Video Blog: A Summary of Full Facelift vs Mini Facelift

Your Albuquerque Cosmetic Surgeon

I have made this video blog to briefly discuss a full facelift vs mini facelift.

Have you tried pushing up your sideburns to see if this tightens up your face? You are simulating what a facelift can do for you. When to consider a full facelift  vs mini facelift depends on many factors with age being just one of them. In fact, good health and the desire to look younger are more important.  We have operated on patients as young as in their early 40’s and as old as in their mid 80’s.

Many people dislike their neck: too much fat and/or skin. A facelift, particularly the full facelift can improve this. Other possible improvements are the nasolabial fold and marionette lines. If the neck is not an issue, you may be a candidate for mini facelift, which can often be done in the office under local anesthesia. I use the short-scar technique, keeping the incision close to the ear with very little extension away from the ear in order to hide the scars well.

Posted in facelift, Facial Surgery Tagged with: , ,

An Albuquerque Plastic Surgeon Discusses Questions About Breast Lift

breast augmentation

Breast lift, or mastopexy, is a procedure to improve the shape of the breasts. Most commonly, its purpose to reduce ptosis, or droopiness, of the breasts. As an Albuquerque plastic surgeon, I have frequently been asked about breast lift.  However, many people find this subject embarrassing to discuss. This is the main reason I would like to share with you some of the more common questions about breast lift.

Common Questions about Breast Lift

  1. Will having implants help my breasts look perky again?  This is the most often asked question about breast lift. The answer is “it depends.” When a woman has relatively little breast tissue and not much stretching of the skin, she can achieve a significant improvement with breast augmentation alone. On the other hand, if she has a moderate amount of breast tissue and, in particular, moderate droopiness, it is very difficult to achieve an acceptable result with just breast implants. Some sort of breast lift is almost always necessary in the latter case. Unfortunately, it often take a personal consultation and evaluation to know which procedure is the the right one for a particular woman.
  2. Can I get larger implants to “fill up” the loose skin to avoid a breast lift?  In theory, the answer may be “yes.”  However, there is a problem with this logic. First of all, the size of the implants needed to achieve enough lift may be so unreasonably large that they appear ridiculous. Secondly, implants increase the total weight of the augmented breasts and this causes the breasts to sag faster. It then becomes a vicious cycle of ever-increasing implants size and droopiness.
  3.  Is there other types of breast lift other than the “lollipop” style incision?  Certainly. If the overall shapes of the breasts are acceptable with the exception of slightly lower nipple positions, the crescent lift may be the answer with a semicircular incision at the edge of the areola. There are also some more variations of the lift incisions that can be tailored to each person.

There may be many more questions about breast lift on your mind. Please set up a personal consultation with me to discuss your concerns.

 

Posted in breast implants, Breast Lift (mastopexy), Breast Surgery, implant size Tagged with: , , , ,

Post-Op Protocols after Breast Augmentation

breast augmentation

There are probably as many post-op protocols after breast augmentation as there are plastic surgeons. You probably wonder why some of your friends after breast augmentation had to wear a special bra while others did not. Some were asked to massage implants and others were not. Some friends had drains tubes while others had none.

You may wonder why so many post-op management methods exist and whether one protocol is better than another.

In my opinion, the protocol a surgeon follows is largely a function of his/her training and experience. What is important is that the surgeon gets the desired results consistently. Having said that, here is the protocol which has worked well for my patients.

  • Activity levels: I generally advise my patients against lifting more than 5 pounds and lifting their arms above shoulder height in the first 5 days. The lifting limit is increased to 15 pounds after the 5 days and they are able to get the arms up.  One more week later they may start to do upper body exercises.
  • Massaging: I feel very strongly about massaging about 5 days after surgery. It helps bring the implants down to the correct position and it also stretches the implant pockets to soften the breasts. In the long run, I believe massaging helps to reduce the chance of implants contracture.
  • Bras: I do not use post-op bras or binders.  I also do not recommend wearing bras for the first month as much as possible to allow better implant settling.
  • Drains: I do not use drains. Some surgeons use drains to decrease the chance of hematoma. I however prefer not to use drains to decrease the chance of infections. I use extreme cares during surgery to minimize the bleeding possibilities.

These post-op protocols after breast augmentation are easy to follow and have worked well for my patients. Hopefully by following these steps, we can achieve the best outcome after breast augmentation.

Posted in breast augmentation, Breast Surgery Tagged with: , ,

A Reflection of My Plastic Surgery Practice

Staff of Dr. Neil Chen

This year we celebrate the twenty-year anniversary of plastic surgery practice in Albuquerque. When I look back, there have been many trends in my plastic surgery practice as well as in the specialty in general.

1. Non-invasive Procedures. Neurotoxin (such as Botox and Dysport) and fillers (such as Restylane and Juvederm) have become common treatments for men and women seeking facial rejuvenation. While they are not necessarily a substitution for surgery, they have changed significantly how plastic surgeons evaluate and practice.

2. Silicone Implants. After over 30 years of absence from the US market, silicone implants finally became available here. This has really expanded the options for our patients. There are many profiles and surface textures as well as different viscosities for various applications. Overall, we find the silicone implants softer and more similar to the feel of real breast tissue than their saline counterpart. In addition, they are less likely to show ripples in thinner people.

3. Trends in Facelift. In the 1990’s there had been more interest in extensive and deeper (i.e., subperiosteal) facelifts. My plastic surgery practice has embraced MACS (Minimal Access Cranial Suspension) and short-scar techniques for quicker surgery time, less bruising and swelling, and minimal pain. This also translates to faster recoveries and less time off from work. We have also done many limited facelift (mini facelift) procedures for those patients who are good candidates. As usually, I generally do these surgery under local anesthesia or sedation instead of general anesthesia.

4. Body Contour Surgery After Massive Weight Loss. As gastric bypass, banding, and sleeve procedures become more common, there has been a significant interest and demand for body contouring operations in my plastic surgery practice. The most popular operations (in the descending order) are abdominoplasty (tummy tuck), mastopexy (breast lift), brachioplasty (arm lift) and thigh lift.  The patients are generally extremely satisfied with their outcome.

Of course, somethings have not changed in my plastic surgery practice over the last two decades. We still have the same knowledgable and caring staff. Our mission to provide the highest standard in plastic surgery remains steadfast.

 

Posted in Botox, breast implants, facelift, filler, General Albuquerque Plastic Surgery, Juvederm, plastic surgeon Tagged with: , , , , , ,

What You Should Know About Fat and Liposuction

liposuction

We hate fat. Let’s face it. Yet, there it is–an inert, undesirable lump that nobody wants. Here is what you should know about fat and liposuction.

People often have many questions about the procedure.  They wonder whether fatty tissue will regrow in treated areas. Whether fatty tissue will accumulate in other areas. Whether the sculpted contours will persist over time.

First of all, we usually perform liposuction in the outpatient surgery. Most of time, the amount of fat removal is generally only a few pounds at most. Compared to a person’s weight, it is merely a few percent. Therefore, liposuction should not be considered a weight reduction procedure. It is a contour-improving procedure and can get rid of many common trouble spots such as the thighs.   Similarly, liposuction is not a license to eat and be idle. If you do this, you will regain the amount of fat suctioned out previously, and far more!!

Most people do not gain more fat cells after seven years of age. When you gain weight, each existing fat cell simply gets larger. When liposuction of a particular area is performed, it removes certain numbers of fat cells and these fat cells are gone forever. It is, however, not possible to remove all the fat cells in any area completely. Therefore, the remaining fat cells can and do get bigger if you gain weight. However, fat cells in other areas of the body also get bigger, too. So, the simple answer to the question of what happens to your body when you subsequently gain weight after liposuction is that you will get fatter at the suctioned area as well as other areas. The contour is likely to remain better than before liposuction.

A lot of exciting research has been done involving fat. Fat grafting is one of the areas that is progressing rapidly. Stem cell research is developing too. I hope in the the near future I will have much more to report to you. Stay tuned.

Posted in Body Contouring, Liposuction Tagged with: ,

Cosmetic Surgery After Massive Weight Loss

Abdominoplasty Example 2Abdominoplasty Example 2

Congratulations! You have lost 100 pounds… now what? You feel more energetic. Your joints feel better. Your diabetes and hypertension are gone. Unfortunately, the excess skin is still there, at your abdomen, breasts, arms and thighs. These are common problems after massive weight loss, and we can help you with the following cosmetic surgery procedures.

After massive weight loss, most people are bothered by excess skin at their abdomen. This can be addressed by abdominoplasty, or tummy tuck. Not only can the excess skin be removed, the laxity of muscles can be tightened and the abdomen flattened. The trade off is that there will be a long scar at the lower abdomen. Vast majority of people with massive weight loss do not have any problems accepting these scars.

Mastopexy, or breast lift, tends to be a very popular request as well. The the massive weight loss, most people will have significant loss of the breast volume while the skin remains. Mastopexy with or without implants can tighten the skin and restore the volume if necessary. It is important to note, too, that mastopexy generally involves some scars on the breasts as well.

Arm and thigh lifts remove the excess skin and improve the contour of the arm and the thigh, respectively. The best results are obtained when there is not excessive amount of fat.  The scars are in the inner sides of the extremities. Because of the thin skin in the inner arm and thighs, the scars tend not to heal as well. You have to be willing to trade better contour for the scars.

Other than the above-mentioned cosmetic surgery after massive weight loss, there are several other procedures which may be useful as well. Back lift, facelift, eyelid surgery are some of them. You can learn more about these procedures in our web site.

You have lost a lot of weight. We will help you look as good as you feel.

 

Posted in blepharoplasty, Body Contouring, Breast Lift (mastopexy), Breast Surgery, facelift, Facial Surgery, massive weight loss, Tummy Tuck (Abdominoplasty) Tagged with: , , , , , , , ,

Breast Implant Size for Augmentation

breast augmentation

When recently answering a question from RealSelf, I was really surprised by how the patient did not have a good understanding of the anticipated breast size she was about to get. She, after a breast augmentation consultation with a cosmetic surgeon, was getting breast surgery with silicone implants. She stated she was 36 B and wondered what size she would be postoperatively after placement of a particular implant size. I recommended that she needed to discuss this with her plastic surgeon further before surgery.

In a breast augmentation consultation, the surgeon and the patient have a chance to get to know each other. The surgeon must make sure the patient’s health condition allows the surgery to be performed safely. Assuming that the breast contour is such that no additional procedures, such as mastopexy, are necessary, he/she needs to figure out the appropriate breast implant size.

Some patients come to the consultation with a particular breast implant size in mind, such as full C cup or mid D size. This helps me narrow down somewhat the range of sizes they are interested in.  However, just because someone has a certain cup size in mind, does not mean I, as the surgeon, envision the same volume as the patient. Furthermore, some people request a specific number of cc’s (for example, 350 cc high profile). When I ask how they arrived at that requested volume, often they respond “that’s what my friend got and I like the size” or “I saw a picture and that girl had that size implants.”

Keep in mind that no two people are the same. Just because your friend got a particular size implant you like, does not mean that size will look the same on you. The starting breast size, the circumference of chest, the thickness of subcutaneous fat, the shape of rib cage and other various factors can influence the size of the recommended implants.

There are many different ways to help the patients decide on the right implant size, such as rice bags, computer simulations, and so on. I have been using the silicone sizers by Mentor for many years. This allows the patient to wear the sizer and more precisely see and feel the anticipated breast sizes. I have surveyed many of my patients after surgery to find out how the recommended sizes and the actual sizes compare. The results showed excellent correlation.

The take home message is that you should have thorough understanding of the procedure, the risks and benefits, and the size you can expect to get before breast augmentation. This is also true with any other surgery as well.

Posted in breast implants, Breast Surgery, implant size Tagged with: , ,

What’s New in Neck Tightening? A Report from An Albuquerque Plastic Surgeon

Many patients come into our office wanting to have neck tightening. The frequent descriptions we hear from our patients are “turkey neck”, “waddle”, and “sagging neck.”  In most cases, the physical exam reveals a significant amount of excess skin and fatty deposits.

In many patients, facial tightening is also needed. They often present with jowling, deep nasolabial folds and marionette lines. The facelift operation addresses all the above concerns in addition to neck tightening and neck liposuction; this accounts for about 90% of the neck tightening treatments we perform.  However, not everyone is a good candidate for facelift and not every facelift can solve the problem of neck laxity.

Direct excision of the excess skin presents an attractive alternative in some people. This method can effectively remove the fatty tissue and skin. We use Z-plasty closure to tighten the neck and to reduce the scar visibility. The scar is the biggest downside to the procedure.  However with time, the scars can become very difficult to see. I use the Z-plasty for neck tightening more frequently for men than women. Men can hide the scars under facial hair while they fade. Remember, these post-op photos were taken at about 3 months and the scars will continue to fade with time.

In summary, I believe that neck tightening with Z-plasty is a very good option in our quest for neck contour improvement in certain individuals.

Posted in Albuquerque, facelift, Facial Surgery, neck tightening Tagged with: , ,

Albuquerque Plastic Surgeon on Breast Augmentation

breast augmentation

Breast augmentation is the most common surgical procedure that the majority of cosmetic surgeons perform. It is also one of the most satisfying procedures for both patients and surgeons alike. My technique for breast augmentation has evolved over the past 20 years. I would like to share with you the way I do breast augmentation.

Patient selection: Most patients interested in breast augmentation are healthy, fortunately. However, we still have to check to make sure they do not have any issue with severe overweight and bleeding/clotting problems. It is also important to recognize if there is tuberous breast deformity or droopiness (ptosis). These conditions will likely require additional procedures. We also spend quite a bit of time discussing the sizes of implants. I have found that sizers provide invaluable realistic “preview” of what a particular size of implants will look like.

Type of anesthesia: I use general anesthesia for breast augmentation. Nerve block or sedation alone, in my opinion, is not adequate.

Place of surgery: I do all my breast augmentation operations in an AAAASF certified ambulatory facility, Sandia Surgery Center. The ambulatory center setting provides the most sterile and safest environment for surgery with maximal efficiency. It also provides the most professional individuals who are most familiar with all the procedures and who have worked with me for many years.

Incision: I prefer under-the-crease incision of the breasts. In the vast majority of patients, the incision is about 1.5 inches long and heals very well in an inconspicuous location. The same incision also provides an easy access if re-operation, such as change of implants, should be performed in the future. I would be happy to discuss with you the other alternative incisions during a personal consultation.

Placement of incision: With very few exceptions, I place implants under the pectoralis major muscle layer. I feel strongly that the submuscular placement reduces the chance of capsule contracture, provides a softer appearance over the implants, and reduces the droopiness over time.

Type of implant: Saline or silicone? Smooth vs textured? Anatomic vs round? Regular gel or “gummy bear” (ShapeStable)? There are certainly many choices. In fact, too many. In the past couple of years, I have used silicone implants in over 90% of cases, and it is getting higher. I also generally use round, smooth, moderate plus profile Mentor implants most of the time. Of course, the final decision is made on an individual basis.

Closure: I generally do not use drains, and I place long-lasting anesthetic medication into the implant pockets to reduce the post-op pain. Absorbable sutures are used in the closure so that no stitches will need to be removed.

Duration: From the time of entering the operating room to the time of exit, the breast augmentation surgery usually take about one hour.

Recovery: Most people spend about 30-40 minutes in the recovery room (PACU). Patients report feeling tightness of their chests, although the pain experience can vary quite a lot. I tell patients not to lift their arms overhead and not to lift over 5 pounds for the first 5 days. It is important to get up and walk to prevent blood clots in the legs (DVT). If your job is not physically demanding, you may be able to return in 4-5 days. Most people are able to do some exercise by 5 days and can do more vigorous exercise in 3-4 weeks.

I have tried to cover some important questions that many patients have asked over the years. Hopefully, this outline addresses your concerns. For your personal free consultation with me, call my office please.

Posted in breast implants, Breast Surgery Tagged with: , ,

Correction of Tuberous Breasts by an Albuquerque Plastic Surgeon

Tuberous breasts

Tuberous breasts occur more commonly than many people may think. It is a congenital breast condition that is often characterized by a narrow breast base, a large areola with herniation, and ptosis (droopiness) despite a relatively small volume of breast. It can be unilateral or bilateral, and each breast is often involved to a different extent. In a more severe variety, the nipple to the crease line of the breast (inframammary fold or IMF) can be very short. Correction of tuberous breasts addresses the improvement of this deformity, often in conjunction with breast augmentation and sometimes with breast lift.

While severe tuberous breasts may need a staged operation with possible tissue expansion, most cases can be done in a single operation. The more complicated cases will also more likely require revisions. In general, the operation needs to address the narrow bases of tuberous breasts by scoring the underside of the breast tissue. This helps to expand the narrower lower poles and the constricting IMF of the tuberous breasts. The IMF needs to be lower too. The implants will then be inserted.  Finally, the large and often herniating areolae will also need to be addressed by areola reduction and breast lift. All these procedures need to work in concert to give us the desired results. Also, remember the changes do not usually take place right after surgery. The stretching and expansion of the lower poles often take time to happen.

Bear in mind that surgery to correct tuberous breasts is not a simple surgery. Furthermore, the breasts are often very asymmetric, which adds to complexity of procedure. Despite this, the patient satisfaction rate after correction of tuberous breasts is generally high. If you would to have a consultation with me, please contact my office.

Posted in Breast Lift (mastopexy), Breast Surgery, tuberous breasts Tagged with: , ,
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