March 2012 Case of the Month: Rhinoplasty
April 6th, 2012
This young woman was interested in creating a dramatic difference in the shape and contour of her nose. I performed a closed rhinoplasty during which I was able to remove the hump of her nose, soften, reduce and elevate the tip, and create a result more in balance with the rest of her face, as seen in the “After” photo take 4 weeks after her procedure:
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Fat Transfer Breast Augmentation: Why using your own fat to enhance your breast is becoming a great option for selected patients
March 7th, 2012
While breast augmentation with saline or silicone implants is still by far the most popular option for breast enhancement worldwide, there is a growing interest in breast augmentation using a patient’s own fat, a procedure known as fat transfer breast augmentation. Only recently has this procedure become more widely accepted, and with advances in technique, including fat harvesting and transfer procedures, we’re now seeing outstanding results from this approach.
How does it work?
The procedure involved harvesting fat from areas of excess (such as the love handles, thighs or tummy) with a specific type of liposuction, filtering and concentrating the fat, and then injecting this fat in the parts of the breast that need to be a bit fuller (usually the central breast, upper breast and cleavage line, although this can be tailored based on the patient’s anatomy and goals). While we usually see nice improvement with one treatment, on occasion patients require a second procedure as some of the fat can be reabsorbed.
Who is a good candidate for the procedure?
Women who have a bit of laxity to their breasts and who want a modest increase in fullness are excellent candidates. In addition, we want our patients to have no personal or family history of breast cancer and to have an imaging study if there is any doubt. Younger patients with tight breast skin or tissue who want a more dramatic result still do much better with traditional implants. However, for these younger patients if they do want the fat transfer procedure we recommend using the Brava system (http://www.mybrava.com/home.asp) prior to and after surgery to help increase the overall effect of the fat transfer, and this is something Dr. Salemy can review at your consultation in detail, as well as the overall process of the procedure.
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Labiaplasty (labia minora reduction) is growing in popularity
March 7th, 2012
Labia minora contouring (sometimes called “labiaplasty” or “labial reduction”) is fast becoming a very popular procedure for women. Although the labia can vary in size, color or symmetry, some women are born with enlarged labia and others develop the enlargement with childbirth or age. Regardless of the cause, this enlargement can cause embarrassment in tight clothing, a swimsuit or with a sexual partner, and can cause discomfort with clothes, sex or exercise. For these reasons, a labiaplasty is a great option for women today.
The goal of a labiaplasty is reduce the length and width of the labia, to create a more youthful appearance more in balance with the surrounding tissues. The procedure involves incisions vertically along the edge of the labia as well as transversely along the inside of the labia. This approach allows for maximum control of the contour, shape and color matching of the labia while reducing the risk of sensitivity or irritation that can occur with other techniques. At your consult, Dr. Salemy will go into further detail with you as to the specifics of the procedure. All of the sutures used dissolve over time, and in general, the procedure takes about 90 minutes and patients go home the same day.
We ask patients to avoid heavy activities (including working out or running) and sexual intercourse for 6 weeks after the procedure in order to allow the healing process to complete. Most patients feel quite good within a few days and return to work within 5-7 days. During the first 2 weeks, it’s important to keep the incisions clean and our nurses will discuss this with you at your visit.
The risks of this procedure are very small, but just like any surgery there is the risk of bleeding, infection, discomfort, cosmetic dissatisfaction, and need for a touch up procedure. While these risks exist, we’ve been very happy with the feedback of our patients and the results we’ve been able to achieve. (read about the experience of one of Dr. Salemy’s labiaplasty patients at: http://bit.ly/wSS0TD
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February 2012 Case of the Month: Mommy Makeover with Fat Transfer to Breasts
March 7th, 2012
This woman in her 50s was interested in both an improved contour to her abdomen as well as a very modest breast enhancement, but did not want to have breast implants placed. I performed a tummy tuck and used the excess fat from her tummy and love handles to very modestly augment the upper portion of her breasts. The results, as seen in the postop photos 6 weeks after her procedure, are dramatic for her tummy and very modest for her breasts– exactly what the patient and I were hoping to achieve:
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January 2012 Case of the Month: Revision Breast Augmentation and Lift
January 3rd, 2012
This young woman had had a previous breast augmentation and lift by another surgeon several years ago and over time had developed a hard capsule formation (capsular contracture) as well as drooping of the breast (called ptosis). I performed a revision breast augmentation where I removed her old implant and capsule and placed a new cohesive gel implant into the pocket, and then did a new breast lift with incisions around the nipple, down the breast and in the fold. This has created a more youthful, perkier appearance to her breasts, as seen in the postop photos taken several weeks after her procedure.
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December 2011 Case of the Month: Breast Reduction
December 22nd, 2011
As 2011 winds down, patients are getting excited about the possibilities for 2012, including travel, fashion and a healthier more active lifestyle. We see a lot of patients in our practice that are not able to enjoy life to the fullest because of significant upper back and neck pain due to the weight and size of their breasts, and for many of these patients a breast reduction is an excellent option. This patient in her late 50s had wanted a breast reduction for a long time and after a consultation decided she was ready to move forward. My goal for a reduction is not only to reduce the size of the breast but to create a lifted more youthful appearance to the breast, and I think we accomplished this for this patient, as seen in her postop photos taken 6 weeks after her procedure. Over the course of the next few months her incisions will continue to fade and become less noticeable, but this process can take up to 6 months or longer.
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November 2011 Case of the Month: Mommy Makeover
December 6th, 2011
This patient was interested in a Mommy Makeover, specifically a tummy tuck and a breast lift. What was unique about her case was that she didn’t have a belly button (it had been removed by another surgeon during a surgery years ago, leaving just some scar tissue). So in addition to the tummy tuck and the breast lift, I also created a new belly button for her– the belly button is a really important part of a woman’s tummy and the abdomen can look a bit unusual if the belly button is missing. Our goal for each patient is have them look and feel their best, and for this patient I think by creating the belly button in addition to the regular Mommy Makeover, we were able to do just that.
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Dr. Salemy Receives Seattle Magazine’s 2011 Reader’s Choice Award as “Seattle’s Best Plastic Surgeon”
December 6th, 2011
Dr. Salemy was honored to receive the 2011 Seattle Magazine Reader’s Choice Award as “Seattle’s Best Plastic Surgeon”! The December 2011 issue of Seattle Magazine is dedicated to highlighting the best our city has to offer, from restaurants and bars to salons, spas, and even plastic surgery, as voted on by not only the magazine editors but also by it’s readers. Dr. Salemy and his staff would like to thank the readers of Seattle Magazine for this honor!
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October 2011 Case of the Month: Breast Reconstruction
November 8th, 2011
October is Breast Cancer awareness month so I thought we could look at an example of breast reconstruction after mastectomy. This patient had breast cancer on her left breast and underwent a nipple-sparing mastectomy, after which she was sent to me for reconstruction. I performed a breast reconstruction in two stages: At the first procedure, I inserted a tissue expander in the left breast and over the course of several weeks slowly filled this expander with saline to create a pocket for her final implant. At the second procedure, I removed the tissue expander and placed a cohesive gel silicone implant, and the performed a breast lift with a small implant on the right side to give her more symmetry and balance in clothing. The After photos are taken 6 weeks after her final procedure.
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September 2011 Case of the Month: Revision Breast Augmentation
September 2nd, 2011
This patient had had 3 previous breast augmentation surgeries by another surgeon, which had left her with hard, painful and uneven breasts with implants sitting in front of her muscle. I performed a breast augmentation revision by removing her old implants and the hardened capsules and placing new silicone implants behind her muscle to create a much more natural and even appearance, as seen in her postop photos taken 4 weeks after her procedure.
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(more before and after photos of this patient as well as others are available in our photo gallery)
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