Your Questions
Your Questions
Q: Dr. Eppley, I am having a rhinoplasty by you later this fall. I was planning on a facelift and breast lift with fat transfer to face and breast. It’s the beginning of a body makeover. I would prefer having you since the surgeons in my area aren’t capable of correcting the nose. Can we do all of the surgery mentioned above, I would really like to do as much as possible.
A: Such combined face and body procedures are often done together and the economy of time, cost and recovery are the obvious reasons why many patients seek to maximize their operative experience. But each patient must be assessed individually to determine if it is the right concept for them. In making that determination the important factors are two-fold; is it safe and is the best result achievable in one combined surgery? From a safety standpoint, 62 years old is perfectly fine for these procedures as long as one is healthy with no major medical problems. (which you are) For your immediate recovery, however, such combination of procedures should only be done if you are observed overnite in the facility. That would be particularly paramount since you are from out of town.
From a procedure standpoint, combining a rhinoplasty and facelift (with or without fat transfers) is very common. The nose is a central facial procedure and the facelift is a lateral facial procedure so one does not affect the other. For a breast lift, however, volume augmentation by fat injections may or may not be affected by the lift. That would depend on what type of lift is being performed and what quadrant(s) of the breast fat may needed to be added. Depending upon your degree of ptosis (sagging) you may only need the Refine internal suspension lift with outward superior nipple lifts. That would allow the maximal volume of fat to be added at the same time. I would need to see some pictures of your breasts to better answer this procedural question.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am interested in getting a pectoral implant on just one side. I have pectus excavatum on the right side of the sternum/chest and have been treated with fat inejctions. They did not do as much as I wanted due to some fat resorption. I think if I just had a small pectoral imnplant as opposed to a full one on that side that would make it much better and no volume would be lost. My question is how would this implant behave with years of abuse (contracting the muscle) through physical work, and working out the chest. and since it would be placed under the muscle it should be rather invisible during the movement of the muscle right? How long have your patients gone with implants? A silly question about this implant, would it be permanent and to my understanding the longer the implant would be under the muscle the more the chances of complications(movement) decrease?
A: Physical activity and chest muscle action have no negative effects on a submuscular pectoral implant or vice versa. Pectoral implants (whole or partial) under the muscle are not seen on the outside. It is implants that are above the muscle in the chest that have concerns in these regards. Pectoral implants are made of a soft silicone elastomer that does not degrade, this it is permanent and would never need to be replaced. I know of no pectoral implant patients who have ever had long-term problems with their implants. The only potential issues are short-term after surgery with the very low risks of infection or seroma formation.
Dr. Barry Eppley
Indianapolis, Indiana