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Category: Plastic Surgery

Before and After Breast Augmentation Photos

The average plastic surgeon performs about 30 to 35 breast augmentations annually.  I performed 135 breast enlargements in 2011.  The best way to evaluate a surgeon is to look at his surgical results.  As a specialist in breast and body contouring, I strive to achieve natural and proportionate breast enlargement results.

Remember that the single greatest factor determining the appearance of your breasts after augmentation is the appearance of your breasts before augmentation.  As you view the photos below, notice that a woman’s breast shape changes very little with augmentation.  The primary changes are increased breast size and increased fullness of the upper breasts.

1. Breast Augmentation with Saline Implants:

Implant size: 330 cc implants; Incision: Inframammary fold

Estimated size change: 34B to 34C;  Height and Weight: 5’7″, 119 lbs

                          Before                                        After                               Before               After


                                            Front view                                                             Side view

2.   Breast Augmentation with Saline Implants:

Implants: 420 cc implants ; Incision: Inframammary fold

Estimated size change: 36B to 36D  Height and Weight: 5’9″, 140 lbs

                        Before                                        After                                       Before                   After


                                           Front view                                                                         Side view

3. Breast Augmentation with Saline Implants:

Implant size: 330 cc implants; Incision: Inframammary fold

Estimated size change: 34c to 34D;  Height and Weight: 5’4″, 122 lbs

                     Before                                  After                                      Before                   After


                                          Front view                                                                Side view

4. Breast Augmentation with Saline Implants

Implant size: 360 cc implants; Incision: Inframammary fold

Estimated size change: 34 small B to Full C;  Height and Weight: 5’4″, 130 lbs

                          Before                                        After                                   Before               After


                                          Front view                                                                         Side view

5. Breast Augmentation with Saline Implants

Implant size: 360 cc implants; Incision: Inframammary fold

Estimated size change: 34B to 34 Full C;  Height and Weight: 5’0″, 95 lbs

                    Before                                         After                                  Before                  After


                                        Front view                                                                   Side view

6. Breast Augmentation with Silicone gel implants

Implant size: 421 cc implants; Incision: Inframammary fold

Estimated size change: 32B to 32C;  Height and Weight: 5’5″, 120 lbs

                    Before                                        After                                 Before                   After


                                       Front view                                                                   Side view


Our breast augmentation patients come from all over Texas (Dallas, Fort Worth, Lubbock, Denton, Wichita Falls, Austin), Oklahoma, Arkansas, and Louisiana.

For blogs that I have written on specific breast enlargement topics, please see:

  1. Determining breast implant size
  2. Saline vs. silicone gel
  3. Safety of silicone gel
  4. Low, moderate, and high profile implants
  5. Smooth vs. textured implants
  6. Implant placement above vs. below muscle
  7. Capsular contracture


For articles that I have written on specific breast enlargement topics, please see:

  1. Cost of breast augmentation
  2. Breast augmentation with vs. without breast lift


Check out our website for more before and after photos.

Ronald M. Friedman, M.D.

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas



Performing Facial Injections

I am fully aware that Botox and facial fillers are available on practically every street corner. Doctors’ and dentists’ offices, medical spas, and even beauty parlors offer injectables. Patients are routinely injected by gynecologists, dentists, nurses, aestheticians, medical assistants, and occasionally personnel with no formal medical education.  The results of the injections are variable: some are pretty good, and some are awful.

In contrast to the other injectors, plastic surgeons make their living by operating on people, not by injecting them.  I am no exception.  So why do I personally perform every injection?

Botox to glabella

botox injection plano tx


botox injection plano tx


Restylane to the nasiolabial folds

restylane injection plano tx



Because I’m good at it.  With an artistic background as a wood and marble sculptor and a medical background as a plastic surgeon, I feel better qualified to perform Botox and Restylane injections than the nurses and medical assistants in my office.  I understand the anatomy of the facial muscles better than your dermatologist—because I perform surgery on those very same muscles.  I can mark the muscles for injection based on your unique anatomy, rather than using a standardized diagram provided by the medical manufacturers.  I know that Restylane and Juvederm are not interchangeable products, and I understand when to use each.  I did not develop my knowledge through a weekend course at a hotel; instead, I developed it over 17 years as a board-certified plastic surgeon.

If I am the most qualified person in my office to perform injectables, I cannot delegate this duty to anyone else.  I really do care about doing my best for my patients, and I am compulsive about providing consistent, quality results.  Although I could hire an aesthetician or train a nurse injector, I still believe that if you want something done right, you have to do it yourself.

Ronald M. Friedman

Director, West Plano Plastic Surgery Center

Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas

Dr. Friedman prides himself on personally performing every Botox, Dysport, Restylane, and Juvederm injection.  Although ice is suitable for many patients, he believes that it is unfair to charge extra for patient comfort.  So he provides effective topical anesthetics and/or 70% nitrous oxide (laughing gas) at no additional charge.  Our practice serves the Plano, Frisco, Allen, and McKinney communities.

Please visit our website for more before and after Botox and Dysport photos and before and after Restylane and Juvederm photos of patients who have been injected by Dr. Friedman.

Restylane for Saddle Noses

A saddle nose entails a concave or “collapsed” look on nasal profile, resembling the shape of a saddle.  Some people’s noses just happen to look that way.  Other people may develop saddle noses following nasal trauma, infection, or rhinoplasty. Typical treatment for saddle noses is complex.  It generally involves a rhinoplasty (“nose job”) with placement of cartilage grafts taken from the nasal septum, ear, or even a rib. I have found Restylane to be a safe, convenient, and relatively inexpensive alternative to major nasal surgery and grafting in patients with saddle noses.  Restylane is a clear gel that is injected into facial wrinkles and folds to provide better contour and volume.  While it is usually used for the lips and cheeks, it is also beneficial in improving the concave or sunken profile associated with saddle noses.  Restylane involves no surgery, no surgical incisions, and no surgical recovery.  It generally lasts about six months, so there is also no commitment. This means that you can always do a rhinoplasty once the Restylane reabsorbs–but I doubt that you will.

                  Before                                                                        After

                  Before Restylane        After Restylane

                  Before                                                                        After

                  Before Restylane         After Restylane

Saddle nose injection with Restylane

Ronald M. Friedman Director, West Plano Plastic Surgery Center Former Chief of Plastic Surgery, Parkland Memorial Hospital, Dallas Dr. Friedman is the Founder and Director of the West Plano Plastic Surgery Center on the campus of Presbyterian Hospital of Plano.  He also serves the Frisco, Fairview, Lucas, and Wylie communities.

Tummy tuck after a 137 lb weight loss: One of Dr. Ronald Friedman’s patients describes her experience on

I have a complaint.  When demonstrating before/after results for tummy tucks, most plastic surgeons carefully select women who are 5’4” and weight 120 lbs and then show an amazingly flat tummy after surgery.  For some reason, many of the patients I see for tummy tuck have less-than-ideal proportions before surgery.  In my experience, these patients are more challenging, but the results are frequently even more gratifying.

Unbeknowst to me, one of our patients has been describing  her experience, both before and after surgery, on a major website,  She is a 35 year-old woman who is 5’6” in height and weighs 203 lbs.  She previously weighed 339 lbs but lost 137 lbs following gastric bypass surgery.  She complained of extreme dissatisfaction with the appearance of her abdomen after massive weight loss.

She underwent full abdominoplasty (tummy tuck) in our West Plano Plastic Surgery Center on March 2, 2012.  Her before and two month postoperative results are below.  Final results are anticipated at approximately one year.

Full tummy tuck

Full tummy tuck


Click here for a complete description of her experience—in her own words.

For more information about tummy tucks, including more before/after photos, please click here.

Dr. Friedman is a board-certified plastic surgeon who specializes in breast and body contouring in Plano, Texas.  In practice for 17 years, his office at Presbyterian Hospital of Plano serves the Frisco, Allen, and McKinney, Texas areas. 

For more information about Dr. Friedman, please visit

Preventing Blood Clots After Tummy Tuck and Body Lift

Tummy tucks and body lifts can be life-changing procedures.  The removal of skin and fat excess along with tightening of the abdominal wall can reverse many of the problems that occur following childbirth and/or weight loss.  But make no mistake: even though tummy tucks and body lifts are cosmetic surgeries, they are still surgery.  And every surgery has risks.

The most serious risk of any excisional body contouring procedure is blood clots.  Due to the immobility associated with any major surgery (especially one that temporarily makes it more difficult to walk), there is a risk of blood clots forming in leg veins (deep venous thrombosis).

If a clot “breaks off” and travels through the bloodstream to the lungs, it can suddenly and seriously impair oxygen exchange.  This life-threatening condition is called a pulmonary embolus.  It requires immediate treatment with blood thinners (to dissolve the clot) and oxygen.

Every plastic surgeon and plastic surgery patient should take these risks very seriously.  The question: what can we do to prevent blood clots following tummy tuck and circumferential body contouring (body lift)?  We have a protocol:

  1. DO NOT smoke for at least one month before surgery and one month after surgery.  Smoking causes constriction of blood vessels, impairing blood flow and oxygenation.  Smoking greatly increases your risk of blood clots (even if you are not undergoing surgery).
  2. DO NOT use contraceptives or hormone replacement therapy for at least one week before surgery and one week after surgery.  These substances can increase your risk of blood clots (even if you are not undergoing surgery).
  3. DO walk regularly after surgery.  Every time you want to eat or use the restroom, you must have a family member or friend help you to the kitchen or the bathroom.  Regular meals in bed are just a bad idea.  Walking helps pump blood through your leg veins, preventing clots from forming.
  4. DO use SCDs. Sequential compression devices (SCDs) are mechanical pumps that intermittently compress the leg veins, promoting circulation by simulating walking.  We place these on all patients undergoing surgery in our nationally-accredited surgical facility, the West Plano Plastic Surgery Center.  We send abdominoplasty (tummy tuck) and body lifting patients home with an SCD machine for the first few days to further reduce the risk of blood clots.  I do not know of any other surgeon or surgery center that does this routinely, and I sincerely believe that they should.
  5. DO consider anticoagulants.  Anticoagulants (blood thinners) can significantly reduce the risk of blood clots.  Unlike #s 1 to 4 above, they do increase the risk of postoperative bleeding, so they must be used with caution.  For example, I will not use an anticoagulant in a patient who bleeds excessively during surgery.  However, in most patients undergoing excisional body contouring, I begin low dose Lovenox (low molecular weight heparin) in the first 24 hours after surgery and continue its use daily for a week.

With this protocol in place over the past five years, we have not experienced a single clotting—or bleeding—episode in a tummy tuck or body lift patient.

We want you to look great after surgery.  But first and foremost, we want you to be safe!

Dr. Friedman, the former Chief of Plastic Surgery at Parkland Memorial Hospital in Dallas, serves the Frisco, Allen, McKinney, and Fairview communities.

© 2018 Ronald M. Friedman, M.D., P.A.

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