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    Breasts Before Baby?

    Breasts Before Baby?

    It has become more common for women to wait until later in life before beginning a family. With higher education and embarking on promising careers, women in their 20’s and 30’s are becoming more financially stable, making cosmetic surgery a more feasible option. One of the most common sought after procedures today is breast augmentation. But the burning question still lingers: “Should I have a breast augmentation before I have a child and breastfeed?”

    So, when exactly is the “right time” to have breast augmentation?

    The good news is, breast implants in no way interfere with your ability to get pregnant or breast feed.  We do know, however, that with pregnancy your breasts do undergo changes. From the hormones, weight gain, and milk production, pregnancy and breastfeeding affects each woman differently. Some women have tremendous changes in breast shape and size, and some have almost none.  Post pregnancy, some women will lose most of their breast volume after breastfeeding, others will develop loose skin, while still others may maintain a larger breast volume post pregnancy.  It is impossible to predict beforehand how much your breasts will change. And it is equally impossible to know how much they will be able to return to their pre-pregnancy state.

    When choosing to pursue surgery, timing is everything. If you’re planning to start a family in the short months following your augmentation, it may be wiser to wait! It would be a pity for you to spend the time and money to achieve the perfect results, only to have them change with pregnancy.  There is no guarantee they will return to your post operative results. That being said, you certainly aren’t required to wait if you don’t want to wait. Should you opt to have your augmentation and after your pregnancy you are left with sagging skin, a breast lift is always a reasonable solution to get your perky breasts back.

    If, on the other hand, you have no immediate plans for starting a family then surgery can be a great option! It is widely agreed upon that safety is not a deterring issue when having a breast augmentation before a family.

    The most important thing you can do when considering breast augmentation is finding a board certified plastic surgeon and having an open discussion about your goals and future plans. Your surgeon can help guide you in determining what timing is just right for you and your needs.  Be sure to give yourself plenty of time to enjoy your results before going through all the changes associated with pregnancy.

    How Much Fat Can Be Safely Removed During Liposuction

    One of the most common plastic surgery procedures performed in the United States is liposuction; in fact, according to official statistics published by the American Society of Plastic Surgeons, it was the third most commonly performed procedure performed in 2014, just behind breast augmentation and nose reshaping. Patients are frequently pushing their plastic surgeons to remove as much fat as possible; their surgeons often times must limit the amount of fat removed secondary to safety concerns,

    So how much fat can your plastic surgeon safely remove during liposuction? For years, surgeons have been following guidelines set forth by the American Society of Plastic Surgeons. In these guidelines, the maximum extraction limit of fat is 5000 mL, which roughly correlates to 11 pounds of fat. These guidelines have applied to all patients, regardless of their weight or body mass index.

    These guidelines, which are widely followed and the basis for liposuction laws in some states, have no real data backing them up them. With that in mind, researchers last month (September 2016) published in the journal Plastic and Reconstructive Surgery an innovative study looking at approximately 4500 patients, all of who underwent liposuction.

    The findings were very important. First of all, none of the patients died following liposuction and the total complication rate was less than 1.5 percent. Second, virtually all of the complications that did occur were considered to be minor in nature.

    Keeping all of that in mind, the plastic surgeons performing the study utilized a sliding scale approach to liposuction. Patients that were obese underwent greater amounts of fat extraction then those that were skinny. The researchers found that those patients with a higher body mass index were better able to tolerate large-scale fat removal (> 5000 mL) compared to those with a lower body mass index. Although they were careful not to advocate large volume liposuction for all obese patients, the researchers concluded that each individual patient’s risk factors must be looked at closely prior to determining the optimal amount of fat to remove.

    It is important to keep in mind that the researchers performing the study were qualified, board-certified plastic surgeons. In their hands, the complication risks with liposuction were quite low. That being said, severse complications can occur with liposuction, including blood clots going to the lungs, possible puncture of internal organs, and infections. To minimize the risks of liposuction, it is important that you seek a qualified provider, preferably a surgeon certified by the American Board of Plastic Surgeons.

    To learn more about liposuction, contact the office of Dallas plastic surgeon Dr. Sam Jejurikar at 214-827-2814.

    Popular Plastic Surgery Procedures for Men

    Very frequently I get asked by male patients in my practice whether or not it’s common for other men to have plastic surgery procedures. These men are usually very sheepish when asking this question, thinking that they are alone in their desire to get cosmetic enhancements. The truth is, they are far from alone! Men make up a significant portion of the global cosmetic surgery market and entire plastic surgery practices exist that cater only to providing services for men.

    So what are the most common procedures that men are seeking? In my practice, I can break it down to four discrete procedures:

    • Liposuction
    • Botox
    • Neck lift and eyelid surgery
    • Kybella

    Liposuction, far and away, is the most common procedure sought by male patients in my practice. Most common areas that men look to have corrected are the abdomen, flanks and upper chest. Most of the men that have liposuction use surgery as an adjunct to a fairly regimented workout routine. These are not obese patients looking for shortcuts; these are healthy, fit men looking to get rid of problem areas that they have been unsuccessful in correcting with exercise alone. I will commonly utilize ultrasound assisted liposuction (Vaser, Lysonix) to achieve a degree of skin tightening and to help melt the fat and fibrous tissue prior to suctioning it out.

    Botox (onabotulinumtoxinA) and Dysport (abobotulinumtoxinA) are injectable agents designed to eliminate wrinkles associated with facial animation. Most common areas treated are transverse forehead lines, vertical lines located between the eyebrows (“the 11s), and crows feet. These treatments give patients a more youthful and more refreshed appearance. Botox and Dysport injections can be performed in the office with virtually no downtime, helping to explain the immense popularity of these procedures. Treatments need to be repeated every 3 to 4 months to maintain a youthful appearance.

    Older professional men looking to maintain a competitive advantage in the workplace often come to the office to learn about facial cosmetic surgery. They are concerned about looking overly feminine or dramatically altering their appearances. These men tend to want to avoid having facelifts or browlifts, but want to look more youthful. In these patients, we will commonly perform necklifts to eliminate saggy skin of the neck and to improve jowls, without giving the patients overly high cheekbones. Eyelid lift (blepharoplasty) is commonly performed at the same time to eliminate a tired or angry appearance. Because bruising and swelling can be significant in men, patients tend to combine these procedures and usually allow themselves two weeks out of the public eye.

    The last procedure, which is rapidly gaining popularity, is Kybella. Kybella is derived from deoxycholic acid, or bile acid, and is used to eliminate troublesome fat of the neck. It has been cleared by the FDA and has been shown to have tremendous benefit without having surgery. Patients usually need at least two treatments, ideally spaced 4 to 6 weeks apart. Although the neck can feel numb and rubbery for a few weeks, patients generally look relatively normal within a couple of days of treatment. As a result, they can schedule the procedure at their convenience without taking time off from work. Not surprisingly, a large number of men are flocking towards this treatment.

    If you’re a man (or woman!) wanting to learn more about cosmetic surgery, please do not hesitate to contact our office at 214-827-2814.

    Be Smart When Choosing to have Plastic Surgery

    All too often we’re hearing about people becoming the victims of botched cosmetic surgeries performed by unlicensed and unauthorized criminals.  So why aren’t some people taking better care of their health and safety by doing their due diligence in finding an experienced, board certified plastic surgeon to operate on them in a safe and clean environment?

    It really doesn’t take that much time and effort to be certain that you’re putting your life in the right hands when choosing to have any type of plastic surgery procedure.  The key things to look for in a plastic surgeon when you’re choosing to have surgery are: experience, knowledge and quality of training, facility accreditation, and where the plastic surgeon has hospital privileges.

    Experienced plastic surgeons regularly perform a variety of cosmetic procedures, and potential patients should feel comfortable inquiring about the surgeon’s expertise of a particular procedure.  The initial consultation is the ideal opportunity for the plastic surgeon and patient to discuss the goals and realistic expectations of the surgery in question, as well as the recovery period and potential risks involved with the surgery.  Expect to see your plastic surgeon multiple times after having surgery in order for your surgeon to monitor your progress and results.  Your plastic surgeon should also be able to discuss his policies in case there is any need for surgical revisions following your initial procedure.

    Seeking a board certified plastic surgeon ensures that the surgeon has completed several extra years of work in plastic surgery and maintains the Boards high standards of ethical and safe practices.  The American Board of Plastic Surgery is the only Board that is recognized by the American Board of Medical Specialties that certifies surgeons in the specialty of plastic surgery.  It is also a good sign that you’re in excellent hands if your surgeon has been invited to become a member of the American Society of Aesthetic Plastic Surgeons.  The membership to this group is by invitation only and confirms that in addition to being board certified, the surgeon has substantial experience in cosmetic surgery.

    Your surgery should be performed by your plastic surgeon in an accredited, Medicare-certified or state licensed surgery center or hospital, along with certified and licensed anesthesiologists and nurses.  Hospital and surgery center review committees assess the surgeon’s training and experience regarding the specific procedures he’s requesting privileges for before authorizing the surgeon’s hospital or surgery center affiliation.

    Regardless of the cosmetic procedure you wish to have, your health and safety should always be your number one priority.  Take the time to choose an experienced plastic surgeon to help you achieve your cosmetic goals.  The constant care you’ll receive from your surgeon, the office staff, and your results will make you happy you did!

    If you are interested in scheduling a plastic surgery consultation with board certified plastic surgeon, Dr. Jejurikar, please contact his office at (214) 827-2814.

     

    Breasts Need a Lift?

    In today’s world of easily accessible plastic surgery procedures, there is a plethora of cosmetic surgery solutions available for our ever changing and aging bodies.  If you don’t like a physical trait and want to tweak it with a little nip and tuck, there are plenty of highly skilled plastic surgeons available to treat you.

    All women experience some type of change to their breasts over time.  A woman’s breasts will start to sag and lose shape and volume due to childbirth and breast-feeding, weight loss or aging.  The best permanent solution for your sagging breasts is not a temporary lift from your bra, but rather a breast lift procedure, or mastopexy, from a board certified plastic surgeon.  Having breast lift surgery can restore the youthful perkiness to your breasts and may improve your self-confidence.  Some women even opt to have breast augmentation done in conjunction with the breast lift procedure.  By combining these two surgeries, the breasts will be lifted and volume will be added to the upper poles of the breasts to create a more youthful breast shape.  Your plastic surgeon will discuss what the best surgical solution is for your breast revitalization goals.

    The breast lift procedure typically takes two to three hours to complete, with or without combination with breast augmentation.  The surgeon preforms the surgery while the patient is under general anesthesia.  Patients and plastic surgeons alike have a strong aversion to scars, so the breast lift incisions are created in locations on the breasts that will minimize scar visibility.  Scar treatment options will likely be discussed prior to having surgery and when you’re able to start treating them post-operatively.  As with any surgery, you can expect to feel fatigued and sore for a few days after your procedure.  You should be feeling well enough to be able to return to work after the first week.

    The ideal candidates for undergoing breast lift surgery are women who are in overall good health, are no longer breast feeding, at a stable weight and don’t smoke.  If you are someone who smokes, it is imperative to have a plan in place to quit smoking prior to surgery in order to ensure reduced risk of post-operative healing complications and optimal results.

    Women who have flat and elongated sagging breasts that have lost their shape and fullness will greatly benefit from having a breast lift procedure.  They will enjoy a more youthful shape and appearance to the breasts along with better fitting clothes and a renewed self-confidence.

    If you would like to schedule a consultation to learn more about breast lift surgery or breast lift surgery in combination with breast augmentation call the office of Dr. Jejurikar at (214) 827-2814

    Allergan introduces new, fuller fill Inspira Silicone Gel Implants

    Breast lovers and those seeking breast augmentation can rejoice once again!  Thankfully, there are already plenty of options available to choose from when it comes to picking out the perfect breast implants for your upcoming breast augmentation surgery.  The U.S. Food and Drug Administration (FDA) has recently approved yet another silicone breast implant option.  Allergan Natrelle’s®new silicone-filled breast implant, Natrelle INSPIRA™ has been FDA approved and is now on the market and available to the American public.

    These new silicone gel implants have been specifically designed by Allergan to offer patients choosing to undergo breast augmentation, revision or reconstructive surgery an additional breast shaping option.  The Natrelle INSPIRA™ smooth, round silicone-filled breast implant is different from the other breast implants available on the market due to its higher silicone gel fill ratio.  This increased volume of silicone gel filled into the implant provides additional upper-pole fullness to the breasts as well as a soft, natural feel of the breasts.

    The new Natrelle INSPIRA™round gel-filled smooth breast implants are filled with the same FDA approved silicone gel that Allergan Natrelle® has been using in its breast implants for the past decade, and the silicone shell is made the same way as well.  The new implant on the block is also a great revision option for women to consider who are in need of replacing their aging silicone or saline breast implants.

    Natrelle INSPIRA™round silicone-filled smooth breast implants are available in 5 different projection styles, and 200 size options to ensure a customized fit and optimal results for each individual patient.  Knowing which breast implant is the right style and size for you can be difficult with so many breast implant choices available to choose from.  An experienced board certified plastic surgeon will help you determine the appropriate projection style and implant size during your breast augmentation consultation.

    Whether you have lost fullness of your breasts due to pregnancy, breast-feeding, weight loss or age, breast augmentation with the new Natrelle INSPIRA™ can restore the youthful volume and fullness you long for.

    As part of the roll out of these new implants, Allergan has introduced a limited time promotion. If you seek breast augmentation from a qualified provider, Allergan will provide you with a free facial treatment, either a one month supply of Latisse or one treatment with Botox.

    If you desire a new silhouette with the help of breast augmentation, or would like to upgrade your current breast implants, please call the office of Dr. Sam Jejurikar at (214) 827-2814 to schedule your consultation.  Let the newly U.S FDA approved Natrelle INSPIRA™silicone gel-filled breast implants inspire you!

     

    Fill me up!

    In this day and age, the idea of being able to assume the real age of women, and men, by looking at their hands doesn’t necessarily apply anymore.  More options are available today than ever before for people seeking treatment for aging hands that are starting to show sunspots and lose volume.

    Medical-grade products that reduce the appearance of sunspots are widely available in specialized doctor’s offices and medical spas.  Laser treatments by your plastic surgeon are also definite go-to’s to that help turn back the hands of time.

    Now, there’s a long awaited addition to the types of non-surgical treatments available to improve the look of your hands.  Radiesse has finally been approved by the FDA as the first injectable filler for hands.  You may already be familiar with Radiesse as a filler used for your face, but this injectable is now officially able to work double duty for the face and back of the hands.  The milky, opaque substance is ideal for concealing veins and restoring lost volume to the hands.  The benefits of just one treatment can last for up to two years!

    If your hands boast the appearance of a teenager’s, then there are certainly other types of fillers available to plump your lips, volumize and lift your cheeks, and fill the creases around your mouth.

    Radiesse is used to plump lips, smooth moderate to severe facial lines around the lower nose and mouth, known as nasolabial folds, decrease frown lines, enhance the cheeks, and aids in facial contouring.  Radiesse also stimulates collagen production in the areas of injection.  It typically lasts 1-2 years and is made of calcium hydroxyl-lapatitie, which is a synthetic form of material that is founds in our bones and teeth.

    Restylane Silk is a hyaluronic acid-based filler that adds volume to the lips and fills and corrects the lines on the upper lip.

    Juvederm and Juvederm Voluma are dermal fillers that offer long-lasting results as well.  Juvederm is commonly used to treat facial lines and plump the lips.  Both Juvederm and Voluma lift and add volume to the cheeks.  Voluma has been specifically made to treat the cheek area.  Since both of these products are a gel, they offer a more natural look and feel to the skin once they’ve been injected.  The results of Juvederm and Voluma last for one year or more.  Patients and their doctor can determine which formula is right for them based on the desired results.

    If you’re interested in learning more about how fillers can enhance your appearance, please call the office of Dr. Jejurikar at (214) 827-2814 to schedule your appointment today!

    Kybella and other forms of neck rejuvenation

    There is great news for everyone suffering from the tormentor we call the “double chin!”  The Food and Drug Administration has recently approved KYBELLA™ injection for the reduction of the stubborn fat that settles in the upper neck just under the chin.  KYBELLA™ is the first of its kind and will likely become a superstar in it’s own right; perhaps becoming as popular as BOTOX® and facial fillers.

    KYBELLA™ is manufactured by California based Kythera Biopharmaceuticals Inc. and is indicated for the improvement in the appearance of moderate to severe fat of the neck below the chin, which is known as submental fat.  One of the wonderful things about this new product is that the active ingredient, deoxycholic acid, is identical to the deoxycholic acid our bodies already produce!  This ingredient dissolves the problematic fat under the chin while enabling your plastic surgeon to reshape and contour the area.

    The injection is made directly into the fatty tissue of the neck, not into the skin.  Treatment only takes around 15 minutes and patients may require up to six visits, no less than one month apart, in order for the desired result to be achieved.  Unfortunately, not everyone is a good candidate for this type of treatment.  Patients that have excess fat under their chin as well as loose skin of the neck will indeed have more loose skin once the neck fat has been reduced with KYBELLA™ injections and may require a neck lift.  An experienced board certified plastic surgeon will help you determine if KYBELLA™ is the best option for you.

    Another type of treatment for one of our most visible areas is liposuction of the chin, neck and jowls.  Liposuction of this area removes excess fat to slim and create a more youthful appearance.  Stubborn neck fat rarely disappears by exercising and dieting; the fat collection under the chin isn’t metabolized as easily as fat in other areas of the body.  It’s very similar to issues some people have with losing localized fat deposits in their hips, tummy or arms.

    Again, the quality of the skin on the neck is an important factor in achieving maximum results with liposuction.  If the skin sags and lacks elasticity, it will not contract after the fat has been taken out.  This creates a whole other issue and adding a neck lift will be necessary to obtain the optimal look.

    A neck lift is the most common treatment for patients that have neck cords and sagging skin caused by severe weight loss or age, as well as fat accumulation in the neck.  This procedure combines liposuction to remove excess fat along with surgical tightening and trimming of the loose, sagging skin of the neck and jowls.  The vertical platysma muscle banding is also thinned to improve the appearance of neck cords.  Having a neck lift procedure can make a world of difference to your appearance and self-confidence!

     

    Resting Bitchface Syndrome? Help is on the way!

    Earlier this week, a patient in her thirties came into the office complaining of “resting bitch face”. When I reported that I had never heard of this particular affliction, she gave me a shocked (and somewhat bitchy) look. After I did a little research, I found out that this a well-described phenomenon.

    From the Urban Dictionary : a person, usually a girl, who naturally looks mean when her face is expressionless, without meaning to. Nah, she’s just got a resting bitch face, she’s actually really sweet.

    Turns out there’s even a facebook support community dedicated to “patients” with resting bitchface syndrome.

    So what facial characteristics may cause others to think you’re mad or tired, even when you’re not? The particular patient who introduced “resting bitchface syndrome” to me had thin lips with prominent, downward corners (marionette lines), which she thought made her look more stern, unfriendly and unapproachable. She also had deep lines between her eyebrows and softer lines across the forehead, which she thought made her look angry. Finally, she had low, relatively flat eyebrows; she said other people always ask her if she’s tired.

    Obviously, it’s important not to let others’ perceptions of our moods actually cause us to have that mood. That being said, it’s hard not to get annoyed or upset when other people are constantly asking us what’s wrong. We came up with a relatively simple solution to treat this patient’s resting bitch face. To improve her thin lips and marionette lines, we used a facial filler made from hyaluronic acid. In my practice, I most commonly use either Restylane or Juvederm for this purpose, the results from both of which last for about one year. This had the effect of plumping her lips and eliminating the deep depression around the corners of her mouth, making her look friendlier and more approachable. To treat her forehead and brow wrinkles, as well as to raise the eyebrows, we used Botox. Botox paralyzes the muscles that cause these facial wrinkles, as well as the muscles that hold the eyebrows in a flat and low position. This simple maneuver made her look more alert and refreshed.

    For older patients suffering from resting bitch face syndrome, surgical solutions may also be appropriate. For patients who look tired, upper and lower eyelid blepharoplasty (eyelid lift) may be appropriate to eliminate excess skin and troublesome “bags” above and below the eyes. Many of these same patients may benefit from facelift, neck lift, brow lift, laser treatments and fat grafting to rejuvenate the face by eliminating jowls, raising the eye brows, treating neck cords and eliminating fine lines and marionette lines.

    Ultimately, there’s no single facial characteristic that makes you prone to having resting bitchface syndrome. That being said, if people constantly ask you if you’re tired or angry, even when you’re not, you may be suffering from it. To learn more about potential treatments, contact our office at 214-827-2814 to set up a consultation!

    A Brief History of Silicone Breast Implants and an Update on their safety

    If you just so happen to be interested in making your breasts larger or are only looking to replace the fullness you’ve lost over time, you’ll be reassured to know that silicone and saline breast implants are some of the most studied medical devices that are used in the United States.

    Americans have always loved the look of full, youthful breasts and that won’t change. Thanks to decades of research and stringent FDA guidelines, women are now able to go big or go home with the piece of mind that breast implants are safe. As a result of all this research, we now have a variety of different types of breast implants to choose from that have been approved by the FDA; not including the different profiles, shapes and textures available.  Currently, silicone gel implants are FDA approved and available to women 22 and older; saline filled implants are FDA approved and available for women 18 & older.

    Breast implants have undergone many changes over the years in order to meet the safety guidelines of the FDA, as well as the sophisticated expectations of plastic surgeons and their patients.  You may wonder what the difference is between the silicone gel breast implants made in the past versus the current generation of silicone gel breast implants.

    The first generation of silicone gel breast implants was introduced in the early 1960’s and consisted of a firm gel that was contained in thick shells.  The next generation of gel implants came out in the late 1970’s and featured a more fluid gel contained in thinner shells.  The new implants were received well by patients and plastic surgeons that viewed the previous silicone gel implants as too firm and too visible.

    After years of women undergoing breast augmentation, concerns arose in the mid 1980’s regarding the rupture rate and the safety of these second-generation gel implants.  The controversy over whether or not the type of silicone gel used in these implants caused autoimmune diseases and other health problems led manufacturers to create a third generation of gel breast implants.  The gel and shells of the new implants were slightly thicker than their predecessor, but still just as soft.  Because of safety concerns, the FDA pulled silicone breast implants off the market in 1992. After years of research, the data revealed that these implants did not predispose to autoimmune disease, but did place patients at increased risk of developing capsular contracture (scar tissue build up around the breast). The FDA approved a fourth generation of silicone implants in 2006; long-term data with these implants demonstrated that the safety of these implants is roughly equivalent to saline implants.

    The fourth generation of gel implants are still available today, along with the fifth-generation of “gummy bear” gel implants.  These implants were given the name of the gummy bear candy due to the thick cohesive silicone gel from which they’re made and the thicker shells that encapsulate it.  This newer model is thicker than most other silicone gel implants and is believed to be less likely to rupture or leak.  Over 90% of patients in Dr. Jejurikar’s practice choose these implants. The gummy bear implants result in a natural appearance of the breasts, feel soft – similar to real breast tissue, and have less of a tendency to ripple. Furthermore, seven-year data demonstrates a safety profile that’s better than saline breast implants.

    If you’d like more information on breast augmentation and the different types of implants available, please call Dr. Jejurikar’s office at (214) 827-2814.

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    9101 N. Central Expwy.
    Suite 600, Dallas, TX 75231
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