December 30th, 2013 Miguel A. Delgado Jr, MD
Reception at Marin County
San Francisco, California-With the same quality of concierge care offered to Dr. Delgado’s cosmetic plastic surgery patients, is the “Non-Surgical Center of Excellence” for those patients that are having one of the many non-invasive procedures that are now available.
These days it is possible to improve your appearance and reduce signs of aging without undergoing surgery. Subtle changes can make a big difference in how you feel about yourself. There are many patients who are not ready for surgery for reasons such as:
1. Busy schedules which do not allow downtime for recovery
2. Minimal signs of aging, not requiring surgery yet
3. Budget restrictions
4. Fear of surgery or anesthesia
Many non-surgical options that are available today have become extremely popular because of great results with little risk, downtime, side effects, and relatively affordable.
The exciting procedures available to patients are:
1. CoolSculpting is a non-surgical treatment that reduces pockets of fat mainly in the abdomen and love handles. An area of fat is placed between two cooling plates bringing intense coldness that kills the fat cells and is naturally eliminated by the body. The treatment takes about an hour per area, and the results will be evident within 2 to 3 months with clothes starting to feel loose within 2 to 3 weeks! There is minimal pain and bruising with CoolSculpting and patients are able to return to normal activities in the same day.
2. Ultherapy is the only FDA approved non-surgical treatment for lifting the skin of the face and neck. Ultherapy stimulates growth of new collagen by ultrasound waves, going 3 times deeper than any other non-surgical procedure. New collagen can continue to develop for up to 6 months. Patients have no downtime and are able return to regular activities. This is an excellent treatment for those not quite ready for a facelift or for those who have a want a refresher.
3. Fat injections or grafting is growing in popularity. A persons own fat is one of best fillers available, producing safe, long lasting, natural appearing results. It is used for rejuvenation the hands and face, filling in scars and depressions caused by liposuction, for example, gynecomastia patients that may have had too much fat removed from their chests leaving what is referred to as a “crater deformity”. Dr. Delgado now has fat banking available to his patients through AdiCyte which makes collection and banking at the time of a surgical procedure easy and convenient.
4. Botox injections improves moderate to severe frown lines between the eyebrows, forehead and crow’s feet. Botox is the single most popular non-surgical treatment in the United States with over six million patients treated in 2012, which is up 8% from 2011.
5. Multiple Facial Injectables come in a wide variety, each with its own advantages for a safe non-invasive way to smooth and beautify your skin. The best way to determine the best injectable for you is to have a consultation with Dr. Delgado to discuss the benefits of; Restylane, Juvederm, Radiesse, Sculptra and Artefill.
6. Diolite is a laser used for the treatment of red facial vessels, age spots, skin tags and cherry angiomas. The Diolite laser can make an immediate and dramatic improvement by closing the vessels which may them vanish.
7. Photo-Facial can even out skin tone, shrink pores, treat rosacea, brown spots, broken capillaries, and spider veins with an intense pulsed light (IPL), restoring the skin’s youthful appearance.
8. Laser Hair Removal is one of the most popular cosmetic procedures performed in the United States. Hair is removed by beams of highly concentrated light designed to penetrate the hair follicles. The amount of treatments that will be needed depends on the area for removal. Popular areas of removal are; the face, underarms, legs and bikini line.
The treatments available for the “Non-Surgical Center of Excellence” continue to grow as Dr. Delgado keeps all safe, innovative procedures available to his patients. Call today for a free consultation at (415) 898-4161 or email.
October 21st, 2013 Miguel A. Delgado Jr, MD
This is a 45-year-old resident of Napa County, California who presented to the Novato office in Marin County for evaluation for a tummy tuck. She is 5 feet 5 inches tall and weighs 135 pounds. She is a mother of two children. She underwent a full tummy tuck and tumescent liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the nice, thin, natural appearance of her midsection and the nicely proportioned belly button
San Francisco, CA-Abdominoplasty, also known as a tummy tuck, is one of the most patient pleasing surgeries performed. The long hip to hip resulting scar, for most women, is a small tradeoff for their new flat stomach. The only other downside to the procedure is the discomfort for the first few days. The tummy tuck procedure is not just for women, it is a very popular procedure for men as well, usually after substantial weight loss and many will have the procedure done in conjunction with gynecomastia surgery.
In the past, to ease the pain after surgery, a pain pump was used. At the end of surgery, the surgeon would place; two small catheters through the skin of the upper abdomen. The pump disperses local anesthetic directly into the surgical site and lasts for about three days. The pumps are fed by a supply of local anesthetic that is in a bulb about the size of a tennis ball. The device is kept in bag with a strap that goes around the neck. The pain pump provides relief, but the device is somewhat bulky and freedom of movement is somewhat restricted as the patient is tethered to a machine.
Plastic Cosmetic Surgery Specialist,
Dr. Miguel Delgado
Always looking for the best treatment for his patients, Dr. Delgado is now using Exparel for tummy tucks instead of the pain pump. Exparel is not a narcotic but an injectable slow release numbing agent injected at the close of surgery. It is a onetime injection lasting up to 72 hours, which is usually as long as the most intense post-surgical pain.
Exparel is an anesthetic that blocks the nerve impulses that send signals of pain to the brain. Exparel contains bupivacaine which is commonly known as Marcaine, and it is suspended in liposomes, which are a delivery vehicle for pharmaceutical drugs over a period of time.
Most patients tolerate the anesthetic well, but your surgeon will need to know if you have; liver, kidney, or heart disease, heart rhythm disorder or history of seizures, also if you have had a reaction to any type of anesthetic.
Patients who have had surgery using Exparel may still need some narcotic pain relief following surgery, but in clinical trials patients took about a third less narcotic pain relievers than non-Exparel patients and they seem to recuperate faster with a lot less discomfort.
The cost for Exparel is about the same as the cost for a pain pump so it is not deemed worthwhile for less extensive surgeries such as breast augmentation or breast reduction. However, for the patient who has a low pain threshold or is overly anxious about upcoming surgery, a discussion with Dr. Delgado about pain control is recommended.
In keeping abreast of the latest innovations for his patients, in addition to Exparel, Dr. Delgado now has the exciting non-surgical fat reducing “CoolSculpting” available. See September’s blog for more information and schedule a consultation with Dr. Delgado to see if you may be a candidate.
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!
November 17th, 2012 Miguel A. Delgado Jr, MD
62 year old Before and After Mommy Makeover
The popular term Mommy Makeover is a combination of an abdominoplasty (tummy tuck) with breast surgery, usually a breast reduction or a breast lift with or without breast implants. Both procedures are complex and extensive.
The patient’s chronological age is not as important as the physiologic age. If the patient receives medical clearance from their doctor, making sure that heart and lung functions are good, and there are no other medical issues, the patient should be able to proceed with surgery. If there is any concern, it is possible to stage the procedures, doing them one at a time. Safety for the patient is of utmost concern, and all aspects need to be evaluated by a Board Certified Plastic Surgeon.
Pictured above is a 62 year old San Francisco Bay Area patient that had her Mommy Makeover staged. She had a tummy tuck first, then a year later had her breast reduction surgery.
October 23rd, 2012 Miguel A. Delgado Jr, MD
Have you ever put on a tight pair of jeans or pants only to have some flab hang over the waistband? Sort of like a muffin top? It is easy to see how the term became popular. For many Marin County patients it seems no matter how many different diets or extreme exercises one does, that stubborn roll just won’t disappear.
Liposuction remains one of the most popular cosmetic plastic surgery procedures done, it is excellent for getting rid of trouble spots such as the love handles or muffin top. The younger patient with good elasticity will get the best result. However, the older patient will benefit, as well. If there is a lot of excess loose skin, it can be excised. This is a great procedure to include with a tummy tuck.
It is important to remember that if you don’t maintain a healthy diet and exercise, fat can come back to a different area.
May 31st, 2012 Miguel A. Delgado Jr, MD
The Journal of the American Society of Plastic surgeons, “Plastic and Reconstructive Surgery”, recently announced the results of a study of 360 patients treated with liposuction, lipoabdominoplasty, and abdominoplasty. Lipoabdominoplasty is a term to describe liposuction of the abdomen and flanks combined with a tummy tuck.
This study was done to compare results of liposuction alone for reduction of the tummy compared to the cosmetic plastic surgery patient that had lipoabdominoplasty and just abdominoplasty from the patient’s point of view.
Before liposuction of the tummy
After liposuction of the tummy
The results showed that liposuction patients recovered more quickly and had less pain that the lipoabdominoplasty and abdominoplasty patients. However, the levels of satisfaction with the results of surgery were much higher than for liposuction alone. Patients stated they had improved self esteem and improved quality of life, with 97.6% saying they would do it again and 99.2% would recommend the procedures to others.
Patient satisfaction is the most important factor of surgical success.
June 26th, 2011 Miguel A. Delgado Jr, MD
Liposuction of the arm can help trim arms and create a more youthful appearance, which can provide motivation for regular exercise to maintain fitness. As with other areas of liposuction and body contouring, the skin needs to be in good condition with good elasticity for smooth and even contraction over the area after removal of fat.
Wearing a compression garment for 4 to 6 weeks will reduce swelling and will hold arms in the new shape until the tissues have adjusted. Most patients that have been self conscious about their heavy arms find they enjoy wearing sleeveless clothing and other styles after liposuction. For the cannula to remove unwanted fat, tiny incisions are made in the crease of the armpit and/or near the elbow. The incision sites will fade with time and be almost undetectable.�
For the patient that has a large amount of hanging skin and fat, liposuction alone will not correct this problem but will cause even more redundant skin. This patient could benefit from an arm lift also known as a brachioplasty. As aging takes place, the skin and tissue go through changes and lose elasticity, thickness and adherence to underlying tissue. It is also affected by gravity and at the same time, the deep layers of fat, muscle and bone thin. The amount of elastic tissue and collagen present in the deep layer of the skin decreases. The upper arm is an area of the body where this can be very apparent. The upper arm lift surgery entails an incision usually from the armpit to the elbow; the resulting scar is unavoidable but usually fades over time. San Francisco Bay Area patients are thrilled with their results allowing them to wear clothing that previously they were unable to.
Dr. Delgado performs the arm liposuction or arm lifts procedures under general anesthesia at his Marin Cosmetic Surgery Center in Northern California, an accredited outpatient surgery center.
December 20th, 2010 Miguel A. Delgado Jr, MD
With so many new terms for liposuction, how does one determine what type is the best? Tumescent, Ultrasonic, Smart lipo, Vaser….and more. What do they all mean? There are many new liposuction machines made by companies that spend a lot on advertising for the “latest and greatest”. They place these machines in offices of non-plastic surgeons with the promise that they will build a successful aesthetic practice. The training they offer with these machines is many times only one or two weekends. It is important to remember that your results are dependent on your surgeon, not the particular machine. So be sure that you find an experienced Board Certified Plastic Surgeon, who can show you many before and after photos of actual patients.
Tumescent is the mode of anesthesia, not the liposuction. Most surgeons use tumescent fluid to numb the area.
UltrasonicLiposuction (UAL) is ultrasound waves that are internally applied to the fatty tissue in order to liquefy the fat to make it easier to remove. Some possible complications from ultrasound are burns and seromas that you don’t get as often with the more traditional technique. Ultrasonic liposuction is thought to work better in some areas that have more fibrous type of fat, like the back, flanks and the chest for men being treated for gynecomastia. Many surgeons will use a combination of liposuction types depending on the areas to be treated.
Smart Liposuction is just a marketing term for laser assisted liposuction. It uses a laser light to emulsify the fat. Vaser Liposuction (Vibration Amplification of Sound Energy at Resonance) uses ultrasonic technology (sound waves) to emulsify the fat because it generates heat during the procedure. Each has its advantages and disadvantages. There has not been a scientific study to prove that “smart” liposuction or “laser” liposuction is better than conventional liposuction. Again it is more important to find a well qualified Board Certified Plastic Surgeon and know that your surgeon is using the method that works best for him or her to get the best results for you.
October 11th, 2010 Miguel A. Delgado Jr, MD
The Mommy Makeover is a procedure made popular by many California celebrities, that entails breast surgery, tummy tuck and some degree of liposuction. It has been popularized over the past year-and-a-half to two years due to the increasing demand for women wanting to regain their shape, body image and self-esteem. The technique involves either a breast lift or a breast lift with a breast augmentation. On some occasions, the patient may require a breast reduction. However, in most cases women lose a fair amount of volume in their breasts and require either a lift or a lift with breast enhancement using an implant. At your consultation in San Francisco or Marin, Dr. Delgado will help you decide the best procedure for you.
The tummy tuck is a key note of this procedure in which the pregnancy has changed the abdomen, both in the abdominal wall as well as the skin. For a pre-pregnancy look, the procedure entails tightening the abdominal wall and stretching the skin down to a nice, taut, contoured figure. Liposuction of the flanks is an added bonus which gives a nice waistline. The Mommy Makeover is a significant procedure which takes approximately two weeks to recover, but the results are amazing. Dr. Delgado performs numerous Mommy Makeover procedures at his Marin Cosmetic Surgery Center,with beautiful results and very happy patients. Please click here to view a Mommy Makeover video of Dr. Delgado’s patients.