Answer:
For a true body lift, I think you should stay overnight afterwards. It is the safest thing to do. Most of the time, this means doing the procedure in the hospital. There are some surgery centers where you can stay overnight and be monitored by a nursing staff all the way until the next morning. In other words, the surgery center is acting somewhat like a hospital. On the other hand, the surgery center will not have all the resources that hospital will have if there are complications, so the final decision will probably have to come down to exactly what is planned during the body lift, and your overall health. Personally, I do my body lifts in a hospital and plan on the patient staying overnight and leaving the next morning, and that has worked very well for my patients in the past, and makes me comfortable because I always like to err on the cautious side.

Answer:
If you really have abdominal fat and skin that hangs down, a tummy tuck is certainly for you. Most patients who have tummy tucks have also had pregnancies, and since you have had a C-section, you are probably just like most patients who also have weakness of the abdominal wall.

Therefore, I would definitely want to tighten your tummy muscles, assuming that my examination at your consult confirms my suspicion. This is the case for probably 95% of my tummy tuck patients.

Usually the incision for tummy tuck can be made low enough that the original C-section incision is removed. I like to keep the scar as low as possible, so that it can be hidden underneath the bikini bottom. The surgery probably cannot be done through the C-section incision alone, because the incision has to be long enough to cut out the whole excess of abdominal skin, going from side-to-side across the tummy. Therefore, the length of the incision has to do with the length of the fold of excess skin, and how much tightening you want. At your consult, what I like to do is draw this on you with a washable marker so you can see exactly what the incision would look like based on how much excess you have.

Answer:
Actually, you have really described the exact timing for when prominent ears should be fixed. This should really be at the request of the child and not the parent, and it should be at the time when the child is motivated to have them fixed because of teasing. Researchers think that it is important to probably do this early on, so that his body image and self-confidence and personality development do not suffer as a result of teasing from the deformity.

The operation to improve prominent ears is actually quite simple and usually only takes about an hour or an hour-and-a-half. It is done as an outpatient surgery, particularly at his age. I have never actually had a patient who regretted having a surgery, so I would not worry too much about that part.

As a parent of three young children, one of whom has had to have a lot of surgery, I know this is a very difficult decision. This is certainly not an easy answer for you, but I can tell you confidently that this is a great operation for most children with this problem, and may be an easy way to avert some of the developmental problems that can come with the teasing. At the very least, you should have a consult so that you can best understand the surgical option, and then make the best decision for your son.

Answer:
Congratulations – you are the first person who has ever asked me about types of materials for chin implants. I think this is a great thing to ask about, because I think the difference in chin implant materials are even more important than the differences in breast implant materials.

Traditionally, most chin implants were done with silicone implants. These smooth devices are inserted into a pocket that is dissected to be exactly the same size as the implant, and the soft tissue pocket holds the implant in place. There can be problems with this, and the implant can move and be more palpable, and this type of arrangement probably leads to a higher chance of infection and malposition. If this happens, it is recommended to remove the silicone implant and put in a Medpor implant (firm, porous-type material) and actually use one or two screws to attach it to the bone.

This latter technique is my preference from the start, and I prefer to use Medpor-type implants in all my facial implant cases. Just like silicone implants, they come in different shapes and sizes. Although these are slightly more difficult to place, once they are placed, I feel like there is less to worry about, and patients have been incredibly happy with them.

Answer:
Actually, tissue expanders and implants are much more commonly performed than autologous tissue reconstructions. I am not surprised though to hear that you think the opposite is true, because autologous tissue reconstruction seems to get more attention in the media. I suppose that’s because it seems more exciting than simply using tissue expanders and implants.

But since you are the patient, I cannot blame you for being more interested in what your best choice is, as opposed to what’s the most exciting. It is true that autologous tissue can get very nice reconstruction, but so can tissue expanders and implants! Autologous tissue is sometimes absolutely required, especially after a patient has had radiation in treating the area of the breast after mastectomy. Other than that, there are usually multiple options. Certainly, the simplest option with the easiest recovery and the least downtime is tissue expander and implants, and that is why most patients chose this. In fact, when done at a time after the mastectomy, all stages of this type of reconstruction can be done as an outpatient. Most patients do stay overnight after mastectomy, though, and having a tissue expander reconstruction at that time usually does not require the patient to stay any longer than the normal one night. Also, there is the ability with tissue expanders and implants to basically choose your size, within some anatomical limits, as the expansion process goes on. In other words, you do not have to commit to a final implant size until the end, particularly in case of doing mastectomies on both sides.

Implants and expanders definitely have downsides such as complications like fluid collections around the implants or even infection, which can require the removal of the expanders. If this happens, it is basically back to stage I six months later. Nonetheless, for most patients, expanders and implants are actually a much simpler and very satisfactory option for most breast cancer patients.

Answer:
There is not really a scarless breast reduction, but there is a breast reduction with very little scarring, which is actually performed with liposuction. In other words, liposuction is done to remove mostly the fatty portion of the breast (breasts are made of both fat and breast tissue), and liposuction can sometimes remove a significant amount of volume and therefore weight from peoples’ breast.

The problem with this operation is that large breasts have a combination of extra fat and breast tissue, and extra skin. If the breasts are already droopy, and you take out more fat or even breast tissue but leave the same amount of skin, you will make them even droopier. For some patients, such as 16 or 17 year old girls with tight skin envelopes, simple liposuction can be a reasonable option. Personally, I do not think it is a great option for most patients. It turns out the scars from breast reduction tend to fade very well over time, and I have seen many patients with almost imperceptible scars after two or three years. The vertical scar almost goes away and the scar in the crease underneath the breast is incredibly well hidden. Usually the only thing that is noticeable is a slight scar around the areola, but this seems to be a fair trade after making the areolas much smaller than they usually start. I hope this helps.

Answer:
Well, I guess you waited till the last minute, but I see this all the time in the office. I even had a patient come in for a facelift three weeks before her daughters wedding! I would say that you have time still, but you better get moving soon. This is because it does take a while for the final result of the rhinoplasty to be visible. Of course, the amount of swelling and the length of recovery is somewhat related to exactly what is done on the nose, so every situation is different. In general though, a lot of the changes are visible the minute the splint comes off one week after surgery. A good bit of swelling is usually gone by about four to six weeks, and the nose is usually looking pretty good by that point. But if you wanted to know how long it takes for all the swelling to go away, that is a complicated question. The vast majority is probably gone by six months. I have seen slide presentations at meetings showing that you can even see changes occurring from six months to one year, from one year to two years, and two years to three years! That does not mean that you have to wait three years to recover. That just means that there are slight changes going on in the nose during that time. In general, you should give yourself a good month after the surgery before any event as an absolute minimum. This is because you can’t even rest something like sunglasses on your nose and have to be very careful up to that point. At six weeks to two months, I would say that you are 90% of the way to your final shape, but there is definitely still some swelling that will continue to improve.

So, you have no time to waste. We need to take a look at the nose and decide whether the improvements that can be achieved in only a month or two are worth it based on the severity of the problem of the current shape of your nose.