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

Dermabrasion

Dermal Fillers

Deviated Septum Correction

Ear Surgery

Endoscopic Technique

Eyelid Ptosis Repair

Eyelid Surgery

Facelift

Gender Affirmation Surgery

Hair Transplant

Injectable Fillers

Laser Skin Resurfacing

Lip Augmentation/Enhancement

Liposuction

Male Breast Reduction

Microdermabrasion

Mommy Makeover

Neck Lift

Panniculectomy

Permanent Makeup

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.

Tummy Tuck

Tummy Tuck

Member Response:

It would be a high risk procedure. Risks would include wound infection, hematoma, seroma, delayed healing, deep venous thrombosis, pulmonary embolism, myocardial infarction, and even death. I do not perform tummy tucks on any patient with a BMI over 35, and preferably below 30. Morbidly obese patients should consider bariatric surgery first to reduce the weight.

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having more than 1

Breast Reduction

Member Response:

Most insurance companies require an amount of tissue removed based on your height and weight. That minimum amount often equates to about two cup sizes. But taking more than two cup sizes off is certainly done all the time. The decision regarding how much tissue to remove depends on your desire, your BMI, what size will keep you proportional, and leaving enough tissue behind to keep everything alive. The incision type (lollipop or anchor) really depends on how much tissue you want removed, and how low your nipples are now. If your breasts are very droopy, then usually an anchor scar is needed. to remove enough skin to fashion a snug, perkier breast.

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Extended Tummy Tuck- Weight Question

Tummy Tuck

Member Response:

Your surgeon has likely asked you to reduce your BMI in order to reduce the risk of this surgery. Your surgeon is thinking of your safety. Reducing your BMI also needs to be done safely, and you could consider a medically-supervised weight loss program. Discuss this with your plastic surgeon and your primary care physician to see what resources they can help you with. Depending on your weight loss journey, you may still be able to have your surgery in September. However, if you are unable to lose the weight, postponing your surgery until your BMI is lower is the most prudent thing to do.

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Explant of under muscle implants under local

Breast Implant Removal

Member Response:

Yes, you can remove the implants under local anesthesia. I often deflate the saline implants in the office (using local anesthesia) a few weeks beforehand, so you can know what your breast size and shape will be. Then, if you are satisfied that your don't need a breast lift or volume adjustment, you can return to have the implant shells removed under local. There are many qualified ASPS-member surgeons in San Diego. You can call some offices to get an idea about costs involved.

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What exactly is going on with my chest?

Male Breast Reduction

Member Response:

Gynecomastia surgery involves removal of the tissue between the areola and the pectoral muscle. Post-operatively, scar tissue develops that can connect between the muscle and the skin. So when you flex the muscle or raise your arms, the scar pulls on the skin causing the indentation. Massaging the area can stretch the scar tissue and reduce the tethering. Sometimes releasing the scar from the undersurface of the areola and then grafting some fat there can lessen the pulling and reduce the skin folding. You should discuss this with your surgeon.

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Going from saline to silicone

Breast Implant Revision

Member Response:

A 450cc saline implant weighs the same as a 450cc silicone implant, so there is no need to significantly adjust the size. Silicone and Saline implants also tend to look the same in a breast. As you have experienced, saline implants can break and deflate, but replacing them is a pretty easy procedure. Silicone implants also break at similar rates to saline, but because silicone cannot be 'absorbed' like saline, they can sit broken under your breasts without you knowing it. The FDA recommends ultrasound or MRI imaging of silicone implants starting 5 years after implantation, and every 2-3 years thereafter. If your silicone implants are found to be broken, replacing them requires removing the surrounding scar tissue capsule as well, to make sure the free silicone is removed. This can mean a 1-2 hour surgery under anesthesia, with additional expense and recuperation. If you've been happy with your saline implants, I'd stick with them, since replacement is far easier than silicone.

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Gynecomastia Question

Male Breast Reduction

Member Response:

You likely have loose skin, due to aging and genetics. There might be some "non-invasive" treatments that could improve things without surgical scars. Radiofrequency devices such as BodyTite or Velashape might work. "Threadlifting" wherein barbed sutures are threaded under the skin to elevate it (often used the face) might work, at least in the short term. Seek a board-certified ASPS member through the Find-a-Surgeon tool on this website, and ask about alternatives to surgery.

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Reverse tummy tuck and breast reduction

Tummy Tuck

Member Response:

A reverse tummy tuck tightens the upper abdominal skin and can repair the diastasis from the belly button upwards. The lower abdomen, which is where most of the loose skin/stretch marks (and diastasis) are located would remain. If you have any stretch marks above the belly button, they would move higher on your abdomen and be more visible. There may be blood supply issues to the abdominal flap that could cause delayed healing or poorer scars. With a breast reduction we try to avoid having a scar that crosses the middle of the chest because of the risk of scar hypertrophy/keloids. Although your idea is intriguing for fewer scars, I would suggest a traditional tummy tuck for the best result.

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Breast reconstruction

Breast Reconstruction

Member Response:

Results after surgery depend on how well the surgery was planned, and then how the body heals. Some patients have a genetic tendency toward more aggressive scarring. Results might be improved with revisional surgery. You should suggest your daughter return to her plastic surgeon to see if revision is recommended. If she doesn't feel comfortable returning, she should seek a second opinion with another board-certified plastic surgeon. You can use the Find-A-Surgeon link on this website to find ASPS members in your area.

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Getting insurance approval

Breast Reduction

Member Response:

Insurance companies require breast reduction tissue volumes that have no basis in reality. Studies have shown that women undergoing breast reduction achieve symptom relief no matter the volume of tissue removed. The difference between a 350 reduction and a 500 reduction is about one cup size. So a 500 reduction would take your breast size down about 3 cup sizes. If that is acceptable to you, then ask your surgeon to resubmit your request for surgery with that volume. If that would make your breasts disproportionately small, then request an appeal of your insurer, and write them a letter detailing your symptoms. Good luck.

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Vaping and Breast Reduction

Breast Reduction

Member Response:

Plastic surgeons often require patients to stop using nicotine products (smoking, vaping, chew, or nicotine gum) for 3-4 weeks prior to surgery because of the increased risk of complications (infection, dead skin, dead nipples, more scarring, etc. ). You should notify your surgeon immediately that you have been vaping. They may postpone your surgery.

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Plasma before threadlift

Thread Lift

Member Response:

Don’t waste your money on either of these would be my recommendation. See a board-certified plastic surgeon to determine your best options.

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Choosing a surgeon

Facelift

Member Response:

These credentials indicate that this provider has a Doctor of Osteopathy degree (DO) rather than an MD. He or she had residency training in Ophthalmology (eye doctor). This provider is not board-certified in plastic surgery. The American Academy of Coametic Surgery is not an American Board of Medical Specialties Member board. As plastic surgeons, we believe you will receive the best care from a board certified plastic surgeon. Search the find-a-surgeon link on this website to find a board-certified plastic surgeon near you.

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RUPTURED SALINE BREAST IMPLANT!

Breast Implant Removal

Member Response:

The implant manufacturer “warranties” your implants. If an implant deflates, the manufacturer will reimburse you for the cost of a new implant(s). If the deflation occurs early, as in your case, they will also provide monetary assistance to cover the OR expenses. Your surgeon’s office should be able to let you know what the cost to replace would be, how much the manufacturer will reimburse you, etc. You may need to consider taking out a short term no interest loan from one of the financing agencies, like CareCredit or Alphaeon, to pay for the surgery, and then get reimbursed from the breast implant company once your failed implant is evaluated by them. You can also contact the breast implant company directly to see what kind of help they will provide. The deflated implant is not “dangerous” to your health, but can be uncomfortable if it folds into a firm knot. You may need to have the surrounding capsule removed as well, to provide enough “room” for a new implant. Good luck!

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RUPTURED SALINE BREAST IMPLANT!

Breast Implant Removal

Member Response:

The implant manufacturer “warranties” your implants. If an implant deflates, the manufacturer will reimburse you for the cost of a new implant(s). If the deflation occurs early, as in your case, they will also provide monetary assistance to cover the OR expenses. Your surgeon’s office should be able to let you know what the cost to replace would be, how much the manufacturer will reimburse you, etc. You may need to consider taking out a short term no interest loan from one of the financing agencies, like CareCredit or Alphaeon, to pay for the surgery, and then get reimbursed from the breast implant company once your failed implant is evaluated by them. You can also contact the breast implant company directly to see what kind of help they will provide. The deflated implant is not “dangerous” to your health, but can be uncomfortable if it folds into a firm knot. You may need to have the surrounding capsule removed as well, to provide enough “room” for a new implant. Good luck!

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PROVIDERS THAT WORK WITH INSURANCE

Breast Reduction

Member Response:

You can check online or call the Customer Service number on the back of your insurance card to find out which plastic surgeons participate with your health plan. If you are in an HMO plan, you will need to get a referral from your primary care physician.

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ASPS vs ASAPS vs ABPS

Body Lift

Member Response:

After residency training, doctors undergo comprehensive written and oral examination administered by the American Board of Plastic Surgery (ABPS). If a plastic surgeon is "board certified" it should be by the ABPS. The American Society of Plastic Surgeons (ASPS) is the main association of plastic surgeons providing continuing medical education for its members and the public. ASPS advocates for patient safety with state and federal agencies. All ASPS members are board certified by the ABPS, so choosing an ASPS member assures they have undergone training and passed examination in the specialty. The American Society of Aesthetic Plastic Surgeons (ASAPS) is another association of plastic surgeons focused on cosmetic surgery. Its members are also board certified by ABPS. Many plastic surgeons belong to both ASPS and ASAPS. Plastic surgeons from outside the US/Canada can become International Members of ASPS/ASAPS if they are qualified. Logo display is a personal choice of the surgeon

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One procedure

Breast Augmentation

Member Response:

Plastic surgeons will often combine breast and abdominal surgery, which has been called a Mommy Makeover. It is a longer procedure with discomfort in both area, so you need to have a frank discussion with a board-certified plastic surgeon regarding the risks and the benefits of doing both procedures together. Use the Find-A-Surgeon link on this website to find an ASPS member surgeon near you.

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Am I a canidate for a mini tummy tuck or a full?

Tummy Tuck

Member Response:

Congratulations on your slim physique. Pregnancy often stretches out the abdominal skin and no amount of dieting or exercise can tighten that skin up. Abdominoplasty removes the excess skin to give you a flat and snug abdominal wall. The trade-off is scar, usually a low horizontal scar within your panty line and a scar around the belly button. If you are otherwise in good health, you should be a good candidate for the procedure. Consult with a board certified plastic surgeon to determine what might work best for you. Use the Find A Surgeon link on this website to find ASPS member surgeons near you.

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Internationally board certified?

Eyelid Surgery

Member Response:

Plastic surgeons who trained outside of the United States or Canada cannot become certified by the American Board of Plastic Surgery unless they are working as a teacher in a medical school. And even then, the requirements are quite strict. Your surgeon may be well trained, but it's a little more difficult to do your background checking when he's from a foreign country. You can ask if he is a member of the International Society of Aesthetic Plastic Surgeons (ISAPS) or an international member of the ASPS. You can also check your state medical board website to make sure there have been no issues with this doctor. You can also ask to speak to one or two of his patients who had the same procedure you are considering to discuss their experience.

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