December 29th, 2012 Dr. Mele
A Breast Lift is used to firm a saggy breast. The procedure, also called a Mastopexy, changes the shape, but not the volume of the breasts. San Francisco Breast Lift patients can have their Mastopexy combined with Breast Augmentation or Breast Reduction, if a change in breast volume is desirable.
Breast Lift with Breast Augmentation Before and After

The Breast Lift is combined with Breast Augmentation when we want to increase the size of the breasts or when more upper pole fullness is desired. Before surgery on the left; After periareolar mastopexy augmentation on the right.
When Breast Size is Good, Just Lift Them
The Breast Lift is primarily a Breast Shaping procedure. Larger breast can be left larger, and smaller breast can be left smaller, depending on what you are comfortable with. Larger breasts do tend to require more maintenance in most cases, and may be at higher risk for needing another Breast Lift in the future. It is important to seek a Board Certified Plastic Surgeon, and be fully informed before any procedure.
Large Breast Lift Before and Afters
Below is an example of a Breast Lift for a patient with larger breasts. If desired, the breast could have been reduced at the same time.

Breast Lift can be performed for larger breasts without a Breast Reduction. Often the vertical scar can be eliminated in these cases.
Small Breast Lift Before and Afters
It is not always desirable to increase the size of small breasts during the mastopexy surgery. The bridge, as they say, is not burned however. If in the future a larger cup size is desired, a Breast Implant can be inserted in the future. There are certain cases when it is better to stage the Breast Lift and Breast AUgmentation, but most the time they can be performed at the same surgery.

Breast Lift can also be performed for smaller breasts without making them larger. This is especially helpful for very active, athletic women who do not want to deal with the added weight of larger breasts.
Mastopexy Before and After – Side View
A breast lift not only raises the nipple up on the breast, but can raise the breast mound on the chest. This is best seen in the lateral (side) before and after pictures. My patient has a conveniently located skin lesion that makes this amount of elevation easy to see. The red spot (hemangioma) along side her breast is seen just in front of her arm, at the level of the elbow. After her Mastopexy, the breast is back on the chest, leaving the hemangioma on the abdomen, and well below the perky breasts.

Mastopexy Before and After Pictures: The side view dramatically shows the amount of lift possible with today’s modern breast lifting techniques. A red spot (hemangioma) is seen just in front of he elbow. On the left, the before breast sags well below this marker, while on the right, after the breast lift is well above it.
Breast Lift Specialist
If you are considering a Breast Lift, Breast Augmentation, Breast Reduction, or any other Cosmetic Breast Enhancement, give us a call at (925) 943-6353. We can discuss all the latest innovations, and find the procedure with the right aesthetics for you. Many Breast Lift procedures exist, and it is good to review your options before surgery. That way you can make the best decision, one that is the safest and most predictable means to achieve the goals you want.
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December 22nd, 2012 Dr. Mele
Six Breast Augmentations are performed for every Breast Reduction; however, bigger is not always better. Large breasts can cause pain and embarrassment. The weight of the breasts can cause discomfort, especially during physical activity. Heavy breasts put strain on the back and neck, and cause chronic lower neck and upper back pain. Shoulder rutting from bra straps digging into the shoulders is another common problem. In the summer months, skin-on-skin contact below the breasts can lead to rashes, infections and even ulcerations.
Female Breast Reduction Before and Afters

Breast Reduction (Reduction Mammoplasty) reduces and lifts the breasts. Notice the mole in the upper inner quadrant of the breast on the right? Before breast reduction, it is well above the south pointing nipple. After reduction mammoplasty, the mole is lower on the reduced and elevated breast mound, between the now perky nipples.
Breast Reduction = Symptom Reduction
Breast Reduction Surgery reduces Macromastia (large breasts) and changes how clothes fit, but it also reduces the symptoms associated with heavy breasts. Less weight means less torque on the back and neck. Less skin redundancy means fewer rashes and firmer breasts that move with you, not on their own. Proportionate breasts also make it easier to find bras and tops that fit.
Reduction Mammoplasty Before and After Pictures

Breast reduction before and after pictures showing the side view. The majority of the scar is hidden in the fold under the breasts. A large amount of breast tissue and skin was removed from the lower breast. The freckles show how the skin is shaped over the breast.
Different Procedures for Different Breasts
The gold standard Breast Reduction in the United States is an “Inverted-T” or “Keyhole” method base on an “Inferior Pedicle.” But one size does not fit all. The top most example on this page was done without the vertical scar that runs down the middle of the breast, from the areola to the base of the breast. Other alternatives eliminate the horizontal scar beneath the breast, or both the vertical and horizontal scars. Scarless Breast Reduction is possible for small reductions when there is little sagging. This is done with liposuction, but liposuction alone is usually not an option for Breast Reduction.

Breast reduction before and after photos. The breasts have been lifted up on the chest, tightened and reduced significantly.
Breast Reduction Consultation
If you are considering Breast Reduction, be certain to seek a Board Certified Plastic Surgeon for your procedure. If know the size you would like to be, a careful history and examination will help to determine the best course of treatment. If you are in the San Francisco Bay Area call Dr. Mele’s Walnut Creek Plastic Surgery office at (925) 943-6353 to schedule your personal consultation appointment today.
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December 14th, 2012 Dr. Mele
You’ve heard of Saline Filled Breast Implants and Gummy-Bear High-Strength Silicone Filled Breast Implants, but did you hear about the Cocaine Filled Breast Implants?
From the Script of Nip Tuck
If you are a Plastic Surgeon you likely feel that the TV show Nip/Tuck portrays plastic surgery as accurately as West Virginia’s Senator Joe Manchin feels Buckwild represents West Virginia. However, in Spain yesterday, fiction became fact.
In Episode 12 of Nip/Tuck’s inaugural season, drug lord Escobar Gallardo blackmails plastic surgeons Sean and Christian to remove liquid-heroin implants from one of his many drug couriers illegally entering the US. Sounds insane right? Well … yesterday, December 13, 2012, airport security in Barcelona, Spain, detained a Panamanian woman arriving from Bogota, Columbia, and found she had three pounds of cocaine on her … actually … in her.
Can I Fly After I Get My Breast Implants?

Cocaine filled breast implants – definitely not FDA approved.
The short answer is yes, you can fly with Breast Implants, but I don’t suggest it immediately after your surgery. It was especially true in this case. Immigration officials were suspicious of the Panamanian woman’s story, and a pat-down revealed bloody bandages in her bra. Long story short, a medical team removed two plastic bags from her breasts containing three pounds of white pasty cocaine. Her Breast Implants were worth about $50,000 each, and a trip to prison. Maybe, if she had liquid-heroin filled implants, the result would have been more natural.
Truth is Stranger Than Fiction
I watched Nip/Tuck. I had to. My patients would ask me about the plot line, and I couldn’t venture a guess of what the characters were up to without actually seeing it. Some of the strangeness was plausible: Ghost surgeon, Alec Baldwin, as founding father of male-to-female surgery, maybe, but the abomination of smuggling drugs within Breast Implants seemed beyond the pale. I can only imagine the desperation and delusions of those involved in this tragedy. Makes Jersey Shore seem pretty reasonable.
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December 7th, 2012 Dr. Mele

Dr. Joseph Mele appears on KRON4′s Body Beautiful.
On Monday, Walnut Creek Plastic Surgeon, Dr. Joseph Mele, MD, FACS, appears on the San Francisco Bay Area’s News Station, KRON Channel 4, with the latest in breast enhancement options. As a guest of Body Beautiful with Janelle Marie, Dr. Mele will discuss Breast Augmentation, Breast Lift, Breast Reduction and even Breast Revision Surgery.
Answers to Your Breast Enhancement Questions
The television show is broadcast live, so you can call in and ask your questions on the air, and get your Breast Enhancement Questions answered during the show. Tune in to channel 4 at 11 AM on Monday (December 10, 2012) for the number to call. Also, feel free to call the office at (925) 943-6353 any weekday, 9 AM to 5 PM.
San Francisco Breast Enhancements
In conjunction with Monday’s topic, the San Francisco Breast website has had a mini lift. New pages have been added to expand the popular Breast Augmentation and Breast Implant Revision pages. More details and the latest information is available about your Breast Augmentation, Breast Implants and Breast Augmentation Revision options.
Click on the banners below to visit the site. Menus for the new pages are available at the top of these pages.

Click above to visit SanFranciscoBreast.com’s New Breast Augmentation Page

Click above to visit San Francisco Breast's New Breast Implant Revision Page
More Information
The goal is to provide you the best information available about Cosmetic Breast Surgery. If you need more information, use the contact form on the left to send our Walnut Creek Plastic Surgery office a question. Information here, and on my web sites, provides good general knowledge; however, it cannot substitute for an in-person consultation with a Board Certified Plastic Surgeon. If you are looking for specific details, or a personalized treatment plan, schedule your private consultation appointment today (925) 943-6353.
Posted in Breast Augmentation, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Women), Home | No Comments »
December 1st, 2012 Dr. Mele

Post Bariatric Plastic Surgery – Tummy Tuck (Abdominoplasty): Despite weight loss, abdominal laxity and redundant skin mask the body shaping benefits of weight loss. A tummy tuck makes things right.
What is Post Bariatric Plastic Surgery?
Post Bariatric Plastic Surgery is Plastic Surgery performed after Bariatric Surgery, to reduce the amount of redundant skin left behind after the fat is burned off. To truly understand Post Bariatric Plastic Surgery, it is important to understand Bariatric Surgery.
What is Bariatric Surgery
Bariatric Surgery is surgery designed to cause weight loss in individuals who are morbidly obese. It is not Liposuction. Bariatric Surgery does not remove fat, it causes weight loss by restricting the intake of calories.
How does Bariatric Surgery work?
Bariatric Surgery works through plication, bypass or a combination of the two. Plication reduces the size of the stomach, causing early satiety so less food is eaten. Bypass bypasses a segment of the small intestine causing fewer calories to be absorbed from what is eaten. Since either technique can be “eaten through” without proper dicipline, a combination of the two tends to yield the largest weight loss.
Is Bariatric Surgery Safe?
Bariatric Surgery is more complex than piercing ones ears, and even piercings carry risk. There needs to be a benefit to the surgery that outweighs the risks. This is why Bariatric Surgery is performed only for people who are significantly overweight.
The Benefits of Bariatric Surgery
There are benefits to Bariatric Surgery besides weight loss. Cleveland Clinic researchers recently published the largest review of weight loss surgery to date. They reviewed 73 bariatric surgery and cardiovascular risk factor studies involving nearly 20,000 thousands patients who had weight loss surgery. For the Post Bariatric Surgery Patients, 63% saw their hypertension improve, 73% saw improvement in their diabetes, and 65% had their cholesterol levels fall. The average follow-up was almost five years. The findings were published in the journal Heart.
What happens after Bariatric Plastic Surgery?
The goal of Bariatric Surgery is to cause massive weight loss. It takes about a year for the body to adjust to its new physiology, and for a pateint’s weight and nutrition to stabilize. During this time, adipose tissue is consumed, and the health benefits are produced. Unfortunately, the skin is frequently left deflated and saggy.
That’s where Post Bariatric Plastic Surgery comes in
Post Bariatric Plastic Surgery is designed to remove the excess skin from the body and extremities, and reduce the skin laxity, revealing the new, slimmer body contours and improving the way one looks and feels. Post Bariatric Plastic Surgery Procedures include:
There’s a Society for that

The American Society of Bariatric Plastic Surgery is dedicated to shaping the body after massive weight loss.
Dr. Mele is an Active Member of the American Society of Bariatric Plastic Surgery, a group of Board Certified Plastic Surgeons dedicated to reshaping bodies after massive weight loss. If you have lost a significant amount of weight, or have completed Bariatric Surgery, and are looking to remove loose skin, give my San Francisco Bay Area Plastic Surgery office in Walnut Creek, California, a call at (925) 943-6353, and schedule a personal consultation appointment.
Posted in Home, Post-Bariatric Surgery (After Weight Loss) | No Comments »