Archive for the ‘Breast’ Category

Sorry I Kept You Waiting for Your Consultation of Cosmetic Surgery

Tuesday, January 31st, 2012

I find myself running behind in the office and sometimes doing what I hate the most… keeping someone waiting for their cosmetic surgery consultation. I am on your side here. I don’t like waiting in the doctor’s office either.

So first and foremost if you are reading this and I have kept you waiting, or will keep you waiting, I offer you my sincere apologies. There is more to this blog however. I thought you might find it interesting to know how and why we can get backed up.

—–The cascading arrival time: While we have a good scheduling program all it takes is one late arrival to shift the schedule off kilter by 30 minutes or more. Unfortunately that will happen on average about twice during an office day at anyone of my plastic surgery practices in the Washington DC, Virginia area.

—–The exploding consult: for the average consultation we have a pretty good estimate the time it will take for me to evaluate, explain and go over treatments. However, it is extraordinarily common for a patient to book a consultation about one type of surgery but then also ask about two or three more. At 25- 30 minute per topic the math gets a little scary. Interested in knowing more about that topic, read my past blog “What Goes Together- More Than One Procedure of Plastic Surgery”.

—–The mom /friend phenomena: I love it when a patient brings a friend or family member to the consultation another set of ears and eyes is comforting and helpful. It is extremely common though that the friend or family member becomes the second consult in that room at the same time.

—–I am long winded: yes, it’s true. I love to teach and educate my patients and I don’t want anyone to leave feeling they did not get the best and most informative experience they could. So if one topic becomes 3 or if mom or friend has a question I will always feel compelled to answer it in detail.

I hope this doesn’t scare you off. A busy cosmetic plastic surgery practice is a good thing.

So a few tips: Morning consults are less prone to cascading delays, if you’re interested in many things, or so is your companion, just let us know ahead and we’ll leave more time. Bring a book just in case. Whether it’s breast, body, face, nose, or liposuction I’d love to meet you and I’ll do my best not to keep you waiting.

If you have any more questions about my office or to schedule a consultation please contact me.

Tags: , , , , , ,
Posted in Body, Breast, cosmetic surgery, Face, Maryland, Plastic Surgery, Rhinoplasty, Rockville, Virgina | Comments Off

PIP and safety of Breast implants

Monday, January 16th, 2012

Recently a French manufacturer of silicone breast implants, Poly Implant Prothèse or PIP, came under Investigation by the French government for using low grade silicone in their silicone gel breast implants. The French have recommended that patients with these implants have them removed and replaced as a preventive, but not urgent matter.

These breast implants are not approved for use in the United States and I have never used them in my practice. The concern is only relevant for patients who have had breast augmentation outside the United States.

The only gel breast implants approved for use in the United States are manufactured by American companies and adhere to strict quality and manufacturing requirements.

The FDA requires extensive bio-compatibility testing on all its breast implants as described in their administration’s Summary of Safety and Effectiveness Data. These guidelines have resulted in silicone shells that have been tested and shown to possess excellent strength, resilience and elasticity.

If you have any concerns or questions about what is going on in France please do not hesitate to contact our office. If you had breast augmentation surgery outside the U.S. and would like to remove or replace your gel breast implants just please let us know.

Tags: , , , , ,
Posted in Breast, cosmetic surgery, Maryland, Plastic Surgery, Virgina | Comments Off

Don’t try this at home

Monday, November 21st, 2011

This is a follow up to a blog I posed a few weeks ago about the pencil test. I am going to describe a sequence of operations that I really do not advocate but I hope makes sense when I describe it.

Every month or two, I will see a woman with a double D or more breasts who wants me to do a breast lift and give them gravity defying breasts. Now I can do a breast lift on just about any size breast. The problem is that if I lift a large and heavy breast that breast will go south again quite quickly. Heavy natural breast tissue will always respond to gravity and usually the patient does not want to be smaller (smaller breasts droop less).

So here’s how you create a gravity defying large breast… and please recall I generally do not recommend this to patients, but I hope the concept makes sense. First do an aggressive breast reduction and remove most of the natural breast tissue, the tissue that responds to gravity. Come back a few months later and then put in a large implant. The implant restores the volume and upper fullness and tends to defy gravity more than natural breast tissue.

When I do a breast lift with an implant I will often remove a moderate amount of tissue if the patient agrees for the reasons listed above. If an aggressive reduction is needed at the time of lift and augmentation, it is often safer to stage the two in order to preserve blood supply to the breast.

To make a breast smaller only to make it bigger kind of seems like the death of common sense to me but for some it may be the only option to achieve their goals. This is a very technical and difficult concept to get across for me.

If you want to know what’s right for you, or to set up a consultation then contact me and let’s chat.

Tags: , , , ,
Posted in Breast, breast lift, cosmetic surgery, Plastic Surgery | Comments Off

Male Breast Reduction

Monday, November 7th, 2011

Gynecomastia means enlargement of the male breast tissue. There are a number of options in Male breast reduction and I just wanted to try to clear up a few things here in this blog.

The most common reason for men to have enlarged breasts is unknown. While a very few patients will have a hormonal abnormality it is quite rare and does not change the surgical solutions.

Rule of thumb: Gynecomastia surgery should be performed after puberty and is best performed at younger ages when the skin is more elastic and likely to shrink up when the tissue underneath is removed.

Types:
1) Long nipple.—far more common in women than men a long nipple can be easily shortened under a local anesthesia.
2) Puffy areola: some men (and even women) have a normal breast contour but the areola is large or puffy as though it is sitting on top. The tissue under the areola can be removed under a local anesthesia.
3)True Gynecomastia- a firm lump of breast tissue is sitting right under the nipple areola area and is visible. It feels like a small egg. This can be removed from an incision around the bottom edge of the areola and can often be done under local.
4) Pseudogynecomastia (fake Gynecomastia)- here the problem is not the glandular breast tissue. It is that the breast is fatty. This is usually treated by liposuction. I tend to use ultrasonic liposuction as I believe it works better in the dense male breast. I usually do this with patients asleep.
5) Combination- Most Gynecomastia treatment is a combination of number 3 and 4 above and will require a combination of liposuction with direct excision.
6) Droopy breasts- In an older male patient or sometimes in a patient that has lost a lot of weight the skin becomes droopy and will not shrink up when the tissue underneath is removed. In this situation I will recommend excising skin as well as long as the patient is ok with the scars.

If you are considering this type of surgery and would like to be evaluated I have offices in Annapolis, Rockville, Maryland and Mclean, Virginia. Feel Free to contact me.

Tags: , , ,
Posted in Breast, Maryland, Plastic Surgery, Rockville | Comments Off

Exchange Saline Implants for Silicone gel breast implants?

Monday, October 24th, 2011

I recently put a special on my website offering patients with saline breast implants the opportunity to switch to silicone breast implants. I think it’s a wonderful opportunity for patients who have considered switching.

So why switch to silicone breast implants?

A silicone gel implant is softer than saline, mushier and generally more natural looking. A gel implant softens the transition from the chest wall to the upper portion of the breast.

So who might make the switch?

- If you wanted silicone in the first place but had your breast augmentation surgery back when silicone was not available in Maryland.

- If you are very slender with little breast tissue and wish to look more natural.

- If you have rippling from a saline implant that bothers you. Silicone gel implants can ripple too but they ripple the least.

- If you’re saline breast implants are old and you’ve been considering an exchange anyway.

- If you’ve thought about changing your size.

To find out if switching to silicone is right for you and learn more details just contact us through my web site or e-mail my assistant Pei@washingtonplastics.com for a complimentary consultation at one of my three locations in Annapolis or Rockville, Maryland or in McLean, Virginia.

Tags: , , , ,
Posted in Breast, Maryland, Plastic Surgery, Rockville, Virgina | Comments Off

« Older Entries