Torn or streched ear lobes can sometimes be a frustrating problem as the patient cannot wear any earrings.  With ear lobe stretching practices increasing, many patients eventually become embarrassed by the shape of their ear lobes and want them repaired.

Unfortunately, I have seen many ear lobe repairs by non plastic surgeons fail.  Although technically not a very difficult procedure, the success of the repair requires certain steps to be taken in order to ensure proper healing.

Actual Patient Before and After Pictures

If the ear lobe has been stretched, excess ear lobe must be excised and the new ear lobe “fashioned” by approximating the remaining parts.

This procedure can be performed under local anesthesia in the office and requires minimal recovery time.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Recently, I took care of a 20 something male that, in a moment of anger (what other reason than to show his love for his girlfriend!) punched a glass and sustained injuries to extensor tendons of his hand.

As I walked into the room to see him for the first time, he was fixated on his mobile phone, frantically texting.  I stood there for 30 seconds to see what his response will be…none.  After 30 seconds, I politely interrupted his texting and started to proceed with the consultation.

I see this alarming trend with young people all around me; are we going to have a generation of adults with no social or communication skills?

Do we really think we can get by in life by trying to respond to life’s situations by texting all the time?

Some of my younger blog readers may be single and not involved in a relationship, but eventually you will.  Having been married for over 8 years, I promise you your relationship will be in jeopardy if you cannot communicate with your partner.

I was delighted to see someone else is concerned about this trend as well.  Here is the link.

Please, and I mean PLEASE, try to develop one on one communication skills.  You will be glad you did.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

The patient has been a paraplegic for the past twenty years and has had multiple closures of ulcers around the back/buttock area with local skin and muscle flaps.  Recently, I was contacted as the on-call plastic surgeon to address a recurrent open area of the left buttock/hip area.  Due to patient’s clinical condition and elevated white blood cell count, a CT scan was obtained which showed multiple abscesses around the femur head.  The femur and the hip joint form a ball and socket where the head of the femur fits in the hip joint groove, thus allowing movement of the thigh.

During surgical exploration, aggressive debridement of non-viable tissue and drainage of multiple abscesses was required.  Most importantly, however, the femur head had been displaced from the hip joint, losing its blood supply.  As a result, the entire femoral head was necrotic.  Orthopedic surgery consultation was requested intra-operatively, and the patient was brought back for surgery several days later for a Girdlestone procedure.

After several weeks of dressing changes to make sure the area is clean and the patient is nutritionally optimized, closure of the open area was performed.  This was a very difficult procedure, requiring two large muscle/skin flap and an third muscle flap to cover the femoral head defect.  This procedure took approximately eight hours!  I was unable to close the defect completely.  However, the open area is significantly smaller than the original wound, and will close with closed vacuum dressing changes (VAC dressing).

The patient is several weeks out and the wound is stable and healing.

Being both a reconstructive and cosmetic surgeon assures I will never be bored!  The next day, for example, I performed a breast augmentation which took about an hour to complete.  Quite a change and what a variety!

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

I am always a bit skeptical when it comes to lasers with less down time than the traditional C02 laser.  The traditional C02 laser essentially causes a controlled superficial degree burn which requires 7-10 days for healing.  As the new skin regenerates, new collagen is deposited, resulting in a better quality skin.  This type of laser resurfacing, however, requires general anesthesia or intravenous sedation with local anesthesia.

The Mixto laser is a fractional C02 laser.  This means each time the laser activates, it skips areas of skin compared to full laser activation with the traditional type.  This allows a less aggressive resurfacing with less down time, and no need for general anesthesia or intravenous sedation.

The traditional laser is indicated in patients with very deep, static lines on the face and severe sun damage.  Fortunately, especially with the new interest in sun protection, most patients do not fall into this category and are good candidates for the Mixto laser.  The key is to choose the right patient for this procedure.

I have performed Mixto laser resurfacing on the face, chest and hands.  Myself, as well as the patients, have been very pleased with the result.  The patients, especially, are pleased with less down time and having the procedure performed with oral sedation and topical anesthesia.

It is important to continue with a maintenance program after any laser resurfacing.  This includes sun block, a skin care regimen, avoiding excessive alcohol and cessation of smoking.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

A healthy woman in her late twenties was referred to me for a soft “lump” in her arm pit (axilla).  She had noticed the mass for several years, but had decided to have it checked since it had gotten larger and was “getting in the way”.

Her medical and surgical history was unremarkable, with no history of breast cancer or other cancer in her family.

A photo of the armpit lump/mass is shown here.  This was a mobile, soft tissue mass and clinically did not present much concern (cancer under the skin is usually hard and immobile).

During excision of the mass, I noticed small amount of milk in the substance of the mass, confirming a diagnosis of accessory breast tissue.

Accessory breast tissue is presence of breast tissue in areas other than the breast itself.  In some cases, accessory nipple can be present and can be found on the breast as well.  The most common location for accessory breast tissue is the axilla.

The procedure was performed under local anesthesia and the entire accessory breast tissue was removed without difficulty.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

A common misconception about breast implants is that a larger implant will give a fuller, more projected breast after a breast augmentation.  Unfortunately, in order to keep the shape of the implant natural, this is physically impossible.

As the implant increases in size, the diameter of the implant increases more than the projection.  To keep the projection/width ratio the same as a smaller breast implant, the implant has to obtain a cone shape, which is very unnatural (any one remember Madonna and her fake cone breasts-you tube it!)  An implant with such a projection cannot be placed inside a body without potentially causing excess pressure on the skin and muscle.

Therefore, if your goal is to obtain a more projected breast shape, it is better to choose a high profile breast implant with a smaller volume than a larger implant with a less projected shape.  Of course, the ultimate style and size will depend on the patient’s anatomy and skin thickness, etc.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

In my opinion, this is one of the best (love) songs ever written.  Why it has remained below the radar is a mystery to me.

I wanted to share this song with you on Valentine’s Day. Hopefully it will bring more love into your life.  If this song inspires and moves you, please share it!  I hope it will receive the attention it truly deserves.

I made a little video for this song.  I hope you enjoy it.

http://www.youtube.com/watch?v=9UaaurZctIM

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  If you like to schedule a complimentary consultation, please call 714-834-0101.

Rhinoplasty (nose surgery) is one of the most common cosmetic procedures performed.  In most cases, rhinoplasty is about balanced removal of anatomy with small additions to the nasal tip, and narrowing the nasal bones.

In some patients, however, only addition or augmenting the anatomy is the key to a better defined nose.  These subset of patients are typically African American, or of Asian-Pacific origin (Vietnamese, Chinese, Japanese, Filipino, etc.).  The patient typically has a flat nose with lack of projection of the dorsum or the tip.  Therefore, augmenting both areas in a balanced fashion is the goal.

In the patient presented below, she also had a small, flat chin and a chin augmentation was also performed.

As one can see, the result is subtle yet dramatic at the same time.  The key is to obtain a natural result without an “over-operated” look.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

Breast Augmentation Before and After Pictures

Breast augmentation is the most popular cosmetic surgery procedure in the United States, with over 300,000 surgeries performed.

Breast augmentation surgery has a very high satisfaction rate, if the patient has realistic expectations and understands the limitations of the surgery within her anatomy.  For example, see the breast augmentation before and after pictures I have displayed for illustration.

Either saline or silicone implant can be used.  Both implants have the same shell covering.  For saline implants, the shell is empty and is filled with saline (salt water) through a valve on top of the implant.  Silicone implants are already filled with silicone cohesive gel and the volume is not adjustable.  The choice of implant depends on the patients desire, amount of breast tissue, degree of breast asymmetry and cost (silicone implants are significantly more expensive).  One cannot determine what type of implant is used by looking at a patient (see adjacent images).

With the news about PIP implants and their high leakage rate, it is important only FDA approved breast implants be used.  Currently, only two companies in the United States qualify: Mentor and Allergan (Natrelle implants).  Both companies offer a life time warranty in case of implant leakage (ALL  breast implants eventually deflate) and provide partial compensation for surgery costs up to ten years from date of original surgery.

Please see below for additional breast augmentation before and after pictures:

Breast Augmentation Before and After Pictures

Breast Augmentation Before and After Pictures

Breast Augmentation Before and After Pictures

Breast Augmentation Before and After Pictures

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.

A previous patient of mine came to my office recently for a left breast  implant deflation.  She had saline breast implants placed in 2006, and now had an obvious asymmetry on the left side.  On examination, the left and right breasts were soft to touch, with no masses or tenderness.  The right breast was significantly larger than the left, consistent with a left breast implant deflation.

As a background, ALL breast implants will eventually leak and ALL breast implants will form a capsule around them.  The capsule is basically our body’s way of “ignoring” the implant, which is a foreign body.  Typically, the capsule is very thin (sometimes almost transparent) and very pliable.  If the capsule becomes thick, it can become tight and squeeze the implant into a tight ball.  This is called capsular contracture and depending on the severity, may require surgery to remove the tight capsule.  In cases of implant deflation, the capsule always closes a bit, and is easily opened up during surgery.  This is not capsular contracture, is as much as the capsule closes a bit due to the deflated implant.

Given the softness of the left breast, I anticipated a relatively easy implant exchange.  Was I in for a surprise!  I found the capsule to be very thick (up to 3mm in some areas) and very tight.  When I placed the new implant in, it became obvious early on that the patient had developed a significant capsular contracture.  Could the contracture have caused the implant to leak?  If the capsule was so tight, why did the patient have no complaints prior to the deflation?

I performed a near complete capsulectomy (removal of capsule) which was very difficult, as the capsule was adherent to the breast tissue, followed by placement of a new implant.  I did recommend bilateral breast lift to position the nipple over the center of the implant.  However, the patient did not wish to have the procedure done at this time.

The patient is one week after her surgery, and the implants and the breasts are soft.  As expected, the left breast is more swollen due to the surgery, and will take several months to “settle in”.

This is an unusual case and shows even an experienced surgeon can sometimes be fooled by clinical findings.

Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 12 years of experience.  His office is located in Orange County, California.  To schedule a complimentary consultation, please call 714-834-0101.