Arm Lift San Francisco Bay Area (Brachioplasty)

Posted March 26, 2017 in Arm Lift (Brachioplasty), Home, Post-Bariatric Surgery (After Weight Loss), Videos

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.

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.

As an active member of the American Society of Bariatric Plastic Surgeons (ASBPS), contouring the body after weight loss is one of my specialties. Whether you have had Bariatric Surgery, or have lost weight with consistent diet and exercise, this video has something to offer.

Arm Lift Scars

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 a scar 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.

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.

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Arm Lifts – No Arm No Foul | SF Bay Area Brachioplasty

Posted June 25, 2016 in Arm Lift (Brachioplasty), Home, Post-Bariatric Surgery (After Weight Loss), Videos

Big Arms are a big deal. I’m not talking about the “big guns” produced by lifting weights. I’m talking about loosing weight, getting in shape and still having big arms due to loose, flabby skin. This is a common problem for anyone who has lost a significant amount of weight. Some people are born with large arms and loose skin, but many of my Arm Lift patients have lost weight through diet and exercise or after bariatric surgery. For them, the larger the weight loss, the bigger the problem.

Arm Lift (Brachioplasty)

Brachioplasty literally means arm changing. The ideal candidate is healthy, with a large amount of loose, redundant upper arm skin. Sometimes called Bat Wings, this skin excess is not amenable to exercise, and further weight loss only exacerbates the problem. There is no skin shrinking ray, so the options are often either an Arm Lift or to live with it.

Arm Lift Video (Brachioplasty)

Below is a recent Body Beautiful segment dedicated to Arm Reduction surgery from the San Francisco Bay Area’s News Station, KRON 4. This Brachioplasty Video answers many of the frequently asked questions about Arm Lifts and reviews the results that some of my patients have received. The information provided is accurate, but cannot be considered medical advice. An in-person consultation with a Board Certified Plastic Surgeon is always recommend prior to choosing a treatment plan.

Arm Lift Before and After Pictures

The above Arm Lift Video includes many Brachioplasty Before and After Pictures. From arm to arm there are differences in appearance, so the Arm Lift is adapted to your unique needs. There is no substitution for an in-person evaluation, but additional Arm Lift Information is available here on the San Francisco Plastic Surgery Blog and on my main web site’s Arm Lift Page.

Arm Lift Consultations

If you want to know more about your options for Arm Reduction, call (925) 943-6353 today and schedule your personalized Arm Lift Consultation. A focused physical examination and medical history are how we start. If you are a candidate, the risks, benefits, procedure, alternatives, limitations and recovery of the Arm Lift are reviewed in detail, so that you can make an informed decision.

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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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Thigh Lifts (Thighplasty) SF Bay Area

Posted December 19, 2015 in Home, Post-Bariatric Surgery (After Weight Loss), Thigh Lifts (Thighplasty), Videos

Plastic Surgery can help tighten loose skin in many places. Cosmetic Plastic Surgery procedures like the facelift, tummy tucks and breast lifts are well known. These procedures tighten loose skin of the face, tummy and breasts. Loose thigh skin, on the other hand, is less talked about.

What Is A Thigh Lift?

The Thigh Lift is a specialized cosmetic surgery that specifically tightens loose thigh skin. Also know as a thighplasty, the thigh lift can provide the finishing touch after weight loss. This is not a procedure that should be routinely performed for thigh skin that is a little loose. It is meant to remove redundant skin, and works best when the inner thigh skin looks less like a skin suit and more like skin drapery.

Thighplasty Video From Body Beautiful on KRON 4

Last week, I discussed Thigh Lifts on the San Francisco Bay Area’s News Station KRON 4. The show, Body Beautiful, gives me the opportunity to talk about the latest and the greatest procedures and treatments that Cosmetic Plastic Surgery has to offer. This week’s show included a segment on a lesser discussed procedure, the Thigh Lift. The video segment below is included in case you missed the television show.

Thigh Lift Video (Thighplasty)

Who Needs A Thigh Lift?

The Thigh Lift is most often performed after weight loss. Post Bariatric Plastic Surgery is a discipline of Plastic Surgery that specializes in tightening loose skin that is leftover after weight loss. The inner thigh is an area that is often left stretched out and deflated after weight loss. The thigh lift is designed to remove the excess skin and tighten the thigh. If is different than Liposuction, which only removes fat and may further loosen the thigh skin.

How Is A Thigh Lift Performed?

There are two main methods for removing loose thigh skin. One uses an incision that runs from the groin, between the legs at the top of the thigh and ends in the fold under the buttocks. The location of the scar makes it easier to hide. The second method uses a scar that runs down the inner thigh and ends at the knee. This method is better for removing skin on the lower thigh, but the scar is more noticeable. When the lateral thigh it the problem, a lower body lift or lateral thigh lift may be a better choice.

Which Thigh Lift Is Best For Me?

Determining which, if any, method is best requires a consultation with an experienced, Board Certified Plastic Surgeon. A focused medical history, combined with the physical examination can help determine the timing and the type of Thigh Lift that is likely to maximize the benefits and minimize the risks.

If you are considering a Thigh Lift, call (925) 943-6353 today to schedule a private and personalized consultation appointment.

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Reconstructive Vs. Cosmetic Surgery

Posted July 24, 2015 in Home, Patient Safety

On July 15th, Alameda County Superior Court Judge Wynne S. Carvill tentatively ruled that Kaiser Permanente cannot systematically classify removal of excess skin following bariatric weight loss surgery as a cosmetic procedure, and that Kaiser misinformed patients and doctors by claiming removal of disfiguring excess skin following gastric bypass surgery is not a covered procedure. This may be good news for Bariatric Patients, but the ruling is not final.

It's a question as old as insurance companies, "Is it cosmetic or reconstructive?"

It’s a question as old as insurance companies, “Is it cosmetic or reconstructive?”

The class action lawsuit, Wendy Gallimore, et al. v. Kaiser Foundation Health Plan Inc, was heard in the Superior Court of the State of California for the County of Alameda. While the ruling would prohibit Kaiser from arbitrarily denying all bariatric patients access to post bariatric plastic surgery, it would allow Kaiser doctors to decide on a case-by-case basis whether patients qualify for a referral to a plastic surgeon.

According to the Insurance Journal Article, Judge Carvill rejected Kaiser’s argument that excess skin is not a disease, and instead ruled that its policy of only providing referrals to plastic surgeons for patients whose excess skin presented a functional problem stands in contrast with the California Health & Safety Code. The code requires insurance companies to pay for reconstructive surgery to repair disfigurement caused by trauma or disease.

Insurance Companies Are Saving You Money

Insurance companies will claim their behavior is aimed at controlling costs, and I understand that they do not want to cover Cosmetic Surgery. What I don’t understand is why Plastic Surgeons have to prove each procedure is not “cosmetic.” More than half the procedures that Plastic Surgeons perform are reconstructive.

How Breast Reconstruction Became “Reconstructive”

There was a time in the not distant past, when insurance companies considered reconstructive breast surgery after a mastectomy for breast cancer Cosmetic Surgery. The insurance companies claimed that since the cancer was removed, there was no immediate threat to a woman’s health, so reconstructing the breast was unnecessary, and that breast reconstruction provided only a cosmetic result. While it is true that a woman can live without her breast, and that a minority of women choose not to have breast reconstruction after a mastectomy, it is equally true that most women do not feel whole until after breast reconstruction is performed.

While some states acted on behalf of their female residents, not all did. Through massive lobbying efforts, including patients, doctors and professional societies like the American Society of Plastic Surgeons, the Federal Government was compelled to act. The choice to have insurance coverage for breast reconstruction was not ensured, or insured, until the Women’s Health and Cancer Rights Act was signed into law on October 21, 1998.

The Women’s Health and Cancer Rights Act of 1998

The law known as Janet’s Law was championed by Republican Senator Alphonse D’Amato from New York, and our own San Francisco, California, Democratic Senator Dianne Feinstein, and twenty-one other US Senators in a truly bipartisan effort.

Janet’s Law

Janet’s Law is named after a 32 year-old Long Island woman, Janet Franquet, who was diagnosed with an aggressive form of breast cancer in late 1997. She required chemotherapy to try to shrink her tumor, followed by a mastectomy. A young woman, she desired reconstructive surgery to restore her amputated breast. Her Plastic Surgeon, Dr. Todd Wider, contacted her insurance company for permission to reconstruct her breast. Janet’s insurance plan refused to cover the reconstructive surgery, and considered it cosmetic. The carrier recommended using a skin graft if the wound could not be closed primarily. Dr. Wider, disgusted by the insurance plan’s idea of medical care, performed the breast reconstruction for free. When insurance companies claim they do not make medical decisions, think about Janet’s plight. If not for the generosity of a Plastic Surgeon, her breast would remain flat, or more likely indented with a skin graft.

Dr. Wider did more than give away his skills, he contacted his federal representatives and went to bat for all patients. Senator D’Amato said the following to then US President Bill Clinton from the floor of congress when he had heard that the insurance carrier had denied Ms. Franquet coverage for her surgery:

  • “Mr. President, I decided that I would give Mrs. Franquet’s insurance company a call. When I spoke with the Medical Director, he told me that “replacement of a breast is not medically necessary. This is not a bodily function and therefore cannot and should not be replaced” … Luckily for her, Dr. Todd Wider agreed to forgo payment of this surgery. … I ask you, Mr. President, how many other Janet Franquets are out there? Will they be lucky enough to have a Dr. Wider to take care of them? … Too many women have been denied reconstructive surgery because insurers have deemed the procedure cosmetic and not medically necessary. It is absolutely wrong.”

Problem (Not) Solved

In case you think the problem is solved, I assure you it is not. This week, I corresponded with a local insurance plan that promises you will “Be Heard.” Despite multiple interactions with the insurance plan by my staff and myself, including writing two letters, sending pictures, twice, speaking with the nurse reviewer, speaking with a physician reviewer, I was told almost exactly the same line that Senator D’Amato was told almost 20 years ago. My patient’s breast reconstruction did not not pose an eminent health risk and reconstruction would be denied. Perhaps he has forgotten, The California Health & Safety Code requires insurance companies to pay for reconstructive surgery to repair disfigurement caused by trauma or disease. Do we need a specific law for every diagnosis?

We do have the right to appeal, but no new information will be necessary, and all of us, my patient, her family, my staff and myself have to spend more time away from our otherwise productive lives trying to get the insurance plan to do the right thing. The only difference is my patient does not have breast cancer, she was born with a severe form of tubular breast deformity. Fortunately, she is a very strong, very mature young woman, and even though she was not even born when Mrs. Franquet’s Insurance Company’s Medical Director proclaimed “replacement of a breast is not medically necessary,” she must again fight the same battle.

Keep The Faith

Without the legislative process, there would be no coverage for breast reconstruction. When Insurance plans can’t justify their actions medically, they simply stop providing coverage. A good example is Breast Reduction. Breast Reduction relieves chronic neck and back pain, among other symptoms. There is overwhelming clinical evidence of the benefits, so now that they can no longer decline the benefit of the procedure, insurance companies are excluding Breast Reduction from their coverage. Check your policy and see if you are covered or excluded. Will we need another law to keep coverage for Breast Reduction when medically indicated?

I look for the good in people, but I’ll admit, I was very disappointed with my patient’s insurance company, especially after spending so much time and effort informing multiple reviewers of the situation. Their decision is troubling, but I suppose made easier by not having to see my patient and realize she is a real person who has a real promising life ahead of her.

On the other hand, Alameda County Superior Court Judge Wynne S. Carvill’s ruling gives me hope. The goal of medicine is enhance our population. By relieving physical pain with Breast Reductions or emotional pain with Breast Reconstruction, Plastic Surgeons improve the quality of our patients’ lives. This is not just true for the patient, but for their family, friends and co-workers. Happier patients are nicer to those around them and more productive citizens. The reconstructive vs. cosmetic arguments will continue; however, if more productive citizens get involved, more reconstructive surgeries can remain reconstructive.

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Gynecomastia and Male Breast Reduction Video | SF Bay Area

Posted April 04, 2015 in Breast Reduction, Breast Reduction (Men), Home, Videos

Breast buds can lead to "puffy nipples," really the enlargement of the areolae rather than the nipple proper. Gynecomastia reduction surgery can remove the disproportionate breast tissue and masculinize the chest.

Breast buds can lead to “puffy nipples,” really the enlargement of the areolae rather than the nipple proper. Gynecomastia reduction surgery can remove the disproportionate breast tissue and masculinize the chest.

Gynecomastia Reduction Surgery on the Bay Area’s KRON 4’s Body Beautiful

A couple of months ago, I had the opportunity to discuss Gynecomastia Reduction Surgery on the San Francisco Bay Area’s News Station, KRON 4. Body Beautiful, was the first live show broadcast from the new KRON 4 studios, and what a beautiful facility it is. It was my privilege to discuss the various forms of Gynecomastia and the many Breast Reduction treatments available.

Types of Gynecomastia Reduction Treatments

Liposuction, direct excision of the gland, removal of excess skin and combinations of all these methods were reviewed and illustrated with Gynecomastia Reduction Before and After Pictures. Excision of the skin is not usually necessary, unless there is a large amount of loose skin. This type of skin redundancy is seen in older patients and after large weight loss, like with Post Bariatric Plastic Surgery.

Gynecomastia and Male Breast Reduction Surgery Video

Breast Buds – The First Wave Effects Us All But Doesn’t Last

Gynecomastia effects every man at some point in his life. Every infant is born with it. The mother’s female hormones cross the placenta and cause the development of breast tissue. Infants will quickly lose the breast buds as their mother’s hormones gradually metabolize in the infant’s circulation.

Breast Buds – The Second Wave Effects Most of Us and Often Stays

The second wave of Gynecomastia might not go quietly. The breasts experience a second surge of hormones during puberty. This can be a problem for young men. Approximately 65% of boys experience the recurrence of Breast Buds during the pre-teen to teen years. In about half those affected, the enlarged breast tissue again decreases as the hormone levels drop. Since this can take several years, it is recommended that early Gynecomastia be observed for 1-2 years. If it persists, and it remains a cosmetic concern, there are surgical options that are safe and effective.

The chances of Gynecomastia can go up with certain behaviors, too. Many medications can promote breast development in men. While young men do not often require water pills (diuretics) or blood pressure medicine (antihypertensives); however, steroid use and smoking Marijuana both promote abnormal growth of breast tissue. There are no medications known to reliably decrease the size of gynecomastia, once it develops.

Breast Buds – The Third Wave Comes Later

The third wave of Gynecomastia is in middle age and later in life. It can be Pseudogynecomastia, fat from weight gain, or True Gynecomastia, often secondary effects of medications, like the diuretics and antihypertensives mentioned above. Gynecomastia can also be a significant side effect of prostate cancer treatments. After puberty, once Gynecomastia develops, it rarely leaves without surgical intervention.

Breast Buds – Outside the Waves Could be Dangerous

While the vast majority of Gynecomastia is benign, certain signs and symptoms, including abnormal timing at presentation, may be a warning, and further investigation may be warranted. Men account for 1% of all Breast Cancer cases, and other tumors, like testicular and pituitary cancer, can produce hormones that promote breast development. Gynecomastia associated with bleeding or discharge from the nipple may also require additional testing.

Gynecomastia Consultations

If you have problems with disproportionately large breasts, areolae or nipples, whether you are a man or a woman, you have options. Explore your options with a private and personalized consultation appointment. Give my San Francisco Bay Area Plastic Surgery office a call today at (925) 943-6353. The San Francisco Plastic Surgery Blog, and my other web sites provide accurate information; however, the best results are obtained by tailoring your surgical plan to your situation.

I repeat this often: when it comes to getting the best results, there is no substitute for an in-person consultation with a qualified, experienced, Board Certified Plastic Surgeon.

More Gynecomastia Reduction Videos

More Gynecomastia Reduction Videos are available here on the San Francisco Plastic Surgery Blog, and also at DrMele.com on the Gynecomastia (Male Breast Reduction) Video Page.

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Abdominoplasty (Tummy Tucks) on SF Bay Area’s KRON 4 Body Beautiful

Posted February 07, 2015 in Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty), Videos

Tummy Tucks are designed to fix flabby bellies. After pregnancy or weight loss, the abdominal skin and the muscle beneath can get stretched out. To get back to a tight tummy, the Tummy Tuck or Abdominoplasty may be just what the doctor ordered.

Tummy Tucks Do What Diet and Exercise Cannot

Diet and Exercise are important to a toned body, but after pregnancy and weight loss, diet and exercise may not get us all the way to the goal. Once over-stretched, the abdominal wall cannot recoil. The abdominal skin often remains flaccid, even with vigorous exercise. Being close to an ideal weight can reduce abdominal girth, but it cannot fix loose skin.

Tummy Tuck Video on KRON 4’s Body Beautiful

Abdominoplasty means abdomen changing, and San Francisco Bay Area Board Certified Plastic Surgeon, Dr. Joseph A. Mele, MD, has all the details in this Tummy Tuck Video Segment from the Bay Area’s News Station, KRON 4, in San Francisco, CA.

Tummy Tuck (Abdominoplasty) Video Presentation in San Francisco

Abdominoplasty Before and After Pictures

Tummy Tuck Before and After Pictures provide examples of what the procedure can do. Unfortunately, the day of the above Body Beautiful broadcast, the video mixer was having a bad day. Fortunately, last month’s post includes Tummy Tuck Before and After Photos on the San Francisco Plastic Surgery Blog. Additional Plastic Surgery Before and After Photos can also be seen in my Plastic Surgery Photo Gallery.

Tummy Tucking Options

There are many options for Abdominal Rejuvenation:

Each of the above Cosmetic Plastic Surgery procedures has specific benefits, and when indicated, each should be discussed during the Abdominoplasty Consultation, so you can make a well informed decision about the options.

Tummy Tuck Consultation

An in-person consultation appointment can help sort through the Tummy Tuck Options, and find the procedure that best fits your tummy. Call (925) 943-6353 to schedule a personalized consultation, or use the contact form in the margin for further Abdominoplasty Information.

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Tummy Tucks, Breast Enhancement and Mommy Makeovers in the SF Bay Area

Posted January 03, 2015 in Breast Augmentation, Breast Lift (Mastopexy), Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Post-Bariatric Surgery (After Weight Loss), Tummy Tuck (Abdominoplasty)

These Mommy Makeover before and after photos display the most popular combination of belly and breast enhancement: The Tummy Tuck (Abdominoplasty) with Breast Augmentation (Breast Implants).

These Mommy Makeover before and after photos display the most popular combination of belly and breast enhancement: The Tummy Tuck (Abdominoplasty) with Breast Augmentation (Breast Implants).

What’s a Mommy Makeover?

A Mommy Makeover is any combination of Cosmetic Plastic Surgery procedures that restore what pregnancy takes away: perky breasts and a flat belly. Pregnancy can be hard on the breasts and the belly, so the most common combination for a Mommy Makeover is Breast Augmentation with a Tummy Tuck. This combination of procedures is also useful after massive weight loss, which also often leaves women and men with deflated sagging breasts and a loose stretched-out tummy.

Other Mommy Makeover Combinations – Upper Half

Another Mommy Makeover is the Tummy Tuck and Breast Lift. If you are happy with your breast size, but not the shape, sagging or looseness, a Breast Lift may be all that is needed.

Another Mommy Makeover is the Tummy Tuck and Breast Lift. If you are happy with your breast size, but not the shape, sagging or looseness, a Breast Lift may be all that is needed.

Breast Implants are not always necessary for a Mommy Makeover. If your breasts are a good size, but have dropped, a Breast Lift may be enough to restore your Breast Aesthetics and Body Confidence. There are many options for your Breast Lift, or Mastopexy. If the breasts have dropped and volume is missing, a combination of Breast Lift and Breast Augmentation (Augmentation Mastopexy) is utilized.

Other Mommy Makeover Combinations – Lower Half

With severe muscle laxity, diet, exercise, even Liposuction is futile. The Tummy Tuck is the only way to fix this. Lesser problems, on the other hand, may improve with smaller procedures.

With severe muscle laxity, diet, exercise, even Liposuction is futile. The Tummy Tuck is the only way to fix this. Lesser problems, on the other hand, may improve with smaller procedures.

The Tummy Tuck repairs skin laxity, lower abdominal disproportionate fat, and it is the only procedure that effectively tightens the abdominal muscles. For the belly above, muscle laxity is the primary problem, so only a Full Tummy Tuck can provide the optimal result. It works like an internal corset to flatten the tummy.

Sometimes, a smaller procedure is enough. If you only have disproportionate fat, and have maintained good skin and muscle tone, Liposuction may be a better option with a shorter recovery and lower cost. If your muscle and skin laxity is confined to the area below the belly button, a Mini Tummy Tuck (Mini Abdominoplasty) may be enough to achieve the desired look.

Schedule Your Mommy Makeover Consultation

Mommy Makeovers are as unique as mommies, so the best way to learn your options is during a personalized consultation appointment with a Board Certified Plastic Surgeon. To schedule a private consultation appointment in our San Francisco Bay Area Plastic Surgery office call (925) 943-6353, or ask a question via the contact form in the left margin of the San Francisco Plastic Surgery Blog.

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Arm Lifts (Brachioplasty) After Weight Loss | San Francisco Bay Area

Posted October 11, 2014 in Arm Lift (Brachioplasty), Home, Videos

This week’s Plastic Surgery Video comes from KRON 4’s Body Beautiful and covers a very specific area of concern seen most frequently after weight loss: the Arm Lift. Also know as Brachioplasty, the Arm Lift tightens the skin of the upper arm which can be over stretched with weight gain.

The Arm Lift Video Presentation below shows many Arm Lift Before and After Pictures. The examples are narrated to describe the specifics in each case. Arm Lifts are a common procedure after Bariatric Surgery or after any large weight loss that leave the arms loose.

Brachioplasty (Arm Lift) Video Presentation

Arm Lifts with Liposuction

When the upper arm is disproportionate due to excess fat and the skin is tight, Liposuction may be all that is needed. Liposuction removes extra fat through small incisions strategically placed in the normal contours of the body. For arm Liposuction, the scars are placed about the elbow or in the axillary regions. For Liposuction of the arms to be effective, the fat must be disproportionate and the skin must have good elasticity. When the skin is loose, removing the underlying fat will enhance the laxity and make the skin fold unpredictably. For loose skin, the Arm Lift is usually the only effective option.

Brachioplasty – Changing the Arms

After massive weight loss, like with the weight loss seen after Bariatric Surgery, much of the upper arm fat disappears. The arm skin, on the other hand, tends to stick around. The excess upper arm skin can be so excessive that the arm remains tight in a sleeve, long after the fat has gone. I have had many patients ask for help with their arm skin laxity. They want to feel comfortable; they want to fit in their clothes, and they want their arms to stop waving when their hands do. Sometimes called Bat Wings, excessive upper arm skin can be a source of frustration and embarrassment long after the weight is lost.

How is the Arm Lift Performed?

The Arm Lift or Brachioplasty is a Cosmetic Plastic Surgery procedure that removes excess skin from the arm. It is performed as an outpatient procedure in an accredited surgery center and takes a few hours. The skin excess is carefully marked for removal with the patient awake and upright so that just enough skin remains to comfortably cover the arm. In the operating room, the excess skin is excised, and the tightened, leaving a carefully closed incision along the underside of the arm. The arm is supported with a compression garment after surgery, and Embrace Scar Therapy is often used to support the repair, speed healing and maximally improve the appearance of the scar. Most patients are back to their normal activities in one to two weeks with few limitations.

Post Bariatric Plastic Surgery

Brachioplasty is frequently performed in conjunction with other Post Bariatric Plastic Surgery procedures. While Bariatric Surgery can cause weight and fat loss, it does not always leave the skin tight. In fact, as we gain weight the excess fat, expands the skin and which grows to cover the increased surface area. When the weight is lost, the skin will shrink, but usually not completely. It is recommended to wait one year after Bariatric Surgery to allow the skin to shrink maximally and the body to heal before having any Plastic Surgery Skin Tightening procedures.

The American Society of Bariatric Plastic Surgeons (ASBPS)

Dr. Mele is an Active Member of the American Society of Bariatric Plastic Surgeons, a group of Board Certified Plastic Surgeons dedicated to reshaping bodies after massive weight loss.

American Society of Bariatric Plastic Surgery

The American Society of Bariatric Plastic Surgery is dedicated to shaping the body after massive weight loss.

If you have lost a significant amount of weight or have completed Bariatric Surgery and are looking to remove loose skin, members of the ASBPS are America’s body contouring specialists. Post Bariatric Plastic Surgery procedures we perform include:

Arm Lift Consultations

Schedule your Arm Lift Consultation today by calling (925) 943-6353. During your visit to our San Francisco Bay Area Plastic Surgery office in the East Bay city of Walnut Creek, CA, we will discuss your options for treatment and what you can expect from the Brachioplasty procedure. As a Board Certified Plastic Surgeon, and an ASBPS member, I can offer a wide range of skin tightening treatments after weight loss, as well as other Cosmetic Plastic Surgery procedures.

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Tummy Tucks Mini vs Maxi – San Francisco Bay Area | Walnut Creek, CA

Posted August 10, 2013 in Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Post-Bariatric Surgery (After Weight Loss), Tummy Tuck (Abdominoplasty)

We all like mini surgery, but we don’t want mini results. When is the mini tummy tuck good, and when is the maxi a must? The decision between liposuction, mini tummy tuck or full tummy tuck is one I face daily in my San Francisco Bay Area Plastic Surgery office. We all want more for less, but when is more really more, and when is less, just less?

Tummy Tuck - Before and afters showing fat removal plus tightening of skin and muscle of the abdominal wall.

Tummy Tuck – Before and afters showing fat removal plus tightening of skin and muscle of the abdominal wall.

Choices in Abdominal Rejuvenation

Whether you were born with the genes for a loose belly, or you earned it with childbirth or weight loss, there are three main choices for abdominal rejuvenation:

  1. Liposuction
  2. Mini Tummy Tuck (Mini Abdominoplasty)
  3. Tummy Tuck (Abdominoplasty)

Indications for Tummy Tucks and the Alternatives

The Cosmetic Plastic Surgery Procedures listed above each have specific indications, benefits and risks. Each option improves the results of diet and exercise, but none can replace them. And while achieving or keeping your weight close to ideal helps with maintaining an attractive tummy, plastic surgery can offer improvements in ways that diet and exercise cannot. The procedure are not an alternative, but are complementary, and the results speak for themselves.

How to Get a Great Tummy

Yes, there is no way to get around taking care of yourself. Maintaining your weight and breaking a sweat once in a while help. However, there are times when a little extra attention is needed.

Weight Loss

Weight Loss is the first line of offense when striving for a great gut. There is no surgical way to remove internal fat. This fat fills the belly from inside and pushes the abdominal wall muscles forward. Most common in men, excess intraabdominal fat is unhealthy, and makes a big hard belly. Losing this fat improves health and appearance.

On the other hand, I see many patients who are close to their ideal weight, who retain disproportionate fat around their waist. These stubborn areas form muffin tops or love handles, and despite the affectionate nicknames, no one really likes them. External fat is something I can help with.

Liposuction

Liposuction is not a substitute for weight loss, but it provides laser beam focus on the problem areas that just won’t go away. Unlike weight loss, liposuction allows you to pick which fat cells are leaving. Those stubborn areas around the waist or thighs are the most frequently aspirated areas. Tumescent Liposuction can safely and effectively remove unwanted bulges, as long as the skin is tight.

Liposuction Before and After Pictures

Liposuction - Before and afters show the removal of disproportionate abdominal fat, and delineation of the abdominal muscles.

Liposuction – Before and afters show the removal of disproportionate abdominal fat, and delineation of the abdominal muscles.

Exercise

Exercise has many health benefits. Tightening up our core helps us with both work and play. It makes us look and feel good too. The absence of strong abdominal muscles allows the gut to push the abdomen forward. Strong muscles make for strong support and a flatter tummy. Exercise also helps eliminate intraabdominal fat, and with less internal stuffing, the abdominal contours improve.

So why do so many of us still feel like our bellies are fat after weight loss? Why can’t all the mommies hitting the gym correct the belly laxity caused by pregnancy? The problem may be that the strong muscles are stretched out of shape. The case around the muscle, called fascia (fash-ya), it stretched with pregnancy and weight gain. Just like the skin, the fascia does not always return to its prestretched tone.

Mini Tummy Tucks (Mini Abdominoplasty)

This is where the tucks come in. Tummy Tucks allow a plastic surgeon to tighten what nature won’t. Abdominoplasty means literally abdomen changing. Loose muscle fascia is tightened, like an internal corset, and excess skin is removed along with the redundant folds around the middle that it causes.

When the problem is isolated to below the belly-button, a Mini Tummy Tuck may be just what the doctor orders. The Mini Abdominoplasty allows for tightening of the skin below the belly button and tightening of the lower abdominal fascia. It is half the operation of the full tummy tuck, so the both the recovery and the results are reduced.

Mini Tummy Tuck Before and After Pictures

Mini Tummy Tuck - Before and afters reveal significant tightening of the lower abdomen and a more flattering figure.

Mini Tummy Tuck – Before and afters reveal significant tightening of the lower abdomen and a more flattering figure.

Tummy Tucks (Abdominoplasty)

The bigger the damage, the bigger the repair. When the entire abdominal wall from ribs to pelvis is stretched out, a Mini Tummy Tuck is not going to cut it. A traditional, full Tummy Tuck has been around a long time because it works. It provides tightening of the entire abdominal fascia, from top to bottom, and allows for improvement above the belly-button. The amount of excess that can be treated still impresses me, and I have done a lot of Tummy Tucking.

Abdominoplasty / Tummy Tuck Before and After Pictures

Abdominoplasty / Tummy Tuck: Before and afters show flattening of the abdomen from top to bottom, with removal of lower abdominal fat and tightening of both skin and muscles.

Abdominoplasty / Tummy Tuck: Before and afters show flattening of the abdomen from top to bottom, with removal of lower abdominal fat and tightening of both skin and muscles.

So Who Qualifies and Who is Qualified for Tummy Tucks?

The San Francisco Plastic Surgery Blog cannot substitute for a carefully performed, in person consultation with a qualified Board Certified Plastic Surgeon. If you are considering any sort of abdominal rejuvenation, be certain to consult with an experienced member of the American Society of Plastic Surgeons (ASPS), or a member who has shown further dedication to the cosmetic side of plastic surgery, by also joining the American Society for Aesthetic Plastic Surgery (ASAPS). Members of these two organizations determined well before their training that plastic surgery was what they wanted to do, and that they had the grades and the drive to make it into a highly competitive, accredited plastic surgery training program.

If you are considering Plastic Surgery, whether it be Liposuction, Tummy Tuck or any elective cosmetic procedure, you are not just choosing a procedure. You are choosing the person to trust with performing that procedure. Learn what you can online, but be prepared to learn more, specifically what will work best for your body, at your consultation appointment.

Cosmetic Plastic Surgery Consultations

If you would like to schedule a personalized consultation appointment, give us a call at (925) 943-6353. My staff will do their best to get you a convenient, private appointment, and I will do my best to provide you the information you need to make a safe and informed decision about what will work best for you.

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