May 1st, 2012 admin
Many women have tightness of the tissues in the breast that can cause the breast to assume a tubular shape. Some of these cases have a very tight circumferential band that cause the nipple areola complex to actually herniate through this band exacerbating the deformity. Most of these case will need an areola reduction procedure and small lift. During this part of the surgery any constricting bands can also be released. Best result are usually had if an implant is also placed to help reshape the breast to give it an attractive contour.
Below is a patient
Tubular deformity
Posted in Board Certified Plastic Surgeon, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures, Home | No Comments »
April 13th, 2012 admin
When the old generation of silicone gel implants were taken off the market back in 1992 saline filled implants were the only option. The implants in use back then had a silicone gel that was very runny, almost like a thick oil and had thin shells. These two aspects helped give a very natural feel but also led to rupture of the implant with the silicone migrating through the breast tissues causing all kinds of problems. Then in 2006 silicone gel implants got approval for use again. The new generation of implant had a much more cohesive silicone and a more durable shell. This implant had undergone many years of trial use prior to full approval and has a very safe track record.
I personally was slow to become a fan of the silicone gel implant but I am now using it in the majority of my patients with very good results. The saline filled implant can still give a very nice result with a smaller incision. The gel implant will give a softer result in most all patients with less of a risk of rippling. These issues are especially noticeable in very thin patients or patients with very large implants. Both types of implants can leak, with the saline the water is just absorbed by the body and you will notice the size discrepancy. Some people feel that if the gel implant gets a crack in the shell that is will never even be a problem and that the cohesive gel will just sit there. I agree with the manufacturer that it would still probably be best to have it replaced. For your lifetime the manufacturers will give you a new implant if one develops a defect and leaks and during the first 10 years they will also give money towards the cost of getting it replaced. The initial cost is higher with the silicone gel implant as the manufacturers charge about double for the gel implant so the surgery will cost about $900 more.
As with many things there are pros and cons to both types of implants. Which you use needs to be a decision reached taking the advice of your plastic surgeon in consideration along with your own wishes, desires and concerns.
Posted in Board Certified Plastic Surgeon, breast asymmetry, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures, Home | No Comments »
March 8th, 2012 admin
Breast asymmetry is a common problem that I see in my office. Most patients have some slight asymmetry but for a few it is enough of a problem to be noticeable and bothersome to the patient. Frequently patients not only have size asymmetry but also have asymmetry with the position of the nipples. If the patient wishes to be larger then I will do a combined augmentation mastopexy procedure. For the augmentation I will either use a bigger implant on the smaller breast or do a reduction on the larger breast. I find in my practice that I am frequently just doing a small reduction on the larger breast at the same time as the lift and then using the same sized implant. This tends to give a better result over the long term. Below is an example.
22 y/o who had breast fed two children resulting in atrophy and sagging of her breasts. She wished to be lifted and augmented to a small D cup in size. She is shown here about 3 months after a round block augmentation mastopexy. She has 330cc on the right and 420cc on the left (to correct asymmetry) using round smooth saline filled implants placed behind the muscle.
asymmetry
Posted in Board Certified Plastic Surgeon, breast asymmetry, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures, Home, Plastic Surgery Procedures | No Comments »
March 3rd, 2012 admin
I have many patients come into see me with complaints about their upper eyelids and saying that they just look tired or angry. Many of these patients have little wrong with their upper eyelids the problem is with the eyebrows. As we get older our eyebrows will sag causing the skin on our upper eyelids to overlap. Our bodies compensate for this by activating the muscles in our forehead to raise the brows. These patients will then have deep creases in their foreheads, low brows and sagging skin on the upper lids. This gives the old, tired and angry look people understandably don’t like.
The solution for this problem is usually not eyelid surgery as that can actually cause the eyebrows to look lower and flatter. The solution is brow lift surgery. This can be done in a couple of different ways but does require going to the operating room. You can find more detailed procedure information on my website.
The cost for brow lift surgery can vary but is usually about $5100. Most people can return to a desk job in one week or less. Patient satisfaction from this surgery is quite high and can make very significant improvements.
Below are photos of one of my patients as an example. You can find others on my website.
58 y/o female that did not like the appearance of her eyes and had a brow lift and lower lid blepharoplasty done. She is shown here about 2 months postoperative.
Posted in Board Certified Plastic Surgeon, Cosmetic Procedures, Home, Plastic Surgery Procedures | No Comments »
February 3rd, 2012 admin
A breast lift or “mastopexy” procedure is performed to raise and reshape sagging breasts. The procedure can also reduce the size of the areola (the darker skin around the nipple). A reduction or augmentation can be done at the same time if needed. Many patients after breast feeding loose breast volume and wish to have this replaced. If only a small amount of sagging is present, an augmentation procedure alone may be all that is necessary. The surgery is performed under a general anesthetic and usually takes about 2 to 3 hours. Many patients can have the procedure done with only a scar going around the areola. But a vertical scar may also be needed. A breast lift procedure will give your breasts a much more youthful appearance. The nipple will be elevated and excess skin removed making the breasts feel firmer.
Below is pictured a 33y/o who has had two children who was a B cup and wished to have her breasts lifted and to be a fuller C cup. She is shown here 11 months post augmentation with 200cc round smooth submuscular implants and mastopexy.
Posted in Board Certified Plastic Surgeon, breast asymmetry, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures, Home, Mommy Makeover, Plastic Surgery Procedures | No Comments »
January 24th, 2012 admin
Breast asymmetry is a common problem that I see in my office. Most patients have some slight asymmetry but for a few it is enough of a problem to be noticeable and bothersome to the patient. Correction of breast asymmetry can be as easy as doing an augmentation but some patients need a reduction. Breast reduction can be done to either one or both of the breast and can be combined with augmentation of one or both of the breasts also. A breast lift is normally part of the reduction procedure. If a reduction is only done to one of the breasts a lift is usually needed for the opposite breast to maintain symmetry but not always.
Below is a 21 y/o female with breast asymmetry who had a 320 gram reduction of the left breast and a mastopexy (lift) of the right breast. Both using the vertical scar technique. The patient is shown here 5 months post op.
reduction for asymmetry
Posted in Board Certified Plastic Surgeon, breast asymmetry, Cosmetic Procedures, Home, Plastic Surgery Procedures | No Comments »
January 19th, 2012 admin
I have previously talked about mommy makeovers. That is the combination of breast surgery with body contouring to correct the damage caused by having children. The source of a lot a my patients. Most commonly this is a combination of a breast augmentation (with or without a breast lift) and an abdominoplasty. I am revisiting this procedure as I just had a 5 year followup on a patient which is unusual as most people get tired of visiting me before then.
This patient had a round block augmentation mastopexy using 420cc implants on the right and 480cc implants on the left as well as a full abdominoplasty with liposuction.
Posted in Board Certified Plastic Surgeon, breast augmentation, breast enlargement, breast implants, Home, Mommy Makeover, Plastic Surgery Procedures, Weight Loss | No Comments »
January 6th, 2012 admin
Some people come into my office complaining of not having a prominent chin. Some of these people actually have a fine chin but the symmetry of their face is off because the nose is too prominent and a rhinoplasty is what they really need. In others the chin is just somewhat hidden by excess fatty tissue beneath it that would respond to liposuction. Others will benefit from chin augmentation. If your teeth do not match up correctly an oral surgeon may need to be consulted for orthognathic surgery to correct the problem.
Most of the patients that come to see me needing chin augmentation do not have dental occlusion complaints and are not wanting involved surgery on the jaw, they just want better facial symmetry with a fuller chin. I find the simplest way to achieve this is with a chin implant. The implants that I use are silicone implants developed by Dr. Robert Flowers in Honolulu. I did a cosmetic surgery fellowship with him many years ago and was trained in the use of these implants.
The silicone implant is placed through a small incision inside of the mouth and is an outpatient procedure taking less than an hour. The recovery is fairly quick. There will be some swelling for a few days and you need to eat soft foods for about a week to protect the incision.
Below is a patient that is shown about 3 months after placing a silicone implant.
Chin Augmentation Photos
Posted in Board Certified Plastic Surgeon, Chin Augmentation, Chin Implants, Home | No Comments »
December 13th, 2011 admin
I have many inquiries on the internet from patients asking if a certain cc of implant will give them a certain cup size. This is an impossible question to answer because there are many variables. Influencing factors include chest wall size and shape, amount of current breast tissue and even what brand of bra as they are different. If you look at breast augmentation pictures on my website you will notice a large variation in the results with different implants.
I find that the only accurate way to approach this difficult question is to meet the patient and to an examination. Then discuss what the patient’s goals are and then look at pictures of similar patients to make sure we are in agreement. Then once we are in the operating room I will use a temporary sizer in the pocket I have created for the implant to see what a certain size of implant it will actually take to give the result wanted. Then, based on the base width of the patients breast I will select what profile of implant in the selected size fits the patients chest wall the best.
After doing over 2000 breast augmentation‘s I can usually guess fairly accurately in the office what implant I am going to use I will still use the temporary sizer in every case because I think that is the only way to be more assured of an accurate result. When you select a surgeon for breast augmentation just make sure that you chose a Board Certified Plastic Surgeon with a large amount of experience. Then make sure you communicate what your desires are.
Posted in Board Certified Plastic Surgeon, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures | No Comments »
December 2nd, 2011 admin
I have many people emailing me asking the cost for certain procedures. Most plastic surgeons do not like to post cost on their websites because cost change frequently and can vary from patient to patient. Some surgeons will show the average fee for a certain procedure but not the costs for operating room and anesthesia and possibly other added expenses. When you discuss costs with a surgeon make sure that you have the entire package and that their are no hidden fees. I am going to post here some cost estimates for several common procedures that I do. My cost estimates include all costs such as surgeon fee, anesthesia, facility fee, and also all office visits needed. Also included is the cost for implants, garments or overnight stays if needed. Keep in mind these costs can change at anytime as any of the above costs change. The only expense not included in my cost quotes is the expense of filling some prescriptions after the surgery.
Saline Breast Augmentation $4600
Silicone Gel Breast Augmentation $5500 (gel implants cost $900 more)
Breast Lift $4953 to $6290
Breast Lift and Augmentation combo $6900 to $9200
Full Abdominoplasty $6300 to $7700 (includes some liposuction)
Lower Body Lift about $13,500 but can vary quite a bit
Mommy Makeover usually about $9,800 but can also vary a lot
These are just a few of the procedures that I commonly do. Feel free to email me if you have questions regarding other procedures. When you come in for your free consultation we always give a written itemized cost quote so you know exactly what you will be expected to pay for. Also included at that time will be some discounts you may be eligible for such as multiple procedure, previous patient, military and cash payment. If you are interested in financing the surgery I have links on my website to several financing companies.
When you are deciding on a plastic surgeon I know cost will be a consideration but should not be the major thing. You need to think about the surgeons experience, number of happy patients, malpractice history, how well you relate to the surgeon in your consultation and Board Certification.
Posted in Board Certified Plastic Surgeon, Body Lift, breast augmentation, breast enlargement, breast implants, Cosmetic Procedures, Lower Body Lift, Mommy Makeover, Plastic Surgery Procedures | No Comments »
