Dr. Stuart Linder is a Beverly Hills board certified plastic surgeon, specializing in body sculpting and reconstructive procedures including breast augmentation, reduction, lift, liposuction and tummy tuck » Continue Reading
The muffin top procedure is basically bi-directional tumescent liposuction of the iliac crest rolls, lower flanks and may or may not include the lower abdominal periumbilical area. The following example below is an excellent example of the muffin top procedure in the patient has lipodystrophy adiposity of the periumbilical, lower abdominal flanks and iliac rolls. The patient has a significant amount of bulge and fat in the pre-jean roll area which makes it difficult for her to wear her jeans, as well as can be irritating as well embarrassing at times. This can usually be addressed by the bi-directional lipectomy or flank plasty performed by suctioning fat with tumescent technique in the iliac crest rolls, lower flanks, periumbilical, lower abdominal area. Her smaller procedure can be done under IV sedation. Larger muffin top procedures require general anesthesia in order to remove more significant amounts of fat in a safe manner.
All women’s bodies are different. They vary depending upon massive amounts of breast tissue, thickness of their muscle, prominence of the thoracic cavity and positions of the nipple areolar complex. For women who are quite thin, who have an ectomorphic build, meaning minimal breast tissue with a prominent ribcage, costochondral junction and involutional atrophy due to breast feeding, basically meaning that their entire breasts have been atrophied associated with the pregnancy and breastfeeding process and their breasts appear to be empty, they do great with high profile silicone implants. Please note, the patients with high profile implants may have slightly increased upper fullness and projection even with the implant placed under the muscle. However, there are great advantages. 1) Greatly reduced visibility and rippling; 2) Narrow base to the implants, especially useful for women with shorter inframammary fold distances; 3) Enhanced medial cleavage, especially in the upper third of the chest wall; and 4) Less matronly appearance.
The below frontal and oblique view shows a typical example of a patient who is a 32A, ectomorphic build, minimal breast tissue, breast fed two children, has pseudo-ptosis and is an excellent candidate for high profile silicone gel implants.
www.sharecare.com was created by WebMD founder, Jeff Arnold, Dr. Mehmet Oz of the Dr. Oz Show, Harpo Productions and Sony Pictures Television. It offers a list of health topics through which web users can browse and submit questions. Dr. Linder is thrilled to be a provider of answers and an expert plastic and reconstructive surgeon, invited by Dr. Oz, as a member of ShareCare. Dr. Linder will answer questions weekly pertaining to issues and plastic and reconstructive surgery. Other members of Share Care include Deepak Chopra as well as Arianna Huffington, etc. ShareCare is sponsored by organizations, including the American Cancer Society, American Heart Association Cleveland Clinic, American Red Cross, John Hopkins, National Academy of Sports Medicine as well as large corporate sponsors, including Dove, Colgate, Palmolive, Johnson & Johnson, Pfizer, and Walgreen. Simply check out www.sharecare.com. Any questions regarding healthcare, medicine or beauty can be answered by a panel of experts at any time. Once again, I am honored and privileged to be a plastic surgeon for ShareCare.
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Patients present to us with severe congenital breast deformities. The next example shows a patient with severe breast asymmetry, and tubular breast deformity. Notice on the right breast there is minimal breast tissue with pseudo-herniation of the breast tissue into the nipple areolar complex, no inframammary fold and blunting along the lower pole of her breast. The left breast has a conical tubular-like shape and is significantly larger in size. In order to recreate normalcy to her breasts, two different size implants will be used in the dual plane (two-thirds under the muscle, one-third over the muscle) and tissue will be removed under the nipple areolar complex along the periareolar incision in order to smooth out the nipple areolar complex. Postoperatively, the patient required six weeks of upper pole compression band in order to allow for inferior displacement of the implants and elevation of the nipple areolar complex as well as to maintain a rounding out shape along the lower pole of the breast. Her after photos show good symmetry with smoothing out of the nipple areolar complex, reduction of the conical and protuberant shape of the breasts and a well-defined inframammary fold along the right breast.
Operations for tubular breast deformity with breast asymmetry are tricky, requiring a skilled, experienced, Board Certified Plastic Surgeon. Although these are challenging cases, they are exceptionally rewarding when the results can improve the self-esteem of a woman for the rest of her life.
When patients are in the decision process of having breast augmentation surgery, it is important to obviously look at the qualifications of your plastic surgeon. Certainly, he or she needs to be a Diplomate of the American Board of Plastic Surgery and be a Board Certified Plastic Surgeon. Also, it is vital that the patient look at hundreds if not thousands of the doctor’s preoperative photos. The examples below show excellent symmetric breasts, pre and postoperatively. Notice, 1) the nipple positions pre and postop are even; 2) the cleavage factor is excellent, not too close and certainly not too far; 3) the inframammary folds are symmetric and even as well; and 4) the volume appears to be the same in both breasts. Evaluation of frontal views is obviously very important in evaluating a plastic surgeon’s results. It allows the patient to be able to see all the possible discrepancies that can occur with asymmetry, which includes nipple position, areolar position, cleavage and inframammary fold position as well as volume discrepancies.