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Robert T. Buchanan, M.D.
- Suite 202
209 Hospital Drive
Highlands, NC 28741 - Tel: Click for phone number
- Fax: 828-526-9730
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- www.plasticsurgerytoday.com
Answered Questions
Q:
Is a second breast reduction possible 15 years after having a first one?
I had breast reduction surgery in 1995. My breasts have grown quite large again causing me to have back-aches, problems with my shoulders, etc. My self-confidence has gone back to where it was pre-previous surgery. Can I have a second reduction now?
A:
Redo of Breast Reduction
It is always possible to redo a breast reduction. However, the second time the risks are higher. The greatest risk is that the nipple will die. You can significantly reduce the risks by knowing the exact method used in the original surgery. Therefore, if possible, you need the operative report from the first procedure. If you were happy with the first surgery, returning to the same surgeon can also reduce the risks even more.
Q:
If I have more children, will my breasts look like they did after breast implant surgery?
If I get breast implants and then have more children, will my breasts look as they did after the breast augmentation surgery or will their appearance change?
A:
The simple answer is no. Pregnancy causes many changes in the breasts. At the end of pregnancy or after completing breast feeding your breasts may return to their pre-pregnancy condition or remain with stretched skin and thus, droop. Whatever happens, however, would have happened if you had not had the breast augmentation. Therefore, you get to enjoy your breasts before pregnancy, and are no worse after pregnancy except that you are larger.
Q:
Is a lower eyelid lift usually performed with a facelift?
I have been consulting with several plastic surgeons concerning a facelift. All are pretty much in agreement with the exception as to how to handle the area below my eyes. Some want to inject fat, others want to perform a lower eyelid lift, and one wants to do nothing to this area. There is some disagreement as to whether the skin will wrinkle underneath the eye as a result of the facelift if a lower eyelid lift is not done. I would appreciate other doctors' experience and advice.
A:
As we age, several things happen. We lose the fat in various places and the tissues sag. These changes occur at different speeds, so you may need only the fat injection, only a blepharoplasty, or more usually, both. Surgeons used to remove the fat from around the eyes. Now, we move the fat to fill the areas of loss. As for the disagreement about whether a facelift will wrinkle the skin under the eyes, this depends on the technique of the facelift. The newer lifts that provide more upward lift (the direction from which the tissues came) also correct the mid-face better and usually also wrinkle the skin under the eyes. My advice is to pick the surgeon with whom you could communicate the easiest and who showed you results that were pleasing to you. Then, discuss any concerns you still have.
R.T. Buchanan, MD
Q:
Can a facelift procedure be performed on only one side of the face?
The left side of my face was injured in an assault. That side of my face is now drooping badly. Can a facelift be performed on only one side of the face?
A:
The simple answer is yes, you can do a one sided facelift. However, you should probably have both sides done in order to get better symmetry. Frequently, if you pull one side tight, you create some asymmetries from the one sided pull. Therefore, putting equal pressure on both sides of the face is generally the best idea. The only way to know what you need for sure is with a full consult with a Plastic Surgeon experienced with difficult facelifts.
Q:
Do I need my Primary Care Physician's recommendation to get approval for breast reduction surgery?
I am 24 years old and my breasts are a size D, most likely larger. I want to have breast reduction surgery as my breasts are causing me neck, back and rib problems. I have insurance through the state and I'm not sure if they will approve the surgery. Do I need my primary care physician's recommendation to get approval from my insurance company for the breast reduction surgery? Since my breasts are causing me pain, do you believe that the state insurance will cover this surgery?
A:
With the symptoms you have, if you need enough breast tissue removed to meet your insurance company's requirements for breast reduction, you may not need your primary care physician's recommendation. However, having a recommendation always helps, as insurance companies are always trying to find some way to deny breast reduction. If he/she is willing to write you a letter, by all means have it done and sent with the pre-certification letter from your surgeon.