X's Q & A

Q&A: Are there any breast augmentation procedures that will result in large, full breasts that stay standing up, even when you lay down?

Using textured implants, and an uplift if you have skin excess, can give you the result you want. David M. Metzner, MD

Q&A: Can I get Botox injections in the lower half of my face?

Like lots of things in cosmetic surgery, you can probably find somebody to perform what you want. Very few plastic surgeons I know will inject botox in the lower perioral area for fear of smile muscle paralysis. I won't inject around the mouth for fear of having a paralyzed smile.

Q&A: How is the artificial insemination procedure done?

Hi Lisa, Sperm is "washed" in our lab, drawn up into a thin, flexible plastic catheter, the catheter is inserted through the cervix into the uterus, and the processed sperm is deposited into the fallopian tubes close to the egg. This is all done on the DAY OF ovulation. Hope this helps! Dr. Roseff

Q&A: Should I donate my own blood for my pregnancy?

I would not recommend that you donate your own blood during pregnancy. If you need blood, banked blood is very safe. All of your MDs points are valid.

Q&A: How much Botox is needed for an injection between the brows?

Dear Nancy, The amount is actually relatively unimportant since the Botox injection is made-up by the person doing the injecting. Each vial contains 100 units of the toxin. For most people, about 20 units is all that is necessary for long-term paralysis of the muscles. Most of us make the volume to contain that amount about 0.5 or, at most, 1.0 cc. If the volume is too large, not only does it hurt more to do the injection but there is also more risk to the Botox migrating to where it is not wanted or needed (usually the levators of the upper eyelid leading to drooping eyelids for a few months). Most of us have an intrinsic tension on the muscles of the forehead (like the muscles elsewhere) and if completely paralyzed, the brows will fall. Most of us to paralyze the forehead, however do so to only a limited extent, ie. where the wrinkles are most prominent. No one wants an inanimate forehead. For severe wrinkles and to permanently remove the frown muscle, a brow lift is the procedure of choice.

Q&A: Which would be less expensive, filling teeth or pulling and replacing with dentures?

The thing about pulling teeth is, once they're gone -- they're gone . . . for good! I would try to avoid that. But it does cost money. Once your teeth are gone, then dentures, implants or bridges also cost money. Without the benefit of seeing you in person, I could not advise you about the costs, or recommended treatment for your specific case. You could go for a consultation with a couple of dentists, get the costs and then make your decision.

Q&A: After having glaucoma & cataract surgery my vision is foggy. What can I do about it?

It often takes longer for visual recovery after combined cataract and glaucoma proceedures often because the decrease pressure in the eye can cause both corneal folds and retinal edema in some cases. You may want to have a second opinion from another ophthalmologist (including a retinal specialist) if this does not improve after a month after you

Q&A: I had disastrous facial cosmetic surgery, what should I do?

Dear Joanne, I could not agree more. The fatty layer of the face is a sign of youth and not aging and most of us are going to very conservative fat removal if any at all. Liposuction of the face is very rarely performed by cosmetic surgeons who perform a great deal of facial plastic surgery. The place where your doctor was a medical student is much less important than where and what type of residency and fellowship training was performed. Many ENT and dermatologists perform plastic surgery and many of them do so well. Even plastic surgeons, should have extra training in cosmetic surgery prior to performing procedures - most plastic surgical residency training is reconstructive. I hope that your fat grafts take well although that is a very "iffy" procedure. There should be some soft-tissue fillers here soon that will offer some long-term help to your problem.

Q&A: If I need a Breast lift, arm lift, and thigh lift, could I get all three procedures done at the same time?

It is possible, but there are a number of factors that will affect the final decision including the extent of the amount of surgery and the areas involved, your overall health, and current weight.  Of course, all of these questions can be answered during a consultation, which would be necessary before your surgery anyway.  I would be very happy to discuss this further with you and invite you to call my office manager, Denise, to schedule a consultation.  I hope this helps and have a wonderful day! :)

Q&A: When do I need to get off the pill to get pregnant?

It sounds like you may have polycystic ovaries. If when you stop the pill you don't have regualr periods, see your gynecologist. You may need a little help.

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