In patients who have undergone radiation therapy, breast reconstruction with mammary prosthesis may be challenging. Often implants may become repeatedly infected or possibly extrude from the body. When repeated infections occur or if implants extrude from the body, these patients are often not candidates for implant based breast reconstruction. The most common donor site used for breast reconstruction is the…
Rhinoplasty is a commonly performed procedure. There are many reasons why a patient would want to undergo a rhinoplasty operation. One of the more common reasons is to soften the appearance of the nose. Often several small changes can add up and lead to a significant change. Small changes to the profile or nasal tip can make the overall appearance…
There are two broad categories of breast reconstruction for mastectomy. There is expander-implant reconstruction and autologous flap reconstruction. Tissue expander and implant reconstruction is often selected in patients who have not undergone radiation therapy. At the time of mastectomy, a tissue expander is placed at the location of the mastectomy pocket and often in conjunction with an acellular dermal matrix…
Patients often undergo unilateral mastectomy. In these patients, depending upon the status of the contralateral breast, the contralateral breast is often best matched with a reconstruction using the patients own body tissues. Depending on previous surgery and on previous radiation, a small portion of the abdominal skin may be transferred to the mastectomy site, not only to monitor the blood…
DIEP Flap Breast reconstruction is a unique opportunity for the breast cancer patient to loose weight. Prior to flap reconstruction, we instruct our patients to consume 80-100 grams of protein per day. There are a significant number of incisions that require healing with DIEP flap breast reconstruction and typically the metabolic rate increases after DIEP flap breast reconstruction as the…
Gluteal fat transfer can be very rewarding for the patient. Patients who have a high satisfaction rate have lower lumbar lipodystrophy as well as a lordotic spine posture. Patients wear a compression garment, abdominal binder, and/or faha beneath the compression garment. The more compliant patients are with the compression garments, the better results they acheive. Patients are allowed to sit…
Gluteal fat transfer is a common procedure. In gluteal fat transfer, liposuction is performed in one or several areas of the body and the harvested fat is transferred to the gluteal region. Satisfaction rate is high with the gluteal fat transfer procedure. The patients with the highest satisfaction rates are those patients who have lipodystrophy in their lower back with…
Rhinoplasty is a common procedure to correct a bulbous tip or to deproject the nose. The nose can overproject for several reasons. One reason can be an excess of the septum or an extrinsic projection, the nose can project because of lower lateral cartilage excess, or the interaction between the extrinsic and intrinsic cartilages. The nose can also overproject because…
There are many different faces in the world and different people want different things. That’s what makes the world great! Facial asymmetries are common and make people beautiful. It often gives us character. Despite these facial asymmetries making one beautiful, there are often certain aspects of the nose that people would like to change or improve upon. One is the…
Often the nasal tip, nasal bones, and nasal septum may be distorted from previous trauma. Trauma to the nose frequently results in a deviation of the nose and can often result in loss of projection to the nasal tip depending upon the trauma to the underlying septum and lower lateral cartilages. Trauma to the septum can result in nasal airway…
One of the more common reasons that patients request rhinoplasty is to remove a dorsal hump. There are also many patients who have a dorsal hump, who also wish to maintain some of the hump post-operatively. There are many and varied reasons for this. Some patients would just like a small change to the appearance to their nose to maintain…
Patients frequently come to the office requesting a “smaller” nose or simply stating that their nose is “too big”. There are many different aspects of the nose that a patient may wish to reduce when they request this and there are many aspects of the nose that can be changed when a patient wants to make this change. Common areas…
