As a plastic surgeon in Beverly Hills, I have the opportunity to see a wide range of patients throughout Southern California as well as outside of the state (and country). We see patients who travel great distances seeking second and third opinions on certain procedures since there are so many plastic surgeons in Beverly Hills. I enjoy meeting patients from all over the world (we even recently had a patient from New Zealand) and helping them with their plastic surgery concerns. I feel a responsibility to manage patient expectations more carefully since patients come to Beverly Hills seeking and expecting the best level of plastic surgery expertise.
There are four different incisions that can be used for breast augmentations. These incisions are 1. Inframammary 2. Periareolar 3. Transaxillary (armpit) 4. Transumbilical (belly button). The two most common approaches are the inframammary incision, which is in the breast crease and the periareolar, which is near the nipple. The breast implant incision associated with the lowest complication rate is the inframammary incision, as it has the lowest incidence of capsular contracture (scar tissue). This incision also allows for insertion of larger, cohesive gel implants (“gummy bear”). The selection of incision should be based on the patient’s anatomy as well as the surgeon’s experience. I prefer the inframammary appproach to breast augmentation because there is significant data in the plastic surgery literature to support this incision.
Excess male breast tissue, known as gynecomastia, affects about one third of the adult male population. The majority of cases do not have a known or defined cause. Some popular causes of gynecomastia are heavy marijuana use, steroids and certain medications. There are several ways to treat this problem depending on the degree of the gynecomastia. Mild cases can be treated with liposuction alone if there is good skin tone in the chest area without sagging skin. Moderated cases of gynecomastia are treated with a combination of liposuction and direct excision of breast tissue through an incision around the nipple/areola. Severe cases will require removal of breast tissue as well as removal of skin from the chest wall. A thorough history and physical exam by an experienced plastic surgeon is needed to determine the best treatment plan for men with gynecomastia.
The two basic ways to reshape or augment the buttock involve either a fat transfer (Brazilian buttock lift) or buttock implant. Fat transfer allows the use of a patient’s own fat to create a softer, more natural feel to the buttock compared to silicone buttock implants. The fat transfer technique also allows for more sculpting and reshaping of the surrounding areas of the buttock such as the hips and waist. Buttock implants are primarily indicated for very thin patients who are not eligible for a fat transfer procedure. These firm silicone implants tend to look and feel less natural and have higher complication rates compared to a fat transfer. During your consultation your specific anatomy will be evaluated to determine which procedure is best for you. In some cases, patients may have to gain weight prior to surgery to become better candidates for a fat transfer to the buttock.
A breast augmentation can reduce the chances of being able to breast feed in certain patients. There a few things you and your surgeon can do to maximize your ability to breast feed after breast implants. One would be choosing an incision away from the areola and placing the implant under the muscle (submuscular or subpectoral). I always advise patients however if breast feeding is a very high priority for them to consider holding off on breast augmentation until after their pregnancies. That is the only 100% effective way to ensure that you will be able to breast feed.
Many patients wonder whether they should have breast augmentation alone, or if they also need a breast lift at the same time. This is a very common yet complex procedure in plastic surgery. If a woman has no sagging skin with a good nipple position, then a breast augmentation with saline or silicone breast implants is usually sufficient to achieve a fuller look. If a woman has had multiple pregnancies and perhaps has breast fed, then an implant ( to restore volume) and a breast lift (to improve shape) combined may be the best choice. Some women are happy with their size but just want some improvement in their shape; in these cases a breast lift alone can achieve a better, perkier breast contour.
A thorough exam and consultation with a board certified plastic surgeon is the best way to determine which breast procedure(s) is best for your specific anatomy.
There are four incisions that can be used to insert a breast implant for breast augmentation and each has its pros and cons. One of the more popular incisions is located in the breast crease, under the breast, which is called an inframammary incision. This incision is about 4-5cm in length and can be used for both saline and silicone breast implants. This incision allows easy access to place the implants under the pectoral muscle without violating the breast tissue/milk ducts and therefore allows a very high percentage of patients to still breast feed after surgery. This incision also has perhaps the lowest rate of capsular contracture rate (which is hard scar tissue that forms around breast implants). Another common approach to breast implant insertion is the periareolar incision, near the nipple. This incision however does disrupt some of the milk ducts and can interfere with breast feeding. It is also associated with a higher capsular contracture rate as the bacteria in the milk ducts can come into contact with the implant and cause inflammation which may lead to hard scar tissue. A less common incision for breast augmentation is the transaxillary (armpit) incision. This incision is heals fairly well in the armpit skin however the implants have a tendency to look a bit off to the side, since they are inserted from a more lateral (side) approach. Creating the breast implant pocket is more difficult and less precise than the previously mentioned incisions. It is also very difficult to create any look of cleavage via the armpit incision. The final and least popular approach is the transumbilical (bellybutton) incison. Only saline implants can be placed through the bellybutton (not silicone). If the implants rupture or need revision, you can not exchange the implants through the bellybutton approach. The final decision as to which incision is best for a breast augmentation depends upon each patient’s anatomy and their specific desires. This should be addressed in detail during the consultation visit.
A lot of my patients ask me if buttock augmentation using fat (Brazilian buttock lift) is a permanent way to increase the size of their buttocks. The answer is yes. Once the fat is injected deep into the gluteal muscles and tissue, the majority of the fat cells will develop their new blood supply and survive. However approximately one-third of the fat cells will not survive and shrink over the first few months following a fat transfer procedure. Therefore, since we end up losing about 30-40% of the fat, it’s important to over-correct at the time of the buttock augmentation surgery. This means that some patients will occasionally need to gain some weight prior to surgery to ensure a good result. It’s also very important not to sit or sleep on the buttock for the first few weeks following a fat transfer procedure. After a buttock augmentation procedure, it takes about three months before we know for certain how much of the fat has survived. Once a patient reaches the three month period after a Brazilian buttock lift, whatever fat they have in the buttock is permanent. If they decide to lose some weight, the fat in the buttock can decrease, but so will the fat in the rest of their body (arms, legs, etc.). Also if a patient gains weight after a buttock augmentation surgery, the buttock size will increase as well.
Buttock augmentation can be performed in one of two ways: gluteal implants or fat transfer to the buttock. Fat transfer to the buttock, also known as Brazilian buttock lift, is by far the most popular and more natural technique. I have been performing this procedure for over six years now in the Los Angeles area and patients seem to be quite happy with the results. Basically, the procedure involves liposuction of a number of areas (usually the abdomen, love handles, back and thighs) then transferring or injecting that fat into the buttock for augmentation. The Brazilian buttock lift is a great way to not only enhance the buttock, but also to reshape the hips, waist and lower back as well. Most women benefit from this gluteal reshaping as well as the increase in size of the buttocks. The surgery takes between two and three hours and is performed under general anesthesia (asleep). Most patients will take off about one to two weeks from work to recover. During the recovery from buttock augmentation it’s important to avoid direct sitting, as your body’s weight can injure the newly transferred fat cells in the buttock. It takes a few months to see your final results and allow for the swelling in the buttock area to resolve.
The other less popular option for buttock augmentation involves the insertion of silicone implants under the gluteal muscle. These implants do not feel as soft and natural as fat, but may be the only option available in very thin patients who may otherwise not be candidates for a fat transfer procedure (Brazilian buttock lift). Buttock implants have a higher complication rate and tend to look unnatural compared to a fat transfer procedure.
Living here in Southern California looking good is a big part of our every day lives. Unlike many other regions of the country Southern Californian’s pride themselves on looking good and living a healthy lifestyle.
For many of my patients living a healthy lifestyle and exercising doesn’t correct some of the imperfections that may be bothering them. Sometimes a simple plastic surgery procedure like liposuction can correct an issue that may be bothering a person.
For many that live the healthy lifestyle but just can’t shed those extra pounds around the mid section or other body areas a simple plastic surgery procedure like liposuction or a tummy tuck can help achieve your goals.
Regardless of the reason, nature doesn’t have to win. Liposuction Beverly Hills has become a safe choice for men and women looking to rid themselves of stubborn fat deposits. If you are close to your ideal weight, liposuction can sculpt your body to give you the finishing touches on the look you’ve worked so hard to achieve.
Learn about liposuction surgery
Liposuction is not an alternative to weight loss, nor can it achieve the dramatic results of a tummy tuck (abdominoplasty). You will still have to maintain a healthy diet and exercise. Liposuction is an effective way to contour the body and remove fat deposits that you are having difficulty with losing. Liposuction is sometimes called liposculpture because of its contour-enhancing capabilities.
A popular procedure with both men and women, liposuction is commonly performed on the stomach, hips, or thighs, but can be performed on almost any part of your body plagued by unwanted fat deposits, from your neck to your arms to your ankles. You can view our liposuction before and after photos to see some of our patients results.
Liposuction permanently changes the contours of the treated areas. Your body has a fixed number of fat cells—once removed, your body does not replace them. You can still gain the weight back, but your results may encourage you to maintain your shape with a healthful diet and regular exercise. Now you can let nature work for you instead of against you.
The recovery time for this procedure is reasonable. You can expect a few days of discomfort, which is controlled with medication. Some swelling lasts longer—the final results are visible in two to three months. Our patients tell us that the reasonable period of downtime they experience with liposuction is well worth it.