Robert Singer, M.D., FACS
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?
Is it safe for a person with diabetes to have a breast reduction?
If a patient's diabetes is under control and her general medical status is satisfactory, breast reduction surgery or other elective surgical procedures are generally safe. Patients with diabetes should have medical clearance from their primary physician or ideally an endocrinologist. It is important that the glucose level is monitored during and after the surgery in order to minimize any
problems. Patients with diabetes have a slightly higher risk of delayed wound healing and infection.
Robert Singer, MD, FACS
Is there any procedure that lifts the breast from the top (something like attaching breast tissue higher under the skin to the shoulder blade, or something similar)?
Is there a breast lift procedure that lifts the breast from the top instead of underneath? There is no reliable breast lift procedure that lifts the breast from above. There are a variety of incisions and techniques that are utilized to lift breasts, which depend on a patient's individual anatomy, desired outcome, and the surgeon's preference, which is based on his or her experience. They all involve an incision around the nipple/areola. To correct a greater amount of drooping, additional incisions are usually placed below the nipple/areola. Robert Singer, MD FACS
How long should swelling and numbness last after a face and neck lift?
Swelling and numbness, which are normal after a facelift and necklift, depend on many factors, including your individual anatomy and genetics as well as the extent and type of facelift procedure that is performed. Most of the obvious swelling subsides by 2 weeks, to the point that patients usually can resume their normal work and social activities, but there is further resolution of the swelling for 1-2 months. Numbness gradually decreases and sensation returns over months.
Robert Singer MD FACS
I have a deviated septum that has caused a host of other problems (breathing, headaches, fatigue, hard mucus, infections inside). If I were to get a septoplasty, would it be normal to ask for reshaping? Would it most likely or less likely be covered by insurance? If not, about how much extra would it be?
An external rhinoplasty and an internal correction of the airway, including a septoplasty, are frequently performed together by good experienced rhinoplasty surgeons. The best nasal surgeons deal not only with the external aesthetics, but also with the internal function. Every insurance company’s approach to reimbursement is different. Many will pay for a portion of the septal surgery, but not the cosmetic aspect of a rhinoplasty. A full consultation with an experienced expert rhinoplasty surgeon is the first place to start and a prior authorization letter can help delineate what may or may not be covered. That can minimize the number of surprises you get with regard to reimbursement.
Robert Singer, MD FACS
I had a revision rhinoplasty. A graft was used to fix the over resected dorsum, but this is now moved to the left, I think it is too big for my nose, because I can feel it almost almost in my forehead, between the eyes brows. Is it possible to fix it placing my own fat and make it look not so crooked or is necessary to go under a third rhinoplasty?
Is it possible to fix a crooked nose placing fat?
What is paramount is seeking an experience rhinoplasty surgeon for any additional revisions. Evaluation to determine the best option for correction should start with a full nasal exam by an experienced expert who is certified by the American Board of Plastic Surgery who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or an ENT doctor certified by the Board of Otolaryngology. It may be useful to bring in prior photos as well as fully discussing your desired outcome and what is realistic. There are many options available and fat has a role as a filler for mild depressions. It is generally thought that 50-70% of the fat remains permanently. Fat, however, is not adequate if you need additional structural support which would require cartilage or bone grafts. If a cartilage graft was placed and is too big or displaced, it may require a revision or trimming of that graft rather than just placement of fat which may make the nose look larger. Healing may take longer to occur in a revision rhinoplasty.
There are permanent synthetic fillers,,but they have significant greater long term problems and I would not suggest using them in the nose.
Robert Singer, MD FACS