As Seen In
RSS Feed

News & Highlights

May 13th, 2014

“Mommy Makeover”

The Problem

Children are awesome, but they can create havoc on a body. Pregnancy can cause weight gain and expansion of the abdominal wall tissue. Breasts enlarge in some women to the point of stretching this skin as well, especially with breast feeding. Even after the  pregnancy is over, many of these changes are irreversible. When skin loses its elasticity, it cannot be restored to normal. Furthermore, the vertical muscles of the abdomen (abdominal recti/ “six pack”) can become separated in the middle by stretching of the tissue that usually  holds them together tightly.

The Solution

Surgery is the usual solution and addresses the problem in a very predictable way in all but rare occasions. Abdominoplasty or “Tummy Tuck” tightens the abdomen by restoring the muscles to their normal position. This procedure also removes the excess stretched skin as well. The result therefore improves contour and skin tone.

The breasts are affected primarily by skin stretching, but can also be accompanied by loss of breast volume as well. This issue is addressed with a skin tightening breast lift. If the patient wants more volume, the breast lift can be accompanied by a breast augmentation. Many times loss of volume is the primary issue. In this instance, breast augmentation alone will suffice to restore the breast to a more youthful and perky appearance.

Potential Side Effects

Unfortunately,  it is impossible to remove significant amounts of skin without scarring. Therefore scars on the abdomen will occur with abdominoplasty, but can be hidden beneath most underwear and bathing suits and bikinis. Breast augmentation scars are minimal and are well hidden. If a breast lift is needed then the scars are more visible but can still be hidden beneath swim tops and bras. Scar placement options exist and should be individualized according to each patient’s wishes. Rare complications can occur such as deep vein thrombosis and pulmonary embolus, but these potential risks can be minimized by proper use of intraperative techniques of compression and early ambulation post operatively.

A major breakthrough is the great improvement in recovery due to minimizing pain. An intraperative injection is now available which greatly reduces pain in almost all patients undergoing tummy tucks. These techniques can and should be discussed in detail with your surgeon.

Summary

Most women want to restore their figures after child birth. They want to be wear the same bras as before pregnancy and to wear sun dresses. Some women are fortunate enough to restore their figures with diet and  exercise alone. That option is always the first and best approach. However, if the skin stretched and the abdominal muscles are displaced then no exercise alone will achieve these goals. Surgery is not for everyone, however “Mommy Makeovers”  achieve great results and are met with high patient satisfaction in the overwhelming majority of patients.

February 6th, 2014

Question and Answers with Dr. Burns

 

Q: I have congenital asymmetric breasts. Do I need a experienced specialist to perform this corrective breast augmentation?

A: Without seeing photographs or doing an examination, it is hard to say what specific treatment you need. However, if you do not have droopy breast and too much assymetry, then most cosmetic surgeons who do breast work could easily handle your issues, say perhaps with different sized implants. However if this is congenital then ptosis (droopy breasts) may be an issue. The good news is that this too can be handled with a breast lift either bilaterally or unilaterally, but scars can not be avoided. Scars can be minimized and strategically placed but often this is the price to adequately correct symmetry and size differences in this situation. Again, all you need is a cosmetic surgeon who has a large experience with both augmentation and breast lifting/reduction surgery and there are many in your area. I recommend you look for a Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery. There are many cosmetic surgeons who claim they are board certified, but I recommend the above credentialling. There are no guarantees, you are only optimizing your chances. I always recommend looking at their results and finding someone you are comfortable with and can communicate to you well. Check references to further optimize your search. Good luck.

 

 

January 10th, 2014

Questions and Answers with Dr. Burns

Q: Is micro-liposuction to facial areas a viable step to take to remove some of the fat from previous fat injections? Has removal of placed fat in these areas been done successfully? Any other options?

A: I am sorry to hear of your situation, especially since it is so difficult to treat. Facial liposuction is to be avoided if at all possible as any irregularity is noticeable. With such treatment you might be changing one problem for another. The good news is that it doesn’t  sound like you have been out a full  year from your fat injection.  Usually there is quite a bit of fat resorption over the first year, which is one of the problems with fat injection, but in your case that could be a blessing.  If it does last a year then it is permanent. Liposuction with small cannulas in expert hands is certainly one option of treatment.

There is a new treatment of injection to melt fat, Kythera, but it is painful and causes swelling  temporarily that can be significant. Such treatment also has to be repeated multiple times reportedly. It is not currently approved in the US but should be shortly. You might look into this in the future, but hopefully the fat will resorb more to your liking.

For all the reasons mentioned above, I am not a fan of fat injections in general. Although this technique remains popular with many physicians, fat injection has many issues. There is a high variability in resorption rate. Granulomas(painful red nodules) can occur and obviously issues like the one you are describing for yourself can happen. You also have to deal with a sometimes painful harvest site location.
Today there are amazing alternatives with injectable fillers. Although they have to be repeated, several can last for 1 to 2 years and no general anesthesia is required.  A new filler, Voluma can last 18 months to 2 years and is reversible if too much is put in and you find yourself in a similar situation to the one you describe in your question. My patient population is growing exponentially each year with very satisfied patients who come in for the excellent filler and injectables offered today.