Please note that I have NEVER used PIP brand implants on my patients, ever!

Juvista® (Avotermin) Scars after surgery or trauma can cause a significant degree of psychosocial distress for people. For centuries, surgeons have been searching for methods of reducing scars and optimizing healing, to reduce these effects. To date, we know that several technique related factors as well as post surgical factors can effect the quality of the final scar. A new drug called Avotermin (trade name Juvista®) is based on the transforming growth factor (TGF)-β family of cytokines. These growth factors play a critical role in the final appearance of scars, and this represents one of the first drugs based on growth factors that may make a real difference in scars. Renovo is a biopharmaceutical product company involved in in the discovery and development of drugs to reduce scarring. I have no relationship with the company whatsoever (I have nothing to disclose). The July edition of the Plastic Surgery Journal (the [Read more...]

Question: I have old breast implants in place but I have bilateral capsules. I am going to get my breasts re-done, and I am not sure whether I should have a new pocket done or just use the existing breast implant pocket. What is your advice? Answer: Breast Implant Re-Do: Which Pocket After Fixing Capsular Contracture? The standard textbook advice for capsular contracture is capsulectomy followed by site change and device exchange(1, 2). That means taking out the old implant, as well as the surrounding scar, closing the pocket, followed by making an entirely new pocket opposite to the original (under the muscle if the original was over the muscle) and using a new implant. There are as many option I have tried using medications (such as ACCOLATE®- aka Zafirlukast) on a few patients to alter the tightness of early capsules (3, 4), but the results have been disappointing. Surgery [Read more...]

QUESTION: I want to have either 500cc or 600 cc silicone implants-but I can’t figure out what size that is. Can you tell me what cup size I should expect? Can I start picking out pretty bras now? ANSWER: Exactly how big is a cup, as in a breast cup size? Wow, that sounds pretty big. Look elsewhere on this website for my comments on getting the right size for your body. For the average height and weight female in the USA, a cup is about 200cc. Speaking in general terms, a 500cc implant will increase your bust size by 2 ½ cups, and a 600cc implant will increase you by 3 full cups. This is ONLY true for an average height/average weight female In international law, there sits, in a deep, dark, secure safe in Paris, the exact standard Killogram Measure, from which all other standard kilogram weights are [Read more...]

This is the third installment on the series of articles about plastic surgery prices. BBL -IPL Treatments (Intense Pulsed Light) This is a great technology to jump-start your skin care program. Get rid of fine lines, brown spots, and red spots and small veins. (This is not a laser treatment). Fees: $200- $400 per session. Most people need at least two sessions to start, then a maintenance program to keep their skin looking great. Laser Hair Removal I have been providing hair removal services since 1994, before almost anyone even knew it was even possible. My team performed some of the original research on this subject. Our staff is extremely experienced, and we have retreated patients who were treatment failures at other clinics, and we have assumed care for patients who were abandoned when the original clinic went out of business. Over the years, I have invested in new equipment [Read more...]

QUESTION: I HAD BREAST AUGMENTATION SURGERY WITH 600 CC BREAST IMPLANTS ( ELSEWHERE) ABOUT A YEAR AGO. I AM 5’3” TALL AND WEIGH 106 LBS. UNFORTUNATELY, I ENDED UP WITH SYMMASTIA, SEVERE MUSCLE DISTORTION AND BOTTOMING OUT OF THE IMPLANTS. – ANY ADVICE? ANSWER: REALLY DISTORTED BREASTS WITH OVERSIZED BREAST IMPLANTS- ARE THE RESULTS OBTAINED PREDICTABLE? First of all, sorry to those women who got what they asked for, instead of what would work best for their body shape and size. Remember, breast augmentation is NOT an easy operation. You have to be FITTED for a breast implant that will work properly for your actual breast/chest size and shape. You CAN’T have any size you want, you can ONLY HAVE A SIZE THAT FITS YOU (sorry for shouting there). There is a range of devices that will properly fit a given breast/chest. That range is typically narrow. Breast implants come [Read more...]

Breast Lift with Breast Augmentation (Mastopexy-Augmentation) Many women will experience significant changes in their breasts following lactation and pregnancy. The skin of the breast will actually increase over time due to the gradual distension of the breast tissue (parenchyma) that develops vital milk for your baby. When lactation ends, the breast tissue, previously engorged, reverts to its dormant state, usually resulting in a rather dramatic decrease in volume. Some women have experienced as much as a two or three cup decrease in the volume of their breasts. So, what happens to the skin during this process? The skin is programmed in a very special way, so that when ever certain stretch is applied to it over a long enough period of time, it actually makes more of itself. You have no doubt seen this yourself in your own body- no matter how big you get, you never seem to run [Read more...]

This is the second post in the series of articles about plastic surgery prices. Surgery Whenever one considers surgery, one has to add the cost of the facility in which it is provided, as well as the cost of anaesthesia. These can be significant, and are added to the cost of the procedure. The typical cost of anaesthesia is about $700 for a one-hour procedure. This covers the cost of the doctor (anaesthesiologist- a medical specialist who has spent about 5 years of extra training AFTER medical school) as well as all the equipment, drugs, and disposable items used to provide you a safe and effective, pain free experience. The facility fee includes the cost of the experienced operating room personnel, the monitors, equipment, fluids, iv’s, and all the other items used, as well as a use fee for all the items you will hopefully never need to use, but [Read more...]

We are always being asked to give prices, even before discussing the requirements of surgery. How much is that? The answer is never as easy as it should be, and it always looks as though we are trying to beat around the bush. Click on the title above to read on…

Some susceptible patients will have recurrent issues with hyperpigmentation, and often the problem will be ongoing for many years unless treated. Surgical scars can become hyperpigmented (darker in colour) and stabilize so that the colour never returns to ‘normal’ unless actively treated. For example, see Figures 1, 2, and 3, showing stable darkened skin along the breast augmentation scar at 2 years and four years after surgery. Clearly, unless the pigment is treated, this problem is not likely to go away on its own. Figure 1: Pre Op-Patient of mixed genetic heritage, Type III skin. Figure 2 Four years Post Op Breast Augmentation Figure 3 Scar hyperpigmentation four years after surgery. (Before Starting Treatment) What is PIH? PIH refers to the increased pigment (darkening) of the area around an scratch, cut, burn or other injury to the skin. Melanocytes are the skin cells responsible for making melanin, the substance that [Read more...]