Thanks to the internet, patients today have access to more information when researching a plastic surgeon and/or a specific cosmetic procedure than at any other time in history. Which is great news. But often times, that information is contradictory. One surgeon may recommend one approach or technique as the best for that specific procedure while another surgeon may say the exact opposite. How does the patient figure out which one’s right? Our experts weigh in on this and the bigger question: Is the internet helpful or harmful to plastic surgery patients?

by Katherine Stuart
and The Plastic Surgery Channel

The Internet Has Revolutionized Plastic Surgery

All of our panelists agree that the internet has revolutionized plastic surgery particularly in terms of how patients find, vet, and pick a surgeon. “I think the most popular page on any website is the before and after gallery,” says Dr. Constantino Mendieta of Miami. But the problem is that “plastic surgeons are like designers”. Each has his or her own unique opinion on beauty and how best to achieve it. Which is one of the reasons that patients can find such differing views on the right approach to a procedure when doing their internet research.

Another, according to Dr. Mendieta, is that many surgeons are now exploiting the marketing aspect of the internet by saying things that are a little “too far out there” in order to garner attention, views and publicity. One of the best ways to ensure that a surgeon’s opinion is valid and sound is to find one who’s board certified by the either the American Society of Plastic Surgeons (ASPS) or the American Society of Aesthetic Plastic Surgery (ASAPS). It’s easy to look for either logo on a surgeon’s website. If you see it then you know that he or she has gone through rigorous training, examinations, and also works to educate colleagues. “If you find one of those logos on their website then all the homework has been done for you,” says Mendieta. One can then examine that specific surgeon’s before & after pictures to see whether or not his or her aesthetic matches your own. It’s really important that you do your homework, but keep in mind that if a surgeon is saying something that’s, “too good to be true, it probably is”.

Just Because It’s On the Internet Doesn’t Mean It’s Right

Dr. Christine Hamori of Boston couldn’t agree more on the importance of finding a surgeon who is board certified and the positive side to the internet in terms of patient research. The downside, for her is, “sometimes patients go to the internet and then they think they’re experts.” They come in for a consultation and start to tell the surgeon how to do the surgery. It’s difficult for the surgeon to have to then shift that perception and let the patient know that, “I am the expert.” Furthermore, a lot of the information that the patients are referencing is actually incorrect. “You have to reeducate those people,” says Hamori.

Certain websites have gotten credibility because of their popularity, not because they are actually accurate. How can a patient know if the surgeon is actually an expert on the procedure or simply an expert on the internet? According to Dr. William P. Adams of Dallas, there are four things to look for on a surgeon’s website to determine if he or she is legitimately an expert:

1. Has the surgeon been invited to educate at national meetings?
2. Has he or she been invited to perform live surgeries at these meetings?
3. Has the surgeon written certain peer reviewed publications?
4. Has the surgeon had any books published?

The right cosmetic procedure performed correctly can change lives. When doing your research, look for the board certification logos and see if the surgeon meets any of the above 4 criteria.And yes, ask questions, but also listen.

The post The Internet: Helpful or Harmful? appeared first on The Plastic Surgery Channel.

Plastic surgeons are constantly evolving, honing their craft to develop new techniques and procedures that rejuvenate the face with as little downtime and scarring as possible. Dr. Cliff Clark of Winter Park, FL discusses how cosmetic surgeons today combat facial aging versus 10 or 20 years ago and the exciting results that can be accomplished with minimally invasive procedures.

by Katherine Stuart
and Clifford Clark, III, MD

It’s About Adding Fat and Subtracting Skin

The eyes are one of the first features to show the early signs of aging, which can make the rest of the face look old even if it’s not. In the past, treating the eyes was all about removing excess skin and fat. Now, it’s about creating balance by taking away a bit of skin and fat, adding volume where needed and moving the position of the brow. All of which can be accomplished through an upper blepharoplasty incision.

An upper blepharoplasty is a procedure in which a surgeon places an incision in the crease of the upper eyelid and removes excess skin. The scar from the incision is hidden within the crease of the eye and so slight that it usually can’t even be seen when the eye is closed. Surgeons such as Dr. Clark can now deliver the kind of facial rejuvenation through this small incision that used to require a full facelift. “You can adjust the position of their eyebrows,” explains Clark. “You can take away some of the furrowing that they have in their central brow and through injection techniques, you can also put some fat around their eyes if they need it.”

If you look at the actress Catherine Zeta Jones, she has a lot of fat in the brow tissues above her eyelid. It’s this fullness that gives her a youthful eye. Older women often look as if you could stick your finger between the eye and the brow. This hollow or loss of fat is one of the face’s biggest “agers”. Generations ago, plastic surgeons took away too much from around the eye. Today, great results are about positioning the eyebrow so that the outer edge is higher than the inner edge. Also adjustments include addressing the muscle that causes some patients eyebrows to come together, removing excess skin from above and/or below the eyelid, and adding volume where needed. It’s an entirely new way of thinking that greatly benefits the patient as it delivers exemplary results with minimal risk and a modest recovery.

Lower Lid/Cheek Juncture is Another Trouble Spot

“As you look at periorbital aging, one of the more profound ways that we age is to lose the volume of our upper cheek” says Clark. This volume loss reveals the underlying facial skeleton which creates a hollow underneath the eye. Patients often refer to this as their “dark circles”. Treatment is about restoring balance. Bottom line, achieving good results takes a couple of different techniques. It’s never a “one size fits all”.

Fat Bulge Beneath the Eye Requires More Invasive Surgery

Some patients have a pad of fat that bulges beneath the eye. This can typically be addressed with a transconjunctival blepharoplasty. In this procedure, a surgeon places an incision on the inside of your eyelid and removes the fat, leaving no apparent scar. He or she may then inject filler or fat into the hollow under the eye to treat the dark circle. “By removing above and adding below, you have the perfect balance,” says Clark. For patients with a “festoon”, which is a laxity in the skin and muscle under the eye, treatment may require a more invasive surgery. But it’s still less invasive than it would have been 10 or 15 years ago.

The post Minimally Invasive Procedures Can Deliver Big Results appeared first on The Plastic Surgery Channel.

“The Brazilian Butt Lift is really a slang term for fat transfer to the buttock and hips,” says Dr. Mark Epstein of Stony Brook, NY. During this procedure, a surgeon removes fat from an area where it’s not wanted – such as the abdomen or thighs – and places it into the buttocks where it is wanted, meaning that the patient is actually getting two procedures bundled as one. Which could explain why there has been a 16% increase in butt augmentations since 2012, according to the latest statistics from the American Society of Plastic Surgeons. And though this doesn’t put the numbers anywhere near the requests for breast augmentations, it does make the Brazilian butt lift one of the fastest growing cosmetic procedures on the market today. Why? Because patients now realize that a butt augmentation actually re-contours the entire torso, delivering the body of their dreams.

by Katherine Stuart
and Mark Epstein, MD

It’s About Re-shaping the Entire Torso

A Brazilian butt lift is not just about getting a larger butt, it’s about a more shapely butt. Furthermore, it’s as much about re-contouring the waist, abdomen and thighs as it is about the buttocks. During your BBL procedure, a surgeon will harvest fat from areas where you have excess such as the abdomen, thighs, upper back/“bra rolls” or arms. The right spots are going to depend on each patient’s individual needs.  The goal for surgeons such as Dr. Epstein is to strategically remove the fat, sculpting as he harvests. This leaves the patient with the bonus of a more well defined donor site in addition to a fuller looking buttock. He typically uses about 80% of that fat for shaping or contouring and about 20% for augmentation.

Some patients come in with large areas that bother them and some come in with small areas. The most common patient that Dr. Epstein sees is the one who wants his or her abs and/or flanks re-contoured with the fat put into the buttocks and hips. “I call that the 1-2 punch,” says Epstein. “It’s the harvesting of the fat from the abdomen and flanks with resultant liposculpting of those areas, followed by the bbl, giving them a more shapely buttock and hip.”

A Bigger Buttock = A Slimmer Waist

By removing fat from certain areas such as the abdomen and placing it into the buttocks, a surgeon can restore harmony to your body, accentuate your waist, and re-contour your entire torso. “You want to have a narrower waist but a more shapely buttock and hip which gives you a slimmer, sexier figure,” explains Epstein. “That’s the goal that we want to achieve.” When a patient comes in for a BBL consultation, a surgeon will examine him or her from a 360 degree perspective, determining the best places for harvesting the fat in order to achieve that patient’s ideal body. It’s truly a tailored approach.

The Right Patient Comes in all Shapes and Sizes

Though celebrities such as Kim Kardashian, Beyoncé, and Jennifer Lopez may have started the trend of celebrating the “derriere”, it has quickly spread across age and ethnic lines. Dr. Epstein’s BBL patients range in age from 20 to 66. While some of his patients are very fit with little fat, others may be carrying a few extra pounds. Bottom line, great results can be achieved regardless of age or body type. Additionally, “patients who undergo fat transfer to the buttocks are very, very happy because this is an area that bothers so many,” says Dr. Epstein. A happy patient is what every surgeon strives to deliver.

The post The Brazilian Butt Lift Is a 1, 2 Punch appeared first on The Plastic Surgery Channel.

A lot of people don’t like the look of their nose. According to the latest statistics from the American Society of Plastic Surgeons, rhinoplasty or nose surgery is the second most popular cosmetic procedure in this country. A surgical procedure to improve the look and/or function of the nose, a rhinoplasty surgeon needs to weigh a patient’s desires versus his or her anatomy. For this and other reasons discussed below, rhinoplasty is “one of the most difficult procedures that we do,” according to Dr. Jarrod Daniel of Charlotte, NC.

by Katherine Stuart
and Jarrod Daniel, MD

Who is a Rhinoplasty Patient?

Rhinoplasty patients come from all walks of life. They can be male or female, older or younger, and any and all ethnicities. However, Dr. Daniel has found that most rhinoplasty patients are experiencing certain, “transitions in life.”  These transitions may include high school to college, college to the workforce, or a big life change such as a divorce. However, they’ve all typically been thinking about a rhinoplasty for a long time because the look of their nose makes them feel self-conscious in social situations, photos, and every time they look in the mirror.

It’s All About Proportion

Most rhinoplasty patients come in with a specific issue. For example, they may not like their profile or their tip. It’s the surgeon’s job to take into account these desires, but then to look at the patient’s nose from an aesthetic standpoint and make sure that the changes they want will be proportional to the rest of the face. It requires a balance between science and art, which makes rhinoplasty surgery so difficult.

Your nose sits in the center of your face. Everyone notices it and it’s not something that can be covered up. To find the right proportion, your surgeon must look at the relationship between your nose and the rest of your face. Dr. Daniel likes to use 3D imaging so that his patients can see exactly what will happen when they remove the dorsal hump, for example. It’s the surgeon’s job to take away those elements that the patients don’t like while still leaving them with their own unique nose. It’s not a one size fits all approach.

It’s a Surgery of Millimeters

Rhinoplasty is a surgery where one millimeter can make a huge difference not just on the look of the nose, but also on its function. When someone has a dorsal hump, the surgeon needs to remove it slowly and carefully. Dr. Daniel will literally shave off a millimeter at a time then re-drape the skin over the bone, and assess the new proportions. He looks at the relationship between the new nose and the forehead notch as well as the tip.

Bottom line, when a surgeon changes one thing, it affects everything else. “Rhinoplasty is a difficult procedure,” says Dr. Daniel “but one of the most satisfying procedures that we do because… we can really change the way somebody looks. We can improve their self confidence, their self esteem.”

Because of the inherent difficulties in rhinoplasty surgery, patients need to go to a board certified plastic surgeon who performs a lot of rhinoplasties. This is definitely a surgery where practice makes perfect.

The post Rhinoplasty: Part Science, Part Art appeared first on The Plastic Surgery Channel.

Even 10-15 years ago, we wouldn’t or couldn’t be having this discussion — whether you should consider surgical or non-surgical options for cosmetic treatments. Times, technology, and techniques are a’changin.

by John Hammarley
and The Plastic Surgery Channel

Honesty is the Best Policy

Dr. Christine Hamori, a board certified plastic surgeon who practices near Boston, MA, says her first and foremost criterion she uses when discussing what approach to take with patients is honesty. So many of her patients, understandably, will come in saying, “Why can’t we do this without surgery?” Sometimes, Dr. Hamori can agree and say this neck treatment or that eyebrow adjustment can be made without picking up a scalpel. Many times, however, she has to level with patients and say, “if you want the result to be x, then we’re going to consider a surgical approach.”

It’s Good to Have Options, but…

Dr. William P. Adams Jr., a Dallas-based board certified plastic surgeon, says just because we have non-surgical options, doesn’t make it better. Patients shouldn’t assume non-surgical is always better than surgical, Adams insists. The most important factor, he says, is having the “to cut or not to cut” conversation with a board certified plastic surgeon with the knowledge of the pros and cons of each approach.

The “Match Game” is Critical, too

Dr. Tino Mendieta, whose board certified plastic surgery practice is in Miami, says matching the right patient with the right approach is fundamental for success. He says for a lot of procedures, it’s a slam dunk: it’s obvious that ”this approach matches this patient.” But… it gets tricky when you get patients who are “in between.” He agrees with Dr. Hamori that an honest discussion is critical at that point to make sure he and his patient agree on what approach they want taken.

The Age of Customization

Having more options, both surgical and non-surgical, is good for everyone. Patient education and a rewarding consult help patients agree with their surgeons that sometimes the less invasive, non-surgical approach to cosmetic improvements may not provide the end result they hope for.

If non-surgical approaches are a good option, most all board certified plastic surgeons say the first place to start is great skin care. And while there are new and improved skin therapies on the market, talking over which one may provide the best results with your plastic surgeon is a must. He or she is going to know your skin the best to decide which brand will do the best job for you.

Fillers and injectables also top the list of approaches to facial rejuvenation that don’t include scalpels and down time and general anesthesia. If you’ve lost volume, fillers can be used to pump up lost facial volume.

Whether it’s fillers and Botox, CoolSculpting, or even ThermiVa for vaginal rejuvenation, non-surgical options persist because they are extremely successful. There is but a limit to how much they can provide, a limit that will be understood and emphasized by a board certified plastic surgeon during a consult.

The post What will it be? Surgical or Non-surgical options? appeared first on The Plastic Surgery Channel.

It’s true, a board certified plastic surgeon with practiced and talented experience can work wonders taking years of worry and work and stress by way of a facelift. That being said, most skin experts say long before you get to the operating room, there’s much that can – and should – be done.

by John Hammarley
and Mark Pinsky, MD

Your Skin is All You’ve Got

Dr. Mark Pinsky sees it every day in his Palm Beach Gardens practice: new and old patients alike coming in asking about the ‘latest’ technique for radiant-looking skin.

“Their number one concern, above all others is pretty looking skin,” says Pinsky. “And that’s why I believe we have to start there – with fundamentals.”

Bond. James Bond. (Girls, that is)

“For example, if you go online and look at the James Bond girls, even from years ago, the women who have had a face lift with bad skin, don’t look quite as good as the women who have good skin and who haven’t had a face lift,” Dr. Pinsky observes. “The point is smooth skin – skin with even tone – makes all the difference in the world.”

He recommends skin care creams developed and distributed through board certified plastic surgeons because of several reasons, including the strength of the active ingredients used and the physician’s expertise in prescribing the most effective dosages and frequencies of these treatments.

Nourishing and Revitalizing the Skin

“Like your body needs good vitamins, the skin needs good nutrients,” says Dr. Pinsky. “If you want a healthy, radiant look outside, you’ve got to be careful what kind of ‘diet’ if you will you sustain the skin with.”

Beyond nutrition and sun protection, the myriad of injectables can provide an immense rejuvenation compared to how small the procedure (injection) is. Ranging from Botox and Dysport to Juvederm and Restylane, plastic surgeons can use these and other options in various combinations to refresh and rejuvenate patients’ faces.

“There’s an unending series of combinations we use to help shape our outcomes,” Pinsky adds. “We’re not just trying to fill in this wrinkle or that crease. That’s where the artistry in our profession is essential. And all of this can be accomplished with little or no down time.”

Regardless of the type, mode, or amount of products being recommended, board certified plastic surgeons say, “the earlier the better.” Women who begin age-defying treatments at a younger age not only will look younger and better earlier in their lives but maintaining those youthful looks will be easier and more effective.

Still not ready for a full-fledged face lift? No problem. Take any combination of all the aforementioned treatments and then add a variety of lasers and you add even more options. Dr. Pinsky says shy away from any med spa or medical practice that only offers a single choice when it comes lasers.

While some fillers and neuromodulators can bring a fresher, younger look relatively fast, board certified plastic surgeons recommend that you set out a long-term plan. “I like a 12-18 month plan,” says Pinsky.

The post What’s the Secret to a Great Face? appeared first on The Plastic Surgery Channel.

Our skin is everything. It is our business card and what others see first. It’s also what sticks out when there are imperfections and blemishes. The most perfect face lift procedure could easily be hampered by poor skin quality. To combat this, plastic surgeons have embraced skin care, working with medical scientists to develop devices and products that actually improve the skin.

One such device is the Halo laser by Sciton. We all suffer skin damage from the sun, and the effects begin to add up and show themselves in middle age. Besides sun damage, acne scarring is an issue for many, the tell-tale signs even when the disease has dissipated. Sciton’s Halo works to correct both by giving surgeon’s extreme precision.

Dr. Jason Pozner of Boca Raton utilizes Halo to help even skin tones and smooth any scarring that may occur. In this segment, Dr. Pozner describes his patient’s issues, how the Halo laser will benefit, and then shows how simple, easy and painless an actual procedure is.

by Adam McMillon
and Jason Pozner, MD

Counteracting the Sun

Unfortunately for many in their late 20’s and older who’ve spent time in the sun, the damage from our mother star has already been done to the skin. Freckles are small signs of what has been happening, while most of the irregularities will surface in time. Undoubtedly, even to a 30-year-old patient with severe sun exposure and potential damage, sunscreen is still the greatest tool in keeping your skin youthful and your appearance young by avoiding current and future damage.

In addition to sun damage, acne is still an enemy to a large section of the population and many will receive scarring that lasts a lifetime. The possibility that even small improvements can be made can help those in their 20’s and 30’s still fighting acne. Lasers like Sciton’s Halo are providing more than hope: results.

“The Sciton Halo is a fractional, ablative and non-ablative laser,” explains Dr. Pozner. “Our goal is to get rid of the darkened and mottled pigment [this patient] has in her cheeks. She has a little acne scarring, but the main thing I see is it’s mottled. You see some highlights and lowlights of different colors.”

With one treatment, the Halo laser makes a significant impact on surface features and coloration, providing the results with very limited downtime compared to ablative lasers.

The post Rewriting Your Facial Past with the Halo Laser appeared first on The Plastic Surgery Channel.

There are 64 million women in the United States between the ages of 18 and 54, and approximately 54 million of them have some degree of cellulite. That means 90% of the women in this country are suffering through bathing suit season with unsightly dimples on their buttocks, and thighs. Until recently, the only cellulite treatment options available were creams, lasers, and freezing that did not deliver long term results. Now there is true help in the form of Cellfina, the first FDA approved, minimally invasive treatment to deliver long-lasting results. Dr. Tiffany McCormack of Reno, NV talks about this game-changing new cellulite treatment and why it works.

by Katherine Stuart
and Tiffany McCormack, MD

What Causes Cellulite? 

Diet, lifestyle, genetics, clothing and hormones are all thought to contribute to the appearance of cellulite, but it’s the underlying fibrous bands that run perpendicular between the fascia and the skin that actually causes the “dimpling” that is the bane of so many women’s existence. These connective bands typically have chambers of fat between them. As the bands become lax, thicken or stiffen, it pulls down on the surface of the skin, causing the fat to bulge up and the skin to pucker.

About 90% of women suffer from some degree of cellulite and, “it’s not always correlated with fat. Sometimes, it’s just genetic,” says Dr. McCormack. She sees many patients who are healthy, fit and thin who still have cellulite. It can can show though your gym clothes, your leggings, and your tight white pants. “It’s not just something that affects you on the beach,” she explains.

What is Cellfina?

Cellfina is the first FDA approved, minimally-invasive treatment that delivers effective results. It’s an out-patient procedure, performed in the office, and only takes about an hour with recovery/downtime of typically less than 3 days, if at all.

So far, Dr. McCormack’s patients have been really happy with their results. Many have been surprised by how easy the treatment is as well as the recovery. Patients may be tender to the touch for a week or two following their Cellfina treatment, but Dr. McCormack has never had to prescribe any pain medication. You can expect some bruising, redness or maybe a little bit of discoloration at the incision sites, but these are temporary and will completely resolve with time.

Any woman between the ages of 18 and 55 with a BMI less than 30 or 35, who is in relatively good shape, but who has cellulite on the buttocks and thighs that bothers them is a good candidate for Cellfina. “It’s a great option” says Dr. McCormack.

The post Banish Cellulite with Cellfina appeared first on The Plastic Surgery Channel.

The biggest fear for many, many patients considering any type of cosmetic or aesthetic surgery is “going under,” or the anxiety of general anesthesia. In an attempt to address and avoid that fear, techniques continue to be refined that allow patients and surgeons to accomplish surgeries while the patient is “awake.” The Plastic Surgery Channel interviews board certified plastic surgeons on whether or not procedures performed without general anesthesia can be effective, or even safe.

by John Hammarley
and The Plastic Surgery Channel

What Exactly Does “Awake” Mean?

The term “awake” may be a touch deceiving when we’re talking about the state of your consciousness while undergoing a surgical procedure, especially when it comes to breast augmentation. Those plastic surgeons who choose to keep their patients “awake” throughout the implant surgery are, in fact, using intravenous sedation medication to reduce the pain and discomfort the patient may be experiencing throughout the operation.

There are many plastic surgeons – some board certified – who prefer awake breast augmentations because the patient can avoid the risks of anesthesia, avoid loss of control, avoid the fear of not waking up, and avoid nausea and/or vomiting.

However, there is a substantial group of practitioners who are less than enthusiastic (to say the least) about operating on “awake” or sedated patients for surgeries as involved as breast augmentations are.

It’s More Marketing Than Anything Else

Rod Rohrich, MD, a board certified plastic surgeon and Distinguished Professor of the Department of Plastic Surgery at The University of Texas Southwestern Medical Center at Dallas (UTSW), doesn’t like the “awake” approach to a surgery such as breast augmentation.

“It’s more marketing than anything else,” Dr. Rohrich recently told The Plastic Surgery Channel. “We have to remember the number one priority with these or any other surgeries is patient safety. And I think having a sedated patient on the table during a breast augmentation isn’t safe for anyone, especially for the patient.

“She’s going to be at the very least uncomfortable and potentially could feel a level of pain that simply isn’t necessary,” Dr. Rohrich continued. “I’m not going to be able to do the best job I can do if I have a patient on the operating table who is moving around during surgery.”

Constantino Mendieta, MD, a board certified plastic surgeon in Miami, says several of his colleagues report having success with ‘awake’ breast augmentation. “They tell me their patients are happy to avoid the fear of general anesthesia and often report a faster recovery period.” But he also says he doesn’t like performing implant surgery unless the patient is completely anesthetized.

“The important involvement with my patients happens before we get to the operating table,” Dr. Mendieta says. “We have great technologies at our disposal now that gives patients precise examples of what different implants will look like, so the guesswork today is minimal at best.

“And I feel much more comfortable in a surgery of this size knowing the patient is completely under and there is no chance she is going to move during surgery,” Dr. Mendieta says.

The post Getting Breast Implants while you’re “Awake”? appeared first on The Plastic Surgery Channel.

Our culture’s obsession with “celebrities” is at an all time high. In fact, the recent uptick in patients seeking Brazilian butt lifts and lip augmentations can be directly linked to what the media calls the “Kardashian Effect”. So, it makes sense that more and more patients are now bringing pictures of famous men and women into their consultations and requesting that actress’s nose or that model’s eyes. But is this actually helpful for the surgeon or is it just a recipe for patient disappointment? Dr. Peter Fodor of Los Angeles, CA believes that celebrity photos can be extremely helpful in managing a patient’s expectations and understanding his or her aesthetic desires.

by Katherine Stuart
and Peter Fodor, MD

Pictures Open Up a Dialogue Between Patient and Surgeon

Most patients today bring pictures of celebrities into their consultations. But is it bad if a woman wants to look like Jennifer Aniston? “In my practice, I encourage patients to bring in pictures of celebrities or anybody whose facial features or appearance of their body they like” says Dr. Peter Fodor of Los Angeles, CA. The key is to use the photos to open up a dialogue between the patient and the surgeon. It can be extremely difficult for a surgeon to get into a patient’s mind and see what he or she desires. Tools such as 3D imaging can help the surgeon to show the patient what to expect from a specific procedure, but first, the surgeon must understand the patient’s ideal. Photos can be a really easy way for patients to communicate with their surgeon. For instance, when a patient brings in a picture of Natalie Portman, requesting her nose, Dr. Fodor “has the benefit of sitting down and saying this part of your nose we can make like this, but this other part, we can not.”

Photos Ensure a Happy Outcome

Celebrity photos also help the surgeon to manage a patient’s expectations. If, for example, a patient will never be able look like his or her dream photo because of their underlying facial structure then the surgeon can say so up front, avoiding disappointment after the fact. Or if a patient brings in 10 photos of very different looking people then this tells Dr. Fodor that “they don’t know what they’re looking for and if they don’t, then it’s less likely for them to be happy with the outcome” regardless of how great a job he performs. In these cases, a surgeon should be very circumspect about performing surgery until the patient has a much clearer idea of their objectives.

Good communication between the patient and the surgeon is paramount to ensuring a happy outcome. Patients who come in with an “ideal” facial feature or body part in their mind are going to be disappointed if the end result doesn’t line up with their fantasy. Celebrity photos can help surgeons to understand the inner workings of their patient’s minds and give their patients concrete examples of what can and can not be achieved.

The post Say You Want to Look Like Your Favorite Celebrity? appeared first on The Plastic Surgery Channel.

Anyone considering breast implants is bombarded with information from friends, family and especially the Internet. While it’s important to be aware of any possible complications, the most important thing is to discuss any fears or concerns you may have with your surgeon. One complication you may have heard about in the news actually involves a type of rare cancer. ALCL stands for anaplastic large cell lymphoma, an extremely rare type of Non-Hodgkins Lymphoma. Unlike breast cancer, which affects breast tissue, lymphoma is a cancer of the immune system.

by Anne Meyer
and Bruce Van Natta, MD

ALCL of the Breast is NOT the Same as Systemic ALCL

Board certified plastic surgeon Dr. Bruce Van Natta addresses the topic of this rare lymphoma with patients in order to add clarity and reassure them of the safety of breast augmentation surgery. “ALCL is a little scary when you hear about it. It’s a form of lymphoma. As a systemic disease, or body-wide disease, it’s a nasty thing to have. But it turns out that there is a form of this that we’ve seen in a few patients that have had implants.” In these few cases, the patients experienced swelling and discomfort in their breasts, often several years after surgery. When the fluid and scar tissue around the implants was analyzed, ALCL cells were found to be present. “This ALCL does not act like the aggressive version that people have in their whole body,” explains Van Natta.  “It turns out, if you remove that scar pocket, in the vast majority of patients, of the very few that have this, it cures them.”

ALCL by the Numbers

Just how rare is ALCL after breast augmentation? The FDA estimates that between 5-10 million women worldwide have breast implants. In 2014 alone over 285,000 women underwent breast augmentation in the United States, hundred of thousands more around the globe. In the millions of cases of breast augmentations worldwide, the FDA’s study found only sixty documented cases of ALCL occurring in the breast region after breast augmentation. 

Textured Implants and ALCL

“One interesting thing,” continues Van Natta, “is that largely this has been associated with highly textured implants. So, for example, with a smooth implant – slick surface – there have actually been no documented cases. There is a theory by Dr. Anand Deva, from Australia, that with more texturing you can get biofilms, or little bacterial contamination on the surface of these implants. If it gets to a certain threshold – and that’s the key – you can potentially stimulate an inflammatory response, and they can then develop this ALCL of the breast.” 

If You Notice Swelling and Discomfort, See Your Surgeon

Does this mean anyone with textured implants should be concerned? No, says Van Natta. “Again, it’s rare. If you have textured implants in, you don’t need to have them removed, but, if you ever got a fluid accumulation, you need to go see your surgeon and have that checked out.”  

The post ALCL: Understanding the Rare Link Between Breast Implants and Lymphoma appeared first on The Plastic Surgery Channel.

Until recently, there were limited options to fix what can be embarrassing marks like acne scars, stretch marks from pregnancy, and lines left from surgical incisions or other trauma. Experts say that’s changing because of a minimally invasive technique called skin needling. It works to rejuvenate skin, through a unique and controlled injury process. Dr. Shaun Parson explains microneedling and why the benefits are beyond skin deep.

by Dawn Tongish
and Shaun Parson, MD

Uses For Microneedling

For the newcomer who has never tried skin needling, it may sound a little bit like ’tilling’ the skin. With microneedling therapy a device with thin needles is used to make tiny holes in the skin that help to revitalize damaged skin. The needles puncture the skin, prompting the skin to repair itself. “I think microneedling is a great device that allows us to change some things that before we only had a surgical fix to repair,” says Dr. Shaun Parson. Parson, a plastic surgeon practicing in Scottsdale, Arizona, says skin needling is an exciting procedure because of the promise it delivers to patients who thought they may be forced to live with their ‘marks’ . “We can now fix things like acne scars and stretch marks using skin needling.”

What Makes Needling Effective

If you are a gardener, you will understand the importance of aerating the soil. If you apply some of the same principles to the skin, microneedling makes sense. “Microneedling is a small, controlled needling into the tissue, so that we have a controlled collagen and elastin release,” says Parson. Think of it has intentionally damaging the skin, to get it to repair itself. Parson adds that in the process the dermis and epidermis will thicken, and become more visually appealing. He says the procedure produces an array of skin improvements including more firmness, and a reduction in scar tissue and wrinkles, along with an overall healthier glow. “When people don’t like the acne scars on their face or the stretch marks from having a baby, this is the fix. There is no area that can’t benefit if they have scars or discoloration.” Parson recommends exercising caution if using an at home needling device. “These procedures are best left to professionals.”

More Benefits of Skin Needling

Alright, you don’t like needles! Most people tolerate microneedling, even those who aren’t a fan of the needle prick. According to Parson, the pain is minimal. “We numb the skin with a topical anesthesia and then it feels like you are rubbing sand paper over the skin.” There may be some redness for 48-72 hours. The treatment is often repeated every six weeks for 2-3 treatments. Microneedling is performed in an office setting and is generally completed in 15-20 minutes and is often more cost-effective than other treatments, like the laser. The price can range from a few hundred dollars for a single treatment into the thousands of dollars for a series of treatments, which is usually recommended. There are additional benefits with some of the improved devices. Parson says that products, like Vitamin C and and repairing anti-oxidants can be delivered deep into the tissue via a microneedling device. “We can get the product in at a deeper level to begin the healing and have the building blocks to heal in a more effective way.” Even though it may be difficult to get past the idea of puncturing the skin to heal it, Parson says needling is here to stay. “I really think this is the way of the future.”

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Vaginal what? Rejuvenation is on everyone’s mind as the sand falls through the hourglass. Skin needs to be smoother and more even, face may need a lift, eyelids trimmed, breasts augmented… but what about the vagina? Is there anyway to improve the symptoms of post-menopause and child birth?

Board certified plastic surgeons of the PSC explain the explosive trend in vaginal rejuvenation and one product in particular that aims to improve orgasm, sex, lubrication, and overall youthfulness, all without surgery.

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Rarely discussed although acutely apparent, Gynecomastia (male breasts) is actually quite common—affecting 40-60% of men. It is characterized by an excess of fat and/or breast glandular tissue in the chest area. In men experiencing considerable weight loss, the cause is may be obvious, but for those within normal weight range it has been linked to drug side effects, heredity, or certain medical conditions. In most cases the cause is unknown.

Not only can gynecomastia cause men to be dissatisfied with their physical appearance, but it can lead to bigger problems like lack of confidence, embarrassment, and even discomfort during certain physical activities.  Dr. James Namnoum from Atlanta wants to spread the word that there is no reason to live with the shame of “man boobs”- and there are many men who are unaware of the options available to correct it. “Gynecomastia is very anxiety provoking because it is difficult to hide,” says Namnoum. “It’s feminizing, strikes a dagger at the heart of masculinity…and it is easily fixed.”

by Isabel Bolt
and James Namnoum, MD

Who is Affected?

If you are embarrassed or self-conscious about your chest, you are in good company. The 2015 statistics published by the American Society of Aesthetic Plastic Surgeons reports that gynecomastia is the 4th most popular cosmetic surgery for men with over 30,500 cases last year. The percentages are astonishing: male breast reduction for the treatment of gynecomastia has risen by 173% since ASAPS initiated its survey in 1997, rising 26% in the past year alone.

There is a common misconception that gynecomastia only affects men who are overweight, when in fact, it occurs in men of all age groups, all body shapes, and all weight ranges. Even athletes who are in top physical and muscular shape can suffer from this condition, and may require male breast reduction surgery.

In actuality, gynecomastia is experienced by the majority of adolescents between 12 and 17 years old. In these cases, breast buds may last up to two years but tend to go away within six to twelve months. Dr. Namnoum explains this is due to hormones happening in a young man’s development. “Because of the surge of androgens, breast buds occur in probably 90% of pre-teens and teens. Obesity in youth is a problem because fat cells convert androgen to estrogen. This condition corrects itself in most cases as hormones level out, and pubescent weight is lost.”

Once a young man reaches his late teens and early 20’s the breasts usually flatten. However, if the breasts are persistent, surgical intervention may be necessary to correct the condition. Conversely, says Dr. Namnoum, the vast majority of men past 50 have breasts. “It’s a combination of fat, fibrous tissue and breast tissue. I have seen men in consultation that have C cups. The reality is, men have bad habits–eating and drinking too much, and not exercising enough. Even if they do lose weight, the breasts may not go away.” In addition, one of the lesser known causes is testosterone, which is separated from estrogen by only one molecule, so the “high T” many men seek may also contribute to the problem.

When to Seek Help

Because gynecomastia can affect men of all ages for many different reasons, there is no right or wrong age for surgery to be performed. In some cases, particularly those of younger patients, the condition is temporary and eventually resolves itself. Moreover, some doctors do believe that there may be a possibility of recurrence if surgery is performed at too young an age. In general, male breast reduction surgery is considered if gynecomastia has been present for two or more years and is stable and has not increased in size. However, every patient is unique, and the decision to operate is based not only on the individual causes of the patient’s conditions but also on the maturity of the patient, his capability of understanding the surgery, and his ability to cope with the post-op recovery. While there is no definitive upper age limit for surgery to correct gynecomastia, older patients should understand that, in some rare cases, the skin may not completely re-tighten after the surgery, as some skin elasticity may have been lost due to the natural process of aging.

The Procedure

Dr. Namnoum explains gynecomastia is a fairly simple procedure. The surgical technique will depend upon whether your condition is primarily comprised of excess glandular tissue or fatty tissue. “For young men, there might be just a small disc of breast tissue to remove. For others, a combination of liposuction (for contour) and direct removal of tissue is a very effective treatment. A small incision is made at the edge of the areola. Eventually you don’t even see it.” Since the procedure removes fat and /or glandular tissue from the breasts, the result is a chest that is flatter, firmer and better delineated. In more extreme cases, excess skin is also removed. “Men with excess skin and tissue can have a breast reduction,” explains Namnoum. “I suction out the fat and remove the redundant skin and tissue, then lift and tighten the remaining tissue. The size of the scar is dependent upon the severity of the condition. In a breast reduction, there is a trade-off between accepting a scar in order to achieve a desired shape and flatness.”

A Return of Confidence

A flatter, more defined chest as well as flatter and smaller nipples and areola are evident within weeks of the procedure. Dr. Namnoum sees relieved, happy patients at their post-op visit. “The thing that affected their self-image and caused such embarrassment and anxiety is gone,” he says. “They’re boating, swimming, wearing tight t-shirts…the younger men are playing sports and going into the locker room for the first time without apprehension.” Dr. Namnoum also counsels those considering gynecomastia to go straight to a board certified plastic surgeon instead of a pediatrician, family physician or general surgeon. “We are accustomed to diagnosing this condition and applying the correct treatment for the best aesthetic outcome. There is no point in having something so correctable affect your confidence.”

The post Male Breast Reduction: Common Problem, Simple Solution appeared first on The Plastic Surgery Channel.

“Are more people—including celebrities—rejecting the notion of plastic surgery?” That was the question recently discussed by board certified plastic surgeons Drs. Stafford Broumand and Richard Zienowicz. Over the last couple decades there has been a veritable evolution in less invasive procedures with virtually no downtime and little risk, and yet, the echo of, “I would never have ‘work’ done” persists. Are people just keeping quiet about their visits to the plastic surgeon, or is there still a stigma attached to those who want to slow the hands of time?

by Isabel Bolt
and Stafford Broumand, MD and Richard Zienowicz, MD

Exposing the Truth

Dr. Broumand of New York City disagrees with the premise that the popularity of plastic surgery is waning, nor does he believe those speaking out have an honest philosophical argument. “First, many people, especially celebrities, are not telling the truth about what they have had done. Secondly, if you wear makeup, color your hair, engage a personal trainer—all in the interest of changing your appearance—who is deciding what improvements are good or bad, right or wrong?”

Bad Plastic Surgery

Dr. Zienowicz is not experiencing any slowdown in his Rhode Island-based practice. In fact, he commented that even younger women are visiting his practice. “By starting early, you can actually delay the aging process without invasive surgery,” says Zienowicz. “What causes hesitation, if there is any, are the negative images in Hollywood perpetuated by people like Joan Rivers, Kim Kardashian, and Melanie Griffith.” Dr. Broumand agrees, “People are not turned off by plastic surgery, they are rebelling against bad plastic surgery. Our role as plastic surgeons is to continue to educate the public about how to prevent bad results.”

What are Friends For?

Both surgeons have heard, “…I want to look like my friend who comes to you…” during consultations. Dr. Broumand says they are often unaware of how much surgery their friend has had. “The work of skilled, board certified plastic surgeons is the opposite of obvious. It can in fact be almost imperceptible.”

No Judgment

For those who feel great about their body and don’t want to change a thing, bravo. But women who vehemently put down others for their nips and tucks might be positioning themselves as morally superior when it might have more to do with envy or financial issues. “It’s better to support those who are seeking positive changes and individual choices being made about aging,” says Dr. Zienowicz.

Ultimately it is a very personal decision. Most will agree it is wrong to be pressured into plastic surgery. Whether the demand is coming from a Hollywood agent or a boor of a significant other —promoting insecurity is not a tenet of aesthetic plastic surgery. Likewise, no one needs to be lectured about being fake when they are simply maintaining a more youthful look and fixing something on their body that makes them uncomfortable. Having plastic surgery doesn’t translate into the notion that you must be ashamed of who you are or that you are committing some form of vandalism.

Better Living through Looking your Best

Dr. Broumand summed it up this way, “This is better living through medicine and the science of plastic surgery. If you go to a board certified, trained plastic surgeon who is like-minded, he or she can give you the best outcome…and you won’t find any patient rebelling against looking better.”

The post Getting Real: Is there a Trend toward Avoiding Cosmetic Intervention? appeared first on The Plastic Surgery Channel.

Gone are the days of the pulled back, wind-tunnel effect facelift that could be spotted from across the room. Plastic surgeons today use innovative techniques they have developed to provide their patients with natural results and shorter recovery times. 

by Anne Meyer
and Mark Epstein, MD

Which Technique is Right for Me?

The technique your surgeon decides to use is often determined not by your age, but by the quality of your skin and tissues, according to Dr. Mark Epstein of Stony Brook, New York. If you have quality tissues and skin, the incisions can be minimized using a short-scar facelift technique known as the Minimal Access Cranial Suspension or MACS lift. “When you have a patient with good tissue, you can do this procedure on someone in their 40’s or you could even do this procedure on someone in their 70s’ and 80’s,” shares Dr. Epstein. 

Face “LIFT” not Face “PULL”

Traditionally, facelifts pulled the face horizontally to tighten the skin. The problem with this approach was the fact that our faces don’t fall forwards as we age, they fall down. “The beauty of this procedure is that it’s what we call a vertical lift,” explains Dr. Epstein. “The MACS facelift just brings everything upward, and it gives a much more natural look to the face, one that looks very unoperated.”

Natural Results that Last with MACS

Facelifts involve much more than just addressing loose, sagging skin on the surface. We all have layers of tissues below the skin that also descend with age, including fat and muscles. During facelift surgery, the surgeon repositions the tissues that exist below the skin, putting them back up where they used to be in youth. “With a MACS lift, you are taking the muscles and you are anchoring them to the tissue that lies right above the bone in the temple,” Dr. Epstein shares. “It’s a very solid anchor point and that gives a lot of support and longevity to the results.”

Less Downtime

The downtime after a MACS procedure is one of the least when compared to other facelift techniques. Dr. Epstein’s patients recover with very little discomfort and are able to comfortably and confidently return to public engagements much quicker than patients who undergo more traditional long-scar facelifts. He recently had one patient who underwent a MACS facelift just thirty days before her daughter’s wedding. Although Dr. Epstein wasn’t aware of the fast approaching event until after he had completed the operation, he happily reports that she recovered beautifully, and in plenty of time for the big day. “It’s a great procedure when you can’t afford a long downtime with prolonged swelling and discomfort,” he adds. 

Less Risk of Complication

Surgery planning for any procedure involves understanding both the benefits and risks involved. “Facial nerve injury is a rare complication, but it’s something that we all want to avoid,” says Epstein.  The MACS lift procedure has one of the greatest safety margins in terms of giving you the greatest degree of correction with the least risk of having a facial nerve injury.”  

The post Short Scar, Long Lasting Results with MACS Facelift appeared first on The Plastic Surgery Channel.

Who doesn’t dream of flat, toned abs? It’s part of the reason why the tummy tuck is one of the most popular cosmetic procedures. Real or perceived, it is also considered one of the most painful operations, which scares some people away. But no longer. Dr. Richard Baxter explains the ‘Tylenol Tummy Tuck’, a cutting-edge procedure that takes the concern (and most of the pain) out of achieving a tighter midsection.

by Dawn Tongish
and Richard Baxter, MD

No More Pain

When it comes to popular cosmetic procedures, the tummy tuck consistently ranks in the Top 5, right behind liposuction and breast augmentation for women. A tummy tuck removes excess tissue and skin that may not respond to diet or exercise, but even with it’s popularity there can be the pain pitfall. There is some reluctance to sign up for the surgery because of the pain associated with getting a trim midsection. Even experts admit it can be a mental hurdle to overcome.

In recent years however, new products are changing techniques and providing pain relief. “One of the things that we have been doing is using an innovative drug called Exparel, which is a long-lasting numbing agent,” says Dr. Baxter. Hesays the success of Exparel has prompted a new procedure called the ‘TAPBlock”. “It’s basically a specific way of injecting the material into a layer where all the nerves come into the abdomen — and so if you get it right there, in the right place it just numbs up the whole wall and there is not much pain.” Baxter uses ultrasound to help place the numbing drug in exactly the right spot to provide maximum relief for the patient. “They feel almost nothing at all,” he says. “It’s amazing.”

What is TAP

It’s a short phrase for some big time relief. TAP stands for Transversus Abdominis Plane, the area where the pain medication is injected. Baxter says injecting the numbing agent allows the patient to use less pain medication throughout the procedure and recovery. “The pain is reduced even more and you need even fewer pain medications.” He says labeling it the ‘Tylenol Tummy Tuck’ may imply there is NO pain, which isn’t the case, but he says with TAP the discomfort is greatly reduced and patients will feel a big difference. The pain level from the tummy tuck of the past is greatly reduced. “They wake up from the tummy tuck, feeling almost no pain at all.”

Less Pain = Better Recovery

One of the first questions about any cosmetic procedure often relates to pain associated with the procedure and how that will impact recovery. Baxter says the use of TAP works to minimize not only pain, but the worry associated with it. “A tummy tuck can be a significant ordeal to recover from, but if you wake up feeling good you are going to be more active and recover more quickly.” He adds that patients who don’t feel as much pain are more likely to recover quicker and report success. “You are just going to have a better experience overall, if you feel less pain.”

The TAP block will provide relief for several days and can help eliminate complications from surgery. “If a patient isn’t feeling pain and is active right away after a tummy tuck, they are less likely to get blood clots, constipation and nausea,” says Baxter. Feeling better sooner is the goal in any tummy tuck operation. “If you can avoid all of that then you will be ahead of the game.”

The post The ‘Tylenol Tummy Tuck’ – Get Results With Less Pain appeared first on The Plastic Surgery Channel.

Although they are tempting (and often very effective), jumping on every new plastic surgery treatment, therapy or surgery to keep as young looking as possible may not be the wisest move. Many board certified plastic surgeons well-versed in these treatments say it’s probably not the best idea just because. When it’s apart of an overall strategy, however, new technologies and non-surgical procedures can help immensely.

by John Hammarley
and Stafford Broumand, MD and Daniel Maman, MD

Don’t Rush In

Most of us have an ongoing love affair with all things new: fashion, cars, styles, etc. As technologies and techniques improve in cosmetic and aesthetic therapies, the temptation and desire become very real for those who may not have considered it before.

Board certified plastic surgeons Stafford Broumand and Daniel Maman, together in practice in New York City, are on the same page when they recommend against the urge to apply the latest and greatest cosmetic advance. “Even though many, many of these new approaches are effective and an improvement, the better way to use them is to incorporate them into a broader, overall strategy,” says Dr. Maman. “Our ideal patient is someone who comes into our office with both short- and long-term goals. That way, we can take advantage of new innovations and combine them with tried and true therapies.”

Think “Novel” Instead of Just “Chapter”

Dr. Broumand stresses the importance of looking at the big picture.

“A patient may come in wanting to do something about his or her neck, for example,” says Dr. Broumand, “which is great. But the better approach may be to link that treatment with others so that we can provide a more comprehensive strategy that addresses what needs to be done now as well as 10 years down the road.”

That also means patients and plastic surgeons can reap the benefits of mixing and matching different treatments — lasers and fillers and Botox and surgical procedures. Finding a board certified plastic surgeon with all these and more approaches allows for a long-term, small treatment plan to slowly – and precisely – help the body age gracefully.

“We can make subtle, holistic enhancements when we’re able to combine a treatment that gets rid of the fat under the chin through surgery or noninvasive means, while at the same time address possible improvements along the brow line or other areas of the face,” says Dr. Broumand.

The Sum of the Parts

The bottom line when you’re staying as young as possible for as long as possible, use the entire alphabet of cosmetic and aesthetic treatments — A to Z — and rely on your plastic surgeon to have the experience and insight to see beyond the immediate need and plan an overall game plan.

The post Staying Young, From A to Z appeared first on The Plastic Surgery Channel.

Turns out that women aren’t the only ones who don’t want to look older than they feel. According to the latest statistics from the American Society of Aesthetic Plastic Surgery, men made up almost 10% of the non-surgical procedures performed last year, a number that is trending upwards. Why? Men “don’t want to look old,” says Dr. James Namnoum of Atlanta, GA. However, they still want to look masculine. It’s a fine line, but one that can definitely be achieved with the right surgeon and the following facial rejuvenation tips.

by Katherine Stuart
and James Namnoum, MD

Aging Men and the Workplace

All of us reach a certain age where we begin to show the ravages of time. When exactly this happens will depend on our DNA as well as how much of our lives have been spent outdoors. For men, one of the earliest signs of aging is that their skin starts to look a little rough. It typically develops brown spots, discoloration and redness. Next, they may develop some fine lines and wrinkles as well as more severe animation wrinkles. Supposedly this is all fine since we live in a society that says it’s OK for men to age.

Many men are finding themselves, however, aging in a workplace filled with younger men. This unfortunately can create an aura of insecurity as well as uncertainty. Furthermore, men aren’t great about vocalizing their concerns or finding the help that they need to deal with them. The internet and magazines such as Men’s Health have helped but, “there’s still a lot of resistance to doing anything,” says Dr. Namnoum. Many men are scared that they’ll wind up looking too weird or overly feminine. So, what can men do?

3 Facial Rejuvenation Options for Men

Botox is the first line of defense when dealing with aging. It’s great for treating the wrinkles around and between the brows. And though we’ve all seen celebrities who’ve had too much Botox, a conservative amount that’s appropriately placed will modulate and soften the animation wrinkles on a man’s face, making him look years younger.

Men experience a lot of photo aging of the skin from a lifetime of sports such as golf, being at the beach, or out on the boat. “Men ignore their skin and they ignore it at their peril,” says Dr. Namnoum. They’re also much less likely than women to use “potions” such as retinoids to treat their sun damaged skin.

Namnoum has found that they will do an intervention such as the Halo laser. “It is the most powerful, transforming laser, I think, on the market today.” A Halo treatment involves the use of two different lasers. One vaporizes the skin with a pinpoint grid of injury so it recovers quickly while the next is capable of reaching down deep into the dermis to eliminate redness and broken blood vessels. This one two punch helps to tighten the pores, even out pigment, and improve skin tone.

The last option for men is fillers. When handled properly, fillers can help restore the lost volume in the cheeks and the hallows under the eyes without making a man look overly done or less masculine. According to Dr. Namnoum, the right surgeon can, “take these nonsurgical approaches to facial aging and make a huge change in your face. You still look like yourself but frankly, you look a heck of a lot better than before you started. It’s pretty amazing.”

The post Facial Rejuvenation Tips for Men appeared first on The Plastic Surgery Channel.

Breast augmentation is the most popular plastic surgery procedure in the United States with hundreds of thousands of procedures done each year. If you find yourself searching for information on the Internet about breast augmentation, you can easily get confused by the multitude of opinions and options floating around online. Miami plastic surgeon Dr. Constantino Mendieta recently took the time to explain the basic five questions that guide the decision making process for every breast augmentation.

by Anne Meyer
and Constantino Mendieta, MD

Question #1: Do You Need A Breast Lift?

During the consultation Dr. Mendieta does a physical examination to determine if a patient is a candidate for a breast augmentation alone or if the breasts also require a lift.  He examines the nipple position and the amount of extra, or droopy, skin that exists. If you fall into the category that you doesn’t require a lift, you are ready for question number two.

Question #2: Where Am I Going to Place the Scars?

Breast implants are inserted through incisions that can be hidden in several different locations on the body with trade-offs to be considered for each option. Together with your surgeon you will determine which incision is the best option for you, based on your anatomy. Most commonly, incisions are placed around the areola or hidden under the fold of the breast. Other options include the armpit and the belly button.

Question #3: Will the Implant be Placed Above or Below the Muscle?

“Once we’ve decided on the scar,” continues Dr. Mendieta, “I need to know, do we want to go underneath the muscle or do we want to go above the muscle?” When patients have very little breast tissue, surgeons often recommend placing an implant beneath the muscle in order to provide more natural coverage.  If a patient begins with a fair amount of breast tissue before they add an implant, it may be an option to place the implant above the muscle. “Now there’s a new plane, called the fascia,” adds Mendieta. “The fascia is a thin layer that exists between the muscle and the breast tissue. Some people feel that going underneath that fascia gives you the benefit of both, without having to go underneath the muscle.”

Question #4: What Size Implants?

During the surgery planning process, Mendieta measures his patient’s breasts to help determine the proper implant size. “We measure your breast width, we measure your breast height, and we decide what implant we will put in based on what your body will accommodate.” Once the measurements determine a ballpark range of sizes, he uses other methods of determining the size each patient desires for their new breasts. Often patients will bring pictures of breasts they have seen in magazines or on his website that they like.  

Question #5: Saline or Silicone?

Another decision all breast augmentation patients must decide is what type of implant they will have. The two basic choices are saline or silicone gel filled implants. Silicone gel is the most popular implant around the world, due to its natural feel and longevity. “Silicone gel has been approved by the FDA, and it is safe,” assures Mendieta.  It is a more expensive option, so if cost is a concern, patients may decide to opt for saline.

The post Five Questions That Guide Every Breast Aug appeared first on The Plastic Surgery Channel.