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18707 Hardy Oak Blvd Suite 455
San Antonio, Texas 78258
During your initial consultation we will discuss with you the reason for breast augmentation, family history of breast issues, and the breast size you desire. The physical exam will help determine the best option of implant location (on top of the muscle or below the muscle), incision (inframammary fold or periareolar) and implant type (silicone or saline).
The implant can be placed on top of the muscle (subglandular) or below the muscle (submuscular). Subglandular implant placement is valid in women who have a moderate amount of breast tissue present before surgery and physically active women or bodybuilders. Incision placement is usually below the breast in the inframammary fold. In women with large areola (pigmented portion of breast) a periareolar incision can be used with and without areolar reduction.
It is very common for women to have some asymmetry of the breasts. After breast augmentation some asymmetry may still exist. Correction of mild asymmetry in size can be improved by filling saline implants with different amount of fluid. To correct severe asymmetry a breast lift or reduction of the larger breast may be needed at the time of the breast augmentation
Breast augmentation is performed as an outpatient procedure. A post operative bra will be placed and you can shower on post operative day 1. Prescriptions for pain control and antibiotics will be provided. A patient can usually return to work after a week depending on your occupation. A full exercise program can be resumed 6 weeks after surgery. Follow up is performed one week, one month and 3 months after surgery.
During your initial consultation we will discuss with you the reason for breast reduction, family history of breast issues, and the breast size you desire. Breast reduction surgery is designed to decrease the size of the breast and move the nipple to a higher, more youthful position. There are 2 basic scar patterns with breast reduction surgery. The Vertical Reduction can be described as a "lollipop" with the scars in the periareolar and vertical inferior breast areas. The scar of the Wise Pattern Reduction looks like an "anchor". In addition to the periareolar and vertical scars, a scar of variable length is place in the inframammary fold.
It is very common for women to have some asymmetry of the breasts. After breast reduction some asymmetry may still exist.
Breast reduction is performed as an outpatient procedure. A post operative bra will be placed and you can shower on post operative day 1. Prescriptions for pain control will be provided. A patient can usually return to work after a week depending on your occupation. A full exercise program can be resumed 6 weeks after surgery. Follow up is performed one week, one month and 3 months after surgery.
Surgery of the upper and lower eye lids may be the answer for the tired or aged appearing eye. In both men and women the area around the eyes is one of the earliest concerns expressed due to aging. Commonly, excision of skin is used to improve the appearance of the saggy upper eyelid. This may be performed in conjunction with a brow lift. Complaints concerning the lower eyelid include bulging, excess skin, or hollowed out appearance. Treatment of the lower eyelid may consist of removal of skin, removal or redraping of the fatty tissues, and tightening of the lower lid. Additional procedures like fat or dermal filler injection, botox, or mid face lift may also be considered.
Eyelid surgery is performed as an outpatient procedure. After the operation it is recommended that you sleep with your head elevated and use an ice pack or bag of frozen peas intermittently during the first couple of days. Prescriptions for eye drops and pain medications will be provided. A patient can usually return to work after a week with minimal swelling and bruising. Follow up is within 1 week, one month, then three months after surgery.
If you are concerned about facial aging and desire a more youthful appearance (facial rejuvenation) then a facelift (rhytidectomy) may be the answer. Evaluation of facial aging takes into account the areas around the eyes, cheek and mouth, and the neck. Signs of facial aging may be seen in all these areas due to excess skin, descent of the underlying soft tissues or loss of subcutaneous fat. These changes with aging result in tired eyes, loss of cheek prominence, deep nasolabial or cheek folds, marionette lines, loss of lower jawline contour (jowling), wrinkles of the skin, and banding of the neck. A facelift addresses the signs of facial aging by removing excess skin and suspending the soft tissues below the skin to a more youthful position. Adjunct procedures may include upper and lower eyelid surgery, fat or dermal filler injections, botox, and neck liposuction.
Not everyone needs a facelift to obtain a youthful appearance. Skin care, chemical peels, fat or dermal fillers and botox may improve your concerns without undergoing surgery. Skin damage from sun exposure or smoking may benefit from some of these treatments prior to undergoing facelift surgery.
My philosophy to facial aging is to rejuvenate your facial features without the obvious signs of surgery. I want people to say that you "look good" or "did you do something different with your hair". I don't want to create a new appearance but rather a younger one.
Facelift surgery is performed as an outpatient or overnight stay procedure. A post operative garment will be placed and used for one week after surgery. After the operation it is recommended that you sleep with your head elevated and use an ice pack or bag of frozen peas intermittently during the first couple of days. Prescription for pain medication will be provided. A patient can usually return to work after two weeks. Follow up is within 1 week, one month, and then at three months after surgery.
Patients concerned with sagging or ptotic breasts may be candidates for breast lift surgery (mastopexy).
This condition may be due to pregnancy, weight loss, or poor skin quality. The ptotic breast is determined by the relationship of the nipple areola complex to the inframammary fold. A youthful nipple position is at or above the fold. Breast lift surgery is designed to move the nipple to a higher, more youthful position. There are 2 basic scar patterns with breast lift surgery depending on the presurgical position of the nipple. The Vertical Lift can be described as a "lollipop" with the scars in the periareolar and vertical inferior breast areas. The scar of the Wise Pattern Lift looks like an "anchor". In addition to the periareolar and vertical scars, a scar of variable length is place in the inframammary fold.
During a mastopexy breast tissue may be removed to correct for asymmetries but usually no breast tissue is removed. The breast will be slightly smaller due to the removal of excess skin. For patients that desire correction of sagging breasts and a fuller appearance breast implants can be placed at the same time as the breast lift. This combination results in a more youthful fuller breast. Also after breast lift surgery the size of the pigmented portion of the breast or areola will be smaller.
Breast lift surgery with and without augmentation are performed as an outpatient procedure. A postsurgical bra will be placed and patients can shower the day after surgery. Prescriptions for pain medications will be provided. Antibiotics will be needed if an implant is placed. A patient can usually return to work after a week depending on your occupation. A full exercise program can be resumed 6 weeks after surgery. Follow up is performed one week, one month and 3 months after surgery.
Also referred to as liposculpture, this procedure is used to address areas where fat deposits create an unwanted appearance. You may have distinct areas or a general area where you are unhappy with the contour. These concerns may affect the type of clothing you wear, intimacy, or self esteem. For women common areas are the flanks under the bra straps, lower abdomen, hips, inner and outer thighs, lower back and occasionally the inner knee and ankle. Men often desire correction of the chest, lower abdomen, and flanks. Both men and women may benefit from a large volume liposuction of the abdomen.
Liposuction is performed by making small incisions in preexisting creases or well hidden areas. A wetting or tumescent solution is injected into the fatty areas. This solution contains a local anesthetic and epinephrine which dramatically decreases the blood loss. A suction canula then removes the fat from the desired area.
Liposuction is performed as an outpatient procedure. Small distinct areas may be performed with only the local anesthetic. Large or very sensitive areas are best performed with the assistance of an anesthesiologist. A post operative garment will be placed and used for one month after surgery. The first 24 hours after surgery you will have fluid leaking from the incisions. Tylenol or motrin can be used for post operative pain. You can shower the day after surgery and return to work within a week. Follow up is within 1 week, one month, and then at three months after surgery.
After having children are you concerned about the size or shape of your breasts and the appearance of your abdomen? If so then the mommy makeover may be just what you need. The "mommy makeover" is a term used to describe procedures of the breast and abdomen for women who have children and are not planning future childbirth. Common concerns after childbirth are sagging breasts with loss of volume and excess skin and bulging of the abdomen. The breast surgery usually consists of breast augmentation with possible breast lift. A Tummy tuck and potentially liposuction addresses the abdominal concerns. For more information read the sections on breast augmentation, breast lift, and tummy tuck.
The mommy makeover is performed as an outpatient procedure or an overnight stay may be arranged. A post operative garment for the breasts and abdomen will be placed and you can shower on post operative day 1. After the operation it is recommended that you sleep with your legs and back elevated during the first couple of days. Prescription for pain medication and will be provided. Antibiotics will be necessary if breast implants are placed. Two drains are used for the tummy tuck, one drain will be removed around postoperative day 7 and the second about day 14. A patient can usually return to work after two weeks. Follow up is within 1 week, 2 weeks, one month, and then at three months after surgery
The neck area can be a major area of concern for a patient. Typical reasons for correction are a fatty neck with the "turkey gobbler" appearance, excess skin or banding. If any of these are a concern then neck lift surgery may be indicated. The surgical options consist of neck liposculpture, anterior neck lift or posterior neck lift (cervicoplasty). Each one has their advantages and disadvantages and together we will choose the option that is best for you.
Neck lift surgery is performed as an outpatient procedure. After the operation a compressive garment is placed and it is recommended that you sleep with your head elevated the first couple of days. Prescription for pain medication will be provided. Follow up is within 1 week, one month, and then three months.
The decision to undergo weight loss surgery is an important step toward improving health and quality of life. If you have undergone bariatric surgery with massive weight loss you may experience the frequent consequence of excess skin. Plastic surgery can provide a safe option for the removal of the excess skin. Common areas of concern for both men and women are the face, neck, abdomen, and buttocks. Women may also have sagging breasts with loss of size and excess skin of the bra strap areas and legs. During the initial consultation we will discuss your concerns and establish a plan designed for you. The risk of complications is higher in the massive weight loss patient compared to those who have not undergone bariatric surgery. This will be taken into consideration when planning the surgery and post operative recovery.
Prior to undergoing plastic surgery the ideal candidate should be in good health, nonsmoker, recent laboratory workup which shows normal nutritional status and stable weight. You should discuss the desire to undergo plastic surgery with your bariatric surgeon.
The operative and postoperative plan depends on what procedures are performed. Multiple surgical dates may be needed to optimize results and decrease potential complications.
If you have concerns about the extent that your ears "stick out" then you may be a candidate for otoplasty. Surgical correction of prominent ears or otoplasty may give you the appearance that you desire. The scars are well hidden behind the ears.
This procedure is performed as an outpatient procedure. After the operation a protective dressing is placed and worn when sleeping for 2 weeks. During the day a headband can be worn. Prescription for pain medication will be provided. A patient can usually return to work after a week depending on your occupation. Follow up is performed one week, one month and 3 months after surgery.
If you have concerns about the size, shape or feel of your breasts after breast augmentation, breast lift, or breast reduction you should first approach the initial surgeon. You may find that they care about your concerns and willing to work with you to address them. Should this not be possible then we can discuss your concerns and after a thorough exam design a course of treatment specific for you. An important aspect of secondary breast surgery is knowing what was done during the initial surgery. Bringing your previous operation reports to the initial consultation will improve the decision making process.
There are many reasons to desire correction of the post operated breasts. With breast augmentation you could experience implant malposition, hardening of the breasts, and visible or palpable implants. Concerns after breast lift or reduction may include size, scarring, and nipple position. Together we will plan a surgery to address your concerns.
Redo breast surgery is performed as an outpatient procedure. A post operative bra will be placed and you can shower on post operative day 1. Prescriptions for pain control will be provided. If implants are used then antibiotics will be needed after surgery. A patient can usually return to work after a week depending on your occupation. A full exercise program can be resumed 6 weeks after surgery. Follow up is performed one week, one month and 3 months after surgery.
A tummy tuck or abdominoplasty is an option if you have complaints of excess abdominal skin with or without pooching of the lower abdomen. The excess skin can be seen after pregnancy or weight loss and is due to loss of skin elasticity associated with stretch marks. Pooching or prominence of the abdomen may be seen after pregnancy and is caused by separation of the abdominal rectus muscles resulting in weakness of the abdominal wall. The excess skin or pooching cannot be corrected by exercise.
The excess skin and pooching of the lower abdomen may inhibit exercising, make you self conscious during intimacy, or prohibit you from wearing certain styles of clothing. A tummy tuck will improve the contour of the abdomen and the scars are placed to allow concealment with most styles of clothing.
An abdominoplasty consists of three parts; excision of excess skin, tightening of the rectus muscles, and transposition of the navel (umbilicus). This procedure may be performed as part of a lower body lift or liposuction may be done to better contour the flanks. The scar is placed just above the pubis and extends out to the hips. Two drains are placed.
Women who have minimal skin excess or lower abdominal prominence may be a candidate for a mini tummy tuck. The incision for the mini tummy tuck is much shorter and there is no scar around the navel.
Tummy tuck surgery is performed as an outpatient procedure. An overnight stay may be arranged especially if multiple other procedures are performed at the same time. A post operative garment will be placed and used for one month after surgery. After the operation it is recommended that you sleep with your legs and back elevated during the first couple of days. Prescription for pain medication will be provided. One drain will be removed around postoperative day 7 and the second about day 14. A patient can usually return to work after two weeks. Follow up is within 1 week, 2 weeks, one month, and then at three months after surgery.
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Botox is a prescription medication that is injected into muscles of the face to improve the look of moderate to severe frown lines. Years of squinting, concentrating, or frowning can cause your skin to crease. As time passes, your skin becomes less elastic and those frown lines remain. Botox will temporarily improve frown lines for up to 4 months and is approved for those lines between your eyes. Other areas like the "crows feet" of the lateral eyes or the forehead may be treated but are considered off label. Botox starts to work within 48 hours with the majority of people seeing significant results within 7 days.
Juvederm temporarily adds volume to facial tissue to restore a smoother appearance to the face. It is a colorless hyaluronic acid that is injected into facial tissue to smooth wrinkles and folds, especially around the mouth and nose. Hyaluronic acid is a naturally occurring sugar found in the human body which delivers nutrients , hydrates the skin by holding water, and acts as a cushioning agent. Injection of Juvederm only takes minutes and provides up to one year of facial rejuvenation.