Élan Institute for Plastic Surgery 2010 East First Street, Suite 270 Santa Ana, CA 92705
January 5th, 2010 Michael A. Jazayeri, M.D.
Tummy Tuck Orange County
As an Orange County mommy makeover surgeon, tummy tuck surgery is one of our most popular procedures. But what happens after the surgery?
Tummy tuck surgery is an out-patient procedure, meaning the patient will go home after the procedure. In rare instances, the patient may be kept in the surgery center over-night.
After surgery, the patient will have 2-3 drains placed under the abdominal skin. The drains will collect any excess fluid which the body produces as the result of surgery. Typically these drains are removed in 7-9 days, depending on their output. The patient’s family or provider will be instructed on how to empty and record the outputs separately on a piece of paper. If the patient has chosen to have a pain pump catheter (which I highly recommend) these catheters will be placed under the abdominal skin as well. These catheters are removed 3 days after surgery. The patient will be instructed on removal, there is no need to return to the office for their removal.
After surgery, it is important for the patient to sleep with their knees or hips bent to avoid any tension on the skin closure. Most of my patients are able to walk fairly straight after the first week of surgery. However, they must sleep in a slightly flexed position for 2-3 more weeks.
The patient will be seen in the office 24-48 hours after the procedure. The dressings will be changed and new ones placed. I instruct the patient and care-giver on how to properly apply and adjust the abdominal binder which was placed at the end of the procedure. The purpose of the binder is to provide support and minimize swelling. It must be worn for 4 weeks. It is important for the binder to fit well and be firm but not too tight. As a general rule, the binder should be as tight as the patient can comfortably tolerate.
The patient will return 7-9 days after surgery. Depending on the drain outputs, the drains may or may not be removed. If the drains are removed too early, the fluid will collect under the skin. This is called a seroma. The patient has to return to the clinic at least once a week to have the seroma “sucked out” with a needle and syringe. This is not fun! It is also critical for the patient to refrain from too much activity for one week after drain removal. It is the movement and rubbing of the abdominal skin against the abdominal wall which produces seroma. If the patient has a “desk job”, they may return to work after the second visit, provided no lifting or bending is permitted.
Minor wound issues, such as small skin sloughs right at the edge of the incision is fairly common after tummy tuck surgery. I would say 30% of patients will have some minor wound break-down which usually heal with antibiotic ointment and daily dressing changes.
The patient returns for a follow-up one month after surgery. Although the swelling has improved, it will take 2-4 more months for the swelling to completely resolve. At this time the patient may chose to remove the binder. Some patients, however, feel more comfortable wearing the abdominal binder. The patient may start light exercises such as walking on a flat surface or light weight lifting. The patient should refrain from sit-ups or abdominal exercises for 6 months. As part of the tummy tuck, the weakness of the abdominal muscles has been corrected with sutures. It takes approximately six months for the repair to be strong enough to allow abdominal exercises.
The patient returns for their 3 month follow-up. At this point, most patients have obtained their final shape. However, in some cases, it may take longer for the swelling to completely resolve. Depending on the patient’s skin color, the incisions may be darker than the surrounding skin. It may take up to one year for the incisions to lighten. Many patients also are concerned about numbness in their skin. It may take one year or longer for the sensation to return to all areas of the abdominal skin.
The last clinic visit is 6 months after surgery. At this time, the patient may resume abdominal exercise as tolerated. The patient should avoid any sun tanning to the abdominal skin for one year after surgery. The skin is very sensitive and even a sun-burn may cause significant damage to the skin.
This is a typical recovery for a patient undergoing abdominoplasty surgery. Not every one will have the same experience and, rarely, complications do occur.
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.
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November 30th, 2009 Michael A. Jazayeri, M.D.
BREAST AUGMENTATION ORANGE COUNTY:
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.
Posted in Breast Augmentation, Breast Implants, Home, Mommy Makeover | 1 Comment »
September 24th, 2009 Michael A. Jazayeri, M.D.
I occasionally come across Orange County plastic surgery patients who have had or know someone who has had plastic surgery outside of the United States.
In some instances, the outcome is good. However, in my opinion, the results are sub-optimal in majority of cases.
This is not to say there are no competent plastic surgeons outside of United States. In fact, there are many outstanding plastic surgeons in Mexico, Brazil, Argentina, and Europe.
The main issue here is the patient going overseas usually does this to lower the cost of surgery. Most outstanding plastic surgeons in other countries charge much higher rates. Therefore, the patient may not be treated by a well-trained plastic surgeon. Nevertheless, many patients tell me by the time they calculated the cost of travel and stay, the overall cost was similar or even more than United States.
However, the main problem arises when the patient has obtained a poor result and wants a revision. This places a huge burden on the shoulder of the plastic surgeon seeing the patient. In most cases, it is impossible to achieve the same result if the surgery was done correctly in the beginning. It is very difficult for patients to understand this concept, and realistic expectations should be encouraged. Unfortunately, in majority of cases the cost of revisional surgery will be higher than the original surgery, if it was done in the United States.
If you decide to travel overseas for plastic surgery, please do your homework! However, in most cases, you will find the price will be similar or even higher, if the surgery is performed by a well-qualified plastic surgeon.
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. If you like to schedule a complimentary consultation, please call 714-834-0101.
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September 10th, 2009 Michael A. Jazayeri, M.D.
IGNORE THE INSIDE AND YOU WILL BE SORRY!
Many of my Orange County rhinoplasty patients complain about the shape of their nose.
Although it is important to address the cosmetic concerns of the patient, one must not forget an intra-nasal examination and address any issues inside the nose as well.
Almost all patients have some degree of septal deviation (the cartilage at the center of the nose which provides support to the non-bony portion of the nose). Many, especially in Southern California, also have enlargement of the inferior turbinates. The turbinates (three rows on each side) humidify the air. The enlargement of the lower turbinate may cause or exacerbate post-operative anatomical obstruction leading to airflow restriction. Pre-operatively, although the patient may not subjectively complain about breathing difficulty, many feel better after the turbinate is temporarily reduced by special medication spray.
It is very critical to address these issues, since in majority of cosmetic cases, the nose is not only reduced on the profile, but also reduced in width as well. This cosmetic “narrowing” may cause breathing difficulty if the intra-nasal findings are not addressed.
In almost all patients, a portion of the septal cartilage is removed as part of the straightening process. The removed cartilage is then used to improve the nasal tip and provide additional support to the surrounding structures. The inferior turbinates are reduced, so the airway passage is more open.
If these issues are addressed properly, the patient will have a cosmetically acceptable nasal shape which is functional 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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September 2nd, 2009 Michael A. Jazayeri, M.D.
I believe this is a valid question, since many of my Orange County plastic surgery patients look at themselves more often after surgery than before the procedure.
For purpose of clarification, I like to divide symmetry into two categories: perfect and relative.
Perfect symmetry means both sides of the area operated on (two breasts in case of breast surgery) are exactly the same. Imagine copying one side and flipping it to the other side. There is absolutely no difference between the two sides.
Relative symmetry means the sides are very even and only on close inspection, one can find minor differences. Have you ever played the game in which ”X” number of differences exist between two seemingly identical photos? That is what relative symmetry is similar to.
Please look at your face and your body critically in front of the mirror. You will be amazed how many minor differences exist between each side. These minor asymmetries are impossible to “erase” even with plastic surgery. If God and or 5 billion years of evolution can not produce perfect symmetry, it is unrealistic to expect any plastic surgeon achieving that goal within a few hours of surgery.
I never forget one of our Plastic Surgery Seminars when a plastic surgeon superimposed one side of the face and flipped it to the other side, so that both sides were perfectly symmetrical. To every one’s surprise, these modified faces did not look “right”. In fact, some of them looked “alien” and a few downright scary! If you don’t believe me, any friend with Photoshop knowledge can do this for you. Try it for yourself.
I hope this blog article will convince you NOT to look in the mirror more than usual after your surgery looking for minor asymmetries. Just enjoy your new you!
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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August 24th, 2009 Michael A. Jazayeri, M.D.
Moles, moles and more moles
Isn’t it sad the way we age?
For men especially, we lose hair on our heads, and gain it in our nostrils and ears! We also develop more moles on our bodies as we age (this is true for women as well).
Moles come in two varieties: malignant and non-malignant (benign).
Malignant moles, by definition, are cancerous and will grow and invade the adjacent skin and underlying structures. Most common skin cancers are squamous cell carcinoma and basal cell carcinoma. For the most part, these are slow growing and may take years for them to invade adjacent structures or become metastatic (spread to other parts of the body).
Of more concern is melanoma, which is much more aggressive than the above. Unlike the above cancers, the risk for melanoma increases with occasional excessive sun burn. Both squamous and basal cell carcinomas arise from chronic exposure to sun. That once in a while trip to Mexico which gave you a bad sun burn will increase your risk of melanoma more than the other tumors discussed.
The most susceptible person for developing melanoma is fair skin with red hair and freckles. My advice to any one with fair or light skin living in Southern California is to have an annual skin examination by their family physician or dermatologist. Any change in size, color or shape of a mole should be investigated. Itching and bleeding is also of concern.
The only way to make the correct diagnosis is to remove all or part of the mole (depending on the size and location) and have a pathologist examine the lesion under the microscope. Depending on the diagnosis, additional surgery may be necessary. The main issue with melanoma is the amount of normal looking skin which has to be removed as part of the treatment. Even if the melanoma is very thin, a margin of 0.5cm (1/4 of an inch) has to be removed around the melanoma. If the melanoma is thicker, up to 3cm (slightly more than an inch) of skin has to be removed around the lesion. This will result in a large wound which typically requires a skin graft from another part of the body. Lymph node biopsy and removal may also be required. Therefore, it is critical to minimize exposure to sun and especially avoid sun burn. Living in Southern California, the only practical solution is to limit outside activities before 3PM and to wear a sun screen with SPF of 30 which has Titanium dioxide and or Zinc dioxide (or both) for maximal protection. The sun block must be applied 30 minutes before going outside and must be applied every 2 hours or less depending on the amount of perspiration and water contact.
I do not want to minimize the seriousness of squamous and basal cell carcinoma. These lesions must be addressed and treated sooner rather than later. However, overall, melanoma is more aggressive and the treatment more drastic than the above.
A non-malignant mole, also called benign, is not cancerous and does not invade adjacent tissue and never metastasize. The reason for removal is usually cosmetic. However, sometimes benign moles, because of their location may become problematic. A good example is a mole in the beard area, which bleeds every time the patient tries to shave.
Most moles can be removed under local anesthesia in the office. My recommendation is to send any mole excised to pathology for confirmation of clinical diagnosis. Normal looking moles are rarely cancerous, but only pathology will confirm this.
The advantage of having moles removed by a board certified plastic surgeon is to minimize chance of undesirable scarring. The plastic surgeon is also able to reconstruct the area if a large amount of tissue has to be removed. However, please note, the risk of developing a wide and/ or hypertrophic scar increases in areas of excessive motion and tension (shoulder, the chest skin between the breasts are common areas) regardless of technique.
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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July 9th, 2009 Michael A. Jazayeri, M.D.
I watched a fascinating show on KCET this weekend called Musical Minds. It was a show about how music affects the brain, and how music can be used to control certain neurological diseases. The show discussed how music can be used to focus the mind of neurological patients. These patients cannot function normally in public and yet, when they played music, the transformation was miraculous. Oliver Sacks, the neurologist featured in the show, is also an accomplished piano player. A functional MRI of his brain was performed while he listened or imagined listening to a piece of music. The MRI showed increase blood flow to multiple areas of the brain. Increased blood flow to any organ, assuming it is not due to a disease process, will result in better oxygenation and a healthier organ.
Keeping the mind active has been shown to delay or slow the progression of Alzheimer’s. It will also keep the mind “sharp” even in older age. My father, who is a retired physician, has one of the sharpest minds around. He has written two movie scripts and a book, and is looking for a publisher. He is 88 years old! His secret is keeping busy, both physically and mentally.
There is more and more evidence the brain is like a muscle. If one trains it every day, it will stay stronger. My Orange County plastic surgery patients always seek plastic surgery of the face and body. Have you ever considered plastic surgery for your brain?
Learning to play a musical instrument is a wonderful way of keeping the brain active. Learning a musical instrument will teach us patience, concentration, discipline and the joy of performing a piece of music. Every time we are learning a new piece, there are new connections forming in our brain. The brain is not a static organ, and will adapt according to the information presented to it, regardless of age (this is called plasticity in medical terms).
If you have a family, learning an instrument and playing together is a wonderful time to bond with each other. There are numerous ensemble sheet music available, covering basic to advanced musical abilities.
I hope you will consider plastic surgery for the mind as seriously as you do for your body.
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 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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February 11th, 2009 Michael A. Jazayeri, M.D.
During my general surgery residency back in the 1990’s, I came across many older, “old school” general surgeons. When these surgeons find out I was interested in plastic surgery, their contempt for our specialty was obvious.
These old-timers felt plastic surgery was for “other surgical specialty rejects”. Plastic surgery was viewed as vain and vulgar in their view.
Unfortunately, most of their belief was out of ignorance, but part of it was based on reality.
During their training, plastic surgery was in its infancy. Techniques were rudimentary and results were acceptable, but not as refined or predictable as today. The results were significantly worse for cosmetic surgery (aesthetic surgery), with the final result having that “operated look.” Perhaps this is why these older surgeons felt plastic surgery was vain and vulgar.
Fortunately, we now receive respect from our colleagues and patients, for both reconstructive and cosmetic surgery.
But is it vain to consider cosmetic plastic surgery?
There are patients who are never happy with themselves. They constantly look at themselves in the mirror, finding “imperfections” which require plastic surgery. These patients probably suffer from body dysmorphic syndrome (BDS). Technically, therefore, they are not vain and suffer from a psychological disorder. In my experience, the percentage of patients with BDS is small. However, the rate may be higher in areas such as Hollywood, due to the movie industry and its emphasis on looks.
Majority of my patients have reasonable concerns and reasonable expectations. Do not get me wrong, they expect a very good to excellent result, but they understand the limitations of anatomy and the healing process.
I cannot tell you how many of my rhinoplasty patients have gone from being shy and timid to confident and out-going.
I cannot forget the time when one of my face lift patients came for her three month follow-up and there was a bite mark on her neck!
How can I forget the mommy makeover patient who bragged about her new bikini? How can I ever forget the constant smile on her husband’s face?
Did I mention the numerous patients who got engaged after their breast augmentation? I hope the proposals were for the right reason!
So, is cosmetic surgery vain? You be the judge.
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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December 30th, 2008 Michael A. Jazayeri, M.D.
O.K., this blog has nothing to do with plastic surgery…or does it? I will let you decide…please read on.
A friend of mine send me a YouTube video and it compelled me to write this blog. I think the topic is relevant, especially now with new year’s resolutions coming up.
A few years ago, around Christmas time, I was in the operating room and the subject of wishes came up. The surgical technician asked me if I could have only one wish, what would it be? I thought about it for a few seconds and said “I just want to be happy.”
I just want to be happy. It seems such a simple concept, and yet, why most of us have such a hard time acheiving happiness?
I can’t tell you what should make you happy. But I do know this: happiness is a state of mind.
Happy people, for the most part, see the glass as half full and not half empty. When hardship or failure occurs, happy people try to learn from the experience and find a positive aspect as a result. To quote the famous German philosopher, Nietzsche, “What does not destroy me, makes me stronger.”
Happy people set realistic goals, with a higher chance of success. Do not confuse this with laziness! Happy and successful people work hard. Yet they succeed because they have realistic expectations.
Do not stress over factors which are beyond your control. For example, none of us have the power to improve the economy. The key, therefore, is to modify things we can control, in order to survive.
Exercise! I have touted the benefits of exercise before, and I will mention it every opportunity I get! Exercise improves blood flow to the brain and body. It also increases the levels of endorphin (your body’s own morphine), resulting in a natural high. It is much easier to achieve a happy state of mind when your are on drugs (naturally, of course!).
A common misconception is that wealth is directly proportional to happiness. In fact, this is not the case. Several studies, comparing different countries and cultures reached the same conclusion: once a person’s income passes the poverty level, there is no correlation between income and happiness.
Some of us are genetically gifted to have a happy state of mind. For most of us our brain needs to be retrained to reach that state. It is not easy, but worth the effort.
If you are unhappy all the time, the easiest thing to do is to rule out any medical condition which may be causing your unhappiness. Thyroid conditions are perhaps the most common cause. You may also consider seeing a psychiatrist for a few sessions. No, you do not have to be crazy to see one! What a good psychiatrist will do, however, is to find the source of your unhappiness and help you retrain your thought process.
Many of you reading this blog are thinking what does Dr. Jazayeri know about unhappiness! He is a plastic surgeon…he is set! It took an incredible sequence of events for all us to be born into this world. We are all, therefore, very special. I am no more special than you are. Like all human beings, I have had my ups and downs, I have my ups and downs now, and will continue to have ups and downs in the future. The important thing is what I choose to do and how I choose to react to my downs.
As a plastic surgeon I can help you achieve “outer happiness”, but only you can help yourself with your inner happiness.
Enough blogging! The link to the video is below. It has a simple and important message, and it brought a smile to my face. I hope you will put “I just want to be happy” on the top of your new year’s resolution list.
http://www.youtube.com/watch?v=Cbk980jV7Ao
Dr. Jazayeri is a board certified plastic surgeon and a member of American Society of Plastic Surgeons, with over 10 years of experience. His office is centrally located in Orange County, in the city of Santa Ana. To schedule a complimentary consultation, please call 714-834-0101.
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