Lower Eyelid Rejuvenation with Dr. Effie Politis

 
 
 
 
 
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There are a variety of treatments to help rejuvenate the lower lids. ⁣

First and foremost, the eyes and upper/middle face are examined in terms of skin quality, bone structure, volume loss, and fat descent/deflation. ⁣

Typically, the upper lids are always paired with the brows as they complement each other, and treating one may leave the other deficient. ⁣

The lower lids must be treated as part of the midface. I typically examine the relation of the globe to the bony orbit and facial width vs projection. ⁣

Most opt for a blending of the lid-cheek junction. This can be done with a single HA filler or sandwiching two different fillers with different lift capacities. ⁣

In addition, some benefit from surgical repositioning of fat and tightening of the lower lid. Others may benefit from energy-based skin tightening modalities in conjunction with neuromodulators or fillers. ⁣

See your board-certified plastic surgeon for a treatment plan that will benefit you and your lifestyle!

Abdominoplasty Procedure with Dr. Effie Politis

 
 
 
 
 
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Here I showed the steps of an abdominoplasty procedure which includes:⁣

1. preoperative evaluation and marking⁣
2. excision of the lower abdominal skin⁣
3. undermining of her abdominal flap to her costal margins⁣
4. recruitment of superior and lateral tissue⁣
5. excision of sub-scarpal fat ⁣

 
 
 
 
 
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6. repositioning of the umbilicus⁣
7. liposuction of the flanks ⁣
8. and finally, sewing of the superior and inferior flaps in a layered closure. ⁣

The various steps of an abdominoplasty as shown here is a methodical process that needs to be precisely executed. ⁣

Preoperative evaluation is key, as well as obtaining ideal weight with diet and exercise. ⁣

Before and After: Abdominoplasty or ‘Tummy Tuck’

 
 
 
 
 
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This lovely patient is 41 years old and has lower abdominal laxity and skin changes consistent with having two children. She was interested in abdominal rejuvenation.

During her evaluation, her diastases were evaluated as well as any previous surgeries and possible hernias. Skin tone and skin laxity were also assessed. With diet and exercise, she was able to get down to her ideal weight. This allowed us to remove more skin during the abdominoplasty and perform a tighter plication. With our enhanced recovery protocols, the patient was back to work within 7 days. ⁣Typically these procedures require drain but there are some patients who are a candidate for drainless abdominoplasty. Please come see me, and find your best option!⁣ Watch out for upcoming posts this week on some behind-the-scenes for this procedure! ⁣

What is Breast Implant Removal?

 

 
 
 
 
 
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A breast implant removal or explantation of a ruptured 35-year-old silicone implant. ⁣⁣
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“Signs that your silicone implant has ruptured can include changes in breast shape and size, and increasing pain, firmness, and swelling over a period of weeks. ⁣⁣

When a saline or silicone gel-filled implant has ruptured, the implant should be surgically removed. In some cases, your plastic surgeon will also remove the capsule of scar tissue surrounding the implant.” (breastcancer.org) ⁣⁣

What is the 14 Point Plan?

 
 
 
 
 
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During your consultation, an important question that you need to ask your surgeon is whether or not they follow the 14-Point-Plan. ⁣

What is the 14-Point Plan

The 14-Point-Plan is designed to minimize the number of bacteria that can contaminate breast implants at the time of surgery. It was first published in 2013 and has since been widely adopted all around the world. Bacterial contamination of breast implants at the time of surgery has been shown to cause capsular contracture – hardening, pain, and deformity following breast implant surgery. ⁣

The 14-Point-Plan outlines strategies that can be incorporated into breast implant surgery that reduce the number of bacteria that can contaminate the breast implant surface. ⁣

Here you can see a funnel is being used to place the breast implant into the dissected pocket.⁣

Finding the Right Surgeon for Breast Augmentation

Whether your breasts are sagging, asymmetrical or too small for your body size, breast augmentation can help you regain a feeling of attractiveness, positive self-image and confidence. But the success of the procedure depends on good communication and the expertise of your plastic surgeon. A skilled surgeon will not only enlarge your breasts to the desired size, but also apply measures and techniques that minimize the risks and complications of the procedure.

What makes someone the right surgeon for breast augmentation?

1. Board-certified

Board certification indicates that the surgeon has undergone rigorous training and testing. It is also proof that the surgeon is competent and experienced enough in performing the procedure. Find a surgeon certified by the American Board of Plastic Surgery (ABPS) or the American Board of Cosmetic Surgery (ABCS) and check the status of his or her license before you schedule a consultation.

2. Experienced

Your breast augmentation surgery is more likely to be successful when performed by a plastic surgeon who conducts the procedure on a regular basis. Remember, the right surgeon will not only determine the type and shape of breast implants to use, but will also align the procedure to meet your goals. Plastic surgeons get better at the procedure with time and frequency.

3. Runs an accredited facility

While breast augmentation is typically an outpatient surgery, it should be done in a facility with the highest standards of safety, quality and patient care. Accreditation is proof that the facility is committed to best practices, and a qualified surgeon will work at or run an accredited and accommodating facility.

4. Candid and compassionate

Breast augmentation is a cosmetic procedure that should be tailored to the needs of the patient. To find a surgeon who can perform the surgery in a way that is in line with your goals and expectations, look for someone who takes the time to get to know you.

At the same time, a surgeon should give you correct, straightforward guidance on the best approach to achieving your aesthetic goals—and tell you the honest truth, not what you want to hear. Pick a surgeon who is open, frank and caring.

So how do you find the right surgeon?

1. Get recommendations

Recommendations by people you trust are a great way to find a competent plastic surgeon. Speak with friends, relatives or colleagues who have had the surgery to give you some references. Ask them to share their experiences with their surgeons, what they liked about the experience, and whether their procedures met their aesthetic goals and expectations.

2. Use the internet

Searching the internet is an easy way to find plastic surgeons performing breast augmentation in your local area. For instance, if you reside in Tampa, type keywords such as “plastic surgeon in Tampa,” “best breast augmentation surgeon in Tampa,” “breast implant surgery Tampa,” or “breast augmentation center in Tampa” and see what comes up in your search results. Open the links that appear in your search results and check out details like names and addresses of the surgeons.

3. Narrow down your options

From the recommendations and internet searches, you should have around 5-10 options to choose from. Further research will help you identify the top 2-3 surgeons. To narrow down your options, check out patient reviews posted on patient forums. You might also look for patient testimonials, before and after photos, gallery of patient cases, and case studies to help you get a clearer picture of the work and outcomes achieved by every surgeon in your list.

4. Book an appointment

Now that you have found 2-3 surgeons you believe can perform breast augmentation that meets your aesthetic goals, you should schedule a consultation session with each of them before choosing one. The meeting should help you determine if you are comfortable with and trust the surgeon, and to get a sense of whether or not the surgeon understands what you want from the surgery.

During consultation, the surgeon will thoroughly explain all aspects of the procedure and answer all your questions. This is when you should ask questions, raise your concerns, and find out what to expect before, during and after the procedure. You can also ask to look at before and after photos, patient testimonials, reference to previous patients, and case studies from the surgeon.

5. Make your decision

From your list of 2-3 plastic surgeons, consider choosing the one with whom you most easily communicated and established a rapport during consultation. The right surgeon is the one who made you feel more confident about your surgery through an open and honest discussion about your overall health, lifestyle, aesthetic goals, and your questions and concerns.

At Politis Plastic Surgery, we believe that working with a skilled and experienced board-certified surgeon is the best way to achieve your aesthetic goals through breast augmentation. Dr. Effie Politis is a candid and compassionate surgeon who can help you on your journey to a happier, more confident you. She performs breast augmentation frequently and with remarkable outcomes for her patients. For more information about plastic surgery, visit the site Politis Plastic Surgery website.

Bioengineered Breast: Hybrid Breast Reconstruction

 
 
 
 
 
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𝘋𝘦𝘷𝘦𝘭𝘰𝘱𝘪𝘯𝘨 𝘢 𝘩𝘺𝘣𝘳𝘪𝘥 𝘤𝘰𝘯𝘤𝘦𝘱𝘵 𝘪𝘯 𝘪𝘮𝘮𝘦𝘥𝘪𝘢𝘵𝘦 𝘴𝘵𝘢𝘨𝘦 𝘣𝘳𝘦𝘢𝘴𝘵 𝘳𝘦𝘤𝘰𝘯𝘴𝘵𝘳𝘶𝘤𝘵𝘪𝘰𝘯. ⁣⁣⁣

I was first introduced to the concept of “bioengineered breast” in 2009 by Dr. Pat Maxwell and colleagues. He originally coined this term to describe an enhanced breast form consisting of a combination of cohesive gel breast implant, regenerative scaffold, and regenerative cells. ⁣⁣⁣

The implant and the soft tissue covering it can both be enhanced to achieve the optimal female breast form.

Enhancing the soft-tissue cover not only supplements volume and shape but also further alters how the recipient’s host tissue responds to the foreign body implant. ⁣⁣⁣

This powerful combination of constructs better allows us to achieve the ultimate goal of breast reconstruction: to recreate a breast that appears and feels like the natural breast. ⁣⁣⁣

This patient had large breasts and underwent bilateral skin-sparing mastectomies. She opted for one-stage reconstruction to minimize downtime. This was achieved using a hybrid concept after the mastectomy flap perfusion was evaluated. ⁣⁣⁣

I was able to pair an anterior acellular dermal matrix sheet with a posterior stable Galaflex base to provide the patient with both softness and stability. ⁣⁣⁣

She plans on having fat grafting during her nipple-areolar reconstruction to further augment her soft tissue envelope and soften her breast borders.⁣⁣⁣
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Can I Still Breastfeed with Implants?

You can still breastfeed after breast augmentation surgery. A typical breast implant surgery involves an incision made in the inframammary fold (crease under your breast) to place the implant behind the pectoral muscle which is below the breast tissue. With this procedure, the implant is away from the breast tissue and does not interfere with breast ducts or mammary glands that produce milk. Even in cases where some glandular tissue is removed, enough tissue is left to facilitate milk production after the procedure.

Incision site

If you intend to breastfeed after breast implant surgery, the location of the incision matters. An incision made under the breast, in the armpit, or in the belly button is less likely to damage your milk ducts, nerves or glands.

But an incision made across or around the areola is more likely to damage nerves, affect the sensation of your nipple, interfere with the signals necessary for the letdown reflex, and reduce milk supply. Speak with your plastic surgeon about whether you might still have children so that an incision site is chosen that reduces the need for future adjustments to facilitate breastfeeding.

Implant location

Since breast implants can alter breast tissue, change the sensation of the nipple area, pinch or damage milk ducts, nerves, and milk glands, or reduce milk availability and release from glands, the location of the implant is critical. If you still want to breastfeed after breast implant surgery, you should make this clear to your plastic surgeon. To ensure implants do not interfere with breastfeeding, they can be inserted between your breast tissue and chest muscle or placed under your chest muscle.

Breast implants and milk safety

Breast implants do not make breast milk unsafe for your baby. Saline breast implants are filled with saline water, but there is no significant harm involved if the saline water mixes with breast milk. Likewise, silicone gel-filled implants are not harmful because the gel does not leak outside the implant shell.

There is no need to worry about chemicals in the implants mixing with the milk and making breastfeeding unsafe for your baby. Whatever implants are used, be sure to ask your plastic surgeon if it is safe for you to breastfeed after your implant surgery.

Reason for the surgery

Whether you can breastfeed after breast implant surgery also depends on your reason for the procedure. If your breasts are fairly symmetrical and regularly shaped and you only want a small boost, you are less likely to run into difficulties breastfeeding. But if you have flat or tubular shaped breasts before the procedure, you may already be at risk of low milk supply even without breast implants.

At Politis Plastic Surgery, we generally advise our patients to wait until they have had children before undergoing breast implant surgery. However, we do evaluate and recommend the procedure on a case-by-case basis after a personal consultation with each patient. If we find the procedure ideal for you, even when you still plan to have children, we will ensure that the incision site and implant location have the least possible effect on breastfeeding.

Would you like to enlarge your breasts and enhance your self-confidence but worry that it will affect you in other ways? Consider a private consultation with Dr. Effie Politis to discuss your specific goals and concerns. She will listen and guide you in making an informed decision about the procedure. For more information about breast augmentation and other cosmetic surgery procedures, visit the Politis Plastic Surgery website.

Removing Ruptured Historic Dow Corning Implants

 
 
 
 
 
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Removing ruptured historic Dow Corning implants in my patient after 30 years. She presented clinically with hardening of her left breast (capsular contracture). ⁣⁣
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Further workup including clinical and imaging examinations revealed extracapsular rupture which means the implant and the shell surrounding were compromised and needed to be removed. ⁣⁣
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These implants were taken off the market by the FDA in the 1980s. After the silicone implant moratorium in 1991, extensive premarket approval studies were required by the implant companies prior to the ban being lifted. This has resulted in extensive research and also produced much higher quality silicone cohesive or “gummy” implants with a much more stable shell and gel to shell fill ratio. ⁣⁣
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Today’s implants no longer demonstrate “gel bleed” and the increased silicone crosslinking adds stability and a higher safety margin. ⁣⁣
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The companies also provide short and long term warranty coverage and as board-certified plastic surgeons, we enter all implantable devices into a databank for better tracking. ⁣⁣

See a board-certified plastic surgeon to discuss treatment options regarding breast implants and safety profiles.⁣⁣
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#tbt #implantremoval #explant #capsularcontracture #siliconeimplants

Implant Removal with Auto Augmentation

 
 
 
 
 
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Liposuction of the pre-axillary and axillary fat as well as lateral chest for better definition after removal of implants and mastopexy with auto augmentation. ⁣

This pleasant 39-year-old patient had previous dual-plane saline (300cc) augmentation and felt her breasts were large, heavy, and cumbersome, after having 3 children. ⁣

Her desires were to be smaller and lifted. She underwent explantation of her implants with a simultaneous mastopexy and auto augmentation to restore upper pole fullness. She also underwent Lipo contouring of her axilla and lateral chest wall for a better definition.⁣