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Bottoming Out, Double Bubble, Lateral Slide, Waterfall: Ten Breast Revision Questions I Keep Getting Asked

November 01, 2026 | Ask Dr. Agullo, Breast, Breast Revision

The same five words come up in almost every breast revision consult: bottoming out, double bubble, lateral slide, waterfall, capsule. Here are ten questions I answered on RealSelf this year, questions paraphrased and de-identified, my answers lightly edited for the page, with the one rule that runs through all of them: fix the pocket, back it up with mesh, and do not trust tissue that has already stretched.

Breast Reduction: What It Changes, Who It Is For, and Why a Photo Cannot Tell You

October 31, 2026 | Breast, Breast Lift, Breast Reduction

The Billie Eilish breast reduction rumor is two photos three years apart and a claim with no source. I am not diagnosing her. I am answering the questions my own reduction patients ask: what the operation changes, where the scars go, how much can come off and why there is a limit, whether to lose weight first, what recovery looks like, and what it costs here.

The First Two Weeks at Home After Plastic Surgery: Who Should Be With You, and When to Call

October 31, 2026 | Patient Safety, Plastic Surgery Recovery, Recovery

Most of my patients go home, or back to the hotel, the same day. What happens over the next two weeks decides the result as much as the operation did. Here is the first week as I plan it: the nurse visit for the first shower and the drains, who needs to stay with you and for how long, the warning signs that earn a same-day call to the hotline on your wristband, and the three things I would insist on if I could only insist on three.

The 18-Month Facelift: What Holds, What Drifts, and When to Judge Your Result

October 30, 2026 | Facelift, Facial Rejuvenation, Neck Lift

Kris Jenner’s premiere photos in Rome, about eighteen months after her facelift, put the result clock back in the news. I am not diagnosing her. I am answering the question my own patients ask at week three, month three and month twelve: when is this the real result? Here is the settling timeline, what holds, what drifts, and why I photograph at twelve months and judge at eighteen.

The Internal Bra: Why I Recommend Mesh on Every Lift, Reduction and Augmentation

October 30, 2026 | Breast Augmentation, Breast Lift, Breast Reduction

Patients call it the internal bra. I call it the part of the operation that keeps the result where I put it. Here is what the mesh does in a lift, a reduction and an augmentation, how long it lasts, why feeling it means your tissue is thin and not that something went wrong, and the answer I give the patient who does not like the idea of mesh in her body.

Your Own Fat, Donor Fat, or Filler: Where Lipoderma Fits Now That It Is on the Menu

October 29, 2026 | Facial Rejuvenation, Fat Transfer, Injectables

Lipoderma, the donor fat graft, is now on the face menu at The MedSpa at Southwest Plastic Surgery. I still graft a patient’s own fat in the operating room every week. Here is how I choose between the three: your own fat, donor fat in a vial, and hyaluronic acid filler, with the GLP-1 face as the case that decides it most often.

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