Élan Institute for Plastic Surgery 2010 East First Street, Suite 270 Santa Ana, CA 92705
February 3rd, 2012 Michael A. Jazayeri M.D.
Orange County Breast Augmentation Surgeon – Before and After Images
Breast Augmentation Before and After Pictures
Breast augmentation is the most popular cosmetic surgery procedure in the United States, with over 300,000 surgeries performed.
Breast augmentation surgery has a very high satisfaction rate, if the patient has realistic expectations and understands the limitations of the surgery within her anatomy. For example, see the breast augmentation before and after pictures I have displayed for illustration.
Either saline or silicone implant can be used. Both implants have the same shell covering. For saline implants, the shell is empty and is filled with saline (salt water) through a valve on top of the implant. Silicone implants are already filled with silicone cohesive gel and the volume is not adjustable. The choice of implant depends on the patients desire, amount of breast tissue, degree of breast asymmetry and cost (silicone implants are significantly more expensive). One cannot determine what type of implant is used by looking at a patient (see adjacent images).
With the news about PIP implants and their high leakage rate, it is important only FDA approved breast implants be used. Currently, only two companies in the United States qualify: Mentor and Allergan (Natrelle implants). Both companies offer a life time warranty in case of implant leakage (ALL breast implants eventually deflate) and provide partial compensation for surgery costs up to ten years from date of original surgery.
Please see below for additional breast augmentation before and after pictures:
Breast Augmentation Before and After Pictures
Breast Augmentation Before and After Pictures
Breast Augmentation Before and After Pictures
Breast Augmentation Before and After Pictures
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Breast Augmentation, Breast Implants, Home, Mommy Makeover | No Comments »
January 26th, 2012 Michael A. Jazayeri M.D.
An Unusual Case of Breast Implant Deflation
A previous patient of mine came to my office recently for a left breast implant deflation. She had saline breast implants placed in 2006, and now had an obvious asymmetry on the left side. On examination, the left and right breasts were soft to touch, with no masses or tenderness. The right breast was significantly larger than the left, consistent with a left breast implant deflation.
As a background, ALL breast implants will eventually leak and ALL breast implants will form a capsule around them. The capsule is basically our body’s way of “ignoring” the implant, which is a foreign body. Typically, the capsule is very thin (sometimes almost transparent) and very pliable. If the capsule becomes thick, it can become tight and squeeze the implant into a tight ball. This is called capsular contracture and depending on the severity, may require surgery to remove the tight capsule. In cases of implant deflation, the capsule always closes a bit, and is easily opened up during surgery. This is not capsular contracture, is as much as the capsule closes a bit due to the deflated implant.
Given the softness of the left breast, I anticipated a relatively easy implant exchange. Was I in for a surprise! I found the capsule to be very thick (up to 3mm in some areas) and very tight. When I placed the new implant in, it became obvious early on that the patient had developed a significant capsular contracture. Could the contracture have caused the implant to leak? If the capsule was so tight, why did the patient have no complaints prior to the deflation?
I performed a near complete capsulectomy (removal of capsule) which was very difficult, as the capsule was adherent to the breast tissue, followed by placement of a new implant. I did recommend bilateral breast lift to position the nipple over the center of the implant. However, the patient did not wish to have the procedure done at this time.
The patient is one week after her surgery, and the implants and the breasts are soft. As expected, the left breast is more swollen due to the surgery, and will take several months to “settle in”.
This is an unusual case and shows even an experienced surgeon can sometimes be fooled by clinical findings.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Breast Implant Complications, Breast Implants, Home | No Comments »
December 28th, 2011 Michael A. Jazayeri M.D.
THINKING OUTSIDE THE BOX – AN ALTERNATIVE METHOD OF TREATING HEMANGIOMA OF THE LIP
Sometimes it helps to think outside the box. A young patient was referred to me for a “lump” on her left upper lip. She had seen another plastic surgeon, who recommended a wedge resection (removing the entire lesion and surrounding tissue). This would have resulted in a potentially visible scar between her nose and lips, and possibly cause a significant amount of bleeding, as the lump was a vascular malformation (most likely a hemangioma).
Although this is a knee-jerk reaction for any lesion (let’s just cut it out), I decided to do further studies. A high resolution ultrasound was performed by the radiologist, which showed the lesion to have no major feeding vessels. This made the treatment much simpler, since I did not have to worry about any major blood vessels complicating the procedure.
I chose to inject the lesion with a sclerosing agent, similar to spider veins on the legs. This is not a new technique, but its use for treatment of hemangioma of the lip is not common either. After the injection and two months of waiting, the lesion had shrunk enough so the entire hemangioma could be removed under local anesthesia, and the incision was small and kept inside the lip, to prevent any visible scars.
This treatment, although somewhat unconventional, resulted in a nice cosmetic result and a happy patient.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Home, Skin Treatment, VARICOSE VEINS | No Comments »
December 19th, 2011 Michael A. Jazayeri M.D.
How is Vaser Lipo different than traditional liposuction?
Vaser Lipo, also known as Vaser liposuction, is another liposuction method which has become popular in recent years.
For clarification, different companies can make the machine used for this procedure. However, since Sound Surgical Technologies (trademarked under the name Vaser Lipo) has become the first company to gain most of the market share, the name has stuck with this procedure. Ultrasound guided liposuction is NOT a new technology, and has been around (at least in practice) for the past 12 years.
How is Vaser Lipo different than traditional liposuction? Well, both procedures can be done under local or general anesthesia. Both procedures require small stab incisions close to the area to be liposuctioned for access. Both procedures use tumescent solution (a solution containing a numbing medication and epinephrine, for minimizing bleeding) to “blow up” the area prior to liposuction. The difference is the next step. In Vaser Lipo, a specialized blunt cannula is inserted under the skin and ultrasonic energy is delivered through the tip to the area. The ultrasound energy disrupts and loosens the fat cells. The theory is the way the fat cells are disrupted may result in better skin retraction and faster recovery. However, there have been no prospective, randomized, blind studies showing the final result is better than traditional liposuction.
At the end, however, the fat needs to be suctioned out by the surgeon. Therefore, with ALL liposuction techniques available today, and in the future, the limiting factor is the quality of the surgeon performing the procedure. An example I frequently use is if I give any one a $7000 top of the line digital camera and a $2000 professional lens, would giving this equipment to someone suddenly make them a photographer? I think you know the answer!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Home, Liposuction | No Comments »
December 14th, 2011 Michael A. Jazayeri M.D.
I am a late bloomer. I married a wonderful person at age 39 and now have my first child, a girl, at age 47.
It has been 8 months since Lena was born, and I feel like a first year resident! As a resident, you are thrown into the “water of residency”, and by trial and error, you learn to stay afloat and eventually (hopefully) swim like a champion.
Now Lena, I have been told by her care-giver is a good girl. She repeatedly says “you haven’t seen difficult children yet.” Believe me, I don’t want to! Lena is a handful as it is.
If you ever want to sweat profusely, try putting clothes on, especially one with long sleeves, on an infant or baby. Talk about a moving target!
Sometimes Lena has difficulty going to sleep and after an hour of trying to calm her, I just want to cry. Here I am, a board certified plastic surgeon, who is almost always in control in the operating room, completely exhausted and defeated by a 20 pound living being, who can’t even walk or talk. Imagine what will happen when she does both!
Have you ever read the instruction manual for a baby car seat installation? Even I had a hard time trying to figure this one out. I rather read a medical journal, thank you!
At the end, however, Lena grows every day and acquires new skills, and so do I. I may not grow physically, but as a person, having a child has changed me for the better. The trick is to survive day by day until Lena can take care of herself. Of course, by then, there will be other issues such as boy friends, wanting a car, which school to go, etc. Will it ever end? Not until I either go bald or my entire hair is white!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
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December 12th, 2011 Michael A. Jazayeri M.D.
I am surprised how little Tintin is known in the United States. Well, this is going to change soon. A new animated (this is high quality animation) movie directed by Steven Spielberg will be released this month: Tintin and the Secret of the Unicorn.
The character, a young and curious detective/journalist was created by Herge’, a Belgian comic writer whose true name was Georges Prosper Remi. Supporting characters include Snowy (also Known as Milo in original version), Tintin’s trusted dog, Captain Haddock, an alcoholic ex sea captain, and two bumbling, identical twin detectives (known as Thompson twins). On a side note, do you remember the successful Eighties band by the same name? That is how they got their name!
Herge’ wrote 23 comic books involving Tintin. I was fortunate to read most of them. The books include elaborate, extremely detailed drawings and mature, sophisticated stories. Most of the stories revolved around events happening around Herge’. Many of these stories have political undertones buried under a “comic book”.
His stories have been translated in multiple languages covering the entire planet. So, it is surprising as to the lack of fame in this country. Amazon.com has a collector’s set including all 23 novels available for purchase.
Do yourself and your children a favor, and see this movie and buy Herge’s book. You will not be disappointed. Furthermore, given that 23 novels were written, Tintin has the potential to bury even the Harry Potter franchise.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
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December 2nd, 2011 Michael A. Jazayeri M.D.
Reeduce Triglyceride Levels By Undergoing Liposuction
A study presented at the annual meeting of the American Society of Plastic Surgeons this year measured triglyceride levels of patients undergoing liposuction before and after the procedure. 229 patients were included in the study.
No difference was seen in patients with normal levels. However, in patients with high triglyceride levels, a 43% reduction was seen, which is almost twice the effect seen with cholesterol-lowering medications.
Of course, long term studies are required to see if this effect is permanent or transient, and whether the reduction has any measurable effect on patient’s health.
Although intra-abdominal fat has always been linked to increased risk of cardiovascular disease, recent studies are pointing to the health importance of subcutaneous fat (which can be removed by liposuction) as well.
Isn’t it nice to know that liposuction will not only make one look better, but perhaps make us healthier as well!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Home, Liposuction | No Comments »
November 18th, 2011 Michael A. Jazayeri M.D.
How is Smart lipo different than traditional liposuction?
Smartlipo, also known as laser lipo, is a relatively new technology which has become popular in recent years.
For clarification, different companies can make the laser machine used for this procedure. However, since Cynosure (trademarked under the name Smartlipo) was the first company to gain most of the market share, the name has stuck with this procedure.
How is Smartlipo different than traditional liposuction? Well, both procedures can be done under local or general anesthesia. Both procedures require small stab incisions close to the area to be liposuctioned for access. Both procedures use tumescent solution (a solution containing a numbing medication and epinephrine, for minimizing bleeding) to “blow up” the area prior to liposuction. The difference is the next step. In Smartlipo, a tiny laser fiber (typically 1mm in diameter) is inserted in the area containing the tumescent solution, and the laser is moved back and forth. The laser generates heat, and will cause some coagulation of the tiny blood vessels. This may result in less swelling and bruising compared to traditional liposuction. The main concept behind using the laser, however, is that heat causes contraction and, therefore, may lead to better skin shrinkage after liposuction. However, to my knowledge, no one has published a randomized, prospective, blinded study showing the final result is better than traditional liposuction. Also, due to multiple variables, such as patient age, amount of fat, skin quality, etc. it is virtually impossible to design a protocol for the amount of laser energy required to give each patient the best result.
At the end, however, the fat needs to be suctioned out by the surgeon. Therefore, with ALL liposuction techniques available today, and in the future, the limiting factor is the quality of the surgeon performing the procedure. An example I frequently use is if I give any one a $7000 top of the line digital camera and a $2000 professional lens, would giving this equipment to someone suddenly make them a photographer? I think you know the answer!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Home, Laser Treatments, Liposuction | No Comments »
November 1st, 2011 Michael A. Jazayeri M.D.
Breast augmentation is the most common cosmetic surgical procedure in the United States. We routinely receive inquires, either by phone or e-mail, about our prices for this procedure.
I, therefore, decided to write about cosmetic surgery and pricing. Please note, since our practice is located in Orange County, California, the prices described here reflect the economy of Southern California and may not apply to other states or even Northern California. However, the principles about pricing shall remain the same regardless of geography.
Being a wine aficionado, I will use wine pricing for comparison, as everyone can relate to wine.
I am going to use the 100 point rating system, popularized by wine critic Robert Parker. A wine rated 90-94 is excellent. A 95-100 point wine is considered a classic wine. Obviously a 100 point wine is considered perfect, and there have been wines which have received this score by Parker and other critics.
In general, due to cost of doing business, it is rare to find a red wine under $10 dollars which rates 90 or above by most critics. The same is true for white wines as well. From $10-20, there are many options, both red and white, for wines rating 90 or above. Obviously, the chance of buying a wine rated 90 or more is higher if the wine costs $100 or more. However, there are many wines in that price range which do not rate that high. The price of a wine is determined by the economy (wages) of that country, the currency exchange rate, and most importantly the demand for that wine. For example, over the past ten years, the price of First Growth Bordeaux wines has increased from $200-300 a bottle to $2000 or more! This is due to new wealth from Russia, China, and India purchasing these wines (mainly as a trophy) thus increasing the demand in relation to supply. In a good to great vintage, many of these wines are extraordinary and will rate 94 or above. Are you as a consumer, willing to pay an extra $1980 per bottle for a 5-10% subjective increase in quality? Only you can answer this question.
The same applies to cosmetic surgical pricing. My recommendation is to find the best quality at the lowest price. Like every thing else, breast augmentation pricing in your local area will follow a bell-shaped curve. The price range for breast augmentation in Orange County and Los Angeles County can be as low as $2700 and as high as $10,000. Many of these lower prices are either by cosmetic surgeons not originally trained as plastic surgeons, or have had disciplinary action by the Medical Board of California (public records are available on their web-site). The higher prices are typically charged by surgeons who are publicly visible, mostly through television, and the higher cost reflects the cost of advertising. Is it worth paying $10,000 for a breast augmentation? See the paragraph above for comparison.
Now there are patients who must buy “so and so” bag or shoe, regardless of cost, mainly to impress their peers, and these patients will probably do the same for cosmetic surgery as well.
I hope most of you are savvier than this! In my opinion, a price range of $4500-5500 for saline implant breast augmentation and $5500-6500 for silicone implant will give you the highest chance of obtaining quality work at a reasonable price. The price range has to do more with geography than any other reason. The cost of doing business is higher in Newport Beach than Anaheim and this will be reflected in the final price. Regardless of the cost, however, it is up to the patient to do his/her homework and most importantly, to like the surgeon’s work (most surgeons in Southern California post before and after photos on-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, California. To schedule a complimentary consultation, please call 714-834-0101.
Posted in Breast Augmentation, Home | No Comments »
October 27th, 2011 Michael A. Jazayeri M.D.
What Age Is Too Old For Plastic Surgery?
Aesthetic plastic surgery, also known as cosmetic surgery, has gained tremendous popularity over the past 15 years and the number of procedures, both surgical and non-surgical, has increased by 200-300%.
We are fortunate, as with this increase in popularity, there has been tremendous improvement in technique, allowing plastic surgeons to obtain reproducible and natural results in most cases.
But what age is “too old” for plastic surgery? There is no black and white answer to this question, as each individual is different. Certainly there have been many patients in their seventies and even eighties who have had facial plastic surgery. The same is true for other procedures as well. Recently, I performed a rhinoplasty (nose surgery) on a spritely 65 year old female. After taking care of every one else in her family, she decided it was time to take care of herself!
If a patient has common medical conditions (such as high blood pressure, diabetes, etc.) which are well controlled, the risk of complications are very low. A recent article from the Journal of Plastic and Reconstructive Surgery looked at advanced age and safety of ambulatory (out patient) surgery. The article states, “In sum, although various data illustrate that older age”(over 65 years of age) “can modestly increase the risk of intraoperative and/or postoperative complications associated with ambulatory surgery, this risk is arguably not great enough to constitute a contraindication to ambulatory surgery based on advanced age alone.”
There has also been data on the risk of death from general anesthesia in an outpatient setting. The risk of death from general anesthesia in this setting is 1 in 50,000. Assuming a plastic surgeon performs 500 cases per year under general anesthesia (I am not aware of any plastic surgeon with such a high volume of procedures), it will take 100 years to reach 50,000 cases! In comparison, the risk of death while driving is 1 in 5,000 (which is ten times higher). To achieve this low risk, however, requires the patient to be medically cleared for surgery, the surgery be performed in an accredited surgery center, with a board certified plastic surgeon who is well-trained and safe.
Fortunately, many procedures can also be performed under local anesthesia, reducing the complication rate even lower. Procedures such as liposuction, upper and lower eye lid surgery, some types of face lifts, ear set-back surgery, chin augmentation, mini tummy tuck, mole removal and certain types of lasers for facial rejuvenation can be performed under local anesthesia. In addition to higher safety, there is an additional benefit of lower cost to the patient as there is no anesthesiologist or surgery center fees.
Michael A. Jazayeri, M.D., medical director for Élan Institute for Plastic Surgery, is a board certified plastic surgeon with over 12 years of experience. To schedule a complimentary consultation, please call 714-834-0101.
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