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Which Breast Reduction Incision Type Is Right for Me?

2 Minute Read: 

Breast reduction is a popular procedure that reduces large breasts’ size and weight for an improved breast contour that is better proportioned to a woman’s body.

Illustration showing the various breast reduction incision types.

When it comes to breast reduction surgery, there are many different incisions options. The technique used depends on the patient’s breast anatomy, the amount of tissue to be removed, and the patient’s specific wishes and desired outcome.

What Are Your Breast Reduction Options?

The most popular breast reduction incision techniques include the donut, anchor, and lollipop.

Donut Method

As implied in the name ‘donut,’ this technique requires two concentric incisions made around the perimeter of the areola. As an added benefit, patients will only have one short scar that can somewhat be hidden by the areola’s dark skin.

The downside to this is that it offers limited access to the breast tissue. The procedure is acceptable for a minority of patients with mildly enlarged breasts.

Vertical or Lollipop Method

As for the lollipop technique, an incision is made around the edge of the areola, and another vertical incision is made from the areola down to the bottom of the breast.

Your surgeon will then remove excess tissue and fat and tighten the surrounding skin. This is a variation of the anchor method and is ideal for patients with mild to moderately large breasts. Therefore, if you have extremely large breasts, this will not be a good option as it offers less control than the anchor pattern reduction.

Many patients prefer the vertical breast reduction technique because of its less invasive approach combined with its long-lasting effects. It also offers a shorter recovery time, considering it is less invasive to the body.

Inverted-T or Anchor Method

This is one of the most common techniques, suitable for more substantial breast adjustments. An incision is made around the nipple with the second incision running vertically down from the areola and another along the crease of the breast for a distinctive T-shape pattern.

The excess breast tissue and skin is removed through the incision, and breasts are reshaped and lifted into a more aesthetically pleasing position.

The anchor method allows for a maximum degree of tissue removal, making it ideal for patients who have considerable sagging or asymmetry to correct.

The major drawback to this technique is that it produces the largest scars, so if scarring is a significant concern for you, your doctor may recommend a more preferable technique.

Which Incision Is Right for Me?

During your initial consultation with our board-certified plastic surgeons, you will get a professional recommendation for the best breast reduction technique depending on your breast anatomy, amount of reduction required, and desired outcomes.

Interested in Learning More About Breast Reduction?

Contact us today at 202-966-9590 or fill out our online form to schedule your breast reduction consultation.

Top 5 Ways to Reduce Scarring After Plastic Surgery

3 Minute Read: 

Many women are hesitant to undergo plastic surgery because of the fear of noticeable and unwanted scarring. While scarring is typically inevitable with any plastic surgery procedure requiring incisions, such as breast augmentation surgery, tummy tuck surgery, or facelift surgery, there are many ways to conceal and reduce the look of scarring. 

Young girl enjoying vacation, sea and warm breeze, summer vacation

By following these easy tips, you can enjoy your plastic surgery results with minimal scarring. 

1. Using a Concealer or Color Corrector 

We all know that a concealer or color corrector can be used on your face to conceal blemishes and other skin imperfections, but did you know they can also be used to eliminate or reduce the look of scars on the breasts or body? It’s simple—find a concealer that matches your natural skin color and put it on your visible scars. 

By blending concealers on scars, you can reduce the redness, so the scars blend better with your skin.

2. Scar Treatment and Moisturizer 

Scars naturally fade over time; however, you can speed up this process by investing in a high-quality scar removal cream. While scar removal cream does not reduce the look of scars immediately, as concealers would, it helps reduce the appearance of scars over time. 

3. Avoiding Exposing Scars to Direct Sunlight 

This tip to reduce the look of scars after breast augmentation or tummy tuck surgery does not involve any additional purchases. Your new scars are extremely sensitive. Exposing your scars to direct sunlight can cause them to burn and blister, resulting in darker and more noticeable scarring. 

It is important to cover your scars with clothing when exposed to direct sunlight, or if you are unable to cover up, use a broad-spectrum sunscreen. 

4. Massaging Your Scars 

This tip may seem odd, but massaging your scars after your wound has healed can actually help reduce the appearance of scarring. Massaging your scars can help increase collagen production and help your scars heal faster and better. You must massage your scars when they are new for optimal results; scar massage will not work to reduce the look of scars more than two years old.  

5. Scar Revision  

Another way to reduce the appearance of scars is to undergo a scar revision procedure. It is important to know that scar revision cannot eliminate scars. Scarring is permanent; however, the look of scars can be reduced. 

Scar revision works to reduce the appearance of scars on your breasts, body, or face. The type of scar revision you undergo will be based on your needs and the severity of your scarring. Some scar revision procedures include: 

  • Dermabrasion 
  • Tissue expansion 
  • Skin grafts 
  • Dermal fillers 
  • Steroid injections 

Schedule a consultation with Dr. Davison to determine which scar revision technique is right for you. 

Want to Learn More? 

Plastic surgery incisions are also made in discreet locations to minimize visible scarring; however, they are still visible to you and may show in particular outfits.

If you would like to learn more about reducing the look of scarring after plastic surgery or are interested in scar revision, please call us at 202-966-9590 or fill out our online contact form

DAVINCI PLASTIC SURGERY ANNOUNCES NEW BREAST RECONSTRUCTION DC WEBSITE

2 Minute Read: 

The website focuses on breast reconstruction for women with breast cancer or a predisposing genetic mutation.

Image showing the homepage for the website breastreconstructiondc.com.

[WASHINGTON, D.C.] – DAVinci Plastic Surgery recently announced the launch of their new breast reconstruction focused website. The website was created as an educational platform for women with breast cancer and for referring doctors to offer as a resource to their patients in the Washington D.C. area. The website offers information regarding the stages of breast reconstruction, the multiple types of procedures offered, what patients can expect during their first consultation, and before and after photos of reconstructions completed at DAVinci.

The website will be a resource for breast cancer patients beginning their journey in reconstruction and looking for the right practice. “As a plastic surgeon who specializes in breast reconstruction, my role is to educate and guide my patients through this process.” states Dr. Ximena Pinell, a physician at DAVinci, “I do my best to be clear and comprehensive, but I recognize that those early conversations can be overwhelming… this website was designed to be a resource for women facing breast cancer or a genetic mutation that increases their risk of breast cancer.”

Breast Reconstruction DC describes several methods of breast reconstruction, including the benefits and drawbacks of each, what to expect throughout the process, FAQs, and a photo gallery to illustrate the results of surgery. Patients can read about DAVinci’s two plastic surgeons, who have extensive experience with breast reconstruction. Dr. Pinell completed her training at Emory University and is double-board certified in general and plastic surgery. She offers many options for patients including those that make use of a woman’s own tissues, novel approaches using breast implants, and breast reshaping techniques at the time of lumpectomy. Dr. Steven P. Davison is a triple-board certified plastic surgeon with decades of experience, including expertise in revision breast surgery. 

The new website is accessible at www.breastreconstructiondc.com.

ABOUT DAVINCI PLASTIC SURGERY

DAVinci Plastic Surgery opened in 2011 and provides plastic and reconstructive surgery to the Washington, DC area. Their core mission is to provide a “patient-centric” environment with a team approach to ensure that patients are ideally looked after.

Gynecomastia: The Under Armour Effect

Steven P Davison, MD, DDS, FACS | Ximena Pinell, MD | Katherine Long Lijoi, MS

5 Min Read

 

In recent years there has been a tremendous surge in interest in contouring of the male chest. Gynecomastia, or male breast tissue, is a common medical condition that affects a third of men in their lifetime. Why the sudden interest for such a prevalent condition? Clothing patterns are to blame, the Under Armour or compression workout fashion that projects a vision of health and vitality. A trip to any mall will have the senses assaulted with images of buffed bodies with defined peck muscles sheathed in tightest fitting workout shirt or less. For the not-inconsiderable population with male breast tissue, this has driven the question of what can be done! 

Before and after image showing the results of a gynecomastia surgery on a 25-year-old male in Washington, DC.

Gynecomastia, or male pattern breast tissue, is a medical condition with excess contour to the chest. It can be fat, true breast gland tissue, or a combination of both. Paradoxically, losing weight will improve a fatty male chest but will accentuate one caused by breast gland. In no way is male gland tissue a feminine trait or symptom; it is just an exaggeration of the natural breast that every man, as a mammal, has.

There are generally considered to be three causes of Gynecomastia. They can be independent or combine to make the condition more prominent. The first is a hormonal imbalance, most common in puberty. The most common time to develop gynecomastia is the worst emotional burden: while in middle school. Occasionally an endocrine or hormonal tumor can cause gynecomastia, but they are rare. The second cause is medication. Any medication that interferes with hormone balance, decreases testosterone, or increases estrogen byproducts are common culprits. Spironolactone, Propecia, Saquinavir, and cimetidine are examples of such medications. Paradoxically, some of these are medications used to reverse other psychologically traumatic conditions like male pattern hair loss. Marijuana in significant doses can cause male breast tissue to enlarge¹. The final cause is weight gain. Obesity or weight gain can cause fat to infiltrate the breast and distort the man’s chest. This is the simpler problem to address with weight loss or liposuction. Unfortunately, the stretch of the chest skin can leave a less than ideal contour. 

The good news is that after a patient has been ruled out for a major medical condition by history or exam, excellent options for treatment exist. The interest in surgical solutions has taken off with Gynecomastia surgery being one of the hottest growing procedures in the field. In fact, Gynecomastia surgery increased 22.6% from 2012 to 2017². Before recommending a surgical solution, the surgeon must first determine the underlaying composition and contour of the male breast. 

Size and Shape: Is the breast mostly fat or is there a pronounced presence of breast tissue located under the nipple? Is the problem of fullness alone or is there excess skin? The excess skin is much more of a problem than bulk of breast tissue. It requires contouring of the skin envelope often with additional scars. How big is the man’s areola? Is it normal sized (19-23 mm) and oval or is it bigger like a woman’s at 40+mm in size? Does it need to be reduced or reshaped into a more oval areola located lower and more to the side of the breast than that of a female patient?

Treatment Options: 

Weight loss: This will only work for obesity-related, fat-infiltrated chest contour. True Gynecomastia or male pattern breast tissue will be made worse as the man’s body fat decreases. The Breast bud doesn’t reduce and with weight loss, becomes more prominent as a bump.

 Liposuction: Various Liposuction techniques can contour the breast. Some deal only with fat. Other modalities such as ultrasonic accentuation (Vasar) can manage to reduce mild breast glands without open surgery. 

Debridement: Mechanical debridement or rotary tools can reduce breast tissue from limited incisions. The limitation of this is completeness of the treatment and managing extra skin. 

Open or Direct Surgery: This is when a limited incision around the nipple is used to remove the breast mound. Liposuction is often added to smooth out the edges. 

Skin Removal: This is a more extensive treatment to address an oversized areola, drooping breast, or a severe female pattern gynecomastia, where the breast looks like a woman’s. It uses skin excision to better shape the breast to that of a man’s. The scars are usually longer but well worth the change in shape and size. 

Surgery: It takes 1-2 hours based on how much is required. Unless very limited, it is more comfortable with IV sedation or general anesthesia. Most plastic surgeons use some form of tumescent fluid to reduce discomfort and decrease bleeding. The recovery is a week or so with potential for drains to collect fluid and old blood. 

Scar Care: With silicone sheeting, lotions, and occasional injections scars can be softened to enhance the results. The use of a compression chest not unlike the workout shirts that started this whole conversation are common for up to a month after surgery. As the male breast is vigorously supplied with blood vessels, the risk of post-operative bleeding or hematoma is not insignificant. The very desire to have the best chest shape, that drives the request for surgery, fuels a not insignificant demand for minor revision of the chest. These should not be considered a failure, but almost an expected sequel to gynecomastia treatment. 

In Conclusion: Gynecomastia, or male pattern breast tissue, is very common and nothing to be ashamed about as it affects a third of men at some time in their lives. Treatment is highly successful with excellent patient satisfaction as long as the patient and surgeon appreciate there may be tweaks to achieve the final result. It is one of the fastest growing surgical requests and most Board-Certified Plastic Surgeons will be happy to consult with you in depth on the solution that would suit you best. 

Interested in Learning More?

If you would like to learn more about gynecomastia surgery in Washington, DC, contact DAVinci Plastic Surgery by calling (202) 966-9590 or by filling out our online contact form.

 

References:

  1. Thompson DF, Carter JR. Drug-induced gynecomastia. Pharmacotherapy. 1993;13(1):37–45
  2. American Society for Aesthetic Plastic Surgery (2017). Cosmetic Surgery National Data Bank Statistics. [ebook] New York, NY: American Society for Aesthetic Plastic Surgery, p.10. Available at: https://www.surgery.org/sites/default/files/ASAPS-Stats2017.pdf [Accessed 4 Feb. 2020].

Kissable Lips for the Month of Love

February is known as the “Month of Love” with thoughts of pink hearts, chocolates, wine, flowers and… sweet kisses…but the weather this time of year can be rough on your lips. Harsh cold, windy and dry climate can make lips very uncomfortable. Whether you received a Davinci Plastic certificate for Valentine’s day or not, one of the easiest, fastest ways reverse the signs of aging is to choose kissable, full lips. Get those luscious lips by taking extra care of them and giving them that sexy boost of fullness with JUVÉDERM®. Here are some ideas for keeping your lips kissable for Valentine’s Day and through the rest of the winter weather.

Exfoliate

Dry lips can crack and get flakey. This is not only makes for a self conscious kisser, but can be very uncomfortable. A simple homemade honey sugar scrub can gently remove the rough skin. At the beginning of your lip repairing regimen, every night gently rub the mix on your lips then rinse. Once the damage is under control, this can be used once or twice a week for maintenance.

Here’s why you should use sugar as the exfoliator:

  • It has rounder granules that are more gentle.
  • Sugar is less drying than salt.
  • It contains a natural form of glycolic acid, which is alpha hydroxy acid to help smooth the fresh new skin once the rough top layer is removed.

Restore and Protect

After exfoliating, you may still need to repair or reinforce the health of your lips. You do this many ways:

  • Rest a green tea bag on your lips to revitalize your skin. Steep the bag in hot water, squeeze out the extra water, let it cool a little and then hold the warm bag against your lips for about three to five minutes. The high antioxidant levels in green tea make it a great choice.
  • Use a vitamin enriched moisturizer on your lips. Moisturizers aren’t just for the rest of the body, they’re good for all skin. The essential vitamins A, B and E can help you retain moisture in your lips. As an alternative you can directly apply vitamin E to sore, cracked lips, but even though it has great healing power, be warned that it doesn’t taste or smell great. Alternatively, both almond and coconut oil can help moisturize your skin and they have a pleasant taste and smell.
  • Staying hydrated is one of the best ongoing ways to restore and maintain the health of all your skin, including your lips. Pale and dry lips are often a tell tale sign of not drinking enough water.
  • Protect your lips from sun and wind burn with an SPF and wind guarding clothes like a scarf. This can help maintain the daily preparations you’ve made to make sure you have soft, smooth lips.

Fill

Along with the environment, age can take its toll on your lips. Everyone wants full, plush, kissable lips. Fortunately, I can help with that part of the lip rejuvenation. JUVÉDERM® is an injectable filler that can replenish the fullness of your youthful lips or even add volume you’ve always wanted but never had. With an expert eye for lip proportion and facial balance, we can help give you gorgeous lips for sexy, confident kissers.

Let us help you love your kissable lips during this “Month of Love.” Contact our office by calling 202.966.9590 or fill out our online contact form to schedule your appointment today.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

Just What She Really Wants for Valentine’s Day

With Valentine’s Day one week away, gift shopping is in full swing. But if you want to get one of the most desired gifts, you don’t need to brave the malls. Simply come in to DaVinci Plastic Surgery to get a gift certificate for your ‘someone special’ because surveys say that 78 percent of women would “be impressed” if they received this for Valentine’s Day gift. And what are they most likely to get? Most certificates are in the price range that is perfect for Botox or dermal fillers.

BOTOX® Cosmetic over chocolates and flowers…

There are certain women who’d be offended by the gift, but you can be sure that your lady would love the gift if she’s:

  • Already a regular user of injectables
  • Has asked for treatments as gifts for other holidays
  • Had one treatment of BOTOX® Cosmetic or filler and expressed happiness with the results
  • Ever mentioned that she’s considered getting injectable treatment to address her aging concerns.

Why women want injectables as gifts…

Injectables such as BOTOX® Cosmetic, JUVÉDERM®, JUVÉDERM VOLUMA® XC, Sculptra® Aesthetic, and RADIESSE® can directly affect the confidence and satisfaction one has with their looks. This goes much further than that designer purse or shoes. Every time they look in the mirror they’ll see the rejuvenated face and think of you in appreciation.

Which injectables to choose…

There is a benefit to giving a gift certificate since it eliminates the guess work as to which treatment to choose. Your Valentine’s sweetheart can select from a variety of the safe, effective treatments to address the area that she wants most. Here are some common choices:

  • BOTOX® Cosmetic is perfect to smooth out those two vertical lines between the brows, crow’s feet around the eyes, smoker’s lines above the lips, nose furrows, and thick lines in the neck. In a quick treatment session of about 10 minutes, there is a noticeable improvement that increases for optimal results within 7 to 14 days post treatment. These relaxed lines will last for several months.
  • JUVÉDERM® is a smooth hyaluronic acid filler to instantly smooth out those lines on the side of your nose and mouth.  This is also a popular treatment used to create luscious lips. Juvederm’s natural looking results can last up to a year.
  • JUVÉDERM VOLUMA® XC is the only FDA-approved filler to instantly add volume to the cheek area. By replacing lost volume, JUVÉDERM VOLUMA® XC creates a non surgical mini facelift that can rejuvenate the midface and lessen marionette lines around the mouth. Results can last up to two years.
  • Sculptra® Aesthetic is the only facial injectable with gradual, subtle results that can last two years or longer. It adds youthful volume to the face while stimulating collagen renewal.
  • RADIESSE® is a semi-permanent filler that uses unique, calcium-based microspheres to create scaffolding for your own collagen to grown around. Long after the RADIESSE® breaks down, the collagen it encouraged will help keep your face more youthful longer.

Take the guesswork out of Valentine’s Day gift giving and get something that your sweetheart would love…a certificate to choose their rejuvenation treatment at DaVinci Plastic Surgery. Contact our office today by calling 202.966.9590 to schedule your consultation, or fill out our online contact form for more information.

Steven Davison M.D.
Board Certified Plastic/Reconstructive Surgeon

Winterize Your Skin With Moisture

Cold, dry winter weather can really cause irritation, discomfort and can age the skin if proper care isn’t taken. You invest in your skin with cosmetic surgery and non invasive procedures, so it is important to take extra care of your skin, when the weather is extreme, to help those age defying effects last. Here are some tips to help you keep your skin healthy and feeling great.

Conserve Moisture

There are many habits that can strip out the moisture from your skin. This dryness can be painful, itchy and contributes to skin-aging by stripping moisture. So you need to work on replenishing this lost moisture using a few simple steps to do so.

First…some habits to avoid – some to do:

  • Taking hot showers or baths removes the natural lubrication and oil on the skin. Although a hot shower always feel good after coming in from the cold, try to keep it short or not too hot.
  • Using cleansers and toners, containing harsh ingredients, strips your skin of natural oil. Real sudsy cleansers usually have a surfactant like sodium laurel sulfate and the acetone in many toners can be too harsh along with already dry conditions. Use mild cream or gel cleansers and toner with no alcohol this time of year.
  • Sipping hot coffee and tea is so comforting when it’s cold out, but beware the dehydrating effects they can have. – Most people only think to drink lots of water when they’re sweating and hot, but cold, windy air can be just as dehydrating for your skin. So, drink lots of pure water everyday!

Moisture Reinforcement

Not only do you need to be on the defensive when it comes to protecting your skin (during the winter) by not participating in certain drying habits, but you need to be on the offense to add the extra help it needs this time of year. Here are some ways to add moisture reinforcement for your skin:

  • Running the heat in a home strips the air of any moisture, so you can counter this by adding a little water vapor back to your home’s air with a humidifier.
  • Diligently use moisturizer morning and night. Never miss moisturizing your face and hands since they’re exposed to the elements the most, but don’t neglect the rest of your body.
  • Exfoliate gently to remove the dull dead skin that builds up, but don’t forget that you must moisturize that fresh new skin to keep it healthy and glowing.
  • Continue using sunscreen. Snow can actually reflect up to 80 percent UV rays. As skiers and snow sports enthusiasts know, you can skill get a sunburn in the winter.
  • Eat foods that encourage your skin to retain and build healthy moisture, such as those rich in essential fatty acids like salmon and other “healthy fats” found in avocados and coconut oil.

I hope these tips help you save your skin this winter. We also offer medical grade, physician prescribed skincare SkinMedica®, which effectively addresses many skin issues and is essential for healthy skin maintenance. Contact our office to schedule your consultation. Call us at 202.966.9590, or fill out our online contact form for more information.

Steven Davison M.D.
Board Certified Plastic/Reconstructive Surgeon

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.