Smoking or the use of any nicotine releasing products, such as patches, vaporizers or gums, has been shown to increase the incidence of serious complications after facelift surgery.   For this reason, many plastic surgeons, myself included, refuse to perform facelifts on patients who are smokers or are using nicotine in any form.  The safety of our patients is always our primary concern.  Therefore at the very least, smoking or the use of any nicotine releasing products should be completely stopped at least several weeks before a facelift, and not restarted for a week or more after such an operation.   I strongly recommend that all smokers permanently quit as soon as possible, not just if they are considering plastic surgery, but purely for their own good health and those around them.

Facelift

Breast surgery of any kind has never been shown to cause cancer nor is such a causal relationship conceivable. Since approximately 11 % of women will develop breast cancer sometime in their lives, it is conceivable that breast cancer may be pre-existing or may develop in women undergoing breast lift surgery. A frank discussion about your concerns with a board-certified plastic surgeon is strongly recommended and a mammorgram prior to such a proceedure may be advised.

D.L. Davis, MD

Breast Lift

Hello Amanda,

From the information you have provided, it is likely that your doctor would recommend that you have breast reduction surgery.  It is also possible that he or she may want to rule out or treat other causes of your symptoms such as arthritis or generalized obesity.

Financial coverage for such surgery and the criteria that insurance companies use to determine it, vary widely from company to company.   Factors such as the presence of physical signs including bra strap grooving on your shoulders, or rashes beneath your breasts might be considered.   An estimate by your surgeon of the weight of the tissue that is to be removed from each breast or the actual weight of the tissue that is removed in an operation is often used in such decisions.   I am also aware that some companies or governmental agencies have insisted that patients either achieve, or try to achieve and maintain a normal body weight before authorizing financial coverage for such surgery.  

My recommendation to you at this juncture, is to consult with a plastic surgeon, certified by the American Board of Plastic Surgery, and discuss these issues with them.

Breast Reduction

The removal of injected liquid silicone from the face, or elsewhere in the body, is difficult and very challenging.  Large accumulations or pools of the material may be partially removed or reduced by aspiration or liposuction.  If the liquid has migrated or is dispersed into small droplets or particles spread over a relatively large area or volume of the face, its complete removal is much more difficult, if not impossible without causing significant deformity.  In such situations, excision of the tissues that have been infiltrated with the material is necessary.  Such procedures are often performed selectively, only to remove those tissues where scar has built up around the silicone or where infected or chronically inflamed cysts have formed.  Because of the structure and nature of the face, removal of even small amounts of tissue can have a very significant and adverse effect on appearance. Often more than one operation is necessary as are reconstructive procedures to improve the resulting deformities.  For these reasons, the injection of liquid silicone is very controversial and should only be undertaken with great caution.  I suggest you seek the help of an experienced plastic surgeon, certified by the American Board of Plastic Surgery.   

Miscellaneous

Northern California is a very large region that includes the San Francisco Bay area where I am sure you can find numerous, well qualified surgeons who can perform earlobe reshaping procedures.  If you are looking for someone in one of the more rural areas of Northern California, you may have to travel some distance to find a surgeon who can help you.

I suggest that you go to the home page of Surgery.org, http://www.surgery.org/

In the center of this page under "Find A Plastic Surgeon" simply enter your Zip Code and then go to the  drop down menu under Procedures.   Scroll down to Ear Surgery and highlight it.  Click on the Submit button and you should then be taken to a list of surgeons that provide the services in which you are interested as well as an indication of distances they are from you.  These are all board certified plastic surgeons that are members in good standing of the American Society for Aesthetic Plastic Surgery.  I suggest that you then call their offices to make further inquiries and set up a consultation.

Ear Reshaping