Labioplasty- reducing the size of the Labia

November 14th, 2011

When I started performing Labioplasty a number of years ago I had no Idea how popular it would become. A patient once told me that she regretted not having had it done when she had her breast augmentation; she just didn’t know that I did it. Because of her I added a “while you’re at it” section to my D.C. breast webpage to point out surgeries that are commonly combined.

Labial tissue comes in all shapes and sizes. Some have more, others less. Common concerns patients share with me include a self consciousness during sexual activity, difficulty wearing certain clothing or swimwear and even discomfort with some athletics.

There are two basic types of Labioplasty and I perform both procedures. I believe both are good as long as the patient’s goals are accomplished. The labia minora is the most commonly reduced.

Straight excision simply cuts away the redundant tissue and leaves a straight narrower labial edge. It is the simplest and removes the most tissue. Some believe that it leaves an unnatural looking edge but I have not found this to be the case.

The other method involves removing a wedge or wedges of tissue which preserves the natural edge of the labia.

Labioplasty can be done under a local or general anesthesia. I am happy to show examples in consultation but I don’t put Labioplasty photos on the web. If you are interested in a Labioplasty then contact me to schedule a consultation.

Male Breast Reduction

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.

Adam and Eve do Plastic Surgery!

November 1st, 2011

I wasn’t looking for it and I didn’t even really think about it until a few weeks after Eve Pandit joined our team. A patient brought the irony to my attention. Yes, together with my Physician assistant we have become Adam and Eve.

So who is Eve? I could tell you about her amazing credentials and her extensive experience in the field of plastic surgery, but she is so very much more than that to me.

She is a good person, a fine and kind and gentle human being with a soul a mile wide. She is my right arm, my closest and trusted advisor and sounding board. She is the kind of person I am proud to have in my practice and proud to have helping care for my patients. She is a passionate and compassionate mother. I feel very lucky to have her.

But what I think may be unimportant, is what my patients think that counts the most. For those of you who know her you know that it’s all true. She has a gentle touch whether it is with Botox, filers or microdermabrasion. The advice she gives is honest and heartfelt and it has won her the trust of countless patients. She is an artist with fillers. It is a case of the student exceeding the master.

So if you have been considering plastic surgery, fillers or Botox and you would like to meet Eve (and Adam) feel free to contact us!

Exchange Saline Implants for Silicone gel breast implants?

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.

The Joys of a go Kart

October 17th, 2011

So this plastic surgeon, thanks to the urging of my 13 year old son, is finally building his first go kart. There is no plastic surgery message in this blog post other than for those of you who know me I love creating things with my hands in the operating or at home in my garage. This summer I attended two macramé classes with my daughter, and now the go kart.

Just before the summer my son got the urge to have a go Kart as he watched a friend in the neighborhood tool around on one his father had purchased. “I also want to learn to weld” he announced. I was relieved about that. Buying him a go kart would have felt like I was spoiling him (let alone the cost!), but building a go kart seemed like an opportunity to learn about mechanics, engineering and even electricity. Not sure how serious he was, I bought a book about welding on Amazon and mailed it to him while he was in summer camp.

“Did you read the book?” I asked when he returned. “ Every word”, he said. I didn’t really believe it until I started reading the book and asked him questions about it. He seemed to have memorized all 300 pages

Well thank god for Craig’s list. A chop saw, grinder and a welding machine later we are well into this project enjoying not only our accomplishments but our time together. My son welds better than I do, but don’t tell him I said that. Our project together has been my joy. I may post some photos when I’m done, and yes I am being very careful with my hands.

To learn more fun facts about our building progress follow me on facebook or to schedule a consultation feel free to contact me!