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What Are Dermal Fillers?

Dermal fillers can be used to fix a variety of concerns related to facial aging, including:

  • Adding volume and smoothing out the deep creases that run from the nose to the mouth (called nasolabial folds or laugh lines).
  • Plumping thin lips and smoothing out vertical lines around the edges of the lips.
  • Augmenting cheeks to enhance their shape, often restoring youthful fullness.
  • Filling out depressions (hollows) under the eye area.
  • Making indented scars from acne or chicken pox more even with surrounding skin.
  • Increasing volume to fill out gauntness in the lower cheek or temple area, which most often occurs due to fat pads shifting beneath the surface of skin.

How Dermal Fillers Work

  • Dermal fillers are a naturally-derived or synthetic material that is directly injected into skin with the purpose of plumping that area to the point where the wrinkle, depression, or fold is gone. Depending on the type of filler, the effects can last anywhere from six months to two years; for semi-permanent or permanent fillers, the effects can last up to five years, and there are reports of even longer-lasting results.
  • Don’t confuse dermal fillers with Botox. Although both procedures involve injections, Botox is most often injected around the forehead and wrinkles around the eyes (crow’s feet) to stop muscle movement that results in wrinkles. It has nothing to do with the plumping smoothing effect dermal fillers have.
  • Because they work in different manners, many people elect to get both Botox and dermal fillers—the combination can produce a remarkably younger-looking face.

Synthetic and Natural Dermal Fillers

There are two primary groups of dermal fillers: synthetic and natural.

  • Naturally-derived fillers (the most widely known is hyaluronic acid) have a much smaller risk of causing an allergic reaction but reactions can occur. Results are immediate but will only last from just three to 18 months (occasionally up to two years) because the filler eventually breaks down, taking the results, for better or worse, with it. Once the filler starts to dissipate you need to go back in and get more filler injected to maintain results. Most people who get fillers will need at least one follow-up injection within a year.
  • Synthetic fillers last much longer than naturally-derived ones and are considered semi-permanent though there many who would call them permanent because they really don’t dissipate. The wrinkles start to return only because your face continues to age or you continue to get sun damage due to being lax about protecting skin with sunscreen daily.

When to Get Dermal Fillers

  • There’s every reason to consider dermal fillers to correct signs of aging that are beyond what skincare products can do. It’s not that great skincare can’t make a huge difference in the appearance of your skin, but age, muscle movement, fat loss, gravity, and sun damage among other factors will eventually take their toll. Without question, fillers can help improve the appearance of deep lines and give skin a more supple, youthful appearance in ways that skincare simply cannot.

Dr. Diana Breister Ghosh is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. She is a member of the American Society of Plastic Surgeons, and the San Diego Plastic Surgery Society, and is an expert in plastic, aesthetic and reconstructive surgery.

Her specialized services include breast augmentation (including silicone breast implants), breast lift (mastopexy), tummy tuck (abdominoplasty), brow lift, and face/neck lift.
Dr. Breister Ghosh is also recognized as an expert in state-of-the-art surgical body modification, body contouring and soft tissue sculpting following bariatric and major weight loss surgery. Additionally, she excels in performing specialized facial procedures that help restore skin and aid in reducing effects of aging without surgery, including laser facial resurfacing, Botox®, Restylane®, Perlane®, Juvederm™ and Sculptra® and Bellafill®.

Facelifts for Men and Women

The facelift is a procedure used to reduce the appearance of facial wrinkles and other telltale signs of aging, with the goal of improving the overall appearance of the face and jaw. Facelift surgery can help to reverse the harmful effects of time, stress, and exposure to sun and pollution. To perform this procedure, Dr.…
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What is Abdominoplasty?

Are sit-ups just not giving you the taut tummy you desire? If you've got a little too much flab or excess skin in your abdomen that won't diminish with diet or exercise, you may want to consider an abdominoplasty, popularly referred to as a "tummy tuck."

This procedure flattens your abdomen by removing extra fat and skin, and tightening muscles in your abdominal wall.

A tummy tuck can be a great procedure for women with stretch marks, but the procedure should not be used as an alternative to weight loss.

Who Are the Best Candidates For Abdominoplasty?

A tummy tuck is suitable for both men and women who are in good overall general health.

It should not be confused with a liposuction (procedure to remove fat deposits), although Dr. Breister Ghosh may elect to perform liposuction as part of a tummy tuck.

Women who have muscles and skin stretched by multiple pregnancies may find the procedure useful to tighten those muscles and reduce that skin. A tummy tuck is also an alternative for men or women who were severely overweight at one point in their lives, and still have excessive fat or loose skin in the abdominal area.

Who Should Not Consider an Abdominoplasty?

If you're a woman who is still planning to have children, then you may want to postpone a tummy tuck until you're through bearing children. Here's why: During surgery, your vertical muscles are tightened, and future pregnancies can separate these muscles.

Are you still planning to lose a lot of weight? If so, you do not want to consider a tummy tuck until you have come within 5-10 lbs. of your goal weight.

Abdominoplasty Procedure

The procedure generally takes 1.5 to 3 hours.

You will receive general anesthesia, which will put you to sleep during the operation. It's important to have someone with you who can drive you home. If you live alone, you also will need someone to stay with you at least the first night after the surgery.

There are two options for a tummy tuck, complete abdominoplasty and partial or mini abdominoplasty. You and Dr. Breister Ghosh will discuss your desired results, and she will determine the appropriate procedure during your consultation.

Dr. Diana Breister Ghosh is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. She is a member of the American Society of Plastic Surgeons, and the San Diego Plastic Surgery Society, and is an expert in plastic, aesthetic and reconstructive surgery.

Her specialized services include breast augmentation (including silicone breast implants), breast lift (mastopexy), tummy tuck (abdominoplasty), brow lift, and face/neck lift.

Dr. Breister Ghosh is also recognized as an expert in state-of-the-art surgical body modification, body contouring and soft tissue sculpting following bariatric and major weight loss surgery. Additionally, she excels in performing specialized facial procedures that help restore skin and aid in reducing effects of aging without surgery, including laser facial resurfacing, Botox®, Restylane®, Perlane®, Juvederm™ and Artefill®.

Breast Implant Replacement

There are two main reasons a women may require breast implant surgery.  The first could be the body’s reaction to the implant (capsular contracture).  The second could be an issue with the implant itself.

Breast implants are not infallible, and as such, are prone to failure at some point in the future. It’s just a matter of when. Typically, if you are happy with your breasts, then you do not need to change your implants unless you are having a problem. The following are common reasons for undergoing breast implant replacement surgery.

  • Deflation of a saline implant:If you have a saline implant, then any leak, whether in the silicone shell (the bag itself) or in the valve used to fill the implant, will result in a gradual deflation which will probably take about two days to occur. You will then notice a marked difference in the size of your breasts. No further diagnostic testing is required; you simply need to remove the implant. Your options are:
    1. Replace ruptured implant it with a similar implant
    2. Replace both implants with similar implants (especially if it’s been several years since the initial surgery)
    3. Replace the implants with saline implants of a different size
    4. Replace both implants with silicone gel implants for a more natural feel to the breasts.
  • Rupture of a silicone gel implant:Rupture of a silicone gel implant is a bit harder to diagnose. With newer implants, a small hole in the implant will most likely not leak any silicone gel due to the cohesive properties of recent technology. If there is a tear in the implant shell, then the silicone will be contained by the natural scar tissue capsule that forms around all foreign objects introduced into the human body—and silicone won’t react negatively with our bodies. Because the silicone is not absorbed by our bodies (nor does it travel), the breast will most likely look and feel the same, even though the implant is compromised in some fashion. Due to this, the FDA recommends getting breast MRI’s at three years after surgery and every two years thereafter. Although this is the recommendation, most women do not do this due to expense and rely on clinical exam to monitor their implants.
  • Capsule contracture:Once this occurs, the breast feels hard and may even be uncomfortable. The implant itself hasn’t changed, rather, the scar tissue that forms around the implant thickens and contracts, causing the implant to feel firmer. Treatment involves removing the scar tissue causing the problem and replacing with a fresh implant of the same type and size.
  • Asymmetry / breast deformity:If there is a shape issue that’s concerning, and Dr. Breister Ghosh believes that she can correct this surgically, then it may be reasonable to proceed. This can include issues relating to the original implant surgery, such as improper pocket creation, improper implant selection, issues due to weight loss or pregnancy/breastfeeding, improper positioning of the implant, improper placement, rippling/wrinkling or visibility of the implant, ptosis (drooping) of the breast, breast over-stretching or any changes where the breasts now look too large or too small for the patient’s frame.
  • Desire to change implant size:Many women opt to change the size of their breast implants.  Breister Ghosh is best positioned to help patients make that determination, in order to avoid over stretching of the skin, or drooping of the skin if downsizing.

Capsule contracture and implant deflation/rupture are the most common reasons for breast implant revision surgery. Ptosis (drooping) may require a breast lift, and rippling/wrinkling or visibility of the implant is usually best mitigated by replacement of the implants (if they are saline) with silicone implants.

If you are happy with the way your breasts look and feel, and are having no issues with them, then there is generally no reason to replace or re-operate.

Dr. Diana Breister Ghosh is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. She is a member of the American Society of Plastic Surgeons, and the San Diego Plastic Surgery Society, and is an expert in plastic, aesthetic and reconstructive surgery.

Her specialized services include breast augmentation (including silicone breast implants), breast lift (mastopexy), tummy tuck (abdominoplasty), brow lift, and face/neck lift.

Dr. Breister Ghosh is also recognized as an expert in state-of-the-art surgical body modification, body contouring and soft tissue sculpting following bariatric and major weight loss surgery. Additionally, she excels in performing specialized facial procedures that help restore skin and aid in reducing effects of aging without surgery, including laser facial resurfacing, Botox®, Restylane®, Perlane®, Juvederm™ and Sculptra® and Bellafill®.