September 25th, 2013 Miguel A. Delgado Jr, MD
Many San Francisco Bay Area patients complain about difficult problem areas of fat, especially for the waist “love handles” and abdomen that do not seem to respond to dieting or vigorous exercise. Previously, the only solution for removing fat other than dieting was by liposuction surgery. For many patients, liposuction is not an option due to required time off work for post-operative recovery and then there are some patients that just do not want to have surgery. CoolScuplting patients are thrilled that there isn’t any downtime, needles, scalpels, suction hoses or scars. The cost of CoolSculpting is significantly less than a surgical procedure.
Now, thanks to research done by doctors at Massachusetts General Hospital in Boston, CoolSculpting was developed. Doctors had noted that children were losing fat in their cheeks that were eating a lot of popsicles and many even developed dimples. This lead them to discover that fat cells treated with intense coldness died and then were naturally eliminated from the body. It is not a fast process, but the results are permanent.
Doctors found that fat is destroyed when it is cooled down to a certain temperature while not harming surrounding tissues and muscles. A machine (CoolSculpting) was developed that has an applicator that pulls an area of fat into the cooling panels, making the area numb from the intense coldness. In order to protect the skin during treatment, a pad with gel is placed over the area to be treated. Patients claim that the treatment is not painful but that they feel a small amount of pressure and coldness from the plates. Side effects are minimal, if any, and would consist of some; numbness, redness and possible minor bruising and swelling which is only temporary. Each treated area takes about an hour, and about 20% of the fat cells in a treated area are destroyed.
Results will begin to be noticed after 2 to 3 weeks and will continue for about 2 to 3 months. For many patients, the initial treatment is all that is needed, however, some patients want to shrink and sculpt problem areas, and may opt for more treatments, but they need to wait 2 to 3 months between treatments.
Many more patients are learning about CoolSculpting, which is now FDA cleared, from friends and television shows featuring the body sculpting benefits. Each year as cosmetic plastic surgery procedures increase, CoolSculpting seems to be gaining a lot of notoriety with both men and women. Cosmetic procedures for men are increasing every year, with liposuction and gynecomastia surgery high on the list. Now with CoolSculpting targeting the abdomen and love handles, the number of men seeking the procedure is gaining significant popularity and women are thrilled to see their “muffin tops” disappearing. CoolSculpting Machine
Advantages of CoolSculpting over liposuction would be; no prescription medications are needed, no pre-operative lab tests, no special recovery garments and no time off work. The skin will retract better since the fat doesn’t go away quickly.
CoolSculpting is not for everyone; it is for people with those stubborn areas of fat, but it is not considered a weight loss program. If you should gain weight in the future, the remaining cells will grow and store additional fat. The ideal candidate is no more than 20 to 30 pounds overweight. For the patient that adheres to a normal diet and exercise program maintaining long term results should not pose a problem.
The best way to determine if you are a candidate for CoolSculpting is to schedule a consultation with cosmetic plastic surgeon specialist, Dr. Delgado at either his 450 Sutter Street San Francisco, CA office or his 165 Rowland Way, Novato, CA office. Dr. Delgado will be able to help you determine if your goals can be obtained with CoolSculpting.
Once you are scheduled for treatment, you will be asked to arrive in comfortable loose fitting clothing. You may bring a book to read or IPad or Laptop for the duration of the treatment, some patients choose to take a nap!
September 2nd, 2013 Miguel A. Delgado Jr, MD
San Francisco, CA-Women may lose fullness and shape of their breasts due to pregnancy, breast feeding, aging, and weight fluctuations. In order to regain a youthful looking breast, many women consider a breast lift. There are different types of breast lifts (also known as mastopexy) to address different issues women may have. Breast lift surgery costs can vary as there are different ways of doing the procedure depending on the patients amount of breast droop.
There are generally 3 degrees of breast sagging or ptosis.
• Minor ptosis is where the areola lies even or slightly above at the inframmary fold of the breast.
• Moderate ptosis is where the areola is 1 to 2 centimeters below the inframmary fold.
• Severe ptosis is where the areola is 2 to 3 centimeters below the fold.
This is a 37-year-old, female resident of San Francisco, California who presented for evaluation for a breast lift. She is 5 feet 8 inches tall and weighs 165 pounds. She is the mother of two children. She underwent a peri-areolar augmentation breast lift with 275 cc Mentor normal-saline breast implants inflated up to 300 ccs. The procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. The approach was peri-areolar with the implants being placed sub-muscular. She went from an A+ size to a C+. Note the larger right breast having asymmetry before surgery and, postoperatively, an improved balance.
With minor ptosis, the peri-areolar mastopexy is a great technique as the incision heals to almost invisible. The incision goes around the areola, and a doughnut shaped piece of skin is removed and is closed with a purse string type suture. Since this procedure tends to flatten the breast and not reshape the underlying breast tissue, many women choose to have a breast implant to give fullness to the breast. This is a very desirable procedure, but not all women are candidates for this as the amount of ptosis to be corrected needs to be minor.
For the woman with moderate ptosis, the vertical mastopexy, also known as the short scar or lollipop breast lift is a good choice and widely used. The nipple/areola complex is repositioned, and the incision extends down to the breast crease giving a youthful conical shape. With the vertical mastopexy, an implant is not needed unless there isn’t enough breast tissue.
This is a 29-year-old, female resident of Sonoma, California who presented to the Novato office in Marin County for evaluation for a breast lift. She is 5 feet 3 inches tall and weighs 135 pounds. She underwent a short-scar vertical breast lift at the Marin Cosmetic Surgery Center in Marin County, California. She also underwent a full tummy tuck and liposuction of her flanks.
The patient pictured here that had the vertical breast lift agreed to have her procedure documented. The BBC had contacted Dr. Delgado as a Board Certified breast surgery specialist, to see if he would be interested in collaborating in the production of a video showing the journey of a patient going through a Mommy Makeover procedure, a Mommy Makeover is a combination of procedures including a full tummy tuck, breast surgery and usually some liposuction. Dr. Delgado agreed to the venture and the BBC brought a full production company to film at Dr. Delgado’s private Marin Cosmetic Surgery Center. The video was hosted by Louise Rednapp, a British pop star and the video focused on the stages one goes through for Mommy Makeover surgery; before, during and after the recovery. In addition to her breast lift, she had a full tummy tuck and liposuction of the flanks. Notice the beautiful result of her vertical breast lift that was achieved without the need of an implant. You can see the BBC video here.
The woman that has severe ptosis will most likely need the Inverted T or the Anchor Mastopexy. This procedure has been around the longest and is considered the Gold Standard with a high success rate. The Inverted T allows for the greatest removal of skin and reshaping of the breasts, with maximum lift. The incisions, however, are the most visible, with the addition of an incision that follows the natural curve of the breast crease, thus referred to as an Inverted T or Anchor. The incisions of the Inverted T usually heal well over time.
At the time of a breast surgery consultation at either the San Francisco, California or Marin County, California office, Dr. Delgado will be able to make recommendations as to which procedure will give the best outcome.