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.
Botox and Fillers are by far the most common cosmetic plastic surgery procedures in the United States, but operative plastic surgery procedures are also on the rise.
There is always a lot of buzz around Non-Surgical Plastic Surgery. The appeal of plastic surgery results, without surgery, is undeniable. If we could truly reshape our bodies with a cream, a pill or a shot, it would seem … too good to be true.
Non-Surgical Cosmetic Procedures
The number of non-surgical cosmetic procedures performed each year out number surgical procedures by more than an order of magnitude. The two most common, Botulinum Injections (Botox and Dysport) and Dermal Fillers (Restylane and Juvederm), work very well to correct smaller cosmetic problems, and they can also provide improvement in the appearance of deeper wrinkles.
It’s Not Surgery
The appeal of these minimally invasive procedures stems from the fact that it is not surgery. The procedures are performed in-office, require minimal equipment and are easier to schedule. Per treatment, there is Less Downtime and a Shorter Recovery Period. These types of procedures appeal to our need for instant gratification.
And It’s Not Surgery
On the other hand, Non-Surgical Procedures require a lot more maintenance. Without surgery, the results will be less dramatic and the longevity of the results is reduced. The half-life of non-surgical interventions is months, so multiple treatments are needed each year. It adds up to additional expense and recovery with each treatment.
The Biggest Problem with Non-Surgical Treatments
Some cosmetic problems respond very well to non-surgical options. In fact, for non-surgical problems, non-surgical techniques work better. A good example is the Minimally Invasion Treatment of fine lines and wrinkles. Botox, fillers, chemical peels, lasers and dermabrasion all may work better than surgery for carefully selected individuals. On the other hand, if you are receiving fillers or botox from someone who only does these minimally invasion procedures, you may never learn what your longer lasting options are.
When Minimally Invasive Means Minimal Results
Non-surgical procedures are complimentary to what I do as a Board Certified Plastic Surgeon; however, when it comes to truly surgical problems, botox and fillers cannot equal surgical results. If your problem is loose skin, or you are interested in more significant augmentation, there is no replacement for surgery. After all, non-surgical surgery is by definition an oxymoron.
When To Get A Plastic Surgery Consultation
If you are interested in maintaining your youthful appearance, or correcting the outward signs of aging, it is never to early to consult an experienced, board certified plastic surgeon. Plastic Surgeons offer a wide range of treatments. From minimally invasive procedures like Botox and Fillers, to Facial Plastic Surgery like Eyelid Lifts and Face Lifts, a qualified board certified plastic surgeon can be your guide and confidant. If you are interested in learning what all your options are, call our San Francisco Bay Area plastic surgery clinic today at (925) 943-6353.
The Cal Aggie Band-uh leads off the 103rd annual Picnic Day Parade.
Picnic Day. If you attended the University of California in Davis, you know what I am talking about. Picnic Day is a 103-year-old campus tradition and the highlight of the University’s April social calendar.
UC Davis Campus-Wide Open House
If you have not been to a Picnic Day, it is a campus-wide open house. Every college, every discipline every major has something to share, and there are a lot of them.
UC Davis is the largest campus in the University of California system. It covers the most area both in acreage and in education. The campus supports over one-hundred majors in the four undergraduate colleges: Agricultural and Environmental Sciences, Biological Sciences, Letters and Science and my alma mater, the College of Engineering.
UC Davis is also home to almost 100 Graduate Studies programs, and six professional schools: The Betty Irene Moore School of Nursing, The Graduate School of Management, the School of Education, The School of Law, The worlds best School of Veterinary Medicine and my other alma mater, the UC Davis School of Medicine.
Tradition and Innovation
This year’s Picnic Day theme was “Growing Together.” Not only did the University celebrate their 103rd anniversary, but the city of Davis also celebrated their centennial. Davis is a true college town, and both have grown together.
The Davis Town Council riding in a vintage firetruck.
The theme also included the growth from old to new. Old firetrucks were followed by new police vehicles.
The Latest in UC Davis Police vehicles
Picnic Day 2017
The first Picnic Days I attended were years before enrolling. My best friend had family who lived next to the campus. We would bring our bikes and ride every mile on the bike paths, and off. As a student, Picnic Day was not to be missed. Friends and family would visit and celebrate the day. It was an easy way for me to share my college and for my friends to see what the UCD campus was about. As an alumnus, Picnic Day is a way to keep in touch with my younger self.
The tradition of learning, innovation and success continues… Here are some of the banners that hang over the Aggie basketball court from back in my era. Go Aggies!
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
Since the last BIA-ALCL update, all the plastic surgery societies and breast implant manufacturers have responded with information sheets. I am encouraged by the free flow of information within the Plastic Surgery profession and the industry that supports us.
ASAPS by the Numbers
The ASAPS has distributed a quick summary of the numbers related to BIA-ALCL. Here are a few.
How Many BIA-ALCL Cases Have Been reported?
Of the estimated 7 million women with breast implant throughout the world, 359 reports have been filed. Since the reports can be filed by patients, physicians or manufacturers, it’s important to note the MDRs (Medical Device Reports) are not individual cases, and multiple reports may be filed for a single case of BIA-ALCL. In contrast, there are currently 139 case reports of BIA-ALCL in the literature. It is also important to realize that this is a very small number in relation to the millions of breast implant patients. Lastly, the number is expected to rise because we are learning how better to identify and diagnose patients with the disease.
Smooth vs. Textured
Of the reported cases, over 90% occurred in patients who had textured implants at the time of their diagnosis. In the US database, there is a single case of a patient with smooth breast implants developing BI-ALCL; however, they had a textured tissue expander prior to the smooth breast implant placement. Unfortunately, the other 27 cases of BIA-ALCL reported in the world databases do not include past breast implant information, so while we can say that BI-ALCL is predominantly a problem with textured breast implants, it is unknown if a case has developed in a person who had exclusively smooth breast implants. Currently, 12.7% of US patients receive textured implants. This includes both textured round and all anatomically “shaped” breast implants, and includes both saline filled and silicone filled breast implants.
How Many BIA-ALCL Deaths Have Been Reported?
Of the 359 cases reported, 9 patients have died. Two patients died from stem cell transplants, one died from development of a second unrelated lymphoma, and 6 patients died from direct extension of the tumor. Early detection is key. Of the deaths, none of them received complete surgical excision at any point in their clinical history, none received targeted therapy, and most were significantly delayed in diagnosis or receiving any treatment (1-2 years from onset of symptoms). On the other hand, 93% of all patients are disease free at 3 years follow up. BIA-ALCL has an excellent prognosis when diagnosed early.
How Do We Diagnose BIA-ALCL?
Early diagnosis is key to successful treatment, so how do we accomplish this? Unilateral (one-sided) swelling or mass should lead to a thorough evaluation. This is common in the months following your breast augmentation. The possibility of BIA-ALCL should be considered in a patient with late onset, peri-implant seroma (fluid collection). The majority of patients present on average 8 years after implantation, but range extends from 2 to 28 years.
Ultrasound imaging followed by fine needle aspiration of seroma fluid should be obtained. Collected fresh seroma fluid should be sent to a qualified lab for immunohistochemistry testing for cluster of differentiation (CD30) testing. Anaplastic Lymphocyte Kinase (ALK) testing of the seroma fluid can help differentiate BIA-ALCL from systemic forms of lymphoma that may appear in the breast.
Current BIA-ALCL Treatment
Most patients with BIA-ALCL are cured by removal of the implant and capsule surrounding the implant, however a small number act more aggressively and may require additional treatments. For 2017, the National Comprehensive Cancer Network defines optimal treatment which is total capsulectomy and implant removal for the majority of patients with disease confined to the capsule (35% of patients) or a resectable mass (40% of patients). Advanced disease with lymph node metastasis (14% of patients) or organ metastasis (1% of patients) may require further treatment with chemotherapy using either CHOP anthracycline based-protocol or targeted therapy with brentuximab vedotin. Radiation therapy is only reserved for locally unresectable disease.
BI-ALCL is not breast cancer. Here are some additional numbers, and some links, to keep the worry about BIA-ALCL in perspective:
The average woman’s risk of developing breast cancer is 12.5%.
The risk of developing recurrent breast cancer after mastectomy is 5-8%.
The risk of capsular contracture through 10 years is 14%.
The risk of breast implant rupture through ten years is 10%.
Chin Augmentation is the most popular Facial Plastic Surgery using an implant. Temporary Chin Enlargement can be performed with several fillers, such as Radiesse, Restylane Lyft (formerly Perlane) or Juvedem; however, long lasting results are only possible with Chin Implants.
Chin Implants provide projection of the chin on profile. In the above Chin Augmentation before and after pictures, the Chin Implant is located on the anterior surface of the lower jaw bone, the mandible, enhancing the chin and pushing the soft tissues under the skin forward.
Chin Augmentation Video (Chin Implants)
The Chin Augmentation Video below is a recent segment from Body Beautiful, which originally aired on the San Francisco Bay Area’s News Station, KRON 4. Host Janelle Marie and I discuss Chin Implants and other complementary procedures such as: Liposuction and Neck Lifts. Surgical options and the recovery period are also covered. Chin Augmentation Before and After Photos are used to illustrate the mechanics of the procedure and to demonstrate what the procedure can do.
Chin Implant Options
The most popular chin implants are made of silicone. Silicone Chin Implants are solid, firm, rubbery prostheses, which come in a variety of sizes. Variations in height, width, projection and style can be used to select the Chin Implant best suited for your chin and your goals. Since these implants are soft enough to fold, they can be inserted through a smaller incision. However, they are more likely to move or buckle over time.
Another type of Chin Implant is the Medpore Chin Implant. Medpore is a hard, porous substance that is more like bone than silicone. Medpore implants can provide larger and more stable augmentation. The soft tissue of the chin grows into it, securing the chin implant in place, so this implant is less likely to move or buckle. They are also much harder to remove and replace too. Since Medpore is not flexible, they require a slightly larger incision for placement. These implants also take a little longer to settle down to their final, post-operative size.
Chin Implant Proportions
There are certain proportions that we Plastic Surgeons try to obtain with the Chin Implant. Whether chin implant or breast implants, size, shape and location matter. For women, the ideal chin projection is just shy of the lower lip projection. For men, the goal is often at, or a little past, the projection of the lower lip. Of course, this can be adjusted, depending on your goals.
Comparing the Chin Augmentation before and after pictures of this man and the woman above, you can see that the ideal chin projection for men is larger with respect to the lower lip. Facial proportions do vary; however, men tend to have larger bony features than women. This is especially true of the chin and the nose.
Chin Augmentation Computer Imaging can be a useful adjunct to the discussion, and can make the abstract more concrete. While computer simulation is not a guarantee of results, it is very helpful in gauging how much Chin Enlargement is enough. A patient who has had the benefit of preoperative Chin Implant Simulation is rarely surprised by the outcome.
Chin Augmentation Consultations
As you can see from this brief overview, there are several options for Chin Enhancement. If you would like to learn more about Chin Implants, and how they can be used to enhance your face, call (925) 943-6353, today. A private consultation appointment will be scheduled, and we can go over the options that make the most sense for your chin.
Excess arm skin can be uncomfortable both physically and emotionally. The Arm Lift, or Brachioplasty, removes excess skin from the upper arm. This Arm Lift Video Presentation reviews many of the frequently asked questions and illustrates the possible results with expertly narrated Brachioplasty Before and After Pictures . All Arm Lift Before and After photos are actual patients of Dr. Joseph Mele, San Francisco Bay Area Board Certified Plastic Surgeon in Walnut Creek, California.
The above Arm Lift Before and After Photos demonstrate what a Brachioplasty can do. Excess skin is removed, leaving the arm tight, firm and with a more muscular contour.
Arm Lift Video (Brachioplasty)
The Arm Lift Video below is a recent segment from the San Francisco Bay Area’s News Station, KRON 4’s, Body Beautiful. Host Janelle Marie and I discuss the Brachioplasty procedure, including the available options and the recovery period. Arm Lift Before and After Photos are used to show what the procedure can do on real patients.
The usual Arm Lifts incision runs along the inner arm, from the elbow to the armpit (axilla). The placement options are reviewed in the Brachioplasty Video above. If you have a small amount of skin laxity, which is located close to the axilla, a Mini Brachioplasty, with the scar located in the axilla, may be possible. If your arm skin is already firm, and the problem is disproportionate fat, Liposuction alone may be your best option.
The above Arm Lift before and after pictures demonstrate how careful scar placement enhances the results. In this case, the excess skin was removed using an incision that runs from the inside of the elbow to the back of the armpit. Even with the elbow rotated backward, the scar is still hidden along the lower border of the arm.
Arm Lift Consultations (Brachioplasty)
There are several options for Arm Rejuvenation. To find out what your Arm Lifting choices are, call (925) 943-6353 and schedule a private, personalized consultation in our Walnut Creek Plastic Surgery office. If loose arm skin is bothering you, learn what treatments are available from an experienced, Board Certified Plastic Surgeon.
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.
Breast Augmentation provides fullness and support. Not only can a Breast Implant enlarge a small breast, but it can restore shape and volume to a breast that has changed due to pregnancy, weight loss or aging.
Breast Augmentation on Body Beautiful
Breast Augmentation was also the first topic discussed on this week’s Body Beautiful. Body Beautiful is a live show, dedicated to the latest in Cosmetic and Plastic Surgery procedures, that airs on the San Francisco Bay Area’s News Station, KRON 4.
Breast implants come in a large variety of sizes and shapes. The best size for you is subjective; however, a Board Certified Plastic Surgeon can supply you with professional guidance in selecting the Breast Implant that will best provide the result you are looking for.
If you are considering Breast Augmentation or have Breast Implants and are looking for Breast Augmentation Revision, give me a call at (925) 943-6353 for a personalized consultation and specific recommendations tailored to your needs.
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.
The San Francisco Plastic Surgery Blog received the Top 100 Plastic Surgery Blogs on the web award from the blog feed consolidator Feedspot. This web site picks top blogs by category year round, and this week they posted the most comprehensive list of best Plastic Surgery blogs from around the world – the Top 100 Plastic Surgery Blogs.
As the creator of the San Francisco Plastic Surgery Blog, I am humbled to be listed among the Top 100 Plastic Surgery Blogs in the world.
The feedspot panelists made their selections based on:
Google reputation and Google search ranking
Influence and popularity on Facebook, twitter and other social media sites
Quality and consistency of posts
Feedspot’s editorial team and expert review
The Best Plastic Surgery Blogs On The Planet
I am honored and humbled to be listed among the largest and most active Plastic Surgery Blogs on the Internet. Honorees include blogs from corporations, news organizations, public discussion boards, national plastic surgery societies, international blogs and a good number of Board Certified Plastics Surgeons covering the United States from coast to coast.
Thank you to Feedspot, and its founder, Anuj Agarwal, for assembling the Top 100 Plastic Surgery Blog List, but the biggest thank you goes to you, my followers. I hope that I can continue to provide you with posts that are both informative and entertaining – nothing but the latest Plastic Surgery News. Also, thank you to my readers for the feedback regarding the new layout. Hopefully, this will make the San Francisco Plastic Surgery Blog easy to read, no matter what size screen you are using. If you enjoy this blog, tell your friends, and follow me on Facebook and Twitter.