000 patients. While many plastic surgeons will agree to perform multiple procedures together, and most patients can come through the process with nice results and without complications, as an individual you must understand you are taking on more risk. Make sure your BMI is below 30 as that is one big risk factor you can do something about. Make sure your plastic surgeon works in a licensed/accredited facility to ensure there is appropriate safety equipment. Ask about who will be providing your anesthesia.
Tummy tuck
Question:
Having a mommy make over with breast lift with silicone implants , tummy tuck and BBL is too much surgery in one day
Debra J. Johnson, MD's Response:
Many patients like to combine procedures so that they have only one recuperation and can save money by having only one surgery rather than two or three. However, the longer the surgery lasts, the higher the risk of complications. Abdominoplasty plus another procedure has a higher complication rate than abdominoplasty alone. BBL or fat transfer to the buttock is a high risk procedure, with a published death rate of around 1:3000 patients. While many plastic surgeons will agree to perform multiple procedures together, and most patients can come through the process with nice results and without complications, as an individual you must understand you are taking on more risk. Make sure your BMI is below 30 as that is one big risk factor you can do something about. Make sure your plastic surgeon works in a licensed/accredited facility to ensure there is appropriate safety equipment. Ask about who will be providing your anesthesia.
Hello is this procedure possible without full sedation?
Tummy TuckMember Response:
The level of anesthesia depends on the kind of surgery you might need. If there is a significant muscle separation, repairing that with only local anesthesia can be uncomfortable. If you require liposuction as well as skin removal, the surgeon must infiltrate higher volumes of dilute local anesthetic. Injecting the local anesthesia can be very uncomfortable in some patients. You should consult with a board-certified plastic surgeon. Use the Find-A-Surgeon link to locate an ASPS member surgeon near you. Based on your anatomy and desired result, your surgeon will advise you on anesthesia choices. I always want my patients to be as comfortable as possible during the procedure, and I do a lot of local anesthetic surgery. But I also tell my patients that if you're uncomfortable, then I'm uncomfortable, and I may not be able to give you as good a result as we both might want if you are unable to lie still during the procedure.
Hello is this procedure possible without full sedation?
Question:
Hello, is this procedure possible without being fully sedated I do not like to be put to sleep?
Debra J. Johnson, MD's Response:
The level of anesthesia depends on the kind of surgery you might need. If there is a significant muscle separation, repairing that with only local anesthesia can be uncomfortable. If you require liposuction as well as skin removal, the surgeon must infiltrate higher volumes of dilute local anesthetic. Injecting the local anesthesia can be very uncomfortable in some patients. You should consult with a board-certified plastic surgeon. Use the Find-A-Surgeon link to locate an ASPS member surgeon near you. Based on your anatomy and desired result, your surgeon will advise you on anesthesia choices. I always want my patients to be as comfortable as possible during the procedure, and I do a lot of local anesthetic surgery. But I also tell my patients that if you're uncomfortable, then I'm uncomfortable, and I may not be able to give you as good a result as we both might want if you are unable to lie still during the procedure.
Hooded eyelids
Eyelid SurgeryMember Response:
A lot of people have hooded eyes, and the problem tends to get worse as we age. Getting rid of the hooding will "change your look"....think Renee Zelwegger, so you have to be ready for that change. All plastic surgeons are very careful to minimize the risk of complications after blepharoplasty. Inability to fully close the eyes (lagophthalmos) is a rare complication that results from taking too much skin out. Blindness, an even rarer complication, can result from bleeding causing pressure on the optic nerve. Consulting with an ASPS-member board-certified plastic surgeon is your first step in minimizing your risk of complications in this procedure. Having had this surgery myself for my naturally hooded eyes, I can tell you it made a very nice difference for me. The surgery was not painful, just a little tender and tight for a while, and I was back at work in three days with only mild bruising.
Hooded eyelids
Question:
Ive always been really self conscious about my hooded eyes and I would like to have them corrected. How do I go about finding the right surgeonbc I dont want to end up blind or not be able to full close my eyes.
Debra J. Johnson, MD's Response:
A lot of people have hooded eyes, and the problem tends to get worse as we age. Getting rid of the hooding will "change your look"....think Renee Zelwegger, so you have to be ready for that change. All plastic surgeons are very careful to minimize the risk of complications after blepharoplasty. Inability to fully close the eyes (lagophthalmos) is a rare complication that results from taking too much skin out. Blindness, an even rarer complication, can result from bleeding causing pressure on the optic nerve. Consulting with an ASPS-member board-certified plastic surgeon is your first step in minimizing your risk of complications in this procedure. Having had this surgery myself for my naturally hooded eyes, I can tell you it made a very nice difference for me. The surgery was not painful, just a little tender and tight for a while, and I was back at work in three days with only mild bruising.
Post bilateral mastectomy recon
Breast AugmentationMember Response:
I hope you are recuperating well after this big surgery. Every woman has to make rapid decisions once a cancer diagnosis is received. Sometimes we are in such a rush we don’t have time to fully consider our options. You may feel that placing tissue expanders was the wrong decision. Removing them is fairly straightforward, although you may require some additional skin removal since often extra skin is left when the TEs are placed, knowing they will take up the skin excess quickly. However, now that you are not in such a rush, be sure and take your time to thoughtfully consider your options. Discuss your concerns with your plastic surgeon and together decide the best way forward. Good luck and good health.
Post bilateral mastectomy recon
Question:
Hello~ I had bilateral mastectomy for bc 11/19. Expanders were placed at that time. Everything happened very quickly, and in short, Upon research and reflection, I do not want reconstruction. Can anyone of you tell me what expander removal without implant placement would involve? Thank you so much for your time.
Debra J. Johnson, MD's Response:
I hope you are recuperating well after this big surgery. Every woman has to make rapid decisions once a cancer diagnosis is received. Sometimes we are in such a rush we don’t have time to fully consider our options. You may feel that placing tissue expanders was the wrong decision. Removing them is fairly straightforward, although you may require some additional skin removal since often extra skin is left when the TEs are placed, knowing they will take up the skin excess quickly. However, now that you are not in such a rush, be sure and take your time to thoughtfully consider your options. Discuss your concerns with your plastic surgeon and together decide the best way forward. Good luck and good health.
Capsular Contracture Options Other Than Surgical Removal
Breast AugmentationMember Response:
Conservative measures may not correct your problem but certainly are worth a try. Talk to your plastic surgeon. In my own practice, I try a variety of things. First, I ask the patient to lay directly on the hard breast on a firm surface, like a hardwood floor or a large coffee table type book, for ten minutes a day. We discuss the short-term, 30-day use of a leukotriene inhibitor like montelukast. I also suggest a weekly cold laser (I use an Erchonia laser) treatment for a minimum of 4 weeks. Some patients do achieve relief of the contracture doing this.
Capsular Contracture Options Other Than Surgical Removal
Question:
Hi, I had my breast implants replaced about 2 years ago. Existing scar tissue was removed. The L breast had become hard and misshapen, but that occurred over several years. After the 2016 surgery, the L breast became hard and contracted within months. I don't want surgery to remove the capsule. Is there ANYTHING I can do? Ultrasound? Accolate? Other drugs? Injections? Please help!
Debra J. Johnson, MD's Response:
Conservative measures may not correct your problem but certainly are worth a try. Talk to your plastic surgeon. In my own practice, I try a variety of things. First, I ask the patient to lay directly on the hard breast on a firm surface, like a hardwood floor or a large coffee table type book, for ten minutes a day. We discuss the short-term, 30-day use of a leukotriene inhibitor like montelukast. I also suggest a weekly cold laser (I use an Erchonia laser) treatment for a minimum of 4 weeks. Some patients do achieve relief of the contracture doing this.
Mommy makeover and scuba diving
Mommy MakeoverMember Response:
Most patients are feeling back to normal, and able to perform their usual activities within about 4-6 weeks after surgery. However, there is always a risk of untoward complications that could derail your scuba plans. I would obtain travel insurance if possible to protect yourself from loss if you are unable to travel for medical reasons. Or consider giving yourself more time to recuperate before planning a strenuous vacation, like 3-4 months. Happy diving!
Mommy makeover and scuba diving
Question:
I am 50-years-old and like to scuba dive.I am a quick healer from previous surgeries but I wonder about the recovery time from a mommy makeover. My concern is being able to pull myself up out of the water into the boat with an extra load of about 25 pounds of tanks and equipment. I want the surgery in June and the dive trip in August. Does this sound feasible if healing goes without any problems?
Debra J. Johnson, MD's Response:
Most patients are feeling back to normal, and able to perform their usual activities within about 4-6 weeks after surgery. However, there is always a risk of untoward complications that could derail your scuba plans. I would obtain travel insurance if possible to protect yourself from loss if you are unable to travel for medical reasons. Or consider giving yourself more time to recuperate before planning a strenuous vacation, like 3-4 months. Happy diving!
Can I fix my uneven nostrils and septum?
RhinoplastyMember Response:
We all have asymmetries. One side of our face often looks different from the other side. Most people don’t notice these asymmetries in themselves, and certainly other people almost never notice them. You should take your concerns to a board-certified plastic surgeon and see if you are a candidate for surgery.
Can I fix my uneven nostrils and septum?
Question:
I’ve been thinking of get a septoplasty and rhinoplasty on my nose but I have noticed that my nostrils look uneven and my nose looks slanted to the right. What would you recommend I do?
Debra J. Johnson, MD's Response:
We all have asymmetries. One side of our face often looks different from the other side. Most people don’t notice these asymmetries in themselves, and certainly other people almost never notice them. You should take your concerns to a board-certified plastic surgeon and see if you are a candidate for surgery.
I have a problem with my eyes: Do I need a blethoraplasty ? or ptosis surgery? or
Eyelid SurgeryMember Response:
Blepharoplasty is performed for people with excess skin on their upper lids which makes them look tired. Ptosis surgery is for patients who have an elongation of the upper lid muscle that causes the lid to droop and cover more of the iris. Some patients need both procedures performed! Your best bet is to consult with an ASPS member surgeon and get advice on what would be the most appropriate treatment for your asymmetry.
I have a problem with my eyes: Do I need a blethoraplasty ? or ptosis surgery? or
Question:
Hi ! I have a problem with my eyes: Do I need a blethoraplasty ? or ptosis surgery? not sure which one s gonna fix the asymetria!
Debra J. Johnson, MD's Response:
Blepharoplasty is performed for people with excess skin on their upper lids which makes them look tired. Ptosis surgery is for patients who have an elongation of the upper lid muscle that causes the lid to droop and cover more of the iris. Some patients need both procedures performed! Your best bet is to consult with an ASPS member surgeon and get advice on what would be the most appropriate treatment for your asymmetry.
Rhinoplasty and Accutane
RhinoplastyMember Response:
The common rule of thumb is to wait at least 6 months after completing a course of Accutane before embarking on any elective surgery. But check with your plastic surgeon to be sure.
Rhinoplasty and Accutane
Question:
Hello, I want to know the waiting period between rhinoplasty and accutane. I took 40mg twice a day for six months. Thank you. Rubal C.
Debra J. Johnson, MD's Response:
The common rule of thumb is to wait at least 6 months after completing a course of Accutane before embarking on any elective surgery. But check with your plastic surgeon to be sure.
I’m sorry,there was no option of choosing brow lift so instead I chose facelift.
FaceliftMember Response:
If you were born with low-set eyebrows, a browlift can reposition the brows and provide a more youthful, open-eyed look. Browlifts can be performed with a coronal incision (all the way across the top of the head), endoscopically (using a few small incisions and a camera to visualize the surgery), or directly (placing an incision just above the brow and removing an ellipse of skin, or along the front hairline). Scars within the hair are less visible. If your front hairline is also low then a a coronal or endoscopic technique would elevate your hairline too. If you don't want your hairline shifted higher, an incision in the forehead skin would be better, but the resulting scar might be more obvious. Your results should be very long-lived, although in your later years you may notice some stretching of the forehead skin with aging that causes your brows to lower a bit. Search for an ASPS International member surgeon near you with this website's Find a Surgeon link.
I’m sorry,there was no option of choosing brow lift so instead I chose facelift.
Question:
I’m 19 yrs old. I'm so bothered about my droopy eyebrows. I wanted to get it fixed later on. I just wanted to ask how long does coronal brow lift last? Is it permanent, since I’m still 19 yrs, and if maintain my health, reduce sun exposure and with excercises?
Debra J. Johnson, MD's Response:
If you were born with low-set eyebrows, a browlift can reposition the brows and provide a more youthful, open-eyed look. Browlifts can be performed with a coronal incision (all the way across the top of the head), endoscopically (using a few small incisions and a camera to visualize the surgery), or directly (placing an incision just above the brow and removing an ellipse of skin, or along the front hairline). Scars within the hair are less visible. If your front hairline is also low then a a coronal or endoscopic technique would elevate your hairline too. If you don't want your hairline shifted higher, an incision in the forehead skin would be better, but the resulting scar might be more obvious. Your results should be very long-lived, although in your later years you may notice some stretching of the forehead skin with aging that causes your brows to lower a bit. Search for an ASPS International member surgeon near you with this website's Find a Surgeon link.
Symmastia
Breast ReductionMember Response:
Breast reduction is a very common surgery for plastic surgeons. There are varying ways to perform the reduction, based on your specific anatomy. Your large breasts may have pulled the skin overlying your sternum away from the bone, making the midportion of your chest look full. Sometimes this can be corrected with liposuction or other surgical techniques. Please use the "Find A Surgeon" link to locate a board-certified ASPS member plastic surgeon in your area who can examine you and discuss your options.
Symmastia
Question:
Hi I am 42 and have Symmastia. I have never had implants. I am a 28 G. I have a small frame and small back but very large breast. I wanted to get a breast reduction and fix my Symmastia. When I put on weight it goes right to my breast. I am afraid that if not done properly it can get worse. What do you recommend?
Debra J. Johnson, MD's Response:
Breast reduction is a very common surgery for plastic surgeons. There are varying ways to perform the reduction, based on your specific anatomy. Your large breasts may have pulled the skin overlying your sternum away from the bone, making the midportion of your chest look full. Sometimes this can be corrected with liposuction or other surgical techniques. Please use the "Find A Surgeon" link to locate a board-certified ASPS member plastic surgeon in your area who can examine you and discuss your options.
Digestive enzyme and probiotic supplements and tummy tuck
Tummy TuckMember Response:
I wouldn’t have a problem with continuing probiotics before surgery. However, there are some supplements that can increase bleeding, bruising, and swelling. Best bet would be to call your surgeon’s office and tell the doctor (or his nurse) exactly what the ingredients are and get their advice. You certainly wouldn’t want to go ahead and take something and then have your surgery cancelled because of it! Your surgeon will want to do what’s safest for you so heed his or her advice!
Digestive enzyme and probiotic supplements and tummy tuck
Question:
I have a tummy tuck scheduled in two weeks, and I was wondering if it’d be alright to keep taking digestive enzyme and probiotic supplements?
Debra J. Johnson, MD's Response:
I wouldn’t have a problem with continuing probiotics before surgery. However, there are some supplements that can increase bleeding, bruising, and swelling. Best bet would be to call your surgeon’s office and tell the doctor (or his nurse) exactly what the ingredients are and get their advice. You certainly wouldn’t want to go ahead and take something and then have your surgery cancelled because of it! Your surgeon will want to do what’s safest for you so heed his or her advice!
Indention on right breast
Breast LiftMember Response:
If you have a result with something you don't like, you should return to your surgeon to discuss this. Sometimes scars are a bit tighter than the natural skin and this can cause a depression. Often this will correct itself over time. I would caution against larger implants since you already needed a breast lift, likely from thin skin. A larger implant will put more weight on the breast and more gravitational pressure on the skin, and could cause the breast to droop more in the future. A tummy tuck can be combined with a breast procedure, but increases the operative time and area of injury. You should discuss this with a board-certified plastic surgeon to determine what your options are and what is safe to do together.
Indention on right breast
Question:
I had a lollipop breast lift done almost a year ago and my right breast has a small indention along the scar that goes down from the nipple. Can you tell me what could cause this?
Debra J. Johnson, MD's Response:
If you have a result with something you don't like, you should return to your surgeon to discuss this. Sometimes scars are a bit tighter than the natural skin and this can cause a depression. Often this will correct itself over time. I would caution against larger implants since you already needed a breast lift, likely from thin skin. A larger implant will put more weight on the breast and more gravitational pressure on the skin, and could cause the breast to droop more in the future. A tummy tuck can be combined with a breast procedure, but increases the operative time and area of injury. You should discuss this with a board-certified plastic surgeon to determine what your options are and what is safe to do together.
Breast Reduction and tank top lipo
Breast ReductionMember Response:
You would need to be examined by a board-certified plastic surgeon to determine your options. The reduction itself may rid you of much of the lateral chest fullness , although some liposuction may be needed to clean up that area nicely. Use the Find A Surgepn tool to locate an ASPS member near you. Call to see if you need a referral from your insurance.
Breast Reduction and tank top lipo
Question:
Hello , I want to get a breast reduction and a liposuction of the underarm and bulging surrounding area. Would you recommend to have both procedures done at the same time or do the breast reduction first and later on do the liposuction. Thank you in advance for your response.
Debra J. Johnson, MD's Response:
You would need to be examined by a board-certified plastic surgeon to determine your options. The reduction itself may rid you of much of the lateral chest fullness , although some liposuction may be needed to clean up that area nicely. Use the Find A Surgepn tool to locate an ASPS member near you. Call to see if you need a referral from your insurance.
Plastic reconstructive surgery
Tummy TuckMember Response:
Guadelupe, Congratulations on your five children! However, multiple pregnancies can make the abdomen look stretched out with hanging skin. You can read more about abdominoplasty (tummy tuck) if you click "cosmetic" on the top banner of this webpage. There you can look under abdominoplasty, or if you prefer to read in Spanish you can click on "en espanol" . What procedure might be recommended depends on your particular body shape, extra skin, fatty tissue, and whether the muscles are separated after your pregnancies. Please use the "Find a Surgeon" tool at the top of the webpage to find an ASPS-member board-certified plastic surgeon near you and make an appointment to discuss your issues!
Plastic reconstructive surgery
Question:
I have disfigured body part I would like to know more about doing plastic surgery on my tummy due to 5 -C-Sections I had on the past it made my tummy disfigured now It looks like a tummy but so how can you fix this
Debra J. Johnson, MD's Response:
Guadelupe, Congratulations on your five children! However, multiple pregnancies can make the abdomen look stretched out with hanging skin. You can read more about abdominoplasty (tummy tuck) if you click "cosmetic" on the top banner of this webpage. There you can look under abdominoplasty, or if you prefer to read in Spanish you can click on "en espanol" . What procedure might be recommended depends on your particular body shape, extra skin, fatty tissue, and whether the muscles are separated after your pregnancies. Please use the "Find a Surgeon" tool at the top of the webpage to find an ASPS-member board-certified plastic surgeon near you and make an appointment to discuss your issues!
Follow up questiom
Breast AugmentationMember Response:
I'm sorry you felt your most recent consult was unsatisfactory. You may want to check out a few websites of ASPS members in your area, and make some calls to get more information. You should definitely not sign up for surgery until you find a surgeon you feel comfortable with. I have performed a number of secondary breast reductions and I warned each woman that she had a higher risk of complications. Fortunately, only a few of them have had minor wound healing issues. I do try to get old records when possible, but sometimes you can't and have to proceed based on your own best judgment of how the surgery was likely performed based on the year, location, and the resulting scars. A good board-certified plastic surgeon should be able to help you through this process with the least amount of risk.
Follow up questiom
Question:
I don’t Know whinny surgeon was 28 yrs ago when I had original breast reduction. I was unable to breast-feed and had a consultation 2 yrs ago but felt that the surgeon was not thorough re: my previous scars and issues. My scars look like an upside down T and my right breast is perfect with the exception of the loss of top volume & size. My left, there is a pucker under it and nipple is weird
Debra J. Johnson, MD's Response:
I'm sorry you felt your most recent consult was unsatisfactory. You may want to check out a few websites of ASPS members in your area, and make some calls to get more information. You should definitely not sign up for surgery until you find a surgeon you feel comfortable with. I have performed a number of secondary breast reductions and I warned each woman that she had a higher risk of complications. Fortunately, only a few of them have had minor wound healing issues. I do try to get old records when possible, but sometimes you can't and have to proceed based on your own best judgment of how the surgery was likely performed based on the year, location, and the resulting scars. A good board-certified plastic surgeon should be able to help you through this process with the least amount of risk.
Previous reduction and need agsin
Breast AugmentationMember Response:
Secondary breast reduction can be performed successfully. However, you are at a higher risk of wound healing problems (both wounds of the incision line, the nipple/areola, and internally in the breast tissue) due to poorer blood supply. Your previous surgery altered the pathways of blood flow. That's why Dr. Petrungaro suggested getting an operative report to determine how your prior surgery was performed. Depending on what your breast looks like and how much tissue needs to be removed, it might be possible to do the small reduction/lift plus an implant at the same time. However, a plastic surgeon might suggest doing it in two stages, since the augment will further reduce blood to the breast tissue. Seek out a board-certified plastic surgeon to determine the best and safest way to go.
Previous reduction and need agsin
Question:
Hi... I had a breast reduction at age 18 in 1990. I’ve been happy until recently in my mid 40’s. I want a reduction with a possible small implant to give me some fullness up top. Overall, my breasts aren’t bad... they’re just too big! 2 baby’s and gravity... HELP!
Debra J. Johnson, MD's Response:
Secondary breast reduction can be performed successfully. However, you are at a higher risk of wound healing problems (both wounds of the incision line, the nipple/areola, and internally in the breast tissue) due to poorer blood supply. Your previous surgery altered the pathways of blood flow. That's why Dr. Petrungaro suggested getting an operative report to determine how your prior surgery was performed. Depending on what your breast looks like and how much tissue needs to be removed, it might be possible to do the small reduction/lift plus an implant at the same time. However, a plastic surgeon might suggest doing it in two stages, since the augment will further reduce blood to the breast tissue. Seek out a board-certified plastic surgeon to determine the best and safest way to go.
Do I need to remove implants?
Breast ReductionMember Response:
If you want your health insurance to cover the cost of your breast reduction, they often require that a certain amount of breast tissue be removed. Usually this translates to about a 2-cup size reduction. Most insurances will pay for a reduction if you are a DD-cup or larger. You would need to consult with a plastic surgeon to determine if you would qualify for an insurance-based reduction. You could leave the implants in place (to maintain upper breast fullness) and remove just breast tissue. Or, if you want the implants out, you could do that as well, but that would reduce your breast size even further. If you don't want such a large reduction, then you could simply under go a breast lift with a smaller reduction, but you would have to pay for that on your own. Use the Find-A-Surgeon link on this website to locate a board-certified plastic surgeon near you to determine all your options.
Do I need to remove implants?
Question:
I had implants inserted in 1996, saline size 36 d I want a breast reduction do to back issues. Do I need to replace implants for reduction or is there a less painful way
Debra J. Johnson, MD's Response:
If you want your health insurance to cover the cost of your breast reduction, they often require that a certain amount of breast tissue be removed. Usually this translates to about a 2-cup size reduction. Most insurances will pay for a reduction if you are a DD-cup or larger. You would need to consult with a plastic surgeon to determine if you would qualify for an insurance-based reduction. You could leave the implants in place (to maintain upper breast fullness) and remove just breast tissue. Or, if you want the implants out, you could do that as well, but that would reduce your breast size even further. If you don't want such a large reduction, then you could simply under go a breast lift with a smaller reduction, but you would have to pay for that on your own. Use the Find-A-Surgeon link on this website to locate a board-certified plastic surgeon near you to determine all your options.
Questions
Breast ReductionMember Response:
Reanna, Deciding to undergo any surgical procedure is scary, but breast reduction fortunately is a very safe surgery. It is performed on an outpatient basis, so after the surgery is over, you go home. Most patients are surprised that the post-operative discomfort is very manageable. Some women don't take any pain medication other than Tylenol. Recuperation is usually 10-14 days before you feel back to normal. This surgery is safely performed under general anesthesia, and the complications from either the surgery or the anesthetic are very low. Meet with an ASPS-member surgeon to get a more thorough discussion and to decide if you are a good candidate for this surgery. Use the Find-a-Surgeon link on this website to locate a board-certified plastic surgeon near you.
Questions
Question:
Hi Surgeons , I Was Interested In Getting A Breast Reduction Like I Am Really Scared Of Getting Put To Sleep Like What Are The Risks Of A Breast Reduction ? What Are The Death Rate Of A Breast Reduction Surgery ? How Long Will I Be Asleep For The Surgery ? How Long Would I Have To Be On Bedrest After I Leave The Hospital ?
Debra J. Johnson, MD's Response:
Reanna, Deciding to undergo any surgical procedure is scary, but breast reduction fortunately is a very safe surgery. It is performed on an outpatient basis, so after the surgery is over, you go home. Most patients are surprised that the post-operative discomfort is very manageable. Some women don't take any pain medication other than Tylenol. Recuperation is usually 10-14 days before you feel back to normal. This surgery is safely performed under general anesthesia, and the complications from either the surgery or the anesthetic are very low. Meet with an ASPS-member surgeon to get a more thorough discussion and to decide if you are a good candidate for this surgery. Use the Find-a-Surgeon link on this website to locate a board-certified plastic surgeon near you.
Nipples/areola
Breast AugmentationMember Response:
While loss of sensation is a rare possibility, nipple and areolar reduction can be performed successfully in most without changing the feeling to the nipples. Some patients will experience a short term change in sensation, sometimes hypersensation, right after the procedure, the feeling usually returns to baseline in a few weeks. You would need to discuss this concern frankly with a board-certified plastic surgeon to determine what your surgical needs are and what the risks might be. The Find a Surgeon tool on this website includes our Canadian colleagues, so you can find a qualified ASPS-member surgeon near you!
Nipples/areola
Question:
Is it possible to reduce the size of the nipple, well areola without losing sensation?
Debra J. Johnson, MD's Response:
While loss of sensation is a rare possibility, nipple and areolar reduction can be performed successfully in most without changing the feeling to the nipples. Some patients will experience a short term change in sensation, sometimes hypersensation, right after the procedure, the feeling usually returns to baseline in a few weeks. You would need to discuss this concern frankly with a board-certified plastic surgeon to determine what your surgical needs are and what the risks might be. The Find a Surgeon tool on this website includes our Canadian colleagues, so you can find a qualified ASPS-member surgeon near you!
Body
LiposuctionMember Response:
Dr. Wallach is correct that heavier patients statistically run a higher risk of complications, so reducing weight prior to liposuction is a smart move. Liposuction is best for "spot reduction": getting rid of pockets of fat that diet and exercise don't budge. Liposuction is not a good way to lose weight, as we surgeons are limited in the amount of fat we can safely remove at any one time. Although the incisions for liposuction are small, the injury within the fat layer under the skin can be quite extensive, and your body will respond to that injury with swelling, pain, and inflammation. The more areas you treat, and the more fat you remove, the stronger your body's response. Some patients do undergo "high volume" liposuction but they may have to stay in the hospital (sometimes in Intensive Care!) as it is a much higher risk procedure. Consult a board-certified plastic surgeon to see what your options might be.
Body
Question:
Is there a weight limit?
Debra J. Johnson, MD's Response:
Dr. Wallach is correct that heavier patients statistically run a higher risk of complications, so reducing weight prior to liposuction is a smart move. Liposuction is best for "spot reduction": getting rid of pockets of fat that diet and exercise don't budge. Liposuction is not a good way to lose weight, as we surgeons are limited in the amount of fat we can safely remove at any one time. Although the incisions for liposuction are small, the injury within the fat layer under the skin can be quite extensive, and your body will respond to that injury with swelling, pain, and inflammation. The more areas you treat, and the more fat you remove, the stronger your body's response. Some patients do undergo "high volume" liposuction but they may have to stay in the hospital (sometimes in Intensive Care!) as it is a much higher risk procedure. Consult a board-certified plastic surgeon to see what your options might be.
Superpubic large fat pad
Tummy TuckMember Response:
A lot of patients who have undergone massive weight loss after gastric bypass end up with a very fatty and hanging mons pubis. This can usually be addressed by a combination of liposuction and skin/fat removal. Sometimes the central portion of the scar you have from the panniculectomy can be redone to correct this, and sometimes this might require removal of a vertical wedge from the mons leaving you with additional scarring. You should consult with an ASPS-member surgeon in your area (check the Find a Surgeon link) regarding your options. While insurance often pays for the abdominal panniculectomy, they may not cover the treatment of the mons if they consider it "cosmetic".
Superpubic large fat pad
Question:
Had gastric bypass 2002 17lb skin apron removed 2010 now large superpubic fat pad want to know if there a medical grade compression for this problem have tried spans and even griddle but it is still noticeable through clothing griddle was a nightmare. Was told Lipo would not help would be lots of loose skin hanging would have to be surgeries procedure I am now 63 was told that at my age I should
Debra J. Johnson, MD's Response:
A lot of patients who have undergone massive weight loss after gastric bypass end up with a very fatty and hanging mons pubis. This can usually be addressed by a combination of liposuction and skin/fat removal. Sometimes the central portion of the scar you have from the panniculectomy can be redone to correct this, and sometimes this might require removal of a vertical wedge from the mons leaving you with additional scarring. You should consult with an ASPS-member surgeon in your area (check the Find a Surgeon link) regarding your options. While insurance often pays for the abdominal panniculectomy, they may not cover the treatment of the mons if they consider it "cosmetic".
Board Certified???
FaceliftMember Response:
As Dr. Law mentioned, The American Society of Plastic Surgeons represents the vast majority of board-certified plastic surgeons in the United States. If you want to make sure your surgeon is certified by the American Board of Plastic Surgery, go to www.abplasticsurgery.org and see if your doctor is listed. However, many doctors call themselves "plastic surgeons" but may have no formal training. Outpatient surgery is poorly regulated, unfortunately. There are also other "Boards" that sound important but are not part of the American Board of Medical Specialties member boards. Many of these "Boards" have been set up to give members the "appearance" of board certification. It really pays to Do Your Homework" and only trust your face to a board-certified plastic surgeon.
Board Certified???
Question:
By many recommendations I chose a plastic surgeon for a mini face, neck and laser procedure but when I went on line to check if he was ASPS, no name was found. One of the reps at my inquiry said that not all doctors register. If so, how do I find out about his credentials??? Is a mini face life, neck lift and a facial laser painful? go
Debra J. Johnson, MD's Response:
As Dr. Law mentioned, The American Society of Plastic Surgeons represents the vast majority of board-certified plastic surgeons in the United States. If you want to make sure your surgeon is certified by the American Board of Plastic Surgery, go to www.abplasticsurgery.org and see if your doctor is listed. However, many doctors call themselves "plastic surgeons" but may have no formal training. Outpatient surgery is poorly regulated, unfortunately. There are also other "Boards" that sound important but are not part of the American Board of Medical Specialties member boards. Many of these "Boards" have been set up to give members the "appearance" of board certification. It really pays to Do Your Homework" and only trust your face to a board-certified plastic surgeon.
Insurance
Breast ReductionMember Response:
Dear Reanna, Breast reduction can help with neck, back, and shoulder pain associated with the weight of heavy breasts. You can use the "Find a Surgeon" link on this website to find ASPS-member plastic surgeons in your area. I do always warn younger women that breast reduction may limit your ability to breast feed, and that a pregnancy after breast reduction may result in breasts that are changed in volume (bigger or smaller) or droopy again. Ideally, women wait until after child-bearing to have their breasts reduced. But sometimes it's just not comfortable to wait. A board-certified plastic surgeon can evaluate you and let you know whether you qualify for a reduction that would be paid for by your insurer. Good luck!
Insurance
Question:
I'm 20 Years Old & I Wear D44 & I Have Real Saggy Boobs & I Have A Lot Of Back Pain & Neck Pain . When I Sleep I Have Very Discomfort In My Back & My Boobs Get Real Heavy On Me . I Cant Even Exercise Or Doing Anything Physical Without My Back Hurting Me .
Debra J. Johnson, MD's Response:
Dear Reanna, Breast reduction can help with neck, back, and shoulder pain associated with the weight of heavy breasts. You can use the "Find a Surgeon" link on this website to find ASPS-member plastic surgeons in your area. I do always warn younger women that breast reduction may limit your ability to breast feed, and that a pregnancy after breast reduction may result in breasts that are changed in volume (bigger or smaller) or droopy again. Ideally, women wait until after child-bearing to have their breasts reduced. But sometimes it's just not comfortable to wait. A board-certified plastic surgeon can evaluate you and let you know whether you qualify for a reduction that would be paid for by your insurer. Good luck!
Making breast augmentation appear natural
Breast AugmentationMember Response:
Dear Brittany, There could be a few reasons why your breast implants haven't "settled". The implants could still be positioned too high on your chest. Even after your revision, if the bottom border of the implant is still above your inframammary fold, they might need to be dropped further. Another reason might be the type of implant. The higher profile implants, particularly those with more highly cohesive silicone, are stiffer and have sharper borders, leading to a more pronounced projection in the upper breast....that "arc" you mention. Or if you have saline implants, those with a higher profile and particularly if your implants are over-filled, can get that same pronounced edge. Implants which are too big for your anatomy can do this, too. If your surgeon is an ASPS member surgeon, I would return to his or her office and discuss your concerns. If not an ASPS surgeon, use the Find a Surgeon link to locate an ASPS member near you for a second opinion. Good luck!
Making breast augmentation appear natural
Question:
I had my first breast augmentation in 2017, however, after 9months, they still haven't "settled" or looked natural, how I was told they were going to look, so I underwent another 30 min procedure at the time to try to "lower" the implants. It has been 6 months, and they still haven't settled and have an "arch" at the top of my chest..is this normal? Any exercises I should be doing?
Debra J. Johnson, MD's Response:
Dear Brittany, There could be a few reasons why your breast implants haven't "settled". The implants could still be positioned too high on your chest. Even after your revision, if the bottom border of the implant is still above your inframammary fold, they might need to be dropped further. Another reason might be the type of implant. The higher profile implants, particularly those with more highly cohesive silicone, are stiffer and have sharper borders, leading to a more pronounced projection in the upper breast....that "arc" you mention. Or if you have saline implants, those with a higher profile and particularly if your implants are over-filled, can get that same pronounced edge. Implants which are too big for your anatomy can do this, too. If your surgeon is an ASPS member surgeon, I would return to his or her office and discuss your concerns. If not an ASPS surgeon, use the Find a Surgeon link to locate an ASPS member near you for a second opinion. Good luck!
Infection prevention
Tummy TuckMember Response:
Wash your abdomen and pubic area with antibacterial soap for 3 days prior to the procedure. You can use a store brand like Dial, or purchase HIbiclens in a pharmacy. Don't shave your pubic hair for at least 3 days prior to the procedure. Shaving actually increased the bacterial count due to this minor trauma. Keep the incision clean after surgery and avoid abrading the incision with tight clothing. Showering is fine, but don't soak in a bathtub, hot tub, or pool until your doctor advises you it is safe. Eat a good diet with plenty of protein and drink lots of fluids. Antibiotic pills after surgery are unnecessary unless you show signs of infection. Most surgeons simply give a "one shot" of antibiotics through your intravenous line right before surgery to protect you.
Infection prevention
Question:
Is there anything I could/should do pre surgery to lower my risk of infection?
Debra J. Johnson, MD's Response:
Wash your abdomen and pubic area with antibacterial soap for 3 days prior to the procedure. You can use a store brand like Dial, or purchase HIbiclens in a pharmacy. Don't shave your pubic hair for at least 3 days prior to the procedure. Shaving actually increased the bacterial count due to this minor trauma. Keep the incision clean after surgery and avoid abrading the incision with tight clothing. Showering is fine, but don't soak in a bathtub, hot tub, or pool until your doctor advises you it is safe. Eat a good diet with plenty of protein and drink lots of fluids. Antibiotic pills after surgery are unnecessary unless you show signs of infection. Most surgeons simply give a "one shot" of antibiotics through your intravenous line right before surgery to protect you.
Burn treating
FaceliftMember Response:
I am sorry for your injuries and the scarring it leaves. Burn scars are a difficult problem. While there are great burn centers in the United States, there are several ASPS member surgeons in the UAE. It certainly would be easier to have your treatment closer to home. You should look at the Find a Surgeon link on this website to find a surgeon in Abu Dhabi, Dubai or other nearer locations who might be able to help you. Good luck!
Burn treating
Question:
I have burn 3rd degree B in the face and chest hands and back I was in Germany for 2 years but I’m not good yet I think I’m worst now, can you advice me for best burns center in USA , I will be thankful for your time.
Debra J. Johnson, MD's Response:
I am sorry for your injuries and the scarring it leaves. Burn scars are a difficult problem. While there are great burn centers in the United States, there are several ASPS member surgeons in the UAE. It certainly would be easier to have your treatment closer to home. You should look at the Find a Surgeon link on this website to find a surgeon in Abu Dhabi, Dubai or other nearer locations who might be able to help you. Good luck!
recommended amount to remove?
Breast ReductionMember Response:
The good news is that your health insurance would be likely to authorize your surgery. Usually, any woman with a DD or greater and symptoms related to her large breasts can qualify for insurance-based surgery. The Schnur scale is used by a lot of insurance companies, even though Dr. Schnur himself thinks its not particularly valuable. As Dr. Van Halen mentioned, patients who wear a 32 bra usually measure about 150-175 grams a cup size. So it sounds like you have plenty of room to decide what size you'd ultimately like to be. A lot depends on keeping you proportional, as well as your age, whether or not you've have children whether you're planning more children, etc. Please consult with an ASPS-member surgeon to get the best advice, as well as the most qualified surgeon, to perform your procedure.
recommended amount to remove?
Question:
According to the Schur scale my 1.73 figure would mean about 400g removed from each breast to qualify for insurance coverage. If my breasts are a 32H(us) what rough size would that take me to? Thank you!
Debra J. Johnson, MD's Response:
The good news is that your health insurance would be likely to authorize your surgery. Usually, any woman with a DD or greater and symptoms related to her large breasts can qualify for insurance-based surgery. The Schnur scale is used by a lot of insurance companies, even though Dr. Schnur himself thinks its not particularly valuable. As Dr. Van Halen mentioned, patients who wear a 32 bra usually measure about 150-175 grams a cup size. So it sounds like you have plenty of room to decide what size you'd ultimately like to be. A lot depends on keeping you proportional, as well as your age, whether or not you've have children whether you're planning more children, etc. Please consult with an ASPS-member surgeon to get the best advice, as well as the most qualified surgeon, to perform your procedure.
Excess skin removal and liposuction
Body ContouringMember Response:
Thighplasty is a procedure performed by plastic surgeons and can be combined with liposuction. Oftentimes, people who have lost a lot of weight through diet and exercise, or by bariatric surgery, will have loose thigh skin. The skin is removed from the inner part of the thigh creating a long vertical scar from the top of the thigh to the knee, and in the crease between the thigh and the pelvis. Sometimes if there is not too much skin excess the incision can just be in the upper thigh crease. It's not an easy operation to go through: it can be very tender and difficult to walk easily or sit for long periods, the incisions are right next to where you urinate and your rectum so it's critical to keep very clean. There is a higher risk of slow healing and infection. You have to avoid sexual activity for a few weeks. Your best bet is to consult with an ASPS surgeon to see what your options are. Use the "Find a Surgeon" link to find an ASPS surgeon near you.
Excess skin removal and liposuction
Question:
I am interested in having excess skin removed from my thighs, along with liposuction. I don’t see that listed in your topics. Is this surgery done for thighs?
Debra J. Johnson, MD's Response:
Thighplasty is a procedure performed by plastic surgeons and can be combined with liposuction. Oftentimes, people who have lost a lot of weight through diet and exercise, or by bariatric surgery, will have loose thigh skin. The skin is removed from the inner part of the thigh creating a long vertical scar from the top of the thigh to the knee, and in the crease between the thigh and the pelvis. Sometimes if there is not too much skin excess the incision can just be in the upper thigh crease. It's not an easy operation to go through: it can be very tender and difficult to walk easily or sit for long periods, the incisions are right next to where you urinate and your rectum so it's critical to keep very clean. There is a higher risk of slow healing and infection. You have to avoid sexual activity for a few weeks. Your best bet is to consult with an ASPS surgeon to see what your options are. Use the "Find a Surgeon" link to find an ASPS surgeon near you.
Awake during Breast Lift
Breast LiftMember Response:
Valetena< It is difficult to do a breast lift with just local anesthesia because it is a large area and the injection of local can be uncomfortable. However, with sedation it is very reasonable to use just local. You don't need to have general anesthesia. But, you need to find a plastic surgeon who is comfortable doing it this way. Please look at the "Find a Surgeon" link for your area and call a few of the offices. Ask if the board-certified ASPS member can perform a breast lift under local with sedation. I bet you'll find a qualified surgeon who is happy to help you. Good luck!
Awake during Breast Lift
Question:
Can a breast lift procedure be performed under local anesthesia?
Debra J. Johnson, MD's Response:
Valetena< It is difficult to do a breast lift with just local anesthesia because it is a large area and the injection of local can be uncomfortable. However, with sedation it is very reasonable to use just local. You don't need to have general anesthesia. But, you need to find a plastic surgeon who is comfortable doing it this way. Please look at the "Find a Surgeon" link for your area and call a few of the offices. Ask if the board-certified ASPS member can perform a breast lift under local with sedation. I bet you'll find a qualified surgeon who is happy to help you. Good luck!
Implants
Breast LiftMember Response:
It really does depend on your natural anatomy and what your goals are. Certainly placing implants along with a breast lift is common, but not always necessary. Some women want to have more impressive cleavage, and implants can assist with that. Some women don’t want the added expense and possible complications related to implants, and mostly want to have their nipples centered again and the skin “bra” tightened. You should think about what your goals are and then discuss this with a board-certified ASPS member to determine the best solution for you. Try the “Find a Surgeon” link on this website to find ASPS members near you. Good luck on your journey!
Implants
Question:
If I want to stay the same size but want a lift do I need implants?
Debra J. Johnson, MD's Response:
It really does depend on your natural anatomy and what your goals are. Certainly placing implants along with a breast lift is common, but not always necessary. Some women want to have more impressive cleavage, and implants can assist with that. Some women don’t want the added expense and possible complications related to implants, and mostly want to have their nipples centered again and the skin “bra” tightened. You should think about what your goals are and then discuss this with a board-certified ASPS member to determine the best solution for you. Try the “Find a Surgeon” link on this website to find ASPS members near you. Good luck on your journey!
Nipple itching
Breast AugmentationMember Response:
Hello Kireid, So sorry you have this chronic itching. Did you have the entry scar at the edge of the areola? And, if so, is the scar flat or a little thickened? Thicker scars can often be itchy and might be helped by injecting a little low dose steroid. If there is no nearby scar, then it is likely that a nerve got "tweaked" during your augmentation. I recommend my patients try Vitamin B6 (Pyridoxine) 100 mg daily (for one month) as it is a nerve stabilizer and can sometimes help frazzled nerves to calm down. It's over the counter. Also, taking an antihistamine like benedryl or claritin can help. Benedryl lotion rubbed on can calm itching. Try not to scratch, as the scratching causes the release of more histamine that worsens the itching. You may also want to return to your plastic surgeon if these home remedies don't break the vicious cycle, and see if steroids (either topical or injected) might be worth trying. Good luck!
Nipple itching
Question:
What causes chronic nipple itching after augmentation? It's been almost 9 years and sometimes I just want to scratch the nipple off. I honestly would rather have no feeling than this itching
Debra J. Johnson, MD's Response:
Hello Kireid, So sorry you have this chronic itching. Did you have the entry scar at the edge of the areola? And, if so, is the scar flat or a little thickened? Thicker scars can often be itchy and might be helped by injecting a little low dose steroid. If there is no nearby scar, then it is likely that a nerve got "tweaked" during your augmentation. I recommend my patients try Vitamin B6 (Pyridoxine) 100 mg daily (for one month) as it is a nerve stabilizer and can sometimes help frazzled nerves to calm down. It's over the counter. Also, taking an antihistamine like benedryl or claritin can help. Benedryl lotion rubbed on can calm itching. Try not to scratch, as the scratching causes the release of more histamine that worsens the itching. You may also want to return to your plastic surgeon if these home remedies don't break the vicious cycle, and see if steroids (either topical or injected) might be worth trying. Good luck!
Breast Reduction at 18
Breast ReductionMember Response:
JeNita, almost any breast size DD or greater causes neck, back, and shoulder pain. With an F-cup you should certainly qualify for a reduction. Most insurance plans cover breast reduction, but you’d need to call your plan’s customer service to be sure. Use the Find A Surgeon link on this website to get the names of board-certified plastic surgeons in your area. You can call to make sure the doctor accepts your insurance, and also to see if you need a referral from your primary care. A plastic surgeon can examine you, determine the best procedure and where the scars will be located, and discuss the risks and benefits. Reduction can affect your ability to breastfeed. But sometimes those big breasts are such a pain that younger women don’t want to wait until after they’ve had children. Good luck!
Breast Reduction at 18
Question:
Hello, I’m 18 and I really think I am in need of a breast reduction. First, I started growing at 11. By 12, I was at a C cup. I was about 4’10 at the time. Now, I am 5’2 and weigh 120 with a size 34F. My chest hangs to my waistline and I’m afraid that I have a curve in my spine. I also have bruising on my neck, shoulders, and chest. I went to karmanos? At 16, I have multiple knots in my chests.
Debra J. Johnson, MD's Response:
JeNita, almost any breast size DD or greater causes neck, back, and shoulder pain. With an F-cup you should certainly qualify for a reduction. Most insurance plans cover breast reduction, but you’d need to call your plan’s customer service to be sure. Use the Find A Surgeon link on this website to get the names of board-certified plastic surgeons in your area. You can call to make sure the doctor accepts your insurance, and also to see if you need a referral from your primary care. A plastic surgeon can examine you, determine the best procedure and where the scars will be located, and discuss the risks and benefits. Reduction can affect your ability to breastfeed. But sometimes those big breasts are such a pain that younger women don’t want to wait until after they’ve had children. Good luck!
TT for Massive Abdominal Scars?
Tummy TuckMember Response:
I am sorry for your multiple surgeries, and for your "scarring". I have seen patients with endometriosis whose abdominal incision lines got seeded with endometriosis. The endometriotic tissue then "grew" just beneath the skin, causing pain and firmness. This was corrected by removing the tissue and revising the scar. However, some unlucky people are prone to overaggressive scarring, either hypertrophic scars or keloids. While plastic surgeons can try and mitigate those scars, sometimes it's difficult to make them behave and bad scars return. Your best best is to consult with an ASPS member plastic surgeon who can examine your abdomen and your scars and determine whether you care a candidate for a tummy tuck, and can give you an honest assessment of your risk of bad scarring.
TT for Massive Abdominal Scars?
Question:
I’ve had 10 previous abdominal and due to endometriosis. My last surgery (1/2015) was a complete hysterectomy. I now have a grapefruit size mass of scaring . It’s a good two pants sizes larger than the other side and hard but mobile. And the scars are a painful mess. Is this something repairable with a TT? If not, what type of surgeon should I see? (I also need a breast reduction from an i cup.)
Debra J. Johnson, MD's Response:
I am sorry for your multiple surgeries, and for your "scarring". I have seen patients with endometriosis whose abdominal incision lines got seeded with endometriosis. The endometriotic tissue then "grew" just beneath the skin, causing pain and firmness. This was corrected by removing the tissue and revising the scar. However, some unlucky people are prone to overaggressive scarring, either hypertrophic scars or keloids. While plastic surgeons can try and mitigate those scars, sometimes it's difficult to make them behave and bad scars return. Your best best is to consult with an ASPS member plastic surgeon who can examine your abdomen and your scars and determine whether you care a candidate for a tummy tuck, and can give you an honest assessment of your risk of bad scarring.
Breast fat transfer
Breast AugmentationMember Response:
Absolutely not! You can only transplant tissue from one human to another if they are closely matched genetically. As you know, many heart, limb, face transplant patients require anti-rejection medication for life to prevent rejection of the transplanted tissue and its loss. As much as many would like to donate excess fat to others, it is just not possible to transplant it. It would cause a serious reaction, even possibly death in the recipient. Don't even think about it!
Breast fat transfer
Question:
Can the fat from someone else’s body be used for a fat transfer breast augmentation on another person?
Debra J. Johnson, MD's Response:
Absolutely not! You can only transplant tissue from one human to another if they are closely matched genetically. As you know, many heart, limb, face transplant patients require anti-rejection medication for life to prevent rejection of the transplanted tissue and its loss. As much as many would like to donate excess fat to others, it is just not possible to transplant it. It would cause a serious reaction, even possibly death in the recipient. Don't even think about it!
Brea
Breast ReductionMember Response:
I always perform breast reductions with the goal of preserving nipple viability and sensibility along with the ability to breastfeed. However, women with very large or very droopy breasts I always warn that I may have to free nipple graft if the nipple doesn't look "happy" towards the end of the procedure. That being said, I can't remember the last time I had to do a free nipple graft. You may want to wait until after you have finished childbearing before undergoing breast reduction. Pregnancy and breast feeding can change the size and shape of the breasts, so delaying reduction would give you the longest lasting result. Younger women who have not had children may not be willing to wait if their large breasts are making them miserable, but realize there may be some "maintenance work" necessary after having your kids.
Brea
Question:
I am being told by my Dr after my visit that he can only do a complete nipple grafting on me because of the size of my breast. Mentally i wasn't looking forward to this method because i wished to retain some probability of breastfeeding. Please do i have other options? Been feeling so depressed about this. Please any advice?
Debra J. Johnson, MD's Response:
I always perform breast reductions with the goal of preserving nipple viability and sensibility along with the ability to breastfeed. However, women with very large or very droopy breasts I always warn that I may have to free nipple graft if the nipple doesn't look "happy" towards the end of the procedure. That being said, I can't remember the last time I had to do a free nipple graft. You may want to wait until after you have finished childbearing before undergoing breast reduction. Pregnancy and breast feeding can change the size and shape of the breasts, so delaying reduction would give you the longest lasting result. Younger women who have not had children may not be willing to wait if their large breasts are making them miserable, but realize there may be some "maintenance work" necessary after having your kids.
Diabetic
Tummy TuckMember Response:
Diabetes is a known risk factor for complications with surgery. In order to try and reduce your risk, you would need to have your Hemoglobin A-1C below 6, indicating that your diabetes is well-controlled. You would significantly reduce risk by having a BMI below 30. Using tobacco is also bad. Consulting with a board-certified ASPS member is your best bet. Our goal is always to get you through surgery safely and with a good result. But surgery is a team effort, so you, the patient, have to do all you can to prepare for a good outcome.
Diabetic
Question:
Thank you all for answering my question.. Is a insulin dependent diabetic 2 now diabetic 1 with a history of ketoacidosis a good candidate for tummy tuck
Debra J. Johnson, MD's Response:
Diabetes is a known risk factor for complications with surgery. In order to try and reduce your risk, you would need to have your Hemoglobin A-1C below 6, indicating that your diabetes is well-controlled. You would significantly reduce risk by having a BMI below 30. Using tobacco is also bad. Consulting with a board-certified ASPS member is your best bet. Our goal is always to get you through surgery safely and with a good result. But surgery is a team effort, so you, the patient, have to do all you can to prepare for a good outcome.
Resume daily activities
Tummy TuckMember Response:
Your surgeon likely advised you on this. Perhaps look over your post-op instructions tl answer your question. In general, most plastic surgeons advise no vigorous activity (heart-pounding, breaking a sweat) for at least two weeks after a major surgery. That's because we worry about stirring up some bleeding from increasing your cardiac output and blood pressure. You should be fine doing low level exercise (walking, slow stationary biking, light weights). I recommend to my own patients to walk the first two weeks after surgery, then after two weeks start back in the gym with half the weight, half the repetitions, half the level and build back up as your body guides you. I don't allow "ab work" like crunches, leg lifts, heavy weightlifting until 4 weeks out. Remember that any more vigorous activity will result in some short term swelling in the operated areas, Drink plenty of fluid after exercising, rest, and use your girdle or other pressure garment as recommended.
Resume daily activities
Question:
I am 2 weeks post operative from tummy tuck breast lift , can I got to a concert or when can I resume my activities ?
Debra J. Johnson, MD's Response:
Your surgeon likely advised you on this. Perhaps look over your post-op instructions tl answer your question. In general, most plastic surgeons advise no vigorous activity (heart-pounding, breaking a sweat) for at least two weeks after a major surgery. That's because we worry about stirring up some bleeding from increasing your cardiac output and blood pressure. You should be fine doing low level exercise (walking, slow stationary biking, light weights). I recommend to my own patients to walk the first two weeks after surgery, then after two weeks start back in the gym with half the weight, half the repetitions, half the level and build back up as your body guides you. I don't allow "ab work" like crunches, leg lifts, heavy weightlifting until 4 weeks out. Remember that any more vigorous activity will result in some short term swelling in the operated areas, Drink plenty of fluid after exercising, rest, and use your girdle or other pressure garment as recommended.
Tummy Tuck Pricing
Tummy TuckMember Response:
Hi, Erica! A lot of women think about a Mommy Makeover after having their children. However, there is a lot of variability in how women look and the recommended procedures depend on how pregnancy has affected your body. Breasts may do well with a breast lift, but sometimes a breast implant may be all that's needed. Some women may need both a lift and an implant to get the size and shape they desire. The type of lift varies as well, depending on the amount of excess breast skin you have. Abdomen surgery can vary from liposuction alone, to several varieties of abdominoplasty. Prices will vary depending on where you live, and what you and your plastic surgeon agree are the best procedures for you. Sometimes the breast and abdomen surgeries can be done at the same time, but if your surgeon thinks that a longer procedure would be too risky for you, please heed his or her advice, as complications increase with longer surgeries. Mommy Makeovers run from about $15,000 to $25,000.
Tummy Tuck Pricing
Question:
Around how much it would be for mommy make over tummy tuck and breast lift
Debra J. Johnson, MD's Response:
Hi, Erica! A lot of women think about a Mommy Makeover after having their children. However, there is a lot of variability in how women look and the recommended procedures depend on how pregnancy has affected your body. Breasts may do well with a breast lift, but sometimes a breast implant may be all that's needed. Some women may need both a lift and an implant to get the size and shape they desire. The type of lift varies as well, depending on the amount of excess breast skin you have. Abdomen surgery can vary from liposuction alone, to several varieties of abdominoplasty. Prices will vary depending on where you live, and what you and your plastic surgeon agree are the best procedures for you. Sometimes the breast and abdomen surgeries can be done at the same time, but if your surgeon thinks that a longer procedure would be too risky for you, please heed his or her advice, as complications increase with longer surgeries. Mommy Makeovers run from about $15,000 to $25,000.
39 year old male
FaceliftMember Response:
Hey, Landin, thanks for coming to the right source for a board-certified plastic surgeon. I agree with Dr Wallach that it is tough to offer any advice without seeing you in person. Early aging signs can often be addressed with some filler (to replace some of the fat your face naturally loses over time) and/or some type of skin tightening procedure using laser or peel. Certainly you get the most skin tightening with surgery and in men without too much lax skin in the neck a mid face or upper facelift can do well. Prices vary by region. An upper facelift here in Sacramento runs about $8000, but is likely twice that in New York or LA. Your best bet is an ASPS member surgeon. Use our Find A Surgeon feature to find members close to where you live. Check websites and reviews and see who makes you feel the most comfortable. You need to find a surgeon who “gets” you, communicates well, and will be there for you from the initial consultation until your recovery is complete. Good luck!
39 year old male
Question:
Doctors, Me: 39 yr old, male. Lifting skin midface knocks years off. I don't have a lot of time for Dr. shopping. My questions: A.) Which "MUST HAVE" attributes must a Dr. have before he cuts me? Follow-up: How can I verify them? B.) What kind of plastic is "TYPICAL" for a 39 yr old? C.) May I have a "FAIR" price range? Thank-you very much for your assistance & time
Debra J. Johnson, MD's Response:
Hey, Landin, thanks for coming to the right source for a board-certified plastic surgeon. I agree with Dr Wallach that it is tough to offer any advice without seeing you in person. Early aging signs can often be addressed with some filler (to replace some of the fat your face naturally loses over time) and/or some type of skin tightening procedure using laser or peel. Certainly you get the most skin tightening with surgery and in men without too much lax skin in the neck a mid face or upper facelift can do well. Prices vary by region. An upper facelift here in Sacramento runs about $8000, but is likely twice that in New York or LA. Your best bet is an ASPS member surgeon. Use our Find A Surgeon feature to find members close to where you live. Check websites and reviews and see who makes you feel the most comfortable. You need to find a surgeon who “gets” you, communicates well, and will be there for you from the initial consultation until your recovery is complete. Good luck!
Concerned
Tummy TuckMember Response:
Certainly there are excellent plastic surgeons in Columbia. You should look at the Find A Surgeon link on the ASPS website to find an International member of ASPS. However, if you have surgery in another country, you may need follow up care after you return home that will require added expense. If you have your surgery in the US, all your post op care is included in the surgical fee. If you have a complication, a local surgeon will care for you. If your surgeon is in Columbia she or he will not be able to care for you, and thus you may have more out of pocket cost. If something goes terribly wrong, patients who have had surgery elsewhere often have no legal recourse. The safest option is to have surgery with a board-certified plastic surgeon close to your home so you can have ready access to your doctor after the surgery is performed.
Concerned
Question:
Plus Colombia is where there is the best plastic surgeon.Thins is safe?
Debra J. Johnson, MD's Response:
Certainly there are excellent plastic surgeons in Columbia. You should look at the Find A Surgeon link on the ASPS website to find an International member of ASPS. However, if you have surgery in another country, you may need follow up care after you return home that will require added expense. If you have your surgery in the US, all your post op care is included in the surgical fee. If you have a complication, a local surgeon will care for you. If your surgeon is in Columbia she or he will not be able to care for you, and thus you may have more out of pocket cost. If something goes terribly wrong, patients who have had surgery elsewhere often have no legal recourse. The safest option is to have surgery with a board-certified plastic surgeon close to your home so you can have ready access to your doctor after the surgery is performed.
inverted nipple
Breast AugmentationMember Response:
Yes, Rajasthan, correction of inverted nipples can be performed using local anesthesia in an office setting. Injecting the local anesthetic is a little uncomfortable but then the procedure itself is painless. After the procedure, over-the-counter pain medication is sufficient. Healing takes a couple of weeks. I use sutures that need to be removed after one week. You should use the Find A Surgeon link to locate a board certified plastic surgeon in your area for a personal consultation regarding your options.
inverted nipple
Question:
Is it a clinic procedure to Correct an inverted nipple or does it need Anaesthesia? How long does it take for the nipple to heal? is it painful?
Debra J. Johnson, MD's Response:
Yes, Rajasthan, correction of inverted nipples can be performed using local anesthesia in an office setting. Injecting the local anesthetic is a little uncomfortable but then the procedure itself is painless. After the procedure, over-the-counter pain medication is sufficient. Healing takes a couple of weeks. I use sutures that need to be removed after one week. You should use the Find A Surgeon link to locate a board certified plastic surgeon in your area for a personal consultation regarding your options.
Do tummy tuck scars go away?
Tummy TuckMember Response:
You can’t get rid of the extra skin and fat without creating a scar. We plastic surgeons use all our tricks to try and get the best scars possible, but genetics plays a big role! Do you have any other scars? They can predict what a tummy tuck scar might look like. If you don’t have any scars, then consider scars on your parents. If they are okay, then yours will likely be okay too. Scars do take a fair amount of time to “mature”. Tummy tuck scars can take a year or more to fade as much as they will, so you have to be patient!
Do tummy tuck scars go away?
Question:
I think a tummy tuck would make me feel a little better about getting into a two-piece bathing suit, but I don't know if a flat stomach is worth ugly scars. Do the scars ever fade or go away, or are they permanent?
Debra J. Johnson, MD's Response:
You can’t get rid of the extra skin and fat without creating a scar. We plastic surgeons use all our tricks to try and get the best scars possible, but genetics plays a big role! Do you have any other scars? They can predict what a tummy tuck scar might look like. If you don’t have any scars, then consider scars on your parents. If they are okay, then yours will likely be okay too. Scars do take a fair amount of time to “mature”. Tummy tuck scars can take a year or more to fade as much as they will, so you have to be patient!
How much pain can you expect after a breast augmentation surgery?
Breast AugmentationMember Response:
No pain, no gain! But, really, it’s not too bad. Feels like you did 100 push-ups the first day, 50 push-ups the second, and 25 the third day. Usually by 4-5 days you’re feeling pretty good, able to drive if you’re off pain med. I suggest one week off work and two weeks without vigorous exercise. Talk to an ASPS surgeon for more definitive. And personalized info!
How much pain can you expect after a breast augmentation surgery?
Question:
I've been thinking about getting my breasts enlarged for a while now, but I'm worried about the pain after recovery. All the stuff I see on the news about the opioid crisis makes me nervous about taking strong painkillers. Is the pain something I could manage with some Advil or will I need something stronger?
Debra J. Johnson, MD's Response:
No pain, no gain! But, really, it’s not too bad. Feels like you did 100 push-ups the first day, 50 push-ups the second, and 25 the third day. Usually by 4-5 days you’re feeling pretty good, able to drive if you’re off pain med. I suggest one week off work and two weeks without vigorous exercise. Talk to an ASPS surgeon for more definitive. And personalized info!
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