Otoplasty SF Bay Area (Ear Pinning)

Posted October 09, 2017 in Ear Shaping (Otoplasty), Home, Videos

Prominent ears can be a source of embarrassment and teasing. Cosmetic Ear Surgery (Otoplasty) includes Ear Pinning to reduce the appearance of prominent ears. Many of my patients are adults who have thought about having the procedure for some time. One of the most common reactions I hear after surgery is, “I wish I had done this sooner.” Otoplasty is a one or two hour procedure that can be performed as an outpatient, and for the right patient, it can make a huge difference.

Otoplasty For Adults

These otoplasty before and after pictures show how prominent ears can be reduced. The entire ear is pinned back. In this case, the upper ear is brought in more than the lower aspect to balance the projection.

These otoplasty before and after pictures show how prominent ears can be reduced. The entire ear is pinned back. In this case, the upper ear is brought in more than the lower aspect to balance the projection.

The gentleman above waited years before having Cosmetic Ear Surgery. He had prominent ears, which are typically more prominent at the top. He also had asymmetry of his ears with differences in shape, prominence and rotation. Each area was addresses and improved with his Otoplasty, making him one happy patient.

Ear Pinning Video

This video segment is from the San Francisco Bay Area’s News Station, KRON 4’s, Body Beautiful with Dr. Joseph Mele. The Otoplasty Video reviews the techniques, recovery and procedure of Otoplasty, and illustrates the results with Otoplasty Before and After Pictures.

Otoplasty Video (Ear Reduction)

Otoplasty For Children

There are two peaks in the age of Otoplasty patients. Young adults are the most common, but a significant number of children undergo Otoplasty also. It is one of the most common cosmetic plastic surgery procedures performed for children in my Walnut Creek Plastic Surgery Clinic, and in general. It is important to wait until at least age 5, for the ear to grow to near its adult size before proceeding.

Prominent ears are something we are born with. Ear pinning or Otoplasty is deferred until age 5, because at 5 -years-old, the ear is 85% of the adult size.

Prominent ears are something we are born with. Ear pinning, or Otoplasty, is deferred until age 5, because at 5 -years-old, the ear is 85% of the adult size.

The patient above has the advantage of long hair to cover her ears; however, her ears gave her trouble when she wanted to wear her hair up. This is a common problem for young athletes in particular. After her ear pinning, she could return to playing sports with confidence.

Otoplasty Recovery

Once healed, the ear does not require any special treatment, and recovery from surgery is just a few weeks. A head dressing is worn for the first week, and then a sweatband is worn at night for a few months, to keep the ears from folding forward while sleeping. Once the initial dressing is removed, no dressing is needed while awake.

Cosmetic Ear Pinning Consultations


If you are considering Otoplasty
for yourself or your child, be certain to consult with a Board Certified Plastic Surgeon in your area for detailed and specific advice. In the greater San Francisco Bay Area, call (925) 943-6353 and schedule a private consultation appointment, tailored to your needs.

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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 Augmentation Lifts – Breast Lifts with Implants – SF Bay Area

Posted June 17, 2017 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Post-Bariatric Surgery (After Weight Loss), Videos

Breast Augmentation adds volume, while Breast Lifts reshape. What happens when you put them together? You get Cosmetic Plastic Surgery that can enhance both breast volume and shape.

Breast Augmentation adds volume, while Breast Lifts reshape. What happens when you put them together? You get Cosmetic Plastic Surgery that can enhance both breast volume and shape.

Total Breast Enhancement – Breast Aug and Breast Lift

Sometimes a Breast Implant or a Breast Lift alone is not enough to get the results we want. The combination of Breast Augmentation with a Breast Lift, or Augmentation Mastopexy, is used when breast sagging is combined with a loss of breast volume. Board Certified, San Francisco Bay Area Plastic Surgeon, Dr. Joseph Mele, discusses the nuances of Breast Augmentation Combined With Breast Lift on this episode of Body Beautiful, a live television show dedicated to the latest in Cosmetic Plastic Surgery news for the greater San Francisco Bay Area.

Breast Lift With Breast Implants Video

Combining Breast Lifts With Breast Implants

After pregnancy or significant weight loss, Breast Augmentation is combined with Breast Lifts as much as 40% of the time.

Breast Implants Make Breasts Larger

Everyone knows that Breast Implants make breasts bigger. It’s a simple concept. Adding volume behind the breast tissue, often behind the pectoralis muscle, enlarges the breasts you have. While the size of the breast changes, the shape does not. It simply inflates the skin you have.

Breast Lifts Make Breasts Perkier

Breast Lifts (Mastopexies), on the other had, are all about breast shape. Lifts do not make breasts bigger or smaller. Breast Lifts reshape the skin envelope. Mastopexies reposition the nipples/areolae into a more attractive position and reduce the amount of breast tissue that sags below the IMF (inframammary fold).

Breast Augmentation Lift Consultations

The subtleties of the procedures, whether considered separate or together, are beyond the scope of one San Francisco Plastic Surgery Blog post, though you will find other posts on the topic here and on my other web sites. But rather than learning everything there is to know about both, why not learn about the aspects of the procedure that apply to your body?

Breast Augmentation Lift Consultations are the best way, and really the only way, to get the information specific to your needs. They focus on your breasts and your goals. You won’t waste time learning about options that won’t do what you want, and you will learn what to expect from the procedures that are most likely to help you.

If you would like to schedule a personalized and private Breast Enhancement Consultation, call my office today at (925) 943-6353. Get specific information that is tailored to address your needs, not generic information meant for the masses.

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Chin Augmentation SF Bay Area (Chin Implants)

Posted April 01, 2017 in Chin Implants/Augmentation, Facial Augmentation, Home, Videos

Chin Augmentation is the most popular Facial Plastic Surgery using an implant. Temporary Chin Enlargement can be performed with several fillers, such as Radiesse, Restylane Lyft (formerly Perlane) or Juvedem; however, long lasting results are only possible with Chin Implants.

Chin Implants provide projection of the chin on the profile view. In the above Chin Augmentation before and after pictures, the Chin Implant is placed on the anterior surface of the bone, pushing the soft tissue of the chin forward.

Chin Implants provide projection of the chin on profile. In the above Chin Augmentation before and after pictures, the Chin Implant is located on the anterior surface of the lower jaw bone, the mandible, enhancing the chin and pushing the soft tissues under the skin forward.

Chin Augmentation Video (Chin Implants)

The Chin Augmentation Video below is a recent segment from Body Beautiful, which originally aired on the San Francisco Bay Area’s News Station, KRON 4. Host Janelle Marie and I discuss Chin Implants and other complementary procedures such as: Liposuction and Neck Lifts. Surgical options and the recovery period are also covered. Chin Augmentation Before and After Photos are used to illustrate the mechanics of the procedure and to demonstrate what the procedure can do.

Chin Implant Options

The most popular chin implants are made of silicone. Silicone Chin Implants are solid, firm, rubbery prostheses, which come in a variety of sizes. Variations in height, width, projection and style can be used to select the Chin Implant best suited for your chin and your goals. Since these implants are soft enough to fold, they can be inserted through a smaller incision. However, they are more likely to move or buckle over time.

Another type of Chin Implant is the Medpore Chin Implant. Medpore is a hard, porous substance that is more like bone than silicone. Medpore implants can provide larger and more stable augmentation. The soft tissue of the chin grows into it, securing the chin implant in place, so this implant is less likely to move or buckle. They are also much harder to remove and replace too. Since Medpore is not flexible, they require a slightly larger incision for placement. These implants also take a little longer to settle down to their final, post-operative size.

Chin Implant Proportions

There are certain proportions that we Plastic Surgeons try to obtain with the Chin Implant. Whether chin implant or breast implants, size, shape and location matter. For women, the ideal chin projection is just shy of the lower lip projection. For men, the goal is often at, or a little past, the projection of the lower lip. Of course, this can be adjusted, depending on your goals.

Comparing the Chin Augmentation before and after pictures of this man and the woman above, you can see that the ideal chin projection for men is larger with respect to the lower lip. Facial proportions do vary; however, in general men tend to have larger bony features than women. This is especially true of the chin and the nose.

Comparing the Chin Augmentation before and after pictures of this man and the woman above, you can see that the ideal chin projection for men is larger with respect to the lower lip. Facial proportions do vary; however, men tend to have larger bony features than women. This is especially true of the chin and the nose.

Chin Augmentation Computer Imaging can be a useful adjunct to the discussion, and can make the abstract more concrete. While computer simulation is not a guarantee of results, it is very helpful in gauging how much Chin Enlargement is enough. A patient who has had the benefit of preoperative Chin Implant Simulation is rarely surprised by the outcome.

Chin Augmentation Consultations

As you can see from this brief overview, there are several options for Chin Enhancement. If you would like to learn more about Chin Implants, and how they can be used to enhance your face, call (925) 943-6353, today. A private consultation appointment will be scheduled, and we can go over the options that make the most sense for your chin.

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Male Breast Reduction | Gynecomastia San Francisco Bay Area

Posted March 20, 2017 in Breast Reduction, Breast Reduction (Men), Home, Videos

About two-thirds of men develop breast buds during puberty, and for half of them, it does not go away. Gynecomastia, male breast development, causes fullness, feminization and often embarrassment. The only cure is Gynecomastia Reduction Surgery. Dr. Joseph Mele is a Board Certified Plastic Surgeon in the San Francisco Bay Area who specializes in Male Breast Reduction or Gynecomastia Reduction. This Gynecomastia Video segment aired live on the Bay Area’s News Station, KRON 4, and discusses the procedure and reviews examples of Gynecomastia before and after pictures.

Gynecomastia may involve just the area beneath the nipple and areolae or the entire chest. In the male breast reduction before and after pictures above, the fullness beneath the nipples was removed through a small incision placed along the lower margin of the areolae.

Gynecomastia may involve just the area beneath the nipple and areolae or the entire chest. In the male breast reduction before and after pictures above, the fullness beneath the nipples was removed through a small incision placed along the lower margin of the areolae.

Male Breast Reduction As Seen On TV

Recently, I had the opportunity to discuss Male Breast Reduction on Body Beautiful. Body Beautiful is a live show on the San Francisco Bay Area’s News Station, KRON 4. The segment is included below, and contains multiple Gynecomastia Reduction Before and After Photos, along with narration about the procedure, alternatives and recovery.

Gynecomastia Reduction Video (Male Breast Reduction)

Gynecomastia Reduction Consultations

Gynecomastia Reduction removes excess breast tissue from the male chest. Excess tissue can be removed with Liposuction or direct excision, depending on the amount, location and nature of the breast tissue.

Gynecomastia Reduction removes excess breast tissue from the male chest. Excess tissue can be removed with Liposuction or direct excision, depending on the amount, location and nature of the breast tissue.

There are several alternative operations for Gynecomastia Reduction. Common methods include liposuction, direct excision of the gland, skin reduction or a combination of each. The best method is often determined by the size, location and nature of the breast tissue.

To find out what your options are, call (925) 943-6353 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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Video – Breast Augmentation on KRON 4 – SF Bay Area’s News Station

Posted March 11, 2017 in Breast Augmentation, Breast Augmentation Lift, Home, Videos

According to the latest American Society of Plastic Surgeons’ Statistics, Breast Augmentation remains the most popular Cosmetic Plastic Surgery procedure in the United States.

Breast Augmentation provides fullness and support. Not only can a Breast Implant enlarge a small breast, but it can restore shape and volume to a breast that has changed due to pregnancy, weight loss or aging.

Breast Augmentation provides fullness and support. Not only can a Breast Implant enlarge a small breast, but it can restore shape and volume to a breast that has changed due to pregnancy, weight loss or aging.

Breast Augmentation on Body Beautiful

Breast Augmentation was also the first topic discussed on this week’s Body Beautiful. Body Beautiful is a live show, dedicated to the latest in Cosmetic and Plastic Surgery procedures, that airs on the San Francisco Bay Area’s News Station, KRON 4.

The Breast Augmentation Video below covers the basics of Breast Implants and Breast Augmentation and illustrates the procedure with multiple Breast Augmentation Before and After Pictures.

Breast Augmentation Video (Breast Implants)

Breast Augmentation Consultations

Breast implants come in a large variety of sizes and shapes. The best size for you is subjective; however, a Board Certified Plastic Surgeon can supply you with professional guidance in selecting the Breast Implant that will best provide the result you are looking for.

Breast implants come in a large variety of sizes and shapes. The best size for you is subjective; however, a Board Certified Plastic Surgeon can supply you with professional guidance in selecting the Breast Implant that will best provide the result you are looking for.

If you are considering Breast Augmentation or have Breast Implants and are looking for Breast Augmentation Revision, give me a call at (925) 943-6353 for a personalized consultation and specific recommendations tailored to your needs.

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Mommy Makeover SF Bay Area

Posted December 26, 2016 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Breast Reduction, Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Tummy Tuck (Abdominoplasty), Videos

Every Mommy Makeover includes enhancement of both the belly and the breasts. The most common combination is Breast Augmentation with a Tummy Tuck (Abdominoplasty). However, other options include:

  • Breast Enhancement
    • Breast Lifts
    • Breast Implants with Breast Lift
    • Breast Reduction
  • Belly Enhancement
    • Liposuction
    • Mini Tummy Tucks
  • Other Body Enhancements
    • Brazilian Butt Lift
    • Lower Body Lift
    • Facial Enhancement

The combination best for you depends on what you need, tempered by safety and predictability.

Mommy Makeover Video Presentation

The television segment included below is all about Mommy Makeovers and includes many of the most popular variations. The Mommy Makeover Video includes Mommy Makeover Before and After Pictures that illustrate what the procedure has to offer.

The following video segment is from my latest appearance on the San Francisco Bay Area’s New Station, KRON 4. The show gives me the opportunity to talk about the latest Cosmetic Plastic Surgery News.

Mommy Makeover Video

Make Your Mommy Makeover Consultation Appointment

When considering a Mommy Makeover, be certain to find a Board Certified Plastic Surgeon in your area who has years of experience with the techniques currently available. If you are in the San Francisco Bay Area and would like to schedule a personalized appointment in my Walnut Creek Plastic Surgery clinic, give me a call today at (925) 943-6353.

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Breast Augmentation Breast Lift Combined (Mastopexy Augmentation) SF Bay Area

Posted December 10, 2016 in Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Home, Videos

Excellent Breast Enhancement is about obtaining the right size and the right shape. If your breast shape is good, more volume is all that is needed, and Breast Augmentation is usually enough to get the results you are looking for.

However, when breasts are the wrong shape, bigger is not always better. For congenital deformities like Poland’s Syndrome or Tubular Breasts, a Breast Implant alone is often not enough. A Breast Lift is added to reshape the breast mound and relocate the misplaced nipple.

Breast Augmentation With Breast Lift Video (Mastopexy Augmentation)

Below is a segment from my latest KRON 4, Body Beautiful show. Several Breast Augmentation With Breast Lift Before and After Pictures are included and narrated, to help illustrate what Breast Augmentation With Breast Lift has to offer. Examples of both the correction of the typical breast deflation with sagging (breast ptosis) typically seen after pregnancy or weight loss, as well as congenital deformities like Poland’s Syndrome or Tubular Breasts are reviewed.

The splash screen of the video above shows Mastopexy Augmentation used for a woman with tubular breasts and very low nipples. Breast Augmentation alone would give her larger breasts; however, the nipple areola complex would still be puffy and the location of the nipple would remain at the bottom of the breast. A more ideal nipple shape and location was obtained by combining the use of Breast Implants for enhanced volume with a Vertical Breast Lift for a better shape. The result is a happy patient.

Breast Augmentation and Breast Lift Consultations

If you are considering Breast Augmentation or a Breast Lift, be certain to choose an experienced and Board Certified Plastic Surgeon who understands how to address your specific breast anatomy and your goals. In the San Francisco Bay Area call (925) 943-6353, to schedule a personalized and private consultation appointment.

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Otoplasty For Prominent Ears SF Bay Area

Posted September 23, 2016 in Ear Shaping (Otoplasty), Home, Videos

Ears come in all shapes and sizes. If you like your ears, Otoplasty is not for you, but if you feel your ears are too big, stick out too much or have an unusual shape, Cosmetic Ear Shaping Surgery may be just what the doctor ordered.

Who Gets Cosmetic Ear Surgery?

I discussed Ear Pinning recently here on the San Francisco Plastic Surgery Blog. The post included several Otoplasty Before and After Photos and answers many of the frequently asked questions about Otoplasty.

Otoplasty Video (Prominent Ear Reduction)

While before and after pictures do illustrate the words, for some, video provides the optimal experience. Below is a segment from my latest KRON 4, Body Beautiful show. More Ear Pinning Before and After Pictures are included, and narrated, to help illustrate what Otoplasty has to offer.

Otoplasty Consultations

If you are considering Otoplasty, call (925) 943-6353 today, and schedule a personalized consultation appointment. We are located in the San Francisco Bay Area’s East Bay city of Walnut Creek, CA. More information is also available on DrMele.com’s Otoplasty Page and in Spanish on Cirugia Plastic San Francisco’s Página de Cirugía de Oreja y Otoplastia.

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