Male Breast Reduction | Gynecomastia San Francisco Bay Area

Posted March 20, 2017 in Breast Reduction, Breast Reduction (Men), Home, Videos

About two-thirds of men develop breast buds during puberty, and for half of them, it does not go away. Gynecomastia, male breast development, causes fullness, feminization and often embarrassment. The only cure is Gynecomastia Reduction Surgery. Dr. Joseph Mele is a Board Certified Plastic Surgeon in the San Francisco Bay Area who specializes in Male Breast Reduction or Gynecomastia Reduction. This Gynecomastia Video segment aired live on the Bay Area’s News Station, KRON 4, and discusses the procedure and reviews examples of Gynecomastia before and after pictures.

Gynecomastia may involve just the area beneath the nipple and areolae or the entire chest. In the male breast reduction before and after pictures above, the fullness beneath the nipples was removed through a small incision placed along the lower margin of the areolae.

Gynecomastia may involve just the area beneath the nipple and areolae or the entire chest. In the male breast reduction before and after pictures above, the fullness beneath the nipples was removed through a small incision placed along the lower margin of the areolae.

Male Breast Reduction As Seen On TV

Recently, I had the opportunity to discuss Male Breast Reduction on Body Beautiful. Body Beautiful is a live show on the San Francisco Bay Area’s News Station, KRON 4. The segment is included below, and contains multiple Gynecomastia Reduction Before and After Photos, along with narration about the procedure, alternatives and recovery.

Gynecomastia Reduction Video (Male Breast Reduction)

Gynecomastia Reduction Consultations

Gynecomastia Reduction removes excess breast tissue from the male chest. Excess tissue can be removed with Liposuction or direct excision, depending on the amount, location and nature of the breast tissue.

Gynecomastia Reduction removes excess breast tissue from the male chest. Excess tissue can be removed with Liposuction or direct excision, depending on the amount, location and nature of the breast tissue.

There are several alternative operations for Gynecomastia Reduction. Common methods include liposuction, direct excision of the gland, skin reduction or a combination of each. The best method is often determined by the size, location and nature of the breast tissue.

To find out what your options are, call (925) 943-6353 and schedule a private, personalized consultation in our Walnut Creek Plastic Surgery office. If Gynecomastia is bothering you, learn what treatments are available from an experienced, Board Certified Plastic Surgeon.

Read More

SF Plastic Surgery Discussed Live Today on KRON 4

Posted March 08, 2017 in Arm Lift (Brachioplasty), Breast Augmentation, Breast Reduction, Breast Reduction (Men), Chin Implants/Augmentation, Facial Augmentation, Home

Dr. Mele and Body Beautiful host Janelle Marie in the KRON 4 Bay Area News studio.

Dr. Mele and Body Beautiful host Janelle Marie in the KRON 4 Bay Area News studio.

Board Certified San Francisco Bay Area Plastic Surgeon, Dr. Joseph Mele, MD, FACS, will be discussing cosmetic plastic surgery, live at noon today (8 March 2017) on KRON 4. Topics include:

  • Breast Augmentation (breast implants)
  • Gynecomastia Reduction (male breast reduction)
  • Arm Lifts (brachioplasty)
  • Chin Augmentation (chin implants)

But you never know what will come up on live television.

Tune in or DVR us at Noon Today

If you have the chance, tune in today at noon and get the latest plastic surgery news, live, on your television. If you are reading this too late to tune in, don’t worry. Segments of the show will be posted to the San Francisco Plastic Surgery Blog and to my web shortly after airing.

You can check out past episodes here by selecting “Videos” in the “Search By Category” drop-down menu in the margin, or on DrMele.com.

Read More

Top Plastic Surgery Procedures – SF Bay Area

Posted March 05, 2017 in Brazilian Butt Lift, Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction, Brow Lift, Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Home, Liposuction, Neck Lift (Rhytidectomy), Plastic Surgery Societies, Rhinoplasty (Nasal Surgery), Tummy Tuck (Abdominoplasty), Wrinkle Reduction (Non-surgical)

The 2016 ASPS National Plastic Surgery Statistic were released this week.

The 2016 ASPS National Plastic Surgery Statistic were released this week.

This week the American Society of Plastic Surgeons (ASPS) published the United States’ national Plastic Surgery Statistics for 2016. It is always interesting to me to see how the national statistics correlate with my own Cosmetic Plastic Surgery practice here in the San Francisco Bay Area. Last year, the correlation was pretty close.

Top Ten Cosmetic Plastic Surgery Procedures

As a group, surgical procedures grew 4% from 2015 to 2016. The top five Cosmetic Plastic Surgery procedures are almost the same. Facelifts edged out Tummy Tucks for the fifth spot, but the popularity of the two procedures remains very close. Here are the top five procedures as reported by the ASPS:

  1. Breast Augmentation (Augmentation Mammoplasty)
  2. Liposuction (Suction Assisted Lipectomy)
  3. Cosmetic Nasal Surgery (Rhinoplasty)
  4. Eyelid Lift (Blepharoplasty)
  5. Face Lift (Rhytidectomy)

The next five procedures, in order of popularity were: Tummy Tuck (Abdominoplasty), Breast Lift (Mastopexy), Neck Lift (Rhytidectomy), Forehead Lift (Brow Lifts) and Breast Reduction (Reduction Mammoplasty).

Brazilian Butt Lifts Grow The Fastest

The fastest growing procedure last year was the Brazilian Butt Lift (BBL). The BBL is not really a buttocks lifts, but more a buttocks enlargement. During the procedure, fat grafting is used to enlarge the buttocks and selectively enhance its shape. The results can be quite dramatic and the resultant shape is usually much nicer than that obtained from buttocks implants.

The Brazilian Buttocks Lifts is again the fastest growing cosmetic plastic surgery procedure. Significant improvement in the size and shape of the buttocks is possible by removing disproportionate fat from other areas, the lower back in this example, and selectively inserting the excess fat into the buttocks.

The Brazilian Buttocks Lifts is again the fastest growing cosmetic plastic surgery procedure. Significant improvement in the size and shape of the buttocks is possible by removing disproportionate fat from other areas, the lower back in this example, and selectively inserting the excess fat into the buttocks.

The number of Brazilian Butt Lifts increased 26%, from 14,705 to 18,489 in 2016. The procedure was also the fastest growing procedure of 2015 when it grew 28%, from 11,505 to 14,705. In fact, for the US population, the number of BBL’s has doubled from 2013 to 2016, and shows no signs of slowing in 2017.

Minimally Invasive Plastic Surgery Procedures

Minimally invasive plastic surgery procedures grew 3% in 2016. The top five procedures remain:

  1. Botulinum Toxin Type A (Botox®, Dysport®, Xeomin®)
  2. Soft Tissue Fillers (Restylane®, Juvederm®, Radiesse®)
  3. Chemical Peels (TCA, Phenol)
  4. Laser Hair Removal
  5. Microdermabrasion

Cosmetic Plastic Surgery Consultations

If you live near the San Francisco Bay Area and are considering Cosmetic Plastic Surgery, be certain to seek out an experienced and Board Certified Plastic Surgeon in your area. To schedule a private consultation, tailored to your specific needs, call (925) 943-6353, today.

Read More

Breast Augmentation and Pregnancy

Posted February 12, 2017 in Breast Augmentation, Breast Implant Revision Surgery, Breast Reduction, Home, Mommy Makeover

Breast Augmentation and pregnancy, the combination is the source of many questions in my San Francisco Bay Area Plastic Surgery Clinic. The answers center around a few themes: timing, breast feeding and how breasts change.

Pregnancy brings many changes including changes to the breasts. If you are considering Breast Enlargement, or if you already have Breast Implants, and you are contemplating pregnancy, this post is for you.

Pregnancy brings many changes including changes to the breasts. If you are considering Breast Enlargement, or if you already have Breast Implants, and you are contemplating pregnancy, this post is for you.

Breast Augmentation and Pregnancy: Timing

If you are done having children, the timing is ideal. The dramatic changes that can occur with pregnancy and breast feeding are over, and the focus is on getting back the breasts you had, or the breasts you always wanted to have. Details like size and shape tend to change slowly with age, but may swing widely with pregnancy. Having this behind you is a big plus in the direction of predictability. Additionally, details like inverted nipples, enlarged nipples or enlarged areolae can also be addressed. The Mommy Makeover can also be discussed if your belly has been stretched and has not recovered to your satisfactionx.

If you are planning to have children whether to have Breast Augmentation now depends on how soon you plan to get pregnant. If you are actively trying to get pregnant, you should wait. Your breasts may change with pregnancy. The changes may be small or dramatic, there is no way to predict. Even from child to child, there may be variation. If you get Breast Implants, and then things change dramatically, Revision Breast Augmentation may be needed to restore the breasts’ volume or shape.

If you are planning to have children later, it may make sense to have Breast Augmentation now. If you consider the immediate gratification of the Breast Enlargement, and you feel you will have enough time to enjoy the results, before possibly needing a touch-up, then go for it. The decision is not purely black and white. Breast Augmentation Revision is not always needed after pregnancy, and Breast Implant Revision Surgery may be necessary, even without becoming pregnant.

Before: This young woman had Breast Augmentation before pregnancy. After two children, the skin of her breasts relaxed, dropping the breast tissue off her Breast Implants.  After: Her Breast Implants were exchanged to adjust volume and a Breast Lift was performed to reshape and rejuvenate her breasts.

Before: This young woman had Breast Augmentation before pregnancy. After two children, the skin of her breasts relaxed, dropping the breast tissue off her Breast Implants. After: Her Breast Implants were exchanged to adjust volume and a Breast Lift was performed to reshape and rejuvenate her breasts.

Breast Augmentation and Pregnancy: Breast Feeding

If you have Breast Implants, there is no reason not to breast feed normally. Breast Implants do not taint the milk, and in many cases, the advantage that breast milk gives your infant is significant. Breast Augmentation may decrease the absolute volume of milk produced. The exact mechanism is unknown, but the easiest way to think about it is that the breast may be tricked into thinking it is already full. The volume of the implant may inversely effect the breasts’ milk production. On the other hand, I have had many women who had Breast Augmentation in their twenties, who later went on to breast feed successfully.

If you are currently breast feeding, and wondering when you can have Breast Enhancement Surgery, it is recommended to wait until the milk has dried up for a minimum of three months. This allows the breasts to finish their post pregnancy changes, and decreases the risks of operating on a lactating breast. However, it is never too soon to have a consultation with a Board Certified Plastic Surgeon, and in the San Francisco Bay Area, there are many to choose from.

Sometimes Breast Augmentation alone is enough to rejuvenate the postpartum breasts, as demonstrated in the above Breast Augmentation before and after pictures.

Sometimes Breast Augmentation alone is enough to rejuvenate the postpartum breasts, as demonstrated in the above Breast Augmentation before and after pictures.

Breast Augmentation and Pregnancy: Breasts Change

We touched on this a little above, but breasts do change with pregnancy. Some change very little, some quite dramatically, and sometimes one changes more than the other. If your breasts change a little, then Breast Augmentation after pregnancy will be very similar to Breast Augmentation before surgery. On the other hand, if the breasts increase rapidly in size for lactation, and then shrink, often to a volume smaller than their original size, adjustments will be needed in your Breast Enhancement. These adjustments depend on the size and shape of your breasts.

Size is perhaps the easier of the two to understand. If breast lose volume, more stuffing is required to perk them back up to the desired size. In cases when the breasts enlarge, but do not shrink back down to the original size, it may be advantageous to have a Breast Reduction, especially when the sizes are uneven. When the breasts shrink too much, Breast Implants are used to restore volume and improve both the shape of the breasts and the fit of clothing.

The shape of the breasts is determined not just by their volume, but mostly by the breasts’ skin. When the volume of the breast shrinks, but the skin doesn’t, excess sagging occurs. Breast Augmentation alone may not be enough. A combination of Breast Augmentation and Breast Lift is needed in as many as 40% of women after pregnancy. The Breast Lift is used to reshape the breast and remove the skin excess, while Breast Implants can restore volume and increase the bust.

Breast Augmentation Consultations

If you are considering Breast Augmentation, give me a call at (925) 943-6353, and schedule a private, personalized consultation appointment. It is never too early to get the facts, and there is no better way to get a plan tailored to your needs than with an in-person consultation with an experienced, Board Certified Plastic Surgeon.

Read More

When Breast Augmentation Needs A Lift | SF Bay Area

Posted February 05, 2017 in Breast Augmentation, Breast Lift (Mastopexy), Home, Mommy Makeover, Tubular Breasts

Mastopexy Augmentation is the combination of Breast Augmentation and Breast Lift. When is Breast Augmentation alone enough? When is a Breast Lift the best choice? When should a combination of Breast Augmentation Lift be performed? It’s a big subject, and requires an in-person consultation for your specific needs, but some general rules for the procedures are explained below. There are many options, so be certain to consult with a Board Certified Plastic Surgeon before making the decision.

Breast Augmentation Lifts Come in May Sizes

Breast Augmentation with Breast Lift was used to enlarge the breasts, elevate the nipple and tighten the breast skin, especially the skin that hangs at the bottom of the breasts. The technique used, a horizontal breast lift, does not require the vertical scar seen in the anchor or inverted-T type breast lifts.

Breast Augmentation with Breast Lift was used to enlarge the breasts, elevate the nipple and tighten the breast skin, especially the skin that hangs at the bottom of the breasts. The technique used, a horizontal breast lift, does not require the vertical scar seen in the anchor or inverted-T type breast lifts.

Breast Augmentation lifts, like the breasts themselves, come in many shapes and sizes. When the shape of the breast is good, but a larger version is desired, Breast Augmentation with a Breast Implant is often enough. When the size of the breast is good, but the breast tissue sags, a Breast Lift alone may be enough. The exception in this case is when there is no upper pole fullness, often seen as gapping of the upper bra. A small implant may be beneficial to add a bit of volume to the upper breast in these cases. When the breasts are small and saggy, the Breast Augmentation Lift is the procedure of choice.

The case above is an unusual lift in that a periareolar (defined below) and an inframammary incision (hidden in the crease beneath the breasts) were used, but there is no vertical scar. The “Horizontal Breast Lift” is great for breasts that have bottomed out or for breasts with more extreme sagging.

Breast Augmentation Lift for Tubular Breast

Smaller Breast Lifts require smaller scars. In the case above, a periareolar scar was used to reposition the nipple and reshape the breasts. Periareolar literally means “around the areola”. The areola is the pigmented skin that surrounds the nipple. While this does provide the smallest scar, it does the least. It tends to flatten the end of the breast and it is not great for reducing the size of the areolae.

The Breast Augmentation and Breast Lift combination with the smallest scar is the Periareolar Mastopexy Augmentation. An incision around the areola is used to raise the nipple and insert the Breast Implant. In the above case, the flattening effects of the periareolar lift are exploited to help reshape these tubular (tuberous) breasts.

The Breast Augmentation and Breast Lift combination with the smallest scar is the Periareolar Mastopexy Augmentation. An incision around the areola is used to raise the nipple and insert the Breast Implant. In the above case, the flattening effects of the periareolar lift are exploited to help reshape these tubular (tuberous) breasts.

For cases of Tuberous Breasts, flattening of the shape of the breast is a plus. It can be used to prevent the puffy nipple from sticking out like a cherry on top of a sundae. This patient’s breasts are narrow at the base, and the constriction gives a narrow, elongated, tubular breast. The Breast Implant helps to round the breast out, but it may not correct the areola when it is puffy.

Bigger Sagging, Bigger Problems, Bigger Breast Aug Lifts

For patients with severe postpartum breast involution (shrinkage), and for patients after massive weight loss, the breast volume has left the building, leaving only a loose, empty flap of skin. Breast Augmentation Lifts are the only solution to this problem. Breast Implants are used to restore the breasts’ volume, and it is combined with a Breast Lift to restore the breasts’ shape.

Severely deflated breasts, like those seen above after massive weight loss, need more volume and bigger lifts. An Anchor shaped scar was needed to raise the nipple, remove the overhanging lower breast skin and to tighten the breast skin in the horizontal direction, too.

Severely deflated breasts, like those seen above after massive weight loss, need more volume and bigger lifts. An Anchor shaped scar was needed to raise the nipple, remove the overhanging lower breast skin and to tighten the breast skin in the horizontal direction, too.

Often, I will see on the Internet the misconception that if a big enough implant is placed, you will not need a lift. This is not true. Imagine an implant, the size of the one used above, placed under the skin of the pre-op picture. The breast would be the same size; however, the loose skin holding the nipple would hang off the end. In the above case, only a Breast Lift can correct the problems with the breasts’ shape, nipple position and excess skin at the bottom of the breast.

More Scar = Happier Patient?

The ultimate goal of Cosmetic Plastic Surgery is a happy patient. So how can more scar lead to a happier patient? It all depends on the circumstances. If a scar is not needed, then more scar is bad. I have had patients on the borderline of needing a lift elect to not have lift because of the extra scar. Some are happy with their decision of not completely correcting the sagging, and not having extra scars. Others have come back for a Breast Lift after their Breast Augmentation, and are much happier now, after the Breast Lift. Staging does make it easier to see what each procedure has to offer the final result.

The main goal of Cosmetic Plastic Surgery is a pretty result. The Breast Augmentation Lift allows for control of both the size and the shape of the breasts. The cost is additional scar. In this case, an Inverted-T scar was needed.

The main goal of Cosmetic Plastic Surgery is a pretty result. The Breast Augmentation Lift allows for control of both the size and the shape of the breasts. The cost is additional scar. In this case, an Inverted-T scar was needed.

Above, an inverted-T Breast Lift was performed along with placement of a Breast Implant. A periareolar lift would have left the nipples low, the areolae much larger and the end of the breasts flat. A vertical lift would not have tightened the lower pole sufficiently, or coned the shape of the breast as beautifully. In my experience, the incision underneath the breasts is well hidden. By keeping its length short, the scar will hide in the shadow under the breasts.

Breast Augmentation Lift Consultations

If you are considering a Breast Augmentation, Breast Lift or the Combination Augmentation Mastopexy, be certain to consult an experienced Board Certified Plastic Surgeon. While there are advantages to combining the procedures, it is also more complicated than both procedures done separately.

If you are in the San Francisco Bay Area, give me a call at (925) 943-6353, and schedule a private comprehensive consultation. Your options will be reviewed and the best course selected to optimize you breast aesthetics.

Read More

Vaping And Cosmetic Plastic Surgery | E-Cigarettes | SF Bay Area

Posted January 15, 2017 in Breast Augmentation, Breast Reduction, Facelift (Rhytidectomy), Home, Smoking and Plastic Surgery, Tummy Tuck (Abdominoplasty)

Smoking around the time of surgery can lead to increased complications.

Smoking leads to more complications after surgery.

There is ample evidence proving that smoking tobacco cigarettes increases the risk of complications after plastic surgery. Most plastic surgeons recommend that smoking be stopped four weeks before and four weeks after cosmetic surgery to reduce complications and improve healing. If you are a smoker, this may seem excessive, but even four weeks is a compromise. For example, it takes eight weeks for the immunosuppression that accompanies smoking to substantially resolve.

Since patients and doctors alike want the best results with the lowest risk of complications, stopping smoking before plastic surgery is aligned with the patients’ ultimate goal of being better, faster. In fact, even if you are not considering plastic surgery, not smoking significantly improves your health and decreases the outward signs of aging.

Smoking And General Surgery

Smoking doubles the risks associated with general surgery (operations like hernia repair, appendectomy and gall bladder removal). The glass-half-full way to look at this is that if you smoke, you can cut the risks of surgery in half by stopping smoking four to eight weeks before surgery.

General Surgery Vs. Plastic Surgery

General surgery procedures and plastic surgery procedures are different. Many general surgery procedures are emergencies, so there is little chance to stop smoking before surgery. Additionally, most general surgery operations are performed on internal organs, rather than the skin. Since general surgeons are not usually rearranging the skin, the circulation to the skin is less likely to be disturbed with general surgery procedures. The mastectomy is the most obvious exception to this rule.

Smoking And Plastic Surgery

Smoking increases the complications of plastic surgery by 600%. Plastic Surgery is Skin Surgery, so most procedures involve rearranging skin, tightening skin, stretching skin or removing excess skin. The sentinel procedures for smoking studies in plastic surgery have been Face Lifts, Breast Reductions and Tummy Tucks.

How long does it take for your body to recover from smoking? The above timeline gives just a few examples and includes the average time it takes for the health benefits to be seen.

How long does it take for your body to recover from smoking? The above timeline gives just a few examples and includes the average time it takes for the health benefits to be seen.

Face Lifts, Breast Reductions and Tummy Tucks

Face Lifts, Breast Reductions and Tummy Tucks require the formation of skin flaps. Skin flaps are sections of skin that are moved based solely on the blood supply within the skin. These vessels are extremely sensitive to smoking. When smoking, the blood vessels in the skin contract, reducing the blood flow, and the ability of the incision to heal. For these procedures, the risk of wound healing problems is not doubled like in general surgery procedure. It is increased by factor of six. Wound healing problems and skin loss are six times more likely for smokers than for non-smokers.

Is Marijuana Safer Than Tobacco?

The banner on the left was meant to convince voters that marijuana should be legalized. The banner on the right is a joke. Any questions?

The banner on the left was meant to convince voters that marijuana should be legalized. The banner on the right is a joke. Any questions?

No. In many ways, smoking a weed is smoking a weed. Both lead to increased coughing, and for most facial plastic surgery and body work, this causes real problems like bleeding and torn sutures. It is believed that the high from marijuana is directly related to the damage done to the alveoli. Just like smoking, this leads to an increased heart rate to compensate for the decreased oxygen delivery and lower than normal oxygen concentrations in the blood. Since normal oxygen delivery is better for wound healing, smoking makes healing worse. Marijuana may decrease nausea, and so does tobacco, but there are better and safer meds for the nausea associated with anesthesia. Marijuana also has psychological effects not present with tobacco, which can further interfere with the medications given around the time of surgery.

Is Vaping Safer Than Tobacco?

An actual Lucky Strike advertisement, trying to make is seem like doctors recommend them. Granted, less information about the long term effects of smoking was known then. The message of the ad is that their cigarettes are less irritating than other cigarettes; however, they still make you cough, and coughing leads to additional surgical complications. Less terrible seems to be a redundant theme in smoking advertising, begging the question that it is still terrible.

An actual Lucky Strike advertisement, trying to make is seem like doctors recommend them. Granted, less information about the long term effects of smoking was known then. The message of the ad is that their cigarettes are less irritating than other cigarettes; however, they still make you cough, and coughing leads to additional surgical complications. Less terrible seems to be a redundant theme in smoking advertising, begging the question that it is still terrible.

The long-term effects of inhaling nicotine vapor are unclear. It may be less likely to cause cancer and heart disease, but research is still early. Early in smoking’s history, it was touted as the new health craze. It is good to know the history, so that we don’t repeat it.

While there seem to be fewer noxious chemicals with e-cigarettes, questions remain about exactly what all the substances in e-cigarettes are, and what they do. The American Society of Plastic Surgery has recommended to all its members that e-cigarettes be treated the same as cigarettes until they have been proven safe. Definitive research on the effects of vaporized nicotine on the survival of skin and soft tissue flaps is not currently available. Nicotine is vasoactive, and inhaling nicotine vapor may have similar effects on skin circulation as inhaling the nicotine in cigarettes. When it comes to your appearance and your health, why take unnecessary risks?

What Do Most Plastic Surgeons Recommend?

It may seem like I am being hard on smokers, but these are not theoretical risks. I have seen Tummy Tucks go from perfect to purple after half a cigarette. I have replanted fingers successfully, only to have a patient go home, weeks later, smoke and have his finger turn black and fall off. Smoking caused the blood vessels in the skin to contract to the point of not working. These are preventable injuries, and there is no better medicine than prevention.

Most plastic surgeons recommend stopping smoking four weeks before and after any procedure that involves skin flaps. The most common cosmetic skin flap procedures are Face Lifts, Breast Reductions and Tummy Tucks. The risks of wound healing problems is six times higher in smokers when compared to non-smokers having these types of procedures.

When the incision used is only an access point, i.e. no skin flaps, like Breast Augmentation, your risks are only doubled from smoking. Only doubled. Think about that.

While most plastic surgeons will operate on smokers for non-skin-flap type cosmetic procedures, it is still better to stop at least four weeks before surgery. And if you can stop for four weeks, there is no reason to restart. Only 15% of Californians currently smoke cigarettes. This is an all-time low, but with the recent passage of Proposition 64, we will have to see if the decline in smoking will continue.

Read More

Mommy Makeover SF Bay Area

Posted December 26, 2016 in Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction, Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Tummy Tuck (Abdominoplasty), Videos

Every Mommy Makeover includes enhancement of both the belly and the breasts. The most common combination is Breast Augmentation with a Tummy Tuck (Abdominoplasty). However, other options include:

  • Breast Enhancement
    • Breast Lifts
    • Breast Implants with Breast Lift
    • Breast Reduction
  • Belly Enhancement
    • Liposuction
    • Mini Tummy Tucks
  • Other Body Enhancements
    • Brazilian Butt Lift
    • Lower Body Lift
    • Facial Enhancement

The combination best for you depends on what you need, tempered by safety and predictability.

Mommy Makeover Video Presentation

The television segment included below is all about Mommy Makeovers and includes many of the most popular variations. The Mommy Makeover Video includes Mommy Makeover Before and After Pictures that illustrate what the procedure has to offer.

The following video segment is from my latest appearance on the San Francisco Bay Area’s New Station, KRON 4. The show gives me the opportunity to talk about the latest Cosmetic Plastic Surgery News.

Mommy Makeover Video

Make Your Mommy Makeover Consultation Appointment

When considering a Mommy Makeover, be certain to find a Board Certified Plastic Surgeon in your area who has years of experience with the techniques currently available. If you are in the San Francisco Bay Area and would like to schedule a personalized appointment in my Walnut Creek Plastic Surgery clinic, give me a call today at (925) 943-6353.

Read More

What To Do Before Cosmetic Plastic Surgery

Posted November 13, 2016 in Home, Patient Safety, Smoking and Plastic Surgery

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

timing

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.

Plan Ahead

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

dieting

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.

Stop Smoking

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.

no_smoking

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

potatoes

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.

Read More

Breast Implant Removal – SF Bay Area

Posted October 15, 2016 in Breast Implant Removal, Breast Implant Revision Surgery, Home

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 will elect to have them removed at some point in their life.

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.

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.

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.

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.

Read More

Gynecomastia Reduction SF Bay Area (Man Boobs)

Posted September 17, 2016 in Breast Reduction, Breast Reduction (Men), Home, Videos

Gynecomastia Reduction, or Male Breast Reduction, is one of the most common cosmetic plastic surgery procedures.

When Do Man Boobs Happen?

Man Boobs can affect men at every stage of life. All men are all born with them, due to the effects or maternal estrogen on the male breasts. This usually resolves in a few months, but can persist. The most common timing of Gynecomastia is during adolescence. With puberty comes hormone surges that can lead to Male Breast Development. The problem impacts about two-thirds of young men. For half these men, the swelling resolves over a year or two. For about one third of men, the breast tissue persists, and can become tender, annoying and embarrassing. Some men will not develop Moobs (Man Boobs) until later in life, and often as a side-effect of medications.

Gynecomastia Treatment

There are several ways to treat Gynecomastia, because it can present in different forms. The Gynecomastia Reduction Video below provides several examples of Gynecomastia Before and After Pictures and a narrative for perspective. This KRON 4 television segment is from Body Beautiful and supplements the information that can be found here on the San Francisco Plastic Surgery Blog and my other web sites. While I hope you find the information useful, it cannot substitute for an in-person consultation with a qualified and experienced Board Certified Plastic Surgeon.

Gynecomastia Reduction Video (Male Breast Reduction)

Male Breast Reduction Consultations

Gynecomastia affects most men at some point in their lifetime. For young teens, it is good to get checked, but waiting is usually recommended unless the problem is extreme or persists. If you have persistent male breast enlargement, and would like to schedule a private appointment, call (925) 943-6353 today, for a personalized consultation in our San Francisco Bay Area Plastic Surgery Clinic.

Read More