September 28th, 2012 Dr. Mele
With the continued popularity of Breast Augmentation, there is a growing need for Board Certified Plastic Surgeons experienced with Breast Implant Revision Surgery.
Breast Augmentation Revision FAQ’s
In trying to answer some of the most frequently asked questions about Breast Augmentation Revision, I have provided information here and on my main web sites. Information on the Internet, however, cannot replace a consultation with a Board Certified Plastic Surgeon. If you are having problems with your Breast Implants, seek the advice of a qualified professional, preferably a member of the American Society for Aesthetic Plastic Surgery.
What Are the Most Common Reasons for Breast Augmentation Revision?
The most common reasons for Breast Augmentation Revision include:
- The desire to Change Size
- Breast Implant Deflation
- Capsular Contracture
- Breast Implant Malposition (often caused by capsular contracture)
Changing Breast Implant Size
One of the most common reasons for Breast Augmentation Revision is to change the size of the Breast Implants. The overwhelming majority of the time, the goal is to increase the size of the Breast Implants. The procedure is usually simpler, and has a much easier recovery, than the initial Breast Augmentation. The pocket is opened, the old implants removed, the pocket is enlarged (capsulotomy or capsulectomy), and new implants are placed. When the goal is to decrease the size of the Breast Implants, the procedure is the same except the pocket is not enlarged, and sometimes it needs to me tightened (capsulorrhaphy). Breast Implants can also be changed from Saline to Silicone Gel, and less frequently from Silicone Gel to Saline.
Breast Implant Deflation

Breast Implant Deflation and Replacement:
Problem – Patient’s left saline breast implant has deflated.
Solution – Patient desired larger breast implants so both sides were replaced with larger breast implants.
With the advent of improved manufacturing and materials, the risk of breast implant deflation is reduced. What happens when a breast implant deflates depends on what is it filled with. Saline Breast Implants go flat, and the solution is safely absorbed by the body. Silicone Breast Implants have a firm center, and initially there may be no sign of a leak. Over time, the gel can leak out of the capsule, and you may feel a lump. Any lump in the breast should be promptly investigated. The sooner a broken implant is replaced, the simpler the procedure will be. The big three US breast implant manufacturers all have warranties: Allergan, Mentor and Sientra.
Capsular Contracture

Capsular Contracture Before and After Capsulectomy:
Problem – Capsular Contracture leads to firmer, smaller and more centralized breast implants.
Solution – Capsulectomy removes the tight scar, softening and expanding the implants.
Capsular Contracture is the term for hardening of the Breast Implants. The breast implants themselves do not get hard, but the scar capsule that lines the pocket in which the Breast Implant sits tightens. The scar squeezes the Breast Implants and can change the firmness, shape and position of the Breast Augmentation. In the before picture above the redness of the breasts is caused by congestion of the circulation. It the most severe cases of Capsular Contracture (Grade IV) not only is the shape of the breast changed, but the breast also become painful.
Treatment of Capsular Contracture includes one, or a combination of:
- Capsulectomy (removing the scar)
- Capsulotomy (opening the scar)
- Breast Implant Replacement
Breast Implant Malposition
Breast Implant Malposition is a large topic by itself. When Breast Implant Malposition is caused by Capsular Contracture, the treatment is similar to that described above. When caused by Breast Implants that are too large for a woman’s frame, reducing the size of the Breast Implants may be an important part of the treatment. When implants are too low, the inframammary fold may need to be repaired, or completely reconstructed as is often the case in Breast Reconstruction after a mastectomy. Symmastia is also a form of Breast Implant Malposition that is seen when the breast implants migrate towards each other, breadloafing and forming a uniboob.
Problems With Breast Augmentation
If you have problems with your breast augmentation, seek the assistance of a Board Certified Plastic Surgeon, who has experience with the correction of Breast Augmentation. Although many of the skills required for Breast Augmentation are necessary for Breast Augmentation Revision, Breast Augmentation Revision Specialists have developed specific skills, and can help guide you to achieve safer and more predictable results.
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September 21st, 2012 Dr. Mele

Best of Walnut Creek Award – Plastic Surgeon Joseph Mele, MD
2012 Best of Walnut Creek Award
WALNUT CREEK August 31, 2012 — Joseph A Mele III, has been selected for the 2012 Best of Walnut Creek Award in the Physicians & Surgeons category by the Walnut Creek Award Program.
Each year, the Walnut Creek Award Program identifies companies that we believe have achieved exceptional marketing success in their local community and business category. These are local companies that enhance the positive image of small business through service to their customers and our community. These exceptional companies help make the Walnut Creek area a great place to live, work and play.
Various sources of information were gathered and analyzed to choose the winners in each category. The 2012 Walnut Creek Award Program focuses on quality, not quantity. Winners are determined based on the information gathered both internally by the Walnut Creek Award Program and data provided by third parties.
About Walnut Creek Award Program
The Walnut Creek Award Program is an annual awards program honoring the achievements and accomplishments of local businesses throughout the Walnut Creek area. Recognition is given to those companies that have shown the ability to use their best practices and implemented programs to generate competitive advantages and long-term value.
The Walnut Creek Award Program was established to recognize the best of local businesses in our community. Our organization works exclusively with local business owners, trade groups, professional associations and other business advertising and marketing groups. Our mission is to recognize the small business community’s contributions to the U.S. economy.
SOURCE: Walnut Creek Award Program

Best of Walnut Creek Award – Plastic Surgeon Joseph Mele, MD
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September 15th, 2012 Dr. Mele
If you’ve ever wished your upper arm skin would stop waving when you do, Brachioplasty, also known as an Arm Lift, may be right for you.
Arm Lift Before and After Pictures

Arm Lift Before and After (Brachioplasty): A large amount of excess skin is present on the left. After an arm lift, on the right, the excess skin has been removed, creating a tight, shapely upper arm.
Arm Lift FAQ’s
- Who is a good candidate for an Arm Lift (Brachioplasty)? Anyone with a large amount of excess skin is candidate for an arm lift. The more excess skin, the more dramatic the improvement. If you have lost weight, and the fat has left the arms, but stretched out upper arm skin remains, Brachioplasty can reveal your hard work by removing the redundant, loose skin. Good health is also a must for any elective plastic surgery.
- What is the recovery after a Brachioplasty? You can go home the same day as your Arm Lift. Light compression sleeves are worn for several weeks afterward for support and to minimize swelling. It takes a few weeks before full activity is permitted. Scar care is instituted after surgery and is maintained until the scar is fully mature.
- What are the alternatives to an Arm Lift? Unfortunately, for very loose skin there is not substitute for Brachioplasty. Despite the promises you will find on-line, there is no dependable way to shrink the skin without surgery. However, if your upper arms are full due to disproportionate fat, and the skin retains good tone, Liposuction can offer excellent improvement without a Brachioplasty scar.
- More Brachioplasty information is available on the Dr. Mele Website on the Arm Lift page.
Brachioplasty Before and After Photos

Brachioplasty Before and After (Arm Lift): Before the arm lift she has twice the skin she needs. After the arm lift the skin conforms to the muscles. The scar is hidden along the lower, inside edge of the arm.
Who should perform an Arm Lift (Brachioplasty)?
When selecting a Plastic Surgeon, you want:
Check Your Plastic Surgeon
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September 7th, 2012 Dr. Mele
Tummy Tucks, in the San Francisco Bay Area, remain high on the list of cosmetic plastic surgery procedures. Whether performed on their own, or as part of a Mommy Makeover, abdominoplasty can repair loose overstretched skin, muscle laxity, disproportionate fat, and even remove stretch marks from the lower abdomen.

Tummy Tuck Before and After: Lower abdominal laxity distorts the appearance of the abs in this otherwise fit woman. In just a few weeks after her tummy tuck, her clothes fit better, and she is much happier with her new look.
Tummy Tuck Alternatives and Options
The Tummy Tuck is the plastic surgery work horse for abdominal rejuvenation. It addresses all three of the major areas on concern for the lower abdomen. Abdominoplasty tightens skin, removes fat and cinches up the muscles like an internal corset. For most patients, after weight loss or child birth, this is the best option. When the skin and muscles are tight, however, Liposuction alone may be sufficient to flatten the belly. When muscle and skin laxity is confined to the area below the belly-button, a mini-tummy-tuck may be a better choice.
Maintaining the Proportions of the Trunk
Sometimes the fat extends around the sides to the back. The love handles or “back fat” may look disproportionate after the belly is repaired. A Tummy Tuck can be combined with Liposuction to extend the results. As long as the skin tone is good, liposuction can be utilized to removed the love handles and back fat to rejuvenate the entire trunk.

Liposuction of the back can be combined with a tummy tuck to further enhance your results. In this case, liposuction allowed for further reduction of the waist, and smoothing of the back. The combination allows clothing to fit better than with a tummy tuck alone.
Liposuction only works when the skin retains the ability to contract and shrink to the new, slimmer shape. When the skin is over stretched, appropriately named “plastic deformation” in Engineering, it can no longer regain its original shape. This is the benefit of operations like Abdominoplasty and the circumferential Lower Body Lift or Belt Lipectomy used for Post Bariatric Plastic Surgery. These procedures remove the excess skin and allow for enhanced, more form fitting results.
Tummy Tuck Frequently Asked Questions
Interested in more information about Tummy Tuck (Abdominoplasty), Mini-Tummy Tuck (Mini-Abdominoplasty), Liposuction, Lower Body Lift or Belt Lipectomy? More is available on my main web site, DrMele.com, and via any of the links embedded above. We would be happy to answer your questions via the contact form to the left or via the phone.
To schedule a private consultation in our Walnut Creek, CA, Plastic Surgery Office call (925) 943-6353.
Live Television Event on Monday, September 10, 2012, at 11:00 AM
Update: Dr. Joseph Mele, will be appearing live Monday, on KRON4′s Body Beautiful. The topic will be all about the abdomen. You can call in and get your questions answered during the show, or email them beforehand using the contact form on the left.
Posted in Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty) | No Comments »