My method is not scientific at all but based on experience, having performed hundreds of breast augmentation surgeries over the past ten years.

I measure the patient’s chest before surgery to come up with bra size.  It is amazing how many of my breast augmentation patients are wearing the wrong size!  Whatever the bra size is, I add 4 and 6 to that number.  For example, if a patient has a bra size of 32, I have the patient purchase a 36 and 38 sports bra (most sports bras come in C cups).

The reason I have the patient purchase two sizes is that every patient will have different degrees of swelling after surgery.  There is no way to accurately predict this pre-operatively.  The two sizes allow me to properly fit the patient with a support bra which is not too tight and not too loose.

With this simple “technique”, more than 90% of my breast augmentation patients have chosen a sports bra which fits properly.

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.

However, I never forget what happened one night when I was a second year general surgery resident rotating at the intensive care unit (ICU).  One evening, I received news about an 18 year old female who was pregnant with her first child.  During or after delivery and the details were not clear, she stopped breathing and sustained several minutes of oxygen deprivation to the brain.  She was subsequently intubated and transferred to the ICU.  Fortunately the child was healthy.  Over the next two days, due to the unknown time of oxygen deprivation and since the patient did not respond appropriately to external stimuli, multiple studies were performed to asses her brain function.   All studies came to the same conclusion:   brain death.

In the evening, when the last set of test results was noted, I approached the family regarding organ donation.  I explained to them her brain damage was severe and irreversible and she will never be able to function or breathe on her own.  The family deliberated for 30 minutes in a private room and decided against organ donation.  They asked me to disconnect her from the breathing machine.

While they were in the room, I hoped the family chose organ donation, since I did not want to face her death.  She was so young!  It also would have benefited another patient who desperately was in need of an organ donor.

With the family in the room, holding hands and with their heads down in prayer mode, I disconnected her from the breathing machine.  It was eight or nine o’clock at night and the ICU was quiet.  This time it was eerily silent.  Although I could have left the room, I did not.  Here was a family I hardly knew, a patient I had known for two days.  After tonight, I probably would never see any of them again.  Yet, I couldn’t leave.  It didn’t feel right for me to leave.

Here I was, a second year surgical resident, helpless.  Neither surgery nor medical technology could save this patient now.  I watched the monitor showing her heart beat gradually slowing down….3 beats per minute…2 beats per minute…one beat per minute…flat line.

No words were spoken to me, but I knew the family appreciated my presence.  I left the room and went to the bathroom and started crying.

I realized something no medical school book or teacher could have taught me.  I was given the privilege and power not only to save lives, but to take life away.  I better not mess up and I better take my responsibilities seriously!

I often think of this patient, just to make sure I don’t forget what it means to be a physician.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon and a member of American Society of Plastic Surgeons.  His office is located in central Orange County.  If you like to schedule a complimentary consultation, please call 714-834-0101.

As have been stated in my previous blog, mommy makeover surgery addresses the changes which occur after pregnancy.  These changes primarily affect the breast and the abdomen.

The breast can be enhanced with an implant (breast augmentation) with or without a breast lift.  A breast lift may be required to reposition the nipple and tighten the loose skin.

Although some patients are lucky enough only to require liposuction, most patients will require a tummy tuck (abdominoplasty) to address the loose skin, stretch marks, and the weakened abdominal muscles which occur after pregnancy.

So, can both surgeries be combined together?  The answer, in most cases, is yes!

There are two limiting factors preventing both procedures to be performed at the same time: the patient’s financial situation, and the total time the patient is under anesthesia.

Mommy Makeover surgery is among the more expensive procedures performed by plastic surgeons.  The surgery may take 4-6 hours and the cost of anesthesia/operating room, implant and surgeon’s fee will add up quickly.  Having said this, if the patient can afford the cost, there are many benefits to having the procedures combined.  First, there is one recovery period, both from anesthesia and from the surgery.  For patients who work, one recovery period is financially advantageous.  Second, combining both surgeries will result in a 10-15% reduction in overall cost.  Surgery centers typically charge more the first hour and the price decreases after that.  Therefore, staging the surgeries will result in more added cost to the patient.

The second limiting factor is the anticipated anesthesia time.  The current recommendation by the American Society of Plastic Surgeons is to limit anesthesia time for elective, outpatient surgery to six hours.   Therefore, if the surgeon feels the surgery may take longer, it is best to stage the procedures.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

So, is breast augmentation worth it?  Remember, you as a patient are going to pay thousands of dollars, temporarily feel bad and look bad, for the hope that your breasts will look better after surgery!

Well, the answer is “it depends”.  If you have realistic expectations and are doing the surgery for yourself and yourself only, then the satisfaction rate is very high.  Although I haven’t done an actual survey, the satisfaction rate for breast augmentation seems to be greater than 90% in my practice.   Realself.com, a reliable web-site, lists a satisfaction rate of 78% amongst respondents who had breast augmentation.  Perhaps the difference is due to patients having unrealistic expectations and/or not achieving the result hoped for.  As I have mentioned previously, selection of your surgeon is critical.  He/she should be board certified in plastic surgery, and have before and after photo gallery either in the office or on-line (preferably both).  It is important you feel comfortable with this person operating on you and like the result of his/her work.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

After breast augmentation, the breasts will be swollen for 3-6 months, although the majority of the swelling will be resolved by 3 months.  Support, therefore, is critical to minimize discomfort.

It is important a sports bra be worn for the first three months, which opens in the front.  It will be very difficult to reach back and close a bra with painful, swollen breasts!

At the time of consultation, I measure the patient’s chest diameter and recommend three sizes to be purchased.  It is very difficult to know the exact bra size which will fit properly after surgery, since every patient will have varying degrees of swelling.  It is critical for the sports bra not to be tight, as it will push the implants up (in effect acting like a push-up bra).  During the first three months, it is important to make sure the implants are not pushed up as the surgical pocket created may close and the implant will stay up permanently.  The only correction is additional surgery!

Many patients are impatient and want to show their new breasts as soon as possible.  Usually, this is accomplished by wearing a push-up bra.  Patience is rewarded if one can resist the temptation during the first three months.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

As an Orange County breast augmentation surgeon, many patients are curious about the differences between saline and silicone implants.

I want to focus on the life span of these implants.  It is important to accept the fact no implant will last forever.  When the implant will leak is unknown.  Fortunately, with the current generation of breast implants, many patients will have intact implants for many years.

As I stated in a previous blog, although both implant manufacturing companies have a life time warranty on breast implants, the company provides financial assistance towards the procedure only up to ten years from the time of surgery.  This means if your implant should fail after ten years, the company will replace the breast implant free of charge, but no assistance will be provided to cover cost of surgery.

Since silicone breast implants contain silicone gel, when the implant fails, the gel is unable to be absorbed by the body.  As long as the breast shape and feel is unchanged, therefore, a patient with a leaked silicone implant will not be aware of it.

For this reason, I always recommend this group of patients to obtain a MRI, which is the gold standard currently for silicone breast implant leak, a few days before their ten year “warranty” has expired.  Yes, it is a nuisance and yes, it will cost money.  However, what if at 11 years post breast augmentation, you should find out one or both implants have leaked?  Since there is no proof when the leak actually happened, the company is under no legal obligation to provide financial assistance towards your surgery.

Of course the safest way is to follow the current recommendation by FDA regarding silicone breast implant.  The FDA recommends a MRI three years after surgery, and every other year after the initial study.  This is not mandatory, and it is up to the patient to follow this suggestion.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

As an Orange County breast augmentation surgeon, a common question is: “How long do my implants last?”

No breast implant is permanent.  Eventually, with time, the shell or other parts of the implant will break down resulting in an implant leak.  When this happens is not known.  Rarely, the leak can occur early (I have had one patient at 18 months after surgery).  For most patients, it will take many years before the implant fails.

Mentor and Allergan are the only FDA approved breast implant manufacturing companies in the United States.  The good news is both companies have a life time warranty if the implant should fail or leak.  This means if your breast implants should leak at any time, the company will replace the implant(s) free of charge.  Both companies also have a limited payment policy towards covering some or all the cost of the surgery.  Up to ten years from the time of implantation, both companies will pay a certain amount towards your surgery.  More information can be obtained through each company web-site.

The ten year time period, at least in my opinion, means the risk of implant failure is low enough that the company is willing to accept the risk and pay a portion towards the surgery.  This does not mean all breast implants are going to leak right after the 10 year period!  With newer generation breast implants currently in the market, these implants last longer than older ones.

BREAST AUGMENTATION ORANGE COUNTY

How do you know if your implant has leaked?  In case of saline breast implants, the leaked saline (salt water) will be absorbed by the body.  The patient can see and feel the difference in the affected breast.  With silicone breast implant, the leak may not be detectable, since silicone is not absorbed by the body.  Silicone is not dangerous and no study has found a link between silicone implants and disease process.  Currently, the gold standard for detecting a leak for silicone breast implant is an MRI.  The FDA has recommended all patients with silicone breast implants have an MRI three years after surgery and every two years after the initial MRI.  It is up to the patient to follow this protocol and is not mandatory.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Orange County Breast Augmentation Specialist Dr. Michael Jazayeri

As an Orange County breast surgeon I am going to take you through a patient’s recovery after breast augmentation.

Orange County Breast Implants Before and after surgery

I see the patient 24-48 hours after surgery.  The breast wrap is removed, which is always a relief, since it has to be somewhat tight.  Many patients feel their pain is much improved after the breast wrap is removed.  The patient looks at her breasts and complains why one breast is slightly fuller on top than the other.  This is so typical of younger patients!  I re-iterate our discussion at the consultation that it will take 3-6 months for the implants to settle.  The patient tries on the various size sports bra which she has brought with her.  Usually one of them will fit.  It is important for the sports bra not to be too tight, as it will push the implants up.  During the first three months, for most patients, the goal is to keep the implant from riding too high.

Orange County Breast Augmentation Specialist Video

Breast Augmentation Surgeon Board Certified by the American Board of Plastic Surgery

I see the patient again 6-8 days after surgery.  At that time, the sutures are removed.  The patient again looks at the breasts and complains about the minor asymmetry.  I go over our discussion again!  I instruct the patient on proper implant massage, which must be performed at least five times a day.

The patient returns for follow-up one month after surgery.  The implants are settling in and are beginning to form a more natural look.  Although the asymmetry has improved, the patient still complains.  I go over our consultation discussion again!  I instruct the patient to continue the sports bra and breast massage.  She may start exercising as tolerated, but no chest exercises are allowed.

The patient returns three months after surgery.  In some patients, the implants are settled in and the patient does not complain.  If the implant has not settled, the patient will complain about the asymmetry.  I repeat our conversation from previous office visits again!  The patient may now wear any type of bra she desires.

Six months after surgery, the patient returns for another office visit.  By now, majority of patients have stopped complaining!  The implants have settled and have developed a natural look and feel.  The patient will schedule her annual follow-up in six months.

The anniversary has arrived!  It has been one year since the surgery.  To my trained eyes, there are subtle changes in the shape and feel of the implant.  The patient is pleased with the result (thank God!).  I recommend patient return for a follow-up annually.

This is a typical recovery scenario for my Orange County breast augmentation patients.  Not everyone will have the same experience and, rarely, some patients will develop complications. 

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Mommy makeover is the catch phrase for cosmetic surgery involving the breast and abdomen, the two areas most commonly affected by pregnancy.

The breasts typically “deflate” after pregnancy and breast feeding and almost always will require a breast augmentation to regain the lost volume.  If there is sagging of the nipple and loose skin, a breast lift (mastopexy) may be needed as well.

Some patients (the lucky ones!) have little effect on their stomach area after pregnancy.  However, most patients will develop loose skin, stretch marks and weakness of the abdominal muscles, resulting in a “beer belly” appearance.  Typically a standard or extended abdominoplasty is required, although some patients can achieve an excellent result with a mini-tummy tuck.

In most cases, both breast and abdominal surgery can be performed together, if the anesthesia time can be kept under six hours (this is the recommended time limit for outpatient elective surgery by the American Board of Plastic Surgery).  Performing both surgeries together has the benefit of one recovery term (this is especially critical for patients who work) and lower cost.

Mommy makeover surgery is amongst the most expensive cosmetic surgery procedures performed.   This is due to the prolonged surgery and anesthesia/operating room time required to adequately address and correct the changes discussed previously.  Whether the time and cost is worth it is a personal question only the patient can answer.  However, if you have realistic expectations and are doing the procedure for YOU and YOU ONLY, it is one of the most rewarding surgeries I perform.  Imagine reversing the effects of pregnancy, what a wonderful concept!  Many patients have told me their sex life has improved since the surgery because they feel more confident about themselves.  The smile on the partner’s lips is always a big give-away!

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

MASSAGING AFTER BREAST AUGMENTATION

Breast Augmentation is the most common procedure requested by my Orange County patients.  Some patients are curious as to why I recommend massaging the breast after augmentation.

A breast implant is a foreign material.   The body, initially, will try to absorb the implant.  Since it cannot, the body forms a thin layer (capsule) around the implant, essentially ignoring it.  This process occurs with any foreign material.  The shell of all breast implants is made of silicone polymer, which is well-tolerated by the body.

In addition to the implant, a “false” space has also been created to accommodate the implant.  Since the body is not used to this space, it will initially try to close it.  The massage, therefore, is critical to maintain the space open.  Usually, by the third month, the body has formed a capsule around the implant, and the need for massage is not as critical.

I always recommend breast massage at least 5 times a day.  The massage is started 7-9 days after surgery.   After three months, massaging occasionally (once a day) is recommended.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.