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This young woman presented with a single unilateral breast cancer. She chose a unilateral left mastectomy. Reconstruction included a staged approach first with tissue expander and allograft. Subsequent second stage surgery three months later included removal of expander on left, shaping of the space and placement of silicone implant. The right breast had a lift and augmentation done at the second stage for symmetry. Finally, nipple reconstruction and fat grafting to the interface between upper mastectomy and implant completes her fine outcome. (Pending tattooing of nipple.)
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This young mother presented with advanced aging of her body after having children. Fat excess of hips and back, breast sag with excess, and large abdominal hernia with excess poor skin were among the issues.
Liposuction of hips and back, breast lift with small reduction, and tummy tuck with abdominal wall repair have transformed her to a wonderful, youthful appearance. Scar is well below bikini line and will fade. Notice the dramatic body reshaping highlighted by the second set of photos shown only 2 months post op. A remarkable result.
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This woman presented with facial aging. Excess hanging lids, lower lid bags, hollow jowls, and neck sag.
Combining techniques of ultratine assisted browplasty, micro-liposuction, eyelid lifts, repositioning fat, fat grafting to cheeks , and face and neck lift have allowed for a youthful, pleasant natural restoration - No excess puling here! Youth is in shape and volume! A very nice outcome.
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This personal trainer presented with breast volume loss and some weakening of abdomen with skin laxity. She insisted on saline implants and a natural breast outcome. She is shown well healed with a C cup breast. Notice the tummy tuck scar positioned below bikini and barely noticeable. Also notice the subtle but very important rectus muscle and obliques repositioning, creating a more fit attractive abdomen. A very nice outcome.
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This young woman presented with a very large abdominal hernia, badly wrinkled skin, back and postural problems, saggy breasts (after implants by others) and fat excess of hips and back, and a flat buttock.
Surgery included breast lift, reconfiguration of implant space (higher and more central), tummy tuck with abdominal wall repair, liposuction of back and hips, and fat grafting to buttocks. Notice the fuller higher breast without tissue sag as well as the abdominal contour and dramatic buttock improvement. A beautiful shape change.
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This case shows the artistry and power of fillers facial rejuvenation also known as "liquid face lift".
I have taken years off just by artistically placing fillers in the lips, jowels, cheeks, and folds. A very nice alternative to the surgical face lift.
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This patient presented with disfigurement after bilateral mastectomy and staged implant reconstruction done elsewhere. Problems included asymmetry, lumpy thinned out, cold "breasts" with irregular, non breast shape, and malpositioned nipple site.
I transformed her by excising the implant scar capsules, replaced the implant with a different type of gel, recreated a new inframammary fold from the upper abdomen (which created a breast shape), repositioned the nipple to a proper location, and fat grafted the entire area including chest wall and breast reconstruction.
She now has soft, warm, well shaped breasts. An outstanding transformation.
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This young man presented with severely crooked nose with bridge hump and airway obstruction from septal deviation. Rhinoplasty and Septoplasty corrected the crooked nose, cleared the airway obstruction and reduced his nose proportionately to fit his masculine face. A fine outcome.
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This patient presented with a crooked overprojecting nose, bridge hump, wide nose and septal deviation. Her upper lip was pulled up into the nose due to the overprojection.
Rhinoplasty and Septoplasty corrected the airway issues, straightened the nose, reduced the hump, lifted the tip, creating an overall nice shape and it now blends harmoniously with her face - allowing us to now appreciate her beautiful facial features.
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Eyelid lift from Botox injection only and eyelash lengthening from Latisse (topical formulation).
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This case highlights how important shaping is in mastectomy reconstruction. This patient presented to me in the top photos after her staged reconstruction (elsewhere by others) with expanders and then a second procedure to place implants. She was dissatisfied with lack of shape and profound asymmetry.
I corrected these issues by removing all internal scar tissues (capsulectomy), reshaping the internal space (capsuloplasty), placing new implants (gel), and then performing nipple reconstruction. A remarkable transformation, just waiting for pigmentation.
So, my version is the bottom row of photos – other surgery outcome – the top row (before) images
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This young woman presented with complaints of asymmetric nipples, asymmetric implants, and irregular uneven breast tissue after a lift-augmentation done elsewhere. Her breasts were left flat and oddly shaped. My surgery included releasing scarring around nipple areola, removing irregular breast tissue, reconfiguring and removing the surrounding implant scarring, recreating a new implant space, placing a better implant, and re-lifting the breast allowed me to completely transform her breast improving projection, shape, and feel. An outstanding result for a complex circumstance.
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This case demonstrates the use of fillers to dramatically improve facial aesthetics without surgery.
3cc’s of restylane were used to treat the nasolabial folds, marionette lines, pre-jowel fullness, and corners of mouth.(The patient declined lip enhancement but allowed injections into the most significant lines around the lips including the horizontal line between nose and lip)
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Three sets of images are presented here. They show a patient who presented with signs of facial aging including; eyelid excess and sag, under eye hollow, cheek flattening and jowel fullness and sag, and neck laxity. I performed a combination procedure on her including; eyelid lift, fat transposition to fill out lower lid hollow, eyelid tightening procedure (canthopexy) (to reverse the bowed out aging of the lower lid), cheek implants to add youthfulness to the cheeks, face and neck lift with platysmalplasty and SMAS lift and micro-liposuction of nasolabial folds and periorbital fat grafting.
An outstanding outcome with return to a youthful appearance without looking too tight! The key here was restoring volume! In my facelift approach this is paramount.
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This case shows how circumferential torso liposuction can dramatically improve shape. Here, fat was removed in the hips, back, flanks, and abdomen. An outstanding example of body sculpting shown only eight weeks later.
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This woman presented with typical features of the aging face; eyelid hooding, wrinkled skin around the eyes, nasolabial fold hollow and folding, lip volume loss, joweling, and loose sagging neck.
Her result shows a natural, restored, volume enriched face and neck without excessive pulling. Eyelid blepharoplasty, facelift, with SMAS lift, neck lift with platysmaplasty and fat grafting (from abdomen) to lips, pre-jowel fold, nasolabials and marionette lines in combination restore an attractive face.
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Liposuction of calves and ankles is regarded as the most challenging of all liposuction. Here the patient is shown in 2 seperate photo groupings. The top group of six shows the patients before and after views of side and rear calves, ankles, and knees. She has obtained a beautiful cosmetic appearance with shapely legs. The second set of photos show the front and back of her legs. Four month outcome.
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This young man presented with a combination of functional and cosmetic issues. He had chronic airway blockage which led to constant snoring. He lacked tip support and had a prominent wide high bump. His surgery included septal work to straighten the internal passages, a turbinate reduction internally to further open the airway, cartilage supports for the tip, nostril narrowing, dorsal bone and cartilage reduction, and narrowing of the base of the nose.
Overall, an outstanding outcome shown at only 7 weeks post op. Additional subtle refinements to follow.
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This case reveals several subtle but critically important points in aesthetic breast surgery. The top views of this patient were after her breast augmentation done elsewhere. She was left asymmetric, implants too high due to incomplete muscle release, and too flat (lacking projection). There was hanging breast over the implants.
I repositioned the implants lower (using a better projecting implant) releasing the bottom muscle, reshaping the breast tissue with a lift, creating a far more attractive rounder breast. A dramatic positive change.
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This case shows only two photos. The top photo before facial contouring and the bottom photo after fat grafting. Fat grafting (where fat is liposuctioned from one area, processed, and re-injected) is a powerful tool that can improve the cosmetic appearance. A beautiful result. Note; lips, cheeks, nasolabial folds, and marionette lines(pre-jowel fold).
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This case shows a young woman with significantly different sized breasts. Both sagging, but one significantly larger (small C vs full D). In this case the patient was okay with her C cup breast. The surgery was designed to reduce the left breast, lift both, reshape both, and most importantly perform "auto augmentation" where her own tissue is used to simulate an implant. This is best seen in the second set of photos. An outstanding result.
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This woman faced a decision regarding management of her breast cancer. She was planning bilateral mastectomy. She had enough tissue in her abdomen for use in immediate reconstruction. Several months later a minor procedure to make nipples completed her reconstruction. Her abdomen is flat, she looks great and feels complete after her mastectomy. An ideal outcome.
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This young woman, diagnosed with breast cancer of her right breast, desired to wake up from bilateral mastectomy "as complete as possible". We decided on the bilateral latissimus flap with implant. A very active athletic woman, she was able to return to full activity within weeks. She is shown shortly after mastectomy and then after nipple reconstruction. A beautiful aesthetic result obtained by the process of creating "a living bra" out of muscle. A superior procedure with long lasting reconstruction site benefits.
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Torso asymmetry - part of the vertebral anomalies, commonly referred to as scoliosis can present unique and complex challenges to the plastic surgeon. This patient presented with a combination of abdominal skin laxity and excess hip fat asymmetry and severe breast asymmetry (top row of photos) with lipodystropy (bulging areas) of armpits.
I performed liposuction of the armpits (pre-pectoral)and hips, back and buttock, together with abdominoplasty
(which includes abdominal wall repair), and breast lift with augmentation. She is shown 3-4 months later (bottom row of three). A wonderful transformation and an outstanding cosmetic result with balance and aesthetics.
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When a patient presents with a C+ cup breast that sags, decisions need to be made based on a patients desired outcome. Those who wish for only a lift - will, by definition, be slightly smaller since the removed saggy skin takes up bra space. Others who desire significantly more fullness in upper pole, need an implant as part of their lift. Removing significant saggy volume while placing an implant creates an environment where there is a better long lasting marriage between skin, tissue, muscle and implant. Bottom three photos are an example of this. An outstanding, natural D cup breast.
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This case represents one of the most common presentations after initial breast augmentation. Although not seen well in the photos, when this patient lies down the implants drifted asymmetrically to the side and in the case of the right breast - all the way around to the back. Correction of this condition (top 3 photos) requires internally reconfiguring the scar space to allow a new implant to fill medially while the lateral space was closed off. A new implant was selected which better compliments her body - allowing for better upper pole fullness, medial fullness and overall superior breast aesthetics (bottom 3 photos). An exceptional outcome from a tricky pre-op condition.
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This young woman presented with complaints of breast asymmetry after previous augmentation. The upper row of photos show her at presentation. Her small C cup breast was uneven and lacked sufficient upper pole balance. The surgery (capsulectomy) released the incompletey released right breast constriction, closed the gap between the breasts, and allowed for more upper pole volume while creating a fuller C cup size. An outstanding cosmetic outcome and overall improvement.
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This case demonstrates breast lifting with implants using two sets of photos.
The first set (top photos show six views - three upper views before surgery, and three views after) show a patient with deflated small C cup sagging breasts. Lifting, reshaping the tissue and skin, and elevating the nipple, as well as, submuscular implant placement helps to create a youthful and attractive small D cup breast. An outstanding outcome.
The second set of 6 photos show the various stages of healing; middle two are at 4 weeks, and right side are at 4 months; softening and refinement of excellent cosmetic result has occured.
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This patient presented with A cup breasts and the typical post pregnancy and c-section findings of loose, poor quality abdominal skin and small overhanging pouch. Her surgery restored her abdomen to a youthful, firm shapely form by repairing her abdominal wall fascia which realigned her muscles, and by redraping her skin -eliminating 7 inches of excess. Breast augmentation to a C cup thru a 3/4 inch incision completes the transformation for this young mom with a beautifully aesthetic outcome. ( The second sets of photos highlight one view at 5 months)
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This patient presented with eyelid skin and fat excess as well as deep naso-labial folds, prominent jowels and a very thick saggy neck.
The procedure designed for this patient included blepharoplasty (eyelid lift)and face and neck lift. Face lift included repositioning jowel tissues into the cheeks and contouring the jaw line to change the square shape (aged) to a V shape (youthful). A fine result.
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The RETAF concept is used here as in all my tummy tuck procedures. Restoration and Equalization of Tone Across the Abdominal Fascia. It is not enough to just eliminate skin excess. I internally restore the ability to obtain a functionally strong abdomen. This always adds to the cosmetic outcome. It dramatically shapes the waist and flattens her abdomen to an extraordinary extent! Compare the after photos (bottom) to the before photos. Night and Day! A very happy patient.
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This case represents the most common condition where women request intervention. Volume loss and sag after childrearing. Her post op photos show how mastopexy (breast lift) with implant augmentation can reshape and restore a woman’s breast to a youthful appearance.
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This attractive female presented with a nose that dominated her face. A high bony hump with long overprojecting tip does not allow us to “see” the rest of her face.
Top row: Pre-operative
Bottom row: Post-operative one year after rhinoplasty which reduced the hump, narrowed the bones, raised and shortened the tip, more fitting to this women’s facial structure.
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This case needs only to show two photos, before body contouring and after. Liposuction combined with tummy tuck creates a slender curvaceous feminine form. Compare and see tight smooth hips, shapely buttocks, tight flat abdomen and breast enhancement by lifting and augmentation.
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This case demonstrates how my technique of "Invisible BRA Creation" aids in achieving outstanding cosmetic results. The chest muscles are released, elevated, shaped, and the smooth surface saline implant is placed. A cup to C cup. The less than one inch incision is not noticeable. Also note that the pre-op nipple ptosis (sag) has been corrected.
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This patient presented with a flaccid, weak abdomen with poor posture and fat excess. Abdominoplasty with liposuction of hips demonstrates once again how my concepts of this combination can transform a woman’s body into a beautiful and shapely form.
Restructuring abdominal wall tissues allow me to improve or establish feminine waist shape and improve posture and dramatically flatten the abdomen (note middle two views: top-bottom)
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This courageous woman had her nose tragically bitten off by a dog. Determined to restore her dignity and self-esteem, she embarked on a series of surgeries designed to use her body tissues to remake her nose.
Top row: At her initial visit several days after injury.
Middle row: After pre-fabrication of nostrils with cartilage grafts and skin grafts to forehead, the entire unit was transferred to reconstruct the complex defect.
Bottom row: After inset and fine tailoring, her nose is restored with her own tissues. This case demonstrates the most complex variety of rhinoplasty surgery and combines both reconstructive and cosmetic techniques.
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This case demonstrates what may happen when patients needing combined breast lift and augmentation (implants) due to loss of breast volume and sag have only the implant part of the procedure done. This patient (top three views) presented to me with a small implant positioned too high with breast sag from surgery done elsewhere...
The bottom three views show her after I removed her original implants, changed the space for the implants, placed appropriate sized implants and reshaped her breasts. Dramatic improvement and a terrific cosmetic outcome.
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This case demonstrates what may happen when patients needing combined breast lift and augmentation (implants) due to loss of breast volume and sag have only the implant part of the procedure done. This patient (top three views) presented to me with a small implant positioned too high with breast sag from surgery done elsewhere...
The bottom three views show her after I removed her original implants, changed the space for the implants, placed appropriate sized implants and reshaped her breasts. Dramatic improvement and a terrific cosmetic outcome
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Fat transfer principles can be used successfully to improve facial aesthetics and restore youthful appearance. Here liposuction of the neck, and fat augmentation (by micrografting) to the lower eyelids and cheek folds eliminate the hollow lower lids, fill the lines around the cheeks, mouth, and flatten and sculpt her neck.
A subtle, yet dramatic improvement of the face.
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This young woman presented with back, neck and shoulder pain. She wore a DDD/EE cup bra. After breast reduction she is shown as a C cup with lifted, rounder, firmer breasts. Her musculo skeletal issues were completely resolved.
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