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Choosing the Best

Breast Augmentation: Adequate vs. Awesome

· Breast, Breast Augmentation, Breast Implants, Choosing the Best · No Comments

 

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. In 2011 over 300,000 breast implant procedures were performed in the U.S., representing an increase over the previous two years.

Most of these procedures were performed by board certified plastic surgeons. However, as with most aesthetic surgery, these credentials are sometimes insufficient to achieve the best outcome. An eye for beauty and balance, as well as a good ear for patients’ desires, are just as important.

Patients are often lured by “free consultations” and car dealer-type discounts. However, simply putting in implants to enlarge the breast mound is not enough. Cleavage, implant pocket sculpting and nipple-areolar position are just a few of the many important fine points that cannot be overlooked if a woman is to achieve her personal best. Bikini season is here, so let’s talk about the difference between just an adequate breast augmentation and an awesome one.

 

It’s All About the Cleavage

 

Cleavage, the separation between the breasts, is an important part of a woman’s breast appearance. It therefore follows that a goal of augmentation surgery should be to narrow, and improve, the breast cleavage. I am often surprised by surgeons at conferences, or on their websites, who tout great results, yet show a wider cleavage gap after than in the before photos. Placing the breast implant closer towards the center of the chest can be a challenge for some surgeons because of the complex anatomy of the area. Nevertheless, an attractive cleavage makes a better result.

 

Drifting: the Breast Implant Kind

 

A significant portion of our practice is dedicated to corrective surgery for patients who are unhappy with their original augmentation. I have observed a common condition where the breast augmentation pocket is too far out and the implants fall towards the armpits when the patient lays flat. I call it drifting. Drifting is definitely not an attractive bikini beach look. The good news is that we have had great success in correcting this problem. Readers can visit our website for examples of before and after pictures of our corrective procedure.

 

And Don’t Forget the Nipples

 

Part of a thorough consultation for breast augmentation is analysis of the patient’s nipple-areola. Sometimes these important structures do not fall in a symmetrical and ideal position. If the patient desires, the areola can be modified or repositioned at the time of augmentation to achieve a more appealing result. Fine points in breast augmentation make the difference between just an adequate result and an awesome one. Take the time and effort to research the right plastic surgeon in order to achieve your personal best.

 

About the Author:

 

Dr. Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan), leading breast implant manufacturers. Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. More information is available at www.PerezPlasticSurgery.com or call (954) 351-2200. Visit our website blog to learn about The Dirty Little Secrets of Plastic Surgery.

 

New Year, New You: 5 Plastic Surgery Procedures to Start the New Year

· Abdominoplasty/Tummy Tuck, Body Contouring, Breast, Breast Augmentation, Breast Implants, Choosing the Best, Eyelids, Face and Neck, Safety · No Comments

            It’s resolution time again. Exercise, weight reduction and improving our appearance are always high on the list of objectives for the new year. Here are 5 popular plastic surgery procedures that produce a valuable, big-bang-for-the-buck change to begin the journey. The procedures featured here are very popular and offer a significant change with a high degree of patient satisfaction.

 

Eyelid Tuck

 

            The first place aging becomes evident is around the eyes. If the eyes are the windows of the soul, then the eyelids are the curtains that allow us enjoy the view. The upper lids develop excess skin causing hooding.  The puffy bags on the lower lids create a tired look.

 

The procedure of choice to correct tired eyelids is the eyelid tuck or blepharoplasty. It is one of my personal favorites to perform and is the most commonly performed aging procedure for men. The procedure takes 45 minutes and patients soon enjoy a refreshed and less tired look.

 

 

Face/Neck Lift

 

Facelift territory includes the area of the cheeks, jawline and neck. As we age the skin and other tissues sag from the underlying bony structures. Although highly advertised under many catchy terms, surgical facelift procedures generally fall into two categories, mini and full. A mini-facelift is best suited for patients in their 40’s or younger who just want to freshen the cheek and jawline.

 

The patient for traditional face and necklift is in her late 40’s and older with laxity of the jawline and neck, often with turkey-like banding. Combined with eyelid surgery, the procedure often produces dramatic results and can reduce the aging appearance by decades.

 

 

Breast Augmentation or Breast Reduction

 

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. Women choosing breast implant surgery want to achieve greater fullness and cleavage and fit their clothing more naturally. Many implant options exist and attention to detail is important. Breast augmentation is also one of the most commonly re-done procedures so women should carefully choose a compatible surgeon based upon credentials and experience.

 

Women who experience neck and back pain from heavy pendulous breasts can achieve a significant lifestyle improvement with breast reduction. Breast reduction can improve exercise tolerance, as well as lead to weight reduction and greater overall fitness.

 

Tummy Tuck

 

 

            Pregnancy or weight loss can create changes in a woman’s abdominal skin and muscles. In these cases, the procedure of choice is an abdominoplasty, also known as a tummy tuck. Tummy tuck surgery results in a substantial removal of excess skin and stretch marks, as well as tightening of the muscles. The result is a remarkable improvement in the belly with a very high degree of satisfaction.

 

Regardless of where you choose to start, these procedures, in the hands of a skilled surgeon, can produce dramatic results and patients who are among the happiest in plastic surgery. Bon voyage.

 

About the Doctor:

 

Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. He has lectured internationally and been featured as a plastic surgery expert for major news outlets. Dr. Perez is a member of the National Council of Leaders in Breast Aesthetics and was selected as a principal investigator for a national FDA-approved study on abdominoplasty. For more information call (954) 351-2200 or visit www.PerezPlasticSurgery.com.

 

Sientra: The New FDA-Approved Shaped Gel Breast Implant

· Breast, Breast Augmentation, Breast Implants, Choosing the Best, Safety · No Comments

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. Following the breast implant lawsuit crisis of the early 1990’s most silicone gel manufacturers fled the U.S. market. Only two companies, Allergan (formerly McGhan/Inamed) and Mentor/J&J, remained and have dominated the market for the past 20 years. One consequence of this implant duopoly is that the cost of breast implants increased from hundreds to thousands of dollars since the 1980’s.

 

Earlier this year the U.S. F.D.A. which regulates medical devices approved a third breast implant manufacturer. Santa Barbara based Sientra was approved to offer silicone gel prostheses for sale in the U.S.  Allergan and Mentor are also based in Santa Barbara, leading to the affectionate term of “Silicone Alley” for the Southern California region.

 

Dozens of breast implant companies exist throughout the world. Many of these brands are sold in Latin America. Sientra’s parent manufacturer has sold implants internationally, but of course U.S. approval is a highly coveted achievement.

 

A Good Thing…and a New Thing

 

The arrival of a third player to the U.S. breast implant market is expected to be a good thing for American women. In addition to providing greater competition, Sientra offers a unique line of shaped gel implants. These “teardrop” or “anatomical” breast prostheses are commonly used in Europe and Latin America. A saline-water filled version has been available for years in the U.S. However, Sientra is the only manufacturer granted F.D.A approval for the gel filled type.

Shaped implants offer greater options for both cosmetic and reconstructive breast surgery. The prostheses come in a variety of shapes, sizes, base diameters and projections giving both the patient and surgeon greater versatility in body contouring.

 

The augmentation procedure using shaped implants is different from the traditional round prosthesis insertion. Therefore it is advisable that patients choosing these implants consult with experienced breast plastic surgeons. As a corporate philosophy, Sientra will only sell and warranty implants placed by plastic surgeons recognized by the American Board of Plastic Surgery.

 

Editor’s Note: Dr. Perez can be seen on ABC News in Miami discussing the Sientra implant at:

www.Youtube.com/user/PerezPlasticSurgery

 

 

About the Author:

 

Dr. Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan). Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. More information is available at

The Forty-Something Facial Freshen-up: Are You Ready?

· Choosing the Best, Eyelids, Face and Neck, Safety · No Comments

The appeal of plastic surgery spans age groups from teens to seniors. Although not always the case, certain procedures such as nose reshaping and breast surgery apply to younger patients. Older candidates typically seek procedures to address aging issues.

 

Forty is a magic number for many of us. In our practice, one of the most common reasons listed for seeking plastic surgery consultation is “turning 40”. Legendary comedian Jack Benny remained at his trademark “39” for decades!

 

Patients in their forties present a unique and interesting demographic subset. Breast and body contouring procedures are popular among the “Mommy Makeover” group (that’s next month’s column).   In addition, forty is the age when many patients begin to first notice the signs of facial aging. Skin care. facial lasers and injectables are very popular.

 

Among the more common surgical procedures that appeal to forty-somethings are eyelid tucks, cheek lift and neck firming. These 3 procedures, each performed by us in under an hour, can offer a natural, fresher look with a rapid recovery and a high degree of patient satisfaction.

 

 

The Eyes Have It

Eyelid changes by age 40 may include extra upper lid skin and lower lid bags. The eyelid tuck procedure known as a cosmetic blepharoplasty, popular among both men and women, address these problems effectively. The results are usually a more rested, less angry and tired look, to the face. Blepharoplasty is the most common facial surgical procedure.

 

Face Time

Full face and neck lift remains the gold standard for facial rejuvenation. Nationally, most of these patients are in their mid-40’s-mid-60’s, although in South Florida we see patients well into their 70’s and 80’s.

 

A less invasive alternative to full face lift that appeals to the forty-somethings is the isolated cheek firming. Lifting the cheek and jawline can be done with a small incision “mini” face lift. Although they come by many catchy names, including the “lunchtime” lift, and others, these “mini” or mid-face lift procedures effectively freshen the cheek and jawline with natural, not pulled, results.

 

Up To Your Neck Yet?

A third area of rejuvenation is the neck. Some patients first notice the effects of aging when they can pinch the skin under the neck. For these patients, an isolated neck tightening procedure is a great option. Loose skin, fat and muscle can contribute to the extra wattle. They can all be addressed through a small incision under the chin.

 

Our preference is to add advanced ultrasonic treatment to achieve greater tightening of the neck skin. We were recently honored to present our unique isolated neck rejuvenation technique at international plastic surgery congresses in Greece and Korea.

 

 

Turning 40 may be a major milestone but with the many skin care and surgical options available today at least the signs of aging can be delayed. The three surgical procedures we’ve outlined here take relatively little time and offer a rapid recovery with a high degree of satisfaction when patients fully understand the risks and benefits. However, as with all plastic surgery, a skilled surgeon, a safe facility, and a competent anesthesiologist are key to a successful outcome.

 

About the Doctor:

 

Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. Surgery is performed at the Broward Health Weston facility.

To schedule a consultation with Dr. Perez call (954) 351-2200. To learn more about any of these procedures, or to view our recent ABC News “Seniors and Cosmetic Surgery” segment, featuring Dr. Perez visit www.PerezPlasticSurgery.com.

 

The Dirty Little Secrets of Plastic Surgery…Part 2 “Free” Consultations: You Get What You Pay For (Original Article)

· Choosing the Best, Safety · No Comments

 

Plastic surgery is booming. A combination of an aging baby boomer demographic, greater disposable income, affordable surgery and greater awareness, have all contributed to an increase in both surgical and non-surgical enhancements.

 

Patients are able to enjoy improvements to their face and body appearance like never before. However, along with the highly publicized successes of plastic surgery, there exist pitfalls and drawbacks that patients need to avoid. We call these the dirty little secrets of plastic surgery.

 

Part 2: The “Free” Consultation: You Get What You Pay For

 

The first step towards self-improvement through plastic surgery starts with the consultation. Some plastic surgeons offer “free consultations” in order to keep their waiting rooms and surgical schedules full. These usually go hand-in-hand with heavy advertising, phony car dealer-type “discounts” and a slick sales pitch. Ironically, places that lure patients with free consultations often charge more for surgery than honest, reputable plastic surgeons.

 

The problem with free consultations is that the patient usually gets what they pay for, nothing. Although there are exceptions, it is difficult to have a thorough and meaningful consultation with a plastic surgeon when dozens of other patients are also waiting for their brief “free” consultation. Patients typically complain that they felt like they were taking a number at the supermarket deli counter. I recall one patient who told us that her free consultation consisted of the doctor shaking her breasts and remarking, “Yup, you could use a boob job”!

 

Our office policy is to charge a modest cosmetic consultation fee. However, even though our fee is modest, it serves as a sufficient screening method. Amazing as it might seem, since plastic surgery is such an important, life-changing process that typically costs thousands of dollars, some patients quibble over paying even a modest fee for a consultation. We’re happy to refer them elsewhere for their freebies.

 

The decision to have plastic surgery is an important one that should be given the time, effort and seriousness that it deserves. The patient should invest in a thorough, honest and meaningful consultation. We have heard no greater regret than the patient who fell for a free consultation and slick sales pitch only to need to have the surgery redone.

 

Remember, unlike bad food, bad plastic surgery can’t be cured the next morning. So take your time, avoid “free” consultations, see several reputable doctors, and choose wisely. Remember, it’s your face and your body, don’t compromise.

 

About the Author:

 

Dr. Perez is a graduate of The Albert Einstein College of Medicine. He has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. A limited number of personalized consultations are offered by appointment only.

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