Ask Dr. Hall: Your Plastic Surgery Questions Answered Part 1 (Ep. 94)

Dr. Jason Hall:

0:36

Are you tired of wasting money on skincare products and treatments that don't work? Or are you afraid of looking unnatural after having some non surgical treatments done? If you are then my new book, The Art Of Aging, is for you. In The Art Of Aging, I break down the aging process and talk about treatments that target specific parts of the aging process, what works and what doesn't. Also, I lay out a biology based skin care and non surgical treatment plan that will keep you looking great without looking fake. Check out your copy of The Art Of Aging on Amazon or in any of your local booksellers. Normally with The Trillium Show, I'm kind of the one choosing the content based on things that people ask me about and and topics that I think are timely and relevant. Today, we're doing something a little bit differently, and we've taken a bunch of questions from you guys, the listeners, the watchers, the people that follow the show regularly, and so it's going to be kind of an Ask me anything. So we've got a bunch of questions here that we're going to go over and get your questions answered directly on this show. If this is cool and popular, we'll do these again in the future. So for now, hope you enjoy this episode of The Trillium Show with ask me anything.

Unknown:

1:55

So Dr Hall, how do I know if I need a breast lift, if I want a breast augmentation?

Dr. Jason Hall:

2:02

How do you need know if you need a breast lift, when you want a breast augmentation? Is a really common question. The common mistake that's made out there is women who don't want a breast lift, which is 100% of women and are looking for some volume end up with an implant that is way bigger than they need to try and compensate for the fact they don't want a lift. This is a terrible idea. Don't do that. Don't let anybody talk you into doing that. The easy rule of thumb is, if you can lift your breast, well, if you can lift your breast up at all, you probably need a lift. But lift your breast up if you can hold a pencil in your breast crease, stand in front of the mirror, no hands, then you probably are going to need a lift with your breast augmentation, if you can't hold a pencil under your breast, then you probably can get away with an augmentation by itself. So how do you know do the pencil test, and that usually gives you the answer before your consultation.

Unknown:

3:02

If I didn't want implants, can you do fat grafting?

Dr. Jason Hall:

3:05

So fat grafting to the breast, is it kind of ebbs and flows in terms of popularity, and yes, the answer is. The answer to that question is, yes, you can do fat grafting instead of a breast augmentation, provided that you don't want too much volume. The fat grafting is a great tool for small volume improvements that look very natural. So, but if you're looking for a significant change in size. So more than, say, a cup size difference from where you are to where you want to be, or you're one of these women who wants a very high, round upper part of your breast, then fat grafting isn't for you. That's an implant look. And really, only implants can give you a significant increase in size. So is fat grafting something we can do? Absolutely do I do it a lot, not really, because most women want a look or a size improvement. That's outside the scope of what fat grafting can accomplish.

Unknown:

4:09

So what's the difference between a facelift and a deep plane facelift?

Dr. Jason Hall:

4:14

So the difference between a deep plane facelift on one hand and a traditional facelift, on the other hand, has to do with technique, what it doesn't have to do with his results. And I'll explain that in just a second. So a traditional facelift, or a SMAS lift, takes the SMAS layer, which is the the connective tissue layer that's underneath the skin, which is where we want to put tension, because we don't want to put tension on the skin and a facelift that you end up with bad results. We take that mass layer out in the outer part of the cheek, and we lift it up a little bit and rotate it to get the lift in the jowl. We typically do work on the neck and the neck muscles at the same time with a deep plane surgery, the dissection and the amount of work that's done underneath that SMAS layer is much more extensive. So instead of just working out on the outer part of the cheek, we're actually going all the way down to almost the corner of the mouth and the jowl to lift all of that up, move it to where we want it to go, and hold it so there's really no tension to it. The reason why I said at the beginning of the answer that the differences in results aren't really that significant is because we've actually looked our society. There's been some research done in this that was published. First 10 or plus or more years ago. And the results for face lift surgeons. They took different surgeons that did different techniques, the deep plane or composite lift the SMAS lift, the SMASectomies and these other ones, and they compared the results and all four surgeons. All four did different techniques. All four got great results to people who had no idea what happened. They just knew they had a facelift. And so the technique for your facelift really isn't as important as the technique that your surgeon is using to get a good result. So if you see good, this is why before and afters are important. If you see good before and afters on a surgeon's website and you go to that surgeon for that procedure, then how he or she gets there really isn't that important. What's important is the outcome. So I've done been doing this for 15 years, and have used this mass highest mass technique. Have used SMASectomy techniques. Have used, you know, been using deep plane techniques for a couple of years now, and in my hands, my patients get great results with the deep plane lift. I got great results with a SMAS lift. I like my results, and I think my patients like my results with a deep plane better. But that doesn't mean the technique is better. So what are the differences? They're really technical. The end, end of the line. The proof of the pudding is in the eating. Look at before and afters before you decide on a surgeon, decide on a procedure. That's the most important thing, much more important than a technique used to get there.

Unknown:

7:21

So do you really remove the belly button during a tummy tuck?

Dr. Jason Hall:

7:24

I don't know how many times I've heard somebody ask a question of whether the belly button comes off and gets put back on during a tummy tuck. And the answer is 100% no. The belly button is kind of a funny little piece of anatomy. All the belly button is, really is a scar. That's where your umbilical cord was, was hooked up. That's where you were, you were hooked up to mom in the uterus. And so it is a, kind of a tubular scar, so it stays attached when we do an abdominoplasty to your muscles, and we tighten everything around the belly button. We make a little hole, make an incision around the belly button, do all of our work underneath the skin, pull the skin down, and then make a new little hole for the belly button to poke out, but your belly button stays attached. Now there are some instances where we have to it is not going to live. If you've got a big hernia in the middle of your belly button, we may have to close the hernia, which kills your belly button. Then we have to make a new one, which can look okay. It never looks like your real belly button, but it looks pretty good. But we try and we leave you that belly button attached so it can live and look normal and live a long, healthy life along with you and your new stomach.

Unknown:

8:40

Does your nipple get detached during a breast lift?

Dr. Jason Hall:

8:43

We got a question earlier about belly buttons getting removed during a tummy tuck. The does the nipple come off during any breast surgery? Is probably the most common you know, does X, Y or Z get removed and put back on and the answer is no. The whole point of a breast lift, a breast reduction, a lift with an implant, is to kind of move your nipple where it needs to go, and then shape your breast around it. To do that, we have to keep it alive, and we have to keep it attached to breast tissue. So what we do, it's like origami on the inside, we leave that nipple attached to like a leash of breast tissue. On the inside, we move it all around and then shape things around to shape your breast, but the nipple stays on. Now, if you've got really, really large breasts, and we're having to do a significant breast reduction. There are some times we have to remove that nipple and put it back on so it doesn't die. If that's the case, called free nipple graft, your nipple is not going to be sensate. Most women that have to have that, their nipples aren't sensate Anyway, before the surgery because of how large their breasts are, but it's something we really try and avoid.

Unknown:

10:00

How do I go about choosing my CC size for breast augmentation when there are so many options?

Dr. Jason Hall:

10:05

And you're exactly right, there are lots and lots of options for breast augmentation, especially when it comes to size, when it comes to projection, so how far the implant sticks out from your chest? And this is something, in my opinion, that surgeons have done a terrible job of in terms of educating the public and women who are interested in breast augmentation. You choosing your size, really is because there are so many variables involved. Is. Really something you got to worry about. The most, most important thing is you need to worry about what you want to look like when you're done. Do you want a natural shape, so a natural slope to the top of your breast? Do you want the top of your breast to be round? How large Do you want your breasts in proportion to your chest and the rest of your body? Do you want to see a bunch of side boob or you? Do you not? And so it's it's having answers to those questions that really help your surgeon to determine which implant to which way to guide you, to choose an implant size during your consultation that's going to help you accomplish those goals. But there's a ton of different measurements that we take in the office that that help us choose that size implant. And even then, in the operating room, there's a little bit of wiggle room that we use. It's kind of like, describe it to my patients, like, kind of like trying on shoes. We measure things out, you know, looks like you're going to fit in a seven and a half, but then we actually try the shoes on. Seven and a half might be a little too tight, you know, we have to go up a size. It may be that, you you know, seven and a half may be way too big, and we have to go down a size. And so there's some wiggle room in the operating room to get the the look that you're going for on the back end, but being hamstrung by choosing the exact size implant in the office just kind of leads to heartache for both the surgeon and the patient down the road.

Unknown:

12:06

What's the difference between a tummy tuck and Lipo 360?

Dr. Jason Hall:

12:10

So what's the difference between tummy tuck and Lipo 360? One works and one doesn't. No, it's that's totally in jest. The so Lipo 360 is kind of this internet term that came about a couple years ago for liposuction that goes all the way around your body, so upper and lower, back, sides, flanks, love handles, stomach, where a tummy tuck really addresses the front of your stomach and addresses extra skin. Liposuction requires your skin to be in good shape and be able to kind of shrink wrap back down around everything once that fat is gone. With a tummy tuck, we do do liposuction during a tummy tuck, but that skin is loose and hang hangs over your belt anyway, and so it's not going to bounce back, and so we have to get rid of it. So the biggest thing, the biggest difference, is skin removal. The the other is the muscle tightening that we do with the tummy tuck. That really is what is responsible for giving that nice hourglass shape from both the front or the front, and then the flat shape from the sides. So skin excess muscle repair probably the biggest thing, biggest difference between the two.

Unknown:

13:29

I lost over 100 pounds and have an apron belly. Do I need a tummy tuck?

Dr. Jason Hall:

13:34

Chances are, if you're somebody who's lost over 100 pounds and has a lot of excess, you probably have excess where you don't see it or don't appreciate it. And so the short answer this question is probably not, what most patients who have lost a significant amount of weight, either with diet and exercise, with weight loss surgery, or with things like ozempic and all of those GLP-1 agonists, what most of those patients end up needing is something called a body lift, or a belt lipectomy, or a 360 where we remove extra skin all the way around. Typically, for patients like that, you're going to have extra skin on your outer thighs. You're going to have extra skin in your backside. And it's not as apparent, because the skin around the sides and the back isn't connected like it is in the front, where it kind of stops and then everything hangs over. So the best I would go into a consultation expecting to have a body lift or a 360 and let your surgeon kind of guide you as to which procedure or combination of procedures is going to help you accomplish your goals.

Unknown:

14:49

I have hooded eyes, and I'm only 40. Do I get an eye lift or a brow lift?

Dr. Jason Hall:

14:54

So this is a great question. Hooded eyes, relatively young. Do we need a brow lift? Do we need a blepharoplasty? And the answer is, it really, it depends on your exam. Just like everything else in plastic surgery, a consultation is going to really be able to tell you what you need. If you when you're looking in the mirror, the thing to look at is where your eyebrows are. So if your eyebrows are sitting at or below the level of your eye socket, or for women, if your eyebrows are flat, then it's likely going to be that a brow lift will significantly benefit kind of how your how the shape and kind of awake look that you get. With your eyes a lot of times, an upper lid blepharoplasty of varying degrees goes with that, not always, but if your eyebrows are in a good spot, and all we're dealing with is a little bit of upper lid excess, then an upper blepharoplasty, by itself, is something that we can do and get a great result with.

Unknown:

15:56

I want a mommy makeover, but I'm not sure we're done having kids. Should I wait?

Dr. Jason Hall:

16:01

Mommy makeovers, tummy tucks, breast surgery. I think one of the keys with all of those is you really need to be done having children, and sure you're done having children before you have surgery, because everything is going to change with surgery, and it is. You're almost 100% guaranteed to undo most of the work that went into getting you looking great with surgery by getting pregnant again. So if you're thinking about getting pregnant again. If you're not sure you're done, put off having any plastic surgery until you're sure, and then go for it.

Unknown:

16:44

What are your thoughts on CoolSculpting?

Dr. Jason Hall:

16:46

Thumbs down. Humongous waste of money. Does it work? Sort of the problem with CoolSculpting, and we've talked about this on previous podcasts, is that the number of patients that would benefit from CoolSculpting are very, very few in number. The number of patients who are offered CoolSculpting, or who have had CoolSculpting, is fairly huge, which is why the ratings and the patient satisfaction for CoolSculpting is in the toilet. It really is not a technology that is worth wasting your money on if you want fat reduction. See a surgeon, talk to him about liposuction, talk to him about body contouring, but CoolSculpting largely huge waste of money. Don't bother.

Unknown:

17:40

What's the difference between liposuction and skin tightening or removal?

Dr. Jason Hall:

17:44

So liposuction and skin tightening, in terms of body shaping and body contouring, really accomplish two different things. Liposuction really depends on your skin, being able to shrink wrap back down around everything once we've removed the extra fat. And so just as a general rule, liposuction alone is for younger patients that haven't had their skin stretched out with significant weight fluctuations with pregnancies and and just time, causing your skin to lose collagen and not be as elastic and so, like I said, liposuction, generally reserved for younger patients, skin tightening, skin removal. You know, you can look at those things, whether it is non invasive, skin tightening, which in the body really isn't worth the time and money to do it, and then skin removal. You're talking about excisional surgeries like tummy tucks, like arm and thigh lifts, and those are for patients whose they may have extra fat, and usually do that, we remove the liposuction, but then that skin is not going to shrink back down, and so we have to remove it, to tighten it surgically. And so that's where a lot of the combination procedures of, you know, arm lifts and liposuction, tummy tucks and liposuction kind of come in and why liposuction is a part of all of those procedures. Thanks for listening. If you enjoy the show, please leave me a review on Apple Podcasts. Please comment down below if you have an idea you'd like to see made into a show. If you have a question you want answered, send me an email media@drjasonhall.com, drop me a DM on Instagram or X@drjasonhall, thanks again, and we'll see you guys soon.