Saline implant deflation and wait several months?

Breast Implant Revision

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Member 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!

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Is a Breast Lift with loss of 3-4 cup sizes normal?

Breast Lift

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Member 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.

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Removing keloid scar from upper chest

General Reconstruction

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Member 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.

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Body Feminization Surgery For A Minor (17)

Cosmetic Surgery

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Member 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.

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Insurance Red Flag

Male Breast Reduction

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Member 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!

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Inverted nipple repair breastfeeding problems

General Reconstruction

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Member 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.

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Incision

Tummy Tuck

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Member 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.

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Had tummy tuck 6 years ago and now experiencing discharge from my belly button

Tummy Tuck

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Member 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.

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I think one of my implants may have ruptured?

Breast Augmentation

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Member 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.

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Bbl

Buttock Lift with Augmentation

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Member 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.

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Tuberous Breasts

Breast Reconstruction

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Member 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.

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what should I do

Breast Reconstruction

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Member 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.

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Do i need surgery?

Body Contouring

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Member 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.

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When/if to do a second breast reduction

Breast Reduction

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Member 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.

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Tummy tuck needed?

Tummy Tuck

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Member 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.

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Itching 10 years After Breast Lift

Breast Lift

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Member 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.

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Asymmetry breasts

Breast Augmentation

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Member 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!

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Minimum age for upper eyelid surgery?

Eyelid Surgery

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Member 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.

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covid-19

Breast Reduction

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Member 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.

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Natural 38h

Breast Reconstruction

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Member 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.

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Going from a small cup to flat chest.

Breast Reduction

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Member 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.

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Breast reduction surgery

Breast Reduction

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Member 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.

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Not sure what I need.... having breast problems?!

Breast Lift

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Member 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!

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Question

Breast Reconstruction

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Member 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.

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Scar revision

General Reconstruction

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Member 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.

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Breast Lift w/out Implants

Breast Lift

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Member 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.

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Saline rupture

Breast Augmentation

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Member 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.

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Help me please i dont know what to do

Liposuction

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Member 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.

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17yo Breast Reduction

Breast Reduction

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Member 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.

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How would breast reduction surgery effect me?

Breast Reduction

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Member 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.

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Saggy tummy and bellybutton

Tummy Tuck

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Member 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.

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Do I need to be tested for BIA-ALCL?

Breast Implant Revision

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Member 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.

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The first time of nose surgery

Cleft Lip and Palate Repair

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Member 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.

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Infantile hemangioma involution

Cosmetic Surgery

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Member 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.

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Denver Area - 13 y/o gel implants - both ruptured, one side capsule ruptured as well

Breast Implant Removal

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Member 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.

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Avoiding latissimus dorsi FLAP on radiated breast

Breast Reconstruction

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Member 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.

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To My skin

Panniculectomy

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Member 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.

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Uneven breast

Breast Augmentation

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Member 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.

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Surgery with BMI over 30

Arm Lift

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Member 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.

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36DDD at 21

Breast Reconstruction

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Member 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.

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Old Implants

Breast Augmentation

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Member 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.

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Breast lift or reduction?

Breast Lift

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Member 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.

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Implants

Breast Lift

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Member 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.

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How will my weight affect getting this procedure?

Breast Reduction

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Member 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.

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Insure what to do

Breast Implant Removal

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Member 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.

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From teardrop over muscle to High profile under muscle

Breast Implant Revision

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Member 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.

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Teen surgery

Breast Reduction

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Member 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.

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Mirror vs Camera

Cosmetic Surgery

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Member 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).

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Explant

Breast Implant Removal

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Member 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).

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Uneven areolas after breast lift

Breast Lift

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Member 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!

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Treatment for vaginal rejuvenation

Vaginal Rejuvenation

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Member 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.

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Earlobe repair

Ear Surgery

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Member 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.

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breast augmentation for minors

Breast Augmentation

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Member 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.

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Guess-timate on Size?

Breast Augmentation

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Member 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!

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Could a Panni with lipo shape enough or tummy tuck necessary?

Mommy Makeover

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Member 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.

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Need help with insurance

Breast Reduction

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Member 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.

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Eye bags surgery

Eyelid Surgery

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Member 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.

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Surgery possible for patient who takes warfarin due to AVR?

Male Breast Reduction

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Member 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.

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Fat grafting in athletes

Breast Augmentation

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Member 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.

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After deflation

Breast Implant Revision

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Member 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.

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Concerned teen needing advice

Gender Confirmation Surgery

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Member 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.

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Wound defet

Cosmetic Surgery

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Member 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!

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Facial mole removal

Cosmetic Surgery

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Member 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.

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Help! When to remove face stitches on 1 yr old

General Reconstruction

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Member 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!

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Question for 13 month old large forehead cut and scar-time sensitive

Gender Confirmation Surgery

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Member 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.

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Is this true about surgical liposuction?

Liposuction

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Member 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.

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Cut Across my face

Cosmetic Surgery

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Member 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.

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Swelling breast

Breast Reduction

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Member 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!

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Gynecomastia issue: Tissue removed through incision, still little swollen/puffy on one side. hematom

Breast Reduction

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Member 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.

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Age

Breast Augmentation

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Member 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.

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Reopening of “new” bellybutton 6 years after Abdominoplasty?

Mommy Makeover

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Member 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.

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Is there an age requirement and does it matter breast size?

Breast Reduction

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Member 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.

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Full Mastopexy & Breast Augmentation

Breast Lift

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Member 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.

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Incision not healing

Tummy Tuck

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Member 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.

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mastoplexy failure

Breast Lift

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Member 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!

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FDL and BTL

Tummy Tuck

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Member 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.

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How expensive is it?

Breast Reduction

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Member 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!

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Boob Reduction

Breast Reduction

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Member 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.

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Financing

Tummy Tuck

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Member 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.

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Weight

Tummy Tuck

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Member 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!

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Tiny breast

Breast Augmentation

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Member 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.

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Age limitation

Tummy Tuck

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Member 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.

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Average cost of reduction and lift

Breast Reduction

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Member 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.

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Autoimmune disorder

Tummy Tuck

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Member 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.

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vaping after surgery

Breast Reduction

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Member 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.

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Recovery

Breast Reduction

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Member 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.

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Can I become flat chested?

Breast Reduction

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Member 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.

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Upper back/shoulder/neck pain

Breast Reduction

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Member 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.

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Revision

Breast Augmentation

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Member 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.

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Possible breast reduction

Breast Reduction

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Member 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!

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Theresa

Tummy Tuck

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Member 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.

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Consideration for 2nd Facelift

Facelift

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Member 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.

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Liposuction and transfer to the breast

Liposuction

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Member 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.

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Prepectoral reconstruction and screening

Breast Augmentation

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Member 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.

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I just want my confidence back

Breast Augmentation

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Member 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.

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Ehlers Danlos and breast reduction?

Breast Reduction

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Member 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.

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Necrosis

Breast Reduction

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Member 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!

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Necrosis

Breast Reduction

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Member 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.

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Smoking issues prior to my operation

Liposuction

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Member 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.

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Mom life

Body Contouring

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Member 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.

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Removal

Breast Augmentation

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Member 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.

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Removal/replace?

Breast Augmentation

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Member 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.

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Adhesions after breast implant removal

Breast Reduction

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Member 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.

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Breast reduction

Breast Reduction

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Member 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!

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Choosing a surgeon

Mommy Makeover

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Member 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.

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North Carolina Medicaid

Breast Reduction

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Member 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.

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Revision

Tummy Tuck

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Member 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!

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Back pain

Breast Reduction

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Member 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.

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Bra indentations

Breast Reduction

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Member 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.

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ALCL and now to diagnose

Breast Augmentation

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Member 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.

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Pain killers

Breast Reduction

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Member 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.

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Breast Augmentation Healing

Breast Augmentation

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Member 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.

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Nose surgery?

Lip Augmentation / Enhancement

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Member 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.

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Choosing size of reduction

Breast Reduction

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Member 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.

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Best surgery for me?

Tummy Tuck

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Member 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.

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Minnesota care

Breast Augmentation

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Member 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.

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Tummy tuck and breast reduction

Breast Augmentation

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Member 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.

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Board Certification

Facelift

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Member 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.

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Blue cross blue shield

Breast Reduction

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Member 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!

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Cis Woman Who Had FTM Top Surgery

Gender Confirmation Surgery

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Member 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.

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What should I expect?

Gender Confirmation Surgery

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Member 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.

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Breast and Bottom

Liposuction

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Member 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.

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Difference in implants

Breast Augmentation

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Member 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.

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Gynecomastia Surgery for Minors

Breast Reduction

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Member 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.

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Breast Pain

Breast Augmentation

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Member 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!

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My left breast

Breast Reduction

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Member 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.

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Necklift same as mini Facelift?

Facelift

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Member 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.

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Breast Reduction at a Young Age

Breast Reduction

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Member 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.

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Consultation costs

Breast Augmentation

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Member 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.

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Weight

Breast Reduction

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Member 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.

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Surgery Abroad

Mommy Makeover

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Member 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.

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uneven breast

Breast Reduction

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Member 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.

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Breast Rupture

Breast Augmentation

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Member 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.

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Surgery cost and payment

Mommy Makeover

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Member 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.

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If there any kind of age limit or concerns

Body Contouring

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Member 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.

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Capsular contracture

Breast Augmentation

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Member 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.

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Insurance is covering panniculectomy. Can I pay the difference for TT?

Tummy Tuck

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Member 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.

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Breast Revision Recovery for body builder

Breast Augmentation

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Member 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.

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What are the side effects of breast implants

Breast Augmentation

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Member 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.

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What age should you get a nose job?

Rhinoplasty

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Member Response:

Most surgeons recommend waiting on cosmetic rhinoplasty until your nose reaches adult size. In men, this is usually around age 16-17.

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Previous Internal Injury

Vaginal Rejuvenation

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Member 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.

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Ruptured implant

Breast Augmentation

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Member 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.

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Risk

Tummy Tuck

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Member 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.

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Vertical Wrinkles on mid stomach

Tummy Tuck

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Member 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.

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Inf request

Eyelid Surgery

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Member 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.

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Hashimoto Hypothyroidism

Mommy Makeover

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Member 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!

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Why can't someone help me at home

Body Contouring

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Member 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.

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Removal of old implants & replacement

Breast Augmentation

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Member 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.

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Breast reconstruction, gel versus saline

Breast Augmentation

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Member 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.

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Breast lift without implant

Breast Lift

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Member 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.

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Breast Implant Illness

Breast Augmentation

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Member 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.

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Accutane and surgery

Body Contouring

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Member 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.

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Ugly jaw/neck definition.

Facelift

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Member 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.

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No definition in neck

Liposuction

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Member 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.

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Sad belly button and indent

Tummy Tuck

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Member 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.

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To lift or to lift and reduce

Breast Lift

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Member 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!

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Tummy tuck

Tummy Tuck

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Member 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.

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Hello is this procedure possible without full sedation?

Tummy Tuck

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Member 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.

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Hooded eyelids

Eyelid Surgery

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Member 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.

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Post bilateral mastectomy recon

Breast Augmentation

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Member 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.

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Capsular Contracture Options Other Than Surgical Removal

Breast Augmentation

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Member 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.

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Mommy makeover and scuba diving

Mommy Makeover

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Member 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!

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Can I fix my uneven nostrils and septum?

Rhinoplasty

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Member 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.

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I have a problem with my eyes: Do I need a blethoraplasty ? or ptosis surgery? or

Eyelid Surgery

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Member 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.

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Rhinoplasty and Accutane

Rhinoplasty

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Member 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.

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I’m sorry,there was no option of choosing brow lift so instead I chose facelift.

Facelift

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Member 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.

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Symmastia

Breast Reduction

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Member 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.

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Digestive enzyme and probiotic supplements and tummy tuck

Tummy Tuck

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Member 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!

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Indention on right breast

Breast Lift

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Member 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.

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Breast Reduction and tank top lipo

Breast Reduction

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Member 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.

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Plastic reconstructive surgery

Tummy Tuck

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Member 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!

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Follow up questiom

Breast Augmentation

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Member 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.

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Previous reduction and need agsin

Breast Augmentation

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Member 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.

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Do I need to remove implants?

Breast Reduction

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Member 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.

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Questions

Breast Reduction

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Member 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.

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Nipples/areola

Breast Augmentation

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Member 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!

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Body

Liposuction

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Member 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.

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Superpubic large fat pad

Tummy Tuck

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Member 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".

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Board Certified???

Facelift

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Member 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.

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Insurance

Breast Reduction

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Member 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!

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Making breast augmentation appear natural

Breast Augmentation

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Member 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!

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Infection prevention

Tummy Tuck

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Member 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.

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Burn treating

Facelift

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Member 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!

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recommended amount to remove?

Breast Reduction

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Member 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.

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Excess skin removal and liposuction

Body Contouring

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Member 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.

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Awake during Breast Lift

Breast Lift

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Member 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!

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Implants

Breast Lift

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Member 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!

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Nipple itching

Breast Augmentation

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Member 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!

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Breast Reduction at 18

Breast Reduction

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Member 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!

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TT for Massive Abdominal Scars?

Tummy Tuck

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Member 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.

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Breast fat transfer

Breast Augmentation

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Member 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!

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Brea

Breast Reduction

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Member 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.

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Diabetic

Tummy Tuck

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Member 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.

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Resume daily activities

Tummy Tuck

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Member 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.

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Tummy Tuck Pricing

Tummy Tuck

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Member 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.

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39 year old male

Facelift

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Member 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!

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Concerned

Tummy Tuck

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Member 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.

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inverted nipple

Breast Augmentation

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Member 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.

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Do tummy tuck scars go away?

Tummy Tuck

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Member 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!

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How much pain can you expect after a breast augmentation surgery?

Breast Augmentation

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Member 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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