SanFranciscoBreast.com has been completely updated. This update includes new content, and it is artfully illustrated with new breast enhancement videos and more before and after pictures. In addition, the fresh content is wrapped in a new skin, improving navigation for the small screen and the desktop alike.
New Breast Augmentation Information
The site includes new pages featuring the most requested Breast Enhancement Procedures. For example, the Breast Augmentation Information has been exploded into a dozen detailed pages including:
The Breast Lift section includes details about five main options for Mastopexy. There are also pages dedicated to the combination of Breast Lift using Breast Implants and Areola Reduction.
Breast Reduction for Women and Men
Options for Breast Reduction for Women are also reviewed, as several techniques have evolved during the 20+ years I have been in practice. Breast Reduction for Men, also known as Gynecomastia Reduction, is covered with attention paid to the causes and the most current treatments available.
Specialty Breast Procedures
A section on the often overlooked details of Breast Enhancement is also included. San Francisco Breast’s Specialty Breast Pages include:
Inverted Nipple Correction
Other Congenital Breast Abnormalities
A Plastic Surgery Web Site Dedicated to Breast Enhancement
I have tried to create an all inclusive Breast Enhancement site designed to provide detailed information about the many Plastic Surgery options available for Breast Enhancement, whether that be Breast Enlargement, Breast Reduction or Breast Reshaping.
While the San Francisco Breast web site in meant to provide information, it is just a starting point. The Internet cannot take the place of a thoughtful, in-person consultation with a qualified Board Certified Plastic Surgeon. If you would like to schedule a private, personalized consultation appointment call (925) 943-6353 today. My San Francisco Bay Area Plastic Surgery clinic specializes in helping you obtain the best possible results.
The Mommy Makeover combines the most common body shaping procedures, breast augmentation and tummy tuck, into one, maximum result, breast and belly shaper.
The Mommy Makeover is one of my favorite combos. The ability to reshape the damage done to a woman’s body after childbirth or weight loss, in a single operation, makes it one of the most satisfying Cosmetic Plastic Surgery procedures.
What Is A Mommy Makeover?
The Mommy Makeover is not a specific procedure, but rather the combination of breast and belly enhancement performed in a single operation. Breast Enhancement may include Breast Augmentation, Breast Lift, Breast Augmentation with a Lift or Breast Reduction. It all depends on what needs fixing. Belly Enhancement is usually a Tummy Tuck; however, for the patient who needs less, Mini Tummy Tucks or Liposuction may be the procedure of choice.
Mommy Makeover Video Presentation
Recently, I had the opportunity to discuss Mommy Makeovers with the San Francisco Bay Area television audience. Body Beautiful airs on KRON 4, the San Francisco Bay Area’s News Station. The Mommy Makeover features the best and the latest in Cosmetic Plastic Surgery. This week, the spotlight is on Mommy Makeovers.
Mommy Makeover Video
More About Mommy Makeovers
The Mommy Makeover Video segment featured above reviews many of the available options and outcomes of the procedure for several of my patients. Additional Mommy Makeover Videos are available here, on the San Francisco Plastic Surgery Blog, and on my main site’s Mommy Makeover Video Page.
Mommy Makeover Consultations
When you are considering a Mommy Makeover, be certain to consult with a Board Certified Plastic Surgeon. Call (925) 943-6353 today, to schedule a private, personalized Mommy Makeover consultation in our San Francisco Bay Area Plastic Surgery Clinic.
The Mommy Makeover is the most popular, and one of the most satisfying, combination cosmetic plastic surgery procedures. With the ability to reshape the breast and flatten the belly, the Mommy Makeover is the procedure of choice to rejuvenate the female form after pregnancy or weight loss.
This Wednesday, June 7, 2017, I will be on the San Francisco Bay Area’s News Station, KRON 4’s Body Beautiful. The show airs live at noon. As usual, the discussion is focussed on the latest Cosmetic Plastic Surgery News for the San Francisco Bay Area.
Body Beautiful Plastic Surgery Topics
This week’s half-hour television show discusses Cosmetic Plastic Surgery of the Body. Planned topics include:
The Mommy Makeover Before and After Pictures that leads this post demonstrate the most popular combination cosmetic plastic surgery. By combining Breast Augmentation and Tummy Tucks, the two areas the often sag after pregnancy, the breasts and the belly, are both addressed. Of course, the procedures can be performed without having had children. The term Mommy Makeover was coined because of the frequent request from mommies to repair the damages of pregnancy on their breast and bellies. Another common situation in which Mommy Makeovers are performed is significant weight loss.
EDIT – The first Plastic Surgery Video segment on Mommy Makeovers is up and live right here: Mommy Makeover Video.
Breast Augmentation Mastopexy (Breast Implants with Breast Lifts)
Breast Augmentation remains the most popular single plastic surgery procedure. Breast implants can provide volume, and as many as 40% of patients also benefit from a breast lift. Breast lifts can improve breast shape in ways the Breast Augmentation alone cannot.
Breast Augmentation is still one of the most frequently performed cosmetic plastic surgery procedures, but what happens if the breasts are saggy, or the nipple is very low on the breasts? Breast Augmentation in these situations may provide larger breasts, but not necessarily perky ones. As many as 40% of Breast Augmentations combine some sort of Breast Lift. The most common reasons for this are low set nipples or saggy breasts due to excess skin.
Additional procedures can also be added to correct other breast problems, Fine details of the breasts that are often targeted for improvement are: Areola Reduction, the improvement of Breast Asymmetry, Breast Implant Revision for women who had Breast Implants before pregnancy and Inverted Nipple Repair. Breast Reduction, perhaps paradoxically, can also be combined with Breast Augmentation Mastopexy when heavy lower breast tissue is distorting the shape of the breasts.
Brazilian Buttocks Lift
The fastest growing procedure is the Brazilian Butt Lift. The procedure takes fat from areas where it is not desired and repurposes it, to enhance the shape of the buttocks.
A newer body procedure is allowing Board Certified Plastic Surgeons to shape an area that traditionally has been difficult. The Brazilian Buttock Lift (BBL), allows us to remove fat with Liposuction and reuse it to enhance the buttock contours. Pioneered by Brazilian Plastic Surgeon, Ivo Pitanguy, the procedure allows for customized augmentation of the buttocks, and shape that is more pleasing to the eye than Buttocks Implants can provide.
Thigh Lifts in the SF Bay Area
The Thigh Lift is used most often after weight loss. Excess skin and fat from the inner thigh is removed to reduce the size of the thighs and tighten the skin.
Thigh Lifts are one of the less frequently performed cosmetic plastic surgery procedures. The numbers have risen in response to Bariatric Surgery and the massive weight loss associated with it. As weight is lost, the thigh skin that is stretched during weight gain becomes loose. As the volume of the thigh decreases, so does the support that the extra fat provides the thigh skin. As a result, the skin can hang like drapery. The Thigh Lift removes this excess skin, and helps to tighten the thigh, especially the upper, inner thigh.
Watch Body Beautiful June 7, 2017, on KRON at Noon Wednesday
If you are interested in learning more about any of the above procedures, I have provided links in this post, and I encourage you to watch me live on KRON 4, this Wednesday at noon. Segments from the show will be posted here, on the San Francisco Plastic Surgery Blog, in the coming days. So if you miss the live show, you can still catch up here or on my local San Francisco Plastic Surgery Web Sites.
Internet education can be very helpful, and it is the goal of the San Francisco Plastic Surgery Blog; however, because information on the Internet is designed to apply to the general population, it is generic in nature. Medical advice cannot be giving without the personal contact that an in-person consultation appointment provides. To get “brand name” plastic surgery information, tailored to your specific needs, call my San Francisco Bay Area Plastic Surgery Clinic today, at (925) 943-6353, and schedule an appointment to get your personal, Board Certified Plastic Surgery information.
The most common Mommy Makeover combination is the one depicted above: Breast Augmentation and a Tummy Tuck. Breast Implants restore the lost breast volume, while the Tummy Tuck flattens and tightens the abdominal wall.
Mommy Makeovers remain one of the most popular body shaping combinations for women. The combination of Breast Enhancement and Belly Embellishment is often performed after childbirth and/or weight loss, with the goal of reestablishing more shapely and youthful proportions. While Breast Augmentation with a Tummy Tuck is the most common combination, it is important to pick the procedures most appropriate to your needs. Below, I discuss the options for rejuvenation of the breasts and the belly.
Breasts often change with pregnancy and breast feeding. Variations are common, but typically breasts increase with pregnancy and then end up smaller after lactation ceases. The problems come when the postpartum breasts are too small, too saggy or remain too large (less common but, can be just as annoying).
Breast atrophy after pregnancy is very common. Breast Implants can restore lost volume and restore the proportions that enhance the breasts’ shape both in and out of clothing.
It is best to wait at least three months after lactation ceases before having any breast procedure. This allows the breasts to settle down to a consistent shape, providing more predictable and safer surgery. Depending on your experience and goals, options for Breast Enhancement include:
Bellies, too, get stretched out during pregnancy. Subsequent pregnancies tend to increase injury, especially if close together. Working out and abdominal exercises help, especially if you are in good shape before pregnancy and maintain a healthy weight during pregnancy. Even under the best circumstances, a big healthy baby can trump a flat healthy belly. The options for tummy rejuvenation include:
After pregnancy or weight loss, the abdominal muscles, skin and fat can all be compromised. Fortunately, a Tummy Tuck repairs all three areas. An experienced Board Certified Plastic Surgeon is the best choice for your Mommy Makeover.
Liposuction can also be used in combination with either of the Tummy Tucks, and the fat removed with Liposuction can be repurposed to enhance other curves, like the buttocks when combined with a Brazilian Butt Lift. If you are wondering which procedure is best for you, an in-person consultation is the best way to find out. I have a page on my main website that explains some of the decision points when trying to decide: Liposuction or Tummy Tuck?
Mommy Makeover Consultations
To explore all your body rebuilding options, call (925) 943-6353, and schedule a personal consultation appointment in our San Francisco Bay Area plastic surgery clinic. A Board Certified Plastic Surgeon is your best guide for explaining what Cosmetic Plastic Surgery can offer. Since we offer a wide variety of procedures, we can offer you the best choices for your Mommy Makeover.
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.
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.
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.
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.
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:
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 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:
Botulinum Toxin Type A (Botox®, Dysport®, Xeomin®)
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.
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.
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.
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.
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.
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 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.
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.
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.
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.
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.
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?
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.
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.