Breast feeding is good for babies nutritionally and emotionally. Above is Naomi Jael, from Germany. She caused a viral sensation this week with this snap of her breast feeding her 10-month-old son at a wedding reception, though comments centered more around her public display than the virtues of breast feeding. A more supportive and more comical imitation can be found here.
A common question I get from women considering Breast Augmentation is, “Will Breast Implants interfere with Breastfeeding?” For women who are trying to reclaim their breasts after finishing having children, this is not an issue. However, if you want Breast Augmentation, and want to have children afterward, here are a few things you should know.
Is Silicone Safe For Babies?
Did you know that silicone drops are used to treat infant colic? An article from 1988, Mylicon drops in the treatment of infant colic, dosed 51 colicky infants with 0.3 ml of simethicone with each feeding. Symptoms of colic improved or resolved in 38 infants (78%) after one day and in 44 (86%) after seven days. Simethicone is an anti-foaming agent that relives bloating, and it is still available without a prescription, over-the-counter at your local pharmacy.
Safe enough to use at every feeding and up to 12 times per day. Active ingredient: Simethicone 20 mg in each 0.3ml dose.
Simethicone is a mixture of polydimethylsiloxane (PDMS) and hydrated silica gel. If you have ever taken Gas-X, you have ingested PDMS. What you may not have known is that PDMS is the same type of silicone found inside breast implants. So it is safe for adults, too. So if silicone is in breast milk it’s safe, but can it get out of a breast implant and into the breast milk?
Can Silicone Get Out of Breast Implants And Into Breast Milk?
PDMS is a silicone polymer which can be cross linked to increase its viscosity. This allows it to remain soft, yet resist flow. It is used inside breast implants, and is surrounded by a soft, solid, tear-resistant shell to further isolate it. Current breast implants are made with shells that do not allow the gel to bleed through them, though this was not always the case.
Modern Silicone Gel Breast Implants are filled with highly cohesive gel that does not flow like the oil found in earlier generations of breast implants manufactured before 1994. Implants made before 1985 have very runny filling and a high rate of rupturing.
Older breast implants, manufactured prior to 1994, did allow a small amount of gel to seep through them without a hole in the shell. It is like Helium seeping out of a balloon; however, rather than leaking out over night, it takes years for measurable amounts of silicone to be detected outside the these older breast implants. New breast implants are made with low-gel-bleed shells, which contains the internal gel, and prevents the gel from seeping through the wall. New breast implants also have high-cohesive gel centers, which do not flow like water. In the most recent long term follow-up studies, there have be no cases of the gel migration, which was seen in the older breast implants. So it is unlikely that silicone can get out of the breast implant, never mind into the breast milk.
Is Silicone Found In Breast Milk?
In 1991, before the more impervious breast implant shells were manufactured, a study measuring the amount of silicone found in the breast milk of lactating women with breast implants was published. The scientific sounding title is, “Determination of low levels of silicones in human breast milk by the aqueous silanol functionality test.”
Silicon compounds are widespread in the environment, making measurement of elemental Si in biological systems difficult. The assay was quite laborious and required 10 days to complete and measures PDMS, not elemental Si. The amount of PDMS in the milk of women with implants was not statistically different from that in water blanks or control human milk samples. The milk from women with polydimethylsiloxane breast implants contained 3.62 ppm (parts per million); control milk contained 3.40 ppm; and water contained 2.25 ppm. Moreover, this was in the older breast implants that had gel bleed, and still the levels were not statistically elevated.
Proper Breast Implant Placement Can Help Too
Surgical considerations for decreasing the risk of breast implants interfering with breastfeeding include scar and implant placement. Incisions made around the areola, may cut some of the ducts going to the nipple. I have had many patients with periareolar incisions maintain the ability to breastfeed, because most of the milk gland is between the nipple and the armpit, away from this periareolar incision; however, for patients wanting to breastfeed, I recommend using the inframammary fold (IMF) incision.
The most frequently used Breast Augmentation incisions are the periareaolar incisions and the inframammary incisions as shown above.
Placing the Breast Implant behind the pectoralis muscle can help, too. This provided an additional barrier between the breast implant and the breast gland, and also takes some of the compression off the milk gland. More pressure may trick the breast into thinking it has made enough milk, and turn off production early. Larger implants may also be more likely to decrease the amount of milk produced for the same reason.
Nipple Sensation is Helpful For Breastfeeding
Nipple stimulation is another stimulus for lactation. If you lose nipple sensation after breast augmentation, this may cause a reduction in milk production as it interferes with the normal milk let-down reflex that nipple stimulation causes. Fortunately, decreased nipple sensation is not common after Breast Augmentation.
Normal Breast Are Better For Breastfeeding
What I mean is that if you have normal breasts before Breast Augmentation, you are more likely to be able to breastfeed after Breast Implants are placed. If your breasts did not develop, you are more likely to have problems breastfeeding with or without breast implants. Other risk factors for not being able to breastfeed are: breasts that are spaced far apart, breasts which are tubular in shape or breasts that are significantly asymmetrical. If any of the above describe your pre-implant breasts, it’s possible you don’t have enough of the glandular tissue you’d need to make milk, and one study found that women with these conditions are 25 percent more likely to be unable to breastfeed and 19 percent more likely to need to supplement.
Can I Breastfeed If I Have Breast Implants?
Yes. The current recommendation for women with Breast Implants is to breastfeed. Breast Augmentation is not a contraindication to breastfeeding. While some women will make a smaller quantity of milk, there is no change in the quality of the milk produced.
Breast Augmentation Consultation
If you are currently trying to get pregnant, of plan to have a child in the next year, now is not the time for Breast Augmentation. If you are considering pregnancy somewhere in the future, or if you are done having children then now is a good time to find out what to expect. For a private, personalized Breast Augmentation Consultation call (925) 943-6353 and schedule an appointment. More information is available here on the San Francisco Plastic Surgery Blog, and my other websites, but there is no substitute for an in-person consultation, tailored to your body and your needs.
Downtown Walnut Creek, CA, was closed this weekend, but it was a good thing. The Walnut Festival Association sponsored Art on the Main. Art, food and beverage is usually available along Main Street, but this weekend, the street was open to foot traffic only. Scores of booths with paintings, photography, ceramics, glass, jewelry, wood, textiles, leather and even tie dye, lined the main drag. There was lots to see and lots of sunshine, too.
What Does SPF Stand For?
Freckles are sun damage. Without sun exposure, freckles never appear.
Today in Walnut Creek, SPF could stand for Spring Paintings Festival. When it comes to sunscreen, SPF stands for Sun Protection Factor. It sounds very scientific, maybe even with some math involved, but how is SPF actually calculated? I always imagined sunscreen, meticulously applied to a glass sheet, with UV lasers and collectors measuring the reflection and transmittance of harmful ultraviolet rays. Turns out, it’s much less complicated and accurate.
How Is SPF Calculated?
Soldiers sent off to fight World War II were given sun protection prior to shipping out. Nicknamed “red vet pet,” it was a sticky, unpleasant, solar barrier made from red veterinary petrolatum. When Benjamin Green, an airman and pharmacist, returned home and mixed his red vet pet with cocoa butter and coconut oil on his stove, Coppertone suntan cream was born.
The modern equation for calculating SPF: A(λ) the erythemal action spectrum, E(λ) is the solar irradiance spectrum and MPF(λ) the monochromatic protection factor, all functions of the wavelength λ. However, the original measurements of SPF were not mathematical.
To evaluate the effectiveness and performance of sunscreens, the Coppertone Solar Research Center was established in 1971 in Memphis, TN. Their scientific method involved measuring how long it took pale volunteers to obtain a sunburn, and then slathering them with sunscreen to see how much longer it took. If it took 15 minutes to get a burn without any protection, and 30 minutes with the cream, this was deemed SPF 2. SPF 40, theoretically, would mean 10 hours of protection.
How Often To Apply Sunscreen?
How quickly we burn is highly variable; moreover, the amount of UV light that reaches us depends on many factors, including cloud cover, the time of day and the reflection of UV rays off the ground or water. Swimming and sweating also dilute and remove sunscreen, so a single application, no matter how strong your SPF, is not enough. Application every two hours is recommended, and more frequently if you are swimming or exercising, even if you are using a water resistant brand.
How Much Sunscreen To Apply?
Sunscreen sun on the back under normal and UV light.
In the original tests, 2 milligrams of product were applied to each square centimeter of skin. That’s about a fourth of an 8 oz. bottle of sunscreen per application. This is more than most of us use in a single day at the beach or by the pool. So if you want the protection listed on the bottle, it’s hard to put on too much. The only way to know you’ve applied enough is if you are not burned at the end of the day. The best approach is to methodically apply an even coat of sunscreen 20 minutes before going in the sun. Missed areas will not make themselves known until know much later, after they burn. Sprays can help with even application.
Preventing Sun Damage, Wrinkles and Skin Cancer
This long haul trucker, famously featured in the New England Journal of Medicine, has unilateral dermatoheliosis, which means one sided sun damage to his skin. With the sun shining through the driver’s side window over the years, the left side of his face has received more sun exposure than the right side.
Even before you burn, your skin is accumulating damage. Direct damage occurs to your collagen and elastin fibers, making the skin more leathery, and to the skin cells’ DNA, disrupting your skin’s ability to repair itself and predisposing you to skin cancer. The result is premature wrinkles, irregular pigmentation and a greater chance of skin carcinoma and worse, melanoma.
The San Francisco Bay Area is a great place for outdoor activitie. The best protection would be avoiding the sun altogether, but that’s not realistic for most of us. Limiting the amount of sun exposure, especially midday, helps. Cover-ups, like hats and swim shirts are good. Properly applied water resistant, broad spectrum sunscreen is recommended. With proper reapplication, SPF 15 or greater is recommended for everyone, and SPF 25 or greater if you are prone to skin cancer.
Mommy Makeovers are a combination of cosmetic plastic surgery procedures that enhance, or repair, the breasts and belly. Since both areas take a hit with pregnancy, it is most commonly performed for mommies, but Mommy Makeover procedures are also performed after weight loss. Post Bariatric Surgery patients often have loose skin on their breasts, bellies and other areas, so Mommy Makeovers are performed after weight loss also.
The Mommy Makeover helps by enhancing both the breasts and the belly in a single combination plastic surgery procedure. Above, a Breast Augmentation Lift (Augmentation Mastopexy) is combined with a Tummy Tuck for the optimal result.
The Mommy Makeover is a not a specific operation, but rather a combination of breast and belly enhancement procedures. Each area is evaluated separately and we choose one from column A (breast enhancement) and one from column B (belly enhancement) and the combo plate is termed a Mommy Makeover. The ability to mix and match is what makes the procedure so powerful. The best procedures for each area are combined.
Mommy Makeover – Breast Enhancement
Breast Enhancement is half of the Mommy Makeover. In this case, a Breast Augmentation Mastopexy is performed. A Breast Implant is used to increase the breast volume, while a Breast Lift is used to raise the nipple and reshape the breast. A larger implant without a lift would not make a pretty breast. A larger implant would make larger breasts, too large for this patient’s desires. Additionally, the larger implant would push the nipple lower on the breast.
Breast Enhancement includes many options. The most common are Breast Augmentation and Breast Lifts, though for those women whose breasts do not shrink after pregnancy, Breast Reduction is also a possibility. Below is a list of Breast Enhancement procedures with links to additional information:
The gold standard of Belly Enhancement is the Tummy Tuck. It reduces loose abdominal skin, removes excess belly fat and tightens muscle laxity including rectus diastasis (muscle separation).
Belly Enhancement also includes several options. The classic Mommy Makeover is a Breast Augmentation combined with a Tummy Tuck. The Tummy Tuck (Abdominoplasty) is the work horse. Abdominoplasty can correct loose skin, lax muscle fascia and remove excess fat. It is the only procedure that addresses all three areas over the entire belly. Sometimes, a Tummy Tuck is more than is needed so “smaller” procedures, like Mini Tummy Tucks or Even Liposuction can be substituted for selected patients. Links to more information about the Tummy Tightening Procedures are provided below:
Liposuction can also be added to help with other problem areas like the love handles, muffin top, thighs, arms or chin, too.
Mommy Makeover – Putting It All Together
Choice is good, but sometimes too many choices leads to confusion. The beauty is that you don’t have to decide on your own. An Experienced Board Certified Plastic Surgeon is skilled in all your options, and can explain which procedure best accomplishes your goal. This can help you choose the best procedures, and help you know before committing, if a Mommy Makeover is right for you.
Mommy Makeover Consultations
If you are considering a combination of Cosmetic Plastic Surgery like a Mommy Makeover, call (925) 943-6353 today, and schedule a personalized and private consultation. The best breast and belly procedures will be discussed, and a specific plan created just for your body.
Natural Facial Rejuvenation depends on selecting the best techniques to correct the natural signs of aging. The Neck Lift is usually combined with the Face Lift to maintain facial harmony, as is shown in the before and after pictures shown above.
Plastic Surgeons and Facial Plastic Surgeons alike have for decades debated the benefits of opened and closed approaches for Facial Rejuvenation. Most often, open vs. closed is debated for Rhinoplasty (Cosmetic Nasal Surgery), but at the most recent American Society for Aesthetic Plastic Surgery meeting in Las Vegas, the open vs. closed debate centered around Neck Lifts.
The Annual Aesthetic Meeting attracts thousands of Cosmetic Plastic Surgeons from around the world.
The American Society for Aesthetic Plastic Surgery
The American Society for Aesthetic Plastic Surgery (ASAPS) is over 2600 Plastic Surgeons strong. Most members are from the United States and Canada, but many countries are represented. Only about one-quarter of all American Board of Plastic Surgery certified surgeons have been accepted as ASAPS members. The ASAPS is the largest plastic surgery society dedicated exclusively to the Cosmetic side of Plastic Surgery. Most members, like myself, are also members of the American Society of Plastic Surgeons (ASPS). The ASPS represents both cosmetic and reconstructive plastic surgeons and has over 8000 members. The ASPS represents about 94% of all Board Certified Plastic Surgeons in the United States.
The Las Vegas Plastic Surgery Debates
The nice thing about a society dedicated to just the aesthetic aspects of plastic surgery is that we can focus on Cosmetic Surgery. There are many scientific sessions, expert panels and instructional courses offered over the week long meeting, each dedicated to a specific aspect of what Plastic Surgeons do. Every procedure is covered, often with multiple sessions exploring every aspect of every technique. Since there is often more than one way to do each procedure, lively debates are common, and some of these debates have been going on since long before I started my San Francisco Bay Area Plastic Surgery practice.
The Neck Debate – Open Vs. Closed
One such on going debate explores the various approaches to Neck Rejuvenation. Neck Lifts seem easy enough, but they are one of the more challenging areas to correct. Just about everyone over 40 has tried lifting their neck at least once or twice in the mirror, but making the change long lasting, without distortion, is the challenge. Several Neck Lift techniques exists, but they are usually divided into two main groupings – Closed Neck Lifts and Open Neck Lifts.
Closed Neck Lifts
There is a tremendous amount of crossover between Neck Lifts and Face Lifts, and since the face and neck age together, the Neck Lift and Face Lift are usually combined to maintain facial proportions and harmony. The term Rhytidectomy (literally wrinkle removal) is used for Neck Lifts, Face Lifts and even Brow Lifts.
When the neck has loose skin without platysmal bands, a Closed Neck Lift may be the best option. If disproportionate fat is present, Liposuction can be used to sculpt an even smoother contour.
Closed Neck Lifts are similar to what we do in the mirror. The skin is tightened in the direction of the jaw line, and the excess is removed to hold the smoothed skin in place. This reduces the loose skin under the chin (the waddle or turkey gobbler), reduces jowls and better defines the junction between the face and neck. For closed neck lifts, the skin is opened around the ears like for a Facelift, but the neck is left closed.
Open Neck Lifts
The platysma is a flat muscle that supports the neck skin. Often it is separated in the midline. As we age, we see this separation as Platysmal Bands, the two cords running down the front of the neck. One goal of the Neck Lift is to diminish to appearance of these bands.
Open Neck Lifts do everything a closed neck lift does, but also include an incision under the chin. The opening allows for direct adjustment of the superficial fat and muscles under the chin and down the front of the neck. When platysmal bands are present, the two cords of skin that run from under the chin down the front of the neck, they can be “repaired” through an open technique. Excess fat can also be removed, and we Plastic Surgeons debate how much and from which levels fat removal is most effective, yet still safe and predictable.
Minimally Open Neck Lifts
I add a third class of Neck Lift to my treatment algorithm: the Open-But-Just-A-Little-Bit Neck Lift. This is a combination of a Closed Neck Lift with Liposuction of the neck. It can accomplish much of the fat removal of the open technique through a much smaller incision. When disproportionate fat is present beneath the chin, Liposuction can be a useful adjunct to tightening up the skin. In this case a small incision is made under the chin to allow the fat to be suctioned, but not big enough to look through or repair the platysma muscle.
Most Plastic Surgeons Use Multiple Approaches
In our yearly ASAPS debates, Plastic Surgeons choose techniques and debate the pros and cons, but in reality most of us use multiple techniques. The choice depends on what our patients need. This month I have used techniques from all three categories of Neck Lifts listed above. I choose different techniques for different patients depending on what is broken, and what I have to fix.
How To Choose The Best Neck Lift For Your Neck
If you are considering a Neck Lift, it is helpful to have an idea of what your options are. Some problems respond better to specific techniques. If loose skin is the main problem, a closed technique may be the best. Platysmal bands may respond better to an open technique, while disproportionate fat may respond to liposuction.
The Internet provides lots of information, but trying to choose your own technique is a bit like trying to pick the wrench your plumber is going to use. Get a working knowledge of what is possible and get the help of a professional. Choosing the best Board Certified Plastic Surgeon is much more important than choosing the best technique. Getting multiple opinions can help, but you will likely learn that multiple approaches are possible. Having multiple choices can be a source of confusion, and this is why you need the best Plastic Surgeon.
Neck Lift Consultation
If you are in the greater San Francisco Bay Area, and would like to come into my Walnut Creek, CA, office for a Neck Lift evaluation, give me a call at (925) 943-6353. During your private consultation we will review your expectations and explore your options, so that the best Neck Lift for you can be selected.
When a patient asks me, “Do you think I need a Breast Lift or could I obtain good results with just large Breast Implants?”, I know I have some explaining to do. It’s a common misconception that larger breast implants can lift the breasts. The reality is that Breast Augmentation and Mastopexy (Breast Lift) are two completely different, but complementary procedures.
How To Evaluate Your Breast Enhancement
Optimal Breast Enhancement pays attention to both the size and the shape of the breasts. Above Breast Augmentation with Breast Implants is performed to enhance the size of the breasts and even out the asymmetry (the uncensored before and after pictures are below under “What Is Breast Pseudoptosis?”.
I separate Breast Enhancement into two areas for optimization: the best size and the best shape. Breast Implants are the safest and most predictable means we have to significantly increase breast size, but they do not lift the breasts, ever. Breast Lifts can change the shape of the breast, but they do not change the size of the breasts. Let’s go over each procedure separately, and then talk about the combination of Mastopexy Augmentation.
Breast Augmentation With Breast Implants
Choosing the best size for your breasts is the most subjective, and challenging, aspect of Breast Augmentation. I could spend an entire blog post on How To Chose the Best Breast Implant Size. Clicking on the link under Categories: Breast Implant Options gives you a quick series of San Francisco Plastic Surgery Blog posts that go over the most common options available for Breast Augmentation. The best advice I can give you is to do your homework. Stuff your bra. Try on different clothes. Look at pictures. Review online before and after photos. Whatever it takes for you to know what size is right, do it.
The Ideal Breast Size
Once you have your Ideal Breast Size in mind, you need to explain it to your chosen Board Certified Plastic Surgeon. If you desire smaller breasts, Breast Reduction Surgery is used. Because the volume of the breast is reduced during the Reduction Mammoplasty operation, the breast naturally deflates. A Breast Lift is incorporated into the Breast Reduction to enhance the shape.
Breast Implants enlarge the shape you already have. The Breast Augmentation before and after pictures above show Breast Augmentation without a Breast Lift.
If you desire larger breasts, Breast Augmentation is safest and most predictable option. Breast Implants provide the appropriate boost in volume to enhance your breasts. If you already have a pretty shape, Breast Augmentation is all that is required. Breast Implants provide a proportionate increase in breast dimensions.
The Ideal Breast Shape
When the breast volume is good, but the breast needs a lift, Breast Lifts can help. The Breast Lift (Mastopexy) before and after pictures above show how the breast can be reshaped without adding volume.
The Ideal Breast Shape is independent of size. The ideal breast has the nipple at the front of the breast; the nipple is located on the most forward projecting part of the breast (or slightly higher), and most of the breast tissue is located above the inframammary fold (IMF). The IMF is the junction between the bottom of the breast and the chest wall. When the nipple is located below the level of the IMF this is termed ptosis (true sagging).
Ptosis does not improve with Breast Implants. In fact, large breast implants increase the chance of developing ptosis due to their weight. Implants over 350 cc’s are more likely to require future surgery. Additionally, when the nipple is lower than the IMF, adding more volume to the breast tends to push the nipple down lower on the breast mound. The bigger the Breast Implant, the more weight, and the more the nipple gets pushed down. Not ideal. The best procedure in this case is a Mastopexy Augmentation, or Breast Lift with a Breast Implant.
What Is Breast Pseudoptosis?
Breast Augmentation can help with pseudoptosis and asymmetry. The breasts appear bottomed out before surgery, with most the breast volume located below the nipple and mild pseudoptosis. The Breast Augmentation before and after pictures above show how Asymmetrical Breast Augmentation can correct the shape of the breasts and the size discrepancy. In this case, the right breast was smaller than the left before surgery, so a larger Breast Implants was used on the right.
There is a specific type of Breast Deflation that can occur with weight loss, or after pregnancy, called Pseudoptosis (fake sagging) that responds well to Breast Augmentation alone. Pseudoptosis is likely the source of confusion about Breast Implants fixing sagging breasts. I review the difference between pseudoptosis and true sagging (ptosis) in the post: Do I Need A Breast Lift? (The Pencil Vs. The Pinch Test). With pseudoptosis, the nipple is above the IMF, while the breast tissue is below the IMF. Pseudoptosis is not the same as breast sagging, so it does not require a Breast Lift when Breast Augmentation is performed.
Breast Lift or Big Breast Implants?
The Breast Augmentation Mastopexy before and after pictures above show what is possible when Breast Implants are used with a Breast Lift. Correction of both size and shape is possible.
So, to answer the question, “Breast Lift or Big Breast Implants?” If you are happy with the shape of your breast, and desire a larger cup size, Breast Augmentation with a Breast Implant is likely the best option. On the other hand, if most of your breast is located below the IMF and your nipple is headed south, a Breast Lift is needed to enhance your breast’s shape. A Breast Lift can be used along with a Breast Implant (Mastopexy Augmentation) if the breast needs to be lifted, and additional volume is desired.
Breast Enhancement Consultations
Above, I have tried to simplify the decision tree for Breast Enhancement, but as more details are considered, the plan may need to be customized. If you are unhappy with your breasts’ shape, or you would like to make them a little larger, give me a call at (925) 943-6353, and make a personalized consultation appointment. We can go over all the details and formulate a plan that works best for your specific situation. Need information in Spanish? Click here: Aumento de Senos.
Liposuction has been one of the most popular Cosmetic Plastic Surgery procedures since the development of Tumescent Liposuction. The American Society for Aesthetic Plastic Surgery (ASAPS) ranks Liposuction number one, with almost 400,000 Liposculptures performed last year. The second most commonly performed procedure, with over 300,000, is covered in last week’s video blog: Breast Augmentation.
The San Francisco Bay Area’s KRON 4 Body Beautiful
More information on Liposuction, also known as Liposculpture, is available right here on the San Francisco Plastic Surgery Blog. Below is a video segment from a recent appearance on Body Beautiful. Host Janelle Marie and I discuss Liposuction, its indications and recovery. Like any elective surgery, safety and predictability are number one. This is why it is important to seek an experienced Board Certified Plastic Surgeon when exploring your Body Shaping options. Only a Plastic Surgeon can offer you all the currently available options.
Liposuction Video (Liposculpture)
More Liposuction for More People
Liposuction procedures increased over 15% compared to the previous year. This is despite the marketing of many minimally invasive and non-invasive disruptive technologies. The fact that more Liposuction was done last year than ever before means it still works, and works better.
The ASAPS Liposuction Page gives Liposuction a 91.6% patient satisfaction rating, based on over 1000 patient reviews. On the ASAPS site, Liposuction gets 4.58 out of 5 stars, with 90.6% of patients giving the procedure 4 or 5 stars. Only 1.6% of patients rate it 1 star. This is consistent with the popular plastic surgery social site RealSelf, which also gives Liposuction a 92% “worth it” rating.
How Do CoolSculpting and Kybella Rate?
The hottest Non-surgical and minimally invasive alternatives to Liposuction are Cool-Sculpting and Kybella. So how do they stack up to Liposuction? Both are less expensive for a single treatment, but a series of treatments are usually recommended, which means additional cost and downtime with each treatment.
CoolSculpting uses cold pads to chill your fat away. CoolSculpting gets a 77% rating on RealSelf, but there is an asterisk *Worth It ratings [on RealSelf] only factor in “Worth It” and “Not worth it” ratings. They do not include “Not sure.” When the not sure votes are added in, the “worth it” rating drops to 50.6%.
Kybella in an injection of bile acid that dissolves fat. It has a very misleading 97% “worth it” rating when comparing only the “worth it” to “not worth it” votes. When the “not sure” votes are considered, the “worth it” rating drops to 48.7%. Although Kybella injections seem less invasive that Liposuction one of the more dramatic complications, temporary paralysis of the lower lip, is five times greater. It turns out that bile acid also dissolves the fat that protects and insulates the nerves. In most cases the nerve heals and returns to normal function in about three weeks. To be fair, Liposuction’s RealSelf “worth it” rating also drops when the “not sure” votes are tallied, from 92% to 65.2%.
What Does Liposuction Do?
Liposuction removes localized and disproportionate fat. Bulges around the waist (muffin tops, love handles, lower bely fat), neck or thighs (saddle bags, inner thigh) can all be effectively removed by vacuuming away the excess fat. Liposuction is not a weight loss tool. Unlike weight loss, however, Liposuction has the advantage of being able to spot remove disproportionate fat directly from the areas in which it is causing problems. Even the most meticulously performed Liposuction cannot tighten skin that is inelastic. Not everyone I evaluate is a good candidate for the procedure. Some patients will choose more effective, alternative treatments other may choose to leave well enough alone. It is an individual decision, but since most Plastic Surgeons offer many different types of cosmetic plastic surgery, they are uniquely qualified to inform you about all your options.
To review all your options, and maximize your knowledge of Liposuction and the alternatives, nothing can substitute for an in-person consultation appointment. If you are in the San Francisco Bay Area, give me a call at (925) 943-6353 and get the information you need to make an informed decision.
Posted in Home, Liposuction, Videos | Comments Off on Tumescent Liposuction in the SF Bay Area | Liposculpture
Breast Implants are used both to provide a larger bust and to augment the natural contours of the breast. The primary goal is to improve body proportions and the fit of clothing and bathing suits. Breast Implants can help when the breasts have always been small; however, the loss of breast volume after childbirth is another common reason for Breast Augmentation.
Breast Augmentation On Television
Below is a Breast Augmentation Video. It contains Before and After Pictures of Breast Augmentation with narration. Breast Implants and Breast Enhancement, including primary Breast Augmentation, Breast Augmentation Revision and the treatment of Capsular Contracture are illustrated and discussed on KRON 4, the San Francisco Bay Area’s New Station. The show is Body Beautiful, and many video segments are available here on the San Francisco Plastic Surgery Blog and Dr. Mele’s YouTube Channel. Just click on Videos under categories in the margin or the YouTube logo.
Breast Augmentation Video (Breast Implants)
Breast Augmentation Consultations
Breast Augmentation is a very personal decision. If you have always had small breasts, or your breasts have shrunk due to pregnancy, weight loss or even age, Breast Implants may be an option. To learn more, schedule a private consultation appointment with a Board Certified Plastic Surgeon in your area. If you are near the San Francisco Bay Area, give me a call at (925) 943-6353 to get all your questions answered.
Blepharoplasty is the plastic surgery term for an Eyelid Lift. It literally means eyelid changing. For upper eyelids, the change is most often the removal of excess skin, which can make you look tired or block your vision. For the lower eyelid, the most common change is the removal of lower eyelid bags. Since the eyelids normally swell when we are overtired, the fullness caused by the fat under the eyes makes us look like we need a nap.
Eyelid Surgery on KRON 4’s Body Beautiful
Over the years, I have appeared on television many times to answer the frequently asked questions about cosmetic plastic surgery. Most recently, I had the opportunity to discuss Eyelid Rejuvenation on the San Francisco Bay Area’s News Station, KRON 4. The show is Body Beautiful, and over a hundred video segments covering many types of cosmetic plastic surgery can be found here on the San Francisco Plastic Surgery Blog. Just click on “videos” under the heading “Categories” in the column for a complete listing. Below is the most recent Blepharoplasty Video. You can also find them on my YouTube channel.
Blepharoplasty Video (Eyelid Lift)
Eyelid Surgery Consultations
An in-person consultation is the best way to get accurate medical advice about your eyelids. A brief exam and medical history are needed to be sure the procedure is right for you. Safety and predictability are the most important aspects of any surgery, but this is especially true of elective plastic surgery. If you would like to schedule a personalized consultation appointment, give me a call at (925) 943-6353.
Otoplasty continues to be a popular procedure. It is one of the few cosmetic plastic surgery procedures that is done for children, but Otoplasty is an ear shaping procedure that is performed every day for people of all ages.
Dr. Mele Discusses Otoplasty on KRON 4’s Body Beautiful
This month, I appeared on the Bay Area’s News Station, KRON 4, to discuss Otoplasty on Body Beautiful. Below is the video segment, which includes a brief description of the procedure and a narrative of several Otoplasty Before and After Pictures.
Otoplasty Video (Ear Pinning for Prominent Ears)
How Often is Otoplasty Performed?
Yesterday, I performed two Otoplasties. It is a common procedure here in the San Francisco Bay Area, especially Ear Pinning for prominent ears. Last year, the American Society for Aesthetic Plastic Surgery reported that 36,727 Otoplasties were performed. Otoplasty missed being a top ten procedure by one slot. If earlobe repairs for torn earlobes were included, it would likely be in the top three.
Types of Otoplasty
There are many reasons for having otoplasty. The most common by far is the correction of ears that stick out with an Ear Pinning procedure. However, many other ear deformities can also be addressed.
Microtia (Absence of the Ear)
The ultimate Otoplasty is the creation of an ear for someone born absent one. It is a very complicated, specialized procedure most commonly begun early in life and under the guidance of a multidisciplinary team at Children’s Hospitals like UCSF Benioff Children’s Hospital in San Francisco, UCSF Benioff Children’s Hospital in Oakland (formerly Oakland Children’s Hospital) and Stanford’s Lucile Packard Children’s Hospital. In fact, one of the world’s pioneers in Microtia Reconstruction is the San Francisco Bay Area’s now retired plastic surgeon and sculptor Burt Brent. The combination of Plastic Surgery and Sculpting is a necessity of today’s total ear reconstruction. In the future, however, with the advent of digital scanners and 3-D printing, future reconstruction may become less dependent on sculpting skills.
Other Ear Deformities
Prominent ears and microtia are at opposite ends of the Ear Deformity spectrum. A Prominent Ear is essentially a normal ear that sticks out. Microtia is the nearly complete absence of the ear. Otoplasty can be used to improve both these extremes as well as the range of ear deformities that exist between them including: losses, redundancies or injuries of ear structure either from trauma or tumor removal.
Restrictions in ear growth can manifest as Cup Ear or Lop Ear. Excess growth can result in Darwin’s Tubercle, Stahl’s Ear or Spock Ears. Injuries to the ear result in missing parts, Cauliflower Ear, Torn Earlobes and Keloids.
If you are considering cosmetic ear surgery, give my San Francisco Bay Area Plastic Surgery Practice a call at (925) 943-6353. The type of procedure best suited to your ears will be selected and discussed, giving you the information you need to make an informed decision about what the next step can do for you.
When I started my San Francisco Bay Area Plastic Surgery practice in 1997, cosmetic procedures were performed one eighth as often as they are today.
In 1997, over 1.6 million cosmetic plastic surgery procedures were performed, and most of them were surgical. The breakdown was 55% (900,933) surgical and 45% (740,751) non-surgical.
In 2015, almost 13 million cosmetic plastic surgery procedures were performed. The number of surgical procedure performed more than doubled, from 900,933 to 1,912,468. Percentage-wise, however, surgery slipped to only 15% of all cosmetic procedures. There was a tremendous surge in the number of non-surgical procedures performed driven by new technology and expanded FDA approval. In 2015 10,879,909 non-surgical procedures were performed, a 1400% increase.
Non-surgical Plastic Surgery Procedures Then and Now
The nonsurgical procedures of 1997 were not the same as today’s. The sole filler was collagen, which only lasted a few weeks, sometimes months. Botox was available, but the use of Botox for wrinkles was not FDA approved. In 1997, using Botox for frown lines and wrinkles was strictly an off label, use confined to selective Dermatology and Plastic Surgery practices (like mine).
In 2016, there are a variety of FDA approved fillers are available, each lasting months, sometimes years. The most commonly used dermal fillers are Hyaluronic Acid based including: Restylane, Juvederm, Restylane Lift (Perlane), but Radiesse (Calcium Hydroxyapatite spheres) has also emerged for boney augmentation (Cheeks and Chins) and the nasolabial folds. Botox is FDA approved for wrinkles, and is now found in just about every spa in the San Francisco Bay Area.
Surgical Plastic Surgery Procedures Then and Now
Unlike their non-surgical counterparts, the majority of the surgical procedures performed today are largely the same. New techniques and material (sutures and implants), have developed, but the most popular procedures of 1997 are the most popular procedure of 2015 too. To date, they have not been replaced by non-invasive procedures because non-invasive procedures cannot accomplish the same results. Women continue to dominate men in numbers, so let’s break down the procedures desired by each sex.
Plastic Surgery for Women
The headlines read that Buttocks Augmentation is the fastest growing cosmetic surgery. The 30% increase is statistically true, but is magnified by the fact that not as many Buttocks Augmentation are done as Breast Augmentation. Looking at the number of cases performed in 2015 reveals the popularity of the procedures:
Buttocks Implants – 5678
Buttocks Lifts – 5008
Brazilian Butt Lifts (Fat Grafting to the Buttocks) – 15,705
Breast Implants – 305,856
Comparing Buttocks to Breast Augmentation, if 3000 more Brazilian Butt Lifts are performed this year, that will almost be a 20% increase. On the other hand, if 3000 more Breast Augmentations are performed, that will be an increase of less than 1%. It’s all relative to how many procedures are performed.
The most popular Cosmetic Plastic Surgeries for women are Liposuction, Breast Augmentation, Tummy Tuck, Breast Lift and Eyelid Lift.
The most popular Cosmetic Plastic Surgery procedures from women have been pretty consistent over the last 18 years:
Comparing the male and female procedures, Rhinoplasty, Facelifts and Breast Reduction are pushed out of the top five by Mommy Makeovers; however, they are next. Cosmetic nasal surgery was number 6; Facelifts was number 7, and breast reduction was number 8 for women. When it comes to Cosmetic Plastic Surgery, men and women seem to want the same things.
Cosmetic Plastic Surgery Consultation
If you are considering Cosmetic Plastic Surgery in the San Francisco Bay Area, call (925) 943-6353 today, and schedule a private consultation appointment. Every consultation is tailored to your specific needs. The decision to proceed, or even to explore, cosmetic surgery is personal. My goal is to provide you the information you need to make your own informed decision.