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Gary R. Culbertson, MD, FACS
- Iris Surgery Center
18 Miller Road
Sumter, SC 29150 - Tel: Click for phone number
- Fax: 803-773-6009
- Send E-mail
- www.garyculbertson.com
Answered Questions
Q:
What would be the best treatment for marionette lines and vertical lip lines?
I am 62 years old and look 19 years younger except for deep marionette lines by my mouth as well as vertical lip lines (I've never smoked). What is the safest, most natural looking, and longest lasting treatment for this problem?
A:
Without photographs this is somewhat of a difficult question to answer. But, the longest lasting most effective treatment for what you have described, deep marionette lines by my mouth as well as vertical lip lines, would most likely be Fat Grafting to the Face and/ or Laser Resurfacing. Depending upon the extent of your deep marionette lines you could require liposuction of the face and a facelift. One of the more common face lifts performed today involves limited incisions with less scaring. If you would like to see some examples of these types of cosmetic surgical techniques please visit our web site at http://www.garyculbertson.com/photolibraryr%202-b.htm. Consider a consult with one of the members of the ASAPS in your area. They are experts in facial plastic surgery. Best,
Gary R Culbertson, MD, FACS
Q:
Is a breast lift surgery with implants a good idea for saggy DD breasts?
Recently I lost 20 kg and lost a lot of weight in my breasts. Now I have loose skin causing my breasts to sag. When they are in a bra they look fine and sit normally. However, when the bra comes off they sag down. I want to get a breast lift with implants to get that full look (I want them to look full and sit up roundly if that makes sense). Would it be better to get a breast reduction to get rid of the fat in my breasts and then get implants to fill in all the loose skin?
A:
Anticipate you must drop at least two cup sizes with a Breast Reduction. A mastopexy which is a cosmetic surgery procedure allows you to actually pick your final breast cup size. But again with most mastopexies, patients are going to drop at least 1/2 to 1 cup size. If your breasts are truly very saggy, then I would recommend a major mastopexy first. If you are unhappy with the final fullness or size, a breast augmentation can later be performed with a much lower complication rate. Consider a consult with one of the many members of the ASAPS to address your concerns. They are experts in Breast Surgery.
Best,
Gary R. Culbertson, MD, FACS
Q:
Can an implant with a fold in it be removed without charge as the augmentation was done for free in England 8 years ago?
I had a lump in my breast and was sent for an ultra sound to make sure it was not cancer. Thank goodness it is not but I was told that I have a fold in my implant. It is very painful. Can they remove this for free as I had the implants done free on NHS when I lived in England eight years ago?
A:
Breast ultrasounds are a screening test for breast cancer. They are not as diagnostic as a breast biopsy.
Regarding your request for additional care of your breast implant issue, contact your health care provider service in England. They should be able to answer your question. Such services are rarely free in in the USA.
Best,
Gary R. Culbertson, MD, FACS
Q:
Can a recent tummy tuck cause capsular contracture in a breast when the agumentation was done 10 months ago?
I am 48 years old and was just told by my plastic surgeon that I have capsular contracture of the right breast, stage 3, after only having had the surgery ten months ago. I have read that mammography cannot be performed in cases of capsular contracture. What are my options for breast cancer screening? Could a recent "tummy tuck" done 8 weeks ago, have caused capsular contracture?
A:
For the screening of patients with capsular contracture that cannot tolerate mammography often specific MRI techniques are utilized. These MRI tests can be somewhat expensive. The exact cause of capsular contracture is unknown. Possible etiologies have included the patient reacting to the prosthesis (implant) and producing a heavy scar, Biofilm or bacteria that somehow have coated the implant causing the scar reaction, etc.
The correction of capsular contracture can be sometimes difficult. Some practitioners start in early cases with use of asthma medications like Acculate or Singular. These medications are recommended by the FDA for the treatment of asthma and not capsular contracture so, this medical treatment would be what is called an OFF-Label Use. There is little data supporting their efficacy but anecdotal cases abound.
Consider returning to your original breast surgeon and discuss your concerns. If you feel your concerns are not adequately addressed, then seek out a consult with one of the many members of the ASAPS. They are experts in Breast Surgery.
Best,
Gary R. Culbertson, MD, FACS
Q:
Does lower eyelid surgery typically require snipping a muscle?
Does lower lid surgery typically require snipping a small wedge of the muscle under the eye where it attaches to the outer corner of the eye?
A:
Lower lid surgery is most dependent upon the patients anatomy and what is desired to be corrected. If there is excessive baggy skin, festoons, etc. it is often necessary to use an external approach. If simple puffiness or fullness is present, sometimes an internal or transconjuntival approach can be considered. And, sometimes laser is even utilized to tighten the perioccular skin. The approach taken is best determined by an experienced surgeon. Look for an ASAPS member in your area to address your concerns. They are experts in Occuloplastic Surgery.
Best,
Gary R. Culbertson, MD, FACS