Q.  I am a 27 year old single woman who is very healthy but not really satisfied with how I look.  I would give anything to look just like Shakira, I think she is so beautiful.  I have been to a couple of plastic surgeons who say they cannot help me and seem to just blow me off.  Where can I go to find someone who will take me seriously about changing my looks?

A.  To be honest, I would start by seeing a psychiatrist.  I have on very rare occasions had patients come into my office with pictures of a famous person and ask to have changes made to look like the picture.  In every instance that I have been confronted with, I have refused to undertake this doomed adventure.  We all may wish that we looked like someone else, but to act on this desire is almost always a bad idea.

Certainly changes can be made to your face to alter the shape or size of your nose or give a more lifted look to your eyebrows or eyelids, but to try to change one of your features to look like someone else’s is next to impossible.  Once you have embarked on this road, you can count on having many surgeries to try to achieve your goal.  The reason for needing so many surgeries is that the problem is in your mind and not on your face.  You will probably never be happy with the results, and therefore “just one more surgery to make me happy” will be a recurring theme in your life.  The problem is that you will never get the exact look that you want and therefore satisfaction (and happiness) will elude you.  Just look online for examples of people who have undergone plastic surgery to try to match their looks to someone they perceive as more beautiful.  The results are at best marginally good, and at worst leads to someone who looks abnormal.  My advice to you is to seek counseling about your desire to alter you looks and to avoid plastic surgery.

Q.  My breasts are very small with an unusual shape and my areola are disproportionately large.  Can the areola be reduced and possibly increase the size of the breasts?

A. Although an exam of your breasts is necessary to accurately diagnose your problem and plan a solution, I can say with some certainty that your breasts can be corrected to improve the appearance and symmetry.  There is a condition called tuberous breasts also known as constricted breasts, where there are characteristic findings similar to what you are describing.  The features of tuberous breasts typically include a narrow base of the breast (narrow width from the inner border to the outer border), an abnormally short distance from the bottom of the areola to the lower fold of the breasts, asymmetry between the two breasts, sometimes sagginess, and disproportionately large areola.  The goal in trying to correct this problem is to increase the width of the breast, improve symmetry using different size implants, lifting the breasts if necessary, and reducing the diameter of the areola.  This is an outpatient surgical procedure performed under general anesthesia.  You can plan to go home after the surgery but there is about a 1-2 week recovery period where you will want to stay home from work.  Return to unrestricted activities such as vigorous exercise is permissible after about six weeks.  You can expect significant improvement in your breasts although they will never be perfectly symmetrical and there will be permanent scars on the breasts that will fade with time.

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William Byron Barber II, M.D.

has been practicing plastic surgery in Greensboro for 20 years and is certified by the American Board of Plastic Surgery.  He is Chief of Plastic Surgery for Moses Cone Health System, and is an active member of numerous local, regional and national plastic surgery associations.

Visit his website at: www.BarberPlasticSurgery.com or e-mail him at: AskDrBarber@BarberPlasticSurgery.com