Picking a Size for your Breast Implants

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As a Board Certified Plastic Surgeon in NYC, I do a tremendous number of breast implant surgeries.  I order 50 implants at a time, and put in hundreds every year.  I take pride in trying to select the perfect size and shape to produce a natural and balanced result.  There is an art to it, and I want to give my future patients a few types on how to decide.

Do not pick an implant size and style because you like the way a picture on a doctor’s website looks and that is the implant he/she used. Every woman’s body is a little different in width, height and bone structure.  The same size implant will look very different in a taller or narrower frame.  Also, the amount of breast tissue and the shape and symmetry of your breasts before surgery play an important role in the final result.

Do not say that you want a B or a C, as this is very inaccurate.  If you tried 10 different c cup bras from different manufacturers, each would fit differently.  Cup size is not an exact measure, it is a difference in circumference from your chest wall to the measure around the center of the breast.

Do not tell me your sister had the surgery, and she had 375cc and you want the same.  Your sister may have a very different body shape or breast shape, unless she is your identical TWIN.

So, what should you do?  Seek out a Board Certified Plastic Surgeon, make sure he/she does at least 100 augmentations each year, and that you feel comfortable with him/her.  Have them show you women with similar heights and breast tissue amounts to you, and tell them which after picture looks good to you.  Say to them if you want a little more or less, if you like fullness at the top or a more natural slope, and be specific.  You can also bring photos of what you like and don’t like as a guide.  An experienced surgeon can then look at you and select the perfect size and shape.

To me, bra size doesn’t matter, it is the way your breasts look to you when you look in the mirror. If you are pleased, forget about what the tag in your bra says and enjoy.

Judging Miss RD US

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As the latin beauty expert in NYC, it was an honor to be selected to judge the Miss Republica Dominicana US pageant this past Saturday at the Symphony Space in Manhattan.  Hosted by Odalys Molina from Telemundo, it was a wonderful evening.

I was surprised by the way in which contestants needed to be judged.  It is not simply on who is the most beautiful, but depends on body proportion, poise, overall personality and how they connect with other people.

Obviously, all of the contestants were beautiful and proud of their Dominican heritage.  I was impressed with the difficulty of the questions posed, and the poise of the finalists in answering on some controversial topics.

Although there could only be one winner, I think all of the young women did an outstanding job of representing the US born Dominican women of the future.  The community wins as well, as it raises awareness and shines a spotlight on my community in Washington Heights.

So, congratulations to all.  It was a special night that I will never forget.  I look forward to being asked in the future, and to help the pageant grow.

Silicone Injections to the Buttocks are Always a Mistake

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Let me first start by saying that this is my personal and professional opinion as a Board Certified Plastic Surgeon, and it comes from both my training at Columbia Presbyterian and from my private practice in NYC, Yager Esthetics.  Although I do not know any Board Certified Plastic Surgeons who do the procedure in the US, and to my interpretation of the legal guidelines it is not FDA approved even as an off label use as this type of silicone has no approvals, I am sure it happens.

Despite the increasing number of horror stories reported in the news in both Spanish and English, I was still asked this week by a friend what I thought about her undergoing the silicone injection in a woman’s apartment for $1500 a session.  She had no idea it was illegal or unsafe.

Virtually every week, I get calls from women and men who have had silicone placed in their bodies who are having problems.  Some have open wounds and nasty infections, others have lumps, darkening of the skin, migration of the product to other body areas, redness, heat and pain.  This can happen immediately, or many years later.  In large quantities, I feel that liquid silicone is a ticking time bomb.

I have patients flying in from other countries, Florida, and states up and down the Eastern Seaboard for me to try and remove the silicone, and help them with these often life altering complications.  While I do not enjoy these procedures, I do them because they are necessary and patients do not have many places to turn as most doctors will not even try to help.

I plead with you to not inject silicone in your body.  Let us work to educate our friends and families so that no more deaths and disfigurements come from a lack of awareness.

Don’t get Sliced by the Cutting Edge

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I love technology.  The advancements in Plastic Surgery and nonsurgical treatments have been tremendous over the last 20 years that I have been following it.  I love to learn about it and study it, but have a problem with using it as a marketing tool before safety and the realistic results can be determined.

We all think about the magic of microdermabrasion, the many uses of laser treatments, and the injectable products we think of as routine now. What a step forward in the ability to achieve better cosmetic results.  What the public, and some of my colleagues, forget is the hyped treatments that did not pan out.

Just because something is new and exciting and promises great things does not make it true.  Experience using new devices takes time, and if someone wants to be the first one on the block to advertise it, it does not mean that they are well trained or capable of giving you what they promise.  With the competitive marketplace for your esthetic dollars, many of the early advertisers are not Board Certified Plastic Surgeons at all.

If you hear about a new device or procedure, do your homework.  Find out what the ABMS specialty of the doctor is, how long he/she has been in training and their Board Certification, and how many of these treatments they have done. Make sure you see pictures of their own work, not photos supplied by the device company (just ask if the photos are patients that they themselves treated personally).  You can also go on the internet and see what the public experience with the treatments is.

Do not take this to mean I am antitechnology.  I love anything that safely improves my patients’ appearance.  What I won’t do is experiment on the people who trust me to be their Plastic Surgeon.