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FAQ
Q: Hi. My name is Heidi. I fell at a concert about a year ago and severly bruised my upper thigh. Upon healing, the skin coloration returned to normal and physically the leg is fine, but the injury left me with a 'dent' in my upper thigh that I would like to fix, if possible, for cosmetic reasons. My primary care doctor told me it was probably due to muscle or fat atrophy during the healing process. Is there some sort of procedure that you do that could possibly 'fill in' this dent ? Thank you for your time
A: What probably happened after the fall is that some of the fat under your skin died (fat necrosis). Skin depressions can usually be improved by injecting fat taken from elsewhere on your body (a potential double benefit!) Because not all the transplanted fat may live, more than one procedure may be necessary.
Q: My sister had ultra sonic liposuction. She is very happy with the appearance of her legs and rear end. Is this the best or most effective procedure to reduce cellulite?
A: Liposuction, whether ultrasonic, power-assisted or traditional usually has no effect on cellulite. All three methods remove fat from a given area but do not improve skin tone or texture. Sometimes when an area is contoured the appearance of cellulite improves. Those patients are luckey and no one should count on liposuction to improve the cobblestone look of true cellulite.
Q: I want a bigger butt via some sort of injection. what is this procedure called and do you do it?
A: Buttock enlargement can be done with fat injections. Because not all the transferred fat lives, more than one procedure is usually needed.
Q: I have been considering a tummy tuck however now I am learning about Power-Assisted Lipsuction or PAL. Would this procedure eliminate the need for a tummy tuck? I am 30-40 lbs. overweight which is mainly in the tummy area. Thank you.
A: Power assisted liposuction (PAL) is a varient of traditional liposuction, as is ultra-sound assisted liposuction (UAL). These procedures remove fat. A tummy tuck removes skin and fat, and tightens the abdominal wall. The two procedures are often used together, but one does not replace the other. Have a plastic surgeon evaluate your situation so you can decide which is right for you.
Q: Dr. Daniels, i am a male and my chest is slightly different from other men's chests. At the solorplex my chest indents about two inches in, its width is a bit less by a few centimiters. My bone stucture is visible at that indent, its like a double water fall...you pour water there while I am laying down and it will go into one dip then another. My question is: is there a name for my disorder/deformitation? and if there is can I get surgury by placing an artificial bone plate or something metalic to make the surface flat plus removing the lower dips?
A: You probably have something called pectus excavatum, which means a depressed sternum. It can sometimes be corrected with a solid silicone implant.
Q: Dr.Daniels, I am a 56 yr. old female and I would like to have my flabby upper arms thightened. Is this possible? Would the scars show? How soon after would I be able to use my arms to accomplish my daily routine? Would I be able to combine this procedure with liposuction to my upper and lower tummy and my hips in order to reduce my waist size.
A: The scars for a brachioplasty ("arm lift") can be quite noticible. Sometimes a little liposuction can help. Combining procedures is quite common and usually very safe.
Q: Dr. Daniels, I am about two weeks pregnant, and I am concerned about stretch marks. Do you have any sugestions on what the best product is that I can use, or what I can do to prevent or reduce the stretch marks caused by pregnancy. Thank you, Dulce
A: Try to gain weight slowly/gradually and not too much. Some patients of mine swear by aloe or topical vitamin E
Q: Dear Dr. Daniels: I am considering having a breast lift and also liposculture to my tummy, flank and thigh area. Would this be risky to do all at one time? I've heard a lot of horror stories about women doing too many procedures at one time. Thank you for your time and expertise.
A: Combining body contouring and breast surgeries is often done and done safely. The key is finding a caring and ethical surgeon who will determine your surgical needs and decide if you are a good candidate for a multiple-procedure surgery. With modern-day anesthesia and surgical technique, the length of surgery does not necessarily mean increased risk (for patient's in good general health!). By combining procedures patients decrease overall recovery time and usually save money over having the surgeries done separately.
Q: My mom undergone a small operation between ankle and heel to remove an small unwatedgrowth. The operated place developed some hard skin. now the surgeon's are asking to go for skin surgery, whether this will give positive result..?
A: I'm guessing the hard skin means scar. If the scar is limiting mobility a skin graft can help.
Q: Apart from the money, why do u perform these proccedures?
A: The changes/improvements in patients' self-esteem can be very gratifying. Plastic surgeons have been called psychiatrists with a scalpel.
Q: I am interested in a breast reduction (Reduction Mammoplasty). My concerns are: 1) I will not be able to breast feed when I have another child (in a couple of years). Do I need to worry about this? Is there a certain time frame you should allow your breasts to heal before even thinking about child bearing? 2) My skin tends to keyloi (I'm not sure how to spell the word :) My skin leaves a scar when it is stitched. Is there a remedy for this so that there is little to no scars? 3) My last question is, I am a 34 H, how long would a surgery take in order for me to be a 34 D and approximately how long would it take for me to heal and return to work? Your attention and response to this e-mail is very much appreciated.
A: Most women are able to breast feed after reduction surgery. I would recommend waiting at least six months after reduction surgery before getting pregnant. Scars vary from patient to patient but in those who tend to scar poorly I use silicone sheeting after surgery to flatten the scars.Surgery takes anywhere from three to five hours and most women could go back to work in a week to ten days.
Q: Dear Dr. Daniels- I am wondering what the recovery time is after breast enhancement surgery. Thanks Ryan
A: The recovery time after breast augmentation/enhancement varies. If the implant goes on top of the muscle( which is fairly uncommon) the recovery time is very quick, a couple of days at most. If the implant goes under the muscle (usually the case), the first couple of days can be rough but most patients are back to fairly regular activity in a week or less.
Q: Is there a minimun age that is considered "right" to perform a breast augmentation, and Is there a waiting period for the procedure?
A: Most plastic surgeons prefer you to be eighteen years old, although there are occasional exceptions, such as developemental problems. The waiting period varies from office to office but is usually a week or more.
Q: Dear Dr. Daniels, I had breast augmentation about 2 years ago and now I notice that there is this ripple like feeling on the inside of my left breast. I noticed it first a few weeks after the surgery. I didn't think anything of it and thought it would go away; however it seems to be getting worse. Furthermore, the right side of my implant seems to be deflating a little. In addition, the scares my surgeon left me are HIDEOUS! I was wondering if you had any insight as to what is going on with me. It would be great if I could set up a consultation with you; how much is it? Sincerly, M. Hwan
A: The ripples you feel are pretty common with saline implants, especially round ones. As skin stretches and thins after augmentation ripples cand often be felt and seen more. Slightly overfilling the implants or changing over to silicone gel can often improve this. Scars can usually be improved with a revision.
Q: (1) Will pregnancy adversely affect the breast enhancement that I plan to have? (2) I have hypertension, and would like to know whether this will put me at risk. I'm 33 years old. Thanks for your valued advice---Jaya
A: The only way that pregnancy could adversely effect your breast enhancement would be if your tissue stretched too much or shrank alot. If either of these happened you may find yourself needing a lift or larger implant or both.
Q: Dear Dr. Daniels, could you tell me if there is a difference between a Mentor breast implant and a Mcghan? Also, what is a Mentor spectrum implant...not the infaltable? Also, what are the benefits of having a texured mentor spectrum implant as opposed to a smooth Mentor spectrum implant? Thanks alot, Sincerely, Jennifer
A: Mentor and McGhan saline implants are similar except where it comes to the texturing. McGhan's texturing is more "aggressive" which keeps their teardrop implants from rotating (a problem with the Mentor implants). Because the Mentor texturing is of limited value, there is no real advantage to it over smooth shelled implants. The spectrum implants are ones that have a little valve under the skin so they can be inflated more after surgery. This requires an additional procedure to remove the valve. I am not a big fan of these implants.
Q: Dr. Daniel, I am currently pregnant and considering a breast enlargement. I am due December 8, 2002. How long do I have to wait before having the surgery and how soon could I start the consultation. Second question, If I decide to breastfeed how long after would I have to wait? Thank you for your time.
A: Ideally you would be done with breast feeding for a few months so we could see what needed to be done: enlargement vs lift vs lift + enlargement.
Q: Does Dr. Daniels perform TUBA procedure?
A: The TUBA (transumbilical breast aug) procedure is adequate for on top of the muscle implants, but,in my opinion, does not allow for a good under-the-muscle dissection. Since most saline implants need the camouflage of being under the muscle I choose not to do the TUBA.
Q: Have you performed any nipple reduction surgeries? If so, how much do you charge for this procedure? Thank you.
A: Nipple reduction can be very effective with minimal scarring. The cost varies depending upon what type of anesthesia is used.
Q: I have fairly small breasts....a small B. I don't really care about increasing the size, but I do look to alter the shape. I am still young (21 years old) but my breasts have always been somewhat shapeless, even for their small size. Kind of saggy. I've started researching mastopexy. I like the idea of being able to achieve a springier shape without having to actually implant anything. I was just wondering what the specifications of this proceedure are. Would a small B be too small for something like this to be successful?
A: The trade-off of any breast-lift or mastopexy is the scars. Most women prefer the fullness provided by a small implant combined with a lift. Without seeing you it is difficult to say what is the best solution for you.
Q: I'm considering breast enlargement; how long does the surgury last? Also, I have 4 children (the youngest is 4), how restricted will my activities be after the proceedure?
A: All implants eventually wear out and have to be replaced. The implant manufacturers are counting on them lasting at least ten years: if they last less then ten years they will not only replace the implant but also give you back some money. Post operative restrictions usually involve no heavy lifting for a few weeks.
Q: Is it wise to get a breast augmentation if I still want to have more children and breastfeed? Does breastfeeding interfere with the implants? Is there special considerations for mamograms with implants?
A: Breast augmentation usually does not interfere with breast feeding. However if you have more children after augmentation you may need to have a lift or implant exchange for the breasts to look their best. The presence of implants requires extra views on mammograms to see as much breast tissue as possible.
Q: Dr. Daniels, I had a small question for you I saw your add in the O.C Weekly about Silicone Breast Implant Study. I was wondering if a breast lift would be considered as an breast reconstruction. If so i would like some more information about your study because im interested in having a breast lift. Im 27 years old and im not to happy with my breast I have no children so i dont think they should look the way they do. And not having the funds right now and no insurance of anytype to help cover for maybe this procedure maybe i would be able to qualify for the study. So if you can please send me more information i would be very thankfull.
A: The silicone gel study is a non-compensated one where the patient agrees to a five year follow-up period as a condition for getting silicone gel implants. The procedure is still at the patient's expense.
Q: Hello Dr. Daniels, My husband is very concerned about the silicone implants and the potential problems from leakage. What are your thoughts on the "Cohesive Silicone Gel" implants. I know they aren't out yet, but are they something to consider instead of the "regular" silcone implants? Thanks, Heather
A: I think cohesive gel implants will be just another option for patients, and not the perfect implant. The longer incision and firmer feel of them may not appeal to all patients. We don't even know if the cohesive gel implants have to eventually be replaced. In any case, they will not be available for routine cosmetic augmentation for at least a few years. Hope this helps!
Q: I am considering breast reduction, however; I am also thinking of the appearance of my breast afterwards. My breast have no separation between them. I would like a large B small C cup, but I also would like the separation look (like I have seen when women get implants). Can a breast reduction achieve this look or is there another alternative such as removing my entire breast and inserting implants?
A: by reducing the breasts you should be able to gain some separation.
Q: Dear Dr. Daniels, I am a 21 year old female with 34DD breasts. I have been experiencing some back pain as well as a curvature of my upper spine. I am wondering if an option for me is to get some of the tissue removed but inserting implants at the same time so that while the weight of my breasts would be reduced, the size would not. Is this an option for people;that is, a reduction/augmentation in one? If so, how is the scarring?
A: Implants weigh close to the same as breast tissue so reducing weight without reducing size is not possible. Some surgeons put in a small implant to help maintain central breast fullness but I would not advise doing it at the time of the reduction as it could jeorpardize nipple circulation.
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