Sara R. Dickie, MD
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Meet Dr. Sara Dickie
Dr. Dickie is certified by the American Board of Plastic Surgery. She is the acting Director of Plastic Surgery for Illinois Dermatology Institute in Skokie and Northbrook, IL. She is also a Clinical Associate of Plastic Surgery at the University of Chicago Hospitals.
Please contact Dr. Dickie's office to speak with Brooks Johnson, surgical coordinator, to set up an in person consultation regarding your needs. Appointments can be made on line by visiting https://drsaradickie.com or calling the IDI office 847-675-9711 option #3. Appointments for spa services can be made by calling 847-558--8888.
Breast Implant Removal
Breast Implant Removal
Chemical Peels, IPL, Fractional CO2 Laser Treatments
Cleft Lip and Palate Repair
Ear Reconstruction Surgery
Giant Nevi Removal
Hand Surgery for Congenital Differences
Head and Neck Skin Cancer Reconstruction
Male Breast Reduction
Post Burn Reconstruction
Skin Cancer Removal
Tram Flap Breast Reconstruction
Ask a Surgeon
Dr. Sara Dickie participates in the ASPS Ask A Surgeon service. View responses to public questions below.
Facial mole removalCosmetic Surgery
Thank you for your question. You have a very common concern and there is not a perfect solution. There is no way to remove moles without leaving a scar. Laser treatments do not often work completely and most moles like yours will regrow. Surgical removal is the only way to completely remove a mole, but that will leave a scar. It may be a small scar and very inconspicuous, but there will be a scar. For someone like you who has many moles, trying to remove all the moles will leave many scars and that will not be the best cosmetically. Some may heal well and some may not, so it is a big risk to try to remove them all. I have found that removing the largest 2-3 moles on the face often makes the other moles less noticeable. You should see a plastic surgeon who is board certified and routinely operates on the face for a consultation to determine the best option. I hope this helps. Good luck to you.
Mole removalCosmetic Surgery
Thank you for your question to this very common problem! This mole should be surgically excised (not shaved) to fully remove it. Meticulous closure by an experienced plastic surgeon will provide the best scar. Even with the best scar, it may still be noticeable. There are several lasers that have excellent outcomes when treating scars. So you may end up needing a laser treatment of this area following the excision. Best of luck to you and be well.
could I get a breast reduction revision??Breast Reduction
Thank you for your question and including a photo. It would help to see other angles, but ideally be seen in person. It is possible to to a second breast reduction or just a lift to make things more even. Insurance may not cover it, unfortunately. I recommend you see your surgeon and at least discuss your concerns. Breasts are not often the exact same on both sides and revisions are quite common. Your surgeon will be the best person to address your concerns now. If you do not feel comfortable with him or her, then seek a second opinion from a board certified plastic surgeon in your area. It would be very helpful to know the type of reduction you had. So if you do seek a second opinion, you should bring your records with you. All the best.
Tuberous BreastsBreast Reconstruction
Thank you for your question, Jenni. I agree with the other respondents that it would help to see photos in order to be more specific. What I can offer is that if your main concern is the areola size and not volume of breast tissue a mastopexy can fix mild tuberous breasts. The mastopexy takes a donut-shaped piece of areolar skin out and allows the surgeon to redistribute some of the tissue in the areola into the breast. The scar typically falls around the areola only. This surgery can often times be done under local anesthesia or twilight anesthesia. The cost will vary depending on your surgeon and the anesthesia needed. The best advice I can offer is for you to have an in person consultation with a board certified plastic surgeon in your area. Best of luck, stay well!
Before getting a Brest reductionBreast Reduction
Hi Emma, thanks for your question! While hormonal birth control can effect the growth and size of your breasts, it is uncommon for it to have such a significant effect that stopping them would bring you down to a size that matches your body. If you started your pills in the 7th grade and that is when you noticed the growth in your breasts, then I would suggest to stop. But if you had very large breasts before the OCPs, stopping them probably won't change much. I don't recommend you change your current birth control method unless you are having other issues with it and want to switch to an IUD as a personal choice. A breast reduction sounds like the best option for you since diet and exercise have not worked. I recommend seeking a consultation with a board certified plastic surgeon to have all your questions addressed. Best of luck, stay well!
can scar treatments create new scars on face?Skin rejuvenation and resurfacing
Thank you for your question. It is very hard to determine the origin of your scar without photos or a physical exam. It is possible some of the subscision and/or fillers has created a new defect. I would recommend you seek a face to face consultation with a board certified plastic surgeon in your area. In your case it would help the examiner to be able to see in person and feel your scars to make the best determination about a treatment plan. Best of luck!
Mental creaseChin Surgery
Thank you for your question and for including such nice photos! The crease is clearly evident and probably a combination of your mentalis muscle (chin muscle) and your natural born anatomy where the tissue below the skin is thinner than in the chin (your profile photo shows that best). It would help to see you in person and see the movement of your lips and chin when you smile, frown and purse your lips. Most likely you will need a combination of something called subscision (releasing the skin crease from the tissue just underneath the crease), fillers (to fill in the space made by subscision) and a neuromodulator (aka, Botox) to relax the pull the mentalis muscle has on that spot. Typically this works as a one-time treatment, but you my need to continue the neuromodulator to keep the crease from coming back. I highly recommend you see a plastic surgeon who specializes in aesthetics of the face for this and not just a spa injector.
I am looking for the best solution for my case to have symmetrical shapeLiposuction
Thank you for your question and including a series of photos that show you in several positions as well as pre-operatively. From the photos it appears the issue is more related to a crease in the skin that is tethered to the muscle below it rather than a lack of muscle per se. This can happen after liposuction as a result of taking too much fat from one place or having garments that are too tight afterwards. Your anterior axillary folds are well defined, indicating that you have a good amount of pectoralis muscle on that side. It might be smaller than the other side, but it does not appear to be the primary problem. Fat grafting can improve this problem. You will never have perfect symmetry, but if the crease is corrected there will be better balance between the sides. I recommend a face to face physical exam with a board certified plastic surgeon. If you have access to the images from the ultrasound, bring those with you.
Asymmetric breastsBreast Augmentation
Thank you for your question because it is SO COMMON. As other posters have said, you are not alone. I always ask patients which breast they like more and start there. If you like the left more than the right, then you are looking at a breast reduction (that includes a lift) on the right side. If you prefer the right one, then you will be offered a breast implant or fat grafting. In that case, to make them more symmetric, you will still need a little lift on the right side if you implant the left. No advice on this forum should replace a physical exam and evaluation in person with a board certified plastic surgeon. Your problem is very common and does require surgery to correct it. Luckily the surgery and the post-operative healing period is usually pretty short.
Ear reconstruction improvement ?Ear Surgery
It is hard to tell from the angle of your photo, but probably the top part of your ear is stuck close against your head. This may appear normal if the right ear is also positioned similarly. If, however, the right ear is sticking out from your head at some distance, when people look at you from the front it will look like your left ear is too close to your head or that it is not there at all. It is up to you if this matters. If it does, the only way to make the ear stand out from the head is to add skin between your ear and your head and put a little cartilage to help hold the ear away from the head. It's a safe surgery and not usually very long. The surgeon will take the cartilage from your chest and the scar is very small. Usually not a big problem. Good luck! The current look of your repair is very good!
One nipple has flattened & got bigger after over the muscle silicone breast augBreast Augmentation
Without pictures it is hard to determine what happened. If your surgeon used a circumareolar gortex suture to tighten the nipple/areola complex this suture might have broken or the knot loosened. If this happens the areola dilates due to the pressure of the implant. The suture would need to be replaced and another small peri-areolar mastopexy preformed. In my practice I wait about 4-6 months or longer to do this revision. Contact your surgeon for a post-operative exam and get his or her opinion since he/she knows what exact technique was used.
After deflationBreast Implant Revision
If your implants are NOT causing any symptoms such as pain, infection, swelling, palpable folds or firm areas below the skin, there is no reason to remove them. Most people will elect to have them removed regardless. With saline implants they can often be removed in the office under local anesthesia, which is cost saving if your implants were placed for augmentation. If you had implants for breast reconstruction following cancer or a congenital chest anomaly your insurance may cover the removal. Lastly, if you ARE having symptoms listed above having them removed with the capsule surrounding the implant is advised.
Breast Reduction after nursingBreast Reduction
This is a great question and I'm happy to answer it in a few parts. First, it's important to consider if you will have another child and want to breast feed. After a reduction it is unlikely you will be able to breast feed again. I typically recommend women wait three months following weaning to have surgery. You will likely have more volume loss at 6 months to one year, but at 3 months the breast should be completely dormant from milk production. Next, I am certain that you have had symptoms that are impacting your health for a long time. Many insurers will want to make sure that you have taken steps to correct your symptoms with other methods prior to surgery. I would recommend contacting your insurer to see what criteria they require prior to coverage. Your surgeon will also help with this, but initiating contact with your insurance company will help expedite the process.
Botox and Injectors- Nurse Injectors or MD?Botulinum Toxin
I would recommend you call the office and let them know your concerns and ask that your surgeon preform your next injection for you. You may also ask to meet the nurse injector at that visit. Likely the RN is well trained, but since she/he has not treated you before the technique, dosage and placement of the Botox may be different than your surgeon. Different isn't necessarily bad, but given the stakes of this treatment, best not take the chance.
Facial mole removalCosmetic Surgery
A lot of great suggestions here. I would only add that moles that grow hair tend to be deeper as the hair follicle is usually located at the deeper layer of the dermis and sometimes below the skin. Shaving or laser for these may improve them initially, but they often grow back. Definitely recommend consulting face to face with a Plastic Surgeon who has experience with mole removal on the face. "cosmetic surgeons" can be any type of doctor, there is not a specific training regimen or accredited board certification for them.
How risky is to have a second breast lift? (Third breast procedure)Breast Implant Revision
Great question! You provide a thorough history, which makes answering your question easier. Most of the blood supply to your nipple comes from the breast tissue below it (aka the pedicle). A circumareolar lift only cuts the skin around the nipple and leaves the nipple attached to the tissue below it. A vertical lift will cut the skin around the nipple and remove some skin between the nipple and the lower breast fold. A repeat skin lift such as these is unlikely to risk nipple loss even if you remove a substantial amount of skin. I assume you are not exchanging or removing your implant since it wasn't mentioned. Changing the implant pocket can risk the blood supply to the the nipple depending on what is being done. It sounds like you are asking the right questions. Good luck to you!
Breast lift without implantBreast Lift
Hi Krissi, Thank you for your question. Honestly, the choice to place an implant depends on your anatomy and your goals. Most of the time a lift alone will provide lovely looking breasts with the nipple lifted to the center of the breasts and a rounded breast shape. However size and cleavage will depend on how much breast tissue you have. An implant will give 'more' if that is what you would like. Talk to your ASPS member surgeon. He or she will help to guide you.
Hi Joseph, Gynecomastia is the overgrowth of breast tissue in males. Sometimes this is due to hormones or being overweight. Before you seek surgery talk to your pediatrician or primary doctor. He or she may order some tests to see whether there is a hormonal problem to fix. If hormonal treatment or weight loss is not needed, the next step is surgery to remove the tissue. Depending on the size, shape and quality of the tissue the surgery can be done in a doctor's office using local anesthesia or in an operating room with general anesthesia. The scars are typically quite minimal and patients are usually very satisfied. For any surgery you will need your parents' consent since you are under age 18. Good luck to you.
Ruptured Silicone Gel ImplantBreast Augmentation
Hello Kelsey, Thank you for posting your question. This must be a very concerning problem for you and I'm glad you are asking this question to the ASPS members. What you describe may be a rupture, but as mentioned earlier, could be other more serious things like a tumor or an abscess. A mass (lump) that has pushed the implant so far up your chest needs to be evaluated by a physician as soon as possible. I would strongly encourage you to either see a board certified plastic surgeon or at the very least your primary care doctor.