A patient of mine from West Chester, Pennsylvania came to me and asked, “Get rid of my scars.” You unfortunately can’t. Scars are permanent. If a person has a laceration or an operation, the incision turns into the scar, and this scar is permanent. It will fade, however! It will become less noticeable, but it will always be there. Understanding this process is very important. Plastic surgery incisions eventually turn into scars.

The factors involved in scar fading, incision healing, and surgical results will now be discussed.

1- The Surgeon:

Everyone wants the best doctor or surgeon to sew up their cuts or lacerations. This is true of their cosmetic operations too. Usually this is the plastic surgeon. Plastic surgeons have extensive training focused on the best techniques to maximize the fading and healing of scars. The techniques used include gentle handling of tissue, meticulous hemostasis, small- delicate stitches, and precise approximation or suturing of the tissues. It is normal to want the best doctor to fix your lacerations or to perform your cosmetic operation. This will play a role in your healing. The plastic surgeon will use his extensive training to maximize the healing and the fading of the incision to give the best result.

2- The Location:

In real estate transactions, there is a phrase used often – “Location, Location, Location!!”
This applies to scars and incisions also. If we get accidentally cut or suffer a laceration, we have no choice of the location or where the cut or scar occurs. However, with operations we have a choice. The location is critically important. Certain areas on the body heal better than others. For example, the face tends to heal extremely well. I call it a “privileged” location. Face lifts, eyelifts, and other cosmetic operations on the face use incisions that almost uniformly heal exceptionally well. The incisions in these areas are placed in “privileged” areas and usually are difficult to see after healing. It is a characteristic of these operations that the scars heal extremely well. If they didn’t, these operations would not be so popular.

However, other locations don’t heal as well as the face. The back, for example, doesn’t heal as well as the face. The scars or incisions in this area tend to be thicker and wider than often desired. The knee or shoulder can heal with wider or suboptimal scars. Some areas of the body do not heal as well as others. Location is critical.

The breasts, like the face, tend to heal very well. Cosmetic surgery operations on the breast often have very nice scar fading and results because of this tendency. This is true also for the incision for an abdominoplasty or tummy tuck. These operations tend to have surgical results with nice incisions and scars that fade well with time.

3- The Operation:

Different operations will have different results and scar healing patterns. As discussed above, certain operations use incisions that are not in the best locations. Thigh lifts, body lifts, buttock lifts have incisions that might not heal as well as other operations. A person might have to except a scar that is not as good as desired or thicker or wider than desired. These locations might have a higher incidence or chance of poor healing. Other operative factors can play a role. For example, operations that have complications, infection, or delayed healing will effect the scar or the surgical result. Delayed healing beyond three weeks is often associated with hypertrophic or keloid scars. Therapy is available if this happens, so this can help the fading if it occurs.

4- Time:

Scars or incisions fade with time. It can take much longer than many people realize to see complete fading of the scar. A good rule of thumb is that scars fade over a year. However, it can take longer for some people. Scars sometimes can take 18 months or even longer. It is important to be patient. It most cases the scar will fade with time. The great majority of people will ultimately be happy about the appearance of the scar. The final surgical result awaits complete fading of the incisions.

5- Individual Differences:

Scar fading is not the same for everyone. Personal differences in skin type, quality, and healing abilities can make a big difference in the final appearance. Patients might have genetic differences that lead to better or worse healing. Some patients will be more prone to keloid scarring. If you know this is the case for you, make sure you tell me as things can be done to enhance healing.

Summary:

Cosmetic surgery requires incisions. These incisions turn into the scars. The final result of the cosmetic operation occurs after the scars have faded to the greatest degree. Scars do not go away completely. They usually heal to the point where most people are very happy with the incisions. Factors that are involved in scar healing include but are not limited to: the surgeon, the location, the operation, time after surgery, and individual differences.

I am a board certified plastic surgeon who practices exclusively cosmetic surgery. Please come in for a complimentary consultation. Details of your cosmetic procedure and your surgical plan will be discussed completely.

People decide to have a tummy tuck to improve and enhance their abdominal or stomach area. The surgery helps with excess and loose skin, stretch marks, and extra fat. The results of the surgery is highly successful and can be dramatic at times. Please see the tummy tuck before and after photos now for those interested. Many patients will ask about the size change they will have after the procedure. Phrased another way, people ask about abdominoplasty change in clothing size. The answer is not always predictable. Some will have this change and others will not.

Clothing sizes are not standardized. A size 8 will vary from manufacturer to manufacturer. Some will run small and some big. European and American clothing can also be a variable. The same can be said for bra sizes. Manufacturing differences exist. A woman’s clothing size will also vary from her hips to her thighs to her stomach. Some women might be an 8 in the legs, but she might fit better in a 6 in the stomach areas.

This  manufacturing difference in clothing, and variation in each women, makes it impossible to exactly predict the change after the surgery. Manufacturing of clothing was indeed standardized after WWII. However, this has long been abandoned. Companies have found it profitable to alter the “fit” or size to sell more clothing. For example, some women will buy a size 6 that decades ago would have fit a size 10. The women purchasing this clothing like the smaller size. It makes you feel better and hence more are sold.

Having said this, most women after a tummy tuck will go down a size or two. Some will go down even more!  However, some patients will not have a change of size, and rarely, some will actually wear a larger size.

Most women will go down a size or two after an abdominoplasty and be very happy with their new appearance. The woman that doesn’t change sizes can unfortunately be disappointed by this. It is important to understand that even if you don’t go down a size, you still can enjoy the flatter and more sculpted stomach that the surgery achieves.

Women that wear a larger size can attribute this to swelling, if it is close to the time of surgery. If a significant time has past since the operation, than the answer lies in wearing the clothing differently. Some women will wear their pants slightly higher or lower after a tummy tuck. A large stomach roll might lead to someone pulling their pants above this “gut.” After surgery, since the stomach roll is gone, they might wear the pants in a different location,  accounting for this size change. Once again, the stomach will “look” better and flatter despite the lack of dropping down in the clothing size.

To summarize, following cosmetic surgery tummy tuck, most women will go down a size or two in their clothing size. Some woman won’t have a change of size, and rarely some will actually go up in size.

I am a board certified plastic surgeon who practices exclusively cosmetic surgery.  Please come in for a complimentary consultation. Details of your cosmetic procedure and your surgical plan will be discussed completely.

Men make an ever growing percentage of people who are interested in plastic surgery and cosmetic surgery. I work closely with my male patients to give them the best care possible. Statistically, men can make up 10% of many plastic surgery practices. Men have the same natural desires, just like everyone else. Men also want to look good, feel better about themselves, and to look younger. It is normal for men to have these desires. It is normal to want to look your best! Patients from Delaware, Pennsylvania, Maryland, and New Jersey come to see me. Please see my before and after photos for men.

According to the American Society of Plastic Surgeons, men had about 750,000 cosmetic procedures, almost 8% of the total last year. This was an increase of over 88% from a decade ago. The top five surgical procedures for men are: liposuction, rhinoplasty, eyelid and facelift surgery, breast reduction to treat enlarged male breast, and cosmetic ear surgery.

Just as it is normal to eat a proper diet, exercise, and dress well, it is normal to desire a more attractive appearance or younger look. The truth is- almost everyone feels this way! People who say otherwise often are not bein honest with themselves. Others may not have enough extra money for cosmetic surgery, so it is easier to just say that it isn’t what they want.

Men have sometimes found that they can lose business to younger male competition, because they are older looking. Many plastic surgery and psychological studies published in the literature have shown very interesting results. If we look older, we are viewed by others as being less intelligent and successful! This might be hard to believe, but it’s true! People do judge us by the way we look – even if they shouldn’t- it happens.

Cosmetic surgery for men can be extremely successful and usually is rewarding. Men have different anatomy and surgical goals than women. I am an expert in these differences and will help my male patients with their desires and wants.

For example, aging of the eyes typically leads to excess skin and fat above the eyelids. This makes us more tired and older looking. The treatment is an eyelid lift or blepharoplasty. The latest way to do this is to treat all three levels of aging. This includes the skin, muscle, and the fat. With this most advanced technique the eyelid lift or eyelid tuck give a natural and youthful appearance.

However, with men, if you remove too much skin and fat with the eyelid lift or blepharoplasty, you run the risk of being “feminized.” Women have a different anatomy above the eyes and the skilled plastic surgeon needs to address this. By knowing the difference, the male patient can get a more youthful and healthy appearance without the feminization sometimes seen. (Michael Douglas, the movie star, had too much fat removed at his first operation and looked unnatural.)

Recovering from eyelid lift surgery or blepharoplasty surgery is surprisingly easy. Blepharoplasty recovery is characterized by very little pain! Most people do not need any pain meds! However, there is bruising and swelling that slowly goes away. The blepharoplasty cost is also surprisingly affordable. The operation for eyelid lift can be extremely successful and with very low risks. Please see my before and after photos on eyelid and facial rejuvenation.

In addition to blepharoplasy, Dr. Saunders works closely with his male cosmetic surgery patients to help them address all their needs. From liposuction for men to facelift for men, he will help you with your goals and wants.

I specialize in cosmetic surgery and will work closely with you for your best results. Please call the office for a complimentary consultation. Also, please see the before and after photos for male patients in the photo gallery!

As covered in Part One, breast lift operations give a certain shape and appearance that is different from breast augmentation or breast enlargement. This different result is extremely important to understand. During consultations, I spend the time to teach and explain these differences to my patients. People from Delaware Valley or Media, Pennsylvania  and Newark or Wilmington, Delaware and surrounding states come in to learn the facts about these operations. Education about these cosmetic operations will help a woman understand and be more satisfied with her procedure. Please also see my educational writing “Breast Augmentation, Breast Enlargement: What is Settling?”

One can think of the changes with breast lift or mastopexy and the changes with augmentation as being on a gradual curve or slope. It is like a mathematical line that is gradually increasing as you go from the left side to the right side. It can be thought of as being a spectrum with breast lift results on one side and breast augmentation results on the other side.

The results of a lift are on the most left hand side or the beginning of the curve or line. Small breast implants will give a result that is slightly to the right. This is further up the line. Medium implants put you still further up the line. Bigger implants push you further to the right. Finally, huge breast implants push you to the far right on the curve or line.

What is changing? The result of the operation changes. The shape of the breast changes. The “look” changes. Simply put- a breast lift gives the breast a more perky and natural shape, but breast implants give extra roundness and fullness on the top aspects of the breast. When you understand this difference, you will understand breast implants versus breast lift.

A mastopexy or breast lift makes the breast perkier, lifted, and more attractive in shape and appearance. However, there will be less volume in the upper aspect of the breasts. As we start adding a breast implant, it will add volume to the breast and give more of an “implanted look.” This is not necessarily fake! As a matter of fact, most people do not think small breast implants are fake looking. Small implants can be extremely attractive and natural. Small sizes are available to give a half cup or other small and natural breast augmentation results. Small and natural appearances can be achieved with implants.

As the implants get bigger, the shape and appearance becomes more round and full up top. The appearance now might be the classic augmented breast that many women like. It still is not necessarily fake. Beauty is in the eye of the beholder. Whether a breast looks fake or not is partially dependent on the woman. As the implants get even bigger, the shape gets even more round and full. Becoming “fake” definitely increases as the implants get extra big. This appearance tends to be really round and extra full. Please see my video on choosing implant size.

Why does the shape of the breast change with different operations? Why does the shape of the breast change with different size breast implants? The answer is the concept of “soft tissue coverage.” This is the tissue that hides or camouflages the breast implant. Soft tissue is the breast and the muscle that covers the implant. It’s soft and not the hard tissue like bone and ribs. The soft tissue covers the implant and makes seeing the roundness and the edges of the implant more difficult.

Understanding soft tissue coverage is very important. Small implants will be hidden well by the soft tissues, and the result will be more natural. Small implants will be hidden well, so it’s less round and full up in the top of the breast. Large implants will be hidden less well, and the shape of the breast will change. Bigger implants give a rounder and fuller shape or appearance. As the implants get bigger, the result is further to the right on the line or curve discussed above.

The amount of breast tissue you begin with plays an important role. The more tissue you have to start with means you have more soft tissue coverage. Flat chested women don’t have as much tissue to hide the implants. It will be harder to camouflage the implant because there is less to hide it. The flat breasted women might choose smaller implants if she is concerned about appearing too round or fake.

Placing the implants beneath the muscle provides extra soft tissue coverage and more natural results. This muscle coverage leads to softer and more attractive breast enlargement results. It also leads to lower complications.

Breast lift results are almost always more natural in shape, because there is no implant to hide. Results are extra natural with lifts. They might not be round enough or full enough compared to implant operations. If this rounder and fuller look is desired, than breast implants should be considered. If a patient gets a lift and after healing wishes the shape was bigger or fuller, she can always safely add implants at a later date. This is safe to do and is an option for the woman who isn’t sure about getting implant or not.

In summary, the shape of the breast changes from a lift to augmentation. Breast lift results are very natural. The operation makes the breast fuller and perkier. Small breast implants give more roundness and more fullness than a lift. This is seen in particular in the upper parts of the breast. Large implants give even more roundness and fullness. Fake results from implants come from extra large implants where you can really see the roundness of the implant. The concept of soft tissue coverage helps understand these changes.

People interested in breast augmentation or breast enlargement or other topics such as breast augmentation cost, breast augmentation recovery, or breast augmentation technique should please call the office for an appointment.

I am a  board certified plastic surgeon who practices exclusively cosmetic surgery. Please check out the breast augmentation before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Breast augmentation, breast enlargement, or implants give different results, shape, or appearance than a breast lift operation. Patients seeking cosmetic improvement in their breasts need to understand these differences. The results are not the same. The outcomes are different. We don’t want to be disappointed by getting different shapes or results than desired. We don’t want to pick the wrong operation. People in Media or Delaware Valley PA or the surrounding areas and states can learn and understand these important facts. For those interested, please also see my educational writing on Breast Augmentation Results = “A Bigger You.”

I have patients who have come in to the office and they say, “I dont like the results of a breast lift or mastopexy. I’ve been all over the web, and I don’t like any doctors breast lift pictures. The result and shape are not what I want. They look flat and not round enough.” Yes, this can be true and is an opinion that can be valid. They might be looking at good breast lift results and just don’t like the shape. They might need a different operation or breast implants instead. It doesn’t mean that a woman won’t be happy with a lift, but she does need to understand the different shapes and results achieved by the two operations. She needs to understand breast augmentation vs. lift.

Americans are used to seeing women in the movies and magazines, such as Playboy. People have come to view these women as having normal or natural breasts. But Mother Nature doesn’t make breasts like this. Normal breasts don’t look like this. These women almost always have implants. In the movies and Playboy, even the smaller breast shapes tend to be women with breast implants – just smaller ones! It is not a normal shape but a breast implant shape. Learning what natural breast augmentation results look like is important.

Breast implants don’t just make the size bigger. It’s more than just a bigger size. Breast implants tend to be rounder and more full in the entire breast, but especially above the nipple in the upper aspects of the breast. The result is rounder, bigger, and perkier too.

With smaller breasts, the appearance can be deflated and droopy. The breast might not actual droop. It just might be partially empty and small, giving it this appearance and shape. Breast implants can give fill the breast up and enhance it’s appearance, giving it a lifted look.

Breast augmentation involves placing breast implants beneath the Pectoralis muscle and breast tissue to enlarge the breast. The shape or result achieved is determined by the size of the implants and the nature of the tissue on top of it.
I have made a video that reviews different breast enlargement results with different breast implant sizes.

What about a breast lift? Breast lift or mastopexy surgery reshapes the breast and elevates the nipple. The operation gives a more natural, perky, attractive, and full appearance to the breast. But, it doesn’t give that extra round or full shape that implants do. Breast lifts tend to give a shape that is more natural or normal, like Mother Nature makes. The breasts are more straight or flat up top in the upper parts of the breast. They become more perky and full than before surgery, but just not the same fullness as with implants.

Breast lift surgery elevates the breast and gets hanging tissue beneath the crease of the breast a lift. It gives the breast a wonderful and improved shape and appearance. This shape is more full and attractive. Most woman are very happy and pleased with the result of their lift. However, it’s not as round or as full as with implants. This is an important distinction between breast implants versus breast lift.

Once a woman understands the differences between the operations, she should work with her doctor to decide the best operation for her. Sometimes this means doing implants and not a lift. This might be the case if more roundness and fullness is wanted. Sometimes this will mean doing a breast augmentation and breast lift, if hanging and small volume are both present.

I work closely with my patients to help them understand the operations and results. By thorough discussion and examination, I can help the woman learn about the procedures. This allows her to be more comfortable and happy with her final decision.

People interested in breast augmentation or breast enlargement or other topics such as breast augmentation cost, breast augmentation recovery, or breast augmentation technique should please call the office for an appointment.

I am a board certified plastic surgeon who practices exclusively cosmetic surgery. Please come in for a complimentary consultation to learn about your choices and options!

In a Breast Lift procedure an incision is made around the areola and excess, sagging skin is removed. The areola may also be repositioned, reshaped, or re-sized to create the most ideal results. The remaining skin is then closed creating firmer, perkier, more youthful breasts. In some cases, a breast augmentation may be coupled with a breast lift procedure.

If you would like to learn more about the breast lift procedure and to find out if you are a good candidate, contact our office to schedule a consultation with Dr. Saunders.