American Society of Plastic Surgeons
For Medical Professionals
 

Debra J. Johnson, MD

Active Member

Active Member


Debra J. Johnson, MD

Debra J. Johnson, MD, is an ASPS Member plastic surgeon who is board certified by The American Board of Plastic Surgery® and trained specifically in plastic surgery. ASPS members operate only in accredited medical facilities, adhere to a strict code of ethics and fulfill continuing medical education requirements in plastic surgery, including training in patient safety techniques. As your medical partner, Dr. Johnson is dedicated to working with you to achieve your goals.


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About

Meet Dr. Debra Johnson


Procedures

Procedures Performed

Arm Lift

Body Contouring

Body Lift

Botulinum Toxin

Breast Augmentation

Breast Implant Removal

Breast Implant Removal

Breast Implant Revision

Breast Lift

Breast Reduction

Breast Reduction

Brow Lift

Buttock Lift with Augmentation

Chemical Peels, IPL, Fractional CO2 Laser Treatments

Chin Augmentation

Chin Surgery

Cleft Lip and Palate Repair

Cosmetic Surgery

Dermabrasion

Dermal Fillers

Deviated Septum Correction

Ear Surgery

Endoscopic Technique

Eyelid Ptosis Repair

Eyelid Surgery

Facelift

Gender Confirmation Surgery

Hair Transplant

Injectable Fillers

Laser Skin Resurfacing

Lip Augmentation / Enhancement

Liposuction

Male Breast Reduction

Microdermabrasion

Mommy Makeover

Neck Lift

Panniculectomy

Permanent Make-up

Retin-A Treatments

Rhinoplasty

Scar Revision

Skin Cancer Removal

Spider Vein Treatment

Thigh Lift

Tummy Tuck

Ask A Surgeon

Ask a Surgeon

Dr. Debra Johnson participates in the ASPS Ask A Surgeon service. View responses to public questions below.

Explant, lift with tummy tuck safety

Breast Implant Removal

Member Response:

Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.

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Explant, lift with tummy tuck safety

Breast Implant Removal

Member Response:

Statistics show that combined procedures carry more risk of complications and even death. One large study showed that although plastic surgery carries a low risk of death, many of the deaths involved an abdominoplasty plus another procedure. Combining procedures increases the anesthesia time. Abdominal procedures and prolonged anesthesia do increase the risk of blood clots forming in the legs, with the risk of pulmonary embolism if the clot moves to the lungs. That being said, I do perform combined procedures often, but only on healthy people who promise to drink plenty of fluids after surgery and walk immediately and frequently after surgery. Make sure your doctor uses a sequential compression device on your legs during surgery, and best if they even send you home with the SCD machine to use for a couple of days when you're sleeping. Although touted in chat rooms, there is no science behind en bloc capsulectomy. To perform it requires a larger incision to get to the capsule.

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Can I get a reduction? Please help!

Breast Reduction

Member Response:

Your BMI is 38.3, in the high obese range. This excess weight increases your risk of a postoperative complication, such as infection , wound healing delays, or reduced blood supply that can result in skin loss, nipple loss, or fat necrosis (scarring) within the breast tissue. The heavier you are, the more tissue has to be removed to satisfy insurance carriers that the reduction is necessary. At your current weight, many insurers would require removal of over 550 grams of tissue from each breast. Weight loss will reduce the size of your breast, so it is much better to lose weight before embarking on breast reduction. If you lose the weight after a reduction, your breasts will lose fatty volume, become smaller and saggier. Your current weight puts your overall health at risk, so I would encourage you to work to get your BMI below 30, which reduces your surgical risk and is healthier for your heart and back. Talk to your doctor about a medically supervised weight loss program.

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Smoking

Breast Reduction

Member Response:

It is never "safe" to smoke. My smoking father died a pulmonary cripple, and my smoking sister died at 60 from lung cancer. You've done something very nice for yourself in having your breast reduction. You should continue that trend by quitting smoking entirely. You've made it 6 weeks, you're over the hump! Keep up the good work!

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Can this be fixed.

Neck Lift

Member Response:

Since it is now over 6 months since your surgery, the results should be fairly settled. If you haven't seen your surgeon since week 6, then I would returnto his office and the two of you can discuss your concerns. Perhaps a touch-up would be suggested. If you aren't satisfied with the results of the discussion with your surgeon, perhaps seeing another ASPS member surgeon for a second opinion would be helpful. Good luck.

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Nearly 1 & 1/2 yr post op, last check up prior covid. Will a local surgeon see me bc of this issue i

Breast Implant Revision

Member Response:

You really can't expect someone to see you for free. Would you call a plumber to unplug your toilet and expect not to pay? If you can't see the plastic surgeon who placed your implants (who should be open now, especially for complications!) then call more local plastic surgeons (use the Find-a-Surgeon tool on this website) and ask for an appointment. If you have health insurance, it should cover the cost of seeing a surgeon for this. You could have a seroma (lymph fluid) or a hematoma (blood) around the implant that would need to be drained and tested for infection and possibly breast implant associated lymphoma (if you have textured implants). This could be serious, so don't delay in getting checked out!

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Can I receive breast reduction surgery if I have arrhythmia?

Breast Reduction

Member Response:

If that is your only medical issue, it would be unlikely to bar you from a breast reduction. If a current EKG shows no abnormality, and your primary care doctor feels you are healthy, you should be able to have surgery. I see you live nearby, so feel free to contact my office for a consultation!

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breast reduction at the age of 16.

Breast Reduction

Member Response:

Many young women are deserving of a breast reduction. You want to assure that you have stopped growing: height and shoe size haven't changed in the last year, you are at least two years from the date you started your period, and your bra size hasn't changed in a year. You need your parents' permission. Usually health insurance will cover breast reduction for women who are a DD or greater, and they often require a 2-3 cup size reduction to qualify. In younger women, you have to think about what will happen to your breasts in the years to come: most women lose breast volume with pregnancy and breastfeeding, breasts to change size depending on your weight (if you are overweight, you should try and lose weight into the normal range first), reduction may limit your ability to breastfeed. I don't want tol trade your self-consciousness about your large breasts for self-consciousness about having scars. If you understand, and want to proceed, find an ASPS surgeon near you!

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Gynecomastia

Male Breast Reduction

Member Response:

It is not uncommon for young men to have a degree of gynecomastia. It usually resolves later in the teen years. But in some it persists and causes embarrassment, anxiety and difficulty camouflaging the excess fullness in clothing. If you have stopped growing (no increase in height or shoe size in the past year) then a plastic surgeon would consider surgery for you. There aren't any hormones or drugs that can diminish breast size that I know of. If your parents are supportive, I would suggest they take you to a plastic surgeon (you can find Israeli International members of ASPS by using the Find-A-Surgeon link on this website).

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Breast Reduction at 16

Breast Reduction

Member Response:

Getting your weight into a healthy range is important for your overall health. You should try to improve your diet. Ask your doctor or your school nurse for help with a plan. Find out what your BMI is and work to get it below 30. This helps reduce your risk of complications after surgery. Your breast may also shrink with weight loss, since there is a fair amount of fat in the breasts. Age is another matter. Breast growth starts in younger girls but continues through the teen years often, so you may not yet be through developing. You want to be at least two years out from the age you started your period. In younger women, I worry about three things: you will have scars that may make you self-conscious, you might reduce your ability to breastfeed, and future pregnancy/breastfeeding may shrink your breasts to a size you think is too small. Operating on younger women is fine, as long as you understand the risks.

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Post-surgery regrets

Breast Reduction

Member Response:

The post-surgical appearance of breasts changes as healing completes. Often the lower skin of the breast stretches out, which can tip up the nipples and make them appear higher. Scarring takes 12 months or so to mature, but will continue to face over time. If you are unhappy, I would return to your surgeon to express your concerns. There might be some revisional surgery that could improve the scarring and shape of the breasts. Best of luck.

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Saline implant deflation and wait several months?

Breast Implant Revision

Member Response:

Yes, that is a very reasonable plan. Deflating the implants makes them immediately smaller and the breast size more comfortable. You can then assess the size of your natural breasts and be better able to decide if you want to replace the implants and what size. Also the skin will have a chance to shrink a bit (kind of like after having a baby for the tummy skin) so you can decide if you need a breast lift and if so what scars you would end up with. I usually wait 3 months in between deflation and the surgery. Good luck!

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

Breast Lift

Member Response:

The postoperative photo looks to be shortly after your surgery, and indeed your surgery was only two weeks ago. A lift does decrease the size of the breasts a bit, since you remove the excess skin and make the remaining breast tissue more compact by elevating it back onto your chest wall. I would wait for healing to complete (2-3 months) and then evaluate the size.

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Removing keloid scar from upper chest

General Reconstruction

Member Response:

The photo wasn't attached so I can't be specific. However, upper mid chest is a common site for keloid formation. Keloids are the result of an injury and a genetic tendency. If you remove the current scar and re-close the wound, your chance of getting another keloid (possibly bigger!) is high. You would need to see a well-trained plastic surgeon. That surgeon might recommend injection of steroid into the scar to soften and fade it, silicone sheeting to try and flatten it, or surgical removal. If it is removed, then the options to try and prevent recurrence include injection of steroid at the time of closure, use of immediate silicone sheeting, and possibly immediately post-closure one time radiation treatment. This is a tough problem, and I wish you well.

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Body Feminization Surgery For A Minor (17)

Cosmetic Surgery

Member Response:

Gender-affirming surgery is a covered benefit in California. Some health plans require a patient to be 18, even though studies have shown the benefit of surgery in adolescents. Your child would need to be following WPATH guidelines: dressing as a female and living as a female for at least one year, on hormone replacement therapy, and been evaluated by a gender mental health specialist who deems her ready to undergo surgery. You can access the Find-a-Surgeon link on this website to locate plastic surgeons near you. Not all plastic surgeons perform gender-affirming surgery, so you'll have to call and inquire. If you have a local gender health clinic, they may be able to provide a good referral.

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Insurance Red Flag

Male Breast Reduction

Member Response:

Gynecomastia can be a covered procedure of your health insurance if there is truly overdevelopment of male breast tissue (and not just due to obesity). Providing surgery for insured patients is absolutely not a red flag. It means the surgeon is committed to providing services to the community, even though insurance payments do tend to be less than what a plastic surgeon can demand from privately paying customers. Some plastic surgeons do not participate in insurance plans, and only accept patients who pay for their services with cash. This does not make them "better" surgeons, it just means they don't want to hassle with obtaining authorizations from insurers or having to work at an insurance-approved facility. Other plastic surgeons feel a commitment to serving all patients, whether they pay with their own money, their health insurance, or via Medicare/MedicAid. If you find a plastic surgeon you like who accepts your insurance, got for it!

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Inverted nipple repair breastfeeding problems

General Reconstruction

Member Response:

No. If you are unable to breastfeed there is not a surgery to reattach the ducts. The reason your nipple was inverted was because the ducts were foreshortened. To repair the inverted nipple the ducts have to be divided and thus disconnected. I am sorry you are unable to breastfeed, but that is a consequence of having any inverted nipple repair.

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Incision

Tummy Tuck

Member Response:

Wound healing difficulties and poor scarring are known risks of any operation. The reasons for it are often unknown, but can stem from poor nutrition, smoking, your body's reaction to suture material, infection, having tension on the wound from standing up straight too fast, or if the surgeon took too much skin or damaged the skin with liposuction. Having a scar revision once the dust has settled will hopefully give you a better scar. It is very generous of your surgeon to offer to do this for free, but there are expenses involved with equipment, sutures, staff time, dressings, etc. that have to be paid for. If you could do this in the office with just local anesthesia, your doctor may be able to charge you less. But if you need sedation and monitoring in an operating room, $1200 is just covering the cost of that.

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

Tummy Tuck

Member Response:

I would make sure your belly button is thoroughly clean. Sometimes debris can get lodged deep in the crevices and can cause drainage. If you have cleaned it well and there is still a discharge, I would see your primary care and ask for a culture to be taken. Also ask for a referral back to your plastic surgeon. Occasionally one of the deep sutures can fester and cause a small opening in the skin with drainage. It might require exploration to remove a suture which is not a huge deal, but should be taken care of. Don't take no for an answer, even if you have to pay a fee to return to your surgeon.

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I think one of my implants may have ruptured?

Breast Augmentation

Member Response:

Your photo shows asymmetry of the implants and the size difference. If you have saline implants, you could have have a failure on the right, with the saline leaking into your tissues and "deflating" the implant. When silicone implants break, there is no absorption of the silicone, so the breasts usually stay the same size, but there can be some shape change. Implants do have a "warranty" and the manufacturer will provide a new free implant. If your implants were placed not too long ago, they will often assist you with OR expenses. You should return to your plastic surgeon for an evaluation. If you need a new surgeon, use our Find-a-Surgeon tool on this website to locate a board-certified ASPS member surgeon near you.

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