Dr. Killeen's Plastic Surgery Blog
Very Little Tissue and Considering a Breast Augmentation: Under or Over the Muscle?
June 15, 2026
Dr. Killeen breaks down the under-vs-over-the-muscle decision for thin breast augmentation patients — the traditional pinch test, why modern cohesive implants and fat grafting have changed the old rules, and the overlooked trade-off: thin patients see the implant more under the muscle, but they also see the muscle move more.
J.Lo, "I Never Did Botox," and the Timeline That Doesn't Quite Add Up
June 13, 2026
Dr. Killeen breaks down the recirculating story of Jennifer Lopez declining Botox at 23 — and why the Botox history timeline (first cosmetic paper published in 1992, the exact year she was 23) makes it a stretch. Plus a bigger point about beauty transparency and why gatekeeping treatments helps no one.
Stitch Abscesses After Surgery: What They Are (and Why They're Not Actually an Infection)
June 12, 2026
Dr. Killeen explains what stitch abscesses (suture abscesses / spitting sutures) actually are — your body pushing out dissolving suture material, not an infection — why some people get them every time, how to treat them with hypochlorous acid spray, and why you should always confirm the diagnosis with your surgeon.
Why I Hate the Donut Lift and the Crescent Lift (And Why the Bigger-Scar Lift Is Worth It)
June 10, 2026
Dr. Killeen explains why she avoids the donut (Benelli) lift and the crescent lift — the donut spreads the areola no matter what you sew it with (even Gore-Tex), and the crescent ovals out the areola and destroys the superior pedicle for future surgery. Plus why the traditional bigger-scar lift is the trade worth making.
In-Office Revisions After a Breast Reduction: Dog Ears and Nipple Inversion
June 9, 2026
Dr. Killeen explains the two most common revisions after a breast reduction — dog ears and nipple inversion — including why they happen, why they often resolve on their own, the in-office options (Kybella, excision, nipple piercing, surgical correction), and the important breastfeeding consideration before correcting inversion.
Can You Reconstruct a Breast With Only Fat Grafting After a Mastectomy?
June 5, 2026
Dr. Killeen explains the reality of fat-grafting-only breast reconstruction after mastectomy — why it takes many rounds of surgery (one patient needed six), the skin retraction problem, the imaging complications that matter for cancer survivors, and why a flap is often the better autologous option.
Please Don't Do Your Own TCA Peel at Home: A Plea About the Worst TikTok Trend
June 3, 2026
Dr. Killeen responds to a viral video of a young man with darker skin doing a 30% TCA peel on himself at home. Why DIY chemical peels are genuinely dangerous, what professional clinicians do that he didn't, and what you're actually paying for at a real aesthetic appointment.
"My Compression Garment Was Sitting Too High and Pushed My Breasts Up — Did I Ruin My Result?"
June 2, 2026
Dr. Killeen reassures post-op patients who accidentally wore their compression garment too high and pushed their breasts up out of position. Including a real-world example of a patient whose implants were sitting at her collarbones from a too-small bra — and how everything settled back without surgery.
Does Insurance Cover Capsular Contracture Surgery? More Often Than You Think.
May 28, 2026
Dr. Killeen breaks down the four scenarios for insurance coverage of capsular contracture surgery — reconstruction patients, other reconstructive indications, cosmetic implants, and how the Baker grade affects coverage. Plus why the "not covered for cosmetic implants" claim you see online is mostly wrong.
What Happens to Your Chest When You Remove Implants? (And Will You Need a Lift?)
May 27, 2026
Dr. Killeen walks through what implants do to your chest tissue, what happens when they're removed, and the specific anatomic clues that predict whether you'll need a lift after explant — including the often-misread scenario where an implant sitting too high makes the nipple appear low when it's actually fine.
Do You Have to Remove the Capsule When You're Explanting for a Contracture?
May 26, 2026
Dr. Killeen explains when and why she removes the entire capsule during implant removal for capsular contracture — and the real trade-off (adding a capsulectomy triples the major complication rate from hematomas). Plus when leaving some capsule behind is a defensible choice.
Drains After a Breast Reduction? I Don't Use Them — and the Data Backs Me Up.
May 22, 2026
Dr. Killeen explains why she doesn't use drains after breast reduction surgery — the data shows drains don't prevent seromas or meaningfully manage post-op bleeding, and patients consistently hate them. Plus what she does instead to manage fluid and bleeding without drains.
You're Having an Implant Problem — Do You Replace Them, or Take Them Out for Good?
May 21, 2026
Dr. Killeen walks through the framework for deciding whether to replace your implants or remove them permanently when you're facing a serious implant problem. Plus the case for the third option — removal now with the option to replace later if you change your mind.
Does a Very Low Nipple Increase the Risk of Necrosis in a Breast Reduction?
May 21, 2026
Dr. Killeen answers whether a long sternal-notch-to-nipple distance — typically over 30 cm — increases the risk of nipple necrosis during a breast reduction, and how careful pedicle planning, backup strategies, and surgeon experience can dramatically reduce that risk even in patients with very low nipples.
How Common Is Breast Regrowth After a Reduction?
May 20, 2026
Dr. Killeen walks through the actual data on breast regrowth after reduction — about 6% in the overall population — and the two patient factors that meaningfully increase risk: surgery very young and surgery young in a larger-bodied patient. Plus why even patients who experience some regrowth have excellent quality-of-life outcomes.
The Evolution of Mastectomy: From Aggressive Surgery to Nipple-Sparing
May 20, 2026
Dr. Killeen traces how mastectomy has evolved over decades — from the disfiguring radical mastectomies of generations past to today's nipple-sparing approach that preserves the muscle, most of the skin, and the nipple-areola complex while delivering equivalent cancer outcomes.
Why Breast Reduction Is the Most Incredible Procedure I Perform
May 18, 2026
Dr. Killeen on why breast reduction is one of the most life-changing procedures in plastic surgery — delivering both immediate medical relief (neck pain, back pain, headaches) and meaningful aesthetic transformation in a single operation, with insurance coverage often available for symptomatic patients.
Do I Need a Breast Lift? How I Actually Decide.
May 14, 2026
Dr. Killeen walks through how she decides whether a patient needs a breast lift — including the ptosis grading system, the difference between true ptosis and pseudoptosis, when added volume can "cheat" a small lift, and why patient aesthetic preferences matter as much as the anatomic grade.
Warning Signs of a Plastic Surgeon Who Doesn't Evolve — and Why Patient Experience Matters
May 12, 2026
Dr. Killeen calls out a specific pattern in plastic surgery: surgeons who do things one way, don't evolve their technique, and don't ask patients what it actually feels like to live in the body they created. With three warning signs to watch for and the under-vs-over-the-muscle conversation as the case study.
Why Choose the Preservé Technique for Your Breast Augmentation?
May 11, 2026
Dr. Killeen explains why Preservé — a tissue-preserving breast augmentation technique that respects your natural ligaments and creates an implant pocket fit to your anatomy — is one of the best options for patients who want a subtle, natural-looking augmentation.
A Tragedy in the News: Joy Barbera and the Risks of Stacking Cosmetic Procedures
May 8, 2026
Dr. Killeen analyzes the publicly reported facts of the Joy Barbera case — a 48-year-old woman who passed away after a 10-hour operation combining an arm lift, breast augmentation, 360 liposuction, BBL, and lower body lift — and the broader lesson for patients about why staging matters when multiple surgeons recommend it.
Implant Removal and Capsulectomy: Insurance, Procedure Types, and Why "En Bloc" Is Almost Never Right
May 7, 2026
Dr. Killeen breaks down the five types of implant removal and capsulectomy, why insurance often says "yes" while plastic surgeons say "cosmetic code only," and why an en bloc capsulectomy is almost never appropriate outside of a documented capsule cancer like BIA-ALCL.
Jennifer's Law: An Update on the Tragic IV Hydration Death in Texas
May 1, 2026
Dr. Killeen breaks down the legal update to the Jennifer Cleveland case — the Texas med spa IV hydration death where a non-medical owner ordered TPN electrolytes — and the new patient-safety law passed in her name requiring qualified physicians, PAs, or NPs to order and administer all IV therapy.
My Plastic Surgery Pet Peeve: Self-Promotion Through Fear-Mongering and Old Implant Photos
April 30, 2026
Dr. Killeen takes on the trend of plastic surgeons misrepresenting valid techniques as dangerous to drive personal practice volume — and the misleading use of decades-old "dinosaur egg" implant photos as if they represent the reality of modern implant care in 2026.
I Like My Size — I Just Want More Upper-Pole Fullness. What Are My Options?
April 30, 2026
Dr. Killeen breaks down how to add upper-pole volume without making the breast bigger overall — including realistic expectations for fat grafting, why a smaller Preservé implant is currently the most consistent option in the U.S., and the new Mia diamond-shaped implants that are coming.
How Many CCs Are in a Cup Size?
April 23, 2026
Dr. Killeen breaks down the average cc-to-cup-size conversion for breast augmentation and reduction — why 150 cc ≈ one cup size on average, why the range is really 100 to 250 cc, and why responsible surgeons don't promise specific cup sizes.
PSA: Get Your Silicone Implants Imaged Before Any Breast Surgery
April 22, 2026
Dr. Killeen explains why anyone with silicone breast implants heading to the OR for *any* breast procedure — revision, biopsy, lumpectomy, or a previous lift revision — should have an ultrasound or MRI first, and how it can change the surgery and unlock insurance coverage.
When AI Cost a Patient His Life: A Tragic Story About Perplexity and Leukemia
April 21, 2026
Dr. Killeen breaks down a devastating New York Times story about a man with leukemia who declined treatment based on a Perplexity AI report — even after the authors of the cited papers told his family the AI had misread their research — and the broader danger of letting AI override your doctor.
Why Didn't the OR Team Stop Surgeon Thomas Shaknovsky?
April 16, 2026
Dr. Killeen answers the most common follow-up question about the Shaknovsky case: why didn't the other staff in the operating room stop him? She breaks down who's in the OR, what they do, and why they often can't see what the surgeon is doing.
Surgeon Thomas Shaknovsky Charged With Manslaughter: What Actually Happened
April 15, 2026
Dr. Killeen reacts to the news that surgeon Thomas Shaknovsky has been charged with manslaughter after removing a patient's liver instead of his spleen — and explains why this case is beyond a normal surgical complication.
How Many Opioid Pills Should You Get After a Mastectomy With Implant Reconstruction?
April 13, 2026
Dr. Killeen explains the evidence-based opioid prescribing guidelines after mastectomy with implant reconstruction, why the numbers are lower than you'd expect, and the multimodal protocol that makes it possible.
Will Insurance Cover Your Breast Reduction?
April 9, 2026
Dr. Killeen explains how insurance coverage for breast reduction works — the Schnur scale, BMI cutoffs, out-of-pocket costs, and why you should never ask a surgeon to lie for coverage.
Surgeon Sues Surgery Center in Rachel Tussey Case: An Unusual Development
April 8, 2026
Dr. Killeen breaks down the unusual lawsuit filed by Dr. Tork against the surgery center and anesthesia group in the Rachel Tussey case, including both sides' claims.
Oncoplastic Breast Reduction: Cancer Surgery and Reconstruction Together
April 6, 2026
Dr. Killeen explains oncoplastic reduction — combining breast reduction with lumpectomy — why it leads to better symmetry after radiation, and why it doesn't compromise cancer outcomes.
My Oura Ring Review After 18 Months: Honest Pros and Cons
April 5, 2026
Dr. Killeen shares an honest review of the Oura Ring after 18 months of daily wear — what works, what doesn't, and whether it's worth it compared to the Apple Watch.
Breast Reconstruction for Larger Breasts: Volume Options Beyond 800cc
April 3, 2026
Dr. Killeen discusses breast reconstruction options for patients who need larger volume — from Mentor's extended size implants and fat grafting to hybrid flap procedures.
Outpatient Surgery Center vs Hospital: Which Is Safer for Cosmetic Surgery?
March 30, 2026
Dr. Killeen explains why freestanding ambulatory surgery centers have better outcomes and lower costs than hospital-based centers for cosmetic procedures, plus her stance on anesthesiologist-led care.
Why Diastasis Repair Should Be Part of Every Tummy Tuck
March 30, 2026
Dr. Killeen explains why she repairs the abdominal muscles (diastasis recti) on virtually every tummy tuck patient and how it improves results.
Breast Implants and Cancer Risk: BIA-ALCL, BIA-SCC, and Motiva Implants
March 27, 2026
Dr. Killeen explains the two rare cancers associated with breast implants — BIA-ALCL and BIA-SCC — and why Motiva smooth cell implants appear to be safe.
Does Hybrid Breast Reconstruction Increase Cancer Recurrence?
March 25, 2026
Dr. Killeen explains why the type of breast reconstruction — implant, DIEP flap, or hybrid — does not affect cancer recurrence rates.
The FDA Is Rolling Back Tanning Bed Protections — A Melanoma Survivor Responds
March 20, 2026
Dr. Killeen, a melanoma survivor who fought for tanning bed bans for minors in Kansas, responds to the FDA's decision to weaken tanning regulations.
Is There a Minimally Invasive Breast Augmentation? The Honest Truth
March 19, 2026
Dr. Killeen reviews every minimally invasive breast augmentation option — PRP, filler, biostimulators, Renuva, AlloClay — and explains why none are recommended yet.
Hospital Privileges: Why They Matter When Choosing a Surgeon
March 16, 2026
Dr. Killeen explains what hospital privileges are, how they work, and why it's critical that your surgeon can follow you to the hospital if complications arise.
Do You Need a Tissue Expander to Downsize During Breast Reconstruction?
March 12, 2026
Dr. Killeen explains whether you need a tissue expander if you want smaller breasts after mastectomy, and why downsizing carries more risk than upsizing.
Breast Reconstruction When You Already Have Implants
March 11, 2026
Dr. Killeen explains how pre-existing breast implants affect mastectomy reconstruction risk, why pre-pectoral placement is now standard, and her published complication data.
Scar Treatment After Surgery: What's Normal and When to Intervene
March 9, 2026
Dr. Killeen explains the natural history of surgical scars, when intervention is needed, and the honest truth about scar treatments — from silicone gel to lasers.
Why Can't My Surgeon Drain My Seroma?
March 5, 2026
Dr. Killeen explains why draining a seroma isn't always straightforward — from fluid thickness and cavity shape to loculations that block needle access.
Preservé vs Traditional Breast Augmentation: Recovery Differences
March 4, 2026
Dr. Killeen compares recovery between Preservé and traditional breast augmentation — from pain management to return to activity and long-term implant placement.
Breast Implant Infections: How We Diagnose and Treat Them
March 3, 2026
Dr. Killeen explains how breast implant infections are diagnosed, when antibiotics aren't enough, and her implant salvage algorithm for saving infected implants.
Can Silicone Breast Implants Get Into Your Lymph Nodes?
March 2, 2026
Dr. Killeen explains silicone migration to lymph nodes — how common it really is, what the studies show, and why modern implants have reduced this risk significantly.
What Is Recovery Like Moving Implants From Under to Over the Muscle?
February 28, 2026
Dr. Killeen explains recovery after switching breast implants from under the muscle to over the muscle — timeline, pain management, and what to expect.
Why UK Plastic Surgeons Are Calling for a Ban on Breast Filler
February 26, 2026
Dr. Killeen explains why injecting filler into breasts is dangerous — from cancer screening interference to infection risk and why most providers doing it aren't qualified.
Why Don't I Have Cleavage After Breast Implants?
February 24, 2026
Dr. Killeen explains why some patients don't get the cleavage they expected after breast augmentation — from chest wall anatomy to breast tissue density and implant profile.
Should You Replace Your Implant During Revision Surgery?
February 23, 2026
Dr. Killeen explains when it's okay to keep the same breast implant during revision and when you absolutely need a new one — from contracture to infection to implant age.
Can Breast Implants Cause a Facial Parasite? A Surgeon's Response
February 19, 2026
Dr. Killeen responds to Brandi Glanville's claims that ruptured breast implants caused a facial parasite, and explains how silicone in lymph nodes actually works.
How Patients Are Being Exploited by Product Liability Schemes
February 18, 2026
Dr. Killeen discusses a New Yorker investigation into how third parties are accessing patient records, scaring them into unnecessary mesh removal surgery, and selling their cases to law firms.
Understanding Implant Profiles in Breast Reconstruction
February 17, 2026
Dr. Killeen explains how breast implant profiles work in reconstruction, why anatomy matters more than profile selection, and common mistakes surgeons make.
Why Won't My Wrinkle Go Away After Botox?
February 16, 2026
Dr. Killeen explains why some wrinkles persist after Botox — from undertreated muscles to etched-in lines — and what treatments can help.
You Have a Seroma After Surgery — What Should You Do?
February 13, 2026
Dr. Killeen explains what to do if you develop a seroma after surgery — from office drainage to when it's actually an emergency, and why you should always call your surgeon first.
When Should You Consider Replacing Your Breast Implants?
February 12, 2026
Dr. Killeen covers six signs it may be time to replace your breast implants — from rupture screening and BIA-ALCL to aesthetic concerns and newer implant options.
Prenuvo MRI: When Marketing Becomes Dangerous Medical Advice
February 12, 2026
Dr. Killeen discusses suspicious bot and influencer comments promoting Prenuvo MRI as a replacement for cancer follow-up care — and why that's dangerous.
Can You Remove Lipomas With Liposuction?
February 10, 2026
Dr. Killeen compares lipoma removal methods — traditional excision vs liposuction vs Kybella — and explains why excision is usually the best option.
Immediate vs Delayed Breast Reconstruction: Which Is Riskier?
February 9, 2026
Dr. Killeen explains why immediate breast reconstruction has higher complication rates — and why the mastectomy, not the reconstruction, is what drives those complications.
Breast Asymmetry After Surgery: What's Normal?
February 5, 2026
Dr. Killeen explains why every patient has breast asymmetries, how fixing one can highlight another, and how to evaluate your results after surgery.
Fat Necrosis After Breast Reduction: Causes and Treatment Options
February 4, 2026
Dr. Killeen explains fat necrosis after breast reduction — what causes it, when it resolves on its own, and treatment options from massage to minimally invasive removal.
Preservé vs Traditional Over-the-Muscle Breast Augmentation: What's Different?
February 2, 2026
Dr. Killeen explains how Preservé breast augmentation differs from traditional over-the-muscle techniques — hydrodissection, tissue preservation, and reduced biofilm risk.
Why Do My Breast Implants Drift Into My Armpits?
January 30, 2026
Dr. Killeen explains why breast implants can slide to the sides when lying down — capsule stretch, tissue quality, implant size, and why it requires surgical correction.
Why Do Breast Implants Flip? AP Malposition Explained
January 29, 2026
Dr. Killeen explains why breast implants can flip upside down — from capsule stretch to implant profile — and when surgery is needed to fix it.
Can You Have a Second Breast Reduction? What to Know About the Risks
January 28, 2026
Dr. Killeen explains the risks of a second breast reduction — why it's the same risk profile as the first, why the pedicle matters, and the five-year rule for blood supply.
How to Fix a Breast Implant That Sits Too Low
January 27, 2026
Board-certified plastic surgeon Dr. Killeen explains three ways to fix breast implant malposition — from underwire bras to capsulorraphy and surgical mesh scaffolding.
How Implant Size Is Chosen for Direct-to-Implant Breast Reconstruction
January 26, 2026
Dr. Killeen explains how she determines implant size for direct-to-implant breast reconstruction — from patient goals and 3D imaging to mastectomy specimen weight.
What to Do If Your Surgical Drain Gets Stuck
January 23, 2026
Dr. Killeen explains why surgical drains get stuck, the different types of drains, and what your surgeon does to safely remove a stuck or accidentally sewn-in drain.
Why Breast Implants End Up in Different Positions and How to Fix It
January 22, 2026
Dr. Killeen explains why breast implants can settle unevenly — from capsular contracture to tight muscles — and the treatments that help, including time, massage, Botox, and revision surgery.
Why Do Breasts Look Like a Torpedo After a Breast Lift?
January 21, 2026
Dr. Killeen explains the reasons breasts can look torpedo-shaped after a breast lift — from implant choice and tissue stretching to tuberous breast anatomy.
Nipple Reconstruction Options After Mastectomy
January 20, 2026
Dr. Killeen explains the options for nipple reconstruction after breast cancer surgery — from 3D tattooing and flap procedures to silicone prosthetics.
How to Tell If Your Implants Are Over or Under the Muscle
January 20, 2026
Dr. Killeen shares a simple at-home test to determine whether your breast implants are over or under the pectoralis muscle.
Can You Have a Breast Reduction While on Accutane?
January 19, 2026
Dr. Killeen explains the current evidence on Accutane and surgery — why the old rule of waiting six months may no longer apply for breast reduction patients.
What Are Dog Ears After Surgery and How Are They Fixed?
January 16, 2026
Dr. Killeen explains what dog ears are, why they happen after surgeries like tummy tucks and breast reductions, and the options for fixing them — from Kybella to in-office revisions.
Do You Need Antibiotics Before Dental Cleanings If You Have Breast Implants?
January 13, 2026
Dr. Killeen explains whether antibiotic prophylaxis before dental cleanings is necessary to prevent capsular contracture in breast implant patients.
Why I'm Not a Fan of Prenuvo and HerScan Self-Service Screenings
January 9, 2026
Dr. Killeen explains her concerns with direct-to-consumer screening services like Prenuvo and HerScan — from fear-mongering to the lack of physician advocacy when abnormalities are found.
Should You Skip a Tummy Tuck in Case You Need a DIEP Flap Later?
January 6, 2026
Dr. Killeen pushes back on the advice to avoid tummy tucks or liposuction in case of future breast reconstruction — and explains why most women will never need a DIEP flap.
Why Thermograms Don't Work for Cancer Screening
January 5, 2026
Dr. Killeen explains why thermography is not an effective screening tool for breast cancer or any cancer, and why the right test for the right condition matters.
Tethered Areola Scars: Causes and Treatment Options
January 3, 2026
Dr. Killeen explains why areola scars can become tethered after breast surgery, and walks through treatment options from cupping to fat grafting to surgical correction.
Can You Permanently Get Rid of Cellulite?
December 30, 2025
Dr. Killeen breaks down the two causes of cellulite — tight bands and loose skin — and explains which treatments work best for each, including Aveli and skin tightening.
Are My Breast Implants Causing My Health Problems?
December 26, 2025
Dr. Killeen explains how breast implant illness is diagnosed, why seeing your primary care doctor first is essential, and what the research says about symptom improvement after explant.
Can You Fix a Diastasis Without a Tummy Tuck?
December 24, 2025
Dr. Killeen explains why diastasis repair can be done without skin removal, but why most patients with a significant diastasis get better results with a full tummy tuck.
What to Do If You Have Complications After Surgery
December 22, 2025
Dr. Killeen explains the steps to take if you're experiencing surgical complications — from calling your surgeon to finding a new one through your primary care doctor.
Belly Button Problems After a Tummy Tuck
December 19, 2025
Dr. Killeen explains the most common belly button issues after tummy tuck surgery — scar stenosis and draining sinuses — and how they're treated.
How to Properly Treat Capsular Contracture
December 19, 2025
Dr. Killeen explains what causes capsular contracture, how it should be treated — including capsule removal, bacterial testing, and recurrence prevention — and common mistakes to avoid.
What Happens If You Leave a Ruptured Silicone Implant?
December 18, 2025
Dr. Killeen explains the complications of leaving a ruptured silicone implant in place — from capsular contracture and silicone granulomas to extrusion through the skin.
Why Do Breast Reconstruction Implants Feel Firmer?
December 15, 2025
Dr. Killeen explains why firmer implants are often chosen for breast reconstruction patients, how they reduce rippling, and when firmness may actually signal a capsular contracture.
Why Refusing Standard Breast Cancer Treatment Is So Dangerous
December 11, 2025
Dr. Killeen responds to a viral case of a young woman refusing breast cancer treatment, comparing survival statistics with and without standard care.
Why Breast Exams and Implant Care Matter More Than You Think
December 9, 2025
Dr. Killeen makes the case for thorough breast exams beyond mortality stats, and calls on breast surgeons to address implant issues when they're already operating on patients.
Do Saline Implants Need Imaging Like Silicone Implants?
December 8, 2025
Dr. Killeen explains why saline implants don't require routine imaging but still need regular follow-up — especially older implants placed through high-risk incisions.
The Crease Incision Breast Lift: Why It's Not Always the Best Choice
December 7, 2025
Dr. Killeen explains why the crease incision breast lift often produces a boxy shape, doesn't fix bottomed-out implants long-term, and when auto-augmentation is a better use of the technique.
Capsular Contracture: Causes, Prevention, and Treatment
December 6, 2025
Dr. Killeen provides a comprehensive overview of capsular contracture — what causes it, how prevention has improved dramatically, and how modern treatment approaches are evolving.
Breast Implant Screening: A Message to Primary Care and OB-GYN
December 5, 2025
Dr. Killeen calls on primary care doctors, OB-GYNs, and radiologists to improve breast implant screening — from ordering imaging to documenting exams to catching contractures early.
Should Patients Record Their Own Surgeries?
December 3, 2025
Dr. Killeen discusses a viral case of a patient who secretly recorded her surgery — why patients want recordings, why secret recording is problematic, and better communication alternatives.
Your Surgeon Should Never Abandon You After a Complication
December 2, 2025
Dr. Killeen explains why surgical complications are always in a surgeon's scope of practice, the red flags of being abandoned after surgery, and why you should ask "what if?" before any procedure.
What Is Biofilm on Breast Implants?
November 30, 2025
Dr. Killeen explains what biofilm is, how it forms on breast implants, its link to capsular contracture, and the prevention techniques that have cut contracture rates to under 2%.
Direct-to-Implant Breast Reconstruction: What You Need to Know
November 28, 2025
Dr. Killeen explains direct-to-implant breast reconstruction, why some patients are told they can't have it, and why the mastectomy surgeon choice is as important as the plastic surgeon.
When Can You Get a Breast Reduction After Having a Baby?
November 28, 2025
Dr. Killeen explains how long to wait after pregnancy and breastfeeding before having a breast reduction — and why timing matters for safety and results.
Can You Breastfeed After Breast Augmentation?
November 27, 2025
Dr. Killeen explains how breast augmentation affects breastfeeding, why the incision location matters more than implant placement, and shares her own experience breastfeeding with implants.
How to Get the Most Accurate Price for a Breast Lift
November 26, 2025
Dr. Killeen explains why breast lift pricing varies, the factors that affect cost, and the best way to get an accurate estimate before your consultation.
How to Hide Implant Edges If You're Thin
November 25, 2025
Dr. Killeen explains options for thin patients concerned about visible implant edges — from fat grafting and fat substitutes to implant selection and placement strategies.
Can You Do Fat Grafting With a Breast Lift or Explant?
November 25, 2025
Dr. Killeen explains when fat grafting can be combined with a breast lift or implant removal, and when it's better to wait and do it as a separate procedure.
Belly Button Necrosis After a Tummy Tuck: What to Expect
November 24, 2025
Dr. Killeen explains belly button necrosis after tummy tuck or DIEP flap surgery — why it happens, what it looks like, how it's treated, and why the outcome is usually better than expected.
Motiva Round vs. Ergonomix: Which Implant Is Right for You?
November 21, 2025
Dr. Killeen breaks down the differences between Motiva round and Ergonomix implants — shape, softness, rippling — and how fat grafting can refine either option.
Alloclae Off-the-Shelf Fat: Why I'm Cautious About the Hype
November 20, 2025
Dr. Killeen explains why she's cautious about Alloclae — the off-the-shelf cadaver fat product — including unknowns about take rate, longevity, cost, and its effects on breast tissue and mammograms.
The Real Problems That Happen With Ruptured Silicone Implants
November 20, 2025
Dr. Killeen breaks down the specific problems that can happen when a silicone breast implant ruptures — capsular contracture, silicone granulomas, lymph node involvement, and why routine replacement beats waiting for rupture.
How to Reduce Seroma Fluid Output: Practical Steps That Actually Work
November 19, 2025
Dr. Killeen outlines the practical ways to reduce seroma fluid output — compression, activity restriction, steroid instillation, and hydrochlorothiazide (HCTZ) — from simple at-home steps to prescription-level interventions.
How Skin Quality Affects Your Breast Augmentation Results
November 18, 2025
Dr. Killeen explains how skin quality affects breast augmentation — from stretch mark risk with tight young skin to the need for mesh support with poor skin quality, and why wearing a supportive bra protects your investment long-term.
Dr. Killeen's Ear Piercing Tour: Current Setup and Favorite Pieces
November 18, 2025
Dr. Killeen shares her current ear piercing setup — Maria Tash and BVLA pieces across both ears, mixed metals in white and rose gold, and the piercers she trusts at Oak and Poppy.
How to Treat Post-Inflammatory Hyperpigmentation (PIH) After Scars and Injuries
November 17, 2025
Dr. Killeen walks through the evidence-based treatments for post-inflammatory hyperpigmentation — topical TXA and hydroquinone, laser and microneedling, oral TXA for stubborn cases, and why sun protection makes or breaks your results.
Kris Jenner's Gloves and the Case for Hand Rejuvenation
November 14, 2025
Dr. Killeen uses Kris Jenner's recent glove appearance to talk hand rejuvenation — topical retinoids, sun protection, and why fat grafting to the hands is her favorite, most cost-effective way to restore lost volume.
Skin Quality and Body Contouring: Why Your Surgeon May Recommend a Tummy Tuck Over Lipo
November 13, 2025
Dr. Killeen explains how skin quality affects liposuction and tummy tuck results — what causes poor skin quality, what topicals and procedures can do, and why a tummy tuck is often the most cost-effective route to a flat abdomen.
Who Should Actually Call You With a Biopsy Result?
November 12, 2025
Dr. Killeen explains why biopsy results with a diagnosis, treatment plan, or life-changing news should come from a physician, NP, or PA — not left on voicemail — and what every good diagnosis call should include.
What We Inject Into Problematic Scars: Kenalog vs. 5-FU
November 12, 2025
Dr. Killeen breaks down the two medications used to inject hypertrophic and keloid scars — Kenalog (steroid) and 5-FU (chemotherapy) — including their trade-offs, complications, and how to space injections for the best result.
Liposuction vs. Tummy Tuck — and Why Some Scars Are Longer Than Others
November 11, 2025
Dr. Killeen walks through how to choose between liposuction and a tummy tuck based on your anatomy, why some patients opt for lipo even when a tummy tuck is technically better, and how your body determines how long the tummy tuck scar will be.
Hypertrophic vs. Keloid Scars — and How They Look on Darker Skin
November 10, 2025
Dr. Killeen explains the difference between hypertrophic scars and keloids, and how they can behave differently on darker skin — including pigmentation that often layers on top of the raised scar and how to treat both issues together.
Radiation May Be Unnecessary for Many Breast Cancer Patients — and Plastic Surgeons Are Thrilled
November 7, 2025
Dr. Killeen breaks down a major new NEJM study showing that radiation may not improve outcomes for intermediate-risk breast cancer patients after mastectomy and chemotherapy — and why avoiding unnecessary radiation is a huge win for reconstruction.
Motiva Implants for Breast Reconstruction: Why They're Still Off-Label
November 7, 2025
Dr. Killeen explains why Motiva implants are currently off-label for breast reconstruction in the US, what the FDA approval timeline looks like, and the real practical limitation patients should know about — the current size ceiling of 625 cc.
A 66-Year-Old, A Secret Surrogate, and a Zoom Hearing She Faked — A Wild IVF Story
November 6, 2025
Dr. Killeen breaks down a wild New York Times story about a 66-year-old mother of 12 who hired a surrogate behind her husband's back, impersonated him on a Zoom court hearing, and was arrested for attempted kidnapping when the twins were born — and the bigger ethical questions it raises about IVF at advanced maternal age.
How to Treat Bad Scars After a Breast Reduction
November 4, 2025
Dr. Killeen walks through how hypertrophic and keloid scars behave after a breast reduction, how to spot them early, and the step-by-step treatment plan — from silicone and injection therapy to scar revision and low-dose radiation in severe cases.
China's New "Influencer Law": Should Credentials Be Required to Post About Medicine?
November 3, 2025
Dr. Killeen breaks down China's new "Influencer Law" requiring credentials to post on social media about medicine, law, education, and finance — why it's interesting, where it falls short, and what a lighter-touch version might look like in the United States.
The Breast Reconstruction Access Bill: Who's Behind It and How to Help
October 31, 2025
Dr. Killeen runs through the major physician organizations, patient advocacy groups, and state medical associations backing the breast reconstruction access bill (#AWHCA) — and how patients can call their representatives and share their stories to help push it through.
Plastic Surgery Price Quotes: Bundled vs. Line-Item Is Not a Scam
October 29, 2025
Dr. Killeen pushes back on viral TikTok content claiming plastic surgeons scam patients with line-item price quotes — and walks through what actually goes into a quote, from surgeon's fees and facility fees to anesthesia and single-use products like Exparel, Prevena, and Renuvion.
Breast Implant Imaging: What You Actually Need (and When)
October 23, 2025
Dr. Killeen breaks down the imaging recommendations for breast implants — why saline implants don't need routine monitoring, when and how often silicone implants should be imaged (MRI vs. ultrasound), why mammograms don't cover it, and what textured-implant patients need to watch for.
How Surgeons Decide Where to Put the Nipple in a Breast Lift or Reduction
October 22, 2025
Dr. Killeen breaks down the three main tools surgeons use to decide NAC placement in a breast lift or reduction — sternal notch measurements, the mid-humerus landmark, and Pitanguy's point — plus why placing the nipple too high is far more problematic than placing it too low.
Subglandular, Submuscular, Dual Plane, Subfascial — Implant Placements Explained
October 21, 2025
Dr. Killeen breaks down the four most common breast implant placements — subglandular, submuscular, dual plane, and subfascial — what each one means anatomically, what the trade-offs are with animation deformity and biofilm, and how to think about which is right for you.
Why Doctors Don't Give Free Medical Advice on Social Media
October 20, 2025
Dr. Killeen responds to a common comment — "it's ironic that doctors argue on TikTok but won't give you free medical advice" — and explains why no responsible physician can safely give individualized medical advice through DMs, why it's a real legal liability, and what helpful use of medical content actually looks like.
How High Up Do We Go When Repairing Diastasis in a Tummy Tuck?
October 17, 2025
Dr. Killeen explains how high the muscle repair extends in a tummy tuck — from pubic bone to rib margin — why diastasis is almost always present, why a strong core matters more than your faja, and the problem with wearing your garment for months too long.
Do You Really Need to Replace Your Breast Implants at 10 Years?
October 16, 2025
Dr. Killeen explains where the 10-year breast implant replacement rule actually comes from, why modern implants have changed the math, when proactive replacement still makes sense, and how to decide whether to swap your implants or watch them with imaging.
Breast Augmentation Incisions: Transaxillary, Periareolar, Inframammary, TUBA
October 15, 2025
Dr. Killeen walks through the four common incision options for breast augmentation — armpit, around the areola, breast crease, and belly button — including the pros, cons, and infection/contracture risks of each, plus why the inframammary is her preferred choice.
How Surgeons Actually Prevent Implant Infection and Biofilm in the OR
October 14, 2025
Dr. Killeen walks through the specific OR techniques used to minimize the risk of infection and biofilm in breast implant surgery — from the Keller Funnel and NAC shields to irrigation solutions like hypochlorous acid and betadine, glove changes, and re-prepping the skin.
Plastic Surgery "Chop Shops": Why They're Dangerous and How to Protect Yourself
October 13, 2025
Dr. Killeen breaks down a recent investigative article on plastic surgery chop shops like Goals Plastic Surgery and Sono Bello — including their hiring of disciplined surgeons, fake "3-month plastic surgery fellowships," consultant-led surgical decisions, and lack of after-hours care.
Do Submuscular Breast Implants Drift Apart Over Time? Yes — Here's Why
October 10, 2025
Dr. Killeen breaks down why submuscular breast implants tend to drift farther apart over time — the fixed sternal muscle attachment, repeated muscle force pushing the implant down and out, and the water-hammer effect of saline implants — and why it's a real but not universal risk.
Breast Implant Rippling: What Causes It and How to Fix It
October 9, 2025
Dr. Killeen breaks down the three types of breast implant rippling — standard edge folds, bending-forward rippling, and traction rippling — and the realistic fixes including fat grafting, switching to a more cohesive implant, moving under the muscle, and why dermal matrix usually isn't the answer.
Mammogram vs. Ultrasound for Breast Cancer Screening: It's Not Either/Or
October 8, 2025
Dr. Killeen clears up the confusion: mammogram is the gold standard for breast cancer screening because it's the only test that reliably catches microcalcifications. Ultrasound is a valuable addition for dense breasts, but never a replacement.
Where Are the Drains Placed for a Tummy Tuck?
October 7, 2025
Dr. Killeen walks through the three common drain placement options for a tummy tuck — through the incision, in the mons, or set back from the incision — including the aesthetic trade-offs, why she avoids the mons placement, and how Prevena wound vacs factor in.
How Long Does It Take Implants (and Any Surgery) to Soften?
October 6, 2025
Dr. Killeen explains the two phases of healing after breast surgery — the firm initial healing phase (2–6 weeks) and the remodeling phase (months) — and why most primary augmentation patients reach their final softness around 6 months post-op.
Breast Revision: Should You Fix Just One Side or Both?
October 2, 2025
Dr. Killeen breaks down the real trade-offs of operating on just the problematic breast versus both during a revision — including aging symmetry, surgical control, cost, complication risk, and a real-world example with mesh.
Do Breast Implants Sag More Under or Over the Muscle?
October 1, 2025
Dr. Killeen breaks down the real factors that drive breast implant sagging — implant size, capsule thickness, tissue quality, weight fluctuations, activity level, and muscle release — and pushes back on the absolute claims you see in Facebook groups about which placement is "always better."
A Federal Judge Just Ruled Nurse Practitioners Can't Call Themselves "Doctor" in California
September 30, 2025
Dr. Killeen breaks down the new federal ruling against three California nurse practitioners who sued for the right to advertise themselves as "doctor" without clarification, the 39% of the public that believes a DNP is a physician, and why this is a patient safety issue rather than a turf battle.
Will a Breast Augmentation Affect My Ability to Breastfeed?
September 27, 2025
Dr. Killeen explains how breast augmentation affects breastfeeding — why the implant placement (under vs. over the muscle) matters less than people think, and why the incision location, especially periareolar, makes the biggest difference in your ability to nurse.
Single or Double Mastectomy: How to Think Through the Decision
September 26, 2025
Dr. Killeen walks through the five main considerations when deciding between a single or double mastectomy after a breast cancer diagnosis — genetic risk, future breastfeeding, surveillance burden, long-term aesthetic symmetry, and personal relationship with the cancer experience.
Thermograms vs. Mammograms: Why Physicians Recommend Against Thermography
September 25, 2025
Dr. Killeen does a deep dive into thermography for breast cancer screening — why the research never panned out, why thermograms can't find early cancers or be used to biopsy, and why the aggressive marketing of thermograms over mammograms is a real patient-safety problem.
How Much Fat Actually "Sticks" After Fat Grafting?
September 24, 2025
Dr. Killeen explains the wildly variable "percent take" numbers in fat grafting — why surgeon technique (tight vs. loose grafting, overgrafting) and patient factors (overall health, GLP-1 medications, radiation) all matter more than any single number, and what you can do to maximize fat survival.
My Thoughts on Over-the-Muscle Breast Augmentation (and How They've Changed)
September 23, 2025
Dr. Killeen explains why she's transitioned the majority of her breast augmentation and reconstruction patients to over-the-muscle placement — what changed in the data, why patients prefer it, what trade-offs (rippling, edge visibility) come with it, and how Motiva implants have helped.
A Cool New OR Tool: A Device That Gets Drains Out Faster
September 22, 2025
Dr. Killeen tries SOMAVAC, a constant-suction drain management system that may reduce post-op drain time by about 30%. She explains how it differs from traditional JP bulb drains, why constant suction matters, and which patients stand to benefit most.
Do Surgeons Manage Their Own Wound Problems? And How We Handle NAC Perfusion Issues
September 19, 2025
Dr. Killeen answers two related questions: yes, surgeons manage their own wound complications (and what wound care clinics actually do), and why we leave NAC perfusion issues alone in non-implant patients — but get more aggressive when an implant is underneath.
Who Is the Best Person to Care for You After Surgery? An Honest Guide
September 18, 2025
Dr. Killeen shares her real-world experience on who actually makes a great post-op caretaker — why moms and ride-or-die friends top the list, why spouses are a coin flip (and how to tell which kind you have), and the personality type who is universally the worst.
Should Medical Creators Monetize Content and Take Brand Deals? A Defense.
September 17, 2025
Dr. Killeen pushes back on the moral superiority some medical creators perform around not monetizing their content or accepting brand deals — and lays out where the actual ethical lines are: authenticity, expertise, and disclosure, not whether money changed hands.
Why Immediate Breast Reconstruction Is the Right Choice for Most Patients
September 17, 2025
Dr. Killeen explains why immediate breast reconstruction — going into the OR with both your breast surgeon and plastic surgeon at the same time — is the right path for most mastectomy patients. The psychological benefit is huge, the aesthetic outcome is better, and it usually means fewer total surgeries than delayed reconstruction.
Can You Use One Prevena Vac for Multiple Incisions? Yes — With a Y Connector
September 16, 2025
Dr. Killeen explains how a single Prevena (incisional wound vac) machine can cover multiple incisions using a Y connector — and when you actually do need two separate machines, like for combined breast and tummy tuck cases.
Breast Reduction Insurance Denied? Here Are Your Cash-Pay Options
September 16, 2025
Dr. Killeen walks through realistic options for patients who are great candidates for a breast reduction but whose insurance won't cover it — including surgical financing, resident clinics at teaching programs, last-minute cancellation discounts, and stronger documentation for appeals.
When a Physician Influencer Spreads Anti-Mammogram Misinformation: A Response
September 15, 2025
Dr. Killeen calls out a family-medicine physician spreading anti-mammogram content on TikTok — including the "expert" list backing her claims (a hypnotist, a health coach, and a physician selling unvalidated screenings) — and explains why this kind of physician-influencer misinformation is so dangerous heading into Breast Cancer Awareness Month.
Am I Too Old for Plastic Surgery? A Surgeon's Honest Answer
September 13, 2025
Dr. Killeen explains why age alone shouldn't disqualify you from elective surgery — what actually matters is how healthy you are as an individual and whether the procedure will meaningfully improve your function or quality of life. With real examples from her own practice in patients in their 70s and 80s.
Why Your Post-Op Follow-Up Visits Are Half of Your Surgical Result
September 12, 2025
Dr. Killeen pushes back on the idea that post-op follow-up appointments don't matter — explaining why the things we catch at follow-up (small seromas, early scarring, perfusion issues) prevent the much larger problems that come from skipping them, and why this matters especially for medical tourism patients.
New Jersey Hospitals Just Lost a Court Battle Over Charity Care — Here's What It Means
September 5, 2025
Dr. Killeen breaks down a recent New Jersey court ruling that sided with the state in a hospital lawsuit over inadequate charity care reimbursement — and explains what it means for EMTALA, hospital closures, and the future of safety-net care across the country.
A Wired Long-Form Article About Surrogacy That Should Be Required Reading
September 4, 2025
Dr. Killeen breaks down a Wired long-form piece about a Silicon Valley intended parent whose escalating behavior toward two surrogates — including one who lost her uterus and another whose pregnancy ended in stillbirth — has produced a cautionary tale about the structural power imbalances in modern surrogacy.
Mastectomy Reconstruction: Over vs. Under, Sensation, and Saving the Nipple
August 29, 2025
Dr. Killeen answers three key mastectomy reconstruction questions in one place: over- vs. under-the-muscle implant placement, whether you lose sensation after a mastectomy (and what resensation is), and whether you can save the nipple if you've had a prior breast lift or reduction.
Six Months of Using Journavx in My Post-Op Patients: Here's How It's Going
August 28, 2025
Dr. Killeen reports honest six-month results using Journavx (suzetrigine), the new non-opioid pain medication, in her post-op patients — including dramatically reduced opioid use, less intraoperative opioid from anesthesia, and concerns about future cost when the manufacturer coupon expires.
What Is "Scaffolding" in Breast Surgery? Dermal Matrix, Mesh, and What They Actually Do
August 21, 2025
Dr. Killeen explains what surgeons mean by "scaffolding" in breast surgery — including dermal matrix products like AlloDerm and Strattice, dissolvable meshes like TIGR and Galaflex, and why this is fundamentally different from the vaginal mesh products you've seen in scary commercials.
A Bad ASJ Paper on Breast Implant Illness Is Being Misused — Here's the Real Story
August 20, 2025
Dr. Killeen breaks down a recent meta-analysis in the Aesthetic Surgery Journal claiming biofilm, autoimmunity, and silicone exposure cause breast implant illness — and walks through why each of those claims falls apart when you actually examine the underlying data the paper analyzed.
Do "Heavy Metals in Breast Implant Capsules" Cause BII? What the Research Actually Shows
August 20, 2025
Dr. Killeen responds to the common claim that heavy metals build up in breast implant capsules and require complete capsule removal — by walking through the published study showing heavy metal levels are identical in capsules of symptomatic patients, asymptomatic patients, and women who never had implants.
I Just Did My First Hemoccult Test — and Now I Want to Apologize to Every Patient I've Ever Sent Home With Anything
August 19, 2025
Dr. Killeen reflects on the experience of being a patient handed a confusing, gross, multi-day at-home medical task — a hemoccult test — and how it changed her perspective on what she asks her own post-op patients to do at home. With surgical drains, wound care, and garment instructions in mind.
Can a Tummy Tuck, Diastasis Repair, and Umbilical Hernia Repair All Be Done at Once?
August 18, 2025
Dr. Killeen explains how a tummy tuck, diastasis repair, and umbilical hernia repair can — and often should — be combined into a single operation. Including why it doesn't meaningfully increase complication rates, when a general surgeon gets involved, and what pre-op workup looks like.
To BII Survivors Defending Aggressive Explant Surgery: An Open Letter
August 15, 2025
Dr. Killeen writes directly to the BII community of women who had aggressive explant surgery and improved — asking them to reconsider defending that approach for future patients. With the research showing simpler explant achieves equivalent symptom relief without the higher costs, complications, or cosmetic deformity.
Do All Explants Need Total Capsule Removal Because of "Toxins"? No — Here's the Evidence
August 14, 2025
Dr. Killeen answers the common question of whether the toxins causing BII stay in the implant capsule and therefore require total capsule removal. The answer: no identified BII toxin, no measurable difference in heavy metals between capsules and unrelated tissue, and no outcome benefit from capsule removal in BII patients.
If You Don't Trust Your Surgeon, Find a New One — We're Everywhere
August 14, 2025
Dr. Killeen on why the surgeon-patient relationship is a load-bearing part of surgical outcomes, why patient referrals are such a strong signal, and what to do if you've lost faith in the surgeon caring for you — including why finding a new one is almost always the right call.
Do Plastic Surgeons Take Insurance? Yes, Sometimes — Here's How It Works
August 13, 2025
Dr. Killeen explains the three categories of plastic surgeon when it comes to insurance — in-network, out-of-network, and cash-pay only — what each one means for your wallet, and how to navigate the conversation with your surgeon's office to figure out what your procedure will actually cost.
The NYT Uber Assault Reporting: What I Found Most Striking
August 12, 2025
Dr. Killeen reacts to the New York Times reporting on Uber's assault and harassment problem — including internal records showing Uber had data on high-risk drivers for years, shelved a female-driver-selection feature for political reasons, and built workarounds rather than solving the underlying problem.
How to Actually Get Insurance to Cover Breast Implant Removal
August 11, 2025
Dr. Killeen walks through the realistic scenarios where insurance covers breast implant removal — including ruptured silicone, severe capsular contracture, acute infection, and capsule cancer — and the practical strategies (physician support letters, longitudinal documentation, working with the right practice, persisting through denials) that meaningfully improve your odds.
Capsular Contracture Recurrence — How I Keep Mine Low, and the STANCE Trial
August 8, 2025
Dr. Killeen walks through the full protocol she uses to minimize capsular contracture recurrence — biofilm rule-out with PCR, intraoperative antibiotics, complete capsulectomy, pulse lavage, glove and instrument change, new implant, and liberal scaffolding — plus what to ask your surgeon and information on the STANCE trial.
When a Patient Targets Their Physician Online: A Hard Conversation Without an Easy Answer
August 8, 2025
Dr. Killeen reflects on a viral situation where a patient is publicly accusing her treating physician on social media — and the broader phenomenon of unwell patients targeting physicians online with essentially no recourse, while also recognizing that the patient doing the harm is often someone in genuine crisis.
A Great Friday in the OR: Back Mice and a Capsular Contracture Trial Patient
August 8, 2025
Dr. Killeen describes two of her Friday OR cases — a "back mouse" lipoma removal that produced immediate pain relief, and a capsular contracture revision as part of the STANCE FDA trial — and why both procedures are favorites for treating patients whose pain has been dismissed by others.
Explant Recovery: Under vs. Over the Muscle, and What Adding a Capsulectomy Actually Costs
August 7, 2025
Dr. Killeen breaks down how explant recovery differs based on whether the implant was under or over the muscle, what adding a capsulectomy does to your complication risk (it doubles, per the Cosmetassure data), and why en bloc capsulectomy should essentially never be performed outside of documented capsule cancer.
Why Is the Operating Room Warm During Liposuction?
August 6, 2025
Dr. Killeen explains why operating rooms are kept warm during liposuction — and why temperature matters for every surgery. Cold patients clot poorly, metabolize medications unpredictably, get more infections, and recover slower. Plus context on why pediatric and burn ORs are kept even hotter.
What Happens When Your Surgeon Is on Vacation and You Need Help?
August 5, 2025
Dr. Killeen explains how surgical coverage actually works when your surgeon is out of town — including how partners and solo practitioners arrange coverage, the cross-city network for traveling patients, and what questions to ask up front so you're never left without help if something happens.
How to Evaluate the Breast Surgeon Doing Your Mastectomy — Questions to Ask
August 4, 2025
Dr. Killeen explains the questions to ask your breast (general) surgeon — not just your plastic surgeon — before a mastectomy. Including flap necrosis rate, follow-up practice, nipple-sparing experience, and how to cross-check their answers with your plastic surgeon for the most honest picture of their skill.
What Cup Size Will My Implants Be? (And the Rice Trick You Can Try at Home)
August 2, 2025
Dr. Killeen explains why breast implants are sized in cc rather than cup sizes, the rough 100-200 cc per cup conversion, and how to use dry rice and your favorite bra to preview different implant volumes at home before you ever walk into a consultation.
How Do Breast Implants Affect Your Cancer Screening? (And What VeriScan Is)
July 31, 2025
Dr. Killeen explains how breast implants actually affect mammogram screening — why the theoretical concerns about over-the-muscle placements haven't materialized in real-world cancer outcomes, when your radiologist should add ultrasound or MRI, and the new VeriScan breast CT technology that may change implant patient screening.
Direct-to-Implant Reconstruction: You Can Come Out Smaller, the Same, Larger, or More Lifted
July 30, 2025
Dr. Killeen walks through the real choices patients have in direct-to-implant breast reconstruction — coming out smaller, the same, larger, or more lifted than their pre-mastectomy breasts — and why reconstruction outcomes should be evaluated differently from cosmetic augmentation results.
How Plastic Surgeons Choose Implants — and What KOL Relationships Actually Are
July 30, 2025
Dr. Killeen answers common questions about how plastic surgeons choose implants and whether they're paid by manufacturers — including why most surgeons use only one or two brands, what consignment agreements are, and the real (and disclosed) financial relationships physicians have with device companies as KOLs and consultants.
Why Leaving Your Area for Surgery Is a Real Problem — Even Inside the U.S.
July 29, 2025
Dr. Killeen walks through the structural reasons medical tourism — both international and within the U.S. — is genuinely a higher-risk choice. Including the role of post-op care in a successful outcome, why complications don't wait for flights, and why local surgeons typically won't take on another surgeon's tourism patient.
You Should Get Immediate Reconstruction If You Possibly Can — Demand a Real Reason if You're Told No
July 25, 2025
Dr. Killeen on why immediate breast reconstruction should be the default for almost every mastectomy patient, and why any "no" should come with a specific medical reason — including the under-discussed reality that the breast surgeon's skill sometimes drives whether immediate reconstruction is even offered.
Can You Breastfeed After Breast Reduction Surgery?
July 25, 2025
Dr. Killeen explains the likelihood of successful breastfeeding after breast reduction surgery, including success rates and preparation strategies.
Motiva's SilkSurface Texturing Is Not the Same as Macro-Textured Implants — Here's Why ALCL Risk Is Different
July 24, 2025
Dr. Killeen clears up the misinformation around Motiva implants and BIA-ALCL. The Motiva SilkSurface is 4 microns deep — dramatically closer to a smooth implant than to the 90-micron macro-textured implants that drove the ALCL signal. Plus why some of the loudest anti-Motiva voices online are clinicians who can't use it.
How Can a Doctor Legally Practice Outside Their Specialty? And Why Isn't the Medical Board Stopping It?
July 22, 2025
Dr. Killeen explains how a medical license technically entitles a physician to practice any kind of medicine they want — and why state medical boards don't typically intervene. Plus why the regulatory trend is moving toward less restriction, not more, and what patients can do to verify their own surgeons.
A Minimally Invasive, Tissue-Preserving Future for Breast Augmentation
July 21, 2025
Dr. Killeen shares what she learned at a recent minimally invasive breast conference in Paris — and what's coming next for breast augmentation. Smaller incisions, less tissue damage, and targeted implant placement that no longer has to fit the breast base.
"Can't You Just Stitch It Up?" Why Re-Stitching a Wound After Breast Reduction Usually Doesn't Work
July 20, 2025
Dr. Killeen explains why wounds after a breast reduction usually open because of blood supply problems, not stitching failure — and why simply re-stitching the same tissue with the same compromised perfusion will fail again. With the timeline for when surgical closure does make sense.
Can You Safely Have a Second Breast Reduction?
July 20, 2025
Dr. Killeen explains when and how second breast reductions are performed safely, including incision choices and timing.
Pushing Back on the Standard Medical Tourism Defenses (From Costa Rica)
July 18, 2025
Dr. Killeen — currently in Costa Rica training with international colleagues — pushes back on the four standard medical tourism defenses she sees in every comment section: "complications happen anywhere," "you're xenophobic," "surgery is just cheaper there," and "I'm a nurse in a border city and never see problems."
Understanding Scars After Breast Reduction Surgery
July 18, 2025
Dr. Killeen explains what to expect from scarring after breast reduction surgery and how scars can be improved.
Medical Records, Language Barriers, and Implant Warranties: An Underdiscussed Problem With Medical Tourism
July 16, 2025
Dr. Killeen walks through three quieter risks of international medical tourism that don't get talked about enough — the difficulty of retrieving medical records across borders, the need for professional medical translation, and how implant warranties often can't be honored for implants placed abroad.
Are GLP-1 Medications Effective for Reducing Breast Size?
July 11, 2025
Beverly Hills plastic surgeon Dr. Killeen explains why GLP-1 medications aren't effective for breast reduction in adolescents and young women with glandular breast tissue.
How Young Is Too Young for Breast Reduction Surgery?
July 10, 2025
Dr. Killeen discusses important factors determining the appropriate age for teenage breast reduction surgery, including development, risks, and individualized decision-making.
A Third Patient Contracted HIV at a New Mexico Med Spa: How "Cheap" Procedures Cost Three People Their Health
July 10, 2025
Dr. Killeen breaks down the update to the New Mexico VIP med spa case where a third patient has now been identified as contracting HIV from a "vampire facial" PRP microneedling procedure. Plus what the $100 pricing told us about the corners being cut, and how to verify safety before any aesthetic procedure.
Can You Breastfeed With Breast Implants? Yes — and the Incision Matters More Than the Pocket
July 9, 2025
Dr. Killeen explains why she sees a real-world difference between periareolar and inframammary incisions for breastfeeding success after augmentation — even though the literature is less strong on this point. Plus why implant placement (under vs. over the muscle) is a smaller factor than studies suggest.
How Insurance Coverage Works for Breast Reduction Surgery
July 9, 2025
Dr. Killeen explains how insurance coverage, deductibles, and ...
What Plastic Surgeons Actually Do (Spoiler: It's Way More Than Breast Augmentations)
July 8, 2025
Dr. Killeen walks through the full scope of plastic surgery training — cosmetic, burn care, hand surgery, trauma reconstruction, cancer reconstruction, microsurgery, and pediatric reconstruction — and explains why the field's breadth is what makes plastic surgeons excellent at any subspecialty they pick.
Why Do Natural Breasts Droop More Than Implants of the Same Size?
July 7, 2025
Dr. Killeen explains the three main reasons natural C-cup breasts tend to droop more than augmented C-cup breasts — stretch marks weakening the dermis, decades more time under gravity, and the lack of an internal capsule providing structural support.
Can You Injure Abdominal Organs During Liposuction? Yes — Here's What Surgeons Do to Prevent It.
July 3, 2025
Dr. Killeen explains how abdominal organ injury (including bowel injury) can happen during liposuction of the abdomen — and why the highest-risk moment is actually during the numbing infiltration, not the fat removal. Plus what surgeons and patients can do to lower the risk.
You Got Lipo and Now You're Lumpy. What Are Your Options?
July 2, 2025
Dr. Killeen walks through how to fix uneven, lumpy contour after a liposuction — including how to diagnose whether the problem is peaks (too much fat in some areas), valleys (over-suctioned dents), or both, and the treatment options for each. Plus the most important lesson for future lipo patients: don't let your surgeon take too much.
Hematomas After Breast Surgery: How They're Managed and the One Scenario That's Genuinely Urgent
June 30, 2025
Dr. Killeen walks through what a hematoma is (and how it differs from bruising), the four management options for hematomas after breast surgery, why hematomas around implants need to come out to prevent capsular contracture, and the one scenario — an expanding hematoma — that's a true emergency.
Is It Unethical for a Doctor to Treat Friends and Family? It's More Nuanced Than You'd Think
June 27, 2025
Dr. Killeen walks through the nuanced ethics of physicians treating their own family members and friends — including the framework she uses (is this a patient I'd see in my office?), the scenarios where it's defensible (in-scope procedures done properly), and the categories that are always inappropriate (controlled substances, cosmetic surgery on a spouse).
What's the Difference Between a Plastic Surgeon and a "Cosmetic Surgeon"? It's Huge.
June 26, 2025
Dr. Killeen walks through the dramatic difference between plastic surgery training (6-9+ years of ACGME residency leading to American Board of Plastic Surgery certification) and "cosmetic surgery" training (6-18 month fellowships with privately-invented boards). Plus why the cosmetic surgery track exists in the first place and what it tells you about a surgeon's priorities.
What's a "Step Off" in a Surgical Closure? (And Why It Makes Scars More Visible)
June 26, 2025
Dr. Killeen explains what a step off is in surgical wound closure — when the two skin edges meet at different heights rather than evenly — why it happens (unequal dermal bites), why it makes scars catch light and shadow, and how good closure technique prevents it.
Should You Add Liposuction to Your Breast Reduction? Here's How I Decide.
June 24, 2025
Dr. Killeen walks through when adding liposuction to a breast reduction actually makes sense — and why she doesn't agree with the "always add lipo" recommendation some surgeons give. Plus the often-overlooked dynamic where abdominal fullness becomes more visible to the patient after her breasts no longer block it.
Can a Breast Implant Slip Out From Under the Muscle Over Time? Yes — Here's What Causes It.
June 20, 2025
Dr. Killeen explains the four main reasons a submuscular breast implant can drift out from under the muscle over time — lower pole capsule stretch, over-release at original surgery, capsular contracture, and combinations of those — and how revision surgery diagnoses and fixes each cause.
Fat Necrosis vs. Infection: They Look Almost the Same — Here's How to Tell Them Apart
June 16, 2025
Dr. Killeen explains how to distinguish fat necrosis from a true infection after surgery — including the fluid characteristics that give it away, why pus and fat necrosis fluid can look so similar to non-clinicians, and why the treatment for both ends up being similar (drain the collection, remove dead tissue, add antibiotics if bacteria are present).
Fat Grafting After Breast Reconstruction: What Complications Should You Know About?
June 13, 2025
Dr. Killeen walks through the donor-site and recipient-site complications of fat grafting after breast reconstruction — from lumpy contour at the lipo site to fat necrosis lumps and seromas at the breast — plus the unique thing about fat grafting complications: they tend to show up later than other surgical complications.
How to Pick an Explant Surgeon: What I'd Look for as a Patient
June 10, 2025
Dr. Killeen walks through the honest checklist for choosing a surgeon to do your implant removal — including board certification, evidence-based individualized care, before-and-after gallery quality, and how to spot the "explant expert" marketing pattern that often signals overaggressive surgery and supplement sales.
Does Under-the-Muscle Placement Reduce Capsular Contracture? It's More Nuanced Than You Think.
June 8, 2025
Dr. Killeen explains why "under the muscle reduces capsular contracture" oversimplifies the picture — modern OR technique has dropped contracture rates from as high as 14% to under 1%, which matters far more than placement. Plus why you shouldn't choose your implant placement based on contracture risk alone.
Fat Necrosis vs. Scar Tissue After a Tummy Tuck (And the Surprising Reason CoolSculpting Works)
June 5, 2025
Dr. Killeen explains why fat necrosis happens after a tummy tuck — fat is more delicate than skin, so when blood supply drops the fat dies first (the same principle that makes CoolSculpting work) — and how to tell a fat necrosis nodule apart from a scar tissue nodule using location and healing history.
Will Insurance Cover a Second Breast Reduction If Your Breasts Grew Back?
June 4, 2025
Dr. Killeen explains why insurance generally denies a second breast reduction — including the two automatic-denial triggers (any prior implants and a prior reduction) — and the specific circumstances where she's successfully gotten second reductions covered through peer-to-peer appeals.
Kylie Jenner Finally Shared Her Breast Augmentation Details — Let's Break Them Down
June 3, 2025
Dr. Killeen translates the specifics Kylie Jenner shared about her breast augmentation — a 445cc moderate-profile silicone implant placed dual plane by Dr. Garth Fisher — into plain plastic surgery terms, including what the size means, the "silicone under 22" myth, and why her numbers aren't your numbers.
Ruptured Silicone Implant: Should You Remove the Capsule or Leave It Behind?
May 30, 2025
Dr. Killeen explains why she removes the capsule when a silicone implant has ruptured — even when it looks soft and normal — because the silicone-contaminated capsule can drive a capsular contracture later. With a real patient example and the honest caveat that surgeons disagree.
Gynecomastia in Adolescent Boys: Why We Usually Wait Before Operating
May 29, 2025
Dr. Killeen explains how gynecomastia (excess breast tissue) is approached in adolescent boys — why surgery is rarely needed because it almost always resolves on its own, the role of medications and marijuana, and how to distinguish true gynecomastia from pseudogynecomastia (fatty tissue from obesity).
Can You Get Mammograms With Breast Implants? Yes — and You Absolutely Should.
May 27, 2025
Dr. Killeen addresses the common worry that mammograms can rupture breast implants — explaining why the risk is very low for normal implants, what actually increases it (severe/calcified contracture and older implants), why a fixable ruptured implant always beats a missed cancer, and the alternative imaging options if compression is intolerable.
Introducing FDA-Approved Motiva Implants
October 23, 2024
Motiva implants may lead to less contractures and a much thinner capsule, offering....
Naturium Skin-Renewing Retinol Body Lotion
February 12, 2024
Today, we're diving into a thorough review of the Naturium Skin-Renewing Retinol Body Lotion...
Brella 3-Minute SweatControl Patch
February 2, 2024
The Brella 3-Minute SweatControl Patch is a new, FDA-cleared in-office approach to sweat control...
When can fat grafting be covered by insurance?
June 19, 2023
Fat grafting to the breast can also be covered by insurance, depending on the situation...
Is my doctor board certified?
June 17, 2023
Everyone should know how to confirm that their surgeon is board certified, here's how...
Unlocking the Benefits of Peptide IV Therapy
March 16, 2023
Peptide IV is a type of intravenous therapy that delivers a specialized mixture of peptides directly into the bloodstream...
Interview with Nicol Concilio
January 26, 2023
Dr. Killeen sits down with patient Nicol Concilio to discuss her surgery...
5 Questions to ask for a Breast Augmentation
January 25, 2023
Let's talk quickly about 5 things every woman should ask their surgeon when they are considering a Breast Augmentation...
4 Tips I've learned as a Plastic Surgeon
January 25, 2023
4 Tips I've learned as a Plastic Surgeon, who was also a patient with a Breast Augmentation...
Should doctors bill like lawyers?
November 18, 2022
Should doctors charge for emails and phone calls? Cleveland Clinic to soon bill for MyChart messages...
What's the deal with separated abdominal muscles?
July 23, 2022
So whats the deal with rectus diastasis? Separation of your abdominal muscles can happen for a variety of reasons...
I'm having surgery, can I add on a cosmetic procedure?
March 29, 2022
It seems like a great idea right? You are already going to be in the operating room, why not?
Liposuction Options
March 7, 2022
One of the most popular plastic surgery procedures in the United States is liposuction. I’ll explain some of the more common liposuction options...
Nipples, Areolas, and More!
March 4, 2022
Patients frequently come to the office worried about their nipples. Often, it’s not even the nipple that concerns them, so let’s go over some anatomy...
4 things that can influence your surgical outcome
February 28, 2022
Pain management, dressings, and activity restrictions are discussed pre-op, but there are other things that can greatly impact your surgical outcome...
Is my doctor being dishonest?
July 6, 2021
Plastic surgery is a strange world compared to normal medical specialties. There is an aspect of sales intertwined with the medicine...
Helpful hints for evaluating Before and Afters
June 10, 2021
There are lots of misleading images out there on social media, here are a few tips to get you evaluating before and afters like a pro...
What will my surgery recovery be like?
June 2, 2021
One of the things that causes the most amount of stress when planning surgery is not knowing how you are going to feel and how long you will need help...
Will Insurance Cover My Breast Reduction?
May 13, 2021
Breast reductions are a life changing procedure for most patients. Not only do you get the cosmetic improvement of smaller, proportionate, and perky breasts...
8 Tips for a Great Consultation
April 29, 2021
Plastic surgery consultations can be very overwhelming. Not only are you talking about an area of your body that you are uncomfortable with and embarrassed about...
Removing Ruptured Implants
January 20, 2021
Today I had the pleasure of ridding a lovely patient of 40 year old silicone implants. With older, ruptured implants like this, it is so helpful to remove them En Bloc...