Surgery possible for patient who takes warfarin due to AVR?

Male Breast Reduction

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Member Response:

Thank you for your great question. One has to outweigh the risks and benefits of stopping Warfarin and bridging to Lovenox and the cardiologist can help figure out exactly these risks. With something like this, the warfarin is usually stopped a few days prior and then Lovenox is started. Lovenox is stopped 6-12 hour prior to surgery. Following surgery Warfrain is started again, however either Lovenox or a Heparin drip must be started until the INR is at a theraputic level. If your cardiologist feels that post op, a heparin drip is required, this necessitates a stay in the hospital until INR is theraputic. In my experience with my own patients, this can take anywhere from 2-4 days. Some cardiologists are very cautious and do not let people go home until an INR is at an acceptable level. You also face two types of risks with this procedure. There is a risk of a thromboembolic event when the blood thinners are stopped, and risk of bleeding when blood thinners are started again.

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Is removal of 20 year old textured implants required?

Breast Implant Removal

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Member Response:

Thank your for your excellent question! Before deciding to remove textured implants a visit to to a board certified plastic surgeon should be the first step. If you are not having any symptoms, and wish to remove your implants, that is a personal decision and the proper procedures that are correct. for you should be discussed with your plastic surgeon. If you remove implants and do not replace them with anything, yes you will definitely be flatter than you are now. A visit to a plastic surgeon should help you determine if you would require a mastopexy ( breast lift at the same time.) In my practice, like many of my colleagues, I have patients with diverse desires. Some women choose to remove implants and replace them with another set of implants at the same time, and I have also had patients who have decided to not to replace implants and opted to have a mastopexy at the same time as well as other patients who have decided not to have any surgery except remove the implants.

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How many units of Botox are injected in one session?

Botulinum Toxin

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Member Response:

Many areas can be combined in one session. The # of units depends de on the severity of the wrinkles you have and how “frozen” of a look that one wants. I’ve injected as little as 10 units in one session or even over 100 units. Please meet with a board certified plastic surgeon to do a full assessment on your face to see how many units would be appropriate for you

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Excise Skin Graft

Burn Reconstruction

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Member Response:

Hi! Yes dermaclose Can absolutely be used on something like this I have done it with success. I see that you are in NYC. My office is in Nj. Would be happy to see you for a consult and determine if this procedure is right for you

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Excise Skin Graft

Burn Reconstruction

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Member Response:

Hi! Yes dermaclose Can absolutely be used on something like this I have done it with success. I see that you are in NYC. My office is in Nj. Would be happy to see you for a consult and determine if this procedure is right for you

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Please help guide me/ very urgent

Breast Reconstruction

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Member Response:

Sorry to hear this happened If the expander is exposed to the environment then it absolutely has to come out. As far as doing a latissimus flap, I don’t know the reasons that your surgeon is saying that they want to do it emergently. If you have a history of radiation, and the wound cannot be closed that may be one reason that they want to do an emergent flap. if your chest wound can be closed without the flap, another option is to place a drain and close the wound. as a form of reconstruction, latissimus flap is one option, depending on your anatomy you may also be a candidate for flaps from the abdomen (DIEP) or thigh (PAP)

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Delayed Diep Flap after NSM

DIEP Flap Breast Reconstruction

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Member Response:

There may be too much scar tissue to get the nipple back into an aesthetic position. It is an very high risk 80-100% failure rate of doing an implant alone after radiation. However, the risk significantly decreases if a procedure called a "hybrid DIEP Flap" is done. In this situation an implant can be placed under the DIEP flap and the failure rate is much lower than doing an implant alone. For my patients, I usually do the DIEP Flap first, then perform at least 1-2 rounds of fat grafting first before putting in an implant.

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I need help ASAP!!

Breast Augmentation

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Member Response:

Would need to see pictures but you have many options which include fat transfer to the smaller breast or augment with an implant You can also reduce the larger side to match the smaller side. Please meet with a board certified plastic surgeon to go over all of your options to figure out which procedure is right for you.

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Open wound

Tummy Tuck

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Member Response:

I think it will close if there is very limited undermining around the wound. A wound vac will definitely help it close faster.

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Incision not healing

Tummy Tuck

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Member Response:

Based on the picture shown here it looks like there is necrotic or nonviable tissue present in this wound. This would would benefit from Debridement which is a procedure to cut away al of the non viable tissue. ONly then will the wound start to heal. Please speak with your surgeon about the timing of the debridement.

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Should I go to a wound center ??

Breast Reduction

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Member Response:

It’s best to have a post operative visit with the surgeon since you are so early post op.

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How easy/hard is it to mess up rhinoplasty results ?? 23 days post op, I did something really stu

Rhinoplasty

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Member Response:

It is best to discuss this with your plastic surgeon. It is always the best policy to be honest with your surgeon so they can provide the proper treatment. Best wishes

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Academic setting or private practice?

Breast Reconstruction

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Member Response:

Plastic surgeons who are skilled in breast reconstruction are in many different type of practices such as academic, group practice and solo private practice. In all of these settings you can get an excellent care and outcome. In all three of these settings your surgeon may utilize residents, fellows and PA's to be part of your care team. For example I am in solo private practice and do a significant amount of breast reconstruction. Residents and PA's are part of my team to help take care of my patients. It is of utmost importance to research your surgeon to make sure that the surgeon is a board eligible or board certified plastic surgeon who's practice involves breast reconstruction. Irrespective of what kind of setting the surgery is done in, important factors that lead to failure of Tissue expanders include, any exposure to nicotine, higher BMI, uncontrolled diabetes and history of external beam radiation. Best wishes

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Best option for frowning belly button

Tummy Tuck

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Member Response:

Based on the pictures you posted as well as your concerns, it seems that you would be a good candidate for a minimally invasive procedure such as liposuction with Renuvion/J plasma. Best wishes!

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Nipple sparing mastectomy

Breast Reconstruction

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Member Response:

Thank you for this question. The ability to have a nipple sparing mastectomy depends on a few things: - The position of your nipple on the breast. The best candidates are women who have no ptosis or "sagging" of the nipple. IF the nipple is at the lower border of the breast and pointing downwards you are generally not a good candidate for a nipple sparing mastectomy In addition equally as important are the characteristics of your tumor. If it is close to the nipple, and a large tumor then you are usually not a candidate for a nipple sparing mastectomy Best wishes

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Revision

Breast Reduction

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Member Response:

Sorry to hear this happened and yes it can definitely be fixed. You would likely require a full revision of both sides. This would be more similar to a breast lift than a reduction. You may also benefit from tattoos to reconstruct the nipple areola complexes. Please meet with a board certified plastic surgeon for an in person examination Best wishes

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Disney trip 8 days post op

Breast Reduction

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Member Response:

It is probably not a good idea to do a Disney trip 8 days post op. I cannot speak for any other surgeon's post op care except for my own instructions. If you were my patient, I would want you to commit to not travelling for 4-6 weeks after a major surgery like a breast reduction.

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Lower abdominal bulge

Tummy Tuck

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Member Response:

You may need some liposuction combined with a modality like Renuvion. Please visit your plastic surgeon. Best wishes

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Breast explant and lift

Breast Lift

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Member Response:

Agree with my colleagues here. Please contact your surgeon for advice

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Finding a resident surgeon

Tummy Tuck

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Member Response:

A resident cosmetic clinic is an excellent way to get high quality cosmetic surgery at a fraction of what one would pay going to a private practice surgeon. You will have the comfort of knowing that you have a board certified plastic surgeon supervising the resident performing your plastic surgery. You would have to call Teaching university hospitals in your area as well as medical schools to see if there is such a clinic with the division of plastic surgery at these respective institutions. Best wishes

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Moving placement of implants

Breast Implant Revision

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Member Response:

Yes can definitely do this. If you have a lot of rippling it could be because you have very thin breast tissue. Agree with my colleagues here on having a highly cohesive implant. You may also want to discuss fat grafting with your surgeon to get a more natural appearance, fill in the cleavage and to minimize rippling Please meet with a plastic surgeon board certified by the American Board of Plastic Surgery Best wishes

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Co2 laser destroyed my face indented lines everywhere

General Reconstruction

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Member Response:

Really sorry to hear this happened. Without pictures, or knowing exactly what type of laser was used, settings, and what type of post procedure care was done, it is impossible to render an opinion here. Your first step would be to consult with a plastic surgeon who is board certified by the American Board of Plastic Surgery. After a full history and physical examination is performed, the surgeon can recommend the most appropriate treatment plan. Best wishes.

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Hashimoto’s

Breast Augmentation

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Member Response:

As long as your disease is controlled, you should be able to get an augmentation. The doctor that is managing your hashiimoto's should be aware of this however. To my knowledge, there is no established link between hashimoto's being made worse with breast implants. Please make you consult with a plastic surgeon that is board certified by the American Board of Plastic Surgery Best wishes.

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Looking to get eye lid surgery.

Eyelid Surgery

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Member Response:

Thank you for your question. A surgeon board certified by the American Board Of Plastic Surgery has passed rigorous written and oral examination in order to practice in this specialty. In addition, search for surgeons in your area to see if they are board certified. If you like what you see on their website, call their office and speak with the staff to see if eyelid surgery is something this surgeon performs. Meet with the surgeon, have an opportunity to ask questions before you make the decision that is right for you. Best wishes

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Lip Reconstruction after a busted lip

General Reconstruction

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Member Response:

Lip reconstructions can be safely performed several years after an injury. Please visit with a board-certified plastic surgeon who is board certified by the American Board of plastic surgery to see what options you have for your procedure.

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Inverted nipples

Breast Augmentation

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Member Response:

Thank you for your question. Inverted nipple surgery is a common surgery that most plastic surgeons perform. Your first step is to make sure the surgeon you are going to go see is board certified by the American Board of Plastic Surgery. I would call the surgeon's office to see if they perform this procedure prior to going in for a consult.

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Tummy tuck skin removal?

Tummy Tuck

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Member Response:

12 weeks is very early to determine final results. Also impossible to render an opinion without reviewing before and after pictures as well as doing a physical examination.

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After breast augmentation

Breast Augmentation

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Member Response:

Three weeks is very early for final results of a breast augmentation and implants take up to 6 months to drop. Also impossible to render an opinion without pictures

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Implant not dropping after falling from snowboarding

Breast Reduction

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Member Response:

How long has it been since your surgery? If it has been several months, and there’s hardness and malposition of the implant, you definitely need an evaluation by a plastic surgeon. You may have counselor Contractor, and the implant may be ruptured as well.

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Implant not dropping after falling from snowboarding

Breast Reduction

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Member Response:

How long has it been since your surgery? If it has been several months, and there’s hardness and malposition of the implant, you definitely need an evaluation by a plastic surgeon. You may have counselor Contractor, and the implant may be ruptured as well.

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Age and insurance

Breast Reduction

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Member Response:

Thank you for your very excellent question. Before doing a breast reduction on someone your age, we want to confirm that you have completed growth. This is usually determined by doing a wrist x-ray to make sure you have completed what’s called “skeletal growth” Based on what you wrote, your symptoms do qualify. However, every insurance company has their own requirements as what they consider insurance criteria for a breast reduction. It varies greatly with different insurance plans. You need to call member services for your insurance company and figure out exactly what your requirements are

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Age and insurance

Breast Reduction

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Member Response:

Thank you for your very excellent question. Before doing a breast reduction on someone your age, we want to confirm that you have completed growth. This is usually determined by doing a wrist x-ray to make sure you have completed what’s called “skeletal growth” Based on what you wrote, your symptoms do qualify. However, every insurance company has their own requirements as what they consider insurance criteria for a breast reduction. It varies greatly with different insurance plans. You need to call member services for your insurance company and figure out exactly what your requirements are

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Massive loss of cologine

Buttock Lift with Augmentation

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Member Response:

Really hard to render an opinion without seeing pictures. There are many options for buttock augmentation such as a "nonsurgical" butt lift with filler such as Sculptra, augmentation with fat transfer or augmentation with implants. Renuvion/Jplasma may also help contract lax tissue. Without pictures and a physical exam as well as an idea of what your goals are, it is not possible to render an opinion here. Please consult with a plastic surgeon that is is board certified by the American board of of plastic surgery to go over all of your options.

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Best White Stretch Mark Treatment

Skin rejuvenation and resurfacing

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Member Response:

Stretch marks are an indication that there has been irreversible damage to the skin. There are things you could do such as radiofrequency, micro needling that may provide some benefit, but the results are usually underwhelming and not what most patients are looking for. The best way to get rid of stretch marks is to do an excisional procedure such as an Abdominoplasty ( tummy tuck) in the abdomen and mastopexy ( breast lift) in the breasts. be very very cautious of noninvasive and non-surgical treatments which caused a lot of money and overpromise results

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Best Treatment for Facial Scar

Wound Care

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Member Response:

This is not looking bad for one month out. One thing you can do is use a scar cream such as biocorneum , good SPF to protect from the sun and massage the scar daily Also visit with a plastic surgeon as you may need steroid injections to improve the appearance and other therapies such as microneedling will also help. Scars take about 1 year to really fade Best wishes

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Best Treatment for Facial Scar

Wound Care

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Member Response:

This is not looking bad for one month out. One thing you can do is use a scar cream such as biocorneum , good SPF to protect from the sun and massage the scar daily Also visit with a plastic surgeon as you may need steroid injections to improve the appearance and other therapies such as microneedling will also help. Scars take about 1 year to really fade Best wishes

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Fleur Des Les

Tummy Tuck

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Member Response:

Excellent question. All depends on how much excess skin you have and exactly where. If people have both horizontal and vertical excess The Fleur-de-Lis would be the best option to get the most contoured look. This is usually reserved for patients who are massive weight loss patients

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DESPERATE FOR HELP/ ASVISE PLEASE

Breast Augmentation

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Member Response:

Very sorry to hear this happened. From the looks of the picture it does look like its healing well and does not look like its infected nor does it look like there is an exposed implant ( an in person examination is needed to confirm this) In cases like this one must have close follow up with her surgeon and follow the surgeon's advice on wound care. Best wishes

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When can the wound be stitched?

Tummy Tuck

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Member Response:

Sorry to hear this happend. With a wound opening like this, unfortunately this is not able to be stitched closed at this point. IT will have to heal by itself called healing by secondary intention. Please make sure you have close follow up with your operating surgeons who needs to be very involved in your care. You will also benefit from being seen at a wound center in addition to your surgeon as well as a device called a wound vac that will accelerate healing. eventually you may need to have a revision surgery to improve the scar, but that is also a high risk procedure given this wound breakdown. This would will take several more weeks to close. Some things you can do to help wound healing here are to avoid ALL exposure to nicotine, even second hand smoke, increase your protein in take, and if you are a diabetic make sure your sugars are controlled. Best wishes for a speedy recovery.

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Capsulectomy necessary with rupture?

Breast Implant Revision

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Member Response:

This is an excellent question. Unless there is some abnormality with the capsule such as thickening showing capsular contracture a full capsulectomy is not necessary. If not necessary, a full capsulectomy adds risk to the procedure. Please be very careful of the resource you read on the internet. The best source is this website, the American society of Plastic Surgeons which has the most reliable resources with the best scientific evidence. Please be very careful of resources such as facebook groups, instagram and tick tock posts which often are highly individualized stories any may not apply to your particular case. Please also make sure that the plastic surgeons you are seeing are ASPS members and board certified by the American Board of Plastic Surgery. Best wishes for a safe operation to achieve your goals

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Tummy tuck (TT)

Tummy Tuck

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Member Response:

Thank you for your question. Without pictures it is impossible to give you advice on what the optimal procedure will be.

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Insurance covers breast surgery revision, can I cash pay for extras?

Breast Reconstruction

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Member Response:

Yes! This is commonly done. What we do is completely separate that times on the operative reports or the insurance portions as well as the cosmetic portion so that we keep with ethical billing practices to insurance for the covered portion of the procedure and the self pay/cash/cosmetic rate for the portions of the procedure which are considered cosmetic and not covered by insurance. Please speak with your surgeon about this so that you get a break down of fees for each. best wishes

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Breast lift after biopsy?

Breast Lift

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Member Response:

Thank you for your question. If there is any questionable area on breast imaging, your radiologist may recommend a biopsy. Depending on the result of the biopsy if it is found to be malignant such as cancer or even a benign mass that needs to be removed; then you should consult with a breast oncologic surgeon. Following this, you may or may not b e a candidate for breast reconstruction. A breast lift after biopsy or removal of a mass can be done at the same operation and is called and “oncoplastic” reconstruction. Best wishes.

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Breast lift after biopsy?

Breast Lift

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Member Response:

Thank you for your question. If there is any questionable area on breast imaging, your radiologist may recommend a biopsy. Depending on the result of the biopsy if it is found to be malignant such as cancer or even a benign mass that needs to be removed; then you should consult with a breast oncologic surgeon. Following this, you may or may not b e a candidate for breast reconstruction. A breast lift after biopsy or removal of a mass can be done at the same operation and is called and “oncoplastic” reconstruction. Best wishes.

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Breast lift after biopsy?

Breast Lift

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Member Response:

Thank you for your question. If there is any questionable area on breast imaging, your radiologist may recommend a biopsy. Depending on the result of the biopsy if it is found to be malignant such as cancer or even a benign mass that needs to be removed; then you should consult with a breast oncologic surgeon. Following this, you may or may not b e a candidate for breast reconstruction. A breast lift after biopsy or removal of a mass can be done at the same operation and is called and “oncoplastic” reconstruction. Best wishes.

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Endolift Scars

Wound Care

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Member Response:

Agree completely with Dr. Obi and others. Please visit an ABPS board certified plastic surgeon in the United States for an opinion. You need good wound care management. Best wishes

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Cost

Breast Augmentation

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Member Response:

Please be very cautious and wary of low cost cosmetic surgery. The price is usually too good to be true. There are many high volume low quality centers in the US and neighboring countries where you may not be operated on by a board certified plastic surgeon or the first time you meet your surgeon is the day of surgery. One viable alternative is to seek out a resident cosmetic surgery clinic at an academic medical center which has a Plastic Surgery Residency program. At such programs, you will be usually operated on by a chief resident in plastic surgery who is in their final year of training. They work under the close supervision of a board certified plastic surgeon. With something like this, you can ensure that you will get the highest quality of care, have someone available for follow up and also have a significant cost savings. best wishes for a safe surgery!

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asking for a friend

Liposuction

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Member Response:

I believe that pretty much in every state / territory in the US one has to be at least 18 years of age to consent to elective medical procedures such as liposuction. The first step is to seek a consultation with a plastic surgeon with a parent / legal guardian present. Elective Plastic surgery for reconstructive purposes are routinely and safely performed on minors with parental consent, many plastic surgeons will not perform cosmetic surgery on minors. Best wishes.

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Scar tissue inside lip removal

Lip Augmentation/Enhancement

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Member Response:

Since the injury was 15 years ago, a steroid most likely will not work. This is most likely scar tissue. An excision can be performed in the office to help this. The scar can be hidden nicely inside the lip. It is my practice that any specimen that is removed should be sent to the lab for pathological examination. Best wishes

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Do I need revision surgery?

Breast Lift

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Member Response:

Based on these pictures I think you would benefit from a revision surgery. There is definitely implant malposition on the right side and possibly capsular contracture. Meet with a board certified plastic surgeon to go over all your options

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Miracle

Body Lift

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Member Response:

Sorry to hear that your friend has had all of these issues. Without examining the patient, it is really not possible to figure out what is going on. However, based on your description of a huge bulk on the side, there must be an evaluation and make sure there is no hernia. In addition, with the weight of over 500 pounds, any type of surgical procedure carries a significantly increased risk of complications. The first step should be to be evaluated by a general surgeon to evaluate for the hernia. And possibly a bariatric surgeon to see if you were friend is a candidate for bariatric surgery prior to a plastic surgery evaluation. Best wishes to your friend

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Miracle

Body Lift

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Member Response:

Sorry to hear that your friend has had all of these issues. Without examining the patient, it is really not possible to figure out what is going on. However, based on your description of a huge bulk on the side, there must be an evaluation and make sure there is no hernia. In addition, with the weight of over 500 pounds, any type of surgical procedure carries a significantly increased risk of complications. The first step should be to be evaluated by a general surgeon to evaluate for the hernia. And possibly a bariatric surgeon to see if you were friend is a candidate for bariatric surgery prior to a plastic surgery evaluation. Best wishes to your friend

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Skin Removal After Bariatric Surgery

Tummy Tuck

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Member Response:

Thank you for your question. If you have private health insurance, this, as you said, may be covered. What you need to do, is call member services for your insurance company, and they can provide you with the exact guidelines that they have for possible coverage for this procedure. Please be advised that these guidelines are very tremendously between insurance plans. It is very important that you must follow the insurance companies guidelines to the letter if you want coverage. Otherwise, they will deny the procedure. Please meet with an ABPS board certified plastic surgeon and ASPS member surgeon to go over all of your options, and out of pocket costs associated with the surgery. Some surgeons also have financing options available to cover uncovered portions of the surgery. Please also be very wary and cautious of places advertising very low prices for surgeries. More often than not these places are high volume and low quality. Best wishes!

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Necrotic tummy tuck

Tummy Tuck

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Member Response:

I am so sorry you are experiencing this. Please make sure you have close follow up with your operating plastic surgeon in order to get the best care. Sometimes all that is needed is local wound care such as what you describe or sometimes there may be more procedures needed. Best wishes

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Explant procedure without capsule removal

Breast Implant Removal

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Member Response:

Thank you for your question. If your. capsule is not diseased ( no evidence of ALCL or capsular contracture, calcifications) there is absolutely no reason to remove the capsule. It can safely be left in. In fact, removing a healthy and normal capsule can lead to disfiguring of the breast and may call for additional procedures. Please meet with a board certified Plastic surgeon in order to go over all of your options

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Failed implant or not?

Breast Augmentation

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Member Response:

so sorry to hear that this happened with your breast reconstruction. Ecoli is a gram negative bacteria. It is unlikely that the implant can be saved. Even though your plastic surgeon is abroad, there should be a covering doctor. Please get in touch with that covering doctor as soon as possible for an examination. Best wishes

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Do I have an infection ?

Tummy Tuck

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Member Response:

This needs to local wound care at minimum and some debridement. Please follow up closely with your surgeon. Best wishes

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Belly Button Died, multiple repairs .looks horrible. Need help

Tummy Tuck

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Member Response:

Sorry to hear this happened. Do you have any risk factors such as uncontrolled diabetes or nicotine exposure ? At this point you may be better off by doing a revision to close this wound and the. Have a 3-D tattoo for your umbilicus

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I am still in pain and died feels too tight after 1 year

DIEP Flap Breast Reconstruction

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Member Response:

Sorry to hear you are having this issue. A lot of things can be going on here and it’s really hard to figure out what the problem is without more information. I suggest returning to your operating surgeon who performed the DIEP flap for an examination to figure out the next steps

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How to get panniculectomy paid for by health insurance

Panniculectomy

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Member Response:

Excellent question and we get asked all the time. Coverage largely depends on your insurance plan and each plan has different criteria. You need to call member services and ask them for the policy document for your particular plan. Also, some plans have what is called a plan exclusion that they will not cover it not matter what. A panniculectomy is also very different from an abdominoplasty. An abdominoplasty entails tightening the muscle ( rectus plication) as well as liposuction of the flanks (love handles), repositioning the belly button. A panniculectomy only involves skin removal and these additional components of an abdominoplasty are considered cosmetic and not covered by insurance. Best wishes to get your surgery covered!

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Breast Reduction

Breast Reduction

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Member Response:

I do a fair amount of insurance breast reductions. If you do not meet insurance criteria, and do not follow their guidelines to the letter, unfortunately, they will not cover it. Each insurance plan has a different requirement. Call member services for your specific insurance plan and have them send you the guidelines for what the criteria is to get the reduction covered.

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Sagging breasts, total different size areolas, uncentered, feels like implant in armpit. Hack job?

Breast Augmentation

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Member Response:

So sorry to hear that you are having a difficult time like this. It is not possible to answer a lot of your questions without seeing your before and after pictures as well as any notes regarding the pre operative discussions you had with your surgeon. Please establish communication with your operating surgeon. Do you know if your surgeon is a plastic surgeon who is board certified by the American Board of Plastic Surgery ? Best wishes

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Wound opening

Breast Lift

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Member Response:

Although your wound does not look deep and from the pictures there is no exposure of the implant, you must be very vigilant about keeping the wound clean. and monitor for signs of infection which include, fever, chills, redness or any type of pus and/or foul smelling drainage from the incision site. You must inform your surgeon of this immediately and do not wait to inform your surgeon Having a lift with an implant at the same time doe have a higher chance of this happening. Best wishes

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How safe

Breast Reduction

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Member Response:

Yes, your surgeon is correct. Any time there is a prior incision around the nipple for prior press surgery, such as a lift or a reduction, a revision surgery always risks that the nipple and Areola can lose blood supply. This can cause you to lose the nipple. Unfortunately, we don’t have any way to predict who this will happen in. Higher risk, for this are multiple prior breast operations, higher BMI greater than 30, smoking or any nicotine exposure, and uncontrolled diabetes. It seems your surgeon is giving you proper informed consent. Should you decide to go through with the surgery Best wishes for a safe recovery .

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Where do I start

Breast Lift

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Member Response:

Thank you for your post. Just based on these pictures, your nipples do not look too high on your chest. What is going on here is you have a condition called bottoming out where the implant is sitting low on the chest and much lower than where it should ideally be. This is a greater risk of happening when an augmentation, and a breast lift are combined and when a larger implant is used. You would benefit from a revision surgery, please visit with a Board Certified Plastic Surgeon for all of your options

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Breast augmentation 4 weeks ago

Breast Implant Revision

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Member Response:

In the United States it is rare for anyone to use textured implants if these are being used at all. I would discuss with your surgeon exactly why textured implants were used and please obtain implant cards as well as the operative report to see exactly what type of implants were used.

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Please help guide me

Breast Reconstruction

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Member Response:

Sorry to hear of your diagnosis. Im glad you are able to meet with a plastic surgeon. Under the muscle tissue expander as well as over the muscle are both accepted techniques. A majority of my reconstructions are over the muscle. If you feel that you want more options, you have a couple of options - get the mastectomy and under the 1st stage under muscle reconstruction and seek additional opinions for your second stage - I see you are not too far from phoenix / scottsdale. There is no shortage of plastic surgeons there who perform breast reconstruction. You may want to seek a consult with others first. My good friend and colleague Dr. Matatov at Southwest breast and aesthetics in phoenix performs all types of reconstructions Best wishes and know all of your options before you proceed

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Breast Revision

Breast Augmentation

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Member Response:

Really had to answer this question without seeing before and after pictures. Trying to correct uneven inframammary folds are challening and often times you do not get prefect symmetry.

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Consultation Costs

Liposuction

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Member Response:

Consultation fees vary by region and practice. I am also in New Jersey Like you. My practice charges $100 for the consultation fee which can then be used towards the cost of the procedure or any other services we offer in the office. With respect to your question regarding liposuction, it is absolutely best to meet with a board certified plastic surgeon to go over all of your options. My preference for liposuction to get the best results are to do Vaser, Power assisted liposuction (PAL) and Renuvion / Jplasma for soft tissue contraction to get the best results. Best wishes.

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Botched Breast lift? Revision needed?

Breast Lift

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Member Response:

3 weeks is way to early to determine fine results. I would wait 6 months and reassess Best wishes

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Mechanical Valve in my Heart

Breast Augmentation

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Member Response:

If you have a mechanical valve you are most likely on a blood thinner such as warfarin. For any surgical procedure that must be stopped several days before surgery, bridged with another medication such as lovenox. Then this is stopped 6 hours prior to surgery. The blood thinners must resume at some point after surgery. The longer you are off blood thinners increases the risk of a blood clot forming around the mechanical valves. This can then break off and go the brain and cause a stroke which can leave you with paralysis or be fatal. Going back on blood thinners too soon can increase the chance of bleeding and surgical complications. There is less of a risk of blood clots if your mechanical valve is the aortic valve vs the mitral valve since the aortic valve has a higher flow rate and less chance of forming clots. If you look disfigured, a surgery may be covered under health insurance and considered reconstructive. I would suggest meeting with a board certified plastic surgeon.

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Mechanical Valve in my Heart

Breast Augmentation

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Member Response:

If you have a mechanical valve you are most likely on a blood thinner such as warfarin. For any surgical procedure that must be stopped several days before surgery, bridged with another medication such as lovenox. Then this is stopped 6 hours prior to surgery. The blood thinners must resume at some point after surgery. The longer you are off blood thinners increases the risk of a blood clot forming around the mechanical valves. This can then break off and go the brain and cause a stroke which can leave you with paralysis or be fatal. Going back on blood thinners too soon can increase the chance of bleeding and surgical complications. There is less of a risk of blood clots if your mechanical valve is the aortic valve vs the mitral valve since the aortic valve has a higher flow rate and less chance of forming clots. If you look disfigured, a surgery may be covered under health insurance and considered reconstructive. I would suggest meeting with a board certified plastic surgeon.

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Complications

Tummy Tuck

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Member Response:

Sorry to hear this happened. Do you have any nicotine exposure ( even second hand smoke) or are a diabetic ? This increases the chances of this happening. The best person to deal with this is your operating surgeon. If you have fevers, or chills please go to your nearest emergency room Best wishes for a full recovery

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Tummy Tuck

Tummy Tuck

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Member Response:

There are several different types of tummy tucks. In addition, people come with all sorts of different names to try to market themselves and even try to trademark some of these terms. Lot of it is hype Best wishes

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Breast size

Breast Reduction

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Member Response:

Thank you for your excellent question. It is impossible to predict bra size prior to a breast reduction. I would not shop for any bras until at least 3 months after surgery Best wishes with your surgery

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Left too big

Breast Reduction

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Member Response:

Thanks for your question. A couple of things here. The breasts will not settle for at least 3-6 months so I would not judge the final size just yet. If you were an F cup and want to go to a B cup, it is usually not possible to do that in one operation and a second operation is required. Best of luck

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Not happy with my breast augmentation

Breast Augmentation

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Member Response:

Sorry to hear that you were not happy with your surgery. Unfortunately without having pictures, it is impossible to say exactly. What is going on.

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Is it covered by medical

Panniculectomy

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Member Response:

Some insurances cover panniculectomy which is removal of skin below the umbilicus ( belly button) and when they do cover this, they have VERY strict criteria that must be met. In addition, a diastasis is not covered by insurance. This is considered a cosmetic procedure. If your insurance approved a panniculectomy, and you want a diastasis repair, speak to your surgeon regarding how much additional cost this will be.

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Can I completely remove my nipples after top surgery?

Transmasculine Top Surgery

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Member Response:

Sorry you had this experience. It is possible to remove the nipple. Doing so would leave a horizontal scar above your mastectomy scar. One option to restore aesthetics after the removal would be to have a 3-D nipple tattooing similar to what we do for cancer patients. The 3-D nipple tattoos look very realistic. However, there will be no projection outward from the chest and will be flat. Best wishes

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How small can a breast reduction go?

Breast Reduction

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Member Response:

Thanks for your question. This is a hard question to answer without an evaluation person. Please meet with a board certified plastic surgeon in order to figure what would be the best procedure for you

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How small can a breast reduction go?

Breast Reduction

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Member Response:

Thanks for your question. This is a hard question to answer without an evaluation person. Please meet with a board certified plastic surgeon in order to figure what would be the best procedure for you

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Pro-bono/Dicounted Surgery/Programs or Non-Profits/Tricare Prime options for Tummy Tuck or Mini ???

Tummy Tuck

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Member Response:

Thank you very much for your question. To get quality surgery at a discounted rate, your best bet would be to seek out the chief resident Cosmetic Surgery clinic at a teaching institution that has a plastic surgery residency program. Through programs like this, you will have a lower cost than going to a private practice, Plastic Surgeon, and your surgery will be done by a chief resident in plastic surgery, who is in his or her final year of training And will be supervised by a board-certified plastic surgeon to ensure the highest quality of care. I see that you are in Louisiana. Both Tulane university and Louisiana state university. Have such programs in New Orleans. I suggest you contact one of these places. I could speak to the great quality of care that we provided to patients such as yourselves when I was a plastic surgery resident at Tulane Best wishes!

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Sad belly

Body Contouring

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Member Response:

Thank you very much for your question. This is something we get asked all the time. Noninvasive options only do so much, and they are usually not a replacement for surgery, but as an addition to enhance the results. Please consult with a board-certified plastic surgeon on surgical options, which include Liposuction, and an energy-based device, such as Renuvion to address your concerns.

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Enlarged nipples after gynecomastia surgery.

Male Breast Reduction

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Member Response:

Thank you for your question. 4 weeks is way to early to see any final results. Things will be swollen for about 6 months, sometimes even a year. Have patience and it should get better.

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Gyno Surgery

Male Breast Reduction

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Member Response:

Thanks for quote question. 4 weeks is way to early to determine. Continue to follow up with your surgeon. It usually takes months for inflammation to resolve

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Complications after tummy tuck

Tummy Tuck

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Member Response:

So sorry you experienced this complication. A blood clot in the lungs (PE) is one of the most feared complications for us plastic surgeons. I agree without on holding off on liposuction at the time being. As far as the dog ear revision, I would also wait until you are off blood thinners. There is an increased risk of bleeding that cannot be controlled. Once you are off of blood, thinners, in order to do liposuction, if it’s just the flanges, that can be done under local anesthesia, wide, awake, without having to go under, which may mitigate the risk of having another blood clot. Sonia, if that time comes, you need to properly be risk stratified by your. Primary care physician, as well as a hematologist. Wishing you the best for your continued recovery

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Breast augmentation with lift complications

Breast Augmentation

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Member Response:

Sorry you are having these issues. From the information given it is not possible to say exactly what’s going on. A full history and physical exam needs to be done as well as a review of your medical records. In general however, for many things we do watchful waiting instead of a return to the OR or another intervention. If you do seek another opinion, please do so with a board certified plastic surgeon.

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Is this fixable?

Breast Reduction

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Member Response:

Thanks for the question. This can definitely be addressed with another surgical procedure. Please meet with a board certified plastic surgeon for an opinion

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XL implants

Breast Augmentation

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Member Response:

Thanks for your question. In general I tell my patients the bigger the implant t the bigger the problem you will have. You will have increased risk of rupture, capsular contracture, asymmetry, implant malposition, and need for revision surgeries. An implant of that size may also interfere with breast cancer screening. Please proceed with extreme caution for a procedure like this.

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Danette

Breast Augmentation

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Member Response:

Yes this is a common operation that is performed. Please see a board certified plastic surgeon who routinely performs cosmetic breast surgery in order to receive the highest quality of care.

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Breast lift

Breast Implant Removal

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Member Response:

Hi! Thanks for your question. This is actually a very common procedure. Please go to a board certified plastic surgeon who performs aesthetic and reconstructive breast surgery. One thing to note, is that the need for a lift as well as how extensive the lift and the type of incisions used depend on the current position of your nipples. If your nipples are more or less in the correct anatomical position and not point downwards you may not need a lift or may be able to get away with a minimal lift.

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Can multiple surgeries be done

Thigh Lift

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Member Response:

Excellent question and this is one we commonly get asked by patients. The surgery can be done all together, but the question, becomes SHOULD they be done all together. My personal limit for surgeries is around 6 hours of time under anesthesia. Anything longer than this significantly increases the risk of complications such as wound infections, heart attack, blood clots ( DVT & PE), and a much longer and more painful recovery. It would be in your best interest to split the surgeries into 2-3 surgeries.

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Breast cancer double mastectomy results

Breast Implant Removal

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Member Response:

Thank you for your question. Very sorry to hear that you experienced this Radiation damages, the microscopic blood vessels in tissue. Once you fail an implant based reconstruction after radiation, another implant based reconstruction without some sort of flap coverage such as the latissimus flap or DIEP flap should not be attempted. I agree with your surgeon. Wait 6 months. Then restart reconstruction with a flap: Latissimus flap + tissue expander, or DIEP flap Given your radiation, if you attempt to do an implant based reconstruction only the failure rate approaches 80% Best wishes.

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Removal with Mastopexy

Breast Implant Removal

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Member Response:

Thanks for your question. Multiple factors come in to play to decide what the optimal operation should be. This depends on the size of the implant that you currently have, if the entire. capsule is being removed or not, the current nipple position (ptosis) as well as the overall quality of your skin. If you have a smaller implant with your nipples in the correct anatomical position without significant ptosis and good skin quality, and a thin capsule that is being left behind, you have a greater chance of achieving your goals with implant removal without a lift. If you have a very large implant, significant nipple ptosis, poor skin quality, and capsular contracture, I think you would benefit from a removal of your implants with a lift. In reality, many people are somewhere in between these two scenarios. Therefore, a detailed discussion is needed that is specific to your concerns and your anatomy. Please make sure that that your surgeon is board certified by the ABPS.

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7 months post op will this ever go away?

Panniculectomy

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Member Response:

Based on these images, looks like you will need a revision. Please discuss with your plastic surgeon

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uneven breasts after explant

Breast Implant Removal

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Member Response:

This is a difficult question to answer without seeing your pre operative pictures as well as an operative report to ascertain exactly what operation was performed. Having said, that 11 days after a surgery is way too early to determine the final outcome. It can take up to a year for your breasts to fully settle after an explant surgery.

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My breast implants look way too natural!! Why?

Breast Augmentation

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Member Response:

Thanks for your question. The result depends on the discussion you had with your surgeon pre operatively. There are multiple right answers and the operation is tailored to your individual needs. If you discussed with your surgeon that you want a smaller implant and have a more "natural and unaugmented look, perhaps that is why a smaller implant is used. Should you desire the look closer to what you posted, you would benefit from a revision surgery to remove the current implant and use and implant that has a wider base diameter and a higher profile or projection. This would most likely get you a result that has an obvious augmented look.

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Leg lift

Body Lift

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Member Response:

This is a procedure that is not covered by insurance. It would incur out of pocket costs. I agree with the other surgeons here that your hip pain is unlikely to be caused by the skin in the thighs.

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Gynecomastia due to child abuse

Male Breast Reduction

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Member Response:

Sorry to hear about the child abuse. Your best bet would be to take him to an academic medical center with a plastic surgery residency training program. At these institutions, there is usually a chief resident run clinic by someone in their final year of training supervised by a board certified plastic surgeon to perform the surgery. You will be treated by a highly skilled and dedicated team of plastic surgeons for the best outcomes. I see you are in Georgia, you may want to reach out to Emory University Dept of Plastic Surgery if they have such a clinic. Best wishes!

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what plastic surgeries do i need?

Brow Lift

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Member Response:

Cosmetic surgery is never a “need” but always a “want” Please meet with a board certified plastic surgeon to go over what your goals are and the safest procedures in order to achieve them. There are many talented board certified plastic surgeons in the greater NYC area. Best wishes!

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Breast Augmentation for MTF patients

Gender Affirmation Surgery

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Member Response:

Hi There are some subtle differences but essential the same operation as a breast augmentation on a cis female. I am in a NJ on the jersey shore and will he happy to see you for a consult

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How to find a thread lift expert?

Thread Lift

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Member Response:

Many plastic surgeons do not offer this procedure because it is fraught with complications and the results are not that good. Be careful and best wishes

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How to find a thread lift expert?

Thread Lift

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Member Response:

Many plastic surgeons do not offer this procedure because it is fraught with complications and the results are not that good. Be careful and best wishes

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My insurance has no breast weight requirement.

Breast Reduction

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Member Response:

Thank you for this excellent question. Many factors go into deciding how much tissue to remove. A lot of it depends on what your breast size is right now compared to what you would like the first size to be after the reduction as well as achieving symmetry in proportion to your body type. All of this Will be discussed with you in the consultation with your plastic surgeon. I agree with some of my other colleagues, if you and your surgeon are not on the same page, it’s good to find someone who you agree with their surgical plan. Other aspect of his is how dense your breasts are with breasts that are more dense, with the same volume of tissue removal, it will weigh more. Best of luck on your journey, and please consult with a board-certified plastic surgeon.

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pulmonary fistula?

Breast Augmentation

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Member Response:

Thanks for your question. You would need cardiac and pulmonary risk stratification to determine you risk of complications from anesthesia. Your cardiologist and pulmonologist should be able to provide this for you. Once that is done, your plastic surgeon will determine if you are an appropriate candidate to undergo the procedure. Please see a board certified plastic surgeon for your consult.

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Asymmetric Breasts After Augmentation

Breast Augmentation

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Member Response:

Thank you for your question. Correction of asymmetric breasts are one of the most challenging surgeries to perform. It is next to near impossible to get perfect symmetry after surgery. In your case, I would wait 6 months from the time to surgery to and assess with photographs to see exactly what is going on. The remaining asymmetry may be minimal where you won't need another surgery or may need another surgery to further improve it. Best wishes!

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Insurance

Breast Reduction

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Member Response:

Medical records are usually held on for 7 years. If it’s been greater than 7 years since the doctor left the practice you may be out of luck to get those records Also, please look at the summary plan description (SPD) of your specific insurance plan. It will tell you exactly what the requirements are for a breast reduction. Sometimes you may have a plan exclusion where they won’t cover it under any circumstance. It is also imperative to follow the requirements of the insurance company for a breast reduction to the letter. The insurance companies will try to do anything possible To deny coverage. Best wishes

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Discharge from my belly button 6 years after tummy tuck

Tummy Tuck

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Member Response:

Very good question. Unfortunately this can happen several years after a tummy tuck. It can be what others here have described, a suture abscess. Also where did you have your tummy tuck done ? I have had patients who had procedures done abroad who had developed atypical mycobacterial infections. The first step would be to visit a board certified plastic surgeon for an examination. If your surgeon is someone local, it is always preferable to address these issues with your operating surgeon. Best wishes

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Consultation breast reduction

Breast Reduction

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Member Response:

Thank you for this very excellent question. It is absolutely normal and okay to be nervous during the consult It is a good idea to have a guardian present during the consultation. I also have a female staff member present during the examination as well. How consults work are that I meet with the patient to determine concerns and take a health history. Then I step out of the room, and have the patient change into a medical gown. My staff member then takes photographs of the breasts as they are part of the medical record as well as a requirement for insurance. coverage. I then perform a full physical exam, which involves checking for masses, abnormal lymph nodes, and breast measurements. After this I ask the patient to cover up and we discuss what the surgical options are to achieve her goals. Best of luck with your consult and please see a board certified plastic surgeon to ensure the highest level of quality.

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recall Allegan

Breast Reconstruction

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Member Response:

Thank you for your question! This is something I get asked all the time. The "recall" pertained to only devices that had not been implanted as of the the recall date. For devices that had been been implanted, the FDA asked to monitor for any signs of Breast Implant Associated Anaplastic Large Cell Lymphoma. Allergan Implants should carry a lifetime warranty where they will reimburse you for the cost of the implant only, but your surgeon's fee, anesthesia fee, and OR facility fee is normally not covered. Best of luck and please make sure you are going to a board certified plastic surgeon.

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Breast reduction

Breast Reduction

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Member Response:

Thank you for your question. Feeling terrified is not as uncommon as you think after a breast reduction. Bra size unfortunately varies by bra manufacturer. I would wait approximately 6 months until you get re-measured for a bra.

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standard of care when patient tests positive for cotinine for fat transfer to right buttock

Buttock Lift with Augmentation

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Member Response:

Thank you for your question. EVery surgeon has different criteria for safely performing an operation. Cotinine is a nicotine metabolite which shows up in the urine and blood when there is recent exposure to nicotine such smoking, vaping, using marijuana rolling papers with nicotine, nicotine gum, nicotine patches, cigars, and second hand smoke. Exposure to nicotine compromises the microscopic blood vessels and causes increased complications such as delayed wound healing and increased surgical site infections. I personally have patients stop 4 weeks prior to surgery and 6 weeks after surgery. It is my policy that I test for cotinine and if positive surgery is cancelled.

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Malignant hyperthermia

Tummy Tuck

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Member Response:

I think it can still safely be done but its not without risk. Agree with my colleagues below who recommend medical and cardiac risk stratification. For this, please make sure that you do see an actual physician and not a mid level provider Also, a discussion with the anesthesiologist also needs be done. For any patient with a history of MH, I do the case in the hospital and not surgical center.

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Neck Liposuction

Liposuction

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Member Response:

I think combining RF with liposuction is a great option. You should definitely meet with a board certified plastic surgeon to see if you are a candidate for either procedure

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Gummy Bear Implants Rippling

Breast Implant Revision

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Member Response:

What does you implant card say ? Should tell you exactly what implant was put in. You can also follow up with your surgeon if possible. Otherwise, obtain the operative reports and follow up with a board certified plastic surgeon in your areas to go over what your options are at this time.

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Open wound

Tummy Tuck

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Member Response:

Sorry to hear that this happened. This is what is called full thickness necrosis. All the non-viable or dead tissue should be removed. Some of this can be done under local anesthesia but would be better to be done under anesthesia in the operating room. Following this, you would benefit from having a device called a wound vac to keep the wound clean and to help it heal. I would also suggest increasing your protein supplementation as this will help heal wounds. A couple of questions: Are you a smoker or exposure to any nicotine such as vaping, and exposure to second hand smoke. Are you a a diabetic with A1c > 7? These are some risks that can cause this. Best of luck and wish you a speedy recovery!

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Tummy Tuck

Tummy Tuck

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Member Response:

It would be an extremely risky procedure. You are exposed to complications around the time of surgery such as bleeding, heart attack, DVT / Pulmonary Embolism. After surgery there is a significantly increased risk of surgical site infections, wound break down and seroma. Overall the aesthetics of the procedure will most likely be suboptimal.

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Post Bil mastectomy ruptured implant

Breast Implant Revision

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Member Response:

Thanks for your question. The switching of the implant can absolutely be done from the sub muscular position to the pre pectoral ( above the muscle) Please meet with a board certified plastic surgeon in who is well versed in this technique. Another option to also consider is a natural tissue reconstruction issuing your own tissue such as a DIEP flap

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Breast augmentation with lift on one side

Breast Lift

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Member Response:

Thanks for your questions . Very normal for things to look off immediately after surgery for asymmetry. ESPECIALLY when one side needs a lift and the other side does not. I agree that it takes about 6 months for everything to settle. and to start looking more even. Especially since this is a revision surgery, may take even longer. I also always tell patients that have significant asymmetry between the left and right breasts that there will always be a degree of asymmetry between the left and right breasts. Best wishes

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difference between mini facelift and lower facelift

Facelift

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Member Response:

Thanks for your question. Sometimes these terms like "mini" facelift are used more as marketing terms and what is actually done in the procedure is not really standardized. Based on your pictures, I think you would be a good candidate for lower facelift and neck lift. The facelift will rejuvinate the lower face and jowels, make your jaw line look more defined and remove some excess skin. The incision starts in front of the ear and goes behind the ear and into the hair line. The incision for the neck lift is usually placed in a crease in the chin. Then the platysma muscle that cause the two bands going down your neck are stitched together. The mid face lift rejuvinates the mid face and is done through a lower eyelid incision. Please make sure you consult with a board certified plastic surgeon. Best wishes!

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East Coast surgeons for Superfat people?

Panniculectomy

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Member Response:

With your situation I think the best place to get this operation would be at an academic medical center. We have several fine institutions along the East Coast and I suggest you reach out to any one of these places. Also please be aware, that this operation is not without complications and with a weight of 225Kg and assuming there are no other medical conditions and or any other medical conditions are optimized; there is a near 100% chance of complications with a panniculectomy. The most common are are wound healing issues. More dangerous ones are Pulmonary embolism. Other factors that increase risks with the procedure, are active nicotine exposure and uncontrolled diabetes (Hgba1c level > 7.0) It may also be a good idea to consult with a bariatric surgeon to see if you are a candidate for a weight loss procedure prior to panniculectomy to improve the perioperative risks with an operation like this. Best of luck.

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Mole on nose

Skin Cancer Removal

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Member Response:

Surgical Excision is your best option. There is no way to avoid a scar. However, going to a board certified plastic surgeon will help minimize the appearance of the scar. With scarring this may be something that you will notice but once healed, an unsuspecting person may not notice any scarring.

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Inquiring

Facelift

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Member Response:

My criteria for operating on diabetics is to have an A1c of 7 or less for all elective surgery. This minimizes the chances of wound healing complications.

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Qualifications for Panniculectomy

Panniculectomy

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Member Response:

Thank you for your question! This is something that is insurance specific. I suggest you call your insurance and get specific guidelines of what their insurance criteria is for it to be covered by insurance. Also, to get the best possible outcome, you should also see a psychiatrist to get treated for the Body dysmorphic disorder. That is an integral part of this journey and just as important as having the panniculectomy. Best wishes.

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Bbl and 360 lipo

Liposuction

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Member Response:

Although you can be bridged with lovenox, your cardiologist has to give you a risk stratification on what the perioperative risk of an adverse event after the operation. As you are most likely aware, the reason you are on coumadin for the valves is to prevent a blood clot which can happen as blood flows across the valves and can lead to a pulmonary embolism - from a tricuspid valve clot or a stroke from the mitral/aortic. The aortic valve has a high velocity flow rate where the chance of a clot is lower so can tolerate being off of blood thinners for longer. The other two are a low flow environment so more prone to clots. The other aspect to consider is that once you go back on the blood thinners you are more prone to hematoma (collection of blood) at the liposuction and fat grafting sites. This can lead to an unaesthetic appearance and may even be severe enough to need a blood transfusion. Please meet with a board certified plastic surgeon as well as a cardiologist

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Pro bono

Rhinoplasty

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Member Response:

Very sorry to hear of your predicament. This would be considered reconstructive surgery and should be covered through insurance. Please contact your insurance carrier for referrals to plastic surgeons. You may also be able to get surgery covered for a significant cost savings if you seek out a clinic staffed by plastic surgery residents at an academic medical center with a plastic surgery residency program.

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Lift

Breast Reduction

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Member Response:

Thank you for your questions. When a breast reduction is performed, it also involves a lift so the nipples are placed back into the correct anatomical position.

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Procedure Pricing Transparency

Breast Lift

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Member Response:

Did you actually go in for a consult in person to see the surgeon? Usually price ranges are given over the phone. After an in person consultation a formal quote is usually given with all of the associated costs with surgery such as the surgeon's fees, implants, surgical garments, Anesthesia, OR facility fees Pathology fees.

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Nipple graft error

Breast Reduction

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Member Response:

Thanks for your question. Really hard to say without seeing pictures. But there may or may not be an option to correct.

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Calf augmentation

Calf Augmentation

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Member Response:

It is possible to do both. Please visit a board certified plastic surgeon to figure out exactly which procedure is right for you.

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Can I remove my breast implants my self

Breast Implant Removal

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Member Response:

I m sorry to hear that you are unhappy. Please do not do this and I agree with my other colleagues, cannot emphasize the dangers of this enough. One must have proper surgical training and the proper surgical facilities to safely do this. I implore you to see a board certified plastic surgeon to for an evaluation.

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Is this an okay option?

Breast Lift

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Member Response:

Thanks for your question. based on the information you provided you may be a candidate for a breast reduction procedure or a mastopexy (breast lift). The two operations are similar but also differ in a couple of ways Breast Reduction - excess breast tissue is removed, as is excess skin, as well lifting the nipple/areola to the proper position so it does not have the "saggy" appearance. This operation is best suited for women who feel that their breasts are too large. mastopexy (breast lift) - Excess skin is removed, and the nipple/areaoa is also lifted to the proper position to avoid the saggy appearance very minimal breast tissue is removed. This option is best suited for women who do not feel that their breasts are too large and like the appearance of their breasts in a bra, but feel that their breasts are sagging. Please meet with a board certified plastic surgeon to determine which operation if any you are a candidate for. Best wishes!

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Lumps on interior lower lip

Lip Augmentation/Enhancement

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Member Response:

Sorry to hear of this situation. I would definitely seek the attention of a board certified plastic surgeon. These look like they need to be removed.

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Bilateral mastectomy after complication using filler injection.

Breast Implant Removal

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Member Response:

So sorry to hear of your situation. This is indeed a difficult situation. I have treated patients who are in your situation. A couple of things to keep in mind - need to find out exactly the filler that was put in was. ( This may be very difficult) - Usually when these fillers are put in, they also inject right underneath the skin, the breast tissue and the muscle. It will be impossible to remove every bit of the filler no matter which option you choose the mastectomy or an attempt to remove a majority of the filler. Most likely scenario is that you will always have some of this material left in your body. As regard to mastectomy vs removal of the filler, without examining you, and without looking at imaging such as a mammogram and an MRI, it is impossible to tell what would be the best option for you. Please meet with a board certified plastic surgeon as well as breast surgeon to see which would be the best option in your situation.

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Extended Tummy Tuck- Weight Question

Tummy Tuck

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Member Response:

Complications associated with surgery significantly go down when your BMI is lower. You may want to consider medical weight loss to lose that extra weight prior to surgery. Not only will the surgery be safer when with your lower weight, but the aesthetic results of surgery will be much better. Best wishes

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Explant of under muscle implants under local

Breast Implant Removal

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Member Response:

Excellent question. Deflation of the Implant can be done under local anesthesia in the office. Then your skin and breast tissue should shrink in about 4-6 weeks. At this point the implants can be removed in the office under local anesthesia. However, if you need a full capsulectomy and /or mastopexy (breast lift), it would be difficult to do under local anesthesia and I suggest that this should be done under anesthesia. Please meet with a board certified plastic surgeon to see which option is correct for you. Best wishes!

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BBL after Tummytuck and C sections

Liposuction

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Member Response:

Yes it can be done and quite common actually. Depending on where your excess fat is, what is usually done in a case like this is a 360 degree circumferental trunk liposuction with fat transfer to the buttocks. Since you already have had a tummy tuck and if any liposuction was already done during your mommy makeover, you may or may not have and adequate amount of fat left to transfer. Please meet with a board certified plastic surgeon who will do a physical examination to determine the right operation to achieve your goals.

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reveal more of penis

Liposuction

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Member Response:

It may or may not work. You may benefit from liposuction of the pubic area with an RF device such as J-plasma to further contract the tissue underneath the skin to provide a flatter contour. This can usually be done in the office under local anesthesia. Please meet with a board certified plastic surgeon to see if this procedure is right for you. The benefit of doing this under local anesthesia is quicker recovery time.

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Is tummy tuck my only option?

Tummy Tuck

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Member Response:

Agree with the other surgeons here. The operation that will get you the best results is an abdominoplasty (tummy tuck) where the excess skin is removed and the space between the rectucs muscle (diastasis) is stitched together (plication.) Other options include liposuction with an RF energy device. The problem with this is that you may get some improvement, or it could end up looking much worse and becomes hard to correct. In addition, if you have any of these procedures and have children after the procedure, you will most likely need a revision operation. Please meet with a board certified plastic surgeon to go over all of your options.

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Lower body lift with augmentation, does this impact the lower front and back thighs?

Body Lift

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Member Response:

Thank you for the pictures. I agree with the other surgeons here. I think a vertical scar in your case would be overkill. I think you would get a good result with minimally invasive / percutaneous modalities such as J-plasma/renuvion to achieve your results. You may also benefit from RF micronedling. Please. consult with a board certified plastic surgeon. Best wishes!

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Double Mastectomy

DIEP Flap Breast Reconstruction

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Member Response:

Thanks for your question. There are several options for breast reconstruction such as using your own tissue (DIEP Flap, Latissimus dorsi flap, PAP Flap) or using either silicone gel or saline implants. After this is done, one can have fat grafting done where fat is liposuctioned, prepared with a special device and reinjected into the reconstructed breasts to provide more fullness as well as mask any rippling with implants. Breast reconstruction usually takes multiple surgeries and rarely are we able to do it in one operation. Please meet with a board certified plastic surgeon in order to see what options are correct for you. Best wishes.

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will this puckering actually ever go away?

Breast Reduction

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Member Response:

It is very common to have puckering at incision sites immediately after breast reduction. The swelling takes approximately 3-6 months to settle. Best wishes

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When should you get new implants

Breast Augmentation

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Member Response:

Thanks for this excellent question. There really is no rule. If you are happy with the appearance of your breasts and if there is nothing wrong ( no rupture, no capsular contracture) then no need to change the implants. If you are concerned please consult with a board certified plastic surgeon

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Discharge

Mommy Makeover

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Member Response:

Hard to say what’s going on without examining you. I would definitely seek medical attention from a plastic surgeon for an in person examination to determine the next steps.

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Guttate Psoriasis Flare up

Mommy Makeover

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Member Response:

It would be best to wait until your flare up is controlled. I would discuss with your dermatologist on getting the flare up controlled as well as medications to minimize a flare up in preparation for your surgery

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which implants are best

Breast Reconstruction

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Member Response:

Thanks for your question. Both methods are safe. Above the muscle implants after mastectomy are becoming more and more popular as the safety of this has improved as well as the techniques. 90+% of reconstructions I perform are above the muscle ( prepectoral) majority of of my patients have very little pain, and the aesthetic results are in my opinion much better. In addition you don’t get what’s called the animation deformity that is seen for under the muscle reconstructions. Best of luck with your reconstruction following mastectomy

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Insurance

Breast Reduction

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Member Response:

It is best to contact Idaho Medicaid to see who is in network as well as get all their criteria for coverage for a breast reduction. Based on their criteria you may or may not be a candidate to have a breast reduction covered by your health plan. Best of luck!

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Left is significantly larger

Breast Reduction

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Member Response:

Thanks for posting the pictures. It is understandably upsetting to see asymmetry or un even appearance right after surgery. However being only 2 months from surgery, things are still settling and its too early to consider revision surgery. What is concerning is the sudden increase in size. I would return to your operating surgeon for an examination to see if you have any fluid collections. If a revision needs to be done, I personally wait 6 months to 1 year from the date of surgery to perform this. Best of luck!

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Reoccuring capsular contracture

Breast Implant Removal

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Member Response:

Sorry to hear about your multiple episodes of capsular contracture. In this situation there are a couple of options. You may want to consider a complete capsulectomy and a complete wrap of the implant in acellular dermal matrix such as strattice which is a porcine (pig) derived matrix. Another thing you may want to consider is taking the implants out and leaving them out for about 6 months to a year before re attempting surgery. Please discuss all of these options with your board certified plastic surgeon. This is a frustrating condition and sometimes requires multiple operations to correct. Best of luck to you!

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Have a few questions.

Breast Augmentation

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Member Response:

Altered sensations and some swelling is expected after breast surgery. Always good to keep in close contact with your plastic surgeon’s office and follow their post operative instructions to ensure that you have the best outcome after your surgery. If you feel something isn’t right or something has changed contact your surgeon. Best of luck with the rest of your recovery!

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Tummy tuck grants/financial help

Tummy Tuck

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Member Response:

First of all, congratulations on your weight loss as well as your transition. The most important part of any body contouring surgery is safety. You may want to reach out to an academic medical center that has a plastic surgery residency program. Many residency programs have a chief resident aesthetic surgery clinic where surgeries are often performed at a reduced rate. The resident who will be operating on you is usually a chief resident in their final year of the long road that is plastic surgery training. Also, there is always a faculty member who is a board certified plastic surgeon that is mentoring the resident and is available for in the operating room if needed. Best of luck!

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Diastasis recti repair covered by insurance?

Mommy Makeover

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Member Response:

Thank you for your question. The diastasis repair is normally not covered by insurance and is generall considered cosmetic in nature by insurance carriers. You may want to get from your insurance plan specific guidelines on this. What sometimes may be covered are the following - Repair of a hernia if present - Removal of excess skin ( Panniculectomy) but most insurances have very strict criteria to get this covered. Again, reaching out to your insurance company and getting specific guidelines for your specific plan would help you figure out if this may be covered. In addition to this, please visit with a Board Certified Plastic Surgeon to help you navigate this. Best of luck!

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Gynecomastia Question

Male Breast Reduction

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Member Response:

Thanks for your question. There are several “grades” of gynecomastia that we use to classify its severity. It also depends on if the gynecomastia is mostly comprised of fat or glandular breast tissue. Depending on your specific anatomy, the severity of the gynecomastia and your goals there are several options. These range from doing liposuction only, to liposuction with removal of some of the glandular tissue. Most people fall into the category of needing liposuction and removal of the gland. If there is ptosis (sagging) of the nipples then a more radical procedure is needed where excess skin is removed as well. When Liposuction is performed, many of us also use an ultrasound liposuction such as VASER. Your first step should be to see a board certified plastic surgeon to see which category you fall into and what the best treatment would be for you.

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Implant Check-up - BIA-ALCL

Breast Implant Revision

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Member Response:

Thank you very much for this question! This is a very common concern amongst women that have had the Allergan textured bio cell implants. For BIA-ALCL The most common presenting symptom is a painless swelling that occurs. This is then usually investigated by an ultrasound and removal of any fluid that may have accumulated and sending it to the lab to test for specific markers that may indicate that there is ALCL present. If you are concerned about the implant. You should seek the opinion of a board certified plastic surgeon in order to determine the next step. In my practice, I see many patients who are concerned about developing ALCL with their textured implants. Some women choose to leave them in and monitor for symptoms, and others request removal of the implants with or without replacement with smooth implants. However, you would need to be evaluated by a plastic surgeon, in order to figure out what the proper thing for you would be. Best wishes!

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Breast reconstruction

Breast Reconstruction

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Member Response:

I am sorry to hear that her surgery was not successful. Sometimes scars have to be revised. Some people tend to form hypertrophic (thick) or keloid scars at their surgical incisions. I would definitely seek the opinion of her original surgeon or another board certified plastic surgeon in order to see if a revision is necessary.

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Breast pain

Breast Augmentation

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Member Response:

Thank you for your very good question! Sorry to hear that you are experiencing the symptoms. Based on your description, it is hard to tell what may be causing these symptoms. You should definitely have your breasts examined by a board-certified plastic surgeon. After the examination, the appropriate steps can be taken. Best of luck!

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Is there a way to tighten/raise the outer corner of my eyes? (Other then botox)

Cosmetic Surgery

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Member Response:

Thanks for your question! Yes there are definitely other options besides botox. You may need surgery to give you a more permanent correction. Without seeing pictures it is difficult to say exactly what procedures you would benefit from. Please consult with a board certified plastic surgeon to see what you would benefit from.

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Botched surgery

Aesthetic Genital Plastic Surgery

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Member Response:

Thanks for your question. Without knowing more information, and examining your medical records, its hard to say why the incision opened up. There are things that can be done to fix this such as a scar revision. In addition, there are factors that can be controlled to prevent further complications such as stopping all nicotine products, and all medical issues such as diabetes is controlled. Please consult with a board certified plastic surgeon to go over all of your options.

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Fat Transfer Breast Augmentation & Nipple Piercings

Breast Augmentation

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Member Response:

Thanks for your question! Nipple piercings will be removed during surgery. They don't need to be removed permanently. Every plastic surgeon has their own different preferences, but my preferences are to leave out any nipple piercings for one month following surgery. Best wishes!

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Jen

Cheek Reduction

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Member Response:

Thanks for your question. Without seeing pictures its hard to say exactly what procedures you would benefit from. I would suggest visiting a board certified plastic surgeon to determine what if any procedures would be right for you.

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Dog bite chunk off lip

Skin rejuvenation and resurfacing

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Member Response:

Thanks for your question. At times, do bites leave worse scars than other types of injuries. If it is within a year of the date of injury you may be able to do steroid injections to soften this up. If that doesn't work I think you would benefit from a revision surgery. Depending on how big the area is; it may be able to be done in the office. Best wishes!

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Post Operative Care

Tummy Tuck

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Member Response:

This is a great question! I ALWAYS see my patients post op. I think that is the mark of a responsible surgeon. I think it is also just as reasonable to be seen by another surgeon in the same practice as well as well being see by a midlevel provider such as an NP / PA for some post op visits as long as they are working in close supervision with the attending surgeon. Be very wary of some of the practices out there that advertise a very low price "too good to be true price" I have had patients come from these places with horrible experiences where the first time they meet their surgeon is right before the operation and they don't see them post op. Best wishes!

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Facelift or Threadlift

Facelift

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Member Response:

Thanks for your question. Without seeing pictures, its impossible to recommend what procedures you would need to achieve your goals. There are many benefits and and drawbacks to a thread lift vs facelift. I am in the school of thought that a facelift is a better and more long lasting operation. Also you mentioned an overbite, you may also be a candiate to correct that with orthognathic surgery where the the a cut in the jaw called an osteotomy is made to move your jaw. Your first step should be to meet with a plastic surgeon that is board certified by the American Board of Plastic Surgery. Best wishes!

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Mini Arm lift

Arm Lift

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Member Response:

Thank you for your great question! Without examining you, it is impossible to determine costs. Costs for procedures depend on region, surgeon fee, OR Fee and anesthesia fee. Depending on your situation, it may be possible to do a mini arm lift in the office under local anesthesia. The same can be said about fat grafting to the hands. Both these procedures can be combined. Your first step is to. visit a plastic surgeon that is board certified by the American Board of Plastic Surgery. Best wishes!

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Surgery for a patient on Suboxone

Mommy Makeover

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Member Response:

Thanks for this question. I have operated on many patients with complex pain management regimens. I always work very closely with my patient's pain management doctors in order to come up with a game plan for post operative pain control prior to undergoing for surgery. Best wishes!

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Eye bags surgery

Eyelid Surgery

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Member Response:

Thank you for this great question! You would need to be examined by a board certified plastic surgeon first prior to figuring out what procedures are the correct ones for you. You may need something as simple as a filler or you may need what it's called a blepharoplasty which is a surgical procedure. Also, there are minimally invasive surgical options also present such as radiofrequency energy devices like an Acutite. And in person examination with a board-certified plastic surgeon, you will be able to determine what procedures are correct for you.

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Grants

Tummy Tuck

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Member Response:

Thanks for your excellent question! Also congrats on the weight loss! Losing that much weight is an amazing accomplishment! You will need to be examined by a board-certified plastic surgeon first, to see if you are healthy enough to undergo surgery. Based on what you are describing, Insurance may cover what is called a panniculectomy. With this, excess skin is removed, however Insurance will not pay for rectus abdominis plication which is part of a tummy tuck. Sometimes, this can be combined with insurance so part of the operation is considered cosmetic and part of it is considered insurance. In addition, to help defray the cost of surgery, you may want to look into being operated on buy a resident cosmetic surgery clinic at an Academic institution where they have a plastic surgery residency program. In addition, normally with this amount of weight loss, you may need several procedures to reach your goals

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Plastic surgeon in training

Tummy Tuck

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Member Response:

Thank you very much for this excellent question! Your best bet is to find a plastic surgery residency program at an academic institution that has a resident cosmetic clinic. Your surgery will be done by a chief resident in their final year of training under the guidance of a board-certified plastic surgeon. I would highly recommend against going abroad as one cannot guarantee safety standards. I have personally taken care of several patients who have gone abroad to either Mexico or the Dominican Republic and have returned with horrible mycobacteria infections that have required return trips to the operating room as well as several months of antibiotics. I would also highly recommend against advertisements that offer cosmetic surgery at a deep discounted price as you get what you pay for. By having your surgery performed through a resident cosmetic surgery clinic, You will get cost savings while not compromising your safety. Best wishes

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How to overcome irrational fear of dying from anesthesia or surgery?

Rhinoplasty

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Member Response:

Thank you for your very important question. Undergoing surgery of any type can be very nerve-racking. It is normal to feel some nervousness prior to any procedure. I always tell my patients that there is no such thing as a minor surgery. If you feel that you have irrational fears, you may benefit by being seen by psychologist or psychiatrist to help get through this. I agree with my other colleagues, and unless this is dealt with and treated, I would not recommend undergoing any elective surgery. Going to a board-certified plastic surgeon Will help ensure that your surgery is done in the safest manner possible and the highest standards of safety are adhered to. In addition, make sure that a board certified anesthesiologist is present for any anesthesia administered and the surgery is performed at a facility that is accredited by your state, Medicare and/or AAAA. All of these things further ensure safety. Best wishes!

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Zygomatic Minor

Cosmetic Surgery

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Member Response:

Thank you for this question. There could be many things going on here that is causing this. You would need a full evaluation by a plastic surgeon that is well versed in facial reconstruction. Depending on what the root cause of the problem is, a surgical plan if necessary can be formulated. Please consult with a board-certified plastic surgeon or board-certified ENT. I would not put this off and get evaluated soon. Best wishes!

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Belly Button

Wound Care

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Member Response:

Thank you for your question. Without examining you, and reviewing medical records of what was performed prior; it is impossible to determine what the exact problem is and what needs to be done if anything to correct it. Since your last procedure was only done two weeks ago, it is too early to determine what the final results of your latest procedure Will be. I would suggest continuing to follow up with your plastic surgeon and follow all of their instructions very carefully. Also, it is very important to keep the line of communication open with your plastic surgeon and let your surgeon know of any trouble your having and if anything doesn't look were seem right. Best of luck!

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Are surgeons comfortable with removing nipples from a male???

Cosmetic Surgery

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Member Response:

Thank you for your question. Nipple reduction surgery is something that is performed on Male patients. I would call a board-certified plastic surgeon and asked them if they have experience in performing this procedure. In addition, without examining you, it is impossible to determine what the proper procedure for you would be. You also have to be evaluated to make sure that you do not have gynecomastia.

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Breast Reduction after nursing

Breast Reduction

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Member Response:

Thanks for your question! For best results, I always recommend waiting three months after you have stopped nursing in order to proceed with the breast reduction. In addition, please be aware that if you plan to have another child, please note that you may have decreased milk production after a breast reduction. Best wishes!

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2 part surgery

Breast Augmentation

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Member Response:

Thank you for your question! Without examining you it is difficult to determine if you are a person that would need eight two part of operation. There are times where I recommend splitting the augmentation and breast lift. This is for patient safety. This is what your surgeon maybe suggesting. It is reasonable to split the procedures. My reasons for splitting the procedure is in massive weight loss patients where the nipple has to be raised more then 10 cm or in patients who desire to have a very large implant where it would be unsafe to perfrom a lift and an augmentation at the same time. Best wishes and make sure your surgeon is board certified by the American Board of Plastic Surgery

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From a non-binary person: Making already small breasts smaller? B to A cup?

Breast Reduction

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Member Response:

Thanks for your question! Yes it is possible. It is best to meet with a board certified plastic surgeon for an in person consultation so that it may be determined what the correct type of incisions to use for this may be. You may be able to do this with a circumvertical "lollipop" style breast reduction or may need the wise pattern or "inverted T" style reduction. Best wishes!

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Injections just dont work

Lip Augmentation/Enhancement

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Member Response:

Thank you for this very wonderful question. Sometimes if you don’t see an effect the filler may be injected in the incorrect place such as injecting too deep. Is a plastic surgeon doing your injections? Other options for lip augmentation are using a silicone lip implant which an be done in the office. In addition, fat grafting can also be done which is more permanent. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Where do I even start for research?

Body Contouring

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Member Response:

Thank you for this excellent question. A great place to start is using the Find A Surgeon tool on this website. ALl of the surgeons listed here are Board Certified by the American Board of Plastic Surgery and are members in good standing with the ASPS. In addition, you need to find a surgeon that will safely help you achieve your goals. You may have to meet with a couple of surgeons before you find the one that is right for you. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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BBL

Buttock Lift with Augmentation

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Member Response:

Thanks for your question. Those meds do not preclude you from having surgery. However, there may be other things in your medical history that may or may not make you a good candidate for surgery. In addition, medications that increase risk for surgery are blood thinners as they can make you bleed after surgery as well as other medications that can increase the risk of blood clots such as DVT from forming. Please visit with a board certified plastic surgeon to to see if you are a good candidate for surgery and to figure out which procedures are right for you to achieve your goals

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Would a breast lift help with my back pain?

Breast Lift

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Member Response:

Thank you for this very great question. The cause of your back pain may be due to large breasts or it may be due to other issues such as problems with your spine. Most patients do report that they do get relief of back pain after a breast reduction but it is hard to say how much relief you will get. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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How long should I wait

Breast Augmentation

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Member Response:

Excellent question! It is usually up to the preference of the surgeon. My personal preference is that I wait a minimum of 2 months between surgeries and sometimes longer. Before proceeding to the next surgery, it is important to make sure that you have fully healed from the first surgery. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Curious about a lot of procedures, unsure where to begin.

Liposuction

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Member Response:

Thanks for your question. At your current height and weight your BMI is a 54 which puts you at increased risk for complications of surgery such as DVT/PE and wound breakdown. I think your best bet is to lose weight either on your own or with the help of bariatric surgery. Once you are at your goal weight, your risk profile improves for surgery and the cosmetic outcome is also better. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Liposuction or Tummy Tuck

Liposuction

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Member Response:

Hi Katie, Thanks for your excellent question. Without examining you it is impossible to tell what procedures would be proper to achieve your goals. It depends on your skin quality and if you have rectus muscle diastasis if you have had children. I am in Wall township not too far from Berkeley Heights, I would be happy to provide an in person consult. If you are interested please email or call my office. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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surgeon disappeared for a month i have complications

Facelift

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Member Response:

Really sorry to hear of your predicament. I would ask who the surgeon's covering doctor is while he is away and request an appointment with the covering physician. If you feel that you are having a medical emergency related to this, then seek medical attention at an emergency Room. Best wishes.

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Very Old Hard Breast Implants

Breast Implant Removal

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Member Response:

Sorry to hear of your situation. There are many fine teaching institutions i the greater Houston Area that have plastic surgery residency programs. You may be able to get into a charity clinic at these institutions such as Baylor, UT Houston, or Methodist. I would call the plastic surgery depts at these hospitals and see if they have such clinics where you can get evaluated by the plastic surgery resident team. You will be in good hands under the care of a resident team as a chief resident who is about to graduate usually performs the surgery under the guidance of a board certified plastic surgeon. Best wishes!

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Breast lift and reduction

Breast Lift

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Member Response:

Thank you for this excellent question. When a breast reduction is performed, you also get a breast lift at the same time. Excess breast tissue is removed, and the nipples are placed in the proper aesthetic position. The procedure that would be best for you can only determined after and in person consultation. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Eyelid Droop

Botulinum Toxin

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Member Response:

Thanks for your excellent question. Sorry to hear that your eyelid is dropping. Sometimes a prescription eyedrop can be prescribed to stimulate a muscle to help lift the eyelid in these cases. You still may not get full relief. Botox usually lasts 12 weeks. You may or may not see some relief by your wedding Please consult with a board certified plastic surgeon to determine what the appropriate course of action will he for you. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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labia minora torn during childbirth

Aesthetic Genital Plastic Surgery

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Member Response:

Thanks for this excellent question. Yes this can be fixed and the procedure is called a labiaplasty. This procedure is also frequently done for cosmetic reasons as well. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes! 📱Facebook: rahulvemulamd 📸 Instagram: rahulvemulamd Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Looking deformed after (medical) surgeries.

Panniculectomy

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Member Response:

Thank you for this excellent question. First of all, sorry that you are experiencing these symptoms. As far as panniculectomy is concerned many insurances have it as a plan exclusion, do you need to read the fine print. Even if it’s not an exclusion, the criteria is usually very strict such as the pannus has to be hanging several Cm below your pubic bone, you must have failed conservative therapy under the guidance of a dermatologist. Please consult with a board certified plastic surgeon to determine if your plan indeed covers panniculectomy and if you would meet the criteria to have it covered by insurance. Best wishes!

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Excessive weight gain during pregnancy

Tummy Tuck

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Member Response:

Thanks for your question. Unfortunately insurance companies do not consider this medically necessary and will not cover the procedure. In some circumstances, Insurance companies will cover a panniculectomy which is removal of skin below the belly button. However, you must meet strict criteria for this and this is usually done for people who have lost a massive amount of weight either through Bariatric surgery or on their own. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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How much will it cost to remove my back neck fat

Liposuction

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Member Response:

Thank you very much for your question. Without examining you and seeing pictures it is impossible to give a price range. You may be a candidate for liposuction or you may need a surgical excision of the excess skin and fat. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Tummy tuck vs Liposuction

Tummy Tuck

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Member Response:

Thanks for your great question. You need to be examined to determine what procedure is correct for you. In addition, liposuction is safe. Unfortunately the deaths you have most likely heard of are due do unqualified practitioners performing liposuction who have taken weekend courses and not properly trained. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Costs

Liposuction

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Member Response:

Thanks for your question. It depends on the area. I see that you are in NJ many of us here in the area charge a consultation fee. My office is in Wall, NJ not too far from where you are. If you are interested in a consult, I’ll be happy to waive the consult fee. Please email me; contact info below. Best wishes!

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Capsule contracture

Breast Augmentation

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Member Response:

Thanks for your question. Unfortunately this rarely happens that one develops a capsular contracture this early. Insurance does not cover this to fix it. Depending on which implants you have, a portion of the surgical cost to correct capsular contracture may be covered. However, you may still have an out of pocket cost. My method to correct this is to remove the implant as well as the capsule. This can also happen again. If someone has recurrent capsular contracture several times, then I would consider taking out the implant and leaving them out for several months. I also send cultures at the time of surgery. Please visit your plastic surgeon to go over all of your options.

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Aspen Technique as alternative to surgery

Breast Implant Revision

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Member Response:

Thanks for your question. I believe that there is currently a trial for Grade 3 capsular contracture but to my knowledge this hasn’t been proven to be effective for higher grade capsular contracture such as grade 3 or 4. If you go this route please know that you may not get any relief and will have spent a lot of money on this

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Age

Breast Augmentation

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Member Response:

Excellent question. You should be done with puberty and breast development should what is considered Tanner Stage 5. In addition to your body being ready, another equally important aspect should be that you need to be mentally ready and be mature enough for breast implants. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Boob job on one side?

Breast Reduction

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Member Response:

Thanks for this excellent question! It definitely is possible to get operated only on one side to achieve more symmetry. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Breast Fat Transfer Health Risks

Breast Augmentation

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Member Response:

Thanks for your excellent question. The changes that are seen from fat grafting appear a specific way on breast imaging and specifically trained breast radiologists are able to distinguish between calcifications that are benign vs potentially malignant. Having said that, if there is any question, this may lead to you having more imaging such as MRI’s or increased number of breast biopsies as well. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Fat Transfer + Breast Lift

Breast Lift

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Member Response:

Thanks for your question! Yes, fat can be harvested from multiple locations. On average with each session of fat grafting, you retain scout 40-60% of fat that’s grafted. You may need multiple sessions to achieve your goal. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Would I be a candidate?

Breast Reduction

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Member Response:

Thanks for your question. If you are generally in good health you should be a good candidate for breast reduction. Most patients also have questions regarding insurance coverage. This depends on your specific plan. Make sure you read the fine print as some plans have exclusions where they won’t cover breast reductions or have very strict criteria. Your next step should be to consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Asymmetric jawline

Cosmetic Surgery

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Member Response:

Thank you for this excellent question and thanks for the pictures! First of all hard to say why you have this. You could have just been born that way or if you had any traumatic injury to the face, this can cause asymmetry as well. If you feel the asymmetry is getting worse over time, it could also be a very condition called Parry-Romberg disease To correct this I always start with injecting an HA filler like voluma to correct. This however is not permanent and will need repeat treatment in 2-5 years. Another option is a silicone implant to permanently correct the asymmetry Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Best Fat Removal Procedure

Liposuction

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Member Response:

Thanks for your question Your husband would need an in person consultation with a plastic surgeon to determine which procedures are best for him. He may be a candidate for liposuction, Abdominoplasty or both. Also he may need to lose more weight prior to any procedures as men tend to carry a lot of their fat intrabdominally around the internal organs. That fat cannot be removed. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Extrusion

Breast Implant Revision

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Member Response:

Thanks for your question. Once an implant becomes exposed it must be removed. If you have had radiation, you are at greater risk for implant exposure and extrusion. If my radiated patients with an extruded implant, I do not put anything in back as the same time. I would wait a minimum of 3 months prior to restarting reconstruction. Best wishes!

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Risk of exposure

Breast Implant Revision

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Member Response:

Thanks for your question: If you feel that your implant is too big or feel that it is at risk for exposure then I would visit your operating surgeon for all of your options. After a mastectomy and subsequent tissue expansion the skin is very thin and implants have a tendency to become visibility and have ripples. This necessarily does not means it’s at risk for extrusion. In a case like this, I would give my patients the option of fat grafting, to decrease implant visibility or if they are a candidate for a tissue based reconstruction, I would offer them a procedure such as a DIEP flap and get rid of the implant all together. Best wishes!

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Age

Breast Augmentation

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Member Response:

Thanks for your question! Age is only one aspect to determine if you are a candidate for breast implant surgery. Your overall health matters too. I have patients that are in their 70’s that are healthier than some of my patients in their 50’s. Your first step is to meet with a plastic surgeon to see what procedures you would need to achieve your goals. Then also need to consult with your primary care physician to make sure you are healthy enough for surgery and are optimized for surgery Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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

Breast Reduction

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Member Response:

Thanks for your question! There is no age limit to do the breast reduction, however you should be completed with breast growth which is also called Tanner stage 5. Once you visit a plastic surgeon, it can be determined if a reduction is the correct procedure for you and the timing of it. You can possibly even get insurance coverage depending on your specific plan. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Body contouring for Post-Op Gastric Sleeve Patient

Body Contouring

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Member Response:

Excellent question! One we get asked all the time. It is definitely possible to do all of those procedures at once, however I wouldn’t advise it. I limit my cosmetic surgeries to no more than 6 hours under anesthesia. You should probably split the surgeries into two or 3 surgeries. I would pick the procedures that are the most important to you. In addition, be wary of some places that advertise that they can do all of this at bargain basement prices. You get what you pay for and can end up with severe complications. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Breast Reconstruction after double mastectomy

General Reconstruction

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Member Response:

Thanks for your question. One breast suddenly becoming larger and more painful a couple of months after your surgery is definitely not normal. It is hard to say exactly what is going on without examining you. I suggest that you make an appointment to see your plastic surgeon as soon as possible. Best wishes!

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Glue removal

Tummy Tuck

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Member Response:

Sorry to hear about your husband. Condolences to you and your family. As far as the glue, without seeing a picture it is hard to say exactly what you have over your incision. I usually use dermabond prineo over all of my incisions which is a combination of glue and tape. I leave this on for 3 weeks prior to taking it off. Please consult with the plastic surgeon that performed your procedure for their specific protocol Best wishes!

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Soft capsules

Breast Augmentation

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Member Response:

Thanks for your question. Anytime any type of implant is inserted into the human body, the body produces a capsule around the implant as a protective measure. A soft capsule is actually a good thing. Sometimes when the capsules become too thick, it can deform the appearance of the breast and cause pain. This is called capsular contracture. If you do not like the appearance of your breasts you can visit your plastic surgeon to see what options you have for revision. Long term, chances are that your capsules will remain soft, however, there is always a chance that in the future you can develop capsular contracture. Best wishes!

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Fat injections in cheeks

Cheek Reduction

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Member Response:

Thanks for your question. How long ago did you have these injections? If it was very recent, please note that on average 50% of fat that is injected anywhere gets absorbed by the body within 6 months of injection. Also immediately after injection, you may have some swelling as well. If you are more than 6 months from the time of injection still have an unsatisfactory appearance, I suggest you visit your plastic surgeons for options. I do agree with my colleagues here that in this scenario, you would benefit form removal with either buccaneers fat pad removal or micro liposuction. Best wishes!

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Cost of proceedurre

Breast Augmentation

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Member Response:

Thanks for your question. It is a little vague from your description. There are some nipple revisions that can be done in the office if minor and if they are more extensive it needs to be done in the operating room. Without examining you, it is difficult to provide answers on price. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Pro bono

General Reconstruction

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Member Response:

Thanks for the question. I think your best bet is to go to an academic medical center with a plastic surgery residency training program that may be able to do the surgery at reduced or no cost. Best wishes!

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ISO surgeon who specializes in breast reduction

Breast Reduction

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Member Response:

Thanks for your question. Breast reduction is a common procedure that most plastic surgeons perform. I am on the Jersey shore in wall township, and more than happy to provide a consultation. Please call my office to set up an appointment. Best wishes!

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Implant and scar revision

Breast Implant Revision

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Member Response:

Thanks for your question. I think at 2 months from the procedure, it is a little too early discuss revision. I wait a minimum of 3 months before any revision if needed, but preferable to wait 6 months. It’s always good to voice your concerns to your surgeon. In addition please follow your surgeon’s post operative instructions as directed. Best wishes!

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Belly Button Revision

Cosmetic Surgery

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Member Response:

thanks for your question. Unfortunately this does occasionally happen after a tummy tuck. The procedure you need is called an umbilicoplasty. Often times this can be done in the office. This is not covered by insurance and there will be an out of pocket cost to this. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Fat transfer with low body fat

Breast Augmentation

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Member Response:

Thanks for your question, On average about 40-50% of fat that is injected gets absorbed by the body. From the body type you are describing it seems like you may not have enough fat to go up two cup sizes. It may best to supplement any fat grafting with a small breast implant. Without examining you, it is impossible to say what procedures would be best. Also note that liposuction in people with an very low BMI who do not have much fat to begin has a higher chance of contour irregularities in the areas where fat is taken from Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Dental Implants and Tummy Tuck

Tummy Tuck

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Member Response:

I would like to echo my colleagues here and strongly advise you to not go abroad for these procedures. Some of the most horrible complications I have seen from cosmetic surgery have been from people who have gone to Mexico, & DR. Fixing a complication could end up costing you more than the original surgery. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Dangerous

Mommy Makeover

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Member Response:

Thanks for your question. If you are not healthy enough for surgery such a procedure can be dangerous. If you are a proper candidate for surgery, a surgery such as you are describing can be done safely in the right patients with an experienced board certified plastic surgery performing the operation. For a procedure like this my criteria is BMI less than 32, non smoker, non diabetic or Hgba1c under 7 if a diabetic, no Major medical problems such as cardiac or lung disease. Also limit surgery to no more than 6 hours under anesthesia. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Waxing after surgery

Tummy Tuck

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Member Response:

Thanks for your question. This is generally left up to when your surgeon clears you. My criteria is that I don’t allow for anything like this until all the incisions are completely healed and my patient is released to full activity; this happens around 6 weeks. However if any open wounds are present, a procedure like waxing should not be Done with open wounds. Please consult with your operating surgeon for their instructions Best wishes!

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Breast Plant Exchange

Breast Augmentation

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Member Response:

Thanks for your question. If your surgeon is just removing the implants and not re-inserting them, it’s reasonable to do that in the office. However, if the surgeon is planning on replacing the implants at the same time as the removal, I personally would not do it in an exam room in the office. I would do it in an operating room setting. If your surgeon has a certified OR in the office, make sure it’s being done in the OR under the most sterile conditions possible. Best wishes!

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Ulthera an option?

Eyelid Surgery

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Member Response:

Thanks for your question! Without examining you, it is impossible to say what procedures are needed to reach your goals. In general, surgical procedures will give a better result. Non surgical modalities such as ulthera only provide subtle improvement and may need to do it multiple time to get results close to surgery. This can end up being more expensive than surgery Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Breast

Mommy Makeover

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Member Response:

Excellent question! A mommy makeover is a general term used for improvement of the breasts and abdomen. It generally involves an abdominoplasty ( tummy tuck) with a breast procedure. Depending on your particular anatomy, for the breasts you may need a breast reduction, mastopexy ( breast lift), just breast implants or a lift with implants. The operation is tailored to meet your specific goals. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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3 breast augmentation—still problems

Breast Reduction

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Member Response:

I am sorry to hear of your situation. Surgeries to remove implants are considered cosmetic. Please also be aware that after removal of implants your breasts will be significantly flatter than they are now. My experience is many patients request a secondary procedure such as a breast left for cosmetic improvement . As far as financial assistance, you may be able to go to a chief resident cosmetic surgery clinic at a plastic surgery residency program to have a lower cost of surgery. I would also strongly advise you from going outside the country as the standards for surgery are not the same as the United States. Best wishes!

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Tummy tuck issues

Tummy Tuck

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Member Response:

Sorry to hear you are having this issue. I would return to the surgeon that performed the procedure for a physical examination. Your surgeon may order additional testing such an ultrasound or CT scan to see if there are any fluid collections that can be causing these problems. You may need revisional surgery. However, one step at a time. First visit the original operating surgeon. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Stuck

Body Contouring

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Member Response:

Thanks for your question. Without pictures and examining you it is impossible to tell if you would be a candidate for coolsculpting. Coolsculpting is a non invasive fat removal device where fat cells get destroyed by the body over several weeks after treatment. You may need additional treatments to achieve your goals. Another option may be liposuction which can get rid of unwanted fat. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Scar Tissue keeps opening

Tummy Tuck

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Member Response:

Thanks for your question. You would need to be examined by a plastic surgeon first to make sure that you don’t have any hernias near your incision. The scar can be revised. Since you have open areas, it is possible to get insurance coverage. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Fat transfer

Breast Augmentation

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Member Response:

Thanks for this question. This is actually a very common question that I get asked all the time by my patients. The answer unfortunately is no. Even though family members are genetically related, another person’s fat would be recognized by your immune system as your body being under attack and the your body would reject any transplanted fat. People with organ transplants avoid this by taking medication to suppress the immune system. Best wishes!

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Am I a candidate for a breast reduction?

Breast Reduction

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Member Response:

Thanks for your question. Based on what you are describing you seem to be a good candidate for a breast reduction. But you most get examined first. I always tell my patients of child bearing age the following: you may have decreased milk production or have the inability to lactate. You may need another cosmetic procedure at some point in the future given your young age. This also may be covered by insurance if you do not have a plan exclusion for breast reduction . Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Diastasis Recti repair

Tummy Tuck

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Member Response:

Umbilical hernias can be done by both plastic and general surgeons. Especially those of us who are double boarded in general and plastic surgery are usually comfortable in handling this. The rectus diastasis repair is generally done by plastic surgeons. Medicare should cover the umbilical hernia, however the rectus diastasis is considered cosmetic and not covered by insurance. Please use the find a surgeon feature on this website to find a board certified plastic surgeon in your geographic area. Best wishes!

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Can I go super small

Breast Reduction

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Member Response:

It is possible to go extremely small. This involves removing the majority of breast tissue. Based on your body habitus going extremely small may not give you symmetry and may be out of proportion to your body type. After an in person consultation, the proper size can be determined. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Gynecomastia with incision under nipple only(no liposuction)

Breast Reduction

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Member Response:

Thanks for this great question. If you will be flat depends on the quality of your skin, if you have skin that is sagging, stretch marks, and the nipple areola complex is hanging low below the fold (ptosis) you may need a skin excision procedure as well. This is my experience with weight loss patients . Many of my weight loss patients main concern is that they no longer have a female appearance to the breast but have a sagging and deflated skin that does not go away with diet and exercise Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Calf augmentation

Body Contouring

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Member Response:

Calf augmentation can be done with either fat grafting, implants or a combination of both. There are advantages and disadvantages to both methods. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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panniculectomy-

Tummy Tuck

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Member Response:

Thank you for your question. It is hard to determine which procedure would be the best for you without examining you. In addition, either a panniculectomy or Abdominoplasty will have the best results when you have lost as much weight as possible and your diabetes is controlled. My criteria for any elective surgery is BMI of 32 or less and Hgba1c < 7 for diabetics. Please consult with a board certified plastic surgeon to determine which procedures are best to achieve your goals. Best wishes!

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Breast uneven

Breast Augmentation

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Member Response:

Thank you very much for your question. Some asymmetry at this time is completely within normal limits. Without examining you, it’s hard to determine what if anything should be done. I would like to echo my colleagues on here and it’s best to visit your operating surgeon for advice Best wishes!

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capsular contracture

Breast Augmentation

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Member Response:

Sorry to hear that you may have capsular contracture. In order to determine if you really have a capsular contracture, you need to be examined. Please return to the surgeon that placed your breast implants for an evaluation. If you’re capsular contractor is very severe, you may need removal of the implants in caps in order to determine if you really have capsular contracture, you need to be examined. Please return to the surgeon that placed your breast implants for an evaluation. If your capsular contractor is very severe, you may need removal of the implants and capsules Best wishes!

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Scar revision

Body Contouring

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Member Response:

Thanks for this very excellent question. The scar can definitely be revised. You need to be examined to figure out how to best revise. At times some people opt to combine the revision with other procedures such as liposuction or a tummy tuck. Please meet with a board certified plastic surgeon who can determine what procedures are best to achieve your goals.

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Cleavage Augmentation

Breast Augmentation

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Member Response:

Thanks for your question. Without examining you, it’s hard to give you a definitive answer. However, in order to improve the appearance of your cleavage, you would probably benefit from fat grafting, +/- implants. Please consult with a board certified plastic surgeon who will be able to best assess the proper procedures to achieve your goals

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Diabetes

Rhinoplasty

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Member Response:

Thank you for your excellent question. The biggest issue with diabetics is delayed wound healing. My criteria for any elective surgery in diabetics is to have the hemoglobin a1c (Hgba1c) under 7. That will greatly improve the risk profile for surgery. It is best to follow up with your primary care doctor and / or endocrinologist to make sure your diabetes is well controlled prior to surgery. Best wishes!

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To begin

Arm Lift

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Member Response:

Thank you for your excellent question. It’s hard to give you an answer without fully examining you first to see the extent of your excess skin. Following this we can formulate a plan to best achieve your goals. The price for a surgery depends on 4 things: 1.) surgeon fee 2.) anesthesia fee 3.) operating room fee 4.) cost of any implants such as breast implants It is very important to consult with a plastic surgeon board certified by the American Board of Plastic Surgery to ensure that you get the highest level of quality and safe care. Best wishes!

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Price

Rhinoplasty

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Member Response:

Thanks for your question. It’s hard to answer that without examining you. Price for cosmetic procedures consists of three things, the surgeon fee, Operating room fee and anesthesia fee. This can vary widely depending upon the surgeon and the facility. Once you have been examined by a board certified plastic surgeon, you can will have a better idea of what price you are looking at Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Mom life

Body Contouring

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Member Response:

Thanks for your question. There are many procedures such as a tummy tuck, breast lift and liposuction and fat transfer to the buttocks to help achieve your goals. However, at a weight of 255, it would be best if you can get your BMI down to 32 or under to make all these surgeries safe. Once you achieve your weight loss goals, you can then safely proceed to surgery with a board certified plastic surgeon Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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I Still look Pregnant but I am not

Tummy Tuck

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Member Response:

Thanks for your question. Without performing a physical exam on you it’s hard say what is going on. I would advise you to meet with a board certified plastic surgeon to ascertain exactly what the problem is and come up with a plan to fix it. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Age limits

Tummy Tuck

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Member Response:

Thanks for your questions. I don’t have any age limits and look at the overall health of a person to see if they are healthy enough for surgery. Thinks like obesity, smoking, uncontrolled diabetes, heart disease may preclude you from surgery. For example, I have patients who are in their 60’s and early 70’s who are healthier than some of the 50 year olds I take care of. Please consult with a board certified plastic surgeon to see if you are a good candidate for the type of surgery you seek. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Lip reduction surgery

Lip Augmentation/Enhancement

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Member Response:

Sorry to hear this happened. Please consult with a plastic surgeon board certified by the American board of plastic surgery to go over all of your options Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Pain killers

Breast Reduction

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Member Response:

Thanks for huge question. I usually use a long acting medicine called experel which is injected into the tissues at the time of the breast reduction. This should last anywhere from 24-72 hours to provide pain relief. Afterwards I did prescribe my patients a low dose opioid such as Tylenol # 3. However most patients don’t even end up taking this and are able to manage their pain with Motrin and Tylenol. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Scar revision

Facelift

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Member Response:

Thanks for your question. Depending on how bad the scar is, we may be able to do it under local anesthesia in the office. My office is not too far from you, if would like to come in to discuss Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Surgery

Mommy Makeover

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Member Response:

Thank you for this question. I agree with all my colleagues here A couple of tips 1.) do not go outside the country especially to places like Mexico and the Dominican republic, they don’t have the same safety standards as the United States 2.) choose a surgeon that is board certified by the American Board of plastic surgery. Surgeons you find using the surgeon finder on this website ensures that they have met this standard 3.) choose a surgeon who you feel comfortable with. Even though someone is board certified, you may not mesh well with that person. This should be a partnership between you and your surgeon Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Ok doctors! I had the gastric sleeve 4 and half months ago. Im down to what is where i should stay a

Breast Lift

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Member Response:

Thank you for your question! Most people take anywhere from 12 to 18 months after the gastric sleeve to stabilize with wait. Before operating, one would want to make sure that you are stable with a wait for at least six months. If you get surgery today and you lose a lot more weight over the next six months or so, you may be unhappy with the results of surgery and may need to have it done again. It’s better for you to wait so that is done right way. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Empty Nose Syndrome

Rhinoplasty

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Member Response:

At your consultation and pre operative visits your surgeon will go over exactly what procedures are being done and obtain your consent. A procedure that you do not consent to cannot be done legally. If you have a discussion with your surgeon regarding all of your concerns, and it is discussed in detail exactly what procedures will be done before hand I do not think you will have anything to worry about. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Thigh and abdominal skin removal after extreme weight loss

Body Contouring

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Member Response:

Hello thanks for your question. Yes they can be performed st the same time. However I usually approach my patients in the following way. I perform the abdominal skin removal first and at the same time liposuction the thighs. Following this, I come back 6 months later to perform a thigh lift. Cost varies by region and surgeon and the three fees you are looking at are surgeon fee, anesthesia fee and OR fee. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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MRI

Breast Augmentation

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Member Response:

Thanks for your question. Your PCPcan write for the MRI as well as your ob / gyn. You can also find another plastic surgeon that is willing to take over your care that can also order the MRI. I also strongly encourage you to have routine breast cancer screening with mammograms. When you go for your mammograms be sure to tell your mammo technician that you have implants so that they can perform and implant displacement technique to do the study. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Penis surgery

Gender Affirmation Surgery

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Member Response:

Thanks for your question! As of right now penis transplant is a Procedure that is only done at select transplant centers around the world. Only a handful of procedures have been done and not mainstream. In addition I believe that the only people that the procedure is being offered to right now are people who have lost their penis due to Trumatic injuries. In addition people who undergo a transplant need to take antirejection medication for the rest of their lives and there is still a chance that the body can reject the transplant. Also prior to any type of transplant, extensive testing to make sure the tissue of the donor and recipient are a match so an organ won’t be rejected For right now, the best option would be to have a penis made using a radial forearm free flap or an anterolateral thigh flap performed by a plastic surgeon that this well versed in transgender surgery. What you propose of a living donor penis transplant may not be a reality for decades. Best wishes

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Capsular Contracture

Breast Reduction

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Member Response:

Thank you for your question. I am seeing more and more of people like your mother who have had early generation implants with severe capsular contracture. Unfortunately there is no effective non surgical treatment. Effective treatment consists of removal of the implants and capsules. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Fat transfer

Body Contouring

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Member Response:

I tell my patients not to put any pressure on the buttocks for 3 weeks after the procedure which includes sitting. Where the fat is taken from May be sore for several months and swollen as well and this will improve over the course of a few months. Most people are able to resume all of their normal activities by 6 weeks. Best of luck! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Am I too old?

Liposuction

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Member Response:

Age by itself does not exclude you as a candidate for surgery. When determining who is a candidate for surgery, I look at the bigger picture and look at a person’s overall medical condition. I would advise you meet with a board certified plastic surgeon to assess what procedures would help you achieve your goals and also meet with your primary care physician to make sure any and all medical conditions are optimized prior to surgery. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Lips

Lip Augmentation/Enhancement

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Member Response:

Thanks for your question. Lip augmentation / enhancement is a very broad topic. There are many ways to augment lips including injectable filler such as juvederm, fat grafting and lip implants. I usually start with injectable filler so one can see if they like how the enhancement looks and then decide if they want a more permanent solution. Depending on what filler is used and how much of it is used you are looking at at least $450+ Please meet with a board certified plastic surgeon to see what options are right for you. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Keloid removed

Body Contouring

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Member Response:

If you have had the keloid removed or injected and it is already recurring, You may want to ask your surgeon about having it removed followed by low dose of radiation therapy. In my experience when doing it this way, there is a 90% success rate. Insurance may also cover this. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Reconstruction

Breast Augmentation

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Member Response:

Reconstruction can be performed at the same time as the prophylactic mastectomy. There are two main ways to reconstructive breast, one is to use implants and the other is to use your own tissue. There are advantages and disadvantages is to each type. I would recommend meeting with a plastic surgeon who does all aspects of breast reconstructive surgery to figure out what is the best method for you. Also please note that reconstruction is rarely involves one operation and you may need multiple procedures to achieve your goals. Breast reconstruction is a big part of my practice and I make sure all my patients understand all their options. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Can I have implants after oncoplastic surgery for DCIS?

Breast Augmentation

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Member Response:

Thanks for your question! It is possible to have implants later. However since you will most likely be getting radiation after your oncoplastic procedure, this can lead to a higher incidence of complications with implants such as capsular contracture. Another option to increase the size of your breasts if you need is fat grafting. Best wishes Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Removing tattoo

Tattoo Removal

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Member Response:

Thanks for the question. It can usually take 6-10 laser treatments to remove a tattoo. It depends how large the surface area is the tattoo is and how many different colors. If it is only one color than only one laser can be used. Cost varies by type of laser used and region. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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General price

Body Contouring

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Member Response:

Thanks for your question. This is a procedure that can be done in the office under local anesthesia. Cost for in office procedures vary by region. I would call plastic surgeons in your area to see how much they charge. Your surgeon will also send this to the pathology lab. There will be a charge for that as well, but if you have insurance it may cover the lab costs. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Consultation costs

Breast Augmentation

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Member Response:

Thank you for your question! Costs will vary from different regions and what you are seeking a consultation for. For cosmetic, some surgeons will offer complimentary consultations or a small fee for consultation which can be applied toward a procedure. For insurance cases you may have to pay a co insurance or deductible. Call some offices to see what their policy is. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Weight

Breast Reduction

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Member Response:

Thanks for your question! Everyone has a different body type. How your skin responds after weight loss has a lot to do with your skin quality. If your skin is stretched out and has a lot of stretch marks chances are your skin will become saggy and will not shrink back. If you do not have a lot of stretch marks your skin may shrink back. Once you are at a stable weight for about 3-6 months is the best time to visit a plastic surgeon. Best of luck with your weight loss! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Planning to recieve a reduction

Breast Reduction

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Member Response:

Excellent question! When doing a reduction, a lift is also performed. Your nipples will be placed in the proper position. Best of luck! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Surgery Abroad

Mommy Makeover

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Member Response:

Thank you for your question. Please consider not going outside the country. You don’t know what you are getting and you don’t know the standards. There are many complications and reported deaths from people going outside the country, especially to the DR and Mexico for surgery. Also all those procedures you listed, should be staged and not performed in one surgery Within the coming weeks I will be operating on a very beautiful girl that went to the DR for her surgery and now has avoidable complications. Best wishes! Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Scar Revision

Dermal Fillers

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Member Response:

Thanks for your question! From your description it seems like your incision may have been closed with staples that’s why you have that appearance. I think the best option would be to excise that scar and perform a more cosmetic closure. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Capsular Contracture??

Breast Augmentation

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Member Response:

Thanks for your question. It very well could be a capsular contracture. You will need to be examined by a plastic surgeon to to determine what is going on. Please consult with a board certified plastic surgeon to investigate this further and to determine the next step. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Surgery cost and payment

Mommy Makeover

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Member Response:

Thanks for your question. A mommy makeover which usually consists of an abdominoplasty ( tummy tuck) with a breast lift (mastopexy) with or without breast implants depending on your anatomy and goals. This is considered a purely cosmetic surgery and will not be covered by health insurance. The cost consists of three things, the surgeon fee, Operating room fee and anesthesia. Cost depends on region and operating surgeon as well as the type of implants used. Please meet With an ASPS member surgeon to go over all of your options for surgery. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Cortisone to fix lower eyelid malposition caused by scar; ectropion

Eyelid Surgery

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Member Response:

Thanks for your question. You have a condition called sclera show ( the white of the eye being more visible ) you may also have a condition called ectropion where the eyelid turns outward. You will need a revision surgery as a steroid injection won’t help in this situation. Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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BBL

Body Contouring

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Member Response:

Thanks for your question. Yes definitely makes sense what you are describing. In order to figure out what procedure is best for you, inplant or fat transfer please meet with a board certified plastic surgeon Rahul Vemula, MD - Plastic Surgery of the Face and Body Diplomate of The American Board of Plastic Surgery Diplomate of The American Board of Surgery Active Member, ASPS

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Breast augmentation with fat

Breast Augmentation

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Member Response:

thank you very much for this very excellent question! In order to do a breast augmentation with fat only , you must have none to minimal ptosis ( sagging of the breasts). If you are found to have ptosis then you would also benefit from a mastopexy (breast lift) at the same time as your augmentation. Please note that if you do fat only, you may need more than one session Of fat grafting to achieve your desired size. As far as where the fat is taken from, it can be taken from areas where there is excess fat that you find undesirable. Please consult with a board-certified plastic surgeon in order to learn all of your options regarding cosmetic breast surgery. Best of luck!

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Compression garment

Tummy Tuck

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Member Response:

Thank you for this question. Compression garments help prevent the formation of fluid collections also called seromas. It is very important to follow your surgeon’s instructions in wearing the compression garment

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Tummy tuck/ hysterectomy

Tummy Tuck

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Member Response:

Thank you for this question. There are many ways that hysterectomies are performed. You would need to ask your gynecologist the way the hysterectomy is being performed. Regardless of the way your hysterectomy is performed the tummy tuck can still be performed.

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Visceral Fat

Tummy Tuck

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Member Response:

Thank you very much for this excellent question. Visceral fat is the fat this is in and around your internal organs. This cannot be removed. Only way to remove it is to remove your internal organs. For my patients with visceral fat I suggest that they lose weight first before any cosmetic procedures. Sometimes it may help to have bariatric surgery to lose weight. Best wishes!

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Payment Options

Mommy Makeover

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Member Response:

Sorry to hear about your credit situation. For cosmetic surgery procedures, it is customary for Payment to be made in full before the surgery is performed. One option I would suggest to you for your surgery is to split it into multiple surgeries. For example pick which procedure is the most important to you and do that one first. This way you can stay within your budget and get the surgery done that you want. Another option is to go to a resident run clinic at at plastic surgery training program to limit your costs. Your surgery will be done by a chief resident under the guidance of a faculty member who is a board certified plastic surgeon. With this you can still expect the highest quality of care with your surgery being done in a safe manner. Doing it this way however might case you to have a long wait for surgery as space is limited in these clinics. Please also be very careful of going out of the country. Standards are not the same as the US

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Breast procedure

Breast Augmentation

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Member Response:

Dear Molly Thank you very much for your question. There are many reasons that one breast can be larger than the other. If the reason is found to be a congenital anomaly, occasionally insurance will consider this reconstructive and may cover your surgery. However, it is advisable to meet with a board-certified plastic surgeon to go over all of your options. Even if your Condition is found to be reconstructed in nature your particular insurance plan may have an exclusion where they want to cover it. Unfortunately all insurances are not created equally and your plastic surgeon should be able to help you figure all of this out. As far as the cost associated with the surgery, it depends on the surgeons fee, anesthesia fee and operating room fee. This can vary a lot between different centers and different regions. Best of luck

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Breast Revision Recovery for body builder

Breast Augmentation

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Member Response:

Thank you very much for sharing your experience. I’m sorry to hear that you have been having so much trouble. You may want to consider switching the location of your implants to above the muscle. However, be aware that if the implant is switched to above the muscle and you do not have enough breast tissue to cover the implant, it may be visible. Please meet with an ASPS surgeon to Learn about all of your options for revision breast surgery

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I need a tummy tuck

Tummy Tuck

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Member Response:

Hi Shatona, Thank you for this question. A tummy tuck or an Absominoplasty is a cosmetic procedure which is not covered by insurance. In certain circumstances, insurance will cover a panniculectomy which is not a tummy tuck. For a panniculectomy, only excess skin is removed and muscle plication ( tightening) is not performed. And liposuction is not performed either. For a panniculectomy each insurance has different criteria for approval and some insurances also have a plan exclusion where they won’t cover it under any circumstance. Please call your insurance company for this. There care times where an operation can be done which is partly cosmetic and partly covered by insurance. Since we do not have pictures, If is difficult to let you know what procedures you will need to achieve your goals. Please meet with Ana ASPS member surgeon to discuss this. Best of luck!

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Will state insurance cover breast reduction for a 16 year old

Breast Reduction

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Member Response:

Thank you very much for this excellent question. Managed Medicaid plans differ from state to state with rules and criteria for covering breast reductions. I would call your insurance provider first to see exactly what your specific plan requirements are. In general most managed Medicaid plans follow Medicare guidelines set by CMS. For this it must be demonstrated and documented that reasonable attempts have been made to relieve symptoms such as neck and back pain. These include but not limited to pain medication, physical therapy, evaluation by an orthopedic surgeon, and weight reduction. You must also have grooving from your bra straps that is 1 cm deep. In addition, if you have skin rashes and infections underneath your breast folds which are worse in the summer months you may qualify. You must also be under the care of a dermatologist and must have documented failure of topical therapy for these rashes. You must also wait until your breast growth has been completed.

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What age should you get a nose job?

Rhinoplasty

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Member Response:

Hi Vivek thanks for your question. A nose job or rhinoplasty should not be done until full growth has been completed. Completion of growth can be assessed by taking an X-ray. Best wishes!

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Tattoo Excision

Tattoo Removal

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Member Response:

Hi Jessie Thanks for your question. The most common way to remove tattoos are by the use of lasers. It can take 6-10 treatments to completely remove the tattoo. In addition more than one type of laser is necessary If the tattoo is made up of different colors. It is possible to do a surgical excision of a tattoo however, this will leads a scar. To find a surgeon that performs Tattoo removal, use the find a surgeon tool on this website. You can be assured that any surgeon that appears on this website is board certified by the American aboard of plastic surgery. Best wishes!

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Pubiaplasty?

Tummy Tuck

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Member Response:

Sorry to hear about your experience this far. From what you are describing, it seems like there is still excess skin that needs to be removed and may be a candidate for an abdominoplasty. Without looking at pictures it is impossible to tell exactly what procedures you need. Please meet with a board-certified plastic surgeon to go over all of your options at this point. Best of luck!

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Is this price fair ? Tummy tuck, make breast

Tummy Tuck

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Member Response:

Dear Kyle, Thank you for your question regarding pricing of your cosmetic procedure. Pricing for cosmetic surgery usually includes the surgeon fee, Operating room fee and anesthesia fee. In addition there may be other fees involved such as for surgical garments, cost of any implants, and medications such as Experel. Many facility and anesthesia fees are also Usually charged by the hour. How many hours your surgery will take depends on the complexity of your surgery and as well as the experience of your surgeon. Surgeon fees can also vary depending on the experience of your surgeon, reputation. All of these fees can vary by the facility as well as the region the surgery is being performed in. Remember that surgery MUST be performed in a safe manner. I personally limit cosmetic surgery to no more than 6 hours of operating time. Also please ensure that your surgeon is board certified by the American board of Plastic surgery. Best of luck with your surgery!

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Surgery for Minors

Breast Reduction

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Member Response:

Hi Naja, Thank you very much for this excellent question. Yes minors (individuals under the age of 18) can get breast reduction. Before being considered for a breast reduction, breast growth must be completed and this is also known as Tanner Stage 5. Performing a breast reduction prior to growth being completed can lead to unacceptable cosmetic results. Another thing to be aware of for any woman of child bearing years is that there is always chance that there’s is a decreased ability or inability to lactate (milk production) during nursing. In order to determine if you are a candidate for a breast reduction, please consult with a plastic surgeon board certified by the American Board of Plastic Surgery. Best wishes!

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Vertical Wrinkles on mid stomach

Tummy Tuck

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Member Response:

Hi Maries, Thank you very much for your question. These vertical lines you are referring to may be stretch marks. There are operations to help this, however, when undergoing a surgical procedure, you will have a scar. Without pictures or examining you, it is impossible to tell exactly what procedure would help you achieve your goals. Please consult with a board certified plastic surgeon regarding the proper procedures needed. Best Wishes!

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Multiple Same Day Surgery

Eyelid Surgery

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Member Response:

Hi Margaret. Thank you very much for this excellent question. All of these procedures can be done under local anesthesia. However my main concern is when combining all of these procedures, I personally tend to prefer doing all of this under General anesthesia. In addition to reduce potential risks of surgery / anesthesia, I also limit my anesthesia time to six hours for cosmetic cases. If you do decide to have all of these procedures done at once and I also limit my anesthesia time to six hours for cosmetic cases. If you do decide to have all of these procedures done at once and decide to proceed with local anesthesia, I would strongly advise that there is a board-certified anesthesiologist that is present to monitor your care. Also please verify that your surgeon is also board certified by the American Board of plastic surgery. Best wishes!

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Lumpectomy

Body Contouring

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Member Response:

Thanks for your question. Having a lumpectomy can indeed leave a cosmetic deformity. If this happens reconstruction can be performed with fat grafting. Another option also may be doing a mastopexy (breast lift) or breast reduction at the same time as your lumpectomy. All of this depends on the size and shape of your breasts now as well as the how much breast tissue may be excised at the time of your operation. When I do these procedures I ALWAYS work in close coordination with the patient’s breast surgeon to maximize cosmetic results while doing an operation that is oncologivallu safe. Please consult a plastic surgeon that is board certified by the American Board of Plastic Surgery to see what the right operation for you will be. This can only be determined after an in person consultation. Best wishes!

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Aspen Therapy

Breast Augmentation

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Member Response:

Thanks for your question! Aspen Ultrasound technique is not proven for advanced capsular contracture and a majority of plastic surgeons do not offer this service. You may benefit from surgery for longer lasting results. Please consult with a board certified plastic surgeon to go over all of your options.

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