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I had the opportunity to spend several hours with Louis Benelli, MD from Paris, France. He is the internationally renowned plastic surgeon who popularized the periareolar mastopexy (i.e., donut or circle breast lift). We shared our thoughts about this surgery, particularly with regard to some of the finer technical points. His technique has changed and evolved since he first described it. I was extremely pleased to see that we both utilize similar techniques when performing this procedure.

The meeting also gave me an opportunity to purchase some of the newest surgical instruments on the market. I can’t wait to get back to the operating room and start using them!

I measure all of my patients to record the specific dimensions of their breasts. This allows me to obtain quantifiable breast parameters to determine what sizes a patient can best accommodate. I then have each patient try on various sizer implants to give her an idea of what she will look like after breast augmentation and also to show me what she wants to look like. Then, by combining my aesthetic evaluation, the particular anatomy of the patient and the breast implant sizers, I am able to get close to that perfect size. The final step in this process occurs in the operating room. After the patient is asleep, I insert sterile sizer implants (based on the above) and then sit the patient up on the operating table. I then move to the foot of the bed and evaluate the shape and size of the breasts. Behind me is my assistant, the scrub nurse, the circulating nurse and the anesthesiologist. I then determine if the breast is exactly the size the patient has requested and will confirm that with my surgical team. Usually I will put in the same size implant that we had planned for, but occasionally it will be different… sometimes larger and sometimes smaller, whatever it takes to get the perfect size breast implant.

If you would like to learn more about the treatment of stretch marks please call us at 866-417-6996, or you can schedule a complimentary consultation online today.

The incisions we use in breast surgery illustrate the ways in which we can hide scars. By placing an incision in the axilla (armpit), the scar is hidden by virtue of the fact it is not on the breast. The down side, of course, is that the scar is readily visible when wearing something sleeveless. When the incision is placed in the breast crease, the scar is hidden by the natural ptosis (droopiness) of the breast. And when the incision is placed around the areola, it is placed at exactly the juncture of the areola skin and the breast skin. By placing the incision at the juncture of two different tissue textures, an optical illusion is created, making the scar less visible.

The treatment for either broken saline or silicone implants is to remove and/or replace the implants. The removal and replacement of saline implants is generally relatively straightforward…the broken implant is removed and replaced with a new implant. In the case of broken silicone implants, removing the broken implant and its filling material can be significantly more complex. This is particularly so in older silicone implants (pre-1994) when the silicone filling was a semi-liquid and the outer shell was relatively fragile. Current modern silicone implants have a much more durable outer shell and a semi-solid cohesive silicone filling. In cases in which old silicone implants have ruptured or leaked, the implant shell, the implant filling material and the outer capsule (scar tissue that the body forms around implants) should all be removed as much as possible. Simply removing the implant shell and filling material, while expedient, is not adequate. It is important to note that while the implant and its contents should be removed, the extruded silicone is not a health threat. It is a condition that ultimately should be addressed, but is not an emergency requiring immediate surgery.

Heart disease from smoking is the result of the accumulation, over many years, of changes to your blood vessels. Initially, smoking affects only the smallest blood vessels. Over time, the changes in the small blood vessels affect the larger blood vessels, and eventually these changes ultimately affect the heart. Someone with heart disease is typically not a good candidate for elective cosmetic surgery. The changes to the heart caused by smoking, however, are not the only changes that can be detrimental with respect to cosmetic surgery. In fact, it is the short term changes that take place in the small blood vessels, as a result of smoking, that can be the most problematic. These changes adversely affect healing and may lead to poor quality scars, delayed healing and even open wounds.

The goal of cosmetic surgery is to improve a condition from good to better. Everything is done to achieve this goal. And because cosmetic surgery is elective, it should be done only when all of the variables that are controllable, such as smoking, are optimized. Not smoking will not guarantee perfect results or no complications, but not smoking will make it much more likely that the outcome you desire is the outcome you will get.