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…)Hollow Cheeks – Treatment with Implants, Fat Transfer, and Fillers
What Causes Hollow Cheeks
The aging, hollow face is typified by soft tissue decent and volume loss. These stigmata of growing older are manifest by the development of nasolabial folds, marionette lines, and jowls combined with a sunken mid-face and hollow cheeks.
In recent years, DeLuca Plastic Surgery has looked past skin tightening as the solution for all of these complaints and has recognized the role that volume loss contributes to the appearance of aging, hollow cheeks. This volume loss occurs as the soft tissue (and even bone) of the face resorbs over time as we get older or secondary to weight loss. To combat these changes we utilize a variety of techniques including several types of non-invasive facial fillers, fat transfer, and facial implants.
Facial Implants
Projection of the cheeks and mid-face is due to the interaction of the bones of the face and the overlying skin and soft tissue. Facial implants are used to add a more substantial foundation to hollow cheeks by adding projection to the bones of the face in patients that have experienced significant resorption as they age or who have always lacked projection. Skeletal implants are powerful tools to modify the framework of the face and can produce dramatic results. In our practice, these implants are often combined with soft tissue augmentation, such as fat transfer, to treat hollow cheeks – restoring harmony and symmetry.

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The Brazilian Butt Lift – Baby Got Back
There has always been a fascination with the posterior of women, however, over the last few years plastics surgeons have seen the demand for the Brazilian Butt Lift to skyrocket. This new found focus has still not eclipsed breast augmentation or liposuction as the procedure of choice, however, the influence of celebrities such as Kim Kardashian and Nicki Manaj have caused demand to surge 58% over the last year.
Dr. David Tauber and DeLuca Plastic Surgery have seen requests for buttock augmentation increase year over year during he same time period. In response to this demand we have recently began offering our patients the world famous Brazilian Butt Lift.
(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.
Botox and Facial Fillers – The Fountain of Youth (Without The Knife)
What Is Botox?
Botox is an injectable used to lessen the movement of specific muscle of the face in an effort to target wrinkles created by the contraction of facial muscle groups. The areas that are treated most often include the forehead, the area between the eyebrows, and the crows feet (on the side of the eyes). The goal is to soften these tell-tale stigmata of aging without leaving the face looking flat and emotionless. This can be a difficult needle to thread. If done correctly, however, Botox can make the face look younger, raise the eyebrows, and make the eyes look more open.

Botox is injected using a very fine needle into the affected areas. Most patients experience little discomfort and by the time they return home or to the office any redness or swelling has disappeared. The affect begins to be noticed over the next week and lasts for about 3-6 months until the effect, again, slowly fades out.
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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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Clinical Diagnosis in Plastic Surgery by Dr. David Tauber
DeLuca Plastic Surgery would like to congratulate Dr. David Tauber on the publishing of the book, Clinical Diagnosis in Plastic Surgery.
Clinical Diagnosis in Plastic Surgery systematically presents a collection of entities, syndromes, and diseases that are diagnosed and treated by plastic surgeons, hand surgeons, otolaryngologists, oral surgeons, and dermatologists.
The goal is to document an extensive array of signs and visual clues that are critical to the diagnostic process, thereby enhancing the clinician’s ability to identify relevant diagnostic features and make correct diagnoses. Skill in recognizing deformities and disease processes by observation is of vital importance in plastic surgery, which is very much a visual surgical specialty. In drawing together key diagnostic signs, this book will spare readers the onerous task of searching through endless resources, books, and websites.
A helpful appendix details the various classification systems used in the book with the aid of appropriate diagrams. Clinical Diagnosis in Plastic Surgery is intended for students, residents, practicing physicians, and surgeons in all of the affiliated fields of plastic surgery. (more…)