New regulations out of Alabama

Earlier this summer, Alabama’s State Board of Medical Examiners (BME) pumped the brakes on the widely unregulated service of elective IV therapy according business and health care law firm Byrd Adatto. Under Alabama law, IV therapy constitutes the practice of medicine, meaning only a licensed physician, physician assistant (PA), nurse practitioner (NP), or midwife may diagnose, assess, and prescribe IV hydration therapy.

This means registered nurses, who can legally administer IV therapy, are not qualified to prescribe IV therapy and the use of “standing orders” (pre-written prescriptions that RNs can follow without consulting the provider) does not meet the legal requirements. The regulations for IV therapy vary by location, but as more states begin to follow Alabama’s lead, tighter regulations may be soon to follow.

Currently in California, the law states that IV therapy must be rendered through a medical corporation, and at least 51% of the practice must be physician-owned. Despite physician ownership, don’t be surprised if, similar to Alabama, the doctor, NP or PA must eventually prescribe treatment in California. In many places, IV therapy businesses are entirely staffed or even owned by RNs. With new state and federal regulations forthcoming, many of these businesses will potentially be out of compliance due to lack of oversight by a licensed provider.

Why is this important?

Ultimately it comes down to patient safety. IV fluids and added supplements have the potential to interact with other meds or even worsen existing medical conditions. For example, a patient with congestive heart failure (CHF) – a condition where a weak heart is already overloaded with too much fluid – should not have a seemingly harmless bag of IV fluids!

When we first discussed the idea of offering IV hydration in our office, this was one of my top concerns as a nurse practitioner. Can I order medications that can potentially be dangerous without seeing (virtually or in-person) the patient myself? I want to know their medical history, what surgeries they’ve had, what medications, supplements, and over the counter meds they take – all the details I need as a provider to determine if IV hydration is appropriate.

Because of this, I review each patient’s intake forms, verify their medical information, and conduct a brief assessment prior to treatment. For IV therapy, our patients come into the office and everything is done in person; for injections that can be self-administered, the entire visit can be conducted virtually, with live step-by-step instruction and visual confirmation of safe technique.

One size fits all?

There is no “one size fits all” for anything in medicine, even for something that may seem simple as a bag of IV fluid. Our safety-focused approach to IV hydration not only keeps us fully compliant with regulations, it allows us to provide customized care to each patient based on their individual needs. As with all medical treatment, we advise patients to do their research when seeking IV hydration therapy to ensure there is appropriate medical oversight of the business. Your health and safety, and those around you depend on it… even if the laws and regulations in your area haven’t kept up.

More Information

Check out our website to learn more about IV hydration therapy or click here to schedule a live or virtual evaluation today!

By Jennifer Cooper, MS, APRN, AGACNP-BC

Click here for the original blog post written by Jennifer Cooper for BuildMyHealth.

The post New Regulations for IV Hydration Therapy Coming Your Way! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

BIA-SCC and BIA-ALCL

Breast implant associated squamous cell carcinoma and breast implant associated anaplastic large cell lymphoma are very rare. In fact, the incidence of these disease processes is not measured in annual rates. They are so rare that the case count is measured by the number of cases that have ever occurred in history. Understanding personal risk is important when recognizing this low incidence.

According to the American Society of Plastic Surgeons, there are 16 cases reported in the literature for BIA-SCC ever. In regards to BIA-ALCL, there are approximately 400 confirmed cases in the United States and a total of 1,227 worldwide as of August 2022.

BIA-SCC is a very rare but potentially aggressive tumor that appears to be associated with the scar that forms around any type of implant (knee implant, breast implant, etc), and in the case of breast implants, from the breast implant capsule. Because there are so few cases, it is not possible to determine what factors increase patient risk for BIA-SCC prior to their breast augmentation.

BIA-ALCL is a lymphoma or lymphoproliferative disease process. More information is available here. Below you can review a comparison of these two entities based on an overview from the American Society of Plastic Surgeons. Some information may be technical and more appropriate for your healthcare provider but it also offers the consumer insight into the language you may need to understand the full scope of these disease processes.

What is it?

BIA-SCC
Breast implant-associated squamous cell carcinoma (BIA-SCC) is a very rare but potentially aggressive, epithelial-based tumor that appears to emanate from the breast implant capsule. Pathology shows sheets of squamous cells lining the capsule in nests and bundles. BIA-SCC can exhibit highly invasive properties including spread to lymph nodes, local tissues and distant sites, such as muscle and bone.

BIA-SCC is not a cancer of the breast tissue itself.

BIA-ALCL
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon and treatable type of T-cell lymphoma that can develop around breast implants. BIA-ALCL can exhibit highly invasive properties, including spread to lymph nodes, local tissues and distant sites.

BIA-ALCL is not a cancer of the breast tissue itself.

Lifetime Risk

BIA-SCC
Unknown.

BIA-ALCL
The current lifetime risk of BIA-ALCL varies widely (e.g., estimates of 1:2,207-1:86,029 based upon variable risk with different manufacturer types of textured implants. More recently, cumulative risk over 20 years in breast reconstruction patients implanted with Biocell devices was estimated at 1:100 (Cordeiro et al, 2020).

Age at presentation

BIA-SCC
55.8 years (range 40-81)

BIA-ALCL
55.3 years (range 28-84)

Average length since initial implantation

BIA-SCC
Average length since initial implantation 22.74 years (range 11-40 years)

BIA-ALCL
10.32 years (range 0.08-41 years)

Implant Surface

BIA-SCC
In case reports, BIA-SCC has been reported in patients who have had smooth and/or textured implants.

BIA-ALCL
No cases of BIA-ALCL have been confirmed in patients who have only had smooth implants in case series, case reports or registries. However, it is not possible to exclude the appearance of BIA-ALCL in association with smooth implants at this time. The FDA states that all confirmed cases worldwide either have a history of a textured device or an incomplete clinical history available for review.

Implant Type

BIA-SCC
BIA-SCC has been associated with both silicone and saline implants in aesthetic as well as reconstructive patients.

BIA-ALCL
BIA-ALCL has been associated with both silicone and saline implants in aesthetic as well as reconstructive patients.

Presentation

BIA-SCC
Delayed seroma (fluid collection), unilateral swelling, pain, erythema, often capsular contracture

BIA-ALCL
Delayed seroma, unilateral swelling, pain, erythema, sometimes capsular contracture

Extracapsular spread at presentation

BIA-SCC
80% at presentation

BIA-ALCL
28% at presentation

Typical Pathology

BIA-SCC
Squamous cells in sheets with varying degrees of atypia and metaplasia and at least one focus of SCC.

BIA-ALCL
Lymphoma with mass confined to single area on capsule.

Diagnostic Assessment

BIA-SCC
Send fluid collection sample to lab for testing of CK 5/6+ protein; p63+; Flow cytometry + for squamous cells and keratin

BIA-ALCL
Send fluid collection sample to lab for testing of CD30+ protein; ALK-; Flow cytometry + for T-cells

Imaging

BIA-SCC
Ultrasound to evaluate for fluid around the implant +/- aspiration; MRI with and without contrast to evaluate capsule to rule out mass; PET-CT for extent of disease, if present.

BIA-ALCL
Ultrasound to evaluate for fluid around the implant +/- aspiration; PET‐CT is performed following a positive diagnosis. Mammograms are not helpful for evaluating lymphoma but are important for the evaluation of breast cancer.

Treatment

BIA-SCC
Official treatment recommendations will need to be based on emerging data. At present, it appears that explantation with complete (en bloc) capsulectomy will provide the best outcomes.

Based on existing case reports, it appears that incomplete resection of BIA-SCC can result in early and/or aggressive recurrence.

BIA-ALCL
In the majority of cases, explantation with complete (en bloc) capsulectomy is curative. Incomplete capsular resection has been associated with both recurrence and significantly lower survival. Rare patients will present with more advanced disease and may require radiotherapy and chemotherapy. Treatment approach should follow international guidelines established by the National Comprehensive Cancer Network (NCCN) for BIA-ALCL. Current treatment recommendation is for bilateral complete capsulectomy and implant removal, as a small number of women have had contralateral disease found incidentally.

Chemotherapy / Radiation Therapy

BIA-SCC
Patients treated within these cases did not appear to respond.

BIA-ALCL
Responds to Brentuximab plus CT.

Reporting

BIA-SCC
The FDA recommends that any suspected or confirmed cases of SCC, lymphomas, or any other cancers around the breast implant be reported to the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database and the device manufacturer. To submit a case to the MAUDE database, which collects medical device reports (MDRs) of suspected device-associated deaths, serious injuries and malfunctions, visit www.accessdata.fda.gov.

BIA-ALCL
The FDA recommends that any suspected or confirmed cases of BIA‐ALCL be reported to the PROFILE registry, the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database and the device manufacturer. To submit a case to the MAUDE database, which collects medical device reports (MDRs) of suspected device-associated deaths, serious injuries and malfunctions, visit www.accessdata.fda.gov. To report a case to PROFILE, go to ThePSF.org/PROFILE.

Patient Counseling and Informed Consent

BIA-SCC
BIA‐SCC should be discussed with any patient considering breast implants as part of the informed-consent process.

BIA-ALCL
BIA‐ALCL should continue to be discussed with any patient considering breast implants as part of the informed-consent process.

American Society of Plastic Surgeon/Plastic Surgery Foundation Recommendations

Prior to implantation of any breast implant, plastic surgeons should provide patients with the manufacturer’s patient labeling, the FDA-required patient decision checklist and any other educational material to best discuss the benefits and risks of breast implants.

Preoperative workup is essential. All patients presenting with a late seroma should have fine needle aspiration (FNA) and cytology testing. Specimens should be sent for immunohistochemistry including CD30, ALK, CK 5/6, p63 and flow cytometry to look for T-cells, squamous cells and keratin.

All patients presenting with a late seroma should undergo a breast ultrasound and MRI with and without contrast. If disease is confirmed, a PET-CT should be considered prior to surgical intervention. A thorough preoperative work-up allows for potentially the most appropriately planned, single-stage surgery with the greatest chance of success for cure.

Consider the possibility of BIA-ALCL, BIA-SCC and other lymphomas when treating a patient with late-onset, peri-implant changes. If you have a patient with suspected BIA-ALCL or BIA-SCC, refer them to experts familiar with the diagnosis and treatment of BIA-ALCL and BIA-SCC.

At surgery, collect fresh seroma fluid, representative portions of the capsule, and specific pathology requests to rule out both BIA-ALCL and BIA-SCC.

Diagnostic evaluation should include cytological evaluation of seroma fluid or mass with Wright Giemsa stained smears and cell block immunohistochemistry/flow cytometry testing for cluster of differentiation (CD30) and Anaplastic Lymphoma Kinase (ALK) markers, as well as Cytokeratin 5/6 (CK 5/6) and p63.

Flow cytometry should include instructions to look for T cells, squamous cells, and keratin.

All confirmed or suspected BIA-SCC data should be entered into the PROFILE Registry (Data entry mechanism forthcoming).

Data for all patients with seroma should be entered into the National Breast Implant Registry (NBIR).

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyHealth.

The post Update on Breast Implants first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Hear from one of our beloved patients:

“I’m so impressed and excited about the work that you are doing with the Weight Management program. Not discounting the incredible work that Dr. Bae and the team do in the surgery center, I credit a good portion of my recovery, results and current lifestyle to the weight loss and exercise that I did prior to any of my surgeries. Above all, I had the opportunity to create healthy habits that I’ve been able to stick to post-surgery, which took the burden of undoing any surgery off the table (no pun intended ).

None of this is easy – changing habits, weight loss, exercise, surgery, recovery, etc – but the support that you and the team have provided me throughout my journey is unmatched. Investing in my health has been the most rewarding and humbling experience and I never could have done it without y’all! Thank you for empowering me to find me .”

The proof is in the pudding:

Let’s talk about the elephant in the room

Lots of patients ask if they should lose weight before surgery… Or even if they should gain weight before their Brazilian Butt Lift! Instead, consider being in a healthy weight range (or close to it!) at the time you schedule your procedure. If you need diet and exercise to get there, putting in the work before the procedure contributes to better outcomes and patient satisfaction.

But that doesn’t mean that you need do it alone. Exercise with friends. Make diet changes with your whole family. Get some fresh air and enjoy more time outdoors. Join a club. Dance!

Shout out to the Bae Lounge

If you still need more guidance and motivation, consider joining a Medical Weight Management Program like the one offered at Dr. Bae’s Health and Wellness Lounge. The program combines medications with lifestyle coaching to give patients the tools to set exercise goals, make healthy food choices, and keep the weight off.

Keep it going

As our patient can attest, the healthy habits instilled before going under the knife translates to better surgical outcomes. There are so many benefits to being in good physical condition prior to surgery, including:

• A healthy BMI decreases the risk of complications with anesthesia and intubation
• Patients who are obese are at greater risk for surgical site infection and slower healing because of reduced blood flow in fat tissue. This impacts every incision, as well as fat transfers such as Brazilian Butt Lifts
• High blood pressure and high blood sugar are more easily controlled
• The fat removal maximum for liposuction is 5L, so being close to your goal weight will maximize your results
• Patients tend to be happier with their results, because they’re often more noticeable when at a healthy BMI
• Recovery is typically faster and easier for patients in good physical condition
• The ability to maintain your post-operative results is easier, since you have already established a health-centric lifestyle

The post Get Those Coveted Mommy Makeover Results… and Keep Them! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

But as with many devices or medications, it is being used for a purpose other than what it is approved for. This isn’t illegal. It’s considered an off-label use. Consider BOTOX® Cosmetic. Doctors routinely administer it to consumers for the 11’s in between the eyebrows, forehead and crow’s feet. But it’s also used off-label for the lip flip or sweaty palms. Not illegal but not was it was cleared for, but since it provides a safe treatment for those off-label uses, it’s considered kosher.

However, heat-based devices to tighten the skin aren’t always safe, especially in untrained hands. These heat-based devices like Renuvion/J-Plasma can cause burns under the skin. In fact, that’s what the FDA reported. The agency received reports such as “serious and potentially life-threatening adverse events with use of this device for certain aesthetic procedures,” including some that have required treatment in an intensive care unit. The statement does not mention whether any cases were fatal.”

The Medscape article goes on to mention second- and third-degree burns, infections, changes in skin color, scars, nerve damage, “significant bleeding,” and “air or gas accumulation under the skin, in body cavities, and in blood vessels.” The last one, “air or gas accumulation” refers to terms you may be more familiar with like “gas gangrene” or “necrotizing fasciitis” aka infections from flesh-eating bacteria. Yes, this is serious stuff.

The reason I do not and will not offer this heat-based device to my patients is the same reason I avoided other heat-based devices like laser lipo. This clever sounding name describes using heat in the form of a laser to melt fat and then suck it out through a metal cannula. The heat from the laser was also promoted to tighten skin. But as you can see below and in this article that I wrote for a peer-reviewed publication, it also caused strange contractions of skin as well as 2nd and 3rd degree burns. To be clear, the photos below are not due to the heat-based Renuvion/J-Plasma device but from a related heat-based “laser lipo” device.

I know it sounds petty to say “I told you so.” But after years of the company attempting to get me to buy their equipment or patients asking if I offer J-Plasma (great marketing, I can’t argue that point), I feel vindicated that I avoided this class-action lawsuit.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyHealth.

The post I told you so (warning, graphic photos) first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

What are some post op complications I should be aware of?

Fever

Fever is a vague symptom that can be normal and even expected after surgery; up to 90% of surgical patients have a low grade fever due to the body’s inflammatory response to injury. However, it can also be a sign of something more serious, such as atelectasis (collapse of small air sacs in the lung), urinary tract infection (especially if you had a foley catheter placed for surgery), wound infection, or blood clots.

A slight fever in the first two days after surgery is most likely nothing to be concerned about. However, if you develop other symptoms or if your fever worsens or persists, contact your doctor. The best way to deal with post-op fever is by preventing the more serious causes, as described in the following.

Atelectasis (collapse of air sacs in the lung)

Atelectasis can stem from the effects of anesthesia as well as a decrease in physical activity and shallow breathing after surgery. It can lead to pneumonia and other more serious respiratory complications. Depending on your procedure, coughing and deep breathing exercises may cause discomfort, but they play an important role in your recovery. Splinting (holding a pillow firmly against your incision) and adequate pain control can help make deep breathing less painful, especially if your surgery involved your chest or upper body.

You may also be sent home with an incentive spirometer. This is a device you’ll use to help expand your lungs thoroughly and gives a give visual representation of your breathing. Not everyone will need an incentive spirometer but everyone should practice some form of deep breathing and coughing to prevent atelectasis during recovery.

Urinary Retention or UTI

Blood Clots

Blood clots can form in the larger veins, commonly in the arms or legs; they can also break loose and travel, making them potentially life threatening. However, proper surveillance and preventive techniques can help reduce the risk. We screen every patient with a deep vein thrombosis (DVT) risk assessment tool and certain patients are required to have a pre-op ultrasound of their legs to check for existing blood clots.

There are also a number of techniques surgeons can use to help reduce the risk of clot formation, including “blood thinners” – anti-thrombotic medications given to help keep blood from clotting; the use of compression or ted hose during and after surgery; and the use of sequential compression devices that massage the calves to keep the blood from pooling.

While recent data call into question these risk reducing techniques for DVTs, the easiest and cheapest form of prevention during recovery is early ambulation. Ambulation, or walking, has several benefits besides blood clot prevention; it also helps promote deep breathing and helps with gas, bloating, and constipation. We want our patients up and walking by the evening of their surgery day, but always follow your surgeon’s instructions for activity limitations.

Written by Jennifer “Coop” Cooper MS, APRN, AGACNP-BC, Sergeant, US Army (veteran)

Click here for the original blog post written by Jennifer Cooper MS, APRN for BuildMyHealth.

The post Preventing Post Op Complications first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

A few things I wish I knew before surgery

Post-op constipation is real.

The combination of narcotic pain medications, decreased activity, and poor dietary intake can lead to some serious constipation, so drink all the water, eat all the fiber, and walk, walk, walk. Unless you have other medical issues, you’ll need 2-3 liters of water (sorry, your coffee doesn’t count), and 20-30 grams of fiber every day. For reference, a serving of bran cereal has about 5.5 grams; fiber supplements like Metamucil can help you meet your goal and are actually pretty tasty these days.

As for walking, we like our patients up and walking the same evening of surgery (but always defer to your doctor’s instructions). Walking not only staves off constipation, it’ll also help prevent potentially fatal blood clots, so win-win.

What you eat, drink, and do can affect wound healing.

We already discussed the copious amounts of water and fiber you’ll be consuming, but there are other nutrients you’ll need to be aware of to help maximize your recovery. Low fat protein, zinc, calcium, and vitamins C & D are important factors in wound healing. And while it’s always better to get your nutrients from whole food sources, supplements may be beneficial to some people. Try a calorie tracking app on your phone to see how your nutritional intake stacks up.

On the flip side, there are a few things you should avoid, as they are known to delay or complicate wound healing. Nicotine is the biggest “NO” out there, but you should also monitor your intake of caffeine (like that coffee we talked about), alcohol, and excessive salt and sugar. A balanced diet of fresh fruits, veggies, and lean protein is almost always best.

What about lymphatic massage? We get asked this a lot. Lymphatic massage purportedly helps relieve pain and swelling, break up scar tissue, and improve blood flow to the area, thus promoting healing. There isn’t much data available to back up these claims, but some people swear by it (while others find it painful). We tell our patients they are welcome to try it if they’re interested, but we can’t promise any specific results from it.

Post-procedure depression can happen.

A lot goes into your emotional wellbeing after surgery, such as a personal history of depression/anxiety, reaction to medications, concerns about recovery, feelings of guilt for depending on others, or financial stress. For some people, these negative emotions can linger to become post-op depression. If you can’t shake the negativity or if you’re having excessive fatigue, changes in appetite or sleep, increased irritability, or any other symptom of depression, it’s important to get the help you need. Talk to your doctor if you have concerns about post-operative depression.

Good help will be invaluable and meal prep is a life saver.

In the days leading up to your surgery, go over your needs and expectations during recovery with your primary caregiver. Will you need dressings or other supplies? Get them now. Depending on the surgery, you might want to have gauze, medical tape (look for soft fabric or paper tape, not plastic), and maybe some “chux”/puppy pee pads  – those absorbent pads you can put down to catch drainage, etc. Have some gloves available if you need help with dressing changes. Check with your doctor to see what you might need. Don’t forget your personal hygiene needs during this time as well. You might want to pick up some dry shampoo, baby wipes, or body powder if full showers are limited. A bidet attachment on your toilet might be worth the investment – they’re under $50 and easy to install. Do you have periods? Stock up on your supplies and discuss any assistance you’ll need with your caregiver.

Also use this time to meal prep – whip up some big pans of lasagna or casserole to freeze for later. Stock up on easy to eat, nutritious foods like whole grain toast with peanut butter, soups, and produce. If you know you’re prone to nausea, crackers and ginger ale are good to have on hand. Fresh out of anesthesia, the B.R.A.T. (bananas, rice, applesauce, and toast) diet is nutritious and easy to digest.

One last consideration is maneuverability in your home. If you’re going to need assistance – whether it’s another person or it’s equipment like a walker or crutches – you’ll probably need to make space. Take some time to move trip hazards like area rugs or power cords and consider if you’ll need things like grab bars in your shower or near your toilet.

Written by Jennifer “Coop” Cooper MS, APRN, AGACNP-BC, Sergeant, US Army (veteran)

Click here for the original blog post written by Jennifer Cooper MS, APRN for BuildMyHealth.

The post Postop Recovery Tips first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey Greg. Thanks for joining me.

Greg:
Absolutely. It’s always great to be here, especially, from month to month when we do these, I compile a list of questions that my friends ask me. They sort of think because I know you, I know all of the things that you know, which is not necessarily true.

Dr. Bae:
Yeah, you’re a plastic surgeon adjacent. You just skipped the whole med school thing.

Breast lift without an implant?

Greg:
Exactly. I had a pride party a few weeks ago and a question. One of my friends who just turned 50 was there and she wanted to actually talk to you. She wants her breasts perkier, but she does not want her breasts larger and she didn’t know, would she have to get some kind of implant to make them perk up or is there a way to do a lift without… She really doesn’t want to go bigger.

Dr. Bae:
Right. So, absolutely. There’s definitely a way to be perkier without going bigger. And so instead of getting breast implants, you would get a breast lift, but it’s not just straightforward. Like what type of breast lift? Everybody’s a little bit different. And some people think that we just decide, okay, we’re going to do this type of breast lift on you just like how we feel that day. We’re going to do that type or that type. But it really is how droopy the breasts are and if you’ve had kids and your breasts are pendulous, my favorite word, after breastfeeding, that can make them a little bit droopier. And so it really just all depends on how droopy they are and basically where the nipple is in comparison to that fold onto the breast. It’s called the inframammary fold.

Where’s the nipple?!

Dr. Bae:
So, basically if the nipple is just below the inframammary fold, then maybe just have a little bit of droop and so that would be one type of breast lift. If it’s further below the fold, then that’s a different type of breast lift. We have to remove more skin to get them back up to where they need to be. And if they’re pointing down and really droopy, then that means we have to remove even more skin, which means we have to make even more incisions. So, that brings me to the different types of breast lifts. One is the one that needs the least amount of lift is maybe you just need a little crescent of skin taken off the top of the areola and that can help just reposition the nipple a little bit. So that’s really just, you want the nipple to be in a better position, but your breasts look fine otherwise.

Dr. Bae:
Now, if you have a little bit more droop, then you have to remove more skin. You can also take skin from around the areola and just basically take a donut of skin and that’s why we call it a donut lift. And that helps tighten up the breast skin and brings up the breast and the nipple at the same time. If you have a little bit more droop, then we’ll do what’s called a lollipop incision where we make an incision around the areola and then up and down and that’s just to take out more skin to give you more of a lift. And if it’s as droopy as you’re worried it is, then we would do an anchor lift where we make an incision around the areola, a vertical incision, and then an incision under the breast. And by removing all of that extra skin, we can bring the breast back up to where it is. And remember, we’re not reducing anything we’re not taking on any breast tissue. We’re just tightening up the skin envelope to give them that perkier breast that they’re looking for without fat injections, without an implant if they choose.

Greg:
So you’re able to keep all of their breast tissue that they naturally have and you’re just able to bring it up into a position where it was when they were 22, rather than my friend, she’s 50. Okay, that makes sense to me, but I’m glad I did not try to explain this to her at my pride party. It would have been very strange.

Dr. Bae:
Especially since there might have been alcohol involved at the pride party.

Greg:
Might have.

Dr. Bae:
So you might not have gotten all that clear. Might have.

Greg:
No, there for sure was.

Breast lift vs Breast reduction

Dr. Bae:
But that’s actually, you bring up a good point. So if they are looking to get a breast reduction, it’s actually the same types of incisions and so the only additional thing you’re doing is you’re taking out breast tissue in addition to doing the lift. So a breast reduction includes a lift, a lift doesn’t necessarily have to be a breast reduction. So very, very key point a lot of patients don’t understand before they come in to see me.

Greg:
Awesome. Well, tell my friend and everybody out there watching these videos how they can communicate with you the best and get in and see you.

Dr. Bae:
They can easily just text us at the office. They can text our office number (415) 923-3005. They can call that number too. They can also direct message us through Instagram @realdrbae. And of course, they can always watch us on social media, realdrbae, Instagram, Snapchat, TikTok, and check pricing at realdrbae.com/pricing. We’re very easy to get ahold of.

Greg:
Awesome. Thanks so much, Dr. Bae.

Dr. Bae:
Thank you, Greg.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post What kind of breast lift do you need? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Hey, Greg.

Greg:
I was thinking about you the other day. I was driving through your neighborhood. I was like, “Where is he? Maybe I can find him in this coffee shop and he can buy me some coffee.”

Dr. Bae:
Shoutout to Wrecking Ball!

Neuromodulators

Greg:
Absolutely. It’s good to see you. I wanted to start with this question. Now, it’s commonly now referred to as getting Botox, if you get an injectable to stop the lines and the wrinkles. However, Botox is actually a brand name. There are many different types of injectables that do the same thing as Botox. So how do we pick the right one?

Dr. Bae:
Exactly right. The idea is that Kleenex or Puffs are a type of tissue paper, and Botox has just been used just the way everybody says, “I’ll give you some Kleenex.” It’s that generic term. Or, get me some Coke to drink. The same thing is happening with Botox. It’s just that term that’s become the generic form of what is actually called a neuromodulator. So you have facial tissues-

Greg:
A what?

Dr. Bae:
Neuromodulator, N-E-U-R-O-M-O-D-U-L-A-T-O-R. If we’re taking the SAT and we’re talking about those analogies, we’re going to be thinking of, tissue paper is to Kleenex as neuromodulator is to Botox. Botox is the brand. There are other brands. Aside from Botox, there is Jeuveau, which is a newer one on the market. They go by #newtox on social media. There’s Dysport and Xeomin, X-E-O-M-I-N. These are all versions of neuromodulators. They’re also just basically called botulinum toxins. The toxin that’s made that you’re not supposed to have kids… No children under six months are supposed to eat honey, because it could have botulinum toxin in it, which could cause botulism. But if you do it the right way, you inject it in your face and it’s fine.

Treatment areas

Dr. Bae:
You’re essentially injecting poison in your face. But whatever product you’re using, Botox, Jeuveau, Xeomin, Dysport, the idea is you inject it into the elevens here or into the forehead, the crow’s feet, you can even do in the upper lip to treat a gummy smile or down here to help with, if you have a bitchy resting face, it can help the corners of your mouth go up.

Greg:
I want to keep mine. I’m not changing that. I’m keeping my bitch resting face.

Dr. Bae:
But the way it works is, you inject into those muscles in those areas and it relaxes those muscles. That makes those wrinkles go away that are caused by those overactive muscles. So again, the elevens, the forehead, crow’s feet, upper lip, along the jaw line. People sometimes think, “Oh, well, you can use Botox for these lines here, the parentheses lines.” That doesn’t work, because these parentheses lines aren’t caused by overactive muscles, so Botox won’t work there. That’s caused by loss of collagen and that’s where you would use fillers.

Greg:
Then how do you find the right brand for you? Are they all basically the same and go with whatever’s on sale?

Is one brand better than another?

Dr. Bae:
Well, every company will tell you that they’re the best for one reason or another. Well, first off, just so you know, right off the top, is that I am a speaker, a paid spokesperson, for Xeomin. A company, Merz, makes Xeomin. It’s a company based in Germany. But they have a North American unit here and that’s where the Xeomin comes from. But I feel they’re all pretty much the same. I would treat all of these on my family members. I think they all have essentially the same result. The only one I don’t use is Dysport and not because there’s anything wrong with the product. It’s because they use a different gradation or measurement technique as far as how much you inject somebody with. But Botox, Jeuveau, Xeomin, you basically can treat 20 units to this area in the forehead, 20 units to the eyes, so it’s all pretty much the same.

How do you choose one brand over another?

Dr. Bae:
But the thing that’s interesting is whenever a new company comes out, they don’t necessarily just come out right and say, “We’re better than Botox.” Because you would think if a car dealer comes out with a new car, a new model, a car company comes out with a new model, they’ll say, “Oh, this car is better than that Ford truck,” or, “This Chevy truck is better than that Ford truck.” What I find with the neuromodulators is they just say, “We’re the same as Botox.” They don’t necessarily say they’re better. They just say, “We’re the same,” because they know that’s the benchmark. They say, “Well, we’re as good as it gets. We’re the same as everybody else. So you can utilize us.” The thing that may make a difference is that some of them have loyalty rewards programs that are different. Maybe you get more points and more freebies, depending on which company you go with.

Greg:
Oh, my God, it’s like every thing else. It’s like choosing an airline or whatever. You choose the one where you can get the most advantages, points, maybe a sale, something from them. Okay, so-

Dr. Bae:
Credit cards.

How to see Dr. Bae

Greg:
Yeah. They’re basically all the same. They’re all safe. And, of course, you can always be educated in Dr. Bae’s office about these types of things. Tell them how to find you and how to book an appointment.

Dr. Bae:
You can always find us, if you’re watching this, you’re already probably on our website at realdrbae.com, R-E-A-L-D-R-B-A-E, not B-A-Y. Or you can watch us on social media, TikTok, Snapchat, Instagram at realdrbae. You can watch us operate. You can actually watch us do injectables on patients that are okay with us showing them on social media. Because it’s different, when we’re doing operations, the patients are covered up. You never see their face. But when you’re doing injectables, the patients are a little bit more reticent to be shown on social media, because you’re actually injecting their face. It’s hard to hide their face, even though sometimes we’ll try and zoom in really well, or we’ll put an emoji over part of their face. You can watch us do those types of injectables with neuromodulators, i.e., Botox, Xeomin, Jeuveau or Dysport in our office, anytime on any social media.

Dr. Bae:
And you can check pricing on all of these injectables on realdrbae.com/pricing. You can even purchase non-surgical services through our website. So you can actually pay for it online and come in and get the treatment and just walk out as though it was free. You didn’t have to pay for it. You [crosstalk 00:06:10].

Greg:
Perfect. And you can show my photos there. I’m such a big boy. I hardly even grimace when the needle goes in.

Dr. Bae:
Thanks. That’s good to know. Thank you.

The post All about Botox, Xeomin, Dysport and Jeuveau first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
I’m good. I’m good. All is well, all is well.

The big news on textured breast implants

Greg:
Well, I’m happy to hear that. I’ve been seeing a little bit in the news lately, these textured silicone breast implants that I think were done, you can correct me if I’m wrong, done years ago. I don’t know that they do them anymore. Maybe they do, but there is some concern about them and a lot of people who have those are wondering, do I need to go and get those replaced? Or, what do I do, because everybody wants to stay as healthy as they possibly can.

Dr. Bae:
Right. Well, I’m glad you asked me about that, because I just happened to have some breasts implants with me right here.

Greg:
Oh, wow. Look at that, props.

Why textured breast implants are textured

Dr. Bae:
What are the chances? So I guess the first thing we should talk about is just kind of some baseline knowledge, fundamental knowledge that there’s the difference between round implants, which are kind of the typical round silicone implants you always think of, versus these teardrop or shaped implants. You can see it’s fuller at the bottom. And so, when you have a round implant, if it spins in the breast tissue, like in the breast pocket, inside the patient’s breast, if it spins, no problem. It’s still a round implant. But if this spins, then you’ve got sort of a sideways boob. So what they do is, they now texture-

Greg:
Nobody wants a sideways boob, Dr. Bae.

Dr. Bae:
I think a lot of people gave that up for their New Year’s resolution, right? So the thing is, the reason they texture these implants, as opposed to being smooth like the other implant I showed you, they texture these-

Greg:
So they don’t move.
Dr. Bae:

So they don’t move, exactly. So, what the … you’re pretty smart. Producer, check out the big brain on Greg.

Greg:
Maybe I’ll go to medical school.

Dr. Bae:
Maybe so, and I’ll go back to being … I’ll be a radio host.

Greg:
We better keep what we’re doing.

Dr. Bae:
So, the thing is, that texturing has become an issue over the last couple years, that people have noticed an issue with it. And what it is, is that there’s something called anaplastic large cell lymphoma, which is kind of like cancer, but not really. And what it is, is that after a few years, two years to 28 years they found, after getting textured implants, what they found is that the scar tissue that naturally forms around breast implants, whether they’re saline, silicone, round, shaped, your body naturally formed scar tissue. But in some cases, specifically with a certain type of textured implant, that scar tissue could get really thick and starts secreting some fluid. And the patients would have this huge seroma or fluid collection that would form around their breast implant. Like I said, two years or 28 years after.

Anaplastic large cell lymphoma (ALCL)

Dr. Bae:
And that was caused by this lymphoma, or this thickened scar tissue. So the way to treat it is you go in, you take out the breast implant, you take out the scar tissue and typically a hundred percent of the time people would be cured if you found that early enough. So that’s anaplastic large cell lymphoma, ALCL, that’s associated with textured implants. But not just any textured implant, specifically one that was made by Allergan, and that one’s been taken off the market. So statistically speaking, is a very low risk for people to get this problem if they have textured implants. If you have smooth implants, there’s really been no evidence that smooth implants cause that problem. And the reason it’s been in the news lately, and also which, I should say, the reason I’ve been thinking about this lately because it’s been in the news, I’ve had patients reach out to me saying, “Hey, I’ve got this brand of a MENTOR silicone textured implant. Does that mean I need to come back in?”

Dr. Bae:
And the FDA says, just like I told this patient, that because they took the main offender off the market and because the risk is so low, that if you have textured implants and it’s not that Allergan product, if it’s MENTOR or Sientra and you’re not having any problems, your breast isn’t blowing up with a bunch of fluid, if you’re not having problems, you don’t have to do anything. You don’t have to go in and get them changed out. So just FYI, the more you know, public service announcement, that if you’re happy with your breast implants, you don’t need to do anything with them. You don’t have to get them taken out every 10 years like some people mistakenly think. So again, just keep going, get your mammograms, get your checkups from your doctor. And as long as you’re happy with your breast implants, you don’t have to do anything else about them.

Greg:
But, if somebody has a question, if somebody has a question about their implants, or if they just want you to examine their breasts and check out where they are, they can reach out to you on social media.

Dr. Bae:
Absolutely. They can reach out to us. Instagram, TikTok, Snapchat @realdrbae. R-E-A-L-D-R-B-A-E, not B-A-Y. And check us out on our website, realdrbae.com, where they can check pricing, all that good stuff. But yeah, people message us all the time. All my surgical patients, they always have my email address and my phone number. So they’re able to reach out to me afterwards if they’re worried. So, there’s no excuse. You can absolutely get in touch with this doctor.

Greg:
And if you’re not a previous patient of Dr. Bae’s, and you’ve never even spoken to him before, if you Instagram him with a question, DM, he will answer you. Right, Dr. Bae?

Dr. Bae:
That’s absolutely true. Yeah. As long as you’re not saying anything mean, I will respond to you.

Greg:
That’s my policy on social media, too. All right. Well, thanks Dr. Bae. Appreciate it.

Dr. Bae:
My pleasure. My pleasure.

The post What you need to know about textured breast implants [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr. Bae:
Things are good, things are good. Baby’s sleeping well, and we’ve got a lot of surgery scheduled for all of our patients, and everybody loves to get their education on by watching us on Snapchat and Instagram. So of course, with the patients permission, but things are going well.

Greg:
What is the Snapchat and Instagram?

Dr. Bae:
Oh, it’s realdrbae, R-E-A-L-D-R-B-A-E, not B-A-Y, that’s realdrbae on Snapchat, Instagram, and TikTok, and the website’s realdrbae.com. But hopefully, if you’re watching this video right now, you probably already know that.

Greg:
Yeah. I have a friend who’s fascinated with watching you do surgery. I sort of do it like this, I can back and forth, but she loves it. So I know some people are really into watching surgery, some people can’t stomach it as much, but it’s cool to be able to see the procedure, such transparency at your office, so we love that.

You can also check out videos of a Brazilian butt lift, I get asked a lot of questions about this people. This is the rage. It’s all over TV, all over reality TV, so what exactly is it and who is the right candidate for a Brazilian butt lift?

Dr. Bae:
Yeah, the Brazilian butt lift, along with all the other operations that we do, people love watching it. They love watching the surgery. Again, we get the patient’s permission to broadcast these things on our social media. And even though I know that you get a little squeamish by it, and obviously I respect people’s choice to turn it off and not watch-

Greg:
People are fascinated, yeah.

&Nbsp;

Dr. Bae:
But it’s the most educational way to show anybody a procedure that they’re considering. Think about before, how you would do a consultation. You would read about it, you would then go and talk to the doctor for 45 minutes for a consultation, who you’d never met the doctor before because you hadn’t seen them on social media. There’s so much more to be gained by watching the operation, by that doctor that you’re thinking about going to for months, and then you see the procedure, then you go in and you actually meet the doctor during the consultation. It’s much more educational now than it ever could have been.

But specifically with the Brazilian butt lift, what we’re doing there is it’s kind of a two for one operation. We’re doing liposuction first, to get fat, and then we inject the fat in the butt. Now, as far as the liposuction, we’re taking fat from the abdomen, the flanks, the love handles, the bra chub, 360 degrees around the torso. So by getting all that fat, you’re already just kind of slimming down, trimming down your torso, trimming down your body. But this being California, everybody wants to reuse, recycle, repurpose their supplies, including fat.

&Nbsp;

Greg:
And you can do that with fat as well, right?

Dr. Bae:
Might as well do it with fat. So we take that fat and we put it into the butt, and it used to be, years ago, just like get a big old butt. Like booty shaking, a hip hop video, or something like that. But people are coming in for all types of shapes and sizes and walks of life now to get it, and they’re not just getting a big butt. They just want to have a little bit more shape to that butt, they want more of that hourglass figure. They want a thin waist, which we can get with liposuction and a tummy tuck, and then they want to fill out the hips, the hip dips, and get a little wider hips. So we can get them that hourglass figure with liposuction and then with fat injections to the buttocks.

So it could be younger girls that feel like they don’t have a butt at all, and we can give them more projection, again, fill in the hip dips, but then also we’re seeing 50 and 60 year old women coming in. And before you think, “Wow, that’s crazy, they think they’re still trying to hang on to their youth.” It’s really not that. Think about older women, after breastfeeding or whatever, weight loss maybe, they get deflated breast. And then they come in and they get breast implants or a breast lift, we don’t think anything strange about that.

The same thing can happen to the butt. It can get deflated, and so you want to lift it up. And one of the ways we lift it up is to do liposuction to their whole body. As far as the abdomen, flanks, back, bra chub, take that fat and then put it in their butt, give them more volume, and that lifts their butt, doesn’t look as deflated, and they are really, really happy patients.

Greg:
Well, listen to this. I have one cheek that’s a little bit full fuller than the other cheek. But that could be fixed, right? You could make me more symmetrical?

Dr. Bae:
Well, that’s true, like a butt cheek. These cheeks or your butt cheek?

Greg:
Yeah. No, no, no, down here, I’m talking about down below.

Dr. Bae:
Absolutely, yeah. People will have, like for a good example, talking about what you’re referring to, is people will get a steroid injection into their butt at some point in their life. And we know steroids can cause fat atrophy, which is where the fat dies, and they get a little depression in their butt, or their whole butt is just a little bit smaller than the other. And so yes, you can take fat, fill in that little defect maybe that was caused by steroid injection, or fill in or just volumize the whole butt cheek to make it more symmetrical. The patient does have to understand, though, that 50% of the fat goes away after about six months, so we do tend to overfill. So I always warn my patients, “Your butt will be bigger than you want it to be, initially, but I promise it will go down.

Greg:
That’s okay, you can go to Brazil or you can go to Miami during those months where you got the really big booty, because they’ll love you down there.

Dr. Bae:
Right, exactly, right. And I have found that the patients who are going to Miami, they do want a certain kind of booty that I might not necessarily be giving them here.

Greg:
Of course, it’s a Miami booty.

Dr. Bae:
It’s a Miami booty, and so we’re giving them more of a San Francisco booty. A little more understated, really helps them fill out their clothes, and they’re very pleased with it. A Pacific Heights booty.

Greg:
All right, I love it. Dr. Bae, shout out your Instagram, and also where you can get pricing on this.

Dr. Bae:
Yeah, yeah. You can check pricing for all of our procedures at realdrbae.com/pricing. That’s R-E-A-L-D-R-B-A-E, not B-A-Y, and you can schedule a consult, virtual or in-person, at realdrbae.com/contact, and watch us on Snapchat, Instagram, and TikTok at realdrbae, R-E-A-L-D-R-B-A-E.

Greg:
All right, thanks. We’ll see you again soon.

Dr. Bae:
Thank you.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Bae Break: What is a Brazilian Butt Lift [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Dr Bae:
I’m great, Greg. How you doing?

Greg:
I am amazing.

Dr Bae:
Well, you’re looking a little bit like, I wasn’t sure if I was with the Terminator or with Greg. What’s up with the sunglasses?

How to fix undereye bags

Greg:
I’ll be back. Listen, Dr. Bae. I had a late night last night and I’ve got a little problem. I usually don’t have such a deep bags under my eyes if I get a lot of rest. I do know that that is a problem for a lot of people. No matter how much sleep they get, they still have bags under their eyes. No matter how much concealer or lotion, is there something you can do about that?

Dr Bae:
Yeah. I mean, you can get deep bags under your eyes, possibly that could be genetic. It could be staying up late drinking, or at a library reading like you probably were doing.

Greg:
Did you say drinking?

Dr Bae:
I did say drinking, but you were probably at the library reading the latest Emily Bronte books.

Greg:
I was drinking at the library.

Dr Bae:
Is it Jane Eyre or Emily Bronte?

Greg:
Jane Eyre.

Dr Bae:
Jane Eyre. Okay. Anyways, so yes, you can get those deep bags under your eyes. Again, it can be genetic, if you look at your parents and they have it, then you’re probably going to have it too. So yes, concealer is the easiest thing to do. But, a lot of people mistake that the dark circles under the eyes are, because they’re just like capillaries, and things like that and it’s really not that. What it is, is that the areas under the eyes, they can kind of get deep and sunken in and in the shadow of the eye. So, one of the ways to treat that is to bring that out from under the shadow of the eye by injecting fillers and things. So you might be thinking, “Well, they’re puffy, is that really going to work?”

Puffy vs sunken eyes

So there’s two things going on there, sunkenness and puffiness, and you can treat both of them with fillers initially, at least non-surgically. So with the fillers, you can just bring out that sunken area out from under the shadow in the eyes and it’ll look a little bit brighter, not as dark. That’s one way of doing it. But the puffiness, that’s when you have the puffiness on the lower lid, and then you have this deep crease, which is called a tear trough, and then you have your cheek. And so what happens is, as people get older, the fat bags are always there, but the difference is that your cheeks are higher up on your face-

Greg:
You think.

Dr Bae:
… and as the cheeks descend and they sink, you start to uncover that deep crease. And then, you start to see those bags of fat. So, you can’t treat that with fillers, but all you’re really doing is camouflaging it. You’re just basically filling in filler in that tear trough area, that deep crease, so there’s a smoother transition from the puffiness of the eyes down to the cheek, so you’re using the filler to kind of fill in that gulf, so it’s a smoother transition. So, that’s the non-surgical treatment, is fillers. It does really work. But, if you’re looking to get something more surgical done, then as far as the puffiness under the eyes, that’s all made from fat. So, you can go on the inside of the lower eyelids, pluck out that fat to take down the puffiness, but then you’ll actually take some of that fat and you can fill in the tear trough that deep crease to help smooth that transition to the cheek, so lots of things to do.

Greg:
Its like with other parts of the body. You can suck out fat, maybe in your stomach and put it in your butt. You can take the fat out of here and put it here, and kind of fix everything.

Off-the-shelf filler vs fat

Dr Bae:
Exactly right. And, the other thing we do is, aside from taking the fat from under the eyes and putting it in that tear trough to fill that in, you can also take fat from other parts of your body to fill in the cheekbones, to fill in the nasolabial grooves of these parentheses lines. And typically, people are coming into the office and we’re just doing regular fillers, like Radiesse, or Juvederm, or Restylane things people have heard of, those are just off the shelf. We can fill in these lines, we can build up the cheekbone with Juvederm, Voluma or Radiesse, and you can still do that. But if somebody is already going to the operating room to get something done with their eyelids, then instead of them, it just seems silly to have an operation and then get discharged, and then come back a couple of weeks later and then get fillers right here. I mean like…

Greg:
Yeah, doing it all at once.

Dr Bae:
… why would you just do the fat, do it all at once, get all that good fat, and it’s also less expensive when you take it because you get voluminous amounts of fat, as opposed to one syringe here or one syringe there, you get a lot of fat. You can fill this in, you can fill this in. You can fill in the jawline, you can fill in the temples. I mean, fat is great. Might as well use it. We’ve all got it. And, if you’re already asleep for another procedure, then utilize it then as opposed to coming back repeatedly for fillers, because the fat does last longer. Some of it does die, no question about it. And, we always tell people after about six months, “50% of the fat dies, but whatever’s left over after six months, stays for good, so.” Long answer-

Greg:
That’s awesome.

Dr Bae:
… but that’s the right answer.

Greg:
That’s awesome. So, tell people how they can get a consultation at your office.

Getting a consultation

Dr Bae:
Yeah. So, if you feel like you’ve got puffy eyes or deep creases, like I said called the tear trough, or you don’t feel like you have enough cheekbone fullness here, then we can… Or the other thing is, we’ll talk about another time, but if you have a too much fullness here in the fat, that’s the buccal lipectomy, we can do, that chubby cheek treatment. But either way, you can come in for a consultation, you can book a consultation at realdrbae.com/contact, R-E-A-L-D-R-B-A-E, not B-A-Y. And before you schedule that consult, whether it’s virtual or in-person, we definitely want you checking pricing, go to our website, realdrbae.com/pricing, and you can see all the cost involved with all these procedures, no hidden costs. You can check out our chat bot on the homepage, which will give you pricing. So, we want everybody coming in fully informed for their procedure.

Greg:
Awesome. Thanks Dr. Bae. Great to see you again.

Dr Bae:
Always, always, thanks for joining me.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post How to fix undereye bags with Greg and Dr. Bae [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Greg:
Hey, this is Greg from Big Bay Mornings on 99.7 NOW, and I’m here with our resident certified plastic surgeon, Dr. Bae. Hey, Dr. Bae.

Dr. Bae:
Hey, Greg.

Greg:
You look like you just got out of surgery. What you been doing today?

Dr. Bae:
I just dressed up in scrubs so people think I’m a doctor.

Greg:
That’s good. Well, I hope you are a doctor because you have one of the, or you do one of the most popular procedures out there right now. It’s a mommy makeover but I hear that phrase all the time, but I don’t quite know everything that’s going on during a mommy makeover.

Definition of the Mommy Makeover

Dr. Bae:
Every doctor maybe has a little bit different definition of a mommy makeover, but I’ll definitely try to explain what I think is the common denominator for all doctors and a mommy maker just includes making you over, getting you back to your pre-pregnancy state. And so that always includes at a minimum, something to reshape the breast and to reshape the abdomen, two things that are obviously affected by breastfeeding and pregnancy and everything. So a mommy makeover, you can be pretty confident in it, it involves a breast procedure and a tummy tuck. And just to clarify, a tummy tuck is when we remove excess skin, but also we tighten up the abdominal wall because it’s something called a rectus diastasis where the abdominal wall stretches out from pregnancy. And we reposition the belly button after removing the excess skin and the stretch marks. So that’s the tummy tuck.

Dr. Bae:
With the breast procedure, it could either be a breast lift where we just remove excess skin to lift the breast. If they’re looking pendulous from having by breastfeeding, we can-

Greg:
Love that word. [crosstalk 00:01:33]. Pendulous.

Dr. Bae:
Ain’t that a great word. I try to use it in every conversation. But we remove the excess skin to lift the breast at the very minimum, or if somebody doesn’t have really droopy breasts, but they’re deflated, then we can just put in implants. And if they have a combination of droopiness and deflation, then we can do a breast lift with implants. And the way I try to explain this to make it a little easier to remember for patients is that we talk about a mommy makeover, but then we talk about a type one, two or three. So mommy makeover, breast procedure, tummy tuck. Type one is just a breast lift. Type two is a breast augmentation where we put in implants. And type three is a breast lift with implants. So the types just help discern what breast procedure we’re doing, but hopefully that makes sense to the patient. But yeah, mommy makeover, great procedure. We can do all those procedures, the breast procedure, the tummy tuck, all in one operation.

Postop Recovery

Greg:
And the nice thing about that is if you get several procedures at once, you can do the recovery all at once and you’re not having to recover several different times.

Dr. Bae:
It’s true. Because I know people are worried about, “Oh, if I do the breast and the tummy tuck all at the same time, I’m not going to be in too much pain,” but the truth is if you get the tummy tuck, you might as well get the breast procedure because most of the discomfort or pain is going to be from the tummy tuck. You’ll have some abdominal cramping where we tighten up the abdominal wall and the breast procedure is maybe, yes, more painful, but within a couple of days, you’re going to be so happy you did them together because if you do them separately, then you have two recoveries and it’s more expensive when you do them separately, because we can save a little bit of time by combining them. So definitely [crosstalk 00:03:10] combining is the way to go.

Greg:
Save the money. Save the pain. Save the recovery. And my last question is, I don’t actually have to give birth to have a mommy makeover. Do I?

You don’t have to be a Mommy for a Mommy Makeover

Dr. Bae:
No, no. That’s a really good point. If, for whatever reason, you’ve lost some weight, maybe you’ve lost about 20 pounds, you had a gastric bypass, something like that. Surgical weight loss, medical weight loss, you’re just eating better and dieting and working out, if you’ve lost some fat and your abdomen is looking a little deflated, your breasts are looking a little deflated, then yes, you can do a mommy makeover without having kids. The other thing is we also can combine a Brazilian butt lift with a mommy makeover, because just the way the breast deflate, the butt can deflate. And we can take fat from your whole torso, liposuction, inject that into the butt. We call that a mommy makeover deluxe. That’s what I’ll say [crosstalk 00:03:59]. Every doctor has their different definitions of mommy makeover, so that’s kind of our made up term is a mommy makeover deluxe, which includes breast procedure, tummy talk, and then Brazilian butt lift. So now you know everything you need to know.

Greg:
The deluxe is with sour cream, because it always goes to the booty. Thanks Dr. Bae.

Dr. Bae:
Exactly right. My pleasure.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Bae Break: What’s a Mommy Makeover and does your mommy need one?! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.