Q: Why do I still have so much extra skin 6mos post op? (Photos)Answered by Dr. ZuriarrainJanuary 13, 2023A: Hello and thank you for submitting your photos. After performing thousands of abdominoplasty procedures and mommy makeovers, I want to say that you have a very nice result. Your breast shape and volume and your scarring are very good. What is happening to your abdomen is absolutely normal after tummy tuck. It does not mean that the surgeon did not try to pull you tight enough it is a situation related to the fragility and weakness of your overall skin. I am impressed that your breasts have not already begun to stretch significantly because that would be the expectation over time. When any patient bends over slightly after surgery there is always going to be some extra skin as we do not walk around hunched over. When you stand straight with proper posture that skin should stretch and not wrinkle at the bottom. Overall what I am seeing with you is a case of a very light skinned Caucasian woman who has very fragile skin with significant stretch marks that is leading to the cosmetic result that you are not satisfied with. After waiting for one year after surgery an attempt could be made to remove further skin to enhance the result. That would be one option for you. Happy to help you along your journey.Alexander Zuriarrain, MD, FACS, FAACSDiplomate, American Board of SurgeryDiplomate, American Board of Plastic SurgeryDiplomate, American Board of Cosmetic SurgeryDiplomate, American Board of Facial Cosmetic SurgeryQ: 6 months post op, swelling after removing compression garment. Will this resolve itself or will I need a revision? (photos)Answered by Dr. ZuriarrainJanuary 13, 2023A: Hello and thank you for posting your photos. As a surgeon who does a tremendous amount of abdominoplasty surgery and liposuction I would tell you that your result is standard. I do not see anything that is out of the ordinary. Many times there is excess roundness to the abdomen due to what is called visceral fat. I would recommend that you calculate your body mass index and it if it is anywhere above 22 you are carrying excess visceral fat which is causing bulging to your abdomen. There are also gastrointestinal issues that arise as we all age and it would be smart to visit your gastroenterologist. I would first encourage weight loss. You could add liposuction to the entire anterior abdomen, flanks and back to enhance your results further. That would be the best way to obtain further body contouring. Happy to help!Alexander Zuriarrain, MD, FACS, FAACSDiplomate, American Board of SurgeryDiplomate, American Board of Plastic SurgeryDiplomate, American Board of Cosmetic SurgeryDiplomate, American Board of Facial Cosmetic SurgeryQ: Want a breast augmentation. Would a lift be necessary also? (photos)Answered by Dr. ZuriarrainAugust 18, 2022A: Hello and thank you for your question. Based on your photographs I would highly recommend doing a breast lift with your desired augmentation. The reason for that is the degree of sagging to the breast that is currently evident on your photographs. If you were only to do a breast augmentation the rest of the breast would sag on top of the implant and this would create a cosmetic deformity that is not pleasing to the eye. By doing a breast lift at the same time as the augmentation you get better upper breast fullness and much better positioning of the areole. Currently there is too much sagging to recommend a breast augmentation alone.Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic TrainedQ: Over muscle or under muscle implants? I love to workout (photo)Answered by Dr. ZuriarrainAugust 18, 2022A: Hello and thank you for your question. You would benefit from a below muscle procedure as the breast tissue is very thin and placing an implant above the muscle will cause a highly visible implant edge and an inferior cosmetic result.Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic TrainedQ: What procedures should I do to make my breast more attractive? (Photo)Answered by Dr. ZuriarrainAugust 18, 2022A: Hello and thank you for your question. Based on your age and photos, I would recommend a procedure that would enhance the upper pole of your breast on both sides with an augmentation. An areola reduction procedure would be of benefit to reduce the size of the areola and improve your overall aesthetics. You do have an asymmetry that would need to be evaluated further in person with measurements during a consultation to decide on the best procedure for you. Overall you have excellent potential to have a fantastic result.Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained
