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Arm Lift (Brachioplasty) Surgery at The Breast Implant Center of Hawaii

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Dr. S. Larry Schlesinger performs a brachioplasty surgery (arm lift) on this 60+ year old woman. They open their operating room to demonstrate how to safely remove excess skin under the arms, in spite of nerves, veins and arteries.

Arm Lift (Brachioplasty) Surgery at The Breast Implant Center of Hawaii – GRAPHIC.

Cosmetic Hand Lift (Rejuvenation) with Restylane

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Dr. Schlesinger demonstrates what hand rejuvenation is like using Restylane. This patient is in surgery for two other procedures so she is under anesthesia. Video includes the before and after image.

Video transcript:
And now we’re going to inject the hand with Restylane. And Restylane will fill up the spaces between the tendons…she’s not showing quite as many veins on this side but you can see the veins going this way. But we are going to make it look younger by injecting Restylane in between the tendons and hopefully in between the veins.

We’re going to put four cc’s of Restylane in. That should give us a really nice long lasting improvement. At least about five to six months if not more.

Up toward the knuckles you have depression too.

And you can see it’s starting to fill it out nicely. Getting rid of a lot of the visible tendons and visible veins. You mold it in there.

There we go. Nice improvement. A little lasering, even better.

How Long Is Recovery for Breast Augmentation Revision for Capsular Contracture?

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How Long Is Recovery for Breast Augmentation

Video transcript:
Hi, I’m Larry Schlesinger and I’m a board-certified plastic surgeon from Honolulu, Hawaii.

Today’s question is What is the length of time of recovery after a capsular contracture breast implant revision?

In a capsular contracture situation, you have this capsule completely surrounding the implant and it makes the implant hard. So what you need to do, these are best perhaps only operated on through a peri-areolar incision, the bottom of the areolar complex. You go in, you take out the capsule, you take out the implant, and then at least at the Breast Implant Center of Hawaii, we put in a drain. And that drain stays for a minimum of three days.

Usually we keep an ace wrap on for a couple more days. You decrease the chance of blood around the implant which could lead to a second capsular contracture.

So the answer to the question of “How long is the recovery?” The recovery is three days for the drain, the recovery is about five to six days to start to go back to work, driving the car, etc. And how soon before you feel completely normal, and you can do anything? Usually it takes about two weeks, perhaps three but that’s about it. It’s not a huge recovery but you do have to decrease the chance of bleeding again and that would add more time to the drain and to the recovery.

I’m Larry Schlesinger from Honolulu, Hawaii and thank you very much for listening. Aloha.

Breast Augmentation Revision – What if I get The Wrong Size Implant?

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Breast Augmentation Revision – What if I get The Wrong Size Implant?

Video transcript:
Hi, I’m Larry Schlesinger and I’m a board-certified plastic surgeon from Honolulu, Hawaii.

Today’s question is what if I get a breast augmentation and choose the wrong size implants? What happens next?

Well, the answer to that question is something you should have done beforehand. Sit down with your plastic surgeon, go over the size, determine that it’s exactly what you want, try on implants and bras which we do, bring in a wish picture so the plastic surgeon understands where you want to go to and be sure you understand where you want to go to.

However, if your plastic surgeon has put in breast implants and they’re not the size that you wanted then I would call my plastic surgeon and have a heart-to-heart about what is the next step. Also, to kind of obviate this problem, whatever your plastic surgeon’s policy is, you should know it before surgery not after surgery.

Thank you very much for listening to me. Aloha.

Tummy Tuck and Liposuction

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Tummy Tuck (Abdominoplasty) and Liposuction Video Review – Honolulu Plastic Surgeon, Dr. S. Larry Schlesinger.

Since All Wounds Heal By Scarring, How Do Board Certified Cosmetic Plastic Surgeons Deal With The SCAR PROBLEM?

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Treatment of Scarring After Cosmetic Surgery

  1. The best way to treat a scar after cosmetic surgery is to prevent it or decrease the chance of it ever happening.
    • Cosmetic plastic surgeons often hide scars where no one really looks, for example, chin implants placed through an intra oral incision (in mouth), breast augmentation scars placed in the armpit, and abdominal liposuction scars that are hidden inside the belly button.
    • Tension is the number one cause of thickened scars (hypertrophic scars). Well done abdominoplasty and breast reduction closures have layers of suture material below the skin to take the tension off the final skin incision,and therefore decrease thick scarring. Many cosmetic plastic surgeons place strong suture material in the SFS (superficial fascial system) originally described by Dr. Ted Lockwood of Kansas City.
    • Removing staples and sutures early decreases the cross hatch markings often seen after tummy tucks. Because of the multi layered closure on abdominoplasties, in my practice, we remove all staples and sutures in the abdominoplasty incision at 3 days and rarely do we get excessive scarring.
  2. In the early post suture removal period, one can place strong tape over the suture lines to decrease thickened and/or spread scars. There are several products on the market including Embrace®, silicone sheeting, and strong tape. These products teach the new collagen to lay flat during the wound healing process and prevent thick scars from forming by mechanically teaching the new collagen to come in flat rather than in whirls and swirls.
  3. If hypertrophic scarring forms, historically, cosmetic plastic surgeons have injected dilute solutions of corticosteroids such as Kenalog. Unfortunately, steroid injections can lead to hypopigmentation, scars spreading, and temporary and/or permanent destruction of surrounding fat leading to scar depression which can be less aesthetic than the original scar.
    • Scars are made up of fibroblasts and the collagen they form.
    • Antimetabolites are known to show antifibroblastic activity decreasing the proliferation of infiltrating fibroblasts, ultimately lowering the production of collagen and decreasing the density of the extracellular matrix. What this means is that the 5-FU prompts a quicker, thinner, and more aesthetic scar formation.
    • 5-FU works best when injected into early scar formation within the first 3 months of the surgery. However, scars present for several years can be advantaged by the use of interlesional 5-FU.
  4. Systemic complications associated with large dose cancer chemotheraphy treatments not seen in interlesional scar treatments of 5-FU.
    • A 2002 study by Manuskiatti & Fitzpatrick showed that interlesional 5-FU caused minimal to no complications as did laser treatment. Interlesional injections of 5-FU caused resolution of scars faster, and the incidence of adverse local reactions was only seen with the use of injectable corticostaroids.

In summary, well done plastic surgery attempts to hide incisions in inconspicuous locations, decrease the amount of scar formation through various topical modalities, and if thickened scars do occur, they are best treated by interlesional 5-FU therapy.

What Was Surgery Like?

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Gina shares what the day of breast augmentation surgery was like for her.

Video transcript:
I felt really prepared which was a big deal for me. I think if I hadn’t had all my ducks in a line I would have been going insane. But it was nice we were ready, packed, my friend came, picked me up drove me over there. I really didn’t get nervous until they went to put me on the table and kind of started the process and I think it sort of hit me like a ton of bricks like oh my goodness am I really doing this right now, my husbands gone, am I crazy, did I make the right decision. All those things started going through my head. I sort of just relaxed into it. We were making jokes and laughing with the staff and everybody and Dr. came in and talked to me and we went over what we needed to and I was just like, OK let’s do this and ready to go and the next thing I know I woke up. I woke up I don’t remember too much and then the next thing I remember is going up the stairs at my house to my bed. My friend did take care of me and I did take the pain medication as I was supposed to. I didn’t see them so I was almost wishing I could see my breasts but at the same time I was resting and the time passed and it was so quick when you go back in to see the doctor when you actually do get to see your results and outcome.