Latest Plastic Surgery Articles - Page 10




Skin tightening in plastic surgery is a common procedure performed on seniors (facelift), massive weight loss patients (body lift), and women who want to reverse the effects of pregnancy (tummy tuck and breast lift).

Any type of elective plastic surgery is only reserved for healthy patients with the right motives and expectations. Meanwhile, individuals with medical condition that could predispose them to higher risk of healing problems and poor cosmetic results are almost always considered as poor candidates.


Blood clot formation or deep vein thrombosis (DVT) that commonly affects the legs is one of the risks associated with skin tightening surgery. Nevertheless, the possibility is greatly reduced if the operation is performed on healthy patients who avoid the “known” risk factors and perform the necessary preparations.

Dr. Tarick Smaili, one of the leading Orange County plastic surgery experts, says the first step to minimize blood clot risk is to avoid tobacco, second-hand smoke, and smoking cessation products such as nicotine gum and patch at least one month before and after surgery.

The association between smoking and blood clot has been well documented, making smokers poor candidates for any type of plastic surgery. Studies have already shown that compared with non-smokers, smokers have a higher incidence of poor healing and “unnecessary” scarring after breast surgery and facelift, explains Dr. Smaili.

Aside from nicotine and other toxic constituents of smoking, the use of contraceptives and hormone replacements is also linked to higher risk of DVT. For this reason, they must be discontinued for at least three weeks prior to surgery.

Another risk factor for DVT is a sedentary lifestyle, so the renowned Orange County plastic surgery expert recommends light exercise or walking after surgery. The idea, he explains, is to pump blood through the leg veins, preventing not just blood clotting but also persistent swelling and bruising.

Prolonged immobility, meanwhile, could significantly increase the risk of DVT, thereby immediate long travel and bed rest are an absolute contraindication after an elective plastic surgery.

With any type of elective plastic surgery, especially if it involves skin tightening, overweight and obese individuals are poor candidates because of the increased risk of healing problem, wound dehiscence, and DVT because of the pressure in the veins of their legs and pelvis.

Aside from obese patients, skin tightening plastic surgery is also not for individuals with blood-clotting disorder, cardiovascular disease, cancer, and inflamammatory bowel disease because of the increased risk of DVT and other types of complications.



The primary aim of liposuction surgery is not to remove all the fat in the treated area, which could even lead to gaunt appearance and skin asymmetry. Instead, the procedure almost always leaves some layer of fat to preserve the natural contours and “valleys” of the body, which is particularly important when treating female patients.

The success of liposuction surgery, as with any body sculpting procedure, is only possible with proper patient selection.


The list below, shared by leading body sculpting expert Dr. Tarick Smaili, explains the proper way to select patients.

*  Normal weight. For the sake of accuracy, plastic surgeons use body mass index, or BMI, to figure out if a patient is at a healthy weight for his or her height. Generally, the higher the number, the more body fat a person has.

Liposuction only works on localized subcutaneous fat, which is underneath the skin and is responsible for the appearance of fat rolls and unsightly bulges. Meanwhile it is surgically difficult, if not impossible, to remove the deeper, obesity-related visceral fat that only responds to real weight loss.

Obese patients are poor candidates for any type of elective surgery—not just body contouring but also facial procedures such as facelift—because of the increased risk of skin necrosis (death of tissue), infection, and wound dehiscence.

*  Healthy individuals. Medical conditions that could prevent a person to heal properly, or could expose him or her to undue risk, is a poor candidate for liposuction or any type of elective plastic surgery. For example, blood-related disorder, diabetes, cancer, heart disease, and autoimmune deficiency can increase the risk of complications.

Also, patients who are taking drugs known to increase bleeding (e.g., anticoagulants, aspirin, and non-steroidal anti-inflamammatory drugs) are at higher risk of complication unless they will discontinue these medications at least two to three weeks prior to the operation.

*  Motives and expectations. The ideal candidates for liposuction should have realistic expectations. First and foremost, it only removes just a small amount of localized fat, thus the preoperative weight and dress size will likely remain the same after surgery.

Liposuction is also not a substitute for “real” weight loss, making regular exercise and healthy diet more important than ever after surgery.

*  Good skin tone. While old age is not an absolute contraindication to liposuction, it is known to decrease the capability to redrape to the new contour. Nevertheless, surveys have suggested that many patients past their prime have reported high satisfaction rate with their more streamlined appearance.

As long as the patient has realistic goals and expectations, liposuction could deliver a satisfying result.



While the use of antibiotics is common in breast augmentation surgery, there are many different opinions on what type and how long they should be utilized. Nevertheless, the primary aim is to prevent infection that is tied to a wide range of subsequent complications such as poor wound healing, capsular contracture, and cosmetic results that are less than optimal.

Antibiotic is a medicine that prevents the growth of microorganism. Nevertheless, it remains important to perform breast augmentation at a fully accredited surgical setting or hospital, avoid or at least minimize contact of the implant shell with the skin at the time of surgery, and practice good hygiene postop to further minimize risk of infection and its subsequent complications.


Some Los Angeles plastic surgery experts recommend antibiotics hours before the actual surgery, while surgeons feel that these should only be given within five to seven days of operation.

However, it has become a common practice to use antibiotic solution to bathe the breast implants, wound, and implant pocket at the time of surgery. The idea is to make everything sterile before and during implantation to minimize risk of infection and capsular contracture in which a copious amount of scar tissue forms around an artificial prosthesis.

Despite the growing popularity of implant and pocket irrigation, a study conducted between 2011 and 2012 involving 55 patients has shown no significant difference in the capsular contracture rate between a surgeon who used the procedure (3.7 percent) and someone one who did not (3.6 percent).

The researchers have concluded that breast implant and pocket irrigation with the use of antibiotics may not have an impact on the incidence or severity of capsular contracture when the surgery is performed at a fully accredited surgical facility using high-quality medical techniques.

When oral antibiotics are prescribed, it is important to finish the entire course and follow the dosage recommended by surgeon. If the treatment is stop early, the bacteria that have not been killed could restart an infection and lead to more serious complications.

Aside from antibiotics, surgical methods such as Keller Funnel could further minimize risk of implant contamination and infection. This involves the use of a cone-shape device that propels an implant towards the breast pocket without actually touching the prosthesis, thus it is sometimes referred to as “no touch technique.”

Some experts also feel that breast augmentation performed at an accredited outpatient facility could minimize risk of implant contamination because it does not handle infectious diseases like most hospitals.



Hematoma is the most common complication after facelift surgery. In this condition, a pool of blood forms under the skin, causing persistent swelling, discoloration, and other untoward side effects.

If left untreated, large hematomas can coagulate and become a solid lump underneath the skin (leading to poor wound healing and “unnecessary” scarring), while small hematomas often heal on their own without the need for aspiration or surgical removal. A physical examination after facelift will determine the right course of action.


Many variables that contribute to hematoma can be controlled, making appropriate preparation, surgical techniques, and postop care indispensable to minimize one’s risk. Nevertheless, some factors are beyond the control of doctors and patients—For instance, male gender is known as a predisposing cause that about 8 percent of men experience this problem, as suggested by one study.

The hematoma rate in female patients, meanwhile, is 1-3 percent. They are less likely to experience this problem because their facial skin is less vascularized than men especially around the beard area.

Another factor associated with increased risk of hematoma is the use of blood-thinners such as aspirin, non-steroidal anti-inflammatory drugs, anticoagulants, and antiplatelet medications. For this reason, it is a common guideline to avoid them at least three weeks before surgery, or sometimes longer.

Some herbal supplements that can be easily bought over the counter have the same thinning effect on blood. The most common examples include ginkgo biloba, green tea, milk thistle, ginseng, and horse chestnut.

Tobacco products, smoking cessation treatments, and alcohol also have detrimental effects on blood clot formation, leading not just to increased risk of hematoma but also to a wide range of short- and long-term complications such as poor scarring, skin necrosis, and cosmetic results that are less than optimal.

To further avoid or minimize risk of hematoma and its subsequent complications, a normal blood pressure must be maintained before and after surgery. According to a study involving 229 facelift patients, those with uncontrolled hypertension were more likely to experience the problem compared with individuals whose blood pressure was well under control.

Because hypertension is an age-related medical condition, which is not uncommon in facelift patients who are typically aged 50 and above, many plastic surgeons choose to work with their patients’ general physician or specialist to make the elective surgery reasonably safe.

Postoperative factors such as rigorous activities, nausea/vomiting, coughing, and even stress are also known to increase hematoma risk. For this reason, it is a sacrosanct rule to maintain a normal blood pressure and heart rate during the initial healing stage to avoid the pooling of blood underneath the skin.



Breast augmentation via periareolar incision technique involves making a small U-shaped opening within the border of the nipple-areola complex. It usually results in well-concealed scars, particularly when the wound has been meticulously closed with sutures that minimize tension on the skin.

One of the most common concerns with the technique is the risk of milk duct injury, which plays a crucial role in breastfeeding and sensation. For this reason, many surgeons will always prefer other incision sites such as the inframammary fold and armpit unless there is an indication for breast lift.


Because breast lift always involves incisions around the areola, it becomes an ideal incision site if breast implant surgery is performed simultaneously, thus preventing additional scars.

While the milk ducts are mostly concentrated around the nipple-areola complex, during periareolar breast augmentation not all of them will be transected or injured. On average, there are 13 to 25 breast ducts found in the female breast, thereby increasing the likelihood of successful breastfeeding in the future even after this technique.

Nevertheless, many surgeons prefer to “err on the safe side” by using the inframammary fold, armpit, or even navel incision instead because of the perceived lower risk of nerve injuries and sensation-related problems.

Some doctors also argue that breast augmentation via periareolar incision leads to higher risk of capsular contracture compared to other techniques, making other sites a more viable option.

Capsular contracture, or the formation of copious amount of scar tissue around an implant (not just breast implant but also artificial heart valves and facial implants), is often linked to low-grade bacteria and implant contamination at the time of surgery. It is believed that the nipple-areola complex contains a high number of staph bacteria, predisposing the patients to such risk.

Many surgeons in Los Angeles plastic surgery believe that the risk of milk duct injury is more closely associated with the implant size, suggesting that larger augmentation leads to higher risk of nerve impingement, breastfeeding difficult in the future, longer recovery, and more postop pain and discomfort.

Breast implants that are too large for the underlying anatomy to handle also result in a wide range of short- and long-term complications such as visible rippling, more palpability, bottomed-out appearance, chronic breast pain, and implant displacement.

To further minimize risk of milk duct damage, many surgeons recommend the use of submuscular technique in which the implants are positioned underneath the muscle rather than above this thick layer, leading to less disruption to the anatomies that play a crucial role in breastfeeding.



Since time immemorial, a narrow waist is a much-coveted feature on women, particularly if it is complemented by wider hips.  According to several studies, a waist-to-hip ratio of 0.7 or at least near this number generally signifies good health and female fertility, thus there seems a biological reason why men are attracted to females with an hourglass figure.

In an attempt to narrow the waist and create a more hourglass figure, some women ask for plastic surgery—particularly with a tummy tuck and liposuction.


If the “thick” waist is primarily caused by excess fat—or particularly the superficial fat found underneath the skin—liposuction alone is enough to create a drastic, long-lasting result.  It involves just a few small incisions the size of a grain of rice where a suction probe or cannula is fit inside and then pulled back and forth to dislodge and remove the fatty tissues.

But as with any body sculpting surgeryliposuction is only reserved for patients who are closed to their ideal weight.  First and foremost, surgical removal of the deeper, obesity-related visceral fat, which covers the organs in the abdominal cavity, is deemed to be too risky.

Visceral fat only responds to weight loss, which is only possible through regular exercise and healthy diet.  In contrast, superficial fat can be surgically removed because it sits just underneath the skin.

For many patients whose goal is to achieve a narrower waist through liposuction, the flanks must also be treated to further contour the midsection.

However, a large waist that is mainly caused by muscle separation due to pregnancy and/or massive weight gain will not respond to liposuction.  Instead, tummy tuck is the only appropriate “tool” because it often uses a hip-to-hip incision to remove the hanging tissue and tighten the splayed abdominal muscle.

In some cases, liposuction and tummy tuck are performed at the same time to further recreate the hourglass shape.

While these two procedures have their narrowing effect, it is important to note that the overall improvements are still largely affected by the underlying anatomies, i.e., muscle and other soft tissue, and pelvis.

Meanwhile, rib removal in an attempt to narrow the waist is rarely performed in the US because of the risks since the ribs are necessary to protect the internal organs from trauma.

The controversial procedure involves the removal of the 11th and 12th ribs, with their rear portion left behind to at least maintain some of their functional purpose.



Several studies have suggested that beauty can be defined by some innate characteristics that go beyond race and skin color.  For instance, scientists have found that high facial symmetry (or the balance between the right and left side of the face), waist-to-hip ratio of 0.70 and babyish features among females, clear skin, and lustrous hair are found to be physically attractive by most people regardless of their economic, social, and racial background.

It is important to note that the intrinsic purpose of facial plastic surgery is not to create an “ideal” shape (since there is no such thing lest people would all look homogenous) but rather to improve the balance and harmony of the face.


Meanwhile, there are ways to alter or at least improve the shape of the face, including jaw reduction, facial implants (chin, jaw, and cheek implants), cheekbone reduction, dermal fillers, and fat transfer.

People with an almost absent chin, weak jaw, or sunken cheek are best served with facial implants that are supposed to last a lifetime.  Usually, they are made of silastic or hard silicone material that is compatible with human tissue, thus the risk of allergic reaction is fairly small.

Chin and jaw implants are particularly popular among men with recessed chin and weak jaw, which almost disappears from the neck, since the features make them look effeminate.

By contrast, female patients tend to ask for cheek implants to correct the deflated-looking cheek area caused by aging, or to achieve the much-coveted patrician look.

Meanwhile, injectable dermal fillers such as hyaluronic acid and fat transfer may be a better option if a patient only needs “minute” improvement or do not want to undergo facial implant surgery which involves a longer downtime.

While some patients need “augmentation” to achieve their goals, others want “reduction” for a more balanced feature.

Jaw reduction requires cutting off a small portion of the mandible, while chin reduction involves shaving off some of the bone in the area.  In the US, these procedures are not as popular as in many Asian countries in which a small ant-shaped face has become the epitome of female beauty.

While most US board-certified plastic surgeons would agree that jaw and chin reductions are only reserved for extreme cases of facial asymmetry, in South Korea, China, and Japan, the procedures are gaining popularity despite the higher risk of nerve damage, permanent numbness, and functional problems.

Cheek reduction is also becoming a popular procedure in some Asian countries where a V-shaped face is much preferred over a rounded face.



Augmentation rhinoplasty is just one of the many techniques in nose-reshaping surgery.  As its name suggests, its goal is to increase the nasal projection and possibly create a more defined bridge and/or tip.

In the US, augmentation rhinoplasty has almost become synonymous with Asian rhinoplasty because the Oriental nose often exhibits a lower nasal bridge, less tip projection, rounder nostrils, and wider base in relation to the height.


Rhinoplasty surgeon Dr. Karan Dhir said that most Asian patients ask for more bridge and tip projection, although not to the point that their racial features are compromised.  For this reason, the technique is also dubbed as ethnic rhinoplasty, even though it is a general term used to describe any nose surgery performed on non-Caucasian patients.

Meanwhile, nostril reduction is rarely performed on Asian rhinoplasty because propping up the tip is often enough to minimize the appearance of nostril flare.

Augmenting the nose comes in a wide range of techniques.  Some patients only need their nasal bone and cartilage to be manipulated, removed, and/or reshaped to achieve good results, while others need a more complex approach.

Because Asians have a thicker nasal skin, they can tolerate solid silicone and other synthetic implants better than Caucasians, meaning there is a lower risk of implant protrusion.  Nevertheless, there is always a possibility that the body might reject the implants.

Instead of using solid silicone implant which is criticized for its relatively high complication rate, some plastic surgeons prefer the use of polytetrafluoroethylene or PTFE (example of brand name: Gore-Tex) with its low rejection rate—only 1.9 percent as suggested by a previous study.

The low complication and high success rate of PTFE is attributed to the fact that it is made of a porous material that allows the patient’s own tissue to flourish inside.

Aside from Asians, augmentation rhinoplasty also appeals to patients with a flat nose commonly seen among boxers and professional fighters due to the constant blows and injuries they sustain from their professions.

In general, these patients need additional framework in their bridge to correct the flat appearance and possibly address the breathing difficulty.  While it is often possible to achieve good improvements in severe cases of nasal collapse, one must not expect perfect symmetry due to the underlying factors.

To further achieve good results, some patients may also need skin grafts during their augmentation rhinoplasty, Dr. Dhir added.



A growing number of medical experts are backing proposals to use body fat percentage as an indicator of obesity rather than the traditional body mass index or BMI.  Once it becomes a “mainstream standard,” the criteria used to filter out “bad candidates” from “good “candidates” in plastic surgery will likely also change.

One recent study titled, “Percentage Body Fat as a Risk Factor for Surgical Complications,” has suggested that obese patients—based on body fat ratio—are at higher risk of developing complications following surgery.


The study involved 438 patients aged between 18 and 64 who had elective surgery (e.g., general, aesthetic, and orthopedic) whose body fat percentage was measured using a technique called bioelectrical impedance analysis.

Obese patients were identified as those having body fat levels greater or equal to 31 percent in women, while 25 percent in men.  Fifty-two individuals meanwhile had experienced complications.

Patients who fell under the category of obese experienced higher rate of complications after their surgery compared to those considered as non-obese (14.1 versus 6.8 percent).  However, there was no significant difference in terms of post-op risk when BMI was instead used to identify obese individuals (14.9 versus 10.2 percent).

While the study did not divulge the reason behind the higher complication rate experienced by obese patients, separate studies have shed some light to issue.  For instance, some experts believe that the high levels of deeper visceral fat—which is linked to obesity—prevent it to efficiently access the blood supply where the nutrient-rich blood flows.

Another study involving breast reduction patients who were 200 pounds overweight has shown that they faced a higher risk of delayed recovery and healing problems (e.g., infection and skin necrosis) than normal-weight patients.

Aside from higher risk of complications after surgery, patients with high body fat percentage may not enjoy predictable results.  For instance, liposuctionwherein the excess superficial fat sitting just underneath the skin is suctioned out—is ineffective in removing the deeper visceral fat that covers the abdominal organs.

In fact, the consensus among medical experts is that any attempt to surgically remove the deeper visceral fat is downright risky.  Thus anyone who wants to shed the extra pounds has to follow healthier lifestyle choices—or as a last resort—to have a bariatric surgery.

And because people with a high body fat ratio are also at risk of significant weight fluctuations, any attempt to surgically contour the body will only provide short-lived results.  While theoretically most procedures can be repeated more than twice, it will only lead to higher risk of skin asymmetry and scarring.



While many rhinoplasty patients enjoy a [near] permanent result, it is important to mention that the revision rate as suggested by medical literature is about 10 percent.  Simply put, for every 10 individuals who had the surgery, one of them would need a secondary procedure at some point in his life.

There are many reasons why a revision rhinoplasty is needed: to correct aesthetic concerns that remain after the initial surgery, asymmetric appearance, functional problems, and “unpredictable” growth.


But for the vast majority of patients, the result of rhinoplasty can last a lifetime that a secondary surgery is often unnecessary, said board-certified facial surgeon Dr. Karan Dhir.

Nevertheless, it is important to mention that rhinoplasty does not stop the natural aging of the nose, the same way as a facelift surgery cannot prevent the process of facial aging.

As people age, the renowned surgeon said that the nasal skin will change the same way as the rest of the body does, which may lead longer or drooping appearance of the nose.  But overall, it is hard to tell the exact effect of aging on one’s nose—either unoperated or operated—because each person will age differently from one another.

However, anecdotal reports claim that in some cases rhinoplasty does slow the aging process particularly if the grafts are used to define and support the nasal tip, an area that may be prone to drooping as people age.

Nonetheless, there are also some rhinoplasty patients who may notice a slight amount of narrowing after hitting the age of 50 as the grafts used to support their nose could be absorbed minutely.  Fortunately enough, in most cases a revision surgery is not necessary.

Meanwhile, there are possible ways to minimize the likelihood of needing a revision surgery in the future.  The best advice is to only consult a board certified rhinoplasty surgeon with a minimum of five-year experience.

Rhinoplasty is arguably the most challenging elective plastic surgery in which even the slightest alteration of the nose in terms of its projection can have a drastic impact on one’s appearance.  To execute this procedure successfully, a doctor should both have artistic skills and surgical dexterity.

Another way to potentially make the surgery’s result long lasting is to have it only when the nasal development is complete.  For girls, it usually occurs at the age of 15 to 16, while for boys it happens one to two years later.

Any attempt to alter the nose younger than intended meanwhile could significantly increase the likelihood of a revision surgery at some point in one’s life.



With the aging Baby Boomer in the US, it is not surprising that facelift has been one of the most commonly performed surgical enhancements over the past several years.  According to a survey released by the American Society of Plastic Surgeons, in 2012 alone about 126,000 patients had the procedure.

Despite the growing popularity of facelift, which has become a common household term, there are still many misconceptions about it.  To better help you understand the procedure, leading plastic surgeon Dr. Tarick Smaili has provided a list of things it can and cannot do.


What Facelift Can Do:

*  It can target the saggy mid-face, an area that fits inside an “imaginary” inverted triangle starting from the lower eyelids to the chin.

*  Deep lines below the lower eyelids caused by skin laxity.

*  The procedure can target the nasolabial folds or the deep creases along the nose that extend to the corners of the mouth, which are caused by repetitive facial movement and tissue laxity that comes with age.

*  Facelift can reposition the displaced fat pad particularly in the cheek area.

*  The surgery can also correct the muscle laxity in the lower thirds of the face, leading to an appearance of jowls and double chin.

What Facelift Can’t Do:

*  It cannot remove the drooping skin in the upper eyelids.

*  The procedure is not designed to remove the furrows across the forehead and the low-lying or asymmetric brows.

*  The surgery cannot address the hanging skin in the neck area, unless the incision that goes around the ear will be modified to reach the lower scalp.

*  It can’t address loss of facial fat that commonly affects the temples, tear troughs, and lips.

*  Facelift cannot address the drooping nose, which is also associated with facial aging.


One effective way to achieve a more dramatic and longer-lasting result is to involve not just the skin but also the deeper muscles.  While this approach leads to longer recovery and more post-op pain than the skin-only lift, the overall aesthetic outcome far outweighs such tradeoffs.

To achieve the most desired appearance, you may also need some procedures that are often used to complement the result of facelift—examples include eyelid lift, brow or forehead lift, fat graft, dermal fillers, chemical peels, etc.

Fat graft is particularly helpful in further improving the result of facelift by plumping up the sunken facial region using the patient’s own fat usually derived from the tummy and hip area.



One of the most common concerns of breast implant patients is the drooping or bottomed-out appearance, which according to popular belief, is primarily caused by breastfeeding.

But such concern has no bearing as suggested by one study presented at the annual meeting of the American Society of Plastic Surgeons.  According to its finding, all the “potential physical changes” of the breasts are solely determined by pregnancy.


The study titled “The Effect of Breastfeeding on Breast Ptosis Following Augmentation Mammaplasty” involved women with implants who breastfed (57) and those who did not (62); the vertical measurement of their breast was measured before getting pregnant and a year after pregnancy or after weaning their babies.

The researchers found out that all patients had experienced a certain degree of breast changes, although not everyone had developed a serious case of drooping appearance.  Overall, there was no difference between those who breastfed and those who did not.

Simply put, with or without breastfeeding the breasts will likely change to a certain degree after childbirth.  This finding both applies to the natural breasts and augmented breasts.

With this finding, the researchers are hoping to encourage all women, whether they have breast implants or not, to breastfeed their babies since it provides countless of benefits including lower risk of childhood obesity, higher metabolic rate for mothers (helping them to shed the dreaded “baby fat”), and better resistant to diseases and infection for children compared to those who were given formula milk.

If one really wants to rule out pregnancy-induced sagging, the best advice is to postpone breast augmentation surgery until she is done having children.

However, pregnant women with augmented or natural breasts can still take proactive steps to at least limit the effects of pregnancy, if not avoid the saggy appearance.  Fortunately, such goal is easy as long as they are equipped with the right kind of information.

Maintaining a normal weight throughout pregnancy is arguably the most important step to limit its detrimental effects on the breast appearance.  Meanwhile, the “ideal” weight gain depends on a woman’s weight prior to her conception and also her height.

In general, women whose weight is at “healthy” or normal range (between BMI of 18.5 and 24.9 as suggested by experts) should only gain 25 and 35 pounds during the first trimester and then 1 pound every week throughout the pregnancy.

And because breast enlargement in preparation for milk production is a common occurrence, pregnant women should make sure to buy a new set of larger bras that provide additional support—they usually come with wider straps and better-fitting band.



While gynecomastia surgery is a body contouring procedure in which the overlarge male breasts are reduced through the use of incisions, its benefits are often far beyond cosmetics; this is particularly true among patients who have been taunted and teased because of their unusual breast size.

As more and more people become aware of male breast reduction surgery, it has been one of the most commonly performed plastic surgeries over the past several years.  In 2012 alone, about 20,700 underwent the procedure (many of them were under the age of 18) performed by US board-certified plastic surgeons.


One recent study has suggested that even the mildest form of male enlargement, whose primary cause is yet to be determined by experts, is enough to have a detrimental impact on one’s body image and self-esteem.

The study involved boys with breast enlargement who scored lower in terms of body image, mental health, and social functioning compared with their peers of the same age and gender who were unaffected by the condition.

Another surprising finding was that boys with the condition were more likely to exhibit eating disorder, which could be their way to cope with emotional and psychological stress of being taunted.

Some plastic surgeons have suggested that eating disorder may also be attributed to the goal of some boys and even adult men to gain more weight in an attempt to hide their distinctly large breasts.

But despite the negative impact of male breast enlargement as suggested by many experts, it is surprising that health insurance rarely covers the cost of surgery to correct this problem.  In contrast, female breast reduction is now often covered particularly if the condition leads to poor posture, chronic back and shoulder pain, rounded shoulders, etc.

Meanwhile, the good thing about gynecomastia surgery is that its results tend to last a lifetime as long as the patients are able to maintain their ideal weight throughout their lives.  Nevertheless, a few may need revisions in the future in the event that enlargement does recur.

The surgery is performed by literally removing some of the excess skin, tissue, and/or fat, while still making sure that the breast’s natural contour is preserved.  For better results, some patients may require nipple repositioning and/or liposuction to further remove the excess fat.



Otoplasty, or more commonly referred to as ear-pinning surgery, has been the most commonly performed plastic surgery over the past several years performed on patients below 18.  In fact, it accounted for about 45 percent of all surgical enhancements sought by minors in 2012, one survey has suggested.

While ear surgery can be performed on a healthy patient regardless of his age, double board-certified facial plastic surgeon Dr. Karan Dhir recommends having the procedure at a young age due to some notable benefits.


First and foremost, children’s cartilage is more flexible and easier to work with compared to adults’, thus they achieve better aesthetic results in general.  However, there are still other factors that can affect the final outcome, and these include the underlying anatomy (length of the ear) and the surgeon’s skills.

By the age of five or six, the ear’s development is complete that otoplasty could already be attempted.

Aside from achieving optimal results, having the surgery at a young age could also curb potential psychological trauma from teasing and name-calling, which have detrimental emotional ramifications on bullied individuals that could last into adulthood as suggested by several studies.

Some experts even suggest otoplasty on children before they begin their education, while others believe that it should only be attempted when they are asking for the procedure themselves or at least confiding to their parents that they are bothered by taunting.

Meanwhile, it is important for parents to explain to their children the ramifications of otoplasty—not just its aesthetic benefits but also the recovery.

In an attempt to hide the scars, the incisions are placed behind the ear that will allow the surgeons to manipulate the cartilage underneath and ultimately reshape the ears and/or bring them closer to the head.  Because each individual has a different anatomy, otoplasty comes in various techniques to achieve the most desired result.

Dr. Dhir said that otoplasty typically lasts one to two hours and is deemed as a “simple” procedure since most patients can resume normal activities, of course excluding physically-demanding tasks, within days of the surgery.



Plastic surgeons have coined the term mommy makeover surgery to describe any procedure that aims to reverse the effects of pregnancy—or at least minimize the physical changes it has brought on.

Basically, a mommy makeover procedure is a type of body contouring in which the saggy skin and sometimes even the deeper muscle (just like in the case of tummy tuck) are removed, tightened, and/or reshaped.


Any attempt to surgically improve the body’s contour demands a perfect timing, which is determined by many factors.  However, having a normal weight that has stabilized for at least six to eight months is crucial to make sure the results can last for decades or even a lifetime.

Tummy tuck is arguably the most popular mommy makeover surgery as it deals with the abdomen, which is the area significantly affected by pregnancy.  While it can effectively tighten the loose muscle and excise the hanging skin, it should only be attempted once the body has fully recovered from childbirth and hormonal fluctuations.

It is important to note that if a woman chooses to breastfeed, her hormones will remain higher than normal even months after giving birth.  This leads to skin and tissue unable to shrink back or at least regain some of their former firmness, thus a longer waiting period is important.

Breast lift is another popular mommy makeover surgery, which is often complemented by implants to help mothers regain the lost fullness in their upper poles.

But before any breast enhancement surgery is attempted, it is a sacrosanct rule to make sure that milk production has completely stopped lest it would significantly increase the risk of infection and poor wound healing—complications which can be minimized with proper planning.

Meanwhile, all types of mommy makeover surgery require long-term maintenance, i.e., making sure one is able to maintain a stable weight throughout her life through a well-balanced diet, regular exercise, and an overall healthy lifestyle.

Aside from having a stable weight maintained through healthy lifestyle choices, another way to keep the results of surgery long lasting is to only have it if one completely rules out pregnancy in the future, which could affect, if not reverse, the results.

If any of the surgical prerequisites is absent, the consensus is to postpone the surgery.  Simply put, each factor determines the perfect or ideal timing to have a mommy makeover procedure to achieve the best aesthetic result possible

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