Question:

I know this a pretty genreal question however my wife really wants a breast lift from a 38DD to a 36C. We went to one consultation here in Las Vegas and the price range was $8000 which we thought was actually steep given what weve heard from friends. Not wanting be skimpy when it comes to my wifes health I dont want to compromise the best care, that being said is this an exorbrant rate for this type of procdeure? You came highly reccomended for skill and fair and balanced pricing.

Answer:

One of the variables is time needed, so hard to say without seeing her, but a usual fee for a reduction is $8,000-$9,500 . JG 6.14.12

Question:

Hi Doc. I am more confused then ever. You recommended that I get a breast lift, because I am not happy with my reduction. After reviewing the procedure I am really confused because my breasts are not really that saggy and the nipple placement is perfect. So with that said when I was younger my breasts were very round and firm. Now that I am older my complaint is that the are not as full. Do you think that I need implants as well. I would hate to go through this again and still not be satisfied. I don`t want to look like a circus show. However, I want my big,round, firm boobs back. Is this possible? And do you think that the limited lift itself will do the trick. PS I want to thank you again for my lips, they are beautiful. I just got your quote today and before I make a final decision, I would like to know your thought. Erin Fitzerald (Lind Walter`s Mom)

Answer:

I am sorry if I did not understand your desires when we talked as we spent most of the time on the fillers and did not have a full examination of your breast. A lift will only take the tissue that has sagged and bring it higher, a lift after a breast reduction does not always move the nipple again, just the tissues. In time though, those tissues will once again fall and we find that usually a breast lift has to be at least partially redone in 5-7 years due to the continued aging and stretching of the skin and tissues. If you want to be larger, then an implant will do that, but the problem is that the weight of the implant will cause your breast skin to sag and that will fulfill your desire for a larger rounder breast, but will bring all of the issues for which you had the breast reduction done.So placing an implant will, at least to some degree, take you back to where you were before all of it started originally. If you would rather proceed with a breast enlargement, I can have the girls in the office give you a quote for that, there are price differences between saline or silicone implants, and we would need to evaluate you for the size implant you would be able to have. Also please understand that the rates of re-operation after a breast enlargement are about 24% over time, so you can plan on that percentage for future surgery Let me know, and you can always communicate with me privately at drgarcia@lvcosmeticsurgery.com

Question:

I`m asking a question a friend. About 12 days ago she had a breast lift. I think he did a keyhole. Something went wrong and the blood supply was cut off to the nipple/aureola complex and it turned black after surgery. He did two subsequent surgeries to fix it and now it is only connected 90 degrees and he plans on doing another surgery. She doesn`t know whether she should trust the doctor at this point and she is in a city where she doesn`t know any other doctors to ask. Any advice?

Answer:

A second opinion would maybe allay some of her fears, but is sounds like that is not possible for her.These things can happen, albeit rare. I think until she is a little better healed, she should continue seeing the surgeon and then possibly seek a different doctor when it comes time to consider some type of nipple areola reconstruction. I wish her the best. JG 4.8.12

Question:

How soon after a breast lift with replecement of implants can you do a new lift, during the lift not enough skin was removed and my breasts are still very droopy with folds on the sides and in the middle. nipples are assymetrically placed , also the scar lines are very different in each breast. One implant is under the scar line. thanks.

Answer:

I would wait 3-6 months if at all possible. 12 months would be better. JG 4.25.11

Question:

I had breast uplift with implants 4 weeks ago and have very strong muscles. The implants were placed under the muscle and they do not seem to drop. I wear a special bra with strap but the muscles seem to stay bulging and the implants do not drop at all. I had bigger implants 10 years ago and they never dropped until 6 months ago because of sudden extreme laxity of the skin, then they dropped. Am i going to experience the samne issue now with smaller implants but breast uplift , not able to drop. I have huge breasts even with smaller implants only 165 cc but i am very tiny and muscular build. I seem very full on top of the breasts but when the volume eventually would come down which i hesistate to think so, my breasts would hang to low. Maybe there is not enough tissue removed ? Thanks for reply.

Answer:

to some degree, yes, but less time though as you are older and the tissues are not as strong now. Until everything settles, it will be too soon to see what you will look like. 3.21.11

Question:

Three weeks after breast uplift with implants i changed the implants for smaller onces, now they seem even bigger or at least the same size then the once before. Is this due to swelling from reopening the pockets ? Will there be again more swelling like before. According to the nurse the swelling would not be much more now, since the healing process was not finished yet and the pockets were opened before. I also still have some bulging on the upper breast which i tought would be gone now with the smaller implants. I also feel bloated everywhere, is this due to the liquids given with the surgery ? Also constipated , is this also common after surgery ?

Answer:

yes, just swelling and should get better in time. Repeat surgery will cause at least the same amount of swelling as the first go around, if not more. Everything you are seeing is normal and will get better with time, got to give it a little bit. Best of luck. JG 3.12.11

Question:

Would the change from a 200cc implant to a 160cc implant on a small frame result in sagging of the upper breast ? Would choosing an implant with the same diameter but less projection be better to avoid this then an implant with smaller diameter but same projection ? Which one would be best ?

Answer:

no way to tell, but it might leave some sagging.Less projection can still lead to the same potential sagging. The diameter of the implant should be chosen by your natural breast diameter and not an end result required. JG 3.6.11

Question:

I read and hear everywhere that i have to wait at least 3 months for having my implants exchanged for smaller ones after a breast lift with implants under the muscle. If not there will be risk for capsulaer contraction or other complications as the tissues are not healed yet. Is this correct, hoe high is the risk to change the implants 4 weeks after the breast uplift ? Would it be safe to do ?

Answer:

I respectfully disagree, as capsular contracture cannot form for the first 6 weeks after the surgery, and after 6 weeks the risks of capsular contracture never goes away. If one is convivnced the wrong size has been used, the sooner the better. At times the surgeon will ask you to wait to make sure that the swelling goes down and then you look like you had desires, rather than having a surgery that was not needed. If the size implant exchange that is contemplated is small, you should wait, if it is a large difference, I would say you could proceed. JG 3.6.11

Question:

When downsizing from a 200cc implant to 125 cc implants, is it nessesary to redo the breast uplift, mening removing more skin ?

Answer:

no, but you will look a little empty towards the top of the breast, or a little saggy. JG 3.2.11

Question:

How long does it take for the swelling to go down after a breast uplift with implants. When can one expect to see the final cup size and shape ?

Answer:

most of the swelling is gone in a couple of months and final result will be in about 6-12 months. JG 3.1.11

Question:

How long is recommended to wait to replace implants for a smaller size after a breast uplift with implants ? Can it be done in two months ? Maybe immediately ?

Answer:

if the implants are clearly not the size desired or planned, it can be done as soon as one wishes,but if you are unsure, it is best to wait. JG 2.28.11

Question:

how much reduction in breast size can i expect after a breast uplift with replacements of implants ? I had a d cup with previous 225cc implants, now a breast uplift with skin removal is done and replacement of 200cc implants. I have the impression my breasts will be fuller then before ? I even don´t fit into my dcup bras any more, have at least an ecup now. One breast is also fuller then the other ? When will they start to drop ? Thanks for reply

Answer:

I cannot say what cup you will be but the diameter of your breast will be more narrow, and the amount of breast volume should be almost the same, just higher up and a different shape is all. They will start to drop the day after surgery and at some point in the next 5 years or so it might require a repeat lift. All depends on your weight size and the strength of your tissues. JG 2.25.11

Question:

Hi Doc, I am 53 yr old. 5`1 tall, 116 pounds.asian. BWD approx 13cm.ribcage 29.I am 11 days post op. I was a full 34c but am probably the biggest I have been in the bust all my life with a little extra weight on.usually a small c.Had a mastopexy and augmentation with 325 mentor mod+ cohesive gel implants.My support bra is currently a c and breasts are high and full/largish.(torpedo`s)Will be a d or dd i guess?.I think I may have gone too big but was told would lose size under muscle placement.Will i shrink a 1/2 cup size after swelling and when they do a lift do you lose a little in size with the removal of extra skin.lollipop technique.they look good but i have a push up bra look all the time.? are implants too wide for my chest.i have almost a centimetre cleavage gap at moment. if i lose weight down to optimum weight will my breasts shrink as well?concerned.thanks

Answer:

I think there is lots of swelling still and I think your size will decrease to a good extent, too early to be worrying about it I believe. If your breast changed in size before the surgery with weight fluctuations, then weight loss after the surgery will likely decrease them again. Best of luck.JG 9.1.10

Question:

I went for a mastopexy and augmentation in november last year now one of the implants is bottoming out. my PS said that we can do a revision mastopexy with the inflamamary crease but what my question is if its done wount the nipples go downward with the surgery ? and cant i replace the low profile implants with high profile implants wount that help with the hanging of the boobs still ?

Answer:

if you have true bottoming out, lifting the implant back up should not change nipple position, just where the nipple is on the mound of the breast. As to changing from a low profile to a high profile will have no effect on preventing the implant or breast from sagging, the bottomong out has to do with poor tissue support rather than implant shape, sorry. JG 8.6.10

Question:

I went to a local doctor, but I`m from a small town where everything costs more. I have previously had gastric bypass. I was told I need an anchor lift and I prefer silicone implants. What would that cost with you?

Answer:

hard to say without seeing you, but maybe about $12,500. JG 7.24.10

Question:

Hi Dr. Garcia. You did my breast augmentation about 7 years ago...however after having twins..they dont quite look as well as they did and the left one has continually giving me problems and pain. How much does it cost to remove the implants and do a breast lift for the extra tissue? And do you give a returning patient discount :-)

Answer:

returning patients are offered a discount yes. I cannto say what it would cost as time is the greatest issue with the fees, so I suggest calling the office, telling them you are a prior patient and then we can meet and discuss what options would best suit you. Congratulations on the twins too! JG 7.20.10

Question:

If you have a breat lift at age 50 about how long can you expect it to last?

Answer:

depending on how large you are, you might need a revision in 3-7 years. JG 7.19.20

Question:

Is there a certain age that you would say a woman should not get a breast lift done? And if so what would the age be?

Answer:

no, there is not, but the older one is the less time it will likely last. JG 7.19.10

Question:

I have size D cup breasts and need/want a lift. I`ve gone to a few surgeons, however there is no answer as of yet as to what procedure I should undergo. My choices so far have been 1) a lift with an implant, 2) a breast reduction 3) just a lift, 4) a reduction with an implant. Please help...confused.

Answer:

well, a lift alone will leave you more perky for a while but the same cup size, a lift with an implant will make you more perky for less time than a lift alone due to the additional weight and will also make you larger, a reduction will make you more perky for a period of time and smaller, and a reduction with an implant does not make sense to remove what you have naturally and replace it with something that has the chance of rupture or scar tissue. If you are happy with your breast size, just get the lift alone. JG 7.6.10

Question:

I would like my silicone inplants removed, they are under the mucsel & 22 years old. Would like to know the down time from work and ball park $ for this to be done. Thank you

Answer:

back to light duty typically in two weeks, what the cost would be depends on whether you also have a breast lift at the same time to correct the loose skin, I would need to see you in person to tell you whether that would be needed. JG 5.27.10

Question:

hi doc. will breast enlargement pills work on some females giving slight fullness? obviously to the breast

Answer:

Sorry but none of them work. JG 4.4.10

Question:

oh yea and if i was to be working out with weights as a female (with little breast tissue) will i lose sum fat from breast too? coz i was reading building chest muscle can tone up breast but also happened to read something bout muscle burning fat ..

Answer:

not every woman that loses fat loses breast tissue, it depends on what percentage of their breast is made up of fat versus breast gland, the more fat in the breast the more they change with weight loss. Making the chest muscles bigger without weight loss will not affect the size of the breast though. Toning muslces will not tone your breasts, it is an old wive`s tale. JG 4.4.10

Question:

Dr. my aunt had a breast lift,it has been over a year and she still has discoloration on her scars like a dark red color,also brownish, is there any kind of laser or prosedure that you can suggest.thank you

Answer:

you can try some YAG lasers to try to fade the color a bit. All the best. JG 3.23.10

Question:

hey dr garcia, if breast implants are performed and then hardened and then tried different things to fix the problem but it only got worse, does that mean breast implants aren`t for me? and if so what about the ugly results? if implants can`t put in how would u fix the deflated and unbalanced look?

Answer:

I would say so, your body just does not tolerate the silicone shell of the implant. You might need to remove the implants and then have a lift of the breast to take care of the stretched out skin. JG 3.13.10

Question:

Hi Dr Garcia. 2 years ago I had an areola reduction using purse string sutures. I am not happy with the look. Sometimes they look puffy and there is some puckering. Is it possible to have the sutures removed? Is there another procedure that looks better? Also if I rub the incision at the bottom of the areola there is a burning sensation. Is that normal? Thanks.

Answer:

puckering is very common with a pursestring procedure because of the technique utilized. The suture can be removed and in most cases the scar and areola will sretch out to the previous size and possible wider. TThe burning sensation is likely scar tissue around a nerve and is nothing serious or anything you nee to worry about. JG 2.20.10

Question:

Dr. Garcia I am researching the breast lift procedure and wondered if you use the Bermant Tumescent LeJour Short Scar Breast Lift Mastopexy technique? Is this better than just the surgery to remove extra skin and raise the nipple? Does this type of lift last longer than the anchor technique? Is this technique more expensive? Thank you for your help.

Answer:

I use the Hall-Findlay technique, the length of the scar is dictated by the amount of skin that has to be removed, one can market a short scar, but if you need a long scar and all you get is a short one, there might be some extra skin where you do not want it. All lifts are intended to lift the nipple, unless it is a secondary procedure being performed for bottoming out of the breast mound where the nipple is in good position but the inferior aspect of the breast skin has stretched out. I think every surgeon believes the technique they use lasts longer than the others, that is why they do it, but in all honesty, they are all pretty similar when you look at them after 5 years in women of equal parity and equal residual breat size. I cannot say that any technique is appreciably less expensive than the others. JG 2.1.10

Question:

When one gets a breastlift do you have drains after? Also what is the pain like after the procedure? Thanks

Answer:

it varies, usually not, but of there is a lot of bleeding at the time of surgery, they are sometiems used. The pain is not bad, easily controlled with pills. JG 1.24.10

Question:

Hello Dr. Garcia, I am a fifty year old woman and have suffered the emabarrasment of having tuberous breasts. I am now considering a lift with implants. Is there a preferred technique for this type of breast deformity. Also Is this condidered a cosmetic procedure? Thank you in advance for your response.

Answer:

it is considered cosmetic and the breast tissue itself usually is cut into to allow the tissue to splay out and then the lift can shape it more effectively. The pressure from the implant also helps push on the tissues to allow them to stretch out and correct the tuberous issue. I wish you the best. JG 1.19.10

Question:

Hi Dr Garcia. I am about 5 weeks out of breast lift surgery and I have a question concerning loss of sensation. My doctor said that she didn`t cut any nerves with the method she used and the only place she removed tissue was the outside of one breast and only 70cc`s. She keeps assuring me that there is no way the sensation loss I am experiencing is going to be permanent. My question is, right now one breast seems to have no swelling left. It`s very soft and natural and hasn`t changed for days. If it`s not swelling and it`s not damaged nerves, what would keep me from being completely numb and this point. The swollen one I feel absolutely nothing. The other one I can feel the slightest pressure when I pinch. Before my nipples were hugely sensitive. I will be devastated if I lose it. Before surgery she told me that if I got an augmentation I ran a lot more risk of losing sensation, but with the breast lift it was almost completely impossible. So this is one reason I skipped implants. Let me know what you think.

Answer:

well, there is always a risk, it can be minimized but never totally removed. There are times where the nerve is stretched and not cut and that can make the senation lessen for a period of time. I would never estimate the sensation to be lost for a full year though, some people just take time to settle in and heal. The risks of nipple sensation alteration are always higher with a breast lift than a breast augmentation, not sure why she said that. I would say to give it some time is all for now. JG 11.29.09

Question:

Hello, I have had four children. During my pregnancies my breasts went from a 34c to a 38DD! Well you can imagine that after 4 episodes of this the skin on my breasts is loose the breasts themselves are not sagging and I do not necessarily want them bigger (I am 5`2 and about 115lbs). I am lucky that I got back into shape and do not have any stretch marks. Short story long, we are going on vacation and my goal is to wear a bikini - is there any procedure to help tighten the skin on the breasts? Thanks!

Answer:

the only thing would be to have the skin in excess cut out, I do not feel that the skin tightening lasers out there are safe nor effective, sorry. JG 11.25.09

Question:

Hello Dr. Garcia. I did a breast reduction about a year ago with you, and I know it takes a year to heal, but a month has passed from within year, and I have been feeling pain still with nerves, like very tight.. And, maybe its muscle rejoining? I am trying to figure it out.. But is there anything I can do to ease the pain?

Answer:

stretching and warm compresses or a haeting pad, it is very common, it is usualy the scar tissue in the breast stretching, not much else can be done, though, sorry. JG 11.17.09

Question:

Hello Dr. Garcia, I have been giving thought to a breast lift with symetry sometime in the future. I am a California resident and was wondering if I could be given a ball park figure for the cost of a consult and the above mentioned procedure? I am 54 years of age and in good health I am currently a 38DD and my left breast is noticably larger than my right. Any information you would be willing to offer would be very much appreciated. thank you for your time. Linda Green

Answer:

our fees are $9300, all inclusive. JG 11.10.09

Question:

Thanks for your feedback Dr Garcia. I`m the lady with the breast lift who has several seromas in the breast that keep blowing up. I`m almost 2.5 weeks from my surgery. I had one other question about areolas. The really swollen breast`s aureola is about twice as big around as the good boob even after it`s drained. Do you think my aureola might change size after all my healing is done? Can it possibly shrink back down half the size it is now? Or will the skin be stretched out from all this swelling and stay twice as big?

Answer:

I do think it should shrink back down, yes. JG 11.8.09

Question:

Hi Dr G. I just got a vertical mastopexy without implant and am a bit over 2 weeks ago. I was a D-cup. The left breast had about 80 cc`s removed to match the other. The left breast has also since gotten a seroma or seromas and keeps getting huge. I`d say at LEAST 1 full cup larger..maybe more. It dwarfs the other. I have gone back twice to drain it. It goes down then fills right back up. Is this ok? Also on the breast that keeps blowing up, I am noticing the aureola is almost double the size. :( Do you think there is anyway the aureolas could even out or do you think it got all stretched out and will remain this size? The aureolas are so different in size I`m fretting that they couldnt even possibly match in the end. Is it possible that the other will expand more..? Is it possible that big hugey boob will go down and aureola will get smaller again? Is it problematic to keep filling back up? Can this mess up my healing? Make stretchmarks, create distortion? Make scar tissue? Thank you for any advice you can give!

Answer:

well, if it is stil like that it might need the surgeon to put in a small drian for a few days to allow the pocket to collapse and allow it then to settle down, best of luck. JG 11.7.09

Question:

Hey Dr. Garcia --- I am looking for a board certified plastic surgeon to perform a laser bra breast surgery. Do you perform this procedure? Approximate cost and downtime. Thanks for your cosideration. I am SWF, 59, no drinkie, no smokie. Have huge saggy breasts from 3 children, starting to have neck/back pain, fatigue, numbness in hands. I live in Colorado...would you consider me for a patient? Thanks for your time. Pam

Answer:

I personally do not do the laser breast lift, the only one I know who performs it is Dr Grant Stevens in Marina Del Rey, Ca. Sorry. JG 10.21.09

Question:

Hi Dr. I have a follow up question, Im the one who had the chin implant and breast implants plus lift. Im glad to know my chin might improve...but on the breast firmness issue...im only 29 and I lost about 50 pounds. I had the lift and the dr said he removed a lot of the loose skin so the skin would be much tighter, it is improved some, but not as much as i wish it would be. Would a future lift procedure that removed even more skin help or is it too late as the skin was already stretched???

Answer:

well, your skin is likely not as strong as it would have been without the weight loss, so in time, it can be redone, but it will give and loosen again over time. JG 9.29.09

Question:

Hi Dr..I had a medium size chin implant put in on May 19, 09. I really like it and my only problem is on the right side below my lips down to the bottom of the chin area is still tingly when I touch it, it doesn`t hurt, but it feels tight sometimes when i move my mouth. Do you feel this may get better?? Also, I had a breast lift with silicone implants placed at the same time. 275 cc. I really liked my breasts at first, but after they dropped i feel they look kinda saggy again, I like when I raise my arms above my head how i can see the roundness of the implandt. Im probably 15 pounds or so from my goal weight, do you think if I lose weight it may make the roundness of the implant show a little more? I wish my my breasts would be more firmer im hoping if I lose some more weight that will be the case. Thank you so much for your time :)

Answer:

it should get better, and it can take up to one year in some patients. As to your breasts, it is impossible for me to say if your breasts will change shape with weight loss, they will likely get smaller though. The firmness or lack thereof is due to the tissues stretching and there is nothing to prevent that I am afraid. JG 9.29.09

Question:

When breasts are droopy and deflated post childbirth, is that fixed with implants, lift, or both?

Answer:

in some women it is just implants, in others it might need both. JG 5.30.9

Question:

on tues i had a breast lift with implants and they seem way too big to be swelling at this point. how long does swelling usually occur for? can i expect my breast to reduce in size even after almost a week since my surgurey?

Answer:

need to give it 6 weeks at least. JG 5.25.09

Question:

HI Dr Garcia. Can you give me an idea on how much a breast reduction cost. I live in the Tampa Bay area. Also is it appropiate to email different doctors to get an idea on prices? Because I went this past week to a consultation, and the cost seems to be too high for me. I don`t think is worth it going around making appts on places I can not afford.

Answer:

I have patients email the photos all the time and fees vary from surgeon to surgeon so its best to decide on a surgeon and then ask the price, or you can see a couple and decide that you like more than one and then ask them their prices. Prices in Las Vegas are between $7500-$9000 all inclusive. Best of luck. JG 5.21.09

Question:

hello Dr pierce, MY DAUGHTER IS 24 YEARS OLD HER BREAST IS AS SHE IS 13 YAEARS OLD .IS ANY SAFE CREAM COULD SHE USE IT TO ENHANCE HER BRAEAST ? THANK YOU

Answer:

no creams trhat will help,only surgery.Sorry. JG 5.17.09

Question:

Hello again doctor, thank you so much for answering my previous question...I asked about the breast lift with implants and am confused if I should get the implants becuase I want the look of a round implant...so basically, if I get an implant and make by breast bigger, they could just end up being a bigger version of my brests now??? Saggy again in just a few years only bigger even??? Because I like that sort of full look under the skin when an implant is there...but since Im already a full C I wont be able to achieve that look??? I I guess those are my two questions....Im sad I can never have that look..:( some people are so lucky and some aren`t I guess huh?...sorry to be a pain but I need to decide by Monday and Ive been racking my brain I don`t wanna have an even bigger version of my saggy boobs I have right now in just a few years I guess is all.

Answer:

that is correct, in time just bigger and they will sag again, the round appearance will not last more than 1-2 years in most cases. Best of luck. JG 5.3.09

Question:

Hello, I am scheduled for a breast lift in 3 weeks (yikes) and a medium sized u shaped chin implant. I was also supposed to get breast implants but the dr just advised against it at the pre op appointment becuase he said they would likely sag faster again. Im 28 and right now a full C cup. I kinda wanna be bigger and am afraid Ill be smaller after surgery, I really want that look where they dont look like fake softballs but I like how implants look...do you think I should get the implants? Will my breasts be smaller after the lift? Im kinda confused because before the Dr. said he thought itd be a good idea and now hes advising against it. He also said hes saving me from future surgeries because breast implants need to be traded out every 15 years or so. Is that true? sorry all the questions, I need to decide asap so they know how long to make the hospital room for. Thanks :)

Answer:

well as there is no breast tissue removed during a breast lift, you will not be smaller in the absolute sense but your breast diameter will be narrower. Placing an implant will make them bigger, will also make them sag faster and that appearance you desire of a round implant look is likely something that you will never have, at least long term. As to implants needing to be traded out, that is not true unless they have had a problem. I cannot speak to as why he changed his mind though. As to the hospital room, I am assuming you mean the operating room, and he needs to agree to place the implant before anything. If he does not want to do it then the time is the time. JG 4.30.09

Question:

I know you in pro of general anestesia for breast surgery instead of local...why this? is general anestesia safer? is it because if the patience can`t breath, the machines will do it for him? please help me to understand the pros. Thanks again

Answer:

I think the adequacy of the anesthsia under local is less and increased pain leads to increased bleeding, and if the is inadequate anesthesia, then controlling the bleeding is more difficult, that least to bigger problems. I find that most of the surgeons that perform breast surgery under straight local anesthesia do so because they are not plastic surgeons, are trained in something else and have started doing breast surgery under local anesthesia as they cannot get priveleges at a hospital or surgicenter. You always need to ask the surgeon, or the person holding tehmselves out to be a plastic surgeon at which hospitals and surgicenters they work at. If they do not, then I think you need to go somewhere else. JG 4.24.09

Question:

Hello, I forgot to add in my last post - what do you know about the breast enhancement pills on the market? Are they safe? I have a friend who used them and they did work, but are they safe - if they are adding breast tissue or causing cells to divide - wouldn`t that be a cancer risk? Thanks again!

Answer:

any pill, if it could cause the breast to grow could also potentially casue a breast cancer to grow, I have seen no pills on the market that have been able to enhance breast size that actally work. JG 4.20.09

Question:

Hello, I am wondering if there is an alternative to a breast lift to tighten the skin on the breasts? I have had four children and the skin appears loose however, the breasts themselves are not really sagging. I know that I do not want implants. Would thermage be effective? Any other suggestions? Thank you.

Answer:

I am sorry but there is no no non-surgical option that is reliable. JG 4.20.09

Question:

Thank you. So regarding the laser bra, what is the advantage over the traditional breast lift? is the laser bra surgery done in less time? will it be safer than the traditional one if done with local anestesia? I am looking for a breast lift but would like to avoid general anestesia if possible...this is one of the reasons I am considering this type of surgery...and for the advantage that it will take less time to do by the surgeon than the other one...please help me with your advice. I am undecided. I have poor circulation, sinus like allergies from time to time and my veins are very much superficial, almost see through my skin. Never had a general anestesia for a long time, only for a c-section and this was 14 years ago when non of these problems were really that bad besides I was younger, now I am over 40. THANKS AGAIN

Answer:

it is a modification over the traditional old-fashioned inferior pedicle technique and I personally do not feel it offers much advantage. I no longer perform that technique and have moved over to a superiomedial pedicle technique so I do not depend on the tissue inferiorly supporting the breast tissue and areola. The time saved is minutes compared to the non-laser inferior pedicle technique. I think all breast lifts should be done under general anesthesia though. A laser breast lift is still invasive surgery, it is not a lift produced by merely lasering the breast skin, that will not work. Hope that helps. JG 4.16.09

Question:

Hi Dr Garcia...I need your wise advice about the laser bra surgery performed by dr stevens in marina del rey, CA...is it safe, good. more lasting? also pleae give me your input about thermacool for the neck, inner thighs and under arms when there is not too much loose skin. Thank you so much.

Answer:

safe, yes, good, no better than when it is preformed without the laser. I think it lasts no longer than a traditional inferior pedicle technique.The amont of dermis that is left does not significantly stop the recurring sagging, that is more relative to what is done to the breast tissue. Think about it, they are lasering the superficial part of the skin in an areas that have aleardy failed and now you want it to support what it coudl not support before just by causing strengthening by the laser. I will grant you that is is less bloody to perform versus the older method of talking the epidemis off. As to Thermacool, sorry, I do not beleive the hype. JG 4.16.09

Question:

Hi Dr Garcia, I am thinking of having breast lift and reduction surgery. Having already gone thru this same procedure before without success, I am a little esqueptical about it, but the same reasons that prompted me to do it before remain there. On my first surgery, I was lifted a little bit and not reduced enough, but when I am checking websites about this procedure, it seeems its really hard to get pleasing effects. Do you know a really good surgeon in the Tampa Bay area or tell me if there is a better way to look for one besides someone that is board certified.

Answer:

I wil say that reductions and lifts are not uncommonly disappointing procedures as the chance of recurrent sagging is high. I usually tell my patients that within 5-7 years another surgery will be required, although all patients start sagging right after the surgery. It usually has gotten saggy enough aftter 5-7 years to warrant a repeat lift. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 3.12.09 http://www.surgery.org/public/findasurgeon.php.

Question:

Hi DR G. Its been two weeks since my friend had a breast lift and small implant. She`s a D and the implant was to replace lost tissue at the top of her breast were she had a lump removed. One of her nipples is 1cm further over from the center of her chest then the other. its the side she had the lump removed from.Could this be due to uneven healing or do you think the PS had not center them?

Answer:

I think it is due to the lump removal and since the implant cannot accomodate for that, there is likley some asymmetry due to that. Swelling can also be present and aggravate the issue, so it might get better as that gets less. JG 3.1.09

Question:

Hi , I HAD A BREASTLIFT , 2 YEARS AGO ,UNFORTUNATELY I STILL HAVE SOME UNSIGHTLY SCARS, I KNOW THAT NO PROCEDURE WILL TOTLALLY RID THE SCARS , BUT IS THERE AN OPTION YOU WOULD RECOMEND THAT COULD LESSEN THE APPEARANCE. MANY THANKS...

Answer:

in most cases the only thing that can be done is to excise the scars, which is essentially a repeat breast lift, but if there is not enough loose skin, then the improvement will be small. JG 2.9.08

Question:

Hi, can the following be performed at one time: breast lift w/implant replacement, mini-abdominoplasty & rhinoplasty. How many days of bed rest is required? How long until full physical activity can be resumed? Regards

Answer:

it could, that is alot of surgery, I would only even remotely consider it in a totally healthy person, I think your downtime would be at least 2-3 weeks, and no bed rest, up and walking the same day to avoid blood clots,not back to full activity for likely 6 weeks. JG 2.3.09

Question:

Hi Dr. Garcia! If I get a breast lift, how much time would I need to take off from work? I have a desk job. Thanks!

Answer:

maybe 7-10 days. JG 1.29.09

Question:

Hi Dr...i want to get a breast lift ...i am a 34 C but I lost 50 lbs years ago and my brasts have been saggy since...im 28 now...i like the look of implants...can i get a lift with implants?? like a small implant? I dont really wanna be much bigger than a 34 c but I am willing to go a little bigger to have the look of an implant...is this a realistic hope for me??

Answer:

a lift and an implant can be done at the same time, yes. Understand though that breast lifts do not last forever. The greater the weight of the breast mound, the less time it lasts. Therefore,if you have an implant with the lift, it will last less time. The desired appearance you want, the look of an implant I am afraid you will likely only have for a couple of years or so. JG 1.24.09

Question:

Hi doc. Can you tell me how long after a lift and small implant do I have to wait before i start training for a marathon? The marathon is August and I am having surgery next month? What are the risks if any?

Answer:

might want to wait 3-4 weeks, the risks are that the bouncing from running will make your breasts sag faster and the lift will not last as long, even in a bra. JG 1.22.09

Question:

Hi!!Almost 4 months ago I got a Implant and Lift, My incesions are through my Areola, I was wondering how long it would take for my sutures to heal? There is still a puckering along my incesion...Its not very attractive!!!!Is this abnormal? PLease help!!

Answer:

the sutures are healed now and the pleats you have will get better over the first year but some might be there always, it is part of what you give up to limit the incision to around the areola alone. They should have told you about that before the surgery. JG 1.22.09

Question:

Hello Dr Garcia...for poor circulatory system and possible sleep apnea(don`t know yet)...is better to have local anestesia with sedation for breast lift and full tummy tuck? or general anestesia? when surgeons use one type of anestesia over the other? Also, should both surgeries be done at the same time when poor circulation and possible sleep apnea is present or surgeries should be done one at the time? thanks for your advice

Answer:

personally I would not do those procedures under local anesthesia and you need to find out what the medical problem is because the lack of oxygen afterwards can cause wound healing problems. It is always safer to do the procedures apart if there are medical concerns in order to shorten the anesthesia time. JG 1.15.09

Question:

Would you use internal purse-string sutures on the areola when doing a reduction for puffiness? I have small areolas from a past unsuccessful surgery that has left them extremely protruded in the relaxed state. My surgeon is going to do a revision and try to flatten the areola by cutting out some of the breast tissue around the areola, since the areola should not be reduced anymore in size. I am worried that although the purse-string sutures are commonly used to reduce scarring, it can cause the areola to stay puffy (or look like it is sitting on top of the breast rather than flat). What type of suture would you recommend?

Answer:

I agree, I would avoid the purse string sutures ands use regular interrupted sutures, JG 1.4.09

Question:

I had a breast reduction 11 months ago in which my breast were reduced, lifted, and the areola was reconstructed to match the size of my smaller breasts (went from a 38DDD to 38D). Understanding that my breasts were going to settle, etc. I noticed about two months ago that the top part of my areola on the left breast is caving in and I have sharp shooting pains more often now in that breast. It`s not visible when it`s cold and my nipple is erect, however it is very noticable when I`m warm and they are not hard. What caused this and what will I need to do in order to have it repaired...or is it repairable?

Answer:

not much I can recommend to repair it, it is due to the technique required to reduce the breast I am afraid, a known risk. JG 1.2.09

Question:

what can i do to tighten up the loose skin from my breast and arms without a costly surgery i am 41 years old and have lost 100 [pounds want to lose 40 to 60 more i do weight training?

Answer:

I am sorry but surgery is the only solution. JG 12.31.08

Question:

what can i do to tighten up the loose skin from my breast and arms without a costly surgery i am 41 years old and have lost 100 [pounds want to lose 40 to 60 more i do weight training?

Answer:

I am sorry but surgery will be the only solution. JG 12.31.08

Question:

Hi Dr. Garcia, I had a breast reduction 6 days ago. Yesterday I saw my surgeon and he said I had blood supply problem on my right breast. He put some staples on the incision from the areola and cut some skin under the breast. Today I have a large black scab under my breast. What does this indicate? Is this sign of an infection? I am seeing my surgeon tomorrow what will be done? Thank You.

Answer:

not an infectio but at times the blood flow to the tissue can be lessened from the surgery and that can cause some superfical skin loss, most of the time, when the scab falls off there is new skin underneath it and in time the pink skin regains its normal color, but it takes time. I cannot predict what they will do tommorow as it depends greatly on how it has changed since yesterday. Hang in there and give it time. All the best. JG 12.9.08

Question:

Hi I had a slight breast lift and breast aug through the areola about 3 months ago. I just noticed right on the scar line on my areola I have a sore spot. It is a very small bump looks like a pimple but its under the skin. It looks kinda blue purple like its blood. I hd quit nursing 3 months before the operation could this sore spot be a plugged duct from old milk or an abcess?

Answer:

more likley it is a slight infection of one of the sutures below the skin. JG 12.8.08

Question:

Hello Dr Garcia, I had implants in my 30`s, had them removed in my 40`s and a mastopexy at the same time. Good results. I need another breast lift. I have had good results in the past with my surgeries, which include a tummy tuck and rhinoplasty. Is there a risk to having another breast lift, The shape is nice and equal, but has simply dropped due to gravity. I don`t need any implants, in fact would like to have some sculpturing down to a small C from a D plus. Is this possible? I am 63. Fair skinned, blue eyed. 5` 11 at 148 pounds. Thank you for your time. Bonnie

Answer:

I think in most cases a repeat breast lift should be OK to have done. Best of luck. JG 12.2.08

Question:

Dr. Garcia, I had a bennelli lift a little over 2 months ago to reduce the size of my areolas. The results were great for the first six weeks or so: breasts not too flattened, small areolas, noticeable lift and minimal scarring. Then a couple of weeks ago, the areolas began to stretch. They are now only slightly smaller than they were originally. Did the purse strings that were supposed to have prevented this fail? Do my size C breasts have too much mass for the suture to compete with?

Answer:

well, the sutures eventually always fail, in your case, they might have failed sooner.That procedure only works in a very small number of pateints and it is more the degree of tension on the skin when closed than the weight. I suggest you go back to your plastic surgeon and see what they have to say. Best of luck. JG 11.15.08

Question:

I had a breast reduction done appx 2 weeks ago. The surgeon said the sutures were disolveable, that the swelling will go down eventually. The problem is that I still notice some hard areas around my nipples with what may be a clear suture, one breast seems to be more swollen still on the side than the other and I am having shooting pain into my armpit on the non swollen side. My surgeon says not to worry, they are not worried...but I am. Should I be worried? Thanks

Answer:

no, all normal and in time should get softer and more even, swelling is never even and the sutures can take a few months to dissolve. JG 11.10.08

Question:

I had an implant revision in June 2007, replaced PIP saline implants with Mentor memory gels. The PS also recommended a binelli lift. Sutures of binelli lift were sewn to tight leaving left nipple misshapen so PS took out pemanent stitch. Nipple stetched so PS wanted to revise both nipples and performed bilateral Areolar reduction in June 2008. The left nipple is now very scarred and is not symmetical with the right. I saw someone who had had a breast lift performed by you several years ago and I saw very minimal scarring. My question is do you do revisions of binelli lifts and after you see my scarring can you tell me what improvement, if any, I can expect? Thanks

Answer:

I do not perfrom revision surgery at present due to my schedule, I will say that what you describe is typical for a Bennelli lift and the areolar reduction will be essentially the same. The biggest limitation you have at present is that the scars to revise the areola will need to keep inching superiorly and eventually the areola will show above your bra. I perform traditional lifts because although the scars are longer, they are beter quality than a Bennelli lift. It might be that you need to go to a significantly smaller implant to improve your end result. Best of luck. JG 10.19.08

Question:

Sorry I mean could he have removed some of my aereola?

Answer:

yes, he could have. JG 10.5.8

Question:

Hi i just had my ba september 11th 2008 so its been about 3 1/2 weeks. I had a slight lift. The doc used purse string stiches on my areola. Is it normal that one areola is bigger than the other? Doc said one is still sinched and will flatten out like the other and be the same size, is this true?

Answer:

it is not uncommon for the type of lift you have to have asymmetry. I think in time the suture purstring will break and they will likely both stretch out to nearly equal. JG 10.5.8

Question:

How long does it usually take for the purse strings to break? The left one broke after the first week it just popped and hurt a little.Is it possible that he removed some of my nipple when he did the lift.

Answer:

it varies on the type of suture used, there is at times some areola removed in order to make the areola smaller in certain cases. JG 10.5.8

Question:

i had a breast reduction 1 yr and 2mths ago, about 5 mths ago i found that i still had the stitch in the bottom left breast. it is very painful as it is pokin at the skin. i was wondering was it left in purposely or was it a way the doctor took the stitches out. ive seen my famliy doctor and he said its not supose to be there and that scar tissue has grown over it.what should i do im affraid to go back th the doctor that did it.

Answer:

it might be one of the stitches palced below the skin that has worked its way to the surface more likely. It might require making a small slit so the suture can be grabbed and pulled out. JG 10.4.08

Question:

HI Dr. Garcia, A year ago I had a breast lift and I have always noticed a black mark on my nipple arola, My husband just told me that it is 2 stitches that the doctor did not remove. Is it safe to just leave it alone or do I need to get them removed., Thanks ,You are the best.

Answer:

if they are not causing a problem you can leave them alone. JG 10.1.08

Question:

I asked yesterday about nursery and breast. But maybe i had to ask in a different way, the question is if is the pregnacy what cause changes in breast or if is it nursery because I read nursery is no the real cause, that is pregnacy because of the enlargement of the tissue during it.

Answer:

they both cause damage. The nursing makes you lose breast tissue but the pregnancy causes the skin to stretch and lose elasticity. JG 9.20.08

Question:

Dr. Garcia, I had my ruptured silicone implants replaced 6 months ago, also had a mastoplexy. Extensive 6 hr. surgery. My areolas had trouble healing due to loss of blood flow (??) to that area (I`d had 3 previous areola lifts). I had open wounds for 4 months that required agressive treatment and to date I`m left with a portion of my areolas that are a different color, scarred and one area slightly indented. Is there a possibility that this could get better with time? Is this usual after this type of surgery or am I just one of the unfortunate people that this can happen to? Thank you for your time.

Answer:

well, I doubt it will lget better but the color might fade with time. In cases where multiple areoalar lifts have been previously done,it might have been better just to remove the ruptured silicone and do the mastopxy later to attempt to damage the blood supply less, but doing that does not bring the risk to zero, it could still happen. Once healed and softer a tattooing of the areola might make it look more symmetrical though. Best of luck. JG 9.20.08

Question:

I wanted to ask you if there any relation between nursery and changes in breast, i mean, i know nursery is very recommended for children but, is there any cosmetic risk for the breast or if is the pregnacy the cause of cosmetic changes in breast

Answer:

greater chance of sagging and loss of breast tissue. 9.20.08

Question:

Hi Dr Garcia. what do you think about Dr Bermant tumescent body lift, tumescent breast lift and tumescent tummy tuck. What is the difference from conventional surgeries? thank you so much

Answer:

I do not think much of them, it is an attempt to claim superiority over traditional methods and there are still risks, so I do not suggest it. More marketing than anything else I feel personally. JG 9.12.08

Question:

what do you think of breast enhancement pills and the serum for the breast to also firm it? thanks

Answer:

both a waste of time. JG 9.6.08

Question:

I had BA in Mid April... 350 Silicone unders. My PS is doing an crescent lift in his office tomorrow as my nipples are still sitting fairly low on my breast mounds. My main concern is am I going to feel pain if I use LMX4 before I go to the office and then local anestetic with valume (sp?) once i get to the office? Is this procudure done in an office setting very often? My PS said the procudure would take about 45 minues.

Answer:

there is always a possibility of that and you might just need more local anesthetic, the LMX4 does not remove all of the pain of the injection, it just lessens the pain from the puncture but not the injection of the fluid. I very very rarely do crescent lifts, either under local or general anesthesia as I find it distorts the areola and makes it look like an inverted tear drop many times. JG 8.14.08

Question:

dR. I RECENTLY GOT A BUTT AUGMENTATION. ABOUT 14 DAYS AGO. I HAVE NOTICED ON MY LEFT BUTT THERE IS A SHARP PAIN THAT RADIATES DOWN TO MY LEFT SIDE OF MY CALF. I CANNO SIT, SLEEP , OR DO CERTAIN MOVEMENTS CONFORTABL BECAUSE OF THE PAIN. IS THIS A NORMAL REACTION? MY RIGHT SIDE IS HEALING WELL, ONLY THE BUTTOCKS IS A BIT SWOLLEN, BUT IT IS NOT LIKE THE LEFT SIDE OF THE PAIN. IM NO LONGER TAKING THE MUSKC RELAXER AND I DON`T KNOW IF I SHOULD ASK THE DOCTOR FOR A REFILL. IS THIS TO SOON TO WORRY? DOES THIS SOUND LIKE A COMMON PROBLEM?

Answer:

it is likely due to pressure on your sciatic nerve, it can happen, is not totally unusual. I cannot say that the muscle relaxants will make much difference. I think you should see your surgeon to see what can be done. JG 8.13.08

Question:

In a previous question I asked about the gortex sutures that were used around the areola for a breast lift. I don`t like the way they feel - I can feel a ridge around the areola. You mentioned that you don`t use that type of suture. What do you use and does it feel more natural or also feel like a ridge? Is this something that I could have redone?

Answer:

I use absorbable sutures in that area to avoid feeling the ridge, some doctors prefer the permanent sutures like Gortex to try to keep the scar from stretching but it does not always work as the tissues can tear awayfrom the suture material. The Gortex suture can be removed but it is possible, due to the technique they used for your surgery that the areola might widen along with the scar. JG 8.13.08

Question:

so I guess general anestesia is better for a BL? i HAD a c-section with general and the other one with local(epidural) because the anestesist said if i was his siter he should advice me not to do general anestesia so i did the last one with local...is it because this was a C-SECTION and not BL SURGERY? I am confuse. Thanks

Answer:

an epidural is not a local anesthestic and if care is not taken with an epidural you can stop breathing. A breast lift and cheeklift cannto be done under an epidural. JG 8.7.08

Question:

Hi Dr Garcia I had a breast reduction 20 years ago am now 43 and after having 3 children had a breast lift with silicone implants 2 years ago. I am starting to see my breast sagging again and am wondering if i put a larger implant will this help the problem? I do not have the greatest skin elacticity I also feel that when i am lying down my implants slide to the side leaving my breasts very deflated looking I think she put a 220 cc impant in i feel like i have a lot of extra space in my breast that if i put a larger implant in it would fill and lift the breast.

Answer:

a larger implant might give you the illusion of a lift for a number of months but then will accelerate the sagging even faster as gravity will win out. JG 8.5.08

Question:

I have had a breast lift and am wondering why I had never heard any discussion about the way the areola would feel after. There is a very distinct feeling ridge around the areola that my Dr said were the gortex stitches and that I would always feel that ridge. Is this correct? It makes my areola almost feel raised above the rest of the breast. I knew there would be scarring, but didn`t realize how it would feel so different.

Answer:

if they used Gortex sutures, yes, you will always feel it unless it is removed. I do not use those sutures. JG 8.4.08

Question:

Thankyou.. how big would the incision be ? and how long would i have to wait until i had it done ? Karla

Answer:

I would need to see you in person, and I would wait three months to see if things change. JG 7.23.08

Question:

What is the difference between a breast lift and a breast enlargement. And what is the appropiate age limit to be having these types of procedures done.

Answer:

A breast augmentation is only done to make the breast larger where a breast lift does not make the breast any larger, it just shapes the breast better and lifts the breast on the ribcage. A breast augmentation does not lift the breast. JG 7.15.08

Question:

Dr. Garcia, your advice and site have been so helpful, I am wondering if you could help me. Two weeks ago, I had a circumareola lift and breast augmentation I used 500 cc silicone implants. I went from a saggy 36B to a very full 36D. I have three questions: 1. I am feeling a very strong burning or pins and needle feeling. Is that normal? Will that go away and my normal sensations return? 2. I noticed that one is much higher than the other (about 1/2 inch). The doctor told me that they will settle . I am sure they will settle, but wouldn`t they settle still one higher than the other is? 3. The stitching around my nipple is coming out in two parts, should they be cut? I am also worried that they are not perfectly circular anymore, king of oval shaped, will this repair itself back to a circle? Please help, starting to panic Kelly

Answer:

the pins and needles are all normal and will get better in a few weeks. The swelling and tissues will react differently from one side to the other so much of what you are seeing right now will change for awhile, got to give it some time. As to the stitches, they likely should be cut out and I think some of the oval shape will correct itself but possibly not entirely. JG 7.15.08

Question:

What is the normal recovery time for a breast lift with implants placed under the muscle?

Answer:

4-6 weeks. JG 7.5.08

Question:

On July 1st I had breast lift with 325cc filled to 375cc and right was 350 overfilled to 405cc, saline smooth moderate profile. Is it normal for your stomach area to get swollen? I put on 7 lbs after the surgery and my stomach fills extended a bit. Is it just the fluid that they use while under? My left nipple is a bit black and blue and they right looks alot more normal. How long does it take for them to settle and look a bit more normal. Thanks and Happy 4th of July!

Answer:

the stomach area can get swollen after that surgery yes, due to the fluid moving down and also due to the anesthesia causing some slowing of intestinal function too. It will take a couple of weeks to start to look better, just follow your doctors instructions and follow up with him when you are supposed to so he can keep an eye on things. Happy 4th to you too. JG 7.4.08

Question:

I was scheduled for breast augmentation and breast lift last Monday and developed a heat rash between my breast so my ps cancelled the surgery. I am rescheduled for the surgery again this Friday but did not know until yesterday. I went swimming yesterday and got a bad sunburn between and under my breast. The sunburn feels and looks better today but do you think my surgery should be cancelled again or do you think it will be okay by Friday? Is there a higher risk of having surgery with a sunburn? Thanks.

Answer:

with a sunburn it is OK to proceed. Best of luck. JG 6.24.08

Question:

heyy,, i wanted to know about breasts.. i have like AA size.. but just want a slight improvement coz i have a small built and very short 154cm... i was reading about fat transfer, i think its called celution.. not sure.. is this a good idea? or is there other ways of getting a little size in the breast without implants? I heard so much bad things about implants... can you make a suggestion?

Answer:

at the present time I think fat injections to the breast are not a good idea. They are studying the issue but I would wait. JG 5.24.08

Question:

Ok, I may win the award for the goofiest question....but can you visibily firm/lift saggy breasts thru exercise (i.e. strengthening chest muscles)?

Answer:

no, it is not possible and it is not goofy, there are alot of people out there promoting that very thing. JG 5.18.08

Question:

I am 24 years old and since I was a teenager my breasts have been very large (DD - DDD) and very sagging. I know that a breast reduction can take out milk ducts and therefore there is a chance that one can not breast feed. I do not have children but eventually would like to. Can a breast lift take out milk ducts? Also, do you have any weight requirements for a procedure like this?

Answer:

A breast lift will take out some ducts, but less than a breast reduction. I have not weight requirements, but I will say that the larger the breast left, the less time the lift will last for. JG 5.7.08

Question:

I would like my nipples to be larger and stand out is there a procedure to do this.

Answer:

nothing reliable. JG 4.27.08

Question:

Hello Dr. Garcia, I need to ask you a quick question. The question is my size of my nipple is 7 cm and when you do the surgery I am wondering about the scar if its going to be a big scar since you are reducing my breast? Thank you for your time.

Answer:

the scars will be long in breast reductions but we do everything we can to make them heal as thin as we can. The more tissue is removed the longer the scars will need to be I am afraid. JG 4.25.08

Question:

Hi Dr. Garcia, I have a question that I forgot to ask you when I was in your office last week. I am fair skinned C/D size cup and in need of a breast lift. You mentioned that I would be a candidate for a lollipop lift. I realize that this lift would be better than the donut lift. However, If I only want the donut lift is it possible to get this. I feel that this lift would still be an improvement, and I feel I would be alot more comfortable with the scarring around the nipple only.

Answer:

I do not do doughnut lifts ans besides for the fact that the amount of lift is limited, the doughnut incision alone will tend to flatten the breast and make it lose projection. JG 4.23.08

Question:

Thanks for the quick response. Ok, so you suggest MRI to detect possible rupture of 35 year old silicone implant. Will do. I looked up ruptured silicone implant and have a clear understanding. I have one more question. If the suggested, smaller implant and lift is procedure is performed can a skilled cosmetic surgeon artist make it look beautiful? I don`t mind paying if Kaiser doesn`t have these type of surgeons. If they do great I still don`t mind paying. Just want do what is the most healthy for a woman my age and still have a healthy self image.

Answer:

beauty is in the mind of the beholder and due to the larger surgery and the longer and more visible scars it will likely not look as aesthetic as the first surgery. JG 4.23.08

Question:

I just posted that last question about thinking it might be time to remove my silicone breast implants that I have had for 35 years. I noticed I didn`t use ? marks after I asked questions. It`s late, I`m tired and probably should buy reading glasses.

Answer:

no worries. JG 4.23.08

Question:

I had silcone implants put in June 1974 with no problems. Very good work. Now I`m 52 and started noticing the shape was changing, and there was a harder look at the top of one. Had a Mamogram at Kaiser which showed nothing but calcification. No one ever talks about how after many years your elasticity changes and the implants may look like two round circles under thin skin. The annual Mammograms required for a woman my age is what I think caused this malformation because they just smash the hech out of them. Also with age there is increased risk of breast cancer and with these silicone implants they can`t see anything. I think I have no choice but to remove them with this strange odd hard thing at the top of the right one. Kaiser said they can remove them at no cost but I have not discussed exactly what that means. What I want to know is ..Is there anyone who can remove these and make it look halfway presentable and desirable. I don`t mind smaller but I am not going to settle for looking undesirable. Honestly I have had a complete change since I was 18 believing I needed bigger breast. I had nice petite pretty breast for my small petite 5`3 105 pd frame but thought I was underdeveloped. It did cure my false self image and I even did some posters when younger. Now I feel big breast make you look matronly when your over 50. I can`t wear tight t-top shirts without looking obscene and just feel ready to go back to my real size. Can this be done and have some satisfactory results. Is anyone skilled enough to accomplish this using my natural tissue.

Answer:

well, I think an MRI is a good idea as I feel that your implants are likely ruptured, I think Kaiser might pay for the removal, but they will not pay for anything to be done to make them look better, that might require new smaller implants and a breast lift, a Kaiser surgeon might be willing to do it but there might be a cash out of pocket charge along with the Kaiser approved issue. JG 4.22.08

Question:

Dr. Garcia, I wrote you back in August 07 about my wife and pleating she had from purse string stitching and you said give it a few months. We are now approaching a year and most pleating has gone but in their place are either stretch marks caused by the purse string stitching are just plain scars and she has a flat place under her left nipple. I read on line that this purse string stitching does not have medical evidence to support its use in plastic surgery and that it often leaves undesirable results such as flat spots under the nipple such as my wife has. Is this method not approved for plastic surgery and is it well known that it results in flat spots and scaring?

Answer:

there are no methods that are approved or not approved, that is left for medications, surgeons learn new teechniques and implement them into their practice but it is up to them. I do not use purse string sutures for all of the reasons you mnetion. These side effects are discussed at our national meetings and surgeons know the risks but they at times feel the benefits of less scars elsewhere outweigh the down sides, I do not. JG 4.18.08

Question:

I had breast reduction and upper and lower abdominal liposuction approximately one year ago. My questions are: why does the lower abdominal area have the overall appearance of linear type depressions surrounded by fat depositions It almost looks like you can visually trace the cannula suction lines which appear depressed while the surrounding tissue is raised?? Is this a normal result? And if do, does it eventually disappear or is there a way of reducing this appearance? Also, on either side of both breasts{armpit side) there remains a fold of tissue. Since the reduction also lifted the breasts, these folds looks very strange. Can this be removed or is this a tendon?? Thank you again for your time and expertise.

Answer:

I am afriad what you are describing is exactly due to what you think. It can happen but is not a normal result. Might need a little more surgery to remove the fat that remains. As to the breast, it is just tissue and can be removed, no tendon in that area. JG 4.7.08

Question:

Hi Dr. Garcia, find your site very informing. Considering having a breast lift with augmentation. What`s the safest amount of cc`s can you use for the implant without putting lift in jeopardy of pulling stitches? My ps said about 300 and I have heard about 350cc`s. They don`t remove any of your breast tissue, just skin? And would only 300cc make much of a difference? (I am between a B and C cup). I am thinking it would just make them a bit more perkier. Thanks

Answer:

there is really no way to answer your question because it varies with tissues and their laxity and skin condition. I do not think 50cc`s will shorten the longevity of a lift but in some small breasted women that can put a large mount of tension on the wound closure.300 cc shoud make a sizable difference in most women, best of luck. JG 3.23.08

Question:

Dr. Garcia, I had an areola reduction about 2.5 weeks ago (I previously had silicone implants--b cup--and a vertical lift). I have internal sutures (purse string?) and also had a few external ones (those have fallen out). This is my problem: now that some of the swelling has gone down, one of my breasts has an indentation around about half of it (from top to side--it creates a shadow and originally I thought it was a bruise). I am not talking about pleating. I do have some pleating, but I expected that. This indentation/depression is about 1/4 inch above the areola incision and is perhaps 1/8th of an inch deep. It looks as though the sutures underneath may be pulled too tight. The result is the indentation (which makes the contour of the top of the breast slope down, then back up at the areola. Have you ever seen this before? Is it possible for the inside sutures to be too tight? Will the sutures relax over time, or will I need to have them cut ? Any info would be greatly appreciated.

Answer:

I have seen that and it does come from the tissue below the skin being folded, in most cases that tends to flatten out in time over a few months though. I do not think the sutures will need to be cut out. JG 3.22.08

Question:

Hi Dr Garcia, I have just had my breast implants replaced after 10 years (silicone). My precious ones were 350cc but had drooped and shrunk. My new ones are 600cc but dont look tat much bigger or firmer.My right one seems less full at the top. I was wondring would it be pos to have a breast lift and keep the same size implants would it affect my new impants?

Answer:

a breast lift is possible and there should be no effect on the breast implant volume. Best of luck. JG 3.8.08

Question:

I wrote to you a couple of years ago about my disappointing breast lift. I have been reading about Dr. Kirwans Autoaugmentation of the breast and can`t seem to find a P.S. anywhere who even knows about them accept Dr. Kirwan, and he is from England and does practice in the U.S. some in New York. Do you know of a P.S. that knows of this new breast lift procedure close to my home in Tennessee?

Answer:

sorry, bt I do not know of anyone here. JG 2.18.08

Question:

is it normal to be told to shower a day and a half after having a mastopexy with breast implants and 2 z-plasty underarm surgeries? i am 4 weeks post-op and the incisions still have some openings, which my surgeon is telling me is normal. i left the o.r. at 4:30 on wed. pm and saw the surgeon per his request fri am in pre-op again, at which time he took the bandages off and told me it was fine to shower. after i got a look at the scars, the anchor scar is an inch above the bottom of my breast, exposing all the old stretch marks, i called the nurse for explanation and she was livid that i had showered, i explained the dr. said i could and she put him on the phone, and he told me once again he said it was fine. i saw him again 7 days post-op for suture removal, but he said he wasn`t going to remove them, they would just fall out on their own. between the misplacement of the anchor scar and the two puss filled openings in the scar line, i am beyond worried and he still says it`s fine. is it time to see another surgeon? does any of this seem normal to you? i think i`m going crazy!

Answer:

really hard for me to say, showering can help get small scabs off and keep the incisions clean, might want to also clean them with a little hydrogen peroxide and apply some neosporin. I think you need to see the doctor again though, this coming week to make sure all is progressing well, best of luck. JG 1.12.08

Question:

i was wondering, for an areola reduction, is it better to have the incisions made around the edge of the areola or at the base of the nipple? which leaves more visible scarring?

Answer:

they both will leave some scars but the amount that can be reduced at the base of the nipple is very small. JG 1.12.08

Question:

Dr. Garcia, My daughter who is 21 wears a 40 H bra size. She is in constant pain, has stretch marks on her breasts and permanant groves in your shoulders form bra straps. I would like to bring her in for an exam, and she has great insurance if you except it. Her quality of life is misrible becasue of the weight and uneven-ness of her breasts. One is much larger than the other. Mostly the size is too much for a young girl to bear. Hoping you can be her doctor and we come see you for consult or will she need a internist referal to come see you. Respectfully, Nancy

Answer:

I am only on HPN at present but it does sound like she should be covered by insurance. If I cannot do it on her insurance I would be happy to look at the list of providers you have and help you select one. JG 1.11.08

Question:

Dr. Garcia, Approx 3 years ago I had BA with a donut redued the aerola. Well it did not turn out very well. Neither match size, shape or level. What is your recommendation? Is it possible to just redo the aeola reduction again and how small is too small?

Answer:

I think areola redcutions, unless quite small are doomed to failure due to anatomy and physics. It will likely take a surgical revision with a vertical incision added to make it longer lasting and more predictable. JG 1.7.08

Question:

i had a mastopexy with breast implants done. i was told the anchor portion of the scar would be under the breast fold, my scar is about 1 1/2 inches from my nipple and atleast an inch above the bottom of my breast. it looks horrific, is there a procedure to fix this? my doctor says it`s because the implant settled, but the implants are submuscular and the scar was there when he saw me about 36 hours post-op. can this be fixed?

Answer:

the only way it can be fixed is to push the implant higher and take the strip of skin out between where it is now and where the fold is. JG 12.28.07

Question:

i had a mastopexy with implants done. i asked for a full c cup, i had a 34 c prior to surgery. my surgeon told me a 325 cc implant would give me a full c cup. two weeks post op, i was just measured for a bra and i`m a 34 b. i look very small compared to prior to the surgery. obviously unhappy, will i fill out down the road? i went submuscular, if not is another surgery my only choice?

Answer:

if the implant was placed under the muscle it can lead to somewhat of a flatter look for a couple of months and you might get a rounder shape in time. If that does not do it, then you will need larger implants. I am unsure how you went form a pre-op 34C cup to a 34B though with a lift and that size implant, not easy to understand. JG 12.28.07

Question:

I have recently had a breast lift with implants and feel like they are still saggy, not to mention one areola is larger than the other. Is this the doctors responsidbility to fix?? I`m really not happy with them.

Answer:

well, I will say that it varies from doctor to doctor about who will pay for the revision. JG 12.16.07

Question:

Hello, I had a breast lift surgery and augmentation. After my surgery i was shocked when my left nipple wasnt centered and it was uneven in width. I called the Dr. about it and he acted as if he couldnt see the problem. It is clearly visible as my husband pointed it out also. He is telling me i would have to pay more money to get this fixed when he cause the problem. My nipples were never uneven beforehand. Is there anything i can do about that? Does he have to fix his problem with no charge? Thanks for any help!

Answer:

well I must say that in most cases the surgeon usually offers to correct such a thing, may just want to speak with the surgeon and see if you guys can work things out. JG 12.11.07

Question:

Thank, you for responding so quickly...so the stiches still being there is not normal? having them removed would usually be simple, my problem is, is there are numerous not just a couple. I can feel them around my entire areola, along the incision line from my areola down to the lower part of my breast up towards my arm pit. There are so many that I feel it would almost be another surgery there`s so many. and when I remove them after they surface they scar horribly. they start out like a little pimple that doesn`t go away and eventually the point of the suture is what surfaces. And like I said before not all the stiches are right at the incision they are over a little. So I don`t know and I don`t know what to do. I started to get little puss pockets on the incision line around my areola and not sure if thats normal either. Sorry to bother you wiht this again but I am starting to get really concerned. Thank you

Answer:

I think if they are getting infected the best way to limit the scarring is to go in, through a relatively long incision and remove all the sutures to avoid the recurrent infections. JG 12.10.07

Question:

Hi, I`m 34yrs old and had a breast reduction when i was 21. The surgery went fine, but since my surgery I continue to this day remove internal stiches that work there way to the surface, and I can still feel some under the surface that have not broke through. Is this normal? and should I have it checked out or is something that I should legally look into. I feel the stiches along the incision lines and close to the incision I just want to know arn`t they supposed to use the stiches that disapear on there own? thank you for your time. Andrea

Answer:

not normal, migth be best to have a small incision made and any ones that remain be removed. They are dissolving sutures in most cases, yes. JG 12.10.07

Question:

What would be the best procedure for a breast lift with implants, for a small person ? Above the muscle or under the muscle ? The implants that I have now are too big for me, they are above the muscle and I feel them under my skin. I will have them replaced by smaller implants and the excess skin will be cut away. What is the recovery time from such an operation ? They will have to cut like a T scar and around the nipples. Thank for respons.

Answer:

I believe under the muscle would be better in the long term in regards to less risk of capsular contracture. I think light duty will be required for at least two weeks and not full duty for 4-6 weeks. JG 12.8.07

Question:

Hi Dr. Pierce, I am a 34 year old woman and would like a breast lift. After having my daughter my breast begin to sag. I would like to know if I have a breast lift will my breast sag if I decide to have more children?

Answer:

unfortunately yes, more children will undo the lift, might want to wait until you are done with child birth. JG 11.18.07

Question:

HELP!!!! Dr., I have had a crescent lift with 450cc silicone implants. However, 6 months later, they still have not dropped like Dr. said they should have, have encapsulated and the nipples are still too low and aereola way too big. Another surgeon whom I initially wanted to go to but didn`t (for the sake of saving some $$) said I should have had a full mastopexy lollipop lift in order to get my nipples in the middle and reduce the aereola size. I literally had to tell MY PS this and he said he would do the revisions the way I suggested. Now i am faced with trusting him to do this the right way or paying the other Dr., whom I trust, more money to do this procedure right. This is my first surgery ever and I never thought I`d be facing such a difficult decision. I`m 41 and just wanted my poor sagging small breasts to look good again! My husband says we can`t afford another surgery from the new Dr. whom I trust more. I`m afraid to go back to my first DR. and don`t trust him to do a good job. What do I do?? I`m sorry if this sounds complicated but it truly is! Although I had this surgery done in CA I am still seeking another opinion. Your site and your expertise seem quite credible.

Answer:

well, tough position, I think ask to look at pictures of the proposed surgery the original doctor has done to see those results of the new revision procedure, sorry. JG 11.4.07

Question:

Thank you for th answers below, is replacing the capsule a better way of preventing the hardening from taking place as opposed to just cleaning out the scar tissue or is this the same thing? The reason I ask is my doctor wants to completely rplac th capsule(if I am saying this correctly). This is why he wants to use drains. Most of the doctors I spoke to did not mention this. They did not feel they would need to do anything other than an open capsulectomy with implant exchange and lift. Only one said if he needed to replace th capsule he would know when he did the surgery. The doctor I have chosen is suppose to be very meticulous, but I am concerned no one esle seemed to be mention this as a definate procedure. What do you think? Let me rephrase my question-Are drains normally needed after an open capsulectomy and breast implant exchange with breast lift. I had the implants for 18 years and thy have startd to harded pretty much. Answer: only if there is a lot of bleeding during the surgery. JG 10.31.07 Dr. Garcia, I have had my implants for 18 years, I need a breast lift and the implants have started to harded, mostly felt when I m standing up or sitting as opposed to laying dowm. I spoken with several doctors who have not mentioned needing drains after this surgery. One doctor feels I should have drains. Can you tell me is this really necessary. My implants are behind submuscular and are silicone. Answer: I only put them in when there is a lot of bleeding during the surgery, but not always, it varies from patient to patient. Putting in the drains helps remove any residual blood that could potentially cause the capsular contracture to return sooner. JG 10.31.07

Answer:

there is no way to replace a capsule, it is either removed during a capsulectomy or just cut and stretched in a capsulotomy. The chances of needing a drain are higehr if you remove the capsule rather than when you just cut the capsule. I think after an open capsulectomy there is a 50-50 chance of a drain. JG 11.1.07

Question:

Let me rephrase my question-Are drains normally needed after an open capsulectomy and breast implant exchange with breast lift. I had the implants for 18 years and thy have startd to harded pretty much.

Answer:

only if there is a lot of bleeding during the surgery. JG 10.31.07

Question:

Dr. Garcia, I have had my implants for 18 years, I need a breast lift and the implants have started to harded, mostly felt when I m standing up or sitting as opposed to laying dowm. I spoken with several doctors who have not mentioned needing drains after this surgery. One doctor feels I should have drains. Can you tell me is this really necessary. My implants are behind submuscular and are silicone.

Answer:

I only put them in when there is a lot of bleeding during the surgery, but not always, it varies from patient to patient. Putting in the drains helps remove any residual blood that could potentially cause the capsular contracture to return sooner. JG 10.31.07

Question:

I`m 19 and my breast have always been large. There starting to sag and my left breast is slightly larger than the right. I`m considering having a lift and an areolar reduction. I do plan on having kids in the future. Is this a bad idea because of my age and possibly becoming pregnant in a few years?

Answer:

well, you need to understand that the lift will need to be re-done once you are done having children and there is a chance you might not be able to breast feed. JG 10.30.07

Question:

My breast reduction/Tummy tuck was 6wks ago. I went from a D cup to a B cup size, my problem now is that my right breast has a hard lump or scar tissue build up my MD says to massage it and it will go away but it hurts to massage it. Is there something else I can do. Also the incision under my breast have this puckering in the incisions on the end under my arm and also at the top. I was given paper tape to help smooth them out, is there something else I could be doing? Same thing is happening at the ends of my tummy tuck incision on my hips ( the puckering thing) it also looks puffy on each end but seems to be fine in the middle, above my belly button is puffy too????

Answer:

warm packs or a heeating pad will help, but mostly it is a matter of time. The puckering is not unsual and will stretch and flatten in time also. I personally have never found the tape to do much. JG 10.23.07

Question:

I gave birth on August 14 of this year and have been wanting to get a breast reduction. I went to a surgeon, Dr. Cambeiro for a consultation and he said that it is disastrous to have the reduction done when I am still lactating. Is this true? I am not breastfeeding and am almost completely dry, is it okay to go ahead and get the breast procedure done? How much do you charge for the breast reduction and does it include the lift as well? I`ve researched and found a doctor who uses laser techniques for breast reduction and the laser bra. I am also a wondering what incision technique is best, a full anchor incision or lollipop incision who needs to go down from a DD to a medium C. What do you think of these methods? Thanks!

Answer:

I prefer to wait for no breast milk for at least three months due to high chance of infection. All breast reduction include a lift by definition. As to the incisions, it all depends on how much tissue and skin is removed, no way to tell what you would neeed and the fees will depend on time required so it is hard for me to tell without examining you. JG 10.23.07

Question:

Hello Dr Garcia, My question is regarding my left breast and nipple which are both significantly larger than the right breast. I have consulted with a top London hospital plastic surgeon who says he can offer some improvement as he recommends a reduction/lift from underneath the breast as well as some improvement in the size of the nipple. He has asked me to get a bra to fit the left side perfectly, and to fill a stocking with rice and tuck it under the right breast to even the cups. This way he will know how many ounces of flesh will need to be removed. Please let me know if this is an unconventional request. Of course I don`t mind doing this if it seems reasonable, however I feel quite responsible for the outcome- and it`s rather unsettling. Many thanks

Answer:

no, it is actually a good way to estiamte it, best of luck. JG 10.10.07

Question:

I talked with you about mastopexy autoaugmentation and you said problems with capsular contracure and ripples, the autoaugmentation is using my own tissue and not implants,implants would be used if I decided not to use my tissue, which is a better option implants or my own tissue. Also what are the complications and problems that can occur using my own tissue. Thanks!

Answer:

if there is enough of your own tissue that would be best. The complications from your own tissue would be if it is moved and it does not have adequate blood supply it will not survive. JG 10.5.07

Question:

Is there a way to reduce the areola size without horrible scars? Mine are big and I would like smaller ones, but don`t want it to look bad, does that always leave noticeable scars to minimize aerolas?

Answer:

the scars from an areolar reduction can be unsightly, the greater the reduction the wider the scars can be. JG 10.3.07

Question:

I had a breast mastoplexy done about 6 months ago. My nipples are too high on my chest and are often visible outside my bra! My surgeon measured and informed me that my nipples were 4cm too high on one side and 6 cm on the other. She recommends another surgery to correct it by removing more skin under the nipple. How does this procedure pull the nipple down and how effective is it? I can`t find any information on-line and don`t want to have another unsuccesful surgery. Please advise!!

Answer:

I cannot say that a skin excision below the areola will move the nipple to a position less visible in a bra I am afraid. It might place the nipple more centrally over the mound and that is about all I would guess it could do. JG 10.3.07

Question:

hello i am 37 years old and had a breastlift and silicone implants done on 09/19/2007 the stiches are healing great but i have a lot of pain in my breasts a feeling of tightness and a very heavy feeling like rocks is that feeling normal? will it ever go away? all i can do is cry every day wishing i never did this can i do anything to make this go away?if i sit still it doesn`t hurt or feel as heavy but as soon as i move even the slightest oh my god,i go to bed can`t sleep and when i get out of the feeling is un real i am sleeping straight up i can`t imagine laying all the way down and it`s not that i got big implants.please help me all i want to do is have them taken out.is it the implants or the lift causing me this feeling?

Answer:

al normal and all should go away in time. It just takes time. JG 10.2.07

Question:

I wrote you on having mastopexy autoaugmentation in 2/08, and you said most likey to have sagging breasts and visible ripples how soon and how visible are the ripples, also what is capsular contracure? Or would you have a lift, then in 3mths have small implants put in instead of autoaugmentation? Thanks!

Answer:

capsular contracture is when the breast implants feel hard and ripples usually start showing after 6-12 months, once the swelling has gone down, but they get progressively worse as the skin stretches.I think doing the implants later is a better option but it does not prevent all of the issues that can occur, but it does yield the best scars and the best size selection for the implant. JG 10.2.07

Question:

Thank you for your response regarding my lift and possible revision. One last question, do you think it is wise to go through with the second surgery? Will it increase the time that the lift will hold because there will be less skin? I have already invested a good amount of money and want the best result but fear a second surgery with potential for the same outcome. My implants are not large (250cc) because of the loss of elasticity so I don`t think size is the main concern but rather my skin tone. Again, thank you for your time.

Answer:

I do not think it will ultimately make the surgery last longer but you will be looking better, so your starting point will be a better appearance after the revision, so I think it is likely worth it. Best of luck. JG 10.1.07

Question:

I am 5 months post an anchor style breast lift with silicone implants placed submuscularly. My PS has now recommended that I undergo a touch up (another anchor style lift) to increase the volume on the top of my breasts since they have fallen a little lower than expected. I am wondering why he wasn`t able to tighten my skin enough during my first surgery? Also, if I do not have great elasticity, won`t this happen again even after another lift? Thanks for any input you can provide.

Answer:

well, the answer in a nutshell, is you are correct, tissue will fall again in time and things will need to be touched up. In general, breast lifts last 5-10 years and less when implants are placed as that adds to the weight and gravity therefore will pull on the tissues more. As to why it was not pulled and tucked tighter the first time, we are faced with a decision at that time to be able to close the incisions with little tension so they heal well. If things are closed too tightly the scars can spread, so we tend to be conservative. I will admit that many times I will do them as seperate procedures and not do them together so I can be more aggresssive with the skin removal, so I commonly do the lift first and then follow up months later with the augmentation. JG 10.1.07

Question:

I`m planning on having mastopexy autoaugmentation, and I used to smoke, I quit 9 wks ago and I`ve had gastric bypass last March, I plan to have the surgery in 2/08, what are the likely problems I will run into. Will the flap they use to build the breast, will it die and what about infection and necrosis. I had a circumferential tummy tuck 9 wks ago and I got an infection and necrosis, also is there a website I can go to see photos of this and see more the complications from? I couldn`t find much on the internet. Thanks

Answer:

likely problem are recurrent sagging of the breasts and visible ripples, capsular contracture rate is likely around 25%. Infections and necrosis are rare. I am not sure of a website where the complications can be seen though. Best of luck. JG 10.1.07

Question:

hi Dr. Garcia I have 375cc`s breast implants and I feel that they are too big I am thinking of having revision surgery and exchanging for 300cc`s but am worried that I will need a breast lift, if I do I won`t exchange them. Do you think I will need a lift if I have only had them in 6 months?

Answer:

well a 75 cc will make some difference but likely not enough to need a lift, there will be less fullness of the upper breast though. JG 9.23.07

Question:

I plan to have a mastopexy autoaugmentation, where do they make the incisions, and is it a big incision? Also is there something else besides tape they can put on you after surgery for support? The reason I ask is when I had my tummy tuck the tape left scars above my incisions, and I don`t want any additional scarring on my breasts. Thanks!

Answer:

there will be scars entirely arond the areola and then besides that it will depend on how much skin needs to be removed, the greater the amount of skin is required to be removed the longer they will be, usually they are in a vertical fashion at the 6 o`clock position of the areola and then can extend into the crease of the breast inferiorly. We use a bra after the surgery for support and try to avoid tape. JG 9.21.07

Question:

I am 4 1/2 months post a full, anchor style breast lift with 250cc smooth silicone implants placed submuscularly. Upon consultation, I was a small C with grade 2-3 ptosis. After surgery I am a full C/small D and now PS is recommending a touch up to raise my breast a bit higher. I do feel that they have settled a bit lower than I expected but was also originally told that I carry low on my chest naturally. Is the risk of the surgery worth the benefit and will the skin just stretch out again anyway? Also does this effect the implant position...will my breast be higher than the implant? Thanks for any input you can offer.

Answer:

I would only do it if it bothers you. Ideally the breast tissue should be directly in front of your implant. JG 9.20.07

Question:

I am 3 weeks PO. I am having alot of itching which my PS says is caused by the chemical in the body that is discharged in the healing process. I have been taking Benadryl for the itching which PS said was okay. The only problem I have, is I cannot take Benadryl at work because it is putting me to sleep. Is there something else I could take that would not make me drowsy? Cheryl

Answer:

could try some Daytime Actifed or Alavert. JG 9.16.07

Question:

On breast lifts, is the amount you pay which I think I asked before and it was between $3,000 and up.. i dont remember but is that all you pay? Or is there other fees and such?

Answer:

I would need to see you but breast lifts cost much more than that, it depends on time too. JG 9.16.07

Question:

HI DR GARCIA, WOULD A PERSON THAT HAD OPEN HEART SURGERY IN 2002 & IS DIABETIC BE ELIGIBLE FOR A BREAST REDUCTION & BREAST LIFT

Answer:

as long as the diabetes is under control and the heart has no problems, yes. JG 9.16.07

Question:

I had a breast lift a week ago and have a severe amount of itching around the area that the stitches were. My doctor went ahead after 6 days and removed the stitches and covered the area with the new skin. I am still itching. I have tried benadryl, hydrocortisone cream and nothing is helping. What would you suggest? The incision looks good and there is no pain. I have also noticed the nipples being very overly sensative. Will it stay this way or gradually go back to the way it was before.

Answer:

could try some Atarax. JG 9.6.07

Question:

I had a breast lift with Moderate + Profile gels and reefing on the muscles under my arm pits. The implants are under the muscle, the left breast is great, but the right one is very lopsided, droopy and under my armpit, even while standing. Is it possible that the stitches did not take or was the lift not done correctly?

Answer:

I think in many cases the reefing sutures do not hold strongly enough. JG 9.4.07

Question:

I recently went to a local PS in Las Vegas who diagnosed me with Tubuler Breasts. I went in for a consultation for breast enlargement and he said he would have to remove the nipple and move it up by an areaola incision and also go above the muscle with the implant. He said if he went below the muscle I would still have tubulous breasts. This concerns me because I am afraid of bottoming out. Is the information I received correct? Also, I have a weight problem and I lose and gain all the time, will this affect my results? The doctor told me this would not affect my results?! Also, I have never been pregnant but in the future I plan to, will this affect my results also?

Answer:

well pregnanacy in the future should not be affected, if your breasts do not change in size with weight loss and gain then they should not change after the augmentation is healed. In terms of a tuberous breast, an implant can be palced below the muscle but there needs to be also direct a incision of the breast gland to allow it to splay and widen, the splaying is aided by the pressure from the breast implant and the pressure applied is greater when placed above rather than below the muscle. Moving the nipple is only needed if the nipple is too low on the chest. Bottoming out is slightly more common with breast augmentation above the muscle but can happen with below the muscle augementation too. Best of luck. JG 9.2.07

Question:

Dr. Garcia - I am interested in a mini-tummy tuck, however my friends and family tell me that you have to be over weight in order to have this done is this true? I am 5ft 6in and weigh about 135lbs. I just have that little pouch I want gone. Thank you for your time. Also is there a fee for a consultation. I am interested in a breast reduction and lift as well.

Answer:

actually, the opposite, it is better if someone is their ideal body weight. The fee for the consultation is $50 and is applied toward the surgery. The breast surgery could likely be done at the same time to save money and recovery time too. JG 8.29.07

Question:

JG 8.20.07I recently had a breast reduction and was curious if I needed to keep them compressed closer to my chest than just a regular cotton bra the dr. gave me, I also try to have a longer bra as to not go under where there anchor scar is. I had a tummy tuck as well andwonder what type of scar medicine to use to accelerate the healing and scaring. All in all the surgery looks good for just a weeks time, and the Dr. put a heart shaped belly button is that the most attractive kind I told him i did`nt want some weird one i always think thats the worst on a tummy tuck that and a crucide line across thae tuck. thank you for your opinion. Tracy

Answer:

the regular bra is all you need. As to the scars we use ScarGuard or Mederma. JG 8.20.07

Question:

i had a breastlift with silcone implantsJuly 14 my doctor never told me to massage them. Is it neccessary to? Also, i feel like there is a knot and it causes me pain three weeks later.i went to the doctor and he told me they look fine you probably pull something. is there anything to do to make it feel better(massage,heat)It hurts to walk.He told me take aspirin there is nothing you can do nor did he tell me when it will go away.

Answer:

I think massage in some people helps but not needed all of the time. As to the pain I think Motrin and warm packs should help. JG 8.20.07

Question:

Dr. Garcia, my wife had a Lollipop mastopexy three months ago. Immediately after surgery she had horrible looking skin rolls extending up and down the vertical incision under both breast. The PS basically made no comment when quwstioned about them. They have smoothed some but are still prominent. I understand these are skin rolls and are extra skin which should resolve, but I have not seen any before and after pics that are as prominent as my wife has on her breast. Are these normal and are they likely to resolve? How long to resolve?

Answer:

yes, they can look disturbing, that is one of the pay offs for the lollipop lift to avoid the horizontal incision which heals the least well of all. As the breast tissues settle the little pleats do smooth out but it can take a long time, 6 months or more, just have to hang in there for a bit. JG 8.13.07

Question:

Hi I currently have partial saline implants and planning a re-do to go under the muscle with silicone and a benelli lift. One Dr will do it all at once and another wants me to take them out wait 3 months for things to heal up then do the procedure. Am i at any added risk to do it all at once for dead tissue, would it be best to do it with taking them out for 3 months?? Please help!

Answer:

I think there are added risks to do it all at onece, things like poor blood supply to the nopple and also affects on nipple sensation, and amount of breast tissue rearrrangement. It might be best to do it in stages. JG 8.12.07

Question:

Dr. Garcia, Is a breast lift only repositioning of the nipples, Or are the breasts actually lifted?

Answer:

it invovles also lifting the breast tissue along with the nipple both. JG 8.10.07

Question:

in your practice, could a breast lift, tummy tuck, face and neck lift be done all at once? does combining procedures save costs on anesthesia, anything else? is it necessary to wait for skin lasers after such procedures? Thanks

Answer:

it does have cost savings but the length of anesthesia also for elective procedures increase risks so we try not to do so many things at the same time. We normally wait at least 6 weeks after the face procedure for the laser unless it is being done on an area of skin that was not lifted. JG 8.10.07

Question:

Hi Dr. Garcia,you were highly recomended by one of your patients. I had breast cancer last year and had a lumpectomy. Now my breast looks deformed and they are uneven. I visited the plastic surgeon in my plan and he said I have too much scar tissue and there was nothing he could do. Is he right? I am a 37 year old single mother and hope to start dating again. What is your advice?

Answer:

well there are a number of reconstuctive options after a lumpectomy. Scar tissue always ensues after that type of surgery and that can make the reconstruction more challenging but not impossible. I think the most important thing is to have is realistic expectations. Can we make it better, probably, can we make it perfect like what you used to have, not likely. An in person consultation might be able to shed more light on what the options might be in youe case. Please feel free to call us and we can see you for a consultation. JG 8.9.07

Question:

Hi Dr. I had a full breast lift with 300cc gel implants under the muscle they are settling off to the side witch is stretching out that skin. My PS said that he could go in and do a pocket revision and make it smaller and pull the skin tigther.He said because I went under the muscle that the implant settled there and with my age my skin stretched out faster Im 46 is this true? And said there would be a charge to do the pocket revision would you charge your patients for this to and how much ? Another thing I still fill mussy Like the only thing the lift did is bring me up I thought that with the implants I would be alot firmmer not so mussy was I expecting to much Im not happy with them PLEASE give me some advise.

Answer:

well all of that could have bene predicted and the pocket could have been made smaller to begin with. I typically do not charge my pateints in those types of scenarios. The mushyness depends on the firmness within your breast and at times is not changed with a lift. JG 8.4.07

Question:

IS THERE A SAFE AND EFFECTIVE WAY TO REMOVE MONTGOMERY BUMPS AROUND THE NIPPLE AREA ON THE BREAST AND STILL HAVE IT LOOK NATURAL ?

Answer:

would have to cut them out and leave a scar. JG 8.3.07

Question:

Hi, I`m nineteen years old and I`ve had sagging breasts with extremely large areolas since puberty. I`m considering getting a breast lift with an areola reduction, but I`m hesistant since I do plan on having children at some point. What`s my best option?

Answer:

I think if it bothers you alot at this time you should go ahead with the surgery but understand you will need to have it redone later after the baby. JG 7.11.07

Question:

I have had 2 children and I had my implants/lift 4 years ago. If I have another child would I need them redone?? I do not breastfeed and mine were put under the muscle. I was wondering if I didn`t breastfed if my breasts would go right back into place.

Answer:

most likely another child will force a re-do. JG 7.11.07

Question:

Gracias por su respuesta anterior.....pero tengo otra pregunta, cuanto tiempo tengo que esperar si quiero hacerme otra ciruguia para levantar mis cenos un poco mas..y si los implantes que me pusieron en la ciruguia de hace 3 semanas que son de 300cc pero los llenaron hasta 330cc , se pueden volver a implantar en la nueva ciruguia ?

Answer:

espere por lo menos tres meces. Se puede usar el mismo implante tambien. JG 7.11.07

Question:

Hola....hace 3 semanas tube una ciruguia de lift and implant con la tecnica around the niple, el problema es que mi busto se sigue mirando caido, un poco menos pero yo lo sigo mirando caido, ....y tengo la sospecha que mi doctor solamente metio el implante y no corto la piel extra alrededor del niple....yo le pedi una copia de mi expediente por que quiero saber exactamente que fue lo que me hizo y pedir una segunda opinion con otro doctor antes de hacer otros procedimientos.....como puedo saber si el enrealidad me hizo el lift, o solamente me puso los implantes?

Answer:

le tengo que decir que el levantamiento del ceno por una cortada alrededor del pezon la verdad que no levanta mucho, para eso se necesita una cortada alli y tambien en una linea vertical para cortar la piel y ajustar el tejido. JG 7.10.07

Question:

Hi Dr. Garcia, My question is since 1993, I have had breast implants, I`ve heard you should have them replaced every ten years, also since i`ve gotten them done I have had a child and just a little older, they have dropped quit abit, I am wondering if someone in my perdicament should consider a lift along with new implants, and around what price range would something like this be. I am a little nervious, about replacement of implants.

Answer:

a lift and a replacement can be done together, the fees vary from surgeon to surgeon though so you need to decide on a surgeon and then probabaly see them in person so they can determine the time and what exactly will be needed so the fees can be decided. JG 7.7.07

Question:

Hi dr. Garcia, yes I believe I will need that crease lift, when I said I want to go down about 250cc I ment decrease down so I still am looking at about 400 for the new implant, but I still will need that extra lift so the nipple is in the right place. Do you think about 400 or 425 is a good amount and how will the pocket that I have now work with a smaller implant? Will the pocket need to be made smaller? Thank you and see you soon

Answer:

I misunderstood, I thought you wanted a 250 cc implant. I think you will need less of a crease lift with the 400cc+ than with the 250cc implant. When the crease is lifted the pocket will be, by definition, be made samller and the implant will be fine in the new smaller pocket. JG 7.7.07

Question:

Hi dr. it is Christine again, and I am sure that I will need some kind of a lift so my aerola is not at the top of the breast. I do not want to make the same mistake twice and have to go under again so if need be I will go through the lift again cause I want to go down about 250cc so a crease lift might be needed along with moving the aerola down, I know this is alot but I can handle it cause I don`t want to be in this position again. Thank so much hope you understand my thoughts.

Answer:

I totally understand, if you are going to decrease the implant size to 250 from 700 instead of the 475 then the horizontal skin excision will need to be done, but that is not a big deal to do simultaneously. JG 7.7.07

Question:

Hi Dr. Garcia, thanks for listening to me today and understanding, I just really am concerned with the aerola/nipple that it will be unaturally high after we put the smaller implants in, I am scared that they will be high if I don`t oppt. for a reverse crescent of the nipple area and might have to tighten the crease area so this won`t happen. I understand that they will not be as firm and I accept that I just can`t have my nipples at the top of my breasts I will be a mess and I don`t need any more worries. LoL. Thank you aganin, Christine

Answer:

well the nipple might be too high if the mound of the breast implant is made smaller, but a reverse crescent on the areola will likley only distort the areola into a comma shape. If anything what might be required is more skin removed at the horizontal extent of the breast lift to push your breast tissue up along with the implant to position it higher behind the nipple location at present. That can be done all at the same time. JG 7.7.07

Question:

Ok another question. I was asking if a reduction or lift would be better cause I was wondering if the lift would have good results since my breasts are 40 C which isnt exactly small, yeah know? So I was just wondering if one would have better results. Im not exaclty sure If I want them smaller,just lifted and where their suppose to be since I am only 18! And to pay for the surgery, is there like a payment plan? Thankyou Dr. I really appreciate your answers.

Answer:

we use some financing companies for pateints and the larger the breast are, the shorter time the lift will last. JG 7.6.07

Question:

Ok I want to ask your advice Dr. I have 40 C breasts and they sag and I`m only 18. I really want to fix this problem because I am so embarassed and self concious. So I am wondering what would be better a breast reduction, or lift?

Answer:

well a reduction will lift them but you only need a reduction if you want them smaller, so you will have to decide that. JG 7.5.07

Question:

I had a breast lift done with implants in Argentina In December. The doctor that operated on me is supposed to be one of the best Dr. in the city. He operated 2 days before I was scheduled to fly back to the states. Well lets make it short no dr would take the stiches out my left breast started leaking and the stiches opened. I went to the ER bc no other dr would see me the leaking stopped for about 3 mths. It has started up again it leaks yellow. Could this be an infection. It is coming from the bottom left where my stiches are. its a little hole that leaks. I doesnt hurt at all. Should I be scared.

Answer:

no need to be scared but it is probably a low grade infection around the implant. If it stops you are at high risk of a capsular contracture and if it continues to drain it might set up an infection bad enough that the implant may need to be removed. JG 6.27.07

Question:

hello again, i just posted a question and forgot something. Also, after the lift with the implant, because of the opening with the stiches i do not wear a bra at night to let air hit the opening, is this ok?

Answer:

yes, OK. JG 6.15.07

Question:

Dr. Garcia: I just had a breast lift with an implant 3 weeks ago. My right breast is slightly but noticably larger and in two areas around my nipple where the stiches are (which are disolvable) they opened about 3/4 of an inch in lengh and 1/2 inch in width. My doctor said this is fine and that in about 10 days the opening will grow new skin and heal on its own without placing another stich, is this true? and will my breasts eventually even out? thank you for your time.

Answer:

I think most likely what he has said is true. JG 6.15.07

Question:

I had a lollipop breast lift and aug. on May 3rd. Today is June 13th. My breasts are sagging fast, in my opinion. I went back last week for my 4-5 week check-up and my doctor told me that it takes 6 months for saline implants to settle, so if I want high, full breasts, I need to wrap them with an ace bandage to where I want them for 6 months, instead of just wearing a sports bra. Is this true? I wasn`t told this before surgery and I don`t know anyone else who had to do this. I got Mentor, smooth, round, moderate profile silicone unders. They are 350CCs. Left is filled to 350, right is filled to 400. My main concern is that my doctor just didn`t lift them high enough. Also, the left one is still biggger. She even said that in another month, she may have another doctor (she`s closing her practive and moving to FL.) pinch a little more skin out of the bottom of it. Does this sound normal? I was under the impression that you do the lift and get the aug, wait about a month, then you can wear whatever bra is comfortable. She also told me that I need to wear 3 sports bras when I work out. I am wondering if she is just covereing b/c she didn`t do enough of a lift on me. Thanks!

Answer:

I do not think the wrapping will keep them up. I think it might be that you do need more skin removed and breast tissue tightening I am afraid. JG 6.15.07

Question:

I RECENTLY INQUIRED WITH 2 PLASTIC SURGEONS ABOUT A BREAST ENLARGMENT AND BOTH SUGGESTED I NEEDED A MINI LIFT. AS A 25 YEAR OLD WHO HAS HAD NO CHILDREN AND IS A 36B AND WAS PLANNING TO GO A SMALL D I DONT FEEL I AM A CANIDATE. I DONT KNOW IF I MADE THE MISTAKE AND BROGHT IT TO THIER ATTENTION OR WOULD THEY HAVE SUGGESTED IT ANYWAY. THEY BOTH MEASURED ME AND BOTH SAID I WAS BORDERLINE. SO MY QUESTION IS IF I GOT THE BREAST ENLARGMENT WOULDNT THAT LIFT ME WITHOUT HAVING TO GET THE MINI LIFT?

Answer:

the brerast augmentation will give you a short term illusion of a lift but will eventually leave you larger and saggier. JG 2.25.07

Question:

sorry, me again..had breast aug 220cc above muscle 6 years ago, since had 2 babies, the skin is slightly loose, slight contracture, palpable implants) i previously asked about what i should do with regards to having them placed partially under the muscle, you suggested a small lift,what type of lift do you usually use in these circumstances, is it the full lollipop one?

Answer:

all depends on how loose the skin is but a lollipop with a short or long stem most likely will be needed. JG 2.20.07

Question:

hello Dr. Garcia, I has a breast reduction in June 06. Eight months later, I am still slighty tender. It is now past time to get a mamogram. Is there a safe timeframe to have a mamogram done following a breast reduction?

Answer:

should be safe and some tenderness can last for up to one year. JG 2.10.07

Question:

Hi Dr. G, Again thank you for your time, it is very sweet of you to answer all of these questions. My question is regarding a breast lift. I DO NOT want any implants put in. I just want my breast to be up where they were before I had my two boys. I was happily able to breast feed them both. I was wondering if you can use tissue under the axillary for extra roundness to the breast once they are lifted up.I was a C cup before and now I am a B cup. Also where is the incision and how does this effect the nipples? What is the approximate cost? What is the recovery time and how soon can I start running again? Thank you very much! LL

Answer:

at times the tissue from the axilla can be rotated into place but not always. If you are a B cup now, a lift alone can certainly be done but you will end up a B cup still. As to the nipples, in rare cases there can be some sensation loss and there will need to be a scar all the way around the nipple too. Cost varies from surgeon to surgeon and recovery is light activity for two weeks and most patients are back to normal in one month. Running is OK after 3-4 weeks, but it will accelerate the sagging of your breasts. Best of luck. JG 11.27.06

Question:

What are your feelings on the potential risks of a medial thigh lift vs. the benefits? I lost 20 pounds and now my thighs are soft and floppy. Thanks...

Answer:

good results but long scars and slow healing. JG 11.24.06

Question:

I had a breast reduction April 19,2005 and I am very dissapointed with my results. My plastic surgeon tried something he had never tried before. I found this out on my first postop visit. He raised my incision site up about 2 inches fron the crease and under the nipple he raised it another inch or so. On my operative report he had a bilateral breast reduction. Have you ever heard of it done that way? I had a 2nd opinion from another plastic surgeon and he said he would have to totally redo it to correct it and that I would need an anchor reduction.

Answer:

I am not really sure what the surgeon did but I suggest getting a copy of the operative report for the next surgeon to be sure what was done so no bridges are burnt. Best of luck. JG 11.20.06

Question:

Dr. about 6 months ago I had a full breast lift with dissolvable sutures. How long do these usually take to dissolve completely? Every once in a while I feel a strong itching/pain around the area of the incisions, especially the breast crease, then it will be sore a couple of days then disappear. Any thoughts???

Answer:

usually three months. The discomfort is probabaly the scar tisue stretching and relaxing. JG 11.19.06

Question:

PLEASE GIVE ME A BALL PARK QUOTE ON BREAST ENLARGEMENT. AFTER A CHILD AND NURSING AND PUSHING 40. . .I NEED A BIT OF MAINTENANCE. IN MY AREA THE GOING RATES ARE OVER $5000. I HAVE A TRIP PLANNED FOR 07 TO VEGAS. I MAY BE INTERESTED IN HAVING THE PROCEDURE DONE THERE IS THE FEE`S ARE MUCH MORE REASONABLE. THANK YOU. YVONNE MILLER

Answer:

$4500-$7900. JG 11.9.06

Question:

OOps wanted to say ultra sound. At least i think that what he said concerning lumps in breast after a breast reduction

Answer:

ultrarsound or sonogram are the smae thing, it is a test to see if a mass is solid or fluid filled. JG 11.4.06

Question:

Got a breast reduction 4 month ago. All looks well, but have some lumps in the left breast. Doctor said if they are not gone by the new year then sonogram .What will that do ? Been massaging them . Yet unable to break up the lumps.Will they go away by them self in time ?

Answer:

it will determine if they are solid and need to be watched or cut out versus filled with fluid which then can be aspirated with a needle. Most times they go away but it can take a year or more. JG 11.4.06

Question:

Hi Dr. Garcia, i`ve read that you don`t recommend any biogel or any gel for use as fillers in any part of the body. How about Collagen injections for the buttocks & breast enlargement? I see people in Asia getting Collagen injections for the both breast & buttocks and it went out fine. I see people here in the US getting collagen injections for lips, how come nobody gets it for breast enlargement? if you don`t recommend it, why wouldn`t you?

Answer:

they do not get collagen injection here for the breasts becasue of the cost , for exaple a 300 cc volume per breast woudl cost $6000 per breast and would not be permanent, and the short time it lasts, I am sure the product they are injecting outside of the US that is being told that is collagen is not the collagen we use here. JG 10.24.06

Question:

how much would it cost to get a breast lift?

Answer:

it greatly depends on time involved so I would need to see you to give you a final quote but it can range from $7500-$9500. JG 10.18.06

Question:

My breast have great skin and are normal how much would it cost for a breast lift?

Answer:

it greatly depends on time involved so I would need to see you to give you a final quote but it can range from $7500-$9500. JG 10.18.06

Question:

dr, why do some people`s scar hyperpigmented and others don`t? does it have to do with age? the scars from my breast reduction and lift stayed white and they blend in very well with my skin, you cannot tell there is a scar, there is almost anything there unless you are really looking for it.

Answer:

it is due to the type of skin they have, it is determined by genetics and it can vary in the same person from one area to another. JG 10.18.06

Question:

I am about 2 weeks post op I am very ill with fever The doctor put me on antibiotics, Now both my breast feel infected the nipples are sore red with yellow pus they feel very heavy the hurt so much I had a lift with saline implant what happens in a case like ths plase help!!! Do they redo the surgery ? He went under the nipple Will they be ok after a second surgery, I am looking for your opion please thank you.

Answer:

well I would finish the antibiotics and hopefully the implants do not get infected, I think you need to wait and see, as to what will happen with more surgery it all depends on how it heals this go round. JG 10.16.06

Question:

DR.Garcia ,i had a breast lift and breast implant 5 weeks ago,i was a 34 dd with implant, then had surgery with a 350 implant with a lift under the muslus,i hate the size that it is it is still big , how long do i have to wait to redo my surgery to a smaller size,and how long until i see result from swelling please help

Answer:

well the sooner you do it the better because the longer you wait the more stretching the skin will do and if you go smaller you might need more skin to be removed. JG 10.13.06

Question:

What do you recommend for reducing scars after breast reduction?

Answer:

Medema or ScarGurad.JG 10.10.06

Question:

i had a breast lift 5 weeks ago with breast implant 350cc , my breast is big ,could i just get a smaller implant ,because my breast is too big ,i wanted to be a d cup,but it look like i am dd cup, when is it best for me to get a smaller implant and do i have to get another lift so i want have extra skin after putting a smaller implant,please tell me what too do ,

Answer:

well a smaller implant is possible but you just had a big surgery and it will take a little more itme for all of the swelling to go down. If you reduce the size of the implant, it is just one of those things that the smaller you go the saggier you wil be, so a large decrease may require a repeat lift where a small decrease will just lose the fullness up top. JG 10.8.06

Question:

I have lost 120 lbs with gastric bypass over 3 years ago but breastfed for two years. Weight loss made me go from full DD to D and now my breasts are sad and in need of being perkier and firmer. Dr. recommends only lollipop lift since I have a lot of breast tissue but I want a fuller feeling up top and am thinking that an implant would help to create that fullness more than just a lift. Is it crazy or unheardof to want to go from D to DD and wouldn`t an implant combined with a lift give me a longer lasting look?

Answer:

Firstly, congratulations on the weight loss, that is terrific. As to the breasts,well, implants can at times give more upper pole fullness but in time the breast tissue will drop again and one of two things will have happened, the implant will have sagged with the breast tissue actually making the sagging come faster due to increase weight of the breast, or the implant will stay high and the breast tissue will drop and then you will look a little out of kilter. I will also say that tissue intergrity in massive weight loss patients such as yourself is not the greatest so surgical results may not last as long in you as in in other patients. All the best. JG 10.5.06

Question:

Hiya Dr. My question is i had breast reduction and lift a little over a year ago, I`m due for a mamogram, is it okay to do it?, no chances of incisions opening? those machines can squeezzeee the boobs to death ya know.

Answer:

nope, OK to proceed, and yes, OUCH! JG 10.5.06

Question:

Dr.Garcia thank you for answering my questions. I am 15 days post op removal ruptured (leaked into breast tissue)silicone implants, breast lift and implants Mentor 350-1610 125 + 25 implant. My breast have a flat wide look. Is there anyway to make them not look this way? Could the shape be coming from the sports bra that I am wearing? Should I expect that I am still swollen and that my breast will get smaller? Thanks again....you give great answers

Answer:

that all should get more shape as the swelling goes down and the tissues soften, hang in there for a little while longer. The regular bra eventually will help too. JG 9.28.06

Question:

Hi, I`m 23 yrs. and have had 2 children, one recently in may 06. My breast are saggy and have shrunk, I want to know if breast lift or implants would take care of this issue and how much scarring would appear? could you give me a figure on price? Thanks!

Answer:

you might need both and I would need to see you in consultation to see what needs to be done to give you a quote. Sorry. JG 9.26.06

Question:

i need a breast lift i would like to know if i can also get them a little bigger with out getting implants are you able to put fat into the breast to make them 1 size bigger

Answer:

fat injections into the breast for size enlargement are still controversial and not endorsed by my national society. JG 9.26.06

Question:

i recently got a breast lift nov 2005 but i keloid around my nipple do you think it will go down by it self i time or can i go back and get the keloid removed and just use the silicone strips while i heal? mybe it wont keloid again an my skin dont keloid from scars this is a first or mybe i didnt treat it rght after surgery?

Answer:

keloids in that area are due usually to tension and the type of skin. Silicone strips might help a small amount, and going back and cutting them out does not always avoid their coming back. At times injections into the scars are needed. JG 9.24.06

Question:

Hi Doc!!!! When you do a breast lift.. do you just cut inverted T below breast? Or Do you work the muscles too to lift it? Can someone have a lift without reduction?(Im a 34-D cup)How`s the utcome? Do you have a quote? thank you!!!!

Answer:

A lift can always be done without a reducttion in size and I try to do it through a lollipop incision and avoid the horizontal incision at the breast crease as much as I can. Outcome is fairly good but a lift will not last forever, the larger the breast the less tiem it will last, maybe 3-7 years or so. As to cost it depends on the time involved so it cna vary from $7500-$9600 in larger cases. JG 9.24.06

Question:

I am 1 week post op...removal of bilateral ruptured silicone breastimplants and removal of silicone material, breast lift, and implants. The implants are Mentor 350 - 1610 .... The drains were removed today. I hope that I am still swollen because I wanted to be a size B. The projection is good, but I am concerned with the width. There seems to be a lot of volume on the sides. My surgeon did a good job, but I am thinking I look too big. Your thoughts on how much swelling a typical patient would still have.

Answer:

I think at one week the swelling with what you had done is considerable and will go down quite a bit, give it some time. JG 9.20.06

Question:

hi, doc i am really worried because i need to loose 20 pounds and i wouold like to have a breast lift and augmentation, but my question is, do i need to loose them first, or it is ok for me to go ahead and do it and then, loose the 20 pounds? thank you in advance for your help liana, miami, fl

Answer:

I think if you lose it after the lift will not be as perky and the size may not be the size you desire as you lose breast tisssue with a diet. JG 9.20.06

Question:

hi, doc, i need to ask you a last question, am i going to loose sensibility in my neaples when i do the surgery? thanks again liana, miami,fl

Answer:

I cannot guarantee it but there is about a 0.5% chance of losing the sensation. JG 9.20.06

Question:

Hi Doc. This is probably the sixth posting with you and I LOVE this site and appreciate your answers. My question is I had a BL and a TT and my PS suggested using a laser to help in fading the scars. Would you suggest this since I am also using the scar cremes or do you feel it would be really beneficial using the laser. Not quite sure what I want to do considering it`s $295 per session and it would take 6 sessions (once a Month) to see the difference. What do you think?

Answer:

I think in certain cases a laser to reduce the redness does help but it is not soemthing I suggest to all of my patients, in most cases with time and topical cream they fade on their own so at one year the differrence between the laser treated and non-laser treated areas are not visible. JG 9.19.06

Question:

Hi Doc. I had a BL and BA done at the same time and I have been very good at keeping up with cleaning them and just being careful not to overdo it. My question is I went to my PS yesterday and he is very happy with the way they are healing for it`s been only three weeks and I told him that I have been using the scar creams during the day and the silicone sheets at night. He told me that I don`t need to use both of them just the cream, and that the silicone sheets don`t work. Do you feel the same way about the silicone sheets and also I was told by my PS and I have seen your postings to other peoples questions that they should use scar guard or mederma to help with scarring but I don`t have either of those 2 brands. Are all scar creams the same. I use Talsyn-CI/bid, and scar esthetique creme but if the other two brands are better please let me know so I can use them if it`s going to work better for me being that it`s only been 3 weeks since surgery. Also with the BL he used dissolving stitches on the inside and I can feel them in certain places along the scar sticking out, about how long does it take for them to fully dissolve. Lastly, I also had a tummy tuck done at the same time as the other two proceedures, when can I take a bath.

Answer:

I personally like the Mederma or ScarGuard better and I think silicone sheeting only works if you can apply pressure and you cannot do that on your breasts. It might take 6-8 weeks for the dissolving sutures to go away. I think after three weeks if no wounds are open you can take a bath, best of luck. JG 9.19.06

Question:

How long after a breastlift should I wait before really considering I need a revision of one breast? I`m already thinking I need one now but I know I`m still healing. Thanks :)

Answer:

I would wait at least 6 months if you can. JG 9.17.06

Question:

I had my 2nd BA in January. I had a circular lift around the nipples done, with 570 CC round saline implants. My right nipple is a half an inch longer (oval shaped) than my left and my nipples are 23.5 cm from the clavicle. My breast look low and saggy, requiring a support bra. The PS said he can`t help the nipples being uneven, and suggested redoing the same lift and going with larger silicon implants to get more volume on the top. What do you suggest? Thank you so much for your time!

Answer:

I do not think repeating something that did not work the first time is a good idea to repaet. I think you need a more formal lifting of the breast tissue and the addition of a vertical scar in order to do a proper breast lift, I do not think a larger implant will help in any way,sorry. JG 9.17.06

Question:

I am 46 years old and I have large breasts.(36-38 DD bra size) I am thinking of getting a breast reduction. But I think I have breast tissue in my arm pits. After my first child, when my milk came in my arm pits engorged along with my breasts. It was painful and later, uncomfortable. Now, after 18 years, it looks like I have fat underarms. With breast reduction surgery can I have that removed? Thank you, KCW

Answer:

yes, it can be removed from there also. JG 5.4.06

Question:

Hey Doc, I had my incision through the areola. If the scar turns into a keloid scar. COuld that cause scar tissue to develop underneath the surface of the skin near the insicion? And can scar tissue feel like an extremely hard solid lump or mass, I mean almost solid hard.

Answer:

It might, but just as likely is a suture granulonma which is exhuberant scar tissue around a suture. JG 5.1.06

Question:

Hi Dr. Garcia- I had full breast lift with implants and the right one is way higher than the other and looks smaller (doesn't have a fold/crease like the left one). I waited paitiently, like my ps said to do for four months and the right one didn't drop. My ps now says that the only thing he can do is take skin off of the left one to make them even. I went to another ps for second opinion and he said that the first ps took way too much skin off of the right breast and that there is no room for the implant to drop, so it is squished upward. He suggested I also redo the left one, cut skin off of that one and make it match the right one. He also thinks I should switch implants (from 550cc) to 800 cc to make them bigger. I am afraid if I take off skin from the left and go to 800cc that I will end up with a super wide chest ( squished implants) and no projection. I am a big girl and the 550 cc's right side is barely a c cup now (the left side is a full c cup. Do you think there is hope for me to get a normal symmetrical looking large breasts with this plan of action? What would you suggest for my dillema? Thank you!

Answer:

Well, I think going bigger will cause more problems, you could consider exchanging them for adjustable implants that cna be stretched so you can regain the lost skin on the right, placement of the implant above or below the muscle wil also affect the result I feel. I don't in general agree with the second PS. JG 5.1.06

Question:

Hi Dr. Garcia, I had breast englargement with a lift done last December. I have had nothing but problems with my left breast. I have had several infections including cellulitus. I have two small areas around the insision sight that keeps bleeding. I tell my doctor and he keeps telling me that I am spitting the stitches out. Last night one of the ares ruptured and what apeared to look like white rubber was poking out. I told my doctor and he assured me that this was normal and it was the gortex coming out. I am not sure what to do. Do you think I may need a second opinion or am I worring about nothing? Thank you, R.C

Answer:

I think it will be hard for the Gortex suture to come out unless it breaks and if it does then the areola will spread out, you may need it taken out and new sutures placed. JG 4.30.06

Question:

Dr. Garcia, I am 8 weeks post op from tummy tuck, breast lift and augmentation and lipo of 2 areas. I was still draining 80cc in 24 hours LAST Thrusday. Dr. injected me with Doxycycline through drain to help the skin adhear and stop draining. I woke up the next day and my lower ab was very puffy and hard. PS says it is a side effect of Doxycycline, now I am going in for ultrasonic treatments 3 times a week to help shrink down the scarring caused by the Doxy. I am very confused, I was totally flat one day (but still draining) then swollen and hard the next day(not draining). What did this stuff do to me? Is this a normal course of treatment? Will this lower ab thing go away? A.S.

Answer:

it wil go away and is common with the medication as it causes a lot of inflammation, the ultrasound treatments will help. JG 4.28.06

Question:

I had breast reduction surgery about 3 weeks ago and the areola was damaged, I wanted to know if it will grow back to normal?

Answer:

it depends on how it was damaged, I would need more information to help you out. JG 4.21.06

Question:

I am a 43 year old women, have had all of the children I am going to have, and have wanted a breast lift/reduction since I was 13 years old. I was recently diagnosed with a grade II brain stem glioma and had brain surgery 12/1/05. The results (biopsy) were positive, but I must undergo radiation for 6 weeks (2-1/2 weeks already under my belt). Due to steriods I have put on 15 unwanted pounds I assume I will lose after radiation. My breast size is and has been for as long as I can remember between a 36DD to a 36DDD. I am 5'3 and although my hubby loves them, I have permanent indentations in my shoulders, have lower back pain that is getting worse, am unable to wear a bathing suit without buying seperate pieces as my bust is so much larger than my bottom half and I feel like one big boob all the time as that is what I believe everyone sees when I walk in the door. My questions: 1) How long after brain surgery can I go under anesthesia again? 2) My breasts are quite saggy as I grew quite quickly during puberty and have little elasticity to my skin, and have had 2 children. Do you do lift, make smaller aereolas and reduction all at the same time? 3) I am also concerned about loss of sensation in the nipple area as this is an important part of my sex life. How common is this side effect? 4) What is the cost for all of the above? 5) What is the general recovery time? 6) How much or what type of pain is involved? 7) Will 15 pounds of weight loss after surgery ruin the lift? (Unsure how long it will take to lose weight after stopping steroids and getting back to the gym, exercise has been last on my list during radiation as I am unbelievably FATIGUED.) Thank you for your help in advance, Pat W.

Answer:

I would wait 3-6 months between the brain surgery and the new one. The lift is part and parcel with the reduction, all comes together. Loss of nipple sensation and partial nipple loss is about a 2-5% risk or so, partial sensation loss is maybe twice that. Cost will vary from surgeon to surgeon so you will need to decide who will do it for you,maybe get a couple of consultations. Should be on light duty for two weeks and resume full activity in 4-5 weeks. Pain is not too bad.15 pounds of weight loss after surgery may make the breast size smaller and leave you a little saggier than desired. Best of luck. JG 4.15.06

Question:

What is your price range for a breast lift? You performed a different surgery for me. My sister has mentioned she is interested in learning more about a breast lift. She asked about your fee, so I thought I'd find out for her, and then she can decide to follow-up with an appt. or not. thanks.

Answer:

it varies depending on the time needed but is ranges from $8000 to $9250, all inclusive. All the best. JG 4.14.06

Question:

Dr.Garcia, thanks so much for your valuable information. I inquired recently about a repeat breast lift, and now have a new question. I had a consult the other day. I was told that in order to acquire the upper fullness I would need a repeat breast lift, and then at a later time in another surgery, implants. Are you in agreement with this? My goal is NOT big breasts, just rounder, firmer breasts with almost no hang to them. It may sound weird, but it's the only description that fits. What is your opinion on the double surgery . She (the PS) said it can't been done w/in the same procedure due to a risk to the nipple area. Thanks for your opinion.

Answer:

I understand what you want, and I guess I have to tell you that it might not be possible, in fact, even if you get that appearance, it will not last, unless that is unless you get a hardening of the implant that will keep it looking round, and that is not desirable. May need to think about it. The hardest thing for a plastic surgeon to say is I cannot help you or it is not possible , they feel defeated, but many times it is the truth. JG 4.13.06

Question:

I am getting my bs in june i found my ps in boston which is 1 hour and 45 mins away. this ps was a second choice since the first ps told me that i need a grade three lift. i didnt think i needed one and still dont this ps said she would not do the bs if i didnt get the lift. not sure if she wanted more money out of me. my new ps said i could get a lift but not needed my nipple and crease are ok. was this a good idea and who should i believe. I also want to go from a small b to a larger d and concerend about the pain

Answer:

sorry but it is really hard for me to tell without actually examining you, pictures don't always tell me enough. JG 4.12.06

Question:

Dr.Garcia I have had a traditional (anchor)breast lift many years ago. I have noticed that after 2 children post-surgery, my breasts look very much like they did pre-breast lift. Can a breast lift be redone ?, or should I maybe consider just implants now (they are a very saggy b, almost c). I have no upper fullness at all, and am wondering how to best achieve that...really don't want implants, just rounder breasts, about a b cup. G.C.

Answer:

I think a repeat breast lift may be the best option. JG 4.11.06

Question:

Hi Dr. I am a 22 year old woman and have very large breasts (36 DD on the verge of DDD) I would like to get a breast reduction / lift but I read that you can't breast feed after a breast reduction because it removes some of the milk ducts. Is this true in all cases? I am very self conscious and unhappy with the size and the sagging of my breats but when I do decide to have kids many years down the road I want the abolity to breats feed them. Thank you for any and all help.

Answer:

about 15% of women can breast feed after a breast reduction. JG 4.9.06

Question:

Dear Dr. Garcia, you suggested that I wait to see about swelling from a second BA. I forgot to mention that I had a full lift. Does this procedure involve additional swelling?

Answer:

The lift adds considerable swelling, yes. JG 4.8.06

Question:

I am considering having breast augmentation and a lift in June, but my youngest child is only 7 months old. How long will it be before I can pick him up after surgery?

Answer:

no lifting more then 20 pounds for the first two weeeks, and then slowly increase after that until normal lifting after 4-6 weeks. JG 4.6.06

Question:

i am three weeks post op. I had brest lift with augumentation. Can I ride on the back of a Harley with my husband?

Answer:

I suggest waiting at least another week. JG 4.4.06

Question:

Do you know the criteria for Blue Cross of California to pay for a breast lift?

Answer:

I am sorry but I do not. JG 4.4.06

Question:

dear dr garcia i have had 3 consultations for ba and lift i learn something new at each consult but i am gettin confused also! each doc has rec different implant types and sizes one doc said only a high profile, one said they did not like high profile, and one did not say what type at all! the cost has also varied by thousands (all docs in the same area)what questions should i be asking ? what should i be looking for? thankyou

Answer:

I think you need to see doctors and see who you feel comfortable with and which one makes sense as to why he wants to do what he has stated and then see pictures of some results. There are many ways to do the proposed surgery, no one way it the only way. JG 4.2.06

Question:

Hi Doc. Wonderful site. Its really great that you offer this for people. Ive read through some of the posts and youve stated that if pigment is lost due to co2 it usually does return. Im about 6-7 weeks post op and have a few areas of lightened pigment. If its going to return how soon could a patient expect to see something. Am I in danger of losing any more, My nurse tells me that its already starting to fill in and that I wont lose any more but I really cant tell. thanks so much.

Answer:

most areas do fill in so give it some time, may take months though to return. JG 4.1.06

Question:

Dear Dr. Garcia: Last summer I had a breast lift with augmentation. The bottom of my anchor scar was visible on the face of my breast ... plus I developed double bubble. On Monday, I had a tuck to revise the IMF. Now my breasts are distorted ... more of a flat bottom/tear drop shape ...they don't look symmetrical ... The left nipple points downward now. the curvature coming off of my rib cage is not very attractive ... more abrupt ... almost perpindicular rather than curved. Is this a typical result at this stage? What can I expect?

Answer:

very typical at this time and should soften over time. JG 4.1.06

Question:

After full breast lift and implant the area around my areolas have small red spike points that come outward all the way around almost like a flower and raised white scar marks. Is this normal? Also the nareola scar goes around in a perfect circle but the areola area looks like it was cut jagged and not straight lines giving the appearance of white areas around the areola and jagged edged areola areas. Is that normal? What can I do to make the reddness and the ugly scarring go away?

Answer:

sounds like some of the normal pleating that occurs with a combined procedure. It may get better in time but I must say that at times what you describe can be permanent. JG 3.29.06

Question:

Hi Dr, I am considering a breast lift. I am 20 and have lost a lot of weight and now I have alot of loose skin on my upper breast. Is a breat lift the best way to get rid of this?

Answer:

yes, but if you have children in the future you may need it done again. JG 3.25.06

Question:

Hello, I have had a full breastlift with implants added, it has been 6 weeks since my surgery. I was wanting to know if it would be safe to go to a theme park, and ride the rides. Will it cause the implants to bust? Also, I would like to know if I can start playing tennis. My doctor is off for Spring Break, and I want to have a good weekend. Thank you so much for helping everyone. MAJ

Answer:

I think 6 weeks is enough. I think tennis is probably OK also, have a good time.JG 3.25.06

Question:

I did not want reconstruction after my mastectomy in Nov'2002 but am cosidering it now using fat and skin from my stomach.I am now, exceedingly healthy,eat well, do not smoke or drink and take lots of exercise,I am 50 yrs old. Is there anything important that I need to know about this operation.I believe it is a long op, this is making me very nervous.Thanking you in advance...kathleen.

Answer:

well, the biggest things are that the size of the reconstructed breast will depend on how much tissue you have to move, it is a long surgery and has some small chances of failure, and also that there may be a hernia in your abdominal wall due to the muscle being partially removed. JG 3.22.06

Question:

Hi. I had a breast reduction on July '99, and I still feel some kind of parestesia on the lateral aspect of my left breast. Do you think it will stay that way forever? Also, I was wondering, do you think underwire bras makes the breast deformed if its the kind of breast that comes from the sides? Thanks.

Answer:

unfortuntely yes, it will be permanent. I think the underwire bra will not deform the breast though. JG 3.18.06

Question:

HI Doc Quick question I have two kids not sure if i want to have any more do you think it is safe to get a tt and a breast lift woul I still be able to breast feed w/ any breast surgery?AG

Answer:

probably be able to breast feed but most likely will need both surgeries repeated after the pregnanacies. JG 3.17.06

Question:

Dr. Garcia, My sister and I are 1 1/2 years apart in age, however she looks 10 years older than I do. She has had a very hard life. My sister has large breasts and they sag very bad. They actually are near her waist. Is it possible to lift or reconstruct them when they are this bad. My sister is forty five. JC Ft. Worth, TX 3/16/06

Answer:

yes, a breast lift sounds like what she may benefit from. JG 3.16.06

Question:

Hello, I have a question for you, I recently had a cresent lift with augmentation under the muscule. I saw one PS who said I needed the full lift. I wanted a second oponion because of scarring and money. My PS said he felt I would be fine with just the cresent lift and 420cc unders. i am now almost a month post-op and i have breast tissue hanging under the implant i look more deformed than before. i was pretty saggy 34B, breastfed 2 children. Now when i stand straight i have my old boob hanging under the implant, and when i bend over it looks awful. My question is will the implant drop down where the tissue is, or will i need the full lolipop lift... I should've listened....AHHHHHH!!AH thank You

Answer:

It might drop but from what you are describing it would need to slide all the way down and no longer be under the muscle which is possible but doubtful. I think you wil need the full lift in due time. Sorry. JG 3.16.06

Question:

I have just had a breast lift and implants, (one week ago) my doctor says he does not agree with wearing support bras after surgery and wants me not to wear one, is this common.

Answer:

no, I think most doctors have you wear a sports bra type of support, but you need to follow his instructions. JG 3.7.06

Question:

Dr. Garcia: I am looking into having a minor breast lift, and am somwhat new to the whole plastic surgery scene. I have had a couple girls who have recomended a Doctor that they used, but I want to make the right decision for me not them. What should I look for in choosing the right doctor? Pictures, Price(doubtful),testimonials? --Still looking...

Answer:

pictures and patients you cna speak to are a good place to get information. JG 3.7.06

Question:

Hi my name is Tracy, and i had breast augmentation in April of 05. I also have tuberous breast on the right side. My right side has not dropped and i just had a second sugery to make it drop 3 weeks ago. As of now it dropped a little but it still moves all the way up to my neck when I lay down and is still to high. Can this be because i didnt get a breast lift. I only had the implants put in through the bottom of the areola. During my research on tuberous breast, I 've found that a breast lift is required or a good outcome will not happen. Please let me know if this is the case, I would really appreciate it. Thank you. Tracy (NYC)2/25/06

Answer:

A breast lift is not always needed, at times you just need to have the tuberous breast incised to loosen it and let it flatten out, as to the implant though, it needs to be allowed to drop lower and the breast lift or action on the tuberous breast will not affect that, totally different. JG 2.25.06

Question:

Hi Dr G! I was wondering how do you determine weather a breast lift is needed or just implants to lift them...

Answer:

easy, implants never lift a breast, they give the illusion of a lift but they never truly lift them. So if you are saggy and need a lift and get implants instead you go from small and saggy to large and saggy. JG 2.21.06

Question:

I had breast lift & augmentation (w/ silicone implants) 6 years ago and was quite satisfied up until about a year ago (no one's fault but mother nature). I have developed several cysts along the incision line around the areola. I went to a dermatologist to have it removed. It came back along with two more. I was told to go back to my original plastic surgeon. He has retired and I cant seem to get any of my medical records. Someone told me that at one time you were handling the follow-up patient care for Dr. Hodnet. I am not sure what else to do or where to go from here. Thanks for any help you can provide. IS

Answer:

Yes we have Dr Hodnett's files. If you would like we can see you and advise you on what can be done. Please call the office and they will get you in for a consultation. JG 2.13.06

Question:

Hello,again doctor Garcia its me again the girl who asked about the breast reconstruction 2 times and didnt get an estemate but I got one here in Mission Tx. and they told me the first surgery would be 3200 and the second would be around the same I was going to have it done but it too far from my goal I guess I should just forget about it cuz I can only afford the first since it took me a long time to save cuz I have 3 kids ,THANK YOU anyways I was just meant to be deformed this way,sorry for your time lost .

Answer:

no problem, I wish you all the best. JG 2.9.06

Question:

Dr.Garcia,I had written to you about a reconstructive breast surgery and asked for a price for the first surgery,and I didnt get an answer,can you please tell?and about the second surgery ,when do you recomend to do?In case you dont remember its about the breast lift on the other side.And how much will it be if done with the first?THANK YOU.VERONICA 02/07/06

Answer:

it is very hard to say without examing you and trying to go over the different options and I will also need to calculate the time needed to give you an approximate fee. JG 2.7.06

Question:

Dr. Garcia, I am 19 years old and am really considering getting a complete reduction (I am a 34DD) and getting implants. I want to stay about the same size, maybe a little bit larger, but I want fake, perky, beautiful boobs! Is this a normal procedure that you do? Can it be done all at one time or does it need to be done in two steps? How bad is the scaring? jmb 2-5-06

Answer:

I am sorry but I cannot recommend the surgical procedure you desire nor do I think it will work. JG 2.6.06

Question:

Dr. Julio have you ever done a reconstructive breast surgery where the breast on one side never developed?Need help,THANK YOU,Veronica 2/3/06

Answer:

yes, I have done that a number of times. JG 2.3.06

Question:

I had a breast lift (Key hole incision) and implants put under the muscle about 6-7yrs ago. Because of saggy breast from nursing my three kids. I finally got some feeling back in my nipples. But i am wanting to have more kids will i be able to breastfeed? Also if i am will it ruin the shape of my breast?

Answer:

There is a chance you might be able to breast feed but no guarantees. It most likely will take its toll on your breast shape though. JG 2.2.06

Question:

Dr Garcia, I am 29 yr. old female and have one nipple that is inverted and has been for sometime. I have read that is is a fairly common and simple procedure to fix by detaching the milk duct from the nipple that is causing the teathering effect. Is this true and how long does it take for the nipple to recover? Is this a permanent fix? thank you

Answer:

It can be done, should be permanent but you may not be able to breast feed and may lose some sensation in the nipple too. JG 2.2.06

Question:

How effective/long term is the BL that goes around the nipple as opposed to the one where incision is nipple to crease? Have implants, want to go smaller, afraid of needing lift to accomodate smaller implant. have consult soon but need some info before hand. thanks.

Answer:

around the nipple only breast lift will not lift it much and I think it might last 3-5 years and it will flatten the breast soemewhat, I feel the vertical incision gives you a better lift. JG 1.27.06

Question:

Dr. Garcia, Is it possible to have a breast lift after having enlargement? How much would that cost?

Answer:

yes it is possible, fees vary though from surgeon to surgeon. JG 1.24.06

Question:

I have red bumps of skin all over my areolas that make this area look bumpy and ugly (not smooth and uniform). What is this from and what can I do to correct these short of surgery?? Furthermore, my nipples are not protruding very much and I am self concious of this as well! RL Jan 23 2006

Answer:

hard for me to say without examining you as to the nipple projection, that can be hard to correct without risks of losing sensation. JG 1.24.06

Question:

how i can reduce my breast size

Answer:

no reliable way except surgery. JG 1.22.06

Question:

Dr. Garcia, I am considering a breast lift. I have seen two plastic surgeons for consultation. One indicated a formal mastopexy and the other one a lollipop lift. Can you tell me which is better in addition, how long will this lift last considering gravity, getting older, etc. 1/20/06 sc

Answer:

How long it will last depends on the size of the breast as gravity will affect it. If you can do it through a lollipop, I would go that route, I always try to do it that way if possible. JG 1.21.06

Question:

Dear Dr. Garcia, I'm 28 years old and had a bilateral implant removal along with a bilateral lift done last Saturday. I took off my bandages last night and I'm not sure if this is what it's suppose to look like. The lift was done via a lollipop incision and this vertical incision seems really tight and there is no real roundness at the bottom of my breasts. Is this normal? Or will they bottom out soon? I'm a little worried. Thank you so much in advance. G.S. 01-19-06

Answer:

yes, it is just tight form the swelling and should round out in a few weeks. Hang in there. JG 1.20.06

Question:

Dr. Garcia, I had a breast reduction on Jan.5/06 and I had internal dissolvable sutures only with steri-strips over my incisions. I've had one post-op appt. and everything is well, however, I was not informed as to when to remove the steri-strips and now my surgeon is on vacation. Can you please help, I'm afraid to remove them too soon but I also do not want them to grow into new tissue and cause more damage when coming off. Thanks JS Jan.17/06

Answer:

My practice is to let them fall off on their own, no need to remove them unless they get too wet and loose. JG 1.17.06

Question:

Dr G, I have stretch marks on the upper part of my breast. I am considering having a breast red/lift because of back problems(34F to 34D/C) Is there away to do the reduction so that it also reduces the amount of stretch marks I have above the areola?? or would such a reduction just lead to more scars?? and is the risks any higher than the key hole method?

Answer:

The stretch marks above the nipples for the msot part would not be removed with any technique known. I think the key hole technique is a good one, but there are many variations that work well. JG 1.11.06

Question:

Hi i had a very large breast reduction done nov 2nd and was just told i have fat nicosis to the right one breast will it go away with meds and lazer treatment and how long will it take ??

Answer:

it will not need lasers to go away nor medicines, although at times antibiotics are given to avoid infections, it will be resorbed by the body in time. It might take months to totally resolve. JG 1.11.06

Question:

i recenty had a breast lift reduction and my left nipple is sunken in ,,,will it fix it self or can it be fixed ??

Answer:

much of the depression should improve in time, if not it can be fixed after 6 months with a little more surgery. JG 1.8.06

Question:

i had a large breast reduction 2 months ago im now back to work and have notice the right breat is very tender and is red around the nipple and inner part of the breast ...almost like inflamation is this normal

Answer:

It can be part of the normal healing process, but you should go see your surgeon for a check up to make sure. JG 1.8.06

Question:

my ba is on saturday. my doc says he can't make my breasts more symetrical in size. If i tell him to before the surgery to fill the smaller breast a little more, does he have to?

Answer:

You are ultimately the one who decides, maybe what he is saying is that he is going to try to make it more symmetrical but that he cannot guarantee it, which is difficult to guarantee. JG 1.5.06

Question:

Dr. Garcia I had a breast lift and implants. My doctor say I should not wear a bra for a month, so they will drop down naturally. Everyone I know who had this they tell to wear a bra all the time- 24/7. Is this normal to not wear a bra after this kind of procedure? Won't my breasts be saggy again? Gracias por su atencion.

Answer:

I allow patients to wear a stretchy bra, just no undewire bras.I wish I could tell you that wearing bras will avoid breast from falling but it does not help. JG 12.30.05

Question:

Hi Dr. Garcia, first thank you for taking the time to answer so many questions...you are a God send! I had a breast lift with implants (first surgery had problems with circulation so my implants were barely filled up) (Second surgery I went in and had them filled up to maximum 375 cc, but the right side always looked smaller then the left because it was too high up (almost to my clavicle!) I just replaced my 375cc implants with 510 cc, hoping this would make them look bigger and to correct the right one that was too high up and never seemed to drop. I am now three days out of the surgery and the left breast looks great, but the right one, to my horror is still too high up and does not fold or crease at the bottom, making it again look much smaller than the other breast. My surgeon at post op said it may just be my body ! Is there a chance that the right one will eventually drop, by massaging or wrapping with tight ace bandages on top? Have you ever had a case like this and what was done to correct? I'm afraid that I will now be left with a pretty breast and unnatural looking breast!! Should I get a second opinion or continue to trust this surgeon?? Thank you for your time and I wish you a Happy and Prosperous New Year!

Answer:

I think there is a good chance the implant will still drop in time, I think you need to give it time for the swelling to resolve. Massage and wrapping are good ideas. I have done cases like that and have handled them in a similar way. I would at least give it a couple of months before you seek a second opinion. JG 12.30.05

Question:

Hi Dr. Garcia, I had a breast lift and had partially filled implants placed 7 months ago. Three months after the initial surgery I went in and had the surgery to fill the regular implants to 375 cc-the most they could be filled (under local anesthesia & it was extremely painful & traumatic!!). After they were filled, they are still extremely small & the right imlant sits very high and to the left on the chest (I feel it almost in my armpit & on my collarbone when I lie down). The implants were also supposed to be a large C cup, but I have been bra shopping and bought a C bra only to find out that my breasts do not fill the cup, leaving a small drooping pocket of material at the end of the bra unfilled. I am afraid to have another surgery, but am very unhappy. If I get these implants replaced with bigger ones, is it normal to have them replaced and the right side lowered under local anesthesia? I prefer general, but my doctor wants to do it under local and no anesthisioligist present. Also, should I be asking for high profile implants? Since the cup size is so small? Thank you & God bless you.

Answer:

I don't think that what you will need to correct what you don't like will be possible under local anesthesia as the pocket will need to be revised. Let me guess, it was done in Hawaii? As to high profile, it is hard for me to say without seeing you in person, remember the high profile implants are more narrow so they can have a torpedo like shape if it is not the right implant for you. I would prefer general anesthesia for the procedure, the choice of local my be a financial one. All my best, hang in there. JG 12.13.05

Question:

Hi, I am very curious to know what is the estimate cost of a breast lift,and areola reduction? Also, do you have any payment plans available, lay-a-way plans, or anything like that. I would like to have this procedure sometime in june,july 2006. Thank you! Tonia

Answer:

we have a couple of financing companies we work with and a breast lift all inclusive is $9250. Jg 12.12.05

Question:

Hi Dr Garcia. I had a full tt 1 year ago although I was overweight 5'4 220 along with a breast reduction with lift.I was left with huge dog ears over my tummy and sides of breasts that look worse than before surgery so same dr, last week did lipo on both areas. Im still very swollen but sides of breasts look worse and tummy is still sagging over scar. What can I expect?

Answer:

I think you need to give it at least 3 months for the swelling to improve but you may need some skin excision along with the fat that was removed via liposuction. JG 12.111.05

Question:

Dr. Garcia, I had breast reduction surgery in 1996. I was taken from a 34 DD to a 34 B. Since the surgery, I have small mucus pocket where the dissolveable stiches once were (around the nipple area and under my breast). I frequently have a sharp burning sensation, pain, in my left breast. Also, both of my breast often itch. Are these problems associated with my breast reduction and are they normal? Thanks for any help, BMA

Answer:

The sharp burning pain is due to scar tisue around the nerves form the surgery. Likewise for the itching, all normal I am afraid. JG 12.5.05

Question:

Dr. garcia, i will be 1 yr post op in january for redo BA, and this past June at 5 months post, i had a pocket revision and capsulonomy. I am still not happy with either the size or placement. when could i safely have more work done on both? Either redo or pocket revisions? I am almost 6 months post of revison in one, almost 1 year from redo of both. I go to PS for consult next week. Is there such a thing as too much work in too little time frame?

Answer:

I think you could have it now. You like to wait 6 months for things to soften up and heal before going back in. JG 12.2.05

Question:

I am 37 and had a breast reduction in 1988. I went from a 34dd to a 34c. Since that time I have had 3 children and my breast are now saggy am now between an A and B cup. I have scars that have stretched out. I want to have the scars cleaned up, a lift and implants to bring me back to the solid C cup that I was. My concern is that my scars will only be worse. Is this something that can be done. I need my self esteem back!! CG

Answer:

I think the scars will be there but most likely will not be any worse than what you have now and probably better. Best of luck. JG 11.22.05

Question:

Hi i received 450cc implants w/ bennilli lift 2 and1/2 weeks ago when can i sleep on my stomach? is it risky to sleep on stomach after receiving impalnts? will sleeping on stomach increase chances of deflation? what do you suggest?

Answer:

I think you can do so in 4-6 weeks and sleeping face down will not cause the implants to break. JG 11.22.05

Question:

I had breast aug w/ benneli lift 2 weeks ago when can i go back to work as a dancer? i still have the tape around the nipples did the dr remove my whole nipple? i thought i was going to get the lollipop lift but he said i reallY didn't need it. what exactly is the benneli lift? what signs should i look for if there is in affection? i was a size 34 c cup before and now i received 450 cc will i be a c cup still or a d cup? why do we need to maasge our breast? how often do i massage my breast and for how long? is it normal to hear water swooshing around when i move a certain way? what does the term slosh mean? thank you for answering all my questions ahead of time!! JG

Answer:

I tell my patients's 3-4 weeks personally. Benelli lift is a skin resection around the edge of the areola alone to try to lift the nipple into better location. Redness and drainage can point to an infection. It is hard for me to predict your size and whether to massage or not depends on if the implants are below or above, although I don't think it makes much long term difference. The swooshing is normal and will go away in time. Slosh is the fluid sound or swoosh you are hearing. JG 11.17.05

Question:

Dr. Garcia I have been suffering from gynecomastia since I was 13 years old. I am now 17. I had a surgery to remove the extra tissue three weeks ago. Up to now I have recovered very well except for the look of the breasts. The right breast is pushed in . The left breast is pushed like it was before. Can you tell if this is the Dr's fault or do I have to have a plastic surgery. Because the Dr. just removed the extra tissue. Please answer back as soon as possible.

Answer:

it is still too ealy to tell becasue of the swelling. Just give it some time and keep me posted. JG 11.7.05

Question:

Dr. Garcia, I had a breast reduction/lifted in May I was healing very well but, around the areola they are always red and puffy, sore.I went to my doctor he said they look very nice to him. I put vitamin E oil and shea butter on my breast am/pm but, they are still red and puffy looking. How long does it take for the areola area to heal. They always feel numb. What is going on what can I do? Thank you, M. L.

Answer:

I am afriad that can take up to one year to totally resolve. JG 11.05.05

Question:

hola doctor soy hispana y quisiera hacerme un breast lift quisiera saber que precio tiene y si tengo opciones de pagos mi mail es nildaestenoz@yahoo.es

Answer:

tenemos companias que ayudan con financiamento. El costo es $9250. JG 11.03.05

Question:

I am not too satisfied with my areolas.Is there anyway to get them smaller?

Answer:

The areolas can be reduced but there will be a scar all around the areola. JG 10.30.05

Question:

To do a breast lift with existing implants and to go with a smaller implant, can it be all done thru areola incision or are best results achieved with vertical(lollipop or keyhole?) incisions? My sister- in-law had a lift and implants(first set) all done thru aerola and she believes they are still too low. I have crease insision now with 550HP saline umders. What is the recovery with such a procedure? thank you

Answer:

I think the breast lift through an areola incision alone will be quite limited. I think the best result will be through the lollipop or keyhole incision. Recovery would be 2 weeks light duty and one month before back to full activity. JG 1030.05

Question:

Dear Dr. Garcia, I'm 28 years old and had a breast lift with augmentation(cohesive-gel) done one month ago and I had originally told my surgeon I wanted to be a full C or small D and now I'm an F post-op and the nipples are still very low as if no lift was performed. I only have a scar around my nipples. I want to get rid of the implants altogether and get the breast lift redone. My surgeon refuses to give me a lift with a lollipop scar because he wants to avoid big scars but I feel it's the only way to really lift my breasts who are sagging due to breastfeeding twins. I'm the patient and shouldn't he give me what I want and what I paid for? How long should I wait before another surgery and who picks up the tab because this is definitely not what I signed up for.Thank you...10/27/05

Answer:

Well, you want something and he offered to do something else. You allowed him to do what he wanted so he will not want to refund your money. I do think your assessment of the situation is correct and if you wanted something he did not want to do he should have refused to do surgery on you. I would go see a different surgeon for your next surgery. You can ask him to give you your money back but I don't think he will, sorry. JG 10.27.05

Question:

i have lost about 20+ pounds and am having a breast lift. if i lose another 15 after the bl - will the procedure have been a waste of time and have to be repeated? they are minimally saggy(36c)now but i have lost some volume with the weight loss. thank you for taking your time to answer my question. this is a great site for info; thank you for providing this service.

Answer:

That amount of weight loss could possibly make you sag a little after the surgery, correct. JG 10.26.05

Question:

What is the usual way to do a breast lift with implant replacement? I am considering a redo(3rd one) BA and suspect the PS might want to do a lift at same time. I have crease incision now. would he go in thru nipple? i would rather not have scar on breat(vertical) if possible. I nursed 2 babies with original implants, had a little sagging so PS insisted that bigger implants during my redo would help lift breasts. I think they are too big and want to down size again. Another PS said i should have had a lift and smaller implants. Does it matter with a lift if implants go over or under muscle? thank you.

Answer:

Usually it is done through the previous incision but where the implant is placed depends on the circumstances. Sounds like you will need incisions around your areola and also vertically. I suggest leaving the new implants in the same location as they are now to decrease trauma. JG 10.26.05

Question:

hi this is jenn again.. i asked u about accutane... should i still be having flare ups after two and half months of being on the medicine? how long does it usually take to go away? also can u do breast lifts without leaving scares?

Answer:

There is no way to lift breast without leaving scars somewhere. As to the accutane, you may get flare ups the entire time you are on it but that is unusual. JG 10.26.05

Question:

Dear Dr Garcia, I have level 1 ptosis and one areola is slightly lower than the other. I've had 3 consults, all completely different. One suggested 400 cc HP overs, another 360 cc MP unders with possible lollipop lift and the last 360 - 390 cc MP unders with benelli lift. I'm leaning towards the last one. What are your thoughts on the benelli lift? My breasts are pretty conical in shape, so the flattening out isn't an issue (I think and so does the surgeon). Can they make my areolas smaller? Do you perform very many benelli lifts? What is approx your cost involved in doing saline implants with benelli lift??

Answer:

Honestly, I think a Benelli lift is fraught with potential complications and makes a revison of it when it goes bad, and it will, almost impossible. In small cases like yours it may be an option but the scars around the areola frequently spread out. I feel that implants below the muscle have sgnificantly less capsular contracture so that is my preference. I could not give you a quote without seeing you and estimating the time involved and the fees will not apply to other surgeons I am afraid. JG 10.25.05

Question:

JM 10/24/05 Dr. Garcia, you are awesome for helping people out like you do! I am a 42 year old female. I had a Benelli lift (w/implants) done 5 months ago. I've now read about the Benelli-Lollipop, which I believe would have been a better alternative for me. I really didn't want that added scar, but I may need more of a lift. 1. Can you tell me typically how noticeable is the scar for a medium skin toned person? I have one breast much lower than the other. That side seems to have a deeper pocket so it appears to not be as high. 2. I want to re-do, but if I don't re-do with the same size implant and I go with a smaller implant on the larger side won't that be bad since my skin is already stretched around this large implant and I really needed more of a lift to begin with?? I believe I am having problems with my milk ducts. I've read that bacteria can be introduced via the milk ducts when placed through the areola (I didn't know that before the surgery). I have always had a problem with my breast milk not drying up after having breast fed each of my 4 children. It can take years for me to completely dry up (I have a 1.5 yr old now). My right side is harder, and gives me pain most everyday, and most always feels like its contracting or bordering on infection. I have had an infection before in that same side but wasn't told that it was from milk ducts, I was not given a reason. 3. Could this be due to the milk ducts and could these be symptoms of infection? 4. I need to have one implant replaced at a minimum, could the milk ducts be a problem if he goes through the areola, or if I decide to have a Benelli-Lollipop? 5. I've heard about an internal lift, or purse strings(?) or something like that, do you know what that is? I wrote you a very long email the other day, it was far too long and I'm sorry for that. I didn't get specific enough with my questions and I rambled so I'm trying again and following up with what you wrote to me. Thanks a whole, whole bunch, and I love Las Vegas!

Answer:

The vertical scar is much less visible than a spread wide peri-areolar scar. The side with the less tissue or implant will need more skin excised so that side's scars will be longer. It sounds more like a capsular contracture than an infection although the theory behind capsules is a small low grade not perceptible infection. Internal lifts do not work, and anytime you cut into the breast, if there is milk the chances of infection go up. JG 10.25.05

Question:

I had a full anchor BL four weeks ago. When looking down at my breasts, from the middle, the areolas are in different positions. For example, if I measure from the middle of my chest to the beginning of the areola on the left, it is 4.5 inches...from the middle to the right, it is 3.75 inches. I know there is still some swelling, but this doesn't seem right and is driving me crazy. Could swelling cause this?

Answer:

Swelling can definitely cause that at this point, just give it some time. JG 10.24.05

Question:

My baby is almost 4 months and i am scheduled for breast lift and implant in a few days is it safe to do so soon i am at my weight i want? can i lift my baby after surgery he ways 13 lbs?

Answer:

As long as there is no milk coming out of your breast you are probably OK to proceed. I would take it easy with lifting the baby for a week though. JG 10.24.05

Question:

dr G, I just found your website and I was reading about breast lifts. I had a breast lift on Monday 10/17 and they look aweso me already, but now after reviewing your site I am afraid. My doctor told me that I could smoke and didn't need to stop and I never did and I still smoke (even after surgery). I wwas just wondering if I were to have complications because of smoking would they have occured already or will they occur later. what should I say to my doctor? he told me I can smoke and I hope that doesnt make my breast turn out to be bad. any advice. Thanks

Answer:

Complications from smoking usually develop in the fisrt 2-3 weeks if they are going to happen. If you can stop smoking now you should. JG 10.23.05

Question:

Hi Dr. Garcia. I am a former patient who had a tummy tuck and inner thigh lift (due to weight loss). I am also interested in a breast lift. I am currently a DD (some of it skin) and would like to know if a breast lift can also reduce the size of your breasts. (would prefer they were smaller). Also, could you give me an estimate of the price for a breast lift. Do you have discounts for repeat patients? Thank you again. LG

Answer:

yes we can reduce the size of the breasts at the same time as a lift. The approximate surgical fee is $9250. We do offer discounts to our previous patients and we can go over that during your consultation. Thanks for remembering us! JG 10.4.05

Question:

I HAD MY IMPLANTS REMOVED AND A UPLIFT IN APRIL 2005, I AM STILL IN PAIN TO THE POINT THAT I AM MISERABLE. MY RIGHT BREASTS HAS GOTTEN VERY HARD. IT FEELS TIGHT AND MY NERVES FEEL LIKE SOMETHING IS GRABING ME. OF COURSE I HAVE NO FEELING IN THE BREASTS AT ALL, BUT ON THE OTHER HAND I FEEL PAIN. IT FEELS NUMB ON THE OUTSIDE BUT HURTS ON THE INSIDE. COULD TELL ME WHAT IS GOING ON AND WHAT THIS COULD BE? THANK YOU TERRY G

Answer:

Extremely unusual this far out, I would go back and see you doctor, it is hard for me to tell without examining you, sorry. JG 9.28.05

Question:

Dr. Garcia: Where should the nipples be? How high after a breast reduction? I had a reduction done last year. Now my nipples are allways higher than my bra. I cannot find bras that fit. Can the nipple be repositioned lower?

Answer:

The nipples can be repositioned lower but then there will be a scar left where the nipples were. They cerainly should not show above the clothing line. In most cases when that happens it is due to the pre-operative marking being misplaced. JG 9.25.05

Question:

Dr. Garcia, Thank you for the quick response related to my Breast Lift/Augmentation issue below. When you say, be sure to stretch the muscle as well , what are you meaning? Thanks! Also, I am contacting your office on Monday for a consult for Rhinoplasty. I live in Dallas so, will be flying in for a weekend. Not bad since it's Vegas. :-) TP

Answer:

You want to stretch the muscle by raising you arms above your head, just like in calisthenics class when you were a little girl. See you soon. JG 9.25.05

Question:

Hello Dr. Garcia... I had a Breast Lift with Augmentation on 9/2/05. My right implant is too high and my doctor is having me to massages (pushing it down, while massaging the muscle underneath the breast). Is there another technique I can use? With my work schedule, etc., I am only able to do this about 1-2/night and I'm worried it isn't enough. I have heard of a chiropractic ultrasound process that can help. I'm worried that it won't fall. Thanks!

Answer:

I dont think the ultrasound will do much for your present condition. I think the massage at this point is the best. I would give it time and make sure you stretch the muscle out too. JG 9.24.05

Question:

I am having a breast lift in a month and my doctor says I can go home after the procedure. I just wanted to know your thoughts on this and if it's a good idea to go home after this type of procedure. Thanks so much

Answer:

most of my patients do go home after that type of surgery. JG 9.13.05

Question:

hello, I am a 34yo female who had major complications from a breast reduction, as a result I had 3 nipple reconstruction, all which the nipples went flat, Do you thing sculptra will keep my nipples erect like!

Answer:

I think it might but for a short period of time as it is a temporary filler. JG 9.11.05

Question:

I have been doing research on tuberous breats. I never knew why my breats looked the way that they did, untill I recently found other pictures on the web. So I went and visited Dr.Roth. A couple days later he called me and said I should see someone who specializes in tuberous breasts. I want to know if you can help? Thank you Lyndsay McCullough

Answer:

we do tuberous breast surgery, please call and make an appointment for us to see you. JG 9.7.05

Question:

Dear Dr.Garcia, I am a 35 years old. I weigh 100 and I'm 5'3. I under went a breast lift and BAM a year ago Sept 30th. They were okay at first, but turned out not what I wanted. size, fullness, ect. So i went back and confronted the Dr. He then told me in 6 months I could fix them to my desire......So another $5000 later I unerwent another BAM. He was suppose to fix the left breast that was smaller than the right one and make them BIGGER. I was to have gone from 300 cc to 420 filled to 450. Well that did not change anything. My bra size was still a small C,I also had real bad rippling. I wanted to be a D and under the mucle, and high profile. Well I did not get that either. So I went to someone else to get there opinion. They told me all different things, I was more confused than before. They said they could fix them to my desire. Well the size is fine, but I still have rippling. How can I get rid of this?????It doesnt look bad. It just feels wierd. Help Help KP

Answer:

The rippling can be diminished with high profile saline implants or silicone implants, but it will only be improved by maybe 60%, it will not be totally eliminated. JG 9.5.05

Question:

I had a breast reduction on 8/24. In the past two days my right breast has had a yellow liquid draining from the bottom. Enough to cover the bottom of my bra. Is this normal? I did not have drains after the surgery, and I am not sure if there is an open wound as the steri strips are still on underneath my breast. I am still on the clindamycin, and my plastic surgeon didn't seemed to concerned when I called her this morning. Any help would be appreciated. AB 9/11/05

Answer:

Not uncommon, it can be some old blood that has gotten soft and ready for the body to absorb. It can also find its way out through a small hole in the incision. I would continue the antibiotics and follow up with your surgeon as directed. If you develop a fever or an area of redness in the breast then call your doctor right away. JG 9.4.05

Question:

Hi Dr. Garcia, Can you explain what a feather lift is for the breast and if it is available in the states yet. Thanks so much I wish I lived in vegas because you are the best doctor around!

Answer:

It is not available yet in the US and it is a waste of time for breasts. The sutures do not support facial tissues more than 6-12 months but I doubt seriously that it will give long term support for a breast lift. JG 9.3.05

Question:

Hi Dr. Garcia, Thanks for the answer to my question about getting a breast lift after being smoke free for only 2 weeks. I was just wondering what are some of the risk and how often do they occur? Should I postpone my surgery?

Answer:

The risks are the incisions not healing, and splitting open, potential skin loss and thicker scars. I think you should postpone, it is not something to be cavalier about. If you were my patient I would not be willing to do it. JG 8.31.05

Question:

DR. GARCIA I HAVE INVERTED NIPPLES IS THERE A SURGERY THAT CAN HELP ME WITH THIS PROBLEM?

Answer:

Yes it can be corrected but at times you will be unable to breast feed in the future and a small percentage of women lose a little sensation too. JG 8.23.05

Question:

I am very unhappy about the size of my areolas. I was wondering if there is a surgery to make the areolas smaller? SL

Answer:

Yes, an areolar reduction can be performed but there will be a permanent scar around the edge. JG 8.13.05

Question:

Dear Dr. Garcia. Thank you for answering my question regarding the breast augmentation to reduce size and breast lift surgery. I suppose what I am trying to determine is whether breast lift surgery can be helpful in removing loose skin from larger implants and aging.

Answer:

Yes, a breast lift can remove loose skin and tighten up a breast that was firmer but has drooped. JG 8.9.05

Question:

Doctor Garcia, after breast reduction surgery, what medication do you recommend to use on your skin/wound when you are experiencing skin/wound breakdown that works effectively.

Answer:

It depends but I have used neosporin, Bactroban, and Silvadene. JG 8.1.05

Question:

I got my breasts reduced May31 2005. Went to doctor two weeks later and had my drainage tubes removed. After my tubes were removed, I have open wounds under both breasts. My PS statd that my skin is breaking down. He stated that I need to keep the prescribed cream on them and keep dry. They have not healed and it is August 1st. How long does it normally take for skin breakdown to heal and do you recommend any other things to do?

Answer:

Leaving drainage tubes for two weeks after a breast reduction is uncommon. As to how long it will take for the wounds to heal, it all depends on how deep and severe they are. Sometimes a few weeks and in severe cases a few months. I think you need to follow your surgeon's recommnedations though as he/she knows your case. JG 7.31.05

Question:

RE: Silicon Polyurethane Implant removal. Dear Dr. Garcia, How might I go about finding the best doctor in Las Vegas to remove my Silicon Polyurethane Implants? I've had to live with my one ruptured implant for the last two years because I haven't had the money to have it removed. It's become very painful and I'm worried about the health risks if I continue to ignore the problem. Is a Plastic Surgeon my best choice or should I seek another type of specialist? I'm suspecting that there is a lot involved in removing all the silicon and polyurethane from the surrounding breast tissue. Hope you can help. Thanks for your time.

Answer:

I believe any plastic surgeon in Las Vegas can do it for you. I have done many over the years. JG 7.24.05

Question:

I noticed this comment that you made to another reader I think a breast lift while leaving your implants in would give you a better look than removing them . I would just like to say that I did have a lift done with implants while in Argentina. Beautiful results. Then fast forward 15 years and I got tired of the higher cup look and had my implants removed 1 year ago in Houston. I am thrilled to tell you that the results were incredible. I am 53 and things just came back into place with the same perkiness from the original uplift surgery. Great results with no futher surgery for uplift. Maybe it was wearing a support bra post explant for 24/7 until now and for the past 15 years.

Answer:

It also can be affected by the size of the implant. If the implant is small to medium, the skin shrinks well, but if a large implant was used and the skin stretched out alot, then the shrinking is not as good. I am glad you had a great outcome and my best to you. JG 6.30.05

Question:

6-21-05 I had a donut breast lift two years ago, and now I have significant scarring. Also, I still have some sagging, and my areola have stretched out. When my areola muscle fibers contract (such as when I am very cold), the scars are much less visible, my breast appear less saggy, and my areola is smaller. Does anything exist to make the areola permanently contract? If not, some sort of product or procedure such be researched, as this would improve several problems women have with their breasts.

Answer:

There is nothing that will make the muscle fibers permanently contract around an areola after a circumareolar breast lift. It will take a repeat surgical procedure with more scarring on the vertical aspect of your breast than you have at present. JG 6.21.05

Question:

Dr. Garcia ~ I am 36 yr old mother of one, with my second pair of saline implants (technically 3rd because the current pair replaced the 2nd pair because there were problems in the OR at time of surgery). Anyway, I wish I had done a lift at the same time because I feel my nipples are low. My husband likes them but I would much rather have them higher so when I am braless, I don't look so droopy. Can this be done without disturbing the implants or do I have to have a whole new revision? WCL, NJ 6/15/05

Answer:

Yes, a breat lift can be done without doing anything to the implants, but you will have scars on your breasts and around your nipples that will be permanent. JG 6.15.05

Question:

I'm a 19 yr old woman, and am going to have some surgeries done (just a matter of money). One is eye muscle surgery (have a lazy eye with retinal detachment that I was born with along with glaucoma and a cataract that developed over the years) and a breast reduction and perhaps a lift, assuming the SEVERE sagging isn't fixed with the reduction alone. Being only 5'4 and 115lbs with a 34DD breast size, you can imagine what I go through. INCLUDING the backpain. Do you have any advice on the whole procedure/situation? Are there ways to get grants or get my insurance to cover some if not all of it? About how much would it cost, total? and are lifts ever included in the package or does that add on? and is the lift necessary, or does the reduction lift enough or at all? All Info is greatly appreciated. Andrea - 6.10.05

Answer:

A breast lift is part of a breast reduction you don't have to have two separate procedures. Depending on your insurance and the amount proposed to be removed from the breast, the insurance should cover that and should also cover your eye surgery. JG 6.11.05

Question:

Hi Dr. Garcia, I had a breast lift 6 months ago after loosing 75 pounds and breast feeding two kids, I am 45 and now where a size 6 at 5feet one inch. I had a lesser scar lift called the donut or benelli. I also had a augmentation at the same time with my fill at 450cc and 475cc, one was slightly bigger than the other. My surgeon had to lift them about 3 inches, as far as the lift they look great where the nipple is. I am unhappy with the size and shape they are a flatten look at the nipple area, the rest of the shape is great. They have a little sag at the bottom but the tops are full which I like. I wanted to know if I put larger implants in would the shape be more of a ball instead of flat shape. My surgeon said I would have to finish off the lift to the anchor type and have more scarring which I dont want to shape them as the round look.If you push up the skin from the bottom a little they also look great. I want to redo them if it makes sense. They look great in a bra and clothes but braless and in my bathing suit they have a flatter shape then a regular breast, what should I do?

Answer:

The flat shape is due to the purse string technique used for the breast lift, a larger implant will not fix that, and the hanging tissue down low is due to an inadequate amount of breast tissue being lifted again due to the technique. I agree with your surgeon that to get a better shape you will need longer incisions, more then the circumareolar scars. JG 6.9.05

Question:

Dr Garcia, I am a 34B and 40yrs , if I have a breast lift, is it necessary to have implants also? Will my breasts be smaller without any implants and just a lift? thank you.

Answer:

A breast lift will do only that, lift. It will not make the breast smaller or larger. If you want to be bigger, you may need a lift and and a breast augmentation both. JG 6.8.05

Question:

How long should I wait before getting a breast reduction after having a baby? TC 5-31-05

Answer:

I would suggest you wait three to six months to see how much the breast will reduce after the child birth. JG 6.5.05

Question:

Dear Dr. Garcia I weight 130 pounds and my breat size is 38 double D, I have problem to find the right close to fit me, because the rest of my body I wear a size small. Beside surgery what other option do I have in order to reduce a few cups for my chest because I do not want to have a surgery

Answer:

I am afraid that surgery is the only option for your large breasts. JG 6.5.05

Question:

I have over the muscle implants, 5 years. I hate them. I hate having big heavy breasts. I am 52, have gained 15 lbs since I got them - even if I loose weight, I will not like them. If I have them removed, will my chest be a total wreck? LM 05/22/05

Answer:

Well, I can imagine that you will need some type of breast lift of whatever breast tissue you still have and a removal of the excess skin at a minimum. JG 5.22.0

Question:

Dear Dr Garcia I am scheduled to have breast reduction surgery in a few months time. My understanding was that most PS would not operate on a patient who smoked so I fully expected to be told I would have to stop in good time (I hoped wanting my surgery would be the incentive I needed to kick the habit). However, the consultant I have seen says he would prefer if I stopped but would not insist on it!! Of course, the addiction in me is immediately reacting to the idea that I may NOT have to stop smoking. I understand about Necrosis and that the risks are increased in smokers but can you give me some statistics or a link to more info that may help my flagging resolve? I obviously do not want to end up losing any part of my nipples but how much greater is the risk for a heavy smoker like me? I am 39 years old and have smoked 20 a day for about 20 years.

Answer:

You need to stop for at least three weeks before and after, the incidence of wound breakdown and infection is increased by about 3 times in people that smoke. Stopping for a week or less is no diffferent than not stopping. I would not do a breast reduction on a person who is still smoking. JG 5.20.05

Question:

Dear Dr. Garcia, I was diagnosed with the auto-immune disease called vitoligo at around the age of seven years old. Today, I am seventeen years old and it is practically almost all gone because of my PUVA treatments twice a week in which I have to consume three tablets of oxsoralen prior to the treatment. I started these treatments at about seven and have for the most part have been consistently completing them with the exception of some breaks until this day. I am going to finish when I am basically 100 percent free of the vitoligo with the exception of some maintenance treatments. Well, my inquiry is about getting breast implants. Although I am 17 years old I will be 18 quite soon and I have been done growing for some time now. I also have been contemplating this surgery for years and realized that it was what I definately want to do. With my past experience with vitoligo, is it possible that I could be able to have breast augmentation surgery done?

Answer:

I see no contraindication for you to proceed with the breast augmentation. Stress sometimes can flare up auto-immune disease though and it may set your vitiligo back a little but if you are responding to the oxsoralen, then it should work again after the stress is over. You may not see any setback of the vitiligo too, it just happens with some auto-immune disease some times. JG 4.28.05

Question:

Dear Dr. Garcia, I am scheduled to have a minor breast lift almost 10 months after my breast augmentation surgery. Although my doctor and I had several discussions regarding my size, we did not get it right and I've gone from a 34B to a 34D. He has been concerned with my overall satisfaction and I hoped that the implants would get smaller. Now that the swelling has subsided, and although I am 5'8 , I do not feel comfortable with this size and am wondering how difficult (costly) it would be for him to remove some of the fluid from the saline implants when he performs the lift in two weeks. P.S. I consult with him in a couple of days but would like a realistic idea of what is possible at this point money-wise.

Answer:

There will be a limit to how much saline can be removed from the implant and not increase the risk of fold failure and leak. If you are that much bigger than you desire, I feel what may be needed is an implant exchange for a smaller size where you can decrease the size more than you could safely by emptying out the implant you have at present. JG 4.19.05

Question:

How long after surgery will be breast be sore and painful?

Answer:

It will vary from patient to patient but an average is 1-3wweeks. JG 4.17.05

Question:

Dr. Garcia, is there a measurement that is used for measuring where the breast nipple is going to be placed when a mastopexy is done?

Answer:

Yes, typically if you mark a spot about 6-7 centimeters from the center of the notch at the top of your breast bone and then draw a line straight down from that point, then take a tape measure and from the same center of the notch, angle the tape towards the line you just drew and where they intersect at 21 centimeters, on average, that is where it shoule go. There are 2.54 centimeters per inch. Some more imprecise measurements are at about the level of the middle of your arm bone, or right at the fold below your breast. JG 4.15.05

Question:

Thank you Dr. Garcia for the answer to the question about where the breast nipple should go. I am getting confused about the centimeters exactly where to start and intersect, but the measuring about half of the arm bone is easier, but now my question is from the shoulder to the bend of the elbow, or the arm pit to the elbow bend, is it half way? Thank you.

Answer:

From the armpit to the elbow, halfway down. Best of luck. JG 4.15.05

Question:

MY DAUGHTER HAD A BREAST REDUCTION LAST AUGUST. THE PHYSICIAN MERELY LIFTED THE BREAST: SHE IS STILL THE SAME BRA SIZE, 34DD. THE AREOLAS KEEP SPREADING, THEY ARE LARGER THAN PRIOR TO BREAST LIFT..........2 1/2 INCHES ACROSS THE BREAST. CAN THE SIZE OF THE AREOLAS BE REDUCED WITHOUT REDUCING THE BREAST. SHE WAS IN SURGERY FOR NEARLY SIX HOURS. MY DAUGHTER CLEARLY LAID OUT IN WRITING EXACTLY WHAT SHE THANKS RO

Answer:

The areolas can be reduced without reducing the size of her breast, yes, but there may be less tension on the wound and therefore less tendency to spread the scars if the breasts are a little smaller. The areolar scars have a tendency to do that though. JG 4.5.05

Question:

Hi Dr. Garcia, I recently (4 weeks ago) had a breast reduction. Unfortunately, I did not adhere by the rules and still smoked (1 to 3 a day). Now, where the stitches meet in the anchor shape have split. On the left breast, I have a HUGH black hard scab with a creamy colored fat like substance around it. The right breast now has split (about 3 inch) and the opening looks as if the muscle is showing. It also has liquid and a fatty substance on the sides of it. The doctor tells me to keep it bandaged and put Neosporin on it. I thought of putting Silver Sulfadiazine on it. He told me to not put heat on the top part because they are still a little numb and I might burn myself. The rest of both breast have healed very nicely. What can I do? It is not getting better with the ointment and bandages.

Answer:

I think placing some dry gauze and then removing it twice a day without it getting wet will slowly remove the dead tissue and allow the ointment to work better in the near future. These things happen and although it may look really bad right now, trust me, in the long run you will be surprised how good it wil look. The fat you see is exactly that, and soon the pink tissue will grow in. Aslo keep in close contact with your surgeon so they can make sure that there is no infection. JG 3.22.05

Question:

I am a black woman looking to have a breast lift and an implant done at the same time. I had a consultation with a doctor who will only do each procedure separately, he suggests there is less scarring. My breast only need a minimal lift. How do you feel about doing both procedures at once.

Answer:

I feel the same way. I think the results are better when done separately, and the risks are less. JG 3.11.05

Question:

THANK YOU FOR YOUR PROMPT RESPONSE TO THE BREAST SURGERY QUESTION (ONE WAS HIGHER THAN THE OTHER AND YOU RECOMENDED DROPPING ONE IMPLANT) HOW SEVERE IS THE RECOVERY FROM A REPOSITIONING? IS IT LIKE HAVING BREAST SURGERY FOR THE FIRST TIME, B/C IT IS MY UNDERSTANDING THAT HE GOES IN THROUGH THE SAME INCISION (AREOLA) AND ADJUSTS THE 'CREASE AREA TO LOOSEN THINGS UP. THE IMPLANT HAS TO BE REMOVED AND THEN PUT BACK. IT SOUNDS SO LIKE ALOT OF MANEUVERING.....WILL I BE UP AND AROUND QUICKLY? OR WILL I BE UNABLE TO LIFT MY ARM IN THE NORMAL RANGE OF MOTION? THE FIRST TWO SURGERIES WERE BOTH EXTREMELY PAINFUL...THANKS AGAIN FOR YOUR OPINION...C.M.3-3-05

Answer:

I would anticipate the recovery will be significantly less than the original surgery. Limited activity for two weeks, but you will feel well much sooner. The hard part has already been done. JG 3.3.05

Question:

Dear Dr. Garcia, I am interested in having a minimal breast lift in the future, I was interested in what the average fee for this procedure usually comes to. Thank you.

Answer:

Limited mastpexy would run about $6800 . This is all inclusive of the surgeon's fees, anesthesia, lab work, operating room, all visits. everything except the medications for after that run about $50. JG 1.28.05

Question:

Dr. Garcia, I have an appiontment with you for a breast enlargement in march. I was thinking of having a lift only. I was wanting to know the difference in price,and do I need to let your office know if I want to change procedures? Can you e-mail me about this at athomesen@cox.net. Thank you!

Answer:

The price for the lift will vary on how long it would take me, but the most expensive lift would run about $9000, if it needs less of a lift, then the price would be less. You can just come in and we can talk about the different surgery, no need to change anything. JG 1.19.05

Question:

The ripples ar eless when placed below th emuscle, but it will not lift what has fallDr Garcia, I am a 27 year old female, who had a breast lift about a year and a half ago. I do not have much scarring, but have treated the vertival scars under the nipple with laser. Much of the color is gone, but there is still a slight raise. What can be done for this? Also, I was looking into augmentation, because my breasts have dropped again slightly, I do not have any children, have stretch marks on top I would like to fill out, and am an entertainer in the lv area. I want them to look natural, not rippled. What do you charge, as opposed to another dr, and who else would you recommend in the lv area. Sorry so many questions.

Answer:

You could consider some kenalog injections into the scars to try to flatten them out. As to an augmentation, it will do only one thing and that is make them bigger, it will not raise what has dropped. The ripples are less when under the muscle in the case of breast augmentation. We charge $4400 for an augmentation above the muscle and $6900 for under the muscle, through the armpit, with a pain pump. It sounds like if you have an augmentation in the near future you will be bigger but also saggier, you should think carefully about the choices. JG 1.18.05

Question:

I am considering a breast lift. Before I get my hopes up for this procedure, I need to ask if my health history would preclude me from having this done. I have linear morphea which is a benign skin condition that tends to be lumped in with the scleroderma family. It is in no way associated with systemic scleroderma but is a collagen based disease. I have no limitations with this condition. It is only on my arm and is already showing wonderful signs of dying out. All of my cuts/scrapes heal normally. Would there be any concern from your standpoint with a breast lift? SP 1-16-05

Answer:

I see no reason why that would be a contra-indication for surgery as long as your cuts and scrapes heal well and the area on your breast is not affected. The stress of the surgery may cause a small step back on the drying out, just so you are aware though. JG 1.17.05

Question:

I have had previous breast reconstruction several times after mastectomy. I am not satisfied, but my plastic surgeon advised me to leave it go. It is highter and flatter than my real breast. Is there anything else to do to make it look more natural and what is the cost. Also I am interested in the forehead lift, also the cost.

Answer:

The breats reconstruction cost is difficult to tell without an examination as many things could potentially be possible. Our forehead lift price, all inclusive except for the peri-operative medications is $6250. Please let me know if there is anything else I can answer for you. JG.6.05

Question:

How much is it to have a breast reduction and breast lift without implants? From a DD cup size to a Med. C cup size?

Answer:

The price, all inclusive except your medications for afterwards is $9250 for the breast reduction. JG 12.27.04

Question:

Thank u for your response re: ultra sound for breast fat necrosis. The PS that did my reduction tells me that he cannot remove the fat necrosis, as it is so large, that I would loose my aerola and nipple (My nipple is retracted, and I have no feeling in the nipple of aerola). What would u suggest? Thank u so much!

Answer:

I think I would give it time and then once stable and no further healing is anticipated, go back and surgically remove the fat necrossis and recontruct whatever can be done. If the nipple and areola are retracted, performing liposuction or ultrasound will make it retract even more. Your breast may end up being smaller after the revision. JG 10.11.04

Question:

Are you familiar with using ultra sound to break up fat necrosis in the breast caused from breast reduction? If so, does it work well? Thank you.

Answer:

Well, that would not make any sense as the fat is already liquifed and necrosed. If there are hard spots, the ultrasound may not break up the nodules with any guarantee. I think regular liposuction would be adequate, and there are still questions about the effect of ultrasound fat dissolution on the breast and potential cancer risks. JG 10.11.04

Question:

I have had a breast augmentation done over the muscle and it has been done last November..... I am sooooooooooo unhappy... I would like to get a lift done but I have hit rock bottom with all the price comparison. I can only afford $5,000.00 and all the doctors I have had consultations with have quoted me around 7 grand. I am at witts end... and my self esteem has gone down to no end.. I am begging for you to please give me a lift with no implant..... and I hope that my dream can be fulfilled. I am only asking this because I am in desperate need to get my self esteem back... please if you

Answer:

Well, a lift is a very long procedure, about 2 1/2 hours compared to a breast augmentation and that is why the cost is more due to operating room fees. Removing the implant alone would be cheaper but would not be a pretty site I am afraid. I think a breast lift while leaving your implants in would give you a better look than removing them. The only other solution I could offer is to maybe go through a finance company, like the ones we offer, to pay for the surgery you desire. JG 9.30.04

Question:

Dr. Garcia, what are your thoguhts on Aptos Thread Lift and do you perform this procedure? If you do, what is the cost? Thank you

Answer:

Aptos threads are still not legal in the US, but that doesn't mean that some doctors are not breaking the law and illegally importing them. I think it is a nice option for a mild lift that will last about 1 year. It should be legally available in the US in a few months. JG 9.30.04

Question:

I just has a breast reduction in May, i was wondering if it is normal for the nipple area to secrete yellow liquid?

Answer:

It is not uncommon for a few months after a breast reduction for some fluid to come out through the nipple. In your case it may be some cystic fluid, and possibly some small ruptured cysts, which do not appear to be anything to worry about. JG 9.22.04

Question:

I had a breast lift on 7-28-04. I have developed fat necrosis in my right breast (pretty big area). My nipples looks retracted, as I can only see a small dark hole that is flat with my aereola. The fat necrosis is directly under the aerloa, and spreads outward. MY PS said it is too large to remove. He didn't seem concerned about it, he mentioned that it would probably get smaller, told me to keep massaging it with lotion. He said some of it may be absorbed by my body. I have heard that it can be and also that he can't be absorbed. Can you tell me if this is permanent. I also have no feeling in the aerola or nipple area of my right breast. Any help you can give is greatly appreciated. Susan T.

Answer:

Your body should absorb the vast majority of it. You need to wait and see what it looks like in a few months because it will improve significantly in time. The feeling or sensation in the nipple may take up to one year, whatever has not come back by that time may never come back. The hardest thing right now is to give it time, we all want to rush in and do something, but just waiting at this point is what I would suggest. JG 9.17.04

Question:

I am scheduled to have a breast reduction in September. I just found out i'm pregnant. Is the reduction still an option for me while pregnant, or will it have to be put off til post-delivery? If it has to be put off, is this due to anesthesia or other reasons?

Answer:

General anesthesia should be avoided during pregnancy unless it is an emergency. I would postpone the surgery, especially as the hormones of pregnancy will make your breasts grow and your reduction may end up being inadequate in terms of amount removed. JG 8.24.04.

Question:

I had a breast lift about 20 yrs. ago and my breast have now lost more volume and are sagging again. Is it possible to have a lift and implants for volume, without enlagement?

Answer:

well, a lift is for shape only, where as an implant will by definition increase your size. At times, doctors use implants on patients getting a lift as the lift has limitation on how high the tissue can be lifted and if the patient wants a lot of fullness up top, an implant can be placed there to fill in that area. It may not require a new size bra to be worn since the implant is up higher, but there is no way you can place an implant and not make the breast volume bigger. JG 7.26.04

Question:

What is your opinion of featherlifts? Do you perform this procedure? J.D. 7/05/04

Answer:

Featherlifts are not legal in the US yet as the prodcut has not cleared the FDA and the doctors that are doing it are either doing research for the company or breaking the law. I think for some small segment of people, it is a great option, but if your skin is really loose, the featherlift alone will not work as you may get pleats of skin. In patients with loose tissues below the skin yet taught skin, it is a good option. We anticipate the Feartherlift to be approved later this year for use in the US. JG 7.22.04

Question:

Hello Dr, I am 24 female. i have a problem of sagging breat. & i also over weight. i m 5'4, weigh around 85. though i dont look bad. these breast which sag do make me feel uncomfortable. i go on 2 regualr walks & swim for past 6-8 months. this has been helpful in reducing my thighs a lot. though the process is slow. is there any other things which i can try out. i can go in for any surgery right now. are there any speacial exercises which i can follow? please my breast which are also big make me look more fatter than i am normally. One more problem of sagging, is that there are marks below my breast as they touch my skin underneath. i need 2 reduce my Stomach. i have been fat from a very young age. Please advise.

Answer:

Exercise will help you lose weight and tone the muscles but will not shrink skin or cause the breasts to be lifted. I would ask that you continue with the weight loss until you have plateaued, then we can do a breast lift and reduction. Your tummy could be tended to at the same time, depending on what we would need to do. Don't give up or be frustrated, keep up the good work, there are solutions awaiting you JG 5.2.04

Question:

I would like to get a breast lift. I am 34-years-old and have had a hysterectomy and am DONE having children. My son, who is now 5 breastfed for 13 months and I think I am ready to improve. I am a C cup now and I think I would probably be a good candidate for just a lift and not an enlargement. I am a pretty small framed person. What would be the approximate cost for that?

Answer:

The cost will vary depending on the extensiveness of the surgery, by that it influences time. It can vary from about $5000 to $8700. The longer the surgery take, typically the greater the cost. An in-person consultation would help us narrow this down for you. JG 2.9.04

Question:

please send me a quote for the a breast lift and augmentation

Answer:

We do not perform the procedures together as the risks of poor scarring and nipple sensation loss are too great, we do them as 2 separate procedures, with the lift being done first, followed by the augmentation 3-6 months later. The augmentation is between $4500 and $6900 depending on the location placed, what the patient can get done by their primary care doctor in terms of pre op testing, use of post op pain pump and other issues, while the lift is about $8500. We offer a discount on the second procedure

Question:

I had a breast lift and 260ml sub muscluar implants. It has been about 5 weeks post surgery, my implants still seem very high, making my breasts look very long (there is about 5 inches of breast above my nipple and 2 below. The part above is the same hight as the nipple area- thus its long appearance). On the sides there is an indentation where my muscle is, giving the sides of my breast a peanut like shape. Is this the natural healing processs?- will the implants actually drop so that my breast will appear round? If so, how long does it take? What a wonderful sight, I'm very thankful for your time and your expertise.
LA

Answer:

It appears that what is occuring is that the muscle is still having spams and holding the implant higher than it needs to be. Eventually, the muscle relaxes and the implant drops. At times this may take up to 3 months. Some doctors put a strap or a bandeau on the upper part of the implant to help the muscle relax. What to do if it does not drop will depend on what the breast tissues that was lifted does. At times during the revision you need to either drop the implant lower, or lift the breast tissue higher.I would ask your physician about massaging and the strap. I would also wait 3-6 months before considering a revision if things don't change, which they probably will.

Question:

Dr. Garcia, today is the 5th week of my breast lift. During my research I found out that I have fat necrosis, very bad in the left breast. Yesterday a hole /knot came on the lower part of the left breast, I'm thinking that it is getting soft and the next step is to heal (no problem). But this morning after I took my shower, the knot burst and a kind of dark yellow stuff drained form it. After 5 weeks should anything like this happen or is it time to really worry?

Answer:

The liquid that is coming out is the liquified fat that has not survived. If it did not come out, in time your body would absorb it. As long as there is no fever and spreading redness, it is fine to drain. If it gets hot and red, which is doubtful, getting started on antibiotics would be good. Otherwise, it is just the tissue that had necrosis coming and leaking out. All will be better in time.

Question:

I am currently 48 and had a breast augmentation about 26 years ago. Now my breasts are shaped differently, one feels much different than the other, one hangs lower than the other and they seem to create a lot of extra strain on my lower back. If I hold them up manually, my back and shoulders both feel quite a bit of relief. Would a reconstruction, possibly a lift and new implants help? How much would such a procedure cost? Thank you.

Answer:

It appears that you are having symptoms from the weight of the breast and implants together. Merely lifting the breast and leaving the same size implant will only change the appearance and not the shoulder/back pains. For the discomfort to get better, there will need to be some size reduction. Reducing the size of the implnat will then cause a need for a breast lift. The more the implant is reduced, potentially the more lifting will be needed. Therefore, the proposed surgery would be a breast lift with an exchange or removal of the implants. the ultimate fees will depend on whther there is a removal completely, or an exchange, with the exchange for smaller implants costing more as there are charges for a new implant. I would imagine that you have silicone implants, so one of the other choices you will need to decide on is whether to have siliocne implants again, or exchange them for saline. I think with all these variables, it would be best to examine you in person to give you an adequate fee quote. Unfortunately, even though we do not accept insurance, I seriously doubt the company woud cover the procedure as they technically would not consider it a reconstruction.

Question:

Dr. Garcia, Can you please tell me what you know about Fat Necrosis (large)in the breast after a breast lift. How dangerous are they to my health and how long will it take before they go away. Should I have them removed after one month or should I give it time to heal on its on? If the answer is to give them time to heal how long should I wait?

Answer:

Fat necrosis in the breast after a breeast lift can be quite common. It usually absorbs in time, but poses no health risks, just something that feels liquid filled, and at times end up with some assymmetry that may need to be revised, although most times the symmetry is fairly good. I would give it a few wmonths, after which if they still bother you, they can be aspirated with a needle if desired. I would wait 3-4 months after the surgery before proceeding with any intervention, best of luck

Question:

Dr. Garcia almost one month after my breast lift, I have a hard area inside my left breast almost like a big rock was placed in there. The the hardness in the right one never got as big, but what was there is almost gone. What is this and is this a problem? Also this hard spot moves around according to how I'm laying down, walking or sitting. I'm in another country now and a little worried that maybe something is wrong. Thank you for just being here.

Answer:

The lump can be one of two things, either an area where sutures were placed to hold breast tissue together, or a cyst formed from the breast tissue. Both are not dangerous and do go away in time. The fact that one went away faster than the other is very common. Time, warm moist heat, and gentle massage will help it get smaller and go away. It moves as the tissue below the skin will move separately from the skin. In rare cases at times a small needle can be placed to see if we can aspirate any fluid in it, and that is very quick and painless. Hope this helped

Question:

Dr. Garcia, I just had a breast lift about 2 1/2 weeks ago. My breast is still swollen and is very hard, at the botton, but there isn't any pain. Should I be worried at this point or is it ok.

Answer:

The swelling and the hardness are common in that area after a breast lift. In that area a number of sutures are placed to give the breast its shape and these take a number of weeks to disolve. Warm moist heat can help, along with some light massage, and in time it will soften. But all sounds like normal healing

Question:

Dr. Garcia I have a two part question. My breast lift is 3 weeks old today. I have a line down the lower part of my breast that still looks fresh, the line is smaller than 1/8 of an inch wide and a small opening at the nipple, both are just skin deep or maybe a little deeper and is white. Is this normal and will it heal correctly? Second, I know I have to keep my bra on for six weeks, 24 hrs a day and I have cream that I have to put on it. But does it need air to heal? The cream keeps it moist/damp, would it heal better if that area is kept dry? Thank You

Answer:

The little opening at the incision line is very common, and should heal in a short period of time. Surely there are pictures of women that do not show that but it depends on the amount of skin that was removed and others factors, such as smoking, tension on the wound, and others. Getting some air to the incison at times feels better but the scars will heal fine with the cream. All sounds normal though

Question:

I'm 54 years old and have 38 c/d cup breasts. Just recently, within this last year, I'm losing the muscle tone above my breasts. Consequently, I'm starting to sag... bad.
What are the best excersises to build/rebuild this muscle mass. I'm healthy and can lift at least 50 lbs. Thank you,

Answer:

flat dumbell flyes or incline dumbell flyes are helpful to build the muscle but I do not think it will elevate your breasts. The muscle in and of itself does lend some support to the breast, but it sounds like your ligaments supporting the breasts have sagged and exercises will probably not lift the breast back up

Question:

What is your usual procedure for implants? In my field, I see all kinds of implants, and I've seen some results that are rather frightening. Do you offer before and after photos of your work? I'm from Idaho and am wondering how much time I'd need to spend there after this procedure before coming home, and how soon would I be able to return to work? I also understand that you are in a free standing surgery center. If complications arose during the surgery, how are those handled? Do you have the equipment and personnel to handle any emergency situations that may arise? Thank you for your time. kj

Answer:

I give patients the option, but probably 90% go under the muscle and transaxillary. Long term capsular contracture is significantly less under the muscle, and it seems that mammograms are a little bit easier. Going through a periareolar approach means having to cut into the breast at least a small amount and we like to avoid that if we can. We do have before and after pictures of breast augmentations, unfortunately we do not have them posted yet on our website, but do have them in photo album in the office. As to how long I would want you in Las Vegas after the surgery I would say 2-5 days depending on your level of discomfort. There is no lifting more than 20 lbs for the first 2 weeks, but we have had some technicians return in 5-7 days. Our surgicenter is nationally accredited and has to meet all national standards to the same way a hospital type surgicenter would. If a complication were to arise requiring admission to the hospital, we follow the same protocol as a hospital affiliated surgicenter, we have all the same equipment, and all of our employees meet the same certifications. Let me know if there are any other questions I can answer for you.

Question:

I am 5'1 feet tall and have gained a lot of weight after my second pregnancy, which I'm trying to loose; I want to have a breast reduction but need to know if my insurance would cover it? Would I need a Lift also, since my breast are really sagging or with the reduction would be enough to have again a smaller and firmer breast? BG

Answer:

A breast lift is part and parcel with a breast reduction. If there is enough tissue to be removed, many insurance carriers will cover the expense. Unfortunately, my office does not accept insurance cases, but if you call us we can refer you to some doctors we recommend for this procedure on insurance

Question:

I have heard wonderful things about your ability as a plastic surgeon, and was wondering the following: I had a partial breast lift with implants 2 1/2 years ago with another plastic surgeon, and was never happy with the size of my areolas. They are stretched out and very large. Is there a procedure to minimize them? Would it be minor surgery? What type of healing? How much would it cost? Lori

Answer:

Firstly, thank you for the kind compliments. There is a procedure to make the areolas smaller but it does involve some surgery, certainly more than minor. Part of the problem in performing a partial lift is that a lot of pressure is placed on the suture around the areola to maintain the size and shape. If that suture breaks, then the areola will stretch out. To revise it would include a lifting of the skin around the areola and then closure to a smaller diameter. There usually is pleating around the areola, and this can persist for weeks. The risk of the suture breaking remains and the only way to possibly avoid that is to place incisons/scars on the breast mound itself.Return to normal activity would be in a few weeks, and the price would depend on which of the above mentioned procedures we would do. My assistant Beth can see you and give you approximate costs so you can compare your options. One of the things that comes into play with the eventual appearnace of the scars is how much tension is placed on the wounds to close them, so the more skin that has to be removed, if one has large breasts, the scars may spread. the less the tension, the better quality the scar.

Question:

With regards to a breast lift, how much scaring will there be? What is the recovery time, how long before lifting things, and or/exercising once again, lifting weights and aroebics which include treatmill of 2 miles per day.How long before I can ride my motorcyle again? The view a Doctor in my home town has is that they are sagging, Ithat is why I wanted to ask an expert. My sister has been to Dr Garcia before and has recommended him to me
(Janice Sands, Las Vegas Nevada).

I would appreciate very much your attention to my questions, and look forward to hearing from you and hopefully being able to meet with you in th near future for this procedure.

I am very much interested in the breast lift due to having two children that I nursed for up to 8 months old, gravity has taken it's course, I am 47 years old, and have always had sagging breast, even as a young teen.

Once again I thank you for your time and I look forward to hearing from you or sending my any info. you may have on this procedure.

Darene Wassel
3943 Leprechaun Lane
Erie, PA 16510

Roadmaster3843@aol.com

Answer:

As to the scarring, there will be at a minimum scars around the areola and then onto the breast tissue, the length of which depends on the degree of sagging. As to the return to activity, there is no lifting or than 20 lbs for 2 weeks and most people are back in the gym without restrictions in 4 weeks. Treadmill would be OK as long as it is walking after 2 weeks. Motorcycle riding would be 3-4weeks.The price will vary depending on what has to be done, but the range is between $5000 to $8500, all inclusive,except for medications (includes all OR, follow ups, anesthesia, labwork, one night stay at hospital). I will forward you a packet with more information if you would like.

Question:

I have had two breast augmentation surgeries, and have developed capsular contracture on one of my breasts for the second time. I have read that there are alternatives to surgery, and I was wondering if you could provide me with some information on whether or not you perform those procedures. The contracture is causing me discomfort, and I am unhappy with the way the breast looks. I would like to treat it as soon as possible. Thank you for your help. 4/8/03 PR

Answer:

There are some people that have very intense reactions to breast implant surgeries. There luckily is a medication that has been tried on patients with recurrent capsular contracture to reduce the risk and severity of this. It is actually an asthma medication which helps control the inflammatory response and therefore limits scar tissue formation. It has to be taken for 3 months. It works best when the scar tissue is removed and the implants replaced and then the patient starts the medication, although in some patients, taking the medication without surgery has helped, albeit to a lesser degree of softening. In your particular case, as there is significant distortion and pain, the best chance of avoiding the problem would be to surgically release the scar tissue and replace the implant so it is softer, then use the medication after surgery to limit the inflammation. If your implants are fine, they can be re-used, or new ones placed if that is your preference. We do perform that type of corrective surgery and I invite you to call the office to make a confidential consultation where we can discuss your issue.

Question:

I am planning to have a Breast lift. What sort of scarring issues do I have to contend with and what is the approximate cost?

Answer:

Where the scars wil be and how long depends to a great degree on how much the breast needs to be lifted. The more lifting, the more skin needs to be removed and therefore the longer the scars. This will also impact on the cost of the surgery secondary to time. An approximate fee would be somewere between $7000-$9200. Either a personal consultation or emailing us some photos would give me more information to narrow things down a little.

Question:

One of my nipples was slightly lower than the other and since I have gotten breast implants about 5 months ago it is very noticable now.The Dr. says thats how they will look.Is there something to be done that can fix that without leaving a scar around the nipple?

Answer:

Unfortunately, nipple position and location will not be changed by an implant. The only way that the nipple can be moved is with incisions around the nipple. Moving the implant on that side further down on your chest may make the nipple look more central to the breast mound, but then the breast as a whole will be lower. I am afraid that it is not able to be changed without an incision around the nipple.