Practice, James J. Romano MD, FACS
2100 Webster St
#412
San Francisco, CA 94115
United States
8
Questions Answered
24
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Questions Answered
Asked 2014-12-27
Dear Sir/Madam, I'd like to ask you about facial implants and fat injections. Which is the better surgery for facial augmentation, the facial implants or the fat injection?
3 Answers
James J. Romano, MD, FACS
Answered: 2015-01-21
There is a difference between when to use a facial implant such as silicone or other materials or fat injection. I prefer to use a facial implant if there are features of the underlying bony framework that needs to be augmented. That is to say an implant adjusts the framework and the foundation, that is the bone. I use fat injection when I need to add volume, create pleasing contours, or fill in wrinkles and furrows. The fat injection allows me to be more artistic and distributes the fat and the volume over a wider area and to blend in and feather the edges. Even with carving implants, this is not as possible. There are occasions when both will work such as augmenting the cheek or sometimes the jawline. Ask your surgeon to distinguish between the above two indications and suggest what is best.
Asked 2015-01-12
Is it standard procedure to use drains for a facelift? I have had three consultations - one surgeon uses drains, one doesn't, and one uses glue. Please advise.
3 Answers
James J. Romano, MD, FACS
Answered: 2015-01-21
I always use drains in facelifts. There are many excellent surgeons who do not do this. The risk of a drain is minimal and the benefits are substantial. In my practice, I ALWAYS use drains because it decreases the swelling, it decreases the bruising, and it allows for the tissues to heal together without any fluid accumulation. I remove these the morning after surgery and it is painless. I have never been sorry I have used a drain. I have been sorry when I did not.
Asked 2015-01-16
I have capsular contracture in one breast and have consulted with two doctors about removal of implants and doing a lift again. One says he won't do both procedures at the same time because of blood loss and loss of nipple sensation. The other, while expressing the same issues about blood loss, has…
9 Answers
James J. Romano, MD, FACS
Answered: 2015-01-21
If you have capsular contracture or regardless of the condition, it is completely safe to remove breast implants. Most of the time patients heal better than they expect and a breast lift is not necessary. If indicated, however, most surgeons prefer to do a breast lift as a secondary procedure as it is then more predictable and safer. I have on many occasions done them both at the same time and it depends on the nature of your anatomy. That is to say if you have enough thickness of the tissues and your circulation is acceptable, we can remove breast implants and then make incisions in the overlying breast tissue and skin and perform a lift. If, however, your skin and tissues are thinned out significantly from the breast implant, it will be safer to do it as a secondary procedure. Whether it is done at the same time or in two stages, you can expect to have a beautiful result.
Asked 2014-06-30
I am 20 years old and after having my first baby 11 months ago (whom I breastfed for 8 months), I am so unhappy with my breasts! They sag and are deflated and they seem much smaller. From what I've read, it's best to do a breast augmentation when you are finished having children. I do plan on having…
1 Answer
James J. Romano, MD, FACS
Answered: 2014-12-29
I have learned from many patient feedback and conversations that women who want implants should have these, because they start enjoying them right away. The effects of pregnancy and breastfeeding are unpredictable from one patient to the next, but they never destroy the effects of the breast implant, sometimes there is more sagging, sometimes it creates a more natural look. Everyone is different and your plastic surgeon can help you predict this based on your current anatomy. Also, they do not interfere with breast-feeding. Any number of my patients where we decided to wait returned later and said, “Dr. Romano, I wish we had done this when we talked because I would have started enjoying them right away.”
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