Robert W. Kessler, M.D., FACS
I am going to have a tummy tuck. Will it be all right to smoke the day before the procedure? Would there be a problem if I smoked right after the surgery?
Smoking and elective cosmetic surgery do not go well together. Certain procedures are less susceptible to wound healing problems than others but the reasons for stopping are clear.
Smoking reduces the amount of oxygen in the blood. The nicotine causes constriction or tightening of the blood vessels. What this means is that less blood makes it to a healing wound and the blood that makes it has less oxygen. The combination leads to an increase in wound healing problems such as tissue loss and wide scars.
When you are having elective surgery the goals are to achieve the best possible results. Smoking is something that can be controlled and eliminated to improve your results. Smoking before and immediately after a tummy tuck will increase your chances of losing abdominal skin and creating wide problematic scars.
I hope this was helpful.
Please advise me how to correct a liposuction gone wrong. I have large wrinkles across the tops and inner sides of my arms that were not there before my upper arm reduction procedure. I am a small thin person and have no fat for a transfer. I need them tightened. Can you please advise me of my options?
This is a difficult problem. As volume replacement is not an option for you, skin tightening is the only other alternative. There are no dramatic skin tightening devices on the market. In fact most are disappointing in my opinion. Skin excision or brachioplasty is mostlikely your best solution. This will be a trade off of a scar for a contour irregularity.
The brachioplasty scar can be limited and placed in the shadow of the biceps.
This is a complex matter and would be best reviewed in consultation with a Board Certified Plastic Surgeon.
I hope this was helpful. Good luck.
I had a breast reduction bringing me from a G cup down to a DDD. I have dense heavy breasts and have gained some weight making my breasts large again. What is the risk of having liposuction done? Will the scar tissue interfere from the previous reduction surgery?
Although liposuction is an option for breast reduction surgery, there are limitations. Liposuction is good at removing the fat from the breasts but not for removing "dense heavy breast tissue." The other limitation is the ability of the skin to retract. Significant volume reduction by liposuction may lead to lax skin and somewhat low lying breasts.
I would consult with a Board Certified Plastic Surgeon to discuss all your options. With education and understanding you will make the decision that is right for you.
I had my breast implants done about 11 years ago. I want to know if I can get them re-done. They are sagging and have lost their lovely perky nature! I'm not sure what happened. Is this common? Im 29 years old, have a skinny upper body, and work out often. I'm worried if they might be leaking or have some other problem.
The current appearance of your breasts may be due to many factors but to answer your question this is not unusual.
Breast implants are essentially weights which are being added to the breast. Position of the implant is important as is the quality of your skin. Cycles of gain and loss or engorgement and deflation will also impact the appearance of the breasts over time. Skin is not a support structure - it is a veneer and gradually loses elasticity over time.
Deflated saline implants will go flat and be obvious to you whereas silicone implants will require a study to determine if they have ruptured. Sono or MRI are good for this. A good clinical exam will also be helpful.
The good news is there is a simple solution for whatever your issue is. It is most likely going to require a surgical procedure but the results are usually excellent.
Your options include a lift if you are pleased with your breast volume, a larger implant if your skin is only mildly loose (but I am not a fan of this), or an implant exchange and a breast lift.
Seek out a Board Certified Plastic Surgeon to help you make this decision.
I'm a 24 year old woman who has 120 pounds (with 30 more pounds to go). I have a huge amount of excess/sagging skin in the breast and tummy area. I'm a size 38DD, with one breast slightly larger than the other. My breast tissue seems to have lost all elasticity. They are extremely wrinkled when I hold them up and when I lay down. I want breasts that reflect my age. I worry because of how loose and thin the skin is and that a lift may require that my nipple be detached. I desire to have children (none yet) and would want to breastfeed them. It's easy to say just wait until you have them, but the excess skin is having a negative impact on my life. It has affected me from finding a mate. For my situation, would it be possible to raise the breast without having to detach the nipple?
There are many variations of breast lifting surgery. If you do not need volume reduction the surgery can be done to separate the skin from the breast and remove the excess skin. Impact on breast feeding after a surgical procedure is difficult to assess. The nipple is not removed from the breast in standard lifts. If the breast tissue is not altered dramatically you may be able to breast feed after this procedure. I would not promise this or guarantee it. There is always the possibility of producing enough milk for the initial colostrum and the bonding experience, but I would prepare you for the need to bottle feed.
With the amount of weight you have lost, and should be congratulated for, body contouring surgery will be necessary to help restore the balance between the scale and the mirror. Discuss these issues with your Board Certified Plastic Surgeon to make the right decision for you.