Mommy Makeovers – Breast and Belly Rejuvenation

Posted March 04, 2019 in Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Women), Home, Liposuction, Mommy Makeover, Tummy Tuck (Abdominoplasty)

Mommy Makeovers may include Breast Augmentation, Breast Lifts or Breast Reduction combined with a Tummy Tuck, Mini Tummy Tuck or just Liposuction, depending on the areas that need improvement and the patient’s wishes.

Mommy Makeovers may include Breast Augmentation, Breast Lifts or Breast Reduction combined with a Tummy Tuck, Mini Tummy Tuck or just Liposuction, depending on the areas that need improvement and the patient’s wishes.

There is no denying that breasts and bellies take a hit with pregnancy. Fortunately, there is a solution. Mommy Makeovers rejuvenate both the breasts and the belly, to help restore your pre-pregnancy body.

Mommy Makeover Options

The term Mommy Makeover comes from the frequently requested combination of cosmetic plastic surgery procedures used to restore a woman’s body after childbirth. The most common combination is Breast Augmentation with a Tummy Tuck, but variations are available when indicated.

Mommy Makeover Breast Options

The motivation for having a Mommy Makeover is the desire to restore the breasts and belly to their pre-pregnancy shape. For breast enhancement, the best procedure depends on how the breasts have changed:

  • Smaller Breast may benefit from Breast Augmentation.
  • Larger Breast may benefit from Breast Reduction.
  • Sagging breast may benefit from a Breast Lift.
  • Changes to the nipples and areolae can also be reversed.

Mommy Makeover Before and After Pictures

This Mommy Makeover included Breast Augmentation and a Tummy Tuck, the most common combination for restoring the body after childbirth.

This Mommy Makeover included Breast Augmentation and a Tummy Tuck, the most common combination for restoring the body after childbirth.

Mommy Makeover Belly Options

Just like with the breasts, there options are available for treating the belly, depending on each patient’s needs. While the most common surgery to restore a pre-baby belly is the Tummy Tuck, sometimes a smaller operation is the better choice. Regardless of the procedure used, the best results are obtained when your weight is optimal.

Common scenarios and treatment options include:

  • Loose abdominal skin and muscle laxity are treated with a Tummy Tuck (Abdominoplasty)
  • Loose skin and muscle laxity confined to the lower abdomen may respond to a Mini Tummy Tuck.
  • If the muscle and skin are tight, but disproportionate fat is present, Liposuction might be the best solution.
  • The abdominal fat, which is removed during the Mommy Makeover, is sometimes repurposed to enhance an atrophied bootie. Fat from the abdomen can often be transplanted to the buttocks as part of a Brazilian Buttocks Lift.

This Mommy Makeover combined a Breast Augmentation Lift with a Tummy Tuck and Liposuction.

This Mommy Makeover combined a Breast Augmentation Lift with a Tummy Tuck and Liposuction.

Mommy makeover Consultations

There are many treatment options for Mommy Makeovers, so it is necessary to have an experienced professional to guide your decision making. The Internet can give you an idea of what is possible; however, there is no substitute for an in-person consultation with an experienced Board Certified Plastic Surgeon.

If you have Mommy Makeover questions, call me at (925) 943-6353, and schedule a private consultation appointment. Your options will be discussed and your questions will be answered in a manner specific to your needs.

Coming Soon to a Station Near You

Stay tuned to the Bay Area’s News Station, KRON 4. Later this month, I will be starting my television show Body Beautiful with a segment dedicated exclusively to the Mommy Makeover, and more before and after pictures will be revealed.

Read More

Saline Breast Implants – SF Bay Area Breast Aug Surgery

Posted February 11, 2019 in Breast Augmentation, Breast Implant Revision Surgery, Home

All breast Implants create larger breasts. While Silicone Breast Implants are more widely used, Saline Breast Implants still have a role to fill.

All breast Implants create larger breasts. While Silicone Breast Implants are more widely used, Saline Breast Implants still have a role to fill.

Over 90% of today’s Breast Augmentation patients choose Silicone Gel Breast Implants, but Saline Breast Implants still play a role in selected situations. Today, I review the pros and cons of Breast Augmentation with Saline Breast Implants.

Saline Breast Implant Cost Less

Saline Breast Implants cost less than Silicone Breast Implants. Since saline breast implants are easier to manufacture, they cost less. Also, saline breast implants are not pre-filled. The saline is actually inserted during surgery by your surgeon.

Saline Breast Implant Leak Detection

Saline is water with a little salt added to make it as salty as we are, about 0.9% NaCl.

Saline is water with a little salt added to make it as salty as we are, about 0.9% NaCl.

With Saline Breast Implants, leak detection is simple. When they leak, the slightly salty water inside escapes and is quickly absorbed by the body. The result is noticeable deflation, usually occurring overnight. Unlike Silicone Breast Implants, expensive diagnostic imaging, MRI is not needed. Saline Breast Implants are also easier to replace, because only the shell needs to be removed.

Saline Breast Implant Projection

Until recently, Saline Breast Implants provided more projection than silicone breast implants. When saline implants are filled, they become firmer and have more projection. For the same volume, Saline Breast Implants have about 10% more projection. Additionally, Silicone Breast Implants are flat on the back side, while Saline Breast Implants are convex.

Saline Breast Implants are convex on the back, so they give more projection than the flat-backed Silicone Breast Implants for the same volume.

Saline Breast Implants are convex on the back, so they give more projection than the flat-backed Silicone Breast Implants for the same volume.

Saline Breast Implant Incision Size

Saline Breast Implants are inserted empty, so the surgical incision is small. They can be collapsed and then filled after they are inserted by way of a filling tube. On the other hand, Silicone Breast Implants come pre-filled, thus they are bigger and require a larger incision for placement.

Saline Breast Implant Drawbacks

Saline Breast Implants feel firmer, tend to ripple (wrinkle) more and move differently than Silicone Breast Implants. For women going up one cup size, there may be enough native breast tissue to disguise the implant. However, for those going from an A-cup to a D-cup, the implant is more palpable, even when the Breast Implant is placed behind the muscle.

Breast Augmentation Consultation

The difference between Saline and Silicone Breast Implants is just one consideration before Breast Augmentation surgery. While the Internet can provide general information, consulting with an experienced, Board Certified Plastic Surgeon will help you translate which options will work best for you.

If you are in the San Francisco Bay Area, call (925) 943-6353 today, and schedule a private Breast Augmentation Consultation.

Read More

Gummy-Bear Breast Implants Have Taken Over

Posted February 04, 2019 in Breast Augmentation, Home

Breast Augmentation before and after photos: Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures. In the above photos, asymmetry, sagging and upper pole emptiness are corrected with Breast Implants.

Breast Augmentation before and after photos: Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures. In the above photos, asymmetry, sagging and upper pole emptiness are corrected with Breast Implants.

Gummy-Bear Breast Implants have taken over as the implant of choice for Breast Augmentation. The vast majority of Breast Implants used in the US today are Silicone Gel filled, and almost all new Breast Implants are Gummy-Bear Breast Implants.

Gummy-Bear Breast Implants – What’s the Big Deal?

Gummy-Bear Breast Implants provide a soft, yet strong option for Breast Augmentation. To really appreciate the advantages that Gummy-Bear Breast Implants offer, it helps to know a little about the history of breast implants.

Brief History of Breast Implants

Since the beginning, Breast Implants have been filled with two materials: silicone and saline. Saline filled breast implants are silicone shells filled with water and a little salt to make the solution as salty as we are. Other than changes in shell shape, saline implants have remained the same throughout the years, and the saline filler has not changed at all. Their main advantages are easy detection of leaks and the fact that saline, like water, is quickly absorbed by the body, disappearing without a trace. Saline Breast Implants can provide more projection, and a rounder look than most silicone filled implants. However, saline filled breast implants tend to feel firm and show wrinkling more than silicone gel implants, especially when less breast tissue and thinner skin are present before Breast Augmentation.

Silicone gel filled breast implants have evolved over the last few decades. The latest options provide soft, strong implants filled with a cohesive, gummy-bear gel to reduce the possibility of gel migration.

Silicone gel filled breast implants have evolved over the last few decades. The latest options provide soft, strong implants filled with a cohesive, gummy-bear gel to reduce the possibility of gel migration.

Silicone Breast Implants, on the other hand, have evolved and improved during their almost 60 year history. The current gummy-bear silicone filled breast implants are considered fifth generation. Older versions were thinner, less cohesive, would bleed gel through the shell, tear easily and the thinner gel would migrate. In 1994, higher quality silicone, more cohesive gel and improvements in manufacturing have led to drastic reductions in gel bleed in intact implants, and reduction in gel migration in cases of breast implant rupture. The latest generation also use optimal gel fill to reduce wrinkling and a more cohesive gel to reduce gel migration to further enhance both cosmetic results and safety.

What Is A Gummy-Bear Breast Implant?

When discussing Gummy-Bear Breast Implants, the term “Gummy-Bear” refers to the filling in the center of the implant, not the shape. Gummy-bear candies are soft, and if you have ever bitten one in half, they are solid. Gummy-bear breast implants are similar. Unlike older silicone breast implants, if you cut a gummy-bear breast implant in half, it behaves like a solid and remains as two intact domes. Like the gummy-bear candy, the center does not flow. In my San Francisco Bay Area office I have a gummy-bear implant which I sliced in half years ago that has a cut surface which continues to remain smooth, flat and intact. The Gummy bear implants offer the safety and predictability that I want for my patients, with a softer result.

Gummy-Bear Breast Augmentation

If you are consulting for Breast Augmentation, be certain to ask your Board Certified Plastic Surgeon about breast implant options. Size, shape and filling all effect results. You don’t have to choose in the vacuum of the Internet. If you can provide your surgeon with your desired goal size, they will help you choose the best Breast Implant available to achieve your augmentation goals.

In the San Francisco Bay Area, if you are thinking about Breast Augmentation surgery, call (925) 943-6353 and schedule a personal consultation appointment. Whether you are interested in a primary Breast Augmentation or desire Breast Augmentation Revision, today’s new Breast Implants offer some never before available features.

Read More

Silicone Breast Implant Warranty Comparisons

Posted January 28, 2019 in Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Breast Reconstruction, Home, Patient Safety

Breast Implant Warranty Coverage

Every few years, the US FDA approved breast implant manufacturers update their Breast Implant Warranties. While implant deflation has been covered for a long time, the warranties now include extended coverage for breast implant replacement and enhanced coverage for specific situations that may occur after Breast Augmentation with Silicone Gel Filled Breast Implants. Expanded coverage now includes Capsular Contracture, late seroma formation, double capsule formation and BIA-ALCL.

Below, I compare warranties offered by the three US breast implant brands: Allergan, Sientra and Mentor, in the three major areas of coverage: Capsular Contracture, Rupture and Seroma Formation. It is important to state that these are the current offerings, and that they may change without notification. You should check with the manufacturer directly for the latest warranty information. Additionally, newer coverage is limited to newer implants, so you need to know the manufacturer, type of implant and the date of your surgery in order to determine which warranty applies to your implants.

Capsular Contracture Coverage

The most common reason for Breast Augmentation Revision Surgery is Capsular Contracture. In the breast implant 10-year follow-up studies, occurrence rates ranged from 12% to 19% for the primary breast augmentation cohort. Breast Implant manufacturers have begun to include Capsular Contracture in their warranty programs.

Capsular Contracture is tightening of the scar pocket that holds the breast implant in place. In the left before-photo, Capsular Contracture elevates this patient's right breast implant and causes severe asymmetry. The right after-photo shows correction after capsule surgery and breast implant revision surgery. Now, Capsular Contracture is covered by all three US FDA approved manufacturers' warranties.

Capsular Contracture is tightening of the scar pocket that holds the breast implant in place. In the left before-photo, Capsular Contracture elevates this patient’s right breast implant and causes severe asymmetry. The right after-photo shows correction after capsule surgery and breast implant revision surgery. Capsular Contracture is now covered by all three US FDA approved manufacturers’ warranties.

Sientra currently offers the best free warranty for Capsular Contracture (grade III or IV). The latest Sientra Platinum20 Warranty offers twenty years of free implant replacement during surgery for Capsular Contracture along with $2000 of financial assistance if capsular contracture occurs in the first two years after surgery.

The Allergan ConfidencePlus Warranty was just updated and is a close second with ten years of free implant replacement during surgery for Capsular Contracture along with $2000 of financial assistance if capsular contracture occurs in the first two years after surgery.

The MentorPromise Warranty offers ten years of free implant replacement during surgery for Capsular Contracture, but no financial assistance. However, Mentor does offer an enhanced warranty. You need to pay $300 to Mentor at the time of your surgery to obtain the MentorPromise Enhanced Warranty. This includes ten years of free implant replacement during surgery for Capsular Contracture and $3500 of financial assistance but limits coverage to primary augmentation or primary reconstruction unless MemoryShape breast implants are utilized. Mentor currently lags, especially when comparing the free warranties; however, Mentor may update their warranty to more closely match their competitors as Allergan did when Sientra announced enhanced free coverage for capsular contracture.

Rupture Coverage

Breast Implant Rupture was the original coverage benefit for Breast Implant Warranties. It is a close second to Capsular Contracture as the reason for Breast Augmentation Revision Surgery. In the 10-year follow-up studies, rupture (deflation) rates range from 8% to 25%.

These Breast Implant Rupture Before and After photos illustrate a common case of Breast Implant Revision Surgery. The coverage is variable and depends on the manufacturer.

These Breast Implant Rupture Before and After photos illustrate a common case of Breast Implant Revision Surgery. The coverage is variable and depends on the manufacturer.

All three manufacturers provide free lifetime breast implant replacement on both sides and financial assistance for the revision surgery. Recently, Sientra increased the financial assistance offered, and it remains to be seen if the other manufactures will match them, as they often do.

The Sientra Platinum20 Warranty offers $5000 in financial assistance toward replacing the breast implants for up to 20 years after the original surgery. This is a recent change and is currently the best in the industry.

The Allergan ConfidencePlus Warranty offers $3500 in financial assistance toward replacing the breast implants for up to 10 years after the original surgery.

The MentorPromise Warranty also offers $3500 in financial assistance toward replacing the breast implants for up to 10 years after the original surgery. This is not increased in the MentorPromise Enhanced Warranty.

Late Seroma Coverage

As shaped implants became more popular, so did the problems associated with them. Shaped implants can rotate and “change” shape. To reduce this problem, shaped implants are textured. This can help prevent rotation and may also reduce the risk of capsular contracture; however, Textured Breast Implants also have unique problems: seromas (collections of fluid around implants), double capsules and possibly BIA-ALCL. Manufacturers have responded with late seroma coverage along with coverage for double capsules and BIA-ALCL diagnostic testing in their latest Breast Implant Warranties.

Seromas are collections of fluid. Small amounts of fluid around the breast implants is normal the first few days after surgery and resolves spontaneously. Seromas that appear years after surgery are not normal or common. The fluid will enlarge the effected breast, making it appear larger than its sister breast. It may present as the picture above shows, with the right breasts appearing larger than the left. There are many causes, most of them benign; however, all should be checked by your plastic surgeon. Breast implant warranties are starting to include testing and treatment for late seromas.

Seromas are collections of fluid. Small amounts of fluid around the breast implants is normal the first few days after surgery and resolves spontaneously. Seromas that appear years after surgery are not normal or common. The fluid will enlarge the effected breast, making it appear larger than its sister breast. It may present as the picture above shows, with the right breasts appearing larger than the left. There are many causes, most of them benign; however, all should be checked by your plastic surgeon. Breast implant warranties are starting to include testing and treatment for late seromas.

The Sientra Platinum20 Warranty provides twenty year coverage for breast implant replacement and $2000 in financial assistance should a double capsule or seroma form in the two years after surgery. They also provide CD30 panel testing for BIA-ALCL evaluation of late seroma fluid.

The Allergan ConfidencePlus Warranty also was recently updated to provide twenty year coverage for breast implant replacement and $2000 in financial assistance should a double capsule or seroma form in the two years after surgery. They also provide up to $7500 in financial assistance and implant replacement in cases of BIA-ALCL.

The MentorPromise Warranty offers ten year coverage for breast implant replacement and no financial assistance in cases of double capsule and seroma formation. However, Mentor does offer an enhanced warranty. You need to pay $300 to Mentor at the time of your surgery to obtain the MentorPromise Enhanced Warranty. This includes ten years of free implant replacement during surgery for Capsular Contracture and $3500 of financial assistance in the ten years after surgery. Like the Mentor Capsular contracture coverage, coverage is limited to primary augmentation or primary reconstruction unless MemoryShape breast implants are utilized. There is currently no coverage for BIA-ALCL testing.

Breast Augmentation and Breast Augmentation Revision

If you are considering Breast Augmentation or Breast Augmentation Revision, be certain to ask your Board Certified Plastic Surgeon about breast implant warranties. For revision surgery, bring as much information as possible about your current implants to your consultation appointment. The breast implant card given to you after surgery is very helpful as it provides the manufacturer, size, type of implant, and date of implantation.

There is much to know about Breast Implants and the procedures used to place and maintain them. It helps to have an experienced guide to answer your questions and provide expert guidance. For Breast Augmentation and Breast Augmentation Revision in the greater San Francisco Bay Area, call (925) 943-6353 today, to schedule a private consultation.

Read More

Tummy Tucks and Mommy Makeovers | SF Bay Area

Posted October 25, 2018 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Tummy Tuck (Abdominoplasty), Videos

The Tummy Tuck is half of a Mommy Makeover. The patient shown above wanted her pre-baby belly and breasts back. The combination of Abdominoplasty and Breast Augmentation with a Breast Lift restored what nature had given and taken away.

The Tummy Tuck is half of a Mommy Makeover. The patient shown above wanted her pre-baby belly and breasts back. The combination of Abdominoplasty and Breast Augmentation with a Breast Lift restored what nature had given and taken away.

The Tummy Tuck remains one of the most sought after cosmetic plastic surgery procedures. Also termed, Abdominoplasty, it literally means belly changing, and that is exactly what it does.

Tummy Tuck and Mommy Makeover Video

Today’s episode of Body Beautiful reviews the Tummy Tuck procedure, and beautifully illustrates what Abdominoplasty can do to restore abdominal contours often lost after pregnancy or changes in weight. This video segment is from the Bay Area’s News Station, KRON 4’s, Body Beautiful. The show features the latest in Cosmetic Plastic Surgery, and uses before and after pictures liberally to demonstrate what is possible.

Tummy Tuck After Pregnancy or Weight Loss

After pregnancy or weight loss, the abdomen is often left flaccid. The muscles, even when strong, are stretched out and cannot support the abdominal contents the way they used to. The skin itself is stretched out, often leaving stretch marks and rolls. The result: clothes don’t fit the way they used to.

What is a Mommy Makeover?

The breasts often suffer a similar fate, so restoring breast volume and perkiness is often performed at the same time as the Tummy Tuck via Breast Augmentation, Breast Lift or the combination Breast Augmentation Lift.

More Mommy Makeover before and afters: Again, Abdominoplasty is combined with Breast Enhancement. In this case, a Breast Lift was combined with a Tummy Tuck for a uplifted, aesthetic result.

More Mommy Makeover before and afters: Again, Abdominoplasty is combined with Breast Enhancement. In this case, a Breast Lift was combined with a Tummy Tuck for a uplifted, aesthetic result.

Because this is commonly a problem after pregnancy, the combination of Breast Enhancement and Tummy Tuck goes by the name Mommy Makeover. In the Mommy Makeover Before and After Pictures above, a Breast Lift (Mastopexy) was combined with a Tummy Tuck for maximum aesthetic results.

Tummy Tuck or Mommy Makeover Consultations

There is no substitute for proper training and experience. When considering a Tummy Tuck, Mommy Makeover or any Cosmetic Plastic Surgery, consult with an experienced and Board Certified Plastic Surgeon. If you are in the San Francisco Bay Area, call (925) 943-6353 to schedule a private and personalized consultation appointment, today.

Read More

Breast Augmentation With Gummy Bear Breast Implants | SF Bay Area

Posted October 05, 2018 in Breast Augmentation, Home, Mommy Makeover, Videos

Summer may be over, but Breast Augmentation is still one of the most frequently requested Cosmetic Plastic Surgery procedures here in the San Francisco Bay Area. For many, this is the best time of year for the procedure. As the weather cools down, it is easier to cover up during recovery. Moreover, you will be well healed by the time Spring comes around.

Gummy Bear Breast Implants are the newest technology. With a strong, cohesive gel inside, they can provide more projection, less rippling and the safety reduced gel migration.

Gummy Bear Breast Implants are the newest technology. With a strong, cohesive gel inside, they can provide more projection, less rippling and the safety reduced gel migration.

This Breast Implant Video Presentation illustrates the options and the results of Breast Enlargement. There are many reasons for Breast Augmentation. Sometimes it’s for size. Sometimes it’s for shape. The latest breast implants provide shape and support for the breasts with the increased safety of strong, highly cohesive gel inside them. These “Gummy Bear” Breast Implants reduces gel migration and some other problems seen in the past after Breast Augmentation with Silicone Gel Breast Implants.

Breast Augmentation Video (Augmentation Mammoplasty)

This Body Beautiful video segment from the San Francisco Bay Area’s News Station, KRON 4, reviews Breast Augmentation with the latest Gummy Bear Breast Implants. This Breast Implant Video reviews many of the options and illustrates the benefits of Augmentation Mastopexy with numerous Breast Aug Before and After Photos.

Breast Implant Consultations

If you are considering Breast Augmentation or Breast Implant Revision Surgery, consult with a Board Certified Plastic Surgeon in your area. When in the San Francisco Bay Area, call (925) 943-6353 today, and schedule a personal and private consultation appointment.

Read More

How to Choose Breast Implants

Posted June 03, 2018 in Breast Augmentation, Home, Mommy Makeover

One of the most common questions Plastic Surgeons get is,”How do I choose the best breast implants?” While more often than not, this is in reference to size, there are multiple aspects to consider. The most important thing to remember is that you are not on your own. Your plastic surgeon should have a wealth of experience in this area, and they can help simplify and reassure you in your selection.

Breast Augmentation remains the most popular Cosmetic Plastic Surgery procedure.

Breast Augmentation remains the most popular Cosmetic Plastic Surgery procedure.

In my San Francisco Plastic Surgery office I depend on my patients to provide me with a clear idea of the size they want, and they depend on me to help them select the details that are most likely to give them a happy result. Let’s review some of the details.

Breast Implant Size

The amount of augmentation is determined by the volume of the breast implants. If you are looking for a particular cup size, the amount of volume needed will depend on many factors including:

  • The amount of breast volume you have before augmentation
  • Which bra you wear – Each manufacturer has a different definition of cup size.
  • The fullness you wish to achieve
  • The tightness of your chest skin and muscles
  • The shape of your breasts
  • The width of your chest

For the best results, do your pre-breast augmentation homework. Buy a bra the size you want to be. Stuff it. Wear it. Try it with different clothes. The clearer your goal, the easier it will be to communicate to your Plastic Surgeon and to achieve your ideal breasts.

Breast Implant Profile

Choosing the right size for you is the most important aspect of Breast Augmentation.

Choosing the right size for you is the most important aspect of Breast Augmentation.

Size matters, but so does shape. If you are trying to make a statement with your breasts, larger, high-profile breast implants will fill the breasts maximally. If you are considering proportionate breast augmentation, moderate profile breast implants may be more to your liking. If you are a marathon runner looking for a B-cup, low profile implants may provide enough augmentation to the breasts’ foundation to give you the shapelier breasts you desire.

Breast Implant Filling

Breast implants are filled with two materials: Saline and Silicone. While the majority of breast augmentation performed today is with smooth round silicone breast implants, sometimes, saline is a better answer. It is important to choose an experienced Board Certified Plastic Surgeon who can evaluate these options and help you determine what is most likely to work best for your goals.

Breast Implant Placement

The best breast augmentation is achieved by selecting breast implants that are proportionate to the chest.

The best breast augmentation is achieved by selecting breast implants that are proportionate to the chest.

Breast Implants can be placed in front of or behind the pectoralis major muscles. There are advantages and disadvantages to both positions. It is important that you know the differences and have guidance to select the placement which works best for you.

FDA Approved Breast Implants

There are currently three FDA approved Breast Implant manufacturers in the US. They provide many variations of sizes, shapes, filler and textures. While there are still some options that are not available, the options we have make it difficult to justify using a non-FDA approved breast implant. You should know exactly which implants your surgeon plans to use, and you should receive a card identifying those breast implants after your procedure. This is very important for warranty enforcement, breast implant replacement and for future breast implant maintenance.

Help Choosing Your Breast Implants

If you are considering Breast Augmentation, call my Walnut Creek Plastic Surgery office at (925) 943-6353, and schedule a private, confidential consultation appointment. I will go over your goals, your options and will use my greater than 20 years of experience to help you choose a plan that is best suited to your needs.

Read More

Post-Bariatric Plastic Surgery Video – SF Bay Area

Posted April 22, 2018 in Arm Lift (Brachioplasty), Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Lower Body Lift (Belt Lipectomy), Mommy Makeover, Post-Bariatric Surgery (After Weight Loss), Tummy Tuck (Abdominoplasty), Videos

Post-Weight Loss Plastic Surgery Video

Massive weight loss will shrink our volume, but does not reliably shrink our skin. In the before and after pictures above, breast volume is restored with breast implants. Sagging breast skin is tightened with a breast lift.  Excess abdominal skin is removed, and the belly bulge caused by stretched out abdominal muscles is flattened by tightening the muscle sheath.

Massive weight loss will shrink our volume, but does not reliably shrink our skin. In the before and after pictures above, breast volume is restored with breast implants. Sagging breast skin is tightened with a breast lift. Excess abdominal skin is removed, and the belly bulge caused by stretched out abdominal muscles, is flattened by tightening the muscle sheath.

Post-Bariatric Plastic Surgery is Plastic Surgery after Massive Weight Loss. Whether this is after a lifestyle change or after Bariatric Surgery, the amount of skin that persists after weight loss is often large and frustrating. This Post-Weight Loss Plastic Surgery Video reviews several of the most common treatments including: Lower Body Lifts, Tummy Tucks, Breast Augmentation, Breast Lifts and Arm Lifts. The results of Post-Bariatric Plastic Surgery are illustrated and narrated in this video with before and after pictures, which describe and demonstrate what Board Certified Plastic Surgeons can do for the skin excess that often occurs after weight loss.

Post-Bariatric Plastic Surgery Video

Extremity Tightening Procedures

The majority of skin tightening procedures performed after weight loss are for the trunk; however, the face, arms and legs can also develop excess skin. Face Lifts (Rhytidectomy), Arm Lifts (Brachioplasty) and Thigh Lifts can help with excess skin on the face/neck, upper arm and thighs. Below is an example of an arm lift.

Brachioplasty literally means arm changing. An arm lift can change the way an arm looks, feels and fits into sleeves.

Brachioplasty literally means arm changing. An arm lift can change the way an arm looks, feels and fits into sleeves.

Brachioplasty changes the arm by removing the excess skin that often hangs off the upper arm after weight loss. The skin is removed from the lower border of the upper arm, leaving a scar along the bottom of the arm. This is the only procedure that can remove large amounts of excess skin.

Post Bariatric Plastic Surgery Consultations

As an active member of the American Society of Bariatric Plastic Surgeons, post bariatric plastic surgery is an area in which I specialize.

The American Society of Bariatric Plastic Surgeons was formed by Board Certified Plastic Surgeons specializing in skin tightening after massive weight loss.

The American Society of Bariatric Plastic Surgeons was formed by Board Certified Plastic Surgeons specializing in skin tightening after massive weight loss.

When searching for an experienced post-weight loss plastic surgeon, be certain to look for a Board Certified Plastic Surgeon who is a Member of the American Society of Plastic Surgeons. Additionally, members of the American Society for Aesthetic Plastic Surgery specialize in the cosmetic side of plastic surgery, and members of the American Society of Bariatric Plastic Surgeons demonstrate additional dedication to the cosmetic side of post-bariatric plastic surgery.

If you are in the San Francisco Bay Area and want to learn more about your skin reduction options after weight loss, call (925) 943-6353, to schedule your private consultation appointment.

Read More

Breast Augmentation and Breast Lifts Combined – SF Bay Area

Posted April 09, 2018 in Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Post-Bariatric Surgery (After Weight Loss), Videos

Aesthetic Breast Surgery

Breast Augmentation Lift combines the Breast Enlargement of Breast Augmentation with the firming and shaping abilities of a Breast Lift.

Breast Augmentation Lift combines the Breast Enlargement of Breast Augmentation with the firming and shaping abilities of a Breast Lift.

The desire for the Best Breast can be divided into two areas: The best size and the best shape. This Breast Augmentation and Breast Lift Video discusses combining a breast lift with a breast implant. The procedure allows your plastic surgeon to maximize your results when both shape and size need modification.

Breast Augmentation Lift Video (Mastopexy Augmentation)

This Body Beautiful video segment from the San Francisco Bay Area’s News Station, KRON 4, reviews Breast Lifts combined with Breast Implants and illustrates the benefits of Augmentation Mastopexy with numerous Breast Aug Lift Before and After Photos.

Breast Size

The ideal breast size varies from patient to patient, and it is important to recognize that the more you do your homework in determining what size makes you happy, the easier it will be for your plastic surgeon to give you the result you desire. Most patients request a cup size in the C plus to D minus range, but you should try it out at home, first.

Buy a bra the size you feel you want to be and stuff it. Ziplock bags filled with rice are a simple way to adjust your breast volume. Try it with different clothing to see how you like it. Do your normal activities, and see how it works. Also, think about your overall body size and your activity level. Marathon runners often go smaller, to avoid the added weight and momentum.

Breast size is determined by the volume of breast tissue you have now, plus the volume of the breast implant. When you have a good shape, Breast Augmentation alone is used to enlarge the breasts to the desired size. For most women this is the procedure of choice. When the breasts are saggy, asymmetrical or tubular, a breast lift may be recommended to improve the overall esthetic of the breasts.

Breast Augmentation Lift Before and After Pictures

Deflated, post child birth or post weight loss breasts can be lifted, tightened and enlarged with the breast enhancing Mastopexy Augmentation. Larger lifts require longer scars. In this case, the healing vertical scar is seen on the lower pole of the breast. After this breast augmentation mastopexy, the breasts are fuller, firmer and lifted.

Deflated, post child birth or post weight loss breasts can be lifted, tightened and enlarged with the breast enhancing Mastopexy Augmentation. Larger lifts require longer scars. In this case, the healing vertical scar is seen on the lower pole of the breast. After this breast augmentation mastopexy, the breasts are fuller, firmer and lifted.

Breast Shape

The ideal breast shape also varies from patient to patient. Most patients desire perky, teardrop shaped breasts. A Breast Lift reshapes the breasts by removing excess skin, lifting and firming the breast mound. When the upper pole of the breast is empty, a breast implant is used to add volume. A Breast Implant can balance the upper and lower halves of the breast, or it can enlarge the entire breast.

Breast Lifts come in many sizes. The most common are periareolar (around the areola/nipple), vertical (lollipop) and inverted T (anchor or keyhole). The amount of lifting needed determines the type of lift recommended. It is always desirable to choose the smallest lift expected to work. Smaller lifts come with shorter scars, but they lift less. Be sure to consult a Board Certified Plastic Surgeon near you to learn what is recommended for your particular needs.

Breast Augmentation Lift Consultations

When considering Breast Augmentation, with or without a Breast Lift, be certain to consult an experienced Board Certified Plastic Surgeon. They can explain your options and select the procedure most likely to get you the results you want in the safest and most predictable manner. Call (925) 943-6353 and schedule a personalized consultation appointment, today.

Read More

Questions For Your Cosmetic Surgeon – Experience

Posted February 04, 2018 in About Dr. Mele, Home, Patient Safety

Experience shapes training into even better results. Ask your Board Certified Plastic Surgeon about their experience.

Experience shapes training into even better results. Ask your Board Certified Plastic Surgeon about their experience.

It is important to have all the information before deciding on a Cosmetic Plastic Surgery procedure. This post reviews question two of the five questions you should always ask before having Elective Cosmetic Surgery. The five questions are:

How Often Do You Perform The Procedure?

How often do you perform the procedure? This question gets to your surgeon’s experience. Excellent Training is a must and was reviewed in the previous post. What happens after training is equally important. You want a Cosmetic Surgeon who actively practices the procedure they are doing for you. Someone who has the skills and good judgement, specific to your needs.

Last year, almost two-million cosmetic plastic surgery procedure were performed by eight-thousand US based Board Certified Plastic Surgeons. This is an average of 225 operations per surgeon. This is a good number to have in mind when we are evaluating how many times a surgeon performs a certain procedure each year. Some surgeons do 100 operations a year, some do 500. Some surgeons operate fast than others. Some work three days a week, some work six. Specialists will do a higher percentage of a certain procedure, and necessarily fewer other procedures.

How To Measure Experience

Quantity and quality do not always correlate. There is a quantity with above which quality suffers. There are also some very busy, below average ability surgeons. They may have slick advertising campaigns. They may always be offering the absolute latest technology. They may provide cut-rate surgery costs. Unfortunately, often by corners are being cut behind the curtain. Buyer beware.

Two simple ways to measure experience are years in practice and a clean record with the medical board. Both are easily checked online, and these should always be checked. For your convenience, I have links for checking Board Certification and standing with the California Medical Board at the bottom of the San Francisco Plastic Surgery Blog’s American Board of Plastic Surgery Page.

How Many Procedures Are Enough?

How often your plastic surgeon does a particular procedure is a gauge of experience. But, how many procedures are enough? The answer varies.

Surgical statistics for each year are available  on the ASPS and ASAPS web sites. Knowing how common a procedure is will help you determine how many procedures a year are reasonable.

Surgical statistics for each year are available on the ASPS and ASAPS web sites. Knowing how common a procedure is will help you determine how many procedures a year are reasonable.

Numbers go up depending on the popularity safety and reliability of the procedure, and there is regional variation. On the other hand, Plastic Surgeons with more skills, better judgement and more experience will require lower numbers to maintain their skills. If a surgeons only does a certain procedure, you should expect them to do a larger volume of that procedure. Unfortunately, there is no guarantee that a surgeon is better, just because they do, or claims to do, more procedures. Numbers are just one way to measure experience, but in general, more is better.

Procedure Popularity

Some procedures are more popular than others, so higher numbers are expected for procedures like Breast Augmentation and Liposuction, and lower numbers are expected for less common procedures like Buccal Fat Pad Reduction and Lower Body Lifts. Dividing the number of procedures performed in the US by the number of plastic surgeons in the US gives us a rough average for each procedure. By the nature of an average, half the plastic surgeons in the US will do less than the average number of procedures. This does not necessarily mean they are worse at it.

Here is an example. If 300,000 Breast Augmentations are performed in one year, and there are 8000 Plastic Surgeons in the US, the average is 300,000 divided by 8,000 or 37 Breast Augmentations per Plastic Surgeon. In other words, the average US Plastic Surgeon would be expected to do about 37 Breast Augmentations a year or about three a month.

Breast Augmentation is often the most frequently performed Cosmetic Plastic Surgery procedure performed in the US. Other very popular procedures include: Eyelid Surgery, Liposuction and Nose Reshaping. Each of these are performed approximately 200,000 times a year or twice a month for the average Plastic Surgeon.

Facelifts, Tummy Tucks and Breast Lifts are at a frequency of 100,000 a year or a once a month average. Gynecomastia Reduction (Male Breast Reduction) is performed about 25,000 times a year in the US, or 3 operations a year for the average Plastic Surgeon. Arm Lifts have a lower frequency. Fewer than 18,000 Arm Lifts are performed each year, which works out to two a year on average. Thigh Lifts are performed even less frequently, so the average is about one a year. Buccal Fat Pad Reduction is even less common. It’s all relative.

Some Procedures Work Better Than Others

Some procedures work better than others. These tend not to be the latest and greatest procedures. The most reliable procedures are tried and true and tend to be mainstream general plastic surgery procedures. Surgeons with good judgement will do more of these general plastic surgery procedures and fewer very specialized niche procedures. You should expect your surgeon to do more “full” procedures than “mini” procedures. I prefer using the smallest hammer that will get the job done; however, mini procedures do less. To get a good result from a mini procedure, you need to have a mini problem. If your surgeon is only doing mini procedures, this is a red flag.

When Is The Last Time You Did This Procedure?

The question, “How often do you perform a procedure?”, is really two questions in one. “How many procedures do you do?” and “How recently have performed the procedure?” Two questions which combine to give insight into how familiar your plastic surgeon is with your procedure. Someone who has done 50 procedures ten years ago, may not be as qualified as someone who performed 50 procedures in the last year. So you might want to ask a follow-up question about the last time your surgeon performed the procedure you are interested in.

The Shape Of The Practice

The popularity of Cosmetic Surgery varies by country. While South Korea, Greece and Italy beat the US by surgeries per capita, the column to the far right shows that no country does more Cosmetic Surgery than the US.

The popularity of Cosmetic Surgery varies by country. While South Korea, Greece and Italy beat the US by surgeries per capita, the column to the far right shows that no country does more Cosmetic Surgery than the US.

As practices are busier, the number of procedures performed goes up. Hopefully, they are busier because they are doing a better job. Additionally, as surgeons specialize, they limit the number of other procedures they perform. Moreover, they should be expected to be doing more procedure in their area of specialization.

Specialists

Specialization is good. It allows a surgeon to focus on a particular area of interest. I am Board Certified in General Surgery and Plastic Surgery. I am trained in many procedures, but I choose to specialize in Cosmetic Plastic Surgery. The majority of my practice is Cosmetic Plastic Surgery. I had excellent training, but I have learned more in my 20 plus years of practice than I learned during my many years of training. Moreover, being a Cosmetic Plastic Surgeon was a goal I set before beginning my training. This goal shaped the entire course of my training as well as the types of procedures I perform on a daily basis.

Super-Specialists

There is an expression which goes: When all you have is a hammer, the entire world looks like a nail. Be a little cautious of super-specialists. Most good super-specialists are well rounded surgeons who still do other procedures. On the other hand, there are some super-specialists who have only learned one way to do a procedure. They may lack the training, experience or ability to offer you alternatives that may actually work better.

The Life-style Lift company is a good example. The company specialized in facial rejuvenation. They promised a bargain basement, one hour fix, under local anesthesia, with minimal downtime. Essentially, they did a mini-facelift on everyone they met. Unfortunately, the downside to this one-size-fits-all solution was not explained. Risks were minimized and outcomes not maximized. They even employed Debbie Boone as their cheerful spokeswoman. She promised a low cost, low downtime solution wrapped in slick advertising and misleading before and after pictures. The company had many complaints, many lawsuits and was fined by multiple states for false advertising and unethical behavior. Lifestyle Lift is now bankrupt, but not before giving many patients, and plastic surgery, a black-eye.

The Only One

Be even more cautious of experts claiming to be the only one performing a certain procedure. Good procedures are like wildfires; they spread quickly. Fat grafting to the Buttocks, better known as the Brazilian Butt Lift, was unheard of in the US in 2000. It has been the fastest growing procedure for several years running. The number of Brazilian Butt Lifts performed increased from 3000 to 30000 procedures per year over the last five years. It has expanded quickly because it solves a problem better than the previous operations. It is by no means a perfect operation, but it is a good operation, that works better than the alternatives (Buttocks Implants). When something works better, word spreads quickly.

Good procedures are very unlikely to remain in the hands of a single surgeon. Most plastic surgeons share their good ideas at our annual meetings. This is done not for personal financial gain, but for the good of the profession. The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) have both stated that trying to patent or restrict the distribution of a medical procedure is unethical and grounds for expulsion. Sharing is caring, even for medical professionals.

Cross-over Procedures

Many plastic surgery procedures are similar. In some ways, Tummy Tucks, Arm Lifts and Thigh Lifts are the same procedure. The require similar skill set. This means there is some cross-over experience between these three procedures. What I learn through experience with common procedures, like Tummy Tucks, can help me achieve better results with less common procedures, like Arm Lifts and visa versa.

There Is No Magic Number

While a greater number of cases implies more experience, there is no number that can absolutely guarantee your results. Some people learn faster than others. This is true for doctors, too, so the number of repetitions needed to be safe and effective with a procedure will vary from doctor to doctor. Good training should make a surgeon safe, while experience makes them more effective. You want to choose a Cosmetic Surgeon who is both qualified and experienced.

We are fortunate. The San Francisco Bay Area is home to some of the best plastic surgery training centers in the world. We have many qualified and experienced Board Certified Plastic Surgeons to choose from. If you are interested in any of the procedures mentioned above, or elsewhere on the San Francisco Plastic Surgery Blog, call (925) 943-6353 today, and schedule a private consultation appointment to learn more.

Read More