Operative Report Question

Rhinoplasty

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Member Response:

It is possible that the surgeon made a dictation error. If a graft was used, there may be a record of the graft in the medical record to confirm that it was placed.

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Cheek/Chin implants

Cheek Augmentation

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Member Response:

An in person assessment is the best way to find out but based on the pictures, some check enhancement may help. You can start with an injectable filler before having implants.

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Is Liposuction dangerous with a lower body lift?

Body Lift

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Member Response:

Based on the information you provided, liposuction of your midsection would be appropriate during the body lift. Consider discussing this again with your surgeon or getting another in-person opinion.

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Bbl by a board certified surgeon despite having lupus and kidney transplant

Body Contouring

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Member Response:

A kidney transplant and lupus alone may not mean that a tummy tuck, liposuction, or BBL cannot be done. There may be other issues. However, if your transplant doctors and lupus doctor don't have any concerns, then it may be possible.

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Bbl by a board certified surgeon despite having lupus and kidney transplant

Body Contouring

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Member Response:

A kidney transplant and lupus alone may not mean that a tummy tuck, liposuction, or BBL cannot be done. There may be other issues. However, if your transplant doctors and lupus doctor don't have any concerns, then it may be possible.

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SURGICAL SUBCISION Deep Acne Scar Removal

Cosmetic Surgery

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Member Response:

I offer subcision with Bellafill injections under the subcised area. Learn more at DrGutowski.com

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Congenital symmastia pinellas county

Cosmetic Surgery

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Member Response:

I have fixed these cases and it can be done as an out patient procedure. Please contact me if interested.

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Pancreas Transplant

Liposuction

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Member Response:

Assuming you are otherwise healthy, liposuction is possible for transplant patients. There are many good Board Certified plastic surgeons in your area.

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How long will they be swollen?

Breast Augmentation

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Member Response:

Some swelling and discomfort is common after breast augmentation. However, if you are experiencing significant pain and swelling, you should contact your surgeon right away.

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Implant type

Buttock Implants

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Member Response:

Buttock implants are made of a similar material to breast implants but they are not the same. A breast implant should never be used for buttock augmentation.

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Need belly button fixed :-(

Cosmetic Surgery

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Member Response:

Based on your picture, you may need to have the scar removed, then a new belly button created a few months later.

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Can I get a breast reduction if my breasts keep growing?

Breast Reduction

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Member Response:

This is a good question to discuss with a plastic surgeon and determine why your breasts are growing. An in person evaluation is the best way to start. If your symptoms are severe, it may be appropriate to do a reduction now.

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Bra Line Back Lift

Body Lift

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Member Response:

A bra line and back lift are both doable on selected patients and can give great results. An in person assessment is the best way to find out.

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Non-Surgical or Mini Lift?

Arm Lift

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Member Response:

The best option is an arm lift which removes the loose skin. See examples here: https://drgutowski.com/before-after-photos/body/arm-lift/

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what to do in the future

Breast Reduction

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Member Response:

It sounds like you may want a breast reduction in the future. However, there are times when a breast reduction can be done at your age. I've treated a few cases like yours just to make the pain improve. In some cases, it can be done with liposuction to avoid obvious scars. Learn more here: https://drgutowski.com/before-after-photos/breast/breast-reduction/

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Saline implant deflation and wait several months?

Breast Implant Revision

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Member Response:

Very reasonable. I would do the same.

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Hematoma

Breast Reduction

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Member Response:

This is a serious problem. Contact your surgeon immediately or seek urgent medical consultation.

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Healing after Iraq along with major weight loss

Tummy Tuck

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Member Response:

Looks like a great result! And thanks for your service to our country.

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Insurance Red Flag

Male Breast Reduction

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Member Response:

There is nothing wrong with accepting insurance. If a doctor accepts an insurance plan, then they have to accept it for all procedures. However, most insurance plans don't cover it so just because a surgeon accepts insurance, it doesn't mean that insurance will pay for it.

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Incision

Tummy Tuck

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Member Response:

Most surgeons have a revision policy that you would have seen before the procedure. As Dr Johnson pointed out, many surgeons will not charge their fee to revise this, but there are other expenses that surgeons can't absorb.

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Scar in chin/neck

Cosmetic Surgery

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Member Response:

It is possible that the scar could be improved but you need an in-person evaluation for a proper assessment.

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Fat and unshapely legs

Liposuction

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Member Response:

You may have lipedema.

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Tummy tuck needed?

Tummy Tuck

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Member Response:

Liposuction may help but will not give you a flat tummy. You have a lot of extra skin that is best treated with a combination of liposuction and tummy tuck. We offer a Rapid Recovery No Drain Tummy Tuck (see results here: https://drgutowski.com/before-after-photos/body/tummy-tuck/) which may be appropriate for you. An consultation can help you learn more.

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Sutures won’t dissolve

Breast Augmentation

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Member Response:

Something doesn't sound right. Consider a second opinion.

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Congenital symmastia

Breast Augmentation

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Member Response:

I've treated a few cases of this with good results. When you are ready, please contact me.

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Length of time

Panniculectomy

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Member Response:

At this point, a hernia repair will not affect you panniculectomy results.

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Question

Breast Reconstruction

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Member Response:

It may be possible to fix this without implants. In some case, I've done this by doing a breast reduction or lift on the larger side. In other cases, moving some of your own fat to the smaller breast may do the job. An in-person evaluation is best. Learn more about my Chicago practice at DrGutowski.com

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Surgery to eliminate “Doggy Ears” after my Tummy Tuck

Tummy Tuck

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Member Response:

This is an easy fix which can be done in the office with just a local anesthetic. It should not cost too much. If you can, go back to your original plastic surgeon and find out.

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Chest tubes

Wound Care

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Member Response:

Yes, these can be fixed. I typically fix them with just a local anesthetic and it can be done awake with minimal risk.

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Permanent Suture Removal

Tummy Tuck

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Member Response:

These sutures can be removed without compromising your repair. At this point, the healing is done. I've done this for a few patients with just a local anesthetic.

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Breast Lift/ Fat Graft/ Smart Lipo/ BBL safe at same time

Breast Lift

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Member Response:

These can be done at the same time in most patients. There are pillows that can provide support to the fat grafted areas and reduce the pressure.

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Male nipple problems

Male Breast Reduction

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Member Response:

If it is just the nipple and not the areola that is sticking forward, the nipples can be reduced but trimming them. This is an office procedure that is done with just a local anesthetic in less than a few minutes.

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Am I a good candidate for a rhinoplasty?

Rhinoplasty

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Member Response:

Thanks for asking about rhinoplasty. Based on your pictures, you would be a good candidate but an in person evaluation is best. Your nose can be improved by reducing the hump and decreasing the projection. Please feel free to see us for a consultation. Dr Gutowski

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Post Liver Transplant

Tummy Tuck

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Member Response:

I've done tummy tucks on transplant patient and the issue is with the old scars. If you live in Columbus, there are good plastic surgeons at OSU who can give you a proper assessment in person.

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What would be the minimum age required to have a chin augmentation surgery?

Chin Surgery

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Member Response:

There is no minimum age for a chin implant but the first thing to do is to find out if it is just your chin, or more of your facial bone structure that is out of proportion. This requires an in person evaluation to see if your jaw, teeth, and other facial structures developed properly. Of course, you need to have a discussion with your parents about how you feel. In some cases, nose and chin procedures can be done at age 15 or 16 with parental approval.

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After deflation

Breast Implant Revision

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Member Response:

Unless the deflated implants are causing you a problem, there is no reason to remove them. However, if you desire to remove them, then it often can be done awake with just a local anesthetic.

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How long should I wait

Breast Augmentation

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Member Response:

There is no rule on how long to wait but it may be better to wait 3 to 6 months to allow your body to recover fully. Also, that would be a good time to address and touch-ups on the tummy tuck (if needed). While each surgeon may have a different view on this, in most cases, it is safe to do a breast augmentation and arm lift at the same time. Learn more at DrGutowski.com

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Tummy Tuck With Hypothyroidism

Tummy Tuck

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Member Response:

You should first have your thyroid function controlled and stable. A tummy tuck will not reduce that much weight so you would have to do it on your own. However, a tummy tuck can help reshape your midsection and reduce loose skin. An in person evaluation is the best way to start.

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how much will I be paying ?

Cosmetic Surgery

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Member Response:

Without an in person evaluation, it is hard to offer a price estimate.

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Transfer fat

Liposuction

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Member Response:

Liposuction of the arms, back, and abdomen can be done and the removed fat can be transferred to other places like you buttocks.

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How risky is to have a second breast lift? (Third breast procedure)

Breast Implant Revision

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Member Response:

A skin only breast lift is not likely to cause problems other than maybe minor healing issues.

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Payments

Liposuction

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Member Response:

Medicaid does not pay for liposuction. This is something you have to pay for yourself.

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labia minora torn during childbirth

Vaginal Rejuvenation

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Member Response:

Most plastic surgeons should be able to do this for you, and possible with just a local anesthetic done awake. Ask for surgeons who do labiaplasty. You can find plastic surgeons in TN on this website: https://find.plasticsurgery.org/

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Financing

Breast Implant Revision

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Member Response:

In house financing is not usually done. CareCredit or outer medical financing options may be a better option.

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Have Implants, Can I have a lift and keep my implants

Breast Lift

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Member Response:

In most cases, you can still keep the implants if you are getting a lift, but an in person evaluation is the best way to find out.

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Looking deformed after (medical) surgeries. 2

Panniculectomy

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Member Response:

These are difficult situations. Consider finding a new PCP who may be more sympathetic to your situation.

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Plasma pen

Neck Lift

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Member Response:

I had one plasma pen treatment on my eyelids and did not see a difference after 4 months. I'm hearing it may take 3 to 6 treatments. If you are looking to improve your neck, I doubt you will see much improvement.

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I'm a monster...

Breast Implant Revision

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Member Response:

Without knowing more and seeing at least your before and after pictures, it is hard to give an opinion. Start by seeing your original surgeon or another surgeon in your area. If you feel comfortable sharing your pictures, others may be able to give you an opinion.

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Inverted Breast Nipple

Breast Reduction

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Member Response:

Its hard to say without an in person evaluation of this problem, or at least seeing a picture. If you are concerned, you may want to get a second opinion.

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Is this true about surgical liposuction?

Liposuction

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Member Response:

This is absolutely not true. The body has no way of knowing the number of fat cells it has. Liposuction does work - otherwise it would not have been one of the most popular plastic surgery procedures for the past 20 years.

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Does my belly button look okay

Tummy Tuck

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Member Response:

Without a picture, it is hard to say but they are usually swollen for 3 to 6 months so give it some time and follow up with your plastic surgeon.

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Cosmetic Face Surgery ?

Cosmetic Surgery

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Member Response:

Depending on your age, it may be better to wait until you are older. However, neck liposuction and Kybella injections may be an option. An in person evaluation is the best way to learn more. See examples here: https://drgutowski.com/Before-After-Photos/Face/Neck-Liposuction

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Vagina Less Fat

Vaginal Rejuvenation

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Member Response:

If by making the "vagina less fat" you mean making the pubic area thinner, then it may be possible with liposuction. Most ASPS plastic surgeons can do this.

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Arm Lift AND Tummy Tuck

Arm Lift

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Member Response:

It really depends on you and your surgeon. They can be done at the same time or a week or months apart. Without knowing more about your case, its hard to give specific advice. Best to discuss with your surgeon and make a plan together.

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Capsule contracture

Breast Augmentation

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Member Response:

Treatment of capsular contracture depends on how far along the contracture is (Grade 2, 3, or 4). Ask your surgeon if montelukast would help. Depending on which implant company warranty you have, some costs may be covered. Ultrasound treatment may help also.

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Aspen Technique as alternative to surgery

Breast Implant Revision

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Member Response:

Aspen ultrasound may help but despite more than 10 years of making claims, there is no well designed independent study to confirm this. So while it seems to work in some cases, more advanced cases of contracture, are less likely to respond. Ask your surgeon if montelukast would be appropriate.

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Pro-bono reconstructive surgery for cancer patient

General Reconstruction

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Member Response:

A social worker at her hospital may be able to help. Parkland Hospital may be a place to start.

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Age

Breast Augmentation

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Member Response:

It depends on what is going on with your body. The best thing to do is to see an ASPS plastic surgeon for an in person evaluation. For some women with uneven or asymmetric breasts, a procedure in the teen years may be appropriate.

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Lose skin vs excessive fat

Tummy Tuck

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Member Response:

Without seeing pictures or an in-person evaluation, it is hard to give specific advice, but in many cases, it is loose skin that is the problem. This can be improved with skin removal. See examples. here: https://drgutowski.com/Before-After-Photos/Body

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Boob job on one side?

Breast Reduction

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Member Response:

Yes, a lift/reduction can be done on one side, and would be less expensive than on both sides. See a local ASPS member plastic surgeon for an in person evaluation.

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One bigger nostril

Rhinoplasty

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Member Response:

Unless your nostril size interferes with breathing, it is not likely that insurance will cover it. Best to see a Board Certified Plastic Surgeon to evaluate and give an opinion in person.

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Fat Transfer + Breast Lift

Breast Lift

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Member Response:

Yes, fat can be taken from ore than one area at the same time. Depending on your breast size, skin laxity, and other factors, one cup size increase may be possible. It may take two procedures in some cases.

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Would I be a candidate?

Breast Reduction

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Member Response:

It sounds like breast reduction may be an option for you. See an ASPS plastic surgeon for an in -person evaluation.

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Surgical scars

General Reconstruction

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Member Response:

The best way to find out is to see a local Board Certified plastic surgeon for an in-person assessment. With limited information, it is hard to give specific advice.

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Fatty shins and calves

Body Contouring

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Member Response:

Calf liposuction may be an option and can be done awake in many cases in about 1 to 2 hours.

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Thick and round nose

Rhinoplasty

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Member Response:

There are limitations to what surgery can do and thick skin makes it hard to have a thin nose. If a few surgeons advised you against more surgery, then you should accept what you have. More surgery may cause other problems.

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Pre-Surgery Prep

Cosmetic Surgery

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Member Response:

In most cases, supplements are not needed before cosmetic surgery but this is best answered by your plastic surgeon who will be doing the surgery.

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Overhanging Skin

Panniculectomy

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Member Response:

Best thing to do is see a local Board Certified plastic surgeon for an in-person assessment. You may want your primary care doctor to document these problems also.

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Black nipple

Breast Reduction

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Member Response:

It depends on how much of the black nipple was just a superficial scab versus a deeper issue. It is hard to say without a picture. Best to follow up with your plastic surgeon.

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Second liposuction

Liposuction

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Member Response:

Same opinion as Dr Wallach and Dr Dowbak. My experience with repeat liposuction in the same area as Laser Lipo (Smart Lipo) is that there is more scar tissue and it is harder to get good results. I tend to use Power Lipo in such cases but there is no evidence that one technique is better than another.

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Debating if I Should Do It or Not

Breast Reduction

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Member Response:

Your insurance may say they cover it and may issue a "Prior Authorization" but the final determination of payment is usually made after the surgery. This is an issue between you and your insurance company.

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What are my options?

Liposuction

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Member Response:

An in person evaluation is the best way to find out what can be done. Liposuction leaves minimal scars that fade quickly. CoolSculpting leaves no scars and works in selected patients.

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What’s included

Mommy Makeover

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Member Response:

A Mommy Makeover can include a number of procedures. The best way to find out is an in person consultation with an ASPS Plastic Surgeon.

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Nonsurgical procedures

Thread Lift

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Member Response:

There is little time that is needed to recover from microdermabrasion so it is up to the person placing the PDO threads. However, before you do the threads, make sure you are well informed on the short duration of the results.

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Best Fat Removal Procedure

Liposuction

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Member Response:

Good questions, but the answer depends on what his goals are and what is seen during an in person physical examination. We offer nonsurgical fat reduction, liposuction, and tummy tucks based on each persons individual expectations, body fat distribution, and skin quality. You may learn more here: https://drgutowski.com/Before-After-Photos

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So Many Questions

Liposuction

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Member Response:

Liposuction is not a weight loss treatment. Based on your information, you should start with your primary care doctor to determine if there is a medical reason for your weight gain and then work on a medically supervised weight loss plan.

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Is there an age requirement and does it matter breast size?

Breast Reduction

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Member Response:

There is no ago limit for a breast reduction but you need to start with an in person evaluation with a board certified plastic surgeon for a proper assessment.

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Body contouring for Post-Op Gastric Sleeve Patient

Body Contouring

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Member Response:

While it is possible, it may not be a good idea. However, only an in person evaluation can help you answer that question,

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Can thread lift be removed?

Thread Lift

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Member Response:

Depending on the type of thread that was used, and how it was placed, may determine how easy or hard it is to remove. An in person evaluation is the only way to find out.

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Is there a loss of nipple sensation if you get implants?

Breast Augmentation

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Member Response:

In most cases, breast augmentation with any type of implant may have temporary nipple numbness that gets better in a few weeks. It is rare for the numbness to be permanent. Once things are healed, you may do what ever you like with your nipples.

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Breast Reconstruction after double mastectomy

General Reconstruction

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Member Response:

This does not sound normal and you should notify your plastic surgeon right away for a proper assessment of the problem.

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Breast reduction for small breasts

Breast Reduction

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Member Response:

There are some limits as to how much breast tissue can be removed and factors such as your desire for breast feeding play a role. There is no way to promise a AA cup but a small reduction (with a lift if needed) is possible. An in person evaluation is the only way to find out.

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Dermal fillers/ with breast implants

Dermal Fillers

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Member Response:

Something does not sound right as off the shelf injectable fillers come in very small amounts and are not practical form correction of breast volume asymmetries. Fat grafting may be the better option.

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Combining BBL with BA?

Breast Augmentation

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Member Response:

I have done this combination of procedures more than a few times in selected patients without any problems. The positioning issue can be overcome with with some creative pillows and pads at night. From a health perspective, either option is fine.

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Fat injections in cheeks

Cheek Reduction

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Member Response:

It depends on how long ago the procedure was done. It takes 2 to 3 months for the swelling to do down. Ask your plastic surgeon for guidance. If more than 3 months have gone by, in some cases, the fat can be removed with liposuction or Kybella injections.

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Breast lift during explant

Breast Lift

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Member Response:

In most cases, it can be done but sometimes it is safer to stage the procedure. If you have large implants and thin breast tissue, it may be better to stage it. An in person evaluation is need to make the proper recommendation.

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3 breast augmentation—still problems

Breast Reduction

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Member Response:

In most cases, implants can be removed in the office with local anesthetic for minimal cost. Ask your plastic surgeon if that is an option. For my patients this is a fast procedure with minimal recovery.

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Scars

Breast Augmentation

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Member Response:

In most cases, your implants can be replaced through the same incision. However, each patient is different so there may be a reason why the surgeon can't do it. Consider a 2nd opinion.

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Removal/replace?

Breast Augmentation

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Member Response:

Based on the information you provided, you seem to have a reasonable request to remove them. Feel free to contact me for a consultation if your surgeon will not address this issue.

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Need a few things

Body Contouring

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Member Response:

This sounds like a reasonable request but it is hard to give an estimate without seeing a patient in person. If you wish, I have an office in Oakbrook where you could get a proper evaluation and quote for a procedure. You may learn more at https://drgutowski.com/

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A Day In The Life Of A Plastic Surgeon

Lip Augmentation / Enhancement

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Member Response:

May be easier to do by email. Feel free to contact me at Karol@DrGutowski.com

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Excision

Tattoo Removal

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Member Response:

I do tattoo excision for selected cases but not all tattoos are in an area that excision is appropriate. I'm nearby in Chicago and can see you in Oakbrook.

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Potential malpractice

Breast Augmentation

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Member Response:

Since there are 100's of implant styles and sizes, most surgeons order the selected implants specifically for each patient. They may stock a few common shapes and sizes but no office or hospital can stock all of the possible combinations.

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Is 45 a good age for my first procedure?

Facelift

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Member Response:

45 may be an OK time for a face lift but for many patients, neck lipo with nonsurgical skin tightening may be a better option with lower cost and less downtime (and can be done awake). An in person evaluation is the best way to find out. The eye lids can be assessed also.

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SOS Please Help

Breast Reduction

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Member Response:

Sounds like you need an in person evaluation. I do see patients in Champaign once per a month.

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Sketchy Dr

Liposuction

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Member Response:

While any doctor can do lipo in their office, it does not mean that they are properly trained or qualified to do it. If someone is offering a "promotion" because they are "just starting to do it" then that should raise a few red flags (no experience, not properly trained). Find a Board Certified Plastic Surgeon near you on this site: https://find.plasticsurgery.org/

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19 and Desperate

Breast Reduction

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Member Response:

May be better to go see a plastic surgeon directly for a consultation. In many cases, a breast reduction is appropriate at your age. Find a plastic surgeon here: https://find.plasticsurgery.org

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Leg area

Liposuction

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Member Response:

It sounds like you are a good candidate for liposuction, however, an in person evaluation is best.

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Dont know what to do!

Breast Augmentation

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Member Response:

The best way to find out your options and pick the one best for you is with an in person evaluation. I lift and reduction can be done together, but sometimes a small implant can help give more fullness. The technique depends on how much loose skin and breast tissue needs to be removed.

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Follow up questiom

Breast Augmentation

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Member Response:

In most cases, the scars can be improved, but not completely eliminated. During an in person consultation, this can be discussed.

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Previous reduction and need agsin

Breast Augmentation

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Member Response:

Yes, in most cases a breast enhancement with implants for upper breast fullness and a breast lift/reduction can be done years after a breast reduction. The best way to find out is with an in person evaluation.

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Gallbladder surgery

Tummy Tuck

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Member Response:

Yes, a tummy tuck can still be done but with some modification. Either a lipoabdominoplasty or a reverse abdominoplasty are possible options. An in person evaluation is the best way to find out.

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