Call us at 469-467-0100


Plano TX Plastic Surgery - Flower Mound TX Plastic Surgery

« Back to Blog

Category: Home

Gauged Earlobe Repair

In this video Dr. Friedman surgically repairs and then re-pierces a young woman’s gauged earlobe. The stretching caused by inserting larger and larger studs over time is reduced to a fine-line scar, and her ears demonstrate improved symmetry and aesthetic appearance.

Ronald M. Friedman, M.D.
Director, West Plano Plastic Surgery Center
Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas
www.plasticsurgerydallas.com

Can I Repair and Repierce My Earlobes at the Same Time?

Yes, you can do both at the same time.

Torn earlobes are incredibly common. Sometimes the earring pulls all the way through (complete tear); sometimes it just stretches out the hole, so that you have droopy earrings–or you start losing your studs. Either way, it would be nice to get your torn earlobe repaired and get new earrings all at once.

I know that many plastic surgeons recommend that you wait 6 to 8 weeks after earlobe repair to have your ears repierced. This has the following disadvantages:

  1. You have to come back to the office a second time for a second procedure.
  2. You have to have local anesthetic injected into your ears a second time.
  3. You have to go without earring for 6 to 8 weeks–when the whole point of the procedure is to allow you to wear earrings.

After practicing plastic surgery for over 20 years and repairing over 50 earlobes per year, I can state that it is perfectly safe to repierce your ears at the same time they are repaired. The keys to doing this successfully are:

  1. The new piercing cannot be performed in exactly the same spot as the old piercing. Otherwise the earring will simply pull through the new scar. This is true whether you have the repair/repierce at the same time or on separate dates.
  2. The new earring should be small, preferably a stud. This will allow you to care for your stitches as your repair is healing.
  3. The new earring must be left in place for at least a month before trying to change it. The danger is that you will accidentally place the earring through the adjacent repair site (see first point).
Before After (1 year)
Before Repair and Repiercing After Repair and Repiercing
59 year-old woman underwent earlobe repair and repiercing at the same time.

 

Before After (2 Months)
Before Earlobe Repair and Repiercing After Earlobe Repair and Repiercing
28 year-old woman underwent earlobe repair and repiercing at the same time.

 

 

Before After (2 months)
Before Earlobe Repair and Repiercing After Earlobe Repair and Repiercing
36 year-old woman underwent earlobe repair and repiercing at the same time.

 

Why wait 6 to 8 weeks for new ear piercings? Out with the old, in with the new–all at the same time.

 

Ronald M. Friedman, M.D.
Director, West Plano Plastic Surgery Center
Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas
www.plasticsurgerydallas.com

Botox Makes You Look Better…

…But can it make you feel better?

With annual sales north of a billion dollars, the makers of Botox must be doing something right. I personally inject Botox to the 11 lines, forehead, and crows feet about 5 to 10 times weekly, and it is highly effective in reducing dynamic wrinkles in these areas.

There is now significant research to indicate that botulinum toxins (Botox and Dysport) may also be effective in treating over half of patients with moderate to severe depression. As reported by Scientific American, The New York Times, and Clinical Psychiatry News, many patients receiving Botox report improvement in their mood. Why? People convey depression, anger, and fear by facial expression. When Botox impairs their ability to look angry or sad, they look better—not only in the mirror but also to those around them—making them feel more confident, youthful, and attractive.

Though it has not yet been studied, many physicians also believe that injection of facial fillers, such as Restylane and Juvederm, has similar positive effects on emotional well-being.

To the adage “you only look as good as you feel,” we must now add the converse: “you only feel as good as you look.”

 

Botox injection to the 11’s
DSC02402 DSC03334
Before After

 

Botox injection to the forehead
DSC02403 DSC03335
Before After

 

Botox injection to the crow’s feet
DSC02404 DSC03336
Before After

 

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

www.plasticsurgerydallas.com

The Skinny on Liposuction: There’s only so much I can do

While visiting my parents in Los Angeles last week, we toured the famous J Paul Getty Museum, which houses a number of famous paintings and sculptures. My wife photographed one of these for me with her iPhone:

As a wood and marble sculptor myself, I certainly appreciate the artist’s skill. As a plastic surgeon, the bronze sculpture got me thinking about—yes, you guessed it—liposuction. Since the sculptor, Rene Magritte, has very purposefully and dramatically divided the sculpture into thirds, let’s categorize these:

Lower third: The preoperative liposuction appearance

Middle third: The actual postoperative result.

Upper third: The desired postoperative result.

Unfortunately, it is very difficult to take the lower third and turn it into the upper third (i.e. if you are significantly overweight, liposuction will make you smaller, but it won’t make you skinny). On the other hand, if you are starting with only a modest amount of excess fat (middle third), then achieving the upper third may be more realistic.

Also bear in mind that the two of us (plastic surgeon and patient) working together are much more effective than either of us working alone. Liposuction with postoperative dieting and aggressive exercise can take a middle third result and push it closer to an upper third result. Liposuction with postoperative binge eating can take a middle third result and push it closer to a lower third result.

Liposuction (liposculpture) in a realistic, motivated patient is generally quite effective. In the unrealistic, unmotivated patient, it is a waste of time and energy.

I am unsure whether the artist was referring to the unrealistic liposuction patient—or perhaps the overzealous plastic surgeon—when she aptly titled her sculpture, “Delusions of Grandeur.”

Before After 5.4 Liters (Post-Op 1 Month)
DSC07080 DSC09419
DSC07088 DSC09433
DSC07090 DSC09431

** This 27 year old woman from McKinney presented to Dr. Friedman requesting liposuction of her abdomen, flanks, upper back, inner thighs, mammary folds, and arms. She underwent 5.4 liters of liposuction and at her 1 month follow up she demonstrates improved contour of all regions including a flatter stomach and smoother waist line.

 

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

www.plasticsurgerydallas.com

Improving Nipple Projection: Surgery for Inverted Nipples and Flat Nipples

Inverted nipples are surprisingly common, occurring in 3 – 5% of women. Instead of the nipple “pointing out,” it retracts inward, usually due to tethering bands of fibrous tissue. Most women with inverted nipples have a normal amount of nipple skin; it’s just pointing the wrong direction.

Inverted nipple repair
inverted nipple front before inverted nipple front after
Before After

 

Flat nipples are also quite common. This entails a lack of nipple projection due to a lack of nipple skin. Flat nipples are not tethered; they just remain flat despite heat, cold, and stimulation.

Flat nipple repair
flat nipple side before flat nipple side after
Before After

 

Surgical treatment of both inverted nipples and flat nipples is essentially the same. Over the last 20 years, my technique has evolved to utilize very small incisions for these repairs.

 

Surgical sequence (about 30 minutes per nipple in the office under local anesthesia):

  1. I mark the outer border of the nipple. In women with flat nipples, this outer border will be widened, in order to recruit adjacent pigmented areolar skin to become nipple skin.
  2. We provide laughing gas (70% nitrous oxide) to help you feel tipsy.
  3. Local anesthetic is injected to the surgical site. After this, you will experience no pain.
  4. Two sutures are placed in the center of the nipple to enable traction.
  5. A small incision (about 3 mm or 1/8th inch) is made adjacent to the nipple.
  6. Fibrous bands are divided to “release” the nipple, enabling improved nipple projection.
  7. An absorbable “purse-string” or drawstring suture is placed around the base of the nipple, further improving projection and preventing recurrent retraction or flattening.
  8. The 3 mm incision is closed with two or three absorbable sutures.
  9. A surgical dressing is applied to protect the repair and to splint the nipple in its new projecting position. The dressing “sticks out” quite a bit, so we usually refer to it as “the Madonna bra.”

 

Postoperative recovery:

  1. You can drive yourself home. The laughing gas wears off in about 10 minutes.
  2. We will remove your Madonna bra dressing and the traction sutures one week after surgery. Your nipple correction should be immediately apparent.
  3. You will treat the 1/8” incision with antibiotic ointment for about another week.
  4. You will need to avoid compression of the nipples for about 6 weeks. This means going without a bra or cutting large holes in the center of an existing bra.

 

Keep in mind that the sole purpose of surgery for flat or inverted nipples is to improve their appearance. Women with these conditions are frequently unable to successfully breastfeed prior to surgery—and will generally be unable to do so after surgery.

 

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

www.plasticsurgerydallas.com

© 2018 Ronald M. Friedman, M.D., P.A.

Contact Us At 469-467-0100

Web design by Ciplex, development & marketing by Plastic Surgery Studios.