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Category: Breast Reconstruction Surgery


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PREVENTIVE BREAST CANCER SURGERY…Angelina Jolie, Sharon Osbourne, Sheryl Crow…

Angelina Jolie’s double mastectomy is big news right now...and is a timely reminder for women around the world…about the risk of developing breast cancer when a person is BRCA1 positive and/or has a strong family history of breast/ovarian cancers. Angelina chose to have a double mastectomy (removal of both breasts) for several reasons….these 3 being the highest priority:

1) Angelina’s double mastectomy (surgical removal of both breasts) greatly reduced her changes of getting breast cancer by 87%.  For people who test positive for BRCA 1…the breast removal surgery reduces the risk of ever getting cancer…significantly.

2) The mastectomy surgery reduced her risk of getting ovarian cancer by 50%.  This is the disease that killed her mother (after fighting it for 10 years) at age 56.

3) Having the double mastectomy reduced her risk of breast cancer down to less than 5%…so she could tell her children: “They don’t need to fear they lose me to breast cancer.”    Her big why was her kids.  Living a long life to be there with and for them.  I didn’t want to leave them or for them to lose me at a young age the way I lost my Mom.  Angelina, age 37, and Brad Pitt have 6 children. Three are her own natural born and three are adopted.

Angelina chose to tell us all about her double mastectomy to encourage other women to:  get gene tested and to raise awareness of the options available to those at risk.

Angelina’s surgery was done in February…but she kept it private until now.  Even her own father, Actor/Celebrity John Voight didn’t know about it until recently at a family birthday party for one of the kids…and was very surprised because she has been very active and looked (looks) perfectly normal and healthy.

Brad Pitt and their 6 children were totally involved in the entire process…and even set up a little post-op recovery area at home so they could help mommy and be part of her recovery.  Brad is thankful and relieved for the clean bill of health….and for the fact that the cloud has been removed!

About BRCA1...BRCA1 is a gene mutation that men and women can carry and pass down to children.  This mutation makes people at risk for breast, ovarian, pancreatic and prostate cancers.  Genetic counseling followed by gene testing (blood tests) allow mutations to be found either BRCA1 or BRCA2…and empowers other family members to get tested also.  See: www.davinciplastic.com

Angelina said:

“This was not an easy decision….but one I’m glad I made! Now I want to encourage other women to get tested…especially those with a strong family history of cancers! ” She encourages us to seek out the information and the experts…learn about all the options…and those who can help you through this aspect of your life…make informed choices and become empowered!

Other Celebs who’ve had double mastectomies include:  Sharon Osbourne and Sheryl Crow.          November, 2012….Sharon disclosed the facts about her breast removal surgery  after a genetic test revealed she was a carrier of BRCA1 genes.  She knew immediately that the odds were not in her favor….she’s had cancer before and did not want to live under that cloud again.

The critical message here is:  if you have a strong family history of cancer….get tested.  Let’s talk about….I’m specialized in all breast procedures including reconstruction options.

Best to you and yours.

Steven Davison M.D.

For Breast Reconstruction or Revision…Natrelle 410 Implants Will Keep Everyone Guessing!

Since Angelina Jolies public announcement, and Brad Pitt’s comments about her double breast mastectomy, removal of both breasts as a “preventive” measure against developing breast cancer…I’ve decided it’s a good time to discuss today’s most popular…most natural cohesive (gummy bear) breast implants.

Natrelle 410 Ultra Cohesive Breast Implants are the most popular in the world today…chosen 2:1 by women having breast reconstruction surgery (after cancer treatment and breast removal)…and by women having implant revision surgery.  The Natrelle 410 also has more “loyal” physician advocates than any other single breast implant in the world!

WITH NATRELLE’s 410 COHESIVE tear shaped BREAST IMPLANTS…YOU WILL ALWAYS KEEP THEM GUESSING!  shutterstock_45617737

The 410 Implant was the very first highly cohesive…anatomically shaped implants and they are now referred to as “gummy bears.”  They have been in use throughout Europe since 1993 with wonderful results.  Natrelle 410 offers 12 shapes for a given volume.  I love them…my patients love them… for many reasons!

  • Natrelle 410 Implants…mimic the natural breast the best
  • They are the implant of choice today for women having breast reconstruction surgery
  • For breast implant revision surgery…the Natrelle 410 is top choice over all implants
  • It’s “tear drop shape” contours resemble the curve of a woman’s breast
  • The highly cohesive gummy silicone filler “holds together” uniformly to prevent migration in the event of a rupture (rarely occurs according to years of studies)
  • 12 shapes for a given volume enables patient/surgeon to be very specific in shape selection…for every single patient
  • Natrelle 410’s are chosen 2:1 by patients because they feel the most natural….soft to the touch
  • It’s the #1 shaped gel implant chosen by surgeons in Europe and Canada…where it’s been available for years  (the FDA just approved it in the US in February, 2013)
  • The textured surface means it will stay where it is placed beneath the breast
  • The implant surgery requires specialized training and skill…I am one of a select group of surgeons currently allowed to offer the Natrelle 410 implants to patients.

Highly Developed Method…used for selecting the ideal implants for each individual patient….no cookie cutter methods here!  Also, incorporating my Vectra 3D Computer Imaging program empowers my patients to see actual potential results…before having surgery.

Hand in Glove Fit! Selecting the right implant is the first step to achieving your desired outcome…Second is “surgical technique and skill.”  Added years of specialized surgical training and years of great success and natural outcomes in reconstructive breast surgeries…have given my patients have the highest level of confidence in my abilities…strong enough to send their friends and loved ones to me also.

OK…been thinking about implant revision/replacement…or have you been through a mastectomy?  Let’s talk…

Spring Graduations, June Brides, New Mommies, Class Reunions, Career Changes, normal facial Aging is really showing…Beach Days are here…are you beach body ready? …and many more reasons to get that Breast Augmentation scheduled, to have a Mini Facelift, to keep them guessing with Botox treatments or have an “instant liquid facelift.”  Take 10 years off the face with an Eyebrow/Forehead Lift…removing years of aging with an Eye Job (Blepharoplasty) or a Nose Job…come on and let’s get to work. See complete info: http://davinciplastic.com.

Helping You Keep Your Best Self Forward….best to you and yours.

Steven Davison M.D.

“DAVinci….where I combine the supreme elements of art and surgical science.”

The Perfect Body and Cultural Perceptions

shutterstock_76782826For Americans the “perfect body” includes big breasts, a small waist, a sexy butt and being fat free…for men and women. Europeans are obsessed with being dimple free…no cellulite period!  Asians prefer smaller breasts and butts but demand long, slim legs. Brazilians gave us the Brazilian ButtLift…curvy buttocks and also voluptuous Big Breasts. Perceptions vary between countries.

US CLOTHING and SOCIETY influences the plastic surgery trend. 1)  Cleavage baring tops (shirts, blouses etc) are a primary factor in breast surgeries.  2) Curvaceous butts thighs sought by American celebrities forced the surge in “Brazilian Butt Lifts”.  First Lady Michelle Obama’s Arm Lift became an inspiration for women of all colors to get their arms toned and in shape with Arm Lift surgery.

TOP SURGERIES WORLDWIDE  Breast Implants,  Leg Refining ProceduresButt AugmentationsCellulite reduction.  In 2011, Mexico led the charge among the top 5 countries worldwide with 800,000 cosmetic procedures.  America led the way with the obsession for “bigger is better” breasts and the most Breast Augmentations (Http://www.davinciplastic.com.).  Younger women want more on top while mature women and post pregnancy Moms want restored fullness.  The Best Butt for American Jeans is  the Braziliain Butt Lift and their trend for a perfectly proportioned backside with curves in all the right places!  American women love it and proved it with a 60% increase in Butt Augmentations during 2012, using their own body fat and Implants to achieve the right size and shape buttocks.

PERFECT BODY... Americans are obsessed with the breasts and being fat free..a narrow waist.  Breast Augmentations, Liposuction with Fat Grafting/Transplanting and Butt Augmentations have been the top choices for a few years now.  Men are also into sexier, fuller butts and get Butt Augmentations to fill out their pants.

EUROPEAN OBSESSIONS are about “NO CELLULITE…Period!”  All Europeans want to be dimple free with a natural looking body that looks as if it could be had easily with a healthy diet and a steady workout regimen. Many of the world’s top cosmetic procedures are born in Europe and after being proven they migrate to other places like the US.

ASIANS SEEK SLIM, TRIM, PETITE AESTHETICS   South Korea ranks #7 for women having plastic surgery before age 50, during 2011.  Their #1 obsession is super skinny, bulk free legs (Radish Legs). They clamor for long slim calves void of heavy looking muscles.  Small Breasts is their other ideal.  If they choose breast enlargement, they want only miniscule increase in size.  Breast implants, however are seeing a major advancement in Japan for reconstructive surgeries, a challenge that Japanese surgeons are overcoming as they get up to speed on the products and procedures.

BRAZILIAN SHAPE = CURVY + VOLUPTUOUS…Brazil’s #1 obsession is Full Perky Breasts and perfectly round buttocks.  They are obsessed with plastic surgery to make sure they have curves in all the right places by having Butt implants and fat augmentation  as well as large breast implants and breast lifts.  Many Brazilian women are naturally blessed with all the curves they desire, but plastic surgery is a major trend for those who are not so blessed.  My website educates you on all these procedures and many more that I offer: http://davinciplastic.com.

At DAVinci Plastic Surgery, I offer “Premium” procedures that  patients travel from around the world to have me perform because….I’m Board Certified, Highly Qualified, Well Experienced and have a host of happy patients…around the world.  I help people put their best self forward!

Best to You and Yours,

Steven Davison M.D.

Board Certified Plastic and Reconstructive Surgeon

“DAVinci….where I combine the supreme elements of art and surgical science.”

The Trend …Gynecomastia surgery is the Ideal solution for many men!

I’ve written several articles this year about men and cosmetic procedures…because men want the information, they appreciate the education and, they love the results they get from each procedure. The trend is that men are having more cosmetic and reconstructive procedures of every type, every year. Male Gynecomastia surgery is done to reduce the size of male breasts (same as breast reduction in women) for various other reasons.  I perform many of these operations every year to help my male patients regain self esteem, get renewed confidence and a new “physique” they can show off without embarrassment.

DATA:  40% to 60% of all men are affected with enlarged women like breasts

  • Male Breast reduction is ideal for men who are self conscious about their condition
  • Gynecomastia usually begins during adolescence & continues for life if not corrected
  • It psychologically impacts men of all ages…starting in the early teen years
  • Causes of large male breasts include:  obesity, Klinefelter’s Syndrome, Gilbert’s Syndrome, normal aging, hormone fluctuations, RX medications, anabolic steroids, impaired liver function

Male Breast Reduction Surgery… Results in a chest that is flatter, firmer, more contoured. Men and boys who suffer with Gynecomastia have found this surgery to be the ideal solution to their problem.  1) Male breast reduction is typically an outpatient surgery performed under general or local anesthesia. 2) I work through one small incision to  and remove excess fat and skin and to sculpt the breast to a masculine appearance. 3) My advanced techniques/skills and experience results in inconspicuous scars. 4) As with any operation, there is some swelling, bruising and discomfort for 2 to 3 days.   Oral pain medication manages this nicely. 5) Final results are seen when all swelling has resolved…usually 2 to 3 months.

Questions Men Ask Most Often:  See my website for info: http://www.DAVinciplastic.com

How much work will I miss?   My patients report back to work in 1 to 2 days.  Choose a long weekend for your procedure.

Will Activities be Restricted?   Yes.  No sex for 1 to 2 weeks following your surgery and no heavy, strenuous exercise for about 3 weeks.    Will Male Breast Reduction surgery change my looks?  NO.  You will look like yourself…just more fit, trim and contoured!

Will Male Breast Reduction negatively affect my sexual activity?  NO…in fact…men report to me it really enhances it due to their renewed self esteem and pumped self confidence!

OK. This gives you a good overview.  Come in soon and let’s talk.

Steven Davison M.D.

“DAVinci….where I combine the supreme elements of art and surgical science.”

STAGE I…Breast Reconstruction

STAGE I – Mastectomy & Expander

Breast Reconstruction usually occurs as a two-stage procedure – starting with the placement of a breast tissue expander – which is replaced several months later with a breast implant. Dr. Davison will place the tissue expander under the same anesthesia as your mastectomy surgery if possible. This is called immediate reconstruction since the process is started at the time of your mastectomy.  You may choose to “delay” the start of reconstruction and wait for a few weeks or months.  This is called delayed breast reconstruction.

Here are the steps involved in mastectomy with expanders:

  1.  During the mastectomy your breast surgeon removes skin and breast tissue – leaving the chest tissue flat and tight.  An expander (balloon type expandable device) is put into place under the chest muscle and skin – to serve as a space saver – into which a breast implant is later placed.  The expander is gradually filled with saline solution – over several weeks – and slowly stretches the remaining chest skin and muscle to allow for the future breast implant.
  2.  Expander surgery is performed under general anesthesia in an operating room. Often a Biologic tissue barrier is used to create an inner Bra to cradle the expander.
  3.  The incision used to perform your mastectomy is used for the expander placement
  4.  After placement – the incision is closed
  5.  Drains are left in place – and are removed when only 30cc fluid comes up
  6.  Healing takes 4-6 months – the surgery takes several hours and is done under one anesthesia.  If delayed expander placement is done – surgery takes 1-2 hours.
  7.  Breast implant is placed when Dr. Davison determines the space is sufficient and the expander is removed.  The same incision is used to do implant placement.
  8.  A nipple and areola is created typically 3 months later – with additional beautification for both breasts.
  9.  Dr. Davison becomes your primary care physician over the next year during this entire process.
For many women…this can be a daunting process.  Over the years I’ve been able to guide my patients through it, helping them make wise decisions, and then watching them appreciate the life changing results.  My rigorous training and years of experience made this possible.  If you or someone you know is struggling with this decision…I’m here to help.
To Your Ongoing Health and Wellbeing.
Dr. Steven Davison
At DAVinci…We combine the supreme elements of art & surgical science.

TOP DOCTOR of the YEAR AWARDS…come with responsibility

Well, here’s my chance to “shine” a bit. I don’t usually hang out or post my “brag sheet”…but being recognized among the top doctors of the nation can make a guy feel proud.  In case you’re not aware…I’ve been named as a “Top Doctor” of the Year by the Washingtonian,  the Northern Virginia Magazine, and others, for Reconstructive Breast Surgeries.  Along with that award, top docs must assume great responsibility.  First let me explain the selection process.

Castle Connolly Medical Ltd. is America’s trusted source for identifying top doctors and the best in American medicine.  Their system for selection is rigorous and includes ascertaining critical information about doctors such as: exceptional training, experience and how they are regarded by their peers etc. etc. Top Doctors can have an enormous impact on healthcare for patients and their families….a “Top Doc” can mean the difference between receiving first class medical care and substandard care.  Top Docs rank among the top 10% in the Nation.

The Washingtonian and Northern Virginia Magazine also use these rigorous guidelines for selecting “Top Doctors”…or “Top” anything e.g. restaurants.  Education (not all schools are equal), experience can make a major difference in outcomes, and most important of all…life changing procedural results that patients are happy with, along with peer recognition (being recommended by other doctors)…comes only from years of growing and honing skills while keeping up with advancements.  This is the stuff Top Docs are made of.

 I love what I do, and the greatest reward is always seeing positive outcomes for my patients.  

I am honored and blessed to be able to serve the population in and around Washington, D.C. and I thank each of you for your  years of trust, confidence and support you’ve shown to me and my family.  I look forward to many more years of helping each of you, and your family and friends…and to enjoying the friendships that grow as a result.

Thank You, Stay Well and may God richly bless each of you.

Steven Davison, M.D.

At DAVinci…we combine the supreme elements of art & surgical science.

BREAST RECONSTRUCTION (Restoration)…Stage II

STAGE TWO BREAST RECONSTRUCTION

From previous blogs you know that Stage I involves placement of the Tissue Expander…often placed under the same anesthesia as your mastectomy surgery… and called Immediate Breast Reconstruction.  Delayed Reconstruction means you choose to wait a few weeks or months before starting the restoration process.

Here are the steps leading up to Stage II Reconstruction:

During the mastectomy skin and breast tissue are removed, leaving the chest tissue flat and tight.  The “expander” is inserted under the chest muscle and skin to serve as a “space saver.” The expander is slowly filled with saline solution (over many weeks) to stretch the remaining skin and muscle to allow for the future breast implant.

Expander surgery is done under the same anesthesia as the mastectomy surgery.  (Immediate Reconstruction)  Healing takes 4-6 months

NOW Stage II begins: The new Breast Implant is placed when Dr. Davison determines the space is sufficient and then the expander is removed.  This is done through the original incision.

Stages III & IV …Begin about 3 months later and Involves A new nipple and areola…with additional breast beautification.

I become your primary care physician during this entire process…generally about a year.

Stage II Breast Reconstruction involves rebuilding a new breast mound by using what is called a Flap Procedure.  There are several options for flap procedures that I will cover in my next blog.

Every year the numbers increase of women who choose breast reconstruction.  Vast experience enables me to gently guide you through the process to eliminate frustration and confusion, until you eventually see the tremendous benefits of your choices.  During the consultation you will come to understand your options and be able to choose a course of action that restores both form and self confidence.

All we do…we do sensitively, expertly and with outstanding results to improve your health and wellbeing. The results of all surgeries should be both…functional and beautiful.

Dr. Steven Davison

At DAVinci…we combine the supreme elements of art & surgical science.

STAGEs III and IV…BREAST RESTORATION BEAUTIFICATION and NIPPLE TATTOO

BEAUTIFICATION…BALANCE…SYMMETRY….Stage III

The goal of all breast reconstruction (restoration) surgeries is to achieve symmetry and balance between both breasts and also for them to look “natural.”  Beautification is started several weeks or months after your reconstruction process is complete and you have healed nicely.  Beautification involves creating balance between the two breasts, breast contour, adjusting flaps if needed, and nipple/areolar reconstruction.  Sometimes, women choose this phase, of their breast restoration process, to include other breast procedures such as a Breast Lift or Breast Reduction.  My goal is that: “all  cosmetic surgery should be functional…and all reconstructive surgery should be aesthetic and look as natural as possible.”

My patients are living testaments to the benefits of having restorative procedures following mastectomy surgery.  Here are just a few of their comments:

“I love being able to wear off the rack clothing since you completed the beautification process and now my breasts are symmetrical and so natural looking.”

“My husband is so glad to see my level of self confidence and a sense of normal self restored again.”

“The breast reconstruction did more than restore normal looking breasts….it restored my self confidence and has allowed me to return to the lifestyle I love…and the love of my life!”

We will discuss your goals for Stage III Beautification in detail.  After decades of helping women through this process…I’ve been able to help them through the challenges…by removing fear and replacing it with knowledge and self empowerment.

STAGE IV…NIPPLE TATTO…this is just as it says…nipple tattooing to create a natural looking nipple and areola on the breast(s).  This process further beautifies the breast by defining the dark area of skin surrounding your nipple(s) and areola(s).

Regardless of when you begin the process of reconstruction/restoration…. I use the most advanced but safest methods along with finely honed techniques.  By combining my meticulous skill with my thorough understanding of the intricacies of the human anatomy, my patients enjoy amazing outcomes that are both functional and beautiful.  You can read more about this entire process at: www.davinciplastic.com

IMPLANT BREAST RECONSTRUCTION (Restoration)

In review, I’ve quickly covered Stages I & II of Breast Restoration surgery. Now, let’s look at breast reconstruction using implants instead of your own body tissue.  Implants are chosen by hundreds of thousands of women every year to restore a natural looking figure with two breasts.  Some women choose to start this process immediately (Immediate Restoration) by having the surgeon place the tissue expanders at the time of the mastectomy…under the same anesthesia and using the same incision. Remember, the expanders are the precursor to the permanent implants. They slowly and gently expand the chest tissue to allow for the implants at a later date. Read more about this: http://davinciplastic.com/

BREAST IMPLANT SURGERY… When it’s time to place the saline or silicone implants…usually 3-4 months (I help you decide which is best for you), the surgery is scheduled to do the implant(s) placement.  This involves going through the same incision used to place the expanders, removing the expanders and precisely placing the correct implants. General anesthesia is used for this procedure. The incisions are closed and healing begins taking place.  Stage II is now complete. Healing for all surgeries takes times and varies with each individual.  Activities are restricted at first, but you gradually move back into full activities…looking and feeling great.

ABOUT IMPLANTS…Today’s implants are the most advanced and safest of all time.  You can choose from either saline or silicone filled implants (both are FDA approved) and both types come in a spectrum of sizes and shapes, and have either smooth or textured surfaces to meet the many individual needs of women today. Implants are not for everyone, but for those who choose them…they restore natural looking, contoured breasts, enhanced self confidence and return to a normal lifestyle.

ABOUT BOARD CERTIFICATION… I am a board certified reconstructive surgeon with specialization in breast reconstruction.  Board certification does not guarantee certain results, but it does ensure that you are working with a surgeon who has been trained by the experts, has had years of extra education and experience and vast knowledge to draw from.  I am ranked among the “Top Docs” in the Nation who perform reconstructive surgeries successfully everyday…not bragging…but you need to know some docs are highly skilled and trained…others are not.

Next time I’ll discuss Stage III breast Reconstruction…known as Beautification. Be sure to read the previous blogs if you missed them.

Stay Well,

Dr. Steven Davison

“At DAVinci…I combine the supreme elements of art and surgical science.”

RESTORATIVE BREAST RECONSTRUCTION…Flap Methods

The reasons women choose to have restorative breast procedures are well stated in these quotes …

I need to feel whole again,” –  “You have given me back what cancer took away,” – “The reconstruction of my breasts made me feel restored…not reconstructed,”  –  “I want to look as good as I feel,”  –  “I want to look and feel sexy again…and want my husband to see me as sexy.” 

These are but a few of many thousands of thoughts from women who wanted to fully recover from their breast cancer…with a whole body.

Today, I review Flap Procedures (Stage II Breast Reconstruction/Restoration).  There are a variety of Flap Procedures used to restore breasts…not every type is right for every woman, but we determine this after careful and thorough evaluation of your needs and goals.  I tailor each flap procedure to achieve beautiful natural looking breasts. There are four muscle flap techniques as follows:


1) Latissimus Dorsi Flap 
uses a flap of skin and muscle from the back on the same side as the operated breast.  This is transferred forward to form a breast mound that will look and feel natural since it is your own living tissue.

2) TRAM Flap is the most common form of living tissue  breast restorative techniques used today.  It creates a natural looking, soft, warm breast.  TRAM Flap involves either free flap or pedicled flap techniques.  Pedicled flap means the tissue remains attached to its blood supply.  TRAM Flap procedures employ skin, fat and muscle removed from the lower abdomen and transferred to the chest.

3) DIEP Flap reconstruction employs excess skin and fat from the lower abdominal area, through an incision similar to that used for Tummy Tucks. This is a “perforator flap” technique that is muscle sparing…meaning no muscle function is sacrificed, but warm living tissue is used instead.

4) Gracilis Flap harvests excess skin and fat from the inner thigh to restore natural looking, soft, warm breasts.  This may be a TUT Flap (without muscle) which is referred to as a Transverse Upper Thigh Flap. When a small amount of muscle is required…a TUG Flap is employed.  Either flap can be harvested so the donor scar is discretely hidden inside the upper thigh.

This is a brief overview of the 4 Flap techniques used for restorative breast reconstructions.  Each of them has it’s own virtues… and all offer beautiful, natural looking and feeling breasts.  I have guided many women through making the right choices so as to ensure optimum results.

GOALS of RESTORATIVE BREAST PROCEDURES

Goals are critical to good outcomes.  You must have yours…here are mine: “all cosmetic surgery should be functional & all reconstructive surgery should be aesthetic & look as natural as possible.”  

ADVICE TO MY PATIENTS

Always ask me questions; ask to see pictures of my patients, gather information and consults with trusted mentors, make your decision.   There are NO wrong decisions. Choose a qualified, Board Certified surgeon with specialized training and expertise in reconstructive surgeries.

Next blog will cover Implant Breast Restoration.

Dr. Steven Davison

At DAVinci…we combine the supreme elements of art & surgical science.”


Schedule Your Consultation With Dr. Davison

The initial consultation with your surgeon is critical! It should always be face to face with your surgeon during which time he/she listens closely to your concerns. Dr. Davison believes this time spent with you is critical to both you and to him. It is during the consultation that he comes to fully understand your concerns, evaluates them correctly and is then able to make the recommendations and develop the treatment plan thats right for you. Dr. Davison invests the time to sit down and talk to you face-to-face.

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3301 New Mexico Ave. Suite 236

Washington D.C.