The NYC Plastic Surgeon

Breast augmentation increases breast size and changes shape using saline or silicone implants, placed either above or below the chest muscle depending on your anatomy and goals. The decision between saline and silicone, and between an inframammary (under the breast), periareolar (around the nipple), or transaxillary (armpit) incision, is anatomical — it depends on your existing tissue, skin elasticity, and the size and profile of implant you and your surgeon choose together.

Most patients return to non-strenuous work within a week and to full activity, including exercise, within four to six weeks. Implants are not lifetime devices — the FDA and most surgeons recommend periodic monitoring, and many patients eventually have an implant exchange or removal decades later. A breast augmentation consultation should cover implant type, incision placement, and a realistic conversation about long-term maintenance, not just a size and a price.

Choosing a size is a collaborative process, not a number picked off a chart — many practices use sizers or 3D imaging during consultation so you can visualize different volumes on your own frame before deciding. It's also worth knowing that mild breast asymmetry is common before surgery and typically remains slightly present afterward; a good consultation addresses this honestly rather than promising perfect symmetry.

Ask specifically about capsular contracture — scar tissue tightening around an implant, which is the most common longer-term complication — including how frequently your surgeon sees it in their own patients and what the treatment path looks like if it happens. This is a more useful safety conversation than a generic reassurance that implants are safe.

Implant profile — how far the implant projects from the chest — is a separate decision from size, and two implants of the same volume can look very different on the same frame depending on projection. Ask to see or feel implant sizers in different profiles, not just volumes, before deciding.

A breast lift (mastopexy) repositions breast tissue and removes excess skin to raise breasts that have lost their shape due to pregnancy, breastfeeding, weight change, or age — without necessarily changing their size. It is a different procedure from augmentation, though the two are frequently combined when a patient wants both a lift and added volume (sometimes marketed as a "mommy makeover" component).

Incision patterns range from a minimal scar around the areola to a full anchor-shaped incision, depending on how much lift and skin removal is needed. Results are considered long-lasting but not permanent — gravity, aging, and any future pregnancy will continue to affect breast position over time, which is worth discussing honestly at a consultation rather than treated as a one-time permanent fix.

A lift alone does not add volume — patients who want both a higher position and more fullness typically combine a lift with implants in the same surgery. It is also worth discussing nipple sensation directly: temporary changes in sensitivity are common after a lift, and while permanent loss is uncommon, it is a real risk that belongs in an honest pre-surgical conversation.

Ask how the specific incision pattern being recommended for you compares to lower-scar alternatives, and whether you are a candidate for a less extensive lift technique. Not every patient needs the most extensive incision pattern, and a thorough consultation explains why a particular pattern is right for your anatomy rather than defaulting to one approach.

If you're on the fence between a lift and augmentation alone, ask your surgeon to explain specifically what a lift addresses that an implant alone cannot — position and shape versus fullness — since patients sometimes request the wrong procedure for what they're actually trying to change.

Breast reduction removes excess breast tissue, fat, and skin to reduce breast size and weight — often addressing real physical symptoms like chronic back, neck, and shoulder pain, skin irritation, and posture problems caused by disproportionately large breasts, rather than being purely cosmetic. Because of the functional/medical component, breast reduction is one of the few procedures on this page that is sometimes partially covered by insurance, depending on documented symptoms and the amount of tissue removed — a conversation worth having directly with your insurer and surgeon's office.

The procedure repositions the nipple and areola to a natural position on the smaller breast mound, and most patients report significant symptom relief within the first few weeks of recovery. As with a lift, some scarring is unavoidable and is disclosed and planned for as part of the incision pattern chosen at consultation.

If you're hoping insurance will cover part of the cost, expect to document your symptoms over time — many insurers want records of back or shoulder pain, skin irritation, or physical therapy attempts before approving coverage, and your surgeon's office can often help navigate that paperwork. Even when insurance contributes, expect some out-of-pocket cost for anesthesia or facility fees depending on your plan.

Ask how much tissue is expected to be removed, measured in grams per breast, and how that maps to a realistic new cup size, since 'reduction' can mean very different outcomes depending on your starting anatomy and goals. This is also a good moment to ask about breastfeeding ability afterward if future pregnancy is a consideration for you.

Nipple sensation and future breastfeeding ability are both worth discussing directly before surgery, since technique choices can affect both to varying degrees — a thorough consultation walks through this rather than treating it as a minor footnote.

"Mommy makeover" is a marketing term, not a single procedure — it refers to a combination of surgeries (most commonly a tummy tuck plus breast augmentation and/or a breast lift, sometimes with liposuction) performed together to address the physical changes of pregnancy and breastfeeding in one recovery period rather than several. Combining procedures reduces total anesthesia exposure across separate surgeries and consolidates downtime, but it is also a longer single surgery and recovery than any one component alone.

Whether combining procedures is appropriate for you depends on your overall health, the specific combination requested, and your surgeon's judgment about safe operative time — not every combination is advisable for every patient, and a responsible consultation will say so directly rather than upselling a package.

Most surgeons recommend waiting until you're done having children and have finished breastfeeding before scheduling a mommy makeover, since a future pregnancy can undo results like a tummy tuck's muscle repair. Weight should also be stable for several months beforehand — significant weight loss or gain after surgery can meaningfully change the outcome.

Ask your surgeon to walk through the order procedures will be performed in during a combined surgery, and how that order was chosen — some sequencing decisions affect swelling and the accuracy of intraoperative measurements for other components of the makeover. A transparent surgeon explains their specific plan rather than treating it as a packaged deal.

Because a mommy makeover is a longer combined surgery, ask specifically about total operative time and how your surgeon manages safety for procedures that run several hours, including where the surgery takes place and what monitoring is in place throughout.

A tummy tuck (abdominoplasty) removes excess skin and fat from the abdomen and tightens the underlying abdominal muscles, which is why it is meaningfully different from liposuction — liposuction removes fat, but it does not address loose skin or separated abdominal muscles (diastasis recti), which is common after pregnancy or significant weight loss. Patients considering a tummy tuck for post-pregnancy changes, or after major weight loss, are typically better candidates than patients simply looking to lose the last few pounds.

Recovery is one of the longer timelines on this page: most patients need one to two weeks away from work and four to six weeks before resuming exercise or heavy lifting, with a compression garment worn for several weeks to support healing. A drain is commonly placed for the first week or so to manage fluid as the tissue heals — a detail worth asking about directly since it affects the first days of recovery logistics.

Not every patient needs a full tummy tuck — a mini tummy tuck addresses a smaller area below the belly button with a shorter incision and recovery, and is appropriate when muscle separation and excess skin are limited to the lower abdomen. The muscle repair itself, bringing separated abdominal muscles back together with sutures, is often what patients notice most, since it restores a flatter contour that diet and exercise alone can't achieve once the muscles have separated.

Ask whether you are a candidate for a fleur-de-lis technique, which adds a vertical incision for patients with significant excess skin (often after major weight loss), versus a standard horizontal incision — the right technique depends heavily on your specific skin laxity pattern, not a single default approach.

Liposuction removes localized fat deposits that have not responded to diet and exercise — common areas include the abdomen, flanks, thighs, and under the chin. It is a body contouring procedure, not a weight-loss procedure: candidates are generally already near a stable, healthy weight and are targeting specific stubborn areas rather than significant overall fat loss, and skin elasticity affects how smoothly skin re-drapes afterward.

Techniques vary (tumescent, ultrasound-assisted, laser-assisted), and the right one depends on the treatment area and your skin quality. Most patients return to light activity within a few days and normal exercise within two to three weeks, with final contour visible over the following months as post-operative swelling resolves.

Skin elasticity matters as much as the fat removed — younger patients with more elastic skin tend to see smoother results, while looser skin may need a complementary procedure like a tummy tuck to address skin laxity rather than fat alone. Liposuction results are permanent in the sense that treated fat cells are removed, but significant weight gain afterward can still add new fat, including in untreated areas.

Ask how many total areas can safely be treated in one session, since there's a real limit to how much fat can be safely removed at once — a surgeon prioritizing your safety over maximizing a single visit will give you a straight answer about staging multiple areas across separate sessions if needed.

A Brazilian Butt Lift (BBL) uses fat harvested via liposuction from another area of the body (commonly the abdomen or flanks) and reinjects it into the buttocks to add volume and shape — meaning it is really two procedures in one, liposuction plus fat grafting, and requires you to have enough donor fat available. Not all of the transferred fat survives the transfer permanently; surgeons typically account for a percentage of graft loss when planning volume, which is worth asking about directly.

BBL has real, well-documented safety considerations tied to injection technique and depth — this is a procedure where your surgeon's specific training and technique matter enormously, and it is reasonable to ask directly about how fat is injected and what safety protocols are followed. Recovery includes restricted direct sitting for a period of time to protect the graft, which is a real lifestyle adjustment worth planning for.

Because a BBL relies on your own fat, you need enough donor fat available in areas like the abdomen or flanks — patients who are already very lean may not be candidates and might be better served by a buttock implant instead, which is a fundamentally different surgery with its own risk profile worth discussing directly at consultation.

Ask specifically whether fat is injected above or below the muscle — injecting into the muscle itself is associated with the rare but serious safety complications linked to BBL, and reputable surgeons now avoid intramuscular injection specifically for this reason. This is one of the most important safety questions to ask directly before choosing a surgeon for this procedure.