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Revision Breast Augmentation—Correction of Implant Malposition and Rippling

Introduction The best way to treat a complication, is to avoid it. Unknown expert surgeon Breast augmentation is a common operation, and it has been estimated that there are currently 5–10 million women with breast implants in the United States alone, based on different surveys. It is a requirement of proper informed consent that we inform our patients of the short- and long-term potential risks and…

Revision Breast Augmentation—Correction of Implant Malposition

Introduction Breast augmentation is one of the most common procedures performed by plastic surgeons. In the United States alone, it is estimated that more than three million breast implants have been inserted for primary breast augmentation since 2005. It is recognized that breast implants are generally not once in a lifetime devices. Various implant outcome studies report reoperations or secondary surgery at rates as high as…

Revision Breast Augmentation –Exchange With a Different Type of Implant

Introduction Women who have undergone breast augmentation live with their breast implants for years and typically want to maintain their outcomes because it adds value to their lives. Revision breast augmentation provides patients an opportunity to maintain or improve their long-term outcomes with the latest in breast implant technology. Breast augmentation is not a one-time surgery, and maintenance surgery will be necessary. There are excellent options…

Composite Breast Augmentation

Introduction Breast augmentation with fat has evolved over the past 12 years. According to the American Society of Aesthetic Plastic Surgery, fat transfer to the breast dramatically increased 41% over 2016, and this trend does not appear to be diminishing. Core breast volume augmentation with fat alone, despite its potential, has experienced poor adoption because of patient and physician opposition to BRAVA pre-expansion and the graft…

Breast Augmentation With Primary Fat Grafting

Introduction Breast augmentation with primary fat grafting has gained increasing popularity in the past decade. It has several advantages over implant-based breast augmentation, including avoidance of foreign body implantation and related capsular contracture, which are appealing to people who want breast augmentation using autologous tissues. Initially, the safety and efficacy of fat grafting to the breasts had been questioned. However, a position paper from the American…

Breast Augmentation in the Asian Patient

Introduction Breast augmentation is one of the most popular aesthetic procedures worldwide, including in Asia. The unique Asian cultural background, which is more conservative, influences various options for Asian breast augmentation. Many Asian women prefer an axillary incision to inframammary fold (IMF) incision because they do not want others to notice any scar on their breasts when they are in a public bath, swimming pool, or…

Breast Augmentation With Implant—Subfascial Placement

Introduction The pectoral fascia is a thin layer of dense connective tissue, covering the surface of the pectoralis major muscle. It can be easily dissected along the subfascial implant insertion. The pectoral fascia helps support the breast implant, and even in slim patients a smoother transition is achieved in the breast upper pole if the fascia is firmly attached to the muscle. Various approaches can be…

Breast Augmentation With Implant— Transaxillary Approach

Introduction Breast augmentation, according to the most recent procedural statistics data from the American Society for Aesthetic Plastic Surgery, continues to have increased popularity as the most common surgical procedure in the United States and was performed in more than 330,000 women in 2017. The most common incision access used is the inframammary approach worldwide, based largely a long-existing bias that this approach is most simple…

Breast Augmentation With Implant—Periareolar Approach

Introduction Breast augmentation using implants has been an important part of plastic surgery practice since the first breast implant was developed in 1963. More recently, some leading plastic surgeons have promoted an inframammary fold (IMF) approach when placing a breast implant. They think this method minimizes implant contact with breast tissue that could be contaminated by bacteria. If contamination can be avoided, the risk of biofilm…

Breast Augmentation With Implants—Inframammary Approach

Introduction Over the last 20 years, considerable effort has been placed on re-evaluating breast augmentation and shifting the focus away from simply volumizing the patient to a more comprehensive approach to breast augmentation. Peer-reviewed articles and prior book chapters have already stressed the critical importance of thorough patient education and informed consent and defining breast augmentation as a “process.” It has become abundantly clear that we…

Complications of Face and Neck Lift: Recognition, Treatment and Prevention: “You learn more from your failures than your successes.”

Revision Facelift Surgery Revision facelift is a broad term that includes numerous variables and common reasons are listed. A. Improving a recent substandard surgical outcome from another surgeon Any given surgeon who performs a lot of facelifts and has consistently natural and long-lasting results can develop a good reputation for the procedure. In this day and age of the Internet and social media, an excellent reputation…

Modified Facelift Procedures

Short Scar (Weekend) Facelift Surgical Procedure In the previous chapters I discussed the pluses and minuses of small facelifts (short scar facelifts [SSFLs]). It is obvious that I feel that these types of facelifts are very limited for the average patient of facelift age, however they remain useful for younger patients with minor aging as well as a means of learning facelift surgery for the novice…

Facelift Anatomy

This chapter marks the third major writing I have done for Elsevier over the past decade on facelift surgery. Although there is some overlap with previous writings (especially the inclusion of excellent drawings or images), I have continually enriched the content of the chapters with new discussion, pictures, and innovations to remain contemporary. My own journey with facelift surgery has changed over the past decade as…

Evaluating the Cosmetic Facial Surgery Patient: The Art of the Consult and the Office Patient Experience

Cosmetic surgery is a very unique specialty as it is, for the most part, totally elective. No one needs cosmetic facial surgery! Very few surgeons begin their journey as “strictly cosmetic surgeons”. Having a total cosmetic surgery practice is actually pretty rare because many “cosmetic surgeons” perform other procedures based on their background training. For instance, plastic surgeons may also do burns, trauma, and reconstruction; facial…

The Aging Face

Numerous times a day, the average cosmetic surgeon will deal with patients who are unhappy with their aging. I tell these patients that “aging is a privilege denied to many.” What is equally important is how the patient is “handling” their aging. A 60-year-old patient who wants to look 30 is unreasonable, whereas a 60-year-old patient who wants to look as good as they can for…

Inner Thigh Reduction: Reshaping Using a Two-Way Vector Technique

The Clinical Problem ( Fig. 39.1 ) The lower extremities, and especially the thighs, are one of the most typical surgery consultations in Argentina. Most patients with massive weight loss desire a better-looking shape of the thighs because they look deflated and have poor skin tone. Deformities in the thigh region vary according to age, degree of skin laxity, and distribution of adipose tissue. Patient dissatisfaction…