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 Reconstruction

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 Reconstruction Surgery

Ear Surgery

Endoscopic Technique

Eyelid Ptosis Repair

Eyelid Surgery

Facelift

Gender Confirmation Surgery

General Reconstruction

Hair Transplant

Hand Surgery

Hand Surgery for Congenital Differences

Head and Neck Skin Cancer Reconstruction

Head-Neck Cancer Reconstruction

Injectable Fillers

Laser Skin Resurfacing

Lip Augmentation / Enhancement

Liposuction

Male Breast Reduction

Microdermabrasion

Mommy Makeover

Neck Lift

Panniculectomy

Permanent Make-up

Post Burn Reconstruction

Retin-A Treatments

Rhinoplasty

Scar Revision

Skin Cancer Removal

Spider Vein Treatment

Surgery for Genitourinary Diseases

Thigh Lift

Tram Flap Breast Reconstruction

Tummy Tuck

Vascular Malformations

Wound Care

Ask A Surgeon

Ask a Surgeon

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

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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Bbl

Buttock Lift with Augmentation

Member Response:

For your overall health, it would be good to lose the weight prior to any elective surgery. Your BMI is currently 32.7, in the obese range. This can increase your risk of complications from surgery. You should work to get your BMI below 30 and be physically fit. For liposuction, the best candidates are patients who are at a stable, healthy weight who want to improve contours. If you gain or lose weight after liposuction, your results can change as you will gain or lose in a different way than before surgery. BBL transfers fat into the buttock to enlarge it. This is the most dangerous operation we perform, with a risk of death calculated at around 1:3000 patients. You definitely want to think long and hard about this, and only have it performed by a board certified ASPS member surgeon skilled at this procedure.

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Tuberous Breasts

Breast Reconstruction

Member Response:

It is very difficult to offer options without knowing what your breasts look like. There are techniques to improve the appearance of a puffy areola, and fat grafting can be considered to add volume to the lower pole without an implant. Any surgery has risks, such as changing the sense of feeling to the breast or nipple, and creating scar. If possible, I would wait until after your have finished childbearing, since pregnancy often changes the way the breasts in terms of size and shape.

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what should I do

Breast Reconstruction

Member Response:

Most women's breasts are different from each other: sizes, nipple position/size, degrees of droopiness. I assume you're an adult. Have you had children? Sometimes insurance will cover if there is a large difference between the two breasts, particularly with neck, back, or shoulder pain. You could have the larger breast reduced to match the smaller, the simplest solution. You could have an implant in the smaller to match the larger, also relatively simple but harder to get insurance companies to pay for an implant in a non-cancer patient. Or you could operate on both breasts to try and get the closest size and shape symmetry. You should discuss this issue with a case manager at your insurance company and convince her of your need for surgery. A squeaky wheel often can get what they need. If they persist in saying the surgery is "cosmetic" then you'll have to save and pay for it yourself.

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Do i need surgery?

Body Contouring

Member Response:

Congratulations on your weight loss! Have you reached your goal weight yet? If you have, and you've been at a stable weight for 4-6 months, then by all means you should consult with an ASPS board-certified plastic surgeon. Exercising your core/abdominal muscles is great too, as people with stronger cores tend to recuperate faster and have less pain than those with weaker abdomens. If you have completed childbearing, and your BMI is less than 30, and your health is otherwise good, you would be a good candidate for an abdominoplasty (tummy tuck). Sometimes health insurance plans will cover the removal of the excess abdominal skin, so you might check with your plan to see if it's covered. Use the Find-a-Surgeon tool on this website to locate an ASPS member surgeon near you.

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When/if to do a second breast reduction

Breast Reduction

Member Response:

I have performed a number of secondary reductions. There is a somewhat higher risk of healing difficulties, due to the fact that the breast tissue contains scar from the original reduction which hampers blood flow. If you have completed childbearing, and your weight is stable and comfortable for you, then considering another reduction is appropriate.

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Tummy tuck needed?

Tummy Tuck

Member Response:

I agree with what my colleagues have already written, but would also suggest you lose some weight prior to any surgery. Heavier patients have a higher risk of complications after surgery. Such complications could be open wounds requiring daily dressing changes, fluid collections under the skin, infection, blood clots in the legs and possible pulmonary embolus. Getting your BMI below 30 is an important thing you can do to reduce your risk in surgery. Also, if you are a tobacco user, you would need to quit at least 4 weeks before and after surgery.

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Itching 10 years After Breast Lift

Breast Lift

Member Response:

It's difficult to know if the itching is a result of the breast lift or just bad luck. The fact that it occurred three years out makes me feel like it is less likely due to the surgery. Did you have any numbness of that nipple immediately after the procedure? Usually itching is a histamine reaction, so an antihistamine lotion like benadryl might be helpful. When you scratch an itchy area, the trauma of scratching causes the release of more histamine, so it's a vicious cycle. Do your best to avoid scratching! I have had some luck with using Vitamin B6 (pyridoxine) to reduce fritzy nerve discomfort. It's over the counter. I recommend patients take 100mg daily for 30 days. If it works, then slowly wean off. If it doesn't work, just quit it. Also, make sure you are up to date on mammography screening, just to be on the safe side.

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Asymmetry breasts

Breast Augmentation

Member Response:

Most women have asymmetric breasts, but it is usually not noticeable in clothes. How many women have you seen with breast asymmetry? See? We are much more self-critical about our bodies. If you like the size of the smaller breast, then a reduction of the larger breast could give you size symmetry. You would have permanent scarring on the reduced breast. If the smaller breast is too small, you could place a small implant or perform some fat transfer to get it to a D cup, and again a small reduction on the larger breast. Options would depend on your anatomy, your goals, whether or not you've finished childbearing, etc. Consult with a board-certified plastic surgeon to discuss your options. I'm pretty close or there are also plastic surgeons in Folsom you could speak with. Good luck!

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Minimum age for upper eyelid surgery?

Eyelid Surgery

Member Response:

There is no minimum age. It just depends on how much your eyelids bug you. Some people are born with pretty hooded lids. But the eyelid skin does tend to stretch out as we age. So if you proceed now, it might be something you would repeat later in life. Personally, I had my upper lids done when I was 39 and now 25 years later they still look fine. As a cosmetic procedure there is no minimum amount of skin excess necessary. But if you want to try and have your health plan cover the cost, then you usually have to have skin hanging down enough that it obscures your vision to a degree. Use out Find-a-Surgeon tool to locate a nearby board-certified plastic surgeon.

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covid-19

Breast Reduction

Member Response:

Many plastic surgeons are offering virtual consultations during the pandemic. Use the Find-a-Surgeon tool on this website to locate a board-certified plastic surgeon near you. Use the contact form on the surgeon's website, or telephone the office, to inquire about a virtual consult. Breast reduction is often a covered benefit of health insurance, but most companies require the patient to be a DD or greater. If your breasts are uncomfortable, but not large enough to qualify for your insurer paying for a reduction, you can still have the procedure performed by paying for it yourself. Many plastic surgeons offer financing options for their patients as well.

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Natural 38h

Breast Reconstruction

Member Response:

The breast is a complex organ in which the blood and nerve supply to the skin travels through the breast tissue. When the breast tissue is removed in a mastectomy, the skin then survives on blood that comes randomly from the periphery. The bigger the skin envelope, the bigger the risk that some of the skin may not survive. If women have very large or very droopy breasts, it is often better to reduce the amount of skin with a reduction or breast lift. The largest breast implant is 800cc in silicone, and 960cc in saline. That converts to about a 38 D-DD. If you have excess fat in your abdomen, a plastic surgeon might suggest creating a free flap of that tissue to reconstruct the breast. But, again, the larger the amount of tissue transferred, the higher the risk that some of the tissue might not survive due to blood supply. You should consult with a board-certified plastic surgeon well experienced in breast reconstruction to see what your options could be.

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Payment

Payment Options

  • Cash or Personal Checks
  • HMO/PPO/Other Insurance
  • Medicare
Locations

Our Locations

Our Office Hours

Monday 2-5 (Sacramento)
Wednesday 2-5 (Sacramento)
Thursday 9-12 (Sacramento) and 2-5 (Granite Bay)
All other hours M-F are for surgery

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