Michael Law, M.D.
I have had three procedures on my breast resulting in vertical scars that are very noticeable and really bother me. The first procedure was done thru the nipple incision but the implant was too large. I had a smaller implant placed but my doctor said the incision would have to be done vertically. Then one night my implant flipped over and back into place the next day. I had another corrective surgery and they are OK now; however, my scars really bother me. What can I do? Help!
A pulsed dye laser, like the V-beam laser can be used post-operatively to improve the appearance of scars.
Can a small amount of my chin bone be shaved off to make my chin profile more symmetrical and how much would this procdure cost?
Instead of having a level chin, the right side of it hangs down slightly, making it appear slanted and uneven. In order to make my chin profile more symmetrical, can a small amount of my chin bone be shaved off? How much would it cost to have this procedure performed?
Mandibular asymmetry is quite common, and most board-certified plastic surgeons who routinely perform aesthetic surgery of the jawline, chin and neck are experienced with the correction of asymmetries. Yes, an excessively projecting contour on one side can be improved by the use of a rotary burr (sort of like sanding) or an osteotome (used like a chisel, driven manually by a mallet) to reduce the projection of a portion of the mandible. But a careful preoperative assessment is required to determine whether the ideal profile is obtained by reducing the overprojecting side, or by augmenting the underprojecting side. Solid implants can be placed against the mandible and secured with tiny titanium screws to 'build up' an area that does not project adequately. In many cases, fat grafting can be used to camouflage asymmetries of the mandibular border, and in some cases is a better, less invasive choice compared to a solid implant. I use fat grafting in most major facial rejuvenation surgeries to restore the prominence of the jawline in areas where it predictably recedes with age - anteriorly between the chin and 'jowl' area, and posteriorly behind the 'jowl' area. It is a highly effective and natural-appearing means for enhancing mandibular contours.
There are some issues regarding mandibular shape and size that require evaluation and treatment by an oral/maxillofacial surgeon, particularly ones where the occlusion of the teeth (how the upper and lower teeth line up together with the jaw closed) is abnormal and needs correction, and when the chin is excessively over- or underprojecting and must be corrected by surgical osteotomies (carefully planned surgical breaking of the bones) that permit a sliding advancement or setback of the mandible. Asymmetries of mandibular projection, on the other hand, can often be corrected or dramatically improved without maxillofacial surgery. Most cases of underprojecting chins or mandibular borders can be corrected by the placement of a chin implant and/or mandibular body implant, or by structural fat grafting.
Cost will vary depending on the technique used, the anatomic extent of the surgery, the length of surgery, the surgical venue, etc. Fat grafting can be performed as an office procedure under local anesthesia and oral sedation, while most aesthetic plastic surgeons prefer to perform implant placement in an operating room setting.
After having breast augmentation with breast implants two weeks ago, how long do I have to wait to have them removed?
I am an athlete and I got breast implants 2 weeks ago. I made a huge mistake and I would like to get them out as soon as possible. How long do I have to wait until they come out? Do you think that my breasts will go back more or less to normal when they are taken out? I was a 34 A/B and had 350 cc's silicone implants. Will the entire implant be taken out as a whole? I do not want any silicone in my body. Will the incision have to be larger than the original? Can I wear a regular bra right after as I did with my implants or will I have to be bound? What is the average blood loss during this surgery? Thank you for your reply.
It can be quite an emotional roller coaster ride for a woman who, being self conscious about her breast appearance, seeks out a surgical breast enhancement, chooses a surgeon, has a breast augmentation, and then ends up with a result that falls far short of her expectations - or even worse, results in a breast appearance about which she is even more self-conscious. I take this situation very seriously, and in my practice we do our very best to not only provide such patients with the enhanced breast appearance that they originally had in mind, but also to make the experience of consultation, surgery and recovery as positive and pleasant as possible.
You did not provide a name or a state where your procedure was performed but there are questions back to back from a female athlete who feels that surgery was a "huge mistake." You need to speak to your plastic surgeon right away and let him or her know about your concerns.
On occasion it takes a period of time for people to become accustomed to their new look following surgery. Perhaps that will be the case with you. I do wonder how many consultations and pre-operative visits you had with your plastic surgeon's office before surgery. Were all of the options risks and benefits made clear to you? Did you have a minimum of several weeks following your consultation before surgery to get comfortable with the idea of surgery or was there pressure to schedule surgery right away?
I regularly perform breast augmentation on athletes and even competitive bodybuilders. These athletes typically want a very conservative result from breast augmentation.
Please discuss your concerns with your plastic surgeon.
I have hollow looking eyes after a blepharoplasty procedure. My excess skin is gone but I feel like I look much older now than before my surgery. Can my hollow upper eyelids be corrected with fat injections?
The area between the brow and the upper eyelid crease is full of subcutaneous fat in most young people, and that fullness looks youthful. I refer to this area as the "brow-upper lid junction," and I add fat to make it fuller in the majority of patients for who I perform eye-area rejuvenation surgery. Take a look at the eyes of fashion models in advertisements: in most cases you actually see little to none of the upper lid. What you see is a youthful soft tissue fullness that extends from the brow to the upper lid lashes.
As we age, this fatty fullness atrophies and the brow-upper lid junction gradually becomes hollow. The outline of the bony structures below the brow (the superior orbital rim) becomes visible, and one begins to look older, sometimes even ill, and in advanced stages even skeletal. In some patients that I treat this appearance is inherited and they have a hollow look at their brow-upper lid junction at a young age. Whether it is something that was always present, something that has developed with aging, or the result of an overly-aggressive upper blepharoplasty, fat grafting of the brow-upper lid junction can rejuvenate the eye area in a manner that is simply impossible by means of standard blepharoplasty techniques. It does not look like ‘surgery’, and patients for whom I perform this procedure return to say that their friends and acquaintances think they look great, but they can’t quite put their finger on why.
A word of caution: this is a delicate surgery that requires a fair amount of experience with fat grafting, and meticulous surgical technique. In experienced hands a smooth, youthful and aesthetically ideal brow-upper lid contour can be achieved. Make sure your surgeon can show you numerous photographic examples of brow-upper lid junction fat grafting.
I gave birth to my son February 9, 2011. I stopped breast feeding on March 3rd. How long should I wait before having a breast augmentation and lift? I am already down to my pre-pregnancy weight and my breasts are the same size that they were pre-pregnancy.
Congratulations on your baby, and your weight loss. If you plan on having more children you may choose to wait. If you are not planning on having more children, wait a minimum of three months after you have finished breast feeding.