• Fat grafts, Stem cells, and the Fountain of youth

    A fountain in a park, symbolizing for the fountain of youth.

    I did my first case of micro fat grafting to the face over 20 years ago. It was a patient that had acne scarring in her face. During the decade of the 90’s I had tried laser for that problem, under the theory that you could level the skin.

    Frankly the results were OK, not great, because the pits were not filled. Fat grafting was used to fill the pits under the skin. The great surprise was how good the skin looked after the fat injections ! The skin became rosier, softer, and just younger looking.

  • How do I get more cleavage with my breast implants?

    Types of cleavage with breast implants.

    A lot of patients who come in for a Breast augmentation or a Breast lift with implants consult will usually make a comment about cleavage. Some patients don’t want “that fake look,” yet others specifically ask for “a lot of cleavage.” It helps when patients bring in pictures, because cleavage is one of those words that, like “natural look,” can have different meanings to different people. In this post I will talk about cleavage, and how it is related to surgical technique and patient anatomy.The word cleavage is derived from the word cleft. According to the Merriam Webster online dictionary… cleft : usually V-shaped indented formation : a hollow between ridges or protuberances The misunderstanding between plastic surgeon and patient comes from knowing which end of the “V” we are talking about. Does the patient want upper pole fullness, which is prominent at the upper part of the breasts? Does the patient want medial cleavage, which is breasts that are close together at the midline? Or is it both upper pole fullness and medial cleavage? The surgeon has two surgical methods to improve cleavage with breast implants.

  • Breast surgery: What type of scar do I get with different breast techniques?

    An illustration showing a breast scar comparison for various techniques.

    I have been looking at some of the breast implant forums, and there are a lot of issues related to breast scars. It seems most surgeons use the Wise pattern, or Anchor scar, and some use the Benelli scar. A few surgeons use the Vertical scar or the Crescent scar. I use all of these breast techniques, except the Wise pattern scar. I feel that the Wise pattern technique makes unnecessary scars.

  • Types of Breast augmentation incisions

    An illustration showing incision types for breast augmentation: inframammary, infraareolar, TUBA

    What type of incision should you get for your Breast augmentation procedure? In addition to the implant size this is another very important decision that you need to make. It seems to me when I ask a patient whether they have a preference as to what kind of breast incision they want, the most common answer is that they want the type of incision that they have seen on a friend. Likewise, the second most common comment is “I don’t want such and such incision because somebody I know had one and it looks bad”. The truth is every type of incision has its pros and cons. Here is my explanation of the types of Breast augmentation incisions…

  • Improving the cosmetic surgery experience: Pain pumps or Exparel to control pain

    An illustration showing common areas where the pain pump offers pain relief (from the OnQ web site)

    Exparel is a long acting local anesthetic which is injected into the operative area at the end of the procedure. Like the pain pump, it focuses just on the operative area, and does not disseminate to the entire body like a narcotic does. The function of the Exparel is to numb the area of surgery so you do not feel pain. With cosmetic surgery, patients only need the one injection, and the pain control lasts for about 3 days. Similar to the pain pump, patients take fewer narcotics post operatively, because the pain is more controlled.

  • Saline vs. Silicone implants: Why I’m happy silicone implants are back!

    A hand pressing down on a implant on a table.

    In my last blog post, I went over briefly how the silicone implant moratorium came about. This week I’ll tell you why it is such a good thing that silicone implants are back as a choice for all breast augmentation patients. Remember, silicon implants weren’t really banned, as we have been using silicone implants for cancer patients, those with congenital defects, and patients needing a breast lift. Over the past 14 years they were just not available for cosmetic surgery patients. However, now all patients will have the choice to use saline or silicone implants.

  • After pregnancy: Breast lift or Breast augmentation?

    A single breast implant.

    A woman’s body goes through so many changes during and after pregnancy. Many of my patients have children and came to me looking for information about Breast augmentation. Did your breasts appear deflated after pregnancy? Did you like the look of your breasts during pregnancy? Are you wanting them to look fuller, perkier, or both? What are your options for breast augmentation after pregnancy?