John H. Moore Jr., M.D., FACS
About 4 or 5 years ago I had a lumpectomy on one breast. I had radiation treatment and all is fine now but I wanted to know, is it at all possible to enlarge the treated breast to match the size of the other one?
It is entirely possible to match the size of your breasts. First, you should consult with your breast surgeon and/or oncologist to see it they are comfortable with this decision. Your next step would be to consult with a plastic surgeon. During this evaluation, your plastic surgeon will examine you to assess the quantity and quality of the breast skin. Radiation therapy can lead to scarring of the remaining tissue of the breast. Thus, there may be limitations on the final size of the breast on the lumpectomy side. The easiest option would be placement of an implant. If the skin is deemed to be of poor quality, a flap (movement of skin with its own blood supply) may be necessary either with or without an implant. Surgery on the opposite breast, which may involve reduction, mastopexy, or mastopexy with an implant, may be necessary to achieve symmetry. Remember, the effects of radiation (skin discoloration, scarring, and uncertain healing) are chronic and slowly progressive over time. Your plastic surgeon is best able to discuss these options with you.
I am 5'6" and 142 lbs, "pear shaped." I weighed 128-132 prior to having a child at 38. I have never been heavy but my metabolism is resistant to weight loss. I have a protruding abdomen from a myomectomy and the c-section. The excess fat "juts out." I am sensitive to epinephrine and other pharmaceuticals. This is of great concern to me in considering elective surgery. I am also considering a reduction of my "saddlebags." First, is there a safe liposuction procedure for me? Will liposuction alone make any improvement to my abdomen? I am seeking a "smoother" as well as flatter profile. Second, I am not "sleek" below the waist. I could use some contouring. Would liposuction of the saddlebags region make a noticeable improvement in my appearance? Can both procedures be performed at the same time?
The problem you describe is a very common one. Lipoplasty (liposuction) is a safe and proven method for body contouring; it is not a method for weight loss. First, an evaluation by your physician or an endocrine evaluation may be helpful to insure there is no medical reason for your appearance. In addition, an exercise program will be helpful to you even if you do not choose to have a surgical procedure. Many people say they are allergic to epinephrine. In reality, epinephrine is a substance that is naturally produced by your body. This "allergic response" may be secondary to some of the medication getting into your bloodstream and causing an increased heart rate following a dental procedure. Other medications can also interfere with anesthesia. It is important to discuss these issues with your plastic surgeon and an anesthesiologist prior to scheduling surgery.
Regarding your abdomen, I feel a combination of lipoplasty with possible mini-abdominoplasty might be the best approach. A mini-abdominoplasty involves smaller incisions than a standard abdominoplasty and is generally used to remove excess skin. Liposuction would help in contouring the saddlebag and leg areas. Both of these procedures are very safe in the proper setting and with proper surgical indications. It may be reasonable to combine both of these procedures at the same time, but this is a decision that will be made following a consultation with a plastic surgeon.
I am considering a chemical peel but have a scattering of tiny red dots on my skin. They look like small pin prick marks. I believe they are probably burst blood vessels. Will a chemical peel highlight these even more and leave my skin smooth, but covered with red dots? Do they need to be treated separately or will they also disappear during the procedure?
Many situations can cause the "tiny red dots." If they are broken blood vessels, in some cases laser treatment(s) may be helpful. On the other hand, the redness that you refer to could be rosacea which may need to be treated with topical agents. The key element is to first obtain an accurate diagnosis by consulting with a plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery. A qualified plastic surgeon can help you pick the appropriate treatment.
Can you tell me if the NLite is effective?
Wrinkles can be the result of many factors which can include sun damage, aging, smoking, alcohol, and hormonal changes. Basically, these changes result in the loss of collagen from the skin with subsequent loss of the smooth stability of youthful skin. Carbon dioxide and erbium lasers ablate the outer layers of skin and heat the deeper skin which results in tightening
of the underlying dermis. A pink glow to the area treated is common as it is a healing wound.
The NLite laser works by causing this inflammation only to the deeper skin (dermis) without removing the outer layer of skin. Healing substances are released following the laser treatment which stimulate new collagen production and resultant smoother skin. The advantage is limited downtime, however the long term results are still being evaluated. Your surgeon will discuss the advantages of the different treatments.