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    Closed Rhinoplasty for Correction of Prominent Nasal Hump Facial Cosmetic Surgeon, Dr. Sam Jejurikar, with Offices in Dallas and Plano, TX

    Tag Archives: Sam Jejurikar

    Rhinoplasty is one of the most popular cosmetic surgical procedures performed for men and women. One of the most common complaints patients have is of a bump on the top of the nose. This is known as a dorsal hump.

    When the dorsal hump is the only cosmetic concern, closed rhinoplasty can be easily performed to correct this. In this form of rhinoplasty, incisions are made only within the nostrils. This means no visible scars and less postoperative swelling. A fine instrument is used to shave the excess cartilage and bone of the nose, leading to a more pleasing profile and nasal appearance.

    Should you have any questions regarding rhinoplasty or any other facial cosmetic procedure, do not hesitate to contact Dr. Jejurikar at 214-827-2814.

    A commonly asked question during Dallas breast augmentation consultations is whether breast-feeding is affected by the placement of breast implants. The most definitive answer is…maybe….but probably not! The official position of the American Society of Plastic Surgeons is that breast-feeding is not affected by placing silicone breast implants or saline breast implants. There are countless women in the world who have successfully breast fed their babies after breast augmentation.

    There are some important facts to know, though. First, it’s well accepted that certain incisions are more prone to causing nipple and areola (the pigmented skin surrounding the nipple) numbness. The periareolar incision is the most likely to do this. It is reasonable to assume that nipple numbness, although not preventing breast-feeding can impede the mother’s ability to do so. Second, there is debate about whether silicone from implants can leak into breast milk, and if it does, whether it’s harmful to a baby. Despite repeated attempts to prove so, no large studies conclusively demonstrate higher levels of silicone in breast milk of mothers with silicone breast implants, nor do they show a higher incidence of autism, autoimmune disorders, swallowing dysfunction, or other disease.

    So, in a nutshell, it’s more than reasonable for mothers with breast implants to attempt breastfeeding and to feel comfortable that they are not negatively impacting the health of their babies. For more information, or to schedule a consultation, don’t hesitate to contact our office at 214-827-2814.

    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.

    This story is taken from the Wall Street Journal

    A Johnson & Johnson (JNJ) unit has decided to stop making and selling a product called Evolence, used to fill facial lines in cosmetic procedures.

    Ortho Dermatologics, a division of J&J’s Ortho-McNeil-Janssen Pharmaceuticals, has a note on its Web site regarding the withdrawal, which it said was announced on Tuesday. The company confirmed the move in a statement.

    The Evolence halt is part of an effort “to refine strategic priorities and focus investment on other growth opportunities,” Ortho Dermatologics said.

    Many options for future management were explored before this decision was made, the company said. It added that patients and medical professionals can be assured that Evolence “remains effective for the correction of moderate to deep wrinkles and folds with a favorable safety profile.”

    The facial filler gained approval from the U.S. Food and Drug Administration in June 2008, but it has been available in certain international markets since 2004. The U.S. arrival coincided with a rough time in the market for cosmetic medical products, which usually are not covered by insurers and came under pressure due to the recession.

    J&J announced on Tuesday that it plans to lay off as many as 8,200 workers worldwide as part of a plan to save up to $1.7 billion in 2011.

    -By Jon Kamp, Dow Jones Newswires

    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 patients have asked if they can continue smoking up until their cosmetic surgery. The procedures most often in question are breast lifts (with or without implants), breast reductions, tummy tucks, and facelifts. Simply put, smoking and these surgeries can be recipes for disaster. Tobacco, nicotine, and carbon monoxide—key components of cigarettes—are proven to impede wound healing, making the stakes incredibly high for patients who smoke. Let’s delve into the risks and evidence, emphasizing why quitting smoking before surgery is not just advisable but crucial.

    How Smoking Impairs Wound Healing

    Smoking significantly affects the body’s ability to heal wounds. Nicotine constricts blood vessels, reducing blood flow to tissues. Carbon monoxide decreases oxygen levels in the blood, while tobacco’s toxic chemicals damage collagen and elastin, which are essential for skin strength and elasticity. Together, these factors severely impair the body’s capacity to recover after surgery.

    In surgeries that involve lifting and tightening large amounts of skin, such as tummy tucks or facelifts, reduced blood flow can result in serious complications:

    • Skin necrosis: A condition where the skin literally dies due to insufficient blood supply.
    • Delayed wound healing: Prolonged recovery time increases the risk of infection and other complications.
    • Dehiscence: This occurs when a wound reopens after being surgically closed, exposing underlying tissues.
    • Infection: Poor oxygenation compromises the immune response, making smokers more susceptible to post-operative infections.

    High-Risk Procedures for Smokers

    Some cosmetic procedures pose greater risks for smokers due to the extensive skin manipulation involved. Here are examples of surgeries where smoking can have disastrous effects:

    1. Facelifts (Rhytidectomy)

    Facelifts involve tightening the skin and underlying tissues of the face to achieve a more youthful appearance. The skin’s blood supply is already reduced during this procedure due to the surgical lifting of the tissues. Smoking compounds this reduction, greatly increasing the risk of skin necrosis, especially around the incisions near the ears. Smokers are more likely to experience prolonged bruising, hematomas, and suboptimal scarring after facelifts.

    2. Tummy Tucks (Abdominoplasty)

    Tummy tucks involve removing excess skin and tightening abdominal muscles. This procedure disrupts a significant amount of blood supply to the abdominal skin, leaving it reliant on a network of smaller vessels to heal. Smokers face an elevated risk of wound dehiscence, infection, and skin necrosis. In extreme cases, large portions of the abdominal skin can turn black and die, requiring additional surgeries to address.

    3. Breast Lifts and Reductions

    Both breast lifts and reductions involve reshaping and lifting breast tissue while removing excess skin. Smoking dramatically increases the chances of nipple necrosis, where the nipple and surrounding areola lose blood supply and die. This catastrophic outcome often requires further reconstruction surgeries and can leave devastating scars.

    4. Laser Skin Treatments

    Even minimally invasive treatments like laser resurfacing can be affected by smoking. Smoking impairs the skin’s ability to regenerate and heal after laser treatments, leading to prolonged redness, irritation, and subpar results.

    Evidence Supporting the Risks

    Multiple studies have documented the dangers of smoking in surgical patients:

    Procedures Considered Safer for Smokers

    Certain cosmetic procedures are considered somewhat safer for smokers, as they involve less extensive skin manipulation. These include:

    • Rhinoplasty: The reshaping of the nose typically doesn’t require significant skin lifting.
    • Liposuction: While it removes fat, it does not heavily impact the skin’s blood supply.
    • Breast Augmentation: Implant placement involves less disruption to the skin’s vascularity.

    Even so, smokers undergoing these surgeries are still at a higher risk of complications compared to non-smokers. Surgeons often provide strong warnings and disclaimers to ensure patients understand the risks.

    Why Quitting Smoking is Critical

    Because cosmetic surgery is elective, the goal is to minimize all potential risks. Quitting smoking even two to four weeks before surgery can significantly improve outcomes. Here’s how:

    • Improved oxygenation: Increased oxygen levels enhance wound healing and immune function.
    • Better blood flow: Nicotine-free blood vessels are more effective at delivering nutrients and removing waste from tissues.
    • Reduced inflammation: Smoking cessation lowers systemic inflammation, which supports overall recovery.

    Surgeons may also recommend quitting all nicotine products, including vaping and nicotine replacement therapies, as these can have similar effects on blood flow.

    Conclusion: Choose Health Over Habit

    The risks of smoking before cosmetic surgery are too significant to ignore. From facelifts to tummy tucks, the combination of smoking and extensive skin manipulation can lead to devastating complications, including skin necrosis, delayed healing, and infection. For those considering elective procedures, quitting smoking is not merely a recommendation but a vital step to ensure a safer surgery and optimal results.

    If you’re planning cosmetic surgery and currently smoke, talk to your surgeon about strategies to quit. Your health, safety, and aesthetic outcomes depend on it.

    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 worry that they won’t choose a large enough implant to see a discernible difference. To address these concerns, I use a variety of tools and techniques to help my patients select the best breast implant size:

    Photos

    Having patients bring photos of breasts they like and breasts they dislike helps me determine their goals. Visual references are invaluable in understanding each patient’s aesthetic preferences. Some women desire subtle enhancement, while others want a much more dramatic enlargement. By reviewing these photos together, I can better tailor my recommendations to their vision.

    Measurements

    Accurate measurements of the chest wall diameter, breast width, and breast height are crucial. These factors ensure the implant fits the patient’s anatomy. The breast skin envelope has natural limits; selecting an implant that is too large can cause it to sit too high, too low, or too far to the sides, resulting in an unnatural appearance. Taking precise measurements allows us to avoid these pitfalls and achieve balanced, proportionate results.

    Trial Sizing

    In-office trial sizing is a less valuable tool, having being largely replaced by 3D imaging. Although not an exact science, trying on different implants in a bra provides patients with a rough idea of how their new breasts might look in clothing. This exercise often sparks important conversations about their goals and helps patients feel more confident about their choices.

    Conversation

    Every implant has unique characteristics, including shape and profile, which significantly impact the final result. For example, a high-profile implant creates a different appearance compared to a moderate-profile implant, even if they are the same volume. Through open and thorough conversations during the preoperative consultation, I ensure that patients understand these differences and how they align with their desired outcomes.

    3D Imaging with Crisalix

    One of the most exciting advancements in breast augmentation planning is the use of 3D imaging technology like Crisalix. This powerful tool allows patients to visualize their potential results in real time. By uploading images of their body, Crisalix creates a virtual simulation of how different implant sizes and shapes would look on them. This technology takes much of the guesswork out of the decision-making process and provides patients with a clearer idea of their future appearance, helping them feel more confident in their choice. To schedule a 3D breast augmentation consultation using 3D imaging, begin the process by clicking here.

    Intraoperative Sizing

    Even with careful preoperative planning, intraoperative sizing plays a vital role. During surgery, I often use trial implants and sit the patient up to evaluate the breasts from multiple angles. This step is especially important for patients with breast asymmetry, as it allows me to make real-time adjustments to achieve the best possible symmetry and aesthetic result.

    Combining Tools for the Best Outcome

    Each of these tools serves a unique purpose, and together, they provide a comprehensive approach to selecting the optimal breast implant size. My goal is always to create results that are both beautiful and in harmony with the patient’s body. By combining measurements, imaging, trial sizing, and conversation, I can help patients achieve the look they’ve always wanted with confidence.

     

     

    Almost all patients have several questions about the meaning of breast implant profiles.  Patients have 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 profile of the implant has nothing to do with the fill of an implant, with the vast majority of implants placed these days being cohesive silicone gel implants, otherwise known as “gummy bear” implants. The two major breast implant manufactures have different names for their implants.  Allergan refers to its implants as low, low plus, moderate, full and high profile.  Sientra has similar names, but also has a moderate profile plus implant, which is between its moderate and high profile implants. Motiva sticks with the same principles, but gets fancier with its names, referring to the implant profiles in the United States as mini, demi and full. In Europe, they offer an additional profile, Corse, which is the equivalent of an extra high profile implant.

    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.

    In recent years, there has been a notable shift in the preferences of patients seeking breast augmentation, with increasing interest in low-profile and low-profile-plus breast implants. These implants are characterized by a wider base diameter and less projection compared to high-profile implants. This design creates a more natural, subtle enhancement that aligns with the growing trend toward understated aesthetics. Many patients are prioritizing proportionate results that complement their natural body contours rather than opting for the more pronounced, rounder look traditionally associated with higher-profile implants.

    The appeal of low-profile implants is also influenced by their suitability for specific body types. Women with broader chest walls often find that low-profile implants provide a harmonious fit that enhances their shape without looking artificial or out of proportion. Additionally, these implants are often favored by patients who wish to restore volume after pregnancy or weight loss while maintaining a soft, natural slope to the breast. As societal beauty standards continue to evolve, the demand for implants that achieve balanced, subtle results is expected to grow, making low-profile and low-profile-plus implants a significant choice in modern breast augmentation procedures.

     

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

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