Once again, breast augmentation and nose reshaping surgery topped the list, with a total of 307,000 breast augmentation procedures and 244,000 nose reshaping procedures reported by members of the ASPS.

Liposuction and eyelid surgery swapped places this year. Last year, eyelid surgery was the third most popular procedure, and liposuction was the fourth. In 2011, liposuction made the top three, while eyelid surgery dropped to fourth.

A major change in the top five most popular procedures this year was the return of facelift surgery, which has not made the top five since 2004. Tummy tuck surgery dropped to number six.

Rounding out the top 10 was breast lift, dermabrasion, forehead lift, and ear surgery.

The number of minimally-invasive procedures also increased this year, to 12.2 million procedures, up 6 percent from the year before. The top five procedures remained the same.

• Botulinum toxin type A: 5.7 million procedures
• Soft tissue fillers: 1.9 million procedures
• Chemical peel: 1.1 million procedures
• Laser hair removal: 1.1 million procedures
• Microdermabrasion: 900,000 procedures

The number of chemical peel procedures that were performed in 2011 was down 3 percent compared to the prior year. There was an increase in the number of Botulinum toxin type A, soft tissue filler, laser hair removal, and microdermabrasion treatments that were performed last year.

Intense pulsed light (IPL photofacial), laser skin resurfacing, sclerotherapy, laser treatment of leg veins, and cellulite treatment also made the top 10.

If you are interested in undergoing plastic surgery, contact Marin Aesthetics today. We will be happy to schedule your personal consultation with Dr. Marin.

We decided that the patient would need a revision augmentation with silicone breast implants placed
in a sub-muscular position. We had concerns about the elasticity of the area of contraction of the left breast prior to
surgery as scar tissue within the breast does not stretch to the same degree as normal tissues. She
had previously undergone a breast lift, and we felt that we would need to repeat this to achieve the best
results.

In her photographs, she is seen here nearly one year from her original surgery with a significant
improvement in her appearance. Her silicone breast implants have helped to reshape her breasts and
give them a more natural look. Although not perfect, our patient is very happy with her results and much
more confident in her appearance. The patient has recently become engaged and looking forward to a
new future.

If you are looking to find a San Diego breast augmentation surgeon to help you with revision breast
surgery, call our Del Mar, CA office to make an appointment at 858-638-9800 for an appointment with
Board Certified Plastic Surgeon Dr. Vincent Marin.

In a report from NPR, the article stated “Because New Jersey is one of the only states in the Northeast with the tax, Godek says patients go into other states without the tax to have their procedures performed to save that 6 percent.

Godek is also president of the New Jersey Society of Plastic Surgeons, which commissioned an economic study that suggests New Jersey is actually losing revenues because of the tax, not gaining them.

“When someone has plastic surgery, they’re not only coming to a plastic surgeon,” Godek says, “they’re utilizing a hospital or a surgery center; they’re staying in local hotels; their family is eating in local restaurants; they’re utilizing pharmacies to fill their prescriptions. So all of that revenue is lost.’”

Hopefully, other states will realize that this is not an effective means to generate revenue. As the majority of patients who undergo cosmetic surgery are middle class women, there is an unfair and biased taxation with this legislation.  We are happy to hear that the cosmetic surgery tax may soon be a thing of the past.

Vincent Marin, MD

San Diego Plastic Surgeon

The rhinoplasty procedure is typically performed to correct the nasal flaws that detract from a person’s appearance. Refinements to the nose can significantly improve facial harmony and balance. Now, an added benefit may be its anti-aging effect.

The Study

In the rhinoplasty study, researchers provided observers with photos of 53 rhinoplasty patients. One photo was taken just prior to the rhinoplasty procedure and the second photo was taken one year after surgery. All of the photos were taken with the same camera, from the same distance, and with the same room lighting.

The rhinoplasty patients whose pictures were involved in the study ranged from age 15 to 61, with an average age of 35. There were 41 female patients and 12 male patients.

The 50 observers were asked to guess the age of each patient. Half of the participants viewed the pre-operative images first, and then viewed the post-surgical images one month later. The other 25 participants viewed the photos in the opposite order.

The Results

On average, the observers indicated that the rhinoplasty patients looked 1.5 years younger in their after pictures. Certain factors did appear to affect the perception of age:

• Patients that had a dorsal hump reduced looked 1.6 years younger, while patients that did not have a dorsal hump reduced looked 1.1 years younger.
• The observers indicated that rejuvenation was more evident in older patients than in younger ones.
• Patients with a greater degree of nasal tip rotation lost more years than other patients.
• Patients that had a dorsal hump reduction and at least a 10-degree rotation of the nose tip appeared 2.14 years younger.

Although rhinoplasty surgery does not rejuvenate a person’s appearance to the same degree as a facelift, older patients that undergo the procedure can enjoy this added benefit. If you are interested in undergoing rhinoplasty surgery, contact Marin Aesthetics to schedule your personal consultation with Dr. Marin.

The French government recently issued an unprecedented statement recommending any woman who has received this implant to have it “explanted” or removed.  It is unclear whether they will cover the cost of a secondary augmentation with a different product.  This implant has possibly also been rebranded as an “M” implant and marketed in other countries – so the exact number of women suffering from this is currently unknown. It is possible that the implants have been sold in Western Europe, South America (Brazil, Chile and Argentina) and Australia.

The UK has not recommended any large-scale removal at this point. The regulatory agency was quoted as saying “We recognize the concern that some women who have these implants may be feeling, but we currently have no evidence of any increase in incidents of cancer associated with these implants and no evidence of any disproportionate rupture rates other than in France.”

One of the women who suffered from a rupture has since died from anaplastic large cell lymphoma, but there is no evidence to suggest any association between the leakage and cancer development.  It is being reported that there was evidence of this being an issue as early as March of 2010, but it has taken as long as 21 months for this to come to light.  The parent company has admitted that two types of silicone were used in the manufacture of this product “But there’s no cause-and-effect link between it and any harm suffered by this or that person,” an attorney for PIP was quoted as saying

Women who choose to not undergo elective implant removal are currently being encourage to undergo ultrasound examinations every six months to be evaluated for evidence of rupture.  The FDA has encouraged US women who possibly received these implants to report their experience through their website – https://www.accessdata.fda.gov/scripts/medwatch/

To read more about the specific issues related to the PIP breast implant controversy, click on the following links:

New York Times article:  http://goo.gl/TAZEA

New Zealand Herald: http://goo.gl/c7Hoy

STL Today: http://goo.gl/U7NOA

The Guardian: http://goo.gl/M1bQb

If you have any specific concerns about your breast implants, please contact our office at 858-638-9800.

Dr. Vincent Marin

San Diego Plastic Surgeon

This patient is a 24 year old San Diego woman who was unhappy about how she looked in clothes and especially when bathing suit shopping and was interested in a breast augmentation surgery. She felt self-conscious about the size of her breasts and felt she could never properly “fill out” the clothes she preferred.  We discussed at length her surgical options for breast augmentation and she felt most comfortable with a 350 cc moderate plus profile silicone implant that would be placed underneath the chest muscle and through a breast crease incision.

She is seen here at 6 months after her procedure with the implants having settled into place. The scars are very well hidden in the breast crease that is more prominent after her procedure. Her confidence has improved and she was very excited about her results. Many patients wonder why they took so long to decide to embark on a relatively simple one hour procedure to fix a problem that has bothered them for years.

If you are interested in knowing more about your breast augmentation options in the San Diego area, call Dr. Marin at 858-638-9800 to make an appointment for an in-person evaluation.  If you are out of the area or out of state, you can easily learn more by completing our simple and confidential on-line consultation.

San Diego Plastic Surgeon Dr. Vince Marin Discusses Board Certification from Vincent Marin, MD on Vimeo.

Is your doctor board certified?
And in WHAT specialty?

• Hopefully your doctor is not only board certified, but also certified in the procedure you are undertaking.
• We routinely hear about OB/GYNs, general surgeons, internal medicine doctors, family practice doctors, radiologists and even dentists performing body surgery.  Just because they are a great doctor, doesn’t mean they will be great in another specialty – especially one they aren’t trained in.
• There are a number of “boards” that have been created that are not even recognized by the American Board of Medical Specialties – different specialties have created these cleverly named “organizations” (such as American Board of Cosmeic Surgery) to help confuse the issue to the public.  To learn more about this patients, can visit the website – http://abms.org/
• Board Certified Plastic Surgeons have
  • a minimum of six years of surgical training in plastic surgery,
  • all have completed oral and written examinations
  • continue to pursue 50 hours a year of continuing education, with an important emphasis on patient safety.
  • None operate in a facility unless it is accredited for the rare occasion when there is a problem.
• The problem stems from the fact that only four states (California, Florida, Louisiana, and Texas) have laws on the books requiring that physicians take steps to disclose the specifics of their medical background. In all other states, no such regulations exist. That leaves a pediatrician or a gastroenterologist, for example, free to cross over into the role of plastic surgeon at will and without disclosure.
• In MOST states – ANYONE with a medical license can perform cosmetic surgery – it is the responsibility of the patient to do their research before choosing a surgeon.
• 40% of all liposuction procedures were performed by NON-plastic surgeons in 2010.
• In July, an Arizona internist was convicted of second-degree murder and manslaughter after three patients died in his care, two after liposuction and the third after a botched fat-shaping procedure.
• You can verify your doctor and degree of board certification at http://fsmb.org/directory_smb.html

How much training has your doctor had?

• Typical plastic surgeon training ranges from 5-7 years dedicated to patient selection and the acute, subacute and out-patient management of plastic surgical patients.  Many non-plastic surgeons will learn techniques over a weekend course and then begin to try these out on their patients – often at a very reduced cost.

Does your surgeon have experience in the procedure you are considering?

Does your surgeon have experience in successfully dealing with complications from the procedure you are considering?

All procedures can have complications, and it is just as important to know that your doctor not only can do the procedure, but also deal with unexpected complications.  Although, a weekend course can help doctors understand what they need to do in “ideal” circumstances, they may not have the knowledge they need to handle more challenging circumstances.

Can you talk to former patients and see representative photographs?

Does your physician operate in a certified facility or hospital?

Does your surgeon have “staff” privileges at a local hospital in their specialty?

• This signifies that they are licensed to perform medicine, and if there is an emergency, they can transfer you to more advanced care.

Who is performing your anesthesia?

Do you need to have overnight professional help? or stay in a hospital?

Will your doctor tell you no?

• A surgeon knows how to operate, a good surgeon knows when to operate and a great surgeon knows when NOT to operate.

The funnel functions much like a cake-decorating funnel and it is lined to facilitate the slide of the implant into the breast. The funnel can work with smooth or textured implants as well as the “gummy bear” implants yet to be released by the FDA into the US market.

The proposed benefits of funnel use are:

• Shorter incision lengths
• Improved comfort and faster healing
• No touch technique
• More choices for incision placement
• Reduced force on the implant and incision

At Marin Aesthetics we are making every effort to keep up to date on the advances in Breast Augmentation in San Diego to help provide our patients with the state of the art techniques.  If you are interested in knowing more about your breast augmentation options with either saline or silicone implants – call our San Diego office at 858-638-9800.

However, despite its popularity, not all procedures are complication free.

I routinely see many patients in need of revisionary breast surgery. Several complications are most frequently seen for either capsular contracture or implant “malposition.”

Capsular contracture results in a “contraction” of the breast implant capsule (a breast capsule is normal, the contraction is not) leading to a change in the shape of the implant, firmness of the breast and, in the later stages, breast pain. We, unfortunately, do not have a clear idea about the true cause of this, and some of the most frequent presentations are in patients who have only one side affected.

Implant malposition is a situation where the breast implant settles in the non-optimal location – most commonly too low, called “bottoming out.”  This also requires corrective surgery in the form of tightening the area that is “too loose” and releasing the “tighter” areas of the capsule.

The revisionary breast surgery procedures involve a combination of tightening the excessive areas of the breast pocket – commonly termed capsulorrhaphy – and releasing the tight areas of the capsule – capsulotomy – and in some cases removing the entire capsule – capsulectomy. These procedures need to be individualized for each patient to achieve the ultimate outcome.

If you feel you are in San Diego or southern California and in need of revisionary cosmetic breast surgery, call our San Diego Plastic Surgery office at 858-638-9800 to schedule an in-person consultation with Dr. Marin.  If you are from outside the San Diego area or would prefer to do this online, visit our internet consultation page.

Dr. Vincent Marin

San Diego Plastic Surgeon

Current breast implants from both of the major manufacturers in the United States warranty their breast implants for life.  They also provide additional funds for a replacement surgery if the implants rupture in the first 10 years.  Manufacturers currently offer $1200 dollars with the standard warranty and up to $2400 with an upgraded warranty.  This can significantly reduce the financial burden associated with an implant rupture.

Silicone Gel Breast Implant Warranty

What do you do if you suffer from an implant rupture?

Deflated Left Breast Saline Implant

If you have saline breast implants, then you will experience what is akin to a “flat tire.” over the course of several days to weeks the implant will slowly deflate and the rupture will be quite obvious to both you and your surgeon.  The implant will need to be replaced and should be done in a somewhat timely fashion.  As the implant deflates, the capsule has a tendency to shrink as well, ultimately limiting the space for the replacement implant. Routinely, the same sized implant will be used as there is normally no need to operate on the other implant. This will maintain your pre-rupture appearance.

If you have silicone implants, the progression will be more subtle. Since silicone gel is more cohesive and less absorbed by the body, a rupture will likely not look terribly different if you have silicone get breast implants. Frequently, women will notice a change – sometimes how the breast feels and more often how the upper aspect of the breast looks.  This results from the gel pooling in the lower half of the capsule, making the upper aspect less “full.” A formal diagnosis is hard to make without a MRI, but if there is enough clinical suspicion we would likely proceed with surgery. The cost of a MRI can be close to that of the entire surgery.

How is it performed?

In most cases, the exchange procedure is relatively straightforward with the old breast incision being used (except that an axillary/armpit or belly button cannot be used for revision procedures), the old implant is removed, the capsule adjustments are made and the new implant reinserted into the new pocket.

What About Recovery?

The recovery is normally much less involved, especially in the case of implants placed beneath the muscle, as the muscle stretch is normally the most painful aspect of the surgery.  After a few days, most women are able to be back at their normal routine aside from exercise.  Pain is regularly mild compared to the first breast augmentation.

What do I do if I think I have a rupture?

Contact your plastic surgeon soon and be seen for an inpatient evaluation to determine what your current issues are and the appropriate next steps to remedy the problem.

Vincent Marin, MD

San Diego Plastic Surgeon