This lady initially came in for breast augmentation. She wanted to look a little fuller but was a worried about the impact of larger breasts on her competitive tennis game. After chatting with her and examining her, I came up with the plan of a lift and a nipple reduction. These procedures would give the illusion of fuller breasts without actually increasing the volume.
A small and saggy breast with a long stretched-out nipple looks – I’m gonna say it – a little pathetic. Once the breast skin is tightened up and the nipple shortened, the breast looks almost the way it did before babies, breast feeding, gravity, general aging, etc. And a procedure like this is maintenance free. It should last a lifetime. But remember to wear a bra most of the time when upright. Gravity never sleeps.
Thanks for reading! Dr. Lisa Lynn Sowder
Follow me on Instagram @sowdermd and @breastimplantsanity.
Seattle Plastic Surgeon Discusses Mommy Makeover on Mother’s Day
Ah, the joys of motherhood! I can wax eloquently about fat little feet, apple cheeks, wet baby kisses and so on but one of the joys I did not expect was a boost in my Plastic Surgery practice, especially my “mommy makeover” patients. Since becoming a mother myself, I speak “mommy” really well. I know first hand the glorious details of feeding, bathing, changing, and schlepping the baby. I can recite the stages of the toddler, the preschooler, the gradeschooler, the tween, the teenager and currently I am becoming an expert on the joys of being the mother of young adults.
Being familiar with all that being a mother requires makes me much better at counseling patients about the process and timing of a “mommy makeover”.
“Mommy makeovers” usually combine breast surgery (augmentation and/or lift or reduction) with body surgery (usually abdominoplasty and/or liposuction). Most women are healthy enough to have a combination of procedures during one operative session. It is, however, the first couple of post operative weeks that are the most challenging for the patient.
Mommy is used to taking care of everyone but herself. After surgery the Mommy needs to take of only herself. She needs to be “Queen for a Week or Two” and resist the urge to cook, clean, change, wipe, mop, vacuum, load, unload, fold, etc. And if her youngest weighs over 20 pounds, she may not pick him/her up for at least two weeks if breast surgery was done and for at least six weeks if an abdominoplasty was done. The little one can crawl into Mommy’s lap for a cuddle but NO HEAVY LIFTING for Mommy. This also applies to the dog.
It’s very important to for patients to discuss these issues with their families. I’ve had a few ladies who have underestimated their recovery time, have done too much too soon and have turned what should be a relatively comfortable and relaxing recovery into a very sore and frustrating one.
So, calling all mothers interested in a “mommy makeover”: Plan ahead and get your husband and your children and your friends on board. Make a sign for your bedroom door. “DO NOT DISTURB – MOMMY RECOVERING”.
Seattle Plastic Surgeon knows how to make the Grinch look a little less grinchy.
It’s those glabellar frown lines and nasolabial folds that make this Grinch look soooo grinchy.
Take a look at the Grinch. What is it that makes him look so old and cranky? It’s his glabellar from lines between his eyes that make him look like he’s having a pretty bad day and it’s his nasolabial folds (those creases that go from the sides of the nose to the corners of the mouth) that make him look a billion years old. All he needs to do to work himself up into a really bad mood is to look in the mirror every morning. No wonder he has such a bad attitude.
If the Grinch were to come into my office, here is what I would recommend:
His forehead creases would be softened and smoothed out with Botox. He looks like he needs a pretty large dose, maybe 60 units. The injection would sting but would be quick and he would see a remarkable improvement within 3 days or so. Also, he would feel so much more relaxed. If he wanted to scowl at his poor little dog, he would be unable to! Smile, yes but scowl, no. This amount of Botox would set him back $900 and would last at least 3 months. If he kept coming back for treatment, his dose would likely drop considerably.
His nasolabial folds could be filled in with one of the hyaluronic facial fillers that I inject almost every day of the week. They are terrific for treating the area around the mouth that is such a problem in some people and is hard to treat with other methods. Even a full face lift doesn’t help this area very much. I would use 2 or 3 syringes to get as full of correction as possible. It’s been my experience that patients who opt for just partial correction (to keep the cost down) are not nearly as satisfied as those who just go for it. Three syringes of a filler such as Juvederm would set him back about $1600. Juvederm lasts at least six months and I have many patients who have had nice lasting improvement for up to two years.
Do what about the redemption of his rotten soul? I’ll leave that up to the transcendent love and forgiveness of Whoville. But he’s got to save his face for me.
Every week I get some questions sent to me by the website RealSelf. I am always amazed by the many questions submitted by patients sometimes within a day or two of surgery. I cannot fathom why a patient would turn to an online community of doctors rather than their own surgeon to answer their questions and address their concerns.
OMG. Is that going to happen to me?
And then there are patients who scrub the web for scenarios that are either much better or much worse than their own. I just don’t get it.
I advise my patients to concentrate on their situation, their surgery, their recovery. Going online and finding someone who is healing quicker than you or slower than you or just differently that you is not helpful and let me tell you, it makes your surgeon a little cranky.
So……………..take your meds as prescribed. Get some rest. Drink lots of water. Go out for a little walk. Make yourself a sandwich. Make your caregiver a sandwich. Clean our your junk drawer. Questions? Concerns? Run them by your surgeon. Just don’t go online.
An empty airline is almost as sad and an empty operating room.
Yesterday I had to cancel a case. This patient was having a tummy tuck and I do not do tummy tucks on smokers. She showed up for her surgery and confessed that she indeed had not completely quit smoking but was only smoking about 5 cigarettes a day. Even that relatively small amount of nicotine puts her at significant risk for major healing problems and also puts her at risks for anesthesia problems because of airway irritability and increased secretions.
Soooo……………………we canceled her surgery, much to her disappointment. This lady had arranged for time off work, child care, a caregiver for herself etc. I don’t blame her for being disappointed and I have to say that I was a little disappointed too. I had assembled an anesthesiologist, two registered nurses and a surgical tech not to mention my operating room. And there we were, ready to go with no patient. Canceling a case is sort of like flying an empty airliner around. Lots of overhead but no paying passengers.
I am grateful that this patient was honest with us about her smoking. I would much rather have an empty airliner on my hands than a surgical complication. We got her rescheduled for after the first of the year and this time, I think she will take the no smoking instructions more seriously.
Thanks for reading and please don’t smoke. Sometimes it can just ruin a good case. Dr. Lisa Lynn Sowder
Fall is the time of year when we get a lot of questions about the common cold. Murphy’s law dictates that about week before surgery, patients wake up with a sore throat and a runny nose and a sinking feeling that we will cancel their upcoming surgery. Here are the guidelines my anesthesia and nursing staff and I use:
A significant cough will probably require rescheduling of most surgical procedures, especially those done with a general anesthetic. General anesthesia can irritate the airway and make a cough worse. Also, some procedures, tummy tuck for instance, does not go well with a cough. If the cough is minor and is likely secondary to post nasal drip, it may be okay to go ahead with surgery. Most of the narcotic pain meds we prescribe after surgery are also powerful cough suppressants.
A mild sore throat with no other symptoms is probably not a reason to cancel surgery. The anesthetic may make your sore throat a little worse for a day or two. A raging sore throat with swollen, nasty tonsils is a reason to cancel surgery.
A runny nose without other symptoms is not likely to interfere with anesthesia or recovery but a nasty sinus infection, either viral or bacterial, should be resolved prior to surgery.
A fever will require rescheduling your surgery. Fever is indicative of something bad enough to get your body fighting back. You don’t want to pile on with surgery.
We always appreciate a “heads up” if a patient thinks there is something brewing that may affect their surgery. Don’t hesitate to give us a call!
The 10th District U.S. Court of Appeals in Denver, Colo., on Aug. 31 upheld the September 2013 dismissal of a lawsuit filed by an ENT and oral surgeon against the Utah Plastic Surgery Society (UPSS), ASPS, the American Board of Plastic Surgery – as well as 19 individual plastic surgeons – which had contended that patient-safety education advertisements amounted to monopolistic efforts and messaging that caused direct financial damage to the non-plastic surgeons.
The appellate court decision provides another victory for patient safety and organized plastic surgery, while also serving as implicit validation of the ASPS “Do Your Homework” public-education campaign to improve patient safety.
The plaintiffs claimed in the original complaint that the Utah Society’s advertising – specifically billboards posted along one of Utah’s main interstate highways, as well as media interviews modeled after the “Do Your Homework” campaign – were in violation of the Sherman Antitrust Act and amounted to false advertising claims in violation of the Lanham Act. The plaintiffs asserted that the campaign was deceptive by indicating that cosmetic surgery is safer when performed by plastic surgeons rather than cosmetic surgeons.
The Appeals Court concluded late last month that the plaintiffs failed to show any plausible antitrust or deceptive advertising violation, and it affirmed the previous ruling in favor of UPSS, ASPS, ABPS and the individual plastic surgeons named in the lawsuit.
“This decision further confirms the value and importance of our efforts to instill public awareness on the distinctions between ABPS-certified plastic surgeons and lesser-trained physicians who present themselves as similarly skilled,” says UPSS President Brian Brzowski, MD. “We were helped tremendously by ASPS through its early financial and material support and its guidance in crafting the overall ‘Do Your Homework’ effort.”
“Despite the hurdles we have had to cross in dealing with the lawsuit, I was always supremely confident that we would prevail in promoting safe plastic surgery in Utah and beyond,” adds UPSS immediate-past President Trenton Jones, MD. “This public-safety education campaign was modeled largely after the ASPS campaign, so it’s a victory for organized plastic surgery and a huge win for the Utah Society.”
“We’re pleased that the legitimacy of the public-education efforts of UPSS and ASPS have been recognized yet again by the federal court,” says ASPS President Scot Glasberg, MD. “We applaud the Utah Society for taking a stand for patient safety and our specialty – and we welcome any local, state or regional society to confer with the leaders of the ASPS Public Education Campaign to raise awareness and promote patient safety in their states and localities.”
ASPS acknowledges Dr. Brzowski, Dr. Jones and the Utah Plastic Surgery Society for their efforts to both bring the ASPS “Do Your Homework” campaign to their state, and for defending patient-education efforts.
Seattle Plastic Surgeon and mother of a 14 year old daughter implores the naked cyclist at the Fremont Summer Solstice Fair to put a fig leaf on it.
I have been attending the Fremont Summer Solstice Fair for many years. I live just a few blocks away from Fremont, the self designated “Center of the Universe”. The fair is a fun and funky and freaky celebration of Seattle’s short but wonderful summer and just about anything goes. But this year, either I’m getting old and cranky or maybe the anything goes has gone too far.
Saturday’s parade has for years included a posse of nude cyclists who seem to appear from nowhere, weave through the parade and crowds and then disappear. And we all cheer for their naughtiness. But this year, after the parade, many of the cyclists just hung out, really hung out with nary a loin cloth. I felt like I was in a urology clinic. My daughter was having a hard time knowing where to look because everywhere she looked, there was another one.
So dudes, next year make sure you look for me. I will be the middle aged lady handing out free fig leaves for those of you who forgot yours.
Seattle Plastic Surgeon wishes everyone a Very Merry Christmas.
The Christmas season is always super busy in my practice. It seems crazy to have surgery around the holidays but it is the choice of many, many patients. They already have time off of work or school for recovery.
In my 23 years of practice, I have only taken time off around Christmas twice; once to take care of my newborn daughter and once to have surgery myself.
So Merry Christmas to everyone. I’ll be working every day except for Christmas, New Years Eve and New Years! It’s a good thing that I love my work!
Thanks for reading and stay tuned for some upcoming New Year’s Resolutions.
Seattle Plastic Surgeon dials it down a few notches for dudes.
The Dude is a good example of a man who just keeps getting better with age.
I’ve been doing quite a few cases on men lately. Almost all of my male facial plastic surgery patients are eager to tell me what they don’t want. Names like Mickey Rourke, Bruce Jenner, Kenny Rogers and Burt Reynolds come up frequently. All of these men have obviously had “a little work” done over the years and I don’t think I would be going out on a limb to say they they have had “a little too much work” done.
The procedures we do to rejuvenate the face are for the most part feminizing. We raise the brow, we trim the eyelids, we lift the face, we smooth the skin. And when these procedures are done on men in the same way they are done on women, the result can be, well, a bit disturbing. A really ruggedly handsome middle aged or older guy can end up looking not quite the way a guy of any age should look.
When I operate on men’s faces, I dial it down a notch or two. I don’t want that brow to high or those eyelids too trim or that jawline too tight. And neither do my male patients.
After chatting with her and examining her, I came up with the plan of a lift and a nipple reduction. These procedures would give the illusion of fuller breasts without actually increasing the volume.
@lisalynnsowder
