Plastic Surgery Blog Answered by Dr. Kenneth Benjamin Hughes

A: Do I need a breast reduction or a breast lift with fat transfer to breast? (Photos) BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered by medical insurance.  If not, your medical insurance may try to deny you based upon a lot of things such as weight, lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed.Ideal candidates for liposuction are at or near their ideal weight and will have good skin elasticity. The procedure is intended to remove stubborn pockets of fat that don’t respond to regular exercise, so the skin does need to be able to smooth back into place after the procedure is complete.Liposuction of the waist with fat transfer to the hips can dramatically change body proportions in the right candidates.  Having a BMI of 30 or below will decrease the probability of obtaining enhanced results from the lipo and could decrease the risks of complications during and after the surgery. A: What's the best treatment to remove brown, age spots? (Photos) The Lumecca IPL is one of the more popular treatments for diminishing age spots. It’s benefits include:The procedure can be customized to suit different skin tones and textures. The intensity of the pulsed light can be varied accurately by the skin care specialist. This helps to improve the efficiency of the method. Even severely damaged skin and pigmentation issues can be corrected thanks to the high power light technology being used. The treatment on the whole is quick and can be used to address a large area. Most conventional IPL methods might call for a lot of repetitions to obtain perfect results, but with Lumecca IPL, most cases may only require one to two treatment sessions to show results. The procedure is non-invasive and does not cause any discomfort. Recovery after the procedure is also almost instantaneous.  A: How soon after the Facetite procedure should I schedule a lymphatic massage and hyperbaric oxygen chamber? I do not recommend lymphatic massages for my patients after liposuction and FaceTite.  Carefully orchestrate any lymphatic massages with your plastic surgeon. A: What does NeckTite actually mean when they say there can be up to a 40% improvement immediately? Clinical studies show that skin is tightened by up to 40% in a BodyTite procedure. Observed at 6-month follow-up varied from 12.7 percent up to 47 percent, depending on patient and treatment variables. With before and after photos, you will be able to see the improvement immediately after the non-invasive surgery.  Final results may take a year and should remain for five years. A: During FaceTite do you suction melted fat or leave it for the body to eliminate? Liposuction is better for debulking fat, whereas FaceTite is better for reducing excess skin.  A thin liposuction cannula is used to permanently remove fatty deposits along the jowl, chin, jawline and neck creating a more youthful contour. A: Wanting to explant, hoping for great breasts not droopy ones. What technique will achieve the look I want? The smaller the implant and the less the amount of time it has been since placement, the greater the chance the breasts will return to their preoperative state. It is very difficult to predict breast size following explant b/c breast implants and weight fluctuations over time tend to thin tissues, cause a decrease in size, and create more droop.Usually removing the breast implants and performing a lift at the same time makes the most sense as some patients clearly need a lift and only want to go through one surgery.  If you are borderline, it is not unreasonable to remove the implants and then observe a waiting period of six months before the determination for breast lift is made. This will give your breasts time to bounce back and your PS time to determine what type of lift, if any, is needed. Fat grafts should always be optimized with the best blood supply available so you might stage the fat grafts three months after the lift or implant removal (if no lift). A: Should I remove my breast implants if I’m still having the same pain 1 year after my capsulectomy? Your should have an annual breast examination by your plastic surgeon to ensure everything is okay and that there are no complications or problems. In addition to this, get an MRI done first three years after the breast implantation, and then once every two years.Any tingling and burning sensations are fairly common after capsulectomy and should decrease with nerve regeneration. If this pain becomes debilitating for some reason, Gabapentin and other neuromodulators are reasonable choices.  If these do not help, ask your PS for referral to a pain management specialist for nerve testing. A: What can I do about my stomach and body after weight loss? (Photos) Healthy people at their ideal weight should have the best overall recovery from a TT and lipo, but some of this will depend upon the surgical technique and adherence to postoperative protocols. Continue to lose the weight to reach your goal (BMI close to 30).  This will ensure enhanced results and minimize risks of complications during and after surgery.Liposuction, combined with the TT, will allow you to have stubborn fat resistant to exercise and diet removed from unwanted areas.  A TT with muscle tightening will create a flat abdomen and would also provide the benefit of placing your incision along the lower pubic region. The TT also creates a more youthful belly button.If the waist was smaller at one time, the waist can likely be reduced to those same measurements or smaller provided the muscular and fascial integrity has remained the same.Consult with a board certified PS who has performed hundreds of TTs and liposuction procedures with favorable patient reviews and great results evidenced in before and after photos on his/her website. A: Will I have to have a tummy tuck (I like my belly button) if I get a BBL and smaller waist? (Photos) You may be able to avoid the TT, but this will depend upon your exam and the precision with which the liposuction is performed.  How flat the abdomen will be will depend upon how much fat is removed from the area as well as how you heal.  The thinner patient requires an expert at liposuction to remove as much fat as possible while leaving the skin smooth. There are a lot of women who can get nice BBL results despite thinking that there is not enough fat. A: Would I be a candidate of liposuction or would I need a tummy tuck too? (photo) A mini TT involves removal of a small amount of skin and fat below the belly button that addresses only the lower portion of the abdomen. No plication or muscle tightening is performed and belly button remains attached and unchanged. This procedure applies to very few patients and is appropriate only for patients who have loose skin at the inferior aspect, or bottom, of the abdomen.  If patients have loose skin above the belly button or muscle laxity, a short scar TT would be more appropriate. You would need to be examined by a board certified PS to determine if lipo only would provide the results you are seeking.