Verified Plastic Surgeon
 Nicholas Moncrieff

Nicholas Moncrieff

  • Hunter Plastic Surgery
  • Charlestown, New South Wales, Australia
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Do I need a full tummy tuck?

After having two children and losing over 30kgs of weight, I am left with a lot of stretch marks and sagging skin below my belly button. I really hate this area but after viewing a lot of post tummy tuck pictures, I am left very nervous about the thought of that huge hip to hip scar. I was wondering whether I might possibly be a candidate for a mini tummy tuck?

Ozlondongirl 15/02/2017 NSW

  • Answer
    Hi Ozlondongirl
    Firstly, congratulations on that weight loss! Having 2 kids is challenging, but losing 30 kilos is almost impossible so well done.
    In relation to you question, I'll be honest and say it is hard to tell, but as a general rule I perform a full abdominoplasty on patients who have similar histories and appearance. The reason is that while the excess skin on the surface may be suitable for a mini, it is what's below that really counts. By that, I mean that a full abdo allows for full muscle tightening and reshaping all the way up to the breasts. 
    Many mums don't even realise they have muscle separation until they see me. They think they just have a 'fat tummy' but the bulge is actually caused by the muscles not sitting together after babies. A quick, at home test, is to try to do a 'crunch', laying on the bed. Then see if you can feel a gap between your abs in the middle of your abdomen. One finger width is very common, but I also see patients with 4 or 5 finger width gap... a recipe for a bulge, back pain and incontinence.
    Of the hundreds of abdos I've done, only a few have really be candidates for a mini. The others have wanted the full tightening and reshaping that I believe only a full procedure can achieve. 
    I know the scar can be daunting, but I ask patients to bring in their favourite undies and I try to ensure the scar will be hidden by them in my surgical planning. The only issue is that my patients end up wanting lower cut underwear after recovery because they want to show off their newly sculpted shape! Most still find the trade off of the result vs the scar was well worth it as with good adherence to the post-op scar management regime, it fades to a thin white line over the following year or so. 
    I hope that helps and you get to finish off your transformation journey with a great surgery that has excellent cosmetic benefits, but also functional ones too. 
    Kind regardsDr Nick Moncrieff 

Can I avoid a breast lift with implants alone??

I am only 24, no children and very much hoping to achieve a full DD, high, round look without a BL! I want to avoid the scar from the nipple downwards and would love feedback on my best option to go about this.

Sam Sandra 20/05/2016 NSW

  • Answer
    Hi Sam 
    In short, yes. 
    The longer answer is that from what I can see in your photos your nipple and a significant proportion of your breast tissue are above the level of the breast fold which are strong indicators that an implant will be enough. 
    I perform a large number of implants like this and find that a large anatomical implant positioned in a dual plane pocket generally gives the fuller, larger breasts that patients like yourself seek, without the need for a lift. 
    I hope this is reassuring for you and we'd be delighted to see you in our Newcastle clinic. We offer new patients the option of a $50 Vectra 3D imaging consultation which allows you to see what your options are before you commit to a full consultation with myself. 

    Kind regards
    Dr Nick MoncrieffCosmetic Plastic Surgeon 

Lift? Or slightly bigger implants?

Hi, I'm super confused after having very different consultations. I want super natural and was thinking 275cc anatomical as a good size. 300cc felt too big in the sizers. First surgeon: 250-300cc anatomical Overs Second surgeon: Periareola lift (I was devastated) Motiva 295cc rounds Dual Plane I do not want a lift, I just don't think I'm prepared mentally for the extra procedure and scars. I discussed this with Surgeon 1 and he agreed I was borderline which was why he was pushing me to 300cc. He feels I will get a good outcome without the lift. I am worried the 300 are too big. To be honest, all the the sizers felt big! I'm just not used to having boobs I guess. I really don't know what to do. I want to stay within a c cup, but am worried I'll end up too big. I'm not expecting perky boobs of and 18yr old, but am scared I will have the 'snoopy boob' look due to the sag and low nipples? HELP

Kiwikat 20/03/2016 NSW

  • Answer
    Hi Kiwikat
    I'd have to agree that you are borderline and could get a good result either with a larger anatomical, high projecting implants or lift and smaller implants. 
    I think the bigger issue is what you feel you can live with. Yes, having a lift does results in additional scars, but given your skin type, I would expect the scars to fade significantly over a year. And a lift does involve a little more recovery, but again, people tend to underestimate the commitment to recovery that a straight augmentation involves, so both procedures will require changes to your normal routine.
    I'd suggest doing the 'bag of rice' method for approximating the weight of a couple of sizes of implants and wearing for a few hours at home - all implants will feel heavy in a clinic but most women find they get used to it over a few hours.
    Ultimately there is no perfect solution, but you have to be comfortable with the positives and negatives of your choice.
    I hope this is helpful and confirms that you have already had some good advice.
    Kind regards, Dr Nick Moncrieff

Are my breasts too far gone and what procedures do I need to achieve my desired outcome?

I'm 38 and have breast fed all 3 of my children the youngest being 10. I haven't had previous surgeries. I live near the Gold Coast and am willing to travel for the right surgeon.. In taking these photos I've noticed the size difference in my breasts has increased being that my left is looking smaller than the right. Perhaps it's due to gaining weight and now getting the weight off. Trying hard anyway, lol. My dream result is to have size D-DD, side boob and a round (not stuck on) natural, full U shape if that makes sense? I definitely don't expect perfect just improved... And a lot bigger, lol. Is this possible with what I have? I would love to hear your suggestions.

Kimi G 02/02/2016 NSW

  • Answer

    Hi Kimi

    Based on your photos I believe you would get the best possible result from a combined lift and implant procedure. This is because your nipple and much of your breast tissue had dropped with gravity and your great efforts with breast-feeding 3 children!

    An implant alone will give you more volume but the nipple will not be high enough on the breast and over time the nipple and breast tissue will likely fall again, which is not cosmetically pleasing.

    Removing some breast tissue and skin from the bottom of the breast will address the existing laxity and give you longevity in the result. We could also obtain better symmetry by removing more tissue and skin on your right side. And your areolae around your nipple could also be reduced to allow for the natural stretch created by the implant.

    A round or shaped implant could be used depending on your preference for cleavage and 'side boob' (anatomical is better for 'side boob').

    A Vectra 3D image would help you understand your options. We include a Vectra simulation as part of your consultation.

    I hope this information has been helpful.

    Kind regards

    Dr Nick Moncrieff

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