Exparel is a long acting anesthetic medication can be injected into the tissues at the time of surgery (you dont even have to experience the injection). This allows for a slow, continuous release of numbing medication for the first 72 hours after the procedure. This is the time that is normally the most challenging for patients and often requires the most medication. With the use of this injectable drug, patients have had the need for little to no postoperative main medication. With our early experience, our San Diego breast augmentation patients have seen a nearly pain-free recovery.

If you’re interested in your options for a pain free San Diego breast augmentation, please contact our office at 858-638-9800 to schedule your in-person, complimentary consultation. Pain maybe a thing of the past for patients who are interested a breast augmentation or tummy-tuck surgery with the use of the latest, most advanced tools on the market.

Dr. Vincent Marin

However, there does appear to be a new approach to liposuction that is showing promise of better results with lessened complications and no additional cost – the best of all worlds. This technique is called SAFE liposuction and was first introduced by Dr. Simeon Wall in Louisianna. This technique involves three distinct steps to help improve the overall results.

• S – separate
• A – aspirate
• F – fat
• E – equalization

SAFE lipo begins with using an “exploded” tip for the lipo to help separate the fat from the underlying tissues without using a suction device. This helps to even out the fat to be removed to improve the suctioning process. You can see a close up of the “exploded” tip versus a normal cannula in the photo. The next step is the aspiration or removal of the unwanted and dislodge fat from the separation phase. This is much like the standard approach that most doctors use to remove fat. Finally, we then use the fat equalization technique to help ensure an even and smooth postoperative body contour. This helps to ensure the underlying fat is smooth and even, even after the previous steps. Each step of the SAFE technique helps to build an improved surgical outcome without the risks or additional costs associated with lasers, ultrasound or water jets.

Here is an example of a patient who was unhappy with previous liposuction and a tummy tuck with significant abdominal wall scarring – often a significant challenge for any liposuction technique. She is seen with a more defined waist with and even and smooth contour.

If you are interested in liposuction or want more information to see if you are a candidate for SAFE liposuction, call us for a complimentary consultation with Dr. Marin 858-638-9800.

A “gummy bear” type breast implant is shaped like a teardrop and has a textured surface. This means that the upper portion of the implant is relatively flat and the lower segment fuller much like the shape of a normal breast when upright, however, this will not change when the patient is laying down. Normally, gravity will direct most of the breasts weight to the lower aspect on the chest giving it this “natural” shape. However, this means that they implant has a specific orientation of top, bottom, front and back. If this implant shifts its position is possible that patient will end up with a fullness in an unwanted area or vice versa. This means that there is more of a challenge in the surgical insertion of this implant as there are very specific requirements. Also, when a woman lays on her back, her breast will take a more flattened position. This allows gravity to distribute the breast tissue evenly across the chest. An anatomic/tear-drop “gummy bear” implant does not change its shape with gravity. And thus, when a woman lies down with these implants will maintain an anatomic appearance, unlike the natural tendency of a breast.

Purported Advantages over current silicone gel implants:

• Improved breast shape
• Decreased capsular contracture rate
• Decrease risk of implant rupture
• Decreased risk of rippling of the breast

Potential Disadvantages:

• Increased cost
• Feel – they are firmer than memory gel implants.
• Longer scar
• Possibility of rotation – The implants are “anatomic” or “tear-drop” shaped and there is a possibility that the implant could rotate early in the healing process leading to an unusual shape [though a textured surface can help prevent this]
• Difficulty with secondary surgeries such as removal and replacement of implants due to the textured surface of the implant causing in-growth of tissue onto the implant capsule

A standard round breast implant will follow along with the natural breast when gravity is factored in. There is a tendency for the cohesive silicone gel to settle at the lower end of the breast when the patient is upright. This allows for an effective teardrop shape of the breast despite the round design. In addition, what a patient lies down the implant will lay in a  flattened out position, much like a regular breast. Finally, since standard implants are round there is no top bottom front or back to these implants. This allows a considerable degree of flexibility with round implants. This implant can move freely within the breast pocket, much like a natural breast, without any of the restrictions related to its anatomic counterpart.

I currently feel that round implants are superior to the new “gummy bear” devices despite the fact that they have been on the market for the past five years. Just because something is new does not mean it is better.

Despite all of this, there are circumstances where the gummy bear implant will prove to be useful for women and breast augmentation. This will be most notably in women who have had previous problems related to breast augmentation. Patients suffering from capsular contracture may find that these implants resists this better. Also, patients who suffer from visible rippling of the implants may see improvement as these implants do not have this tendency related to the cohesive nature of the implants. Also, women who undergo breast reconstruction surgery will likely see improved overall outcomes from these implants.

In conclusion these implants do add additional choices to the marketplace for women considering breast augmentation. That being said, it may not be the best choice for every patient but something you should discuss with your surgeon. It is of utmost importance to choose a board-certified plastic surgeon when scheduling your consultation. This will allow you will be able to determine which implant is best for you and your specific circumstances so that you have the highest chance for success with your breast augmentation.

Dr. Vincent Marin

Board Certified Plastic surgeon

There are several current thoughts as to why this happens in patients, but even in the scientific community is not fully understood. It happens almost equally in patients with both saline and silicone breast augmentations, and more often than not, it will happen only on one side. This makes understanding capsular contractures even more of a challenge.

There are several potential ways in which we can help minimize the occurrence of this in our patients. As a result, we have made every effort to implement all of these potential cutting-edge techniques to help improve our patients overall breast augmentation experience. Firstly, we use very specific antibiotics to help purposely treat the bacteria that is commonly on the breast and within the breast’s ductal system – as these are unique organisms found to be associated with capsular contracture from breast augmentation. Secondly, the majority of patients we see in San Diego, undergo placement of the implant beneath the chest muscle which also reduces the risk. Then, the breast undergoes a second “sterile prep” to help remove any unwanted bacteria that can hide within the breast ducts. Next, the implant is inserted with the use of a Keller funnel which significantly limits the exposure of the implant to the surrounding breast skin. Studies have shown that the use of the Keller funnel will reduce the breast implants exposure to bacteria by 27 times. This is remarkably significant.

The breast implant is only handled by Dr. Marin, and the breast is rinsed with triple antibiotic solution prior to inserting the implant itself. Finally, the breast pocket is immediately closed after insertion to again help limit the exposure of the implant to any of the potential causes of capsular contracture.

Although we haven’t cured capsular contracture, we have found a way to significantly reduce the incidence of this problem for our breast augmentation patients and will continue to be on the cutting edge for our San Diego and Southern California patients.

If you are interested in knowing more about your options for the correction of capsular contracture in San Diego or Southern California, call our office at 858-638-9800 to schedule a formal in-office consultation with Dr. Marin.

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.