Educational Purposes: Questions and Answers by Dr. Amy Bandy
Q: Should I Get a Breast Lift if I Plan on Having More Children?
A: Dr. Amy Bandy says.. As long as you understand that you will likely need a secondary breast lift after future children, I would definately tell you to go for it! There is no reason that you cannot enjoy perky breasts until you are ready for more children.
Q: Uneven Breasts – Insurance?
A: Dr. Amy Bandy says.. No, Sorry! This is considered cosmetic by the insurance industry standards. Breast reduction is only covered when there are symptoms sucha as back pain, shoulder grooving or severe rashes under the breasts. Even then, the insurance companies will require a minimum gram weight removed before they would cover it.
Q: Can I Breastfeed w/ 14 Year Old Silicone Implants?
A: Dr. Amy Bandy says.. As long as you do not have problems with your breasts or implants, there is no reason that you should not be able to breast feed. Good luck with your pregnancy and bonding with your baby!
Q: Is Exercising Changing my Implants?
A: Dr. Amy Bandy says.. It is highly unlikely that the exercise has anything to do with the fact that you now seeing rippling. You are likely seeing rippling because the implants are settling and the swelling has resolved. You had very little breast… more
Q: Should I Have Implants Replaced or Removed Entirely?
A: Dr. Amy Bandy says.. If you were a 34b prior to surgery, and you want to return to a B cup, it is quite possible that you will still be a B after removal without another implant. However, if you have lost a significant amount of weight since your surgery, or you have had children and breast fed, your breasts could be smaller than a B cup. If you have saline implants, it is possible to deflate the implants before surgery so that you can get an idea of how much volume of your own natural breast that you have. This could help you decide. The other option that I offer my patients is to have surgery under local anesthesia so that during the procedure, you can see your size, and determine if you want implants or not.
Q: How to Fix the Dent on Breast Implants
I write this on behalf of my friend. She had breast augmentation 3 weeks ago with the incision in the armpits. Four days ago, she started to notice a ‘dent’ on her right breast (see the picture). Her surgeon said she got capsular contracture grade 1 and told her to massage her breasts to smooth out the dent. Then yesterday she found out her left breasts start to appear a ‘dent’. Is it true that massaging can smooth out the dent like in the picture or she does need a revision? Her implants are smooth ones, and if the surgeon replaces the implants with textured implants in the same pockets, will she still get the same capsular contracture? And how much does the correction cost with another surgeon in California?
Amy T. Bandy, DO answers: How to Fix the Dent on Breast Implants
A: Dr. Amy Bandy says.. How to Fix the Dent on Breast Implants
The photo does not indicate capsular contracture. Her implant pockets were not created symmetrically. However, she is still very early in recovery, and this can change. I would recommend that she wear a breast strap, and elastic strap that fits tightly over the upper part of her breasts. This will help to strech out the pocket as the capsule is developing. This may help alleviate the need for revision surgery. She should wait at least 3 months before being too critical of her lower breast shape, as this can change during the early recovery. If at that time it has not changed at all, she should discuss her options with her surgeon.
Q: Could I Have CC or Am I Just Paranoid?
I am 6 weeks post op, and am worried that I haven’t dropped enough. I have Smooth Moderate Plus Saline implants (300cc’s)and I had very little breast tissue to begin with. They’re not super soft, but they’re not super hard either. My PS suggested silicone for me- but I worry and went with saline. I’m ok with slightly harder breasts as long as they’re ok! Hopefully I’m just being paranoid.
Amy T. Bandy, DO answers: Could I Have CC or Am I Just Paranoid?
A: Dr. Amy Bandy says.. Could I Have CC or Am I Just Paranoid?
From your photos, you appear to have expected results for this point in your recovery. However, the only way of truely knowing if you are developing a capsular contracture is by physical exam. Ask your surgeon, and have him/her evaluate you. You should continue to soften a bit over time. If you only continue to get more firm, then a capsular contracture would be likely.
Q: My Saline Breast Implants Are Lumpy and Shelflike. Need Advice.
Four weeks ago I had saline implants put in under the muscle with a breast lift. I’ve had a lot of swelling and bruising, and even pitting sternal edema and hardened tissue at the lower portions of each breast. Briefly it seemed to improve but then the bilateral swelling again worsened and new bruises appeared. Twice my doctor drained hematomas, and once tried to break up scar tissue-SO painful. Now the breasts are dropping and softening, but the lower halves look lumpy and awful, like shelves.
Amy T. Bandy, DO answers: My Saline Breast Implants Are Lumpy and Shelflike. Need Advice.
A: Dr. Amy Bandy says.. My Saline Breast Implants Are Lumpy and Shelflike. Need Advice.
4 weeks after surgery is early, and your breasts can still change immensely. That being said, it sounds like you experienced capsular contracture after the hematoma’s. You should discuss your options with your surgeon about early treatment of the capsules, such as ultrasound treatments and possible Accolade- an asthma medication that works well on inflammation in breast capsules. This may help alleviate a possible need for a future surgery. You should also be realitic that you may need a secondary surgery for best results.
Q: Hematoma from Breast Implants
I receieved breast augmentation on Feb 28, 2 days later I had a hematoma in my right breast and went back in for surgery to remove it. That was March 2 and my right breast is still considerably larger and higher up than the other. Is this normal? How long does the swelling usually take to go down after a hematoma is removed?
A: Dr. Amy Bandy says.. Hematoma from Breast Implants
Hematoma after breast surgery can be very discerning. After secondary surgery to evacuate the hematoma, you can remain more swollen than the other side for several weeks. This is because of the repeated trauma to the tissues in that breast after 2 surgeries, as well as the possibility of bruised tissues (blood that seeped into the breast tissues and not in the pocket of the breast implant). The higher position of the implant may be due to the swelling, but it also may be because of the pocket itself. You should follow closely with your surgeon to be sure that you are not developing a capsular contracture, or a secondary seroma or hematoma.
Q: Can Stitches Still be in my Nose 5 Years After Rhinoplasty?
1)I had my nose done 5 years ago by Dr.Gary Friedman in SF.He’s now out of business.Since the surgery I have a big bump/growth inside of my left nostrill,it looks like cartilage but lately it’s getting much bigger!What is this? 2)Also when I touch the inside of my nose kind of by the tip,I feel something short and sharp that feels like stitches.This never went away since the surgery.Why would they leave parts of the stitches in? What to do? Thanks for your help!
Amy T. Bandy, DO answers: Can Stitches Still be in my Nose 5 Years After Rhinoplasty?
A: Dr. Amy Bandy says.. Can Stitches Still be in my Nose 5 Years After Rhinoplasty?
Unfortunately your photo is not clear enough to tell what your problem is. The suture material that you doctor used could have been a permanent stich, which over time can poke through the mucosa. This is not the only explanation though, and you really should be evaluated if you are feeling something sharp. Good luck!
Q: Should Reconstruction Expanders Move Under the Skin?
I have had my tissue expanders in place since bilateral mastectomy 11/15/10. I stopped getting fills after December 20th so I could heal from my pain, get back to work full time, and spend time with my family. I have noticed that my left implant moves all around under my skin, but the right stays fixed in place and tends to cause much more discomfort, and cramps during times of over-activity with my arms. Is this normal?
A: Dr. Amy Bandy says.. Should Reconstruction Expanders Move Under the Skin?
Tissue expanders are typically textured, specifically to prevent movement. However, anytime a pocket is made, there is the potential for movement. It is unclear from your message whether it is the expander that is moving, or the stable expander that is causing pain. You should have your operating surgeon evaluate you and consider an ultrasound to determine if you have a seroma around the expander.
Q: Can an Injury to the Pec Area Trigger Gynecomastia?
I was hurt in 2008 at work lifting some heavy stone. I tore my rotator and labrum and had surgery in 2009. I also had a pop in my right pec that went from the nipple to almost under my arm. The area was 2 to 3 times the size of my left pec and black and blue for a few weeks. The swelling went down after about 6 months, but is still bigger than the left. My doctor sent me to a cosmetic surgeon that was unsure and said i may have damaged the pec minor, but also it looked like gynecomastia.
A: Dr. Amy Bandy says.. Can an Injury to the Pec Area Trigger Gynecomastia?
It sounds like you developed a hematoma from your injury that has now partially resolved, but you probably have scar tissue associated with the hematoma. You may have some excess breast tissue or fat on your breast as well, but this would not have developed from the injury.
Q: How to Get Rid of Pubic Swelling?
A: Dr. Amy Bandy says.. It it has been one year since you had liposuction, it is not swelling that you are seeing. You likely need additional liposuction to get the results that you are seeking.
Q: Broke Nose 3/2/11 – How Soon Can I Have Rhinoplasty?
A: Dr. Amy Bandy says.. I agree that unless it is a compound fracture and extremely swollen, you should be safe to have your surgery in 4-6 weeks after your injury. Ask your plastic surgeon for advice on timing.
Q: Upper Arm Liposuction
A: Dr. Amy Bandy says.. From you photo, you appear to be a good candidate for arm liposuction. The expertise of the surgeon is primary, and the type of liposuction is secondary. All techniques are good, if performed by an excellent surgeon. GOod luck!
Q: Can Implant Size Be Doubled?
A: Dr. Amy Bandy says.. Unfortunately, 800cc is the largest implant size that is made. Your situation shows the shortcomings of the implant manufacturers limits on the sizes of implants. Sorry there is not a better option in implants for you!
Q: Nipples Below Crease: Breast Lift and Implants or Implants for Me?
A: Dr. Amy Bandy says.. From the looks of your photos, I wuold recommend going with implants only. You can always have a mastopexy later if you want your nipple higher- and you can do this under a local anesthesia!
Q: Why Are my Nipples Facing Different Directions?
I had a TUBA 4 days ago. When the wrapping was taken off two days ago, it was very apparent that my right nipple is facing down and my left nipple looked normal and was facing forward. When I mentioned it to the Dr he said he noticed it during the surgery, but that it should even out. My right breast also sits a lot higher than the left; and the right is flat on the side, while the left is rounded out. It does not seem to be straightening out yet. Is this normal/common? I am very nervous
Amy T. Bandy, DO answers: Why Are my Nipples Facing Different Directions?
A: Dr. Amy Bandy says.. Why Are my Nipples Facing Different Directions?
From your photo, it appears that your right breast pocket is smaller, and I do see where your nipple looks like it is pointing down likely from the difference in pocket dissection. I would recommend that you have a breast strap placed over just your right breast at the top of your breast for pressure, and to wear it 24/7 until they have evened out. This will help strech the pocket while the tissues are still healing. If you wait too long, it likely will not work. This may not be 100% effective, but it can help alot.
Q: Vicryl Reaction in Inside Stitches After Labiaplasty
5 weeks post op and I have numerous (20+) painful knots inside my labia all up and down it. My doc says to wait until 13 weeks post op and if they haven’t fully disappeared by then, he will remove them. He said this is a rare occurence and I am one of the “lucky” few. Is there any chance these will dissolve on their own and if so, is there anything I can do to encourage this? They are sore..Anything you recommend for the pain? Hopeful but unsure 
Thanks in advance for your input!
A: Dr. Amy Bandy says.. Vicryl Reaction in Inside Stitches After Labiaplasty
I dont use vicryl for this type of surgery, I use a faster absorbing suture so that stiches do not even need to be removed and are typically dissolved in 5-7 days. Vicryl lasts longer than other abdorbable sutures. If you are having painful knots after 5 weeks of surgery, I would not wait to remove the sutures! Have them removed now! You are sufficiently healed that you should not need sutures for wound support. If you are worried about the pain of the suture removal, you surgeon can prescribe you a topical anesthetic that will make you numb before removing the sutures. Alternately, you can leave them in and they will eventually dissolve, but that will prolong your misery!
Q: Unhappy with Labiaplasty Results – Can It Be Corrected?
I had a labioplasty almost three years ago and the doctor removed both of the labias completely, which was a surprise for me as I just wanted them reduced. She said there’s nothing she can do about the clitorial hood. Now I think it looks too disproportionate and the lack of continuity bothers me. I did not let any of my partners or anybody except this doctor to look at my vagina, and now I feel too embarassed as well as I feel it looks so unnatural.Could it be corrected by another operation?
A: Dr. Amy Bandy says.. Labia correction
I agree that it is difficult if not impossible to correct any area of the body where too much tissue has been removed. But what I also understand you to say is that your clitoral hood looks out of proportion to the rest of your genitalia. If that is the case, you should be able to get this area reduced. Seek out an experienced surgeon in your area and find out what can be done. Good luck!
Q: Looking for Doctor who Offers Under Eye Surgery (Blepharoplasty) w/o General Anesthesia?
Hi, I’m in the Los Angeles area and I am looking for a surgeon who specializes in lower blepharoplasty, who is willing to do the procedure without general anesthesia. I know of ONE a couple hours away that actually prefers only local anesthesia, but I’d prefer to do this closer to home.
A: Dr. Amy Bandy says.. Looking for Doctor who Offers Under Eye Surgery (Blepharoplasty) w/o General Anesthesia?
I agree that most Plastic Surgeons will offer blepharoplasty under a local anesthesia. It is rare that I perform this surgery under a General Anesthesia, unless the patient is having multiple procedures at the same time, or specifically requests General Anesthesia. Good luck!
Q: Saline to Silicone – Do I Need to Go Up in CCs to Have the Same Result?
I currently have 275 mentor round smooth saline implants filled to 300cc’s. I am considering switching to silicone and I am looking to be a little bigger but not much. My rib cage measurement is 30 and I am currently a 34 full C small D.My doctor suggested going with 350cc’s silicone but will this be enough?I mentioned I want to go to 400cc’s but he said it would be too much.I am only 5’0 and I don’t want my breasts to have the “fake” look. I am changing because I am hoping to get more cleavage.
A: Dr. Amy Bandy says.. Saline to Silicone – Do I Need to Go Up in CCs to Have the Same Result?
If you are switching from saline to silicone, 50cc difference in volume is going to look the same to you. I think that you should consider a minimum of 100cc difference, ie: 400cc like you stated. I would be hesitant if I were your operating surgeon to offer you an exchange with only an increase of 50cc as I feel you would be highly disappointed in the results. The volume of fluid is spread out over the entire implant, and will be such a subtle change if you are increasing only 50cc; even 100cc sometimes can be quite subtle. And going from saline to silicone, the silicone gel implant is a softer implant, so naturally tends to look a bit smaller than the saline for the same volume size. If you were unsure, in my practice, I would offer you to have your surgery under a local anesthesia and placing sizers during surgery so you could see for yourself. I would put a 350 on one side, and a 400 on the other side, and sit you up to see for yourself prior to making the final decision on size. I would also have a few other sizes available, just in case you wanted bigger! Good luck!
Q: Belly Button Pain and Swelling Four Weeks After Tummy Tuck and Lipo
I am four weeks post op from a tummy tuck and lipo. I am experiencing a bit of discomfort in my belly button, ands welling more in my lower abdomen. I find that my swelling is not that bad in the morning, but as the day goes on i do have a substantial amount of swelling by the evening. My plastic surgeon did examine me two weeks ago and i do not have a seroma. Is this type of swelling and discomfort in my belly button normal at this stage in my recovery? what can i do to help w/swelling.
Amy T. Bandy, DO answers: Belly Button Pain and Swelling Four Weeks After Tummy Tuck and Lipo
A: Dr. Amy Bandy says.. Belly Button Pain and Swelling Four Weeks After Tummy Tuck and Lipo
The question is if the pain in the belly button is increasing, decreasing or staying the same. You should follow up with your surgeon to be sure that you do not have an infection or seroma. If it has been 3 weeks since he evaluated you, things could change. You should be pleased, your results look excellent!
Q: Bump on Bridge of Nose After Rhinoplasty
Soon after my rhinoplasty I noticed (through feeling) a small bump on the right side of my bridge. As the weeks go on it appears to be growing in size, I’m assuming this may just appear larger as the swelling goes down. Also, the area below looks dented. However, if I push on this area the bump, while very firm, will temporarily flatten out. It is sore to the touch, and it’s just getting worse over time, appearance wise. I’ve uploaded a photo. My doctor says I have to let things settle.
Amy T. Bandy, DO answers: Bump on Bridge of Nose After Rhinoplasty
A: Dr. Amy Bandy says.. Bump on Bridge of Nose After Rhinoplasty
Are both photos after the surgery? I see the bump you are talking about; this may be bone, but if it is bone, it wouldnt temporarily go away when you press on it. Best to give it time to know for sure if it is just swelling, or if it is bone/callus or scar. You may end up needing a revision, but should wait at least 6 months.
Q: Have I Bottomed out?
Hi, I’m exactly 1 month post operation…and I was wondering if I bottomed out from my left breast? I was extremly flat pre surgery…had absolutley nothing there…and I had 280cc saline impants put in. Will they eventually even out…or have I bottomed out? If I have, now what?
Amy T. Bandy, DO answers: Have I Bottomed out?
A: Dr. Amy Bandy says.. Have I Bottomed out?
You do not appear to have bottomed out. Were your nipples even before surgery? If so, then you may want to ask your surgeon about placing a breast strap over the breast with the lower nipple- the one on the right when looking at your photo. (the one with the hand that took the picture!) This can often help strech the capsule during the healing process, thus alleviating the need for future revision surgery. If your nipples were not symmetric before surgery, then you likely have an amplification of your previous asymmetry. They will not “eventually even out” on their own. You may need revision surgery, but it is too soon.