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I have heard the scars are terrible. Can they be avoided?
The incision pattern is very dependent upon your anatomy. They are necessary in order to remove the right amount of fat and tissue. Keep in mind that the skin of an enlarged breast has been stretched over time and increases your risk for raised, wide or irregular scars. The trade off of physical scars over psychological scars is one many women are willing to accept.
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Will my breasts ever grow big again?
Breast reduction is considered a permanent procedure, however significant weight gain or pregnancy can affect the overall result. It is important to maintain a healthy diet and exercise program post surgery.
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Can a nipple die?
Despite maintaining circulation and innervation to the nipple during relocation, it is possible that the nipple can partially or completely die. This is a very unlikely event and if this did occur, reconstructive options exist.
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Why is a mammogram necessary?
A mammogram is necessary prior to any breast surgery. In the event cancer is present, aesthetic surgery must be postponed until treatment is concluded.
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My doctor advised Liposuction of the armpit along with my reduction. Why?
It is common to have Liposuction as a complementary procedure with a breast reduction. The new shape and size of your breasts can be optimized if surrounding fat is removed for better overall contour.
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My breasts only droop a little bit. Can lifting weights lift my breasts?
Exercise, diet and creams will not change the lift in your breasts. A breast cannot contract to its original size without surgical intervention. |
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Can I have a breast lift and still breastfeed someday?
This depends on the type of lift performed. Some lifts involve restructuring the breast which could have an impact on breastfeeding and may prevent the breast from producing/delivering adequate amounts of milk. |
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What if my nipples are not at the same level?
Perfect symmetry in any surgery is not always attainable. Even Mother Nature does not provide symmetry. However, both the nipples and the breasts should be close to mirror images of each other. We will strive to make the breasts as symmetrical as possible. The likeliness of improving symmetry will depend upon the severity of the differences of the breasts preoperatively. |
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Do you recommend implants with breast lifts?
Breast size is very subjective. If a patient is satisfied with their breast size and just wants more “perky” breasts, a lift is all that is necessary. If enough volume has been lost, an implant can create a more proportioned result. |
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How do you determine incision location?
Incision location is determined during consultation. It depends upon breast size, shape, degree of ptosis and elasticity of your skin. You cannot have a breast lift without incisions, but there are techniques Dr Wagh can discuss with you to minimize scarring. |
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How long will my facelift last?
There is no way to give a definitive answer here because no rejuvenation will completely stop the aging process. A successful facelift can help you look younger than your years for more than a decade if you take very good care of your skin. |
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I have heard endoscopic facelifts have fewer incisions and heal better. Why do a full facelift?
There is quite a menu of face “lifting” procedures available and the patient must be educated as to their effectiveness and application. For younger patients, a limited or mid-facelift procedure may be fine if only a small degree of correction is needed. An endoscopic facelift can only address muscle and is best reserved for browlifts since facelifts must take into account muscle, fat and skin. A suspension lift is a relatively new procedure and could be appropriate for younger patients who need an interim step before a full facelift. None of these procedures mimic the results of a true facelift. |
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What is a suspension lift? My dermatologist does them in her office in one hour.
A suspension lift, sometimes erroneously called a “lunchtime” lift uses minimal incisions and barbed sutures which are threaded and tightened to suspend the skin. Even in the most capable hands, there is swelling and bruising with this procedure and associated aesthetic and medical risks as well. |
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What about scars?
You will have scars from a facelift because incisions are necessary if the surgeon is to get familiar with your facial “foundation.” Telltale scars are not as common as they used to be. At Bay Area Aesthetic Surgery we typically place incisions….and use….so only your hairstylist will notice. |
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Will a facelift take care of all my wrinkles?
A facelift is not the solution for wrinkles. While it will minimize deep lines and folds, wrinkles are best attended to with non surgical alternatives that can be requested as part of your procedure such as laser resurfacing. |
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How can I be sure I won't look like I came out of a wind tunnel?
A great facelift is dependent upon your anatomy, your choice of surgeon and his or her artistic sense. Make sure you see plenty of before and after pictures of the surgeon's work. You cannot control your DNA, but you can choose wisely and carefully. A board certified plastic surgeon, or facial plastic surgeon with a good reputation will minimize the chances you will look unnatural. |
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How do I know what style or size is right for me?
The science of implants has been greatly refined over the last 10 years. The sizes and shapes currently available are sufficient to provide a natural looking result for all patients. Computer imaging is used extensively in our practice to assure your expectations are met. |
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How long does the procedure take?
It depends upon the area treated. Generally speaking, an hour for lips and six for a full face (when combined with a facelift procedure). Buttock fat grafting takes anywhere from 4 to 6 hours. |
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How is fat grafting different from other fillers?
Synthetic fillers are temporary. It is used to build lasting structural changes in the face and body. It is biocompatible, versatile, stable, long lasting and natural appearing. |
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Why would I do fat grafting instead of a facelift?
New fillers actually fill out the face rather than lift it. Gravity is not the enemy of youth—rather a loss of volume and tissue underneath the skin. Facelifts are still indicated for some patients, but fat grafting is very specific to area: brow, midface, or eyelids. |
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Is fat grafting always successful?
Successful fat grafting is dependent upon the nature of the fatty tissue, the methods of harvesting, transfer and placement, and the preparation of the patient. Fatty tissue is complex and delicate and easily damaged. It takes complete precision because of the millimeters involved in facial elements. Fat is very small and grafting is a painstaking procedure as it is injected in layers to adhere together. |
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Which is better if I want buttock augmentation: a buttock implant or fat grafting?
Buttock implants have the potential of moving or sliding in the pocket where they are placed. Fat grafting is particularly attractive to most people because you are taking fat from fatty regions of the body and using this to contour the buttocks. Best of both worlds! Once the fat lives in its new location, fluid collections and mobile implants are not a concern.
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What are some of the complications?
Most complications occur in the aesthetic arena and are due to over or under correction. The technique is crucial. A sharp needle can pierce an artery. Fat injected in the wrong location can block capillaries shutting off blood flow or damage soft tissues. Other complications include infection or fat necrosis (dead fat that may potentially need to be removed through a small incision because of a “bump” felt on exam). Smoking and drinking alcohol can cause additional complications.
It is important to be confident in your practitioner's credentials and experience with regard to this special technique. |
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What Liposuction/Liposelection® technique is the best? Tumescence, ultrasound or power assisted?
Before defining which Liposuction/Liposelection® technique is best for you, your doctor must look at your overall health, skin quality, body mass, estimated volume of fat to be removed and number of sites to be treated. This is easily determined at your consultation. |
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Who is not a good candidate for Liposuction/Liposelection®?
Candidates with a history of poor healing and serious complications brought about by conditions such as lupus, diabetes, chronic blood or heart disease should not have this procedure. Older patients have less elasticity in their skin—their results will not be as favorable as someone younger with good skin tone. |
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Can my dermatologist do Liposuction/Liposelection® on me?
A dermatologist can perform Liposuction/Liposelection® if they have completed specialized training in Liposuction and if the procedure is of limited scope. Facial plastic surgeons are well suited to do Liposuction if the case involves only face and neck. A board certified plastic surgeon is the only medical professional who you should consider for any area of you face, breast or body but particularly if Liposuction/Liposelection® is combined with other surgical procedures. |
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Can Liposuction/Liposelection® give me a 6 pack?
No. Liposuction/Liposelection® does not tighten skin, it sculpts the body. A 6 pack is muscle, and only exercise will help achieve this goal. |
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Is it true that Liposuction/Liposelection® can help cellulite?
No. In fact, it can make it worse. Cellulite is not fat. |
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Will my fat come back, or is Liposuction/Liposelection® permanent?
Not all fat cells removed, so if the patient gains a lot of weight, the treated areas will get larger. It is very important to commit to a regimen of healthy diet and exercise to maintain and maximize your results. |
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What is involved in the initial exam?
Your initial consultation is very important. You will be asked to bring your medical history. Because underlying conditions such as liver disease, use of estrogen medications or steroids have been linked to gynecomastia, both your history and your breasts will be examined to rule out these obvious causes. Should a medical problem be detected, you will be referred to an appropriate specialist. Depending upon the degree of fat and glandular tissue involved, we will discuss the best surgical approach for you and answer any of your questions. |
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What kind of scars can I expect?
You can expect a two to three millimeter scar at the bottom of the areola when the procedure involves Liposuction of the fatty tissue only. There is a chance that an extended scar along the areola could be necessary if additional breast tissue must be removed. |
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When can I go out in the sun?
This is a very important question. You must avoid exposing your chest to the sun for at least 6 months. Sun can permanently affect the skin's pigmentation, causing the scars to turn dark. In any case, it is advisable to use a strong sunblock (SPF 45 or greater) and be cautious. |
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Will my chest ever return to its preoperative condition again?
Male breast reduction is permanent. However, significant weight gain, or exposure to drugs and steroids can affect the size of your “breasts.”. |
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How do I know if I need a lift along with a reduction?
Depending upon the amount of breast tissue and redundant skin, a breast lift may be indicated. In some cases, not only fat and breast tissue is removed, but also excess skin. An exam by the plastic surgeon will be needed to definitively know if a reduction and/or lift will be necessary for the desired result. |
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What complications should I be aware of?
Risks and uncertainty are part of every surgical procedure. Complications associated with gynecomastia are infrequent and usually minor. Having said this, risks include infection, skin injury, excessive bleeding, an adverse reaction to anesthesia and excessive fluid loss or accumulation. It can also result in noticeable scars, permanent pigment changes or slightly mismatched breasts or nipples. Some patients experience temporary loss of breast sensation (rarely permanent) or numbness. |
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I want a nose like Julia Roberts. Can you do that?
Years ago noses were fashion statements. A “Roman” nose, a “bobbed” nose. Today proportion is the key. To copy a celebrity nose may not be the right thing for you considering your other facial features. Your nose is the most prominent part of your profile and it should be highly individualized and in relation to your overall appearance. |
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Will you have to break my nose?
No, this is a myth. In nose surgery today, the smallest possible instruments are used to cut and shape structures of the nose including the bone. Bone re-molding will depend on your initial shape. It is often used when there is a substantial reduction required of the hump on the nose or to narrow a wide bridge. |
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Why did the last surgeon I consulted with want me to have more than just a “nose job?”
It is very common to consider other procedures along with nose surgery to achieve optimal facial harmony. Chin implants and cheek augmentation are the most popular options. Your surgeon may also demonstrate how procedures of the lower eyelid, neck lift or even ear set back could improve overall results. Remember, it is ultimately your decision as to the look you desire. |
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Do you use an open or closed technique?
Each technique has valuable aspects in nose reshaping. If the tip of the nose is the focus of the surgery, then open rhinoplasty is the preferred technique. On the other hand, if the dorsum of the nose is the focus, a closed approach is preferred. In our practice, we perform whichever procedure will give us the best result. It is important to have the knowledge and technical skill to be flexible in any approach to the nose, or for that matter, anywhere on the body. |
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My friend looked awful after her surgery. Can you help me heal better?
Anytime there is trauma to the nose, you will experience bruising and swelling around the immediate area. Some patients are more resistant than others. Your friend probably looked worse than she felt, but in any case there are herbal supplements such as arnica that can indeed help. It is also important to sleep upright for the first week and use cold compresses to reduce the swelling. More or less swelling and bruising is no indication of the overall success of the surgery or surgical skill. |
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Can I have an abdominoplasty if I intend to have children?
You can have Liposuction and/or a tummy tuck prior to having children, but if you get pregnant you will likely lose the benefits you have gained. |
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If I exercise after having a baby, won't that get me back to a pre-pregnancy shape?
It depends on your body. Some women are fortunate to resume near pre-pregnancy shape while the majority of women complain that they cannot return to their “previous” body proportions. While exercise will help strengthen the muscles stretched open during pregnancy, it cannot replace the effectiveness of surgery for damaged or loose skin. |
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I have heard of a non surgical tummy tuck. What is that?
A new form of light based energy uses laser heat to tighten excess skin. This does not address even minor fat pockets but can improve very mild sagging. |
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My stomach hangs over my pubic region ever since I lost weight. Can a tummy tuck pull this up and tighten it?
What you are describing may necessitate a procedure called panniculectomy to reduce significant skin and fat hanging below the abs. This degree of skin sag is often experienced by those who were or are morbidly obese. Gastric bypass patients often need this type of body contouring for overall hygiene as well as aesthetic considerations. |
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How soon can I wear my contacts?
Barring any complications, you can usually resume contact lenses within 10 to 14 days. Dry eyes that temporarily accompany this procedure could make wearing them any sooner uncomfortable. |
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Will I have trouble closing my eyes after surgery?
Eyelid surgery is a common procedure and usually carries low risks. In very rare cases severe asymmetry or a lower lid that pulls down preventing effective closure of the lids can occur. This may require additional surgery to correct. Be sure you carefully evaluate your prospective surgeon to be sure you are in good hands. |
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Will I also need a browlift?
The perceived shape of the eye is sometimes associated with brow ptosis (droop.) Your complete condition should be addressed at consultation. The surgeon will explain what eyelid surgery alone will or will not accomplish. Patients with true brow descent or who want a higher position of the brow may have to consider a browlift. |
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I have wrinkling, extra skin and puffiness under my eyes. Will surgery treat this?
Wrinkling can be smoothed with laser resurfacing and botox. Puffiness is addressed with surgical fat removal. Extra skin also indicates surgery to tighten and remove any excess. |
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What determines whether I am a candidate for internal or external incisions?
In younger patients when all we need is removal of lower lid fat, an internal incision through the lower eyelid can be used. A more comprehensive approach for older patients requires the loose eyelid skin to be removed and tendon be tightened. This type of incision must be external, but is nicely hidden close to the lashes. |
