Practice, James J. Romano MD, FACS
2100 Webster St
#412
San Francisco, CA 94115
United States
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24
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Questions Answered
Asked 2014-11-15
I have had 2 children. I used to have a full B, small C cup size. After the birth of my first child there were complications with milk production overload. I went from a C to double E easily. It has left me with what I see as hanging bags of flesh. It has been 12 years since the birth of my second…
4 Answers
James J. Romano, MD, FACS
Answered: 2014-12-29
Implants can improve and essentially totally fix the appearance of the breast in situations like yours. However, it is strictly dependent on how much excess skin exists and the relationship of your nipple to the foundation of your breast that is the breast fold. If your nipple is at or below the fold and in combination with a lot of excess skin, then you will most likely need implants to improve the volume, create some perkiness, and some degree of skin excision, often this could be done with just a periareolar lift. If you have mild to moderate loose skin and not much sagging, an implant will often “take up the slack” create perkiness and eliminate the need for incisions.
Asked 2014-11-05
I'm planning to have my implants removed with a breast lift. My questions are: Will the removal and lift be done during the same surgery? I have Essential Thrombocythemia and am concerned about increased risks during surgery. Should I have my surgery in a hospital instead of surgery center?
1 Answer
James J. Romano, MD, FACS
Answered: 2014-11-18
Essential thrombocytopenia is not a contraindication to surgery. I have seen many patients with this condition; and once you are evaluated and we determine the number and the health of your existing platelets, we can determine if surgery is safe or, at most, you need a platelet transfusion prior to surgery. Regardless, removal of implants can be done very predictably and safely; and in fact, most of my patients do well without any lift. If lifting is required, that can be done at the same time or at a later stage. It is perfectly fine to do it as a secondary procedure, and often the results are best with this. I hope this helps.
Asked 2014-11-01
Hi there, I'm a 28 year old woman currently living in Australia. I have been doing a little research on plastic surgery since I'm not currently happy with my looks. I was born via vacuum delivery and so my mum would always tell me that my head and face would sag on one side if I so happened to lie…
1 Answer
James J. Romano, MD, FACS
Answered: 2014-11-18
Facial asymmetry is something we see in virtually every patient; however, it occurs to varying degrees. Careful analysis of your photographs, x-rays, and physical examination should provide you with an excellent course of action. It may involve the different tissue layers in your facial architecture starting with your bony foundation that may be adjusted by cuts and moving bone and securing this with screws or with implants or a combination. The volume layer, which is the fat, can be adjusted with fat grafting or liposuction. Finally, the skin layer can be adjusted if necessary by removing excess skin if indicated, however, does not sound like that is the case. I hope this helps.
Asked 2014-10-28
I'm about 5'7" and 185 pounds. I'm curious about the fat grafting procedure because I have excess weight in my lower stomach that I'd love to flatten out. My breasts are large B's/small C's and I have a flat buttocks - I'd love to inject my tummy fat into both areas. I'm wondering how flat this…
3 Answers
James J. Romano, MD, FACS
Answered: 2014-11-18
From your description, you are perfect for fat grafting. It always works best when someone has a little extra “reserve.” Standard liposuction using small caliber cannulas and low setting on the suction machine should retrieve excellent fat that I like to process with the “Revolve” system. To this, I add your own platelet-rich plasma and some antibiotics. It is excellent at retrieving the most fat possible. I then use very small microcannulas to thread the fat into your buttocks and into the underside of the breasts. I have done this many times with permanent results. The recovery is mostly comfortable. You should have a noticeable improvement that you recognize right away. There are some limitations in sitting for the first two weeks, but you can mostly pursue all activities.
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