Question 1

What options does Dr. Blau offer for lower eyelid skin tightening?

Accepted Answer

For younger patients with elastic skin, Dr. Blau may use a CO2 laser or a chemical peel on the lower lid to achieve skin tightening.

Question 2

What is a tuberous breast and how is it corrected?

Accepted Answer

Tuberous breast, sometimes called a constricted breast, occurs when the breast tissue is constricted and hasn't expanded fully, often appearing cone or tube-shaped. In severe cases, tissue is concentrated behind the nipple-areola. Clues include a breast not occupying the full chest width or a very short distance from nipple to inframammary crease. Correction involves releasing constrictions and can sometimes involve an implant, but not always, as different techniques can be used; a lift is not always necessary.

Question 3

What is dual-plane breast augmentation and how does it relate to 'under the muscle' implants?

Accepted Answer

Dual-plane is the most common way under-the-muscle implants are placed, with 99% of 'under the muscle' augmentations being dual-plane. It means the implant is partially covered by the pectoralis major muscle (typically the upper two-thirds), with the lower portion not covered. There are three variations (Dual-Plane 1, 2, and 3) based on the degree of muscle separation from breast tissue. Dr. Blau primarily uses Dual-Plane 1, where the implant is placed on the muscle, but not completely wrapped by it, a technique more common in breast reconstruction.

Question 4

What are the post-operative bra recommendations after breast augmentation?

Accepted Answer

After breast augmentation, patients are advised to wear a gentle compression bra for approximately six weeks. This helps keep everything in place without excessive pressure on the breasts or incisions. Dr. Blau's practice provides this bra. Underwire bras should be avoided during this initial period as they can press on the incision, potentially impacting scar appearance, and may not effectively support the implants.

Question 5

What is the 'no-touch' technique for implant insertion?

Accepted Answer

The 'no-touch' technique aims to minimize bacterial exposure from the skin and nipple during implant procedures and facilitate thinner incisions. It uses a sterile funnel with a small opening to deliver the implant into the pocket by squeezing or pushing it, without the implant touching the skin. This technique can be used for both breast reconstruction and augmentation.

Question 6

How are breast implant size and profile determined?

Accepted Answer

Breast implants are geometric objects with three main factors: width (or diameter), projection (or profile), and volume (or cc's). Only two of these three can be chosen independently, as the third is then mathematically determined. For example, if a high profile implant with a width of 12 is chosen, its volume must be 350 cc's. The best approach for implant sizing is a consultation, where measurements are taken, goal photos reviewed, and a solution developed collaboratively to match both anatomy and aesthetic goals.

Question 7

How does Dr. Blau perform a breast lift to avoid upper scars?

Accepted Answer

Dr. Blau utilizes a 'push-up maneuver' for breast lifts to avoid the large, undesirable scars typically created at the top of the breast area in traditional lifts. This technique involves a geometric approach to bring specific points together, effectively lifting the breast without creating scars on the upper part of the area.

Question 8

What is involved in an implant exchange procedure?

Accepted Answer

Dr. Blau performs implant exchanges, including 'awake' procedures. Patients are offered choices in implant sizes and types (e.g., larger, more cohesive, gummy bear implants). Pre-operative steps include medication and gowning. During the procedure, new implants are placed, and dissolvable stitches are used. For example, a patient might receive 510 cc implants.

Question 9

What is Canthopexy (lateral canthal tightening) and what results can be expected?

Accepted Answer

Canthopexy is a procedure to tighten the lateral canthal region of the eyelid. Dr. Blau performs this in 99% of lower blepharoplasties to effectively hold the eyelids up and prevent drooping after surgery, contributing to a stable and aesthetically pleasing result.

Question 10

Does the 'no-touch' technique reduce the risk of implant complications?

Accepted Answer

The 'no-touch' technique is designed to minimize bacterial exposure from the skin and nipple during implant insertion, which is a factor in reducing the risk of infection. While the doctor aims to exclude bacteria as much as possible, the video does not explicitly state a significant reduction in capsular contracture.

Question 11

Does the 'no-touch' technique significantly reduce the risk of capsular contracture or infection?

Accepted Answer

The 'no-touch' technique is designed to minimize bacterial exposure from the skin and nipple during implant insertion, which is a factor in reducing the risk of infection. While the doctor aims to exclude bacteria as much as possible, the video does not explicitly state a significant reduction in capsular contracture.

Question 12

How does the 'math' of implant design translate into choosing the right size and projection for an individual patient?

Accepted Answer

Breast implants are geometric objects with three main factors: width (or diameter), projection (or profile), and volume (or cc's). Only two of these three can be chosen independently, as the third is then mathematically determined. For example, if a high profile implant with a width of 12 is chosen, its volume must be 350 cc's. The best approach for implant sizing is a consultation, where measurements are taken, goal photos reviewed, and a solution developed collaboratively to match both anatomy and aesthetic goals.

Question 13

What exactly is the lateral canthal region and what kind of results can be expected from tightening it?

Accepted Answer

Canthopexy is a procedure to tighten the lateral canthal region of the eyelid. Dr. Blau performs this in 99% of lower blepharoplasties to effectively hold the eyelids up and prevent drooping after surgery, contributing to a stable and aesthetically pleasing result.

Question 14

What does Dr. Blau say about their techniques?

Accepted Answer

Sometimes with an implant, sometimes not, you know different techniques that we can use. But most cases, it's going to be a dual-plane 1, which means we put the implant on the muscle. We don't drag the muscle down to completely wrap the implant in the muscle. The practice aims to exclude bacteria from the skin and nipple as much as possible during implant procedures.

Question 15

What does Dr. Blau say about what they specialize in?

Accepted Answer

The practice performs a 'push-up maneuver' to lift things without creating scars higher up. When an implant is placed in the 'under the muscle' position, only part of it (e.g., maybe two-thirds) will be covered by the muscle, and the rest will not be.

Question 16

What does Dr. Blau say about recovery?

Accepted Answer

The practice advises against underwire bras in the early post-operative period because they put too much pressure on the incision.

Question 17

What does Dr. Blau say about safety?

Accepted Answer

The practice performs awake implant exchanges.

Dr. Jared Blau, MD

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