1. What to do before seeing a Plastic Surgeon.

The first step is to get a small pad and carry it around with you to write questions down as you think of them. Next, peruse the web to get some basic information, but not too much. There are sooo many self proclaimed ‘experts’ out there giving you wrong information. Next, it’s time to pick a Plastic Surgeon. You may try to go on sites that rate different physicians such as RateMD.com. Speaking to friends to try to get referrals is also very important. Make sure that your surgeon is a board certified Plastic Surgeon. You may also consider going on a physician profile web site (usually state run) to see if there are an unusual number of cases brought against them. Ask to see actual before and after photos of the doctors work. http://www.taranow.com/TAR_List.asp?type=Proc&data=Breast_Augmentation

Don’t be afraid to insult the doctor with any questions you may have. Consider his/her personality. You will be having a ‘foreign body’ (implant) inserted inside you and you want to make sure that this surgeon is one you feel a connection to and know that they will be available to you if ever you have a question or problem. Ask them how many breast augmentations they perform each year.

2. What are the different types of incisions used to place the implants?

There are four types of incisions:
a. Transaxillary- armpit incision
b. Periareolar- around the bottom of the areola (colored area below the nipple)
c. Inframammary- in the crease below the breast
d. Transumbilical- through the belly button

My favorite is the transaxillary incision which leaves no scar on the breast. The periareolar is my second favorite with the scar hidden in between the dark area of the lower areola and light area of the breast skin. The inframammary is the easiest and most commonly used incision, but it leaves a visible scar on the bottom of the breast and may become darker especially in Hispanic or Dark Skin patients. The transumbilical is the furthest incision from the breast and a long tunnel must be made to insert the implants.

3. Types of implants.

There are two different types of implants:
Saline- salt water filled
Silicone- silicone gel filled
Saline filled implants are safe and do not require any monitoring outside of the recommended yearly mammograms for breast cancer detection. They are known to ‘ripple’ or develop small creases on the outside of the implant which may in some instances be felt or even seen. Silicone implants tend to feel more ‘natural’ and ripple much less. As such, they are not as easily felt or seen through the skin. The silicone implants are recommended to have an MRI three years after their placement and every two years there after to monitor for leakage.
The outside of the implant called the shell comes in two different types. Smooth (just like it sounds) and textured (fuzzy outside). Both types are made of a solid (non-gel) silicone. The type used is based on the surgeons preference. I allow the patient to decide which implant best fits their situation and lifestyle. Make sure you ask your surgeon to let you feel the implants.

4. Round versus shaped (anatomical).

The round implant is the most common breast implant used today. Some surgeons prefer a shaped or anatomical implant. The choice of implant is based solely on the surgeons preference.

5. Placement of the implants.

Submuscular- under the chest muscle (under the breast) and subglandular-under the breast tissue on TOP of the chest muscle are the two options. Placement depends on you shape, size, chest wall, implant selection and physician’s preference. More commonly, I place my implants under the muscle unless there is significant breast droopiness (ptosis), very wide cleavage or sternum (breast bone) or tubular type breasts.

Implants just like hip replacements etc are man made and will NOT last for life. The saline implants are easy to diagnose when they leak as your breast will rapidly deflate over several days if one leaks. The leaking silicone implant may not be detectable without performing an MRI. The implant companies warrantee their implants for several years and there is even a low cost insurance available through the companies that you may consider.

Please feel free to watch my video on Breast Augmentation in my Video Gallery-Breast Augmentation by Dr Douglas Taranow

A Mommy Makeover most commonly combines several of the following procedures:

Breast Augmentation

Breast Lift (Mastopexy)

Liposuction

Tummy-tuck (Abdominoplasty)

Brazilian Butt Lift

The traumatic effects of pregnancy on the abdominal muscles and skin as well as the excess fat deposits of all areas of the body are either difficult or impossible to correct with diet and exercise alone. Breast feeding further complicates your post delivery appearance by causing engorgement followed by multiple deflations daily. These changes may cause your breasts to be deflated, pancake in appearance, droopy with excess skin and even stretch marks.

Love handles, arm, chin or thigh fat that was never a problem suddenly appears after the baby weight is lost. Many women complain that their buttocks has lost its’ shape and that nothing fits right anymore.

Most Moms complain about several of these issues and can have multiple procedures performed together as a single procedure on an outpatient basis. They are performed in an accredited surgical facility (private office) and you are sent home that same afternoon! Depending on the procedure(s), you may be up and around from just one to seven days.

Some questions you should ask yourself before doing the Mommy Makeover are:

Am I finished having children?
If you are planning on having more children in the near future, you may want to wait to avoid re-stretching the skin of your abdomen or breasts.

Have you completed breastfeeding?
Before considering a breast lift or breast augmentation, you should wait several months after cessation of breast feeding to allow the milk ducts to contract and for the increased blood supply to return to normal. This will reduce the potential for either bleeding or incorrect post-operative sizing due to normal post partum deflation.

Have you been maintaining your weight, or are you still gaining/losing?
It is always best to be at a stable weight (even if it is more than you would like). If you are actively losing, you may want to have the procedure performed after you hit ‘the wall’. This will allow me to remove more of your skin in a tummy-tuck or breast lift procedure. If you are doing liposuction alone and need an incentive or “jump start”, then you may perform the procedure at any time regardless of your current weight status.

Procedures

Breast augmentation is used to increase the size, refill the empty areas, make the breast shape more round giving them a youthful appearance. Saline (salt water) or silicone gel filled implants may be used. The implants can be placed either above or below the muscle depending on your anatomy, physical fitness or desires. The incisions used to insert the implant may be in the armpit (axilla), under the colored area of the nipple (areola), below the crease of the breast (inframammary), or through the belly button (transumbilical). This procedure generally takes 45 minutes to 11/2 hours.

Breast Lift (Mastopexy)

A breast lift removes only breast skin and elevates the height of the nipple and areola. The nipple and areola are not removed so the sensation and breast feeding capabilities should remain intact. This procedure takes between 2-3 hours and may be combined with a breast implant to further increase the size of the breast.

Liposuction

Liposuction entails the PERMANENT removal of fat from almost any area of the body. It is performed through tiny incisions in inconspicuous places. Abdomen, sides (love handles), back, thighs, knees, calves, ankles, upper arms, upper back, chin and neck are just some of the places that may be treated.

Tummy tuck (Abdominoplasty)

An abdominoplasty is the removal of the lower belly skin and fat with the tightening of the abdominal muscle s which stretch and loosen with pregnancy or weight gain. It is your same belly button but just made shorter and smaller and brought back through the new skin that was stretched down from the top of your belly. The elongated ‘c-section’ type scar should be hidden in your bikini or panty line. All stitches dissolve and you are usually back to driving in about a week.

Brazilian Butt Lift

Many women complain that their buttocks have changed shape and size over time. Some of these patients may do well with liposuction alone reshaping the areas around the buttocks. However, many of you have lost or never had the volume in the right areas of your buttocks to begin with. For these women, an autologous fat transfer (moving the fat from one area of your own body to another) is the perfect solution. Not only is your own fat used to enlarge or reshape your buttock, the fat is taken from other problem areas of your body so you get the reduction in those parts as well.

The Mommy Makeover is a combination of any or all of these procedures performed together as an outpatient basis in an accredited surgical facility.

Douglas A. Taranow, D.O., FACOS
Board Certified Plastic Surgeon
www.Taranow.COM
212-772-2100

The controversy over which product (Botox vs Dysport) gives better or longer lasting results are many and quite varied. In polling numerous of my facial patients, Dysport seems to be slightly less tender on injection and have a shorter onset than my Botox patients. Many of my Botox clients tell me that they feel the Botox lasted longer on them than the Dysport treatment. There is no proof to any of these claims by my patients, so I offer both products.

Botox and Dysport stop your muscles from moving by blocking the nerve impulses so the muscles never get the ‘message’ to contract causing wrinkles. This stops you from frowning or wrinkling the skin of your forehead, in between your eyebrows or around your eyes (depending on where you have the Botox or Dysport injected). The muscles may take one to fourteen days to be completely paralyzed. Generally, the duration of the effects of the treatment lasts for 3-4 months.

A recent article by Dr Verne…http://drverne-botox-drverne.blogspot.com/ discusses other information about Botox and its indications.

Douglas A. Taranow, D.O., FACOS
www.TARANOW.com
212-772-2100

Your own fat has been used to augment the face, lips, ankles as well as a treatment for cellulite.  Large amounts of fat are processed from liposuctioned areas and  re-injected into the deficient areas of your buttocks.  Tiny needle holes are all that is required to inject the fat.  There is little added pain from the buttock augmentation over the normal discomfort following a liposuction.  Patients generally return to work in a week and wear a custom garment for two weeks.  A recent blog posted by Dr. Rose of New York City also gives other information regarding liposuction.  http://www.drroseblog.com/2010/03/liposuction-the-basics/

Taranow Plastic Surgery

Limited Time Offer: Save $150.00* on Radiesse Dermal filler 

Radiesse wrinkle filler instantly corrects facial wrinkles to give you a natural, younger look that lasts.

 Radiesse wrinkle filler:

• Instantly corrects facial wrinkles to smooth out signs of aging
• Stimulates your body to produce your own natural collagen to restore fullness
• In many patients the results may last a year or more
• Radiesse patients are significantly more satisfied than patients treated with other leading wrinkle fillers.

Why are more and more patients being treated with Radiesse wrinkle filler every year?

Radiesse wrinkle filler is more effective at correcting wrinkles than any other leading wrinkle filler

Twice as many patients preferred Radiesse treatments to Restylane treatments

Radiesse dermal filler has more viscosity and elasticity than hyalurinic acid fillers, which makes it ideal for adding volume

Radiesse has been combined with lidocaine to enhance patient comfort. (read the full article from Cosmetic Surgery Times, click the link below)

Find out how you can transform your look today!  212-772-2100

http://cosmeticsurgerytimes.modernmedicine.com/cosmeticsurgerytimes/News/Filling-with-comfort-Its-all-about-the-accessories/ArticleStandard/Article/detail/617356

*Offer expires October 31, 2009

Common questions about Botox cosmetic:

Will I still be able to make facial expressions?

Although you will see marked improvement, a treatment with Botox Cosmetic doesn’t make you look like you’ve “had work done.”  The muscle activity that causes frown lines is reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.

How soon will I see a difference?

You can expect to see results within days after your treatment, and the appearance of the treated area may continue to improve over the next 10-14 days.

How do I know if Botox is right for me?

If you are between the ages of 18-65 with moderate to severe frown lines, you may be a candidate for Botox.  You can schedule a free consultation to find out if Botox is right for you, 212-772-2100.

Dr. Taranow is a licensed, trained, Board certified Plastic & Reconstructive Surgeon with the experience necessary to administer Botox Cosmetic by Allergan Inc.

For more information go to www.Obagi.com