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3

Questions Answered

13

Years of Membership

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Practice, David R. Stephens MD

10687 NE 2nd St
Bellevue, WA 98004
United States

Questions Answered

Questions Answered
Asked 2017-05-30

I went to a highly recommended plastic surgeon for a breast augmentation consult. Right now I'm a 36F/36G. The doctor told me that I'd have to have a breast lift first & then wait a year to have implants put in. I left in tears. I've waited 15 years and to be told that I have to have a lift and then…

5 Answers
David R. Stephens, MD
Answered: 2017-09-22
Although you don't have photos I think that I would agree with you surgeon; he or she sounds highly recommended so this is important; just make sure that your surgeon is a board certified plastic surgeon though. I will perform a combined breast lift/implant augmentation in almost all situations with the exception of a patient that is already full breasted or one who has small breasts and is a big woman; you are a 36 G/F! You have had to deal with these breasts all of your life and it is important to get a safe reliable result than to risk surgical and aesthetic outcomes. Large breasts will fall over time more than small breasts and may need a revision. My exception is I think that an implant could be placed in 6 months which provides enough time for settling and healing; no harm in waiting though.
Asked 2017-04-27

I am 24 years old, and had saline implants at 19. My natural breasts (before surgery) sort of faced out, not forward. Now that I have larger breasts, I can really tell. When not wearing a bra, I have no cleavage because of the way my breasts lay. When I lay flat on my back, my breasts fall to the…

7 Answers
David R. Stephens, MD
Answered: 2017-09-22
It is quite common for implants, particularly smooth saline implants to migrate out into the armpit, particularly if you have a round chest and nipples that face out. You likely need a procedure to fix the pocket called capsulorraphy, to bring them in. If you are very athletic, you might consider some reinforcing material as well, to support the outer pocket. I might consider switching out to silicone implants or the Ideal Implant as well as they are softer and don't move out as much to the side. I textured implant is a consideration as well . At the very least you need a outer breast pocket repair.
Asked 2017-09-20

Is it possible or advisable to have an abdominoplasty with liposuction to abdomen and hips, breast augmentation and liposuction to my thighs all during the same surgery?

8 Answers
David R. Stephens, MD
Answered: 2017-09-22
When performing an abdominoplasty, I typically include liposuction of the hips and lower back as they complete the transformation of the torso. Our body is 3 dimensional this makes everything fit well aesthetically. These can be combined with a breast procedure. Liposuction of the abdomen is not typically done unless in a mini abdominoplasty or in some cases of lipo-abdominoplasty that some surgeons do. I find that the combination does not give as good a result as a classic-standard abdominoplasty if there is significant abdominal laxity. Liposuction can then be performed later on, if necessary, and this gives a better overall result. I have seen many patients that had the lipo-abdominoplasty done inappropriatly who were unhappy with the persistent abdominal skin laxity following the procedure. There is also the question if a muscle plication should so be done as well. Thigh liposuction can be done in the outer and inner thighs or as a circumferential thigh liposuction which is more involved and time consuming. I recommend this as a stand alone procedure. For safety reasons, it is important to limit the length of other procedures when abdominoplasty is preformed due to the higher risk of DVT and of consequent pulmonary embolism, so don't try to do too much at one time.

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David R. Stephens, MD

Practice, David R. Stephens MD

10687 NE 2nd St
Bellevue, WA 98004
United States