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Blog of Staten Island & NJ Plastic Surgery Articles

Andrew Miller
22 Apr
Posted in: Breast Implants, Rhinoplasty, Tummy Tuck
By Andrew Miller      Comments Off

Facial Transplants: Morally Objectionable or Necessary?

Plastic SurgeryEdison, NJ – For years, plastic surgeons and the public have been divided on one big issue – facial transplants. Some viewed the procedure as morally objectionable, while others have seen it as a necessary development to assist severely disfigured patients. Is the tide beginning to turn, marking more acceptance for this controversial topic?

“For years, cosmetic surgery has been relegated to the idea of just procedures such as tummy tucks, nose jobs and breast implants,” says Dr. Andrew Miller, a plastic surgeon in NJ. “But is there more we can do to help patients who are or become severely disfigured? As technology advances, making the impossible now possible, our ideas of what is necessary to better the lives of others needs to shift as well.”

As of November 2013, a total of 25 facial transplants have been performed. Once viewed as crossing the ethical line, more surgeons are embracing the procedure as both feasible and necessary, meaning we may be seeing facial transplants become more commonplace in years to come. The American Society of Plastic Surgeons topic paper, Plastic and Reconstructive Surgery, recently analyzed this topic, looking at how the ethical debate has changed over the years.

In the early years of the procedure, many viewed it as having science fiction undertones, and surgeons and others were concerned about the impact transplantation would have on a patient’s identity. Over the years, these concerns have faded as we have seen patients with severe facial disfigurement able to return to normal lives after a facial transplant.

The first facial transplant was performed by a French team of doctors in 2005. The report published by the ASPS found that the majority of articles questioning the morality of facial transplants were published prior to this time. But by 2008, opinions seems to shift with all published papers concluding that the benefits of facial transplant outweigh any ethical concerns.

Physicians were most concerned about the idea of a patient essentially wearing someone else’s face, reminiscent of the movie Face Off, in which an FBI agent’s face is switched with a criminal’s. But over time these concerns have faded, as results have shown that after a transplant, the patient has a new look that is neither identical to his or her previous face, nor is it identical to the donor’s.

The first full transplant in the United States was performed in 2011 to repair the face of a man who lost his entire face due to burns. The procedure took 15 hours and is now providing doctors and researchers with evidence on how the facial tissues react to the procedure. What biological changes occur after the procedure?

Researchers have found that blood vessels reorganize themselves after the procedure, maintaining excellent blood flow. This is crucial because it is the key factor in the viability of the facial tissues and the restoration of both form and function.

Learning more about how these blood vessels work after surgery can help surgeons plan for future transplant patients, and may even give them the ability to shorten the amount of time spent in the operating room.

In March 2012, the most extensive facial transplant procedure was performed by a team at the University of Maryland. The procedure took 36 hours and involved a team of faculty physicians from the University of Maryland Medical School and involved more than 150 nurses and professional staff. Dr. Eduardo Rodriguez, the chief of plastic, reconstructive and maxillofacial surgery, led the team of physicians.

The transplant recipient was a 37-year-old named Richard Norris, who lost his much of his face due to a gun accident in 1997. Since the accident, he had lived behind a surgical mask, and only left the house at times he was least likely to encounter other people. The goal of the transplant was to restore both facial harmony and functional balance to Norris in an aesthetically pleasing way. It involved the transplant of bones, nerves, muscles, soft tissue and even teeth and a tongue.

After surgery, Norris had to spend much time with therapists to regain function of his face, tongue and jaw. While Norris has gained back much sensation in his face and is able to talk and smile,  over time, the nerves will continue to learn to talk to each other, allowing for more normal movements and speech.

The transplant was made possible due to an anonymous donor, who also saved the lives of 5 others through organ donation. And this poses an interesting concern for both surgeons and potential recipients – how are donor candidates decided? Organ donation has become commonplace, but how many people are willing to also donate their face?

“Organ donation is an easy ‘sell’,” says plastic surgery expert Dr. Miller. “Donors know they will be saving someone’s life when they donate their organs. But facial transplant patients are in no risk of death, and the idea of someone else ‘wearing’ their face may be off-putting for some. Encouraging people to consider being a face donor will take some time and education to show the benefits.”

So what exactly are the benefits?

Carmen Tarleton was completely disfigured after her estranged husband attacked her with industrial strength lye. She suffered burns on more than 80 percent of her body. She underwent a facial transplant and reported being in a better place than she ever imagined after the procedure.

Dallas Wiens, recipient of the first full facial transplant in the U.S., has reported being able to now feel his daughter’s kisses, a sensation that brings him to tears.

And Norris reports being able to leave his reclusive life behind and being able to focus on what his future holds for him.

While not a life-saving procedure, facial transplantation is known as a life-giving procedure because it allows severely disfigured patients the ability to participate in life once more. Severely disfigured patients are often left to lead lives as virtual recluses, afraid to leave their homes. And many may suffer emotional trauma in addition to the physical trauma they have suffered. Our faces are our window to the world, intimately connected to our identity. Thinking of losing that identity shows how patients can spiral into emotional difficulty after their already devastating injury.

“And that is one reason why this type of procedure is gaining more acceptance,” says Dr. Miller. “Giving patients the ability to smile, smell, eat and talk again, not to mention be able to comfortably go out in public, are some of the rewards from this type of surgery. As technology continues to improve and advance, we will see great leaps in what we are able to do, and in how we are able to better the lives of many, many more people.”

What are the issues related to race/ethnicity? As face transplant becomes more common, how will donor tissues be allocated? Kiwanuka and coauthors conclude, “These questions belong in today’s field of face transplantation, and must be further investigated for the sake of evolving this field to its maximum potential in a safe, ethically sound manner.”

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Shain Cuber
21 Apr

Siblings and Plastic Surgery

Edison, Warren, & Marlboro, NJ -  Anytime people go through something significant in their lives, they usually tend to go to someone close to them for support. Sometimes these people will even go through the same procedure at the same time in order to better support their family member or friend and to share the experience.

Plastic surgery, such as a tummy tuck, can be a life changing procedure, and having the support of family and friends can really help recovery. “We have found that family members sometimes even have surgery at the same time so they can take care of each other,” says Dr. Shain Cuber, a top plastic surgeon in New Jersey.  When siblings are younger they used to share things like toys and candy. As they get older they can still retain similar thought processes. Often times, if one sibling wants liposuction, the other one also wants liposuction and they may use the same plastic surgeon.  There are several sets of siblings that undergo surgery together every year.  This way, they can relate to what each other is going through, and a lot of times they form a bond through the whole process, which brings them even closer together.


An article from ITV.Com shows how two twin sisters are determined to retain their similar appearance, so they each undergo identical surgeries. These two sisters want to share the same exact experiences all the way down to the shape and size of their breasts by having a breast augmentation. They both want larger breasts so they are doing it for the right reason. They will be able to share their experiences and help each other, which will fortify their bond. Also, there may be a touch of sibling rivalry.  One sister would probably not want the other sister to get all the attention after an enhancement procedure.

“Sometimes I do feel some sibling rivalry when I am consulting with these patients,” says Dr. Cuber, who also specializes in breast augmentation. “I just try to keep the focus on their individual goals and expectations and not make it a competition.”  When patients begin to get too competitive, they start to try and achieve unrealistic expectations which is the last thing the patient or the doctor wants. 

Another story from the The New York  shows another example of sisters (identical twins) getting exactly the same cosmetic surgeries.  They spent over $200,000 to look as identical as possible.  It is important to remember that people can go overboard in their plastic surgery desires. You must maintain a realistic expectation with regards to your results and not do anything that looks unnatural.

Having family involvement in plastic surgery is always a good thing because they can provide help and comfort during recovery. It is almost fun when a family member actually goes through a procedure at the same time. It is a bonding experience that can last a lifetime.

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Andrew Miller
18 Apr

The Rise in the “Forbes Facelift”

Facelift in NJEdison, NJ – Our culture is becoming increasingly obsessed with maintaining our youth and beauty, and even men are no longer immune to this trend. While the numbers of plastic surgery patients continues to rise each year, we are seeing more men turning to surgeons. The American Society of Aesthetic Plastic Surgeons reports that there was a 106 percent increase in the number of men receiving cosmetic procedures between the years 1997 and 2012.

While most people think men turn to surgery for the same reasons as women, primarily to stay looking young, Dr. Andrew Miller says there may be another reason.

“Men want to stay competitive in the job market,” says Dr. Miller, who is a top plastic surgeon in NJ. “We are seeing a trend in the marketplace where men feel they need to stay looking younger and more fit to compete and climb the corporate ladder. This trend is being referred to as the ‘Forbes facelift.’”

Men aren’t immune to the effects of aging, and they also aren’t immune to the effects aging can have on one’s self-esteem. Baby Boomers may fear the effects aging could have on their careers, especially those looking to re-enter the job force or change careers. Those in hiring positions may have preconceived notions about this age group, such as they are bad at technology, set in their ways or a poor investment because of their age. So more Baby Boomers are visiting surgeons like Dr. Miller for mini facelifts, eyelifts and even liposuction to give them a more youthful appearance.

“Aging of the face involves several factors,” says Dr. Miller. “Over time, the downward pull of gravity can cause sagging in the jawline, resulting in what we refer to as jowls. The neck may also begin to droop. As we age, we also lose some of the fullness as fatty tissue begins to break down. This loss of fatty tissue can accentuate the lines in our faces and make our cheeks and eyes appear hollow, prematurely aging us.”

A facelift is a major surgical procedure that results in tightened skin throughout the face, while a mini facelift is a minor procedure that eliminates the sagging look around the cheeks, jawline and neck. A mini facelift focuses on specific areas and does not affect the forehead or eyes. It’s a great option for patients who are looking for a quicker procedure with a faster recovery time than a full facelift. Patients will wear a bandage for 48 hours and sutures can be removed after one week. Patients can return to work in just a few days. While a mini facelift is not permanent, the results can last up to ten years.

It is important to have a consultation with your plastic surgeon to determine if a mini facelift is right for you. Dr. Miller says only a small percentage of the population will be proper candidates for this procedure. Patients with minimal jowling and neck sagging are ideal candidates for the procedure. It is also important to see a certified plastic surgeon who has experience in this procedure. If the surgeon pulls the skin too tight, noticeable scars may result.

The eyes are the focal point of the face, so it’s no surprise that eyelifts continue to rise in popularity. During the aging process, the skin in the upper eyelids will sag and the lower lids will form bags under them. The eyebrows may begin to fall due to gravity, resulting in a tired looking appearance.

During an upper eyelid procedure, the heavy and excess skin will be removed. The eyelid will be contoured, resulting in a rejuvenation to the entire face. A lower eyelid procedure will remove the fat pockets under the eyes that cause heaviness. Excess skin will be tightened or removed. There will be mild swelling, but recovery is typically painless.

Liposuction can be used to remove the stubborn pockets of fat that don’t seem to go away, even with proper diet and exercise. As we age, we see fat settle around our midsection, resulting in what we call love handles. Liposuction will target those areas of fat, breaking it up and removing it.

The Forbes Facelift may involve one or more of these procedures, and allows men to regain their youthful looks, giving them the confidence they need to remain competitive in the job market. If you are looking to once again capture the confidence of your youth and stay ahead in your career, consider scheduling a consultation with Associates in Plastic Surgery.

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Andrew Miller
15 Apr

Real life Barbie and Ken

Edison, Warren, and Marlboro - Growing up, many girls love their Barbie dolls. They dress them up and fix their hair just the way they want it. Usually this behavior stops after childhood, but sometimes people take things a bit too far. Recently a couple of people have undergone many surgeries to actually become Barbie and Ken. Valeria Lukyanova is a model inbarbie-and-ken the Ukraine and is referred to as the “Human Barbie.” She has had plastic surgery and does abstract makeup to complete her look. Justin Jedlica is known as the Human Ken. He is a New Yorker who has gone above and beyond to resemble the Ken doll. The two real life “dolls” recently met and did a photo shoot together, but they did not get along, so I guess the fairy tale has not come true.

Valeria states she only had one surgery to enhance her appearance, although tabloids state otherwise. She said she has only had breast implants, and has denied any other surgery. She claims to be on a liquid diet and looking to become a breatharian meaning she would not eat or drink and would attempt to subsist on air and light. This article, which was an interview with GQ magazine demonstrates that she may be a little out of touch with reality.

Justin Jedlica, the human Ken doll, really went to the extreme to become the real life doll. With 140 surgeries totalling close to $150,000 he is just about content with his outcome. “We sometimes have patients come in with the unrealistic expectation of looking like someone else,” says Dr. Andrew Miller, a top plastic surgeon in New York and New Jersey. “Plastic surgery should be used to enhance your own appearance, not to look like someone famous. If the appearance achieved through plastic surgery is not close enough to the desired celebrity, then the person often keeps having surgery that may be risky, never obtaining the result wanted.”

Justin has been working with silicone fabrication to do artistic muscle implants to enhance his shoulders, quads, abs, and lats. His shoulders are his prized possession because he has divided them into several areas—front, middle, and back, just like the actual anatomy. He has also told Huffington post that’s he has had several rhinoplasty procedures to achieve that perfect tiny nose. “I don’t recommend doing multiple rhinoplasty surgeries just to obtain a smaller nose because eventually the cartilage can collapse, causing breathing obstruction and deformity – everyone remembers Michael Jackson’s nose,” says Dr. Miller, who performs rhinoplasty every week.

There are all types of people in the world, which makes it an interesting place. However, it is difficult to understand why two people would go to such measures to become something they’re not. It is always important to be happy with yourself, but if a physical flaw is disturbing and you want it improved in a natural way, then plastic surgery is a great option. Just be realistic in your expectation and you should be happy.

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Andrew Miller
15 Apr
Posted in: Plastic Surgery Articles
By Andrew Miller      Comments Off

Aging Gracefully – Lessons Learned from Celebrities

NJ FaceliftMarlboro, NJ – We constantly look to celebrities for the latest trends and fashions. And often they can provide lessons in things to do, and things to avoid. Some celebrities choose to age gracefully, embracing age appropriate looks that sometimes include just the right amount of plastic surgery, while others desperately try to hold on to their youth by going a bit overboard.

While some celebrities readily admit to having a bit of help in order to achieve their beauty, others haven’t quite admitted to going under the knife. And others admit they may have had an obsession that led to them looking unnatural for any age.

Let’s start with a few celebrities who many consider to have done it the right way.

Sylvester Stallone’s former wife Brigitte Nielson definitely didn’t try to hide her 2008 total body transformation – she did it all televised! She underwent a facelift, eyelift, fat injections, liposuction and breast lift. The result? Many are saying she looks better than ever and has taken 15 years off of her age.

Jane Seymour is another celebrity who hasn’t been afraid to admit she has had some work done over the years. She has admitted to having an eyelift after hearing photographers talk about constantly needing to touch up that area in pictures of her. And she also openly discussed having a breast lift after nursing her children and realizing her breasts weren’t what they once were. She credits the surgery with helping her get her confidence back by being able to wear clothes that fit and looked better.

Demi Moore has been turning heads since her days running with the Brat Pack, but in recent years, she has been even more stunning than before. Moore is rumored to have undergone a few surgeries, including to remove fat in her knees to give her those gorgeous gams. One thing is for certain – Moore is one celebrity who has gotten better with age, and whose use of plastic surgery is age appropriate and subtle.

Another celebrity who is no stranger to plastic surgery is Joan Rivers While her love of Botox has been the butt of many jokes, Rivers has embraced her affinity for surgery and many applaud that. She has been known to tell people that if it will make them happier, to embrace surgery. While many think she may have gone a bit overboard (she’s admitted to having had over 700 procedures performed!), at 77, Rivers looks and feels good, as every plastic surgery patient should.

Other celebrities, however, haven’t fared so well. Dynasty star Linda Evans has had a face and brow lift and so much filler that she now looks unnatural for her age. Actress Kim Novak of Vertigo fame shocked everyone with her recent appearance at the Academy Awards. The 81 year-old star sported a startling “youthful” look that had many discussing that she had perhaps embraced too much surgery in an attempt to stay young.

Janice Dickinson, the self-proclaimed world’s first supermodel, has had a tummy tuck, neck and face lifts, liposuction, Botox and breast enlargement over the years. She has admitted she once lived for plastic surgery, and many now believe she is paying the price by looking a bit too overdone.

“Women aren’t the only ones who want to look and feel younger, and they’re not the only ones to overdo it when it comes to surgery, either,” says Dr. Andrew Miller, a top plastic surgeon in NJ. “More and more men are embracing plastic surgery to maintain their youth, but occasionally, it can go the wrong way.”

Kenny Rogers is a prime example of too much plastic surgery. The country music star has admitted that he went a little overboard after marrying a younger woman, referring to himself as the bionic man. He wishes he hadn’t had so much surgery and could once again regain the warmth that he once had in his eyes. Comparing recent pictures of Rogers to those from earlier in his career show a dramatic difference, and one that isn’t for the better.

No list of Hollywood stars who’ve had too much surgery to recapture their youth would be complete without Mickey Rourke. Once one of the most handsome leading men in Hollywood, Rourke left acting and turned to boxing. Years of having his face pummeled sent him to a surgeon to attempt to recapture his former looks. Unfortunately, he chose the wrong surgeon and has had to undergo additional surgeries to try to correct the first botched procedures. What is left is someone who is almost unrecognizable when compared to photos of his youth.

“The key to surgery is to have just enough done to capture the essence of your youth,” says Dr. Miller. “As surgeons, we can turn back the hands of time a bit, but we can’t stop time altogether. We can successfully help you look a few years younger, but most importantly, we can help you regain the confidence of your youth. If you are 70 and want to look 30 again, that’s just unrealistic. But if you are simply looking to regain the confidence that accompanied your youth, plastic surgery is a great option.”

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Andrew Miller
12 Apr
Posted in: Plastic Surgery Articles
By Andrew Miller      Comments Off

How Much is Too Much?

plastic surgery in NJEdison, NJ – Plastic surgery procedures are becoming more and more common among both celebrities and the average public. Experienced surgeons are everywhere, from large metropolitan cities to even the smallest cities. While it is becoming easier and more accessible, some may be abusing the system. How much is too much? When does a desire to improve oneself turn into body dysmorphic disorder?

“Surgeons walk a very fine line between wanting to meet our patients expectations, but also being sure they have realistic goals and aren’t abusing plastic surgery,” says Dr. Andrew Miller, a top plastic surgeon in NJ. “Some want to unrealistically turn back the hands of time, while others perceive imperfections that simply don’t exist. It’s my job as a surgeon to manage expectations, and to help people who may be bordering on body dysmorphic disorder.”

What is BDD? BDD is a mental illness in which the patient cannot stop finding flaws in his or her appearance. The flaw can be minor or imagined, but to the patient it makes their appearance unbearable. People suffering from BDD spend hours agonizing over their looks and can suffer great stress due to what they perceive to be imperfections. They may seek out excessive surgical procedures to correct what they see as flaws.

“While most people have tiny flaws they might like to change if they could, people with BDD obsess over them,” says Miller. “BDD sufferers cannot control their negative thoughts, and even plastic surgery cannot provide satisfaction. Part of my job is to be able to identify patients who may potentially have BDD in order to get them the help they truly need.”

About one percent of the population suffers from BDD and it affects men and women equally. It typically affects adolescents and young adults. BDD has been found to be as much as 15 times more prevalent in patients seeking out cosmetic surgery.

How can a surgeon recognize that a potential patient may suffer from BDD? The first step is by obtaining a thorough history from the patient. If the patient has made excessive requests for surgeries, voices dissatisfaction with the results of previous surgeries, has expectations that surgery will solve all of their problems, or has a preoccupation with one perceived defect, the patient might suffer from BDD. Additional signs include psychiatric history, an unusual motivation for surgery or demanding behaviors. If a plastic surgeon believes a patient may suffer from BDD, the next course of action is to refer the patient to a psychiatrist.

While surgery such as breast augmentation can help the average patient increase their self-esteem, it is a fine line for surgeons to walk when determining if a patient has realistic expectations for their surgical outcome or not. A responsible surgeon has an ethical obligation to weigh whether or not the patient will truly benefit from the procedure, or if it will simply fuel even more dissatisfaction with their appearance.

While some patients may suffer from BDD, others may simply have unrealistic expectations of what their surgical results will be. If you are 60 and desire to look like you did when you were 25, chances are you’ll be disappointed with your results. While surgery can make people guess about your true age, it can’t shave decades off your look.

These are some of the reasons why it is so important that patients seek out a well-qualified surgeon to perform their procedures, even those considered to be non-invasive. Many non-doctors are now performing procedures such as Botox and other fillers, and they may not be trained to recognized plastic surgery addictions or be able to effectively manage patient expectations. While they may be fueling the fire, they can also cause damage by not having the experience and proper knowledge to safely treat patients.

Examples of Going too Far
We see it in celebrities and we’ve seen it with regular people. A desire to look younger or have the perfect body sends them to the plastic surgeon for nips and tucks over and over again. While most patients simply seek a rhinoplasty or other procedure to correct a minor flaw, these examples can’t stay away from the surgeon.

You may not know the name Jocelyn Wildenstein, but chances are good you’d recognize her if you saw a picture. Wildenstein has spent more than $4 million on surgeries to craft a more feline look for her husband. She has undergone lip augmentation, breast augmentation, facelifts, brow lifts and much more, all to resemble a cat.

TLC’s reality series, My Strange Addiction, has featured real people with very strange desires. One such episode featured a mother of six who had undergone 30 different procedures and was seeking an additional breast augmentation to take her up to a size QQQ cup.

The show has also featured someone we have written about before, Toby Sheldon. The 33-year-old has spent more than $100,000 to look more like teen pop star Justin Bieber. Sheldon has admitted to having a phobia of aging and that he is jealous of Bieber’s baby-faced looks. He has undergone hair transplants, face and lip fillers, eye surgery, smile surgery and Botox to look more like the teen sensation.

Like Sheldon, there are more and more people turning to the surgeon to look like their favorite celebrity, says Dr. Miller.

“We constantly see people who want a certain celebrity’s nose or cheeks or arms,” says Dr. Miller. “While most patients understand that they will still look like themselves following the procedure, others have a desire to completely change their look to that of the celebrity. While we might be able to give patients a resemblance to the celebrity, facial proportions and bone structure are different for everyone. We can mimic a certain feature, but we can’t clone the celebrity. It is our job to enhance the patient’s own beauty.”

Regular people aren’t the only ones who may suffer from surgery addictions. Celebrities suffer unique pressure to stay youthful looking, and that sends many running to the surgeon.

When you think of celebrities and plastic surgery, Joan Rivers might be one of the first to pop into your mind. And for good reason. The funny lady has reportedly undergone over 700 procedures over the years.

Former reality star Heidi Montag is a self-proclaimed surgery addict, even undergoing ten procedures in one day. Montag has had a brow lift, nose job revision, liposuction on her thighs and stomach and a butt augmentation. She also had a breast augmentation to increase her cup size to a DDD, but has since removed the extra-large implants.

Some celebrities aren’t as forthcoming about their procedures, but their looks seem to defy the natural aging process. Demi Moore is one of those. She seems to get better and better as she ages, but many speculate that is because she has spent more than half a million dollars on cosmetic procedures. She is reported to have undergone a breast augmentation, liposuction, brow lift, collagen injections and even a cosmetic knee surgery to remove excess fat from the area.

Olympian Bruce Jenner has become a common subject of jokes for his more feminine looks in recent years. Jenner is almost unrecognizable as the strapping athlete he once was, and it is the result of multiple procedures, such as chin and cheek implants, facelifts, eyelid surgery and a nose job.

So how do you know when you’ve gone too far?

“Plastic surgery should simply enhance the natural beauty already inherent within each patient,” says Dr. Miller. “If you desire to completely change your look and become someone else completely, it may be time to reevaluate. I love helping people discover the beauty they’ve had all along, and seeing the increase in their confidence. But I also want them to understand that beauty is unique to each individual, and what may be beautiful on one person might not be right for them.”

If you think you may suffer from BDD, schedule a consultation with a psychiatrist as soon as possible. If you are looking for small updates to your look or to turn back the hands of time a few years, plastic surgery may be right for you. After a consultation with a trained surgeon, you can create a treatment plan that will give you the added confidence, while bringing out your natural beauty.

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Andrew Miller
9 Apr
Posted in: Plastic Surgery Articles
By Andrew Miller      Comments Off

Can Breast Implants Interfere with Mammograms?

MammogramEdison, NJ – Are you considering having breast augmentation surgery, but have been hesitant because you worry it could interfere with a cancer diagnosis during a mammogram? Dr. Shain Cuber, a NJ plastic surgeon, discusses the reality of breast implants and mammograms.

“It is recommended that most women begin regular screening mammograms at the age of 40,” says Dr. Cuber. “For many women this age, they may already have breast implants, so it is important to understand the effect these implants may have on their mammogram. For younger women considering augmentation surgery, how an implant affects mammograms should be part of the research and decision-making process.”

The truth is, a breast implant can diminish the ability to view the entire breast during a mammogram. But how much depends on where the implant is placed. If the implant is inserted below the chest muscle, there is less of a chance that the breast image will be obscured. Both silicone and gel implants are considered to be to some degree opaque, which means they may look like white blobs during mammography, preventing the technician from fully seeing what lies below it.

In some cases, the implant can affect the rest of the breast by displacing breast tissue, which can make it harder to see the indications of early breast cancer, such as micro calcifications, tissue distortion and small dense masses. Scarring from the implant surgery can cause calcifications, which can mimic cancer. Additionally, an implant is less compliant than breast tissue, so it can limit the amount of compression that can be achieved, meaning the technician may not get the optimal breast visualization needed.

“But that doesn’t mean you should avoid the plastic surgery if it’s something you have been longing for,” says Dr. Cuber. “Because breast augmentation procedures are so common, most mammogram technicians and physicians are adept at ensuring women with implants receive more thorough screenings.”

That means additional images may be taken, via X-ray in most cases. X-ray pictures with implant displacement and compression views can provide a more thorough examination of the breast. Women with implants may receive several more views that other women, including views from above the breast and from each side.

Another common question women may have is whether the pressure of a mammogram can cause an implant to rupture. This occurrence is extremely rare and not cause for concern. In fact, in the 10 year span between 1992 and 2002, the FDA reports only 41 cases of implant rupture during mammography. That means having breast implants should not be a deterrent against having a mammogram.

Some women may also wonder if there are other ways cancer could be detected, without having to undergo a traditional mammogram. Ultrasound will not pick up minute calcifications that can be an indication of early breast cancer, and therefore is not effective as a primary screening tool. An MRI can be used to detect silent ruptures in silicone implants, but its use for breast cancer detection is limited to only high-risk women.

Finally, those seeking breast implants may wonder if the surgery could increase their risk for cancer. The answer is no. In fact, some studies have actually shown that women who have implants have a lower cancer incidence than the rest of the female public. One Swedish study found that women with implants had a 30 percent reduced risk for breast cancer. Some believe this may be because the implants compress the breast tissue, thereby interfering with the blood supply, while at the same time decreasing the temperature of the breast and stimulating an immunological response, which could help destroy the cancer cells. It is important to note, however, that these have not been proven and are just speculation.

The decreased risk could be attributed to other factors, though. Most women who have breast augmentation tend to be near their ideal weights. Obesity is a significant risk factor for breast cancer. Additionally, women with implants tend to be from a higher socioeconomic status and have better nutrition and exercise habits. They tend to visit their physicians more often, including breast specialists, and because they have better access to medical care, they have more frequent mammograms.

While breast implants can cause slight interference with mammograms, women should be sure to seek out technicians who have experience treating women with implants. By seeking out experience, women can ensure they are receiving the best screening possible, including additional views that accommodate for the breast implants. With proper care and regular screening, women with implants can enjoy the same peace of mind as women without.

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Andrew Miller
4 Apr
Posted in: Plastic Surgery Articles
By Andrew Miller      Comments Off

Is Now the Time for a Breast Augmentation?

Breast Augmentation in NJEdison, NJ – If you watched any of this year’s major awards shows, you probably noticed something on the red carpet – plunging necklines are in. Starlets proudly showed off their bust lines in gowns that were daringly low. Have you dreamed of wearing similar fashions, but don’t feel your current breast size is adequate? Of do your breasts droop, making you self-conscious to show them off?

Breast augmentation continues to be one of the most sought after enhancement surgeries, and for good reason. Women don’t need to feel self-conscious over the size of their small breasts when there are wonderful plastic surgery options that can enhance their bust line, while increasing their confidence at the same time.

“I’m betting after the awards season, women everywhere were looking in the mirror wondering if they could carry out some of the looks they saw,” says Dr. Shain Cuber, a top plastic surgeon in NJ. “The good news is, if you have always wanted a larger or firmer bustline, we’re here to help you achieve the look of which you’ve always dreamed.”

The numbers of women turning to breast augmentation procedures continues to climb, and according to a recent study published in Plastic and Reconstructive Surgery, the professional journal of the American Society of Plastic Surgeons, nearly 98 percent of women report that their results met or exceeded their expectations. And of the women surveyed, 92 percent reported an increase in their self-esteem.

“The reasons women choose plastic surgery are very personal to them,” says Dr. Cuber. “But one of the most common themes we hear is that people are looking to increase their self-esteem. Plastic surgery can help people feel more confident, and help them lead a better quality of life, all while looking their best in the clothes they’ve always dreamed of wearing.”

A breast augmentation procedure can enlarge naturally small breasts, restore breast volume lost after a pregnancy or as the result of breastfeeding or weight loss, and help women achieve better symmetry if their breasts are moderately disproportionate in size or shape. Breast augmentation, however, will not correct drooping breasts. Women who want a fuller and lifted bust line will need to undergo a breast lift procedure. This can be done on its own or in conjunction with a breast augmentation in cases where both may be required to achieve the patient’s desired look.

Stars on the red carpet are no strangers to plunging necklines that show off their beautiful breasts, and women everywhere can achieve the same look and confidence in a procedure that has been perfected over the years to give the most natural look possible. If you want to confidently show off your assets as Kate Hudson, Kate Mara and other starlets did on the red carpet this awards season, now is the time to schedule a consultation with your New Jersey plastic surgeon today and have your new, beautiful bust line and increased self-confidence in no time.

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Andrew Miller
3 Apr
Posted in: Plastic Surgery Articles
By Andrew Miller      Comments Off

Plastic surgery for teenagers

Edison,Warren, and Marlboro NJ In  recent years, more and more teenagers are making thedecision to go under the knife to change their appearance.Interestingly, the American Society of Plastic Surgeons (ASPS) reports a difference in the reasons teens give for having plastic surgery and the reasons adults offer: Teens view plastic surgery as a way to fit in and look acceptable to friends and peers. Adults, on the other hand, frequently see plastic surgery as a way to recapture their youth. According to the ASPS, more than 300,000 people 18 years and younger had either major or minor plastic surgical procedures in 2012.

“Teenagers face hard criticism from their peers,” says Dr. Andrew Miller a top plastic surgeon in New Jersey.  It can be hard going through adolescence and all the changes these young people experience because teenagers can be downright cruel sometimes.  Several of these changes include issues with their appearance such as acne, the appearance of unwanted hair, and the growth of the nose, and these things can cause an enormous amount of stress in the life of a teenager.  Some people turn to plastic surgery to correct a physical defect or to alter a part of the body that makes them feel uncomfortable. For example, a young boy may have excessive breast tissue that makes them feel uncomfortable in the locker room. This can possibly be improved by undergoing gynecomastia surgery.  This surgery removes the excess breast tissue and flattens the chest nicely. Then the young man will not have to worry about being teased any further.

Many teens are self-conscious about their bodies. Some may not like the way their ears stick out which can be improved with an otoplasty. Some do not like the big bump on their nose and this can be corrected with rhinoplasty. “Many people think that these individuals should just accept these issues, and that the real worth of a person comes from the inside,” says Dr. Miller, who specializes in rhinoplasty surgery. “Theoretically, that may be true, but when one of these procedure is performed and a natural result is attained, it is great to see the change in the patient’s personality and self-confidence.” It is important for teens to ask themselves if they are considering plastic surgery because they want it for themselves or whether it is to please someone else. Most doctors would like to ensure that teenagers are emotionally ready for these kinds of procedures, and maturity has a really big effect on how they think they look. People who are depressed, extremely self-critical, or have a distorted view of what they really look like sometimes expect to much from surgery and are not good candidates.

The best way to start the journey is to make sure there is truly a need for cosmetic surgery The ASPS offers these guidelines for teens considering plastic surgery:

  • The teen must initiate the request, not the parent, and must have realistic goals and expectations.
  • The plastic surgeon should be experienced and board-certified in a specialty recognized by the Facial procedures American Board of Medical Specialties.
  • The surgery should be done in an accredited surgical facility with the ability to handle rare complications.
  • The surgery must be done under a policy of full, informed consent. That means the details of the procedure are understood and agreed to by the patient and the patient’s parent or guardian.
  • Age appropriate

There is no reason that a teenager cannot enjoy the benefits of a well-peformed plastic surgery procedure. As long as they are mature enough to understand the situation properly and have the support of their parents, the improvement in confidence that can be seen in these patients is wonderful.



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Andrew Miller
29 Mar
Posted in: Armlift, Bodylift
By Andrew Miller      Comments Off

Brachioplasty Explained

Arm lift in NJEdison, NJ – Do you hate the appearance of your saggy, droopy upper arms? As we grow older, we experience fluctuations in weight, not to mention hereditary issues, which give us a flapping appearance in the upper arm, from the underarm to the elbow. While exercise can improve the muscle tone, it doesn’t take care of the excess skin that is there as the result of lost elasticity, weakened tissue or localized fat deposits.

“If you’ve been working out those upper arms like crazy, yet still have sagging skin, a brachioplasty might be right for you,” says Dr. Shain Cuber. “Commonly referred to as an arm lift, the procedure reshapes that upper portion of the arm, making you happy to wave hello to friends in a sleeveless shirt.”

Arm lifts are performed by NJ plastic surgeons like Dr. Cuber to help patients reduce the excess skin and fat found in their upper arms, giving them a smoother, more toned and proportionate look.

Women are paying closer attention to their arms, as evidenced by the American Society of Plastic Surgeons estimate that arm lifts have grown over 4,000 percent in a little over 12 years. Some plastic surgeons think celebrities might play an influence, as they’ve seen a rise in the number of women coming into their offices asking for the arms of First Lady Michelle Obama, actress Jessica Biel and talk show host Kelly Ripa.

But whatever the reasons for undergoing an arm lift, one thing is clear – women of all ages are flocking to the procedure.

The ideal brachioplasty patient will have significant arm skin laxity and will have a stable weight. Patients who are significantly overweight will not be suitable candidates for this plastic surgery. Patients must be in overall good health, with no issues that could impair healing or increase the risks of surgery.

“The procedure itself is fairly straightforward,” says Dr. Cuber. “But it is still surgery, so patients need to take it seriously. Anytime anesthesia is involved, there are inherent risks.”

Your surgeon will determine where your incision should be placed and how long it will need to be, depending on the amount of skin to be removed and its location. Typically, they are placed on the inside or back of the arm. Depending on how much skin needs to be removed, the incision could extend from the underarm to just above the elbow. If you also have excess fat to be removed, liposuction will be used to eliminate the fat cells.

Once the incision is made and the excess skin is removed, the underlying supportive tissue will be tightened and reshaped with sutures. The skin will then be smoothed over the arm. The incision will be closed with either absorbable sutures, or sutures that will be removed one to two weeks after surgery, depending on your surgeon’s preference.

You results will be visible almost immediately, but some swelling and bruising will occur immediately after surgery. Bandages will be applied and your arms may be wrapped in elastic bandages or compression garments to ease any swelling that might occur. Some patients may require a temporary drain to remove excess fluid and blood.

You will be given specific care instructions to follow after surgery, as well as when to follow up with your surgeon. Follow-up is important to be sure the incisions are healing properly and the right results were achieved. At the first sign of infection, or if you experience severe pain post-surgery, immediately call your surgeon.

An arm lift procedure will take one to two hours and is performed on an outpatient basis. Your discomfort will be mild to moderate, and you may need prescription pain medication in the week following surgery. Swelling will minimize after the first two weeks, and you can be back to work in just three to seven days. You can then resume exercise two weeks following surgery.

“Patients should note that this surgery will leave a visible scar on the arm,” says Dr. Cuber. “While the scar will fade over time, if you are adverse to the idea of a scar on your body, this surgery may not be right for you. I always encourage my patients to have a realistic expectation of the outcome of surgery, and scars are one thing that needs to be discussed.”

The success of your procedure depends on your honesty with your surgeon and that includes being open about why you want the procedure and what your vision is for after the surgery. Additionally, you’ll need to disclose a complete medical history, including any medications or herbal supplements you are taking, and whether or not you are a smoker.

With the right physician and the right attitude going into surgery, patients achieve beautiful, long lasting results with arm lift surgery. So what are you waiting for – get rid of that pesky arm flab and start waving proudly again. Schedule a consultation with your plastic surgeon to see if you are a good candidate for a brachioplasty.

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