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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