Here, Dr. Kotler is known as the “FaceDocBlogger” because his surgical work is devoted to plastic surgery of the face and neck, with heavy emphasis on rhinoplasty. (He’s done over 4,000!) Our other expert, Dr. Linder, is referred to as the “BodyDocBlogger” because his plastic surgery practice is limited to procedures of the lower body with emphasis on breast surgery, tummy tuck and liposuction. Together, Drs. Kotler and Linder offer half a century of plastic surgery experience.
Exclusive to YourNewBodyBlog.com, Drs. Linder and Kotler appear here most weeks as the ultimate plastic surgery insiders with unique takes on the news, trends and practices in cosmetic plastic surgery.
Top 10 Things that Can Go Wrong in Plastic Surgery
Even in the best of hands, an unexpected wrinkle or complication may crop up after cosmetic plastic surgery. Of course, part of the reason for seeing a board certified, highly experienced plastic surgeon is because he or she will have seen it all, and knows what to do when the unexpected happens.
But some complications occur more often than others. Tuck ‘N’ Stitch tell which ones to watch for and what can be done for the top five breast and top five nose complaints. (Read our related blog on the Top 5 Remedies for Unsatisfying Plastic Surgery.)
FaceDocBlogger: When you see unhappy breast augmentation patients, is there a most common complaint doctor?
BodyDocBlogger: That’s easy! The number one complaint is capsular contracture, a type of scarring around the breast implant. In many cases, it becomes painful because the scarring makes the breasts feel hard. Sometimes, the surgeon removes only the scar tissue inside the breast but other times, the implant must also be removed. It all depends on the case. Doctor, what about less-than-pleased rhinoplasty patients?
FaceDocBlogger: The number one problem that brings nose surgery patients back to the surgeon is trouble with breathing. Over correction, under correction and problems with the septum or turbinates inside the nose during the first operation are usually the bug bears. It may require a revision surgery.
BodyDocBlogger: The next most common thing with breast implants is ruptured implants. There are many reasons an implant can rupture. So I do have a hint for potential patients thinking about having breast implants: consider a smooth implant. They rupture less often. However, if a woman does experience a ruptured implant, it’s important for serious medical reasons to see a surgeon as soon as possible.
FaceDocBlogger: The thing many nasal surgeons see over and over is a healed nose with some grooves, depressions and moguls that show on the outside. Those marks can be easily repaired, sometimes using small drops of silicone injected into the depression to fill it out. (Read more about silicone nasal injections.)
BodyDocBlogger: The third most common problem after a breast revision is because the implant is positioned less than perfectly within the chest. By the way, in my humble opinion, that tends to happen more often when the surgeon inserts the implant through the belly button in the TUBA (Trans Umbilical Breast Augmentation) procedure or through the armpit. Both approaches often result in an unnatural looking bust line or one with no cleavage. (Read more about why Dr. Linder does not favor this approach in TUBA: Not My Favorite.)
FaceDocBlogger: The facial surgeon also sees people coming for a revision when a nose is overdone and looks too pinched; it’s because the first surgeon took out too much tissue. But it can be corrected by replacing the missing parts with a similar tissue, usually nose cartilage or cartilage from behind the patient’s ear.
BodyDocBlogger: Another of the top five breast issues is bottoming out. That happens when the implant falls out of the pocket in the chest into the bottom of the breast, making the nipples point up. Bottoming out also may be due to overly large implants placed above — instead of under — the chest muscles. Technically, the problem is very difficult to repair and requires a highly trained and experienced revision surgeon.
FaceDocBlogger: For every rhinoplasty case that was overdone, a patient comes in with a nose in which not enough was done. The problem is usually that the first surgeon did not remove enough excess tissue and now the tip of the nose points downwards. So, the revision surgeon must redo the tip.
BodyDocBlogger: The fifth most common thing that goes wrong with breast augmentation is a patient being unhappy about her size. Usually, about six months after the procedure, when swelling caused by the procedure has gone down, that patient can see her final result and asks for a change. About 90 percent want a larger implant, while 10 percent want to go smaller. Some do not realize that some bodily conditions — height, body type, the width of the shoulders and hips, and so on — dictate the most appropriate implant size. In some cases, removal of implants may create a need for a breast lift.
FaceDocBlogger: The bent nose is a common complaint. It’s usually the product of nature or a sports accident — instead of a neophyte surgeon. But the patient’s nose just does not face straight ahead. You can also usually assume that the patient has breathing problems, too. The septum inside the nose is usually the key feature causing a nose to lean to one side and that the structure must then be repaired by the revision surgeon.
BodyDocBlogger: Having corrective surgery carries both bad and good news. The good news is that every nose and breast can be repaired!
FaceDocBlogger: That’s correct doctor, but before going ahead with any re-do, it’s smart to get a second opinion from another plastic surgeon who specializes in the area needing repair.