Dr. David N. Clayton, M.D., F.A.C.S.

Thank you for your question.

After a brachioplasty (arm lift), I usually recommend that my patient wears the compression sleeves until it feels better to leave them off. That usually takes about 3 weeks. Sometimes it feels good to take them off, but after an hour or so, it will feel better to put it back on. Our bodies are smart. If you listen to what your body is telling you, 90% of the time you will be right. That's how it is will arm sleeves after an arm lift.

All the Best,

Dr. Clayton

Yes, plastic surgeons are perhaps the very best qualified doctors to do your breast augmentation. Cosmetic surgery is one of the major things done by plastic surgeons and especially by those of us who have narrowed the scope of our practice to do almost entirely elective cosmetic surgery. In fact, breast implant surgery is one of the most common procedures I do in my practice! Be sure to look for certification by the American Board of Plastic Surgery. It is the premier credential in the field of cosmetic surgery.

All the Best,

David N. Clayton, MD, FACS

Thank you for your question.

There are many different kinds of surgeries that are done on the face - from simple surgery to remove moles to complex facelift surgeries to laser skin resurfacing to ear pin-backs for prominent ears, to eyelid surgery for saggy eyelids, nose reshaping, etc. Each procedure is tuned to the needs of the patient. I'm not quite sure what information you were looking for.

All the Best,

Dr. Clayton

Thank you for your question. There are a couple of different ways to look at that. How long will it take for the lateral forehead and brow area to begin to descend again? The answer is about 3-5 years. But even in 10 years it will look better than if you hadn't done it at all. So, from that standpoint, it lasts for MANY years. And a temporal brow lift can be repeated, if necessary, although at some point, you might consider a more generalized way to lift the brows and upper face since repeated lifting of the temporal area only will eventually result in some distortion that might not look as natural as you would like.

Dr. Clayton

Thank you for your question. No, Botox doesn't make you look older when it wears off. It may seem that way because you are looking YOUNGER while it is still working! If used regularly, Botox can make you look younger and can help keep you looking that way.

Dr. David N. Clayton, MD, FACS

Thank you for your question. Elective surgeries were canceled for a couple of months back in March and April. But now that PPE is more available, elective surgeries have been allowed. We are still doing a full range of elective cosmetic surgeries including breast enhancement, body contouring, and facial rejuvenation and cosmetic procedures.

Dr. Clayton

Thank you for that question. I'm assuming that you are referring to a surgery to make the ears less prominent, is that correct? I can appreciate your concern about that recovery. I have actually had that operation myself when I was about 16 years old. The ears are wrapped for security and protection for the first few days. After that, you are able to shower, and you will probably want to wear a skier's head band at night for about a month to protect the ears from accidentally turning over in your sleep. Tenderness varies from patient to patient. For the first couple of days, the ears may throb a little, but the strong early pain settles down quickly and is well controlled with good pain medication. The ears should be looking very good within a couple of weeks.
I hope that answers your question. All the Best!

David N. Clayton, MD, FACS

I'm not sure what you mean by "hip filler." I assume that you mean "lip filler," since that is a very common treatment. Lip fillers give benefit in a couple of ways. First, they give immediate volume enhancement to the lips that lasts about 6 months. But each time you get a treatment, the body heals itself by adding some of your own natural collagen to the area. That collagen lasts longer than the filler itself, so after a few treatments, the volume should hold up longer and longer.
I hope that helps.

Fortunately, infections after nasal surgery are rare. This is at least in part because the blood supply to the nose is very robust. If you follow your surgeon's instructions carefully you should have little problem with infection.

The risk of infection after nasal surgery is dependent on several factors - whether you are a carrier of certain harmful bacteria, whether the nose has been operated previously (scar tissue doesn't have as rich a blood supply as virgin tissue), and whether or not you smoke, since smoking restricts blood flow into the nose and increases the risk of infection. Your general state of nutrition and health also are factors. As always, follow your surgeons instructions carefully.

The degree of improvement a plastic surgeon can offer your daughter depends on the extent and location of the scar. Burn scars of the hand often involve contractures, or shrinkage of the scar which can cause limitation of movement Such scars are usually treated with Z-plasties or flap surgery to improve the function of the hand. If the scar is mostly cosmetic in nature, then the degree of improvement available to her may be more limited. But even in those cases, some improvement is often possible.

The best preparation for having liposuction is to be in generally good health and avoid aspirin or ibuprofen for about a week before surgery. While some surgeons may recommend being near your "ideal" weight, in my 35 years of doing liposuction, I have found that if you are about 10 - 15 lbs OVER your ideal weight, it is easier to give you an accurate correction since the fat cells are expanded, and the true extent of the deformity is more apparent.

Liposuction brings your body into better proportion - it is NOT a weight loss tool. As you gain or lose weight, the fat cells that you already have just get bigger or smaller. Liposuction permanently changes the number of fat cells that live in the problem areas, so after your surgery, you don't selectively gain weight there any more. It is a wonderful and long-lasting solution to the problem.

It is also very important to follow your surgeons recommendations and instructions in the immediate post-operative period. It can make a significant difference in the quality of your outcome how well you obey your surgeon's instructions.

Breast augmentation is a very common surgery. As with all surgeries, there are risks. The most common complication after breast augmentation is called capsular contracture. Our bodies have only one way to heal after a surgery - by forming scar tissue. There is a thin layer of scar tissue that forms around any breast implant, whether over or under the pectoralis muscle. A contracture happens if the natural scar tissue that surrounds your implants begins to shrink, squeezing on the implant and making it feel too tight. It may feel like the implant is going hard, but the implant itself never goes hard, it's just the scar tissue that may squeeze on the implant. If that happens, there are nonsurgical things that can be done, but it sometimes requires a surgery to reopen the scar and restore natural softness. If capsular contracture occurs, it will usually happen within the first year, although it can happen at any time. The exact reason why the scar tissue contracts is not fully understood. Capsular contracture rates may vary, but in general, there is at least a 10% or greater chance that an uncomfortable degree of firmness may develop sometime in the implant's lifetime.

Immediately after surgery, the most common complication is bleeding. Perhaps a small vessel which was controlled at the time of surgery would reopen and begin to bleed after you get home. What you would notice is a dramatic swelling of the affected breast. Even the nipple may turn blue, and pain increases. This complication is usually not dangerous, but if left untreated, it would not heal properly, so surgical intervention is usually required. This is a simple opening of the affected breast, removing the implant for a moment while the vessel is controlled, then replacement of the implant, and closing the incision. This complication will happen to about one patient in 60. While many surgeons offer correction of a hematoma (blood around the implant) without additional charge, there is usually a cost involved with the use of an operating room, or for an anesthesiologist or nurse anesthetist to put you to sleep for the procedure. These costs are usually outside the control of your surgeon.

Infection is a rare complication after breast augmentation. Most surgeons use antibiotics during and for a short period after the surgery as a preventative. Also, many surgeons place a disinfectant solution around the sterile implant at the time of surgery to further minimize this risk. Although extremely rare, if a significant infection were to occur around the implant, oral antibiotics may have a hard time eliminating the infection, and it may require that the implant be removed. Then the infection is cleared, and several weeks later, the implant would be placed again. I stress that such a complication is rare. I have been in practice for 37 years, and have seen a significant infection after augmentation surgery only once.

Placement of breast implants may stretch or damage sensory nerves to the nipples or areolae causing numbness. Usually the sensation returns, but occasionally, longer lasting numbness of the tissues can persist. This complication is also quite uncommon. To a degree, this risk is greater the larger the implant that is placed, since larger implants put more stress on the nerves. Most surgeons are careful to watch out for those nerves, and minimize this risk.

This risk of implant rupture has largely gone away these days with the advent of highly cohesive gel which doesn't leak out, even if an implant becomes ruptured. Have your doctor demonstrate for you the characteristics of the gel in the implants you are going to have placed. I often show patients a gel implant that has been cut in half. Holding it upside down, nothing leaks out! Modern implants are also very strong, and the risk of rupturing an implant during even contact sports or having a mammogram are extremely small. Of course, if you choose a saline filled implant, there is a greater possibility that such an implant could eventually fail, in which case the breast would simply deflate overnight as the saline leaks out and is absorbed. This is not a medical emergency, but it IS a cosmetic emergency!

I hope this information has been helpful. I wish you All the Best!