Posts Tagged ‘Plastic Surgery’

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.

What goes together? More Than One Procedure of Plastic Surgery

Wednesday, December 7th, 2011

When a patient comes in for a consult I never want that patient to feel as though I am trying to add additional plastic surgery, but it is my job is to point out where certain combinations are more powerful than just the one surgery alone. In plastic surgery there are certain procedures that must at least be considered together.

Some classic examples:

Rhinoplasty: Rhinoplasty really needs to be considered with the chin. The reshaping of the nose has a dramatic effect on the profile. If the chin is receding only half the battle is won. Chin implant may be an option.

Eyelid surgery: The eye brow position really must be considered particularly when looking at the upper lids. If the space between the brow and eyelid lashes is short and cramped eyelid surgery will have less of a result. Brow lift, or a combination of brow lift and eyelid surgery, may do a better job.

Tummy tuck and flank liposuction: Unless the skin is loose, many of my tummy tucks include frontal flank liposuction. If the flank fullness goes around the backside, I will discuss liposuction of the posterior flank (love handles) as well. The overall contour must be considered.

Facelift and eyes: If the neckline looks tight and youthful but the eyes don’t match the face won’t balance. Facelift is about the entire face and it all has to blend harmoniously.

This is not a complete list but I hope the concept comes across. The parts of our body do not exist in complete isolation. My role as a board certified plastic surgeon is to teach my patients where and how to look for the best balance.

If you are considering a consultation, please contact my office of cosmetic plastic surgery in Maryland or Virginia to schedule a consultation.

Labioplasty- reducing the size of the Labia

Monday, 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

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.

Adam and Eve do Plastic Surgery!

Tuesday, 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!