March 15th, 2014 Miguel A. Delgado Jr, MD
San Francisco, California-The American Society of Plastic Surgeons (ASPS) has reported their statistics for cosmetic and reconstructive surgery for 2013. Each year the report comes out around the end of February after the numbers have been tabulated from the Board Certified Members. It is interesting to see which procedures are the most popular and how they compare to previous years.
This is a 35-year-old resident of Sonoma County, California. She is the mother of two children. She presented to the Novato office in Marin County for an evaluation for breast enhancement. She is 5 feet 2 inches tall and weighs 115 pounds. She underwent bilateral breast enlargement using 300 cc, Mentor High Profile, silicone gel breast implants. The procedure was performed at the Marin Cosmetic Surgery Center in Marin County, California. The approach was a peri-areolar incision with sub-muscular placement for the breast implants. She went from a size A cup to a C cup.
ASPS reported that breast augmentation is once again the number one cosmetic plastic surgery procedure; it even increased over 2012. It is interesting to note that there has been a 37% increase for breast augmentation surgery since the year 2000, and the number one procedure since 2006 when it surpassed liposuction. It is not known why there was an increase for 2013, but it is believed that it may be due to new technology and approval by the FDA of form stable breast implants. Form stable implants are teardrop shaped silicone implants, also known as the “gummy bear” implant.
Taking a look at surgery trends over the last seven years (after breast augmentation), the number two procedure has been nose reshaping every year, except 2007 when it was liposuction. The third and fourth positions are fairly equal between liposuction and eyelid surgery. Fifth position had been tummy tuck surgery for six years and then for the last two years facelift surgery surpassed tummy tuck surgery taking the number five spot.
Patients have an increasing desire to look and feel their best, many come to their plastic surgeons complaining how they appear on Skype and Face Time on their phone. It is believed that competition in the work force is also a factor that has lead to an increase in all facial procedures.
In addition to cosmetic surgical procedures, the minimally invasive procedures have seen quite an increase for 2013. Botox remains in the number one position with an increase of 3% over 2012, with an amazing overall increase of 700% since 2000. The soft tissue fillers have seen an increase of 13% over 2012.
ASPS predicts that cosmetic surgical procedures will continue to see steady growth in the coming years, and especially the newer non-invasive body sculpting, (such as CoolSculpting), will see a dramatic increase.
Dr. Delgado is an expert in his field of cosmetic plastic surgery and has been since 1988, serving the greater San Francisco Bay Area, including San Jose and Sacramento.
December 30th, 2013 Miguel A. Delgado Jr, MD
This is a Marin County, California 45 year old mother of two children. She is 5’5″ tall and weighs 135 pounds. She had a full tummy tuck with liposuction of the flanks at Marin Cosmetic Surgery Center.
San Francisco, California- Abdominoplasty or tummy tuck surgery is noted as having one of the highest satisfaction rates for cosmetic surgery. For women the most popular procedures are: breast surgery, liposuction and a tummy tuck, which can be combined making for a “mommy makeover” procedure. For men the most popular procedures are: male breast reduction (also known as gynecomastia), liposuction and abdominoplasty. The only downside for the tummy tuck procedure is the long hip to hip scar and discomfort from the first few days of healing.
Most men and women find the scar is an easy tradeoff for their new flat tummy, and in fact, most are pleased to find that after about a year of healing the scar fades to white or silver and is much less noticeable.
In the past, the pain has been managed quite well by a pain pump. The pain pump is a device that disperses an anesthetic to the surgical area by way of a couple of tubes, positioned by the surgeon at the end of surgery, through the skin of the upper abdomen. The anesthetic solution is stored in a bulb about the size of a tennis ball and is automatically dispersed over a period of about three days. The system has worked quite well in keeping the patient comfortable, however, the device is in a bag worn by the patient with a strap going around the neck, proving to be somewhat cumbersome and restricting the patient’s movements.
In keeping up to date with the latest innovations, Dr. Delgado now uses Exparel for his tummy tuck patient’s pain control.
Exparel is a slow release numbing agent that is a onetime injectable done by the surgeon at the end of surgery. This injectable lasts for about 72 hours, which is the duration of the worst part of the post-surgical pain. Exparel allows the patient the freedom of not having the pain pump tethered to them.
When the brain receives signals of pain, Exparel will block the nerve impulses, providing relief to the patient. The anesthetic used in Exparel is bupivacaine, more commonly known as Marcaine, which is suspended in liposomes that slowly release the drug.
Dr. Delgado’s anesthesiologist, Dr. Randy Gaynor, will need to know if you have had any problems in the past with anesthesia. Most patients tolerate Exparel very well, but it is important to know if you have any history of; kidney or liver problems, any history of seizures, heart rhythm disorders or heart disease.
It is not unusual for tummy tuck patients to need some narcotic pain relief in addition to the Exparel. However, studies show that patients that had the Exparel injections took about a third less pain relievers than the non-Exparel patient, and the Exparel patient had a faster recovery time with less discomfort.
Exparel is comparable in cost to a pain pump, so it is mostly used in extensive surgeries. For the patient with a low pain threshold or for one who is overly anxious about an upcoming surgery, it would be worthwhile to discuss pain management with Dr. Delgado.
To schedule a consultation, call (415) 898-4161 or send an email.
April 30th, 2013 Miguel A. Delgado Jr, MD
San Francisco, California-Haute MD is an upscale internet publication with current articles on health and beauty trends. This trusted online publication offers readers concierge access to premiere cosmetic specialists around the country. Dr. Delgado was selected for his exceptional reputation and talents in plastic surgery, with emphasis on surgical procedures of the body, such as; breast augmentation, breast reduction, tummy tuck, mommy makeover, and gynecomastia.
Along with a referral to top physicians, Haute MD includes a detailed profile with the doctor’s before and after pictures of actual patients, videos (if submitted) and testimonials.
The informative website offers San Francisco Bay Area men and women fascinating reading with articles like:
· “Cupping Celebrity Health Fad: Groundbreaking or Totally Useless?”
· “Benefits of Dead Sea Salt”
· “Power Juice and How it Helps You”
“Haute MD connects the most trusted doctors and specialists with the country’s most discerning affluent audience. The network is an exclusive, invite only membership circle with only one representative per market for each of the nine medical specialties.”
February 15th, 2013 Miguel A. Delgado Jr, MD
Before and After Full Tummy Tuck
A frequent question San Francisco Bay Area patients ask during consultation for a tummy tuck, is can they get a “mini” tummy tuck? They are hoping for a smaller scar and less involved surgery.
Although the names sound similar, the procedures treat different issues. The mini treats patients with minimal skin laxity, mild to moderate abdominal fat and mild to moderate stretched or separated abdominal muscle. There is a limited amount of tightening of the abdominal muscle, and it is only tightened below the belly button. The removal of stretch marks with this procedure is also limited. The incision is much smaller than for the full tummy tuck. Patients that are within 10% of their ideal body weight may be good candidates for the mini.
The full tummy tuck is usually recommended for women who have had children and have completed their child bearing. The full tummy tuck tightens all of the abdominal wall skin and muscle above and below the belly button. The incision generally goes from hip to hip but is placed so that it is hidden in the panty line. There is also an incision around the belly button. For the optimal result, a waist enhancement procedure can be done to give more definition to the waist line.
Many Marin County women opt to have breast surgery done at the same time, this may be a breast lift with or without implants, or breast augmentation or in some cases a breast reduction to have what is known as a “mommy makeover”, one of the highest patient satisfaction procedures available.
Before and After Mommy Makeover
November 30th, 2012 Miguel A. Delgado Jr, MD
Before and After Tummy Tuck
When diet and exercise won’t get rid of excess body fat around the abdomen and the elasticity of the skin has deteriorated with age and physical changes such as weight gain and weight loss, then an abdominoplasty or tummy tuck may be the answer.
The term “tummy tuck” may sound like a quick or simple procedure, it is not. It is considered major surgery. The incision generally goes from hip to hip and recovery is about 4 weeks. The scar can take from 9 months to a year to lighten in color and flatten out
A good candidate is one who is in good general health, is at a stable weight, does not smoke and has realistic expectations.
A tummy tuck should not be used as a weight loss plan, but more for someone who is at a stable weight needing removal of excess fat and loose skin. If you plan to lose weight or get pregnant, you need to wait for a tummy tuck.
San Francisco Bay Area patients should arrange for a ride home after surgery and will need assistance for a few days.
Risks are much the same as with any surgical procedure, including; bleeding, infection, blood clots and risk of anesthesia. Dr. Delgado has a team of licensed and credentialed professionals and with his accredited Marin Cosmetic Surgery Center, risks are minimized making the tummy tuck procedure very safe.
September 28th, 2012 Miguel A. Delgado Jr, MD
29 year old female, breast lift, tummy tuck liposuction of back and flanks
Many Marin County women ask, “How soon can I have a mommy makeover after having a baby?” The mommy makeover procedure usually includes some type of breast surgery (breast augmentation, and/or breast lift, or breast reduction), a tummy tuck and some liposuction. A woman can proceed with the mommy makeover procedure once she has finished having children and it has been at least 6 months since she has stopped breast feeding. It is important for a woman to wait until she is finished having children because other than destroying the tummy tuck result, if she should become pregnant the abdomen may not expand properly while the fetus is growing.
62 year old female, staged mommy makeover. Tummy tuck followed by breast reduction 1 year later.
The Mommy Makeover procedure is not only for the young!! Women today are eating healthy, not smoking, and have an active life style including regular exercise programs. This makes them excellent candidates for elective surgery. Cosmetic plastic surgery is reaching all time highs; San Francisco Bay Area women want to look as good as they feel, and for many older women they now can afford to treat themselves after the time and expense of raising a family has past.
June 25th, 2011 Miguel A. Delgado Jr, MD
Tummy tuck and liposuction are completely different procedures that solve different problems. Liposuction will only remove fat under the skin and above the abdominal muscles, where a tummy tuck removes fat, skin and tightens the abdominal wall. If the patient has good muscle tone, and probably has not had children, the result with liposuction body sculpting alone can be quite dramatic. The incisions are very small and in time fade to almost invisible. I have had San Francisco Bay Area patients come in thinking that they wanted a tummy tuck or abdominoplasty only to find out that they are excellent candidates for liposuction alone. When possible, liposuction is a great procedure with excellent results, allowing the patient to return to work or regular activities within just a few days. Even though age is not a factor, older patients tend to have less elasticity in their skin which means they will not get an optimal result.
For women who have had children, or patients that have had a significant amount of weight loss, liposuction will not give them a smooth, flat stomach. In fact liposuction alone can make the condition worse by removing the foundation on which the skin rests (the underlying fat) and end up with even looser skin. To get the best result, they will need to have excision of fat, skin and tightening of lax abdominal muscles, which the tummy tuck procedure includes. In most cases, the tummy tuck procedure also includes some liposuction. There are some tradeoffs though when opting for a tummy tuck that the patient needs to be aware of. First of all the incision from the tummy tuck generally goes from hip to hip. It is placed low on the abdomen so that it is hidden in the panty line. When tightening the abdominal muscles, the belly button will need to be repositioned. The tummy tuck is one of my favorite cosmetic procedures with one of the highest ratings in patient satisfaction. Many patients find that they have an even flatter abdomen than before childbirth or weight gain. And an additional bonus is removal of a majority if not all stretch marks.