Videos | Tummy Tuck | SF Bay Area | Abdominoplasty

Posted December 31, 2016 in Home, Tummy Tuck (Abdominoplasty), Videos

The Tummy Tuck is the Plastic Surgery workhorse for repairing the abdominal contour after childbirth or weight loss. Abdominoplasty is consistently one of the most frequently performed cosmetic plastic surgery procedures, because it can provide the best, safest and most predictable results possible.

Abdominoplasty on Body Beautiful

I had the opportunity to speak about Tummy Tuck surgery on the San Francisco Bay Area’s News Station, KRON 4’s, Body Beautiful. The following Abdominoplasty Video contains multiple sets of Tummy Tuck Before and After Pictures. Each exemplifies the possibilities available with Abdominoplasty.

Tummy Tuck Video (Abdominoplasty)

Abdominoplasty Consultation Appointments

When considering your Tummy Tuck, be certain to ask how the procedure is performed, what can be improved and what will remain the same. I prefer to keep my Abdominoplasty patients overnight. This allows for a supervised and more comfortable recovery, and assistance with mobility. I find once the initial pain is well controlled, and you are confident in your ability to move about, the recovery goes much smoother.

Be certain to consult 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.

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Body Beautiful TV This Week – SF Bay Area

Posted December 04, 2016 in Breast Augmentation, Breast Lift (Mastopexy), Home, Liposuction, Mommy Makeover, Tummy Tuck (Abdominoplasty)

Dr. Joseph Mele appears on the Bay Area's News Channel, KRON4's Body Beautiful this week.

Dr. Joseph Mele appears on the Bay Area’s News Channel, KRON 4’s Body Beautiful this week discussing Breast Augmentation, Breast Lifts, Tummy Tucks, Liposuction and Mommy Makeovers.

Body Beautiful Live Wednesday at noon on KRON 4

San Francisco Bay Area’s News Station, KRON 4, will be airing the latest installment of Body Beautiful this week. The show will be broadcast live, at noon, this Wednesday (Dec 7, 2016) on channel 4, and will include the latest in Cosmetic Plastic Surgery with the emphasis on Body Sculpting.

Cosmetic Plastic Surgery – Body Sculpting

The topics this week include:

So Many Topics; So Little Time

I try to keep the show fast-paced, accurate and informative, but I did not learn about these topics in a half-hour television show. More information is available online by clicking on the links above, but nothing can substitute for an in-person consultation tailored to your specific needs. If you are serious about learning what Cosmetic Plastic Surgery can offer you call my Walnut Creek Plastic Surgery Clinic at (925) 943-6353.

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Tummy Tuck SF Bay Area Abdominoplasty

Posted October 31, 2016 in Home, Tummy Tuck (Abdominoplasty)

Tummy Tuck Before and After: These side views of Abdominoplasty before and after pictures show what a Tummy Tuck can do to address overstretched abdominal muscles and abdominal skin laxity seen after pregnancy or weight loss.

Tummy Tuck Before and After: These side views of Abdominoplasty before and after pictures show what a Tummy Tuck can do to address overstretched abdominal muscles and abdominal skin laxity seen after pregnancy or weight loss.

The Tummy Tuck remains one of my most frequently performed cosmetic plastic surgery procedures, and one of my favorites. Plastic Surgeons have to be a bit obsessive to get the very best results. The Tummy Tuck, or Abdominoplasty, gives us the ability to not only remove fat, like Liposuction, and remove extra skin like a panniculectomy, but also allows a Plastic Surgeon to tighten the abdominal wall muscles. Tightening the abdominal muscles is the only way to tighten the foundation of the abdominal wall and obtain the flattest possible results.

Muscle Tightening – The Foundation of the Tummy Tuck

The Tummy Tuck Before and After Pictures above show what can be accomplished. The bulge that starts well above her belly button is from laxity of the muscles that make up the abdominal wall. This is often seen after pregnancy, and no matter how many sit-ups are performed, if the muscle fascia is over-stretched, the muscles will not tighten properly.

During your Abdominoplasty, the tough case the covers the front of abdominal muscles (the fascia) is tightened. Sutures are placed that act like an internal corset and flatten the belly. It is effective as long as the fascia is normal and the belly is not full of fat. Tummy Tucks are best performed when we are near our ideal body weight and are not planning to have more children.

Abdominoplasty Before and After Pictures

Abdominoplasty Before and After Pictures: The front view of the above Abdominoplasty shows how much the abdominal muscles and skin are tightened. The shadows of the muscles are brought closer to the midline and skin is much smoother. The belly button is also rejuvenated.

Abdominoplasty Before and After Pictures: The front view of the above Abdominoplasty shows how much the abdominal muscles and skin are tightened. The shadows of the muscles are brought closer to the midline and skin is much smoother. The belly button is also rejuvenated.

Skin Tightening – The Icing of the Tummy Tuck

Sometimes the abdominal muscles are in good shape, but there is too much skin covering them. Abdominoplasties directly remove extra skin right off the front of the belly, and the skin removal is sometimes continued around the sides for an extended Tummy Tuck, if the skin excess continues around to the sides. An Abdominoplasty will not tighten the skin of the back. This is why the Lower Body Lift was invented.

Fat Removal for Disproportionate Fat

Liposuction is frequently combined with the Tummy Tuck to maintain the trunk’s proportions. If the sides or back are full, but the skin is tight, Liposuction can be used to reduce this fullness. More recently, this fat has also been repurposed to enhance the buttocks as part of a Brazilian Butt Lift (BBL). In the BBL, fat is grafted into the buttocks to enhance its shape and restore absent volume. An example is shown below.

Tummy Tuck and Brazilian Butt Lift Before and After Pictures: In this case, Abdominoplasty is combined with Liposuction of the back and flanks. The fat is harvested and grafted into the buttocks to create fuller, curvier buttocks.

Tummy Tuck and Brazilian Butt Lift Before and After Pictures: In this case, Abdominoplasty is combined with Liposuction of the back and flanks. The fat is harvested and grafted into the buttocks to create fuller, curvier buttocks.

Tummy Tuck Consultations

If you are considering a Tummy Tuck, give my San Francisco Bay Area Plastic Surgery office a call today at (925) 943-6353. My friendly staff can help arrange a convenient appointment time, so that we can discuss the details of your procedure, and choose the type of Abdominoplasty that is best suited to your needs.

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Mini Tummy Tucks (Mini Abdominoplasty) SF Bay Area

Posted July 02, 2016 in Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty), Videos

When is a Mini Tummy Tuck enough? It’s a question I answer every day. Cosmetic Plastic Surgery options for Abdominal Rejuvenation range from Liposuction to Tummy Tuck, with the Mini Tummy Tuck covering some of the middle ground. Unlike Liposuction alone, the Mini Abdominoplasty can tighten the skin and muscle wall of the lower abdomen. But a Mini Tummy Tuck doesn’t do everything a Tummy Tuck can, and it’s important to know the benefits, as well as the limitations, before proceeding.

Mini Tummy Tuck Video (Mini Abdominoplasty)

The Mini Abdominoplasty is discussed below. This video segment is taken from a recent Body Beautiful episode, which originally aired on the San Francisco Bay Area’s News Station, KRON 4. The following Mini Tummy Tuck Video answers many of the frequently asked questions about Mini Abdominoplasty and reviews the results that can be achieved. Indications for a Mini Tummy Tuck vs. Full Tummy Tuck or Liposuction are reviewed. The information provided is accurate, but cannot be considered medical advice. An in-person consultation with a Board Certified Plastic Surgeon is always recommended prior to choosing a treatment plan.

YouTube videos sometimes get stuck in Apple’s latest Safari Browser (9.1.1). This video may hang at 1:04. Click on the red time bar to fast forward to 1:05 and it should play to the end. Alternatively, you could use another browser.

Mini Abdominoplasty Before and After Pictures

Mini Tummy Tuck Before and After Pictures are included in the video above. The indications and results are illustrated and explained. Additional before and after photos are also available on my main website. For more information about determining what Liposuction, Mini Tummy Tucks and Tummy Tucks can do, see my Liposuction or Tummy Tuck Article.

What Is A Foopa?

Foopa comes from the acronym F.U.P.A., which is short for Fat Upper Pubic Area. Originally, this was meant to identify a disproportionate collection of fat above the privates and below the belt line; however, its meaning has expanded to include all lower belly fat, especially the fat that sticks out above a C-section scar. Foopas cause the fullness seen in “Mom Jeans.” Larger foopas can simulate the appearance of early pregnancy.

Can A Mini Abdominoplasty Fix A Foopa?

Small foopas, both above and below the belt-line, can often be fixed with a Mini Abdominoplasty. Larger foopas are associated with larger amounts of abdominal laxity, and often require a Full Tummy Tuck for the best results.

Mini Tummy Tuck Quick Check

Here is an easy way to check if a Mini Tummy Tuck is enough. Cover the area below the belly button and look at the belly. If the area above the belly button looks good, a Mini Tummy Tuck will often be enough to obtain a good result. If there is loose skin above the belly button, or if the abdomen bulges above the belly button, a Full Tummy Tuck will give a superior result. If the area below the belly button is full, but the skin is tight, Liposuction may be the easiest fix.

Liposuction, Mini Tummy Tuck or Tummy Tuck?

The decision between Liposuction, Mini Tummy Tuck or Tummy Tuck is not always easy. When in doubt, consult a professional. A Board Certified Plastic Surgeon can sort it out and review your options in less time than it takes to read this article. If you would like to schedule a private, in-person Mini Tummy Tuck consultation call (925) 943-6353 today. A personalized approach is taken with each patient.

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Mommy Makeovers SF Bay Area

Posted May 07, 2016 in Breast Augmentation, Breast Lift (Mastopexy), Breast Reconstruction, Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty)

Mommy Makeovers are a combination of cosmetic plastic surgery procedures that enhance, or repair, the breasts and belly. Since both areas take a hit with pregnancy, it is most commonly performed for mommies, but Mommy Makeover procedures are also performed after weight loss. Post Bariatric Surgery patients often have loose skin on their breasts, bellies and other areas, so Mommy Makeovers are performed after weight loss also.

The Mommy Makeover helps by enhancing both the breasts and the belly in a single combination plastic surgery procedure. Above, a Breast Augmentation Lift (Augmentation Mastopexy) is combined with a Tummy Tuck for the optimal result.

The Mommy Makeover helps by enhancing both the breasts and the belly in a single combination plastic surgery procedure. Above, a Breast Augmentation Lift (Augmentation Mastopexy) is combined with a Tummy Tuck for the optimal result.

The Mommy Makeover is a not a specific operation, but rather a combination of breast and belly enhancement procedures. Each area is evaluated separately and we choose one from column A (breast enhancement) and one from column B (belly enhancement) and the combo plate is termed a Mommy Makeover. The ability to mix and match is what makes the procedure so powerful. The best procedures for each area are combined.

Mommy Makeover – Breast Enhancement

Breast Enhancement is half of the Mommy Makeover. In this case, a Breast Augmentation Mastopexy  is performed. A Breast Implant is used to increase the breast volume, while a Breast Lift is used to raise the nipple and reshape the breast. A larger implant without a lift would not make a pretty breast. A larger implant would make larger breasts,  too large for this patient's desires. Additionally, the larger implant would push the nipple lower on the breast.

Breast Enhancement is half of the Mommy Makeover. In this case, a Breast Augmentation Mastopexy is performed. A Breast Implant is used to increase the breast volume, while a Breast Lift is used to raise the nipple and reshape the breast. A larger implant without a lift would not make a pretty breast. A larger implant would make larger breasts, too large for this patient’s desires. Additionally, the larger implant would push the nipple lower on the breast.

Breast Enhancement includes many options. The most common are Breast Augmentation and Breast Lifts, though for those women whose breasts do not shrink after pregnancy, Breast Reduction is also a possibility. Below is a list of Breast Enhancement procedures with links to additional information:

Mommy Makeover – Belly Enhancement

The gold standard of Belly Enhancement is the Tummy Tuck. It reduces loose abdominal skin, removes excess belly fat and tightens muscle laxity including rectus diastasis (muscle separation).

The gold standard of Belly Enhancement is the Tummy Tuck. It reduces loose abdominal skin, removes excess belly fat and tightens muscle laxity including rectus diastasis (muscle separation).

Belly Enhancement also includes several options. The classic Mommy Makeover is a Breast Augmentation combined with a Tummy Tuck. The Tummy Tuck (Abdominoplasty) is the work horse. Abdominoplasty can correct loose skin, lax muscle fascia and remove excess fat. It is the only procedure that addresses all three areas over the entire belly. Sometimes, a Tummy Tuck is more than is needed so “smaller” procedures, like Mini Tummy Tucks or Even Liposuction can be substituted for selected patients. Links to more information about the Tummy Tightening Procedures are provided below:

Liposuction can also be added to help with other problem areas like the love handles, muffin top, thighs, arms or chin, too.

Mommy Makeover – Putting It All Together

Choice is good, but sometimes too many choices leads to confusion. The beauty is that you don’t have to decide on your own. An Experienced Board Certified Plastic Surgeon is skilled in all your options, and can explain which procedure best accomplishes your goal. This can help you choose the best procedures, and help you know before committing, if a Mommy Makeover is right for you.

Mommy Makeover Consultations

If you are considering a combination of Cosmetic Plastic Surgery like a Mommy Makeover, call (925) 943-6353 today, and schedule a personalized and private consultation. The best breast and belly procedures will be discussed, and a specific plan created just for your body.

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Breast Augmentation SF Bay Area with Breast Implants

Posted April 09, 2016 in Breast Augmentation, Breast Implant Revision Surgery, Capsular Contracture, Home, Videos

Breast Augmentation remains one of the most popular cosmetic plastic surgeries year after year. The 2015 Plastic Surgery Statistics show Breast Augmentation was a close second to Liposuction, with 305,856 breast enlargements performed.

Breast Implants

Breast Implants are used both to provide a larger bust and to augment the natural contours of the breast. The primary goal is to improve body proportions and the fit of clothing and bathing suits. Breast Implants can help when the breasts have always been small; however, the loss of breast volume after childbirth is another common reason for Breast Augmentation.

Breast Augmentation On Television

Below is a Breast Augmentation Video. It contains Before and After Pictures of Breast Augmentation with narration. Breast Implants and Breast Enhancement, including primary Breast Augmentation, Breast Augmentation Revision and the treatment of Capsular Contracture are illustrated and discussed on KRON 4, the San Francisco Bay Area’s New Station. The show is Body Beautiful, and many video segments are available here on the San Francisco Plastic Surgery Blog and Dr. Mele’s YouTube Channel. Just click on Videos under categories in the margin or the YouTube logo.

Breast Augmentation Video (Breast Implants)

Breast Augmentation Consultations

Breast Augmentation is a very personal decision. If you have always had small breasts, or your breasts have shrunk due to pregnancy, weight loss or even age, Breast Implants may be an option. To learn more, schedule a private consultation appointment with a Board Certified Plastic Surgeon in your area. If you are near the San Francisco Bay Area, give me a call at (925) 943-6353 to get all your questions answered.

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2015 Plastic Surgery Statistics

Posted March 20, 2016 in Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction (Men), Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Home, Liposuction, Plastic Surgery Societies, Rhinoplasty (Nasal Surgery), Tummy Tuck (Abdominoplasty)

The numbers are in and America, you like Plastic Surgery. The American Society for Aesthetic Plastic Surgery has released the data collected for Cosmetic Plastic Surgery performed in 2015.

Plastic Surgery 1997 – 2015

When I started my San Francisco Bay Area Plastic Surgery practice in 1997, cosmetic procedures were performed one eighth as often as they are today.

When I started my San Francisco Bay Area Plastic Surgery practice in 1997, cosmetic procedures were performed one eighth as often as they are today.

In 1997, over 1.6 million cosmetic plastic surgery procedures were performed, and most of them were surgical. The breakdown was 55% (900,933) surgical and 45% (740,751) non-surgical.

In 2015, almost 13 million cosmetic plastic surgery procedures were performed. The number of surgical procedure performed more than doubled, from 900,933 to 1,912,468. Percentage-wise, however, surgery slipped to only 15% of all cosmetic procedures. There was a tremendous surge in the number of non-surgical procedures performed driven by new technology and expanded FDA approval. In 2015 10,879,909 non-surgical procedures were performed, a 1400% increase.

Non-surgical Plastic Surgery Procedures Then and Now

The nonsurgical procedures of 1997 were not the same as today’s. The sole filler was collagen, which only lasted a few weeks, sometimes months. Botox was available, but the use of Botox for wrinkles was not FDA approved. In 1997, using Botox for frown lines and wrinkles was strictly an off label, use confined to selective Dermatology and Plastic Surgery practices (like mine).

In 2016, there are a variety of FDA approved fillers are available, each lasting months, sometimes years. The most commonly used dermal fillers are Hyaluronic Acid based including: Restylane, Juvederm, Restylane Lift (Perlane), but Radiesse (Calcium Hydroxyapatite spheres) has also emerged for boney augmentation (Cheeks and Chins) and the nasolabial folds. Botox is FDA approved for wrinkles, and is now found in just about every spa in the San Francisco Bay Area.

Surgical Plastic Surgery Procedures Then and Now

Unlike their non-surgical counterparts, the majority of the surgical procedures performed today are largely the same. New techniques and material (sutures and implants), have developed, but the most popular procedures of 1997 are the most popular procedure of 2015 too. To date, they have not been replaced by non-invasive procedures because non-invasive procedures cannot accomplish the same results. Women continue to dominate men in numbers, so let’s break down the procedures desired by each sex.

Plastic Surgery for Women

The headlines read that Buttocks Augmentation is the fastest growing cosmetic surgery. The 30% increase is statistically true, but is magnified by the fact that not as many Buttocks Augmentation are done as Breast Augmentation. Looking at the number of cases performed in 2015 reveals the popularity of the procedures:

  • Buttocks Implants – 5678
  • Buttocks Lifts – 5008
  • Brazilian Butt Lifts (Fat Grafting to the Buttocks) – 15,705
  • Breast Implants – 305,856

Comparing Buttocks to Breast Augmentation, if 3000 more Brazilian Butt Lifts are performed this year, that will almost be a 20% increase. On the other hand, if 3000 more Breast Augmentations are performed, that will be an increase of less than 1%. It’s all relative to how many procedures are performed.

The most popular Cosmetic Plastic Surgeries for women  are Liposuction (Suction Assisted Lipectomy), Breast Augmentation (Augmentation Mammoplasty), Tummy Tuck (Abdominoplasty), Breast Lift (Mastopexy) and Eyelid Lift (Blepharoplasty).

The most popular Cosmetic Plastic Surgeries for women are Liposuction, Breast Augmentation, Tummy Tuck, Breast Lift and Eyelid Lift.

The most popular Cosmetic Plastic Surgery procedures from women have been pretty consistent over the last 18 years:

When the men are added, these five procedures account for 1.2 million of the 1.9 million cosmetic surgeries performed in 2015.

Plastic Surgery for Men

Men account for about 10% of all the cosmetic plastic surgeries performed in the United States.

The most popular Cosmetic Plastic Surgeries for men are Liposuction (Suction Assisted Lipectomy), Nose Surgery (Rhinoplasty), Eyelid Lifts (Blepharoplasty), Male Breast Reduction (Gynecomastia Reduction) and Facelifts (Rhytidectomy).

The most popular Cosmetic Plastic Surgeries for men are Liposuction, Nose Surgery, Eyelid Lifts, Male Breast Reduction and Facelifts.

The most popular Cosmetic Plastic Surgery procedures from men are also pretty consistent over the last 18 years, but there has been a proportionately larger increase in Gynecomastia Reduction:

Since men do not get pregnant, procedures like Breast Augmentations, Breast Lifts, Tummy Tucks and other Mommy Makeovers are not as often needed.

Comparing the male and female procedures, Rhinoplasty, Facelifts and Breast Reduction are pushed out of the top five by Mommy Makeovers; however, they are next. Cosmetic nasal surgery was number 6; Facelifts was number 7, and breast reduction was number 8 for women. When it comes to Cosmetic Plastic Surgery, men and women seem to want the same things.

Cosmetic Plastic Surgery Consultation

If you are considering Cosmetic Plastic Surgery in the San Francisco Bay Area, call (925) 943-6353 today, and schedule a private consultation appointment. Every consultation is tailored to your specific needs. The decision to proceed, or even to explore, cosmetic surgery is personal. My goal is to provide you the information you need to make your own informed decision.

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Liposuction or Tummy Tuck SF Bay Area?

Posted February 14, 2016 in Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Tummy Tuck (Abdominoplasty)

The question of Liposuction vs. Tummy Tuck is one I get every week. In fact, this week the discussion of the differences between Liposuction and Full Abdominoplasty and Mini Tummy Tucks was had at least ten times.

I have discussed the topic several times here on the San Francisco Plastic Surgery Blog, but it’s been a while and it seems like now is a good time to review the differences between Liposuction, Tummy Tucks and Mini Abdominoplasties. They are not interchangeable, and each has specific indications, advantages and limitations.

Liposuction

Liposuction Indications: Liposuction specifically and exclusively removes fat. It is designed to sculpt the body by removing localized pockets of disproportionate fat. It does so very well.

The most effective method is Tumescent Liposuction. The procedure involves injecting the tumescent fluid, a balanced salt solution with a local anesthetic and epinephrine added. The fluid allows for compression of the small blood vessels and less bruising. The anesthetic helps with post-operative pain, and the epinephrine helps to reduce bruising. Adding additional energy to the liposuction, like lasers and ultrasound, have been tried. They can cause burns, and have not demonstrated a significant advantage over tumescent liposuction alone.

Liposuction of the abdominal wall removes disproportionate fat and smoothes the belly.

Liposuction of the abdominal wall removes disproportionate fat and smoothes the belly.

Liposuction Advantages: The main advantages of Liposuction are: small scars, the ability to remove significant amounts of fat in a directed manner, relatively less expense when compared to procedures that remove (actually tighten) the skin less and less recovery time and discomfort. To be fair to the Tummy Tuck, the reduced recovery time and expense is because Liposuction is doing less; however, if less is what you need, Liposuction is a better option.

Liposuction Limitations: Liposuction requires smooth, tight and elastic skin over the area of fat removal. This allows the skin to tighten and the best possible results. Despite what you may see advertised, lasers, ultrasound, radio frequency, heat, cold, microwaves and other added modalities to not significantly shrink loose skin. Removing the fat from under loose skin will reduce girth, but this rarely looks better when the skin folds irregularly. The loss of support that occurs when the stuffing (the extra fat) is removed is the problem. When the skin is already folding, a Tummy Tuck is the better option.

Tummy Tuck (Abdominoplasty)

Tummy Tuck Indications: Loose abdominal skin, loose abdominal muscles and disproportionate fat of the lower abdominal wall are all indications for Abdominoplasty. Unlike Liposuction, a Tummy Tuck can tighten the muscle behind the fat and tighten the skin in front of the fat. This is especially useful after weight loss or pregnancy, the two main reasons Tummy Tucks are performed.

The Tummy Tuck, or Abdominoplasty, removes fat like liposuction, but is also tightens the abdominal wall muscle and skin in one procedure.

The Tummy Tuck, or Abdominoplasty, removes fat like liposuction, but is also tightens the abdominal wall muscle and skin in one procedure.

Tummy Tuck Advantages: The open Tummy Tuck procedure allows for direct visualization of the abdominal wall muscles. When the rectus abdominus muscles are loose or separated (Diastasis Recti), the tough case of the muscle can be tightened like an internal corset to flatten the abdominal foundation and maximize the results of your Abdominoplasty. Likewise, the skin over the abdominal wall is tightened by removing any excess from the lower belly.

Tummy Tuck Limitations: Tummy Tucks do not work as well if you store your fat behind the abdominal muscles. It is best if this fat is lost, we’re talking diet and exercise, prior to surgical intervention. Trying to tighten the abdominal muscles when the belly is stuffed with fat is like trying to close a suitcase when it is stuffed full of clothes. Additionally, it can be hard to contour the upper abdomen when there is disproportionate fat in this area, or when the upper abdominal skin is very loose. Additional treatment, like staged liposuction or a Fleur-De-Lis Tummy Tuck, respectively, may provide better results.

Mini Abdominoplasty (Mini Tummy Tuck)

Mini Abdominoplasty Indications: A Mini Abdominoplasty is best when any skin or muscle laxity is confined to the region beneath the belly button. The Mini Tummy Tuck has some of the advantages and disadvantages of both Liposuction and Full Tummy Tucks.

The Mini Tummy Tuck combines aspects of Liposuction and Abdominoplasty to repair abdominal laxity that Liposuction can't when a Tummy Tuck is too much.

The Mini Tummy Tuck combines aspects of Liposuction and Abdominoplasty to repair abdominal laxity that Liposuction can’t when a Tummy Tuck is too much.

Mini Abdominoplasty Advantages: The Mini Tummy Tuck’s recovery is closer to that of Liposuction, but it can do more than Liposuction alone. The procedure tightens the skin below the belly button by removing skin, like a Tummy Tuck, since less skin needs to be removed in patients who qualify for the mini procedure, the scar is shorter. Since less muscle is tightened, only below the belly button, there is less post-operative discomfort and a speedier recovery.

Mini Abdominoplasty Limitations: Since less skin is removed with the Mini Tummy Tuck, it cannot tighten the skin as much as a Full Tummy Tuck. Since the belly button and its surrounding skin are left attached, the mini procedure cannot tighten the upper abdominal wall. A “Floating Belly Button” technique can be used when just a little tightening is needed above the belly button, but an in-person consultation is needed to make the determination. Since less muscle is tightened, bulges in the upper abdomen cannot be addressed with this procedure.

Abdominal Rejuvenation

Instead of trying to figure out which procedure is best for your belly on your own, schedule an in-person consultation with a Board Certified Plastic Surgeon like Joseph A. Mele, MD. Your Plastic Surgeon should be familiar with all the above Abdominal Rejuvenation procedures and many more. This allows them to evaluate your abdomen first, and then pick the procedure that will work best for your specific needs. To schedule a personalized consultation about your Cosmetic Plastic Surgery, give me a call at (925) 943-6353, and learn all your options.

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Zika Virus News You Can Use

Posted January 30, 2016 in Breast Augmentation, Home, Mommy Makeover, Patient Safety, Tummy Tuck (Abdominoplasty)

Updated: 15 March, 2016 – new evidence of link between Zika virus and microcephaly and the sexual transmission of virus.
Updated: 28 March, 2016 – new recommendations for couples trying to conceive who have potentially be exposed to the Zika virus.
Updated: 09 April, 2016 – transmission rate estimates from mother to infant.
Updated: 07 May, 2016 – 80% of those infected with the Zika virus have no symptoms.

It’s no secret that most Plastic Surgery Patients are women. While most Plastic Surgery Procedures are for age management, a significant number of Cosmetic Surgeries are performed to repair the ravages of pregnancy. In fact, surgery to repair the changes after pregnancy is common enough to have it own name: Mommy Makeover. The Mommy Makeover is a combination of procedures that provides Breast Enhancement and Abdominal Sculpting, the most common combination being Breast Augmentation with a Tummy Tuck.

Pregnancy and the Zika Virus

Since many of my patients are of child bearing age, and since the Zika virus has been in the news, this week’s post is a PSA with the latest information and links to more information about the Zika Virus.

If you’ve seen the evening news lately, then you know the Zika virus is associated with severe birth defects when it infects a pregnant woman. To date, there have been no cases of direct transmission between people (except sexually), so how is it transmitted and what exactly does it do?

How the Zika Virus Spreads

In almost every documented case, the Zika virus needs a vector to spread. In the case of the Zika virus, the vector is the Aedes mosquito, the same mosquito that spreads dengue and chikungunya. If a mosquito bites a person infected with the Zika virus, it can then spread the virus to the people it bites subsequently.

An Aedes albopictus female mosquito feeds on a human blood meal. Photo by James Gathany, Centers for Disease Control and Prevention

An Aedes albopictus female mosquito feeds on a human blood meal.
Photo by James Gathany, Centers for Disease Control and Prevention

The virus can also be transmitted through a blood transfusion of infected blood, and cases of suspected sexual transmission have now been confirmed. In terms of the numbers of people infected, these are extremely rare means of transmission. If you are pregnant, or trying to get pregnant; however, prevention is the best medicine. For most people infected by the virus the symptoms are mild, but for pregnant women there is substantial new clinical and epidemiological research, which strengthens the association between Zika infection and the occurrence of fetal malformations and neurological disorders. One particularly devastating disorder is microcephaly. Microcephaly is a severe birth defect resulting from decreased brain size, and it seems to be more likely to occur with Zika virus infection.

Zika research is still in its early stages. Despite what you may have heard on the evening news, information on transmission from mothers to babies during pregnancy or childbirth is currently very limited. Current estimates are that one infant in one-hundred is affected. Perinatal transmission has been reported with other mosquito-borne viruses such as dengue and chikungunya, so transmission of the Zika virus seems likely. Research is currently under way on possible mother-to-child transmission of the virus and its effects on babies. Pregnant women in general, and particularly those who develop symptoms of Zika virus infection, should be closely monitored by health providers.

On November 28, 2015, Brazil’s Ministry of Health established a relationship between an increase in cases of microcephaly in newborns and Zika virus infections in the country’s northeast. According to a preliminary analysis of research carried out by Brazilian authorities, the greatest risk of microcephaly and malformations appears to be associated with infection during the first trimester of pregnancy. How often Zika virus infection leads to microcephaly has yet to be determined. Precise numbers will be hard to determine, especially since the virus can infect without symptoms. Only a small fraction of infections seem to lead to birth defects; however, the World Health Organization (WHO) has recently strengthened there warning to pregnant women. The WHO ‘s original recommendation urged pregnant women to avoid bites from the mosquitos that carry the virus. Now the WHO is advising them to avoid travel to areas where the transmission of the virus is widespread. Next may be advice to avoid having sexual relations with anyone recently traveling to areas where Zika virus exposure is on going.

How Long To Wait Before Conception If Exposed to the Zika Virus

On March 25, 2016, the CDC updated the guidelines for reproductive-age women and their partners who have been exposed, or potentially exposed, to the Zika virus. Women who have been diagnosed with acute Zika virus disease should wait at least 8 weeks from symptom onset to attempted conception. Zika-diagnosed men should wait at least 6 months. Both men and women who may have been exposed to Zika virus should wait at least 8 weeks from possible exposure to time of attempted conception. Possible exposure events include travel to or residence in a Zika-endemic area or unprotected sexual intercourse with a man who has traveled to or resided in a Zika-endemic area up 6 months after his latest potential exposure.

The History of the Zika Virus

The Zika Virus was discovered in 1947 in the Zika forest of Uganda. For much of its history, it remained in Africa, with small sporadic outbreaks in Asia. In 2007, the first major Zika virus epidemic occurred on the Micronesian island of Yap. Nearly 75% of the population was infected.

In 2014, a case of Zika virus transmission on Easter Island was reported by Chile. The virus was detectable from March until June, 2014.

Human Cases of Zika virus for 2015-2016 from the Pan American Health Organization.

Human Cases of Zika virus for 2015-2016 from the Pan American Health Organization.

In May of 2015, Brazil confirmed an outbreak of Zika virus in its northeast quadrant. According to the Pan American Health Organization (PAHO), in 2015 and 2016, the virus has spread to most of northern South America, Central America, the Caribbean and Mexico.

Since the Zika virus is not currently being spread by mosquitos in the US, it has become the hot spot for research on alternate means of spread, especially sexual transmission. While cases have been identified, it is still not clear how easily the virus spreads with this methods of transmission.

Symptoms of the Zika Virus

Zika virus infections can be without symptoms; however, symptoms usually begin 2-7 days after the bite of an infected mosquito. It commonly presents as mild fever with a skin rash (exanthema), often with eye irritation (conjunctivitis), muscle and joint pain, and general malaise. There is no association between the Zika virus and death. An increase in Guillain-Barré syndrome (GBS) has been observed in areas where a Zika virus epidemic has been documented (e.g., in French Polynesia and Brazil).

Zika Virus Treatment

Blood tests can help to confirm the diagnosis. Some (virological PCR tests) are useful in the first 3-5 days after the onset of symptoms, while others (serological tests) detect the presence of antibodies but are useful only after five days.

Like most viral infections, there is no vaccine or specific treatment for Zika virus infection. Therefore, treatment for everyone, including pregnant women, is directed at alleviating symptoms such as fever and body aches. To prevent dehydration, it is recommended to control the fever, rest, and drink plenty of water.

Prevention is the best treatment available. Avoiding travel to regions with ongoing transmission is the best prevention, especially if you are pregnant. When this is not an option, precautions should be taken to avoid mosquito bites.

Since mosquitos spread the virus, prevention is directed toward control of the vector and prevention of mosquito bites. The Aedes mosquito bites mostly during the day. Long sleeves, mosquito nets and repellents can help, but repellents should not be used on children younger than two years of age. A more complete list of preventive measures is available on the CDC website.

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Tummy Tuck SF Bay Area (Abdominoplasty)

Posted January 09, 2016 in Home, Liposuction, Mommy Makeover, Tummy Tuck (Abdominoplasty), Videos

Skin laxity after pregnancy or weight loss can be corrected with a Tummy Tuck. The Plastic Surgery term for tightening the tummy is Abdominoplasty, and abdominoplasty literally means abdomen changing. In cases where there is a lot of extra skin, the difference can be life changing, too.

When Diet and Exercise are not Enough!

After Weight Loss, the belly often does not spring back into its original shape. The fat will go away, but skin and the abdominal muscles remain loose and redundant. They are stretched by the excess fat and over time this over-stretching becomes permanent.

Loose Skin can remain unsightly, and lax muscle allows the abdominal contents to push the belly out. Both these problems rarely respond well to diet and exercise. Loose skin and Over-stretched Muscles cause unsightly bulges. Well after the excess pounds are lost, these continue to effect how we look and feel about our body, even in clothing.

Abdominoplasty Videos

In the Tummy Tuck Video below, I discuss the procedure, indications and recovery. The process is further illustrated with Tummy Tuck Before and After Pictures. More information about Tummy Tucks is available here on the San Francisco Plastic Surgery Blog by clicking on the Tummy Tuck (Abdominoplasty) link under Categories in the column.

Tummy Tuck Video (Abdominoplasty)

Tummy Tucks Tighten Skin

The Tummy Tuck removes excess skin from the lower belly. Often, in the center of the abdomen, the skin from below the belt line to above the belly button is removed. Any stretch marks in this skin are also removed. The remaining skin from the upper abdomen is redraped over the entire abdomen. The result is vertical skin tightening and a flatter tummy.

Tummy Tucks Tighten Muscle

While the skin is elevated, the abdominal muscles are addressed. If they are lax, or if a separation (diastasis recti) is found between the muscles, it is repaired. The repair is like a corset running from the ribs to the pubic region, underneath the skin. You won’t see these reinforcing sutures, but you will see what they do to help flatten the abdominal wall – just another way that Abdominoplasty is a belly changer.

Tummy Tucks Remove Fat

The fat on the abdomen is usually not distributed evenly. There tends to be more fat on the lower abdomen. The good news is, when the skin of the lower belly is removed so is this fat. So if your loose skin has some hitchhiking disproportionate fat, they will both be removed with the Tummy Tuck.

Fat that extends to the sides, or is continuous with the love handles, can also be removed during your Abdominoplasty with Liposuction. Tummy Tucks can also be combined with Breast Augmentation as part of a Mommy Makeover.

Tummy Tuck Consultations

If you are considering a Tummy Tuck, give our San Francisco Bay Area Plastic Surgery office a call at (925) 943-6353 today, to schedule a private consultation.

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