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Breast lift and tummy tuck - reasonable results?

Q:

I had a mastopexy and tummy tuck 11 weeks ago.  I am very happy with my results, for the most part.  I do have two questions that I don't want to "overly offend" my plastic surgeon with by harping on them.  There is a "ring"- only way I know how to describe it - around my belly button that I am concerned with which will be obvious during swim suit season.  The ring is a very fine but red line where the scarring from the new hole was created.  It is obviously well outside the circumference of the belly button itself.  Will it fade a good deal more?  Also, my left breast was a full DD while my right was a small D.  While they are MUCH perkier, my left is still bigger than the right and the shape is a little different than the other. Is it reasonable to expect the breasts to still be dissimilar?  The left is still a tad bit bigger than the right and spills out over my bra cup somewhat.  I go back to my plastic surgeon in May.  What do you advise?

A:

It sounds like you have had a successful surgery.  The combination of breast lift, implants, and tummy tuck is always a challenging case and it looks, based upon your description, that your case has been managed well by your plastic surgeon.  The "ring" around your belly button is most likely due to histamine release in your wound and it is normal. It may take 12 to 18 months for that to improve.  In some cases, cortisone injected or topical might help to speed the process.  In fact, Scarguard has a hydrocortisone that may help.  With regards to the breast asymmetry - it looks like there is an improvement.  You should not expect perfection, but if you are comfortable talking to your plastic surgeon, addressing this issue is reasonable.  Tell him how happy you are and then ask about what other improvements might occur.  I recommend you review the before and after photos with your surgeon and give the healing at least several more months before undergoing any other procedure.

Aldo Guerra, M.D.
Scottsdale, AZ

A:

The redness around the umbilicus (belly button) is normal for 11 weeks; it should improve over time.  It takes a year or so for scars to mature. There are various agents that can improve scarring that you can apply as well as massaging them.

Your breasts were uneven before surgery and most likely will be now; exact symmetry is not a reality.  You need to contact your surgeon to discuss your concerns.  I am sure if you call the office he/she would be glad to see you.

A:

It is difficult to give an opinion without an examination.  Bring these issues to your surgeon and he/she will be able to answer your questions.

As for the asymmetry of the breasts, it is not unusual when you start asymmetrical to have some asymmetry after surgery.  It is very difficult to achieve 100% symmetry.

A:

It is only 11 weeks since your tummy tuck and mastopexy, (breast lift surgery), so these concerns that you have expressed likely represent some post operative swelling of your breasts, and early scar healing.

The breasts will settle, the scar will lighten, and these concerns should resolve over time.

You  should check with your plastic surgeon about these issues as well as regarding sun exposure, as this may prolong the pinkness of your exposed scars.

Fredrick A. Valauri, M.D. - View Other Answers by this Doctor
New York, NY

A:

The scarring should improve around the umbilicus.  I have injected steroids in the area if the scar becomes raised.  With time it should fade.  In terms of breast size and shape, it can be extremely difficult to control all the variables.  Just relay your concerns to your surgeon; he/she  should not be offended.

A:

it is much too early to assess your results since you definitely have swelling in place. 

the scarring around the umbilicus will definitely improve with time. 

be more patient but if it is bothering you a lot, your plastic surgeon should be happy to see you and reassure you before may.

sincerely

david berman md

plastic surgeon, northern va. 

A:

At 11 weeks, one would still expect scars to be very immature - i.e., reddened and thick.  This will improve over time, but could take a year or more.  Regarding your breast size, it sounds as if you had a lift on one side and a small reduction on the other, and that your symmetry is improved, but the two breasts are not exactly alike.  There is still a lot of healing which has to occur before you can make any judgments about final results.  Swelling must all go down, scars soften and fade, etc.  I would wait until at least 6 months post-op before you critically compare them.

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