Answered Questions

Q:

What is the best filler for under the eye?

What are the best fillers for under the eyes?

A:

Lower blepharoplasties with transposition of the fat to the hollow areas will likely provide the longest lasting correction.  Short of surgery, any of the fillers can be used.  However, the skin of the eyelid is very thin and may show lumpiness or irregularity.  Thus, make sure the injector is very experienced with using fillers in this area and that the filler is placed deep, near the bone, to try to avoid an unacceptable result, which may take months or longer to resolve.  Also, care should be taken to avoid an intravascular injection, which can lead to skin necrosis (loss) or blindness.  I prefer using Radiesse, which lasts clinically about one year, for augmenting this area. 

Soft Tissue Fillers

Q:

Is it safe to do two different procedures at the same time to save on cost?

I had a consult in May 2009 for a breast augmentation and was happy with the doctor I chose.  I want to have the augmentation as well as a procedure called a smooth tuck to help with a 40 pound past weight loss.  I saw this on "The Doctors" TV show; the smooth tuck is different but similar to a tummy tuck.  It is where fat from the stomach and abdominal areas are liposuctioned, loose skin is pulled down and removed, and the bellybutton is repositioned.  The abdominal muscles are not tightened.  I've never had children and don't intend to so I don't think I would need an actual tummy tuck.  Would having these two procedures at the same time be safe, or would it be best to do one first, then the second at a later time? Thank you.

A:

First, there are many names for similar procedures, which sound less invasive and better, but really aren't.   What you described is a type of tummy-tuck, but without tightening the muscle fascia (the layer covering the muscle).  Some people call this a mini-tummy-tuck with or without liposuction.  In any case, both procedures can be performed together assuming you are in good health and are a satisfactory candidate to have both procedures performed during the same operation.  The procedure should not last more than six hours, especially if it is going to be performed as an out-patient.  Typically, doing procedures together will save you some money.  Additionally, it would only require one anesthetic and one recovery course, rather than multiple.  You should consult with a board certified plastic surgeon about which option(s) are best for you.  Be aware of new-fangled names that may sound too good to be true.  Often, someone is just trying to get a marketing edge.

Breast Augmentation

Q:

Is there any treatment that can make pores smaller and have lasting effects

What procedure is recommended to treat large pores (on face) to make them smaller?  Will the treatment have lasting effects or need to be repeated?

A:

Laser resurfacing and chemical peels can make pores appear smaller with a lasting effect.  However, these procedures may be a lot to go through just to make pores smaller.  These procedures are really more designed to tighten facial skin, reduce wrinkle and pigmentation variation, and in addition they do make pores appear smaller.  I would suggest you speak with a board certified plastic surgeon to discuss your options.

Miscellaneous

Q:

Can injected fat be removed?

I had fat injected in the nasolabial folds seven years ago.  It looks like I have swellings on both sides where it was injected.  Can it be removed?  Would I risk being disfigured if it were removed?

A:

Micro-liposuction with a small aspiration needle/cannula can be attempted to try to remove or break-up the fat deposit.  I've done this for a patient with a bulge on the upper lip and another patient with a bulge in the lower eyelid tear trough from fat injections many years prior and it yielded satisfactory results.  You can be left with a depression or contour irregularity if too much fat is removed.  I would recommend you see a Board Certified plastic surgeon to discuss your specific situation in more detail.

Fat Injection

Q:

I've had my implants since 1987. With no problems, when should I consider redoing them...how much is it.

I've had my implants since 1987.  With no problems, when should I consider redoing them and what would be the cost?

A:

I would not change your implants unless you wish to be larger or smaller, the implants are hard (capsular contracture), markedly rippled or ruptured.  If you have silicone gel implants, you may wish to get an MRI to see if the shell of the implants are ruptured.  If they are ruptured, the recommendation is to change them.  I would see a Board Certified plastic surgeon who can help you with this process. 

Breast Augmentation

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