American Society of Plastic Surgeons
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Debra Johnson, MD

Active Member

Active Member

Debra Johnson, MD

Debra 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 Lift

Breast Reconstruction

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

Down Syndrome

Ear Reconstruction Surgery

Ear Surgery

Endoscopic Technique

Eyelid Ptosis Repair

Eyelid Surgery

Facelift

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

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

Ask A Surgeon

Ask a Surgeon

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

Age limitation

Tummy Tuck

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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Payment

Payment Options

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

Our Location

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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