Sourced directly from Dr. Kelly Killeen's social posts and replies.
Which cosmetic procedures does Dr. Killeen advise against or personally avoid, and why?
Dr. Killeen strongly advises against several procedures due to high risks, unpredictable outcomes, or aesthetic concerns. She highlights the Brazilian butt lift (BBL) as having the highest death and complication rate, and dislikes the associated 'hero worship culture.' She would never undergo an upper lip lift, citing the visible scar that she believes is not worth the benefit, and the potential for permanent 'weird texture' of the lip. The 'fox brow/fox eye lift' is also on her list, as she finds it looks 'weird' and advises against permanent facial surgery for temporary trends, recommending non-surgical alternatives like makeup. She would also never undergo massive fat grafting to the breast due to higher risks of complications like cysts, fat necrosis, and the potential for a 'dumpier looking breast' lacking structural support. Lastly, she considers thread lifts an 'awful procedure' due to visible thread pull during motion and complications like infections and extrusions. While acknowledging rhinoplasty can be amazing for the right person, she personally would not undergo it due to the year-long swelling and unpredictable scarring.
What specific safety measures does Dr. Killeen employ during liposuction to prevent complications?
Dr. Killeen treats liposuction with the same respect as any major plastic surgery, focusing intensely on patient safety. She always places her hand on the patient's stomach to continuously monitor the cannula's position and angle, ensuring it remains superficial and does not enter the abdomen, which could cause intestinal injuries (aneurotomies). She is also vigilant about patient positioning, avoiding angles created by pillows or patient tilt that could lead to dangerous cannula placement. To manage bleeding, she uses tumescent solution containing epinephrine to constrict blood vessels and frequently administers TXA (tranexamic acid) to help with bleeding and bruising. Crucially, ethical surgeons like Dr. Killeen limit the total amount of tissue and fluid removed to 5 liters or less to prevent severe complications such as fatal lidocaine toxicity, dangerous drops in blood count, and fluid shifts that can lead to cardiac arrhythmias or cerebral/pulmonary edema.
What is symmastia, and how does Dr. Killeen approach its correction?
Symmastia is a condition where the breasts connect in the middle, eliminating the distinct cleavage valley. There are two main types: surgically created (a complication of surgery) and naturally occurring. The sternal area is a 'zone of adherence' where skin is aggressively stuck to underlying tissue; if this is disrupted, it's very difficult to restore. Surgically created symmastia typically results from implants being placed too close together and is much easier to fix. However, natural symmastia, often seen in women with large breasts where skin floats over the sternum, is considered by Dr. Killeen to be 'not a fixable problem,' with many attempts failing and reverting within six months. She emphasizes that surgeons must respect natural breast anatomy to avoid causing this difficult-to-correct complication.
What is tuberous breast deformity, and what is Dr. Killeen's approach to insurance coverage for its correction?
Tuberous breast is a congenital deformity where a tight ring of tissue causes the breast to grow in a tubular shape, resulting in a narrow, long breast and a wide areola. While there's nothing functionally wrong, Dr. Killeen strongly believes surgery for tuberous breasts should always be covered by insurance. However, insurance coverage is highly inconsistent; some insurers don't cover it at all, while others have specific age qualifications (e.g., 26 or younger). Her practice always attempts to secure insurance coverage, with approximately a 30% success rate. She notes that even if covered initially, insurers often refuse to cover ongoing maintenance or care for implants in these patients, which she considers 'really wrong.' She advises patients with tuberous breasts that it's always worth trying to get insurance coverage, especially if they are young.
What factors does Dr. Killeen consider for teenage breast reduction surgery?
When discussing breast reduction with families and teenagers, Dr. Killeen considers several key factors. Primarily, she assesses how long it has been since the teenager's first period and if their breasts are still growing. Studies suggest that two to three years post-menarche, breast size should be relatively stable, making it a suitable time for surgery. However, if breasts are still actively growing, it's generally not the best time. Breast size is also crucial; while an F-cup is different from an M-cup, early intervention may be considered for 'juvenile gigantomastia' where enormous breast size significantly impedes function and clothing. During consultations, she ensures the young woman fully understands the procedure, its risks, and long-term implications, such as the potential inability to breastfeed. It's vital that the patient is fully on board, understands the risks, and is ready to proceed, as this is a complicated and highly individualized decision, acknowledging the significant psychological and physical torment large breasts can cause young people.
What are typical post-operative care expectations after cosmetic surgery with Dr. Killeen?
After cosmetic surgery, it is standard to return to see your plastic surgeon the day following the procedure. Common medications prescribed include a trio like Cipro (though Dr. Killeen usually uses a different antibiotic, Cipro is commonly used), Oxycodone for pain, and Zofran for nausea.