Ask Dr. Kagan

Looking to find answers to recent questions answered by Dr. Kagan? Read the latest Q&A:

Your Answers

  • Rhinoplasty: primary, revision or secondary w/ rib graft?

    Generally, rib grafts are used for more advanced nasal problems. A patient who presents with a traumatic nasal dorsal deformity or a collapsed nasal dorsum may require grafts for nasal support. A primary rhinoplasty is one which usually describes the procedure performed for general appearance improvement. This may require surgical correction of nasal cartilage and /or reshaping of the nasal bones. Revision rhinoplasty refers to secondary correction of nasal deformities which may be treated with surgical intervention.
    Most importantly, each nose has its’ own “character” and is evaluated individually as to what may be the best surgical plan for the most optimal outcome.
  • How soon could I get back to work after rhinoplasty?

    One could generally return to work one week after a rhinoplasty. The two main factors are not related to discomfort, but rather appearance. The nasal splint is removed in one week. There may be some bruising which may resolve in 7 to 14 days.
  • How long does a facelift usually last until I have to have another one done?

    The longevity of a facelift is dependent on several factors. The most important is the quality of ones’ skin elasticity. Those with better elasticity will have longer lasting results than those with genetically poorer skin quality. Other factors affecting results include  health concerns, weight fluctuations, smoking, and excessive sun exposure. Even with potential adverse influences, an individual who has a facelift will still look better in 10 years than if it was never done initially.


  • What is the difference between silicone and saline breast implants?

    The difference between silicone and saline is the following…..silicone may feel more natural than saline…especially in a thinner skinned patient.  The downside, if it fatigues over time, may be more difficult to tell as the silicone will remain in the pocket.  If a saline implant breaks, the water is absorbed immediately, easily demonstrating the deflation…..It really comes down to as whether the patient never wants to worry about having to get MRI’s to determine fatigue of implant (silicone)… which makes saline more attractive, or the patient wants a more natural feel…silicone.  Lastly, its like comparing water in a zip lock bag vs. jello.
  • Too FAT for breast reduction? Is there a restriction on a person's BMI in order to have breast reduction done?

    I weigh 240lbs, 5’8″, 32 yr old. 40 DDD. Have been refused consultation based on BMI. Is there a restriction on a person’s BMI in order to have breast reduction done? Does OHIP have a BMI rule for coverage? Severe and prolonged back pain, bra indents, rash under breasts. I do not feel obese and feel my ability to engage in physical activity will improve with a breast reduction, as i am often restricted by their size.

    I understand your situation, however every insurance plan is different with different guidelines for approval of any procedure. We have experienced in the past, patients being declined due to weight.

    It is a possibility you could schedule a cosmetic consult and pay out of pocket.

    Having a breast reduction would definitely help you become more active, and would be a life changing procedure for you. You would need to keep up an active lifestyle along with lifestyle changes.

  • Is it usual that skin needs to be lifted again after face and neck lift?

    I had a face and neck lift by a very well know Dr. who is very respected. But i noticed right after surgery the skin under my neck had folds. Now 7 months later slight jowl and neck skin loose. The PS said he will redo the facelift only lifting skin with full incisions around ears again. I am still numb and concerned this will cause more numbness. I am waiting for a full year before surgery.

    Everyone heals very differently and has different expectations. Hopefully there is significant improvement in your jowl and neck area.

    Your Dr. is doing the right procedure with removal of your skin with the same incisions. It seems as if you’re in good hands.

  • What is the best post-op scar cream after a periareolar lift?

    I’m currently 4 weeks post-op and had a periareolar lift with augmentation. My doctor recommend I use a scar cream but I’m not sure which one to use. Any advise would be greatly appreciated! TIA

    Hopefully you will heal well, however healing is very genetic but scar creams do help. Vitamin E cream or oil works well or any silicone based cream such as new gel or over the counter mederma cream. Do not use if you have any openings. Apply daily.

  • Which procedure will give me the full shape I want in my breasts? What is best state to go to with reasonable pricing?

    I am an 18 year old female, I want a breast lift within the next 2 years. I have 36DDD breast but I believe most of my size is sagging skin. I want nice D/DD breast, lifted and firm, but still a natural look. I live in NJ but I’m willing to travel within the states (around 8 hours away). How much should I expect for a procedure like this?

    Without a photo it is hard to tell whether you would benefit from a mastopexy (breast lift) or a mammoplasty (breast reduction) If you like your size, you would benefit from a breast lift. If you’re looking to be a little bit smaller, you would benefit from a breast reduction A breast reduction involves removal of breast tissue with a breast lift. A breast lift involves just removal of skin. In either case, drains may need to be put in. The trade off is the scar you will have. There is a lot of scar therapy out there you can do to minimize the scarring.

  • Browlift Vs Blepharoplasty - Which is Best for Sagging Eyelids?

    Is a brow lift (forehead lift) better to raise sagging eyelids than a blepharoplasty?

    It depends on what end result you’re looking for. The brow lift is to raise the upper brow so it sits correctly on the brow bone. It may also raise the upper lid a small amount. If you want a lot more upper lid exposure you would need the upper eyelid skin removed along with fats pads.

  • Do eyelids become smaller after the swelling is gone?

    I really need help. I just had blepharoplasty couple days ago. I told my doctor i want small eyelids but after the surgery i realised my eyelids were much bigger than i expected and i am so worried if it is gonna stay like this. Is there any chance that after swelling is gone the lids become smaller or after they remove the stitches it will look smaller? I heard it becomes small by time but will it be smaller after removing the stitches or it will stay how it looks now? Thank you for your help

    The swelling and bruising will peek out after about 3 or 4 days or so… the healing process will really pick up after that. Cool gauze pads on the eyelids and keeping your head elevated will help the healing process. An eyelid procedure does not change the shape of the eye or placement of the brow You will have more upper eyelid exposure. Be patient and compliant and you will notice a great improvement over the course of the next few weeks!

  • What are the complications of having a Breast Lift at the same time as an explant?

    I have had breast implants for 24 years & are wanting them out (I am now 45). I would like a minor lift as well. My breasts have always been quite soft & supple (never hard) & I have successfully breastfed two children. Would a donut lift be ok for me (I don’t want major lifting or scarring) and are the complications of doing a lift at the same time as a explant quite high ? & the chances of my breasts concaving? The implants were put through the bottom of my areolas.

    Most women need a lift after a breast explant… the skin has stretched and most likely lost its elasticity. Looking at the picture, you most likely would need a full mastopexy. The trade-off is the scar. You may also want to discuss what size you will want to be… it’s a possibility you may not be the size you would like due to lack of breast tissue. It is definitely safe to perform both explant and lift at the same time, one recovery.

“Completely, totally happy with my tummy tuck”

Absolutely, 100% satisfied! I feel fantastic and I have the tummy I have always wanted but (obviously) never had. After 2 c-sections and gaining an excess of 60 lbs with the pregnancies, I had A LOT to get rid of. I would do it again in a heartbeat!