I am a mother of two with a sagging stomach when I bend at the waist. When standing, it’s not saggy – just an excess layer of loose fat beneath the skin that I cannot work off with exercise. If considering a tummy tuck & breast augmentation, which of these surgeries should be done first and which second to get the best overall results? I do have very young children, and therefore think it would be best to break up the surgeries so I can have a more manageable recovery period and manage them.

Answer from Dr. John Squires:

You can do both breast augmentation and tummy tuck at the same time. This will save you both on total cost and recovery time.

I’m planning on having breast augment & tummy tuck in one procedure (like a ‘mommy makeover’). My twins are 10months (my boy is quite a big guy, weighs 25 lbs or more, I weigh 106, plus, I have an older child). I was thinking of hiring help for the first 2 weeks after the surgery (lifting kids etc). Do you think 2 weeks will be sufficient? Will I be able to lift my kids & take care of them after 2 wks again? Not worried about the pain, but will it affect how the scars develop?? Thanks!

Answer from Dr. John Squires:

Traditional plastic surgeons were taught to not have patients lift more than 10-15 lbs. for 6 weeks after abdominoplasty. This was to prevent the muscle sutures from pulling out and spoiling the result.  I repair the muscle in two layers, which makes a very strong repair. I caution people to tighten their abdominal muscles before lifting, use mostly their legs and go by what their body is telling them. For the past 10 years I have allowed patients to lift their kids at 1 week and have not had any repairs fail. This makes sense to me considering that coughing or sneezing puts way more stress on the repair than reasonable lifting.

Question for Denver Plastic Surgeon Dr. John Squires about Breast Reduction:

If I do chest exercises and build an underlying muscle will it lift and shrink my breasts, I am a 32D and I hate that they are so big and sag quite a bit for my age ( I am 20). SO I am looking for a way to fix those problems I want smaller breasts but I also would like them to sit higher up once I get there without surgery.

Answer from Dr. John Squires:

Building the muscles under the breasts will only make them more prominent. Exercise will do nothing to tighten the breast skin or breast tissue. The only way to reduce the sag is with a surgical lift.

Had revision breast lift in one breast & scar revision in 1/2011. 1st lift was performed 12/2009. First surgery left me quite asymmetrical. Right breast measured 21 cm from sternal notch while the left measured 19 cm. I’m extremely worried that the breast that was relifted appears way too high. The surgeon’s nurse explained that he “tacked” my breast tissue to my chest wall because that is his technique. First surgeon never did any tacking. Is it too early for me to panic about my results?!

Answer from Dr. John Squires:

The breast tissue will take time to settle, up to 3-6 months. Since your most recent surgery was just on one breast, some  asymmetry is expected. I would wait at least 6 months before considering any more surgery.

What procedure could be done for a breasts lift which will not leave evidence of cosmetic surgery or scaring. I have seen videos and I am afraid of noticible scars. My breast sit on my abdoment and my nipple are shifted looking downward. I am a 34DD.

Answer from Dr. John Squires:

Small amounts of lifting can be done with only an incision around the areola, the so called Benelli lift. I frequently use this for combination lift and implants. It usually gives a very good scar but is only useful for small lifts. Downward pointing nipples will require a more powerful lift such as vertical mastopexy. These scars are more noticable but usually fade with time.

I have consulted with two board certified plastic surgeons in regards to having full abdominoplasty and breast lift. One surgeon said all I would need is a Benelli lift, the other said I need a full “anchor” lift. Why is there such a discrepancy? And why not a lollipop? After having 6 kids, and breastfeeding all of them, I just want my breasts to be back where they once were, and to stay in my bra when I lean over!! All of this just seems to get more confusing… Please help!

Answer from Dr. John Squires:

Breasts with minimal to moderate ptosis often can be treated with several different types of breast lift, depending on what you want your results to be. If you are happy with a conservative amount of lifting that will leave you with a natural but still not extremely perky result, a well done Benelli lift will give you a good result. Since the Benelli lift is not an extremely powerful one, I commonly use an implant to help fill out the breast volume and lift the breasts. If you want a very perky appearing result, a vertical mastopexy with the lollipop incision would be more appropriate.

My breast implants are way to large for me. I currently have 400cc high profile implants, and I want to downsize to 250cc moderate. My doctor won’t do it for another 3 months. Will my tissues be stretched out too much by then for my smaller implant? I am young and in good shape. I wanted much smaller than what I got, maybe a nice B or small C size but I’m a D! I started with a small A.

Answer from Dr. John Squires:

In many cases, the results of breast augmentation may initially look too large and round. The shape will frequently mature into a more natural appearing breast over the first 3 to 6 months. I have seen many patients who initially thought there implants were too large who after 3 to 6 months were very happy with their appearance. However, if you are absolutely sure that the breast implants are too large for you, there is no need to wait to have them exchanged. The longer you have excessively large implants in place, the more stretching of the tissue you will see.

I got breast implants in 2006. It’s been 3 years and everything has been fine, up until this past week when a small area of my right breast has been slighty hurting. It feels as though it was bruised, yet there are no visual indications of a physical, darkened bruise. What could this be? Thanks.

I am a bartender. Could it be possibly because I lifted something too heavy/too quickly and torn something?

Answer from Dr. John Squires:

At three years after surgery, I think the most likely thing you are experiencing is a pull of the muscle or perhaps a small tear in the scar tissue capsule around the implant.

The most prudent course would be to have your plastic surgeon examine you to make sure nothing else is going on.

I am a week out of breast augmentation. I received 250cc saline smooth implants under the muscle. And ever since day two, I’ve noticed the left breast implant showing on the side and sticking out the bottom. Making it hang lower, yet the nipples are symmetrical.

Is this a problem or is this normal while it heals? My right breast has looked normal (minus minor swelling) from the beginning. Which is why I am more alarmed with the left breast. I feel that depending on the angle and light hitting my breasts, you can see the implant sticking out more on the left side & underneath. It feels squishy too.

Answer from Dr. John Squires:

It appears that the implant is too low and is causing a double bubble deformity. Take off the upper pole band and begin wearing a supportive bra 24/7. You may be able to get the implant to heal in the proper position. If not, you may need surgery to close the lower portion of the implant pocket.

I have 15 year old silicone breast implants. Are today’s silicone implants any safer? I have been ill on and off ever since having the implants, but now I am sick most of the time.

I have had blood results back which say that I have high levels of silicone and high levels of nickel in my blood. I am not ready to live life without boobs, but I don’t want to be ill for the rest of my life. So as you can see, I need to weigh the odds. This brings me back to the question above, are the silicone breast implants today any safer than they were 15 years ago?

Answer from Dr. John Squires:

Silicone implants of any age have not been found to cause any disease. The illnesses that we were concerned were linked to the implants have been found to be just as common in women without implants as with silicone implants. The FDA has published all the pertinent data.

That being said, today’s implants are much less likely to leak than the old implants. The old implants had a very thin outer shell that could rupture easily. They were filled with liquid silicone and caused a big mess if they leaked.

The current implant design is approximately 8 years old. The shell is much tougher and the silicone inside is a cohesive gel, meaning that if the implant should rupture the gel sticks together and does not run everywhere.

In an MRI study, the leak rate of these new silicone implants at seven years was less than 1%.