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.

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Male Breast Reduction | Gynecomastia Reduction | SF Bay Area

Posted April 14, 2018 in Breast Reduction, Breast Reduction (Men), Daddy Makeover, Home, Liposuction, Videos

Male Breast Reduction is one of the most requested cosmetic plastic surgery procedures year after year.

Male Breast Reduction is one of the most requested cosmetic plastic surgery procedures, year after year.

Male Breast Reduction Video (Gynecomastia Reduction)

Gynecomastia is the medical term for Male Breast Enlargement. The enlargement can be isolated to the nipple areolar complex (puffy nipples), or may involve the entire chest. This Gynecomastia Reduction Video reviews the most common treatments and illustrates the results of Male Breast Reduction with multiple, narrated male breast reduction before and after pictures.

How Is Gynecomastia Reduction Performed?

Gynecomastia Reduction is often a combination of procedures. The most common combination is Liposuction plus direct excision of any firm glandular tissue which remains attached to the back of the nipple.

In situations where the skin is loose or the gland is saggy, skin reduction may also be necessary. The key it to pick the procedure, or combination, that gets the job done.

With good skin tone, even large breast reductions can be performed through small, minimally invasive incisions.

With good skin tone, even large breast reductions can be performed through small, minimally invasive incisions.

Which Male Reduction Procedure is the Right One for You?

For more information about Male Breast Reduction, visit the links in this post. For specific information, there is no substitute for an in-person consultation. Call (925) 943-6353 today, and schedule a private and informative consultation appointment. A proper evaluation and plan are the keys to excellent results.

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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.

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BIA-ALCL January 2018 Breast Implant Associated Lymphoma Update

Posted January 13, 2018 in Home, Patient Safety

Through the years, I have posted several updates on the rare, but very treatable, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on the San Francisco Plastic Surgery Blog. As of January 4, 2018, a pivotal new study was released in JAMA Oncology.

An advanced case of BIA-ALCL. Arrows on this MRI point to white patches of increased fluid around the tumor cells.

An advanced case of BIA-ALCL. Arrows on this MRI point to white patches of increased fluid around the tumor cells.

What Is The Risk of BIA-ALCL in Women With Breast Implants?

The article, available on-line, is titled, “Breast Implants and the Risk of Anaplastic Large-Cell Lymphoma in the Breast.” The key question which the authors tried to answer is, “What are the relative and absolute risks of breast anaplastic large-cell lymphoma (ALCL) in women with breast implants?”

To properly frame the answer obtained, it is important to note that BIA-ALCL is not breast cancer. However, the relative risk of BIA-ALCL compared to the risk of breast cancer is often used to give proper reference to how rare BIA-ALCL is.

What Was Found – The Absolute Numbers

The study utilized the Netherlands’ Nationwide Network and Registry of Histo- and Cytopathology (PALGA). Over the 27 years, the study identified 32 patients with primary breast ALCL with a breast implants. Overall, 782 female patients were diagnosed with a non-Hodgkin lymphoma (NHL) of the breast in the Netherlands during 1990 to 2016. 43 primary breast-ALCL cases were confirmed. The median age of the 43 patients with breast-ALCL was 59 years. 32 of these patients had ipsilateral (same sided) breast implants, compared with 1 among 146 women with other primary breast lymphomas (OR, 421.8; 95% CI, 52.6-3385.2).

Other Associations With BIA-ALCL

BIA-ALCL seems to form on the surface of textured breast implants. The cells can also be found in the fluid  that accumulates around the breast implant. The bacteria that form a biofilm around the textured implants have been associated with this tumor.

BIA-ALCL seems to form on the surface of textured breast implants. The cells can also be found in the fluid that accumulates around the breast implant. The bacteria that form a biofilm around the textured implants have been associated with this tumor.

BIA-ALCL is associated with textured breast implants. Out of 109,448 breast implants sold in the Netherlands, 49,109 were textured (P < 0.01). This means of the breast implants sold in the Netherlands, and presumably used, 45% are textured. In this study, however, 23 of 28 patients diagnosis with BIA-ALCL had textured breast implants at the time of their diagnosis or 82%. So the actual number of BIA-ALCL cases associated with textured implants was almost twice what would be expected if BIA-ALCL occurred at the same rate in textured and smooth breast implants. Even more importantly, in this study, it was unknown if the patients with smooth implants had previously had textured breast implants, but more on that below.

Textured Breast Implants & BIA-ALCL

The Plastic Surgery Foundation has the most complete and largest database of BIA-ALCL cases. As of December 1, 2017, of the 183 unique reported cases in the PROFILE database, every patient has had a textured breast implant prior to their diagnosis. Even women who had smooth breast implants at the time of their BIA-ALCL diagnosis, had previously had either a textured breast implant or a textured tissue expander prior to receiving their smooth breast implants.

Comparisons With Breast Cancer

If you live to 80 years of age, your risk of developing breast cancer is 1:8. If you have breast implants, your risk of developing BIA-ALCL ranges from 1:1000 to 1:30,000 for women with textured breast implants, depending on which epidemiological study you read. In 2018, about 40,920 women in the U.S. are expected to die from breast cancer. World wide there have been 17 deaths from BIA-ALCL over the 56 years that breast implants have been available. Like breast cancer, early diagnosis is the key to a cure. Unlike breast cancer, BIA-ALCL is very treatable.

The Signs of BIA-ALCL

Current treatment of BIA-ALCL is usually curative, but depends on early diagnosis and appropriate treatment.

Current treatment of BIA-ALCL is usually curative, but depends on early diagnosis and appropriate treatment.

Although it is unlikely that a woman with breast implants will ever have to deal with BIA-ALCL, it is important to know the symptoms and seek care if they develop. When BIA-ALCL is confined to the capsule, removing the breast implants and capsules has been curative for every patient to date. The majority of early stage patients require no additional treatment. Chemotherapy is required for unresectable disease to metastasis.

Delaying or declining treatment is not advisable. Analysis of the known deaths from BIA-ALCL revealed that patients either received radiation (x-ray therapy) or chemotherapy alone, died of the treatment itself, had incomplete surgical resection or had distant metastasis. All cases of BIA-ALCL should be reported to the PROFILE registry.

BIA-ALCL usually presents as unilateral (one-sided) swelling of the breasts, an average of 8-9 years after the insertion of textured breast implants (range 2-28 years reported). This can occur even if the breast implants have been replaced with smooth breast implants. Fluid around a textured breast implant is not usually due to BIA-ALCL, but it can be sent for analysis when the conditions are suspicious. BIA-ALCL can also present as a lump in the breast or in the armpit like breast cancer does.

Risk Factors

The FDA does not recommend any additional screening or treatment for BIA-ALCL. BIA-ALCL is extremely rare, and it is impossible to predict who will develop it, but there are 4 identified risk factors: TIMD

  1. T – Textured Breast Implants – There have been no reported smooth-walled device cases at this time.
  2. I – Inflammation – Chronic inflammation has been implicated. Certain bacteria in the biofilm that forms around breast implants have been associated with an increased risk of BIA-ALCL.
  3. M – Mutations – There may be a link with genetic mutations in JAK1 and STAT3. Further research is necessary.
  4. D – Duration of Augmentation – Presentation is usually 8-9 years after textured breast implant insertion.

What To Do If You Suspect You Have BIA-ALCL

Get checked out. See your primary medical doctor or your plastic surgeon. Get an updated medical history and physical examination. If enough fluid is present around the breast implant, a sample can be sent for analysis. 2-3 tablespoons are required for cytology and CD30 immunohistochemisty to rule out BIA-ALCL. Mammograms are not useful. PET/CT scans are used for staging.

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Breast Augmentation With Breast Implants Bay Area

Posted December 16, 2017 in Breast Augmentation, Home, Mommy Makeover, Videos

Breast Implants can enlarge and enhance the shape of a woman's breasts.

Breast Implants can enlarge and enhance the shape of a woman’s breasts.

Breast Augmentation remains one of the most requested Cosmetic Plastic Surgery procedures year after year. My San Francisco Bay Area Breast Augmentation patients are no exception. Whether breast shape or volume has become a problem postpartum, after weight loss or if you have always had small breast, Breast Implants may be the answer you are looking for.

Breast Augmentation Before and After Pictures

Breast Implants can put the stuffing back into deflated breasts.

Breast Implants can put the stuffing back into deflated breasts.

This week I discussed Breast Augmentation on the SF Bay Area’s New Station, KRON 4, with host Janelle Marie. The video segment below includes information about Breast Implants and how they are used. In it, I narrate multiple Breast Implant Before and After Pictures of my actual patients.

Breast Augmentation Video (Breast Implants)

Breast Augmentation Explained

Breast Augmentation with Breast Implants has been around for over 50 years. The procedure involves creating a pocket for the Breast Implant behind your breast tissue to augment the breasts. This enhances both the size and shape of the breasts. More information is available here on the San Francisco Plastic Surgery Blog, by selecting “Breast Augmentation” under the “Search By Category” heading in the sidebar. There is also information about Breast Augmentation Lifts, Breast Implant Selection, Breast Implant Revision, Breast Implant Removal and a wide variety of other cosmetic breast, face and body procedures.

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 Augmentation Consultations

If you are considering Breast Enhancement Surgery, call (925) 943-6353, today, and schedule a personal consultation appointment, tailored to your goals. We are conveniently located in the East San Francisco Bay Area city of Walnut Creek, CA.

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Cup sizes and CCs – SF Bay Breast Augmentation

Posted November 19, 2017 in Breast Augmentation, Home

How many ccs in a c-cup? This is a question I hear every day. The question is simple; however, the answer is complicated. I will try to explain in today’s San Francisco Plastic Surgery Blog post.

In 1937, Warner introduced its Alphabet Bra with four cup sizes (A, B, C and D)

In 1937, Warner introduced its Alphabet Bra with four cup sizes (A, B, C and D)

Math is Beautiful

Volume of a hemisphere

Please explain how this equation answers the question,”How many ccs are there in a C-cup?”

If you are still reading this, I will explain. The equation above is the approximate volume of a breast, given its radius (r). The volume of the breast is directly related to its radius cubed. In other words, if you double the radius of the breast, this will increase the volume eight-fold.

The upside to using an equation is that equations are 100% objective. Measuring the base width of the breast gives us the radius, and via the equation the volume. The beauty of mathematics is that there is a defined answer. The downside is that even this simplified equation is hard to relate to for most people. Additionally, the actual volume will be less than calculated, because breasts are not perfect hemispheres. At least they should not be, but this segues nicely in the subjective side of the C-cup.

Objective vs. Subjective

At the latest American Society for Aesthetic Plastic Surgeon (ASAPS) meeting, a company was offering a high-tech laser scanner that can be used to measure the exact contours of a patient’s body. If plastic surgery were 100% objective, this would be great; however, even though we can measure and calculate volumes with great precision, what exactly a C-cup represents is subjective. It depends on each patients experience, body shape and even the brand of the bra worn.

Bras were much pointier in the past.

Bras were much pointier in the past.

It is estimated that 75-80% of women wear the “wrong” bra size. My grandmother was a corsetiere. She sold lingerie at I. Magnin’s in Walnut Creek until the day it closed. She fitted women for bras, and even for prosthetics after a mastectomy. She had a loyal following, because she could find the right size for each customer and each manufacturer, and she confirmed that most women wear the wrong bra size. On the other hand, we wear what is comfortable.

Why Women Wear the Wrong Size Bra

Bra researchers have studied what size bras women wear and have documented through the years that most women do not wear the size bra for which they measure. Moreover, two trends are consistent. Women with smaller breast tend to wear bras which are too large, and women with larger breast tend to wear bras which are too small. Oprah Winfrey had an entire show dedicated to this, so it must be true. I think it’s an extension of the saying, “The grass is always greener on the other side of the hill.” In this case, the hill is a C-cup.

Inflatable cup sizes.

Inflatable cup sizes.

To add to the confusion, boutiques that tailor their products to younger/thinner women tend to inflate the cup size for a given volume. The best example is Victoria’s Secret. It is no secret that if you wear a C-cup in VS, you likely wear a B-cup in other mainstream bra manufacturers like Warner’s and Bali. This brand specific sizing, and often style specific sizing, leads to further confusion over what a C-cup really represents. There is no industry standard for bra sizing, so if you wear a 34C from company A, a 34C from company B may not fit.

Cup Volumes And Band Size

Cup volumes are also dependent in band size. The measurement under the breasts, the size of the chest without including the breasts, determines the band size. A larger chest means a larger band size. In the US, the measurement is made in inches, and then 4 or 5 is added to this to get to an even number. Other countries simply use the closest even number, so it is important to know the method of sizing.

Measurements are made around and below the bust for bra fittings.

Measurements are made around and below the bust for bra fittings.

When measuring around the breasts, each increase of one inch equals and increase in one cup size. Again, there are variations, some countries use 2 cm and others may use 3 cm. Since is takes more volume to increase an inch around a larger chest, cup volumes increase, for a given letter size, as the band size increases. For example, the cup volume of a 34C is 25% larger than that for a 32C and 23% smaller than that for a 36C.

So How Many CCs Are There In A C-Cup?

Bra sizing can be frustrating and confusing, and this is why it is hard to promise a certain cup size after Breast Augmentation. As it was so eloquently put by a presenter at the ASAPS annual meeting, “If a patient wants a guarantee for a specific cup size, I tell her I can, if I get to buy the bra.”

The simple answer: Objectively: When we do the math using the most commonly used US system of bra measurement, a 34C cup is 480ccs.

The real answer: Subjectively: It depends. It depends on many factors including:

  • Who’s C-cup you wear. A pretty, cleavage enhancing, Victoria’s Secret bra may only hold half the volume calculated above. Some of the cup size is filled with padding, and the wire length may be reduced to force the breasts together.
  • How you like your bra to fit. You can wear a cup size larger if you are smaller, or wear a tighter band size to support larger breasts. Research shows most women do.
  • Skin tightness. Tighter, higher breasts fit into a bra differently than deflated, lower breasts. Larger natural breasts do not fill the upper portion of the cup without support, while larger implants do.

How To Choose The Best CCs For Your Breast Augmentation?

This is a question that is asked every five minutes on the Internet, if not more frequently. The best way is to:

  • Seek guidance from a Board Certified Plastic Surgeon who is experienced and fully trained in Breast Augmentation.
  • Be honest with yourself, your goals and your surgeon.
  • Do your homework. Buy a bra that is the size you want, the band number should be the same, and stuff it. Ziplock bags filled with (uncooked) rice is a simple way to vary the size and try on different looks. Be sure to use different clothes too, to see how your look changes. This short post is as true today as the day it was published: How to Choose the Correct Breast Implants: Size.

Also remember, there is no perfect answer. Your ideal size may change from day-to-day, and through the years. So the goal should be to find your comfort zone and aim for the center of it. Additionally, breasts change. They can change with normal monthly cycles. Breast size and shape morph as we age, have children and gain/lose weight.

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Gynecomastia Reduction SF Bay Area (Male Breast Reduction)

Posted October 02, 2017 in Breast Reduction, Breast Reduction (Men), Home, Liposuction, Videos

Disproportionate development of male breast tissue is called Gynecomastia. It’s also called man boobs, or moobs for short, and Gynecomastia Reduction is a cosmetic plastic surgery procedure which I perform every week.

Gynecomastia Reduction Surgery

The above Gynecomastia reduction surgery before and after photos show what is possible with a combination of liposuction and direct excision for an enlarged male chest.

The above Gynecomastia reduction surgery before and after photos show what is possible with a combination of liposuction and direct excision for a enlarged male breasts.

Asymmetry is more the rule than the exception for Gynecomastia. For the Gynecomastia Reduction patient shown above, the right breast was significantly larger than the left, both areolae where dilated and the breasts appear feminized. In fact, the feminine appearance of the breasts is what gives rise to the term Gynecomastia (feminine breasts).

Gynecomastia Correction was accomplished with a combination of liposuction to debulk the disproportionate fat and direct excision of the glandular tissue located under the nipple. The end result is a masculine chest that conforms to the pectoralis major muscles, a reduction in the size of the areolae and significant improvement in his asymmetry, all with minimal scarring. A short incision is hidden in each axilla (armpit) and around the lower border of the areolae (from 4 to 8 o’clock).

Gynecomastia Reduction Video (Male Breast Reduction)

Puffy Nipples

The start screen for the above Male Breast Reduction Video shows a man with Puffy Nipples. The enlarged and protuberant areolae are due to overdevelopment of the glandular breast tissue located directly behind the nipple. A focused surgical approach was used in this cases to remove the excess tissue and allow the nipple-areolar complex (NAC) to conform with the chest and look masculine.

The above Gynecomastia Reduction Video is from the San Francisco Bay Area’s News Station, KRON 4‘s, Body Beautiful. This segment discussed Gynecomastia Treatment and shows numerous examples of Gynecomastia Before and After Pictures to illustrate what the procedure can do for the properly selected patient, in the hands of an experienced, Board Certified Plastic Surgeon.

Global Gynecomastia

When Gynecomastia is distributed throughout the chest, more must be done. In this case, Liposuction was used to remove the bulk of the disproportionate chest tissue. If a glandular component is present beneath the nipple, this tissue also needs to be removed.

When Gynecomastia is distributed throughout the chest, more must be done. In this case Liposuction was used to remove the bulk of the disproportionate chest tissue. When a glandular component is present beneath the nipple, it is unlikely that liposuction alone will remove it, and this tissue is removed directly.

For more globally distributed Gynecomastia, Liposuction is used. Liposuction has the advantage of a long reach through a small incision. Often the 1/4 – 3/8 inch incision is hidden up in the axilla (armpit). For Pseudogynecomastia, breast enlargement due to fat and not glandular development, Liposuction alone is often enough to contour the chest. When a glandular component is also present, direct excision is also used to avoid creating a puffy nipple.

Gynecomastia Reduction Consultations

Every Gynecomastia Reduction Surgeon should be versed in multiple techniques of Gynecomastia Reduction. Depending on your situation, liposuction, direct excision of the gland, skin reduction or a combination of these may be recommended.

To find out what your options are, call (925) 943-6353 today and schedule a private, personalized consultation in our Walnut Creek Plastic Surgery office. If Gynecomastia is bothering you, learn what treatments are available from an experienced, Board Certified Plastic Surgeon.

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Breast Implant Revision SF Bay Area

Posted September 25, 2017 in Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Home, Videos

Breast Augmentation with Breast Implants remains the most popular cosmetic plastic surgery. Three to four-hundred-thousand women have Breast Augmentation each year in the US alone. It is the safest and most effective means of enlarging the breasts available, but even FDA approved devices, like Breast Implants, need touch-ups from time-to-time.

Do I Need Breast Implant Revision Surgery?

The following Breast Implant Revision Surgery Video originally aired on the San Francisco Bay Area‘s news Station, KRON 4. It reviews Breast Augmentation Revision Options and describes some of the most common breast augmentation revisions. Multiple before and after pictures are included as examples.

Breast Augmentation Revision Surgery Video

Breast Implant Deflation

The introductory photo for the video above shows deflation of this patient’s left breast implant. For Saline Breast Implants, loss of the breast implant’s shell integrity results in complete deflation and loss of breast augmentation. Replacement of a deflated breast implant can be done with minimal downtime. It is also a good time to consider if your breast implants are the right size, profile or style (saline vs silicone), as there is no better time to replace both implants. In situations like the above, it is extremely helpful if you know what type and size of breast implants you have.

Breast Implant Revision – Bigger

The most common reason for Breast Augmentation Revisions is to go bigger. This is especially common after pregnancy with preexisting breast implants as shown above.

The most common reason for Breast Augmentation Revisions is to go bigger. This is especially common after pregnancy with preexisting breast implants as shown above.

The above Breast Implant Revision Before and After Pictures show two common reasons for revision. The first, and the most common, is to go larger. The second, and often seen after pregnancy with preexisting breast implants, is to correct breast tissue sagging off the breast implants.

This patient has already had a Breast Augmentation Mastopexy, also known as a breast lift, using breast implants for additional volume. The larger the preexisting breast tissue volume, the more likely the breast is to sag. This is true with or without breast implants. She desired larger breasts and a perkier appearance. A larger Breast Implant provides both additional volume and support for her breasts.

Breast Implant Revision – Smaller

The above Breast Augmentation Revision pictures demonstrate the correction of bottoming out.

The above Breast Augmentation Revision pictures demonstrate the correction of bottoming out.

Sometimes, the breast implants are too large to be supported. The before picture, in the above Breast Augmentation Revision Before and After Pictures, demonstrates what happens when breast implants are too large, even with a breast lift. Over time, the Breast Implants have over-stretched the skin of the lower breast and moved down the chest. The previous breast lift (mastopexy) scar is red and irritated, and the nipple is riding high. This patient presented with a desire for correction of the shape of her breasts, and also wanted to be smaller.

The after photo shows the results after the mastopexy was revised and the breast implants were replaced with smaller, lower profile, Breast Implants. The mastopexy scar looks less irritated. The distance between the nipples and the bottom of the breast is reduced to normal. The new breast implants are smaller, but maintain the width of the breast to preserve cleavage.

Breast Implant Revision Surgery Consultations

With the popularity of Breast Implants it is not surprising that Breast Augmentation Revision Surgery has become its own specialty. If you have breast implants which are:

  • too small
  • too large
  • too high
  • too low
  • too close together
  • too far apart
  • too hard
  • deflated or leaking
  • not supporting your breast tissue

then give my San Francisco Bay Area Plastic Surgery Clinic a call at (925) 943-6353. With 20 years of experience, I will give you up-to-date options that are personalized to your unique situation. Previous operative reports and your before and after pictures help, so bring them with you, too.

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Breast Implant Warranties – SF Bay Area

Posted July 30, 2017 in Breast Augmentation, Breast Implant Revision Surgery, Home

If you have Breast Implants, here's some peace of mind to help you chill this summer.

If you have Breast Implants, here’s some peace of mind to help you chill this summer.

Did you know your Breast Implants come with a manufacturer’s warranty? It’s true. All FDA approved Breast Implants in the US come with a Breast Implant Warranty automatically. The details of coverage have changed throughout the years, but here are the latest details for the summer of 2017.

The Big Three Breast Implant Manufacturers

In the US, there are currently three FDA approved Breast Implant manufacturers:

  • Natrelle® (Allergan)
  • Mentor (Johnson & Johnson)
  • Sientra

Below are the latest details. These have been fairly consistent over the last two decades; however, contact your breast implant’s manufacturer directly for the latest information.

Allergan Natrelle® ConfidencePlus® Warranty

Natrelle breast implants are manufactured by Allergen.

Natrelle breast implants are manufactured by Allergan.

The following applies to Breast Augmentation using Natrelle® breast implants performed on or after November 1, 2014.

Enrollment:

  • For Natrelle® Silicone Gel Breast Implants:
    • Automatic and Free
  • For Natrelle® Saline Breast Implants:
    • Standard Warranty: Automatic and Free
    • ConfidencePlus® Premier: Enroll within 45 days and pay $200

Coverage:

  • Natrelle® Silicone Gel Breast Implant coverage:
    • Lifetime FREE breast implant replacement for rupture
    • 10-year FREE breast implant replacement for grade III or IV capsular contracture
    • 10-year up to $3500 surgery cost assistance for rupture
  • Natrelle® Saline Breast Implant coverage:
    • Standard Natrelle® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture (deflation)
    • Premier Natrelle® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $2400 surgery cost assistance for rupture

Mentor® MentorPromise Warranty

Mentor breast implants are manufactured by Johnson & Johnson.

Mentor breast implants are manufactured by Johnson & Johnson.

The following applies to Breast Augmentation using Mentor® breast implants performed on or after May 1, 2017.

Enrollment:

  • For Mentor® Silicone Gel Breast Implants:
    • Basic warranty: Automatic and Free
    • Enhanced warranty: Enroll within 45 days and pay $300
  • For Mentor ® Saline Breast Implants:
    • Basic Warranty: Automatic and Free
    • Enhanced warranty: Enroll within 45 days and pay $200

Coverage:

  • Mentor ® Silicone Gel Breast Implant coverage:
    • Basic Mentor® Silicone Gel Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $3500 surgery cost assistance for rupture
    • Enhanced Mentor® Silicone Gel Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $3500 surgery cost assistance for rupture, grade III or IV capsular contracture, double bubble or late seroma
  • Mentor ® Saline Breast Implant coverage:
    • Basic Mentor® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture (deflation)
    • Enhanced Mentor® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $2400 surgery cost assistance for rupture

Sientra® Warranty

Sientra manufactures only silicone breast implants for use in the US.

Sientra manufactures only silicone breast implants for use in the US.

Sientra® offers the following Breast Implant Warranty on all their breast implants.

Enrollment:

  • For Sientra ® Silicone Gel Breast Implants:
    • Sientra warranty: Automatic and Free

Coverage:

  • For Sientra ® Silicone Gel Breast Implants:
    • Lifetime FREE breast implant replacement for rupture
    • 10-year up to $3600 surgery cost assistance for rupture
    • 5-year FREE breast implant replacement for grade III or IV capsular contracture

Breast Implant Warranty Updates

Breast Implant Manufacturers are constantly updating their warranties. Be certain to check with your Board Certified Plastic Surgeon and your Breast Implant’s manufacturer for the latest details.

If you are considering Breast Augmentation or Breast Implant Revision Surgery, give my San Francisco Bay Area Plastic Surgery Clinic a call today at (925) 943-6353.

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San Francisco Breast 2.0 Enhancement (Augmentation, Lift and Reduction)

Posted July 09, 2017 in Areolar Reduction, Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Options, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Men), Breast Reduction (Women), Capsular Contracture, Home, Inverted Nipples, Nipple Reduction, Tubular Breasts

New Breast Enhancement Content

SanFranciscoBreast.com has been completely updated. This update includes new content, and it is artfully illustrated with new breast enhancement videos and more before and after pictures. In addition, the fresh content is wrapped in a new skin, improving navigation for the small screen and the desktop alike.

New Breast Augmentation Information

The site includes new pages featuring the most requested Breast Enhancement Procedures. For example, the Breast Augmentation Information has been exploded into a dozen detailed pages including:

  • Breast Augmentation
  • Breast Implant Options
  • Breast Augmentation Incisions
  • Breast Implant Placement
  • Today’s Breast Implants
  • History of Breast Implants
  • Breast Implant Warranties
  • Breast Implant Care
  • Breast Augmentation Lift
  • Breast Augmentation Revision
  • An Expanded Breast Augmentation Photo Gallery
  • And Hours of Breast Augmentation Videos

Breast Implant Revision Surgery

The Breast Augmentation Revision Section includes pages devoted to specific problems like:

  • Capsular Contracture
  • Breast Implant Deflation
  • Breast Implant Infection
  • Breast Implant Malposition
  • Breast Implant Removal
  • Breast Implant Rippling
  • Breast Implant Scar Revision
  • Breast Implant Replacement
  • Breast Lifts (Mastopexy)

    The Breast Lift section includes details about five main options for Mastopexy. There are also pages dedicated to the combination of Breast Lift using Breast Implants and Areola Reduction.

    Breast Reduction for Women and Men

    Options for Breast Reduction for Women are also reviewed, as several techniques have evolved during the 20+ years I have been in practice. Breast Reduction for Men, also known as Gynecomastia Reduction, is covered with attention paid to the causes and the most current treatments available.

    Specialty Breast Procedures

    A section on the often overlooked details of Breast Enhancement is also included. San Francisco Breast’s Specialty Breast Pages include:

    • Inverted Nipple Correction
    • Areola Reduction
    • Nipple Reduction
    • Tubular Breasts
    • Poland Syndrome
    • Other Congenital Breast Abnormalities
    • Areola Reconstruction
    • Nipple Reconstruction

    A Plastic Surgery Web Site Dedicated to Breast Enhancement

    I have tried to create an all inclusive Breast Enhancement site designed to provide detailed information about the many Plastic Surgery options available for Breast Enhancement, whether that be Breast Enlargement, Breast Reduction or Breast Reshaping.

    While the San Francisco Breast web site in meant to provide information, it is just a starting point. The Internet cannot take the place of a thoughtful, in-person consultation with a qualified Board Certified Plastic Surgeon. If you would like to schedule a private, personalized consultation appointment call (925) 943-6353 today. My San Francisco Bay Area Plastic Surgery clinic specializes in helping you obtain the best possible results.

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