Preoperative Planning with Computer Simulation

With all of the advancements in plastic surgery procedure techniques and the technology employed, procedures are becoming safer, and surgeons are now able to better predict the results. California plastic surgeon Dr Craig Creasman does exactly that with a new technology for breast augmentation surgery called 4-d Simulation. This technology is aimed at aiding in the pre-operative planning stage of the surgery.

Dr Creasman states"I discuss surgical options with my patients using this new computer imaging, which can demonstrate the changes I would suggest for the changes we would make during the surgery. Using this technology, 4-D images can be obtained in short time, which I then manipulate to give an educated estimate of what might a patients breasts will look like after breast augmentation surgery. This system also allows for more flexibility in the choice of breast implant, which helps to create a more personalized result. "

Though this technology is not a guarantee or warranty of the proposed surgical result, it does help to provide the patient and the surgeon with a visual communication aid. This is important because it allows the patient to give the doctor feedback and allows the surgeon an opportunity to convey to the patient the limitations of what can be done, as well as the possible results. It is very important for the patient to visualize how she will look with the breasts she desires, and this system becomes an educational tool in with which the patient can view the result third-party, rather than just listening to the surgeon visualizing the results while standing in front of a mirror with a breast implant held up to her body.

Gynecomastia Affects Half Of All Men, But Surgery Can Help

Gynecomastia is the proper medical term used to describe irregular breast development in males. Gynecomastia is a condition that affects almost half of males during development and it is a fairly common condition that can occur on either one or both sides of the chest. This condition is the result of extra breast tissue, fat, or both. Usually, gynecomastia develops during a normal phase of development. This condition can happen at the beginning stages of puberty, however in most cases reverts by the age of 20. This condition can also happen during aging in normally healthy males. Other "pathological" causes of gynecomastia can occur, usually due to both a decline in the production of the male hormone testosterone, and an increase in the production of the female hormone estrogen. The use of certain drugs can also contribute to the cause of gynecomastia.

A plastic surgeon will usually treat this condition by reducing the size of the soft tissues by removal of the fatty tissues through a liposuction procedure or through the open removal of the breast's glandular tissues through a tiny incision around the areola. In cases where the patient has excessive amounts of skin, longer incisions are ultimately necessary for the removal of the excess skin and tissue. These longer incisions will also result in a larger scar.

An Under Developed Chin Can Be Corrected Through Surgery

A person with a small chin can appear weak and a small chin can also be the source of teasing and ridicule. A lower jaw that has not properly developed, with an irregular contact of teeth in the upper and lower jaw (a condition known as malocclusion) or an overbite requires a combination of orthodontic and maxillofacial surgery to relocate the entire jawbone forward thereby correcting the imbalance. However, in most cases, the teeth and upper and lower jaw are properly aligned, but the chin has not developed normally. In such cases, major surgery is not necessary. The use of a prosthetic facial implant can result in a very effective correction of this problem. When choosing an implant the correction method, the plastic surgeon will insert the implant through a small incision either under the chin or though an incision in the mouth.

What is Liposuction Surgery?

Liposuction involves the removal of fat by small tubes, or cannulas, attached to a vacuum aspiration device. Only fat in the subcutaneous layers of the body are accessible for liposuction. Patients with fat inside their abdomen, for example, are not helped by liposuction, but instead must resort to dieting and exercise for this visceral fat loss. Liposuction is not a substitute for proper diet and exercise. Although liposuction, per se, is not a reliable way of losing weight; it is a very reliable means of contouring.

Once the fat cells are removed, your net fat cell number is reduced permanently, thus making it theoretically more difficult for you to regain the fullness in the treated area. Liposuction is essentially a redistribution operation in that the fat in the areas treated is reduced in proportion to the rest of the body. We are frequently asked if the fat "goes somewhere else", or if one tends to put on weight in other areas of the body. One explanation for this perception may be that without a change in caloric intake, in the setting of stable or declining basal metabolic rate (which occurs as we age), it is predictable that fat would accumulate as a means of storing energy. If the depots of fat that were once present have been significantly reduced in capacity, then it follows that those fat depots remaining untreated may tend to accumulate more fat if energy intake exceeds energy expenditure.

It is therefore very important that patients considering liposuction understand the importance of diet and exercise in maintaining their weight, and realize that liposuction is not an alternative to a healthy lifestyle.

A comprehensive assessment by the plastic surgeon of each patient on an individual basis is essential to the development of a specific treatment plan directed at identifying those specific areas that may be responsive to liposuction. In many instances, patients seek consultation for what amounts to a desire to lose weight. A stable Body Mass Index of less than 27 is necessary to be considered a candidate for liposuction. You should be aware of your Body Mass Index (BMI) and your surgeon's guidelines for what constitutes good candidacy for liposuction . In most surgeon's experience, patients with a BMI above 27 are usually too overweight to derive a good result with liposuction. Their problem is more generalized, and liposuction would not typically be able to access areas of fat accumulation, such as the fat within the abdominal cavity. The ideal candidates have very specific areas of their bodies, which cause them concern and seem to be unresponsive to dieting and/or exercise. Liposuction affords us the ability to sculpt those specific areas with very small incisions (and thus very inconspicuous scars), thus bringing the patient into proportion with the rest of his or her features.

Most plastic surgeons offer a complimentary consultation during which he/she gathers a medical history, including the patient’s weight gain and loss pattern, diet and exercise regimen, and goals for the procedure. Any previous medical conditions need to be identified prior to assessing the patient for surgical candidacy. Height and weight measurements are taken and a physical examination is done to assess the skin tone and texture, skeletal abnormalities such as scoliosis, and muscle bulk and tone. Digital images are obtained and using sophisticated morphing software, surgeons who employ this technology can demonstrate a realistic estimate of the result you might obtain with liposuction. This provides you with an image of yourself which is enormously useful to your decision-making about whether this is a procedure which would satisfy your goals.

4D Simulations are personalizing Breast Implant Surgery

After examining your breasts, your surgeon will generally want to discuss your surgical options with you using this new computer imaging, which can demonstrate for you the changes he would suggest for your breasts. 4-D images will be obtained very quickly, which he can then manipulate to show an educated estimate of what might be achievable with surgery, with the ability to vary the implant choice.

Though this is not to be implied as a warranty of the surgical result, it does provide a visual communication aid both for you to give the doctor your feedback and for him to convey to you the limitations of what can be done, as well as the possibilities. It is important to see how one actually looks with the breasts you think you want, and it becomes an educational process to view the result as a third party, rather than just leaving it to the verbalization of the plastic surgeon while looking in a mirror with an implant held up to your body.

Pre Op

Post Op (9 month)

Simulation