the question is what's missing so Destiny had a lipoblastoma which is a very very rare benign tumor in childhood that grows very rapidly let's bring in Destiny and see if we can help her absolutely would you mind sending in Destiny hello Destiny nice to meet you Destiny Dr are Terry de bro pleasure Maria well welcome thank you ah I have a lot of your old medical records it was called a lipo blastoma yes yes that's what they called it it first like around 3 months it was just like a pimple on her right heel several months later I noticed it grew to the size of a marble and what did they tell you about it it was a benign tumor it was just fatty cells okay and they would have to remove it and there was going to be a big gap and so pretty much the best way that it can heal is taking off a piece of her back and putting it on her on her foot on her heel and it worked it worked so when I had my first surgery and there's only six other people who have a lipoa and they wrote a case on mine okay medical journal the medical journal they to you're in the medical journal yeah wow the surgery that Destiny had at 13 months of age was a very intricate microvascular transfer of tissue from her back to her foot even an adult that's a really complicated operation imagine how complicated is intricate it is in a 13-month-old where the nerves the arteries and vessels are a fraction the size of adult vessels some really impressive surgical Feats right there if we are to debulk this if we don't want to come back although this is a high-risk case because the potential to disrupt the blood supply to Destiny's flap and have the whole thing necrose and die is high I think I'm really interested in helping her because she's 19 she's got a long way to go and it's affecting her both functionally and cosmetically walking barefoot at the beach feels like I have freedom and it feels awesome I want you to bring me a bikini and we're going to Mark the top of the bikini in pre op and if you don't have a belly button in there got to try to make you one out of some scar not easy to do this is complicated fixing this that exact complication that happened to you could happen to us dying infection the whole thing because now I have beaten up damaged tissue I have a special consent form that I have patients in your category sign called highrisk consent which says besides all of those scary forms you just signed oh this is a little different what do you think I'm just nervous now that you're saying it's a highrisk surgery scary stuff my dear it scares me that I may go through this all over again but there's a risk in any surgery so it's just having trust in your doctor and I have lots of faith in Dr Theo and Dr nass before my surgery I had no belly button and ugly scars going across and up my stomach that resembled Frankenstein but now thanks to Dr Deo my stomach is beautiful he removed Toth thir of the vertical scar so I'm able to wear high cut bikinis and it's not very visible I'm completely in love with my belly button that Dr de bro created it's something that I didn't know was possible rest in peace old belly button what you do is you grab hands with the kids and then you go in a circle and then you know we were going too fast and I was going like this I ran into the wall oh so you hit the wall with your chin with my chin first yes and then after that as time went by it was just deforming so we call the deformity po range which is Orange Peel in French if you look at the orange there's like these little bumps and little indentations in it so with Yasmin chin that's what it looks like and that's because of trauma to the mentalis muscle that's what causes the irregularities of her chin when I was about 14 years old we found a a plastic surgeon they took out fat from my tummy and reconstructed my chin did it work at all uh I did see a slight difference uh it was just a little bit Fuller after the time went by it just went away yeah the fat went away yeah especially an area where there's a lot of movement and that muscle underneath the chin here it's constantly moving as you speak did you have any other procedures I did I had one when I was 25 another fat transfer and then until again time passed by and it just went away again so nothing else after that no I have not is it wor worse now than it was before you had anything done or is it better now I would say it's worse yeah Yasmin had fat transfer to try to smooth the Contour regularities of her chin the problem with fat transfer is some of the fat will take some will absorb and that really predisposes you to more lumps and bumps and more regularities they really should have focused on a procedure to try to smooth the skin and the overall Contour the goal will be to iron in this somehow which means make it smooth we lift up the tissue we look at the Contour of what we call the chin fat pad do we need to put a a blanket on top of that deeper fat pad so what do we put there fat don't really want to do that I don't think I think you've already had enough fat in there so the thing that I think about is using some kadaver skin no matter what we do there is a risk a decent risk that I can make that worse and probably probably about a good 25 30% it's not 5% it's higher do you still want to do this well at least there's some percentage there's not a full not there's some hope before my surgery I was living with a giant on my chin my chin was lumpy and bumpy and I will get asked about my chin every time I went out which made me never want to leave the house but now thanks to Dr nassi my chin is smooth I no longer shy away from the public Nothing Stops me anymore so for us to help you okay tell us exactly what you want us to do you know to me it looks like dog dooo I don't know what to say about it other than I just want to look normal Lisa had a short scar facelift because the incision only went up a little bit behind her ear and if you're trying to correct a neck you have to make those incisions a lot longer so you can R drape and get rid of that extra neck skin this isn't easy I believe it we have to redo something it's called a revision deep plain facelift wow and we have to go underneath the muscles and try to rearrange things to get things a little bit more smooth before my surgery my neck was a wreck now thanks to Dr Nassif I am turning necks and causing some wrecks and I love it the question is what's missing so basically you have some remnant of muscle here you have have nothing right here it's pure skin graft on bone you have some remnants of soft tissue here another option is to make an incision across your entire abdominal wall extending into the unaffected right side it'll have a better shot at matching the left side right the advantage of that is you probably don't love this little extra LAX tissue it's a tummy tuck on a guy okay big downside is complications I mean there's a big difference between working on this smaller area although substantial area than lifting everything up doing a full tummy talk but I'm willing to go after it if you're willing to go after it if you want to do the whole thing yeah I'm there for you I'll do the whole thing I think the best option sounds like you know even though it's a bigger risk probably do the whole thing and try to make it look as symmetric as we can before my surgery there was a b gaping hole in my side but now thanks to Dr de bro the hole is gone I have symmetry and I'm no longer in pain when my work belt rubs against my side or anything there's no way you could possibly tell what my side looked like before I'm back to dating again and it just feels amazing