Beverly Hills Plastic Surgeon Answers ALL Your Questions!

Rapid fire, Dr. Barrett here, board-certified plastic surgeon. I'm here to answer your ask me anything questions. Let's get started. Please show me your massage technique for breast augmentation recovery. It's pretty simple. You can see my website or my YouTube. You basically pinch it this way typically and go that way, but often depends on your particular anatomy, so make sure you follow up with your doctor. What do you think about over the muscle implants and thin patients if their lines are softened with Alloclay? I'm not a big fan of it. I do most of my patients partially underneath the muscle because you get a softness at the top, so it's always typically much more natural result and way less capsular contracture. Can you do over the muscle for certain people? Yes, you can. You got to have some volume there. So if you're thin and trying to buffer it with Alloclay, yes, That may work, but why not just go half enough muscle? How to minimize nipple sensitivity? You know, time is generally the best way to kind of minimize nipple sensitivity. If you keep them covered, sometimes that helps. It also depends on what kind of surgery you had. Is 450 too big for a fit woman who is 5'9"? It depends on your weight and your base width. It is a little bit on the bigger side, maybe if you're fit. I generally try to keep people under 400 cc's. Try to run a marathon with 450 cc's, it's, it's hard. Do you use any AI tools to help girls visualize what the results will look like on their body? I don't— they haven't been 100% accurate. So I've been kind of hoodwinked thinking one size would work in the operating room with some AI tools, Vectra 3D analysis, stuff like that. We get to surgery, I, I put it in, I see exactly how it looks. That's why I do on-table sizing. So it's not there yet. I love the idea of it. I think ultimately if you're a really good surgeon, I always tell my patients just to kind of give me a picture of the look that they want and then I match it. When is it okay to fly after breast augmentation? The next day. What is the risk for blood clots post-surgery? Typically it's really low if your, if your Caprini score is very low. So Google Caprini score. And so things like Previous blood clot history, cancer, previous cancer diagnosis, over 50, over 60. Go online, calculate your Caprini score if you're really worried about it. Is Sculptra worth the money? Depends, it is a lot of money. Some people money's not really an object and they just get lots of Sculptra and it eventually works, but it does take a lot. It's definitely a bigger buck for your bang, alright? How much is a breast lift and reduction together? How much is lipo 360 by itself? That all depends. We do have some standardized pricing, you can reach out to us so we can get that to you. Do you do jawline implants, what are your thoughts? I don't, there's a few people that do it, I think Dr. Dear is one of them. He does like these custom implants, it's pretty awesome. You really gotta kind of specialize. I give you a CT scan, all that other stuff. I do chin implants and I do fat grafting, which works for like mild cases. When you have asymmetry, does the smaller or larger implant reflect your final result? So if you do differential sizing, a lot of times it can actually correct for it. Sometimes it could overcorrect, so you got to be really careful. Breasts are always asymmetrical. It's just a measure of how much asymmetry we have, and sometimes we can improve that with different size implants, different profile, a lot of tricks we have, or even a mastopexy on one side versus the other. On the topic of abdominoplasty, can you talk more about the effect of the pelvic floor and bladder? That's a good topic. I've seen improvements in bladder function in the pelvic floor with doing rectus diastasis repair for tummy tucks. I've had patients who have come back and said their sexual satisfaction is way better, their urinary incontinence is gone, not to mention their core strength. I don't have any studies on that, that's just been my patient experience. I'd love to hear what your thoughts are on that. Did you have a tummy tuck? Did you have improvement or worsening? What happened? With a breast lift, do you lose sensation in your nipples? Typically not. You could always lose nipple sensation anytime you do breast surgery. Make sure you pick a surgeon who's really careful. How soon can you lift a 2-year-old after breast implants? My recommendation is 6 weeks. You can hold them with a tush baby, you can sit next to them and lie next to them, but you can't engage your pec muscles, otherwise you risk of getting bleeding, hematoma. Is there anything other than lower facelift surgery that can help with the double chin? Liposuction. You can do liposuction here and you can do a chin implant. That generally gets rid of a double chin without the facelift, nor would really a lower facelift be the, the main improvement for that. How long do you need to massage implants for? I generally massage until 6 months, sometimes longer. Can you get inflammation from implants? Do they cause inflammation themselves? They're silicone, they're inert. Typically, if they're not contaminated with bacteria, they don't really cause any inflammation that we really know of. When we get a biofilm, a bacteria gets on here somehow, either through insertion or like something else within the body body, like flossing or dental procedure or tattoo that seeds the body with bacteria, can get on here. Once it's on here, forms a biofilm, it's hard to get rid of it. That can cause inflammation. Really, it's an unknown thing. In general, the majority of people don't form any kind of response to silicone. You know, some people are sensitive to certain things, and if that's you, then implants may not be good and we have to take them out. Is fat transfer to the breast permanent? Yes, it pretty much stays. It may not always stay as fluffy, you lose fat with time. Do you help with peptide education or offering services there? Yes, we do. Right now we offered some of the GLP medications. We're looking into some of the other peptides. The main reason I did it is we started offering it when people wanted to come in for tummy tuck or surgery and they, they need to lose more weight. So we're like, here, here's your plan, and we get people to lose weight and then we get them ready to get their surgery and we counsel them through the whole process. You can reach out to us for that if you're interested. Would you refer patients for revision rhinoplasty? I do some revision rhinoplasty. I don't do a whole lot of them, as you probably know from my channel. You don't see me talking about it too much. They're very challenging. A lot of times it's, it's good to go to a doctor that does primarily revision rhinoplasties. There's probably one of the most challenging surgery you could do. Pricing for Mama Makeover Is there a waitlist? We have a waitlist for our consults. My surgery schedule is booked out several months. And then the pricing obviously depends on what combination you need. Breast lift? Do you need your butt? Do you need tummy? What else do we need? Differentiate between intracapsular and extracapsular breast implant. So if your implant's ruptured inside the capsule, that means the capsule is kind of containing it, which is good. Still bad, but not, not the worst. If the silicone is going outside the capsule, that's bad. It's interacting more with your body, and especially if it's an old type of silicone, can go throughout your body. So if you have a rupture, period, just Come call me. Is it safe to go through the nipple incision twice to get a revision the same year? Yeah, you basically just make the same incision, you cut out the old scar, you go the same pathway. It is safe. When is the time that we do a breast augmentation? Do they expire? This debatable. I say just swap it out at 10 years. Otherwise, I would get an MRI every couple years. The swap out is not such a big deal. It's like a 45-minute operation, and then you don't have to worry about as much because brand new implants, they don't rupture as much until about 10 years, and then it starts to go up. If you're always curious, you could always get an MRI anytime. Would you stay away from Halo and Hero lasers on your face. I would stay away from some of the radiofrequency stuff. I think there's some reports that it's decreasing fat content in the face, and sometimes you need a little bit of fat to look good. Internal versus external lift? Both are good. I do both. Is there anything you can do to help breast implants under the muscle drop faster? You got to figure out why they're not dropping. So like, you could take Singulair, you could take fish oil, you could do massage. Those are things to help things drop faster. But if they're not really dropping by like 9 to 12 weeks, you could be having capsular contracture. You could have a pocket issue that needs to be looked at. Is it harder to achieve more cleavage going through the nipple? No. I would say it's probably— you have a higher rate of cleavage because you can go all the way across without disrupting the bottom part of the breast. If you disrupt the bottom part of the breast by going in from mammary, the breast implant can kind of drop off to the side. What's your favorite procedure to perform and why? Breast augmentation. It's a big dopamine hit. It's, it's something I've perfected over the years. It looks so good if done right. It's like you can't tell. That's my favorite. I love lots of all the different procedures I do. That's— if you have had to pick a favorite, that's it. What are the pros and cons of fat transfer rather than silicone implants? Pros and cons? Fat has a mind of its own. You can get about a half cup size improvement. Implants, you can get any kind of size you want, but you do have an implant, right? Fat, you have to harvest it from somewhere. So if you're completely skinny, you're not going to have enough fat, and then the fat will kind of respond to your body weight. Implant won't. It'll be the same size 10 years from now. Jill Cheo, what are your thoughts on peptides for surgical recovery? I think they have a role. We got to be really careful with it because there's not a whole lot of studies on it. There's definitely some evidence that peptides could potentially help recover faster after surgery. There's not a whole lot of evidence on it, but there's some new evidence coming out that's, that's great, and look forward to seeing those studies. Substantial weight loss, how many procedures can be done at one time? That's Depends on the procedures. Typically, you know, if you had a lot of massive weight loss, like we're talking like 100 pounds, I would do the breast and tummy at the same time. Then we do the arms and the thighs. Sometimes if we have to do circumference body lift, that's all we're doing, and we combine it with a lateral thigh lift. Just depends on how much you need. What's your chance of losing sensitivity if the incision is made under the areola? Well, it's somewhere around less than 5%, but you know, it's interesting when they looked at sensitivity loss, it has more to do with the size of the implant in your pocket than incision. So whether it's border of the areola or inframammary, the loss of sensation is the same. So incision location doesn't matter there. If you go through the armpit, way more likely to lose nipple sensation, because that's where the nerve comes from. It comes from the side. So that's why if you have a big implant, it disrupts the nerve over here, or at least the major nerves that go there. That's why I typically don't do through the armpit. Typically do border the areola because that scar heals like nothing happened. All right, last one. Do I like Mentor Boost? Yeah, they're good. They're good for options. They have a little less rippling if you have a situation, but sometimes it could be firmer. But if you're a really thin patient, they work sometimes. It just depends on your situation. If you like what you saw today, please hit thumbs up. Just do it right now, that'd be great. Thank you so much. And hit subscribe if you want to see more cool videos like this. If I didn't get to your question, leave it in the comments. I'll get back to Thanks so much.