Dr. Walter Joseph, MD

Breast implants are very strong and can handle a lot of abuse. While they can be cut with a scalpel, tearing one by hand requires significant effort, indicating their durability.

Clavicle shortening surgery is indicated for narrowing the shoulders and creating a more feminine shoulder-waist-hip ratio. The practice typically removes about 1 inch (2 to 2.4 centimeters) from each clavicle, resulting in an overall 1 inch shortening of total shoulder width. This procedure can only be performed once, as excessive shortening can lead to an aesthetically unpleasing forward roll appearance and limit arm/shoulder range of motion. However, a 1-inch shortening is the maximum and is expected to result in a narrower, less square appearance with a slight, aesthetically pleasing forward rotation, without limiting range of motion or strength. Patients can return to 100% normal activities once healed.

There are two main options for hip augmentation: fat grafting or hip implants. Dr. Joseph generally recommends fat grafting because it looks, feels, and ages much more naturally. Hip implants, made of solid silicone rubber (not gel-filled like breast implants), are placed just above the muscle. A common problem with implants is that their edges can often be visible due to the dynamic nature of the hip area, and achieving an ideal, unnoticeable implant outcome is very difficult due to anatomical and implant manufacturing limitations. Dr. Joseph advises that hip implants should only be considered if a patient lacks sufficient fat for grafting, and if used, the smallest size the patient is happy with should be chosen, ideally camouflaged with a little fat.

Lipomas are benign fatty growths that some people develop, sometimes in multiples. The treatment for lipomas is surgical removal. It is crucial to remove the entire lipoma, as incomplete removal can lead to recurrence.

Genioplasty is a safe and effective surgical procedure designed to reshape the chin for both men and women, aiming to achieve a stronger, more balanced jawline and enhance facial harmony. It can address concerns such as a receding chin, a protruding chin, and chin asymmetry. Dr. Joseph's practice offers both sliding genioplasty (bone repositioning) and chin implants to achieve customized, long-lasting, and typically permanent results. Consultations are available to discuss goals and determine if genioplasty is the right procedure.

A Brazilian butt lift (BBL) involves fat grafting into the buttocks, using fat harvested from other areas of the body. Common indicators that someone may have had a BBL include a very tiny waist combined with a very large bottom, which makes it difficult to find pants designed for more typical body proportions. Another sign can be a bigger bottom with disproportionately skinny legs. While these proportions can occur naturally, they are not common, and often suggest a BBL or at least liposuction of the waist.

The liposuction process involved in fat grafting is very traumatic to the body and takes a while to heal. A main advantage of fat grafting, however, is that it does not involve an implant.

Cellulite is caused by three factors: skin quality, the fibroceptile band, and the fat in between. While any one factor can contribute, in most people, all three are involved. If there's too much fat, reducing it can lessen cellulite's appearance, but this isn't always the solution as many thin people have cellulite. For specific bands causing indentations, surgical cutting and releasing them can fix individual dimples. Treating the skin is the hardest approach, as collagen reduces and changes with age, predisposing to cellulite. Treatments that improve collagen, such as RF microneedling, certain lasers, and endermology, can help. However, skin treatments for cellulite rarely provide long-lasting or significant results with a single session, requiring an ongoing series for the best outcome. Cellulite is totally normal, and the practice offers both non-surgical and surgical options tailored to body goals.

Gray market peptides and non-regulated GLP-1 medications are sold outside standard medical channels, often with unclear sourcing and inconsistent quality. These products are potentially dangerous because their contents are unknown; you may not be getting what you think, or only what you think. Without proper oversight, they can be unpredictable, poorly compounded, inaccurately dosed, or mislabeled, creating real safety risks. It is crucial to be very careful and always talk with a qualified healthcare provider before considering any peptides to ensure they are appropriate, safely sourced, and properly monitored.

A BBL, or Brazilian butt lift, involves fat grafting into the buttocks using fat taken from another part of the body. Indicators of a BBL often include difficulty buying pants designed for more 'normal' body proportions, having disproportionate proportions such as a very tiny waist combined with a very large bottom, or a larger bottom and small waist combined with skinny legs. While these proportions can occur naturally, they are not common. This aesthetic is currently popular and can look 'really good,' even if the results do not appear entirely natural.

Grey market peptides and GLP-1 medications are sold outside standard medical channels, often with unclear sourcing and inconsistent quality. These products are potentially dangerous, as their exact contents are generally unknown, leading to uncertainty about receiving the intended product or components. Without proper oversight, they can be unpredictable, poorly compounded, inaccurately dosed, or mislabeled, creating real safety risks. Extreme caution is required. It is crucial to consult a qualified healthcare provider before considering any peptides to ensure they are appropriate for the individual, safely sourced, and properly monitored.

Certain plastic surgery procedures are often covered by insurance if deemed medically necessary. These typically include breast reconstruction, breast reduction, rhinoplasty (if for functional reasons), panniculectomy, and transgender-related plastic surgeries.

Clavicle shortening surgery is performed to narrow the shoulders, creating a more feminine shoulder-waist-hip ratio. Patients can expect about 1 inch of overall shortening, resulting in a narrower appearance where shoulders are less square and rotate slightly forward in an aesthetically pleasing way. This procedure can only be performed once due to limitations on how much bone can be shortened. Too much shortening can lead to an aesthetically unpleasing 'forward roll' look and limit arm/shoulder range of motion. Taking one inch of bone does not affect shoulder mobility or strength, and once healed, patients can return to 100% normal activities.

The main options for hip augmentation are fat grafting or hip implants. Fat grafting is generally preferred as it looks, feels, and ages much more naturally. Hip implants, made of solid silicone rubber, are placed just above the muscle. A common problem with implants is that their edges can often be visible due to the dynamic nature of the hip area, and achieving ideal placement and blending is very difficult. Dr. Joseph recommends using an implant only if a patient lacks sufficient fat for grafting, and in such cases, advises using the smallest size that satisfies the patient, camouflaging it with any available fat. Otherwise, fat grafting is the recommended option.

Lipomas are benign fatty growths that some individuals can develop, sometimes in multiple locations. The treatment involves surgically removing them. It is crucial to remove the entire lipoma, as incomplete removal can lead to recurrence.

Genioplasty is a safe and effective surgical procedure that reshapes the chin to help men and women achieve a stronger, more balanced jawline. It addresses concerns such as a receding chin, a protruding chin, or chin asymmetry. The practice offers both sliding genioplasty (bone repositioning) and chin implants for customized results. Genioplasty creates a more defined jawline, enhances facial harmony, and boosts confidence and self-esteem, with results that are long-lasting and typically permanent. Consultations are offered to discuss patient goals and determine suitability for the procedure.

The liposuction process, which is a part of fat grafting, is very traumatic to the body and requires a significant amount of time to heal. A primary advantage of fat grafting for augmentation procedures, such as breast augmentation, is that it does not involve an artificial implant.

Cellulite is caused by three main factors: skin quality, fibroceptile bands, and the fat in between. While any one factor can contribute, most people experience all three. Treatment approaches vary: reducing fat can help if there's too much, and cutting specific fibroceptile bands can fix individual indentations. Treating the skin, which becomes more predisposed to cellulite as collagen reduces and changes with age, is often the hardest. Treatments that improve collagen deposition, such as RF microneedling, certain lasers, and endermology, can improve appearance. However, skin treatments for cellulite typically require regular, ongoing series of treatments, as few are long-lasting or provide significant results with a single session. The practice offers both non-surgical and surgical options tailored to individual body goals.

Breast implants are very strong and can handle a significant amount of abuse. While they can be cut with a scalpel, tearing a breast implant with bare hands requires a lot of effort.