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Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman’s breast, and is performed for a number of reasons. Some women feel that their breast size is too small for their body contours, while others may be seeking to turn the clock back on the effects of age and gravity. A lack of symmetry and living with the discomfort of ill-fitting clothing that comes as a result; lost volume due to weight loss or pregnancy; coping with missing or misshapen breasts as a result of trauma, disease (such as cancer), or congenital abnormalities.

If you would like more information or would like to schedule a consultation, contact the office of Dr. Hallak, a plastic surgeon in San Diego. He specializes in all aspects of plastic, cosmetic and reconstructive surgery.

It is important that you understand that no person is perfectly symmetrical from one side to the other even before a surgical procedure. Every attempt will be made during surgery to minimize your side to side dissimilarities, but such differences always persist to some degree even after the most successful operation.

There is no evidence that breast surgery alters the possibility of developing breast cancer. Mammography techniques have improved in recent years. In spite of these advances, there is a theoretical risk of compromised detection of early breast cancer following an augmentation mammoplasty. If a cancer were to develop, its detection by mammography could be made more difficult, depending on the location of the cancer within the breast, the position and size of the implant and the type of implant employed. Regardless of your decision to have an augmentation mammoplasty or not, it will still be necessary for you to examine yourself monthly for breast lumps and undergo mammography as suggested by your personal physician.

Dr. Todd Gerlach is a board certified plastic surgeon in Torrance, California. He specializes in all aspects of breast surgery, tummy tuck and many other plastic surgery procedures.

Breast Augmentation Torrance
Tummy Tuck in Torrance

What about liposuction? Is it still a viable option for someone who wants to rid himself or herself of unwanted weight? A good candidate for liposuction is someone who is in fairly good shape, relatively close to his or her ideal weight, but wants to trim down localized areas. The person should be physically healthy, psychologically stable with realistic expectations.

The fat will not re-accumulate in these areas in the same manner as before and leaves small, if any, scars. Newport Beach Plastic Surgeon Dr Boris Ackerman states” I perform hundreds of liposuction procedures each year. I have many patients who come to me after they have given birth and request liposuction. Even though they have returned to their previous weight, many of these women have some resistant areas as a result of the pregnancy.”

Breast enhancement and breast lift surgery procedures are suitable solutions for women suffering from postpartum depression and are also unhappy with the shape of their breasts following pregnancy and nursing. Most women, after having children, begin to lose tissue volume in the upper part of the chest, resulting in a hollowed appearance in the upper breast.

The medical term used to describe sagging of the breasts is breast ptosis. In such cases, the plastic surgeon may elect to perform a breast lift procedure (also referred to as a Mastopexy). The surgeon may also insert a breast implant in the breast to restore the lost volume. The size of a woman’s breasts depends on the volume of breast tissue. If a patient has sufficient volume, only a simple lift is required in order to provide a tighter, more youthful appearing skin envelope, thus allowing the breasts to stand high and firm.

Even if you are maintaining a healthy diet and sticking to a proper exercise plan, you may still experience areas of stubborn fat that will not respond to your exercise and diet. Liposuction surgery, also commonly referred to as liposculpting or body contouring is a plastic surgery procedure developed to target those areas of stubborn excess fat. Liposuction surgery is most commonly utilized to remove the excess fat, and shape the body, providing a more natural contour. This surgery procedure is frequently used in combination with other procedures such as a face lift procedure and tummy tuck surgery. The liposuction surgery procedure is not meant to be used as a method or alternative for losing weight. The best candidates for liposuction are following a proper diet and exercise regimen, are close to their ideal weight and have healthy skin with good elasticity.

The plastic surgery consultation is an opportunity to meet your plastic surgeon, get comfortable with one another and most importantly, you will discuss with your plastic surgeon the areas of your appearance for which you desire improvement. When you contact the plastic surgeon’s office to schedule your consultation, the surgeon’s staff will send an you a packet that contains important information. This packet should include information about the plastic surgeon, the Surgeon’s office, policies and of course, information about your chosen plastic surgery procedure as well as information about the surgical facility where the procedure will be performed. It is important that you completely read and fully understand this information in order for you to be aware of what to expect, the surgery process and options available to you prior to your consultation. This packet will also includes a patient questionnaire about you, and your medical history.

During your consultation, the surgeon will perform an examination. Depending on the procedure, the surgeon will measure the area(s) of concern, take notes and the surgeon may also take “before” photos. The surgeon will discuss with you the options available for your procedure, such as the size of breast implants. In addition the surgeon will also offer his recommendations for you. You and your plastic surgeon will also thoroughly review the planned procedure, what to expect as you recover and your anticipated results.

Many plastic surgeons believe that when the correct individual dermal filler, or in some cases, the correct combination of fillers to treat wrinkles, the results are very similar to those achieved from much more invasive procedures.

Dermal fillers widely accepted and used in modern cosmetic dermatology and cosmetic surgery procedures as an instant aesthetic treatment. A dermal filler treatment is one of a small number of cosmetic procedures that typically provide immediate results and a noticeable improvement and does not require down time like procedures such as a face lift.

These days there is a mind boggling number of choices when electing to have a dermal filler treatment. It is not an uncommon practice for a cosmetic surgeon to utilize a single type of filler to treat more than one area of concern.

New York Cosmetic Dermatologist Dr. Karyn Grossman states “Each individual dermal filler has qualities that differ from other fillers, and therefore provide different results. By utilizing multiple filler types to treat different areas of a patients face, and using the best filler for each treatment area, one can achieve the most beautiful and natural looking results possible.”

Unfortunately for some, the body’s healing may result in the formation of scars that are unsightly or that cause unwanted symptoms such as pain or tightness. The plastic surgery or scar revision involves the removal of the offending scar and its replacement with an
improved surrounding soft skin or tissue. This is capable of allowing for the scar to become minimized and camouflaged in a much more functional and aesthetic way.

A scar is the natural result of the body attempting to heal an open tear or wound in the surface of the body or skin tissues. Every person forms scars, and scars are always resulting from surgical incisions or trauma which goes all the way to the deeper layers of skin and sometimes the structures. In fact, a scar will result from any type of plastic surgery procedure. There is no such thing as a cosmetic surgery procedure that does not leave a scar, regardless of what is advertised or hyped.

Santa Monica Fertility Specialists in Santa Monica California, home to world renown Fertility Specialist Dr John Jain, recently implemented a ZIFT program for women over 40. ZIFT stands for Zygote Intra-Fallopian tube Transfer, a process where embryos are transferred to the fallopian tube soon after fertilization so that they can grow in their natural environment. The reason we offer this is that the increased rate of infertility and miscarriage seen in women over 40 years of age is primarily due to chromosomal errors that occur during egg and embryo development. Growing embryos in the artificial environment of the IVF laboratory puts further stress on developing embryos.

The results with ZIFT and early intrauterine transfer have led to ongoing pregnancies in approximately 60% of the first group of women treated in this manner. ZIFT is also a viable alternative to those women who have encountered multiple IVF failures.

Liposuction is a cosmetic surgery procedure that helps to sculpt the body by removing excess fat from specific areas of the body. Through a small incision, a slim tube is inserted through the incision to remove the fat layer that lies deep beneath the skin. The cannula is then inserted and moved through the fat layer, breaking up the fat cells and suctioning them through a vacuum pump or a large syringe. Liposuction surgery is not a substitute for dieting and exercise, but it can help with the stubborn areas of fat that do not seem to be affected by normal weight loss methods.
Good candidates for a liposuction procedure are people who are within 30% of their ideal weight and have firm, elastic skin with pockets of excess fat in certain areas. You should be realistic about your expectations and in good physical and mental health. Individuals with certain medical conditions may not be suitable candidates for liposuction surgery – check with your plastic surgeon if you have such a medical condition.

Saline breast implants have been used in the majority of mammoplasty surgeries over the last fifteen years. One advantage of saline breast implants is that, if they rupture, the saline will be absorbed by the body without fear of any complications. Additional benefits include the ability for a plastic surgeon to subtly change the volume of the implant within the operating room to accommodate any small differences in the volume of the two breasts. The disadvantages of saline implants are that they have a higher risk of rippling in breast reconstructive or small-breasted patients. For patients with little breast tissue to cover the implants, rippling or wrinkling of the implant may become visible. However, the majority of breast augmentation procedures performed today with saline implants lead to beautiful, youthful, natural breasts.

An area that some plastic surgeons have an expertise in is primary or secondary breast augmentation. Most of these plastic surgeons perform mammoplasty using all types of implants including saline and silicone. Cosmetic surgeons have important decisions to make when it comes to breast implants. Breast implants are available in many different shapes, projections, and sizes. The type of implant that your plastic surgeon selects should be based on your physical and soft tissue characteristics, as well as the goals that you have for your appearance. Another important thing that these surgeons specialize in is the decision of where to create the pocket and incision for the breast implant.

Currently, there are many lasers used to treat sun damage/photo-aging of the skin. One older laser system, the carbon dioxide laser, has been very effective for laser treating sun damaged skin but has fallen out of favor. This is because it routinely caused extensive rawness of the skin that typically required over 2 weeks of “downtime” to recover. In addition to the time it took to heal, it frequently caused skin discoloration and occasionally scarring. Many lasers available today require very little downtime and yield some improvement of the skin but are not nearly as effective as the carbon dioxide laser. San Francisco Plastic Surgeon Dr. Cedars in conjunction with Dr. Wall are doing a study designed to assess the effectiveness of a new, modified carbon dioxide laser system.

The MiXto laser is a “fractional” carbon dioxide laser, meaning that, rather than “zapping” 100% of a treated region of skin, it zaps scattered tiny zones of skin comprising a total of perhaps 25% of the treated region. Tiny treatment zones mean no skin rawness. The trade-off appears to be that more than one treatment is needed to get good results. The laser has been used to safely treat over 160 patients in Italy. It has been FDA-approved for treatment of fine lines. Patients who have been treated with this laser report less pain, less downtime, and better results than are reported with other lasers. Dr. Michael Cedars and Dr. Tomi Wall have successfully patients with this laser.

A forehead lift will set the eyebrows to a higher level and will stretch out the upper eyelid skin. Often times none of the skin will need to be remove, but if it does, many cosmetic surgeons choose to trim it later after the new brow position has been established. This is done so that the two procedures will not work against one another and eye closure will not become an issue. With your eyebrow higher set, you will stop wrinkling your brow since there will no longer be a need for conscious elevation.

A lot of people go into a cosmetic surgeon‘s office and request an eyelid lift procedure to correct an excess of skin that they have in their upper eyelids. Many times the actually problem lies within their brow and a brow lift is the answer. For these patients, the brow itself has fallen which has resulted in a “bunching” of skin in the upper eyelid area. With an aggresive removal of skin during an eyelid lift, typically the brow will be pulled further down which will just make the issue even worse and can sometimes create a tired or weary appearance.

With all of the advancements in plastic surgery procedure techniques and the technology employed, procedures are becoming safer, and surgeons are now able to better predict the results. California plastic surgeon Dr Craig Creasman does exactly that with a new technology for breast augmentation surgery called 4-d Simulation. This technology is aimed at aiding in the pre-operative planning stage of the surgery.

Dr Creasman states”I discuss surgical options with my patients using this new computer imaging, which can demonstrate the changes I would suggest for the changes we would make during the surgery. Using this technology, 4-D images can be obtained in short time, which I then manipulate to give an educated estimate of what might a patients breasts will look like after breast augmentation surgery. This system also allows for more flexibility in the choice of breast implant, which helps to create a more personalized result. “

Though this technology is not a guarantee or warranty of the proposed surgical result, it does help to provide the patient and the surgeon with a visual communication aid. This is important because it allows the patient to give the doctor feedback and allows the surgeon an opportunity to convey to the patient the limitations of what can be done, as well as the possible results. It is very important for the patient to visualize how she will look with the breasts she desires, and this system becomes an educational tool in with which the patient can view the result third-party, rather than just listening to the surgeon visualizing the results while standing in front of a mirror with a breast implant held up to her body.

When excess skin and wrinkles are present around the lower eyelid, the cosmetic surgeon may choose to use and external incision approach. With this, the incision is made just beneath the lower eyelashes. This is easily camouflaged during the healing process. Through this lower eyelid incision excess muscle and skin, and even fat may be removed. The incision will then be closed with sutures that will be removed about a week after surgery. Swelling and bruising are slightly more common with lower eyelid surgery, however the problems will typically resolve within a week. Regular activities may be resumed within one to two weeks.

When a cosmetic surgeon performs a lower blepharoplasty, patients are offered a gentle intravenous sedation from their anesthetist. This surgery is capable, however, of being comfortably performed with only the use of a local anesthetic. For any patient who has fat bags under their lower eyelids that are prominent and only have a small amount of excess skin or muscle, the blepharoplasty can be performed with no external sutures. Instead, an incision will be placed on the inner side of the lower eyelid and extra fat will be carefully removed. There are no sutures required for this approach, and patients are asked to use a topical eye drop for a week after to aid in the healing process.

The unique circumstances of each patient help to determine the best option for the method of reconstruction that can be used. The goals of breast reconstruction surgery are to re-create a breast which matches the opposite breast, or in bilateral cases, to reconstruct two breasts of a patient’s desired size. The nipple and areola (the pigmented area surrounding the nipple) are also reconstructed. It is ideal to consult with a plastic surgeon prior to mastectomy. This allows the plastic surgeon to plan the treatment that is best suited for the patient, even if the patient decides to wait to have reconstructive surgery at a later date.

Immediate breast reconstruction occurs when reconstruction is performed at the time of mastectomy. Immediate reconstruction has the advantage of usually saving the patient at least one subsequent operation, and has been shown to have a significant psychological benefit, as the patient never has to experience the total loss of a breast. All of the reconstruction options listed below can be performed at the time of mastectomy.

Delayed breast reconstruction is done at a later time. For some women, this may be advised, especially if radiation to the chest area is needed after the mastectomy. Delayed reconstruction is appropriate for these women because radiation therapy following breast reconstruction can increase complications after reconstructive surgery.