If you are having breast augmentation, you should have the opportunity to select the breast implant that will give you the look you want. Although implant volume (cc’s) is important, the shape of the implant is just as important.

Implant shape has two components. One is the base, or how much space the implant occupies on the chest wall. The other is projection, or how much the implant stands out from the chest wall. For example, a 350cc implant can be moderate profile or high profile.

• Moderate Profile Implant : The moderate profile implant will occupy a larger diameter of your chest wall, it is wider and taller. It will not project outward so much, as it is distrubuted in a flatter, wider fashion.  This implant is often chosen by patients who want fullness to the side of the breasts. In the video snapshot below, this profile is that implant to your right.
• High Profile Implant: The high profile implant will occupy a smaller diameter on your chest wall as it is narrower but it also stands out more from the chest wall. This implant is often chosen by women who are slender and want more projection outward, instead of fullness on the side of the breast. In the video  below, this profile is the implant to your left.

I prefer that the patient starts the process by first selecting the type, or profile of the implant. Then, after the shape of the implant is determined, Read More »

The lips are an important feature of your facial appearance. It is one of the first things women address as they begin to show signs of aging in the face. They are looking for a more youthful appearance, but think they need a lip augmentation. In other words, they think that making their lips fuller will make them more attractive. However, often times, the real solution is not a lip augmentation, but a lip lift.

Most beautiful lips have these  defining characteristics :

• well shaped cupid’s bow
• 1.1 cm distance between the bottom of the nose and the top of the red part of the lip
• a degree of fullness

For some reason, society has focused on the ‘fullness’ part, with a complete disregard for the other features that make beautiful lips.  The result is that there are a lot of duck lips out there. I know you have seen them–Not to pick on Melanie Griffith Read More »

Remember the movie “Minority Report”? There was a scene where Tom Cruise is walking through the streets with large screens flashing the conversations of people. Now imagine this: People are talking about stem cells from your own fat. Below you can see what people are saying about fat stem cells on Twitter.

Stem cells from your own fat is the new frontier of plastic surgery. Fat is an abundant source of stem cells. When they are used for autologous use, clinical trials show that these stems cells have healing capabilities.

The future is here.

What are the goals of a great face lift? Plastic Surgeons approach the face lift procedure in a variety of ways. A full facelift has several components: the browlift, the upper eyes, the mid facelift, and the lower facelift.  If a patient wants to rejuvenate the face, which of these procedures are generally the most important?

Read More »

If you are getting medical treatment, you deserve to have the best care. The first step is to identify your physician’s credentials. Is your physician Board Certified? In what? Is it in the specialty that you are being treated for?  Furthermore, WHO is the organization deeming the Board Certification?

The dirty little secret is that there are various agencies who issue Board Certification. HOWEVER, there is only one agency, the American Board of Medical Specialties, the ABMS, who is considered the ‘gold standard’.  Your physician or surgeon should be board certified in a specialty recognized by the ABMS.

There are 24 Member Boards recognized by the ABMS, the American Board of Medical Specialties.  The list of specialities is detailed at their website.  Note that in the field of Plastic and Cosmetic Surgery there is only one Read More »

What are the advantages of IV sedation over general anesthesia? Dr. Todd Hobelmann is one of the Board Certified Anesthesiologists who works with Dr. Ricardo Rodriguez at CosmeticSurg.net in Baltimore.  Dr. Hobelmann administers the anesthesia to Dr. Rodriguez’s surgical patients. Dr. Rodriguez is a Board Ceritifed Plastic Surgeon who owns and operates a AAAASF accredited surgery center. Dr. Rodriguez prefers to perform  his cosmetic procedures under IV sedation.

Dr. Hobelmann is experienced with various types of anesthesia and explains why IV sedation is a better choice for most patients. According to Dr. Hobelmann there are two main differences between IV sedation and general anesthesia. With IV sedation: Read More »

Breast reconstruction after lumpectomy and irradiation poses a difficult choice for the patient who wants reconstruction. After treatment the breast can be noticeably different from the opposite breast, and sometimes can be indurated with hardened irradiated tissue. The alternatives usually offered are reconstruction with implant or a more extensive and complicated reconstruction with vascularized tissue.

Because irradiated tissue has impaired healing abilities, the use of implants has a high rate of complications, including fluid collections, infection, and a high rate of capsular contracture. The alternative is to use tissue from another part of the body which has not been irradiated and carries its own blood supply. These operations are lengthier, with a more prolonged recovery period, and carry their own risk. They can entail significant scarring in the donor tissue area. Because of this, patients who have had lumpectomy and irradiation are rarely encouraged to have reconstruction.

Recently investigators in Italy and Japan have perfected techniques for reconstructing breast lumpectomy and irradiation defects using fat grafts from the patients own body. The results are very encouraging, sometimes spectacular, and the techniques used are reliable and reproducible.

Lumpectomy and Radiation performed

lumpectomy scar after fat injections

Fat grafting has existed for many years, but only recently have techniques that work consistently been developed and refined. Like all procedures, the success of fat grafting depends on the techniques used. Although many clinicians voice doubt over the reliability and longevity of fat grafting, Read More »

All breast implants used in the breast augmentation procedure have a risk of creating some amount of wrinkling. Wrinkling is the effect which can make the skin look like it has ripples. This occurs in a small percentage of cases, and the risk can be reduced if the surgery is planned well.

There are several factors which contribute to  visible breast implant rippling. The most common factors are:

1. Consistency of  the implant: saline, gel silicon, or gummy bear silicon
2. Your own soft tissue cover (skin, breast gland, fatty tissues)
3. how much of the implant is placed under the muscle

In terms of potential to wrinkle, saline implants are the most likely to show wrinkling, because they are the most flexible. Gummy bear implants are firm and are the least docile, so they are least likely to show wrinkling. Read More »

Plastic Surgery doesn’t have to be painful.  You can have a pain pump which will greatly reduce pain, reduce nausea, and result in a much quicker recovery. Watch my video blog about why pain pumps are awesome!

Think of the pain pump as having two main parts: 1) ball with the medication 2) long tubes. The ball holds a local anesthetic and the long thin tubes feed the anesthetic into the operative site. The pain pump is placed into position Read More »

Patients nowadays are bombarded with infomercials for exercise apparatus to tighten your stomach. Does it work? Will exercise alone flatten your stomach? Or, do you really need a tummy tuck?

The answer is . . . Read More »

It is no secret that Michael Jackson experienced breathing problems throughout the last years of his life.  Was it a pulmonary condition, or was it something else?

I have strong reason to believe that Michael Jackson had internal valve collapse within his nasal passages. How did this happen? Multiple rhinoplasty cosmetic surgery procedures Read More »

Dr. Conrad Murray was the physician who administed CPR on Michael Jackson. According to the web site of the American Board of Internal Medicine, http://www.abim.org:

Dr. Conrad Robert Murray- not Board Certified (expired)

Certified 8/26/98

Expired 12/31/2008

The rhinoplasty procedure is a reshaping of the nose.  In your initial consultation with your plastic surgeon you should  describe the things you want to change about your nose in specific detail.  Plastic surgeons think about the nose using certain terms and you can paint a better picture of how you want your nose to look if you use these terms in your initial consultation.

In this video blog about rhinoplasty, I explain the following terms used to describe the nose: Read More »

I have previously written about the types of anesthesia used in cosmetic surgery. The various types of anesthesia include local anesthesia, various types of IV sedation where you breath on your own (twilight anesthesia) , and general anesthesia (assisted breathing with a tube).

I perform all of my major procedures, including multiple procedure makeovers with IV sedation.

The use of IV sedation offers several advantages over general anesthsia:
1- less nausea than general anesthesia
2- quicker recovery immediately following the surgery
3- eliminates the risk of pulmonary embolism which is a major concern with general anesthesia.

It is a myth that long multiple procedure cases can not be performed under IV anesthesia. I perform 8-9 hour multiple procedure cases every week. Read More »

In Episode #3 of my CosmeticSurg Video Blog I discuss the difference between two types of liposuction:
tumescent (suction) liposuction vs. laser/ ultrasonic assisted liposuction. If you are considering laser or ultrasonic liposuction you must watch this video to understand why these new technologies may not necessarily be as good as regular tumescent liposuction!

Traditional tumescent liposuction

Tumescent liposuction has been around well over a decade and allows the surgeon to have complete control of the amount of fat being taken out. Read More »