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.

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.

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.

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.

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!

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.

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!

If you can’t hold a pencil under the fold then you have what I call “gravity defying breasts”. There are two groups of women who have the gravity defying breasts; those women who have little or no breast tissue at all and teenagers where the skin has not yet relaxed. Any woman with a reasonable amount of natural breast tissues will eventually gain some droop. The skin relaxes over time as we age. Pregnancy, weight gain and weight loss can certainly affect this.

But guess what. I think a little droop is a good thing. It is the sign of a mature, normal, and most importantly a natural looking breast. In heavier breasted women a breast lift or reduction will always regain some droop over time as gravity weighs on the breast that remains. The skin is smarter than the doctor. Skin responds to gravity and relaxes over time (thank goodness or my tummy tuck patients would never stand straight again). In fact in a breast augmentation a little droop tends to look more natural and hide the implant better.

So as you read this please know that I spent my life in trying to improve upon or find a balance in the degree of droop. Too much droop and a breast lift and or reduction may be in your future, a little droop and some volume enhancement in the form of an implant may be the way to go. The key is to find the right balance.

Contact my office with any questions or to schedule a consultation.

While I can’t really change the diameter of the neck, I have liposuctioned liters of abdominal and flank fat from servicemen (and women) at bases all over the Maryland, D.C. and Virginia area.

So why talk about this here? I want you to know you are not alone. Liposuction is far more common than you think in the service. I have treated almost every rank with a great sense of pride.

How much you will shrink depends on how much you carry in the first place. I can never guarantee a waist size but it is not uncommon to lose at least two pants sizes or more. The flanks or love handles tend to make the biggest difference as most men wear their belt below the lower abdominal fullness.

I perform many other surgeries for men including breast reduction, rhinoplasty facelift and others, but thanks to the United States government, flank and abdomen liposuction remains the most popular.

If you are considering liposuction and you are part of our armed forces here in Maryland. Washington D.C. or Virginia you are in good company and I would be happy to evaluate you. Yes, we offer military discounts. So please contact my office for further details.

Because of improved techniques for gastric bypass and the lap band procedure, we are seeing more and more patients after dramatic weight loss hoping to look normal again. Tightening all the areas of concern in the weight loss patient covers almost every aspect of cosmetic plastic surgery. Rather than going over every option, I hope to give some guiding principles.

It is best to consider cosmetic surgery for weight loss when you achieve your goal weight and have been stable for a while. If I do a tummy tuck and then that patient loses another 40 pounds, he or she may need it done again. A stable weight does not necessarily mean rail thin, it means a realistic weight that you are comfortable with and can maintain. Being at the weight you want is worth the wait. It will make your surgery safer and more successful.

Dramatic weight loss patients are what I call “works in progress”. There are always areas that can be tightened. It is important to have a long term plan to define which plastic surgery procedures can be safely combined and which cannot. I ask my patients to create a wish list so that we can determine the best order of procedures so that one procedure will not interfere with another.

If you need help learning about surgery after dramatic weight loss or even help achieving your weight loss goals please let me know. Contact my office today, to schedule a consultation with me at one of my three offices located around the DC, Virginia and area of Maryland.