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And the range is enormous, with some people having twice as many fat cells as others have. Even if you gain or lose weight, your fat cell-count remains the same-holding tight to the fat already inside and forever thirsting to be filled up with more. (To add insult to injury, the fat cells of overweight and obese people hold more fat too). Urgh! Thank God for Liposuction.

My name is Beatrice (everyone calls me “B”)

I am the head Patient Coordinator / Administrator for Dr. G. Married, 2 children (18 & 21)

I was born in Colombia, South America some 41 years ago and have extensive experience working for some of the most talented and well reknown Plastic Surgeons in South Florida and Beverly Hills.     16 years to be exact!!

I have also owned and managed a MedSpa, DaySpa and Consulting business. I absolutely LOVE my profession. It’s awesome to be a part of and witness someone’s physical and mental transformation. Every morning I wonder and look forward to what the day will bring.  Great feeling!

I have known and worked for Dr. G for about 12 years now. I LOVE HIM. Great surgeon.  Takes great care of the patients, gives FABULOUS results.  Really is a pleasure working for him.

We have a great mixture of patients here. Celebrities are particularly exciting, but our regular people (like you and me) are awesome too!!

There is a wealth of information out there.  My goal will be to keep you informed. I will be researching new procedures, techniques and services available to you and add them to the blog.

So log in, KEEP INFORMED. 

p.s. - write me back!

B.

Cosmetic Surgery Times Oct 08

With the U.S. dollar continuing its decline against the Euro and Bristish pound, the United States has become a big bargain for European travelers, particulalry for higher-priced items - and that includes COSMETIC SURGERY.

While hard figures are hard to come by on just how many are coming and how much the cosmetic traffic has risen since the dollar began its descent, U.S. based cosmetic surgeons say they have witnessed a substantial uptick in foreign patient in recent years.

“I dont’ know exactly how many, but there is usually at least one patient per week having surgery from out of the country” - says Dr. Sam Gershenbaum.

We are seeing patients from around the world, particularly from the middle east and the U.K.

Lots of ‘walk-in’ traffic for same day, non-invasive procedures such as Botox, Facial Fillers, Laser Hair Removal.

Greetings friends.Last time, we looked at what happens during the breast augmentation operation. Today, we’ll discuss breast augmentation surgery recovery.

If you have any questions about this or any other cosmetic/plastic surgery procedure, feel free to ask or visit my Web site.
In the coming weeks, we’ll look at many procedures, including rhinoplasty, male pectoral implants and many others.

Best,

Dr. Sam G.

Following breast augmentation surgery, patients report mild to moderate discomfort, which is easily controlled with medication. Varying degrees of swelling, bruising and firmness subside in several weeks to months.

Sutures (stitches) are removed after seven days. Patients can usually return to work after several days to one week. Light exercise may begin after four to six weeks.

A support bra is worn for two to three months following surgery and is encouraged as much as possible thereafter to maintain the contour. Recovery and healing will vary and will depend on the extent of the surgery.

During the weeks and months after surgery, the breasts will soften and relax, looking and feeling more natural as swelling subsides and the effects of gravity and tissue relaxation act on the newly implanted breasts.

Complete healing takes time and patience, taking up to one year before realizing the ultimate result of the surgery.

Next time, we’ll discuss possible breast augmentation surgery complications.
If you have any questions, please feel free to ask. To see before and after photos of my work, please visit my gallery page.

About Dr. Sam Gershenbaum

Based in Aventura, Florida north of Miami, Dr. Sam Gershenbaum is Founder and Director of the Aventura Center for Cosmetic Surgery. Cosmetic and reconstructive plastic surgery blends art and science, combining intuition, creativity and artistic sense with extensive surgical training, discipline, and medical knowledge. Dr. Gershenbaum is Board Certified in Plastic Surgery and Hair Transplant Surgery. A renowned specialist in aesthetic plastic surgery, he also has specialized training in reconstructive surgery for birth defects, traumatic injuries, and deformities from cancer including microsurgery and breast reconstruction.  With this extensive background and experience, Dr. Gershenbaum has become the go-to specialist for corrective and revisional surgery for cosmetic surgery problems.

Greetings all.

Today, we are going to discuss what happens during a breast augmentation operation.

If you have questions about this or any other cosmetic procedure, please feel free to ask anytime or visit my Web site.

Before moving forward, I wanted to say that cosmetic/plastic surgery is not just for women. Many men are also having procedures done, such as calf implants and male pectoral implants. In the not-too-distant future I will be discussing some of those procedures.

For now, we are going to continue discussing breast augmentation, as this is the procedure about which we get the most questions and inquires. If there is a subject related to plastic/cosmetic surgery that you like to see covered, please let me know.

Thanks,

Dr. Sam G

Breast augmentation surgery is performed in our state-of-the-art outpatient facility under general anesthesia and will take approximately one-and-a-half hours to perform. In the holding area prior to surgery, your “before” pictures are taken and then the breasts are marked.

After speaking with the anesthetist/anesthesiologist, you are brought to the operating room. After asleep, local nerve blocks are combined with medication, which is administered to shrink blood vessels and capillaries to reduce bleeding.

Next, the incisions are made and the “pockets” created  generally under the pectoralis muscle  and the implants are placed. Saline implants are inserted into the “pocket” while empty and then filled after they are in position.

An antibiotic solution is added to the saline, which some studies suggest reduces the incidence of capsular contracture (firmness and hardening of the healing tissue around the implant).

Cohesive silicone gel implants are filled prior to surgery and require a slightly larger incision. The operating room table-back is elevated, placing you in a sitting position to check implant position and symmetry.

Minor adjustments are made to the implant “pocket,” as necessary, to obtain the best results and symmetry. After the table back is lowered, a long acting anesthetic is placed into the “pockets,” which greatly reduces postoperative discomfort.

The incisions are closed with sutures predominantly below the surface of the skin, to avoid cross-hatching suture marks and optimize the chances for the finest scars. Steri-strips are applied, as well as being placed in a post surgical bra.

If you have any questions about this or any other procedure, please feel to ask. If you would like to see before and after photos of my work, please visit my gallery page.

About Dr. Sam Gershenbaum

Based in Aventura, Florida north of Miami, Dr. Sam Gershenbaum is Founder and Director of the Aventura Center for Cosmetic Surgery. Cosmetic and reconstructive plastic surgery blends art and science, combining intuition, creativity and artistic sense with extensive surgical training, discipline, and medical knowledge. Dr. Gershenbaum is Board Certified in Plastic Surgery and Hair Transplant Surgery. A renowned specialist in aesthetic plastic surgery, he also has specialized training in reconstructive surgery for birth defects, traumatic injuries, and deformities from cancer including microsurgery and breast reconstruction.  With this extensive background and experience, Dr. Gershenbaum has become the go-to specialist for corrective and revisional surgery for cosmetic surgery problems.

Greetings friends,

Today, as part of our Breast Cancer Awareness Month focus on breast procedures, we will discuss what happens at a breast augmentation consultation.

If you have questions about this or any other procedure, please feel free to ask questions anytime or visit my Web site.

Best,

Dr. Sam G

During the initial consultation, it is important to review your medical history, goals and expectations as well as build mutual trust and rapport. Numerous before and after photos are reviewed; the procedure is explained; and the alternatives discussed.

The breasts are examined to ensure that expectations can be met, as well as to review the surgical plan, implant size and incision/scar placement.

An ideal candidate for routine breast augmentation will have all the breast tissue above the inframammary crease (the crease under the breast) and the nipple in the middle of the breast. If the breast tissue and/or nipple is at the level of the inframammary crease (or lower), additional procedures may be needed.

Appropriate implant size will be determined by your request for cup size and a physical examination, including the width of the breast, distance from the crease under the breast to the areola and the thickness of soft tissue coverage.

I will offer a range of implant sizes appropriate for your cup size in relation to the physical examination. For patients who desire the most natural result, the size of the implant will be determined by a physical examination and their available soft tissue coverage.

When a placed implant is is larger than the breast and surrounding tissues can adequately cover, the more rippling that can be felt and seen.

For example, a woman with a medium frame and a “B” cup breast can accommodate a larger implant than a petite woman with an “A” cup breast. Breast implants are easier to feel (or palpable) if there is inadequate soft tissue coverage (skin, breast tissue, muscle) in relation to the size of the implant.

Other causes for a palpable implant may include subglandular placement (over the muscle) and textured implants.

It is also important to understand that breasts are not symmetrical. Often different size implants are used to improve symmetry. Every effort is made to make the breasts symmetrical and as close as possible to the desired size, however no surgeon can guarantee the exact size, shape or symmetry.

Prospective patients are encouraged to try on various size implants to help determine size, as well as speak with previous patients about their surgery and results. My staff and I are always available for questions.

Following the initial consultation and after appropriate time for reflection, an appointment is scheduled for routine preparation and informed consent. Additional questions and concerns are also addressed. Routine blood analysis and medical clearance is required prior to surgery.

If you have any questions about this or any other procedure, please feel free to ask. To see examples of my work, please visit my gallery page.

About Dr. Sam Gershenbaum

Based in Miami, Dr. Sam Gershenbaum is Founder and Director of the Aventura Center for Cosmetic Surgery. Cosmetic and reconstructive plastic surgery blends “art” and “science,” combining intuition, creativity and artistic sense with extensive surgical training, discipline, and medical knowledge. Dr. Gershenbaum is Board Certified in Plastic Surgery and Hair Transplant Surgery. A renowned specialist in aesthetic plastic surgery, he also has specialized training in reconstructive surgery for birth defects, traumatic injuries, and deformities from cancer including microsurgery and breast reconstruction.  With this extensive background and experience, Dr. Gershenbaum has become the “go-to” specialist for corrective and revisional surgery for cosmetic surgery problems.

Greetings friends,

As part of our ongoing blog series in honor of Breast Cancer Awareness Month, we continue to focus on Breast Augmentation Surgery.

If you have questions about this or any other procedure, please feel free to ask or visit my Web site.

Best,

Dr. Sam G

Breast augmentation is one of the most frequently performed cosmetic surgery procedures in the United States today. Breast implants enhance the size and shape of the breasts adding firmness and fullness, while improving body image and self esteem.

Breast augmentation can be performed to make smaller breasts appear larger, balance breasts that are asymmetrical, or restore fullness that has diminished with age or as a result of pregnancy. Breast implants can also be used for reconstructive purposes.

Types of Breast Implants

I perform breast augmentation using either saline filled breast implants or the new, FDA-approved cohesive gel silicone implants. Saline breast implants contain an outer shell of silicone within which the saline solution is placed.

The new and improved silicone gel implants have the same outer silicone shell within which is a new cohesive silicone gel. Unlike the old silicone implants, which were more like a liquid, the new cohesive gel implants act more like a solid, holding together uniformly while retaining the natural give and feel of natural breast tissue.

This gelatin-like cohesive silicone gel is much less likely to leak, rupture or tear as compared to the older, traditional silicone implants. This type of implant does not leak even when cut in half.

Most surgeons and patients agree that the new cohesive silicone gel implants have a more natural feel and are less likely to ripple than saline implants. The cohesive gel implant, however requires a slightly larger incision to allow placement.

Breast Implants also come in different shapes and profiles. Anatomic or “teardrop” shaped implants were created with a more natural shape in mind and were designed to be fuller at the lower half similar to a natural breast.

However, this distinct vertical orientation can result in distortion or breast asymmetry if the implant should rotate. A textured surface allowing tissue in-growth helps reduce the chance of rotation, but it may result in more visible or palpable rippling. For these reasons, anatomic implants are not commonly used.

I use the most common, round implant. Since the breast implant is round, it is free to rotate without any adverse consequences. With gravity alone the saline or cohesive silicone gel will gravitate or fill the bottom portion of the implant when sitting or standing erect or fill the breast more uniformly when lying down, more closely imitating a natural breast.

Next time, we will cover breast augmentation implant profiles, as well as implant location.

Again, if you have any questions, feel free to ask. If you would like to see before and after photos of my work, please visit my gallery page.

About Dr. Sam Gershenbaum

Dr. Sam Gershenbaum is Founder and Director of the Aventura Center for Cosmetic Surgery. Cosmetic and reconstructive plastic surgery blends art and science, combining intuition, creativity and artistic sense with extensive surgical training, discipline, and medical knowledge. Dr. Gershenbaum is Board Certified in Plastic Surgery and Hair Transplant Surgery. A renowned specialist in aesthetic plastic surgery, he also has specialized training in reconstructive surgery for birth defects, traumatic injuries, and deformities from cancer including microsurgery and breast reconstruction.  With this extensive background and experience, Dr. Gershenbaum has become the go-to specialist for corrective and revisional surgery for cosmetic surgery problems.

Greetings friends,
As this is Breast Cancer Awareness Month, I would like to share an FAQ concerning Breast Augmentation Surgery. If you have questions about this or any other procedure, please feel free to ask anytime via this blog.

For more information, including before and after photos, please visit my gallery page.

Best,

Dr. Sam G.
Are connective tissue diseases caused by silicone gel-filled breast implants?

The Institute of Medicine recently concluded that “evidence suggests diseases or conditions such as connective tissue diseases, cancer, neurological diseases or other systemic complaints or conditions are no more common in women with breast implants than in women without implants.”

Do silicone gel-filled breast implants cause cancer?

Published studies indicate that breast cancer is no more common in women with breast implants than in women without breast implants. In its authoritative 1999 report, the Institute of Medicine (IOM) concluded that, “There is no increase in primary or recurrent breast cancer in implanted women.”

What are the effects of silicone gel-filled breast implants on pregnancy and breastfeeding?

Women with breast implants do not risk exposing their breastfed children to excessive amounts of silicone. The Institute of Medicine concluded that “no evidence of elevated silicone in breast milk or any other substance that would be deleterious to infants was found in women with silicone gel-filled breast implants.”
Although we have had numerous patients able to breast-feed after breast augmentation, breastfeeding difficulties have been reported following breast surgery including breast augmentation.

How will silicone gel-filled breast implants effect having mammograms?

Current recommendations for mammogram screening are no different for women with breast implants than for those without. Radiologists experienced in the evaluation of women with breast implants should interpret mammography exams. It is essential to tell the mammography technologist about the breast implant before the procedure.
Those with implants should request a diagnostic mammogram, rather than a screening mammogram, because more pictures are taken with diagnostic mammography. The technologist can use special techniques to reduce the possibility of rupture, as well as getting the best views of the breast tissue.
Are breast implants permanent?

Breast implants are not considered lifetime devices. Patients will likely undergo implant removal with or without replacement at some point in their lives. Whether undergoing augmentation or reconstruction, be aware that breast implantation is often not a one-time surgery. Often, additional surgery and doctor visits during the course of one’s life are required.

Is it possible to develop a silicone allergy?

It is possible for anyone to develop an allergy to almost any substance on earth. However, silicone allergies are rare. We are all exposed to silicone in our environment every day. It is found in many household items such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings and chewing gum.

If you have any questions, feel free to ask. If you would like to see before-and-after photos, go to my gallery page.

Smaller Breast Implants
Today, breast augmentation is more popular than ever. According to the American Society of Plastic Surgeons  329,000 breast-augmentation surgeries were performed last year in the United States-an almost 30% increase from 2003. But the days of bigger is better may be diminishing.

Some plastic surgeons and their patients are rediscovering the aesthetic ideal for the female breast-one that is soft and supple, fuller in the lower than the upper pole, and in proportion to the rest of the patient’s figure.

Part of the change may be attributed to the changing demographics of breast implant patients. Today, women in their 30s and 40s-particularly moms-are the fastest-growing group of patients seeking breast augmentation. This patient population has lost breast volume following pregnancy and lactation, and simply want to restore a natural, more youthful breast contour to their chests.

Even women who have not had children are opting for smaller, more realistic-appearing breasts. Professional women do not want to look like they’ve had breast implants.

Potential breast augmentation patients should also give serious thought to the following consideration: one great advantage of a conservative breast enhancement is that small implants are much more likely to feel natural.  It is possible to provide an enhancement that is soft, supple, and even undetectable (by touching) with a small implant.

Implants of a moderate (and in my opinion, appropriate) volume, whether they be saline or the new FDA approved cohesive  silicone gel implants, can look and feel natural exceedingly natural.

First, let’s look at the “real costs” of international plastic surgery for Americans.  Let’s say you travel to Rio, Brazil for your surgery.  Here are some additional prices to add to the surgeon’s fee:

-Airfare

-Hotel

-Transportation (taxi’s, etc)

-Meals

-Incidentals

-Insurance in case of emergency

Airfare: I chose 5 starting points from the US to Rio de Janiero: Chicago, Seattle, St Louis, NY and Miami, leaving July 26th and returning two weeks later, August 9th. I booked for 2 people (I assumed most people would take someone along for moral and physical support). The average airfare for two was $2,468, tourist class. NY was lowest at $1885, Seattle highest at $2900. The average flight time was 14 hours each way.

Hotel Costs: I chose a 2.5 star hotel, though you can imagine most plastic surgery patients would want 4-star. Still, to be fair, I priced all flights with the same 2 ½ star hotel. The average was $1800 when booked with the flight through Expedia. Keep in mind that the hotel average for the big cities was lower ($1574) but the Seattle patient would have paid $2613 for the identical hotel, when booked with airfare (how does that work?). This leads me to believe that if you live outside the largest US cities, you might pay more for a hotel if you book through an online service like Expedia.

Taxi and other transportation: Taxi from the Rio airport to either Copacabana or Ipanema averages $25 USD each way based on today’s Real to dollar conversion. Pretty cheap by American standards! Figure a total of $200 while you are there, for preop, day of surgery, postop, and shopping.

A person’s gotta eat, right? Like any big city, there are expensive places to eat and cheap places to eat. Figure $100 a day per person, which is actually pretty basic. That totals $2800 for 2 for 14 days.

And don’t forget the incidentals, like bottled water, a couple sodas per day, some fresh fruit from the street market to have around the hotel room, movie rentals, tips for the bellhops and the guy who gets you a cab, perhaps a laundry bill during that 14- day stay. Let’s add $25 a day for incidentals, which adds $350 to our tally.

Now, let’s consider the issue of health insurance to cover any unforeseen emergency created by plastic surgery outside the US. What if something goes wrong on the table? What if there’s a dehiscence? Or an infection?

Will US-based health insurance cover a complication created as a result of an elective procedure performed outside US borders? According to our sources at a NY agency, maybe they will and maybe they won’t. And even if the insurance company does cover it, coverage is generally limited to “life-threatening” emergencies (ie, they won’t let you die in Rio). The patient would pay out of pocket first, then negotiate with (more likely beg with) their US-based insurance company after returning to the States.

OK, so what about Travel Health Insurance? Travel health insurance, according to my inquiries to InsureMyTrip.com and Eisenberg Associates, does not cover any medical emergency arising as a result of an elective procedure. Both firms offer over a dozen plans, and they told me none of them would cover an illness or trauma caused by an elective procedure. Broken leg? Sure! Food poisoning? Without a doubt. But if it’s created by an elective plastic surgery procedure, fuggeddaboutit. This means that traveling outside the US for elective plastic surgery puts the patient at a definite risk for out-of- pocket costs if a complication occurs.

The grand total for this bargain overseas procedure?
Using my estimates, it would run around $9,643 for a breast aug with lift or a facelift in Rio. Cheaper than the US? Certainly not for a breast aug with a lift. Probably yes, for a facelift. And of course, assuming you feel up to it, you get a vacation thrown in. However, doing the tourist thing is a big assumption for a postop plastic surgery patient. I had a great face lift surgeon but I sure didn’t feel like running around the first 10 days afterwards. And I’m quite certain that a 14+ hour airplane trip wouldn’t have felt like a great plan either.

And remember, these are just Rio estimates. If you want a breast aug in Phuket it’s $3000 US. And the airfare will run around $3000 for two, plus hotel and all the above items.

Most importantly, of course, none of the above addresses the quality issue. The surgeons might be fabulous, but how can the prospective US patient judge this? How can one assess the surgical facility or the anesthesiologist from 5,000 miles away? How does one obtain stats on deaths or infections for foreign plastic surgery procedures? Jeepers, how does one go back for a 6-month postop check up? I’ve read nasty reports on some of the international plastic surgery forums written by patients who got themselves involved with a plastic surgery “mill” and had horrible experiences. Conversely, some people had great experiences.