Cosmetic Surgery Frequently Asked Questions

Plastic Surgery FAQ's - The definitive self help guide to cosmetic plastic surgery frequently asked questions and answers on the internet by Dr. Arian Mowlavi.

Cosmetic Surgery FAQ2020-05-21T07:50:39-07:00
How Many Days After BBL/Lipo Can I Take a Long Flight (10+ Hours)?2020-01-08T23:38:36-08:00

You can travel after 2 weeks with such a long flight after BBL. This is to ensure that all of the fat cells have been revascularized.  I would also recommend getting an in isle seat so you can stand up and walk at least once every hour so that you take the pressure off of your buttock.

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I’m Already Skinny, Do I Need To Gain Weight If I Want a BBL?2020-01-08T23:41:12-08:00

I do not recommend gaining weight for a BBL as this will only make your fat cells get injured and die during the transfer process. This is because when you gain weight, the fat cells get larger in size thus making them prone to injury as they travel through the small holes of the cannulas used to harvest fat. 

The definitive technique for you, since you are thin, is ultrasound assisted liposuction which should be performed by a high definition body contouring specialist. Additionally, the use of our Buttock Assessment Tool to determine the ideal buttock shape and size for you is critical.

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Is There Filler For The Dip In My Hip To Be A Little Less Noticeable?2020-01-08T23:54:25-08:00

There is no filler that will fix this hip dip better than your own fat can. In addition, the filler is temporary and not permanent. This hip dip is the result of a lack of mid-butt fullness. It is one of the most popular areas to target during a BBL and can be easily remedied with the use of VASER liposuction and fat grafting.

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Will a BBL Leave Sagging Skin In The Areas That Were Liposuctioned?2020-01-09T00:04:21-08:00

Essentially, it is dependent on your skin elasticity to determine if an additional skin tightening procedure may be needed. Most people in their 20-30s have good elasticity. However, skin tightening is needed if the skin has been stretched out from excessive fat or following aggressive weight loss, or even with natural aging. Renuvion skin tightening may occur if you have minimal to moderate skin redundancy. Excising the skin may be utilized if there is moderate to severe skin redundancy.

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Is a BBL less painful than a Tummy Tuck?2020-01-09T00:06:14-08:00

A tummy tuck is widely regarded as a much more painful procedure due to the repair of the muscle required. Liposuction and BBL are much gentler. You will still feel discomfort but since the muscle is not directly manipulated, the pain level is much more tolerable.

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What’s the best treatment to help get rid of deep depressions and cellulite on my buttocks?2020-01-09T00:08:06-08:00

In order to completely eliminate your cellulite on your buttock, posterior thighs, lateral thighs, we will typically have to tuck your skin using a lateral thigh and buttock tuck. This is because cellulite is created by skin redundancy that needs to be eliminated. Even though the skin redundancy may be on the mid and lower buttocks, by tucking it from the upper buttock skin, the tightness is transcended to the lower and mid buttock.

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If I have peripheral neuropathy can I get a Brazilian Butt Lift?2020-01-09T00:10:59-08:00

Neuropathy does not prohibit a BBL surgery necessarily. If you are determined to be a good candidate for a BBL, we would ask for help from your primary care physician to have you worked up for pre-operative clearance, making sure that it is safe for you to undergo the anesthesia and surgery.

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What’s the main differences between heart and round shape buttocks?2020-01-09T00:13:08-08:00

Heart vs Round Shape Buttocks

Any surgeon should be able to communicate with you exactly what your butt will look like after the procedure. You should be wary of a surgeon who cannot adequately demonstrate and communicate what your buttocks will look like post-op. Also, our Buttock Assessment tool shows exactly what you are talking about in terms of upper, middle vs lower pole maximum fullness as well as overall size.

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Would I still be able to exercise and decrease body fat percentage without losing the fat transferred?2020-01-09T00:15:26-08:00

When considering any type of liposuction or augmentation, it is important to get your body to a level that you will be comfortable with for the rest of your life. You want to keep the same activity level as you had prior to the procedure. However, losing a couple of pounds, i.e. less than 10 pounds, is not likely to affect your overall proportions.

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Can I still have kids after a BBL ?2020-01-09T00:17:35-08:00

There are no complications to becoming pregnant and having children after a BBL

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Is it possible to have butt implants removed and do a BBL at the same time?2020-01-09T00:26:24-08:00

Yes, it is possible to have buttock implants removed and have a BBL at the same time. This is because the pocket where the implant is removed is sealed shut. In addition, the fat is transferred using ultrasound guidance, so that it is not inadvertently placed into buttock implant pocket. In this way, fat viability is preserved.

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Does the price of BBL depend on how much you weigh?2020-01-09T00:30:22-08:00

The cost for a BBL is dependent on your weight because it depends on how much time is required to remove the fat. It also depends on if you want to liposuction just the front, the back, or 360 degrees (circumferential). We do not charge you for replacing the fat back into your buttocks as this doesn’t take very long.

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Should I get a BBL before kids or after kids?2020-01-09T00:31:54-08:00

A BBL can be performed before or after pregnancy. However, pregnancy can cause changes to the body if you gain more than 30 pounds and this may affect your overall contour. The decision to get a BBL is a personal one and can be performed before or after kids.

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Is it best to do a fat transfer/BBL before a tummy tuck?2020-01-09T00:34:26-08:00

Using the VASER liposuction, you don’t lose any significant amount of fat transferred to the buttocks. As long as you use VASER fat harvesting, you should be fine to sleep and sit after the procedure. VASER has a 95% viability of the fat cells and retention of the volume. Thus, you do not have to worry about having a tummy tuck and sitting for extended periods. 

In summary, you can perform your BBL and tummy tuck at the same time.

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What are the long term effects of a BBL on the gluteus muscles?2020-01-09T00:37:35-08:00

Fat was once injected into the gluteus muscle to increase it’s girth and tilt the pelvis, giving a curvier appearance. However, this is now outlawed as it carries the tremendous risk of a life-threatening fat embolus. 

For the safety of our patients, we utilize ultrasound during our BBL’s to assure that we DON’T inject any fat into the muscle of the butt. As far as viability of the grafted fat, it is dependent upon the quality of the fat harvest. The optimal outcomes are achieved with VASER liposuction to harvest the fat, a closed looped system to process the fat, and strategic micro-packet transplant technique. These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight.

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Can I combine a BBL and fat transfer to the breast?2020-01-09T00:38:38-08:00

Fat grafting to the breast and to the buttocks (BBL) is absolutely possible at the same time. Remember that although the up to 1500cc of fat can be transferred to the buttocks, no more than 200 to 300 cc can be transferred into breast. As long as you have enough fat to graft both the buttocks and breast you can do both at the same time.

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How much fat will be removed by liposuction for my BBL ?2020-01-09T00:41:02-08:00

The amount of fat to be removed by liposuction and grafted to your buttocks is decided between you and the doctor at the time of your consult, and only by reviewing the areas you want worked on. 

There are no hard-and-fast mathematical amounts and it’s dependent upon your body and the results you’re going for. In general, 30 to 40% of the total amount of liposuctioned fluid and aspirate can be transferred back. For example, if you have 4500cc of liposuctioned aspirate, you will have approximately 1500cc of fat available for transfer back into the buttocks or breasts.

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Will I get an hourglass shape from Liposuction to the flanks?2020-01-09T00:43:38-08:00

VASER liposuction would help you achieve the hourglass look you desire. This is achieved by liposuctioning the flanks and love handles as well as the lateral thighs and with fat transfer into mid buttock region. In order to exaggerate the hourglass look, not only will your buttocks be built up but your waistline must be maximally narrowed.

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Do I need a lift with my breast augmentation?2020-01-09T01:27:54-08:00

Whether or not you will need a lift is dependent on you nipple position. If your nipple is below or at your inframammary crease, then you will need a simultaneous lift at the time of your breast augmentation. 

The amount of lift is based on your chosen implant. The reason for this is to allow your nipple to be centered on your implant. This follows the fact that the implant must sit on your inframammary crease and such that the radius of your implant will be centered on your nipple. This is the most important consideration. 

The breast lift can only raise your nipple  approximately 5 cm so it can only be performed for minimal to moderate nipple sagging. A virtual consultation with a breast specialist is recommended to make sure you appreciate what needs to be done to get you an excellent outcome.

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Can I be allergic to silicone?2020-01-09T01:35:01-08:00

Universally patients are not allergic to silicone. In fact, silicone is found in your diet as it is present in potato skin. It is also used in your acrylic nails! Finally, it can be found in our cartilagenous structures such the knees and ears. There has not been a single case of a true allergic reaction to silicone to date.

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How long after my BA until I can comfortably sleep on my side?2020-01-09T15:09:46-08:00

You can side sleep immediately after breast augmentation. The idea is to not allow your implants to move from the dissected breast pocket until the pockets have scarred down (creation of a capsule). 

This occurs by 4 weeks following surgery. Regardless, as long as you wear a breast band (my favorite is the Mermaid band), you should have no problems with any activities that don’t require heavy weight lifting with your arms. The only exception is sleeping on your tummy in the early postoperative period which can push the implants out of their pocket.

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Why do my breasts appear so small at 2 months post-op?2020-01-09T17:21:55-08:00

The only way to ensure that your chosen implants are going to provide you your desired breast size augmentation is to complete breast sizing during your consultation. During this visit, you are provided the opportunity to try out amongst a variety of breast implant sizers in order to hone in on your desired breast size. 

Also, when the implants are placed inside you, they will be actually 5% smaller in size. As a result, you must take this into account. A final reason why you may feel that your breasts are smaller at two months is that you have gotten used to your swollen breasts over the first six weeks that is now resolving.

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How soon after a breast augmentation can you massage your breasts?2020-01-09T19:34:57-08:00

Capsular contracture prophylaxis exercises can be initiated as early as one week following surgery but you have to make sure that you don’t push your breasts up; I recommend using a breast band over the first two weeks that minimizes risk of malposition. When messaging your breasts, it is very important to keep one hand over the top of the implant while the other hand messages your breasts so that you don’t inadvertently push the implants up.

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Why is one of my breasts firmer than the other?2020-01-09T19:40:00-08:00

There are many reasons why you might feel that one of your breasts is firmer than the other. This can be caused by early capsule formation or it may be that the implant was malpositioned. You will need to follow up with your plastic surgeon for this as this diagnosis is more accurate when made by feel during an examination.

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What is covered in my breast augmentation consultation?2020-02-17T19:08:45-08:00

Consultation

During your breast augmentation consultation we will discuss:

  • The ideal implant size, shape, and form
  • Breast sizing
  • Discussion of various approaches for implant placement’
  • Preoperative management and planning
  • Postoperative care
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What is the best way to fix capsular contracture in a radiated breast?2020-02-14T20:31:20-08:00

Capsular Contracture

A radiated breast will always feel firmer and sit higher but this is not capsular contracture.  This is caused by fibrosis of your skin, underlying fatty and fibro septal network. The capsule in fact, might be absolutely normal assuming that you placed your implant after the radiation. Fat grafting has been recommended as a treatment to soften your breasts.

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What Is Excisional Surgery?2020-04-29T08:10:51-07:00

Excisional Surgery

Excisional surgeries are associated with longer incision lines that require prolonged recovery and potential for visual scarring. These side effects of more invasive surgeries deter three subset of patients that include the older community that wants to avoid general anesthesia and more arduous recovery. 

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What is the purpose of having drains during gynecomastia surgery?2019-12-04T23:42:14-08:00

You should be cautious of anyone who uses drains during gynecomastia. If a provider is recommending drains, this means that they are performing the surgery blindly and by feel. Instead, we perform the gynecomastia under direct visualization with a mammary retractor so that drains are not required because any bleeders are cauterized instantly.

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How can I tighten my breast skin for gynecomastia without having an incision?2019-12-04T23:44:19-08:00

You could benefit from male chest optimization with Renuvion to avoid incision lines. Renuvion J plasma is used to heat the collagen in the subcutaneous tissues using a process called subdermal coagulation. Subdermal coagulation results in tightening of the collagen molecules working almost like shrink wrap. Please consider a virtual consultation with a high definition male contouring provider to help you appreciate what is possible.

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What surgery can be done for gynecomastia revision surgery?2019-12-05T00:07:35-08:00

Gynecomastia revision requires a high definition body contouring specialist who is accustomed to adding fat and removing fat strategically in order to achieve appropriate contour lines. High definition body contouring specialist use a number of tools including ultrasound liposuction, fat grafting, and scarless skin tightening using Renuvion.

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What surgery is recommended based on the severity of gynecomastia?2019-12-05T00:09:09-08:00

Gynecomastia repair maneuvers are dependent on the severity of your gynecomastia. Gynecomastia severity is based on the degree of excess fat and skin redundancy. Gynecomastia surgery can involve liposuction only for mild cases, liposuction and gland excision for moderate cases, and liposuction, gland excision, and skin excision for severe gynecomastia.

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What if I notice unevenness following gynecomastia?2019-12-05T23:21:25-08:00

Uneven soft tissue size or shape is a concern following gynecomastia. If it occurs quickly in the early period, you should be concerned about a hematoma that is caused by a bleeding vessel. This is an emergency and requires you to contact your surgeon so the pool of blood can be evacuated. If the pooling of blood is not removed promptly it can cause compromise of your skin. If the unevenness develops gradually over weeks, then it is indicative of uneven contouring by your surgeon. This is definitely not an emergency and can be corrected when all of the swelling has resolved. Any gynecomastia revision surgery should be performed no earlier than 3 months following surgery.

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Is it true that only 60% of the buttocks volume is retained long term following fat transfer to the buttocks?2020-01-24T21:58:56-08:00

The reason that a 60% buttock volume retention is published on the internet is because most techniques used to harvest the fat graft are suboptimal. For example, the added force required to harvest fat cells with traditional liposuction techniques results in unnecessary damage to the fat cells. Another example, involves use of the Laser liposuction technique(marketed as Smart Liposuction) that results in directly piercing the fat cells. As a result, it is not unreasonable to appreciate why a 60% volume retention is published on the internet.

Instead, the Ultrasound energy of Vaser liposuction gently loosens the fat cells so that they can be siphoned off with minimal trauma. This results in 90 plus % viability of the fat cells. This means that what you see is what you get permanently.

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How do I convey my desired buttocks size and shape to my surgeon?2020-01-08T22:58:48-08:00

This is a very important question since most patients struggle with conveying to their surgeon exactly the buttocks size and shape. As a specialized center for high definition liposuction and Brazilian buttocks lift (BBL) surgeries, we see unhappy BBL patients weekly. The two most common complaints are that patients did not get adequate buttocks cheek volumes and the second complaint is that the buttocks shape was not created to the likening of the patient. The reason why adequate volumes of buttocks cheek are not routinely attained include:

1) Inadequate fat volume harvest with use of traditional liposuction. Instead, VASER liposuction allows for harvest of both the deep and superficial fat which results in 40 % more volume on average than other liposuction modalities.

2) Fat volume that is reduced in viability since it has been injured in the fat removal process. For example, with traditional liposuction, the semi-solid fat is drilled using liposuction cannulas. Another example is Laser or Smart liposuction, where a laser beam literally pierces the fat in the melting process. In contrast, the Vaser ultrasound gently tickles the fat cells into single cells without injuring the outer cell membrane. As a result, the fat cells provide near 90 % viability when transferred to the buttocks.

 

The benefits of Vaser liposuction include 90 plus percent graft take to the buttocks. As such, what you see right after surgery is what you are going to keep with respect to shape and volume. This is why Dr. Mowlavi has created the Buttocks assessment tool which allows you to convey to him exactly the buttocks shape and volume you are desiring.

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What is the Buttocks Assessment tool?2020-01-08T22:59:58-08:00

The buttocks assessment tool is a figurative survey tool that allows you to choose the exact shape and volume of buttocks cheeks desired. It allows you to define the lateral prominence size and position desired on your buttocks cheek as well projection located over the central buttocks. Figures were created with the waist kept constant but the buttocks size and shape altered in order to determine each patient’s desired preferences. Dr. Mowlavi has been able to consistently deliver desired buttocks shapes and sizes to patients treated from around the world using the buttocks assessment tool.

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What do I need to do to fix my hips?2020-01-08T23:01:20-08:00

Incredible waistline and female silhouette shaping is achieved through the use of VASER HD Liposuction BBLs. The optimal BBL outcomes are achieved with: 1) use of VASER liposuction to harvest the fat from problems areas (in your case it would be the hips), 2) a closed looped system such as Puregraft to process the fat, and 3) strategic micro-packet transplant technique. 

These three processes have demonstrated over 95% fat graft take. This means that your results will be stable as long as you maintain your weight. As an official VASER trainer, I am routinely referred unhappy BBL patients. One of the most common reasons for disgruntled BBL patients is that patients are not able to accurately communicate their desired buttocks goals to their surgeons.  

A buttocks assessment tool can be an invaluable tool to communicate to your surgeon the exact buttocks size and shape you are desiring.

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Is Fat Reduction in Buttock Augmentations Permanent?2020-05-29T12:59:00-07:00

Is Fat Reduction in Buttock Augmentations Permanent?
Ideal Buttocks shape is often achieved through contouring the surrounding areas and actually reduce the buttocks. Butt size can be reduced using two techniques:

1) Butt HD liposuction using VASER and Renuvion skin tightening.

2) Butt lift

Whichever of these procedures is ideal for you depends on the amount of fat versus skin redundancy you have and the butt shape that you desire. Please observe some of our Brazilian Buttocks Lift Before and After Photos.

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Is a BBL safe if you already have Silicone Implants?2020-01-08T23:12:24-08:00

A High Definition BBL is safe after silicone implants and can be protective of them extruding if the fat is layered superficially to pad the silicone implants from making their way out. We only use VASER liposuction for the harvest of your fat cells due to the improved fat volumes and fat cell survivability. In addition, we use high resolution ultrasound to direct fat graft transfer to avoid injury of the implant or placement of fat near the implant which would result in fat non-take.

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How Do I Know What My Butt Will Look Like After a BBL?2020-01-08T23:24:49-08:00

Deciding on the ideal buttock shape is a critical step in any butt enhancement surgery! Through the use of my Buttock Assessment Tool you can tell me the EXACT butt shape and size you want and that’s what you will get. Through the use of VASER© Liposuction, RENUVION© skin tightening and surgical cutting, the possibilities are endless so it is important that you take the time to research different body types and come to a conclusion with your surgeon about your ideal figure.

We also do Virtual Consultations daily to assist patients that are stuck between different surgical options.

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What Are My Buttock Enhancement Surgery Options?2020-01-08T23:29:21-08:00

To get an accurate surgical plan, I recommend contacting us to do a Same-Day virtual consultation so I can see your current body type. There are various ways I can perform a buttock shape optimization. The key to body contouring is taking into account the excess fat as well as the amount and quality of the skin. 

High definition liposuction, RENUVION skin tightening, buttock tuck, thigh tuck, and lower body tuck are all tools I can use to get you to your ideal shape and size.

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How can I benefit from revision gynecomastia surgery?2019-12-05T23:47:32-08:00

Revision gynecomastia surgery should be considered if your have chest contour irregularity either from uneven removal of fat or from skin redundancy. If you have residual fat, this can be best removed with ultrasound assisted liposuction. If you have redundant skin, then this can be removed with Renuvion J plasma skin tightening and rarely with a skin excision.

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Should gynecomastia repair be performed under local anesthesia or general anesthesia?2019-12-06T00:34:21-08:00

Anything is possible but high definition sculpting requires removal of fat comprehensively, which means scraping the fat off of the skin and the muscle; it is this last bit of fat that separates high definition sculptors from the rest, but removal of this fat is very painful to the awake patient. As such, I feel that the best contouring can only be achieved with general anesthesia. If you need a minor revision of single spot, then local anesthesia is considered.

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Is there a reason why gynecomastia should be performed early rather than when you are older in age?2019-12-06T00:35:15-08:00

Although there is no dire medical necessity to perform gynecomastia surgery urgently, I would recommend you perform this surgery sooner rather than later.  The reason why early gynecomastia is to your benefit is that the increased soft tissue fullness can stretch out your breast when left untreated. The problem with stretching out your skin is that it will result in you potentially needing a skin reduction as well. Early removal of soft tissue fullness will result in you not needing more extensive skin reduction surgery.

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I am a man with man boobs. Can you help me?2019-12-06T00:36:23-08:00

Many boobs is another terminology for gynecomastia. Man boobs can be corrected with a combination of direct gland excision and liposuction of the periphery. If you wish to be considered for gynecomastia repair by making a consultation.

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It’s been two weeks following gynecomastia surgery and I don’t see any changes?2019-12-06T00:37:08-08:00

Although there is some reasonable swelling following any surgery, it is concerning that you don’t see any changes. Did you go to a high definition body contouring specialist?, I recommend that you consider VASER liposuction on your revision surgery and make sure that all of the discoid tissue has been removed.

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Can the discoid tissue be removed during gynecomastia surgery with liposuction or does it need direct excision?2019-12-06T00:37:59-08:00

Using ultrasound assisted energy liposuction, the discoid tissue can usually be removed. On occasion, if the discoid tissue is prominent, it will require direct excision which is performed using a hidden incision on the undersurface of the areola. 

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Is swelling normal after gynecomastia surgery?2019-12-06T00:38:32-08:00

Swelling after surgery is normal and related to generalized edema. Regardless, the swelling should not negate chest contour improvement following surgery. Generalized swelling can be minimized using compression garments that are worn 24/7 for the first two weeks following surgery.

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Do I have gynecomastia?2019-12-06T00:39:11-08:00

You have gynecomastia if your breasts look feminized. This means unnecessary fullness and rounded appearance. In contrast, a masculinized chest will appear flat but bold with strong chest borders and linear or pentagonal borders.

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Why does my nipple look dilated and enlarged in appearance?2019-12-06T00:40:28-08:00

Nipple prominence results from prominent glandular tissues. Gynecomastia surgery focuses on eliminating this prominence. When the glandular tissue is minimal to moderate, ultrasound assisted liposuction will reduce its prominence. When the glandular tissue is moderate to severe, then direct glandular excision is often required.

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Why do I have a depression over my nipple and areola following my gynecomastia surgery?2019-12-06T00:41:00-08:00

A depression under my nipple and areola is caused by over aggressive excision of the glandular tissue and inability to feather this area with the chest periphery. Instead, proper contouring of gynecomastia requires conservative glandular tissue excision and feathering of the nipple areola region with the breast periphery.

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Why is my chest contour uneven following gynecomastia surgery?2019-12-06T00:41:47-08:00

If your chest contour is uneven following gynecomastia surgery, it is because the liposuction was not performed evenly. Patients that are seen for consideration of revision gynecomastia will often demonstrate dents and/or unevenness. Using ultrasound assisted liposuction with high definition contouring protocols will result in the smoothest contouring available.

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Why is my chest contour uneven following gynecomastia surgery?2019-12-06T00:48:28-08:00

If your chest contour is uneven following gynecomastia surgery, it is because the liposuction was not performed evenly. Patients that are seen for consideration of revision gynecomastia will often demonstrate dents and/or unevenness. Using ultrasound assisted liposuction with high definition contouring protocols will result in the smoothest contouring available.

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