Liposuction of the Trunk Before and After Pictures – San Francisco Bay Area

Posted July 15, 2019 in Breast Reduction (Men), Home, Liposuction

Liposuction of the Trunk, in order of popularity includes liposculpture of the:

  • abdomen
  • flanks (sides)
  • back
  • chest

If you have disproportionate collections of fat in these areas that are bothersome, Liposuction may offer a solution.

Liposuction of the Abdomen

Liposuction of the Abdomen removes disproportionate fat from the belly. Fat is removed from between the skin and the abdominal muscles. This is usually stored in the lower abdomen, and may run around to the sides. Less commonly, fat is also deposited on the upper abdomen and along the ribs. Results are best with localized collections of fat, as opposed to globally deposited fat. Tight, thin skin helps reveal the results, while fat inside the abdomen, behind the abdominal muscles, cannot be removed with Liposuction. Internal abdominal fat requires weight loss for removal.

Liposuction of the Abdomen

Liposuction of the abdomen can help flatten the belly.

The woman above is close to her ideal body weight, yet continues to have disproportionate fat of the abdomen, especially within the lower abdominal wall. Tumescent Liposuction was performed to remove fat from the upper and lower abdomen and smooth her belly. Her clothes fit better, and she is much happier after her tummy nipping procedure.

Liposuction of the Flanks and Back

Back fat is annoying for everyone. It impacts the way clothes fit, and sometimes bulges over the top of jeans causing a Muffin Top or the hated Love Handles. It can be stubborn and persistent, even with exercise and after weight loss.

Liposuction of the Back (Love Handles)

Liposuction of the Love Handles or Muffin Top is one of the most popular areas for Liposculpting with a high degree of patient satisfaction.

The gentleman above is in great shape before his Liposculpture; however his physique is hidden under stubborn, localized fat surrounding his flanks and back. Liposuction was performed through small incisions located discretely below the belt line. The excess fat was removed on a Friday, and by Monday he was feeling fine.

Vigorous activities after Liposuction are limited for a week or so to prevent complications and reduce the duration of post-operative swelling. Additionally, an abdominal binder is worn postoperatively for a few weeks to help the skin stay smooth.

Liposuction of the Chest and Abdomen

Liposuction is best for fine tuning fat removal and improving body contours. It is not for weight loss. In fact, the maximum amount of fat that should be removed in one operation is five liters, or about eleven pounds. The more fat that is removed, the more likely the skin will fold, as support provided by the fat is lost. Much like the stuffing in a pillow case, the fat not only makes the skin bigger, but also holds it up. If skin laxity is present before liposuction, removing the fat will shrink the treated area, but it might also make the skin look worse.

Liposuction of the Chest and Abdomen in a Man

Liposuction of the chest can reduce mild gynecomastia. Liposuction of the back and abdomen can give a leaner look.

The patient above is in great shape, but complained of fullness in his chest and abdomen. He had disproportionate fat of the chest (pseudogynecomastia) and abdominal wall. He was a good candidate for Liposuction, because he had little intra-abdominal fat and no skin laxity. Liposuction was performed to remove the bothersome fat. His elastic skin shrunk, revealing better muscle definition and the physique he desired.

Liposuction Consultations

Before and after pictures are a good way to see what Liposuction can do. More Liposuction Before and After Photos with descriptions are available on DrMele.com on our new Liposuction Before and After Page. However, there is no substitute for an in person consultation with an experienced, Board Certified Plastic Surgeon.

To schedule a Liposuction Consultation in our Walnut Creek Plastic Surgery Clinic, call (925) 943-6353 today.

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Breast Augmentation Video | Walnut Creek | San Francisco Bay Area

Posted July 08, 2019 in Breast Augmentation, Home, Videos

Great Augmentation Before and After Pictures

Breast Implants provide volume and shape for small or empty breasts.
(To view uncensored before and after photos, click on the image.)

Today’s Breast Augmentation Video includes multiple examples of Breast Augmentation Before and After Photos and reviews the indications, procedures and recovery after Breast Enlargement with Breast Implants.

Breast Augmentation Video (Breast Implants)

The following Breast Augmentation Video includes several examples of Breast Enlargement with Breast Implants. This video is a segment from KRON 4’s Body Beautiful and first aired on the San Francisco Bay Area’s News Station a few weeks ago. In this video, I review multiple Breast Augmentation Before and After Pictures and the photos provide narration for the indications, procedure and recovery of Cosmetic Breast Surgery.

Breast Augmentation for the Flat Chest

Breast Augmentation with Breast Implants Before and After Photos

Breast Implants can provide natural feminine contours, even when the chest is flat.
(To view uncensored before and after photos, click on the image.)

You might think the above result required Shaped Breast Implants, but this natural, teardrop-shaped result was achieved with smooth, round breast implants placed behind the pectoralis major muscle. If there is a situation where shaped implants might give a better result, it may be the flat chest with tight skin. The situation is found in young women who develop very little breast tissue and women who have had a mastectomy for breast cancer removal.

Unfortunately, shaped implants require texturing to help prevent rotation, and texturing comes with controversy and an increased risk of the rare development of BIA-ALCL. Moreover, despite texturing, shaped implants still rotate as often as 10% of the time. If smooth breast implants can give natural, teardrop-shaped results like the above, textured shaped implants might be relegated to reconstructive surgery only.

Breast Augmentation for Small Breasts

Breast Augmentation Before and After Pictures

Small breasts still maintain projection in the lower pole, so a round implant provides a natural teardrop-shaped result.
(To view uncensored before and after photos, click on the image.)

Small breasts usually have all the breast tissue in the lower pole of the breast. Like in the case above, Smooth Round Breast Implants behind the muscle were used to achieve a beautiful and natural shape. The majority of Breast Augmentation in situations where there is little natural breast tissue utilize Silicone Gel Breast Implants, because they feel more like breast tissue and have a lower incidence of rippling (visible wrinkling).

Breast Augmentation for Asymmetrical Breasts

Breast Asymmetry is normal. Breast are more like sisters than twins, and trying to make them look like twins poses many challenges. This is compounded by the fact that there are many factors which contribute to breast asymmetry. A few examples include the:

  • Size of the breasts
  • Shape of the breasts
  • Distribution of the breast tissue within the breast
  • Amount of breast skin
  • Location of the breasts on the chest
  • Nipple position on the breast mound
  • Location and definition of the inframammary folds
  • Shape of the under lying ribs
  • Shape and size of the chest wall muscles

Breast Implants can compensate for differences in volume but cannot compensate for any of the other common reasons for asymmetry. Asymmetry is normal, and improvement is likely. However, unless you are perfectly symmetrical before Breast Augmentation, expecting complete symmetry after surgery is unrealistic. So rather than correction of asymmetry, I call it improvement of asymmetry. Here is an example:

Breast Augmentation before and after pictures for Breast Asymmetry

Breast Asymmetry cannot be completely corrected; however, it can be improved with asymmetrical breast augmentation.
(To view uncensored before and after photos, click on the image.)

The Breast Augmentation Before and After Pictures above show breast enlargement with improvement of asymmetry. Before surgery the right breast was smaller and higher and the right nipple was higher and more medial. There were also significant asymmetries with the cleavage: the breast folds medially (in the middle) had different heights, shapes and depths of folding (definition). Additionally, the left cleavage is closer to the midline than the right. Careful selection of implant volumes, shapes and location of the breast implant placement can all help achieve reduction of the asymmetry. The after photos reveal better size equality, inframammary fold location, cleavage symmetry and nipple location. To see the nipples, and remove the black-out squares, click on the picture.

Breast Augmentation for Tubular Breasts

Tubular Breast Augmention Before and After Pictures

Breast Augmentation, often combined with a Breast Lift, are used to correct congenital breast deformities like Tubular Breasts.
(To view uncensored before and after photos, click on the image.)

Tubular Breasts, like normal breasts, come in different sizes and shapes. Often, one breast is more involved than the other, and the size of the breasts is quite different. The base of the breast is constricted and the breast tissue often herniates into the nipple areolar complex. The above example is of mild tubular breast deformity, with low-set nipples. Silicone Breast Implants were used to augment the breast volume and round out the disproportionately filled lower pole. A breast lift was needed to elevate the nipples to the front of the breasts. The breasts were transformed from a deflated, saggy appearance to the full, perky and aesthetically balanced shape you see above. Again to see the nipple location, click on the picture to remove the censoring black square.

Breast Implant Consultations

To learn more about Breast Augmentation, schedule an in-person consultation with a Board Certified Plastic Surgeon near you. If you are in Walnut Creek, or the San Francisco Bay Area, call (925) 943-6353 and schedule a private consultation, tailored to your needs.

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Eyelid Lifts (Blepharoplasty) Video | Walnut Creek | San Francisco Bay Area

Posted July 01, 2019 in Asian Eyelid Lift (Asian Blepharoplasty), Eyelid Lift (Blepharoplasty), Home, Videos

Today’s post reviews Eyelid Surgery and includes a Blepharoplasty Video from KRON 4’s Body Beautiful.

Indications For Eyelid Surgery

Eyelid Surgery is performed for men and women for both cosmetic and functional reasons. In the Blepharoplasty Video below, you will see Eyelid Lift Before and After Pictures and learn the indications, procedures and recovery for Blepharoplasty.

It is common for people to assume we are tired solely by the look of our eyes. Heavy, droopy upper eyelids and bags under our eyes occur when we need sleep. Unfortunately, these changes also occur with aging.

Lower Eyelid Surgery (Blepharoplasty) for Eyelid Bags - before and after pictures

Bags under the eyes contribute to the perception of being tired. Lower Blepharoplasty (Lower Eyelid Surgery) removes the fullness of the lower eyelids, thereby smoothing and tightening the lower eyelid skin and rejuvenating your appearance.

There are a variety of indications for Blepharoplasty. Aging is the most common reason for upper and lower blepharoplasty. Aging causes skin laxity and hooding of the upper eyelids which not only makes us look tired, but can also block upward and lateral gaze. Aging also causes elongation of the lower eyelids, thinning of the skin and atrophy of the subcutaneous fat, revealing the fat pads beneath the eyes.

There are other reasons why eyelid lifts are performed. Sometimes it is functional, like when the muscles that open the eyes are not functioning properly. This should always be checked before having Blepharoplasty. Sometimes it is cosmetic, like when Asian eyelids have a poor or absent fold. This allows the skin and fat of the upper eyelid to descend and close the eyes. When a fold is present, often it is low and indistinct, giving a sleepy appearance and blocking vision. When desired, Double Eyelid Surgery (Asian Eyelid Surgery) is used to form a clear fold to better support and open the eyelids.

Eyelid Lift Video (Blepharoplasty)

The following Eyelid Lift Video includes several examples of:

  • Upper Blepharoplasty
  • Lower Blepharoplasty
  • Double Eyelid Surgery (Asian Blepharoplasty)

This segment from Body Beautiful first aired on KRON 4, the San Francisco Bay Area’s News Station. In this video, I review Cosmetic Eyelid Lift Before and After Pictures and narrate the indications, procedure and recovery of Blepharoplasty.

Blepharoplasty for Aging Upper Eyelids

Upper blepharoplasty removes excess upper eyelid skin - before and after pictures

Excess upper eyelid skin causes heavy upper eyelids and projects a tired appearance. The upper eyelid before and after pictures above reveal the alert, interested and friendly appearance that upper blepharoplasty can provide.

As we age, the skin on our upper eyelids thins, sags and can take on the appearance of crepe paper. The skin also loses elasticity and its attachment to the muscle beneath it. As a result, the skin drops toward and sometimes in front of the eyes. Upper Blepharoplasty removes the excess upper eyelid skin and rejuvenates our appearance. If the brow also sags, it pushes additional skin down onto the eyelids. An open or endoscopic Brow Lift may be recommended to further improve facial harmony and balance.

Blepharoplasty for Aging Lower Eyelids

Lower eyelids bags can be corrected with lower eyelid surgery. See these lower blepharoplasty before and after pictures.

Lower eyelid bags can make even young eyelids look old and tired. Lower blepharoplasty (lower eyelid surgery) unstuffs those bags, smooths the lids and provides a more rested, attractive appearance.

When the lower eyelids age, they become longer and fuller. The bags that form in the lower eyelids are caused by fat “pseudoherniation.” The excess fat pushes forward and gives the overstuffed look we associate with aging. A Lower Blepharoplasty removes the excess fat and smooths out the lower lids. The result is a more rested and youthful appearance.

When the eyelid skin is wrinkled and crepey, a lower eyelid chemical peel may also be recommended to address the fine lines. The peel helps tighten the skin on the surface, and can remove excess dark pigmentation. More about alternate ways to remove wrinkles can be found on my Skin Care Page.

Blepharoplasty for Sagging Upper Eyelids

Blepharoptosis (saggy upper eyelids) is corrected with levator advancement in these eyelid surgery before and after photos.

Blepharoptosis (saggy upper eyelids) is corrected with levator advancement during blepharoplasty in the above eyelid surgery before and after photos. In the before pictures on the left, her eyelids are blocking her pupils and obstructing her vision.

Blepharoptosis can occur at any age. If present at birth it is called congenital ptosis; if it appears later in life, it is called senile ptosis. Eyelid sagging can have multiple causes, so a careful evaluation is required prior to choosing the best procedure for correction. In the case above, her eyelid sagging was caused by stretching of the tendon that opens the eyelids. During her blepharoplasty, the levator muscle tendon was shortened, allowing the eyelids to retract properly. This technique, Levator Advancement, is just one of many procedures available to help correct Eyelid Ptosis.

Blepharoplasty for Asian Eyelids

Asian Eyelids surgery (Double Eyelid Surgery) is used to create more symmetrical upper eyelid creases, as seen in the Asian Eyelid Upper Blepharoplasty before and after pictures.

Before surgery, multiple folds are seen in this patient’s right upper eyelid, and a single, low fold is present in her left upper eyelid. Asian Eyelid Surgery (Double Eyelid Surgery) was used to create more distinct, symmetrical and yet natural appearing upper eyelid creases.

Asian Eyelids may have no fold, a single low fold or multiple folds. The fold is dependent on if and how the eyelid skin is attached. Caucasian eyelids normally have a single, strong line of attachment. To form the fold in the Asian eyelid, a line of attachment is created. For the patient above, Double Eyelid Surgery was performed to correct her asymmetry, and provide her with crisp, clean eyelids folds.

Blepharoplasty Consultations

Eyelid Surgery is one of the most detail oriented procedures performed by Facial Plastic Surgeons. The key to achieving your best results is to consult with an experienced, well trained and Board Certified Plastic Surgeon. A professional who can balance achieving the ideal aesthetics with maximizing the function of your eyelids is necessary for a great result and satisfying patient experience.

People from all around the San Francisco Bay Area come to my Walnut Creek Plastic Surgery office for just that. Call (925) 943-6353 today to schedule your private consultation.

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Abdominoplasty, Tummy Tucks, Mommy Makeover Videos – SF Bay Area

Posted June 24, 2019 in Brazilian Butt Lift, Breast Lift (Mastopexy), Fat Grafting, Home, Liposuction, Tummy Tuck (Abdominoplasty), Videos

Year after year, Tummy Tucks remain a top-ten Plastic Surgery procedure. Also known as Abdominoplasty, the procedure tightens and sculpts the abdomen on multiple levels. Tummy Tucks reverse and repair the damage to the abdominal wall caused by the overstretching of the skin and muscle that comes with weight gain and pregnancy. Damage that despite proper diet and exercise, often does not improve to the point of satisfaction. The result of Abdominoplasty is a flatter abdomen, and a more pleasing figure, boosting both self esteem and confidence.

Tummy Tuck Video (Abdominoplasty)

The following Tummy Tuck Video includes several examples of Abdominoplasty, after both weight loss and pregnancy. This segment is taken from the San Francisco Bay Area’s News Station, KRON 4’s Body Beautiful. In this video, I review Tummy Tuck Before and After Pictures and narrate the indications, procedure and recovery from Tummy Tuck Surgery.

Tummy Tuck With Brazilian Buttocks Lift

The Tummy Tuck may be combined with other procedures to enhance the results and keep the body in balance. The most common combination is Tummy Tuck plus Liposuction of the sides and back to improve the waist line all the way around. This is helpful when there is a disproportionate amount of fat causing a muffin top.

Today, fat is often transferred to provide volume in areas of deficit or areas that have atrophied. The most common area that fat is grafted to is the aging face. Fat Transplantation can reduce wrinkles and revitalize saggy cheeks by optimizing facial volume. Less common, but the fastest growing area for fat grafting is the buttocks, no pun intended. Fat Grafting to the Buttocks is also known as the Brazilian Butt Lift. The Tummy Tuck Before and After Photos below also include the results of liposuction and fat grafting to optimize body proportions.

Tummy Tuck with Brazilian Butt Lift Before and After pictures

Tummy Tuck with Brazilian Butt Lift Before and After pictures show: flattening of the tummy, improvement in abdominal muscle tone and perkier, rounder and more defined buttocks.

In the above case, a Tummy Tuck was used to tighten the abdominal muscles, reduce skin laxity and remove disproportionate abdominal wall fat. Liposuction was used to further enhance the results by removing disproportionate fat from the abdomen, waist, lower back and thighs. Normally, the fat removed by Liposuction is discarded; however, additional improvement in my patient’s body proportions was obtained by repurposing the fat to enhance the buttocks. A Brazilian Buttocks Lift was performed to create more shapely buttocks. For her, rounder, firmer buttocks were created, and the indentations on the outer aspect of the buttocks were corrected. Combining procedures repaired the postpartum damage improved her appearance in form-fitting clothes. She is happier and more confident with her new shape.

Tummy Tuck As Part Of A Mommy Makeover

Tummy Tucks are an important part of the Mommy Makeover, enhancement of both the breasts and the belly, frequently after pregnancy. The most common combination of procedures for Mommy Makeovers is Breast Augmentation with a Tummy Tuck; however, other procedures can be substituted as needed or desired. In the following case, Abdominoplasty was performed with a Breast Lift (Mastopexy), rather than Breast Augmentation, because she was already happy with the size of her breasts, but not the shape.

Mommy Makeover Before And After Pictures

Mommy Makeover Before And After Pictures – In this case, Abdominoplasty was combined with a Breast Lift to complete this Mommy Makeover. (To see the movement of the nipple in the uncensored photos, click this picture.)

The above Mommy Makeover Before and After Pictures reveal the results of combining Abdominoplasty with a Breast Lift. Prior to her Mastopexy, she was happy with the size of her breasts, and how they looked in a bra; however, the droopy appearance and downward pointing nipples were not acceptable. Breast Augmentation would have enlarged her breasts, but size was not the issue. Also Breast Augmentation alone would not correct the low nipple position, therefore a Breast Lift was the best option and the procedure of choice. An uncensored version of the before and after is available for viewing by clicking on the picture.

Abdominoplasty After Massive Weight Loss

After weight loss, especially massive weight loss, the abdominal wall is left lax and redundant. This is true at multiple levels of the abdominal wall including both the superficial skin and the deeper muscle and fascia layers. Abdominoplasty is uniquely appropriate for correcting both problems. A Tummy Tuck repairs the muscle by tightening the tough fascial case that encloses it, much like applying an internal corset. This flattens the abdominal wall’s foundation and supports the guts. Tummy Tucks also remove the excess skin and fat from the lower abdomen, thereby eliminating the redundant skin that impairs hygiene and blocks wearing clothing with a cinched waist.

Post Bariatric Plastic Surgery - Tummy Tuck Before and After Pictures

Post Bariatric Plastic Surgery – Tummy Tuck Before and After Pictures. Abdominoplasty was used to flatten the belly by tightening the muscles, removing the fat and reducing the redundant skin.

Abdominoplasty is often used after Bariatric Surgery to “clean-up” excess skin and complete the journey to a better body. It is normal to wait one year after Bariatric Surgery before having Plastic Surgery. Earlier surgery increases the risk of wound healing problems. By waiting for the body to recover nutritionally, we can enhance wound healing and achieve superior results.

Tummy Tuck Plastic Surgeon

If you’ve recently had a baby or lost weight and are contemplating plastic surgery to flatten your belly, you are going to want a Board Certified Plastic Surgeon for your procedure. Board Certified Plastic Surgeons are uniquely qualified due to their years of training and experience performing Cosmetic Plastic Surgery.

To find out more about Abdominoplasty, call me at (925) 943-6353. Each patient is unique in their needs and desires. In every case, both are considered when planning your specific procedure. Enter your questions in the contact form on this page, or for a faster response, give us a call and get answers now.

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Male Breast Reduction for Gynecomastia Video | SF Bay Area

Posted June 20, 2019 in Breast Asymmetry, Breast Reduction, Breast Reduction (Men), Home, Liposuction, Nipple Reduction, Tubular Breasts, Videos

Gynecomastia Reduction for male breast enlargement before and after pictures

Gynecomastia Reduction is performed for male breast enlargement. These before and after pictures show a reduction in breast projection on the oblique view.

Gynecomastia is the growth of excess breast tissue in the male chest. The resulting mass causes fullness, embarrassment and often tenderness, for men who develop what is colloquially known as “man boobs.” Gynecomastia Reduction removes the excess breast tissue and restores the masculine physique. This Gynecomastia Reduction Video illustrates and narrates several typical cases.

The Gynecomastia Reduction Before and After Pictures shown above and below are of the same patient. The oblique views (above) show the reduction in projection that Male Breast Reduction can achieve. The front view (below) reveals that more tissue was removed from the larger left side. The Gynecomastia Reduction improved his breast symmetry by equalizing his breast volume, reducing the size of his areolae and elevating the position of the left nipple. Areola Reduction and Nipple Reduction are separate procedures used to reduce the size of the areolae and nipples. In this case, these ancillary procedures were not necessary.

Before and after pictures of Gynecomastia Reduction for male breast enlargement.

Gynecomastia Reduction is performed for male breast enlargement. These before and after pictures show improved symmetry and reduction in breast and areolar size.

Gynecomastia Reduction Video

The following Gynecomastia Reduction Video reviews several typical Male Breast Reduction Surgeries, and narrates the indications, procedure and recovery. This video originally aired on the San Francisco Bay Area’s News Station, KRON 4.

Gynecomastia Reduction for Tubular Breasts

Tubular Breasts can occur in both men and women. For women, the goal of Tubular Breast Surgery is the creation of normally shaped and symmetrical breasts, For men, the goal is the same as with all Gynecomastia Reduction Surgery: the reduction and flattening of the chest.

Gynecomastia Reduction for Tubular Breasts before and after photos.

These before and after photos show how Gynecomastia Reduction can improve the appearance of Tubular Breasts for men.

Gynecomastia Reduction for Bodybuilders

Gynecomastia Reduction is particularly useful for the reduction of breast buds in bodybuilders. As they lean out for competition, the fat flattens; however, the gland does not. This causes increased projection of the nipple-areolar complex. These buds are distracting, and they lead to penalties during competition. Since Gynecomastia can occur with steroid use, removing the mass removes the stigmata.

Gynecomastia Reduction for Body Builders before and after photos

These Gynecomastia Reduction before and after photos show reduction of the glandular tissue under the nipples for a Bodybuilder.

Gynecomastia Reduction for Asymmetry

Most breasts are asymmetrical. For men this is usually subtle, but when Gynecomastia forms, the asymmetry can become quite pronounced. In the case below, the left breast is significantly larger than the right. Even in a dress shirt, the left breast protruded and was a source of embarrassment for my patient. Gynecomastia Reduction was performed on both sides, and more tissue was removed from the left to provide a flattened, masculine chest.

Before and after photos of Gynecomastia Reduction for the asymmetrical male chest.

Sometimes Gynecomastia occurs primarily on one side of the male chest. These before and after photos show the improvement of breast symmetry after Gynecomastia Reduction.

Consultations For Male Breast Reduction

If you are among the one-third of men who have persistent Gynecomastia after puberty, and would like to learn exactly what treatment options are available for you, call (925) 943-6353 today, and schedule a private consultation appointment in my San Francisco Bay Area Plastic Surgery office.

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Breast Augmentation Before and Afters In The San Francisco Bay Area

Posted June 10, 2019 in Areolar Reduction, Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Home, Tubular Breasts

Year after year, Breast Augmentation remains the most popular cosmetic plastic surgery procedure in the United States. This is true in the San Francisco Bay Area also. Common reasons include congenitally small or misshapen breasts and changes in the breasts seen after weight loss, pregnancy and breastfeeding. Today, we will review a few examples.

Breast Implants For Breast Augmentation And Lifts

Breast Augmentation Lift for Tubular Breasts adds volume and improves the shape of the breasts.
(To view uncensored before and after photos, click on the image.)

Breast Implants are used for Breast Augmentation, either alone or in combination with a Breast Lift (Mastopexy) for Augmentation Mastopexy. The implants provide volume while the lift improves the shape, elevates the nipples and reduces skin redundancy.

The before and after pictures at the top of this post are of Breast Augmentation with a Breast Lift. In the above case, Augmentation Mastopexy was used to enlarge and reshape a congenital breast deformity named Tubular Breasts. In addition, Areola Reduction was included in the Mastopexy to prevent the areolae from expanding with the Breast Augmentation.

Breast Implants For Breast Augmentation

Breast Augmentation Before and After Pictures

Breast Augmentation Before and After Pictures: Breast Implants alone are enough to enlarge the breasts and improve their shape when we are starting with “normal” anatomy.
(To view uncensored before and after photos, click on the image.)

The above case in simpler than the first. In this case, the patient has normal anatomy. The nipples are in a more ideal location, the breast skin has good tone and there is no excess skin causing sagging. A lift was not needed, so straight-forward Breast Augmentation was performed via an incision under the breasts via the IMF (inframammary fold). The scar is hidden in the shadow under the breast.

Breast Implants For Asymmetrical Breast Augmentation

Breast Augmentation before and after pictures: Breast Implants areused to enlarge and improve breast asymmetry.

Breast Augmentation before and after pictures: Breast Implants are used to enlarge and improve breast asymmetry.
(To view uncensored before and after photos, click on the image.)

Asymmetry is as challenging as it is common. The third case is an example of Asymmetrical Breast Augmentation. The right breast is smaller and higher than the left breast. In these cases, a larger implant can be placed behind the smaller breast to balance the volume disparity. Additionally, the right IMF was lowered to match the left breast. The right nipple follows, to further improve symmetry. Larger asymmetry can sometimes require a Breast Lift or Breast Reduction on the larger size for the best results.

Breast Augmentation Consultations

As you can see from the examples above, breasts are like snowflakes; no two are exactly alike. In fact, a woman’s breasts are more like sisters than twins, and each requires careful individual evaluation. In the San Francisco Bay Area call (925) 943-6353, to schedule your personal Breast Augmentation Consultation. We have the experience, certifications and the latest technology in breast implants for you.

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2018 ASAPS Plastic Surgery Statistics

Posted June 03, 2019 in Home

American Society for Aesthetic Plastic Surgery National Plastic Surgery Statistics for 2018

American Society for Aesthetic Plastic Surgery has released their National Plastic Surgery Statistics for 2018.

Two months ago, I posted about the release of the 2018 National Plastic Surgery Statistics by the American Society of Plastic Surgery. Today, I have the 2018 Plastic Surgery Statistics from the American Society for Aesthetic Plastic Surgery. According to the ASAPS, the Top 10 Cosmetic Plastic Surgery Procedures are the same as last year’s; however, there was some shuffling of positions within the group. Breast Lifts, Tummy Tucks, Breast Reduction and Rhinoplasty (Cosmetic Nose Surgery) gained in rank, while Eyelid Surgery, Facelifts and Fat Grafting to the Face dropped. Below are the 10 most popular cosmetic surgery procedures.

Top 10 Cosmetic Plastic Surgery Procedures

Here are your top ten Cosmetic Surgeries for 2018:

  1. Breast Augmentation (Augmentation Mammaplasty) – 329,914
  2. Liposuction (Liposculpture) – 289,261
  3. Breast lift (Mastopexy) – 158,964
  4. Tummy Tuck (Abdominoplasty ) – 157,492
  5. Eyelid Surgery (Blepharoplasty) – 115,508
  6. Breast Reduction (Women) – 84,599
  7. Facelift (Rhytidectomy) – 73,174
  8. Breast Implant Removal (+/- replacement) – 49,834
  9. Nose Reshaping (Rhinoplasty) – 41,213
  10. Fat Grafting to the Face – 39,461

Top 5 Surgical Cosmetic Procedures

The Top 5 Surgical Cosmetic Procedures for 2018

Here are the Top 5 Surgical Cosmetic Procedures for 2018.

Top 5 Non-Surgical Cosmetic Procedures

The Top 5 Non-Surgical Cosmetic Procedures for 2018

Here are the Top 5 Non-Surgical Cosmetic Procedures for 2018.

The Biggest Gainer and Losers

The top 10 procedures have been pretty consistent through the years, but four procedures stand out for the large percentage changes when compared to last year.

The biggest losers:

  1. Fat Grafting to the Face – down 28%
  2. Blepharoplasty (Eyelid Surgery – down 20%

Both these operations are “work horses” for facial rejuvenation, and procedures I do every week. I expect they will be up in numbers again next year.

The biggest gainers:

  1. Thigh Lift ranks 19th – up 24%
  2. Male Breast Reduction (Gynecomastia Reduction) ranks 13th up from 15th last year – up 22%

Both these procedures have been around a long time. Thigh Lifts are almost always associated with weight loss. As people have lost larger amounts of weight, the number of Thigh Lifts has increased. Gynecomastia Reduction is one of my specialties, and I do a lot of them. The popularity of Male Breast Reduction has increased year after year in my San Francisco Bay Area Plastic Surgery practice.

International Cosmetic Surgery Numbers

2019 Global Plastic Surgery Survey

Dr. Mele is an active member of the International Society for Aesthetic Plastic Surgery and has submitted data to the 2019 Global Plastic Surgery Survey.

The US accounts for the largest number of worldwide cosmetic plastic surgery procedures. Mostly because we have more people than most countries, but also because the United States has many well trained plastic surgeons who can provide you with safe and predictable results. On the other hand, several countries do more cosmetic surgery on a per capita basis. South Korea usually leads in this category, but we will have to see what the new numbers reveal.

Is Cosmetic Surgery Safe?

Is Cosmetic Surgery Safe? The short answer is yes. When the correct procedure is paired with the appropriate patient, cosmetic plastic surgery is both safe and effective. However, it is important to keep in mind that cosmetic plastic surgery is still surgery. If you are considering elective plastic surgery, you need to be properly evaluated by an experienced board certified plastic surgeon, and the procedure needs to be performed in the appropriate setting. And while the Internet can be helpful, the information necessary to make an informed decision should always be specific to your needs. There is no substitute for an in-person consultation. If you are in the San Francisco Bay Area and would like to schedule a plastic surgery consultation, call (925) 943-6353.

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Memorial Day 2019

Posted May 27, 2019 in Home, Uncategorized

Thank you for your service. I try to say these words as often as possible. We owe everything to our veterans. This was made crystal clear during a recent visit to the National World War II Museum in New Orleans, LA.

The Annual ASAPS Meeting

I was in New Orleans last weekend for the American Society for Aesthetic Plastic Surgery‘s annual Aesthetic Meeting. It is my favorite plastic surgery meeting. Each year board certified plastic surgeons like me, who specialize in Cosmetic Plastic Surgery, get together to share their knowledge and see what’s new in Plastic Surgery. The majority of the time is spent sitting in lectures and taking courses, but I also like to get a taste of the local culture. On my list for New Orleans was the National World War II Museum.

The National World War II Museum

National World War II Museum Loby, New Orleans, LA

The entrance to the National World War II Museum complete with C-47 and the L.W. “Pete” Kent Train Car Experience.

The National World War II Museum is the most popular attraction in town, and in New Orleans there is lots of competition. The museum sits on five acres and is currently divided into five buildings. Above is the entry where you can buy tickets and see a Higgins boat. More than 20,000 boats were designed and built by Higgins Industries in New Orleans and used in all major amphibious landings of the war. You can also see Sherman and Stuart tanks, jeeps, a halftrack and a restored C-47 aircraft that dropped paratroopers over the fields of Normandy and saw action in the Battle of the Bulge.

Louisiana Memorial Pavilion

The museum entrance is in the Louisiana Memorial Pavilion, pictured above. On the far wall is a train station. This is the entrance to the museum and you get a small taste of what it was like enlisting. You are given a “dog tag” card, which you initialize on the train and use throughout the museum to view extra content and collect artifacts. This building houses exhibits on D-day, the home front and is a great place to start.

Solomon Victory Theater

The next stop was the Solomon Victory Theater. It houses the theater for Beyond All Boundaries, a 4-D experience produced and narrated by Tom Hanks. I sat next to a veteran in camo-fatigues. The movie includes special lighting, sound and smoke effects to create the sights and sounds of battle. I could see he was shaken by the simulation, as he clasped his wife’s hand and wiped the tears from his eyes. I thought of my Uncle, a combat veteran of three tours, who passed away this year. The war affected him his entire life. If he was napping, and you had to call him for dinner, you best do it from a distance. Sometimes he’d wake ready to fight. I don’t think my uncle would have enjoyed the movie, and I was prepared to clear a hole for the veteran next to me if he had the same survival instinct. Fortunately, the man in uniform made it through the movie. I thanked him for his service, knowing that his sacrifice was part of the reason I could sit through the “4-D” presentation informed about, but without experiencing the true fear of war.

Campaigns of Courage Building

A shark-faced P-40 Warhawk hangs in the "Road to Tokyo" exhibit at the National World War II Museum in New Orleans, LA.

A shark-faced P-40 Warhawk hangs in the “Road to Tokyo” exhibit at the National World War II Museum in New Orleans, LA. These fighters were flown by the legendary “Flying Tigers.”

The Campaigns of Courage Building houses exhibits on the European and Pacific Theaters. It is divided into two sections. The Road to Tokyo tells the story from Pearl Harbor to Tokyo Bay. The Road to Berlin focuses on the American campaigns throughout Europe.

Throughout my life, the US has always been a world power and has had the strongest military on the planet. It was interesting to learn that prior to World War II, the US Military was ranked 19th in the world, behind Portugal and Romania. In 1939, the US armed forces numbered 180,000, and our military hardware was also less than cutting edge. As the war progressed, what we lacked in equipment quality, we made up for in speed of production. By the end of the war, over 16 million (roughly 11% of the US population) fought in World War II.

Kushner Restoration Pavilion

The John E. Kushner Restoration Pavilion features glass exterior walls that allow you to look behind-the-scenes and view of the restoration and preservation of the museums WWII artifacts. It also has a section on how Science Technology Engineering and Math (STEM) where used to solve problems during the war.

US Freedom Pavilion

Boeing B-17E Flying Fortress at the National World War II Museum in New Orleans, LA

Boeing B-17E Flying Fortress flies in front of a Vought F4U Corsair at the National World War II Museum in New Orleans, LA.

The U.S. Freedom Pavilion – The Boeing Center houses resorted aircraft, tanks, the Final Mission Experience and the Laborde Services Gallery. The Final Mission: USS Tang Submarine Experience lets you go along with the crew of the USS Tang on their final mission. You receive the name and assignment of a crew member and operate their station during the simulation. At the end you get a taste of warfare. As the Tang in sinks and the lights do out, you learn if you perished, or if you were one of the very few “lucky” survivors taken into Japanese captivity.

In elementary school, I wrote a report on the USS Tang. Some might not find this politically correct in the Bay Area these days, but the USS Tang’s story should not be forgotten.

The USS Tang was built here, in the San Francisco Bay Area, at the Mare Island Naval Shipyard. She first set sail on December 15, 1941. Crew training was completed in San Diego, and from there she sailed to Pearl Harbor, HI. She only survived five patrols; however, the USS Tang is credited with sinking 33 ships totaling 116,454 tons. This places her number one in both the number of ships sank and tonnage sank during World War II by an American submarine.

Warbirds

You can’t miss the warbirds flying inside the Freedom Pavilion. They include the B-25 Mitchell, B-24 Liberator, B-17 Flying Fortress, SBD Dauntless, TBM Avenger, F4U Corsair and last but not least, the P-51 Mustang. Sadly, my personal favorite, the P-38, was not present.

F4U Corsair at the National World War II Museum in New Orleans, LA

This Vought F4U Corsair hangs at the National World War II Museum in New Orleans, LA. It’s the type of fighter flown by Pappy Boyington’s “Black Sheep” Squadron.

The F4U Corsair reminds me of the 1970 TV show Baa Baa Black Sheep. The opening credits read: “In World War II, Marine Corps Major Greg ‘Pappy’ Boyington commanded a squadron of fighter pilots. They were a collection of misfits and screwballs who became the terrors of the South Pacific. They were known as the Black Sheep.” Like most TV shows, is was fiction; however, it was loosely based on real squadron commander: Pappy Boyington.

Major Gregory “Pappy” Boyington was born December 4, 1912, in Coeur d’Alene, Idaho, where the airport bears his name. His military service included being a Marine Corps aviator with the Pacific fleet, a legendary “Flying Tiger” (1st American Volunteer Group) in the Republic of China Air Force in Burma and commander of Marine fighter Black Sheep squadron (VMF-214). He was shot down and held prisoner by the Japanese for more than 18 months. After the war he was released and moved to California. He died January 11, 1988, at the age of 75, in Fresno. I was fortunate to meet his grand-daughter, a friend of a friend, who retains the family spirit. After all, this is the reason wars are fought.

Medal of Honor Winners

Medal of Honor recipients display at the National World War II Museum in New Orleans, LA.

The faces of many of the Medal of Honor recipients are displayed in the US Freedom Pavilion at the National World War II Museum in New Orleans, LA.

The U.S. Freedom Pavilion also houses the Laborde Services Gallery and the Medal of Honor exhibit. The exhibit puts a face and story to each of the 473 Medal of Honor recipients honored there. Pappy Boyington received both the Medal of Honor and the Navy Cross for exceptional heroism.

Currently, there are over 23 million living veterans in the US, and 17 million of them are war veterans. These are people who put their lives on hold to serve their country and protect our freedom. About 10% bear the physical wounds of their service, and many more have wounds which are less apparent, but just as real. If you have any doubt about what service means, I encourage to visit the National World War II Museum in New Orleans. Every veteran has made a significant contribution, so I say to all veterans, “Thank you for your service.”

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Plastic Surgery Recovery and RICE Therapy

Posted May 20, 2019 in Home, Patient Safety, Recovery

RICE = Rest Ice Compression Elevation

Over the years, I have posted more than 500 articles about a wide variety of Plastic Surgery Procedures. They are easily accessible and categorized in the side column under the “Search By Category” menu. Each post provides specific information about the procedure; however, this post is dedicated to the recovery process.

Generic Plastic Surgery Recovery

Before getting into the generic recovery rules, I provide the following disclaimer: Every procedure has specific post-operative instructions, and your plastic surgeon will provide you with post-operative instructions paired to the specific methods that they employ during your surgery. We plastic surgeons shape how we do each procedure to each patient based on our experience. I will try to provide some general guidelines. It goes without saying, but I’m going to say it: If you choose an Experienced Board Certified Plastic Surgeon because you trust them and you like the results they achieve, the best course of action is to do things their way.

RICE therapy

Surgery is a form of injury and the common acronym for treating injuries is RICE. RICE stands for:

  • Rest
  • Ice
  • Compression
  • Elevation

All of these can help ease discomfort and speed your recovery, when used appropriately.

Rest

The R in RICE stands for Rest.

The R in RICE stands for Rest.

Rest: Avoiding vigorous activity, heavy lifting and sudden movement helps prevent increased swelling and further injury. Immediately after surgery, rest prevents elevated blood pressure and post-operative bleeding. In the weeks after surgery, movement is good, but rest allows you to heal with increased comfort and a more predictable outcome.

Ice

The I in RICE stands for Ice.

The I in RICE stands for Ice.

Ice: Ice therapy is effective, especially for the first few postoperative days, and it can be continued if it feels good. I recommend using it for 15 minutes and then leaving it off for 45 minutes. Always keep a thin cloth between you and the ice to prevent frostbite. I had a patient fall asleep with ice directly on the skin and it froze causing blisters. He recovered fully, but prevention is the best medicine.

Compression

The C in RICE stands for Compression.

The C in RICE stands for Compression.

Compression: Compression garments are very important to control swelling and keep the skin smooth for many procedures. After procedures like Liposuction, the skin loses support as well as stuffing, so the garment is important for keeping the skin flat and smooth. It should be worn 24/7 for the first two weeks.

Elevation

The E in RICE stands for Elevation.

The E in RICE stands for Elevation.

Elevation: Elevation helps the surgical site drain. During the day this is easy, as our face and body are elevated. At night, laying flat will cause some increased swelling; however, sleep is very important. If you can sleep with the operated body part elevated for a few days, it helps.

Common Sense Recovery Advice

RICE therapy is based upon common sense, and it is a proven treatment. While it provides a grounded framework for comparing treatments, before starting any new therapy, it should be approved by your surgeon. Your surgeon has the most information and the greatest experience with your procedure. It is a good idea to discuss recovery during your initial consultation appointment, because while the surgery may be elective, once the procedure is performed, the recovery becomes mandatory.

If you are in the San Francisco Bay Area and want to learn more about a cosmetic plastic surgery procedure, feel free to use the contact form on this page, check out my main website: DrMele.com or call my office directly at (925) 943-6353, to schedule a personalized consultation appointment today.

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Tummy Tucks (Abdominoplasty) SF Bay Area

Posted May 13, 2019 in Butt Lifts, Home, Tummy Tuck (Abdominoplasty)

Tummy Tuck Before and After (Abdominoplasty)

The Tummy Tuck tightens loose abdominal muscles, removes excess abdominal skin and reduces abdominal fat.

Abdominoplasty is an elective plastic surgery procedure created to restore the appearance of the belly after weight loss and childbirth. Commonly known as a Tummy Tuck, the procedure is extremely effective because it uses a three-step approach to abdominal rejuvenation.

Why Won’t My Belly Flatten?

A common question my patients ask after childbirth or weight loss is, “Why won’t my belly flatten?” Unfortunately, the abdominal skin and muscles can permanently stretch during pregnancy or weight gain.

The abdomen does not always flatten after weight loss. Diet and exercise can increase abdominal muscle tone and reduce abdominal fat; however, they do not remove excess skin and cannot tighten the abdominal muscle sheath.

How Does Abdominoplasty Work?

As mentioned above, the Tummy Tuck is a three-step procedure. It optimally flattens the abdomen by:

  • Tightening the muscle fascia
  • Removing excess abdominal skin
  • Reducing excess abdominal wall fat

Here are the details.

Tightening The Abdominal Muscles

The patient above has very little excess skin and fat; however, her muscles are stretched out of shape. A Tummy Tuck was performed to tighten her abdominal wall, like an internal corset. Also, the available fat she had was used to reshape her buttocks with a Brazilian Butt Lift.

The patient above has very little excess skin and fat; however, her muscles are stretched out of shape. A Tummy Tuck was performed to tighten her abdominal wall, like an internal corset. Also, the available fat she had was used to reshape her buttocks with a Brazilian Butt Lift.

The muscles of the abdominal wall lie beneath the abdominal skin and subcutaneous fat, and superficial to the abdominal organs. With weight gain and pregnancy, the abdominal muscles get stretched out. The muscle fibers still contract and they are strengthened with exercise; however, the case around the muscles (the muscle fascia) remains distended.

As part of the Tummy Tuck, the lax fascia is tightened. It is like applying an internal corset. Since the muscle is the foundation of the abdominal wall, failure to tighten this leaves the abdomen round and poochy. Abdominoplasty is very effective for candidates who are near their ideal body weight. Unfortunately, fat around the organs cannot be removed during a Tummy Tuck, and this internal fat can interfere with the results. For some patients, weight loss is recommended before Abdominoplasty in order to obtain the optimal result.

Removing Excess Abdominal Skin

Tightening the skin removes any skin that folds over. The above Abdominoplasty Before and After Pictures show a small amount of excess skin, but as the muscle is tightened it increases. The pictures in the next section show a large amount of skin excess.

Tightening the skin removes any skin that folds over. The above Abdominoplasty Before and After Pictures show a small amount of excess skin, but as the muscle is tightened it increases. The pictures in the next section show a large amount of skin excess.

Abdominoplasty means abdomen changing, and one of the biggest changes is the removal of redundant skin. When skin is folding over, weight loss and exercise rarely fix it. Moreover, as additional fat is lost, the support for the skin is reduced, and the skin folds over even more.

Tummy Tucks remove excess skin directly via an incision below the belt line. The low placement of the scar helps keep it well hidden. The wider the skin redundancy, the wider the required incision. In cases of extreme weight loss, the redundancy may extend all the way around the body and a lower body lift is performed.

Reducing Excess Abdominal Wall Fat

My patient above has lost a lot of weight. You can see that her muscle laxity is causing the bulge in her upper abdomen, and that excess skin and fat on the lower abdomen are hiding the results of her work-outs. Her Abdominoplasty tightened skin and muscle and removed excess fat which drastically improved the appearance of her belly and her confidence.

My patient above has lost a lot of weight. You can see that her muscle laxity is causing the bulge in her upper abdomen, and that excess skin and fat on the lower abdomen are hiding the results of her work-outs. Her Abdominoplasty tightened skin and muscle and removed excess fat which drastically improved the appearance of her belly and her confidence.

The subcutaneous fat of the abdominal wall tends to be located on the lower half of the belly. This is convenient because when the skin is removed from the lower abdomen, the fat beneath it is also removed.

Fat that extends around the sides and back can also be removed in the same operation with Liposuction. Liposuction of the central abdomen, however, is often delayed a few months to protect the skin’s circulation and to maximize the fat removal.

Tummy Tuck Consultations

For the safest and most predictable Tummy Tuck results you will want an experienced, Board Certified Plastic Surgeon. In the San Francisco Bay Area call (925) 943-6353. My Walnut Creek Plastic Surgery office will schedule a convenient, private and personalized consultation appointment to review all the details of the Abdominoplasty procedure.

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