It’s been a while!

Some of you may have noticed that it’s been a while since I last posted.  In the interim, I’ve started my own practice!  We’re starting great things, and I’ll be resuming my blogging shortly.  In addition to the internet, I’ve taken an interest in other media.  This is a modest start to being on camera:


Breast Augmentation Consultation Videos – Overview

After a long winter’s nap, I’ve begun the creative process again.  We’ve come up with several ideas for instructional videos people can use to educate themselves on a variety of plastic surgery topics.  The idea is that you can watch these videos before you go in for a consultation, so that you are more informed from the get-go.  Obviously this first set will be on breast augmentation.  This first video is just an overview, and we have several other videos that will go into some detail on the particulars of augmentation.  After we get this series completed, we’ll move on to other topics (liposuction, tummy tucks, etc).  Feel free to contact me with more ideas for topics you’d like to hear about!

Getting all settled in.

After four months, Angela’s implants have now settled.  Seeing people in the office at this point gives a rough idea about how the implants are going to look over time, although one must keep in mind that breast tissue will continue to change.  Skin, breast gland, and breast fat all undergo alterations that occur with normal aging, not to mention rippling, contracture, and other changes that may take place with time.

As you can see from the following before and after pictures, we accomplished our preoperative goals well.  Angela was initially a small B, and desired a full D cup.  She is now very pleased with her results, and eagerly awaits swimsuit season.




Like many plastic surgery procedures, breast augmentation comes with risks and benefits that are best understood by consulting with an actual surgeon.  When I discuss options with patients, I strive to help them understand many things, including what is possible, what will look good for their particular body, and what they should expect before and after surgery.  I truly enjoy educating, collaborating with, and improving the lives of my patients.  If you are interested in breast augmentation, I encourage you to come in and see me.  Through the end of the year 2013 your consultation is complementary, and the potential benefits can be sizable.  Go ahead, give it a try!

Patience, grasshopper

Between the 1-month and 4-month appointments, many changes were afoot.  Around the 2-month mark, I got an update that Angela’s implants were just starting to drop, but they were doing so unevenly.  This was a cause of concern.  Looking at her picture, this unevenness is apparent.   This is not uncommon, however.  Whether this is because of being right- or left-handed or because of differences in tightness of the pectoralis muscles, sometimes implants do tend to drop at different rates.  This does not mean that the implants will wind up being in different positions.  Here she is around two months:


The left side has begun to drop into proper position, and the right remains high; but now look at things a month later:


The position of the implants has now evened out, giving her a nice, symmetric look.  At this point she breathed a sigh of relief, and her buyer’s remorse was replaced with excitement for the coming bikini season.  Also, some decreased nipple sensation, which is transient in some patients (due to nerve stretch  because of the size of the implants), was now relieved, making her even happier with her results.

Tomorrow I’ll post her pictures we took at her 4-month follow up appointment.  Angela’s case is a good one in that it illustrates that not everything goes according to patient expectations, but this doesn’t mean results are compromised.  For those interested in breast augmentation, come in and see me – for those who schedule augmentation consultations before the end of the year, you can get 1/2 off the surgeon’s fee for your surgery, and you, too, can be excited for the coming bikini season!

Houston, we have a problem

Ah, buyer’s remorse.  That nauseating feeling that something is wrong – that what you have experienced isn’t normal, and that you may have just made a huge mistake.

Somewhere about a month out, I saw Angela, and she was concerned.  Normally by that time, the implants have started to drop, but hers continued to be positioned high, and her implants appeared very tight.  Perhaps she was comparing her results to friends who had implants, who didn’t seem to still have breasts up to her collarbones a month out.  Doubt started to creep in, and the possibility of revision surgery loomed in her thoughts.  We talked for a while about possibilities, and I encouraged her to hang in there.  Her concerns were logical and realistic, but over time I have found some people, particularly petite women, have tighter musculature, and it takes longer for their implants to drop.  She seemed to match that profile.

Around this time she started taking occasional pictures to document her progress.  With this picture, you can compare her appearance with where she was right after the procedure and you can see not much progress has been made.  In fact, some may even say her implants seem to have shifted upwards.  This is not uncommon, and as you’ll see, truly does improve with time.  Over the next few days, pay close attention to how the breast volume, position, and symmetry can change.


What do they do in there anyway???

So your big day of excitement comes.  You’re a little nervous.  Not quite sure what it means to be operated on.  You want things to go well, not knowing exactly what “well” means.  Don’t fret – you’re not alone!  On the day of surgery patients generally show up about an hour before we begin.  An IV is started, and you’ll get some pain medicine before we even begin.  The nurses help you prepare every little thing.  The anesthetist will talk to you, and I’ll talk to you.  We go over your operative plan, to make sure we’re on the same page, and then I draw my map to help me do things just the way we’ve agreed.  After that, you walk into the operating room, you become sleepy, and then we prepare for the operation.  To let you know how things look at this stage, it’s something like this:


Here’s Angela just before we begin.  As you may be able to surmise, we’ve chosen to place her incisions in the inframammary folds – the folds where her breasts hit her chest wall.  The incisions are about 3.5 cm long – around an inch and a half.  We placed 450cc silicone implants below her pectoralis muscles, using high profile implants (relatively narrow width but more projection).  After the procedure she looked something like this:


You’ll notice a few things about this picture.  You can already see that the implants look very large, and that they look like they come up to her collar bones.  This can be alarming to some people, but is very normal.  With time, the implants will settle, and will take on a more normal appearance.  Some people take longer for this to happen, as was the case with Angela.  As the days progress you’ll be able to see the implants’ position change.

Up next – that goofy in-between period!

Making the Holidays bigger and brighter

Yes, I admit it.  Perhaps the purveyor of this blog has become derelict in his responsibility to post new and exciting plastic surgery updates.  But guess what?  Doctor’s gonna make everything all better, because I have yet another weeklong series based on a patient’s experience.  This time – Breast Augmentation.  Everyone please meet a girl we’ll call “Angela.”  No silly, that’s not her real name, but that’s ok.  We keep everything confidential, and you benefit because Angela has done us all a great favor and has recorded her experience with her iPhone.

During my consultations with patients, I discuss how things change over time, with the normal progression being something as follows:  regarding their shape and volume, on the day the breast implants are put in, they appear something like their eventual outcome.  Because of swelling and muscle tension, the implants tend to rise soon after surgery, giving the breasts a constricted but high-riding look.  With time this resolves, giving people the cosmetic outcome they were desiring.  This takes time – usually about a month, but sometimes longer.  The natural tendency is for people to want their “new” boobs right away.  Angela was no different.  Unfortunately for her, but fortunate for us, this process took her a little longer, thus providing her the incentive to document her progression.  She is petite and active, and it took a few months for her implants to really find their new home.  Each day this week I’ll add a picture to the series to show you what you can expect with a breast augmentation.

Some initial information: Angela is 26, initially had small-B cup breasts, and desired D to DD.  She desired silicone implants, and we chose to place these underneath her pectoralis muscles.  Here are her initial preoperative pictures:


Tune in this week as we take you through Angela’s journey.  For those of you who are interested, come in and see me.  Right now we’re offering 1/2 off the surgeon’s fee for breast augmentation patients who come in for their consultation during November and December!

Looking scary out?


As we approach Halloween, we can’t help being swept up in traditions of ghosts, goblins, and zombies.  In a few days the constant parade of grim reapers and spooky ninjas will come across our doorsteps.  Seeing the kids enjoy the time is great.  But somewhere along the way of being barraged with scary movies and evil laughter, I start asking myself – “hey, where’s the pretty in life?”  Many of us have seen enough scary things in life – whether from divorce, monetary problems, or illness – we’ve all had our trials and tribulations.  At some point you want relief from the bad.  You ask “where’s the joy?”  One of my greatest joys comes from being part of the creative and healing processes.  Plastic surgery is one way of accomplishing both.  It can heal us of our outer scars and blemishes, and help restore our sense of inner peace.  Don’t get weighed down by life’s scary side.   We all have our goblins that need “treating.”  I’m here to help restore the “pretty” in life amidst the spooks and spells that life throws our way.

Take two of these…

Screen shot 2013-10-17 at 4.03.31 PM

I’ve known Sue for several years now.  She is a close friend.  For more than a year now she’s also been my patient.  It was then that I learned she suffered from painful, chronic migraine headaches, sometimes every other day, especially when the seasons change.  She would not want to leave her room, would be on the brink of throwing up, and sometimes did.  When I first learned of her problem, I told her there was a way to relieve her suffering, that involved something in the plastic surgeon’s standard bag of tricks – Botox.

Current research shows people with chronic migraines can benefit from botox treatment – with regards to headache severity and frequency, but also in general quality of life and headache-related disability.  In addition, the longer someone is treated, the more they seem to benefit.

Screen shot 2013-10-17 at 4.07.30 PM

Since Sue started using Botox, she has noticed a dramatic reduction in the number of migraines she gets.  Where she used to get 2-3 per week, she now only gets 1-2 per month.  The injections usually last her around 4 months.  If she goes too long, the headaches return, and I get gentle reminder text messages.

At Waldman Schantz we offer Botox, Dysport, and Xeomin.  Based on your needs and desires, we can find a product that will work for you.   Say goodbye to wrinkles (or headaches!), say hello to a better you.

Right now the makers of Botox have started a program where you can save on future injections (or even shopping online) every time you use Botox, Juvederm, and Latisse.  Come in and we’ll help you start saving today!


Aurora SK, Dodick DW, Diener HC,  et al.  OnabotulinumtoxinA for chronic migraine: efficacy, safety, and tolerability in patients who received all five treatment cycles in the PREEMPT clinical program.  Acta Neurol Scand. 2013 Sep 20

What is a gummi bear?

If you’re a candy lover, this question is just silly.  If you’re one of my children, you’d start pulling up Youtube and start playing a highly repetitive, mind-numbing trance song embraced the world over (in 17 languages!).  But if your mind is turned towards plastic surgery, you just might be thinking about this:


That’s right.  The new highly cohesive silicone gel implants.  These are being touted as the next generation, the latest and greatest thing in implants.  Silicone implants have been through several revisions since their inception in 1961 by Cronin, Gerow, and Dow Corning.  They were not the first to try to enhance breast volume, and many others have tried other methods (not implants) to bring women larger cup sizes since then.

So what’s all the hubbub about?  If you look at them, first you’ll see they are tear-drop shaped, following the natural contour of the breast.  They hold their shape better than standard implants because of the “stickiness” of the silicone used.  Not all silicone is the same.  Because of their shape, they are also textured, to help them stay in proper position.

Depending on what look/shape/feel you are interested, a plastic surgeon can choose an implant from a wide variety.  Here are a few types we have available here:


So, after all that, you know you want to listen to the song.  Go ahead.  Nobody’s watching…