Michael L. Kreidstein, M.D.
I would like to have a tummy tuck. I had a spinal fusion 11 years ago which left me with a 12 inch scar up the left side of my chest. At that time, the surgeon also removed a rib for a graft. I saw a plastic surgeon recently to discuss my having a tummy tuck/mommy makeover. He expressed concern over the scar and the risks performing the surgery because of the old scar and blood flow. However, another surgeon said it would not be an issue. Who is right???
The abnormal blood supply to your abdominal skin is an issue, but the surgeon was likely trying to convey that it would not prevent you from undergoing a tummy tuck. It would be reassuring if you did ask your surgeon about any concerns regarding the blood supply below the scar, but a CT scan is not required to provide you with good advice about your suitability for this surgery.
M.L. Kreidstein, MD
I have very large breasts (size 50-52 DD bra size). I want to have breast reduction but I am diabetic. Would this surgery be safe for me?
Your large breast size, large chest size, and diabetes make it likely that you will suffer wound healing complications with breast reduction surgery. A safer technique for you would involve a free-nipple graft. Make sure that the surgeon you see is comfortable with offering you this option, and that the risks and benefits of each technique are clear to you.
M. L. Kreidstein, MD
I had my breast implants with a trans-areola incision which I have regretted all my life. I am now pregnant and extremely worried about complications with breast feeding. I want to know is it just a matter of being unable to breast feed or are there other issues like milk rotting in the glands because it cant flow? What can I do to avoid risks?
Glands that are unable to transmit milk along their ducts (because of previous surgery) will simply stop producing milk and the glands/ducts that are intact will function in their place. You may well be successful in breast feeding, and rotting milk will not be an issue.
R. L. Kreidstein, MD
Eight days ago I had saline implants removed, replaced with silicone under the muscle, and a breast lift. After the saline implant surgery I developed a hardening in my left breast. The doctor removed all scar tissue in the breast, but it is still very swollen. He said there is a blood clot in that breast. He told me I could either have it surgically removed or take Singulair for a few months and it will dissolve by itself. What is your opinion?
Singulair has been used to prevent capsular contracture (excessive scarring around breast implants. A small surgical hematoma can be allowed to dissolve and be absorbed, but if it is large, it must be removed to prevent healing problems. The hematoma may predispose you to capsular contracture, and as you already have a history of capsular contracture the use of Singulair is consistent with the goal of preventing a recurrence of the capsular contracture.
Should I reschedule Liposuction and Tummy Tuck surgery scheduled for next week as I've regained 20 pounds of the 105 lost?
I'm to have liposuction and tummy tuck surgery at the same time next week. I had lost a total of 105 pounds; however, since seeing my surgeon three months ago I have gained 20 pounds which makes me now 30 pounds from my idea weight. Should I reschedule the surgery and lose the weight again or doesn't it make a difference because both procedures are going to be done?
The issue of weight variation and surgery comes up often. Weight loss before surgery (more than 10% of your body weight a month) can be a problem, as you may be malnourished and thus prone to surgical complications. Excisional surgery (e.g. tummy tuck) is best done when you are at a stable weight that is at the low end of your range. It would be a problem if you lost substantial weight after a tummy tuck as this may result in you re-developing loose skin, but as you are fairly close to your ideal body weight this is unlikely. Liposuction can be done at any weight and is generally more accurate at a higher weight (bigger target tissue!). That said, the decision to have liposuction is best made when you are at your ideal weight. Your plastic surgeon will consider your personal circumstances and health to help you confirm that surgery next week is appropriate. Good luck!