Tag Archives: plastic surgeon

Unfortunately gravity is unceasing and combined with age and sun related skin loss of elasticity a woman’s tissues surrounding her breast can lead to the breast mound falling lower on the chest. Additionally, the volume inside the breast can diminish with hormonal changes after pregnancy and menopause and with significant weight loss.  All these factors triumphantly combine to give an aged appearance that can be significantly disproportionate to the otherwise youthful feeling of a women. Sound depressing? Sure it does but the artistry and science behind plastic surgery can offset these changes to a woman’s breasts and make them feel good about the skin they are in.

If someone is unhappy with the appearance of their breasts it is helpful for analysis sake to deconstruct the breast into two separate components: the overlying skin brazier, and the volume and its distribution of the breast mound on the chest wall.

The mound itself may have adequate volume but most of the distribution of the volume is in the lower pole of the breast well below the breast fold requiring a bra to perform a heroic task of keeping the breast on the proper location on the chest wall. This situation can be improved by a mastopexy (lift) with creating a lower pole breast flap of tissue transposed under the rest of the breast mound and fixated to a non-mobile portion of the chest wall to provide upper pole fullness. In this situation the skin brazier is loose and has allowed the breast mound to sink inferiorly and requires and generous amount of skin to be removed and repositioned to be coincident with the newly shaped breast mound. For some women this may produce a nice result but particularly individuals who have a very long trunk with a great distance from the breast fold to the collar bone, creating the appearance of low set breasts, the above technique requires another means of providing upper pole fullness. Some women are comfortable with adding an augmentation with a breast implant to enhance shape and form and creating a nice upper pole roundness. Some surgeons are comfortable offering an augmentation at the same time as the mastopexy. Other surgeons would argue, based on data which has shown a 25% revision rate with the combined procedures, would prefer to stage these techniques. I personally like to perform the augmentation mastopexy in a single stage because I would rather have the implant in place to provide shape and volume to the overlying breast mound prior to tailoring the skin envelope of the lift procedure. I find this saves the patient a second general anesthesia, reduces expenses, and can be performed in the office setting with much less cost. Generally, it is only a minor skin re-tailoring to minimally reposition the nipple-areolar complex vertically on the breast mound.

Implants can provide structural shaping and volume enhancement of the breast mound but there are definitely limitations to their effect. Women who have structural limitations to their chest wall anatomy can have difficulty in achieving satisfactory results with implants alone. Individuals with very wide sternums and rapidly sloping chest walls cannot achieve meaningful cleavage with implants alone because the devise cannot be placed on the sternum. Another anatomic limitation eluded to in the above paragraph is the long chest wall with the accentuated length of the breast fold to collar bone giving the illusion of the low set breast. Even an anatomic shaped breast implant which is taller than it is wide still cannot mask this affect. In both of the above situations in which implants are chosen as the enhancer of choice the addition of fat grafting is necessary to create a much enhanced result. The beauty of fat grafting is that it can be placed in any position on the chest or breast. It can be similar to the concept of photo-shopping an image and allows the surgeon to truly sculpt the breast and chest wall to closer reflect an ideal form and helps to hide these difficult anatomic variants with your very own fat.

Other women may prefer to avoid implants all together and in consultation with their surgeon may choose to enhance the shape and volume of the breast mound and chest wall in conjunction with a mastopexy with just fat grafting lone without implants. Just as implants have limitations so does fat grafting. The current art and science of the techniques of autologous fat grafting has a yield of around seventy percent sustainable take of the viable fat implanted into the tissues. This has been reproducible shown over many series of papers presented in the literature. Since fat is a very soft material that cannot resist significant opposing forces of the skin it is difficult to globally enhance a breast mound much larger than a cup to a cup and a half sizes larger in one session. Therefore a women who has a large skin envelope and very limited breast mound volume and desires to have a very full shape should not consider enhancement solely with fat alone. A combined implant with fat grafting provides a much better and stable result. In my experience fat grafting alone is best to sculpt and shape the cleavage and upper poles of the breast and chest wall interface. It can enhance the overall volume by a cup size as well. The other nice advantage of fat grafting for breasts is it allows the removal of unwanted fat volume from places like the flanks, abdomen, and thighs to achieve improved breast shape and sculpting of the body contour.

If you feel self-conscious about the appearance of your breast and feel it is disproportionate to the rest of the body and how you feel about yourself, consult a board certified plastic surgeon in LV Nevada to define your goals and options for rejuvenating your breasts.

Stephen M. Miller, MD, PC, FACS
8435 S Eastern Ave
Las Vegas NV 89123
Phone: (702) 369-1001

http://www.drstephenmiller.com

2 for 1: Remove the Fat and Sculpt the Body

Full beautiful bottoms are a sign of youth and vitality, and enlargement procedures are becoming increasingly popular. Statistically, The American Society for Aesthetic Plastic Surgery (ASAPS) notes that buttock augmentation took one of the top spots recently for the most significant increases in the number of procedures performed, by a whopping 58 percent!

This comes as no surprise to board certified plastic surgeon, Dr. Peter Fodor. “We’ve seen a significant increase in buttock augmentation in the U.S. It was slow catching on, but that’s no longer the case.”

Celebrities Jennifer Lopez, along with Kim Kardashian’s voluptuous body could be attributed to some of the buttock enlargement frenzy!
Sculpting the Entire Body

“Not only do we harvest fat to create a full beautiful bottom, we also sculpt the body,” says Fodor. “It’s a 2 for 1 procedure.”

“Buttock augmentation gives you curves you never had and makes you feel sexier and more confident in clothing that you were never able to quite fill out.”

Finding the right balance, and ensuring your body is in proportion requires a lot of artistic sense, judgment and finesse.

“When considering the procedure, the best results are from board certified plastic surgeons who are willing to devote ample time to assessing the appropriate hip to waist ratio.”

buttock-augmentation

How Buttock Augmentation is Performed

Buttock augmentation reshapes and enhances your gluteal area, for an uplifted and shapelier buttock profile. Fat grafting with your own natural fatty tissue is frequently used.

“We can perform augmentation with an implant. However the preferable method in my practice is to use a patient’s own tissues (fat) and occasionally combine it with an implant,” says Dr. Fodor. “First, we evaluate where there is sufficient donor fat. Those areas are then suctioned, leaving a more aesthetically pleasing contour. The fat is appropriately processed and reinjected into the buttock area creating a beautiful overall figure.”

Buttock with fat grafting

Candidates for the procedure

If your buttocks are too small for your body frame
If your buttock shape is too flat or square and you would like more curves and a more youthful appearance
If weight loss or the aging process has left your buttocks loose, sagging, and/or flat
If clothes and swimwear do not fit properly

Fat is a good thing … like money in the bank!

“When people think about fat, it’s often viewed as an ugly reminder to lose weight,” says Fodor. “It doesn’t need to be perceived that way. The way we are able to harvest fat and successfully attach to stem cells our success rate is phenomenal.”

“Appropriate fat harvesting and the addition of stem cells, also isolated and derived from fat, has led to a phenomenal success rate.”

“As it turns out in my practice, at least 80 percent of the fat transferred survives. What you see at three months is a permanent result. This is quite exciting!”

Dr. Fodor perfected his technique of implant augmentation during dozens of teaching trips to Rio de Janeiro and other areas of Brazil. Using your own fat remains the preferred method at his practice.
Recovery

There is initial swelling and some pain associated with buttock augmentation. More with the implants however, than with transferring fat. When compared to buttock implants, recovery time for fat transfer patients is more rapid.

Most normal activities can be resumed within the first week and on average most people are back to work within a week or 10 days.

Consulting with a board certified plastic surgeon is the way to evaluate what works best for YOU!

Peter B Fodor MD, FACS
2080 Century Park East
Suite 1511
Los Angeles, 90067
(310) 203-9818

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