What is a mastopexy?

A breast lift, or mastopexy, is done to make the breasts more “perky”.  Ptosis is the term used to describe droopiness of the breast, and a mastopexy reverses this process. There are three common types of mastopexy incisions:

  1. Peri-areolar: this type of incision extends only around the areola. It may even be limited to just the upper portion of the areola if only a small crescent of skin needs to be removed (below, left).
  2. Lollipop: A lollipop incision will correct a greater amount of ptosis than a peri-areolar incision. This type of incision starts around the nipple, then extends down the front of the breast (below, center).
  3. Anchor-style incision: identical to the incision used in breast reduction, an anchor-style incision is essentially a lollipop incision with a horizontal incision in the crease below the breast. This will correct even very severe ptosis (below, right).

Photo credit: www.plasticsurgery.org

Picture

Picture

Picture

A small amount of breast tissue may be removed during a mastopexy to help reshape the breast mound, but this does not generally result in a visibly smaller breast.

Recovery after mastopexy is very similar to recovery after a breast reduction. Most of my patients take prescription pain medicine for the first 2 or 3 days, then transition over to ibuprofen or Tylenol. I also recommend no lifting >15lbs and no vigorous exercise during the first four weeks to allow your incisions to heal. The majority of my patients return to work within a few days unless their job requires intense physical activity.

Do you have a question about mastopexy? I will do my best to answer questions in the comments section.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Is there a way to prevent skin cancer?

I think we all understand that skin cancer is caused by sun exposure, and that the best prevention is using sunscreen.  But what if you’ve missed the boat on that option? Every day I see patients in their 40s, 50s and older who have already been subjected to many years of sun damage. Wearing sunscreen moving forward is certainly important, but is there a way to improve some of the damage that’s already been done? Thankfully there is.

Topical retinoids may help reduce chronic sun damage. I’ve covered how to use these products in a previous post, so we’ll skip over that here. Two other options are also effective:

  1. Skin resurfacing. Skin resurfacing includes treatments such as dermabrasion, laser peels and chemical peels. These treatments remove the outer layers of the skin, which is where most of the sun-damaged cells reside.
    Pros:

    1. Skin resurfacing will improve fine lines and pigmentation as well as reduce the risk of skin cancer.
    2. The recovery time is only about a week, and these procedures can be done in the office.
      Cons: Skin resurfacing is usually considered cosmetic, and thus is not covered by insurance.
  2. Topical medication. Efudex (fluorouracil) is actually a chemotherapy drug used to treat cancer, which was formulated into a skin cream. It kills abnormal cells, such as those at risk of turning into skin cancer. The medication is used for a few weeks until most of the abnormal cells have been killed.
    Pros:

    1. Efudex is covered by most insurance plans.
    2. Efudex will remove sun-damaged cells that are not visible to the naked eye.
      Cons: Efudex causes skin irritation, rash, and redness, which may persist for up to two months after you stop the treatment.  No makeup can be worn during the treatment period. The photo below is what a typical patient looks like during treatment.

      Side effects of Efudex. From: http://alaneg1948.blogspot.com/2012_05_01_archive.html

      Side effects of Efudex. From: http://alaneg1948.blogspot.com/2012_05_01_archive.html

 

If you are interested in pursuing Efudex or skin resurfacing, I would recommend seeing a board-certified Plastic Surgeon or Dermatologist in your area who has experience treating skin cancer with both of these treatment options.

 

Questions? Leave them in the comments section and I’ll do my best to get back to you.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Will tattooing cover up a scar?

I’ve written previous blog posts about what makes a scar good or bad, but I never addressed the topic of tattooing. Tattooing done to camouflage a scar is referred to as medical tattooing. This is in contrast to cosmetic tattooing, which is done to apply permanent makeup, and the tattooing of artistic designs for body modification.

Tattooing does have a role in scar camouflage, but it must be done after the scar has completely matured. Scars may be raised up and appear red or purple during the initial healing period. They then begin to settle over a period of 6-12 months, eventually becoming flat. The final scar may be lighter than the surrounding skin (hypo-pigmented) or darker than the surrounding skin (hyper-pigmented).  Hypo-pigmented scars may benefit from tattooing, which essentially adds pigment to match the surrounding skin. This should be done on un-tanned skin, so the scar is pigmented the correct color. Remember, however, that if the surrounding skin is exposed to sun, the resulting tan will make the scar more noticeable.

hyper-pigmented scar

hyper-pigmented scar

hypo-pigmented scar

hypo-pigmented scar

 

 

 

 

 

 

 

 

In contrast to a hypo-pigmented scar, a hyper-pigmented scar is darker than the surrounding skin. In this case the treatment is to remove pigment rather than adding it. This can be done with laser or broad-band light (BBL) treatments. I would recommend waiting at least a year to allow your scar to mature, and then seeing a Board-Certified Plastic Surgeon to evaluate your scar. He or she can recommend the best course of treatment, and refer you to a tattoo artist with experience in scar camouflage if necessary.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is the recovery after liposuction?

As with any operation, your recovery will be unique to you. Everyone has a different pain tolerance and recovers at a different rate. That being said, the recovery from liposuction is generally very tolerable.

Image courtesy of office.com

Image courtesy of office.com

  • Pain is usually less than with an abdominoplasty, C-section, or other types of surgery that go through the muscle layer. You’ll likely have moderate pain the first one to two days after surgery, and then you’ll experience more soreness than anything. Most of my patients take narcotic pain medication for the first couple of days, and then transition over to ibuprofen or Tylenol within a few days after surgery.
  • You will have a large amount of drainage from your incisions over the first 24-48 hours. This will taper off and stop by day two after surgery. This fluid is the numbing fluid which is used to break up the fat during liposuction. It is tinged with blood, so it is usually pink or red.
  • Liposuction also causes quite a bit of swelling and bruising. The bruising fades within a couple of weeks, but you will have to wear a compression garment for up to three months after surgery to help the swelling resolve.

If you are considering having liposuction, be prepared to take from several days up to a week off work, depending on how physically active your job is. Walking and light exercise are fine after the first week, but I do recommend my patients avoid any heavy cardio (e.g. running) or weightlifting for a full month after surgery.

 

Any questions regarding liposuction? I’d love to hear them in the comments section!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is the difference between Botox and fillers?

I perform many minimally-invasive procedures to treat wrinkles in my office, and I’ve noticed that there is often a lot of confusion about exactly what the difference is between a neurotoxin such as BOTOX, and a filler such as Juvederm or Restylane. My blog post today is written with the intent of clearing up that confusion.

Confusion is understandable, as the two treatments do share many similarities. Both neurotoxins and fillers are injected in the office. Both treat wrinkles. And both are temporary, meaning the results wear off over time. But the two products actually work quite differently.

As I mentioned before, Botox is a neurotoxin. This means it is actually toxic to nerves, thereby preventing muscles from contracting in the areas where it is injected. Muscle contraction is responsible for what are called “dynamic wrinkles”, i.e. wrinkles resulting from motion. Dynamic wrinkles are commonly seen between the eyebrows, over the forehead, and around the eyes. Preventing the muscles from moving stops the wrinkle from forming. Because neurotoxins cause localized muscle paralysis, I do not like to use them around the mouth as this may result in drooling or difficulty speaking and eating.

Fillers do what their name implies: they fill volume. Volume loss in the soft tissues contributes to an aging appearance. This is partially responsible for the formation of the “smile lines” which run from the nose to the corner of the mouth, and the marionette lines which run from the corner of the mouth to the chin. Ptosis or droopiness of the overlying tissue secondary to gravity is the other main contributing factor, and this can be corrected surgically. But adding volume directly under a wrinkle can significantly soften the appearance. Unlike neurotoxins, which require several days to take effect, the results from fillers are immediate.

If you’d like to learn more, check out my previous posts on Botox and other neurotoxins as well as fillers.

Any questions? Leave a comment and I’ll do my best to get back to you.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.