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I have been struck by the number of fit mothers that have come to my office looking for liposuction, when most of these women really need a tummy tuck (abdominoplasty).  Many of these women have loose abdominal wall skin, stretch marks, and separation of the abdominal wall muscles.  They have the perception that, because they are close to their ideal body weight, they are not appropriate candidates for a tummy tuck.  Instead, they think that they would be better served by liposuction.

This could not be further from the truth.  The best candidates for an abdominoplasty (tummy tuck) are actually those patients that are close to their ideal body weight.  With a limited amount of liposuction, removal of the loose abdominal wall skin, tightening of the abdominal wall muscles, and reshaping of the belly button, achieving a pre-pregnancy tummy is actually an achievable goal!

Click on above photos to enlarge.

Many other women are far from their ideal body weight and come for abdominoplasty consultation.  Although their results are different from patients that are close to their ideal body weight, these still can experience significant benefit from a tummy tuck.

For examples of pre- and postoperative abdominoplasty photographs, please refer to the photo gallery.  If you would like to schedule a complimentary consultation, contact our Dallas or Plano office at 214-827-2814.

Buttock augmentation is becoming an increasingly popular procedure in the Metroplex. If you want to enlarge or re-shape your buttocks and have discovered that they do not respond to diet or exercise, buttock augmentation may be the solution you’ve been looking for. A buttock augmentation (butt augmentation) or buttock lift (butt lift) contours the buttocks and compensates for low amounts of fat in the area. Women and men who enlarge their bottoms can enjoy a more voluptuous and perky profile. Augmentation most commonly is achieved through injections of the patient’s own body fat (“Brazilian Butt Lift”).

Who is a candidate for buttock augmentation?

Buttock augmentation can enhance the natural curves for patients who are unhappy with the shape of their rear ends. It can also add volume and roundness to a flat or small butt for patients seeking a more balanced body profile. Body-builders may seek buttock augmentation if they are unable to develop gluteal muscles in proportion with the rest of their bodies. Generally, if you are looking for a fuller, curvier butt, buttock augmentation may be for you.

Implants vs. Fat Transfer

The preferred method for performing buttock augmentation is fat transfer, the use of the patient’s own body fat to reshape the butt. Fat injection achieves a more natural result, has a lower risk of infection, and also contours the areas around the buttocks to enhance the overall effect. However, implants may be recommended for patients who have very little body fat to harvest, such as body-builders and naturally thin patients.

Buttock Augmentation with Fat Transfer (”Brazilian Butt Lift”)

Buttock augmentation with fat transfer, also known as the Brazilian Butt Lift in honor of the country in which it was developed, involves two steps. First, the patient’s own fat is collected through liposuction. The most popular areas for liposuction before buttock augmentation are the lower back, waist, flanks (love handles), thighs and stomach. This not only provides the raw material for buttock enhancement, it also contours the areas around the butt for a more dramatic result. The liposuctioned fat is then purified in a special process so that the best fat is ready to be reintroduced to the body.

In the second step, the donor fat is added to the buttocks with hundreds of tiny injections at different depths to ensure an even, attractive augmentation. This method of fat injection lends a shapely contour to the buttocks that lasts a long time. Special attention is given to the upper buttocks so the entire rear looks youthfully and naturally lifted.

Recovery

After buttock augmentation with fat transfer or silicone implants, patients should avoid sitting directly on the buttocks or lying on their backs for two weeks to maximize results. During this time, compression garments are worn to reduce swelling. Patients may experience some pain or discomfort, bruising and swelling after the procedure. Most patients return to work two weeks after their buttock augmentation and are able to resume all normal activities within four weeks. Swelling typically dissipates by the sixth week. Patients are asked to use padding under the buttocks while sitting through the sixth week after surgery.

Side Effects

As with any surgery, there are risks to buttock augmentation with fat transfer. These include infection, bleeding, fat necrosis (hard lumps), reaction to the anesthesia, and damage to nerves or muscles. Occasionally, a repeat operation is necessary to achieve the desired results.

Results

When performed by an experienced surgeon using the proper techniques, buttock augmentation is a highly satisfying and permanent procedure that enhances the profile of the buttocks and surrounding areas for a younger, firmer, curvier look.

Patient Profile

The patient is a 25-year-old woman who was unhappy with her flat buttocks. She underwent gluteal augmentation with her own fat, otherwise known as a Brazilian Butt Lift. This consisted of liposuction from her trunk and thighs, followed by a fat purification process, and then enhancement of the buttocks with her own fat. She is seen 2 months after surgery with fuller buttocks.

It’s been my impression that more and more of my patients are seeking silicone breast implants, which have been FDA-approved since 2006. This impression has been confirmed by recent data published by the American Society of Plastic Surgeons. Breast augmentation remains the number one cosmetic surgical procedure in the United States.  Last year, 289, 328 breast augmentations were performed in the United States, and half of them utilized silicone implants.

This confirms that more and more patients are realizing that silicone implants are softer, more natural devices with an excellent safety profile. Silicone implants also tend to have less problems with visible rippling than saline implants. For patients who have experienced significant changes to the breasts after breastfeeding, pregnancy, weight loss, or breast cancer surgery, augmentation or reconstruction with silicone implants often yields superior cosmetic results.

Silicone implants do have a few negatives. They are more expensive than saline breast implants and require a slightly larger incision for placement. It’s also more difficult to detect an implant rupture and may require an MRI to detect it with certainty. In certain patients, particularly younger woman with some breast tissue, breast augmentation with saline implants may provide nearly as nice a result as surgery with silicone implants.

To learn more about breast augmentation, do not hesitate to contact our office at 214-827-2814. Act now to take advantage of our summer specials on breast augmentation!

Taken from http://today.msnbc.msn.com/id/36101073/ns/today-parenting_and_family (published 3/30/2010)

Experts mull Pros and Cons of letting youths go under knife

by Laura T. Coffey

Teens can be mean. Just ask Jen Selter, Jon Escalante and Hannah Olson.

For years, Selter endured taunts because of her nose size. Kids ridiculed her by saying she looked like a pelican and by calling her “butter face” — code for “She’s hot, but her face!”

Escalante deliberately grew his hair out to hide ears that had branded him with the nickname “Dumbo.” And Olson’s self-confidence flagged as she tolerated “horrifying” name-calling after developing DDD-size breasts as a teen.

In a world where people of all ages increasingly turn to plastic surgery for reasons that are purely cosmetic — and, in some cases, narcissistic — Selter, Escalante and Olson said they opted to go under the knife as teenagers for different reasons. It wasn’t something they did solely because of the relentless name-calling. It also had a whole lot to do with how they felt about themselves on a deeper level.

“My advice to teenagers is don’t have a nose job just ‘cause you’re worried about what other people say or think,” said Selter, who had rhinoplasty done last summer at age 15. “It all has to do with how you feel on the inside. And getting a nose job made me feel good inside and out.”

TODAY Once Jon Escalante had his ears surgically pinned back, he felt confident enough to cut his hair in order to pursue his dream of becoming a firefighter.

Like ‘braces for crooked teeth’?
To be sure, the very notion of doing any kind of plastic surgery on teenagers raises concerns for many parents and health professionals — and there are valid reasons for concern.

“Mom and Dad, please be sure your adolescent or your teen is aware that this is not a coping skill — that every time we feel uncomfortable about ourselves, then we go out and we get surgery,” psychiatrist Charles Sophy told TODAY. “Because that’s how we begin a huge line of problems.”

Reputable cosmetic surgeons with teen patients typically recommend a series of at least four sessions with a therapist before moving forward with any procedures. The point of these sessions is to uncover underlying motives for wanting surgery, as well as to determine the emotional maturity of the patient.

Such precautionary steps are important because demand is on the rise. Although just two percent of all plastic surgeries are performed on teens, the number of teens getting plastic surgery has doubled since 2002, according to the American Society of Plastic Surgeons. Nose reshaping, ear reshaping, acne and acne-scar treatment, breast augmentation and breast reduction are popular procedures among teenage patients.

TODAY Hannah Olson’s breast-reduction surgery gave her relief from pain and made it possible to maintain an active, athletic lifestyle.

Generally speaking, plastic surgeons report that many teens want plastic surgery because they long to fit in with their friends, while many adults pursue plastic surgery because they want to stand out.

But when a teen seeks out plastic surgery to correct a noticeable physical defect or to change a body part that’s caused prolonged psychological distress, that can be a good thing, doctors say.

“It’s no different than kids getting braces for crooked teeth,” said Dr. Sam Rizk, Selter’splasticsurgeon.

Dr. Nancy Snyderman, NBC’s chief medical editor, agreed that plastic surgery can be altogether positive in the right circumstances. In the cases of Selter, Escalante and Olson — all of whom were featured in Friday’s edition of People magazine and interviewed on TODAY on Tuesday — Snyderman thought they made responsible choices when they decided to have plastic surgery done at ages 15, 17 and 19.

“Remember we’re not looking at 10- and 11-year-olds,” Snyderman said. “We’re looking at young adults who were part of the decision-making process, and that plays a big role. … You’re looking at three very appropriate cases for wanting to change things.”

TODAY Jen Selter’s nose job at age 15 made her a more confident and carefree teen.

How young is too young?
Before moving ahead with any kind of plastic surgery, parents and teens are encouraged to remember that surgeries are never risk-free. They should read up about any possible complications and be sure they can handle the risks involved. A real awareness of the risks can prompt parents and children to pursue non-surgical options for changing body image, such as diet and exercise.

Parents and children also should be aware that guidelines do exist for younger patients. Facial plastic surgery generally should not be done on anyone until facial growth is complete. For a female, that happens by about age 14; for a male, it’s about age 15.

The U.S.Foodand Drug Administration will not allow breast augmentation to be done on anyone younger than 18, and most surgeons will refuse to perform liposuction on anyone younger than 17 or 18.

(Generally speaking, it can be wise to choose a surgeon who has experience working with younger patients. Be sure to check the surgeon’s complaint history.)

For their parts, Escalante, Olson and Selter all told TODAY that they have no regrets about their plastic surgeries. Escalante’s decision to have his ears pinned back made him feel good about cutting his hair to pursue his dream of becoming a firefighter. Olson’s breast-reduction surgery gave her relief from pain and made it possible to maintain an active, athletic lifestyle. And Selter’s nose job made her more confident and carefree.

“Jen is so happy now,” said Selter’s mother, Jill Weinstein. “I would say to parents … it’s the greatest gift you could give to your child. What greater gift is confidence and to help them feel happy in who they are?”

This is an interesting conglomeration of facts, published onTBO.com (http://www2.tbo.com/content/2010/mar/17/171510/brief-history-breast-implant) on March 17, 2010

Despite its litigious history, breast implant surgery is the most popular surgical cosmetic procedure in the country.

Here are some events that have kept breast augmentation in the news throughout history:

1890s: The first surgical breast augmentation procedure is performed with paraffin wax injections, resulting in infections and lumps. By the 1920s, the practice is discontinued.

1895: German surgeon Vincenz Czerny is known as “the father of cosmetic breast surgery” for reconstructing a woman’s breast by transferring fatty tissue from the belly and buttock areas into the breast. The procedure isn’t very successful because the body quickly reabsorbs most of the fat, leaving the breast lumpy and lopsided.

1940s: During World War II, Japanese prostitutes have silicone liquid injected into their breasts to appear more voluptuous, causing health problems and death. Even so, the procedure catches on and spreads to the United States before the practice is banned.

1950s: Well-endowed Hollywood icons Marilyn Monroe, Ava Gardner and Lana Turner help make the bombshell’s hourglass shape popular, causing many women to turn to padded bras and augmentation to keep up.

1961: Surgeons Frank Gerow and Thomas Cronin develop the first silicone breast implant with the Dow Corning Corp.

1962: Timmie Jean Lindsey, a 30-year-old mother of six, visits a Houston Hospital to have a pair of floral tattoos removed from her breasts and becomes the first woman to get silicone breast implants.

1965: A surgeon develops the first saline-filled breast implants in France.

1977: A woman wins a $170,000 settlement from Dow Corning for pain and suffering after her breast implants rupture.

1980s: Ralph Nader’s Public Citizen Research Group sends out warnings that silicone breast implants cause cancer.

1992: After reports of women claiming implants are hazardous to their health, the FDA stops the cosmetic use of silicone-gel implants.

2000: The FDA approves saline-filled implants, finding them safe and effective for use in breast augmentation and breast reconstructive surgery.

2004: While being photographed at a party, actress Tara Reid accidentally exposes her scarred breast. She later admits to having botched breast surgery.

2006: The FDA approves silicone breast implants again.

2008: Breast augmentation surgery replaces liposuction as the most popular cosmetic surgery in the United States.

2009: Hungary holds a beauty pageant, “Miss Plastic Hungary,” to highlight the positives of plastic surgery.

2010: A Beverly Hills plastic surgeon says breast implants saved the life of one his patients by helping stop a bullet to her chest.

Sources: beyondniptuck.com; pbs.org; breast-plastic-surgery.org, breastimplantsusa.com and ofc.berkeley.edu

Are breast implants permanent?

Breast implants are not permanent devices, but can sometimes last for up to 25 years with no problems.

Can breast implants be removed?

Implants can be removed, but the breast skin and tissue may become stretched over time.  As a result, the breasts may develop redundant skin and a breast lift (mastopexy) may be required after the implant is taken out.

Is breastfeeding possible after breast augmentation?

Breast implants usually do not affect the ability to breastfeed.

Who is eligible to get breast implants?

You are not eligible to get breast implants for cosmetic purposes if you have untreated breast cancer or infection, are under 18 years of age, or are pregnant or nursing.  Silicone implants cannot be placed for cosmetic purposes in patients under 21 years of age.  Breast implants may be placed in younger patients if needed for reconstructive purposes.

Will insurance cover breast augmentation?

Insurance companies do not cover breast implant surgery performed for cosmetic purposes.

What happens if the implant ruptures?

Patients often worry about implant rupture even though it is not a terribly common problem. Within 10 years of surgery, only one in ten implants will rupture.  If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water.  If a silicone implant leaks, it may not become apparent for several years.  For that reason, the FDA recommends that patients get an MRI 3 years after breast augmentation, and then every two years thereafter to assess for rupture.

How will my breasts look and feel after breast augmentation?

Some bruising and swelling occurs right after the procedure, but disappears relatively quickly.   Once the swelling is gone, the breasts feel healthier and firmer. Saline breast implants feel a bit firmer (both inside and outside the body), while silicone gel breast implants are softer and more natural feeling.

Will there be scars?

Although scars are a part of the breast augmentation process, Dr. Jejurikar’s goal is to make the scars as aesthetically pleasing as possible.  Dr. Jejurikar places the incisions around the areola, under the arm, or under the breast. Breast augmentation scars, regardless of where they are located, tend to heal extremely well.

When can I return to work and resume normal activities after breast augmentation?

It will take a few days to return to normal activities, and even then, patients often feel fatigued. It is often possible to return to work within one week after breast augmentation surgery. Strenuous physical activity should be avoided for three weeks following surgery.

Who is a candidate for breast reduction?

Women with large, disproportionate breasts with pain, discomfort or embarrassment due to their breast size may be good candidates for breast reduction  (reduction mammaplasty). Ideal candidates for a breast reduction are women who are not pregnant or breastfeeding, are done having children, and are at a stable weight. Although breast reduction is generally recommended for mature women with fully developed breasts, surgery may be performed on younger women if their breasts are causing serious pain and physical discomfort.

When can patients return to work and resume normal daily activities?

After breast reduction surgery, it is often possible to return to work within one to two weeks, depending on the patient’s job.  Many patients resume most of their normal activities, including some form of mild exercise, within a few weeks. You may continue to experience some mild, periodic discomfort during this time, but these feelings are normal.

Because sexual arousal could cause incisions to swell and create the possibility of delayed healing, sexual activity should be avoided for at least two weeks after breast reduction surgery.

When can patients shower after breast reduction surgery?

Patients are often concerned that limited mobility after surgery will prevent them from showering for several days.  Dr. Jejurikar recommends that patients shower as soon as their drains are removed after surgery, generally about 48-72 hours postoperatively, to help them feel refreshed and to keep their breast skin clean.

Will health insurance cover the breast reduction procedure?

Breast reductions may be covered by medical insurance if the purpose of the breast reduction surgery is to alleviate physical discomfort and pain caused by oversized breasts. Many factors determine your eligibility, including the specific terms of your insurance policy and the amount of breast tissue to be removed.

Insurance companies require specific documentation from plastic surgeons prior to approving reduction mammaplasty.  This usually includes photographs demonstrating large breasts and shoulder grooving from bra straps, as well as a letter describing patient’s symptoms, other treatment modalities attempted, and the estimated amount of tissue that will be removed.

Supporting documentation from other physicians and health care professionals can be very helpful in facilitating the approval process.  Letters from physical therapists and chiropractors documenting failed therapy for back pain and neck pain, as well as from primary care doctors demonstrating neck pain, shoulder pain and heat rashes despite appropriate use of a support bra, all help immensely.

How long will the results of breast reduction surgery last?

After breast reduction surgery, provided patients do not gain or lose a significant amount of weight or become pregnant, breast size should remain relatively constant in size. However, the effects of aging and gravity cause all tissues to sag over time; the breasts are no exception. If, after a period of years, the breasts become saggy or droopy, patients may choose to undergo a breast lift procedure to restore a more youthful contour.

Will there be scarring?

The various techniques for breast reductions require different incisions. Traditional breast reduction surgery uses anchor-like incisions that extend around the nipple, down the middle of the breast, and at the crease at the base of the breast. Vertical incision (lollipop) breast reduction surgery creates shorter scars that also circle the nipple and extend vertically down the breast, but avoid making an incision at the crease below the breast.   Dr. Jejurikar designs his incisions with the goal of minimizing scars while still creating an aesthetically pleasing breast. Scars from breast reductions tend to fade over time and can be hidden under bras, bathing suits, or a low cut top.

Can I breastfeed after a breast reduction?

There is a significant chance that breastfeeding is not be possible after breast reduction.   It is not possible to predict with certainty who will be able to breast feed after breast reduction surgery. Thus, if this is of paramount importance to a patient, she should delay surgery until a later time.

What are the risks and complications of breast reduction surgery?

Breast reduction surgery may have potential complications that are possible for all surgeries, including bleeding, infection, hematoma, adverse reactions to anesthesia, and poor scarring.  Potential risks that are specific to breast reduction surgery include asymmetrical breasts, altered or loss of nipple and areola sensitivity, and the inability to breastfeed.

The numbers of women presenting to Dallas Plastic Surgery Institute complaining of sagging, droopy and deflated breasts, not to mention bulging tummys with extra fat and skin, continue to climb.  Very few of these women ask for a mommy makeover, but they all share one common goal: to restore their pre-baby body!

Mommy makeovers, or post-maternity breast and body reshaping, are individualized for every patient, but can include tummy tuck (abdominoplasty), breast augmentation, breast lift, breast lift with breast implants, breast reduction, and liposuction.  No two patients are the same, so the specifics of the mommy makeover vary from patient-to-patient.

Through the end of April, enjoy 10% off surgeon’s fees for all mommy makeover procedures.  Call 214.827.2814 to schedule a consultation today!

This is a story profiling the benefits of Zeltiq, a noninvasive system for removal of fat.  It has significant benefits for both male and female patients and is available at our Dallas and Plano offices.  If you’re interested, call 214.827.2814 to learn more.

Breast augmentation is an intensely gratifying procedure for patients, as they see immediate results after the procedure.  Like any surgical procedure, though, patients need to allow some time for recovery.

Recovery is variable from patient to patient. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week.  After a week, most patients have mild fatigue and soreness, but no other significant symptoms.

Surgeons vary in the amount of time they restrict their patients from exercising postoperatively.  I ask my patients to refrain from all vigorous exercise for 2 weeks postoperatively and from all upper body exercises for 4 weeks.  Patients don’t always want to comply with this, as they feel relatively normal well before their postoperative restrictions are lifted.

Scars from breast augmentation incisions will begin to fade in a few weeks and will continue to fade for months or years.