Featured Question of the Week

What types of breast lifts are there?

There are literally dozens of breast lift procedures that have been described over the years, however in North America there are 3 common types that are used. In lay terms they are: the donut lift, the lollipop lift and the anchor lift.

A periareolar lift (donut lit) leaves a scar around the areola and is used when only 1-2cm of nipple elevation is needed. If more of a lift is required, a vertical extension may be added (lollipop lift) or a vertical extension and an incision along the breast crease (anchor lift).


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Breast

Enhancement

Does getting breast implants make you gain weight?

Breast implants will cause you to gain the weight of the breast implants that are inserted, but should not cause you to gain any weight above and beyond that. While there will be some swelling initially after surgery that will definitely add to the number on the scale, this is temporary and will resolve with time. The only weight a patient gains should be the number associated with the volume of an implant. A 450cc implant, for example, will increase the patient’s weight by about 450g per side, so roughly 1 pound per breast.

Is it possible to get breast implant surgery without removing piercings?

Metal piercings need to be removed before surgery. Each office will have different policies on plastic jewelry but if you did have to remove the piercings you would not need to keep them out for a year. If your incision was not through the nipple then you’d technically be able to put them back in right after surgery.

How significant is the risk of nipple necrosis with a Benelli lift?

Out of all the lift techniques the periareolar lift is definitely the safest. The Benelli is one specific type of periareolar lift that is NOT skin only as it involves a lot of dissection around the breast gland. A straightforward periareolar lift using the Hammond wagon wheel technique will give the most reliable result with the least risk of complication.

Is it possible to get breast implant surgery without removing piercings?

Metal piercings need to be removed before surgery. Each office will have different policies on plastic jewelry but if you did have to remove the piercings you would not need to keep them out for a year. If your incision was not through the nipple then you’d technically be able to put them back in right after surgery.

If a saline implant ruptures, how long until I need to have it replaced or removed?

Because saline can be safely absorbed by the body in the event of a rupture, there is no immediate urgency for a replacement. However, the sooner you can go in for a replacement procedure the better. Once the implant deflates, you risk the breast pocket contracting, which results in a more involved replacement procedure. For a smooth replacement procedure with successful results, you shouldn’t wait longer than a month after the rupture occurs.

I have had breast implants for about 10 years now. How long until they need to be replaced?

Your breast implants only need to be replaced if you have developed a complication like capsular contracture, rippling or rupture of the implant. An examination by your plastic surgeon or an MRI scan (if you have silicone implants) can determine the integrity of your implants to see if there has been a silent rupture and a replacement is necessary. While having a replacement procedure for fresh implants would renew your warranty, every procedure comes with risks of developing complications so as the old saying goes: “if it ain’t broke, don’t fix it!”

How can someone interested in silicone implants avoid the double bubble?

Double bubble is a pocket problem, not an implant problem, so whether you get saline or silicone implants won’t really have much of an impact. The size of the implant can affect the likelihood though because a double bubble occurs when the implant slides down the chest, below the existing inframammary crease. A heavier implant will have an increased likelihood of dropping, however the main issue is that the inframammary crease was divided during the creation of the incision, leaving a weak point for the implant to slide down over time. The key to avoiding a double bubble is for the surgeon to secure the inframammary crease before closing the skin incision.

How many additional operations on my breast implants can I expect to have over my lifetime?

It’s impossible to predict exactly how many operations someone may need over their lifetime, but I tell all breast implant patients to expect at least one more over the course of their life. The best case scenario is someone gets their implants put in when they are younger, they stay in without problems for many years and then they get them removed later in life simply because they’re older and don’t want breast implants however this is a pretty rare occurrence. On average patients can expect to have to do something to their breasts every 10 years or so if they have implants.

Which Implant Placement Gives the Most Natural Results?

There is no implant pocket that gives the most natural appearance across the board. It is all about choosing the right pocket for the right patient to achieve their own individual goals. Both subglandular (above the muscle) and dual plane (“below” the muscle) pockets can give very natural results when done properly in the right candidate. Having the implant placed behind the muscle can result in a more sloped upper part of the breast and is ideal for patients with less breast tissue or thin skin. Patients with adequate breast tissue and good quality breast skin can have great results with a subglandular placement which is a little bit more comfortable during recovery and doesn’t require the pectoralis major muscle to be cut. As with everything else in breast augmentation, there is no one right answer that applies across the board, the choice for pocket location has to be made to suit each patient.

Would a fat transfer augmentation help to diminish wide cleavage?

In some cases it would, but it would vary patient to patient depending on the natural shape and position of their breasts. The increase in size from fat transfer is typically limited to half a cup and it adds volume but does not really alter the shape of the breasts. While it can help women whose breasts are already relatively close together, women with a wide sternum will still have to rely on a push up bra.

Does it make a difference to the firmness of my breasts if the implants are made of silicone or saline?

Typically silicone implants are felt to be softer, but as with everything else it is somewhat patient specific. In a very thin patient then saline will be much firmer. If someone has a lot of breast tissue to begin with then chances are they won’t really feel either saline or silicone.

I want to get my girlfriend a breast augmentation for christmas, can I pay for surgery then surprise her with it?

Technically you probably can at some offices, but in my practice the only person that can book surgery is the patient themself, and only after seeing me for a consultation so I can make sure they’re a good candidate. If you do find an office that will allow you to buy a surgical procedure as a gift for a patient they’ve never seen, I would still strongly recommend against it. Unless you have discussed this with her previously and are 100% sure that she wants the procedure (and wants it done with that particular surgeon) the chance of offending her is pretty high and rather than seeing this as a thoughtful gift it will probably be viewed as a statement that you think she “needs improvement”, which is probably not the message you are trying to send. If it is the message you are trying to send, then instead of buying her breast implants a better gift would probably be getting out of her life and out of the way of her finding a different partner who loves her for who she is.

What is the best incision for breast augmentation?

All procedures need to be customized to each patient, so there is no general rule that applies to everyone. In the absence of any reasons to make me choose a different incision, I always favour an incision in the inframammary crease for multiple reasons including a decreased rate of capsular contracture, no damage to the breast tissue itself (which is better for breastfeeding and mammograms) and the fact that it is a very well hidden location. If you do scar poorly then it will at least be under the breast rather than right on the front of it.

How do I choose the right implants? How many CCs will give a natural large B cup?

It’s very difficult to predict a specific cup size after breast augmentation. The answer depends partially on how large your breasts were before the operation and what size implants are being put in, but also what brand of bra. There is really no consistency anymore between what any specific cup size really is from one brand to another. One woman may be a double D in one brand and a C in another. The best way to determine the right size of implant is to try on sizers at your sizing session and see if they look right for your frame. Consider whether they look like what you picture a B cup should look like on you rather than focus on what the actual letter of the new bras you eventually buy is.

How long does it take for implants to drop?

Usually it takes about 6 weeks for breast implants to “drop and fluff”. It can take a little longer with IDEAL implants, sometimes up to 8 weeks. The implants will continue to soften and settle beyond this, typically it takes a full year to see the truly final results.

How Soon Should I Start Massaging After a Breast Augmentation?

In my practice, NEVER! I work painstakingly to create a pocket that fits your body and breast implant to give the look we’ve discussed at your consultation and keep the implants where we want them. Massage is something that older surgeons used to advocate because they thought it would decrease the rate of capsular contracture by creating a huge pocket. While the rate of clinically significant capsular contractures are possibly decreased, it is only because the contracted capsule is humungous, not because there isn’t a capsular contracture happening. The side effect of this is that you have a humongous pocket, which allows the implant to move all over the place in an unnatural fashion. Most commonly women complain that their implants slide down the side of their chest into their armpit, something we call a lateral malposition.

Do sizers and/or the rice test underestimate final implant size if I am going submuscular?

Both are there to guide you to the right size, but neither should be taken as a true representation of the final results as they will actually overestimate your final result. In general the implants will actually look a little bit smaller once they are inside your body vs. when they are outside your body in a sizing bra – regardless of whether you go above or below the muscle. The difference between certain sizers can be marginal so you’ll probably never know the difference after the fact. Keep in mind that 25cc difference is less than 2 tablespoons! Although having regrets after breast augmentation is rare, of those who do have regrets there are WAY more women who wish they went larger compared with those who wish they went smaller, so if you are concerned that your implants may end up looking too small, then just go with the larger of the two options you’re choosing between.

How long do I have to wait before a breast implant revision?

Generally patients should wait until at least 6 months after their first procedure before considering the results final however a full year is bet. If they are still unhappy at that point then it would be reasonable to consider a revision. Before 6 months the implants may still be dropping and fluffing and the scar tissue is still immature so there will be excess inflammation after the revision surgery which could definitely affect the results. If there is an acute complication then that changes everything of course and needs to be dealt with as soon as possible.

Looking to get breast implants, should I wait until I’m done having kids?

Pregnancy and breastfeeding can affect the appearance of your breasts, causing some volume loss and sagging. This is one reason why many women opt for the procedure after having children. If the plan is to have children and breastfeed in the near future, then it is probably best to wait on having a procedure to ensure lasting results. Breast augmentation procedures do not last forever and need revision after a period of time whether someone has kids or not, so if the plan is not to have children for a few years, there’s no reason not to do the procedure now. Many young women opt for the procedure to enhance the appearance of naturally small breasts and still enjoy their results after childbirth.

Should I get teardrop or round breast implants to get a natural look for a petite build?

Both anatomically shaped (a.k.a. teardrop) and round implants can give natural-looking breasts for women of all frames. The right implant has to be chosen for each woman depending on her specific body and what she is looking to achieve. “Natural look” means different things to different women so it’s important to discuss the specifics of exactly what you are looking for with your surgeon. While in theory, the teardrop-shaped implants should give a more natural appearance with the gentle slope at the upper half of the breast and a natural curve at the bottom, in practice it is very difficult to tell the difference between them in most cases once they’ve been put behind a woman’s natural breast tissue and she is standing upright. The choice of the implant must be individualized for each patient depending on the measurements of her body and the quality of her tissues, which means there is no cookie-cutter answer as to whether one of these is better in all cases.

What Are Some Common Signs That A Breast Implant Has A Capsular Contracture?

First, it is important to know that all breast implants have a capsule that forms around them as part of the normal healing process and most are not problematic. Capsular contracture is a problem, and is assessed based on several criteria and then classified according to the Baker grading system. There are four grades of severity, grades 3 and 4 usually require some sort of surgical management. Grades 1 and 2 are considered “normal” and generally do not require any treatment.

Capsular contracture is classified as follows:

  • Grade 1: the breast feels soft.
  • Grade 2: the capsule around the implant is palpable.
  • Grade 3: the capsule around the implant is palpable and visible.
  • Grade 4: the capsule around the implant is palpable, visible and painful.

Patients typically notice a capsular contracture when it starts to move from Grade 2 to 3 typically as the breast begins to feel harder and the implant actually starts to ride up on the chest. The edges of the implant may start to become visible as the capsule forces the implant into a more spherical shape. If allowed to progress then the breast will typically start to hurt as well.

Will Smoking Marijuana or Cigarettes Affect my Recovery from Breast Augmentation Surgery?

It is not recommended that you smoke cigarettes or marijuana while healing from your breast augmentation procedure. Nicotine products like cigarettes restrict blood flow and can have a negative effect on your healing process. Good blood supply is necessary for proper wound healing after your breast augmentation. It is best to avoid smoking cigarettes for several weeks after your procedure (and ideally use it as an opportunity to quit). Although marijuana does not contain nicotine, it can induce coughing, resulting in strain on the chest muscles and your incision sites. Marijuana can however be an effective pain medication so I don’t discourage its use in edible or vaporized form after surgery. This is something that should be discussed in person on a case by case basis before attempting to use marijuana as a postoperative pain medication.

Will going from 800cc to 1600-2000cc be difficult?

While it is probably technically possible to fill the implants to that size, I would strongly caution against it. The larger an implant is, the more likely you will have complications both early and late. Also, stretching your breast skin that much will guarantee that you will need multiple procedures down the road to address the sagging of the implants as well as to deal with the excess skin when you eventually have them removed (you’re not going to want these in your 90s!). Stretching your skin to that point may result in you needing something as extreme as a mastectomy to deal with the skin at that point. I would really advise you not to proceed with this procedure.

What are the effects if I keep wearing my sports bra after breast augmentation?

Wearing a sports bra following breast augmentation does not cause any problems and is typically encouraged for the first 6 weeks after surgery. At that point you can switch into any bra, but if you prefer sports bras then there is no issue wearing it indefinitely.

Do you need two surgeries for breast lift and augmentation?

Breast lift with augmentation is a very powerful and safe operation to overcome the “deflated” look many women experience following pregnancy or with significant weight loss. In my practice, I most commonly perform this procedure in a single operation. That said, there are several variables among patients that might create the need to stage this procedure into two separate operations. These include the severity of ptosis (drooping), thinness of skin and breast tissue, smoking history, and size/reshaping aesthetic goals.

I have nipple tattoos. Is there a type of breast lift that would work for me?

All breast lifts involve incisions around the areola so it is unlikely that the tattoo won’t be affected somewhat.

What exactly does under-the-muscle mean? How does the placement work?

A true total submuscular placement is rarely done for modern cosmetic augmentations, but during this procedure, the implant is placed entirely behind the pec muscle, which is left attached to the ribcage, and will stretch in time to take the shape of the implant. A bandeau usually is needed after surgery to force the implant into position while the muscle stretches. Most modern submuscular augmentations use a dual-plane pocket where the bottom of the muscle is actually released, dropping the implant into place behind the breast gland and eliminating the need to stretch out the muscle.

Can silicone breast implants last 30 years?

Breast implants absolutely can last 30 years, but it may not be wise to keep them that long. While breast implants do not have a specific ‘expiration date’, they are not considered lifetime devices and therefore should most likely be replaced every 10-15 years. These are subject to stress and strain from the repetitive movements of the arms over the years and the shell can lose integrity, so at the very least patients with silicone implants should have an ultrasound or MRI done by the 10 year mark.

How much downtime do I need after a breast lift with implants?

I would generally recommend that patients take about a week to recover from a combination mastopexy-augmentation (lift + implants). If you aren’t lifting anything heavy you may be ok to get back to work earlier, but it will be difficult to know until you’ve had your procedure and can see how you actually feel.

Can compression garments help mould the breasts following a breast lift?

Garments can’t actually mould the body but they can help to support it during recovery. Compression is good for liposuction but for a breast lift a supportive bra is usually all that is necessary. The “moulding” of the breasts will be done by your surgeon on the operating room table and there should not be much left to settle into place afterwards

How will I be able to tell if my breast implant has ruptured or if there is a problem with my breast implants?

It really depends on what type of implants you have. If you have saline then a rupture will be obvious because your breast will deflate. If your implant is silicone it will be more subtle and an ultrasound or MRI will be needed to assess the implant. If you are having other issues with your implant they will typically present with pain or a change in appearance in the breast that will prompt you to go see your surgeon and find out what is going on.

Will a mammogram give obscure results or rupture my breast implant?

If you have breast implants and are getting a mammogram then make sure to let the technician know. They will take special views of the breast to make sure they capture all the breast tissue in a way that is not obscured. Usually the mammogram will compress the breast tissue on top of the implant, so it would be very rare for a mammogram to damage an implant.

At what age do your breasts stop changing?

In general most women will reach full breast maturity between 18-20 years of age however the breasts continue to change over a woman’s entire life. In addition to age and gravity, things like pregnancy, breastfeeding and menopause will cause changes in the breasts as well.

Will having my nipples pierced cause any complications during a breast augmentation and/or the healing process?

For the breast augmentation they will have to be removed because they’ll interfere with my judgement of the appearance and if they’re metallic they can cause the electricity from the cautery to cause a burn to the nipple. It won’t cause a problem during the healing process but I wouldn’t recommend putting it back in for at least a few weeks after your surgery.

Will silicone implants make my osteoarthritis worse?

There is absolutely no evidence to support the claims that breast implants cause inflammatory diseases but the weight of large implants could impact hip or knee osteoarthritis depending on how bad it already is.

How do you shower after a breast lift?

This answer is very surgeon specific and depends on the dressings used. In most practices you will have traditional gauze bandages that get removed after about 5 days at which point you can shower. In some practices, such as ours, waterproof dressings are used allowing you to shower the next day!

Does getting breast implants make you gain weight?

Breast implants will cause you to gain the weight of the breast implants that are inserted, but should not cause you to gain any weight above and beyond that. While there will be some swelling initially after surgery that will definitely add to the number on the scale, this is temporary and will resolve with time. The only weight a patient gains should be the number associated with the volume of an implant. A 450cc implant, for example, will increase the patient’s weight by about 450g per side, so roughly 1 pound per breast.

Can ideal implants be placed on top of the muscle or ONLY sub-muscular?

Whether the implant goes above or below the muscle is almost entirely decided based on your measurements and tissue quality. Any implant can be placed in either plane and choosing the right plane is one of the 3 big choices when it comes to breast augmentation: Implant, Pocket/Plane and Incision location.

Why do you put breast implants below the muscle?

There are several reasons that I would decide to put implants under the muscle rather than over it. In general, I prefer to put implants above the muscle because it makes sense anatomically. There are situations where I will place the implant in a dual plane pocket (half under the muscle at the top, under the breast at the bottom). I almost never place it entirely sub muscular for cosmetic surgery. The most common reason to put an implant in the dual plane pocket is that the patient doesn’t have enough tissue to cover it and will end up with “edge show” at the top. Other reasons would include the need to change pockets during revision surgery or in a patient with a high risk for breast cancer so that mammograms will be easier to obtain and read. The muscle can flatten the top of the implant a bit as well, so for some patients who are really worried about having roundness at the top and want that sloped look it can be helpful as well. The only reason I would put an implant totally sub muscular would be if we did a transaxillary procedure where there really is no other option for pocket choice because of the mechanics of that specific operation.

How long do the results from Breast augmentation with fat grafting last, and how much fat is retained?

60-70% of fat is retained, and the results that are present at three months tend to be permanent unless there is a significant weight loss.

Are Ideal implant widths measured differently than other brands?

Yes, IDEAL implants do measure out differently than the others. Because the dimensions given by the manufacturer were measured on a convex surface (which more accurately reflects the shape of the chest) they tend to be about 5 mm wider and have 5mm less projection on average when put on a flat surface. The other manufacturers in North America did all of their measurements on a flat surface, and that is what the majority of surgeons are used to so it does take a bit of adjustment when getting used to sizing IDEAL implants.


Body

Contouring

How Much Does A Tummy Tuck Cost?

The cost of your tummy tuck procedure will vary depending on a number of factors including the area in which you live, the techniques involved in your procedure, the size of your abdomen and any other complicating factors. Your price will include your surgeon’s fees, surgical facility charges, medication, and may or may not include the required post-surgical garments (it does in my practice). Your total will be gone over in more detail during your consultation. When it comes to any plastic surgery procedure, the most important thing to remember is that cheaper is not necessarily better. More important than the cost is to ensure that your surgeon is board certified and experienced in the procedure so that you receive the safest, most effective care possible.

How much weight should I lose before getting BBL and TT?

For optimal results from your contouring procedures, it is best to be within your ideal weight range first, but also at a weight you can actually maintain. A lot of patients try to lose weight before their procedure only to gain it back 6 months later and ruin the results. It’s always better to be at a weight that is realistic to maintain long-term so your surgical results can be tailored to THAT body and will look good for many years to come.

How long does the swelling last after a tummy tuck procedure?

In the first week of your recovery from tummy tuck, you will experience the worst of your swelling and other side effects. Over the next two to three months, you will see the majority of this swelling subside and you can begin to enjoy your new contour. However, it can take up to a year for your last bit of swelling or puffiness to completely resolve. If you wear your compression garment as directed it can help speed the improvement. Source

Can I get a tummy tuck a few minutes after giving birth?

It is not recommended that women undergo an abdominoplasty right after giving birth.You must first let your body heal from childbirth and return to your pre-pregnancy weight before a good assessment of whether a tummy tuck is right for you can be performed. If you had a caesarian section birth then there is also a significant increase in risk of infection were you to have a full abdominoplasty at the same time.

What can I do to help prevent wound separation and skin necrosis following my Tummy Tuck?

The best way to prevent complications and ensure the most successful results from your procedure is to follow all the post-op care instructions given to you by your plastic surgeon. In the first week or two there is a risk of separation if you make certain quick movements but by three weeks into your recovery you should be relatively safe and it would be unlikely to suddenly develop a complication like wound separation or tissue necrosis. Your incisions should be almost fully healed at that point.

How long should I expect to have surgical drains after mommy makeover surgery?

Although I generally use a drainless approach to my abdominoplasties (which is the most likely place someone would have drains after a mommy makeover) surgical drains are sometimes required to help collect the excess fluid that the body wants to release into the surgical site. If the fluid collects too much, then if forms a pocket called a seroma which can have both medical and aesthetic effects. For those who do need drains, most can have their drains removed after about two weeks, although every patient is different.

How much arnica gel do I need after a BBL?

If you are massaging the suctioned areas and the areas where the fat was transferred to twice a day (as is my typical protocol) the honest answer is a LOT. I’ve personally contemplated contacting the company to see if they’d be willing to sell by the pint rather than a small tube.

Do stem cell butt augmentations last longer than a regular BBL?

This is not new science, this is new marketing. ALL fat transfers involve the transfer of stem cells that naturally live within the fat. These cells have been shown to rejuvenate the skin of the breast and face when transplanted, but in the butt it’s unlikely to make much difference to the overlying skin because of how thick it is. The secret to longevity is handling the fat properly to maximize how much of it gets a new blood supply in the area it’s transferred to so it will live there permanently. Stem cells have nothing to do with it and further “enrichment” of the stem cells is just a technique used to take more of your money for the exact same procedure. I’d suggest you get a consultation with a board-certified plastic surgeon near you who has a history of performing high-quality BBLs without having to resort to tricks and gimmicks to sucker unsuspecting patients in. Best of luck!

Can You Have a Baby After a Tummy Tuck?

You can have a baby approximately 12 months after your tummy tuck procedure if absorbable sutures were used for the tightening of the muscles. If you are planning to have children in the short term I would recommend waiting to have your procedure until after you’re done having children. If you know you are having children someday but not for a while then you could consider having a tummy tuck as long as you know a future pregnancy could stretch out the abdominal tissue once again, reversing the effects of your tummy tuck. If this occurs, a second tummy tuck procedure may be needed.

How much arnica gel do I need after a BBL?

If you are massaging the suctioned areas and the areas where the fat was transferred to twice a day (as is my typical protocol) the honest answer is a LOT. I’ve personally contemplated contacting the company to see if they’d be willing to sell by the pint rather than a small tube.

Does a BBL also widen your hips?

BBL is a very customizable procedure that can widen the hips if you want it to, or not if you don’t. The only way to know what can actually be accomplished in your specific case is to have a consultation to see what your options are. Make sure to bring in wish photos so you can best express what you are looking for and discuss what would be required to get you from where you currently are to where you want to be.

Can a breast reduction, tummy tuck and liposuction be safely combined in a healthy patient?

While each case is unique and every patient needs to be examined by a surgeon to know if they’re a good candidate, in general terms combining those three procedures is not a problem. It can safely be done in less than 6 hours which means that it would still be day surgery in Ontario.

How much weight can I lose from a tummy tuck procedure?

Although the tummy tuck is not a weight loss procedure, it can help patients lose several pounds in loose skin and tissue and take inches off their waistline. The amount of weight lost will depend on the patient and how much excess skin they have. You should not expect to lose a significant amount of weight from your tummy tuck alone. The best results will come to those who are already within their ideal weight range and suffer from mostly excess skin (not skin and fat) and are committed to maintaining a healthy lifestyle through proper diet and exercise after their procedure.

Is it safe to have a tummy tuck after a sleeve gastrectomy?

Absolutely! It is very common for patients who have had any sort of bariatric/weight loss surgery to undergo tummy tuck and other skin removal surgeries once they have lost the weight. When you have reached your goal weight and are stable for about 3 months then book a consultation to see what your options for body contouring are. Hope that helps!

How do I know if I have enough fat for a Brazilian Butt Lift?

It depends on what the goals are, but generally patients with a BMI over 20 will have enough fat for a reasonable sized transfer. For patients who are thinner, something more subtle like liposuction to the love handles with transfer to the butt and hips can still give a great shape change even if the total volume of fat transferred is not significant.

When getting a BBL, why do some doctors do different incisions?

The incisions a surgeon uses are generally a personal choice based on the instruments they use and the way they feel they can get the best results. Surgeons who use syringes are working with shorter cannulas and as a result need to make more incisions, usually one above each cheek and sometimes one below. I use the expansion vibration lipofilling technique which allows me to use only one incision between the cheeks right at the top of the “crack”. Incisions below the butt should serve as a caution sign as injecting from below pointing upward runs a high risk of injecting into the vein or artery, which can cause fatal complications. Injecting from above leaves those structures covered by your pelvis so it is very difficult to accidentally inject into them.


Facial

Rejuvenation

Can Botox help to prevent teeth grinding?

Yes it absolutely can. Botox to the masseter muscle will weaken it enough to reduce grinding and clenching. Typically 30 units per side is needed as a starting dose but some patients require more. It is not a permanent solution so you will need to repeat the dosing every 3-6 months to maintain the results.


General

Questions

How long does it take a seroma to heal?

The time for a seroma to resolve will vary with each particular case. It depends on many factors including the size of the seroma, the location, how fast your body is producing more fluid and what you are doing to treat it. Sometimes they will resolve within a few weeks with nothing but a few in-office drainage procedures and compression, sometimes it takes months and the insertion of an indwelling drain.

I would like to have surgery in the Dominican Republic, but I am very scared. How do I know that my doctor is certified and safe?

The fact that you are asking means you know the answer. Outside the US and Canada where we have board certification it is very difficult to do your homework properly. Like everywhere else, the DR will have good doctors and bad but if you aren’t from there and don’t speak the language it will be very difficult for you to tell who is who. Even if you did find an amazing surgeon there, it’s wise to be near your doctor while recovering in case you have any complications. If you go abroad then you probably won’t be staying more than about a week, so if you have any late complications your surgeon will not be available. In general, if you are going to have cosmetic surgery then do it safely near home or don’t do it at all.

Is it possible to be allergic to silicone?

Anything is possible, but it is highly unlikely. Silicone is used in breast implants (and pretty much every other implantable medical device) because it is relatively inert to the body, meaning the body does not react to it. If someone is really worried about being allergic to silicone (or anything else) then a visit with an allergist should be able to help determine whether that is the case.

When can I start dieting after surgery? Do you really need extra calories for breast lift scar healing?

You do not need any extra calories for healing a breast lift scar. If you eat a well rounded diet with enough protein then you should not need to make any modifications to it for healing. Wait 4-6 weeks after surgery before starting any type of diet to ensure that your body has had enough time to heal the scars solidly. Hope that helps!

How long after surgery can I expect to have post-op appointments for?

It really depends on the procedure but I personally like to follow-up with every surgical patient for at least a year and ideally annually from that point on for as long as they are willing to come in for follow-ups. In particular, I try to have all of my breast implant patients follow-up annually so I can make sure that there are no issues with the implants or capsules.

What can I do to address the scars, if any, after my procedure?

Each surgeon will have a slightly different protocol for scar management, but in general it involves keeping the incisions clean and applying some pressure with a surgical tape in the first few weeks (steri-strips in my practice) followed by the use of a silicone based product (gel or sheeting) combined with scar massage and sun avoidance. It takes a full year for a scar to completely mature, so whatever protocol you use, make sure it’s something you can maintain for a while.

How long do you wear a binder after tummy tuck surgery?

Each surgeon will have a different postoperative protocol, but in our practice patients will wear a compression garment around the clock (with the exception of when they shower) for 3 weeks, then during the day for another 3 weeks.

Can Botox or Dysport help to prevent teeth grinding?

Yes it absolutely can. Botox or Dysport injected into the masseter muscle will weaken it enough to reduce grinding and clenching. Typically 30 units per side is needed as a starting dose but some patients require more. It is not a permanent solution so you will need to repeat the dosing every 3-6 months to maintain the results.