Gynecomastia, or male breast enlargement, often causes significant physical and emotional distress. This condition may develop during teenage years or earlier, when it can be especially traumatic, but also occurs later in life. Patients are usually embarrassed to remove their shirts in public, and sometimes have such severe gynecomastia that the breasts appear feminine even in a shirt. Fortunately, treatment such as male breast reduction surgery by an experienced plastic surgeon certified by the American Board of Plastic Surgery frequently results in substantial improvement.

Gynecomastia can be caused by drugs (such as marijuana or anabolic steroids used for bodybuilding), medications, hormonal imbalances or genetic conditions. Often, the condition is idiopathic, meaning that it arises for no clear reason. A properly trained physician, usually the plastic surgeon, should evaluate the patient for possible presence of underlying or treatable causes.

The first line of treatment for gynecomastia, or male breast enlargement, usually involves use of liposuction. Many patients obtain excellent results with liposuction alone, which can be performed using very small, usually inconspicuous incisions. There are various techniques to make it easier for the plastic surgeon to remove the fat and breast tissue during liposuction, including ultrasound-assisted liposuction, power-assisted liposuction, and others.

Sometimes the breast tissue is too thick and tough to be removed by liposuction alone (especially the tissue directly behind the nipple and areola). This tissue can be excised, or cut out, in combination with liposuction. Frequently, a fairly small incision around the areola can be used, resulting in a very reasonable scar.

Less commonly, some patients may have so much excess skin that a procedure similar to a breast lift or mastectomy is performed, removing the loose skin and tightening the chest. Scars can be more noticeable with such procedures. Even for patients who seem to have too much skin, it is usually advisable to begin with aggressive liposuction, reserving a second surgery to remove extra skin for later if necessary.

It is extremely important to consult a plastic surgeon certified by the American Board of Plastic Surgery, such as Orange County and Newport Beach area plastic surgeon Andres Taleisnik, M.D., when seeking evaluation and treatment for gynecomastia. For a free consultation, please call Dr. Taleisnik’s office at 714-835-6500.

In recognition of Breast Cancer Awareness Month, I think it is appropriate, and very important, to discuss the impact of breast implants and breast augmentation on mammograms and breast cancer detection.

Breast implants do interfere slightly with the ability to visualize ALL of the breast tissue during a mammogram. Reputable breast care centers and mammography centers are very familiar with the techniques necessary to obtain the highest quality mammograms. Mammograms are still important and helpful for patients with breast implants. The likelihood of damaging the breast implants or the breast augmentation surgery during a mammogram is extremely low.

Perhaps most important is the fact that large scientific studies have documented that the outcomes for women with breast cancer are similar whether they’ve had a breast augmentation or not. The size of the tumor when first detected, the staging of the cancer (how advanced it is, and how much it might have spread), and the survival rate are comparable for women with breast implants and those without implants.

In summary, most physicians believe that breast augmentation is not excessively risky from the standpoint of cancer detection. Indeed, implants are often used to reconstruct the breasts after mastectomies for cancer, in women who are truly at higher risk. It remains important for women to perform monthly self-exams of the breasts, and to obtain annual exams from their physician, in addition to regular mammograms.

The medication must be prescribed by a doctor, such as myself. Some women may experience mild irritation at first, but most can use Latisse without difficulty. It’s important to continue for at least 6 weeks, since the benefits may take more than one month to appear. If you stop after one tube (one month supply), you may incorrectly assume that Latisse isn’t helping you.

If you’re interested in Latisse, please contact my office at 714-835-6500. We have introductory discounts to get you started. Please also visit my website http://www.ataleisnikmd.com for more information about me and my practice in the Newport Beach area and Orange County.

Breast augmentation is an extremely popular procedure for good reason: most women are very happy with their results, and with their decision to undergo this surgery. One of the conditions that can lead to dissatisfaction is capsular contracture, although this too can often be treated and improved.

The human body will naturally form a membrane or tissue layer around any foreign object. We call the layer that forms around a saline breast implant or silicone breast implant the “capsule.” There is always a capsule around any breast implant, but usually the capsule remains thin and soft. Occasionally, the capsule tightens and thickens, or “contracts,” around the implant. This can cause the implant, and the breast, to feel too hard. Capsular contracture can push an implant out of its proper position, creating a breast asymmetry. It can also produce an abnormal breast shape, or a very unnatural appearance to the breasts. At times, capsular contracture can be painful.

The cause of capsular contracture is not fully understood, despite extensive research on this topic. Certain factors that increase the likelihood of developing capsular contracture have been identified, however. Excessive bleeding around the implants immediately after surgery, touching the implants with gloves that are coated with powder, and patient smoking are some of these factors. Some surgeons believe that, if a breast implant is placed in front of the muscle, a textured implant may have a lower contracture rate than a smooth implant. Some surgeons also recommend massaging the implants after surgery, although it’s not established that implant massage makes a measurable difference. Clearly, there are things that your surgeon can do, and things that you can do (avoid smoking!), to decrease the chances of a capsular contracture.

Even when all precautions are taken, however, some women will still develop capsular contractures. As a plastic surgeon specializing in breast augmentation and breast revision surgery, I frequently treat patients for this problem. A “capsulectomy” is a surgical procedure that involves cutting out the capsule and scar tissue, leaving behind soft breast tissue. It’s basically like starting over. Some women may again develop a capsular contracture after the capsulectomy, but many will not. It’s very important to avoid smoking if you are undergoing a capsulectomy. Some surgeons prescribe a medication called Singulair when operating on a patient with a capsular contracture. This is actually a medication for asthma, but many doctors believe that a beneficial “side effect” of Singulair is a reduced rate of capsular contracture. When undergoing a capsulectomy, the implants may also be replaced, so that they are brand new, with no wear or bacteria. The implant size can be changed too if desired. Sometimes, the capsular contracture may be holding the implants and breasts up, giving a perky appearance even though the breasts are too hard. Once the scar tissue is removed, the breasts may look more ptotic, or droopy. To counteract this, it may be helpful to use a larger implant, or to include a mastopexy, or breast lift.

To give yourself the best chances for a great outcome after breast augmentation, or to obtain treatment if you’ve already developed a capsular contracture, it’s critical that you consult a plastic surgeon certified by the American Board of Plastic Surgery, the only organization that board certifies fully trained and experienced plastic surgeons. I treat patients with capsular contracture (and other problems after breast augmentation) from throughout Orange County, Los Angeles County, Riverside County, San Bernardino County and elsewhere. If you’d like to schedule a consultation to meet with me, either for a first-time breast augmentation or a revision surgery, please call my Newport Beach area office at 714-835-6500. Please also visit my website for more information: ataleisnikmd.com.

One of the most important questions many patients have when considering cosmetic surgeries such as breast augmentation or breast lift, tummy tuck, or liposuction is “Where and how long will the scars be, and how will they look?” Although there is not a single answer to this question for all types of surgery and all patients, there are several factors to consider that may be helpful to most prospective patients.

Scars take a long time to mature fully, and can actually keep changing (usually for the better) for up to one or two years after surgery!  New or immature scars are often red, and frequently feel firm and sensitve or tender. With passage of time, the scars usually soften and fade in col0r. Many patients that are concerned about their scars a few months after surgery are later very satisfied when the scars improve with maturation.

Different areas of the body, and different surgical procedures, also tend to produce scars of different quality. Eyelid lift scars, for example, tend to heal extremely well, with scars that become almost imperceptible in many patients. Scars along the lower border of the areola, as used for a breast augmentation, also heal beautifully in most cases. Scars from breast lifts and tummy tucks tend to be somewhat more visible, partly due to different healing in those parts of the body, and partly to additional tension placed on the scars by the surgery. Even so, the vast majority of my breast lift and tummy tuck patients are ultimately very satisfied with the scar appearance. I make a point of placing the scars in areas where they can be easily covered by most types of clothing, underwear and bathing suits in case they do remain visible. For example, I place my tummy tuck scars very low on the abdomen, so they are covered even by very low-riding jeans or a bikini bottom. Liposuction or liposculpture scars are usually very short, around 1/4 inch, and can generally be placed in very inconspicuous areas, such as in natural creases.

It is imporant to recognize that there are some patients who may form a thicker or more visible scar no matter what is done. Patients with darker skin pigmentation are at greater risk of poor scar formation, although even my darker-skinned patients usually form acceptable scars, and are glad they chose to have surgery.

If it looks like a patient might be forming a poorer scar, or is at risk for that given a history of prior poor scarring, there are some measures that can be taken. These include topical agents such as silicone gel, cortisone, Vitamin E and others, or cortisone injections. If a scar in a “tight” area becomes to wide or raised, it is often possible to improve the scar appearance with a minor “scar revision” procedure performed many months later, when the skin has relaxed.

In order to maximize your chances for good scars and a nice outcome from your surgery, it’s important to find a plastic surgeon who is certified by The American Board of Plastic Surgery. I treat patients from all over Orange County, Riverside County, San Bernardino County and Los Angeles County, as well as other states, and would be happy to meet with you to discuss your cosmetic surgery goals and expectations. Please call my office at 714-835-6500, and visit my informative website, ataleisnikmd.com.

Dr. Andres Taleisnik

Serving Newport Beach, Riverside County, San Bernardino County, Los Angeles County

Unfortunately for our bodies, gravity is always pulling. This leads to drooping eyelids, drooping faces, drooping tummies, and yes, drooping breasts. Big breasts tend to droop or sag more than small breasts as time passes, but no breast is immune. There are other important reasons that breasts can droop. Pregnancy is a major cause of breast drooping (medically referred to as “ptosis”). I’ve recently written several articles about “The Mommy Makeover,” a combination of procedures (including breast enhancement) designed to counteract the effects of pregnancy and breastfeeding. Some women develop breasts with unsatisfactory shapes, often with ptosis, right from the start, during puberty. Other women experience severe breast drooping after losing large amounts of weight. Fortunately, procedures are available to improve all of these problems.

Breast drooping, or ptosis, is usually improved with a surgery known as a mastopexy, or breast lift. A mastopexy can raise the nipple and the areola (the darker skin around each nipple) to the appropriate height. It can help to restore cleavage, lift the breast off the chest wall, and improve the appearance and feel of breast fullness. If the areola diameter is too big, the areolas can be reduced to a more pleasing size. Many women tell me that it’s much easier to find properly fitting bras, and attractive swimsuits or clothing, after undergoing a breast lift.

The first step is to determine whether you actually need a breast lift, or if your breasts are simply “empty” or “deflated,” as can often occur after pregnancy and breastfeeding. Many patients who see me in my Orange County office requesting a breast lift actually benefit more from a breast augmentation. It’s important to consult a plastic surgeon certified by the American Board of Plastic Surgery if you’re thinking about enhancing your breasts. Your surgeon must have the necessary education, training, experience, and judgment to help you to decide which procedure will provide the improvement you desire. Certainly, there are many women who do require a lift, and others who benefit most from breast augmentation in combination with a breast lift. A breast lift alone may not be able to restore the volume and upper breast fullness that some women seek. For such patients, adding implants to a breast lift can produce beautiful results.

Any breast lift will create come scarring on the breast. In most patients, the scars fade and become fairly inconspicuous with passage of time. Some patients, however, will form scars that remain more visible (but not in clothing or a swimsuit). There are different types of lifts, each producing different degrees of scarring. Many factors determine which type of lift is appropriate for any given patient.

When ptosis, or breast drooping, is quite severe, patients require a traditional type of mastopexy, or lift. This type of lift creates more scars, but is also very powerful. The breasts can be totally reshaped and repositioned with a full mastopexy. Once again, it may be helpful to add implants as well to improve upper breast fullness and cleavage.

I often perform a modified type of breast lift for my patients undergoing breast augmentation who also require slight tightening of the breast skin and slight elevation of the nipples and areolas. This is referred to as a “concentric mastopexy.” This type of lift creates a scar around the areola only. Since the scar is at the border of two different colors and textures of skin, it tends to blend in well. Photos illustrating this can be seen on my website

If your breasts are heading south, or if you’re unhappy with them in any way, please don’t hesitate to contact my office at 714-835-6500. We can arrange a free consultation, where I can help you to decide the best way to obtain the improvements you want. I evaluate and treat patients from all over Newport Beach and Orange County, Riverside County, San Bernardino County, and LA County, as well as patients from other states, who are dissatisfied with their breasts. I look forward to helping you too.

As many women know so well, there can be a physical price to pay for having children. Unfortunate changes often occur in the breasts, abdomen (tummy), or other areas. I recently wrote an article about The Mommy Makeover, a combination of plastic surgical procedures designed to help women to regain their pre-pregnancy figures (or even better). A Mommy Makeover almost always includes a tummy tuck (or abdominoplasty), and procedures to improve the breasts. I also wrote recently about the tummy tuck component of The Mommy Makeover in greater detail. This article addresses the enhancement of the breasts after pregnancy.

Many women who were entirely satisfied with their breast size and shape prior to pregnancy complain of decreased volume, emptiness of the breasts, or sagging afterwards. Fortunately, I can offer surgical options to improve each of those problems. It is important to consult a plastic surgeon certified by the American Board of Plastic Surgery, as I am, since the surgeon must have the training, knowledge and experience to provide an individualized plan for every patient, since every woman’s needs and desires are unique.

Some women complain to me that their breasts are “saggy” after pregnancy, when they are actually just “empty.” Such patients may do extremely well with breast augmentation alone, using either saline or silicone implants (I’ve discussed the differences in a prior article). The implants can restore fullness, which is usually quite lacking in the upper breast and cleavage area in particular. There may be choices as to the final size or volume of the breasts as well. When you meet with me for your consultation, I will help you to determine whether augmentation alone will achieve your goals.

While augmentation alone may be sufficient for many women, there are certainly others who might benefit from a lift, or mastopexy, with or without implants. If the nipples are on the lower part of the breasts, or point downwards, a lift could be helpful. A lift is often beneficial if the nipples are near or below the level of the inframammary fold, which is the crease or fold beneath each breast.

If the breasts already have enough volume, a lift alone may be fine. Often, however, it’s not possible to restore the degree of fullness in the upper breasts that many women want without using implants. Such patients are candidates for an “augmentation mastopexy,” or lift plus implants.

There are also different types of lifts that can be used. If there is significant drooping (breast “ptosis”) or laxity of the breasts, a larger, more traditional type of mastopexy, or lift, must be used. Such lifts create more scars (which usually fade and become fairly inconspicuous as time passes), but are also more powerful, reshaping a severely saggy breast very nicely. If a more minor degree of lifting or tightening is required, there are lifts that involve, for example, scars only around the areolas. These are known as “concentric mastopexies,” “crescent lifts,” and others.

The good news is that a caring, well-trained plastic surgeon can improve MANY of the unwanted body changes that accompany pregnancy, childbirth and breastfeeding. As you might imagine, it’s critical to seek a surgeon who is not only well-trained and certified by the American Board of Plastic Surgery, but who will also take the time to evaluate your specific issues and desires, and to review them with you in an understandable fashion so that you can make the best possible choices. I take pride in caring for my patients with more individualized and complete attention than can be found anywhere else, as you’ll discover when we meet. Please call my office at 714-835-6500 to schedule your free consultation.

Three unwanted changes can often occur to your tummy, or abdomen, after pregnancy: stretching or sagging of the skin, loosening or bulging of the muscles, and development of stretch marks. Fortunately, a well-performed tummy tuck can often improve all three of these problems. The main purpose of a tummy tuck is to remove excess, loose skin (and some fat at times). Every woman’s skin recovers differently after pregnancy. Some women are fortunate that their skin tightens up nicely, staying smooth and without stretch marks. More often, the skin doesn’t tighten back to its pre-pregnancy state. The tummy tuck excises, or cuts out, the excess skin. The extra skin, accompanied by drooping, folds or creases, and jiggling with movement, can occur in women of any age or size. I have performed tummy tucks, with excellent improvement, on women who are 5 feet tall and weigh over 200 p0unds, and on women who are 5’7″  tall and weigh 110 pounds. ANYONE can develop loose, hanging skin after giving birth. There are photos of women of different sizes on my website.

Another important part of the tummy tuck involves tightening the abdominal muscles. I don’t remember ANY post-pregnancy tummy tuck patients who wouldn’t benefit from tightening and flattening the muscles. Muscle laxity, of varying degrees, is just a fact of pregnancy, and occurs even in athletes and fitness trainers who do hundreds of sit-ups each day. Strong, permanent sutures (stitches) are used to tighten the rectus abdominis muscles. This pulls in the waist and flattens the bulging of the tummy.

Fortunately, tummy tucks can also frequently eliminate or markedly reduce stretch marks. Much of the skin containing the stretch marks may be cut out, with the remaining skin pulled tight and smooth. If the stretch marks are mainly at the level of the belly button or below, you may have few or no stretch marks after surgery.

It’s important to remember that, although Mommy Makeovers or tummy tucks are cosmetic procedures, they are indeed surgeries, and should be performed by plastic surgeons with the highest degree of training, ongoing education, and experience, including certification by the American Board of Plastic Surgery. Dr. Andres Taleisnik has been a highly respected member of the medical community in the Newport Beach and Orange County areas for well over a decade. Please call 714-835-6500 to schedule a free consultation. You will meet only with Dr. Taleisnik, not a nurse or assistant. He will help you to determine which procedures are best and most appropriate for you, and will start you on the path back to the body you had before, or never had and always wanted.

Please watch for upcoming articles on other components of The Mommy Makeover, including breast augmentation/lift and liposuction.

Orange County, Newport Beach, Riverside County

Having children is a wonderful experience for most women, but it often leads to many undesired changes in their bodies. Some women are fortunate (not many!), since their bodies recover almost to the pre-pregnancy shape. Most never quite regain the figures they had before giving birth.

Common unwanted changes include deflation or emptying of the breasts, sagging of the breasts, and development of stretch marks or loose skin and muscles on the tummy. These problems can develop even with an excellent diet, vigorous exercise, or use of creams and other “potions.” Fortunately, as a plastic surgeon certified by the American Board of Plastic Surgery, Andres Taleisnik, M.D. frequently helps women in Orange County to regain their more youthful, pre-pregnancy bodies.

The popular term today for a combination of surgeries designed to reverse or improve the damaging effects of pregnancy is “Mommy Makeover.” Dr. Taleisnik often performs abdominoplasties (tummy tucks) together with breast surgery (breast augmentation, breast lift, or both) to provide a rapid and dramatic appearance improvement. Liposuction, such as for the hips or flanks, can be added as well.

For most women who are in reasonable health, it’s reasonable to do the various procedures at once. This results in a single anesthetic, a single recovery period or absence from work, and a lower overall cost than doing procedures separately. Dr. Taleisnik will help you to determine which procedures will be most beneficial for you, and whether you’re a candidate for the full “Mommy Makeover.” Please call his assistant Linae at 714-835-6500 to schedule your free consultation with Dr. Taleisnik.

Please watch for future articles on the individual surgeries that make up the “Mommy Makeover.”

 I perform revision breast surgeries for many different reasons. After augmentation, some women feel that their size is not what they were seeking. Implant size and shape can be changed to produce a result that pleases the patient. In my own practice, very few patients request a change of implant size, since I routinely insert sizer implants at the time of surgery to best determine what size implants will best accomplish the patient’s goals. Patients come to me who have had breast augmentations that resulted in one implant sitting higher than the other. I’m usually able to improve that situation as well.

 Sometimes a patient can be very happy with her original augmentation, but she develops problems as time passes. The implants can leak (either suddenly or gradually), since we don’t expect them to last forever. It’s usually straightforward to change the implants when that occurs. Some patients may develop capsular contracture. This refers to the tightening and hardening of the scar tissue (or capsule) that always forms around foreign objects in our bodies. Usually, the capsule stays thin and soft. Occasionally, it becomes thicker and harder. This can make the breasts unnaturally hard, and can distort the shape or position of the implants. Sometimes, it can even be painful. The treatment involves exchanging the implants, combined with performance of a capsulectomy. This means that the hard scar tissue is cut out, leaving the breast soft again.

 Another cause of dissatisfaction after breast augmentation can be the breast drooping that may occur as time passes. Skin loses elasticity as we age, and may begin to stretch out. This can happen often to women who haven’t undergone augmentation as well, but the extra weight of the implants can contribute. I frequently perform breast lifts, or mastopexies, to help women in this situation. The breasts can be lifted and tightened to provide a nicer, more youthful appearance (often with more comfort as well).

 I also see women in my practice who have undergone breast lifts or reductions elsewhere, and now need a revision of those procedures. As with anything else, the breast tissue can stretch and sag even after a lift or reduction, especially as the patient ages. A revision of the lift or reduction can often improve the situation significantly.

 Once again, please remember that any revision surgery is more complex than the original procedure. It’s important to consult a plastic surgeon certified by the American Board of Plastic Surgery who performs revision procedures often.