Considering Transgender Top Surgery? What You Need to Know!
Each year, more than 9,000 patients across the United States undergo transgender top surgery. Also called sex reassignment surgery, both FTM (female-to-male) and MTF (male-to-female) variations are widely performed, with patients most appreciating the marked improvement in confidence, body image, and overall quality of life.
If you’ve been considering transgender top surgery, you probably have questions. Are you a good candidate? What is the preparation and recovery process like? Will this procedure affect any other part of my transition?
At DeLuca Plastic Surgery, we’re here to help. We want to make every procedure as transparent and beneficial as possible. Before you decide on FTM or MTF transgender top surgery, here’s what you need to know.
Transgender Top Surgery: MTF
MTF transgender top surgery, also known as transfeminine top surgery or transgender breast augmentation, aims to feminize the patient’s chest by enhancing the size and shape of the breasts. As the latter name suggests, the procedure most commonly involves breast augmentation–or implants–to recontour, reshape, and revitalize the chest for a fuller, feminine look.
More importantly, for many patients, the procedure means no more wearing artificial breasts or padded bras–or dealing with body or gender dysmorphia.
Transgender Top Surgery: FTM
FTM transgender top surgery, or masculinizing chest surgery, aims to masculinize the patient’s chest by removing breast tissue. However, the goal is more than just a flat chest–it’s a sculpted, masculine aesthetic. Whereas MTF procedures enhance and fill the breast via implants, FTM procedures reduce and flatten the chest through subcutaneous mastectomy.
Like its MTF counterpart, masculinizing chest surgery can help alleviate body and gender dysmorphia and avoid the risks and complications of chest binding.
Preparing For Your Procedure
During your initial consultation, we’ll go over your goals, medical history, and overall physical and mental health to ensure you’re a good candidate.
Before top surgery, most surgeons recommend patients obtain a letter of support from a mental health provider. This letter asserts that patients meet the World Professional Association of Transgender Health standards of care criteria.
Additionally, like any other procedure, patients must be in good physical health.
Once approved for surgery, patients should discontinue smoking or nicotine use as well as caffeine and alcohol intake. Patients taking testosterone, estrogen, or other hormone treatments may continue taking them depending on your schedule.
Your surgeon will give more precise instructions on what you can and cannot take as the date of your procedure approaches.
What to Expect During Your Procedure
FTM top surgery is done outpatient under general anesthesia. Depending on your breast size, we’ll work with you to develop the best surgical method for optimal results.
During the procedure, we’ll make incisions in the skin to remove breast tissue, contour and reduce the breast wall, reposition the nipples and areola, and reshape the chest.
MTF top surgery is also done outpatient under general anesthesia. Again, depending on your intended breast size, we’ll work with you to develop the best surgical method for optimal results.
During the procedure, we’ll use silicone or saline implants to augment breast shape and increase breast size to reshape the breasts into a feminine look.
Both procedures take anywhere from 2-4 hours and patients are free to return home post-procedure.
Recovery & Outlook
Recovery time varies from patient to patient, but most patients can return to work within a week or two post-procedure.
For most patients, the first-week post-procedure is the most uncomfortable, but most side effects, including swelling, discomfort, and soreness, typically subside within a few weeks.
During that first week, we recommend patients sleep on their back and avoid both showering and strenuous activity. To control swelling and discomfort, we recommend the use of an ice pack.
About a week after your procedure, you’ll meet with your surgeon for a postoperative appointment. At this point, we’ll remove the dressing and you’ll get to see your new chest for the first time.
Ready to Schedule Your Consultation?
Research–including scientific studies–has found an overwhelming majority of patients approve of their decision. Less than 1% of study participants expressed regret. The consensus is clear: FTM and MTF transgender top surgery helps patients achieve a new lease on life.
DeLuca Plastic Surgery is proud to offer the most advanced, cutting-edge techniques in FTM and MTF transgender top surgery. From your initial consultation to your stunning results, we’re in your corner to answer all your questions, alleviate your concerns, and improve your confidence, body image, and quality of life.
If you’ve been thinking about transgender top surgery, don’t wait. Schedule an in-person, phone-in, or instant email consultation with us today!
Feel Your Best in Your Summer Skin!
The summer months are a time for sun-kissed skin, showing off your glistening, bronzed summer body, and feeling your best and most confident. At the same time, too much exposure to the sun can have a major detrimental impact on your summer skin.
Let’s take a look at how to keep your skin safe and healthy during the most UV-intensive summer months!
Taking Care of Your Skin
Your skin makes up about 15% of your total body weight. Though it may grow, stretch, blemish, scar, or otherwise change, you only get one set in a lifetime. But did you know the outermost layer of skin–the epidermis–is actually made up of a bunch of dead cells?
It actually gets its strength and suppleness from the dense makeup of keratin–a complex protein–found in those cells. You can also find keratin in the organs, glands, hair, and nails.
The biggest danger to healthy skin is overexposure to the sun. In fact, one in five Americans will develop skin cancer during their lifetime. Exposure to UV rays, combined with a lack of preventative, hydrating measures (which can be found below), can lead to irreversible skin damage–including premature aging, wrinkles, loss of elasticity, increased risk of skin cancer, and even increased risk of cataracts.
That’s because the sun’s UV rays–especially in summer–easily break down collagen and other vital skin components. When sunlight hits unprotected skin, it damages healthy cells. Over time, the signs of damage become more noticeable. Some people even develop more freckles, age spots, skin growths, and even skin cancer.
How can you keep your skin safe, strong, and healthy? Combined with a healthy skin care regimen, the answer is sunscreen!
The Importance of Sunscreen
Your skin gets bombarded by harmful UV rays on a daily basis, and even more so in the summer. The very first line of defense is a sunscreen with a good sun protection factor or SPF. While most people mistakenly believe SPF refers to the amount of time one can spend in the sun, it actually refers to the amount of UV exposure. As SPF value increases, so does protection against sunburn and additional skin damage.
Selecting the proper sunscreen depends on myriad factors, including time in the sun, time of day, amount of sunscreen applied, and even your skin type. The American Cancer Society recommends a sunscreen with broad-spectrum protection, SPF of 30 or higher, and reapplication of water-resistant sunscreen (water-resistant ≠ waterproof).
In addition to the regular application of sunscreen, you should also cover up as much as possible if you’re going to be in the sun for an extended period of time. That can include wearing covering clothing, a wide-brimmed hat, and sunglasses–especially those that block at least 99% of UV light.
Look to limit your time in the sun between 10 am and 4 pm–when UV rays are at their strongest. Finally, avoid artificial tanning beds and sunlamps–as both can cause serious, long-term skin damage and contribute to skin cancer.
Summer Skin Care Tips
Summer skincare doesn’t begin and end with sunscreen and UV protection protocols. In addition to sunscreen, the cornerstones of healthy skin are cleansing, detoxification, antioxidants, Vitamin A, and hydration. In other words, sunscreen is just one part of keeping your skin radiant, beautiful, and healthy during the summer.
Cleansing, detoxifying, hydrating, and antioxidizing your skin starts at night. Essentially, you work off the stress, wear, and grime of the day with a blend of premium skincare products, like Ageless Millenial Aesthetics by Estéticoceuticals. Removing toxins, exfoliating, and hydrating your skin is the key to starting each new day with a blank canvas.
Daytime skincare products, like the Days skincare line, help protect against the damaging rays of the sun, prevent cellular damage, and rehydrate and restore suppleness to the delicate tissues of the eyelids and lips.
A combination daytime/nighttime skincare regimen works in concert to help to improve skin turnover, repair the damaging effects of pollution and sun exposure, smooth the appearance of fine lines and wrinkles, and hydrate the skin. That means healthy, glowing skin not only in the UV-intensive summer months but in the cold, dry winter months as well!
Read More About Skin Care Tips!
Keep Your Skin Healthy All Year Long!
Your skin lasts forever. While it’s tempting to have a toned, tanned body all year long, there are good and bad ways of going about it. In other words, there’s no reason you can’t feel your best all year long–as long as you do it safely.
Choose and maintain a skin care regimen, take care to apply sunscreen and wear sunglasses/sun protection when out in the sun, and avoid artificial tanning salons.
Together, that’s a healthy starting point for soaking up rays and getting the most out of what should be a beautiful summer!
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Pre and Post-Op: What to Know About Your Body Procedure
Obtaining a beautiful, healthier body is easier than you might think. Whether you’ve become dissatisfied with your appearance due to age, genetics, pregnancy, or the rigors of life, cosmetic body procedures can help restore a tighter, more youthful look–and your self-confidence! If you’ve been thinking about a cosmetic procedure, such as liposuction, tummy tuck, mommy makeover, or body contouring, here’s what you need to know to prepare for best results, including what to do and what to expect before, during, and after your procedure.
Early Pre-Op: First Steps
So you’ve noticed some extra skin-or perhaps things simply aren’t as tight and young-looking as they once were. If diet, exercise, and other lifestyle changes aren’t enough, the next step is a consultation with your surgeon. We’ll go over all the options available to you, including:
-Tummy Tuck
-Liposuction
-Mommy Makeover
-Labiaplasty
-Brazilian Butt Lift
-Thigh Lift
-Arm Lift
-Gynecomastia Correction
If any of the above is a fit, it’s time to plan your surgery date and start preparing for your procedure.
Like for any other procedure, smokers should aim to stop nicotine usage for at least 4 weeks pre-procedure and stay smoke-free for 4 weeks post-procedure to reduce the risk of complications like infection. Nicotine use may also cause nausea, aggravate the lungs, and decrease blood flow during surgery–all of which puts your body at more risk of heart attack or stroke.
Your surgical team will also advise on what medications to continue or discontinue. Typically, patients are advised against taking NSAIDS, blood thinners, and Vitamin C, herbal, or weight-loss supplements for at least 2-4 weeks pre-procedure. Be sure to go over your complete list of medications and supplements with your surgical team to avoid potential interactions with anesthesia and/or post-operative prescribed medication.
Finally, depending on the procedure being performed, patients may be asked to complete lab work (such as CBC, blood chemistry tests, or liver function panel) in order to be cleared for surgery. Your surgeon may also ask for body scans or imaging, such as MRI, CT, or X-Ray.
Pre-Op: Just Before Surgery
The best time to plan your recovery is just before your procedure. Recovery time may vary depending on the procedure, from as little as 5-7 days for liposuction or up to 6 weeks for a Brazilian Butt Lift.
In the days leading up to your surgery, fill any prescriptions you’ll need post-op, plan out easy meals, and clear your schedule so you can rest and recuperate. It can also help to have someone nearby for the first 24 hours post-op to help with basic tasks and ensure the patient can rest comfortably.
Additionally, patients should abstain from alcohol for roughly 72 hours before their procedure, as it can affect their immune system.
The Day of the Procedure
If you have questions or concerns, don’t wait until the day of your procedure to bring them up. Remember, communication and transparency are crucial to both a quick recovery and best results.
Your surgeon will tell you what medications you can and cannot take leading up to, directly before, and after your procedure, including the morning of. Be sure to follow your surgeon’s recommendations regarding food and drink; most procedures don’t permit eating or drinking after midnight the night before your procedure.
Dress comfortably and avoid wearing jewelry. Have your insurance card and all proper documents handy, as well as your personal effects securely organized.
Make arrangements for someone to drive you both to and from your procedure, as well as to stay nearby for at least the first 24 hours so you can rest and focus on your recovery. Try to arrive at our facility to give yourself enough time to adequately check-in and prepare for your procedure.
Post-Op: Just After Surgery
After your procedure, the most common side effects are mild discomfort, bruising, swelling, and redness. The most important immediate treatments are rest and ice. We recommend taking any prescribed pain medication before you start to feel pain and/or discomfort. Preventing pain is easier than trying to manage it.
Depending on which procedure you had (namely liposuction, Brazilian Butt Lift, and arm lift), your surgeon may provide a compression garment to help the skin tighten up and facilitate healing. These also reduce swelling and provide much-needed support to core muscles as part of the healing process. Your surgeon will provide instructions, including how to wear it and how long to wear it.
Once our team has determined it’s safe, you can return home. As mentioned, it’s important to have someone to drive you home and stay with you so you can rest and recover.
Within a few days post-procedure, your doctor will check your bandages, assess your condition, and ensure you’re well on your way to optimal recovery. Make sure to let your doctor know if you’re experiencing any significant pain or discomfort, as these may be signs of something serious.
Post-Op: What to Expect After Your Procedure
You should expect soreness, swelling, and mild discomfort for at least a few weeks post-procedure. It’s normal to experience fatigue or tiredness as part of the healing process; it can take 5-6 weeks for you to return to your pre-procedure energy levels.
Try to walk a little each day and remember to stay hydrated. Avoid strenuous activity such as exercise or heavy lifting. Start with light activity and bit-by-bit, ramp up the intensity, but avoid abdominal exercises and stay away from bicycle riding, jogging, weight lifting, and aerobics for at least 6-8 weeks.
Recovery from body procedures can range anywhere from a few days to 6 weeks or more. Typically, however, patients can return to work within one week of the procedure (depending on how strenuous the job is). Again, depending on what procedure you had, there are various limitations. For example, labiaplasty patients are advised against sexual intercourse for at least 6-8 weeks post-procedure.
Your surgeon will also schedule a follow-up appointment (within a week of the initial procedure) to monitor your progress and recovery, as well as to finalize any parts of the procedure. It is possible you may need an additional follow-up procedure to correct any issues that arise from the first surgery or if you’re not satisfied with your initial results. However, it may take months before you can accurately determine your satisfaction with your new look.
Women Who May Become Pregnant
A common question often asked is whether or not women who may become pregnant again should undergo cosmetic surgery like liposuction, tummy tuck, or a mommy makeover. While there is no inherent harm to fertility, we typically advise patients to wait until they’re done having children. The significant changes that occur during pregnancy often counteract the work done by cosmetic procedures, meaning patients often require revisional procedures if they become pregnant again after surgery.
Pre and Post-Op Recap
Early pre-op:
Quit smoking & nicotine use.
Talk to your doctor about what medications you can and cannot use.
Complete lab work.
Ask any questions/clear any concerns.
Late pre-op:
No alcohol for 72 hours pre-procedure.
Fill any prescriptions you need post-op.
Clear out your schedule to prepare for rest and recovery.
Day of procedure:
Arrive early enough to check in and prepare for your procedure.
Dress comfortably, and avoid jewelry.
Have insurance card/important documents handy.
Days-weeks post-op:
Rest & ice.
Wear compression garments
Avoid strenuous activity for ~ one-week post-procedure.
Follow up appointments with your team.
Love your new body!
Ready For Your Procedure? Schedule Today!
At DeLuca Plastic Surgery, the difference is in the details. Whether you’re looking to regain your pre-pregnancy body or roll back the years, our team of experienced professionals has the proven results you’re looking for. From the moment you meet with us for your consultation to the moment you revel in your new look after your procedure, you’ll feel comfortable, listened to, and taken care of. Get in touch with us today to schedule your in-person consultation, phone-in consultation, or instant email consultation, and start on the road to loving your new body!
Correcting Tuberous Breasts with Surgery
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What Are Tuberous Breasts
Tuberous breasts is a condition where the breasts form into a tube-like shape because of constriction at the base of the breasts during development. The breasts also tend to develop farther apart and unevenly than a normal chest. The breasts are often characterized by enlarged areolas and sagging. Although this condition may prevent a woman from breast-feeding, it doesn’t lead to any other pregnancy or fertility related issues.
Women with tuberous breasts may range from type one, which is the mildest to type five, which is the most severe. With type one, only the lower inside of the breast is constricted. In the most severe cases, the entire breast is constricted and can be physically deforming.
Impact of Tuberous Breasts
While having this condition isn’t necessarily a physical concern for health related reasons, it can be psychologically troubling to women who suffer from this condition. Many women tend to be self-conscious about their breasts, and shy away from intimacy, or are embarrassed to get undressed in front of their partner.
There are also other issues to consider for someone with tuberous & tubular breasts. Many women tend to have trouble finding bras or other undergarments that fit properly. Some women have to specially order their bras in order to support their breasts correctly.
Surgical Correction
The correction of tubular breast deformity is to augmentation with a lift surgery. For women who are self-conscious or frustrated about the shape of their breasts, a surgeon can correct the size and fill out the shape. The doctor can also thin the area around the nipple in cases where the areola is large or puffy.
Although the surgery is challenging, the surgeons of Deluca Plastic Surgery have a track record of being able to achieve beautiful results for their patients. It’s important to discuss the surgery and your expectations with your doctor before heading into the operating room, if you are considering this type of surgery. In many cases, surgery can correct this condition restoring the breasts completely.
Recovery
Initial recovery after tuberous breast surgery is about 2 weeks. During this period the implant position is managed and the skin is allowed to begin healing. Patients of Dr. David Tauber at DeLuca Plastic Surgery can often return to work or social engagements in 2-3 weeks. Physical activity and exercise are started at 4 weeks and patients are back to full activity without restrictions at 8 weeks.
Get more details on the management of swelling and scars in blog post: Post-Operative Care After Plastic Surgery.
Do I Really Need A Breast Lift?
The decision to do a breast augmentation without lift versus a breast augmentation with a breast lift, however, is less based on patient preference and more dictated the saginess, the nipple position, and the ratio between the breast volume and the amount of excess skin that is present.
How Ptotic Are My Breasts?
The gold-standard method of assessing the need for a breast lift is the “pencil test.” Standing in front of a mirror, lift the breast and lay a pencil in the fold under the breast and allow the breast to settle over the pencil. Look at the position of the nipple in relation to the pencil.
The lower the nipples and breast are below the pencil and the more excess skin you have, the greater the chance you will need a breast lift and the more of a breast lift you will need. If your nipple and a majority of your breast are at or above the pencil (Normal), you will likely get a great result from a breast augmentation alone. Larger implants can shift this equation slightly for patients that have borderline ptosis (Grade 1).
(more…)Current Trends in Labiaplasty – The Edge vs. The Wedge
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Women seek labiaplasty for many reasons ranging from discomfort with intercourse and pinching in tight clothing to purely cosmetic reasons. According to the American Society for Aesthetic Plastic Surgery there has been a significant increase in the number of these tissue reduction and restructuring procedures — an astonishing 48 percent rise in 2014 from 2013. Workout gear is becoming tighter and women are becoming more self conscious about how they look in lycra enhanced tight clothing.
Although there are variations in technique and equipment used, labiaplasty most often involves reducing the size of one or both of the labia minora through one of two basic techniques. Both techniques attempt to preserve the nerves to the skin within the mucosa instead of simply removing it. In addition, both techniques can be extended to reduce some of the excess clitoral hood.
The first technique is a straight-line (trim) excision. It reduces the excess tissue in straight line front to back. This technique is more straightforward and has the added benefit of reducing the unsightly thickened free border of the labia. There are variations on trim that include the Lazy-S Labiaplasty and the Extended Excision Labiaplasty.
The second most common technique is the wedge excision. It reduces a pie-shaped wedge of tissue from the central portion of the labia. The remaining tissue at the front and back is then brought together and closed. This technique preserves the free border, however, it is more complex and requires additional incisions to reduce the dog-ear that forms. There are variations to the original wedge resection including the the Z-Plasty Wedge Labiaplasty, the Hockey Stick Wedge Labiaplasty, and the DOVE (Double Opposing V-Plasty with Extended Deepithelizing) Wedge Labiaplasty.
The choice of technique is based on patient preference and is tailored by Dr. David Tauber to each patients needs. A detailed examination will help delineate the best surgical treatment.
Get more details on the management of swelling and scars in blog post: Post-Operative Care After Plastic Surgery.
Blepharoplasty with Fat Redraping – Solutions For Aging Eyes
Aging eyes are characterized by the development of wrinkles, fine lines, drooping skin, midface hollowing, and eyelid bags. These changes make patients look tired and angry. The bulging of the lower eyelids occurs as the tissue wall (orbital septum) that holds the fat in the orbit begins to weaken and stretch. Traditional blepharoplasty attempts to address this bulge by reducing the fat.
This approach to treating the aging eyes reduces the bulge, however, it can produce two unwanted effects. The first is an unmasking of midface hollowing that was masked by the fullness of the bulging lower eyelids. The second occurs as the face continues to age. Over time, the orbital fat begins to lose volume. This produces hollowing around the eyes. If the fat is reduced during a blepharoplasty, this hollowing is accelerated. This leaves the patient with a skeletal look that is difficult to correct.
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There is No “Right” or “Best” Age for a Facelift
The facelift is experiencing a bit of a renaissance it would seem. I have patients of all ages ask about the surgery and whether or not they would be a “good” candidate for the procedure. It’s a good question.
Fifteen years ago, the average age of a patient was about 60 to 65 – today it’s closer to 45 to 50.
Why? Previously, patients were waiting until signs of aging had become extremely visible before opting to ‘turn back the clock’ 10 to 15 years (which is what a well done facelift can do). These days, patients are taking a more proactive approach in reducing the appearance of aging skin – and so are opting for less extensive lifts in their 40s and early 50s. That said, there’s absolutely no “right” or “best” time to undergo a facelift and if anything, having the procedure a little later on makes for an even more dramatic* result (because the face ages at a faster rate the older we get, so the difference between 30 years old and 40 is less than 40 and 50). (more…)
Breast Q&A: What’s the Best Way to Correct Grade 1 Breast Ptosis (Sagging)? Implant, Lift or Both?
Question – What is the best way to correct breast ptosis, high or moderate profile implants, a breast lift or both?
Breast sagging after pregnancy
I am 36 years old, breastfed 2 kids, and have lost volume in my breasts. I have some sagging but my nipple is still over the fold. I weigh 130 pounds and am very fit and toned.
I am 5″4″ and my breast size is a 34B. Before my kids I was a 34C cup. When I was breastfeeding I was a 34D cup. I would like to be a D cup and wonder what type of procedure would be best to correct my ptosis?
Answer – Since you have a small amount of glandular ptosis (pseudoptosis), you not only want to fill-OUT, but lift-UP a little as well. Therefore, my approach would be a dual plane breast augmentation, which would fill out the inferior/lower pole nicely, give you muscle coverage across the upper two thirds of the breast and a nice, slightly lifted appearance.
More specifically, given your body measurements and photo (which shows pseudoptosis with mild Grade 1 ptosis), I suspect that 450cc moderate plus profile implants are needed to give you both the breast size (D cup) and breast lift you desire.
How To Classify/Grade Breast Ptosis
Simply put, grade 1, 2 or 3 glandular ptosis, which refers to how far the areola is sagging below the inframammary fold beneath the breast, the lower attachment point of the breast to the chest wall.
- Grade 1: Mild Ptosis – The nipple is at the level of the inframammary fold, but most of the breast tissue is below the nipple.
- Grade 2: Moderate Ptosis – The nipple is located below the inframammary fold and below the majority of the bottom breast tissue.
- Grade 3: Advanced Ptosis – The nipple is far below the inframammary fold and points towards the floor.
- Pseudoptosis – The nipple lies above or at the level of the inframammary fold while the majority of the breast has descended below the level of the fold. This is not true ptosis, or sagging.
The degrees/stages of breast ptosis (drooping/sagging)
Botox Q&A: How Long Does Botox Last and What Makes the Effects Last Longer?
Question – How long does Botox last? What determines how long it will work for me?
Answer – In most patients, Botox lasts between 3-4 months. However, there’s quite a bit of anecdotal evidence suggesting that it’s possible for patients to achieve results that last up to 6, 9 or even 12 months after consistent, long-term and properly-administered use of the Botox product.
In other words, what determines how long the effects of Botox lasts is:
- the dosage (and whether or not it’s been properly diluted)
- the duration & consistency of use
- the skill/experience of the injector or surgeon who administers the injection
The x factor within the “consistent, long-term and properly-administered” conditional I included is, of course, “properly administered”. After all, consistent treatments over several years will matter very little if the wrong amount of Botox has been injected imprecisely/incorrectly. That’s why 2 of the 3 factors explored in this post address it (re: ‘dosage’ and ‘skill/experience of the Botox injector‘).
1. Dosage: Why injecting & diluting the proper amount of Botox = key
Recommended Botox dosage (in units) – American Society of Plastic Surgeons.
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