Should Ulthera Be Painful?

It does not need to be.  Discomfort experienced during Ultherapy treatments varies between patients and the areas treated.  In general patients with thin skin experience more discomfort than those with thicker skin.  The neck region seems to be the area that tolerates the Ultherapy treatment the best.  Pain control in my patients is achieved with oral Ibuprofen (Motrin), Valium (anti-anxiety) or Percocet (narcotic), and local anesthesia.  In general I try not to give a narcotic as it can be nauseating to many patients.  I use the oral regimen alone if I am treating a small area.  For the larger treatments (full face, lower face, brows and around the eye, cheeks) patients are given local nerve blocks.  I have a special local anesthetic mixture and it is injected into specific anatomic sites where the nerve provides sensation to that specific part of the face. Once the nerves are blocked patients tolerate the procedure well.  One woman even slept during a full face treatment.

How Long Does It Take to See Ulthera Results?

Ulthera works slowly and naturally by building Collagen.  Ulthera delivers focused ultrasonic energy to two levels in the body - the muscle/SMAS layer and the deep skin (dermis).  The ultrasonic energy creates several small tiny injuries at both of these levels.  As the injuries heal, new smooth collagen is layed down resulting in tight, smooth, firmer skin.  Collagen formation takes about three months and this is the length of time it takes to see results.

Can You Have a Baby After a Tummy Tuck?

It is possible to have another baby after a tummy tuck and body sculpting.  The earliest I would recommend becoming pregnant is six months after your surgery.  However, that being said, I highly recommend waiting to have a tummy tuck until after you have finished having your children.  Pregnancy stretches out your rectus abdominus muscles which are tightened during tummy tuck surgery, as well as your skin which has been molded and trimmed to fit your new contour.  An additional pregnancy will undo all the work your plastic surgeon has done.  Your pregnancy and delivery of the baby will not be affected.  It is possible to have your tummy touched up after the delivery, although there is the chance you may have to have the entire tummy tuck performed a second time.  The body sculpting/liposuction procedure will not be affected by your pregnancy.

Is Ultherapy Effective For Lifting Brows?

While Ulthera does not provide the same degree of lifting as a surgical procedure, it is an option for the patient who requires or desires a minimal or very moderate elevation of the lateral brow.  Treatment of moderate brow ptosis or a brow with greater droop requires a temproplasty or full brow lift.  The incision is placed two to three finger breathes behind the fronto-temporal hairline and the brow is elevated under direct vision or endoscopically.  Ultrasonic lifting of the brow with Ulthera is advantageous as it is a quick, walk-in and walk-out procedure with no down time.  Patients may experience slight swelling after the procedure which disappears after a day, and tingling in the lateral forehead because of the large nerve bundles under the skin for about two weeks.

Can I get a Tummy Tuck, Breast Augmentation and Hysterectomy all at Once?

Yes.  I often operate with a ObGyn and perform a tummy tuck while ObGyn is performing a hysterectomy. The patients are very pleased with the result.  Recuperation may be a slight bit longer than if either procedure were performed alone, but not significantly.  Breast augmentation is commonly performed with a tummy tuck as part of a plastic surgery marketing package called "Mommy Makeover".  This is a term I actually do not like as it makes women seem like "Stepford wives", but that is just my opinion.  It is very safe to perform these procedures together as long as you are in good health.  You are also able to recover from three procedures at the same time, which is very convenient for a woman who is busy with three children and a job either at home or out of the home.  Make sure you have someone at home to take care of your children while you recuperate, as well as a person devoted to taking care of you the first few days after surgery.

Will my dorsal hump go away eventually? I had a Rhinoplasty to remove a dorsal hump about two weeks ago and still have the hump, except now it's higher up on the bridge of my nose.  If this is just swelling, what can I do to help the healing process go by faster?

Dorsal humps do not grow back after rhinoplasty.  You may experience swelling in the post-operative period that can take up to six months to go down, but this would still not be as large as your dorsal hump.  After a six month period of time if you have a dorsal hump it usually is due to inadequate dorsal hump removal and scar tissue.  I do not know why your surgeon would leave you with an open roof deformity.  Are you sure he/she did not close it when your nasal bones were broken at the end of the rhinoplasy procedure?

Two weeks after surgery is too soon to make any judgements regarding your surgical result.  It is probably just swelling which decreases at intervals of 6 weeks, 3months, 6months and 1 year.  Continue to elevate your head while sleeping, drink plenty of water, and be patient.  I am sure you will have a great result!

My nose droops significantly when I smile and also loses its shape.  I want to fix that as well as refine the tip and slightly rotate it up as I get older it looks longer.  However, I have a long face and I am afraid that it will look worse from the front if the tip rotation shortens the nose. Do you think a small tip rotation and tip narrowing can be achieved without optical shortening the nose?

When your face is animated you have an over active muscle that is definitely pulling the nasal tip down.  You would benefit from nasal cartilage refinement, but it must not be overdone.  It appears your skin is thick and if too much cartilage is removed you may experience alar valve collapse and have difficulty breathing after surgery.  Your nose should not be shortened.  The muscle that is pulling your nose down with smiling should be released.

In what circumstances do you prefer Dysport to Botox?

Botox and Dysport are both neurotoxins that give the same results.  Dysport is not a lighter toxin, it is a smaller molecule and has a more rapid onset than Botox by one to two days. There are some reports that Dysport is more advantageous for use on crows feet because it lasts longer in the area around.  I have not compared Botox and Dysport in this fashion so cannot endorse this recommendation.

On a Facelift, how does the skin re-attach to the tissues when it's redraped?  I am worried about how the skin can be pulled up in a facelift (back to the cheek area), and then after the underlying work, it is redraped and tightened.  How does the skin "re-attach" and what is the protection for not taking too much skin so the mouth doesn't close, etc.

During a "facelift" procedure the underlying tissues are "injured" in a controlled fashioned, as the platysma and deeper tissues are tightened.  The overlying skin has been surgically lifted off these tissues also creating a "controlled injury".  The body then heals these areas by laying down sheets of collagen - which are the bodies own natural glue.  The collagen is smooth and provides the facial skin a new smooth, not overly tight, look.

I'm a 24 year old female-- healthy and normal. But, I have been worried of late that my nose has gotten larger in the past few years.  I was wondering if this is possible, or an issue of self image?

Your nose does not grow once you reach full body maturation around 15 to 17 for females and 17 to 20 for males.  The nose may appear longer due to several factors including thickness of the skin, thin or weak nasal cartilage (the support structures inside the nose), skin laxity as you age, and a decrease in the volume of bone in the maxilla (the bone under the nose that holds your upper teeth.)  You have not provided a photograph of your nose but since you are young, 24 years old, the reason your nose appears long to you is probably because of thin cartilage or thick skin.  If you have been in an accident and fractured your nose this may also contribute to the appearance of a larger nose.

I'm 31, 5'2, and between 150-153 pounds. I've had three children, my last by C-section.  I was told I have an umbilical hernia, but all 3 disagree on exactly how large it is. (My pain comes and goes, barely feel it weekly) I plan to get the hernia repaired first, but do I need lipo, a TT, or both? I've had three (board certified PS) consults so far, and as many suggestions and I'd like another opinion.  One PS said my skin is too tight for a TT, 2 others said I can get both the TT and lipo.

If you have excess skin that would benefit from a tummy tuck.  Your umbilical hernia could be repaired at the same time as the tummy tuck.  Some of the stretch marks in your lower abdomen would also be removed with the tummy tuck procedure.  It is possible you may desire liposuction on your upper hips.

Can a Tummy Tuck Make an Existing Hiatel Hernia Worse After the Procedure? I had a TT in April 2011, and my heartburn was always controlled by OTC meds.  I started to have major stomach issues, severe burning and hardness, bloating, etc.  I was prescribed Protonix, which makes my stomach hurt worse.  Could the TT surgery be related to the hernia issue? I also had an issue with my incision splitting open after surgery and will have to have that repaired sometime.

Hiatal hernia symptoms may be worse after a tummy tuck.  The abdomen is made much tighter and the abdominal contents (stomach and bowels) are pushed upward toward the diaphram.  This increased pressure causes the hiatal hernia (a hernia of the diaphram) to become more symptomatic.

I had my TT in Dec. 2000.  Six months later emergency surgery, scar adhesion connected to my bowel and ruptured.  That happened a second time five months later.  So all done and healed up from it by March 2002.  I have been fine since.  Now since October 2011 I have the sensation of pulling and ripping in all my muscles in abdominal.  I had a CT scan 2 weeks ago, waiting for results from the general Doc.  They did not see bowel problems. Could TT sutures be falling apart?

The problem you are encoutering is related to the scar adhesions that occured after your emergency surgery for a ruptured bowel.  The tummy tuck sutures were most probably cut during this operation and have not been intact for the past eleven years.  The pulling you are experiencing is probably due to more adhesions.

I was told last summer that I may have had a MRSA infection. It was never cultured or tested, but I was given medications to treat it as if it was one.  My question is two parts: Am I still a candidate for a tummy tuck if I have had a MRSA infection in the past?  I am allergic to Penicillin, Zythromax (Z-Pack), Clindamycin and Sulfa Drugs.  Are there still antibiotic options for me if I have a tummy tuck?

It is not clinically documented (by bacterial culture) that you had an MRSA infection, but you still may take precautions.  Schedule a consultation with your internal medicine doctor and ask for recommendations for testing family members, as well as your environment.  If any of these persons test positive they may be treated with anti-staph (MRSA) ointment and referred to an infectious disease specialist.  Prior to surgery you should be given pre-operative antibiotics that the MRSA in your area is sensitive to.  Vancomycin, may be one of these antibiotics, but it is best to have your plastic surgeon check with the infectious disease physician in the town where you will be having the procedure preformed.  Resistance to antibiotics effective in treating MRSA is on the rise.

I am 31 years old, 5'2 and 150 pounds. Three years ago, I went to the hospital with chest pains and found out I was pregnant.  A month later, my DVT was discovered (don't know why it took so long).  I was on Lovenox throughout the pregnancy, delivered a healthy 8 lb. baby (C-section under general anesthesia, no complications), and had minimal scarring.  I'm considering a Mommy Makeover, but my family is worried.  Am I still a candidate for elective surgery having had a clot in the past?

Mommy Makeover surgery - tummy tuck, breast reduction, and liposuction may be performed after a history of a DVT but only after a thorough workup by your internist.  Your surgeon and anesthesiologist must also be in agreement as to what type of anesthesia and DVT precautions including the use of low molecular weight heparin prophylaxis.  I have performed tummy tucks on patients with histories of DVT's using the precautions stated above, without any problem. The components of the "Mommy Makeover"  surgery should be performed separately.  I would recommend the abdominoplasty first, then the breast reduction, and lastly the liposuction.  After each procedure you should ambulate with assistance as soon as possible after surgery and compressive stockings and venodyne boots should be used throughout all surgical procedures. Good luck! I think the tummy tuck will make you very happy!

Hello, when I smile my nose tip droops a bit.  I am not really interested in rhinoplasty, I just want the depressor septi muscle cut. Would this require a surgery or just a minor procedure? What is the recovery time?

The depressor septi muscle attaches from the upper lip to the base of the nasal septum.  During smiling an over active muscle will pull the nasal tip downward and cause a broad appearance of the nose.  The problem is easily corrected by cutting this muscle through a small incision made inside the mouth just under the upper lip. It may be performed on an outpatient basis.  It is considered a minor procedure and the recovery time is about 5 to 7 days.

I had a CS a year ago for failed induction.  I am 22.  My scar is thick, red and raised about a cm.  It hurts a lot especially when I wear underwear. When I am out I almost pass out from the pain!  My mom is a theatre sister and said it is the worst she has seen (and that she can't understand why my Ob "butchered" me).  Will a revision correct the pain, and will I need to wait another 18 months before trying to conceive, or if the revision avoids the uterus can I TTC in the present 18m?

Unfortunately, some individuals develop thick, heavy red scars after any surgical procedure.  These scars are very sensitive and painful.  Surgical revision is definitely helpful and the addition of 5-Flurouracil into your new surgical scar may also prevent hypertrophic scar formation.  The revision should be helpful in correcting the pain.  The uterus is not attached to the scar on your abdominal skin, and the revision surgery should not interfere with your ability to conceive.

 

For a low or flat bridge, what rhinoplasty technique will give my Asian nose a more defined angle?

The most sure methods to increase length to an Asian nose is to add an implant to the nasal dorsum and tip. I usually use the patient's own tissue.  I prefer septal cartilage, but often the Asian nose has a thinner septal cartilage and the ear is a better source.  Cartilage is an excellent graft source because it becomes incorporated into the patients own tissue after surgery.  Synthetic hyluronic acid fillers are rarely used and if I do use an injectable filler it is usually fat to soften a prominent cartilage edge.  I avoid Medpor, Gortex and Silicone grafts because of the risk of extrustion and infection are greater.

How Can I Avoid Wrinkles Until After 40?  I Am 26 Now.  I have very good skin for my age.  I am very careful with sunscreen (spf 70+ with zinc because I'm allergic to regular sunscreen) and I try to wear hats and sunglasses.  I do have a lot of freckles but I don't burn because I'm half Italian (southern).  ANYWAY, I know that preventative Botox is big and so is retin A, but before I invest all this money over a long period of time, I want to know if it will really make a difference.  Can you REALLY look 26 at 36 or is it all a scam?

How to look 26 at 36!  The best way to maintain a youthful, natural and healthy look is to avoid the sun, keep well hydrated, use sunscreen daily with a zinc or titatinium dioxide in the base.  It is also important you do not smoke.  The rest is up to your heredity.  Ultherapy which treats skin laxity and stiumlates collagen production is also an excellent way to maintain a youthful appearance once skin starts to sag or wrinkles become visible.  Other viable options alone or in conjunction with Ultherapy are Botox injections (which prevent muscle contraction) and injectable fillers.

I am about to have my third baby.  I have always been unsatified with my breasts.  I'm doing my research and trying to figure out if this is what I want or not.  I'm 23 going to be 24 in a few months with three kids and a great fiance.  I want to do it for myself and no one else though.  My fiance loves me for me, and says I look fine, but I want to be satisfied with my body!! I'm the heaviest I have ever been in my whole life!!  Hoping I can lose most of my weight by the time I go in for a consult!!

Breast lift and/or breast implants.  Your research has paid off and you are taking an educated approach to plastic surgery.

1. Breast Augmentation and mastoplexy (breast lift) will give you the best and longest lasting results after you have finished having your children.

2. After having three pregnancies even though you are young, you probably need both a mastopexty and augmentation.

3.  Yes, losing weight prior to surgery is ideal as the surgeon will be better able to judge your ideal breast size.  The correct sugical procedure will then be selected.

Is a coronal brow lift a better option for removing frown or scowl lines?

Coronal forehead lifts are rarely used to treat glabellar scowl or frown lines.  Endoscopic browlifts do not distort the hairline and through this incision the corrugator muscles which cause the wrinkles in between the eyes may be eliminated.  The lateral brow is best addressed through a temproplasty.  A small incision is placed in the temporal region of the scalp to raise the lateral part of the eyebrow.  The hairline is not distorted.  The above two procedure may be used in women with receding hairlines.  A full coronal brow lift would only be performed if a patient required lowering of her frontal hairline.

I am 26 years old and am considered to have somewhat of a weak chin.  I have undergone consultations with 2 doctors for lipo in the chin area and both have advised I do not have enough fat to remove.  One suggested a dermal filler to create a stronger chin.  What are the approximate cost differences between an implant, fillers and a fat transfer?  Also, which filler is best recommended for this area?

The most definitive way to improve a weak chin is with a chin implant.  The use of autologous fat and fillers is a temporary solution or best used to soften the edge of a implant.

Is It Possible to Move Fat from Lower Part of Cheek, to Upper/Cheekbone Area?

The procedure which you are referring to is called a malarplasty or malar imbrication.  I perform this procedure in patients at the time of a facelift, with a need for a larger augmentaion of the malar bone.  I perform this procedure less commonly since I started augmention the malar region with autologous fat.  However, fat is never removed from the face - the autologous fat is usually taken from the upper hip or abdomen.

I want to get breast aug, lift & TT. I'm 37 and I've had 4 children/4 c-sections no keyloid-ing.  Do you think the TT is worth the trade off since muscles are not too bad?  Can a mini do the job or full?  My main concern is the bottom bulge & the stretch marks. Regarding breast aug, lift w/silicone (over muscle was rec since I workout a lot. I want to avoid the lollipop if possible. I despise it! Will a donut work for me? Armpit incision for the implant? I want to go to D cup.

Your photographs suggest the procedures that would give you the optimum results are a standard mastopexy with or without breast implants.  The top of your breasts are flat secondary to being engorged and stretched after pregnancy.  A mastopexy alone does not always provide the fullness you might desire, so I would discuss the possiblity of placing a submuscular breast implant at the time of the mastopexy.

A mini-tummy tuck is best reserved for someone with a small amount of skin laxity.  You will need a standard full tummy tuck to tighten your skin, remove some of the stretch marks and address you rectus diastasis - spread stomach muscles. I know you will be pleased with the difference in your figure after the mastopexy and tummy tuck.

What are some Mommy Makeover options that don't involve a knife? Surely there are great ways to look better (and also feel better) without surgery after having kids and experiencing a less perky shape?

The best option before even considering surgery is diet and exercise.  Occasionally, lax abdominal skin  and breast will not contract and then surgery is the most viable option.

Which other specific Mommy Makeover will help me look healthier and perky? Do smaller chested mothers do better with just a lift?

If your breasts are sagging and have lost volume, a breast lift will make them more full and youthful.  Another option, if you do not have "too" much ptosis (breast sag), is an augmentation with an implant. The size of the breast is not as important as the shape of the breast.

What common Mommy Makeover procedures offer free touch-ups? Does any procedure with a free touch-up mean that it has a high risk of post-operative complication or a high failure rate?  Should surgeons offer or not?

I offer a free touch up for all plastic surgery procedures I perform within the first year after surgery.  Touch up after an abdominoplasty or breast reduction surgery is not uncommon.  The surgeon walks a fine line between making the abdomen "tight" enough and not leaving "dog ears" on the sides of the abdominoplasty incision.  I inform my patients of this before surgery and will do minor touch -ups in my office under local anesthesia.  An example of this would be removing "dog ears."

Should I Get Revision Rhinoplasty? I had rhino/septoplasty 6 months ago.  Since 1 month post-op, I've been concerned about how the swelling looks asymmetrical, making it appear crooked.  I thought this was swelling, but yesterday I went for my check-up, and my surgeon said that the new cartilage is growing on only the right side so that it looks crooked.  He told me I should wait until the year mark to make any revisions, which consists of the simple procedure of reducing the cartilage to make the tip even. Any expert advice?

New cartilage does not grow after a rhinoplasty.  The tip cartilages may have not been shaped symmetrically or if a graft was used it may have shifted.  I perform revision rhinoplasty procedures six months after the original rhinoplasty, unless there is pronounced swelling.

Hello, I have been told by doctors that I need spreader grafts and a graft on my bridge for a scoop. I have thin skin, what are my best options for grafts that won't show under my thin skin?

Spreader grafts will not be seen if properly placed in thin skin individuals.  The dorsum of your nose may be corrected by placing cartilage grafts.  The grafts may be camouflaged by injecting your own body fat as a filler over the top of the cartilage.

Is it possible to have revision Rhinoplaty and Otoplasty at the same time and could this affect the results? Rhinoplasty is performed with the patient lying on the back so how is it possible to perform a surgery on ears when the head rests on the operating table? Could this affect either of the two surgeries?

Otoplasty is often performed in combination with rhinoplasty or revision rhinoplasty.  The patient is lying with the back of their head on the table, and the head is rotated side to side so the ears are easily accessible.  I perform the otoplasty first and harvest cartilage if needed for the revision rhinoplasty. There is little risk performing both procedures at the same time and it is efficient.

Years ago, my dentist suspected that I had a deviated septum but I just left it.  Just recently, I broke my nose and was referred to a specialist.  My breathing is not too bad, but if I take a deep breath through my nose it feels like my nostrils get sucked in.  I've always hated the bridge of my nose but I'm afraid to have surgery on my face, plus I just had a breast augmentation about a year ago and I'm afraid to have another surgery so soon.  Judging by my picture, is it worth the risk?

You are definitely a candidate for a septorhinoplasty with minimal resection of you nasal tip cartilage.  The septoplasty will treat your deviated septum and fix some of your breathing difficulties.  Cartilage strut grafts should be place in the alare valves to prevent further valve collapse.  You should have little risk if performed by an experienced boarded rhinoplasty surgeon.

I just did open rhinoplasty surgery 2 weeks ago, the surgeon used gortex for my bridge and my ear cartilage as the tip graft.  The main reason I did the surgery is because I hate my upturn nose caused by sunken face at the nose region.  My nose currently still looks upturned and is pointing 45 degrees upward, will it go down?  Is it that the plastic surgeon has not done enough to bring my nose down?  Even the front profile of my nose looks weird.  I'm very annoyed and depressed.

You can not make any judgements about your final result two weeks after surgery.  Your nose is still swollen.  It takes a minimum of 6 weeks for the swelling to recede.  Your surgeon has placed both cartilage and gortex grafts which also extends the recovery time.  Patience is what you need and a little hand holding.  Your nose is straight and the majority of swelling is in the tip.  It may take six months to one year for the swelling to completely resolve.

I've been told that internal swelling from a Septoplasty could last a few months.  I went in for septoplasty surgery to take care of difficulty breathing through my right nostril in October.  Now December I am still having difficulty breathing through that nostril.  When I had my last appointment with my ENT doctor a month ago and asked about the breathing he said no further surgery could be performed, that internal swelling could last a few months after the operation and that that could be partly the reason for the blockage. If it's not the swelling, can I do anything else?

Swelling after a septoplasy is normal.  It may take up to six months for the swelling to completely subside.  The structural component of your breathing problems has been corrected by the septoplasty, the lining of your nose is still swollen and this is not abnormal after two months.  Continue using saline nasal rinses and a humidifier at nights.

I had a septoplasty with turbinoplasty for my blocked nose.  I had the packing removed after 48 hours.  I have no splint in my nose.  Instead there is a stitch at the base of my septum near the upper lip.  I have been asked to use liquid paraffin drops daily for the next month.  This liquid paraffin is causing the gunk and debris from surgery to stick.  I am also concerned about paraffinoma.  Is it safe to continue?  What are other alternatives?  Can I use coconut oil instead?

I have never heard of using liquid paraffin after septoplasty.  I instruct my patients to rinse their nasal cavity with saline water - purchased over the counter.  Paraffinoma, a granuloma caused after paraffin is injected under the skin will not occur in your case as you are not injecting the paraffin.  I would not use any oil or paraffin after septoplasty, simply use saline rinses.

How will septoplasty affect my nasal drip? What other things will a septoplasty change besides improved breathing?

A septoplasty will help to straighten a crooked nose that has occurred from a nasal fracture or a naturally occuring deviated septum.  If you have severe nasal obstruction from your deviated septum it will open your nasal passages and improve your sense of smell.  It also un-blocks the opening to some of your sinus passages and should be effective in decreasing large amounts of mucus drainage that may occur with blocked sinuses.

Can I have septoplasty with bilateral turbinate reduction to improve my breathing problems at the same time I improve my look?

The combination of a septoplasty with a rhinoplasty and turbinate resection is very common.  It is an excellent way to improve your breathing problems.  The rhinoplasty portion of the procedure addresses your beauty by improving the shape and size of your nose, while the septoplasty and turbinate resection address a deviated septum that can obstruct your breathing.  Resection of your turbinates is beneficial when both a rhinoplasty and septoplasty are performed as it keeps your nasal passages from becoming too narrow.

I had a full TT a little over 2 weeks ago and was taken out of the compression garment 3 days ago. Since then I have had increased swelling throughout my stomach.  I also have some increased pain. Is this something that normally happens when the compression garment comes off or should I be worried?

It is normal that you have increased swelling after removing your compression garment this soon after surgery.  If you feel more comfortable in the garment, speak to your surgeon and ask permission to wear the garment a little longer for support.

Some surgeons recommend an overnight in the hospital after a tummy tuck, but I could go home the same day.  What is the main health risk that they are monitoring in the hospital, or is it just to be able to give better pain medication?

The majority of my patients and patients in the Washington, DC metro area go home after a tummy tuck.  The main reasons to stay overnight are:

1. Tummy tuck is combined with other procedures - breast reduction/augmentation and liposuction

2. Severe post-operative nausea and vomiting

3. Pain control

4. Medical reasons - blood pressure monitoring requiring a 23 hour stay.

How Long Does the Average Patient Wear Their Girdle After a Tummy Tuck? Are there times after the recovery period has ended that a patient may want to wear the girdle again?

I generally recommend my patients wear the Veronique compression girdles four to six weeks after liposuction surgery.  The abdominoplasty procedures depend on the extent of the surgery, a mini-abdominoplasty is 3 weeks while a full abdominoplasty is 6 weeks.

I just had Liposuction and a full Tummy Tuck done a week ago. I'm very pleased with what I've seen so far.  However, I have extensive bruising from my hips to my knees, both sides of my stomach area, and the pubic area.  How long before these bruises heal, and how can I speed up the healing process?

You have an excellent result and should be pleased with your outcome.  The bruising is from the liposuction and will resolve over the next two to three weeks.  Wear your compression garment and remember to drink plently of water and walk. I think you have an excellent surgeon!

How long will a seroma last after Tummy Tuck and Liposuction?  I had tummy tuck surgery combined with liposuction 40 days ago, and although I am pleased with how I look as I have got my body back to what it used to be, I have also developed a seroma. One week after surgery my doctor determined I had a seroma and for the two weeks following he has been taking this fluid away by syringe every day.  It has now been three weeks since he took the last syringe of fluid and my doctor has now advised me that my body will remove the small amount of remaining fluid itself.  It's now been six weeks since my surgery and although I feel well I am still worried that there may be some remaining fluid, which could be harmful to me.  Can anyone tell me how long a seroma should last and how I should examine myself to ensure there is no remaining fluid?

Seroma is the most common complication to occur after tummy tuck surgery.  It is not a serious complication and is usually prevented by the placement of drains during the surgical procedure.  The drains are removed when the drainage is less than 25cc for a 24hr period of time (The average length of time drains stay in place is ten days).  The small amount of serous fluid that accumulates after this will be absorbed by the body.

Even with the placement of drains a seroma may develop.  It is treated with serial aspiration just as your surgeon is doing.  The seroma usually goes away after a week or two.  On rare occaisions the seroma may persist for 4 to 6 weeks or longer and require treament with a sclerosing agent.  Seromas are not harmful if treated appropriately and not allowed to become infected.

Will cardio work or is a tummy tuck needed?  I am 22 years old with a two year old and a 1 year old and I have lost 20 lbs but the sagging still remains.

Over stretched excess skin is very common after pregnancy, and will not go away with cardiovascular exercise alone.  Pregnancy also stretches your abdominal muscles.  A tummy tuck addresses both the skin and muscle problem and is the best way to fix your sagging belly.

Can I Combine a Tummy Tuck with Uterine Myomectomy?  I've just been referred to a surgeon for a myomectomy and I'm trying to anticipate how to best plan for my upcoming procedure since I also want to have a tummy tuck.  I've been working aggressively at weight loss and have shed 32 pounds in the past 6 months and I still need to lose 48 pounds to get to my goal weight. Can I combine the tummy tuck with the myomectomy?  What are the disadvantages to having the procedures separately?

Yes, a tummy tuck may be combined with a uterine myomectomy if both the plastic surgeon and the gynecologist agree.  However, the procedure carries slightly greater risk than a tummy tuck alone.  These risks include a higher incidence of bleeding and DVT.

I am a 30 year old mother with 3 children.  I am in good health and want to know if its possible to have a tummy-tuck, breast agumentation and hestorectomy at once?  I am 52kg and 1.68m.

Yes, I often operate with an ObGyn and perform a tummy tuck while ObGyn is performing a hysterectomy.  The patients are very pleased with the result.  Recuperation may be a slight bit longer than if either procedure were performed alone, but not significantly.  Breast augmentation is commonly performed with a tummy tuck as part of a plastic surgery marketing package called "Mommy Makeover."  This is a term I actually do not like as it makes women seem like idiotic Barbie dolls or Stepford wives, but that is just my opinion.

How much does Ultherapy cost?

The cost of Ulthera treatment is between $1000 and $4000 depending on the area treated.  Full face Ultherapy treatment in the Washington metropolitan area is $4000.

What does underlying supportive tissue in the skin have to do with Ultherapy wrinkle treatment?

Treatment of the underlying supportive tissue (SMAS and connective tissue over facial and neck muscles) is the hallmark of the "deep see" Ulthera procedure.  Ultrasound focused energy is delivered to this deep supportive tissue stimulating the growth of collagen thus tightening and lifting the skin.  The cosmetic procedure is performed without cutting or damaging the skin surface.  The Ulthera system is the first FDA approved medical device with specific lift indications for the face and neck.

Skin laxity or wrinkles are treated in two planes, one being the deep layer of the skin (dermis) and the other the underlying supportive tissue.  New collagen production is stimulated during the healing process, and results in tighter skin.

I had a permanent filler in my nasal area and along the mouth. Can I still do Ulthera or are there risks associated with it?

Ulthera procedures may be performed after injectable fillers have been placed.  Ulthera is not usually performed near the nose so fillers in these areas will not be affected.  Fillers placed in the cheeks will be affected by Ulthera in that they will be diminished slightly in volume.  This is the only risk associated with Ulthera and injectable fillers.