The tummy tuck is popular after pregnancy. It can help give you the flat stomach you had before or have always desired. Below are the three types of abdominoplasty that I offer patients. During a consultation, we can discuss your specific needs and find the option that best suits your goals.

Full Tummy Tuck

A traditional tummy tuck also utilizes an incision around the belly button in addition to the incision across the lower abdomen. During this extensive procedure, extra skin is removed, muscles are tightened, and liposuction may be used to further contour the area. This procedure produces a new opening for the belly button because it’s necessary to free the navel from surrounding tissue.

Mini Tummy Tuck

A mini-abdominoplasty is often done on my patients whose fat deposits are located below the navel and entail shorter incisions to restore a flat stomach. During this procedure, the patient’s belly button will not be moved. The skin will be detached between the line of incision and the belly button. I remove excess skin, tighten slack muscles and I use liposuction to further refine the area. Depending on the patient’s own personal condition and the difficulty of the technique, the procedure may take up to two hours. A mini-tummy tuck is usually suggested for patients who have a history of good physical activity and shape, and have lost as much fat as they could with diet and exercise.

Extended or High Lateral Tension Tummy Tuck

A regular tummy tuck doesn’t remove skin in the love handle or hip area. The extended abdominoplasty is great for addressing love handles when liposuction doesn’t help. This is a relatively new procedure where the abdominal muscles are tightened both vertically and horizontally. With a conventional tummy tuck, the muscles are tightened only vertically. High lateral tension tummy tuck produces outstanding results in flattening the tummy and enhancing the waistline. The entire procedure takes approximately four to five hours.

The compression garments play a huge role with swelling reduction after a plastic surgery procedure. My staff will supply you with comfortable support garments after surgery. Our office stocks the top brands to provide patients with the peace of mind that the compression garments will be comfortable and effective. No matter what your body shape is, surgical garments come in a variety of sizes and designs to fit your needs.

Following cosmetic procedures, patients need to wear a compression garment or post- operative garment. It is important that patients are comfortable and that they have the correct fit and compression to aid in the recovery process. These garments are designed to decrease swelling and expel fluids out of your surgical site. Using compression wear can help ease some discomfort and accelerate the healing process so patients can recover faster. A quality garment will apply consistent and constant compression over a prolonged period.

For patients who undergo a liposuction or tummy tuck procedure, a garment is crucial in order to maintain the proper results and prevent fluid from collecting. The compression garment helps guide the skin that is retracted into place. The garment will also play a vital role in tightening the skin, reducing the swelling, and stimulating better blood and fluid circulation. It also helps with unwanted folds or creases by ensuring maximum contraction and even healing of the skin. The fact that the garment must be worn for a minimum of six weeks is a small inconvenience for a lifetime of pleasure.

The garment is also extremely important for breast surgery patients. It is important to wear the bra day and night for the first two weeks. In order to help maintain the new breast shape, I strongly recommend that patients wear their bra or any supportive top when sleeping. All compression garments may be removed before showering, but should otherwise be worn at all times.

It is important to follow the directions provided for the best results. Some garments should be worn continuously for several weeks to months. We recommended that patients purchase two compression garments so one can be worn while the other garment is being washed.

Proper maintenance of your body is critical during the recovery process. It would be a shame to go through the expense and discomfort of a cosmetic procedure and not reap the benefits of a better body because compression garments were not worn. The importance of these post-surgical garments cannot be overstated.

General anesthesia is used during the breast augmentation procedure. Post-surgery, you will feel slightly dazed and fatigued for up to two days. I prescribe pain medication to decrease the amount of discomfort or tenderness felt in the chest area during this time. You can expect your breast area to be sore for one to two weeks following the surgery. Common side effects include inflammation, bruising, swelling, and soreness. This is the time when your skin and natural breast tissue is healing and adjusting to the new breast implants.

The incisions are usually one inch long, and may be positioned in the armpit, around the areola and nipples, or in the crease under the breasts. Many of my patients report that the incision sites itch as they heal. Even though I make the incision is an area that promotes minimal scarring, some scarring will form. Luckily, any scars will diminish steadily in appearance in less than a year. Initially, the scars are red, but return to the surrounding skin color as they heal.

How to Decrease Swelling after Breast Augmentation

For patients undergoing cosmetic surgery procedures like breast augmentation, swelling is one of the most common side effects. Swelling of the breast tissue may mask the results of the procedure after the first few days post- surgery. The good news is that patients will be able to see the outcome of the breast augmentation and resume daily activities as the swelling lessens.

I recommend to my patients that a breast augmentation recovery plan should be in place before the surgery. This helps ensure that they are able to rest their body and have adequate food and water on hand during the course of the healing process. Here are a few ways to reduce swelling and minimize your recovery time following breast surgery:

• Ensure you are always hydrated
• Eat a healthy diet and avoid sodium
• Get a sufficient amount of rest and ease back into your daily life slowly
• Lightly massage the breast area to improve circulation and decrease fluid retention
• Stay clear of medications that can lengthen swelling. Make sure that you inform me and my staff about all of your current medications before the procedure to reduce the risk of complications.

“While the rate of economic recovery in the U.S. is still uncertain, 2011 proved to be a good year for plastic surgery,” said ASPS President Malcolm Z. Roth, MD. “Consumer confidence was up, auto sales rose 10 percent, so it is not surprising that we would also see increased demand for plastic surgery procedures.”

There were nearly 1.6 million cosmetic surgical procedures in 2011, a two percent increase. The top five surgical procedures were:

• Breast augmentation (307,000 procedures, up four percent)
• Nose reshaping (244,000 procedures, down three percent)
• Liposuction (205,000 procedures, up one percent)
• Eyelid surgery (196,000 procedures, down six percent)
• Facelift (119,000 procedures, up five percent)

Since 2004, facelifts are among the top five cosmetic surgical procedures for the first time, substituting tummy tucks. Chin augmentation, which is a procedure popular with men, nearly doubled in 2011 with 21,000 procedures performed. This is up 71 percent. And up 49 percent is lip augmentation, which saw more than 25,000 procedures performed.

As Dr. Roth indicates, “we are seeing notable increases in surgical procedures, such as facelifts, that reflect the demands of an aging boomer population. However, the overall growth in cosmetic procedures is being primarily driven by a substantial rise in minimally-invasive procedures.”

Those minimally-invasive cosmetic procedures that Dr. Roth eludes to increased six percent, with nearly 12.2 million procedures in 2011. The top five minimally-invasive procedures were:

• Botulinum toxin type A (Botox) (5.7 million procedures, up five percent)
• Soft tissue fillers (1.9 million procedures, up seven percent)
• Chemical peel (1.1 million procedures, down three percent)
• Laser hair removal (1.1 million procedures, up 15 percent)
• Microdermabrasion (900,000 procedures, up nine percent)

The largest growth in the minimally-invasive market during 2011 was the use of soft tissue fillers like hyaluronic acid (Restylane®, Juvederm Ultra®, etc.), calcium hydroxylapatite (Radiesse®), and fat injections. More than 1.3 million hyaluronic acid procedures were performed in 2011, up nine percent. There were 286,000 calcium hydroxylapatite procedures, up 36 percent. And there were 68,000 fat injections performed, up 19 percent.

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.