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Breast Augmentation

I want to get breast implants. What size do you think that is not to small or too big?

There is no one answer for what size is too big or small. The size depends on your desires and your aesthetic ideals. There are also potential anatomic limitations having to do with how much breast tissue you have and how much stretch your skin can tolerate.

I had reconstructive surgery with silicone breast implants 20 years ago. Should they be replaced?

That depends on the implant. Breast implants are not meant to be life-long devices, which is why most companies guarantee them for only 10 years. If you have not had any problems (capsular contracture, leak, etc.) with your current implants and they have not been placed on recall (like the French PIP), I do not see a reason to remove them. You should continue to do self breast exams and get mammography to screen for cancer.

What causes Tuberous Breasts? What can be done about it?

The tuberous breast is a congenital malformation of the breasts that is thought to be caused by a constrictive ring of fascia around the breast tissue underneath the skin. This prevents the present tissue from expanding and developing properly and often leads to herniation of breast tissue through a large areola. There is a spectrum of how much this ring ends up restricting breast growth.

Treatment for tuberous breast depends on the amount of breast tissue present, the pliability of the soft tissue, and the breast shape. The constrictive ring is broken up by dissecting the breast tissue from the underlying muscle and making radial incision. This technique enables the breast tissue to lay in a more circular fashion. A nipple reduction is often an integral part of this surgery as is, at times, a breast lift.

The surgery can be done in one or two stages with or without a breast implant. Tissue expansion is sometimes necessary to prepare the breast envelope to receive an implant. The bottom line is that there are multiple ways to do this so we have to decide together what is the best way to help you achieve your goals when you come in for your physical examination.

Breast Reduction

What is a breast reduction?

Breast reduction surgery can help to reshape, lift, and reduce the weight of the breasts to enable patients to lead more active lifestyles. Most women in this situation who undergo this procedure wish that they had done it sooner!

How noticeable are scars from a breast reduction?

Scars do occur in breast reduction, as with any surgery. The question is how well do you tend to heal, what type of scar patterns are you willing to tolerate on your breasts, and whether or not you think that trading scars on the breast for improved shape and decreased back pain, if you have it. The scars tend to fade nicely for most people.

How long does swelling last after a breast reduction?

4 months is usually enough time for most of the swelling to resolve after breast reduction surgery. Occasionally there can be some fluid buildup after surgery (seroma) which might increase the time for apparent swelling to resolve. The other thing to note is that bra sizes are very different between companies and there is no great way to guarantee an exact postoperative size. Hopefully you are happy with your new overall breast shape. You should continue to follow with your plastic surgeon regarding any concerns that you might have.

Am I too young for breast reduction? (I’m 17)

I often postpone surgery until breast growth is complete with stability in size for approximately 1 year. I have done surgery for 16-17 year old girls previously because they were in significant pain related to their large breasts. For those girls, this often requires a hormone evaluation and trying conservative measures such as core strength exercise, pain meds, & wide bra straps before surgery.

Breast Lift

Is breast lift a very common procedure?

Yes, very common. This procedure addresses sagging, deflated breasts by removing skin, raising the nipple location, and sometimes readjusting the shape of the breast tissue itself. The patient trades a scar on the breast for an improved overall breast shape. This surgery is often combined with breast implants for augmentation and improved upper breast fullness.

Rhinoplasty

I have recently had a septoplasty to correct a breathing problem in my right nostril. That well and the left was fine. Now it’s the complete opposite!

If this was early in your postoperative course, your symptoms could be related to persistent swelling, which takes a few weeks to resolve. If you are already a few months postop, then you should return to your surgeon for re-evaluation. It is possible that your trouble is coming from collapsing ala, large turbinates, allergies, or other reasons.

Why is nasal septum surgery performed and what happens during the procedure?

A septoplasty is performed to correct damage to the septum, the bridge of cartilage that divides the nostirls. Nasal obstruction arises due to many issues, including compensatory hypertrophy, trauma, birth defect and more.

Nasal septum surgery is most commonly done in two ways:

1. If there was a recent fracture to the septum, a “closed reduction” can be performed in which a blunt instrument is inserted in the nose and pressure is applied along the septum until it straightens.

2. In the more common scenario, there is a long-standing curve to the septum. In this case, an incision is made inside the nose along the septum, where it cannot be visualized. The covering layer is lifted away from midline and offending portions of cartilage and bone are removed. The septum cover (mucoperichondrium) is then replaced and splints are often left inside the nose for a week. Turbinate reduction surgery is often a useful adjunct to

Can you have rhinoplasty if you are 15?

16-17 years is the average age of nasal maturity. The age at which rhinoplasty can be performed has to do with the time at which nasal growth is complete. If surgery is performed too early, the growth centers of the nose can be disturbed and the nose might not develop fully. Nasal growth is usually complete around 16 years old, on average. Another necessity is that, until you are 18 years old, your parents should be involved in the consultation.

Other Face Procedures

What are the risks and benefits of septoplasty?

The benefits of septoplasty are improvement of breathing through the nose and sometimes changing the cosmetic appearance of the nose. Very infrequently, however, the latter can be a risk or unintended consequence. The more common risks are bleeding, intranasal scarring, failure to improve nasal breathing, and smell sense/voice changes.

What is deviated nasal septum surgery?

Deviated nasal septum surgery, also called a “septoplasty,” is a medical procedure that corrects breathing problems resulting from damage to the septum, the bridge of cartilage that divides the nostrils. The damage could be the result of many issues, including severe allergic reactions, trauma or birth defect.

The procedure can be performed either “open,” meaning the skin is opened during surgery, or “closed,” meaning the surgeon works through the nostrils to avoid leaving a scar on the nasal bridge. The surgery is relatively quick, sometimes just 60 minutes, and requires a few weeks for recovery.

Tummy Tuck

What are successful ways to diminish stretch marks?

Stretch marks occur due to cracks in the dermis skin layer. Some of these will fade with time. If the red color does not go away, a pulsed dye laser can help to fade the color. Laser is less helpful for white marks. Otherwise, the most definitive treatment is a tummy tuck, which will completely remove as much of the damaged skin as possible while restoring smoothness to the abdominal contour.

Do tummy tucks hurt? Is it worth it to remove my stretch marks?

Tummy tucks can feel tight for a while and can hurt, just as with any other surgery. I often use special catheters after surgery that give extra local anesthesia to the abdominal wall postoperatively and help with the pain. Whether or not it is “worth it” is a personal decision, since you have to weigh the risks of surgery with the benefits. Most patients are quite happy after getting this done!

Fillers

Is it true that a nasal filler can move out of place and get inside the body, causing problems?

Fillers are not FDA approved for use in changing nasal shape. Temporary ones are usually safe as long as the filler is placed deeply against the cartilage / bone. Temporary fillers do not spread systemically. They do not migrate locally unless manipulated a lot after injection. If injected too superficially, they can cause irregularities in the soft tissue or get infected, causing scar. I do not recommend using any permanent fillers or anything temporary filler other than a hyaluronic acid (Restylane, Juvederm, etc…) product if you are getting injectibles in your nose.

BOTOX

What is Botox?

Botox is a drug made from a neurotoxin produced by the bacterium Clostridium botulinum called botulinum toxin. It is used medically to treat certain muscular conditions and cosmetically remove wrinkles by temporarily paralyzing muscles.

Is botox into the eye muscle possible to correct a small squint?

Botox is extremely helpful to relax the “squint lines” around the eyelid for cosmetic reasons. If it is a tic-like squinting that is involuntary, this might be blepharospasm and is something that might be covered by your insurance.

My dermatologist recommended Dysport for deep forehead wrinkles, but I heard that could make my eyebrow droop?

Dysport can potentially lower the brow if too much is injected. The idea is to put in just enough to soften the horizontal forehead lines without causing other problems. This will only treat the active component of the wrinkles that you have, not any part that remains when you are not activating those muscles.

Will Dysport immediately smooth my wrinkles?

Dysport, like other neurotoxins, takes at least 3 days before any relaxing effects are noted. Sometimes it can take up to 2 weeks to see the final product. If you have wrinkles that are present without muscle activation, you might be a candidate for filler in the area, which takes effect immediately. Seek consultation with a Miami plastic surgeon for more information.

Is there any downtime after Dysport injections? Can I have Dysport injections on my lunch hour and then go right back to work?

There is no significant downtime related to dysport or botox injections. You might have a small amount of brusing that goes away in a few days, but this is usually minor if it occurs.

It has only been 2.5 months since my last Botox session, but I have an event 6-8 weeks from now and I think i’m getting some movement back!

Maintain your appearance with Botox every 3 month on average, which is how long Botox usually lasts. It may last longer or shorter depending on the individual. If you are preparing for a party and start to see that you are getting too much muscle motion return, you should consider getting botox again at least 7 days before your party to allow for bruising to disappear (if there is any) and for the full effect to take place. Have fun!

Liposuction

What do you think of plastic surgery for weight loss?

Plastic surgery should not be used as a means to lose weight. You should try to lose weight with diet and exercise. If you are obese in the former does not help, you should consider speaking with a bariatric surgeon. The best plastic surgery results with few complications are achieved with patients who have attained their weight loss goals and have only excess hanging skin left over to be removed.

Thigh Lift

What is the difference between a thigh lift and liposuction?

A thigh lift and liposuction address two different problems that can occur in the lower body. Liposuction is ideal for patients who have tight skin with minimal laxity. This is particularly useful when fat deposits are localized to a certain area. A thigh lift, on the other hand, addresses the skin laxity that occurs as we age or after significant weight loss. This allows the surgeon to tighten the thigh by surgically excising and redraping the area of loose skin, which may have a component of fat associated with it as well. These two surgeries are sometimes combined to obtain optimal results.

Abdominoplasty

What is Abdominoplasty?

Abdominoplasty is the technical term for a tummy tuck. The procedure removes the excess, unwanted skin and abdominal fat to restore a flat contour to the tummy. A tummy tuck can help to achieve that hour-glass, bikini-ready figure that you have been waiting for!

Blepharoplasty

What is Blepharoplasty?

Blepharoplasty is the plastic surgery operation for correcting defects, deformities, and disfigurations of the eyelids; and for aesthetically modifying the eye region of the face. Find out more in our eyelid surgeries section.

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