Dr. Joseph Mele appears on the Bay Area’s News Channel, KRON 4’s Body Beautiful this week discussing Breast Augmentation, Breast Lifts, Tummy Tucks, Liposuction and Mommy Makeovers.
Body Beautiful Live Wednesday at 11AM on KRON 4
San Francisco Bay Area’s News Station, KRON 4, will be airing the latest installment of Body Beautiful this week. The show will be broadcast live, at 11 AM, this Wednesday (Bec 7, 2016) on channel 4, and will include the latest in Cosmetic Plastic Surgery with the emphasis on Body Sculpting.
Liposuction – Sculpting the body by removing disproportionate fat
Abdominoplasty – Using a Tummy Tuck to tighten the abdominal wall and remove excess skin and fat
Mommy Makeover – Combining Breast Enhancement with Abdominal Enhancement to reverse the damage done by pregnancy
So Many Topics; So Little Time
I try to keep the show fast-paced, accurate and informative, but I did not learn about these topics in a half-hour television show. More information is available online by clicking on the links above, but nothing can substitute for an in-person consultation tailored to your specific needs. If you are serious about learning what Cosmetic Plastic Surgery can offer you call my Walnut Creek Plastic Surgery Clinic at (925) 943-6353.
Miami, Florida, seems to be hot bed for Deceptive Plastic Surgery Practices, and is giving good Miami Plastic Surgeons a bad name. The most recent incident to make the national news is a Botched Brazilian Butt Lift at Encore Plastic Surgery. The clinic is linked to a chain that focuses on cheap plastic surgery for medical tourists visiting Florida for a procedure and a vacation.
Fake San Francisco Plastic Surgery
Miami is not unique, however. This year, Carlos Guzmangarza was sentenced to 20 years in prison for performing illegal plastic surgery out of his fake San Francisco, California “plastic surgery” clinic. His Mission District clinic preyed on many Central American immigrants. Allegations include: smoking a cigar during surgery, flushing Liposuction fat down the toilet, sexual assault, the injection of unknown skin fillers and leaving a four inch needle in a patient’s buttocks. Eventually, he was convicted of thirty-three felonies and eight misdemeanors.
Caveat Emptor – Let the Buyer Beware
In most cases, there are clues that everything is not up to the usual standard of care. In the case of Mr. Guzmangarza, not only was he not a Board Certified Plastic Surgeon, he was not a doctor. He did not have a medical license, and that’s something that anyone could check.
Check the Medical License
Notice the medical license is for a “Physician and Surgeon.” California, like all states, does not differentiate.
I am Certified by the American Board of Plastic Surgery. The only ABMS recognized board for Plastic Surgery.
The American Board of Plastic Surgery offers a free, online certification lookup. Click here to see if your doctor is certified by the American Board of Plastic Surgery. Most doctors claiming the title “Plastic Surgeon” are not certified by the American Board of Plastic Surgery. In fact, it is estimated that only one in twelve practitioners practicing plastic surgery are Certified by the American Board of Plastic Surgery. Does your doctor have the best training?
Check For Other Board for Certifications
I am also certified by the American Board of Surgery, because I completed a residency in General Surgery, too.
If your doctor is certified by the American Board of Ophthalmology, they are trained in surgery of the eyes. So if you are having Eyelid Surgery, they should have had the appropriate training. On the other hand, if you are having Liposuction, buyer beware.
If your doctor is certified by the American Board of Otolaryngology, the are trained in ear, nose and throat surgery, so Facial Plastic Surgery is within the scope of their training. If you are having Rhinoplasty, this is an appropriate board for certification. If you are having Breast Augmentation, buyer beware.
Non-Surgical Board Certification
The non-plastic surgery boards listed above are at least surgical boards. Some “cosmetic surgeons” have non-surgical board certifications. Certification by Family Practice and Internal Medicine Boards is not reassuring if you are having a surgical procedure. Proof of additional surgical training should be made available, and it should be years or training, not a weekend course.
Do Your Homework
A well trained, experienced practitioner will be up-front and honest about their training and abilities, but those who are not honest may be even more convincing. You need to do your homework. Use the links above to confirm what you are being told. If it does not fit, do not commit.
It is no secret that the number of Buttocks Augmentations has been growing exponentially in the United States over the last decade. The procedure most responsible for this rise in popularity is the Brazilian Butt Lift.
Brazilian Butt Lift
Tummy Tuck and Brazilian Butt Lift Before and After Pictures: In this case, fat is harvested from the abdomen, back and flanks and is transplanted to create fuller, curvier buttocks.
The Brazilian Butt Lift was pioneered by Brazilian Plastic Surgeon Ivo Pitanguy. It involves three steps.
First, fat is collected via Liposuction, so if you are considering Buttocks Enhancement with Fat Grafting, you need to have a little extra fat to donate.
Second, the fat is cleaned. While many methods exist, decanting, centrifuging and filtering remain the most popular. At the recent American Society of Plastic Surgery Meeting in Los Angeles, all methods were shown to be safe and effective; however, the original decanting method seems to provide the greatest amount of fat take in the buttocks.
Fat in syringes ready for grafting.
Third, the best fat cells are transplanted into the buttocks. The greatest benefit of Fat Grafting to the Buttocks is its ability to not only enlarge, but to reshape the buttocks. Fat can be placed selectively into the areas that need it more. The primary limits to the amount of fat that can be grafted are the amount available, and the blood supply available to support it. Too much fat in one area can lead to less graft take and a greater change of contour irregularities. This is where craftsmanship counts.
Alternatives to Buttocks Fat Grafting
A simple Google search for Buttock Enlargement reveals that there are other ways to get a larger posterior, but are they effective? Other surgical techniques include Buttock Implants and the injection of other substances. The pressure for these types of operations comes from the fact that often, there is not enough fat available for grafting into the buttocks. Unfortunately, the results are not great. Buttocks Implants tend to ride higher that the cosmetic ideal and cannot selectively enhance specific quadrants of the buttocks. Fillers have a long history of disaster associated with them, including infections, granulomas, redness, hardening and even death. There are no FDA approved fillers for the buttocks, and many of the substances used for Buttocks Enlargement, silicone and PMMA, are well known to cause permanent disfigurement, and should be avoided.
Non-surgical alternatives include exercise and creams. Exercise is a very healthy alternative and has many other benefits that fat grafting does not provide. Leg curls, squats and lunges have been proposed as buttocks enhancers. Like muscle building in general, it will work for some, but not many. For women in particular, it is more difficult to build bulky muscle, which is want is needed for any significant enlargement. So while exercise is safe, it is often not effective. Buttocks creams have been available in Brazil for many years. I will not get into the details, but none have received FDA approval for safety or efficacy, so buyer beware.
Buttocks Enhancement Consultation
If you are considering a Brazilian Butt Lift, be certain to seek an experienced Board Certified Plastic Surgeon. It is a highly artistic procedure and is as dependent on technique and craftsmanship as it is on the method selected.
A personal consultation is the best way to learn what the procedure can do for you. Call (925) 943-6353 to speak directly with our San Francisco Bay Area Plastic Surgery staff in the East Bay City of Walnut Creek for your private, confidential appointment.
Last week, I blogged about What to Expect After Breast Augmentation Surgery. Well, several of my proactive patients wanted to know what they could do before surgery to help their recovery. Great question, so today we are talking about how to plan for your Cosmetic Plastic Surgery.
How To Prepare For Cosmetic Plastic Surgery
First and foremost, Cosmetic Surgery is elective. Since you are making the choice to proceed, you should also plan to succeed with a quick and safe recovery. Making a few arrangements and taking a few precautions can really boost the safety and predictability of your procedure.
Timing Is Everything
Very few of us have a plethora of free time. Recovery takes time, and giving yourself adequate time for recovery is very important. For some procedures, doing too much activity will increase swelling and discomfort, for others, it can reverse the progress made with your procedures. Be sure to ask your Board Certified Plastic Surgeon about how much time you will need and what precautions to take, specific to your body and your procedure.
You want to arrange your schedule so that you have the time necessary to take care of yourself. So get your resources organized early, and have your recovery tools ready. Ice packs, prescriptions and a little help from your friends should all be arranged before surgery. With the crack-down on the abuse of prescription drugs, it can take more than one visit to the pharmacy to get pain pills. If you have small children, additional child-care may be very helpful during the days after surgery. Preparing a few days of meals that can be easily warmed up can also help.
Eat A Healthy Diet
Eating healthy is always a good idea, but it is especially important to consume the building blocks your body needs to heal. Balance is important, and more is not better. Supplementing in situations were vital elements of nutrition are lacking can be important, but filling these needs through a healthy diet is always the first choice. In certain situations, like after Bariatric Surgery, certain nutrients may need to be supplemented to make up for the malabsorption these procedures are designed to produce.
Hydration is equally as important. Dehydration contributes to increased nausea after surgery, so stay hydrated before and after surgery. Dehydration after surgery leads to lower blood pressure, decreased circulation and slower healing.
In case you haven’t heard this yet, smoking is bad for you. If you’re a smoker, smoking cessation will improve your results, your recovery and your health in general. For some operations, smoking increases your risk of wound healing problems by 600%, and most Plastic Surgeons will ask you to stop at least four weeks before and after them.
Operations that have a problem with smoking include:
Smoking tobacco is bad, but smoking marijuana may be worse, because unlike cigarettes, pot often it is inhaled completely unfiltered. Even casual pot smoking, now legal in California, will restrict the blood flow to the surgical site, leading to decreased healing, prolonged inflammation and swelling and a reduced result. Marijuana is not the only herb you should avoid before surgery.
Avoid Things That Will Make You Bleed
Certain medications, supplements and herbal remedies are known to increase bleeding. You should review your diet, and everything thing else you take before your surgery. Many herbal remedies seem harmless, but those derived from root and bark often contain salicylates, which will make you bleed just like aspirin can. You can find lists of supplements to avoid on the Internet, like this short List from the Otolaryngologist at Stanford, but the best thing to do it to bring all your medications, herbs and supplements to your pre-op visit for your surgeon to review.
It’s Harder To Hit A Moving Object
Keep moving. The better shape you are in before surgery, the easier it will be to get up and move after surgery, too. Be certain to follow your surgeon’s limitation for activity, but do not become a “couch potato”. Early ambulation has been shown to decrease the risk of problems like pneumonia and blood clots, but it will also make you feel better faster. Humans were not designed to sit around.
Ask Your Surgeon
Be certain to ask your surgeon what you can do to speed your recovery. They can tailor their recommendations to you and your surgery, and help you feel better faster. If you are considering Cosmetic Plastic Surgery in the San Francisco Bay Area, give me a call at (925) 943-6353, and we can go over all the details, together.
Breast Augmentation remains one of the most frequently requested Cosmetic Plastic Surgery procedures.
Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures, but what is the recovery like after Breast Implants?
Breast Augmentation – The Procedure
Breast Augmentation is simple to understand. Breast Enlargement is performed by placing a Breast Implant behind the breast tissue to increase the breasts’ volume. Of course, there is more to it than that, and it is important to seek the advice of an experienced Board Certified Plastic Surgeon, before your Breast Enhancement Surgery.
Breast Implants are placed in the operating room, almost always under general anesthesia. This provides maximal safety and predictability of the operation, especially when Silicone Breast Implants are being placed behind the muscle, or when a Breast Lift is also being performed.
Breast Augmentation Recovery Time – The First 24 Hours
After the anesthetic is given, the next thing you will know, you will be in the Recovery Room. It feels instantaneous. Your breasts will be sore and many patients feel pressure, like an elephant is sitting on their chest. Pain is present, but should be manageable. Local anesthesia is frequently placed around the Breast Implants to help with the initial discomfort. Medications will be given intravenously to make you feel better. The primary goals are to allow you to wake-up and to reduce your discomfort.
At home, prescription pain medications are often used for the first few days. Acetaminophen (Tylenol) is also safe, because it does not increase the risk of bleeding like aspirin can. Acetaminophen should be taken instead of, not with, your prescription pain medication because most prescription pain medications already have acetaminophen in them, and too much, can cause liver damage.
RICE Therapy for the Breasts
Post-operative discomfort can also be helped with RICE. The acronym RICE stands for:
REST – Not overusing your chest muscles after surgery can speed your recovery. Your Plastic Surgeon should review what precautions to take after surgery. To read a copy of my Breast Implant Instruction Sheet, click the following: Post-Operative Breast Augmentation Instruction Sheet.
Ice is Nice: Ice provides natural pain relief with few side-effects.
ICE – I cannot stress the importance of icing down after surgery. Like after any injury, ice can effectively decrease swelling and discomfort after surgery, often better than pain medication. Ice should not be applied directly to the skin, to avoid frostbite. A thin cloth should be placed between you and the ice, and the ice should be applied hourly for 15 minutes at a time.
COMPRESSION – The amount of compression will vary by Plastic Surgeon. Some surgeons recommend no support, while others bind the chest. Remember, your Plastic Surgeon will choose the method that works best for the surgery they perform. I prefer the combination of Bra and Band to keep the Breast Implants in their proper position, and to provide some post-operative support and comfort.
ELEVATION – Keeping the head elevated day and night the first few days after Breast Augmentation also helps reduce swelling and discomfort in the breasts. Sleeping on an extra pillow or two is all that is needed. If you are not used to sleeping on your back, a pillow behind the knees can help. It helps you maintain the correct position while you are sleeping and makes your back more comfortable.
Breast Implants have been an option for women with small breasts for over fifty years. During that time, the Breast Implants, the techniques and the recovery time have all improved.
Getting Back To Normal
After the first few days, your activities will begin to get back to normal. Most patients can drive by three or four days. However, if you are still sore or are taking pain medication, you should wait. By the end of the week, office work is usually doable. After two weeks, light physical activity is encouraged, and by six weeks, you should be able to return to all your usual activities.
It is also important to know that your results will vary. Good results and experiences are a product of teamwork. Choosing a Board Certified Plastic Surgeon who you are comfortable with is paramount. Doing the Breast Enhancement well is only part of my job, getting you through the recovery is equally as important to a good result.
Breast Augmentation Questions
If you have questions about Breast Augmentation, please call my San Francisco Bay Area Plastic Surgery Office today at (925) 943-6353, and schedule a private consultation appointment. While a lot of good Breast Augmentation information is available here, on the San Francisco Plastic Surgery Blog, and the links provided, an in-person consultation allows us to discuss the details specific to your Breast Enhancement.
Tummy Tuck Before and After: These side views of Abdominoplasty before and after pictures show what a Tummy Tuck can do to address overstretched abdominal muscles and abdominal skin laxity seen after pregnancy or weight loss.
The Tummy Tuck remains one of my most frequently performed cosmetic plastic surgery procedures, and one of my favorites. Plastic Surgeons have to be a bit obsessive to get the very best results. The Tummy Tuck, or Abdominoplasty, gives us the ability to not only remove fat, like Liposuction, and remove extra skin like a panniculectomy, but also allows a Plastic Surgeon to tighten the abdominal wall muscles. Tightening the abdominal muscles is the only way to tighten the foundation of the abdominal wall and obtain the flattest possible results.
Muscle Tightening – The Foundation of the Tummy Tuck
The Tummy Tuck Before and After Pictures above show what can be accomplished. The bulge that starts well above her belly button is from laxity of the muscles that make up the abdominal wall. This is often seen after pregnancy, and no matter how many sit-ups are performed, if the muscle fascia is over-stretched, the muscles will not tighten properly.
During your Abdominoplasty, the tough case the covers the front of abdominal muscles (the fascia) is tightened. Sutures are placed that act like an internal corset and flatten the belly. It is effective as long as the fascia is normal and the belly is not full of fat. Tummy Tucks are best performed when we are near our ideal body weight and are not planning to have more children.
Abdominoplasty Before and After Pictures
Abdominoplasty Before and After Pictures: The front view of the above Abdominoplasty shows how much the abdominal muscles and skin are tightened. The shadows of the muscles are brought closer to the midline and skin is much smoother. The belly button is also rejuvenated.
Skin Tightening – The Icing of the Tummy Tuck
Sometimes the abdominal muscles are in good shape, but there is too much skin covering them. Abdominoplasties directly remove extra skin right off the front of the belly, and the skin removal is sometimes continued around the sides for an extended Tummy Tuck, if the skin excess continues around to the sides. An Abdominoplasty will not tighten the skin of the back. This is why the Lower Body Lift was invented.
Fat Removal for Disproportionate Fat
Liposuction is frequently combined with the Tummy Tuck to maintain the trunk’s proportions. If the sides or back are full, but the skin is tight, Liposuction can be used to reduce this fullness. More recently, this fat has also been repurposed to enhance the buttocks as part of a Brazilian Butt Lift (BBL). In the BBL, fat is grafted into the buttocks to enhance its shape and restore absent volume. An example is shown below.
Tummy Tuck and Brazilian Butt Lift Before and After Pictures: In this case, Abdominoplasty is combined with Liposuction of the back and flanks. The fat is harvested and grafted into the buttocks to create fuller, curvier buttocks.
Tummy Tuck Consultations
If you are considering a Tummy Tuck, give my San Francisco Bay Area Plastic Surgery office a call today at (925) 943-6353. My friendly staff can help arrange a convenient appointment time, so that we can discuss the details of your procedure, and choose the type of Abdominoplasty that is best suited to your needs.
You may have noticed that the silver and black are wearing pink this month. For the last few Octobers, the National Football League has teamed up with the American Cancer Society to highlight breast cancer awareness and raise funds for breast cancer research.
Who Gets Breast Cancer?
One in nine women will develop breast cancer. That’s 12% of the female population, and women make up 99% of the cases of breast cancer. Less than 1% of people with breast cancer are men, and a man’s chance of a breast cancer diagnosis is about one in a thousand.
How Does Breast Cancer Spread?
By definition, breast cancer starts in the breast. Theses abnormal breast cancer cells begin to grow uncontrollably and invade the normal breast tissue. It takes months, sometimes years, for enough cells to amass to be felt. A one centimeter lump contains about a billion cancer cells. As the cells grow they continue to directly invade their neighbors, but cancer cells can also float through the circulatory system.
The most common place that breast cancer cells are found outside the breast are in the axillary lymph nodes. Let me translate that from medicine to English. Lymph is the liquid part of the blood, also called plasma. It slowly leaks out of the blood vessels from the capillaries and needs to be collected and returned to circulation. If lymph is not returned to circulation, we swell. If you ever looked at pictures of Elephantiasis as a kid (maybe it was just me) this disease is what happens when lymph does not return to circulation. In Elephantiasis, the lymph vessels become clogged and the lymph fluid become trapped in the legs. The legs begin to resemble elephant’s legs as the lymph fluid continues to build up and inflate the skin.
What Are Lymphatics (Lymphatic Blood Vessels)?
The lymphatic vessels are a third type of blood vessel, the first two being arteries and veins. Lymphatics are found throughout the body, including the breasts. Breast cancer cells can float through the lymphatic system and migrate to other organs. For cancer cells, this migration is called metastasizing. After a breast cancer lump reaches a critical size, the chances of a metastasis increases rapidly. This is why breast cancer awareness and early detection are so important.
What Are Lymph Nodes?
The breast’s main drainage system is through the axillary lymph nodes.
Lymph is only fluid, so unlike other blood vessels, it is not normal to have a lot cells traveling through the lymphatic blood vessels. In fact, the body has filters along the lymph vessels, called lymph nodes, which trap unwanted cells, preventing them from moving freely throughout the body. The two types of undesirable cells that lymph nodes filter most frequently are bacteria and cancer cells. In both cases, the lymph nodes present the invaders to the body’s immune system, it’s police force if you will. When the immune system recognizes the invaders as bad, it kills them, and prevents any further invasion. This probably happens all the time without us being aware of it. Unfortunately, sometimes the immune system cannot handle the invasion, and the problem spreads.
The majority of the lymph from the breast drains to the armpit (the axilla), so the most common place we find breast cancer outside the breast is in the lymph nodes of the armpit or the axillary lymph nodes. This is why checking the axillary lymph nodes is so important in staging breast cancer. No nodes involved (negative lymph nodes) is good, and means there is a higher chance that the cancer has not escaped the breast and thus a higher chance of curing the breast cancer. Breast cancer found in the lymph nodes (positive lymph nodes) are a worse sign, and often means additional treatment will be recommended to try and kill any cells that have escaped the breast.
Why The Push For early Detection?
If you understand how breast cancer usually spreads, then the emphasis on early detection becomes clear. The sooner breast cancer is detected, the smaller it is and the less likely it is to have spread. Small tumors found in the breast early can often be cured by simply excising them. Larger tumors will be more likely to require a mastectomy, but once the tumor has left the breast, surgery alone is not enough. Additional treatment is needed to kill the cells that have escaped. Unfortunately, the more cells that have escaped, the harder it is to cure breast cancer. The goal of breast cancer awareness and early detection is to find tumors when they are small are treatable and to prevent the larger tumor that cannot be cured.
Different Breast Cancers Require Different Treatment
Since there is more than one cell type in the breasts, there is more than one type of breast cancer. The most common types of breast cancer behave as described above, the majority of the time. However, there are exceptions to every rule. For example, some less common tumors that arise in the breast spread directly through the blood stream, bypassing the lymphatics. Moreover, tumors that develop at the edge of the breast can directly invade the skin, muscle or bone of the chest wall. In every case though, the earlier it is detected, the better your chances of survival. If you don’t do monthly breast exams, I hope this makes you reconsider how such a small chore can prevent an enormous amount of suffering.
What Can I Do About Breast Cancer?
Awareness is the first step. Next comes action. Do your monthly breast self-exams, get your mammograms as recommended, and if you find something, don’t be scared, be proactive. Most breast lumps are not dangerous, cysts and benign fibroadenomas are the most common, but if you find one that is not benign, the sooner it’s identified the better your chances. Do it for yourself. For men, the most common breast lump is Gynecomastia.
Early detection means you increase your chances of living a longer, cancer-free, life.
If you want to help others there are many avenues available. The American Cancer Society accepts donations, which are used to accelerate breast cancer research, and many volunteer opportunities are available if you can spare a little time. If you want more information on how to get involved check out the Get Involved page on the American Cancer Society’s website.
If your are feeling that your Breast Implants are too big, like the bowling balls Holly Madison is holding at the Bowling For Boobies Fundraiser in Hollywood, CA, it might make sense to have them reduced or even removed. About 1% of women who get Breast Implants have them removed at some point in their life.
Breast Implant Removal is not the most popular Cosmetic Plastic Surgery procedure. In fact, for most of my Breast Augmentation patients, Breast Implant Removal is unthinkable. Longterm plastic surgery statists show that only about 1% of women who get Breast Implants have them removed. Sometimes it is elective; sometimes it is medically necessary.
Why Have Breast Implants Removed?
Breast Implant Removal Before and After: This patient has great breast skin elasticity, so she has no skin sagging after her Breast Implant Removal. Breast Implant Remova surgery is just as personal as Breast Augmentation surgery, and the reasons for it vary. Only 1% of all Breast Augmentation patients have their Breast Implant removed.
While it is not common, there are many reasons for Breast Implant Removal. Since Breast Implants are used for both an elective and reconstructive procedure, the reasons for Breast Implant Removal can also range from elective to required.
Elective Reasons: Changes in one’s personal physique preference, body image and physical changes associated with weight, pregnancy or aging can all lead to a desire for less breast augmentation. Elective reasons For Breast Implant Removal include:
Breast Implants were placed at a young age and things have changed
Increased breast size after pregnancy
Increase in breast size associated with menopause
Planning to get pregnant and don’t want breasts to have a head-start in getting stretched out
Breast Implants are just no longer desirable or wanted
Required Reasons: Required reasons for Breast Implant Removal is more common for Breast Reconstruction patients than for elective Breast Augmentation patients. Reasons include:
Breast Implant Deflation (In most cases the Breast Implant is replaced rather than left out)
Breast Implant Infections
Breast Implant Exposure
Other severe complications of Breast Implants where the pocket needs to be reconstructed
Uncommon forms Breast Cancer treatment which include Hyperthermia
How Are Breast Implants Removed?
Breast Implant Removal Before and After Photos: Larger implants and less native breast tissue increase the desire for a Breast Lift after Breast Implant Removal Surgery. This patient above had large volume breast implants, small natural breast tissue volume, but good skin tone and nipple placement. She elected not to have a Breast Lift.
Uncomplicated Saline Breast Implant Removal can be performed under local, local with sedation or general anesthesia, depending on the motivation and tolerance of my patient. Silicone Breast Implant Removal is more often performed under general anesthesia. The reason for the difference is in the filling.
Saline Breast Implant Removal
Saline Breast Implants are filled with water essentially. The implants can be opened, the contents suctioned out and the implants’ silicone shell can be removed without fear of spillage through a small incision. While many saline breast implants were placed via a peri-areolar incision, they are often removed via the infra-mammary fold incision (IMF) to decrease the risk of dimpling at the areolar incision.
Silicone Breast Implant Removal
Silicone Breast Implants are filled with silicone gel. Unlike a Saline Breast Implant, it is sometimes difficult to know before surgery if a silicone breast implant is ruptured. Even MRIs are only 90% accurate. If your silicone breast implant is ruptured, more needs to be done than just remove the implant, so your surgeon will want to have the option, and this is more easier on you, and your surgeon, under general anesthesia. This is especially true of breast implants manufactured before 1994. These can have free silicone gel in the pocket around the implant, even without being ruptured due to “gel bleed.”
After Breast Implant Removal Will I Need A Breast Lift?
Breast Implant Removal Before and After Pictures: The patient above wanted her Breast Implants removed because she felt too big. She also has some bottoming-out of her breast implants. Her breast implants were removed and a special, inferior-pole lift was performed to reduce the amount of skin hanging below her nipple and to move the native breast tissue that she had back up under the nipple.
This is question that can only me answered with a Plastic Surgery Consultation. In general, the larger your implants and the smaller your natural breasts, the more likely you are to need a lift. An option that is always available though is to have the Breast Implants removed, allow the breasts to heal and then evaluate if a lift is beneficial. While this means two operations, it also means that you can make the decision to lift or not to lift without having to guess what your breast will look like without breast implants.
Recovery After Breast Implant Removal
Recovery after Breast Implant Removal is usually pretty quick. Most patients are wearing a firm, jog-type bra immediately after surgery to help the breast implant pocket seal and heal. Light compression provides decreased swelling, increased support and decreased discomfort after surgery. In cases where full capsulectomies are performed, or when free silicone needs to be removed, more surgery is required, so the recovery would be expected to increase proportionately with the amount of additional work required.
To schedule a Breast Implant Removal consultation, give my San Francisco Bay Area Plastic Surgery Office a call at (925) 943-6353. We are centrally located in the SF East Bay city of Walnut Creek, CA.
Dr. Joseph Mele maintains his Board Certifications with two ABMS recognized boards: The American Board of Plastic Surgery and the American Board of Surgery to demonstrate his commitment to excellence in up-to-date Plastic Surgery
Plastic Surgery Board Certification and MOC
Another year, another round of American Board of Plastic Surgery MOC (Maintenance of Board Certification) chores. I have two American Board of Medical Specialties (ABMS) recognized board certifications. One is from the American Board of Plastic Surgery and the second is from the American Board of Surgery. Both represent years of training and hard work and now with the additional MOC requirements, the completion of yearly chores.
Achieving Board Certification
Achieving Board Certification is an important milestone in a doctor’s training. It certifies that they graduated from a recognized residency training program and that they have passed a series of written and oral examinations, and if I had graduated two years sooner, that would have been the end of the story. I graduated and certified in the era of time-limited certification, so every year there are some requirements to fulfill.
Maintenance of Board Certification
The MOC examinations are given at computer based testing centers throughout the nation. All sorts of examinations are given at these centers and most have nothing to do with medicine. The staff at these institutions have strict regulations to enforce. The rules are designed to stop cheating and protect the proprietary information that is contained on the examination. I recently visited one such institution to take my ten-year recertification examination for the American Board of Surgery, and am required to take the American Board of Plastic Surgery MOC examination by 2019.
Why Maintain Board Certification?
This question is becoming more and more controversial as the fees, exams and other hurdles are raised higher and higher each year. It took several days to complete the application and collect the required information, and it’s not cheap. Those in favor of MOC claim that board certification is a way to make sure that your doctor is still good. Those opposed cite the ever escalating cost and time away from the practice required as prohibitive. They are also correct in pointing out the lack of evidence that MOC actually makes us better doctors. Personally, I don’t mind. It is a hassle, and it does not change the way I practice. On the other hand, it shows my patients a clear commitment to being the best Plastic Surgeon I can be. I don’t mind being tested. Plus, when I pass, I will have another lovely certificate to show everyone.
My Board Certifications
I completed a General Surgery residency in 1994. I passed my General Surgery Boards in 1995 and have recertified twice. I am good until 12/31/2025, as long as I complete my yearly chores and pay my yearly fees.
I completed a Plastic Surgery residency in 1997. When I finished my training, it took two years to take the certification exams. I passed my Plastic Surgery Boards in 1999, and have recertified once, so I am good until 12/31/2019. Looking forward to the next exam.
American Board of Medical Specialties
There are many boards out there, but the “real” boards are those under the umbrella of the American Board of Medical Specialties (ABMS). This is the longest standing body for Medical Certification in the US. The American Board of Plastic Surgery was born from members of the American Board of Surgery and the American Board of Otolaryngology who did what is now recognized as Plastic Surgery, and remains the only ABMS Board certifying Plastic Surgeons.
Board Certified Plastic Surgeon
If you are considering Plastic Surgery, be certain to check your doctor’s training. Good training, and the maintenance of that training, are essential for providing the safest and most predictable results.
If you are in the San Francisco Bay Area and would like to schedule an appointment, call (925) 943-6353. And if you want to check out my, or any doctor’s, qualifications, here are some links to help you:
Eyelid Surgery, aka Blepharoplasty, remains one of the most popular Cosmetic Plastic Surgery procedures. Last year, according to the American Society for Aesthetic Plastic Surgery (ASPAS), it ranked number four, ahead of Breast Lifts, and behind Liposuction, Breast Augmentation and Tummy Tucks. The statistics do not break down the number of Occidental vs. Asian Eyelid Surgeries performed, but here in the San Francisco Bay Area, the Asian Blepharoplasty accounts for a significant percentage of all the Eyelid Surgery Performed.
You don’t have to be a Board Certified Plastic Surgeon to see that the Asian and Occidental eyelids have different shapes. These differences are directly related to ethnic changes found in the Eyelid Anatomy. While the goals of Blepharoplasty are the same, the techniques to achieve these goals must be modified for differences in the anatomy between Occidental and Asian Eyelids.
Asian Eyelid Surgery Video (Asian Blepharoplasty)
Below is a segment from my latest KRON 4, Body Beautiful show. Several Asian Eyelid Surgery Before and After Pictures are included, and narrated, to help illustrate what Asian Blepharoplasty has to offer.
Asian Eyelid Surgery Goals
The goals for Asian Eyelid Surgery depend on whether the problem is congenital or acquired. Congenital Eyelid Problems we are born with, and these are often caused by deficiencies in the eyelid’s anatomy. The most common problem is poor connections between the upper eyelid skin and the tarsus, causing a poorly formed eyelid crease and the skin to drop into the eye’s visual field. Acquired Eyelid Problems we earn over time and are caused by aging and relaxation of the soft tissues that protect the eye. Protecting the eye is the primary goal for both types of eyelid surgery. Plastic Surgeons aim to restore the normal anatomy and to provide you with eyelids that look good while they are doing their job.
Asian Eyelid Surgery
If you are considering Asian Blepharoplasty, be certain to choose an experienced and Board Certified surgeon who understands, and knows how to repair, your specific eyelid anatomy and achieve your goals. In the San Francisco Bay Area call (925) 943-6353, to schedule a personalized and private consultation appointment.