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Breast Augmentation Recovery – Breast Implants Dallas – Board Certified Plastic Surgeon – Sam Jejurikar, MD – Dallas Plastic Surgery Institute

Tag Archives: Plano plastic surgery

Breast augmentation is an intensely gratifying procedure for patients, as they see immediate results after the procedure.  Like any surgical procedure, though, patients need to allow some time for recovery.

Recovery is variable from patient to patient. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week.  After a week, most patients have mild fatigue and soreness, but no other significant symptoms.

Surgeons vary in the amount of time they restrict their patients from exercising postoperatively.  I ask my patients to refrain from all vigorous exercise for 2 weeks postoperatively and from all upper body exercises for 4 weeks.  Patients don’t always want to comply with this, as they feel relatively normal well before their postoperative restrictions are lifted.

Scars from breast augmentation incisions will begin to fade in a few weeks and will continue to fade for months or years.

Awake Liposuction

Wide-awake liposuction is one of the newest trends in body sculpting surgery.  Dr. Jejurikar can perform liposuction on selected areas of the body without his patients needing general anesthesia. Not only does this lower the costs, but it avoids some of the side effects traditionally associated with general anesthetic agents.  The procedure is performed at EpiCentre Park Lane (Dallas) as well as at EpiCentre Legacy (Plano).

Technique

Dr. Jejurikar utilizes vibroliposuction for wide awake liposuction. In this system, which was invented in Beligum and is now used extensively in Europe, Asia and South America, the liposuction cannula is activated by air pressure, producing a complex movement of the tip. The complex cannula movement allows local anesthetic to infiltrate more evenly in the patient’s fatty tissue, creating less patient discomfort. In addition, the cannula movement causes emulsification of the patient’s fat, allowing for quicker and more uniform fat removal.  In addition, this technique promotes much less post-procedure swelling and bruising.

Recovery and Results

After wide-awake liposuction, patients may experience mild swelling, bruising and discomfort in the treated area. Compression garments or elastic bandages may be used to help reduce these symptoms while the area heals. Patients usually can return to work in one or two days. Exercise and other strenuous activities should be avoided for two weeks.

Call 214-827-2814 to arrange a comprehensive consultation for body contouring surgery

In the current health care climate of diminishing reimbursements, more and more physicians are performing cosmetic surgery treatments and procedures.  Unfortunately, many of these physicians are not plastic surgeons and have not undergone the same rigorous training as board-certified plastic surgeons.  All patients should take certain steps prior to scheduling a consultation to ensure that their physician has the highest qualifications to perform cosmetic surgery.
  • Ask if the doctor is a member of the American Society of Plastic Surgeons (ASPS).  Membership in the ASPS ensures that the doctor is certified by the American Board of Plastic Surgery and meets requirements for ongoing continuing medical education.
  • Confirm that the doctor is certified by the American Board of Plastic Surgery.  Merely hearing that a doctor is board certified does not indicate which board has certified that doctor.  There is only one board, the American Board of Plastic Surgery, that is recognized by the American Board of Medical Specialties to certify surgeons in the field of plastic surgery.
  • Find out more about the surgeon’s specific hospital privileges.  Although some procedures are commonly performed in an office or ambulatory surgical center, it is important to learn whether the surgeon has the same privileges in an accredited hospital.  Hospital credentialing committees carefully evaluate a surgeon’s training and competency for specific procedures.  If a surgeon performs a procedure in an office or surgical center, but does not have privileges to perform the same procedure in a hospital, it may be because he was deemed unqualified to perform that procedure.

Taking these steps before scheduling a consultation with a cosmetic surgeon will ensure that you find a plastic surgeon with the highest qualifications.

Many of my patients ask how I choose the optimal size for a breast implant. Some women are very concerned about choosing too large of an implant, as they know this can make their breasts look unnatural. Other women are afraid that they won’t choose a large enough implant to see a discernible difference. There are a variety of tools that I use to help my patients select the best breast implant size:

  • Photos. Having patients bring photos of breasts they like and breasts they detest help me determine their goals. Some women desire subtle enhancement and others desire much more dramatic enlargement.
  • Measurements. The chest wall diameter, breast width and height are all important factors in selecting an appropriate implant. The breast skin envelope is only so large; selecting an implant that is too large invariably means that implant will sit too high, too low, or too lateral.
  • Trial sizing. Although it is inexact, having patients try different implants in a bra in the office is a useful exercise. It gives them a crude idea of breast size and shape in clothing and often helps them verbalize their goals.
  • Conversation. Different implants have vastly different shapes and profiles. It’s important that patients understand how this differs in appearance from other types of implants, and that can only conveyed adequately in the preoperative consultation.
  • Intraoperative sizing. I will often utilize intraoperative trial implants and always sit the patient up during surgery to ensure that the breasts have a pleasing appearance.  This is particularly the case for patients with breast asymmetry, to ensure that the final implants utilized provide the greatest possible symmetry.
All of these tools play a valuable role in choosing the best possible implant size.

In the past couple of weeks, I’ve had some patients engage me in conversations about breast implant profiles.  They had seen pictures on the Internet of patients with breast augmentation results they liked and wanted the same style implants as in the pictures.  These patients had a limited understanding as to what breast implant profile refers, prompting this blog entry.

The naming for implant profiles predominantly refers to smooth, round implants, which are the most common type of implants used for cosmetic breast augmentation.  The two major breast implant manufactures have different names for their implants.  Allergan refers to its saline implants as low, moderate, and high profile and its silicone implants as moderate, midrange and high profile.  Mentor has similar names, but also has a moderate profile plus implant, which is between its moderate and high profile implants.

The profile of an implant equates to the projection of that implant.  For a given volume, the higher the profile, the fatter and narrower an implant is.  As a result, higher profile implants tend to provide more fullness and a rounder appearance to the upper portions of the breast.  Higher profile implants tend to be really useful in women with relatively narrow breasts who want significant enlargement of the breasts; in these women, if a low or moderate profile implant were selected, to achieve the desired volume may entail the implant riding into the underarm region.  In contrast, a patient with a wider build or wider breasts may find that high profile implants may fail to adequately fill their entire breast; they often times benefit from implants with lesser projection.  Higher profile implants also tend to be useful in women who desire a small breast lift without the incisions associated with a formal lift.

Almost no patients choose low profile implants for aesthetic breast augmentation; the limited amount of projection provided with these implants does not coincide with their aesthetic goals.  Generally speaking, women looking to maximize their cleavage and perkiness often times opt for high profile implants.  Ultimately, though, the best implant profile for a patient can only be determined after a careful examination by a board certified plastic surgeon, taking into account the specifics of a patient’s breast anatomy, as well as their desired appearance.

Treatments with injectable fillers, such as Juvederm, Restylane, Radiesse, and Evolence, not to mention others, can restore a youthful appearance to the lips, nasolabial folds, marionette lines, midface, jowls and lower eyelids, with minimal to no downtime.  Many patients avoid these treatments, though, because they have heard horror stories from friends or colleagues about the pain associated with these treatments.  Suffice it to say, this needn’t be the case – there are steps your plastic surgeon can take to make these treatments more comfortable.

Recently, BioForm Medical, Inc., makers of Radiesse, received approval from the Food and Drug Administration to mix the filler with lidocaine, an injectable local anesthetic, prior to injection into the skin.  This approval was based on a large study of patients, in which 100% of patients reported feeling less pain when Radiesse was pre-mixed with lidocaine.  Many plastic surgeons, including me, have begun to pre-mix lidocaine with all fillers, including Juvederm, Restylane, and Evolence, not to mention Radiesse, prior to injecting into patients.  The results of treatment are still great, but patients are significantly more comfortable during treatment.

Others things your plastic surgeon can do to make your treatment with injectable fillers more comfortable include:
•    Using topical anesthetic gel for at least 30 minutes prior to commencing any injections.
•    Augmenting treatment with topical anesthetic gel with injections of local anesthetic into nerves above and below the lips.
•    Using small gauge needles and slow injection techniques

Combining all of these treatments can ensure that you’ll not only look fantastic after your treatment with injectable fillers, but you’ll feel pretty good during the treatment too!


<!–[endif]–>Evolence®, a collagen-based injectable filler used for the correction of facial wrinkles and folds, has recently been given permission by the FDA to advertise results lasting 12 months. While relatively new to the United States, Evolence® has been available in Canada and Europe for many years.

The filler uses porcine (pig) collagen to restore a more youthful appearance. This new generation collagen filler is injected into the mid-to-deep layers of the skin for the correction of moderate to deep facial wrinkles and folds, such as nasolabial folds. Results are visible immediately after treatment.

The most common side effects include mild swelling, redness, and pain. A skin test is not required because porcine collagen is the most genetically similar to human collagen.

Evolence® is now clinically proven to last for 12 months! Call 214-827-2814 to learn about our special rates!

This is a news release directly from the American Society for Aesthetic Plastic Surgery

New York, NY (July 16, 2009) – Have you seen the commercial for in-office procedures that will make your face wrinkle-free or sculpt your stomach, with no downtime and no scars?  Lifestyle Lift, Lunchtime Lift, Thread-Tox, and Smart-Lipo, are just a few of the brand-name surgical procedures being marketed to the public as a cosmetic quick fix with a clever name.Brand name surgical procedures generally fit under two categories; first, those that are legitimately assigned the name of the person that has popularized the technique, for example Saldanha’s lipoabdominoplasty or Furnas’conchal setback technique, (either through the efforts of that same person or others assigning his or her name to it) and second, those that are simply created by someone to market a the procedure to the public.  The first situation is usually a very legitimate situation and is often in the scientific literature, but not in the public domain.  However, the second situation has become very popular for cosmetic surgery procedures.  But are highly marketed procedures really the right choice when deciding on aesthetic surgery?

“In the wrong clinical setting, the results may not come close to the promises made in the advertising,” says J. Peter Rubin, MD, a plastic surgeon in Pittsburgh, PA.  “What is really indispensible for the best results, however, is not a specific procedure but the judgment of a board certified plastic surgeon who can match the right patient with the best procedure for them.”

“These named procedures are used by the marketing entity to popularize the technique so that patients ask for it whether it fits their situation or not.  This is a problem that can be very dangerous,” said Dr. Al Aly, a plastic surgeon from Iowa, and a member of the Aesthetic Society’s Body Contouring Committee.  “A procedure is only as good as the hands that perform it.”

“Patient safety and efficacy need to be the top priorities, not commerce or marketing,” says Robert Singer, MD a plastic surgeon from La Jolla, CA and a past-president of ASAPS.  If you decide a procedure is right for you, make sure you have done your homework, that the procedure has been fully explained, you know exactly who will be performing your procedure and that they are qualified to perform the exact procedure you are undergoing, and that you have thoroughly read and signed informed consent documents.

Facial surgery and body sculpting procedures are often marketed to the public with brand names.   “One does not have to be a plastic surgeon to know intuitively that one facelift technique will not be appropriate for all individuals undergoing a facelift,” says Sherrell Aston, MD, past-president of the ASAPS and member of the Society’s Facial Surgery Committee.  “The human anatomy and the aging process vary significantly from person to person. The so-called minimally invasive surgical procedures have gained popularity in all surgical specialties. For many procedures the work that is performed through the small incisions is rather extensive, and requires significant expertise on the part of the surgeon. A short incision facelift can give an excellent result, when properly performed for the appropriate patient.”

“The issue of untrained or inadequately trained practitioners, some of whom are not medical doctors, performing cosmetic plastic surgery is an extremely serious patient safety concern,” says Salt Lake City, UT plastic surgeon and president of the American Society for Aesthetic Plastic Surgery (ASAPS), Renato Saltz, MD. “For ultimate patient safety it is essential that the media and the general public be better educated about what constitutes appropriate training to perform operations such as facelifts, rhinoplasty, liposuction, abdominoplasty, breast surgery and cosmetic eyelid surgery.”   The demanding residency program that all plastic surgeons must complete before they can be considered for certification by the American Board of Plastic Surgery (ABPS) ensures that they not only acquire general surgical knowledge and experience but, additionally, that they master the principles, ethics and practice of plastic surgery.

Source: The American Society for Aesthetic Plastic Surgery

http://www.surgery.org/press/news-release.php?iid=531

Dysport is the first competitor to Botox  in the U.S., but has been used in Europe in for several years.  These products seem relatively similar; a great analogy is Coke versus Pepsi. Competition can only be a good thing for pricing, though, and  that should become evident over the next couple of years, as more products are released.

That being said, the major differences between Dysport and Botox seem to be the following:

1) A faster onset of effects is noted with Dysport in some patients.  Whereas Botox may take 3-7 days to take effect, some patients who receive Dysport see results in a day.

2) Some studies indicate a slightly longer duration of effect, but not all of them.  Clinical experience in the U.S. over the next several months will help guide consensus on this.

3) The dosing for Botox and Dysport is different.  A Botox unit is not equivalent to a Dysport unit.  The converision is approximately 2.5 Dysport units to 1 Botox unit, but there is some variation between the upper and lower face, as well as variations based on the patient’s facial muscle mass.

A recently published study showed Dysport is highly effective in women, as well as highly effective and longer lasting in African Americans.  It also demonstrated that Dysport was highly effective in patients who previously had a good response to Botox.Right now is a great time to try Dysport – our office is offering $50 off your initial treatment.  If you’ve had a good response to Botox in the past, or have simply wanted to try it, the time may be right to try Dysport.

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9101 N. Central Expwy.
Suite 600, Dallas, TX 75231
Tel: 214.827.2814
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