Laurie A. Casas, M.D., FACS
- 2050 Pfingsten Road
Glenview, IL 60026
- Tel: Click for phone number847-657-6884
- Fax: 847-657-6552
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After having a facelift, what is the likelihood that skin necrosis will cause permanent scarring? The area affected is about 1/2 inch wide and about 1 1/4 inches long, just in front of the ear.
The scar in front of the ear will fade over the next 1-2 years. I recommend you consult a plastic surgeon who is certified by the American Board of Plastic Surgery and is an ASAPS member (www.surgery.org) to evaluate whether a scar revision may help reduce the appearance of the scar. This kind of minor surgery typically can take place after the scar is soft and is white in color. That occurs after 16-18 months.
My 17 year-old daughter is embarrassed by her large breasts, and they even cause her physical pain and discomfort. She is talking about breast reduction surgery, but I'm not sure it's a good idea. What if she regrets it later on?
Once breast tissue is removed, it cannot be put back. Breast reduction surgery is irreversible, so you are correct to approach the surgery with the utmost caution. However, in many cases, breast reduction surgery is the right choice and can significantly improve a woman's quality of life. If your daughter's large breasts interfere with normal physical activity, or if their weight causes back or shoulder pain, breast reduction may be recommended. In addition to relieving these symptoms, the surgery may improve the shape of her breasts. It also is likely to make her feel less self-conscious about her appearance.
Your daughter needs to be realistic about what is involved -- breast reduction is a major operation, usually requiring a brief stay in the hospital. There are a number of possible techniques, but, in most cases, there will be visible scars. However, most women who decide on breast reduction find that the freedom from pain and the ability to find clothes that fit well are worth it. Most plastic surgeons agree that breast reduction surgery has one of the highest satisfaction rates of any surgical procedure they perform. Start by taking your daughter to a board-certified plastic surgeon for an evaluation. The doctor can help you decide if breast reduction is appropriate and if your daughter has the maturity to make such an important decision at this time of her life.
How soon after delivering my baby can I have an abdominoplasty done?
How soon a woman can have an abdominoplasty following childbirth depends on individual factors including how quickly your tissues contract or shrink. Typically, I would recommend waiting at least 3, and possibly as long as 9, months after delivery. I would encourage you to resume a daily exercise regime including abdominal toning and strengthening exercises, starting 6 weeks after delivery. The advice of a board-certified ASAPS-member surgeon, following his or her examination of your abdominal area, is the best way to determine when you may be ready for surgery.
I received breast implants in 1988. The breast implants used on me were subsequently taken off the market, were said to increase the risk of cancer due to their polyurethane outer coating used to prevent capsulation. Currently I am having pain on one side near the nipple area and do not know if it is nerve related pain or a problem with leakage. The implants are uneven and the texture feels funny on that side. I am having a problem finding anyone that wants to get involved with removing these and replacing them. In the past I have had annual mammograms which are painful and I question their accuracy. I am presently afraid to have a mammogram for I fear that the implants are ruptured and will further rupture during the procedure. Do you recommend ultrasound to detect rupture? I would greatly appreciate it if you could offer some suggestions and possibly referral information for a surgeon in the Baltimore area.
First I would like to ease your mind regarding the association between polyurethane coated silicone implants and cancer. To date there is NO evidence to support this claim. Secondly, there is no perfect test to detect leakage, and unfortunately ultrasound is not that helpful. An experienced Radiologist at a Breast Center can help you decide whether any of the available tests are really cost effective (e.g. MRI of the breast can cost as much as $2,000 yet not always give you the answer). I suggest to all patients with silicone implants over 15 years old that have symptoms of pain, and who have also experienced a change in breast shape, that they consider surgery. The breast pocket can be explored with the plan to remove the implant if broken, and replace it if you desire. As far as the details of exactly how this should be performed, including specifics regarding anesthesia, incisions, capsulectomy or capsulotomy and replacement in the same or different position (above or below the muscle) – this should be decided after a careful examination of you and all the facts regarding your previous surgery.
We can give you the names of three of our surgeons in the Baltimore area, Navin Singh, MD, Alexander M. Guba, Jr., MD, and Paul N. Manson, MD. All are Board Certified by the American Board of Plastic Surgery.
How soon after having a breast reduction can I start to stretch the muscles around my shoulders and pectorals?
Following breast reduction surgery, as a plastic surgeon, I am most concerned about allowing the scars to heal without spreading. To accomplish this I ask that the patient keep her arm activity to a minimum for 4 to 6 weeks. However, I teach the patient slow deliberate shoulder and pectoralis stretching exercises that do not spread the scars starting two days after surgery and ask the patient to do them two to three times a day. This will not affect the scars but will prevent shoulder and pectoralis stiffness.