Rahul Vemula, MD, FACS
Active Member
Rahul Vemula, MD, FACS
Dr. Vemula grew up in Northern NJ in Morris county and returned to the Jersey Shore to practice plastic surgery in August, 2016. After working in the area for a few years, Dr. Vemula founded V Plastic Surgery of Monmouth County (NJ) in 2020. He believes that patient safety is of utmost importance and every procedure should be approached with precise attention to detail and an aesthetic sense. He employs the latest techniques & technologies available in both aesthetic and reconstructive procedure
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Meet Dr. Rahul Vemula
Dr. Rahul Vemula is a leading NJ expert in both reconstructive and aesthetic procedures such as breast reduction, breast reconstruction, facelifts, browlifts, upper and lower blepharoplasty, primary and revision rhinoplasty, breast augmentation, mastopexy, body contouring, liposuction, abdominoplasty, brachioplasty, body lifts, thigh lift, and Brazilian butt lifts using the latest techniques in fat grafting. In addition - at V Plastic Surgery of Monmouth County - he also practices non-surgical aesthetic medicine including BOTOX and injectable fillers such as Juvederm and Restalyne.
Dr. Vemula has a special interest in breast reconstruction. Dr. Vemula completed his plastic surgery training in New Orleans, LA which and worked under world renowned microsurgeons to learn perforator flap breast reconstruction such as the DIEP flap and PAP flap. Dr. Vemula is very excited to bring this and other skill sets to help women on the Jersey Shore and surrounding NJ areas including Eatontown, Ocean County, Rumson, Fairhaven, Red Bank, and Ocean County.
Breast procedures
Dr. Vemula specializes in the following breast procedures:
- Breast augmentation – this is a plastic surgery treatment to increase the shape and volume of the female breasts. Breast augmentation - also referred to as breast enlargement - is the most popular cosmetic surgery treatment today.
- Breast lift – women who have sagging or drooping breasts can benefit from a breast lift. Scientifically referred to as mastopexy, this cosmetic surgery improves the shape of the breasts in order to deliver a perky, youthful, and lifted appearance.
- Breast reduction – women whose breasts are overly large can suffer from physical symptoms such as back and shoulder pain, or psychological consequences such as low self-esteem. Dr. Vemula performs reduction mammoplasty or breast reduction procedures in order to suit the patient’s aesthetic or functional goals.
- Breast revision – patients who are dissatisfied with the outcome of a previous breast augmentation procedure can benefit from Dr. Vemula’s breast revision surgery procedure. This surgery is a highly delicate procedure that requires an artistic eye.
- Asymmetry correction – breast asymmetry is a fairly common complication after breast augmentation surgery. Dr. Vemula performs breast asymmetry correction surgery in order to deliver an even breast implant appearance.
- Implant removal – some women choose to have their breast implants removed or replaced for one reason or the other. Dr. Vemula customizes this treatment to suit the patient’s goals.
- Breast reconstruction – women who have gone through breast cancer can benefit from breast reconstruction surgery. This procedure may be completed using artificial implants or natural tissue extracted from the patient’s body.
Face procedures
The team at V Plastic Surgery of Monmouth County offers a variety of facial cosmetic procedures:
- Facelift – this procedure aims to reverse the signs of aging and improve the appearance of the patient’s face.
- Neck lift – patients who have a ‘turkey wattle’ or other cosmetic imperfection in the neck or jaw region can benefit from neck lift plastic surgery.
- Eyelid surgery – also referred to as blepharoplasty, this treatment alleviates eyelid appearances that can ruin the patient’s cosmetic appearance or impair vision.
- Rhinoplasty – Dr. Vemula offers nose reshaping surgery in order to correct the appearance of bumps, enlarged nostrils, and other cosmetic imperfections. This cosmetic procedure can also benefit individuals who have a broken nose, or septum deviation that impairs breathing.
- Laceration repair – proper treatment and care of skin lacerations is crucial to optimal healing. Dr. Vemula utilizes advanced techniques that reduce the risk of infection and deliver an excellent outcome.
- Reconstructive pediatric surgery – unforeseen trauma or accidents can leave burns, scarring, or disfigurement in children. Dr. Vemula offers this surgery option to repair physical defects that can lead to unwanted attention.
Body procedures
The surgeon also specializes in a wide range of body procedures:
- Mommy makeover – new mothers often feel that their new body shape is inadequate and unattractive. A mommy makeover is a combination of procedures that alleviate post-pregnancy changes to give women a youthful appearance.
- Tummy tuck – also referred to as abdominoplasty, this cosmetic procedure alleviates the appearance of a bulging lower belly. Many patients who receive this treatment benefit from a slimmer and tighter abdominal contour.
- Brazilian butt lift – this is a buttock enhancement technique that utilizes natural fat extracted from other parts of the body. This procedure usually does not involve skin incision as is the case with the typical ‘butt lift’ surgery.
- Labiaplasty – enlarged or overhanging vaginal labia can lead to a host of cosmetic or functional problems. Dr. Vemula offers this sensitive treatment to give women increased comfort, and a renewed aesthetic sense.
- Liposuction – this is a highly effective treatment that addresses stubborn pockets of fat in different parts of the body. Dr. Vemula uses advanced equipment and techniques to deliver excellent results with this procedure.
- Arm lift – also referred to as Brachioplasty, this is a cosmetic surgical treatment that addresses sagging in the underarms, thus delivering a slimmer and shapelier upper arm contour.
- Thigh lift – many individuals have loose sagging skin on their inner thighs after losing a significant amount of weight. Thighplasty is a surgical procedure that removes excess skin from this region to deliver a better contour.
- No-mesh hernia repair – Dr. Vemula offers both mesh and non-mesh hernia repair techniques to suit the needs of the patient.
Nonsurgical procedures
Dr. Vemula offers a number of non-surgical, non-invasive, cosmetic procedures to alleviate mild cosmetic issues.
- BOTOX – this is an injectable drug that reduces skin wrinkles and helps treat some muscle-related conditions. BOTOX is the most popular nonsurgical cosmetic treatment.
- Juvederm – this is a cosmetic filler treatment that can restore facial contours and improve the signs of aging. Juvederm treatment is typically administered on the face, particularly around the mouth, lips, and cheeks.
- Rhinoplasty – non-surgical rhinoplasty utilizes injectable fillers to alter the shape or appearance of the nose without invasive surgery. This technique is ideal for correcting minor cosmetic concerns on the nose.
At his V Plastic Surgery of Monmouth County office in West Long Branch (NJ), Dr. Vemula works with highly qualified professionals, including a certified anesthesiologist and nursing staff who are committed to patient safety and comfort.
Your Consultation
V Plastic Surgery of Monmouth County | Rahul Vemula, MD, FACS Double Board Certified Plastic SurgeonPatient Testimonials
It's been a journey! It started with having to have a lumpectomy on my left breast and I decided to have a breast reduction / lift at the same time. Couldn't have been happier that Dr. Vemula was my surgeon. He is very patient and thorough and really made me feel at ease with the procedure. With their Symplast patient portal he is accessible at any time. I am very happy with the results and will definitely recommend Dr. Vemula ~ Erline
It has now been two months since I got a breast reduction and everything is more perfect than I could imagine. From the beginning Dr. Vemula and all of the staff were super welcoming and helpful. Any question you had, they always provided an answer. It took around a year for me to meet the requirements for insurance covering and the staff was there to help me every small step of the way. At first insurance declined my coverage, but Dr. Vemula fought for me because he understood how much I wanted to get the reduction. When the surgery approached, Dr. Vemula was super flexible and he made sure I knew what to expect. When the actual surgery came, he ensured I was comfortable and he explained everything that would happen. Recovery from surgery went super well and Dr. Vemula answered all questions while having frequent check-ins in which he gave clear instructions on how to care for my wounds. Now, I am so happy with my results. My chest is exactly how I wanted it to look and I have no regrets. Everything is healing so well and my confidence has never been better. Dr.Vemula and his staff have been a miracle to me. They helped lift this weight off of my shoulders (literally). If anyone was looking into a breast reduction or plastic surgery, I would definitely recommend going to V Plastic Surgery. This has been life changing. ~ Rhonda P.
Dr Vemula is the most caring doctor. He listens to everything you say. He addresses all your questions and concerns. Nothing is silly or unimportant to him. All his staff are the same as Dr Vemula. I can't imagine going to anyone else. ~Ilean C.
Contact
Locations
West Long Branch Office
Suite 201, 107 Monmouth Road
West Long Branch,
NJ
07764
Languages
- English
Board Certifications
- American Board of Surgery 2013
- American Board of Plastic Surgery 2017
Memberships
- American Society of Plastic Surgeons
- New Jersey Society of Plastic Surgeons
Hospital Affiliations
- Monmouth Medical Center - Long Branch, NJ
- Riverview Medical Center - Red Bank, NJ
- Jersey Shore University Medical Center - Neptune, NJ
- Bayshore Medical Center - Holmdel, NJ
- Surgicare of Freehold - Freehold, NJ
- Institute for Advanced Surgery - Neptune, NJ
- Ocean Medical Center - Brick, NJ
- Community Medical Center - Toms River, NJ
- Monmouth Medical Center Southern Campus - Lakewood, NJ
- Newark Beth Israel Medical Center - Newark, NJ
Education
- Rutgers University - New Brunswick, NJ - BS in Finance and Economics - May, 2004
- UMDNJ - Robert Wood Johnson Medical School - New Brunswick, NJ - Doctor of Medicine - May 2008
- Monmouth Medical Center - Long Branch, NJ - July 2008 - June 2013 - General Surgery Residency
- Tulane University - New Orleans, LA - July 2013 - June 2016 - Plastic Surgery Residency
More Links
Procedures Performed
Arm Lift
Body Contouring
Body Lift
Botulinum Toxin
Breast Augmentation
Breast Implant Removal
Breast Implant Removal
Breast Implant Revision
Breast Lift
Breast Reconstruction
Breast Reduction
Breast Reduction
Brow Lift
Burn Reconstruction
Buttock Implants
Buttock Lift with Augmentation
Calf Augmentation
Cheek Augmentation
Cheek Reduction
Chemical Peels, IPL, Fractional CO2 Laser Treatments
Chin Augmentation
Cleft Lip and Palate Repair
Cosmetic Surgery & Computer Imaging
Dermal Fillers
Deviated Septum Correction
Down Syndrome
Ear Reconstruction Surgery
Ear Surgery
Eyelid Ptosis Repair
Eyelid Surgery
Facelift
Facial Implants
Free Flap Breast Reconstruction
Gender Affirmation Surgery
General Reconstruction
Giant Nevi Removal
Head and Neck Cancer Reconstruction
Head and Neck Skin Cancer Reconstruction
Injectable Fillers
Lip Augmentation/Enhancement
Liposuction
Lymphedema Treatment
Male Breast Reduction
Male Chest Implants
Microdermabrasion
Microsurgery
Migraine Surgery
Mommy Makeover
Neck Lift
Nonsurgical Fat Reduction
Panniculectomy
Post Burn Reconstruction
Retin-A Treatments
Rhinoplasty
Scar Revision
Skin Cancer Removal
Surgery for Genitourinary Diseases
Thigh Lift
TRAM Flap Breast Reconstruction
Tummy Tuck
Vascular Malformations
Wound Care
Specialty
Dr. Rahul Vemula and his team at V Plastic Surgery of Monmouth County have performed numerous breast reduction and breast reconstruction procedures in New Jersey. The surgeon's office is able to get many of these procedures covered by health insurers. Dr. Vemula is also highly trained and experienced in other areas of plastic surgery (both aesthetic and reconstructive) including facial rejuvenation (e.g. facelift and rhinoplasty), body contouring (e.g. liposuction and mommy makeovers), and breast procedures like breast augmentation and mastopexy (breast lift). The surgeon's office also offers cutting edge non-surgical technology and procedures such as Renuvion, Botox, and Juvederm for patients who'd like to see some moderate improvements without having to undergo surgery.Ask a Surgeon
Dr. Rahul Vemula participates in the ASPS Ask A Surgeon service. View responses to public questions below.
Surgery possible for patient who takes warfarin due to AVR?
Male Breast ReductionMember 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.
Surgery possible for patient who takes warfarin due to AVR?
Question:
Would any plastic surgeon even consider a male breast reduction for a patient who is on warfarin therapy with a target INR of 1.5-2.0 (mechanical On-X aortic valve replacement due to congenital bicuspid valve), by working with the patient's cardiologist on the appropriate Lovenox bridging plan? My husband is extremely unhappy with his appearance and I want to help him. Thank you.
Rahul Vemula, MD, FACS's 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.
Is removal of 20 year old textured implants required?
Breast Implant RemovalMember 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.
Is removal of 20 year old textured implants required?
Question:
I recently received an invite for a free consultation, to discuss connections between textured implants and cancer. Teardrop implants under muscle 20yrs ago, AA cup to a large C cup. I was very thin. Am now 30lbs heavier so natural breasts are larger. She suggested explant as skin is good and have enough tissue. Do I have to soon? Am worried of results as heard could be flat and deformed.
Rahul Vemula, MD, FACS's 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.
Asymmetric jawline
Cosmetic SurgeryMember 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!
Asymmetric jawline
Question:
G
Rahul Vemula, MD, FACS's 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!
PRP Vampire Breast Lift - Tissue Damage
Breast LiftMember Response:
I’m sorry to hear that you had such an awful outcome. Based on the information provided, I do not know exactly what was done here. You definitely should seek out a consultation with a board certified plastic and reconstructive surgeon for an evaluation. You may also need breast imaging to further characterize these nodules. Unfortunately, this is an inappropriate form to ask if legal action should be taken,.
PRP Vampire Breast Lift - Tissue Damage
Question:
I recevied a "vampire breast lift" where they inject PRP+ HA into the breast/fatty tissue to stimulate growth/enhance cleavage area. A few months after, I had hard nodules form all around my breast cleavage where I was injected. My breast sonogram shows multiple cysts in the area/suspected necrosis. This is not a side effect of the procedure, blood flow should be increased. Can I sue ?
Rahul Vemula, MD, FACS's Response:
I’m sorry to hear that you had such an awful outcome. Based on the information provided, I do not know exactly what was done here. You definitely should seek out a consultation with a board certified plastic and reconstructive surgeon for an evaluation. You may also need breast imaging to further characterize these nodules. Unfortunately, this is an inappropriate form to ask if legal action should be taken,.
Procedure
Breast Implant RemovalMember Response:
You do not need a big incision to remove a saline implant. My incisions to remove a saline implant is about 2 cm. This is however considering that there is no capsular contracture and the capsule does not need to be removed.
Procedure
Question:
I want to know if it is always necessary to have the large incisions to remove saline implants. Is it possible to deflate the implant than remove it through an incision around the areola.
Rahul Vemula, MD, FACS's Response:
You do not need a big incision to remove a saline implant. My incisions to remove a saline implant is about 2 cm. This is however considering that there is no capsular contracture and the capsule does not need to be removed.
does this scar will have improvement
Wound CareMember Response:
14 days is very early and wounds are still very inflamed at this stage. Talk to your surgeon about scar massaging as well as the possibility of doing microneedling to the scar
does this scar will have improvement
Question:
I have cut on forehead 14 days ago , I had suture which removed today and I want to know does this scar will improvement and what shall I do get ride of redness and flatten the scar
Rahul Vemula, MD, FACS's Response:
14 days is very early and wounds are still very inflamed at this stage. Talk to your surgeon about scar massaging as well as the possibility of doing microneedling to the scar
Wound pus not healing
Breast ReductionMember Response:
Please have close follow up with your plastic surgeon to figure out the best course of action
Wound pus not healing
Question:
I had surgery 22 days ago, my incisions are just not healing and leaking a yellow discharge, they have tried aquacel dressings (lasted a day) and pico 7 dressings which also only lasted a day. I have had 2 courses of antibiotics and still incision is not closing or stopping leaking. What is next option?
Rahul Vemula, MD, FACS's Response:
Please have close follow up with your plastic surgeon to figure out the best course of action
Liposuction on Outer Thighs
LiposuctionMember Response:
16 days after surgery is a very short time and and you will be swollen. I would not judge the results until at least 6 months from the date of the surgery. Best wishes
Liposuction on Outer Thighs
Question:
Hi, It’s now been 16 days since I had liposuction on my outer thighs. Immediately after surgery and a day after, I saw a significant improvement and a huge difference on my thighs - it was great. But now I basically see my saddlebags because there’s this hard area there when I touch. It’s swelling I assume cause it’s hard and I haven’t seen them after surgery. Is it going to down? Is it normal?
Rahul Vemula, MD, FACS's Response:
16 days after surgery is a very short time and and you will be swollen. I would not judge the results until at least 6 months from the date of the surgery. Best wishes
Replace Implants
Breast Implant RevisionMember Response:
This is a very common question we get. If your only symptom is rippling and do not have any signs of capsular Contractor, I think doing a pocket change will suffice without needing a capsulectomy. in the absence of any disease of the capsule, doing a capsulectomy can actually increase the rate of complications.
Replace Implants
Question:
I have 14 yr old saline implants over the muscle and want to replace them with silicone under the muscle. I have no complications, other than rippling hence the reason to replace under with silicone. Do I need a capsulectomy?
Rahul Vemula, MD, FACS's Response:
This is a very common question we get. If your only symptom is rippling and do not have any signs of capsular Contractor, I think doing a pocket change will suffice without needing a capsulectomy. in the absence of any disease of the capsule, doing a capsulectomy can actually increase the rate of complications.
Butchered circumcision
Aesthetic Genital Plastic SurgeryMember Response:
Sorry you are going through this. You would be best managed with both a urologist and plastic surgeon. Without more information it is not possible to say what needs to be done, but it is not uncommon for a urologist and plastic surgeon to do an operation together for a condition like this
Butchered circumcision
Question:
Been butchered via circumcision. All inner skin and outer skin removed. Painful erections. Any chance for me? Can you grow/ transplant mucosa
Rahul Vemula, MD, FACS's Response:
Sorry you are going through this. You would be best managed with both a urologist and plastic surgeon. Without more information it is not possible to say what needs to be done, but it is not uncommon for a urologist and plastic surgeon to do an operation together for a condition like this
What went wrong
Breast LiftMember Response:
So sorry you have had this experience. Although we do not have your before picture as well as immediate post op pictures, one can infer from this that you most likely had some full thickness skin loss after your lift. This can happen for many reasons and without complete information, its impossible to give you an exact answer on what why this happened. You need to have close follow up with your plastic surgeon until this is healed. You may need a revision surgery in the future once all the inflammation has subsided. Best wishes. Things you can do to help wound healing are increase your protein intake, and stay away from any nicotine products even second hand smoke, and if you are a diabetic make sure your diabetes is controlled.
What went wrong
Question:
I am 7 weeks post op from breast lift and I have been dealing with a major complication. The 1st picture is from 26 days ago and the 2nd picture is from the other day. The wound has double in size and no one can tell me why. I am seeing a wound specialist but he says just change the dressings every other day. This wound has gotten bigger and it hurts.. I don't know what to do
Rahul Vemula, MD, FACS's Response:
So sorry you have had this experience. Although we do not have your before picture as well as immediate post op pictures, one can infer from this that you most likely had some full thickness skin loss after your lift. This can happen for many reasons and without complete information, its impossible to give you an exact answer on what why this happened. You need to have close follow up with your plastic surgeon until this is healed. You may need a revision surgery in the future once all the inflammation has subsided. Best wishes. Things you can do to help wound healing are increase your protein intake, and stay away from any nicotine products even second hand smoke, and if you are a diabetic make sure your diabetes is controlled.
7 week since scar revision 4 weeks since breakdown
Breast LiftMember Response:
From this picture the wound looks clean without any signs of infection. I would continue to visit your plastic surgeon for close follow and follow his or her wound care recommendations. It is unclear from this picture if there is any implant under here. If there is, I would also be very vigilant for exposure of the implant. Some things you can do to help your wound healing - avoid any type of nicotine exposure including second hand smoke. - increase your protein in take - If you are a diabetic make sure your diabetes is controlled. - Do not submerge in a body of water like a swimming pool or ocean - Keep all animal dander away from this area Best wishes
7 week since scar revision 4 weeks since breakdown
Question:
Hi, I had scar revision on my breasts 7 weeks ago , I was very bruised on my right breast, I had removable stitches 11 days after procedure which caused a little breeding where the stitches were. A week later a hole at the bottom t jyction started to open where there were blood clots , since then my wounds broke down even further. Theyer being dressed by a nurse, will these heal ok?
Rahul Vemula, MD, FACS's Response:
From this picture the wound looks clean without any signs of infection. I would continue to visit your plastic surgeon for close follow and follow his or her wound care recommendations. It is unclear from this picture if there is any implant under here. If there is, I would also be very vigilant for exposure of the implant. Some things you can do to help your wound healing - avoid any type of nicotine exposure including second hand smoke. - increase your protein in take - If you are a diabetic make sure your diabetes is controlled. - Do not submerge in a body of water like a swimming pool or ocean - Keep all animal dander away from this area Best wishes
Stinging pain under breast when lift arm over head
Breast AugmentationMember Response:
Hard to say what happened. Could have been some scar tissue that could have been stretched. I would go see a plastic surgeon for an evaluation. Best wishes
Stinging pain under breast when lift arm over head
Question:
I have 15 year old smooth round moderate profile saline implants placed above the muscle. I stretched my arms above my head this morning in bed and felt what felt like a rip or tear feeling under my breast. Now when I lift my arm above my head or bend over I feel a burning stinging pain under that breast. Any idea what could have happened?
Rahul Vemula, MD, FACS's Response:
Hard to say what happened. Could have been some scar tissue that could have been stretched. I would go see a plastic surgeon for an evaluation. Best wishes
Partial breast reconstruction after lumpectomy with radiation
Breast ReconstructionMember Response:
There are many options after a partial breast reconstruction . It largely depends on the size of your natural breasts, your desired size after reconstruction as well as the extent of the tumor that is being removed. If you are in a situation where the are of microcalifications is so large that a significant area needs to be removed, your breast and plastic surgeons may be correct that a mastectomy is the only option to get clearance of all the suspicious areas as well get an aesthetic reconstruction. Without seeing pictures as well as your radiology results it’s not possible to render an opinion here. I would encourage you to get a second opinion though
Partial breast reconstruction after lumpectomy with radiation
Question:
What are your opinions on partial breast reconstruction with silicone implants after lumpectomy & radiation? My breast and plastic surgeons indicate I would be unhappy with the outcome and I should just do bilateral mastectomy given the relatively large area of microcalcifications that need to be removed from my small breast. I am concerned about implants without breast tissue feeling hard.
Rahul Vemula, MD, FACS's Response:
There are many options after a partial breast reconstruction . It largely depends on the size of your natural breasts, your desired size after reconstruction as well as the extent of the tumor that is being removed. If you are in a situation where the are of microcalifications is so large that a significant area needs to be removed, your breast and plastic surgeons may be correct that a mastectomy is the only option to get clearance of all the suspicious areas as well get an aesthetic reconstruction. Without seeing pictures as well as your radiology results it’s not possible to render an opinion here. I would encourage you to get a second opinion though
Will I my chest tighten as I heal?
Male Breast ReductionMember Response:
7 days is way to early assess the final result. your tissues are very swollen and inflamed from surgery. The swelling will go down and it will start to look better every week. I would not assess the final results for about 6-12 months from the date of surgery. Best wishes for an uneventful recovery!
Will I my chest tighten as I heal?
Question:
I am a 27 year old male and 7 days ago I received a chest lift/bra line back lift. I took my bandages off to see my incisions and I am not happy with what I see. My left side (non-bruised side) has a lot of skin tucked into the incision and definitely does not match the opposite side. Will the skin settle into place as I heal over the next 6 months? Or am I botched?
Rahul Vemula, MD, FACS's Response:
7 days is way to early assess the final result. your tissues are very swollen and inflamed from surgery. The swelling will go down and it will start to look better every week. I would not assess the final results for about 6-12 months from the date of surgery. Best wishes for an uneventful recovery!
Scar Pain Help - what is possible?
Wound CareMember Response:
It could be a neuroma. You need to have an evaluation by a plastic surgeon to see what your options are
Scar Pain Help - what is possible?
Question:
I have a scar on my scalp that is almost ten years old and a small area of it hurts to the touch still. I think there may be a nerve trapped in the scar tissue. Is there anything I can do to help with this pain?
Rahul Vemula, MD, FACS's Response:
It could be a neuroma. You need to have an evaluation by a plastic surgeon to see what your options are
Can you have high BP post-op? Should I ask for BP meds in case?
Breast ReductionMember Response:
Before you have a reduction you should definitely have an evaluation by an internal medicine doctor to make sure all of your medical conditions are optimized. Best wishes
Can you have high BP post-op? Should I ask for BP meds in case?
Question:
I am having a breast reduction this week. My blood pressure normally is ok (120s/80s). I definitely have some white coat syndrome and my blood pressure will sky rocket due to my anxiety. The only other surgeries I had were two c-sections. Both of those ended in postpartum preeclampsia and months of BP meds. Should I worry about high BP happening after this reduction? Should I ask for BP meds?
Rahul Vemula, MD, FACS's Response:
Before you have a reduction you should definitely have an evaluation by an internal medicine doctor to make sure all of your medical conditions are optimized. Best wishes
Are women happy with removal if they are very flat chested or wish they got implants replaced?
Breast Implant RemovalMember Response:
THis is a great question and one we get asked all the time. This is highly individualized as every patient has different goals as to what their ideal shape and size of the breasts are. It is very important to meet with a board certified plastic surgeon who will do a physical exam and discuss with you all advantages and disadvantages of all of the different options of removal only, removal with a lift, removal and replacement with a lift. In my office we have 3-D imaging which helps. Its not an end all be all but it helps both the surgeon and the patient be on the same page regarding the patient's goals as well as realistic expectations.
Are women happy with removal if they are very flat chested or wish they got implants replaced?
Question:
I’ve had a deflation of a 325cc saline implant that was 12 years old and am torn between removing them vs replacing. I’m a runner and very active . I’m 42 and scared that if I remove them I’ll be very unhappy with how much they sag or scared they will just look horrible. I am 5’8” and 115lbs. Not sure I want to keep having surgery every 10 yrs either. What do most women end up doing?
Rahul Vemula, MD, FACS's Response:
THis is a great question and one we get asked all the time. This is highly individualized as every patient has different goals as to what their ideal shape and size of the breasts are. It is very important to meet with a board certified plastic surgeon who will do a physical exam and discuss with you all advantages and disadvantages of all of the different options of removal only, removal with a lift, removal and replacement with a lift. In my office we have 3-D imaging which helps. Its not an end all be all but it helps both the surgeon and the patient be on the same page regarding the patient's goals as well as realistic expectations.
Deoxycholic acid for gynecomastia
Male Breast ReductionMember Response:
Not possible to give an opinion without pictures. A double incision mastectomy is probably the best option
Deoxycholic acid for gynecomastia
Question:
My boyfriend spent several years living as a transgender woman, and detransitioned a few years ago. While doing research on methods to eliminate the breast tissue that he grew during his medical transition, I saw that deoxycholic acid (Kybella) could work to eliminate male breast tissue. Would this work for tissue that was grown with HRT?
Rahul Vemula, MD, FACS's Response:
Not possible to give an opinion without pictures. A double incision mastectomy is probably the best option
Coverage
Breast ReductionMember Response:
Some Medicaid plans do cover breast reduction, especially if you live in a state where you have a Medicaid HMO. The best thing to do is to call the member services phone number on the back of your insurance card and ask if CPT code 19318 which the code for a breast reduction is covered. If it is covered then you need to find out the exact criteria for coverage and see if you would qualify. You would also need to find a surgeon that accepts your specific Medicaid plan.
Coverage
Question:
So I'm 25, 5'2 and weight about 149. My breasts are maybe D36-38 I haven't been measured in such a long time. But I have always had bad back pain, and some shoulder pain. My bras feel like they are digging into my shoulder and skin. They just feel so heavy with and without a bra its just uncomfortable. Would medicaid maybe cover the surgery or assist in it?
Rahul Vemula, MD, FACS's Response:
Some Medicaid plans do cover breast reduction, especially if you live in a state where you have a Medicaid HMO. The best thing to do is to call the member services phone number on the back of your insurance card and ask if CPT code 19318 which the code for a breast reduction is covered. If it is covered then you need to find out the exact criteria for coverage and see if you would qualify. You would also need to find a surgeon that accepts your specific Medicaid plan.
Which Procedure is More Effective for Me: RF Vanquish or CoolSculpting Elite
Body ContouringMember Response:
Without pictures, it is impossible to give you an opinion on what procedures would be best to achieve your goals
Which Procedure is More Effective for Me: RF Vanquish or CoolSculpting Elite
Question:
After HIP replacement on both sides and knee replacement due to an accident, which procedure is more effective for me: RF Vanquish or CoolSculpting Elite? HIPS and my right knee, which are made of titanium, may be damaged by RF Vanquish.
Rahul Vemula, MD, FACS's Response:
Without pictures, it is impossible to give you an opinion on what procedures would be best to achieve your goals
Type 1 diabetic
LiposuctionMember Response:
The main risk of surgery in a diabetic is wound healing and infection risk. The risk of the goes lower with a lower a1c. 7.5 is considered uncontrolled diabetes. Best to get it under 7 to lower your risk of wound complications . I have successfully operated on type 1 diabetics and they have worked with their endocrinologist to get their diabetes under control, especially with an insulin pump. Best wishes
Type 1 diabetic
Question:
I'm 26, 122 lbs with type 1 diabetes and my a1c is 7.5 and currently working on getting it lower. I want to do liposuction on my stomach to get the shape I want. Will I be a good candidate and what are the risk ?
Rahul Vemula, MD, FACS's Response:
The main risk of surgery in a diabetic is wound healing and infection risk. The risk of the goes lower with a lower a1c. 7.5 is considered uncontrolled diabetes. Best to get it under 7 to lower your risk of wound complications . I have successfully operated on type 1 diabetics and they have worked with their endocrinologist to get their diabetes under control, especially with an insulin pump. Best wishes
Clinical trials
Tummy TuckMember Response:
There are really no clinical trials going on for tummy tucks. This is a well established procedure
Clinical trials
Question:
How can I register for a tummy tuck clinical trial?
Rahul Vemula, MD, FACS's Response:
There are really no clinical trials going on for tummy tucks. This is a well established procedure
Tummy tuck with or without drain safer?
Tummy TuckMember Response:
Both procedures can be done safely. It depends on the preference of your surgeon. I personally use drains and have colleagues that do not and have excellent outcomes.
Tummy tuck with or without drain safer?
Question:
I would like to know if a drainless TT or one with drains is better for someone who has lost 85lbs and is 5' tall, and now weighs 143
Rahul Vemula, MD, FACS's Response:
Both procedures can be done safely. It depends on the preference of your surgeon. I personally use drains and have colleagues that do not and have excellent outcomes.
Open T area
Breast LiftMember Response:
Based on this picture it looks like you have some necrotic (non-viable) skin at the T junction. This would benefit from a debridement which is a procedure to cut away the dead skin to promote wound healing. You may also have some fat necrosis underneath this, but no possible to tell from this picture. Please continue to have close follow up with your surgeon for wound care. Risk factors for this are large amounts of skin that were removed with the lift, high BMI, any exposure to smoking and uncontrolled Diabetes. You can also increase your protein intake to promote wound healing if you do not have any health conditions that warrant a limited protein intake. Once this is fully healed, and the scar has matured you can be evaluated for scar therapies which can range from a chemical peel and microneedling to a full surgical revision. Best wishes!
Open T area
Question:
3 weeks out from my explant and lift/aerola resize procedure. The spot at the bottom of the T is still open a bit.. Went last week for follow up and he said it’s doing fine. They it was i believe he called it fat necrosis. The bandage fell off today and it is open and It is oozie and has a green spot. It also has an odor but i felt it was the steristrips. Infected? Image attached
Rahul Vemula, MD, FACS's Response:
Based on this picture it looks like you have some necrotic (non-viable) skin at the T junction. This would benefit from a debridement which is a procedure to cut away the dead skin to promote wound healing. You may also have some fat necrosis underneath this, but no possible to tell from this picture. Please continue to have close follow up with your surgeon for wound care. Risk factors for this are large amounts of skin that were removed with the lift, high BMI, any exposure to smoking and uncontrolled Diabetes. You can also increase your protein intake to promote wound healing if you do not have any health conditions that warrant a limited protein intake. Once this is fully healed, and the scar has matured you can be evaluated for scar therapies which can range from a chemical peel and microneedling to a full surgical revision. Best wishes!
Skin/Scar Reconstruction following Emergency Ileocolectomy
PanniculectomyMember Response:
Sorry to hear that you had to go through this and glad you are in better health now! This actually may be considered reconstructive. You would need to meet with a plastic surgeon as well as look at the guidelines from your insurance company. Stuff like this can be found in a document called the Summary Plan description which outlines exactly what they will and they will not cover. Best of luck!
Skin/Scar Reconstruction following Emergency Ileocolectomy
Question:
In 2002 I had a life saving emergency ileocolectomy after my bowel was perforated during a laparoscopic endometriosis removal surgery. I developed peritonitis and went all sorts of septic. While I've always worn my scar as a badge of honor, not so much the two pouches of skin that adorn it on either side. Can I get insurance to cover the removal of this skin, or any sort of scar revision surgery?
Rahul Vemula, MD, FACS's Response:
Sorry to hear that you had to go through this and glad you are in better health now! This actually may be considered reconstructive. You would need to meet with a plastic surgeon as well as look at the guidelines from your insurance company. Stuff like this can be found in a document called the Summary Plan description which outlines exactly what they will and they will not cover. Best of luck!
Options after disfiguring lipo
Thigh LiftMember Response:
Very sorry that you have contour irregularities. You may be a candidate for vaser liposuction and renuvion to help with this. You would need an in person physical examination first to determine if this procedure is right for you
Options after disfiguring lipo
Question:
Slim athletic 44yo F, 6’ tall. 2021 lipo on flanks & inner thigh w/great results. In 2022, a surgeon (billed as an expert who charges about 2x her competitors) convinced me to lipo multiple areas to harvest fat for a breast lift (including front of thighs). Thighs now covered in dimples and divots. Unnatural, disfigured & weird dents at every incision point. Anything I can do? Thigh lift?
Rahul Vemula, MD, FACS's Response:
Very sorry that you have contour irregularities. You may be a candidate for vaser liposuction and renuvion to help with this. You would need an in person physical examination first to determine if this procedure is right for you
Double Mastectomy with Breast Implants
Breast AugmentationMember Response:
It is unclear what you mean by the veins being too small. If you are getting a DIEP flap, your surgeon can do pre operative imaging in the form of a CT scan to assess the quality of the vessels. If you have a small amount of abdominal tissue sometimes a “hybrid” reconstruction is performed where your abdominal skin and fat is used along with a small implant. Please speak to your surgeon about all of these options.
Double Mastectomy with Breast Implants
Question:
Im 37. Im having a double mastectomy. The plan is to use my stomach to reconstruct. Today the doctor told me that if my veins in my stomach are too small, I can either have small implants placed in (currently a C and they will be an A) or I can have expanders and be larger. Will A’s look funny on me (size 38 back)? Do expanders hurt? I don’t want to be in pain for months. Scared and confused
Rahul Vemula, MD, FACS's Response:
It is unclear what you mean by the veins being too small. If you are getting a DIEP flap, your surgeon can do pre operative imaging in the form of a CT scan to assess the quality of the vessels. If you have a small amount of abdominal tissue sometimes a “hybrid” reconstruction is performed where your abdominal skin and fat is used along with a small implant. Please speak to your surgeon about all of these options.
Would you as a doctor allow me to get a breast reduction
Breast ReductionMember Response:
A breast reduction is an elective procedure. The immunosuppression, PE, kidney failure and anticoagulation make you a very high for a breast reduction. Even in the best of circumstances you are likely to get some type of complication. If this is to be done, your best bet is to reach out to an academic medial center
Would you as a doctor allow me to get a breast reduction
Question:
I am a 24 female diagnosed with acute kidney failure, pulmonary embolism, and lupus all in December 2019. I am in remission for the acute kidney failure. I am on warfarin and hydroxychloroquine. I want to know if I would be a good candidate for breast reduction or will it be dangerous
Rahul Vemula, MD, FACS's Response:
A breast reduction is an elective procedure. The immunosuppression, PE, kidney failure and anticoagulation make you a very high for a breast reduction. Even in the best of circumstances you are likely to get some type of complication. If this is to be done, your best bet is to reach out to an academic medial center
Had Tummy tuck and 360 lipo 2 years ago this morning i woke up big, like if no tummy tuck was perfor
Tummy TuckMember Response:
Without viewing pictures before your procedure, after your procedure and pictures of what you look like now, it is impossible to answer this question.
Had Tummy tuck and 360 lipo 2 years ago this morning i woke up big, like if no tummy tuck was perfor
Question:
I had a tummytuck&360 lipo 2 yrs ago, I still don't have sensibility, but I been feeling like a bruise pain on my left side in the middle of the tórax area. For the last 3 weeks my stomach started to be noticeable this morning my stomach was big but my waist was still visible, 6 hours later my stomach is bigger and I lost my waist, like if i never had a tummytuck. Do the stitches opened?
Rahul Vemula, MD, FACS's Response:
Without viewing pictures before your procedure, after your procedure and pictures of what you look like now, it is impossible to answer this question.
Best Facial Procedures
RhinoplastyMember Response:
This is a question that is impossible to answer in a forum like this. This largely depends on exactly what feature you are seeking improvement of as well as your end goals. Beauty is in the eye of the beholder. If I asked 10 different people who looked exactly like you what they wanted to improve I would get 10 different answers. My job as a plastic surgeon is to figure out if you have realistic expectations and if I can deliver what you are looking for in a safe manner
Best Facial Procedures
Question:
Hello, I would like to the most minimal amount of work with the biggest impact. I'm looking to do simple changes to both keep a natural look and for financial reasons. I've had advice to do rhinoplasty and perhaps a procedure to decrease jowels. However, others have suggested lip augmentation and fillers to achieve the best results. Not really sure what I should prioritize to achieve my goals.
Rahul Vemula, MD, FACS's Response:
This is a question that is impossible to answer in a forum like this. This largely depends on exactly what feature you are seeking improvement of as well as your end goals. Beauty is in the eye of the beholder. If I asked 10 different people who looked exactly like you what they wanted to improve I would get 10 different answers. My job as a plastic surgeon is to figure out if you have realistic expectations and if I can deliver what you are looking for in a safe manner
Should i seek additional care from hospital
Breast ReductionMember Response:
Looks like you definitely lost some skin and does not look like it is finished yet and you are most likely to lose a little bit more skin. Keep in close contact with your surgeon for wound care Best wishes
Should i seek additional care from hospital
Question:
Should I go to hospital? 1 week post op blister showed and surgeon said it would resolve but if it showed other symptoms let him know. later blister popped and surgeon told me to wipe any loose skin away and apply and antibacterial cream and then told me to doxicyline. That Monday went in to visit and he removed the tape and told me to drench the area in aquaphor and use tefla.
Rahul Vemula, MD, FACS's Response:
Looks like you definitely lost some skin and does not look like it is finished yet and you are most likely to lose a little bit more skin. Keep in close contact with your surgeon for wound care Best wishes
What can I do
Breast AugmentationMember Response:
Given the appearance of the wound there is a chance that the implant is exposed. Please see a local plastic surgeon as soon as possible. If you are having fevers / chills, worsening redness or pus draining from the incision you need to go to the emergency roll immediately
What can I do
Question:
I am about 16 days out from getting my breast augmentation with implants and a lift. Recently I had a lot of drainage and now my incisions have started to open. I have contacted my surgeon but due to him being in a different country it takes awhile for him to respond. Is this normal or is there anything I can do to help it close? I change my gauze 3-4 times a day and clean everything.
Rahul Vemula, MD, FACS's Response:
Given the appearance of the wound there is a chance that the implant is exposed. Please see a local plastic surgeon as soon as possible. If you are having fevers / chills, worsening redness or pus draining from the incision you need to go to the emergency roll immediately
Implant rippling due to damaged tissue from revision.
Breast AugmentationMember Response:
Without seeing any pictures it is really hard to say what the proper treatment for you would be. Since you said your implant is over the muscle, if you have very thin breast tissue a 450 cc implant would ripple and the ripples will be visible. Anytime a needle is inserted, there is always a chance of rupture with an implant. In addition, you may want to.
Implant rippling due to damaged tissue from revision.
Question:
I had a 2nd breast aug revision 6 months ago. Motiva 450cc/over the muscle, my 2nd revision was due to capsular contracture, but now I can see visible ripples where the capsule was formed before, my PS says this is due to the removal of it. I’m considering Renuva, but I’m worried that since I can see and feel my implant that the needle might rupture it?Can Renuva cause me another encapsulation?
Rahul Vemula, MD, FACS's Response:
Without seeing any pictures it is really hard to say what the proper treatment for you would be. Since you said your implant is over the muscle, if you have very thin breast tissue a 450 cc implant would ripple and the ripples will be visible. Anytime a needle is inserted, there is always a chance of rupture with an implant. In addition, you may want to.
Skin Laxity in Armpit After Axillary Breast Tissue Removal
Body ContouringMember Response:
Hard to say without seeing pictures. Depending on the extent of the surgery, it may contract or you may need a revision. Please discuss this with your surgeon.
Skin Laxity in Armpit After Axillary Breast Tissue Removal
Question:
I underwent surgery to remove painful "bra roll fat" in my armpits. One was larger than the other so there's more loose skin on one side. In fact there's a lot of loose skin "skin laxity" in the armpit area. I had a straight excision of the tissue and thought that some of the skin was being excised along with it so this wouldn't happen. Do you ever have to go back in to excise more skin ?
Rahul Vemula, MD, FACS's Response:
Hard to say without seeing pictures. Depending on the extent of the surgery, it may contract or you may need a revision. Please discuss this with your surgeon.
Breast Lift/Reduction with new Silicone
Breast LiftMember Response:
One week is way too early to determine the final results. Especially since this is a revision surgery, I would wait 6 months and reassess. Please discuss this with your surgeon as well
Breast Lift/Reduction with new Silicone
Question:
Dear My wife had surgery a week ago and I am noticing her left breast is different than the other. 10 Years ago she had breast augmentation and that breast got encapsulated. Also that breast was lower than the right one (pre-op). Should we worried about her current left breast form ? Thanks
Rahul Vemula, MD, FACS's Response:
One week is way too early to determine the final results. Especially since this is a revision surgery, I would wait 6 months and reassess. Please discuss this with your surgeon as well
Buttock booster and enhancement capsules
Buttock Lift with AugmentationMember Response:
Unfortunately there are many scams out there that promise results which are unrealistic. We as plastic surgeons see patients who have spent thousands of dollars on treatments that are inappropriate for their goals and they have to have surgery to achieve their goals. Please meet with a board certified plastic surgeon who will take the time to do a full examination, listen to what your goals are and suggest the procedures that are safe and effective to achieve your goals.
Buttock booster and enhancement capsules
Question:
Hello, I'm asking about some capsules that went viral, which promise to boost, enhance, and enlarge the buttock, also, it could be in a cream or suppositories formulation. Could those be safe or effective? What are some possible harms could be associated with such products?
Rahul Vemula, MD, FACS's Response:
Unfortunately there are many scams out there that promise results which are unrealistic. We as plastic surgeons see patients who have spent thousands of dollars on treatments that are inappropriate for their goals and they have to have surgery to achieve their goals. Please meet with a board certified plastic surgeon who will take the time to do a full examination, listen to what your goals are and suggest the procedures that are safe and effective to achieve your goals.
About slow healing
Male Breast ReductionMember Response:
I just reviewed the picture, thank you for uploading it. The black area indicates necrosis or in other words the skin did not survive. It is hard to say how deep this is. Sometimes it is only the outer layer of the skin and sometimes it goes much deeper. At the present time, you need close follow up with your plastic surgeon for wound care and possibly may need a revision surgery in the future. Best wishes
About slow healing
Question:
Sir/ medam i had my gynecomastia surgery 16 days back but my nipple area of left side is not good . Its looks as hyper delicating, feels i am losing nipple.pls see my image and send suggestions
Rahul Vemula, MD, FACS's Response:
I just reviewed the picture, thank you for uploading it. The black area indicates necrosis or in other words the skin did not survive. It is hard to say how deep this is. Sometimes it is only the outer layer of the skin and sometimes it goes much deeper. At the present time, you need close follow up with your plastic surgeon for wound care and possibly may need a revision surgery in the future. Best wishes
Huge Mass Underneath Stomach
PanniculectomyMember Response:
Without pictures provided it is impossible to say what operation you would be a candidate for. The first step is to find a board certified plastic surgeon that will perform a full evaluation on you. I see you are in Charlotte, and that is a major city with very good plastic surgeons. I suggest that you do a search on this website for board certified plastic surgeons in your area. Best wishes !
Huge Mass Underneath Stomach
Question:
Good day. I am looking for a Certified Physician to perform a panniculectomy. I have suffered with this for years and as I am getting older; it has grown; it prevents me from being mobile and my hygiene is very hard to control.
Rahul Vemula, MD, FACS's Response:
Without pictures provided it is impossible to say what operation you would be a candidate for. The first step is to find a board certified plastic surgeon that will perform a full evaluation on you. I see you are in Charlotte, and that is a major city with very good plastic surgeons. I suggest that you do a search on this website for board certified plastic surgeons in your area. Best wishes !
Post Breast Augmentation Pain
Breast AugmentationMember Response:
Any time you are experiencing pain after a breast implant surgery I would keep your surgeon informed. It is common to feel tight and have some asymmetry. It is also common to have some bruising. Very important to keep the lines of communication open with your operating surgeon so that your surgeon can bring you in for a physical exam if needed. 3 weeks from the time of surgery is very early to develop a capsular contracture
Post Breast Augmentation Pain
Question:
It’s been three weeks since my augmentation surgery, using a gummy implant. My first & second week of recovery were fine. In my third week, my right breast feels very tight, is slightly higher & slightly painful. Is it normal to have one breast heal differently and the other with no pain? I was worried about capsular contracture. I have slight bruising, no hematoma. Is it a cause for concern?
Rahul Vemula, MD, FACS's Response:
Any time you are experiencing pain after a breast implant surgery I would keep your surgeon informed. It is common to feel tight and have some asymmetry. It is also common to have some bruising. Very important to keep the lines of communication open with your operating surgeon so that your surgeon can bring you in for a physical exam if needed. 3 weeks from the time of surgery is very early to develop a capsular contracture
Triple point wound please help I’m scared my implant will expose or is exposed?
Breast LiftMember Response:
Thanks for posting the pictures. You are definitely at risk for implant exposure. Please keep in close contact with your surgeon. There is a chance that this is superficial and your implant is protected but there is also a chance that this is tracking all the way to the level of the implant. Best wishes
Triple point wound please help I’m scared my implant will expose or is exposed?
Question:
Tomorrow I will be 3 post breast lift & implant exchange last week after removing my tapes as advised to do after two weeks and one day post op I noticed puss through the tapes on my bra and uncovered an opening. At this point it has gotten worse, my surgeon prescribed me silver sulfi cream and I have applied that maybe 3 x & alternated with medi honey covered I’m scared my implant will show
Rahul Vemula, MD, FACS's Response:
Thanks for posting the pictures. You are definitely at risk for implant exposure. Please keep in close contact with your surgeon. There is a chance that this is superficial and your implant is protected but there is also a chance that this is tracking all the way to the level of the implant. Best wishes
Indented Lip/Vermilion Border Scar
Cleft Lip and Palate RepairMember Response:
cannot really see the full lip in this picture. 2 months is a very short time for a follow up. Please visit with a plastic surgeon for an evaluation
Indented Lip/Vermilion Border Scar
Question:
Hi, I hope it's ok to post this here. My 1 year old sustained an injury 2 months ago to his lip (the laceration crosses the vermilion border) and it is still looking indented. How long would it take to fill in, and can I even expect it to fill in? I know 2 months isn't very long in the grand scheme but really hoping this won't remain indented. Picture attached. Thanks in advance for any advice
Rahul Vemula, MD, FACS's Response:
cannot really see the full lip in this picture. 2 months is a very short time for a follow up. Please visit with a plastic surgeon for an evaluation
High BMI
LiposuctionMember Response:
Thank you for this very good question we get asked a lot. first of all liposuction is not considered a weight loss procedure. You will not lose significant weight from liposuction. Liposuction is best done on someone who is already at their goal weight to get rid of stubborn fat that is resistant to diet and exercise. Also a BMI higher than 30 is an independent risk factor for complications from anesthesia as well as post surgical complications. For the best results and for your own safety you are getter served by losing weight and then meet with a plastic surgeon to figure out what procedure are right to achieve your goals. Best wishes
High BMI
Question:
Hello l’m a 48 year old woman that wants to get some work done on my body. I have a BMI of 48.5, l’m 320 lbs, I am 5’8, and l have high blood pressure. I am active but my knees hurt my feet hurt standing to long. I get tired fast. I just want to get liposuction and an arm lift. Most of the doctors say get a gastric bypass and that’s not for everyone. One I don’t eat a lot. Any recommendation?
Rahul Vemula, MD, FACS's Response:
Thank you for this very good question we get asked a lot. first of all liposuction is not considered a weight loss procedure. You will not lose significant weight from liposuction. Liposuction is best done on someone who is already at their goal weight to get rid of stubborn fat that is resistant to diet and exercise. Also a BMI higher than 30 is an independent risk factor for complications from anesthesia as well as post surgical complications. For the best results and for your own safety you are getter served by losing weight and then meet with a plastic surgeon to figure out what procedure are right to achieve your goals. Best wishes
DIEP Flap is red
DIEP Flap Breast ReconstructionMember Response:
From the looks of the picture your DIEP flap seems to be fine. However your mastectomy skin flap looks like it is compromised. Parts of it may recover but looks there going to be some loss of the mastectomy skin. There are things that can be done to minimize this such as hyperbaric oxygen therapy. You need to contact your plastic surgeon as soon as possible.
DIEP Flap is red
Question:
Is this ok? My surgeon saw the scarring while I was in hospital and wasn’t concerned. I had Double Mastectomy with Nipples and DIEP Flap on June 5, 2024, discharge from hospital on June 7 and have a follow up appointment on June 13, 2024; making sure I can wait or if I should go to Emergency Room Close up was taken this morning, the other picture was yesterday and I included the breast fine
Rahul Vemula, MD, FACS's Response:
From the looks of the picture your DIEP flap seems to be fine. However your mastectomy skin flap looks like it is compromised. Parts of it may recover but looks there going to be some loss of the mastectomy skin. There are things that can be done to minimize this such as hyperbaric oxygen therapy. You need to contact your plastic surgeon as soon as possible.
MOHS repair on nose
Skin Cancer RemovalMember Response:
This is a severe defeat that is full thickness. I think the best repair would be as flap surgery and you will most likely need multiple stashes
MOHS repair on nose
Question:
I'm wondering what the most likely method of repair would be after this MOHS surgery? As you can see the surgery was extensive and I'm wondering what the best course of action would be.
Rahul Vemula, MD, FACS's Response:
This is a severe defeat that is full thickness. I think the best repair would be as flap surgery and you will most likely need multiple stashes
How many surgery/revision can one have?
Male Breast ReductionMember Response:
It all depends on the severity of your gynecomastia that you had prior to any operation and the techniques that were used for the operation. It is impossible to say in your specific case without seeing pictures or doing a physical exam.
How many surgery/revision can one have?
Question:
I had multiple gynecomastia surgery(roughly 3 and an additional one touchup), it gets better each time but i have still have residual breast gland and deformities only noticable when arm raised, per doctor evaluation. I was told scar tissue makes it harder to operate, I am wondering how many gynecomastia surgical procedure is consider too much?
Rahul Vemula, MD, FACS's Response:
It all depends on the severity of your gynecomastia that you had prior to any operation and the techniques that were used for the operation. It is impossible to say in your specific case without seeing pictures or doing a physical exam.
Is it possible to get a free chin surgery to help with confidence issues?
Chin SurgeryMember Response:
Without seeing pictures or examining you it is impossible to determine what procedures will achieve your goals. Regarding costs for surgery, please beware of low cost clinics and clinics abroad where the standards may not be up to the standards of care for safety that we are accustomed to in the United States. Your best bet may be to get an evaluation at a teaching hospital’s plastic surgery resident cosmetic surgery clinic. Here you will be evaluated by a resident in their final years of training supervised by a board certified plastic surgeon. The costs are much lower and you get quality care. I see you are in MN, so I would reach out to the depts of Plastic surgery at University of Minnesota or Mayo Clinic to see if they have a resident cosmetic surgery clinic. Best wishes for a safe surgery to achieve your goal.
Is it possible to get a free chin surgery to help with confidence issues?
Question:
Hello and I am a 21 F who is in University to become a teacher, and I have always been bullied because of my chin, I am almost embarrassed to go in public because it’s so bad. Is there any way it would be possible to get surgery when insurance doesn’t cover it?
Rahul Vemula, MD, FACS's Response:
Without seeing pictures or examining you it is impossible to determine what procedures will achieve your goals. Regarding costs for surgery, please beware of low cost clinics and clinics abroad where the standards may not be up to the standards of care for safety that we are accustomed to in the United States. Your best bet may be to get an evaluation at a teaching hospital’s plastic surgery resident cosmetic surgery clinic. Here you will be evaluated by a resident in their final years of training supervised by a board certified plastic surgeon. The costs are much lower and you get quality care. I see you are in MN, so I would reach out to the depts of Plastic surgery at University of Minnesota or Mayo Clinic to see if they have a resident cosmetic surgery clinic. Best wishes for a safe surgery to achieve your goal.
How I get deemed medically necessary for a reduction
Breast ReductionMember Response:
It depends on the size of your breasts and how much tissue needs to be removed from each breast to achieve your goal. The insurance company has specific criteria that must be met in order to get coverage for the reduction. Unless the insurance criteria is followed to the letter, you won’t get insurance coverage. Unfortunately some plans may also have plan exclusions where they won’t cover a breast reduction under any circumstance. Please obtain a consultation with a board certified plastic surgeon who performs breast reductions in order to determine if you are a candidate. Another thing you can do in the meantime is call the member services phone # for your insurance company and ask them the specific criteria for a breast reduction (CPT code 19318). See if you can get as policy document or SPD that will speak about specific criteria. Every time you speak with someone from the insurance company ask for their name & ref # for the call. Best Wishes!
How I get deemed medically necessary for a reduction
Question:
I just had an MRI and found out I have multilateral degenerative disk disease with facet joint effisions, 2 tumors on my spine, canal stenosis, 8 bulging discs..No suspicious soft tissue mass. No sizable fluid collections. No fracture identified. Hemangioma T12 vertebral body measuring 11 mm. Hemangioma L3 vertebral body measuring 9 mm. There is no bone marrow edema. Bilateral facet joint effision
Rahul Vemula, MD, FACS's Response:
It depends on the size of your breasts and how much tissue needs to be removed from each breast to achieve your goal. The insurance company has specific criteria that must be met in order to get coverage for the reduction. Unless the insurance criteria is followed to the letter, you won’t get insurance coverage. Unfortunately some plans may also have plan exclusions where they won’t cover a breast reduction under any circumstance. Please obtain a consultation with a board certified plastic surgeon who performs breast reductions in order to determine if you are a candidate. Another thing you can do in the meantime is call the member services phone # for your insurance company and ask them the specific criteria for a breast reduction (CPT code 19318). See if you can get as policy document or SPD that will speak about specific criteria. Every time you speak with someone from the insurance company ask for their name & ref # for the call. Best Wishes!
Breast Reduction Effects on Breast Feeding.
Breast ReductionMember Response:
The majority of women after a breast reduction are able to breast-feed. Unfortunately, it is hard to predict if you will have any issues with this. Some people have no issues at all, some have decreased milk, production, and some not able to breast-feed at all. This is something that I discuss with all of my Breast Reduction Patient who are of childbearing age prior to the surgery.
Breast Reduction Effects on Breast Feeding.
Question:
Hi all, I'm 19 years old and currently a F cup. I have back/shoulder/neck pain and it's a big insecurity for me. Even with weight loss, they have stayed large. However, I really want to have kids in the next 6-10 years, and it's important to me that I would be able to breast feed. I would love to hear the different methods that have the most success w/ breast feeding? As well as any other advice.
Rahul Vemula, MD, FACS's Response:
The majority of women after a breast reduction are able to breast-feed. Unfortunately, it is hard to predict if you will have any issues with this. Some people have no issues at all, some have decreased milk, production, and some not able to breast-feed at all. This is something that I discuss with all of my Breast Reduction Patient who are of childbearing age prior to the surgery.
Is this surgery possible for patient who takes warfarin due to AVR?
Calf AugmentationMember Response:
It can be done but a few considerations. Every time you stop your blood thinners with an aortic valve you do risk developing a blood clot at the site of the valve which can be fatal. You need to discuss with your cardiologist what the risk of this is. Also, once you go back on your blood thinners there is an increased risk of bleeding even if it is a type of surgery where minimal bleeding is expected. If you develop a bleed, then the blood thinners have to be stopped and you may need to return to the operating room to evacuate the blood. So this procedure is not without risk, and more risk than if you were not on any blood thinners I would also recommend getting this done at a hospital and not at a surgical center .
Is this surgery possible for patient who takes warfarin due to AVR?
Question:
Is it possible to have a plastic surgeon perform a male calf implant on a patient who is on warfarin therapy with a target INR of 1.5-2.0 (mechanical On-X aortic valve replacement), by working with the patient's cardiologist on the appropriate Lovenox bridging plan? Really hoping to get this procedure done. Thank you very much.
Rahul Vemula, MD, FACS's Response:
It can be done but a few considerations. Every time you stop your blood thinners with an aortic valve you do risk developing a blood clot at the site of the valve which can be fatal. You need to discuss with your cardiologist what the risk of this is. Also, once you go back on your blood thinners there is an increased risk of bleeding even if it is a type of surgery where minimal bleeding is expected. If you develop a bleed, then the blood thinners have to be stopped and you may need to return to the operating room to evacuate the blood. So this procedure is not without risk, and more risk than if you were not on any blood thinners I would also recommend getting this done at a hospital and not at a surgical center .
Pointy helix after otoplasty, can I reverse it?
Ear SurgeryMember Response:
Looks like this can be fixed with removing one of the sutures that were used to creat the fold called the anti helix which you are showing as bothersome. I would discuss this with your surgeon. Also would help here to see your pre operative pictures to see what the fold looked like prior to the operation
Pointy helix after otoplasty, can I reverse it?
Question:
I had otoplasty done 2 years ago and I’m not satisfied with the result. My ears are asymetrical (though the form of them are not the same). The surgeon did a antihelical fold on one of my ears but not the other so it looks weird to me because the fold is very pointy. Can I reverse this fold and make it more soft like before again if the surgeon did not remove any cartilage and used dissolvable sut
Rahul Vemula, MD, FACS's Response:
Looks like this can be fixed with removing one of the sutures that were used to creat the fold called the anti helix which you are showing as bothersome. I would discuss this with your surgeon. Also would help here to see your pre operative pictures to see what the fold looked like prior to the operation
Skin folds
Breast LiftMember Response:
It is really not possible to tell what’s going on with only one picture and not seeing before pictures. However, 7 days is very early in the post operative period. Thinks take approximately 6 months to settle down and for all of the swelling to resolve. Please discuss your concerns with your operating surgeon
Skin folds
Question:
I’m not sure if this is normal, I had a breast lift 7 days ago and I have these skin folds. Please see photo.
Rahul Vemula, MD, FACS's Response:
It is really not possible to tell what’s going on with only one picture and not seeing before pictures. However, 7 days is very early in the post operative period. Thinks take approximately 6 months to settle down and for all of the swelling to resolve. Please discuss your concerns with your operating surgeon
Platysmal band contracture
Neck LiftMember Response:
Thank you for this question. I would do lymphatic massages if you have not done so already. Also ask your surgeon about injecting steroid to these areas to soften then up. You may need a revision but I would wait a minimum of 6 -12 months before a revision. 12 months would be preferable
Platysmal band contracture
Question:
Hi, I had a neck lift 3 months ago. I had a hemorrhage and had to go back into surgery. This is what my neck looks like. I know I need to wait for more healing but what can I do about my platysmal band contracture?
Rahul Vemula, MD, FACS's Response:
Thank you for this question. I would do lymphatic massages if you have not done so already. Also ask your surgeon about injecting steroid to these areas to soften then up. You may need a revision but I would wait a minimum of 6 -12 months before a revision. 12 months would be preferable
forehead lump
General ReconstructionMember Response:
Without examining you it is hard to say if this is an osteoma or a lipoma. Please visit a plastic surgeon for an examination. The surgeon will most likely order an imaging study as part of the surgical planning.
forehead lump
Question:
I have this hard immovable forehead lump. Noticed it a few years ago and it keeps growing. It does not hurt. Feels like a knob growing out of my skull. Is this something that can be shaved off?
Rahul Vemula, MD, FACS's Response:
Without examining you it is hard to say if this is an osteoma or a lipoma. Please visit a plastic surgeon for an examination. The surgeon will most likely order an imaging study as part of the surgical planning.
Is it okay to show photos of what I want?
Breast AugmentationMember Response:
Not a bad idea to bring photographs into your consultation. It helps your surgeon figure out if your expectations are realistic or not. At times, I have patients that bring in pictures that are very unrealistic to their body. I have found the best thing is to do 3-D imaging where I can show a patient, a 3-D model generated from their own pictures. What certain implants would look like
Is it okay to show photos of what I want?
Question:
I want to get a breast augmentation and have a specific look I want to go for, however I’m not sure if it’s appropriate to show my surgeon photos of what I am going for. Is it okay to show photos to surgeon and what kind of photos are appropriate? I know results will still vary
Rahul Vemula, MD, FACS's Response:
Not a bad idea to bring photographs into your consultation. It helps your surgeon figure out if your expectations are realistic or not. At times, I have patients that bring in pictures that are very unrealistic to their body. I have found the best thing is to do 3-D imaging where I can show a patient, a 3-D model generated from their own pictures. What certain implants would look like
6 months post op breast augmentation with lift
Breast AugmentationMember Response:
Would need to see your pre operative pictures to see what your nipple position was prior to the placement of implants. A breast lift with implants is a very challenging procedure and has a high revision rate. I would meet with your surgeon to go over all of your options for a revision surgery.
6 months post op breast augmentation with lift
Question:
I am 6 months post op breast lift and under the muscle breast augmentation and have a snoopy nose deformity. What can be done for this and what might have cause med this. My nipples are also low. I figured getting a breast lift with it would have been enough for this not to happen. I paid 15000. And it's only been 6 months . What should I do?
Rahul Vemula, MD, FACS's Response:
Would need to see your pre operative pictures to see what your nipple position was prior to the placement of implants. A breast lift with implants is a very challenging procedure and has a high revision rate. I would meet with your surgeon to go over all of your options for a revision surgery.
Problems with pectoral muscle years after explant
Breast Implant RemovalMember Response:
IT is really impossible to render an opinion without seeing pictures and doing a physical examination. There can be many things that may could be the cause of your symptoms. Please visit with a board certified plastic surgeon for a physical exam and to go over all of your options
Problems with pectoral muscle years after explant
Question:
I have terrible pain at the incision site of my implant removal, which was 8 yrs ago. I did some cupping under the right breast to alleviate scar tissue, now have chronic pain, especially under that breast and into my back and ribs. My muscle was not repaired, however, seemed to lay back close to where it was. Is it possible for the muscle to come loose again after scarring down to the chest? Or?
Rahul Vemula, MD, FACS's Response:
IT is really impossible to render an opinion without seeing pictures and doing a physical examination. There can be many things that may could be the cause of your symptoms. Please visit with a board certified plastic surgeon for a physical exam and to go over all of your options
Breasts are lopsided after lift and implants
Breast AugmentationMember Response:
Thank you for this question and providing the pre and post operative photographs. 10 weeks is still very early in the post operative process, especially if your implants were put under the muscle. The muscle can be in spasm for several weeks. Based on these photographs, it looks like you are healing very well. I agree with my colleagues here as I also feel that your surgeon did a very good job on this procedure. I would wait a minimum of 6 months from the date of the procedure to see how the breast settle. Best wishes.
Breasts are lopsided after lift and implants
Question:
I am 10 weeks postop, right after surgery my breasts looked amazing. I noticed after 4 weeks my left breast is still high and is leaning towards my sternum. I am distraught about this outcome the lopsided appearance is very unattractive and obvious. I assumed they would fall into the correct position with time. I have an appointment with my surgeon in 2 weeks but the wait is giving me anxiety.
Rahul Vemula, MD, FACS's Response:
Thank you for this question and providing the pre and post operative photographs. 10 weeks is still very early in the post operative process, especially if your implants were put under the muscle. The muscle can be in spasm for several weeks. Based on these photographs, it looks like you are healing very well. I agree with my colleagues here as I also feel that your surgeon did a very good job on this procedure. I would wait a minimum of 6 months from the date of the procedure to see how the breast settle. Best wishes.
How many units of Botox are injected in one session?
Botulinum ToxinMember 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
How many units of Botox are injected in one session?
Question:
How many units of Botox are injected in one session, and how many different areas, i.e. forehead, lip, chin, eyes, eyebrows, etc., can be combined in one session?
Rahul Vemula, MD, FACS's 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
Excise Skin Graft
Burn ReconstructionMember 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
Excise Skin Graft
Question:
Hi, I would like to excise a 3.5inch wide split thickness skin graft on my shin. I have read a lot about external tissue expanders like DermaClose. I have been told by one plastic surgeon that these devices can be used to excise an existing skin graft, but it appears most don't have experience in using them on the lower extremities. Does any surgeon here have experience or can give a referral?
Rahul Vemula, MD, FACS's 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
Excise Skin Graft
Burn ReconstructionMember 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
Excise Skin Graft
Question:
Hi, I would like to excise a 3.5inch wide split thickness skin graft on my shin. I have read a lot about external tissue expanders like DermaClose. I have been told by one plastic surgeon that these devices can be used to excise an existing skin graft, but it appears most don't have experience in using them on the lower extremities. Does any surgeon here have experience or can give a referral?
Rahul Vemula, MD, FACS's 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
Please help guide me/ very urgent
Breast ReconstructionMember 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)
Please help guide me/ very urgent
Question:
46 yo had bilateral skin sparing mastectomy in Oct. 2023, with TE placement. incisions opened surgical closure in dec 2023.resumed fills ..reported problem but surgeon was unavailable, pics and concerns dismissed...sent to w.c, i watched my incision open. only tonight, surgeon called, expander exposed, wants emergency lat flap, w/ no visit before, only 1 day to decide. never discussed. terrified.
Rahul Vemula, MD, FACS's 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)
Delayed Diep Flap after NSM
DIEP Flap Breast ReconstructionMember 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.
Delayed Diep Flap after NSM
Question:
Hi- I had a double MSX a year ago with TEs. Both failed. One several weeks after my Masectomy and the second after radiation treatment. The surgeon I saw recommended a diep flap but said are can’t save the nipple on the radiated breast. Why? Is there anyway to save it? Also, I was told I couldn’t do implants with a diep flap. Is this true too as well? I have read online that it is possible.
Rahul Vemula, MD, FACS's 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.
I need help ASAP!!
Breast AugmentationMember 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.
I need help ASAP!!
Question:
My left boob is a C cup and my right boob is a D cup. This has been embarrassing for me because it's completely noticeable. Especially when I wear bathing suits. Could I transfer fat from another part of my body to my left boob to even them out? I've jus been so embarrassed of this for so long, and I don't know what else to do.
Rahul Vemula, MD, FACS's 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.
Open wound
Tummy TuckMember Response:
I think it will close if there is very limited undermining around the wound. A wound vac will definitely help it close faster.
Open wound
Question:
Feb 28 I got a tummy tuck with "T cut". For about six weeks after surgery I had a seroma and the water was dripping out of a small open wound at the "intersection" of the two cuts. For over two weeks the seroma is gone and I can concentrate on closing that open wound. Currently it's treated with a new alginate tamponade every two days. Can you calm me? 😅 Can/will it close till summer?
Rahul Vemula, MD, FACS's Response:
I think it will close if there is very limited undermining around the wound. A wound vac will definitely help it close faster.
Incision not healing
Tummy TuckMember 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.
Incision not healing
Question:
I am 4 weeks post op and my incision is not healing. My surgeon keeps saying it will heal…eventually. I feel that he should send me to wound care. Instead he is telling me to pack it with just a gauze each day and let the water run over it in the shower. I would like opinions on what you would do if I were your patient.
Rahul Vemula, MD, FACS's 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.
Should I go to a wound center ??
Breast ReductionMember Response:
It’s best to have a post operative visit with the surgeon since you are so early post op.
Should I go to a wound center ??
Question:
I had my breast reduction 17 days ago . My surgeon told me I problably had a hematoma since I experience alot of bleeding for the last 3 days : it finally stopped but now I have this new opening. Should I get this close up? My surgeon it’s 2 hrs away!
Rahul Vemula, MD, FACS's Response:
It’s best to have a post operative visit with the surgeon since you are so early post op.
How easy/hard is it to mess up rhinoplasty results ?? 23 days post op, I did something really stu
RhinoplastyMember 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
How easy/hard is it to mess up rhinoplasty results ?? 23 days post op, I did something really stu
Question:
Hi ! So this is probably really stupid and I’m honestly too embarrassed to tell my plastic surgeon. I had a rhinoplasty 24 days ago. I had a revision rhinoplasty that was really complicated with cartilage grafting .I had nasal valve collapse . Yesterday (23 days post) my nose felt really blocked. So I did something stupid. Please read my text in photos !
Rahul Vemula, MD, FACS's 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
Academic setting or private practice?
Breast ReconstructionMember 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
Academic setting or private practice?
Question:
What is the difference between having breast reconstruction with a physician in a large academic hospital and physician at a private practice? I am exploring all options. I had a NSM in May 2023 with immediate reconstruction w/TEs.. Both TE’s failed. The 1st several wks after surgery and the 2nd a month after rads 10/3/23. I was referred to a surgeon who can do a Diep but not until Feb ’25
Rahul Vemula, MD, FACS's 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
Best option for frowning belly button
Tummy TuckMember 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!
Best option for frowning belly button
Question:
I recently lost over 80 pounds and have done it gradually over the course of 2 years. I wouldn’t say I have droopy loose skin but when I bend over I definitely notice. I’m very insecure about my belly button and feel as though it makes me look chubbier than I am. What options are there for me? I don’t plan on ever having kids so this would be a permanent solution! Is there procedures without scars
Rahul Vemula, MD, FACS's 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!
Nipple sparing mastectomy
Breast ReconstructionMember 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
Nipple sparing mastectomy
Question:
Roughly what percent of breast cancer patients who are having or had mastectomies are NOT eligible for nipple-sparing mastectomies?
Rahul Vemula, MD, FACS's 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
Revision
Breast ReductionMember Response:
These are all excellent questions. The best place to have these concerns addressed on the type of revision and recovery would best be answered by an in person consultation. Also regarding infections, you surgeon would need to figure out what was the cause of these infections. In general, you are at higher risk for infection if you have some sort of immune compromise, uncontrolled Diabetes, any type of nicotine exposure, and BMI greater and 30. Best wishes.
Revision
Question:
I had a breast reduction little over a year ago. Unfortunately I developed a severe infection in both breast. Along every incision line and I had a loss of nipple and areaola with a big indention where nipple should be. I also have scars on both breast that are very ugly. Do you think it can be fixed? Very sloppy job and sagging beast that were to be lifted.
Rahul Vemula, MD, FACS's Response:
These are all excellent questions. The best place to have these concerns addressed on the type of revision and recovery would best be answered by an in person consultation. Also regarding infections, you surgeon would need to figure out what was the cause of these infections. In general, you are at higher risk for infection if you have some sort of immune compromise, uncontrolled Diabetes, any type of nicotine exposure, and BMI greater and 30. Best wishes.
Disney trip 8 days post op
Breast ReductionMember 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.
Disney trip 8 days post op
Question:
Would it be a smart decision to do a day long Disney trip 8 days after my reduction? I’m really worried about it
Rahul Vemula, MD, FACS's 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.
Lower abdominal bulge
Tummy TuckMember Response:
You may need some liposuction combined with a modality like Renuvion. Please visit your plastic surgeon. Best wishes
Lower abdominal bulge
Question:
I’m 15 mo post op of tummy tuck and have a bulge in my lower abs. I still feel the need to wear compression and experience some pain. This area was flat and had progressively gotten larger. Any feedback is appreciated. Thank you.
Rahul Vemula, MD, FACS's Response:
You may need some liposuction combined with a modality like Renuvion. Please visit your plastic surgeon. Best wishes
Breast explant and lift
Breast LiftMember Response:
Agree with my colleagues here. Please contact your surgeon for advice
Breast explant and lift
Question:
I was told not to remove tape so I can't see my incisions well. I have 3 concerns 1. The color of my nipples (the first pic is 5 days post op) has gotten drastically darker (2nd & 3rd pic, 10 dpo) 2 . Concerned with the extra skin visible on the vertical incision that seems to be bugling and it seems the incision is not straight 3. Concave nipples post surgery, nipples were not concave preop
Rahul Vemula, MD, FACS's Response:
Agree with my colleagues here. Please contact your surgeon for advice
Finding a resident surgeon
Tummy TuckMember 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
Finding a resident surgeon
Question:
I have lost 150lbs after WLS and have kept if off for 5 years. I have read threads where people are looking for more economical ways to get a tummy tuck and see that it's recommended to reach out to a plastic surgery training program. Who (what position/title) would I reach out to in my area to find out if it's possible to get the procedure for a reduced cost at a residency/training program?
Rahul Vemula, MD, FACS's 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
Moving placement of implants
Breast Implant RevisionMember 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
Moving placement of implants
Question:
I replace 26 year old calcified implants 2 years ago. I had saline over the muscle and went back with saline over the muscle. I now have a lot of rippling. After now 28 years of implants over the muscle can I relocate them to under the muscle, go with silicone and get a more natural appearance? I have been reading that the implants being over the muscle for this long could make this a bad option?
Rahul Vemula, MD, FACS's 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
Co2 laser destroyed my face indented lines everywhere
General ReconstructionMember 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.
Co2 laser destroyed my face indented lines everywhere
Question:
Could a plastic surgeon skin graft my whole face
Rahul Vemula, MD, FACS's 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.
Hashimoto’s
Breast AugmentationMember 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.
Hashimoto’s
Question:
I really want to get breast augmentation and reading that since I have Hashimoto I am not a good candidate. Could someone explain why specifically Hashimoto’s and does it change things if I take thyroid meds and have a good diet to control it? And if the answer is no would fat transfer be an option?
Rahul Vemula, MD, FACS's 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.
Looking to get eye lid surgery.
Eyelid SurgeryMember 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
Looking to get eye lid surgery.
Question:
The skin above my eyes are effecting my vision. How do I select a doctor who is well experienced?
Rahul Vemula, MD, FACS's 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
Lip Reconstruction after a busted lip
General ReconstructionMember 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.
Lip Reconstruction after a busted lip
Question:
This happened in 8th grade playing basketball. I’m now 28. I was wondering if this can be fixed(have read
Rahul Vemula, MD, FACS's 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.
Inverted nipples
Breast AugmentationMember 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.
Inverted nipples
Question:
Hello all. I’m a man who has had inverted nipples for years and wants to get rid of them. How do I find a surgeon who will do that procedure only, because it seems that that is a surgery geared mostly for women and mostly follow breast augmentation which I don’t need. There is no “inverted nipple” tab so does this procedure fall under breast augmentation? And in your experience what is the cost?
Rahul Vemula, MD, FACS's 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.
Tummy tuck skin removal?
Tummy TuckMember 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.
Tummy tuck skin removal?
Question:
Tummy tuck 12 weeks ago and struggling with my results. While I had some muscle separation, my fascia was very loose. My doctor said he did not make my core as tight as he could have due to concern about removing too much skin on my abdomen and skin dying. 2 lbs of skin removed. Type two diabetic, controlled, no complications, 5.2 A1C 24 BMI. Steady blood sugar the whole procedure. Thoughts? Thx
Rahul Vemula, MD, FACS's 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.
After breast augmentation
Breast AugmentationMember 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
After breast augmentation
Question:
Hello! I have breast augmentation befor 3 weeks. Till second week I see that one of my breast is bigger than other. Is that normal? My second question is - are breast get bigger in the bottom after they drop and fluff?
Rahul Vemula, MD, FACS's 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
Implant not dropping after falling from snowboarding
Breast ReductionMember 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.
Implant not dropping after falling from snowboarding
Question:
Got my breast done in another state, from Arizona so it’s hard going back and forth, 1 month after I got a reduction and implant, I went snowboarding- I know stupid. I ended up falling on my breasts, ended up being infected from falling and I drained lots of green fluid, finally healed 2/3 weeks later. Will my right breast ever drop? Or did I create scar tissue to where it’s not dropping been 2mo
Rahul Vemula, MD, FACS's 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.
Implant not dropping after falling from snowboarding
Breast ReductionMember 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.
Implant not dropping after falling from snowboarding
Question:
Got my breast done in another state, from Arizona so it’s hard going back and forth, 1 month after I got a reduction and implant, I went snowboarding- I know stupid. I ended up falling on my breasts, ended up being infected from falling and I drained lots of green fluid, finally healed 2/3 weeks later. Will my right breast ever drop? Or did I create scar tissue to where it’s not dropping been 2mo
Rahul Vemula, MD, FACS's 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.
Age and insurance
Breast ReductionMember 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
Age and insurance
Question:
I’m 16 almost 17 years old and really want a breast reduction. I’m a 34F and they cause me extreme pain in mid back, shoulders, and where neck and back meet. I get terrible rashes under them and the weight makes me naturally hunch. I’m worried my insurance won’t approve because of my age despite my problems. Are these bad enough for them to approve me dispute my age?
Rahul Vemula, MD, FACS's 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
Age and insurance
Breast ReductionMember 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
Age and insurance
Question:
I’m 16 almost 17 years old and really want a breast reduction. I’m a 34F and they cause me extreme pain in mid back, shoulders, and where neck and back meet. I get terrible rashes under them and the weight makes me naturally hunch. I’m worried my insurance won’t approve because of my age despite my problems. Are these bad enough for them to approve me dispute my age?
Rahul Vemula, MD, FACS's 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
Massive loss of cologine
Buttock Lift with AugmentationMember 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.
Massive loss of cologine
Question:
I’ve had massive loss of cologine in my buttocks and I’ve been working out everyday twice a day for 4 months now with little results I’ve consulted with a plastic surgeon he recommends injections but at that price I can’t afford.. Please help!!! I’d like to feel like a woman again…
Rahul Vemula, MD, FACS's 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.
Best White Stretch Mark Treatment
Skin rejuvenation and resurfacingMember 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
Best White Stretch Mark Treatment
Question:
I have stretch marks which immediately turned white after having a child. I’m not sure why I never went through the stage of red stretch marks, but a lot of them appear white and even glisten or shiny and thick. I have researched treatments but I would like advice on what treatments may be best to smoothen the skin and fade as much as possible, though I know complete removal may not be possible
Rahul Vemula, MD, FACS's 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
Best Treatment for Facial Scar
Wound CareMember 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
Best Treatment for Facial Scar
Question:
I had a fall a month ago resulting in over 15 stitches below my lip and on my chin. What is the best treatment for a facial scar to help with discoloration and bumpiness? I read about silicone gel, is that the #1 recommendation and if so..which brand is most effective?
Rahul Vemula, MD, FACS's 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
Best Treatment for Facial Scar
Wound CareMember 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
Best Treatment for Facial Scar
Question:
I had a fall a month ago resulting in over 15 stitches below my lip and on my chin. What is the best treatment for a facial scar to help with discoloration and bumpiness? I read about silicone gel, is that the #1 recommendation and if so..which brand is most effective?
Rahul Vemula, MD, FACS's 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
Fleur Des Les
Tummy TuckMember 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
Fleur Des Les
Question:
Who
Rahul Vemula, MD, FACS's 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
DESPERATE FOR HELP/ ASVISE PLEASE
Breast AugmentationMember 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
DESPERATE FOR HELP/ ASVISE PLEASE
Question:
I had an uplift & micro implant 12 weeks ago . After 10 days everything started splitting underneath my breast to start with then it opened like a zip very quickly and one point I had 1/2 a nipple . I have been seeing my surgeon every single week at the clinic for check ups and he said there is nothing he can do for me . I put manuka honey , actilite gauzes and dress it everyday . It’s very deep
Rahul Vemula, MD, FACS's 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
When can the wound be stitched?
Tummy TuckMember 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.
When can the wound be stitched?
Question:
I’m after 1.5 months after a tummy tuck and liposuction surgery. After 14 days, I discovered that I have necrosis; the necrotic part was removed 10 days ago, and since then the wound is treated with VAC. Since I don’t think that at this point I have any patients left in me… I was wondering when is the right time to stitch the wound? I really want it to happen ASAP…
Rahul Vemula, MD, FACS's 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.
Capsulectomy necessary with rupture?
Breast Implant RevisionMember 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
Capsulectomy necessary with rupture?
Question:
I recently was found to have a ruptured silicone implant seen on an MRI done for a regular cancer screening. The two PS’s that I’ve seen don’t feel I need to have the capsule removed when I have my implants replaced but most of what I’m reading is that’s recommended. I am having some mild pain recently and minor swelling on that side but no suspected CC and no other symptoms.
Rahul Vemula, MD, FACS's 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
Tummy tuck (TT)
Tummy TuckMember Response:
Thank you for your question. Without pictures it is impossible to give you advice on what the optimal procedure will be.
Tummy tuck (TT)
Question:
Hello! I’m having a TT with lipo on flanks & abdomen. My dr said he doesn’t think i need to add the back lipo because the flank lipo and contouring in the front will pull my back inwards. I’m afraid to look top heavy with a big back & flat stomach.. he reassured this would not be the case & lipo could be done later if i really want. do you think my body will look odd & will my back be pulled in?
Rahul Vemula, MD, FACS's Response:
Thank you for your question. Without pictures it is impossible to give you advice on what the optimal procedure will be.
Insurance covers breast surgery revision, can I cash pay for extras?
Breast ReconstructionMember 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
Insurance covers breast surgery revision, can I cash pay for extras?
Question:
My insurance will cover a breast surgery revision needed. Is it okay to add an additional cosmetic procedure for which I can cash pay, such as lipo?
Rahul Vemula, MD, FACS's 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
Breast lift after biopsy?
Breast LiftMember 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.
Breast lift after biopsy?
Question:
Breast biopsy actually removal of neoplasma?
Rahul Vemula, MD, FACS's 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.
Breast lift after biopsy?
Breast LiftMember 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.
Breast lift after biopsy?
Question:
Breast biopsy actually removal of neoplasma?
Rahul Vemula, MD, FACS's 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.
Breast lift after biopsy?
Breast LiftMember 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.
Breast lift after biopsy?
Question:
Breast biopsy actually removal of neoplasma?
Rahul Vemula, MD, FACS's 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.
Endolift Scars
Wound CareMember 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
Endolift Scars
Question:
I was treated with chin Liposuction and Endolift in my neck, face and eyes. It has scared me on my neck, cheek, and eyebrow area. What can I do to fix the scars. This happened on Dec. 15. The Dr. I saw in Tijuana will see me - to correct - but what kind of correction is needed, and do I trust the guy who scared me to fix it?
Rahul Vemula, MD, FACS's 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
Cost
Breast AugmentationMember 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!
Cost
Question:
This might be a rather “silly” question but is there anyone or any establishment that might offer a pro bono or reduced cost for a breast augmentation? After breastfeeding my child for over a year my breasts are completely gone. I don’t have the extra money at the moment for the procedure
Rahul Vemula, MD, FACS's 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!
asking for a friend
LiposuctionMember 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.
asking for a friend
Question:
my friend is wanting fat removal surgery, but they aren't 18 and they want to know if there a way they can get it, and if so what are the risk?
Rahul Vemula, MD, FACS's 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.
Scar tissue inside lip removal
Lip Augmentation/EnhancementMember 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
Scar tissue inside lip removal
Question:
I have a lump of hard scar tissue on the inside of my lip from an injury 15 years ago. It causes me to have the appearance of a slight fat lip. I am not as concerned about the appearance of it, but it is bothersome having this in my lip. One plastic surgeon who saw an image of it wants to inject a steroid into it but I am skeptical this will work. What would be the best course of action?
Rahul Vemula, MD, FACS's 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
Do I need revision surgery?
Breast LiftMember 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
Do I need revision surgery?
Question:
I had a breast lift with implants about three months ago. The surgeon that I went to took out the stitches after 7 days, which caused several infections at incision sites. I took antibiotics and eventually the infection went away, however, I am left with ugly infection scars. On my right breast, it looks like my nipple is being pulled down from the shape of the scar.
Rahul Vemula, MD, FACS's 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
Miracle
Body LiftMember 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
Miracle
Question:
I have a friend who has struggled for a long time with her health. She had colon surgery and the side effect she had was a stomach disfigurement-huge side bulk bigger than a basket ball on the side of her stomach. She has continuously suffered health complications. She gain a ridiculous amount of weight-over 500 lbs. She needs a miracle. Any pro bono doctor willing to help her gain her life back?
Rahul Vemula, MD, FACS's 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
Miracle
Body LiftMember 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
Miracle
Question:
I have a friend who has struggled for a long time with her health. She had colon surgery and the side effect she had was a stomach disfigurement-huge side bulk bigger than a basket ball on the side of her stomach. She has continuously suffered health complications. She gain a ridiculous amount of weight-over 500 lbs. She needs a miracle. Any pro bono doctor willing to help her gain her life back?
Rahul Vemula, MD, FACS's 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
Skin Removal After Bariatric Surgery
Tummy TuckMember 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!
Skin Removal After Bariatric Surgery
Question:
Good Day, are there any pro bono plastic surgeons in the Springfield, MO area that could assist me in having all my excess skin removed? I would be at goal weight if this would occur. I went from 413 to 219. I'd love to feel normal in my own body plus I have issues with yeast infection, hernia, and back issues. I do have private health insurance that could possibly cover the procedure.
Rahul Vemula, MD, FACS's 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!
Necrotic tummy tuck
Tummy TuckMember 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
Necrotic tummy tuck
Question:
I had a TT&ended up with necrosis/open wound.It is healing slowly&I am putting gaze soaked in water& cleaning it in the shower as instructed.I am having pain in any position besides laying down.The bottom region from the incision&below burns.The corners have tunnels,discharge&hurt.I’m told I shouldn’t have pain&should be able to go back to work.I don’t foresee being able to.Is pain atypical&work e
Rahul Vemula, MD, FACS's 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
Explant procedure without capsule removal
Breast Implant RemovalMember 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
Explant procedure without capsule removal
Question:
I want to remove my silicone implants after having them for 13 years. Never had any problems with them doesn’t feel like they rupture everything fine. I want an explant procedure without capsule removal. Is it harmful/dangerous if I leave capsule?
Rahul Vemula, MD, FACS's 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
Failed implant or not?
Breast AugmentationMember 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
Failed implant or not?
Question:
I had a breast reconstruction with implant under the muscle 7 weeks ago. After week 1 I developed a seroma that drained for 5 weeks. Didn’t respond to antibiotics so culture threw E.coli. Did 9 days of IM Ertapenem to save the surgery. Breast feels that pulls when I use the muscle. Draining stoped but how do I know if I will have to remove the implant or if antibiotics were enough? My PS is abroad
Rahul Vemula, MD, FACS's 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
Do I have an infection ?
Tummy TuckMember Response:
This needs to local wound care at minimum and some debridement. Please follow up closely with your surgeon. Best wishes
Do I have an infection ?
Question:
I am 5 weeks post op and started spitting stitches, at first it was just one but everyday I had a new opening with a stitch coming out. I pulled out all the stitches but I’m worried about how my incision line opened up in so many places. Does it look infected ?
Rahul Vemula, MD, FACS's Response:
This needs to local wound care at minimum and some debridement. Please follow up closely with your surgeon. Best wishes
Belly Button Died, multiple repairs .looks horrible. Need help
Tummy TuckMember 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
Belly Button Died, multiple repairs .looks horrible. Need help
Question:
I recently had a belly button revision (again) 12/8 and the stitches opened (again). Can I put a belly button shaper in the hole to help give me somewhat of a button? I need a new surgeon as this one tried 7 times and my skin isn’t cooperating. I’m in IL, can anyone help and has had experience with a dead button. Original surgery was in 2018.
Rahul Vemula, MD, FACS's 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
I am still in pain and died feels too tight after 1 year
DIEP Flap Breast ReconstructionMember 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
I am still in pain and died feels too tight after 1 year
Question:
My breast feels tight and swollen and have had a rash all over my body that will not go away.
Rahul Vemula, MD, FACS's 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
How to get panniculectomy paid for by health insurance
PanniculectomyMember 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!
How to get panniculectomy paid for by health insurance
Question:
I wanted to get some additional information of how to get health insurance to pay for Panniculectomy. I have read most health insurance want to see a massive weight loss (e.g., over 100 lbs). I recently lost 30lbs. However, my bigger loss was my body fat percentage. When I started I was at approximately 30%, today I am around 16-17. Thoughts??
Rahul Vemula, MD, FACS's 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!
Breast Reduction
Breast ReductionMember 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.
Breast Reduction
Question:
I want to know that even though I don’t have 12 months documentation of pain and extreme discomfort in my medical records, could I still get my insurance to cover my breast reduction with the help of a doctor of some sort?
Rahul Vemula, MD, FACS's 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.
Sagging breasts, total different size areolas, uncentered, feels like implant in armpit. Hack job?
Breast AugmentationMember 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
Sagging breasts, total different size areolas, uncentered, feels like implant in armpit. Hack job?
Question:
Is all this normal? I'm 4 weeks post op. Can't get answers from Surgeon. Paid for lift ans implants, he determined I didn't need lift. My areolas are different sizes now, not straight or centered. My boots sag straight to the ground like I'm 80 years old. Breasts are two different sizes. He didn't listen/read notes, I started with different sizes. Stitching looks like a hack job. Sagging breasts??
Rahul Vemula, MD, FACS's 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
Wound opening
Breast LiftMember 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
Wound opening
Question:
I am nearly 5 weeks post op from a breast uplift and implant replacement, I have been cleaning and re dressing my wounds every day as advised as well as using an antibiotic cream and iodine daily, I have also been on antibiotics until a few days ago, my wound on one of my breasts seems to have split open and is worrying me! Any advise please? Thank you
Rahul Vemula, MD, FACS's 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
How safe
Breast ReductionMember 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 .
How safe
Question:
20 years ago I had a breast lift after having kids and a little gain weight my breasts gotten bigger, I went for a consultation to get a breast reduction I'm a little concerned due to what the doctor said to me because he doesn't know how my last surgery was done there is a possibility I could lose my nipples and I'm really nervous about proceeding with surgery he said he won't know until he cuts
Rahul Vemula, MD, FACS's 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 .
Where do I start
Breast LiftMember 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
Where do I start
Question:
I had a breast aug and lift in April 2021. I started noticing my nipples were way too high at my 1 mo post op. I knew it was too soon and I had to wait for them to settle. By my 3 mo appt, I brought it up and was told it was still too soon. By my 6 mo appt, I was told they “saw what I meant” and would consult the md and get back to me. Didn’t happen. Now I’m here and want to see where do I start?
Rahul Vemula, MD, FACS's 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
Breast augmentation 4 weeks ago
Breast Implant RevisionMember 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.
Breast augmentation 4 weeks ago
Question:
I had breast augmentation 4 weeks ago and found out my surgeon used textured implants. I was under the assumption he was going to use smooth implants due to the risk of bia-alcl, however did not confirm this. I am now full of anxiety relating to the textured implants and am wanting to get these removed and replaced with smooth implants, how long should I wait before getting this done?
Rahul Vemula, MD, FACS's 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.
Please help guide me
Breast ReconstructionMember 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
Please help guide me
Question:
46 year old female with high grade DCIS, 8cm in right breast all malignant biopsies. I am on my 2nd opinion at a major cancer hosp and they have me scheduled for a double non nipple sparing skin sparing mastectomies with immediate placement of under muscle expanders. I am alone, I don't understand. have 1 plastics surg and they perform limited techniques as center seems to lack advanced tech.
Rahul Vemula, MD, FACS's 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
Breast Revision
Breast AugmentationMember 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.
Breast Revision
Question:
I had my breast augmentation just over a year ago. My right breast implant is higher. My surgeon said this was due to the inframammary fold being uneven and that she had tried to adjust during surgery, but sometimes it just doesn't work. She is suggesting a revision and offering a discount. Is this normal? Should she have caught and fixed the asymmetry during the original surgery?
Rahul Vemula, MD, FACS's 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.
Consultation Costs
LiposuctionMember 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.
Consultation Costs
Question:
I looking to find few surgeons in my area for a consultation and determine which liposuction treatment will be best (i.e Smart Lipo, Vaser, tumescent). What is the consultation fee?
Rahul Vemula, MD, FACS's 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.
Botched Breast lift? Revision needed?
Breast LiftMember Response:
3 weeks is way to early to determine fine results. I would wait 6 months and reassess Best wishes
Botched Breast lift? Revision needed?
Question:
I just had a breast lift 3 weeks ago, but my left breast has a deep crease now leaving a strange sack shape underneath it. My surgeon said it's caused by normal swelling and stitches that are going to dissolve, so the shape will look normal in a few weeks, but I'm no so sure. Will I have to get a revision surgery to achieve a natural shape? Or can this go away naturally like he said?
Rahul Vemula, MD, FACS's Response:
3 weeks is way to early to determine fine results. I would wait 6 months and reassess Best wishes
Mechanical Valve in my Heart
Breast AugmentationMember 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.
Mechanical Valve in my Heart
Question:
Is it possible to get breast augmentation if I have a mechanical valve in my heart. The heart surgery left behind horrible scares/bumps/large space between my breast. I look disfigured and would like to get it fixed. Would I be considered for surgery? Would my health insurance cover the cost?
Rahul Vemula, MD, FACS's 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.
Mechanical Valve in my Heart
Breast AugmentationMember 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.
Mechanical Valve in my Heart
Question:
Is it possible to get breast augmentation if I have a mechanical valve in my heart. The heart surgery left behind horrible scares/bumps/large space between my breast. I look disfigured and would like to get it fixed. Would I be considered for surgery? Would my health insurance cover the cost?
Rahul Vemula, MD, FACS's 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.
Complications
Tummy TuckMember 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
Complications
Question:
Hello my name Ciara I have a tummy tuck out if state and iam 3 weeks post po and my incision open up on one side red and draining also hard iam keeping it clean but don't know what eles to do I've been given cephalexin again but still no relieve
Rahul Vemula, MD, FACS's 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
Tummy Tuck
Tummy TuckMember 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
Tummy Tuck
Question:
My question, is there such a thing as a extended tummy tuck plus?
Rahul Vemula, MD, FACS's 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
Breast size
Breast ReductionMember 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
Breast size
Question:
I was wondering what size I would be after surgery. I’m currently a 42J, and have been approved for surgery. My doctor when I asked what size I’ll be stated “I don’t know what size you’ll be but I can say you’ll be smaller and perkier but not small”…he also informed me that he would be removing 3.3lbs from each side. It’s hard to shop for bras if not knowing the size, any help would be great.
Rahul Vemula, MD, FACS's 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
Left too big
Breast ReductionMember 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
Left too big
Question:
I had breast reduction 2 months ago. My surgeon said the swelling is pretty much done and I'm very disappointed in my results. I started out about a very full 36F and was just sized at 36DD. They look lovely but I was very clear with my surgeon that I want to be TINY, about a B. He only took 372/380g respective. Do I have any hope they'll get any smaller yet or is a second procedure in my future?
Rahul Vemula, MD, FACS's 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
Not happy with my breast augmentation
Breast AugmentationMember 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.
Not happy with my breast augmentation
Question:
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Rahul Vemula, MD, FACS's 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.
Is it covered by medical
PanniculectomyMember 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.
Is it covered by medical
Question:
I have diastasis recti and I have medical. I have been suffering from back pain because of it. I have been exercising and losing weight but the pain still there. Ii still have it. Would it be a reason to have it covered by insurance?
Rahul Vemula, MD, FACS's 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.
Can I completely remove my nipples after top surgery?
Transmasculine Top SurgeryMember 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
Can I completely remove my nipples after top surgery?
Question:
I am a 22y/o transgender male that had top surgery 2 years ago. The surgery went well but I did not like how my nipples turned out at all. I’ve been thinking about it and I would prefer to just not have them. Is this a procedure that’s allowed? If so, how would it go?
Rahul Vemula, MD, FACS's 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
How small can a breast reduction go?
Breast ReductionMember 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
How small can a breast reduction go?
Question:
I have a DD chest and am heavily considering breast reduction surgery. How small can it make my chest? I don’t care about them looking proportional to the rest of my body, just as small as possible. Also, are there any more health risks than normal if I were to do this? Thank you!
Rahul Vemula, MD, FACS's 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
How small can a breast reduction go?
Breast ReductionMember 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
How small can a breast reduction go?
Question:
I have a DD chest and am heavily considering breast reduction surgery. How small can it make my chest? I don’t care about them looking proportional to the rest of my body, just as small as possible. Also, are there any more health risks than normal if I were to do this? Thank you!
Rahul Vemula, MD, FACS's 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
Pro-bono/Dicounted Surgery/Programs or Non-Profits/Tricare Prime options for Tummy Tuck or Mini ???
Tummy TuckMember 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!
Pro-bono/Dicounted Surgery/Programs or Non-Profits/Tricare Prime options for Tummy Tuck or Mini ???
Question:
I am a 30 y/o mother of 3 and army National guard wife. I had to have numerous operations over the years all culminating in a total abdominal hysterectomy at 25 due to severe endometriosis. All of this combined with my short abdomen and 3 pregnancies (4’9” and 95lbs) has caused stretch marks and excess skin/crépe skin.Are there any programs/organizations/tips for price reduction? Pic for reference
Rahul Vemula, MD, FACS's 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!
Sad belly
Body ContouringMember 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.
Sad belly
Question:
I have finished Venus legacy & em sculpt …. I paid $1300 for 3 emsculpt & 3 venus legacy on my stomach. They said that should do it but I don’t see results. I am 5’7 140 lbs. I workout on a regular basis & have a bmi of 15 according to the body fat scale. I still have my fat folded over my bb. Place I bought package told me I need to buy more sessions of ‘em sculp & legacy. Help!
Rahul Vemula, MD, FACS's 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.
Enlarged nipples after gynecomastia surgery.
Male Breast ReductionMember 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.
Enlarged nipples after gynecomastia surgery.
Question:
4 weeks ago I underwent gyno surgery. Specifically, the glands were removed from both nipples as there was no fat but only the gland. It's been 4 weeks since the surgery, but the nipples are still a little swollen and prickly (puffy nipples). I wanted to ask how long it takes for them to come back and how long it takes for the chest to be completely flat. Many thanks.
Rahul Vemula, MD, FACS's 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.
Gyno Surgery
Male Breast ReductionMember 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
Gyno Surgery
Question:
.
Rahul Vemula, MD, FACS's 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
Complications after tummy tuck
Tummy TuckMember 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
Complications after tummy tuck
Question:
I had a tummy tuck in 4/2023. I developed a small blood clot in my lungs. I'm still on blood thinners for this and will be for the next few months. On my 6 week check up my surgeon asked if I was interested in dog ear revision with lipo to the flanks. I said no to the lipo because I'm scared to go under again. But are there any serious complications of dog ear removal if it's a minor procedure?
Rahul Vemula, MD, FACS's 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
Breast augmentation with lift complications
Breast AugmentationMember 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.
Breast augmentation with lift complications
Question:
breast augmentation &lift, 20 yr ago I had augment & was left with constant itch left breast. Went back &they did another surgery &itch didn’t change. I lived with it. 4/24 replaced w silicone & lift, 1 week later pulled fluid out due to pain & 1 larger, 2 week later open it up in OR took out blood clot 1 1/2 month later won’t do anything about it. See another surgeon? Same left breast issue
Rahul Vemula, MD, FACS's 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.
Is this fixable?
Breast ReductionMember 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
Is this fixable?
Question:
I had breast reduction surgery about 28 years ago. On one side my body, I have a huge chunk of fat? Skin? Both? That causes me to br unable to find a suitable bra from a band perspective. The first photo my left side without a bra. The second photo is of me with my best fitting bra and as you can see, I have all of this stuff hanging out.
Rahul Vemula, MD, FACS's 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
XL implants
Breast AugmentationMember 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.
XL implants
Question:
I have size E breasts, would it be possible for me to get about 1200cc breast implant extender safely? Or are there too many risks?
Rahul Vemula, MD, FACS's 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.
Danette
Breast AugmentationMember 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.
Danette
Question:
I had a breast augmentation almost 30 years ago. The implants are a mess & are totally encased. Can these be removed & new implants put in?
Rahul Vemula, MD, FACS's 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.
Breast lift
Breast Implant RemovalMember 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.
Breast lift
Question:
I have Breast implants over the muscle, now I want my implants removed and a reduction / lift. How complicated is this procedure?
Rahul Vemula, MD, FACS's 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.
Can multiple surgeries be done
Thigh LiftMember 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.
Can multiple surgeries be done
Question:
I am very much in need of abdominoplasty. I also need a thigh lift. I have lost considerable amount of weight. I also want breast reconstruction or augmentation. Years ago, due to my breasts being extremely large, I had breast reduction. The plastic surgeon actually took me way to small. Now due to the weight loss, I don’t have any breasts to speak of. Is it possible to have all 3 of these done?
Rahul Vemula, MD, FACS's 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.
Breast cancer double mastectomy results
Breast Implant RemovalMember 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.
Breast cancer double mastectomy results
Question:
I have had implants put in and taken out twice, the last time they took them out I had a staph infection. The surgeon said that nothing could be done to my right breast to loosen up the hardness, puckering and pressure due to the fact that I had radiation on that side. My only choice is to wait at least 6 months and then I would have to have skin taken from another area of my body. Help?
Rahul Vemula, MD, FACS's 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.
Removal with Mastopexy
Breast Implant RemovalMember 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.
Removal with Mastopexy
Question:
Having an under the muscle explant & capsulectomy. Small breasts before & after but don’t want new implants. 1 surgeon recommends waiting to see how they settle and if I’d need one at all. The 1 I’m leaning toward though is pushing to do the maxtopexy at same time insisting I won’t like the result between loose skin & nipples pointing down if I don’t do it & recommends not waiting for 2 stages.
Rahul Vemula, MD, FACS's 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.
7 months post op will this ever go away?
PanniculectomyMember Response:
Based on these images, looks like you will need a revision. Please discuss with your plastic surgeon
7 months post op will this ever go away?
Question:
Because I lost a lot of weight I ended up having a panniculectomy . As a result all is well except for the seroma in left side of belly and these dog ears. Will this ever go down?
Rahul Vemula, MD, FACS's Response:
Based on these images, looks like you will need a revision. Please discuss with your plastic surgeon
uneven breasts after explant
Breast Implant RemovalMember 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.
uneven breasts after explant
Question:
11 days ago my breast implants were removed. I had 370 cc of hydrogel. The right side had been deflated for 3 months. Currently, the right breast looks nice. The left breast appears much smaller and the breast fold is higher. Could it be that the left breast still has to drop?
Rahul Vemula, MD, FACS's 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.
My breast implants look way too natural!! Why?
Breast AugmentationMember 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.
My breast implants look way too natural!! Why?
Question:
Why the shape doesnt look round? My breast goes to the side, and I dont even look like I have an implant. Will this change? I got the implant 1 month ago it was under the muscle, and gummy bear! I was expecting a completely different shape! (Like the result of the last picture for example)
Rahul Vemula, MD, FACS's 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.
Leg lift
Body LiftMember 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.
Leg lift
Question:
I am definitely in need of a leg lift. I have pain in my hips and groin area after losing 150 lbs. I am just beginning my search for a surgeon. Is this something that I might be able to get insurance to pay? I have been to two orthopedics. I’ve had shots in my hips and my groin with no relief. I’ve been doing physical therapy for over six months. I work 30 hours a week on my feet as a waitress.
Rahul Vemula, MD, FACS's 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.
Gynecomastia due to child abuse
Male Breast ReductionMember 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!
Gynecomastia due to child abuse
Question:
My nephew, who is about to turn 18, just moved in with us. To say this boy was abused was an understatement. We found out that he was put on Risperidone as a child (even though he has no issues because it meant more free $ for his mother from the government). Any doctor willing to take this case and help him as he cannot afford the surgery and it is very embarrassing to be 18 and have man boobs
Rahul Vemula, MD, FACS's 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!
what plastic surgeries do i need?
Brow LiftMember 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!
what plastic surgeries do i need?
Question:
hi. when i pout my face, my nose looks smaller, my lips look better, and my eyebrows look lifted. ill put a before and after picture of when i pout vs when i dont. i would like to know what procedures i would need to get the look that im doing when i pout. i was thinking a brow lift, ptosis correction, alarplasty, and lip fillers. is this right?
Rahul Vemula, MD, FACS's 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!
Breast Augmentation for MTF patients
Gender Affirmation SurgeryMember 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
Breast Augmentation for MTF patients
Question:
Hello, I would like to ask if the breast augmentation process for MTF patients is radically different than that which is performed on cis-women? I am finding that a number of plastic surgeons are refusing to accept me as a patient and stating that it's a 'specialized' procedure. Nothing I have researched suggests this to be the case. I am interested in understanding what the real facts are.
Rahul Vemula, MD, FACS's 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
How to find a thread lift expert?
Thread LiftMember 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
How to find a thread lift expert?
Question:
I have been reading up on thread lifts, but the several plastic surgeons whom I contacted when direct from your website do not do this procedure. How do I find a practitioner who is highly experienced in it?
Rahul Vemula, MD, FACS's 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
How to find a thread lift expert?
Thread LiftMember 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
How to find a thread lift expert?
Question:
I have been reading up on thread lifts, but the several plastic surgeons whom I contacted when direct from your website do not do this procedure. How do I find a practitioner who is highly experienced in it?
Rahul Vemula, MD, FACS's 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
My insurance has no breast weight requirement.
Breast ReductionMember 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.
My insurance has no breast weight requirement.
Question:
How will he/she determine how much to remove?
Rahul Vemula, MD, FACS's 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.
pulmonary fistula?
Breast AugmentationMember 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.
pulmonary fistula?
Question:
Hi, I have a genetic condition called Hereditary Hemorrhagic Telangiectasia and as a result I have a pulmonary fistula that was diagnosed with bubble echocardiography. It's under 3 mm so I'm told there's no need to treat it. How does this change my risks related to breast augmentation or other cosmetic surgery? How does it change my risks related to dermal fillers?
Rahul Vemula, MD, FACS's 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.
Asymmetric Breasts After Augmentation
Breast AugmentationMember 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!
Asymmetric Breasts After Augmentation
Question:
Hello. I had a breast augmentation done about 4 months ago. I also had a liposuction done, axilla. And my right implant is 15CC’s bigger. During my 6 week follow up, my surgeon noticed my left breast was dropping a lot faster than my right. It wasn’t a big deal and barely noticeable. But it has become more noticeable since. They’re very soft and there’s zero pain. Any advice?
Rahul Vemula, MD, FACS's 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!
Insurance
Breast ReductionMember 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
Insurance
Question:
My doctor that I had for many years is no longer at the practice, and all medical records were disposed. I’m in need of reduction mammaplasty for YEARS now what can I do to get it approved?
Rahul Vemula, MD, FACS's 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
Discharge from my belly button 6 years after tummy tuck
Tummy TuckMember 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
Discharge from my belly button 6 years after tummy tuck
Question:
Hello I had a tummy tuck in 2016. Now, I am having a discharge from my navel that isn't healing. This happened 3 years after the procedure and again 6 years after the procedure. My surgeon doesn't know what's causing the discharge. Should I see a wound care doctor? Taken several rounds of antibiotics. CT scan doesn't show anything. Colonoscopy is good.
Rahul Vemula, MD, FACS's 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
Consultation breast reduction
Breast ReductionMember 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.
Consultation breast reduction
Question:
I am very nervous as I have a breast reduction consult scheduled. What all happens during the physical exam? Will I be uncovered the whole time? Also I am a minor so will I need to have a guardian present.
Rahul Vemula, MD, FACS's 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.
recall Allegan
Breast ReconstructionMember 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.
recall Allegan
Question:
On 11/06/2022 my left breast implant from Allegan bursted. I contacted the Dr office where I had the work done and the DR who performed my surgery as retired so I set up an appointment with his partner Dr Moser. I went in to have the DR exam me and he said I need to have it fixed as soon as possible. That i have to pay to fix them.. because they are recalled isn't Allergen responsible
Rahul Vemula, MD, FACS's 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.
Breast reduction
Breast ReductionMember 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.
Breast reduction
Question:
I did my breast reduction a week now. My best size was 34HH. Yes I have a small body naturally. My bread size appear smaller than I wanted. During the consultation I said I wanted about DDD. I'm reading the surgeons' responses and I'm terrified. I feel like I lost all of my beauty. I do not like small breasts. You said to wait 6 months to see if I like my new breast. I'll do that but I'm scared.
Rahul Vemula, MD, FACS's 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.
standard of care when patient tests positive for cotinine for fat transfer to right buttock
Buttock Lift with AugmentationMember 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.
standard of care when patient tests positive for cotinine for fat transfer to right buttock
Question:
Patient, an active smoker, tested positive for cotinine on the day of surgery for a fat transfer to her right buttock to repair an "indentation" from a prior injury. The clinic's smoking informed consent form included a paragraph that the patient was to quit smoking 6 weeks prior to the scheduled surgery date. Is there a standard of care under these circumstances.
Rahul Vemula, MD, FACS's 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.
Malignant hyperthermia
Tummy TuckMember 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.
Malignant hyperthermia
Question:
I am very interested in having a tummy tuck but I do have MH. I am having difficulty finding a surgeon who will take me on. I live in Fauquier County but am willing to travel for the right surgeon. Any suggestions on how to find one?
Rahul Vemula, MD, FACS's 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.
Neck Liposuction
LiposuctionMember 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
Neck Liposuction
Question:
Is neck liposuction typically accompanied by radiofrequency in men with skin laxity? Or this determined by the surgeon upon consultation?
Rahul Vemula, MD, FACS's 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
Gummy Bear Implants Rippling
Breast Implant RevisionMember 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.
Gummy Bear Implants Rippling
Question:
I had gummy bear implants put in on March 18, 2020. They have been "rippling" and I have went down in size almost 1/2 cup. I had them done out of state and am not sure what to do now. They feel fine and look fine unless I bend over. Do you think the surgeon put in saline instead? Or maybe did not put them fully under the muscle?
Rahul Vemula, MD, FACS's 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.
Open wound
Tummy TuckMember 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!
Open wound
Question:
My Dr had to open my incision because one of the drains was stuck then he sent me home to stuff with gauze. I was concerned bc the incision was so open that I went back. He removed the black dead skin that opened my wound even more. He told me to again stuff with gauze. This just doesn’t seem right having an open wound this big. Help?
Rahul Vemula, MD, FACS's 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!
Tummy Tuck
Tummy TuckMember 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.
Tummy Tuck
Question:
How safe it is to do a tummy tuck on a patient with a BMI of more than 50
Rahul Vemula, MD, FACS's 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.
Post Bil mastectomy ruptured implant
Breast Implant RevisionMember 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
Post Bil mastectomy ruptured implant
Question:
I had bil mastectomy for breast cancer in 2018 with expanders and implants under the muscle . My recent MRI showed right intracapsular implant rupture. Noticeable changes in right breast shape. I always felt tightness with the implants felt uncomfortable. Since I now need to have the implants removed what are your thoughts on having the implants placed above the muscle? Any complications?
Rahul Vemula, MD, FACS's 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
Breast augmentation with lift on one side
Breast LiftMember 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
Breast augmentation with lift on one side
Question:
Breast augmentation 2wks ago I know it takes up to 6 months for final results.I would like some opinions. I had my breasts redone and one side needed a lift but not the other. My side with the lift looks significantly smaller than the other and it was my bigger breast b4 surgery. The one without lift has dropped but the lift side has not and I know that’s normal but will it look bigger with time?
Rahul Vemula, MD, FACS's 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
difference between mini facelift and lower facelift
FaceliftMember 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!
difference between mini facelift and lower facelift
Question:
I would like to know the difference between a "mini" facelift and a mid or lower facelift, or are they the same? If not, which one costs more? Also by my picture, could I be a candidate for a thread lift?
Rahul Vemula, MD, FACS's 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!
East Coast surgeons for Superfat people?
PanniculectomyMember 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.
East Coast surgeons for Superfat people?
Question:
The ASPS supports panniculectomy on Superfat people, but I am struggling to find a surgeon on the East Coast who will do them. Would you please provide names of surgeons or practices who have operated on people who weigh as much as 225kg?
Rahul Vemula, MD, FACS's 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.
Mole on nose
Skin Cancer RemovalMember 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.
Mole on nose
Question:
Hello. I have always had this protruding mole on my nose, its larger now I'm close to 50. I wonder what do you think is the best procedure to remove this considering its location?
Rahul Vemula, MD, FACS's 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.
Inquiring
FaceliftMember 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.
Inquiring
Question:
I am inquiring about diabetic type 2 . I want a full deep plane facelift if you are diabetic does this mean you can’t get surgery?
Rahul Vemula, MD, FACS's 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.
Qualifications for Panniculectomy
PanniculectomyMember 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.
Qualifications for Panniculectomy
Question:
I've read in regards to the procedure, & qualifications to get ins. to cover the procedure: low hanging apron that causes rash, ulcers or impacts your daily life. Would impact ones daily life also being their mental well-being? I had my son's in my early 20s, since then I feel repulsed at the fat apron. I suffer from BDD & a lot of it is bc of the apron of fat that doesn't go away no matter what.
Rahul Vemula, MD, FACS's 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.
Bbl and 360 lipo
LiposuctionMember 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
Bbl and 360 lipo
Question:
Hello, I’m on Coumadin for artificial heart valves aortic mitral and tricuspid I can’t come off but can be bridged with lovenox. Are there surgeons that can safely perform this surgery for me?
Rahul Vemula, MD, FACS's 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
Pro bono
RhinoplastyMember 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.
Pro bono
Question:
I became a heroin addict at 15 years old. I was addicted and snorting it daily for 5 years. I have been sober since 04/10/07. Through years of addiction I eventually ended up with a perforated septum and a partially collapsed nose or saddle nose. I hate looking in the mirror and refuse to take pictures of my profile. I’m a single mom and can’t afford surgery. Do drs do pro bono rhinoplasty?
Rahul Vemula, MD, FACS's 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.
Lift
Breast ReductionMember 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.
Lift
Question:
When having a breast reduction procedure, does a lift come standard with it, or is that something you have to ask for along with reduction?
Rahul Vemula, MD, FACS's 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.
Procedure Pricing Transparency
Breast LiftMember 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.
Procedure Pricing Transparency
Question:
We recently received a quote for a breast lift with implant change. My concern is when I am asking for a detailed quote of services that are being provided, I am told by the practice manager. They don't provide quotes like that. Its only a verbal quote and a request for payment to book surgery. Is this common practice? Or should I push back for a detailed itemized quote?
Rahul Vemula, MD, FACS's 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.
Nipple graft error
Breast ReductionMember Response:
Thanks for your question. Really hard to say without seeing pictures. But there may or may not be an option to correct.
Nipple graft error
Question:
Breast reduction with nipple graft The left nipple was placed in the wrong location. What are the options for correcting this situation? Thank you
Rahul Vemula, MD, FACS's Response:
Thanks for your question. Really hard to say without seeing pictures. But there may or may not be an option to correct.
Calf augmentation
Calf AugmentationMember Response:
It is possible to do both. Please visit a board certified plastic surgeon to figure out exactly which procedure is right for you.
Calf augmentation
Question:
I have really small calves and really thin ankles. I was born with a foot deformity that was corrected as a child. One ankle has more flexibility than the other so there is no symmetry between the calves. Is there a possibility of doing a fat graft on the ankles and doing implants to augment and make the calves symmetrical?
Rahul Vemula, MD, FACS's Response:
It is possible to do both. Please visit a board certified plastic surgeon to figure out exactly which procedure is right for you.
Can I remove my breast implants my self
Breast Implant RemovalMember 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.
Can I remove my breast implants my self
Question:
I was wondering if I could just remove my breast implants at home I had them done January 4 2022 I just hate them they hurt I’m depress sad tired all the time dry mouth and i just don’t have the income to get them explanted just wanted to ask if I can just do it my self
Rahul Vemula, MD, FACS's 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.
Is this an okay option?
Breast LiftMember 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!
Is this an okay option?
Question:
I am 16 and I feel that I have extremely sagging breasts. They are cup size C maybe slightly bigger but no bra properly fits because of how low they are. It hurts my back as well. I don’t know if this is normal but I feel like I need to have them lifted. What do I do?
Rahul Vemula, MD, FACS's 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!
Lumps on interior lower lip
Lip Augmentation/EnhancementMember 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.
Lumps on interior lower lip
Question:
I received lip filler (Juvederm ultra xc) on 11/18/2021. I noticed lumps immediately after the injection. About four months have passed but they still remain. They are interfering with my ability to eat as I often accidentally bite down on them. Who do I reach out to for help with this?
Rahul Vemula, MD, FACS's 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.
Bilateral mastectomy after complication using filler injection.
Breast Implant RemovalMember 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.
Bilateral mastectomy after complication using filler injection.
Question:
Hello, I am a 61 yo and I had done breast augmentation in Eastern Europe around 8 years ago using filler injections. Now I have complications (lumps, pain, etc). I was offered 2 different strategies- filler removal or mastectomy with breast reconstruction. I cannot decide which one is better for me. I am also post-hysterectomy (uterine sarcoma).
Rahul Vemula, MD, FACS's 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.
Extended Tummy Tuck- Weight Question
Tummy TuckMember 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
Extended Tummy Tuck- Weight Question
Question:
So I am trying to get a lower BMI (under 35) for my surgery at the end of September, I have never been as heavy as I am right now and my weight has been stable up until this past year while gaining weight due to a medication I started taking. I have obviously stopped taking that medication but I already scheduled my surgery and want to know if I would be able to drop 5 BMI points in time.
Rahul Vemula, MD, FACS's 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
Explant of under muscle implants under local
Breast Implant RemovalMember 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!
Explant of under muscle implants under local
Question:
I want to remove my implants. After having kids, my breast have become bigger than I’d like. I have never had problems with the implants (saline) no pain or discomfort. They are under the muscle so they are not sticking out and I don’t feel them moving or anything. I would like to just remove them without any lift/reconstruction and would like to be only under local anesthesia. costs? time?
Rahul Vemula, MD, FACS's 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!
BBL after Tummytuck and C sections
LiposuctionMember 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.
BBL after Tummytuck and C sections
Question:
Hello, I was wondering if it is safe to have a bbl 11 months after a tummy tuck. I also had 2 babies back to back C- section. Baby 1 2010 c- section Baby 2 2019 c-section Baby 3 2021 c -section 11 months later mommy make over with removal of breast implant. Now I’m considering a BBl for shape. I was thinking of doing it at the end of the year which would be 11 months later. Is this safe
Rahul Vemula, MD, FACS's 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.
reveal more of penis
LiposuctionMember 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.
reveal more of penis
Question:
hi just wondering if a male can get liposuction on his public area to reveal more of his penis. i’m not obese or fat i’m normal weight but i can grab and pull on my public area a bit. is there a way to remove all that so i can reveal maybe another half inch of my penis? or will this not work
Rahul Vemula, MD, FACS's 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.
Is tummy tuck my only option?
Tummy TuckMember 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.
Is tummy tuck my only option?
Question:
I had twins 4 years ago, and have been left with this very wrinkly saggy belly button area. Is there any surgeries or procedures other than a tummy tuck? I’m not sure if I’m done having children yet, and aren’t looking for something as invasive. I’m not worried about scars, or even the rest of my belly, just the navel area for now.
Rahul Vemula, MD, FACS's 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.
Lower body lift with augmentation, does this impact the lower front and back thighs?
Body LiftMember 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!
Lower body lift with augmentation, does this impact the lower front and back thighs?
Question:
51 crepe loose skin on thighs. Initially interested in thigh lift and yes understand the large long veriticle scars. Does a lower body lift with augmentation REALLLY improve lower thighs - all thighs on front expecially? how much improvement?
Rahul Vemula, MD, FACS's 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!
Double Mastectomy
DIEP Flap Breast ReconstructionMember 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.
Double Mastectomy
Question:
Hello, My chest was left uneven and concave after having both breasts removed. Is there anything that cab be done to correct? At the very least, make the chest was even and flat?
Rahul Vemula, MD, FACS's 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.
will this puckering actually ever go away?
Breast ReductionMember 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
will this puckering actually ever go away?
Question:
I am post op day 3 and I know it is too early to know for sure but I am extremely concerned with thr amount of puckering along my incision lines. I also seem to still have excess skin, especially on my left side - there I'd a pocket of extra skin it appears. Will this truly ever go away snd is this amount of puckering along the incision lines normal or excessive?
Rahul Vemula, MD, FACS's 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
When should you get new implants
Breast AugmentationMember 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
When should you get new implants
Question:
I'm wondering when you should get new implants without having any issues with them. I had my second surgery for augmentation in 2005 and I think it may be time to get new ones. What is the general rule?
Rahul Vemula, MD, FACS's 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
Discharge
Mommy MakeoverMember 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.
Discharge
Question:
I had a tummy tuck years ago and I just had discharge come out my belly button. It is very stinky. I have never had this happen and am quite freaked out. The thing is I wouldn't think anything was wrong except small amount of goo got all over shirt. How concerned should I be? It is reddened in there.
Rahul Vemula, MD, FACS's 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.
Guttate Psoriasis Flare up
Mommy MakeoverMember 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
Guttate Psoriasis Flare up
Question:
I am do for a mommy makeover (tummy tuck and breast augmentation) would it be ok to still have that done when my psoriasis flared up all over body.
Rahul Vemula, MD, FACS's 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
which implants are best
Breast ReconstructionMember Response:
No. The risk of nipple loss largely depends on the mastectomy that is performed. Under normal circumstances 90% of the blood supply to the skin is disrupted after a mastectomy performed and we rely on the 10% or so that is left to provide the nipple and mastectomy skin with good blood flow. Sometimes a nipple is not able to be saved. I always tell my patients who are having nipple sparing mastectomies that they may wake up without a nipple. I use intraoperative ICG imaging to help determine if the nipple can be saved or not.
which implants are best
Question:
I am having a double mastectomy with nipple sparing reconstruction. My plastic surgeon is recommending subglandular implants however it seems like submuscular are more often the recommendation . I am looking for some further advice on this.
Rahul Vemula, MD, FACS's Response:
No. The risk of nipple loss largely depends on the mastectomy that is performed. Under normal circumstances 90% of the blood supply to the skin is disrupted after a mastectomy performed and we rely on the 10% or so that is left to provide the nipple and mastectomy skin with good blood flow. Sometimes a nipple is not able to be saved. I always tell my patients who are having nipple sparing mastectomies that they may wake up without a nipple. I use intraoperative ICG imaging to help determine if the nipple can be saved or not.
Insurance
Breast ReductionMember 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!
Insurance
Question:
I'm looking for a surgeon that accepts IDAHO MEDICAID, it would be a referral due to my back problems I'm looking in Coeurd'Alene Idaho , or Spokane Wsshington can anyone help me please
Rahul Vemula, MD, FACS's 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!
Left is significantly larger
Breast ReductionMember 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!
Left is significantly larger
Question:
I got my surgery done 1/14/22 going from about DDD to a D.. everything was going well, however now that all my swelling has gone down, I’m about 2.5 months out and my left breast is very noticeably larger/ heavier than the right. Wearing a bra I need to adjust my straps differently and I just look lopsided. I’m so upset. Can I get an implant done now to even out? What can be done??! 😭💔
Rahul Vemula, MD, FACS's 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!
Reoccuring capsular contracture
Breast Implant RemovalMember 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!
Reoccuring capsular contracture
Question:
Hello, I currently have sub-muscular implants, and have capsular contracture. This is the second time now that I have capsular contracture, and both times it appeared within 1 year of surgery. I am wondering if I change the method of placement of the implant, eg. swap to on top of the muscle, whether that may reduce a risk of getting capsular contracture yet again? Thank you!
Rahul Vemula, MD, FACS's 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!
Have a few questions.
Breast AugmentationMember 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!
Have a few questions.
Question:
I had my breasts done around 2 1/2 weeks ago. I weight train and my surgeon informed me he had to cut my pecs due to how developed they were. It feels like my sides are chaffed and my nipples and the areas around are constant being stung. Only relief is laying down with nothing on and not moving at all. Also one breast is still swollen and higher than the other and both are rarely warm still.
Rahul Vemula, MD, FACS's 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!
Tummy tuck grants/financial help
Tummy TuckMember 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!
Tummy tuck grants/financial help
Question:
Hi! I dropped from 367 lbs to 162 lbs over the last year and a half while transitioning male to female and was wondering if anyone happened to know of any grants or programs that could help someone in my situation pay for a tummy tuck? Or if there are any surgeons attached to nonprofits that help with this sort of thing?
Rahul Vemula, MD, FACS's 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!
Diastasis recti repair covered by insurance?
Mommy MakeoverMember 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!
Diastasis recti repair covered by insurance?
Question:
I am a mom of 3 boys(who were all huge babies) & all c sections. After my last baby I have been having lots of abdominal pain and back pain. I recently was told I have severe diastasis recti. My stomach also hangs over very far at the bottom. Would insurance potentially cover the repairs for these? My last c section was difficult with recovery due to the overhang on my incision from my stomach.
Rahul Vemula, MD, FACS's 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!
Gynecomastia Question
Male Breast ReductionMember 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.
Gynecomastia Question
Question:
I read surgical methods to reduce Gynecomastia; they seem radical. Mine are not horrible, but noticeable, and at 67, I'm fit. Here's the thing, if I just simply pull up my skin above my breasts' tissue, a common term might be "breasts lift", they look great. In fact, I'm on the skinny side so get an appearance of a nice muscular chest. Yet, I don't see this anywhere as an option. Is it?
Rahul Vemula, MD, FACS's 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.
Implant Check-up - BIA-ALCL
Breast Implant RevisionMember 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!
Implant Check-up - BIA-ALCL
Question:
I am having Allergan textured implants with the high risk of developing BIA-ALCL and I am searching for a doctor who is familiar with that and can do an ultrasound to check on my implants. Can you tell recommend a doctor for that? And/or know how to go about it? Thank you.
Rahul Vemula, MD, FACS's 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!
Breast reconstruction
Breast ReconstructionMember 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.
Breast reconstruction
Question:
My daughter 4 years ago had a breast reduction. The scar tissue has truly affected her and feel the surgery wasn’t successful due to her nipples are distorted and unbalanced. This has caused much depression & mental health problems onto my daughter. She is 23 now. We would like to know if there are cases where this may be fixed. Shall we seek consult for this type of situation? Is there help?
Rahul Vemula, MD, FACS's 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.
Breast pain
Breast AugmentationMember 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!
Breast pain
Question:
I’ve had breast implants for 15 years the past few months have been experiencing pain in my right breast. It’s been itching, sore, occasional burning sensation no just a constant dull pain. My obgyn didn’t feel any lumps and has ordered a mammogram but I can’t be seen for another couple months. Could my implant be causing these symptoms my other breast feels fine?
Rahul Vemula, MD, FACS's 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!
Is there a way to tighten/raise the outer corner of my eyes? (Other then botox)
Cosmetic SurgeryMember 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.
Is there a way to tighten/raise the outer corner of my eyes? (Other then botox)
Question:
I’m a 21 year old Caucasian male and my eyes and eyebrow area have this tired/lazy look. Its not to the point where it’s like abnormal or the result of some underlying issue, but it bothers me nonetheless. When I push up on the skin around my temple, obviously my eye and brow raise, the skin tightens, and it looks much better. Is there any way to simulate that look with some sort of surgery?
Rahul Vemula, MD, FACS's 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.
Botched surgery
Aesthetic Genital Plastic SurgeryMember 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.
Botched surgery
Question:
Hi, I had a tummy tuck that ended up leaving me with an open wound for months, part of the result was that my vagina ended up looking deformed. I’m really self conscious and have not been intimate in the last 5 years because of it. My armpit area has giant scars due to the incisions opening as well. Is there anything that could fix this? Thank you for your attention I look forward to hearing back.
Rahul Vemula, MD, FACS's 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.
Fat Transfer Breast Augmentation & Nipple Piercings
Breast AugmentationMember 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!
Fat Transfer Breast Augmentation & Nipple Piercings
Question:
What would happen during this surgery if I have my nipples pierced? Do they have to be removed permanently or can sterilized jewelry been put in before surgery?
Rahul Vemula, MD, FACS's 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!
Jen
Cheek ReductionMember 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.
Jen
Question:
I'm almost 30 yrs old now, and weigh 220 lbs, even when I was skinny when I was younger and very athletic looking! The skin on my face always seemed to be loose, when I tilt my head the skin drags down, or if I look down it all falls into my cheeks and feels as if it's going to fall off my face! I know it cannot be fat! Just maybe extra skin that I will never grow into? Not sure what I can do??
Rahul Vemula, MD, FACS's 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.
Dog bite chunk off lip
Skin rejuvenation and resurfacingMember 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!
Dog bite chunk off lip
Question:
My sister got bit by a dog and a chunk of her lip was bitten off. The lip has healed but there’s a lot of scar tissue build up so the lip looks like there’s a bump on it. What can we do? We went to a plastic surgeon a month after it happened and they did the laser treatment but the scar tissues are still there.
Rahul Vemula, MD, FACS's 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!
Post Operative Care
Tummy TuckMember 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!
Post Operative Care
Question:
Is the surgeon required to see his patient for post operative care? If there is an issue, how quickly should he or his office respond?
Rahul Vemula, MD, FACS's 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!
Facelift or Threadlift
FaceliftMember 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!
Facelift or Threadlift
Question:
I am trying to figure out how to add photos but I just have saggy jowls amplified by an overbite. I am wondering if thread lifts and maybe a chin implant might work instead of a pull on a facelift?
Rahul Vemula, MD, FACS's 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!
Mini Arm lift
Arm LiftMember 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!
Mini Arm lift
Question:
I am curious about what the cost of a mini arm lift would be and the recovery time. I am also curious about fat injections in the hands and would cost and if these things could be done together. I can add pictures here in a bit.
Rahul Vemula, MD, FACS's 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!
Surgery for a patient on Suboxone
Mommy MakeoverMember 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!
Surgery for a patient on Suboxone
Question:
Greetings! I was wondering how surgery is done medicinally for a patient on suboxone. Does it affect the anesthesia and how the doctor helps the patient deal with pain following surgery? Would anyone recommend that the patient try to decrease their daily dose of suboxone as much as possible prior to surgery to help deal with the pain of surgery? Thank you, Whitney- over 2.5 years clean
Rahul Vemula, MD, FACS's 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!
Eye bags surgery
Eyelid SurgeryMember 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.
Eye bags surgery
Question:
How much does eye bags surgery cost including everything involved with surgery?
Rahul Vemula, MD, FACS's 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.
Grants
Tummy TuckMember 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
Grants
Question:
Are there any companies that offer assistance to get a tummy tuck or like a mommy make over. I had gastric bypass in 04 I was 350 and currently 179 but I have severe excess hanging skin and cant afford it to have it removed . I am a mother of 3 kids that would like to see if there is any help out there.
Rahul Vemula, MD, FACS's 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
Plastic surgeon in training
Tummy TuckMember 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
Plastic surgeon in training
Question:
I have insurance but not financial anmvle to pay for a tummy tuck and breast lift. How do i find a pro bono or surgeon in training help me loose this 15 year old baby fat?
Rahul Vemula, MD, FACS's 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
How to overcome irrational fear of dying from anesthesia or surgery?
RhinoplastyMember 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!
How to overcome irrational fear of dying from anesthesia or surgery?
Question:
I've wanted a nose job for years & finally got the support of my parents who are both doctors. I'm a bit scared of surgery&GA since I've heard stories of people getting cardiac arrest or duying in the OR. I have consultations with 2 board-certified surgeons soon. How can I address my general anesthesia fears and fear of dying to ensure a safe, successful surgery?
Rahul Vemula, MD, FACS's 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!
Zygomatic Minor
Cosmetic SurgeryMember 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!
Zygomatic Minor
Question:
Over the past year or two I’ve noticed a loss of function in my right zygomatic minor nerve. The right side of my smile drops and I’m unable to use the top right side of my upper lip to make facial expressions. I was just curious if you knew of any ways to stimulate that muscle into working again to even out my smile.
Rahul Vemula, MD, FACS's 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!
Belly Button
Wound CareMember 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!
Belly Button
Question:
I had 3 surgerys this year , the first was tummy tuck and some liposuction and they also fix my belly button , I had some complication with a Sedona , they did another procedure after on my belly button to fix it . The healing left a really bad scar , so the plastic surgeon just did it again 2 weeks ago, but I’m having the same problem I’m having hard time healing , keeps bleeding.
Rahul Vemula, MD, FACS's 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!
Are surgeons comfortable with removing nipples from a male???
Cosmetic SurgeryMember 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.
Are surgeons comfortable with removing nipples from a male???
Question:
I want to get my nipples removed cut off completely and i want to make sure before i go see a plastic surgeon that he will be okay with me asking about the procedure :)
Rahul Vemula, MD, FACS's 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.
Breast Reduction after nursing
Breast ReductionMember 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!
Breast Reduction after nursing
Question:
I have been large chested since high school. After getting pregnant with my first I went from a G cup to an I cup within the first trimester without weight gain. I’m due with my second soon and pushing a J cup. I have intense back pain and will be up for hours at night. I want a breast reduction as soon as I’m done nursing my second. How many months after weaning can I pursue surgery?
Rahul Vemula, MD, FACS's 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!
2 part surgery
Breast AugmentationMember 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
2 part surgery
Question:
Is there a such thing as a two part breast augmentation? I was told by my plastic surgeon that I would have to go back to get a lift is this common?
Rahul Vemula, MD, FACS's 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
From a non-binary person: Making already small breasts smaller? B to A cup?
Breast ReductionMember 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!
From a non-binary person: Making already small breasts smaller? B to A cup?
Question:
Hello. I’m a 28 year old non-binary person, 4’9”, 82lbs, my rib cage is 27.5” and my bust is 30” with no sagging at all. I’m not looking for masculinized chest like the results of traditional top surgery, but I would like to make my already small breasts smaller to relieve some dysphoria and suit my gender identity. Is it possible to make breasts that are around a B cup into small A’s?
Rahul Vemula, MD, FACS's 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!
Injections just dont work
Lip Augmentation/EnhancementMember 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
Injections just dont work
Question:
Hi, I have tried several lip fillers/injections and nothing seems to stick. The results last never more than a week no water what cocktail of fillers are used. I would like to augment my lips but is not possible in Canada. Any suggestions on something more permanent and at what price? Thanks!
Rahul Vemula, MD, FACS's 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
Where do I even start for research?
Body ContouringMember 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!
Where do I even start for research?
Question:
I don't even know where to start looking for this kind of procedure with limited scarring. I have lost over 170 lbs. over the years and am looking for a experienced surgeon who will give me what I want but also tell me what I need. I am only 22, so having a normal looking body for once means a lot to me. My biggest fear is having a botched surgery that I can't fix anytime soon.
Rahul Vemula, MD, FACS's 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!
BBL
Buttock Lift with AugmentationMember 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
BBL
Question:
Good morning....I am in the process of trying to find a Dr. to do my bbl. I currently only take remeron 15mg for depression and 8 mg of Cyproheptadine to help with sexual dysfunction...would either of these put me at risk for getting plastic surgery?
Rahul Vemula, MD, FACS's 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
Would a breast lift help with my back pain?
Breast LiftMember 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
Would a breast lift help with my back pain?
Question:
I am a 34DDD, weigh 104 lbs and am almost 5’1. Would a breast lift be enough to help with back pain?
Rahul Vemula, MD, FACS's 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
How long should I wait
Breast AugmentationMember 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
How long should I wait
Question:
I am 40y in good health. I had a full tummy tuck without lipo 2 weeks ago. I am healing well without any complications. Returning to work in 1 week( extra week off due to physicality of my job). My question is how long should I wait to have subsequent surgeries that I am interested in( i.e. breast augmentation and/or brachialplasty).? My surgeon wouldn't due them all together.
Rahul Vemula, MD, FACS's 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
Curious about a lot of procedures, unsure where to begin.
LiposuctionMember 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
Curious about a lot of procedures, unsure where to begin.
Question:
I am a former collegiate athlete who has been heavy for the last 11 years mostly due to sedentary jobs and poor diet. I 5'11-3/4" and weigh somewhere between 370 and 390. My biggest concern is the excess fat/skin in my groin, under my arms, and my sides. I know lipo isnt a weight loss option but I was hoping to do it while dieting and working out. What options are there for someone w/o insurance?
Rahul Vemula, MD, FACS's 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
Liposuction or Tummy Tuck
LiposuctionMember 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
Liposuction or Tummy Tuck
Question:
I am unsure of what procedure I would need in order to get the results I want. I have some lower belly fat and some on my flanks/hips which I would like to be flat and a bit more hourglass figured. I am only 24 and it isn't much (I weigh 135 and I am 5'5") but it's enough to bother me. Is it possible to get the results I want with JUST liposuction?
Rahul Vemula, MD, FACS's 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
surgeon disappeared for a month i have complications
FaceliftMember 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.
surgeon disappeared for a month i have complications
Question:
I had facelift 3 weeks ago . I saw surgeon 5 days after then he went away and will not return for another 3 weeks. He has NOT left any other qualified plastic surgeon to help patients while he has I have complications hard painful nodules in eye tissue and other concerns. I need to see a qualified doctor to deal with these issues . I am concerned i will be permanently disfigured from complication
Rahul Vemula, MD, FACS's 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.
Very Old Hard Breast Implants
Breast Implant RemovalMember 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!
Very Old Hard Breast Implants
Question:
I'm a 65yr old trans woman living below poverty level in Houston TX with no income other than disability for rent and no means to pay for surgery. I had breasts implanted in 1983. They are now hard and incapsulated. I have been treated for Hep C and am now cured. Have some auto immune problems and believe perhaps rupture or leakage from implants makes it worse. Any information appreciated.
Rahul Vemula, MD, FACS's 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!
Breast lift and reduction
Breast LiftMember 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
Breast lift and reduction
Question:
I was just curious on how all of it works my boobs are a double D and they give me back pain and it’s hard for me to sleep but they’re also droopy and not the shape they need to be for my age what do I do..?
Rahul Vemula, MD, FACS's 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
Eyelid Droop
Botulinum ToxinMember 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
Eyelid Droop
Question:
I got Botox on my right eyebrow 2 weeks ago. My right eyebrow was slightly lower than my left and I wanted to raise it before my wedding since it showed more in pictures. Anyways, 5 days ago my eyelid dropped. It looks awful and my wedding is in 6 weeks. The lady who did it says she only used 4 units and it’s a strong muscle so shouldn’t last too long. Is this true?
Rahul Vemula, MD, FACS's 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
labia minora torn during childbirth
Aesthetic Genital Plastic SurgeryMember 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
labia minora torn during childbirth
Question:
after childbirth I came out with a horizontal tear to my labia minora. At this point it is completely separated into two separate halves. I did have 1 stitch put in after birth that didn’t hold, and at a follow up appointment they placed another stitch, which also didn’t hold. Is this something that can be repaired, and if so, what procedure would I ask for?
Rahul Vemula, MD, FACS's 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
Looking deformed after (medical) surgeries.
PanniculectomyMember 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!
Looking deformed after (medical) surgeries.
Question:
Why won't my insurance approve the reconstruction? During the early 2000's my body was overcome by endometriosis, tumors, cysts, etc and my uterus, etc needed to be removed. Piece by piece beginning with my uterus. It took 5 surgeries & 5 yrs. With each surgery my lower abdomen grew. Exercise & proper diet don't help. I've been depressed/sickened by it & need the pannus gone. Please help.
Rahul Vemula, MD, FACS's 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!
Excessive weight gain during pregnancy
Tummy TuckMember 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!
Excessive weight gain during pregnancy
Question:
Hi- I gained an excessive amount of weight - approx 80 lbs - during my first pregnancy because I had a condition called polyhydramnios which causes too much amniotic fluid to be produced. The end result was a lot of loose abdominal skin and significant abdominal muscle separation with chronic back pain. Is there any way insurance will cover a procedure to fix my abdomen?
Rahul Vemula, MD, FACS's 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!
How much will it cost to remove my back neck fat
LiposuctionMember 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!
How much will it cost to remove my back neck fat
Question:
Hello, I am wondering how much will it cost to get the fat off the back of my neck removed ?
Rahul Vemula, MD, FACS's 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!
Tummy tuck vs Liposuction
Tummy TuckMember 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!
Tummy tuck vs Liposuction
Question:
as a result of two back to back pregnancies i have around 22 pounds still to lose. most if the fat is on my belly plus some on hip and flanks. my belly skin is very good no stretch marks what so ever. to got ride of this belly fat do i need lipo or tummy tuck? i dont have excess skin? Also i need to know if liposuction is safe, i know couple of people died from liposuction?
Rahul Vemula, MD, FACS's 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!
Costs
LiposuctionMember 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!
Costs
Question:
Hello! I was trying to make an appointment to discuss the two surgeries I asked about here. I was advised it’s $200 for consultation plus $100 consultation fee for questions around each surgery? Is this the norm in the industry ?
Rahul Vemula, MD, FACS's 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!
Capsule contracture
Breast AugmentationMember 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.
Capsule contracture
Question:
I just had my implants done 8.5 months ago. My left implant has a capsule they told me to take vitamin e and massage. I noticed this first 3 months after surgery, it’s gotten a lot worse since then. I don’t have to pay for this to be fixed do I? Should be covered in the first year isn’t that right?
Rahul Vemula, MD, FACS's 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.
Aspen Technique as alternative to surgery
Breast Implant RevisionMember 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
Aspen Technique as alternative to surgery
Question:
Do plastic surgeons recommend the Aspen Technique as an alternative to capsular contraction corrective surgery and are there any studies to show results. I cannot find any surgeons in the area that offer such technique.
Rahul Vemula, MD, FACS's 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
Age
Breast AugmentationMember 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!
Age
Question:
What is a good age to do breast augmentation? How do I know my body is fully developed and ready?
Rahul Vemula, MD, FACS's 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!
Boob job on one side?
Breast ReductionMember 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!
Boob job on one side?
Question:
Hello! I have a very odd issue. I'm 20 and I have two uneven breasts. One is a size B and the other is a large C/small D. I want to get something done about it but cannot find any info about just getting one breast done. I want them both to look like the smaller one. My question is, is it possible to get a reduction on just one boob? Would this be cheaper?
Rahul Vemula, MD, FACS's 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!
Breast Fat Transfer Health Risks
Breast AugmentationMember 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!
Breast Fat Transfer Health Risks
Question:
I've read fat transfers to the breasts increase the risks of calcification and of hindering mammograms. What happens when breast fat calcifies? And does transferred fat hinder mammograms any more or less than breast implants? Are there workarounds for this mammogram problem?
Rahul Vemula, MD, FACS's 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!
Fat Transfer + Breast Lift
Breast LiftMember 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!
Fat Transfer + Breast Lift
Question:
I'm interested in a fat transfer to my breasts. I have 2 questions about this: 1) can fat be taken from multiple body parts for this procedure? (e.g. thighs, knees, and arms) 2) I've read breast fat transfers increase cup size by up to 1, but could this be increased by multiple fat transfer + breast lift procedures to keep adding volume while maintaining shape?
Rahul Vemula, MD, FACS's 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!
Would I be a candidate?
Breast ReductionMember 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!
Would I be a candidate?
Question:
I am a 19-year-old woman with 36 F breasts. Would I be a candidate for breast reduction surgery? It does affect my back, and how I can lay sometimes, it also hurts to sit straight.
Rahul Vemula, MD, FACS's 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!
Best Fat Removal Procedure
LiposuctionMember 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!
Best Fat Removal Procedure
Question:
I am researching the best fat removal procedure for my husband and want to know if lipo, tummy tuck or any of the noninvasive fat removal procedures will work/are best. He's a big guy (ex athlete) and has stomach fat he wants removed that has been hard to get rid of with just diet and exercise. What are the factors in determining which is the best option? Thank you.
Rahul Vemula, MD, FACS's 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!
Extrusion
Breast Implant RevisionMember 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!
Extrusion
Question:
Once an implant has become exposed due to the skin being too thin to support it or the implant being too big to be supported, how is that treated? Do you just exchange the implant out with a new one or how does that work?
Rahul Vemula, MD, FACS's 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!
Risk of exposure
Breast Implant RevisionMember 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!
Risk of exposure
Question:
If after a mastectomy and full reconstruction the implant is showing to be too heavy for the chest to support causing the incision to widen placing the patient at risk of exposure, how is that treated? Is there anything that can be done before extrusion happens to hopefully avoid that from happening?
Rahul Vemula, MD, FACS's 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!
Age
Breast AugmentationMember 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!
Age
Question:
Ism 56 years old. Is it too late in life to get breast implants?
Rahul Vemula, MD, FACS's 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!
Is there an age requirement and does it matter breast size?
Breast ReductionMember 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!
Is there an age requirement and does it matter breast size?
Question:
I'm a 38G Cup and I just recently turned 18. I was thinking by the time I'm 20 of going into get breast liposuction reduction surgery. They sag and make it hard for me to get clothes and bras that fit and have always caused back pain and I wouldn't participate in running and stopped doing my favorite sports a long time ago. What do you guys recommend?
Rahul Vemula, MD, FACS's 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!
Body contouring for Post-Op Gastric Sleeve Patient
Body ContouringMember 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!
Body contouring for Post-Op Gastric Sleeve Patient
Question:
I was 410 lb. and now I am at 180 lb and even though I have gone to the gym and got muscles, I still have a lot of loose skin. I want to know if it is possible to get Abdominoplasty, Gynecomastia Mastectomy and Inner Thighplasty all at once.
Rahul Vemula, MD, FACS's 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!
Breast Reconstruction after double mastectomy
General ReconstructionMember 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!
Breast Reconstruction after double mastectomy
Question:
I am 6 months out from exchange surgery, expanders to 800 cc implants. One breast is becoming painful again and seems to be larger than the other. This breast also has a dimple/ indentation which has been there for about 2-3 months now. I am worried something could be wrong but not sure if this is just still part of the healing process?
Rahul Vemula, MD, FACS's 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!
Glue removal
Tummy TuckMember 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!
Glue removal
Question:
I had an FDL Tummy tuck with exparel at the VA hospital in Houston. Two days after my surgery my husband passed at 37 of a heart attack. I have the glue tape over my incision and part of the tape came off. How or what can I use to get the glue residue off without hurting my incision.
Rahul Vemula, MD, FACS's 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!
Soft capsules
Breast AugmentationMember 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!
Soft capsules
Question:
In April I tore some scar tissue when doing pull-ups resulting in one breast drooping more then the other. I saw my doc right away who advised a bra to see if tissue would repair its self. No changes. I was informed I have soft capsules and a capsulorrphy was suggested as well as lowering both breasts. What exactly does soft capsules mean and long term effects if no revision?
Rahul Vemula, MD, FACS's 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!
Fat injections in cheeks
Cheek ReductionMember 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!
Fat injections in cheeks
Question:
I had about 20 cc’s injected into my cheeks. Now I look like the joker. Is there a procedure that I can to reverse what I had done? What are my options? Thank you!
Rahul Vemula, MD, FACS's 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!
Cost of proceedurre
Breast AugmentationMember 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!
Cost of proceedurre
Question:
How much does it cost for a nipple correction procedure
Rahul Vemula, MD, FACS's 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!
Pro bono
General ReconstructionMember 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!
Pro bono
Question:
I am 51 and am a post polio survivor. My right leg was mildly affected and wonder if there is any surgeon that can do either implant or fat transfer to make my right leg similar to my left . I am a single parent and can’t afford it. Ihave looked up several polio sites and am unable to find a foundation that offers pro bono surgery for polio survivors. Any information would be appreciated.
Rahul Vemula, MD, FACS's 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!
ISO surgeon who specializes in breast reduction
Breast ReductionMember 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!
ISO surgeon who specializes in breast reduction
Question:
We live in the South Jersey/philadelphia area. I am interested in identifying a few surgeons in this area who have done thousands of breast reduction procedures and have a positive reputation re this expertise.
Rahul Vemula, MD, FACS's 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!
Implant and scar revision
Breast Implant RevisionMember 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!
Implant and scar revision
Question:
I had a reduction, lift, and 325cc mentor mod saline plant on 5/20. I see my surgeon on 8/12 to discuss scar revision. However, I’m incredibly unhappy with my results and have no volume in my upper pole area. Is it too soon to replace the implants? My breasts are not symmetrical at all and I was never given the chance to see or try any implants before surgery.
Rahul Vemula, MD, FACS's 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!
Belly Button Revision
Cosmetic SurgeryMember 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!
Belly Button Revision
Question:
I had a tummy tuck 2005, and my beautiful belly button was reduced to look like a dried up raisin, sitting higher on my tummy. I have not worn a 2 piece bathing suit as a result. I am in my fifties with excellent fit shape, and just want my belly button to look normal I'm want this fixed now.....I've waited forever. I can live with the position, I just want my belly button to look normal.
Rahul Vemula, MD, FACS's 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!
Fat transfer with low body fat
Breast AugmentationMember 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!
Fat transfer with low body fat
Question:
How much body fat is required to do fat transfer to go from 34A to 34C (assuming using Brava prep)? I have very lean body composition (in the mid or high teens %bf) and it’s very hard for me to gain fat but I gain muscle unusually easily for a woman. I definitely don’t want to lose any from my hips or butt, but there’s a little bit in my inner thighs I could do without. Any hope for this approach?
Rahul Vemula, MD, FACS's 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!
Dental Implants and Tummy Tuck
Tummy TuckMember 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!
Dental Implants and Tummy Tuck
Question:
Hello. I am going to be traveling to a different country for Dental Implant surgery. I will be getting about 8-12 implants, and extractions as well and will have IV anesthesia for the procedure. I am interested in also getting a tummy tuck. I will be there for 7-10 days, so the tummy tuck and implants would have to be done at about the same time. Is it safe to do both at once?
Rahul Vemula, MD, FACS's 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!
Dangerous
Mommy MakeoverMember 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!
Dangerous
Question:
Hi, I would like to know if it’s dangerous to have a mommy makeover that includes a circular tummy tuck with breast lift and implants.
Rahul Vemula, MD, FACS's 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!
Waxing after surgery
Tummy TuckMember 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!
Waxing after surgery
Question:
How long would you normally wait to do a Brazilian wax after a FDL cut tummy tuck? I don’t want to interfere with the incision line.
Rahul Vemula, MD, FACS's 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!
Breast Plant Exchange
Breast AugmentationMember 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!
Breast Plant Exchange
Question:
I had a breast reduction with new implants placed in 3/2019. After the sx, I developed wounds to both breasts. The surgeon wants to take out the implants and put new implants. His staff said he would do this in office under local anesthesia, not in a surgery center. Is this common? I am concerned he will be cutting into my muscle in office and not in a facility with only local anesthesia!!
Rahul Vemula, MD, FACS's 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!
Ulthera an option?
Eyelid SurgeryMember 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!
Ulthera an option?
Question:
I have some excess upper eyelid skin that bothers me but I don't feel like it warrants surgery yet. I've heard that ulthera or thermage can tighten the skin, however my excess skin isn't due to age (i'm 20) and I was wondering if this is an option for me? thanks!
Rahul Vemula, MD, FACS's 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!
Breast
Mommy MakeoverMember 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!
Breast
Question:
The breast augmentation comes with mommy makeover right?
Rahul Vemula, MD, FACS's 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!
3 breast augmentation—still problems
Breast ReductionMember 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!
3 breast augmentation—still problems
Question:
I am a 33 year old who got my first breast augmentation at 21. I have had a total of three surgeries. My last surgery left the worst after product. Both breasts are uneven I have a bulge sticking out of my right breast and capillary contraction. Looking for somebody willing to help financially and remove the implants. Single mother of three and realize implants are not meant for me. Both brea
Rahul Vemula, MD, FACS's 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!
Tummy tuck issues
Tummy TuckMember 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!
Tummy tuck issues
Question:
I had a tummy tuck in March of 2018 after my tummy tuck I had a lot of soramas and infection that caused me to not be able to wear my garment from all the pain I had and still have I was wanting to get checked out and see what exactly is wrong with my tummy tuck area and why is it that it hurts all the time
Rahul Vemula, MD, FACS's 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!
Stuck
Body ContouringMember 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!
Stuck
Question:
Hi, I’m a 27 year old female. I weigh usually around 115 pounds. I try to eat right and have been exercising regularly for 6 months now. I have never been happy with my tummy “pouch” and can’t seem to get it to shrink. Lately I’ve been debating coolsculpting but am seeing so so reviews and am looking for a professional opinion
Rahul Vemula, MD, FACS's 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!
Scar Tissue keeps opening
Tummy TuckMember 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!
Scar Tissue keeps opening
Question:
I've had several bowel surgeries, all openings in middle of belly. It's been two years since last surgery but I've had issues with skin/scar tissue giving way and dealing with small to large topical openings. Is there a plastic surgery that can fix this? I'm getting frustrated
Rahul Vemula, MD, FACS's 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!
Fat transfer
Breast AugmentationMember 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!
Fat transfer
Question:
Can a family member have their fat cells transferred to another family member to their breasts?
Rahul Vemula, MD, FACS's 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!
Am I a candidate for a breast reduction?
Breast ReductionMember 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!
Am I a candidate for a breast reduction?
Question:
I am 18 years old, and have ongoing scoliosis. As I got older my scoliosis became worse. I am 5’6 130 lbs and am a 34DDD and would like to go down to at least at C to make sure they no longer cause more back issues. I have problems finding tops and bras that fit.
Rahul Vemula, MD, FACS's 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!
Diastasis Recti repair
Tummy TuckMember 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!
Diastasis Recti repair
Question:
I am a 76 year old white female. And have been diagnosed w diastasis Recti w umbilical hernia. Could you recommend an experienced surgeon to repair this condition within 100 miles of Hendersonville NC? Do I need a plastic surgeon or general? I have been advised that due to complications caused by this condition I may qualify for Medicare. I also have Tricare for Life. Thx. Elaine
Rahul Vemula, MD, FACS's 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!
Can I go super small
Breast ReductionMember 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!
Can I go super small
Question:
I am currently a 38 c and would prefer to be an A cup . Is that possible?
Rahul Vemula, MD, FACS's 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!
Gynecomastia with incision under nipple only(no liposuction)
Breast ReductionMember 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!
Gynecomastia with incision under nipple only(no liposuction)
Question:
I weigh 212 lbs as of now. Last year I had reduced my weight to 155lbs but yet I had a female like appearance to my chest. It was puffy and just didn’t look right. I weigh a lot now and gynecomastia has increased in appearance. The surgery hospital I consulted will be operating using nipple incision I believe it was. My question is, with future exercise will my chest look flat with just incision?
Rahul Vemula, MD, FACS's 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!
Calf augmentation
Body ContouringMember 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!
Calf augmentation
Question:
I am quite embarrassed as I was blessed with quite skinny legs..I am so self conscious...I have a lot of space between ankle and calf...the area is so thin...I read something about fat injections but wasnt sure if it worked???
Rahul Vemula, MD, FACS's 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!
panniculectomy-
Tummy TuckMember 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!
panniculectomy-
Question:
Please guide- I am 60 male, diabetic-, huge hanging abd, belly weight. which proceedure shoud I go for-, abdominoplasty./Tummy tuck/liposuction /panniculectomy .
Rahul Vemula, MD, FACS's 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!
Breast uneven
Breast AugmentationMember 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!
Breast uneven
Question:
I got a breast implant about 7 weeks now. At first when i just done it looks good but recently my breast kinda look uneven. My left one is dropping more than right side. Is it normal because i know it will take around 3 to 6 months to see the final result. And is there any way to make my right side drop down to even because it looks so awkward now. Can anyone help me?
Rahul Vemula, MD, FACS's 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!
capsular contracture
Breast AugmentationMember 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!
capsular contracture
Question:
Hi I need some help I did surgery for breast implants with water saline. And for the past 10 months. Since I got surgery I have a capsular .. what do I need to do ?
Rahul Vemula, MD, FACS's 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!
Scar revision
Body ContouringMember 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.
Scar revision
Question:
I have an indented scar from an appendectomy that I got over 25 years ago. Can that be fixed? I don't mind having a scar, I just hate how mine goes in so much!
Rahul Vemula, MD, FACS's 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.
Cleavage Augmentation
Breast AugmentationMember 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
Cleavage Augmentation
Question:
Born with naturally wide-apart breasts. Is there a way to bring them closer together?
Rahul Vemula, MD, FACS's 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
Diabetes
RhinoplastyMember 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!
Diabetes
Question:
What is my risk of having a facial surgery being a diabetic patient?
Rahul Vemula, MD, FACS's 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!
To begin
Arm LiftMember 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!
To begin
Question:
I have had significant weight loss and now have very large bat wings. I'm really interested in a complete body lift and would like recovery times n ball park costs
Rahul Vemula, MD, FACS's 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!
Price
RhinoplastyMember 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
Price
Question:
I am international student so I would like to know what is the average of the price in rhinoplasty
Rahul Vemula, MD, FACS's 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
Mom life
Body ContouringMember 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
Mom life
Question:
Really want to get back down to 160 the weight I was before my first child in now 255 after my 3rd child I would also like to fix all the flabbiness in my body my arms, my legs, and my chin. Get my butt back to plump instead of flat and my boobs back where they should be. I was wondering a price range for body contouring?
Rahul Vemula, MD, FACS's 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
I Still look Pregnant but I am not
Tummy TuckMember 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
I Still look Pregnant but I am not
Question:
Hi, I had a full hysterectomy this past December for Fibroids. They removed all of it. I thought I would lose the pregnant appearance. Nothing on my body is big except my belly, even after the hysterectomy. In fact, I think either they have came back or something else because I am in fact bigger. I am 48. I have had 4 children. Everybody is still asking when my baby is due. What to do?
Rahul Vemula, MD, FACS's 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
Age limits
Tummy TuckMember 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
Age limits
Question:
Is there an age limit for safely having a tummy tuck with lipo? I'm 53 and have always wanted this done since delivering twins weighing both over 8 lbs.
Rahul Vemula, MD, FACS's 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
Lip reduction surgery
Lip Augmentation/EnhancementMember 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
Lip reduction surgery
Question:
There was an excessive amount of fat injected into my lips and my cheeks, making me look abnormal, what specialists in this area could I consult with?
Rahul Vemula, MD, FACS's 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
Pain killers
Breast ReductionMember 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
Pain killers
Question:
Hello, my 16 yr old daughter wants to get a breast reduction and we have several consultations scheduled but I’d like to get as many opinions as possible. I am worried about her being prescribed an opioid as a pain killer. Is there a non-addictive pain reliever she can take even if it isn’t quite as effective?
Rahul Vemula, MD, FACS's 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
Scar revision
FaceliftMember 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
Scar revision
Question:
Hello I’m looking for a doctor to take a look at the scar on my forehead that I got from a car accident. I am wondering how much it would cost to get it fixed. I’ve never been under the knife before so don’t know how to go about it. I’m willing to send pictures for an estimate of the cost. Thank you.
Rahul Vemula, MD, FACS's 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
Surgery
Mommy MakeoverMember 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
Surgery
Question:
How do you know how to find the right doctor? I want a couple things done, but I’m scared because of horror stories I’ve read and heard about.
Rahul Vemula, MD, FACS's 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
Ok doctors! I had the gastric sleeve 4 and half months ago. Im down to what is where i should stay a
Breast LiftMember 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
Ok doctors! I had the gastric sleeve 4 and half months ago. Im down to what is where i should stay a
Question:
Docs sat i should lose 10 lbs and then gain a lil back..which im 5 ft 7 and 144 lbs now. Id like to gaine to 155 and stay there. But i want a breast lift and Brazilian butt lift so bad . there saying no one will touch me for 2 years after my surgery. I dont believe that especially if im paying for. I am extremely unhappy with certain areas at my age of 32 and want to feel my age. Ley me know
Rahul Vemula, MD, FACS's 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
Empty Nose Syndrome
RhinoplastyMember 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
Empty Nose Syndrome
Question:
Hi, I scheduled myself for a rhinoplasty because my nose has been broken multiple times and I really dislike the look of it. The more I read about this ENS, I'm freaked out and don't want my turbinates touched. How do I get in writing and guaranteed my turbinates won't be touched, and can I still get the other things about my nose fixed without turbinate surgery?
Rahul Vemula, MD, FACS's 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
Thigh and abdominal skin removal after extreme weight loss
Body ContouringMember 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
Thigh and abdominal skin removal after extreme weight loss
Question:
I will need both thigh skin removal as well as abdominal skin removal after 200 lb weight loss. Which should be done first, or can you have both areas done at the same time? Will that affect healing time? What would be the approximate cost for both procedures?
Rahul Vemula, MD, FACS's 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
MRI
Breast AugmentationMember 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
MRI
Question:
Hello, who should I call to schedule an MRI to have my breast implants checked? I was told by my PS to have an mri done every 3 years. (I have silicone textured implants and had them done 5 years ago!) Anyways He is no longer practicing and the office has been permanently closed. I was told to contact PCP and schedule an MRI but bunch of loops to go through before they will do MRI. I just need MRI
Rahul Vemula, MD, FACS's 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
Penis surgery
Gender Affirmation SurgeryMember 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
Penis surgery
Question:
I'm a 25 year old FTM. My question is : is it possible to have a penis transplant from a dead/alive male body? For example a male wants to have a vagina, so his genitalia can be transplanted to me. The price doesnt matter. Maybe I can pay diff surgeons to work as a team. So is it possible to find a person maybe with my type of skin and have a full genitalia surgery? Not a prosthetic with a pump
Rahul Vemula, MD, FACS's 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
Capsular Contracture
Breast ReductionMember 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
Capsular Contracture
Question:
My mother is 93 years old and had a subcutaneous mastectomy with silicone implants in 1975. Over the years, her breasts have hardened and the right one is becoming enlarged and misshapen. I found info on your site about capsular contracture. Are there effective alternatives to surgery to help her? She's in exceptional health for her age but we're concerned about having surgery at 93.
Rahul Vemula, MD, FACS's 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
Fat transfer
Body ContouringMember 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
Fat transfer
Question:
How long does it take to heal after fat transfer to butt?
Rahul Vemula, MD, FACS's 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
Am I too old?
LiposuctionMember 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
Am I too old?
Question:
I’m over 60 years old and have been thinking about having abdominal lips and a tuck procedure. To be completely honest, I have been thinking about it for more than 30 years, but I feel ready to do it now that I don’t have any obstacles, financial or time considerations. I am concerned being the age I am the healing and recovery time may prove more of a hindrance. Any thoughts?
Rahul Vemula, MD, FACS's 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
Lips
Lip Augmentation/EnhancementMember 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
Lips
Question:
How much does this procedure cost
Rahul Vemula, MD, FACS's 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
Keloid removed
Body ContouringMember 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
Keloid removed
Question:
I wanted to know how much does it usually cost to remove a keloid thats been injected and is soft already and just sagging
Rahul Vemula, MD, FACS's 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
Reconstruction
Breast AugmentationMember 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
Reconstruction
Question:
Prophylactic double mastectomy with reconstruction. Is this done right after the removal of both Breast. Is it implants? some people say they had problems with the implants and had them removed is that true? Or do you have the implants removed after several years?
Rahul Vemula, MD, FACS's 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
Can I have implants after oncoplastic surgery for DCIS?
Breast AugmentationMember 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
Can I have implants after oncoplastic surgery for DCIS?
Question:
I was recently diagnosed with DCIS and am scheduled to have an oncoplasty with breast lift to other side. Since this surgery reduces breast size because of large amount of tissue removed is it possible to have implants later on? Thank you
Rahul Vemula, MD, FACS's 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
Removing tattoo
Tattoo RemovalMember 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
Removing tattoo
Question:
I need to see how much it will cost to remove tattoo from my left and my right arm it is a total of 10 letters
Rahul Vemula, MD, FACS's 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
General price
Body ContouringMember 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
General price
Question:
What would roughly be the cost for a category six third nipple removal?
Rahul Vemula, MD, FACS's 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
Consultation costs
Breast AugmentationMember 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
Consultation costs
Question:
I'm looking for a few good surgeons to have a consultation with, what are usually the cost of them and what should I look for?
Rahul Vemula, MD, FACS's 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
Weight
Breast ReductionMember 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
Weight
Question:
I was wondering if I go ahead and get the reduction, if I plan to workout, will my breasts become saggy? Or will they slim down along with my body? I want to get the reduction then I will be able to work out the way I want to. I wear a 38O !
Rahul Vemula, MD, FACS's 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
Planning to recieve a reduction
Breast ReductionMember 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
Planning to recieve a reduction
Question:
I wear a 38H and I have alot of back problems because of my breast. I was wondering if I recieve a dramatic change in size does the breast reduction automatically come with a lift??? Or do i have to personally request a lift after the reduction. Curious to know what happens with all the extra skin that would be left if I recieve a reduction.
Rahul Vemula, MD, FACS's 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
Surgery Abroad
Mommy MakeoverMember 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
Surgery Abroad
Question:
Hi, I'm looking for a surgeon that could give me a mommy makeover with some extras. Tummy tuck, lipo on abdomen, back, arms, inner thighs, and breast lift. I'm having a hard time choosing a surgeon. There is one in Tijuana that I like but I'm worried about safety and recovery since it wouldn't be performed in the US, I wouldn't have a PS to go to. Thoughts? Advice? Thanks in advance! Amanda
Rahul Vemula, MD, FACS's 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
Scar Revision
Dermal FillersMember 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
Scar Revision
Question:
Hi! I have a surgical scar from fractured femur. It's 20 cm long and 1/2 cm wide and it's not even, has little holes and bumps(of skin color). Also the intervention then, kind of sliced my side of the leg so my legs are not of the same size in circumference. I'd like to have a scar revision that'd make it look even, without bumps and fill my side of the leg to make my legs even. Options?
Rahul Vemula, MD, FACS's 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
Capsular Contracture??
Breast AugmentationMember 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
Capsular Contracture??
Question:
I’ve had my breasts for about 2 years. I started a new job about a year ago which is an active job that requires some lifting. I’ve noticed that my right breast has become a little higher than the left & feels slightly firmer. I first thought it may be the development of stronger muscles so I started doing more lifting with my left which has helped a little but I’m still not even can it be CC?
Rahul Vemula, MD, FACS's 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
Surgery cost and payment
Mommy MakeoverMember 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
Surgery cost and payment
Question:
Im wondering if its possible to have a mommy makeover with out insurance and to just pay completely out of pocket? Is that aloud? Also how much would that even cost fully out of pocket no insurance?
Rahul Vemula, MD, FACS's 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
Cortisone to fix lower eyelid malposition caused by scar; ectropion
Eyelid SurgeryMember 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
Cortisone to fix lower eyelid malposition caused by scar; ectropion
Question:
7 years ago I suffered an orbital blowout fracture to my right eye socket. The surgery to repair the orbital bones required an incision below/along my lower eyelid. My lower eyelid does not cover my eyeball the same way as my left side and it’s noticeable in pictures. Could a 5-FU/kenalog injection eliminate the tension and pull that the scar has on my eyelid? If not, what would you recommend?
Rahul Vemula, MD, FACS's 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
BBL
Body ContouringMember 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
BBL
Question:
I suffered from a condition since childhood (12 years-old) called slipped capital femoral epiphysis. Three years ago (30's) I got my left hip replaced. One can imagine all them years of poor posture and compensating walking left my buttocks non existent. I also lost over 100 lbs. I don't believe I need bbl but more of a reshaping procedure. Does this make sense to anyone?
Rahul Vemula, MD, FACS's 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
Breast augmentation with fat
Breast AugmentationMember 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!
Breast augmentation with fat
Question:
I'm 5'2 and weight roughly 150 pounds. My weight is more in my butt,thighs, and love handles. Where would the fat be taken from? Would I be a candidate?
Rahul Vemula, MD, FACS's 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!
Compression garment
Tummy TuckMember 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
Compression garment
Question:
Hi. Why is the compression garment necessary after surgery?
Rahul Vemula, MD, FACS's 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
Tummy tuck/ hysterectomy
Tummy TuckMember 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.
Tummy tuck/ hysterectomy
Question:
I’m having a TT and a hysterectomy next Friday. Is the hysterectomy performed Lipo scopic through the muscle after my cut is made? Surely it’s no need to cut my muscle right? I forgot to ask this question the other day.
Rahul Vemula, MD, FACS's 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.
Visceral Fat
Tummy TuckMember 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!
Visceral Fat
Question:
The spelling of the word may be in correct, but I've been told by a few doctors that I have Visceral fat, or fat that can't be helped through Liposuction, because of the type and location of the fat in the abdomen region, but I want it removed and I'm not sure if a Tummy Tuck is the correct procedure if not can you tell me what would be?
Rahul Vemula, MD, FACS's 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!
Payment Options
Mommy MakeoverMember 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
Payment Options
Question:
So, my parents ruined my credit when I was only 22. In 2012 I lost 150 pounds after having 2 kids. I have had a few consult.s, But nvr can afford it all at once and financing isn't an option because of the credit. I have 7000 in cash to give now upon appt. w/ a great job Is there anyone anywhere that let's someone do a payment plan for the remainder within their office w/out credit financing?? :-(
Rahul Vemula, MD, FACS's 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
Breast procedure
Breast AugmentationMember 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
Breast procedure
Question:
Hi, I have a dramatically larger beast than the other. I would like to know if insurance covers any of this procedure at all & if not the price for a single breast fix. Nothing is wrong with the smaller side at all
Rahul Vemula, MD, FACS's 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
Breast Revision Recovery for body builder
Breast AugmentationMember 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
Breast Revision Recovery for body builder
Question:
Not a question, but asking you to post: I had submuscular implants in 2009 and began body building in 2014. By 2016, I had severe distortion in my pec area. After a revision in 2018, I was cleared for workouts after 8 weeks; same result. After a successful, beautiful revision in January, my PS stated I should never be doing pec work again. I wish my surgeon had warned me. Please share!
Rahul Vemula, MD, FACS's 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
I need a tummy tuck
Tummy TuckMember 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!
I need a tummy tuck
Question:
How do I get my primary doctor to approve a tummy tuck so my insurance can pay for it ?
Rahul Vemula, MD, FACS's 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!
Will state insurance cover breast reduction for a 16 year old
Breast ReductionMember 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.
Will state insurance cover breast reduction for a 16 year old
Question:
So I have state insurance and I am 16, i turn 17 in may. I have an E cup and recently I have been having very bad neck and back pains and headaches and i have a rash in between and under my breasts. I went to my doctor and she said to start doing physical therapy first to show the insurance that im trying other options first, but would state insurance cover it if i am 16?
Rahul Vemula, MD, FACS's 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.
What age should you get a nose job?
RhinoplastyMember 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!
What age should you get a nose job?
Question:
What age should you get a nose job?
Rahul Vemula, MD, FACS's 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!
Tattoo Excision
Tattoo RemovalMember 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!
Tattoo Excision
Question:
How do I find a surgeon who offers this service? I'm interested in having a piece removed surgically.
Rahul Vemula, MD, FACS's 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!
Pubiaplasty?
Tummy TuckMember 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!
Pubiaplasty?
Question:
Is there a procedure called pubiaplasty? I have had 6 abdominal surgeries, I am 47 yrs old. I have no feeling from the top of my pubic area up to my belly button. The entire area is just hanging, loose & is controlling my life. I am completely happy with myself & comfortable in my own skin except this area. Now, the skin is so thin that it is opening, at times bleeding. It gets irritated & itches.
Rahul Vemula, MD, FACS's 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!
Is this price fair ? Tummy tuck, make breast
Tummy TuckMember 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!
Is this price fair ? Tummy tuck, make breast
Question:
I was quoted $18,800 for all this to be done . I’m just wondering where on the scale this price falls. Low, fair, too high ? Tummy Tuck including PAL liposuction of abdomen and flanks/love handles Chest liposuction and gynecomastia at
Rahul Vemula, MD, FACS's 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!
Surgery for Minors
Breast ReductionMember 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!
Surgery for Minors
Question:
Can minors get breast reduction?
Rahul Vemula, MD, FACS's 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!
Vertical Wrinkles on mid stomach
Tummy TuckMember 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!
Vertical Wrinkles on mid stomach
Question:
I'm a very fit, slim woman with vertical lines on my mid stomach. Id like to have the skin pulles to my sides, which would make my stomach very smooth. Is this possible? I do not have lower stomach sagging.
Rahul Vemula, MD, FACS's 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!
Multiple Same Day Surgery
Eyelid SurgeryMember 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!
Multiple Same Day Surgery
Question:
I recently had a consultation with a doctor about getting the following procedures done during the same day: brow lift, upper/lower eyelid surgery, CO2 laser, neck lift, face lift, lipo from thighs, fat transfer to face. No general anesthesia. Numbing, Xanax, etc. Total estimated time 6:30AM - 2:30PM. I am concerned about the lack of general anesthesia. Perhaps is more safe but concerns me.
Rahul Vemula, MD, FACS's 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!
Lumpectomy
Body ContouringMember 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!
Lumpectomy
Question:
I’m scheduled to have a lumpectomy done due to a recent stereotactic core biopsy determination of ALH. Im concerned about the cosmetic results, but particularly because my weight right now is extremely low for me. I’m 5’10” and about 135 lbs. My norm is close to 150. My bra size is down from a C to a B. Will that affect the long term results negatively, when I have gained back to my healthy weight
Rahul Vemula, MD, FACS's 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!
Aspen Therapy
Breast AugmentationMember 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.
Aspen Therapy
Question:
I’m interested in a consultation for Aspen Therapy as I believe that I have capsular contracture of my right breast implant. How do I locate a board certified physician who provides this service in the San Antonio or Houston TX area?
Rahul Vemula, MD, FACS's 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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Our Location
West Long Branch Office
Suite 201, 107 Monmouth Road
West Long Branch,
NJ
07764
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| Monday | 9:30 AM–6:30 PM |
| Tuesday | 9 AM–5 PM |
| Wednesday | 9 AM–5 PM |
| Thursday | 9 AM–5 PM |
| Friday | 9 AM–1 PM |
| Saturday | Closed |
| Sunday | Closed |
Patient Testimonials
It's been a journey! It started with having to have a lumpectomy on my left breast and I decided to have a breast reduction / lift at the same time. Couldn't have been happier that Dr. Vemula was my surgeon. He is very patient and thorough and really made me feel at ease with the procedure. With their Symplast patient portal he is accessible at any time. I am very happy with the results and will definitely recommend Dr. Vemula ~ Erline
It has now been two months since I got a breast reduction and everything is more perfect than I could imagine. From the beginning Dr. Vemula and all of the staff were super welcoming and helpful. Any question you had, they always provided an answer. It took around a year for me to meet the requirements for insurance covering and the staff was there to help me every small step of the way. At first insurance declined my coverage, but Dr. Vemula fought for me because he understood how much I wanted to get the reduction. When the surgery approached, Dr. Vemula was super flexible and he made sure I knew what to expect. When the actual surgery came, he ensured I was comfortable and he explained everything that would happen. Recovery from surgery went super well and Dr. Vemula answered all questions while having frequent check-ins in which he gave clear instructions on how to care for my wounds. Now, I am so happy with my results. My chest is exactly how I wanted it to look and I have no regrets. Everything is healing so well and my confidence has never been better. Dr.Vemula and his staff have been a miracle to me. They helped lift this weight off of my shoulders (literally). If anyone was looking into a breast reduction or plastic surgery, I would definitely recommend going to V Plastic Surgery. This has been life changing. ~ Rhonda P.
Dr Vemula is the most caring doctor. He listens to everything you say. He addresses all your questions and concerns. Nothing is silly or unimportant to him. All his staff are the same as Dr Vemula. I can't imagine going to anyone else. ~Ilean C.