Élan Institute for Plastic Surgery 2010 East First Street, Suite 270 Santa Ana, CA 92705
June 24th, 2009 Michael A. Jazayeri, M.D.
Abdominoplasty (tummy tuck) is one of the most requested surgeries from my Orange County patients.
Seroma is one of the most common problems which may occur after abdominoplasty. In my practice, approximately 10% of patients develop seroma.
Seroma is a collection of fluid under the skin. It can develop early (while the drains are in) or late (after the drains have been removed). If the seroma is small (one ounce or less), it usually absorbs with time. If the seroma is large, however, it must be removed. This is done by aspirating the seroma through the abdominal skin with a syringe and needle. Multiple aspirations, once a week, may be required for several weeks. In majority of patients, this treatment will alleviate the problem. Rarely, other steps (even surgery) may be required to treat the seroma.
The main reason seromas occur is due to the abdominal skin rubbing against the underlying surface. It is this rubbing motion which promotes seroma formation. It is for this reason I emphasize to my patients to avoid excessive movement of the abdominal area while the drains are in and for one week after the drains have been removed. In my experience, majority of patients who develop seroma started their activities too fast and did too much.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in central Orange County. If you like to schedule a complimentary consultation, please call 714-834-0101.
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June 17th, 2009 Michael A. Jazayeri, M.D.
Capsular contracture means tightening of the capsule. Any non-absorbable foreign body which stays inside us will eventually form a capsule around it. In effect, since the body can’t expel the foreign body, our bodies ignore it by hiding it inside a “cocoon”.
The same principal applies to breast implants as well, no matter what style of implant or manufacturer is used.
In my Orange County practice, on a yearly basis, I see a handful of patients who develop capsular contracture after breast augmentation. When I say a handful, I am describing the patient which has visible and non-visible effects from the contracture. The percentage, therefore, is low. However, the incident of contracture increases with the age of the implant.
The most common system used for describing capsular contracture is the Baker-Gordon Classification:
Grade I-the implant and the breast feel soft, and look natural
Grade II-the implant feels slightly firm (not-objectionable), and the breast looks natural
Grade III-the implant feels hard and the breast looks abnormal
Grade IV-the implant feels hard, is painful to touch, and the breast looks abnormal
Once grade III and IV contracture has occurred, the only solution is surgical correction.
There are two surgical options to correct the deformity: capsulotomy and capsulectomy. Capsulotomy means cutting the capsule. Radial cuts are made in the capsule, resulting in expansion of the capsule. Capsulectomy involves removing the capsule. As can be expected, capsulectomy is a more involved process, and as careful as a surgeon is, a small amount of breast tissue is attached and thus removed in the process. This can result in a higher chance of skin thinning, compared to capsulotomy. I, therefore, reserve capsulectomy for a very thick capsule which does not “yield” easily, or in someone who develops recurrent capsular contracture after capsulotomy.
In my experience, most early capsular contracture is usually due to two factors: post-operative bleed inside the breast 1-7 days after surgery, and patient non-compliance.
It is critical the patient refrain from any rapid upper body activity or heavy lifting the first month, and especially the first week. I have had patients who picked up their child the next day after surgery, or vacuumed the house within the first week (talk about being tough!) and developed a hematoma (collection of blood) inside the breast. If the hematoma is small, it will absorb with time. If the hematoma is large, then surgery is required to remove it. Regardless, patients who develop post-op bleeding are at much higher risk of developing capsular contracture. This may be due to the inflammatory, “attacking” response of the body to clear the blood clot.
Patients who are non-compliant with their implant massage also are at higher chance of developing contracture. My theory is that the body is not used to the new pocket created for the implant, and the massage is critical to keep the pocket from closing. It typically takes 2-3 months for the body to form the capsule. That is why it is critical to massage the implants often during the first three months.
Capsular contracture with aging of the implant is out of our control. Neither the patient nor I can predict when the contracture will occur and how to prevent it. Having said that, majority of patients enjoy their “new” breasts for many years to come!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in central Orange County. To schedule a complimentary consultation, please call 714-834-0101.
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June 4th, 2009 Michael A. Jazayeri, M.D.
BREAST LIFT-WHY IS IT NEEDED?
Some of my Orange County patients are surprised and sometimes shocked to find out in addition to a breast augmentation, they require a breast lift (mastopexy) as well. Since most of my practice is referrals from previous Orange County patients, the patient compares herself to her friend. This is a common quote: “But my friend didn’t need a lift, why do I need one?”
One cannot compare apples to oranges, and the same applies to one’s body. Your body is different than your friends, sister, neighbor, etc. Your friend did not receive a breast lift because she did not require it.
It is important to keep in mind the position of the nipple relative to the breast implant. For a breast augmentation to look cosmetically pleasing, the nipple has to be at the center (the highest point) of the implant. Otherwise, the breast shape will look strange. This is an important point to remember: a breast implant without a lift will look much worse and unnatural than a breast which is naturally saggy and loose.
Therefore, if a patient has nipple and skin ptosis, both must be corrected to achieve an aesthetically pleasing result. The only way to do this is by moving the nipple up so that it is at the center of the implant, and then removing the excess skin, so the skin is not loose and hanging.
Scarring is always a concern for patients. However, having done hundreds of mastopexies, I can say the risk of noticeable scarring (scars which are thick and raised) is rare.
Michael A. Jazayeri, M.D. is a Orange County board certified plastic surgeon with over 10 years of experience. His office is located in Orange County, CA. To schedule a complimentary consultation, please call 714-834-0101.
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May 28th, 2009 Michael A. Jazayeri, M.D.
-THE NON-OPERATED OPERATED NOSE
I know the title is confusing. However, I chose this title to make a point.
What is the purpose of having one’s nose cosmetically altered if it screams “I had surgery on my nose”?
So what makes a nose look unnatural? In my opinion, the most common alteration is to shave off too much from the dorsum (the hump) of the nose. This will result in a “ski-slope” look, which is most obvious on the profile. The next time you are walking in the street, look at people’s noses. In nature, noses either have a hump on the nose or are flat. A “ski-slope” dorsum does not occur naturally.
This “style” of nose was, in fact, in vogue in the seventies and early eighties. However, our goal today is to make the nose look as natural as possible.
The other common problem is inadequate distinction between the dorsum and the tip of the nose. In females, there should be a slight step-off between the dorsum and the tip. This is called the supra-tip break. In males, this break should be very subtle or not exist at all. One does not want to see the dorsum higher than the tip. This will result in a “parrot-beak” deformity, which is most visible on the profile.
Visible irregularities of the dorsum are an obvious sign of operation. Again, if one looks at noses in nature, visible lumps and bumps do not occur.
There are other subtle signs which may point to a rhinoplasty. However, only a rhinoplasty surgeon can pick those up. My goal, as an Orange County plastic surgeon, is to aim for a natural looking nose. I want people to do a “double-take” and guess if the nose was operated on. It is a challenging goal to meet, but worth the time and effort!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon, with over 10 years of experience. His office is located in Santa Ana, California. To schedule a complimentary consultation, please call 714-834-0101.
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May 20th, 2009 Michael A. Jazayeri, M.D.
I have always said “God is a Man.”
After the man “delivers the goods”, it is the poor woman who has to suffer the effects and after-effects of pregnancy. Cosmetic footprints of pregnancy include varicose veins, deflation and sagging of breasts, stretch marks and weakened abdominal muscles.
Of course I, as a man, can never experience the joy of carrying and nurturing a life form inside of me. In the long run, however, I rather have an enlarged prostate than suffer the consequences of pregnancy!
Fortunately, mommy makeover surgery can reverse many of these effects. Mommy makeover surgery is a catch phrase. It involves reversing the effects of pregnancy on the breasts and abdomen.
If the breast has firm skin and the nipple is in a correct position, then only breast augmentation is necessary. If, however, the breast tissue and nipple have sagged, then a breast lift (mastopexy) is also required.
To address the abdomen, if one is lucky enough only to have excess fat, then liposuction will be performed to remove the fat. Most patients, however, will have loose skin, stretch marks and a “beer belly” due to weakened abdominal muscles. A tummy tuck (abdominoplasty) is then performed to address these issues.
It is important to realize many of the changes mentioned above also occur in patients with significant weight loss. Therefore, even if you are not a mother, plastic surgery can be of benefit to you.
I have noticed a dramatic change in the dynamics of couples after mommy makeover surgery. I think the renewed confidence and sex appeal of the female has a positive effect on the husband as well.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in central Orange County. To schedule a complimentary consultation, please call 714-834-0101.
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May 13th, 2009 Michael A. Jazayeri, M.D.
Abdominoplasty (tummy tuck) surgery is one of the most common surgeries I perform in Orange County. Many patients from Orange County request this surgery, since we are a “beach” community and appearance in a bikini or swim suit is important.
I have examined many before and after tummy tuck photos to determine what makes a result pleasing.
The most important factor for a tummy tuck is the amount of fat under the skin. If a patient has too much fat under the skin, the result will not be pleasing. As the thick skin is pulled down, it will “bow out” and a flat stomach is not obtained. Therefore, it is critical the patient be at or within 10-15 pounds of ideal body weight and have thin amount of fat under the skin.
The other important factor is the shape of the umbilicus (belly button). I have seen many nice results being less than ideal due to the distracting shape of the umbilicus.
The third factor is the amount of skin removed and the tightness of the closure. If too little skin is removed, the abdomen will be loose and “jiggly”. If too much skin is removed, the recovery time is prolonged. Eventually, when the patient can stand straight, the skin will curve inwards due to excess tension. Not very attractive!
The flanks (love handles) also need to be addressed. If the patient has too much fat around the love handles, liposuction is recommended to smooth out the area and give more definition to the waist line.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in Orange County, CA. To schedule a complimentary consultation, please call 714-834-0101.
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May 11th, 2009 Michael A. Jazayeri, M.D.
One of the most common causes for breast surgery re-operation after augmentation is patient dissatisfaction with the size of the implant.
Most Orange County patients who see me for a consultation ask to be a “full C cup”. This “size” has always baffled me, since bras come in C cup and D cups. One cannot buy a “full C cup” bra. Therefore, it is critical to synchronize the patient’s thought process into an actual size which the patient can see.
My philosophy is to find the largest implant which fits the patient’s body. By doing that, the implant complements, rather than exaggerate.
I have all my patients try the implant on with a sports bra. The patient can then see themselves in the mirror with and without clothing.
Since using this process, my re-operation rate due to implant size is less than 1%.
Many of my younger patients want to be “big”. I always tell my patients an exaggerated breast will get you attention, but not necessarily respect! It is better to gain people’s respect first, the attention will follow automatically.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon, with over 10 years of experience. His office is centrally located in Orange County. To schedule a complimentary consultation, please call 714-834-0101.
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April 21st, 2009 Michael A. Jazayeri, M.D.
I recently came across an article by Reuters, which I think is interesting. The article discusses an increasing trend in patients seeking cosmetic plastic surgery in order to improve their chances in the job market.
Just a few weeks ago, there was an article in the Los Angeles Times about the same trend occurring in China!
Is there any merit to all of this?
Unfortunately beauty is NOT in the eye of the beholder. Studies have shown an attractive, tall person has a higher chance of obtaining a higher paid position, given the same qualifications as an unattractive, short person.
This is not to say if you are tall and attractive, you are automatically guaranteed a better position. Eventually your merits (or lack thereof) will catch up with you!
I think what happens is cosmetic surgery (especially on the face, which is visible all the time) causes the patient to increase their confidence level. This, in turn, will “unleash” the hidden confidence and ability which that person had from the beginning. Again, it goes back to merits. The surgery allows that person’s potential, which was buried under a heap of shyness, to blossom.
If you are realistic about your abilities and have a prominent, unattractive nose or a tired and aging face and neck, I think cosmetic surgery has a high likelihood of improving your self-confidence. 
My personal philosophy about cosmetic plastic surgery is NOT to have an over done look. A face lift or a nose job should look natural. I never forget a patient of mine who had nose surgery, face and neck lift. She returned from her 20 year high school reunion for a follow-up. She said every one had complimented her on how well she had aged. No one asked her if she had plastic surgery!
I feel the same about breast augmentation. Many of my younger patients want to go “big”. I always tell them an exaggerated breast, face or body will get you attention, but it does not necessarily gain you respect! It is better to gain people’s respect first…the attention will follow.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in Santa Ana, California. To schedule a complimentary consultation, please call 714-834-0101.
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April 15th, 2009 Michael A. Jazayeri, M.D.
Has the economy gotten you depressed? I know I am!
Many of my friends are putting off or delaying “luxury” activities. However, this does not mean we have to die either!
Many of us, especially women, suffer from spider veins (telangectasia) and varicose veins on the thighs and legs. Many are embarrassed by them, but do not realize treatment is available.
I prefer to inject the spider or varicose vein with a sclerosing agent (which causes scarring inside the wall of the vein, causing it to scar down). I have been performing this technique for many years and have had great success with it.
This is an outpatient procedure and does not require pain medication or anesthesia. The patient can drive home after the injections are completed. The only necessary requirement is to wear a support panty hose for 72 hours after the procedure.
There may be bruising at the site of injection and the final result may take 1-2 months.
If you have very large varicose veins which are painful and bleed, you are not a good candidate for this procedure.
The cost is very reasonable. The treatment can cost as low as $50. The usual range is $400-500, depending on the amount of injections required.
I have attached a before and after photo to illustrate the effectiveness of this procedure.
If you like to schedule a complimentary consultation with Dr. Jazayeri, please call 714-834-0101.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is centrally located in Orange County, in the city of Santa Ana.
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April 3rd, 2009 Michael A. Jazayeri, M.D.
Gynecomastia is the medical term for enlarged breast in men.
In majority of men, the cause is genetic and idiopathic (no known cause). Typically, the breast tissue grows around puberty and remains large.
It is important to rule out reversible causes such as certain medication, anabolic steroid use, excessive alcohol intake, and medical conditions causing hormonal imbalance.
Probably the most common medication causing gynecomastia is Cimetidine, which is an antacid.
Increased estrogen levels leading to enlarged breast can be due to testicular tumors or hyperthyroidism. Any liver disease may cause decreased clearance of estrogen, leading to gynecomastia.
Certainly, if any doubt exists, breast cancer should be ruled out by mammography or ultrasound. Male breast cancer is rare, but it does occur.
Assuming all reversible or treatable causes have been ruled out, what options does a patient have for gynecomastia? The most common procedure is liposuction, which involves suctioning of the fatty breast tissue. Liposuction alone is adequate for most patients. However, in a patient who has excess skin or non-fatty breast tissue, actual removal of breast tissue (subcutaneous mastectomy) with or without a breast lift may be necessary.
Gynecomastia surgery is a rewarding procedure both for the patient and the surgeon. Many patients who were embarrassed to wear a bathing suit are now proud to show off their new breasts (or lack of!)
I have attached a before and after photo to illustrate the effectiveness of this procedure.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. To schedule a complimentary consultation, please call 714-834-0101.
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