All surgical procedures are accompanied by a certain degree of risk, whether the procedures are for medical or cosmetic reasons.  Our expert team is dedicated to making your operation go smoothly.  We careful review your medical history and current health condition before deciding if it is safe for you to proceed with surgery.  It is important that you fully disclose all pertinent information so that we are able to make an accurate assessment of the risks involved.  We will take every precaution necessary to reduce the possibility of any complications.

It is a relatively common practice for a plastic surgeon to perform multiple procedures during one operation.  This allows the surgeon to better "sculpt" your final appearance.  In addition, having several procedures done simultaneously saves you the expense of paying the operating room and anesthesia costs more than once.  However, having too much done at one time can lead to complications.  The decision to have multiple procedures done depends on which procedures are being done, the extent of surgery, the operating time, and your age/health.  Ultimately, the surgeon decides whether or not it is appropriate to include more than one procedure in your operation.

Facelift surgery is a broad set of cosmetic facial surgical procedures designed to improve the appearance of the face and neck. There are a variety of facelift techniques that address each specific areas of concern. A consultation in our Seattle area plastic surgery practice is essential to design a treatment plan that is right for you.

Fat transfer techniques can aid with cosmetic facial rejuvenation. Fat transfer is a useful tool to optimize facelift outcomes outcomes. Fat transfer techniques can be used to improve cheek volume and reduce the appearance of tear troughs beneath the eyes. Fat injection techniques are offered in our Seattle area cosmetic surgery clinic.

Necklift procedures are usually combined with a facelift procedure to maximize the rejuvenation of the face and neck. Most necklift procedures involve a small incision beneath the chin which is well concealed. The muscles of the neck (platysma) are tightened and fat is also removed from the neck region. This tightens the neck contour significantly. Dr. Scott Sattler offers facial plastic surgery and necklift surgery in his Seattle area cosmetic surgery practice.

It is possible to do a facelift under local anesthesia. For most patients, the cosmetic surgery is more comfortable and can be done more efficiently with the addition of intra-venous sedation or general anesthesia. We use certified anesthesia providers to enhance patient safety during facelift surgery. In my Seattle area plastic surgery practice, it takes me about three hours to do a face and neck lift. Other procedures, such as eyelid lift, brow lift, fat grafting and rhinoplasty can be added to a facelift to enhance the overall result.

Weight gain and weigh loss will affect the appearance of your face, and other regions of you body. Time will determine if you would benefit from a facelift revision after losing a substantial amount of weight. A common scenario in our Seattle cosmetic surgery clinic is a patient that has lost substantial amount of weight after bariatric surgery. These weight loss patients are generally excellent face and neck lift surgery candidates.

Spreader grafts are pieces of cartilage that are added to the nose between the nasal septum and upper lateral cartilages. These grafts can be used for a variety of problems - they can reduce airflow resistance within the nose, widen the dorsum of the nose, and even lengthen the tip of the nose. After rhinoplasty surgery using spreader grafts, there is typically some post-op nasal swelling which makes the nose less 'soft'. Within a few months, this problem should improve. We frequently perform complex rhinoplasty in our Seattle plastic surgery clinic.

Rhinoplasty surgery is an art. Good results come from careful pre-operative diagnosis of all cosmetic and functional issues, and then designing a plan with the patient to achieve those goals in a reliable fashion. Success in rhinoplasty surgery really comes down to attention to detail and experience in the operating room. Our Seattle plastic surgery practice performs rhinoplasty surgery frequently.

In most cases, I am able to do breast lift and breast augmentation surgery simultaneously in my Seattle plastic surgery practice. I can typically  do a mastopexy augmentation procedure in a single stage. You certainly could do a simple breast augmentation, but you would have to accept that your breast tissue would continue to look 'saggy' relative to the implant. This issue worsens as the years go by. Doing a combined breast lift and breast implant will address both issues at the same cosmetic surgery procedure.

Breast augmentation for constricted breasts is a common procedure in my Seattle plastic surgery practice. Mild constricted breast anatomy is actually a good anatomic sub-type for form-stable gummy bear implants produced by Sientra, Allergan and Mentor. The implants are texturized to help prevent rotation. The breast implant incision using gummy bear implants is typically beneath the breast in the infra mammary fold. The scar is well concealed.

Breast implant sizing is best based on anatomic considerations. Shaped breast implant sizing is best when based on anatomic considerations. There are a variety of shaped breast implants on the market now, with form-stable silicone implants just recently available for cosmetic use. The gummy bear implants produced by Sientra, Allergan and Mentor are available in our Seattle and Bellevue area cosmetic surgery clinic.

In plastic surgery- scars are least conspicuous when placed in natural border between aesthetic subunits. The best place for an arm lift scar (in my opinion) is in the groove between the biceps and triceps muscle on the inside of the arm. Scars on the back of the arm are very conspicuous.

Brachioplasty surgery can be revised to improve arm contour and sometimes improve the scar quality. Achieving good scar quality with brachioplasty is challenging.

A bilateral brachioplasty is an arm lift procedure for both arms (bilateral)- its a great procedure for patients with arm laxity. It places a substantial scar on the arm, but offers excellent and long lasting arm contouring.

Brachioplasty is not a technically difficult operation, but getting good quality brachioplasty scars is a challenge for any surgeon. For this reason, there is a fair amount of collective experience revising brachioplasty procedures. It may be that you had the 'wrong' operation for the arm problem that you had- a limited incision brachioplasty is not a great operation for most patients. Most patients with any degree of arm laxity from armpit to elbow have better results with a 'full length' brachioplasty technique. Obviously, this is a long scar, but the 'trade off' is much improved arm contour. Seek out a good plastic surgeon in your area for some expert advice.

Only a in-person visit with a physical exam can answer this question. Looking at the photos you sent to our Seattle cosmetic surgery office, I think some well-planned thigh and flank liposuction would improve your figure and create the illusion of more buttock projection. Liposuction does very little to address skin laxity, which you do have.

In my experience, the lower body lift (belt lipectomy) cosmetic surgery has the potential to lift and improve the appearance of the mons, abdomen, flanks, thighs and buttocks. There are a variety of types of lower body lift procedures. We offer consultations for body contouring surgery in our Seattle area cosmetic surgery office.

Thank you for sending your photos to us. The buttock Lift is a great procedure. You have already had the 'front half' a lower body lift done. I would recommend completing your lower body rejuvenation with a buttock lift. This procedure will lift your sagging buttock and smooth the lines and folds that your photos demonstrate. We are happy to see you in our Seattle area plastic surgery clinic.

Don't expect any lifting effect along the inside of your thighs after a circumferential body lift - you will get some lateral and posterior thigh lifting effect from this cosmetic surgical procedure. My advice is to do the circumferential body lift and wait several months. Come back and do the medial thigh lift. We are happy to see you in our Seattle area cosmetic surgery clinic.

Lower body lift for massive weight loss patients. Without the benefit of an exam, its difficult to say what type of circumferential body lift procedure you need. A circumferential abdominoplasty and a 'lower body lift' are basically synonymous. There are a couple of type of lower body lifts, each with its advantages and disadvantages and scar positions. Seek out a board certified plastic surgeon with a practice in post-weight loss body contouring surgery for an opinion.

Combined procedures in plastic surgery save just a little money. There are some efficiency and therefore, some cost savings in having a lower body lift done in combination with fat transfer to the buttock- you won't save much compared to doing them independently- but you would save some. There are a couple of nice techniques using vascularized buttock tissue to augment the buttocks during a LBL- you probably would be able to avoid fat transfer using these procedures. Seek out a surgeon that does a lot of LBL work for an opinion. We are happy to see you in our Seattle area cosmetic surgery clinic.

A lower body lift is a truly transformative cosmetic operation and is one of the biggest that we do in cosmetic plastic surgery- expect to pay $12-20K for the procedure- which would include anesthesia and after-care visits. Some surgeons are doing the lower body lift in an outpatient setting with close RN monitoring at home and aggressive DVT protective measures- this can hold the cost down considerably- the hospital is an expensive venue to have this cosmetic surgery....

Botox for smile asymmetry is risky business. I think you are thinking along the right lines anatomically, injecting the 'uninjured' side to weaken your lip elevators (LLSAN and other muscles) innervated by the buccal branch of facial nerve would probably work - but may result in a new type of asymmetry. I personally would wait this one out - most facial nerve injuries recovery spontaneously and you should have full lip elevator function back in a few months. We offer cosmetic Botox treatments in our Seattle clinic to rejuvenate the face, soften line and wrinkles.

Sorry to hear that you had a drooping eyebrow after a Botox treatment. Brow asymmetry often represents natural variation is not Botox related. My guess is that you have natural asymmetry of your brow position. As you age, this may become more obvious. For patients with any hint of brow ptosis, I typically treat the 'brow depressor' muscles with Botox (glabella and lateral orbicularis muscles) and leave the frontalis muscles alone (brow elevators). We offer experienced and consistent Botox injections in our Seattle area cosmetic surgery clinic.

Botox touch up treatments can be done safely. You could certainly have your Botox treatment 'touched up' to further weaken the glabellar muscle group. The other consideration for residual vertical lines is the use of a dermal filler such as Restylane or Juvederm to soften this line even further. We offer experienced Botox and Juvederm injections in our Seattle cosmetic surgery clinic.

Botox is effective for jaw reduction. Injection of Botox into the masseter muscles can induce atrophy of this muscle and reduce the appearance of facial width. Botox dosing for jaw treatment varies, but is typically a relatively heavy dose, in the 50-80 unit range. Give our Seattle cosmetic surgery clinic a call and schedule a Botox consultation. 

The Botox mechanism of action is well understood. Botox is a protein that blocks the transmission of nerve signals to muscles. It temporarily weakens the muscle that it is injected into. The drug's effect is evident at about the 7-10 day point after injection and should last 4-5 months, based on the amount of toxin (the unit dose) injected and other factors. Our Seattle Botox clinic offers injections for facial wrinkle reduction.

Brazilian Butt Lift results depend on the underlying pelvic anatomy. A BBL is a great procedure- but its not going to alter the shape and proportion of your pelvic skeletal and muscular anatomy- A 'boxy' shaped buttock will benefit from from liposuction to improve shaping, but if your flank anatomy is relatively 'boxy', liposuction is unlikely to give you the 'hourglass' shape you desire. A BBL will augment the soft tissues of your buttock, add projection- but it will not give an 'ideal' buttock shape unless that shape is there to start with.

Brazilian Butt lift will improve your figure. I think its reasonable to combine liposuction of the tummy, flanks and other areas with a Brazilian Butt lift. I would not recommend combining a BBL with a tummy tuck- the positioning during recovery would be challenging and would likely compromise the result of the BBL.

Frozen fat for fat grafting is viable. We freeze fat for future touch-ups for our fat grafting patients - we have re-grafted fat into faces, breasts and body and have noted no significant difference in post-grafting viability and volume. I would say that 'fresh' fat is better than frozen fat for large volume touch ups.

Brazilian Butt Lift is really an augmentation using fat. This is a poorly named procedure, but its popular enough that the name has stuck- a BBL is simply fat grafting and liposuction done to contour the buttocks, flanks and thighs. There is an excisional procedure called a Buttock Lift that involves removing lax tissues and lifting sagging buttocks- this leaves the scar that you describe.

Beware of combination plastic surgery. The combination of procedures that you list is not recommended. After fat grafting to the buttock, it is recommended that you keep pressure off of the treated area for several days. After a tummy tuck, it is difficult to lie flat in bed. After an augmentation, it is unwise to lie on your stomach.

Breast implant revision surgery is done in our Seattle area cosmetic surgery clinic. Sometimes silicone implants leak and need to be replaced. I typically recommend removal and replacement with smooth silicone implants in the submuscular position for patients that present with subglandular silicone implants. If you need a lift, it can be done at the time of surgery, or in a delayed fashion. I recommend up-sizing the implant about 75 cc when switching to the submuscular plane- this position tends to 'blunt' the volume of an implant.

Breast implant removal will make breast look different. If most of your current augmented breast volume is composed of implant, then your breasts will have some laxity for a period of time after implant removal. If your tissues are youthful and elastic, some of this laxity may recover on its own. You might need a lift. We can discuss your breast implant removal and breast lift options in our Seattle area cosmetic surgery clinic. 

Breast implant removal will make a breast look different. I guess it all depends on what your idea of 'better' is. Removing implants just a few weeks after augmentation will result in a breast that looks much like what you started with, with the addition of a new scar. Unless you are dealing with a substantial implant malposition issue, implant removal in the early post op phase will not improve your breast appearance. You'll have a brand new scar ! Depending on what you decide to do, we are here to help with breast implant removal or replacement in our Seattle area plastic surgery clinic.

Capsulectomy is often needed for complex revision breast surgery. If you are having a simple implant removal procedure, the capsule should be excised and the 'pocket' obliterated, in order to prevent a long-term fluid collection from forming. This procedure is called a capsulectomy. I generally remove the anterior capsule only (in a sub-muscular argumentation) and then place a drain in the space for a few days. You cannot feel the remnants of the capsule when it is handled in this manner. I perform breast implant removal, implant replacement and capsulectomy in my Seattle area cosmetic surgery clinic.

Breast implant removal - aesthetic outcome expectations. Without a photo- its difficult to judge how your breasts will look with the implants out- if you have a ruptured silicone implant- it should be removed. The appearance of your breast after removal will depend on how much native breast tissue you have, and its positioning on your chest wall. Your choices are three: remove implants, remove and replace implants, remove implants and get a breast lift. I perform breast implant revision surgery in our Seattle area breast plastic surgery clinic.

Based on the photos that you sent to us, I'm guessing that you dislike the sagging lower pole of your breasts, but are otherwise happy with your augmentation. I would recommend a standard vertical breast lift with reduction of the lower pole tissues of each breast. This would leave a vertical scar on each breast, and a scar around the areola. Your areola are in good position, and don't need to be 'moved', but the skin should be tailored around each areola for the best possible result. I perform breast lift and breast implant revision surgery in my Seattle, Washington area plastic surgery clinic.

Breast position on the chest is a determinant of augmentation result. Your breast footprint appears to start relatively low on your chest. You have quite a distance from your collar bone to the 'top' of your breast. I personally do not think a breast lift would improve upper pole fullness. A larger diameter implant would, but would create a 'fake' look with a very rounded upper pole.

Considerations prior to revision of breast augmentation. Impossible to answer this question without several key pieces of info : when was augmentation done, what do you look like prior to surgery etc. Wait a few months and keep in touch with your plastic surgeon.

Revision of breast augmentation to improve 'bottoming out'. I'd recommend supporting the implants with a 'internal bra' composed of Strattice, a useful biomaterial used in breast reconstruction. This will help improve positioning - bottoming out and lateralization, in your case.

'Rock in the sock' deformity can be improved with revision breast surgery. You have a classic 'rock in the sock' deformity - heavy implants stretching and elongating the breast skin envelope. My recommendation would be to switch implants to sub-muscular plane, support with Strattice infra-mammary sling, and perhaps use a smaller implant. You may need a mastopexy to deal with skin excess. Good luck!

Its impossible to make implant sizing recommendations based on the limited information presented. Based on the photos that you sent to us, your tissues appear tight and you don't appear to have a wide breast width - be careful about using large implants. During an consultation in our Seattle Washington area cosmetic surgery clinic, I can give you reasonable implant sizing recommendation based on the dimensions of your chest and your aesthetic goals.

Saline implants can be replaced with modern silicone implants into the sub muscular position. This often improves soft tissue coverage over the implants, especially important for patients with thin tissues. Implant support can be improved with Strattice to reinforce to create an 'internal bra' for the implant. This type of complex breast implant revision surgery is frequently done in our Seattle Washington plastic surgery practice.

Breast augmentation for 'full breasted' women is more challenging that it might seem. Based on the photos you provided, I'm not sure that breast augmentation is going to help you meet your cosmetic goals of looking completely un-augmented. A small implant could be used in your case to provide some upper pole roundness, but I'd worry that over time, you would develop breast sagging over the implant and would require a lift in that situation, later in life. Using a big implant is only going to create an augmented appearance in your situation. Our Seattle, Washington area clinic is a cosmetic breast augmentation center.

Differential breast implant sizing sometimes creates a new assymetry. I think there are different philosophies on differential breast implant sizing. In most cases like yours, I'll use the same volume breast implant to establish a symmetric breast width and height. Using different sized implants in patients without a lot of breast tissue can create new asymmetries related to the implant diameter/height/projection etc.

I think there were some differences in your infra-mammary fold position and nipple/areolar position that make your case a little more challenging to achieve perfect symmetry.

I perform complex cosmetic breast augmentation surgery in my Seattle Washington plastic surgery practice.

Benelli mastopexy is good for areolar reduction but not for breast lifting. My experience with a Benelli, or peri-areolar purse string mastopexy, is that the procedure is good for areolar diameter reduction, but does tend to flatten breast projection. It certainly does not have the 'lifting' capability of a vertical mastopexy. I think long-term breast shaping and scar quality  is much better with vertical mastopexy and breast implant combination surgery. I frequently perform breast lift surgery in my Seattle Washington cosmetic surgery practice.

Based on your description, you sound like your are having a routine recovery after vertical mastopexy and breast augmentation. My patients are quite swollen after this surgery. This takes a few weeks to settle down. I frequently perform breast lift and augmentation surgery in our Seattle area cosmetic surgery practice.

Breast lift without implants is a powerful operation. You have severe nipple and parenchymal ptosis (sagging) and lack upper pole volume. This is a challenging situation to optimize. I would offer a vertical breast lift with a Graf flap which would move your sagging breast tissue beneath the central portion of your breast. This would vastly improve your breast shape.  You'll need to decide if you actually want larger breasts before deciding if a breast implant is right for you. A breast implant is the only reliable way to achieve volume in the upper pole of your breast.

Breast asymmetry cases often require mastopexy. You appear to have substantial differences in breast volume, nipple position, breast footprint and shape - A breast lift on right side may be necessary to balance the position of your nipples. The type of photo that you posted is not helpful in making these assessments. Seek out a plastic surgeon with substantial cosmetic breast surgery experience and get an informed opinion on your unique situation.

Constricted breast anatomy can be improved with conservative augmentation. I don't think you have a tuberous breast anatomy - I would describe your breasts as 'constricted' - the breast footprint is narrow relative to the width of your chest and the fold beneath the breast is relatively high.

I think an areolar reduction would improve your aesthetic result - but if you wanted to avoid this, I would offer augmentation using a implant with a base width diameter  that is narrower than the width of your breast.

You could start with this basic cosmetic intervention, and then decide later if you wanted a mastopexy.