As a plastic surgeon, I’ve heard many myths about aesthetic medicine. It doesn’t matter how often they’re repeated, it still doesn’t make them true. But consumers and potential patients certainly think they’re true after hearing them so many times. So here is the truth!

5 myths about aesthetic medicine

1. Liposuction – Myth: After lipo, I’ll get fat in other parts of my body!

Fact: Your fat isn’t that smart. It doesn’t change direction based on previous surgery. Sure you have fewer fat cells in the area where you underwent liposuction, so other areas may look fuller by comparison. But any fat intake you have will go to the same places it is genetically predisposed to go to.

For example, if most of your fat goes to your hips, it will continue to go to your hips even after liposuction to the hips. That’s why you should use liposuction as a launchpad to get in even better shape, not a shortcut.

2. Botox – Myth: I can’t lay down or work out after treatment!

Fact: Botox is not like sauce in a saucepan, it doesn’t slosh around after treatment. So when you lay down, the Botox will not diffuse over to your eyelid and give you a droop. If you get a droop, it may be because the Botox was injected too close to your eyelid in the first place.

3. Surgery in general – Myth: I can’t get the incisions wet

Fact: What’s the alternative to getting your incisions wet? They’ll just get grimy and sweaty if you don’t clean them. How is that good for a fresh incision?! Not everyone agrees so ask your doctor first but I recommend that my patients get in the shower the night following their surgery and let soap and water run over the incisions. This keeps them clean. However, do NOT soak underwater in a bathtub, swimming pool, lake or other body of water because you could be bathing in your own, and someone else’s, filth.

4. Tummy tucks and/or a breast lift – Myth: The scars will disappear eventually

Fact: You had an operation, and the only way to get rid of excess skin from the abdomen or breasts is to cut it out. That means incisions. You will always have those scars. Sure they may fade to the extent you’re happy with the scars but they will not disappear. This is also why incisions are often placed in areas that will be covered by clothing or under garments.

5. Breast augmentation – Myth: I have to get the implants exchanged every 10 years

Fact: Nope. There was a study years ago that showed about 20% of women who had breast implants had to get them exchanged after 10 years for one reason or another. Leaking implant, capsular contracture, malposition, etc. But that also means that 80% of women were just fine.

The study involved older generation implants. So if the study was done today with newer implants, the percentage could be even lower. Bottom line: if you’re happy with your implants and you know it, clap your hands…because you don’t have to change them out!

So that’s the truth on the matter. All 5 myths debunked. So tell your friends so we can put these 5 myths about aesthetic medicine to bed!

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

The post 5 myths about aesthetic medicine first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

The BBL: It’s more than just a bigger butt

If you listen to what most women are looking for in a butt, it’s not about the size. You hear words like contour, shape and hip dips. Very few are coming in asking for huge buttocks.

1. Silhouette

Many women want a BBL to accentuate their silhouette. Specifically, they’re looking for that hourglass figure. This requires aggressive liposuction to the abdomen and flanks to make the waist as narrow as possible. The combination of a narrow waist and fuller buttocks will achieve that hourglass shape.

2. Filling in the hip dips

The hips dips are perfectly normal anatomic features. this is the depression between the hip bones and the thighs bones.

Even though these are normal contours in the body and no one should feel as though something is wrong with them, popular culture is driving women to fill these in (as seen below). Rounding out the thigh does contribute to that idyllic hourglass figure so many women strive for.

3. Rounded buttock shape

Ultimately patients want fat injections to the buttocks but this does not require liters upon liters to achieve their stated goals. Fat to provide projection as well as rounding out the upper portion of the buttocks to blend into the hip dips provides a very aesthetically pleasing shape. Gone are the days of the upper buttock shelf. That’s not currently in vogue.

With just the right amount of fat, an older woman can lift and volumize her buttocks just as one would for deflated breasts. With different aged women, their goals vary and we must adjust our techniques to help them attain those goals.

To check pricing for a BBL or any procedure from a doctor near you, click here.

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

The post The secret to the BBL isn’t a bigger butt first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Abdominal bulge after pregnancy

The upper abdominal bulge, shown above, that occurs after pregnancy is very typical. It’s a combination of fat, excess skin and a stretched-out abdominal wall (aka rectus diastasis). Exercise alone won’t fix all three of these. Liposuction alone won’t either. But a combination of procedures is just what the doctor ordered!

During a tummy tuck, your surgeon makes an incision below your panty line. So even though it’s a long incision, it can be hidden by underwear or bikini bottoms. After the incision is made, your surgeon will perform liposuction to the abdomen and flanks but also to the upper abdomen if there is excess fat there.

However that bulge is also due to excess skin that hasn’t tightened or recoiled after the pregnancy and due to a rectus diastasis. A rectus diastasis is not the same thing as a hernia. It’s when the six pack muscles and the tough tissue (fascia) that wraps around them, separate. This leaves a weakened abdominal wall that bulges out in the middle of the abdomen.

To bring the six pack muscles back together in the middle where they should be, requires a rectus plication. This is the use of stitches, like a corset, to bring the muscles back together and remove the bulge. Working out in the gym may strengthen your six pack muscles but it won’t remove the bulge. That’s why you need a 1) tummy tuck with 2) liposuction and a 3) rectus plication to remove excess fat, skin and flatten the abdominal wall to finally get rid of that bulge after pregnancy.

To check pricing on a tummy tuck from Dr. Kaplan, click here.

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

The post Three ways to treat your abdominal bulge after pregnancy first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Pain point: surgical vs non-surgical

Let’s say a patient is trying to decide between liposuction or non-surgical fat freezing with CoolSculpting (CS). First and foremost is education. I emphasize to the patient that these procedures are not equivalent. CoolSculpting won’t produce the same results as liposuction. Even the folks at CoolSculpting would agree.

So I ask, what’s your pain point? If they’re a candidate for both procedures, what’s more important to them? Getting a 25% fat reduction (CS) without surgery or 85% with liposuction (surgery)? What’s a greater concern? Surgical downtime (liposuction) vs no downtime (CS)? Obvious results (lipo) vs more subtle results (CS)?

The decision is ultimately up to them if they’re a candidate for both procedures but it’s critical they have reasonable expectations regarding the results.

Pain point: shape vs incisions?

Here’s another example from a recent patient. She wanted a breast lift. She was very clear that she wanted perky breasts (improved shape) without implants. Forgoing implants in a breast lift is totally reasonable because the success of the lift is mostly dependent on removing excess skin. If minimal skin needs to be removed to tighten the “skin envelope,” fewer incisions are required. And conversely, more skin removal, more incisions.

If someone has a slight droop or ptosis to their breasts, an incision only around the areola (well hidden) allows the removal of enough skin to give an adequate lift. See photo above. If they have more droop, they’ll need a “lollipop” lift (see below). That’s an incision around the areola and extending down to the fold under the breast. If they have a greater degree of droop, then they’ll need the “anchor” incision which includes the “lollipop” incision plus an incision within the fold under the breast.

With that background, they have a decision to make. Is their pain point achieving the perkiest breast possible? Then that may require the “lollipop” or “anchor” incision to remove more skin. If they want fewer incisions, they need to understand they won’t get as much lift. So again, what’s your pain point? Nicely shaped breasts with more incisions that will fade with time or droopy breasts with fewer incisions? The pain point, and resulting answer, is different for everyone!

To check pricing on any of these procedures, click here.

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

The post What’s your pain point when it comes to cosmetic surgery? first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

What is lipoetching?

Believe it or not, lipoetching is using what is normally a bad technique, in the right context. When performing liposuction, the surgeon sucks out as much fat as possible. At the same time, you don’t want to remove too much fat in one area and leave too much behind in another. The goal is to remove fat but keep the skin and contours of the body even and symmetrical.

But if too much fat is removed in any area, this results in contour deformities. If the surgeon didn’t mean to do that, it looks terrible and is hard to fix. And that’s essentially what lipoetching is: a purposeful contour deformity! By performing liposuction very superficially, just below the skin, a contour deformity or divot is created. This technique can be successful in the context of abdominal liposuction.

Someone with a toned abdomen typically has natural divots in the midline of their abdomen and along the sides of the six-pack muscles. These are the linea alba and linea semilunaris respectively. In the video below, you’ll see lipoetching in the midline of the abdomen. Notice how superficial the cannula is under the skin. You can see how subtle but effective lipoetching of the midline can be in the patient’s photo above.

Video on lipoetching

To check pricing on liposuction or lipoetching from Dr. Kaplan, click here.

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

The post Why work out if you can get lipoetching?! first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

What’s the purpose of postop garments

It’s not clear why postop garments became such an integral part of cosmetic procedures. There’s not a peer-reviewed, multi-center, high quality study showing the effectiveness of using postop garments. Nothing similar to a drug trial with and without postop garments.

However, many surgeons use them. Here are some possible reasons.

After a breast augmentation, with fresh incisions under the breast, your surgeon may worry you’ll wear a bra with underwire. This could cause irritation to the incision, possibly risking it to open. To avoid this problem, your surgeon may recommend a special postop bra because they are usually soft, without much structure. And certainly don’t have underwire. Therefore, your surgeon knows exactly what you’re wearing after surgery and can rest easy it’s not a bra that will place undue stress on “their work.”

In the case of a tummy tuck or liposuction, the patient is often sore and the potential for fluid to collect under the skin is high. With swelling, the skin stretches, causing pain fibers to fire, putting the patient in more pain. To alleviate some of this pain, the garment can reduce the amount of swelling, theoretically reducing skin stretch and therefore pain.

While there’s no proof of these benefits in a large study, many patients like the garment and the “sense of security” it provides after surgery. It’s also interesting to see how many patients are reluctant to embrace the idea of a postop garment before the operation but come to appreciate its benefits after surgery.

Click on the links to check pricing on the procedures that often require a postop garment. Breast augmentation, tummy tuck, liposuction.

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

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