There are many cosmetic options available to men. Chest reduction, ear lift, chin liposuction, and rhinoplasty are just a few of the many procedures men are having performed. A growing number of older males age 40 to 58 are turning to plastic surgery to keep themselves looking younger. According to a recent CBS News article, many doctors agree that men want to look younger to remain competitive in the work force. Also, those who are divorced and dating again want to project a youthful image to attract potential mates.

I treat a lot of male patients who wish to have liposuction or SmartLipo (laser liposuction) performed. They want to rid themselves of love handles and sagging abdomens. Trim and athletic-looking, broad shoulders and chest, a flat abdomen, and a narrow hip-thigh area are features of the ideal male body. As men age, areas of fat tend to accumulate around the abdomen, love handles, chest area (referred to as gynecomastia), and along the chin and neck. These fatty areas that are resistant to diet and exercise are what male patients request to have removed via liposuction.

If a man loses a large “beer belly” through diet and exercise, a full abdominoplasty or tummy tuck may be needed to reduce the appearance of hanging abdominal skin, loose abdominal muscles, and in some cases, neglected hernias. This is a major procedure that removes excess fat, tightens the muscles of the abdominal wall, and trims the waistline. Recovery time requires the patient to refrain from returning to work for four weeks.

There are a few emerging procedures currently gaining popularity. Botox and injectable fillers are now the most popular procedures performed in plastic surgery offices nationwide. Men particularly enjoy the results of these minimally invasive procedures since the creases that make you look tired or angry can be erased without the visible scars that other procedures leave behind.

There’s little doubt that the world of male cosmetic surgery is growing rapidly with more and more new procedures becoming available to men. Please contact us to schedule a consultation at our Pasadena, California office. During your visit, we can further discuss the many options for male cosmetic surgery based on your individual needs.

For those who don’t think before they ink, tattoo removal is a growing procedure available at most cosmetic surgery offices. Regrettably, not all tattoos can be completely removed, but the majority of the artwork can be. The difficulty in removal is due to recent ink technology and professional tattoo artists improving their skills. With a few patients, some residual scarring remains even with the best tattoo removing technique applied.

The most effective way to remove unwanted tattoos is with a laser. Lasers work by directing highly concentrated colored light beams toward ink in the skin. The laser beams break up the ink particles into tiny fragments; over time, they are disposed of by your own body’s scavenging cells. Depending on the depth of the ink, fragmenting the ink particles via a laser requires numerous sessions. The good news is that the procedure is bloodless and no incisions are made.

Another benefit is that the laser selectively targets the pigment of the tattoo without damaging the surrounding skin. However, the deeper the laser needs to go and the more treatments required will cause the heat generated by the lasers to induce pain and form blisters. Multiple treatments can also produce scarring. Every tattoo and skin pigment is different, so these side effects will vary from patient to patient.

A successful tattoo removal is based on several factors, such as the size, location, application, age, and color of the tattoo. Also, like most cosmetic procedures, the health of the patient and their body’s ability to heal is another major factor. As mentioned above, newer tattoos are generally more difficult to remove.

Although it may not be as painful as when you received the tattoo, getting it removed is not a painless procedure. The lasers generate rapid pulses, which feel and are tolerated differently for each patient. Luckily, each session only takes a few minutes. For those with a low threshold for pain, I usually recommend taking Tylenol a few hours before the procedure, but under no circumstances should anyone take pain medications that might thin the blood.

Please contact us to schedule a consultation at our Pasadena, California office.  During your visit, we can further discuss the number of sessions needed to remove your tattoo based on the factors previously mentioned.

I have confronted this question many times and I always tell my patients that it depends on their personal preference. But there are some steps you can take to help you decide. Before or after your consultation, you may want to ask the opinion of your spouse, family, or friends. The final decision is yours, but you should try to alleviate any doubts on the size.

I find that having an honest discussion with my patients and finding common ground helps make them and myself more comfortable with the procedure. Breast augmentation is no doubt a life changing experience. Although breast size is important, there are other factors to take into consideration. Below are some areas of importance that I discuss with my patients:

• The type of implant (silicone or saline)
• The implant profile; low, intermediate or high
• Placement behind or in front of the muscle
• Location of the scar
• Your body size and shape
• Skin quality
• The possible need for a breast lift as well

At the end of the day, it’s your decision. I will always offer my expert opinion, but you have the final say.
Please feel free to contact us to schedule a consultation at our Pasadena, California Plastic Surgery office. In your consultation we can further discuss your individual needs with regards to breast augmentation.

Giuliana’s battle with breast cancer will hopefully serve as a reminder for all women to regularly have breast examinations. Catching the cancer early increases your survival rate. When an abnormal breast change is found during a breast exam, a biopsy may be performed.

The journey that Giuliana and the many women in her position go through after a double mastectomy is not an easy one. I have performed numerous breast reconstruction procedures for patients after a double mastectomy. Breast reconstruction helps to restore the breasts to a  more normal shape, appearance, and size. This is achieved through several cosmetic surgery techniques.

The results of breast reconstruction are highly variable. A reconstructed breast will not have the same sensation and feel. Whether from reconstruction or mastectomy, visible incision lines will always be present on the breast. If only one breast is being reconstructed, I recommend a breast lift, breast reduction, or breast augmentation for the opposite breast to improve symmetry of the size and position of both breasts.

There are two types of ways a breast can be reconstructed. The first are implants. These are filled with either silicone or saline and can be inserted during or after a mastectomy. They are placed underneath the chest muscle just like during a normal breast augmentation procedure.

Flaps are another type of reconstruction. During a flap reconstruction, the breast is created using tissue taken from other parts of the body. Tissue from the abdomen, back, buttocks, or thighs is transplanted to the chest by reconnecting the blood vessels to new ones in the chest region. This procedure requires a high level of skill and the appropriate equipment and staff needed. Because of this, a flap procedure must be performed at specialized surgical centers.

A positive note about breast reconstruction is that federal and state laws require insurance companies to pay for all or part of the cost of the procedure at any time after removal of a patient’s breast tissue. Surgery required on the opposite breast for symmetry is often times also covered. The extent of coverage varies among insurance carriers, so please feel free to contact us to see what your insurance company will pay for. It’s my goal to not only provide the best plastic surgery for my patients, but to also minimize their out of pocket expenses when possible.

The FDA states that silicone breast implants are safe.

The food and drug administration’s center for devices met for two days this summer to discuss testimony about silicone breast implants and determine their safety. The FDA official Dr. William Maisel confirmed that silicone implants have been deemed safe ever since 2006 and they continue to remain safe today. He did state that although known risks include possible implant leakage or rupture, contracture, possible need to remove the implants in the future, possibility for pain infection in a symmetry, that “women should feel assured that the FDA continues to believe that currently marketed silicone breast implants are safe”.  Another recommendation from the committee was that MRI (magnetic residence imaging) testing is not necessary for follow up. Previously it had been recommended to obtain an MRI every three years. They do however believe that MRI is still the gold standard for evaluating the integrity of breast implants if a rupture is suspected.

This report is significant since approximately 90 percent of patients choosing to have new implants in 2011 choose silicone over saline in my Pasadena plastic surgery practice.

If you have questions regarding silicone breast implants please feel free to contact us or schedule your consultation for a breast augmentation with silicone breast implants.

The trend lately has been in favor of placing most implants beneath the muscle. However, there are exceptions when this may not be indicated.  When breast augmentation began over 40 years ago the original implants were typically placed in front of the muscle.  However since 1992 the use of saline implants became the standard and therefore most surgeons favored placing the implant beneath the muscle in order to minimize the affects of visible wrinkling especially in the upper portions.  Silicone implants came back on the market for general use in 2006 and most surgeons continued to place the silicone implants beneath the muscle as well.

Although each case should be individualized, in my Pasadena plastic surgery practice, near Los Angeles, approximately 90% of breast implants are placed beneath the muscle.  In my opinion most women who have minimal breast volume in the upper portions, and who choose saline implants, should elect to have implants beneath the muscle to give a more natural appearance.  Most patients who choose silicone implants for the softer feel also elect to have them placed beneath the muscle if they have a lack of fatty breast tissue in the upper portions of the breast.

There is slightly more pain after surgery if the implant is placed beneath the muscle and the recovery can be slightly longer.   Also, once the implants have settled into place the muscle can act as an aid in helping to massage the implants and keeping them soft.  The only down side of placing them beneath the muscle is in thin patients who contract their pectorals muscle with heavy exercise or lifting.  Occasionally it can be visible to see the inner portion of the breast contracting with this type of movement.

Please feel free to contact us to schedule a consultation in Pasadena California.  In your consultation we can further discuss your individual needs with regards to Breast implants and Breast Augmentation.

The original breast implants used for breast augmentation were Silicone rubber bags filled with a silicone gel. These implants were removed from the market here in the US in 1992 due to fears of toxicity if the implant shell leaked. In 2006, they returned for use once again since the studies could not find a connection with the leaking gel and the symptoms that many women claimed were caused by the gel. The alternative had always been the saline implant and some still prefer it today.

Recently, a panel of experts concluded that the silicone breast implants used today are safe. They also recommended that patients do not need to get a magnetic resonance imaging test three years. This was the previous recommendation to check for leaking implants.
A top government health official, Dr. William Maisel, chief scientist for the Food and Drug Administration’s Center for Devices, said silicone breast implants were safe. “We felt that way before the meeting, and we continue to feel that way after the presentations and discussions over the past two days”. He admitted that there are risks of all types if breast implants including ruptures, a hardening of the area around the implants, the need to remove the implants, scarring, pain, infection and asymmetry. He said “Women should feel assured that the F.D.A. continues to believe that currently marketed silicone breast implants are safe”.
Diana Zuckerman, president of the National Research Center for Women and Families felt that Johnson & Johnson and Allergan had not collected enough data to prove implant safety. “And without proper data, we still don’t know how safe or effective they are and whether there are certain patients at risk for extremely negative outcomes,” she said.
The panel of experts agreed that patients should no longer be told that they should get a magnetic resonance imaging test three years after getting implants and every two years following. Dr. Maisel said. “F.D.A. continues to believe, as does the panel, that M.R.I. is the gold standard for evaluating breast implants for silent rupture, but there was consensus among the panel that the requirements for ongoing M.R.I.’s should be removed.”
In my Pasadena Plastic Surgery practice, I offer both types of breast implants and make recommendations based on the anatomy and on the expectations of each patient. Currently, approximately 80% of my patients chose silicone gel breast implants.