Bilateral mastectomy breast reconstruction is common in patients who have BRCA gene positivity. Bilateral mastectomy is also common in patients who choose to undergo mastectomy and contralateral prophylactic mastectomy. When the breast is ptotic, defined by a nipple areola complex that descends below the level of the inframammary fold, the nipple areola complex cannot maintain a blood supply sufficient to…
Breast augmentation is a common aesthetic procedure performed in our practice. The most commonly used implant is a smooth silicone gel implant. There are several options for the incision choice in breast augmentation with silicone gel implants. The three choices are inframammary crease, periareaolar, and transaxillary. There are different benefits to each incision. It is helpful to select an implant…
Mastopexy and abdominoplasty are a very powerful combination of procedures. Mastopexy involves lifting the nipple areola complex and some component of the parenchyma of the breast. Often a mastopexy may involve removing the lateral aspect of the breast tissue or “bra fat” to improve the contour of the breast. The mastopexy markings involve determining the position of the nipple areola…
There are many occasions when patients acquire infections in their breasts. This can occur from previous mastitis during breast feeding or from previous galactocele, intraductal papilloma, or previous breast trauma. When the breast has been previously infected, scarring between the skin and the chest wall can occur. This can cause breast asymmetry and deformity of the breast. If the infections…
Breast cancer is common among women with approximately 1 in 9 women developing invasive breast cancer in the United States. When a patient chooses to undergo mastectomy, the patient may also choose to undergo mastectomy on the contralateral or opposite side of the breast that has breast cancer. This choice can be made because of a genetic predisposition to breast…
In certain patients with breast cancer, they may be a candidate for a lumpectomy with oncoplastic reconstruction and intra-operative radiation therapy. In patients with smaller tumors and certain biologic characteristics radiation can be undertaken at the time of lumpectomy during the operation. This can have fewer deleterious effects on the breast tissue, skin, and the overall aesthetic result. Oncoplastic reconstruction…
Rhinoplasty is one of my favorite procedures to perform. One of the more common reasons for people to request a rhinoplasty operation is to decrease the projection of their nose and to reduce the hump on their nose. When changing the characteristics of the nose it can be advantageous to keep or maintain many aspects. In this way, the new…
Patients with breast cancer can undergo lumpectomy and oncoplastic reconstruction of their lumpectomy defects. Depending upon the size of a cancer the patient can undergo intra-operative radiation therapy at the time of the lumpectomy. Breast implants can be removed at the time of the operation. The satisfaction rate with oncoplastic reconstruction of lumpectomy defects is high.
Bilateral upper blepharoplasty is a common procedure in men and women. As the upper eyelid ages, the skin below the eyebrow starts to encroach on the upper eyelid. This can obstruct the lateral aspect of the visual axis. This can make it more challenging to place eye makeup and can produce a more tired appearance to the face. The upper…
Trans-Axillary breast augmentation allows implants to be placed through the armpit without a visible scar on the breast or chest wall. Revision of the implant is possible through the same trans-axillary incision but can be challenging. Silicone implants can be placed through the trans-axillary incision, but the volume may be slightly limited. Patient satisfaction is high with the trans-axillary incision.…
