How Do I Choose A Cosmetic Plastic Surgeon In Hawaii?

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How Do I Choose A Cosmetic Plastic Surgeon In Hawaii?

The criteria for choosing a plastic surgeon in Hawaii is the same exact criteria for choosing a plastic surgeon in Detroit, Michigan.  Not too long ago, my sister Kay called from Detroit and asked how she could pick a plastic surgeon.   An obvious statement is that only plastic surgeons should do plastic surgery, therefore the minimum criteria for a plastic surgeon is that he or she should be Board Certified by the American Board of Plastic Surgery. 

Plastic surgery is a very broad specialty encompassing hand surgery, head and neck cancer surgery, cranial facial surgery, and of course, cosmetic plastic surgery.  The next criteria for choosing a plastic surgeon for your cosmetic surgery is to only go with the plastic surgeon who is a member of the American Society for Aesthetic Plastic Surgery.  This is an inner group of plastic surgeons who have identified themselves as having strong interests in cosmetic surgery.

In Hawaii, as in Michigan, almost zero cosmetic plastic surgery is done in a hospital anymore, therefore the third criteria for choosing the right cosmetic plastic surgeon is that he or she operates in a certified surgery center.  The highest certification and the one held by most plastic surgeons’ surgery centers is the American Association for the Accreditation of Ambulatory Surgical Facilities known as Quad ASF.  Of course, some very good cosmetic plastic surgeons may operate in other facilities, but I told my sister Kay the safest way to pick the right surgeon is to find one who operates in a Quad A facility.

It’s true that around the country, many plastic surgeons used nurse anesthetists to give the anesthesia, and some nurse anesthetist are excellent.  But the greatest safety, in my opinion, is if the person giving anesthesia is an Board Certified M.D. anesthesiologist.

    To operate in a surgery center, a plastic surgeon needs credentials at a local hospital.  I told my sister Kay to find out which hospital the various plastic surgeons she was interested in worked at, then call those hospitals and see if the doctors had privileges to do whatever procedure she was contemplating.

Online patient reviews have become a very important part of how patients choose their plastic surgeon.  The #1 plastic surgery online review website is Real Self.  Also important are Vital Signs, Health Grades, and Make Me Heal.  I suggested Kay review these sites.

Above, I have listed the criteria which I recommended to my sister and which I recommend to every patient considering cosmetic surgery in Hawaii.

Below is a link to Dr Schlesinger’s Video Website.

http://plasticsurgeryhawaiivideos.com/video-gallery/practice-videos/#top

To learn more about Dr Schlesinger please visit one of his websites;

www.breastimplantcenterofhawaii.com

www.mauibody.com

Cosmetic Plastic Surgery In Hawaii – Is It Safe and Can I Get the Latest Technical Innovations?

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Hawaii, and especially Honolulu, is actually a hotbed of modern, safe and technically innovative cosmetic plastic surgery.  One of the plastic surgeons in Hawaii routinely publishes in the white journal of plastic surgery.  He is very academic and knowledgeable.  A second Honolulu plastic surgeon is in line to become the president of the Aesthetic Society, an inner circle of plastic surgeons who have some of the greatest skills in cosmetic plastic surgery.  A third Honolulu plastic surgeon is a past president of the Northwest Society of Plastic Surgery and was the first plastic surgeon to hold the title “Physician of the Year” for the State of Hawaii.

 

Cosmetic plastic surgery done by the right plastic surgeon in the right surgery center is both safe and amazingly up to date for a tiny island in the middle of the Pacific.  Few people know this, but liposuction came from Europe in 1982 and was introduced to America at a meeting held in Honolulu where the best and brightest of that day came to learn about this new innovation.

 

    Honolulu can count among its cosmetic plastic surgeons some of the most intelligent and technically skillful surgeons in the Aesthetic Society.  Cosmetic plastic surgery is rarely done in hospitals today, and the highest certification that the patient should look for is AAAASF surgical facility.

 

When looking for the right plastic surgeon in Hawaii, be sure that he is Board Certified by the American Board of Plastic Surgery, is a member of the Aesthetic Society, and operates at a Quad ASF surgical facility,  Be sure during the consultation, you spend most of your time talking to the surgeon and minimal time to his business manager or nurse.  In today’s world, the surgeon must not be only technically skillful, but also available to deal with problems should they occur.   During the decision making process of which plastic surgeon to use, be sure you get a warm and fuzzy from the surgeon because this is not emergency surgery, and if you don’t feel comfortable with the surgeon within the controlled environment of his office, just imagine what will happen if things go south.

 

Surgery, especially plastic surgery, requires a surgeon with an eye for what is aesthetic, i.e. what looks good.  If your surgeon truly does not have good taste, rarely will he be able to give you a great cosmetic outcome.  The second requirement of a cosmetic plastic surgeon in Hawaii is a steady hand and completely knowledge, not only of the latest technical innovations, but which ones work and which don’t.  Finally, be sure your cosmetic plastic surgeon has a heart.  By that, I mean he cares about the outcome of the surgery and your happiness.

To learn more please visit one of our websites;
www.mauibody.com
www.breastimplantcenterofhawaii.com

Labiaplasty Kona

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Labiaplasty Kona

 Labiaplasty is becoming a very popular portion of the Mommy Makeover.   The reason for this increased interest in the internal labia of the female vagina is because of the increased visibility of this area of the body.  This visibility is directly related to a pattern of both young and older women removing their pubic hairs through shaving, waxing, and laser known as the Brazilian wax, etc.

Once this area became more visible due to hair removal and also due to the increased acceptance of adult films and its mainstream acceptance in our society, women began seeing this portion of the body on other women, and a community standard then developed as to the external appearance of the vagina, mostly referring to the labia minora, but also at times to the labia majora.

Young women and teenage girls being much less modest than their male contemporaries are actually showing this portion of their bodies and discussing it with their girlfriends.  This has also hastened the solidification of a community standard as to what looks good and what does not.

In the 20th century due to a lot of pubic hair and very little communication about this portion of the female anatomy and a lack of surgical options, very little attention was placed on this area.  Now into the second decade of the 21st century, a community standard of beauty has arisen.  Labia minora that hang outside of the labia majora are considered unattractive, and to some extent, looking like “grandma’s vagina”.  The physiologic cause of the labia minora to grow in size and therefore hang outside the major lips of the vagina is usually due to pressure from pregnancy and delivery, and also due to hormonal influences.   The physiologic purpose for the lips of the vagina is to keep moisture within the vagina.  However, as these pieces of vaginal tissue increase in size, they at times become an impediment to intercourse or riding a bicycle, and can now end up being a social embarrassment.

The original surgical treatment to decrease the labia minora is known as the TRIM technique.  This technique, while apparently simple in its design, is fraught with many potential complications.  This technique also gives the neophyte surgeon the concept that surgery in this area is simple and “anyone can do it”.  Nothing could be farther from the truth.  There is a limited amount of tissue in this area, and once gone, it is almost impossible to replace.

The technique of choice amongst Board Certified plastic surgeons very experienced in labiaplasty plastic surgery is the WEDGE technique.  This technique was invented by Gary Alter, M.D., a Board Certified plastic surgeon from Beverly Hills.  Dr. Alter recognized the similarity between the labia minora and the earlobe, and invented a technique similar to one used in earlobe reduction, the WEDGE technique .  This technique decreases the chance of asymmetry so often found in the TRIM technique.  It also has the amazing ability to decrease the overall diameter of the vaginal introitus, that is removing the laxity of the tissue around the opening to the vagina normally seen post pregnancy.   This tighter opening does a better job of keeping moisture in and also increasing friction during intercourse.

Depending on the size of the labia minora, interesting geometric angles are added to the basic WEDGE technique to keep the resulting scar in the gully between the labia minora and labia majora.  Labiaplasties, if done correctly, can give both an anatomic and physiologic improvement to this area, as well as increasing a woman’s self-esteem by decreasing embarrassment, not only during intimacy but, at times, when showering and changing clothes in a women’s locker room.  Labiaplasty has now gained solid footing along with abdominoplasty and breast surgery as an integral part of the complete Mommy Makeover.  Before and after photographs on this surgery can be seen both at breastimplantcenterofhawaii.com and mauibody.com. You can also visit labiaplastyinhawaii.com.

Breast Lift Kona

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Breast Lift Kona

             The breast lift has become the third most popular portion of a total Mommy Makeover after the tummy tuck and the breast augmentation.  Historically, the breast lift was a natural consequence of the breast reduction invented in Germany during the 19th century.  The original technique, commonly referred to as the ANCHOR technique, reduced the overall volume of the breast, elevated the nipple areolar complex, decreased the nipple areolar complex in size, and eliminated the breast tissue that was hanging on the chest wall.  Newer variations on this lift/reduction technique have allowed minimal tissue removal and lessening of the original scarring.

The reason or necessity for a breast lift is basically the breast hanging on the chest wall.  This is usually a post pregnancy phenomenon, although at times, it is seen as a genetic variant, i.e. some women just get droopy breasts as a consequence of their genetic makeup.  The medical term for breast droopiness is breast PTOSIS.  Breast ptosis usually has four components:  1) the areola is too big; 2) the areola is too low on the breast mound; 3) the breast is hanging on the chest wall; 4) there is no fullness in the upper quadrant of the breast.

The ANCHOR technique has been given a bad rap due to excess scarring.  However, this technique normally gives an excellent breast shape, and when a subpectoral breast augmentation is added to it, corrects all four of the major problems seen in a droopy or ptotic breast.  There are many techniques in the anchor breast lift surgery to decrease scarring.  The majority of these techniques include taking tension off the suture line by putting strong heavy sutures deep in the breast tissue to bring the tissue together, and therefore decrease tension on the actual suture line.  I personally place a dart of breast tissue along the horizontal limb of the breast reduction surgery to also decrease tension.

Surgery does not end at surgery.  It ends when the patient has the least possible scarring based on their genetics.  To that end, I always tape along the suture line post surgery for weeks to months to increase the likelihood of minimal scarring and redness.

The VERTICAL breast lift has gained a great deal of popularity in the past decade, but I personally feel this surgery is overused by many plastic surgeons leading to the appearance of too high a nipple areolar complex, and very often breast tissue fallout.  I believe the vertical lift should be used in cases of minimal to moderate droop, and I feel that correction of “star gazing” nipples seen in many vertical lifts can be accomplished by adding a horizontal limb which then makes it obvious that the standard or anchor breast lift should have been done in the first place.

For lesser degrees of droop, the BENELLI MASTOPEXY leaving minimal scar just at the edge of the areola, is an excellent alternative to more scarring, and therefore less aesthetic techniques.  My video on the Benelli mastopexy can be seen on the front page of the breastimplantcenterofhawaii website as well as on Youtube (key words “Benelli mastopexy/Schlesinger”) or even the home page of the mauibody website.

For the minimal droop of ptosis or for low placed nipples, I recommend the INTERNAL MASTOPEXY, also known as the DUAL PLANE MASTOPEXY which allows nipples to rise higher and offers minimal to no scarring when done through a surgical approach through the armpit.  This is a unique technique, and it is not for every patient, nor should it be done by every plastic surgeon.  This technique allows the nipple to move up on the breast mound without any visible scarring, while at the same time keeping thebreast implant below the pectoralis muscle in its upper portion.  Examples of the dual plane technique can be seen at the breastimplantcenterofhawaii.com

Cosmetic Surgery Magazine-Invisable Scar Breast Lift

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http://www.cosmeticsurgerymagazine.com/postview.cfm/postid/196

Cosmetic Surgery Magazine-Invisable Scar Breast Lift

Hawaiian plastic surgeon Dr Larry Schlesinger explains to Jodi Thiessen the benefits of the Benelli Mastopexy (breast lift) Schlesinger modification.

Traditional breast lift will lift a droopy breast, but can leave behind up to 9cm of scarring per breast. The Benelli Mastopexy technique was first described in 1949 and popularized in the 1980s by French plastic surgeon Dr Louis Benelli.

In this procedure, the scar is only around the nipple. Hawaii plastic surgeon Dr Larry Schlesinger often combines it with an implant. This particular type of lift is successful with first and second degree ptosis (droop); a standard mastopexy is needed for third degree ptosis.

A general way to test the amount of ptosis is by placing a piece of paper under the breast and letting the breast hang. First degree ptosis will show breast tissue drooping over the paper; second degree ptosis is when the nipple hangs slightly over the paper; and third degree ptosis is when the nipple is more than 2cm below the paper.

The Benelli Mastopexy with implants corrects all four of these problems.

“The procedure is done by drawing an outer circle – the top of which is determined by where the new position of the nipple aerolar complex will be,” explained Dr Schlesinger. “The bottom of the outer circle is anywhere from 5-8 cm from the infra mammary fold (breast fold). Then an inner circle is drawn by using a 38-45mm size cookie cutter as outline.”

The key to achieving the correct shape and position for the patient is by testing the outcome before actually cutting the skin. Dr Schlesinger does this once the patient is asleep on the operating table. “Once the patient is asleep, I suture the outer circle down to the inner circle and pull it up like a purse string without cutting the skin. Then I sit the patient up and check it is the right lift, and the new position of the nipple is where you want it to be.”

When the new position is established using this technique th( incisions are made. “I cut around the nipple areolar complex ano around the outer circle and remove the skin between the two circles,” explained Dr Schlesinger. “I leave the breast tissue with the nipple areolar complex completely intact, sitting where it was, and I loosen the skin all around it. Then I go straight down beneath the muscle and put the implant sizer in. Because the size of the implant will determine where the nipple will sit, this is another way of checking before a permanent implant is inserted. Then I take the sizer out and put a permanent implant in.

“By putting the permanent suture in, the tissue is held in place, so the scar doesn’t spread and the areolar complex doesn’t spread,” said Dr Schlesinger. When the two circles are joined together, the nipple has moved to a higher position.

The procedure takes approximately 2.5 hours; the sutures are removed in five days. Patients are normally back at work in one week, able to swim again in two weeks and back to rigorous exercise in four weeks.

Dr Schlesinger concluded: “With this method I can attain the shape patients are looking for, with minimal scarring.”

The four basic problems droppy breast have are:

  1. The areola/nipple complex is too low on the mound.
  2. The areola/nipple is often too large.
  3. The breast is hanging off the chest wall.
  4. There is no fullness in the upper quadrant.

 

Mommy Makeover Honolulu

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Mommy Makeover Honolulu

 The Mommy Makeover means different things to different people.  Some patients see the Mommy Makeover as liposuction of the abdomen and breast surgery.  Rarely are we able to make the post pregnancy abdomen look good with just liposuction.  However, in rare instances for a few females, this is all they need.  Other patients find that pregnancy caused asymmetry and/or droopiness in their breasts and stretched out internal labia of the vagina but minimally affected their abdomen.  Some patients want a full on tummy tuck, liposuction and eyelid surgery since the entire process of pregnancy and delivery not only affected their bodies but made their face and eyelids age faster than they had anticipated.

 

As you can see, the Mommy Makeover means different things to different people.  At the Mommy Makeover Institute of Hawaii, our Board Certified plastic surgeon, Dr. Larry Schlesinger, has performed over 20,000 cosmetic procedures of all kinds in Hawaii, and therefore whatever additional cosmetic procedures you request or require, Dr. Schlesinger will be able to assist you with them at the same time as rejuvenating your post pregnancy body.

 

The tummy tuck, of course, is the cornerstone of almost all Mommy Makeovers.  It has been impressive that almost every mother who comes in for a breast augmentation consult has no problem exposing the breast they want improved upon, but all feel very uncomfortable about showing the stretch marks, fat and distorted belly buttons of their post pregnancy abdomen.  Breast augmentation has become the #1 cosmetic procedure in the United States.  However, tummy tucks with and without a complete Mommy Makeover are becoming more and more popular when women find out that they can have an attractive belly button and a well hidden abdominal scar.

 

At the Mommy Makeover Institute of Hawaii, we feel that surgery doesn’t end at surgery.  It ends when you have the best conceivable post abdominoplasty abdomen that your genetics will allow.  Dr. Schlesinger uses special tape for up to 3 months after surgery to minimize the signs of an abdominoplasty surgery.

Please feel free to visit our sites

www.mauibody.com

www.breastimplantcenterofhawaii.com

www.liquidfacelifthawaii.com

www.gynecomastiahawaii.com

www.mommymakeoverhawaii.com

www.labiaplastyinhawaii.com

www.plasticsurgeryvideoshawaii.com  (coming soon)

Tummy Tuck explained by Dr Larry Schlesinger in Honolulu, Hawaii

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Tummy Tuck

The key to a great tummy tuck is a great belly button. The belly button has two blood supplies – one from the skin around it and one from the liver. There are two veins and one artery that come from the liver and go to the bottom of your belly button. This is how your mother fed you when you were inside her. In a full tummy tuck, the belly button is circumscribed (a cut is made all the way around it), and it is dropped inside to be brought out through a new opening.

Another little known fact about the belly button is that it is not a midline structure. It is usually slightly off to the right or the left. This has to be taken into consideration when your plastic surgeon creates a new belly button. I attempt to center the belly button. Many plastic surgeons try to make a very natural belly button by giving it a slight hooding. It has been my experience that this hooding rarely looks natural and takes away from the potential beautiful looks of a new belly button (neo-umbilicus). The opening to the new belly button should be neither too big nor too small since both of these choices again detract from an attractive belly button.

Technically, I use a vertical ellipse measuring 15 mm in vertical height and 8 mm in width. It is important to take all the fat off the bottom of the skin around the belly button for a distance of 20 mm. This allows the skin to indent in a very natural fashion since the belly button should have a gentle slope down to it from the tissue around, and not an abrupt step off. The scar around the neo-umbilicus should be deep inside the belly button, therefore not visible to the outside world leading to a more natural appearance. The way to do this once the surgeon has repaired the muscles of the abdominal wall, he or she should anchor the belly button at 3, 6, 9 and 12 o’clock to the fascia covering the muscles. This allows the defatted skin around the neo-umbilicus to be pulled downward leading to a hidden scar. The sutures that connect the abdominal skin to the edge of your old belly button should be below the surface, and only super glue should be used at the scar edge to prevent railroad tracking which is a dead giveaway for a tummy tuck.

A great looking belly button should be centered as much as possible, having a gentle slope down to its edge, and the scar should be hidden as much as possible inside the belly button.

The abdominoplasty incision scar should be hidden under the upper edge of one’s panty or bikini line, therefore the belly button is truly the key to a well done abdominoplasty. What is taken away during an abdominoplasty is, of course, important, but what is left after an abdominoplasty is more important. A great belly button gives you a great midriff. Feel free to visit our websites,

www.mauibody.com
www.breastimplantcenterofhawaii.com
www.liquidfacelifthawaii.com

Mommy Makeover explained by Dr Larry Schlesinger in Honolulu, Hawaii

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Mommy Makeover

Why the Mommy Makeover? Our grandparents and great grandparents did not have such a thing, but then again mothers stayed home with the children while fathers went out into the workplace. Divorce was rarely an issue 50 years ago. Today’s women are out in the workforce in great numbers. Women who have had children are competing with women who have not and also with men for the same positions. TV and the internet have exposed everyone to amazingly trim and well built females leading to some nagging insecurities for women who have had children.

Since many marriages end in divorce, not only do young women who have had children need to look good in the workplace, but dating once you have had children can lead to some insecurities about your body. The Mommy Makeover is a way for women to regain their pre-pregnancy bodies, tighten their stomachs, lift their breasts, and get rid of fat in places they never anticipated. The latest portion of the female anatomy to be beautified is the opening to the vagina known as the labia. As one of my patients has said after a labiaplasty, she feels it is a return to innocence.

Whatever your reason for wanting a Mommy Makeover, at the Mommy Makeover Institute of Hawaii, we have discovered that when all these surgeries are done together, it can be less expensive, safe, natural in appearance, and raise not only your spirit, but your self-esteem. Patients have reported, after a Mommy Makeover surgery, they now have more psychological energy for their family and friends that used to be wasted not feeling good about the post pregnancy bodies.

Since part of my practice is known as the Breast Implant Center of Hawaii, I see ten to twenty new women each week in consultation for some form of breast surgery. During the consultation, at some point, pre-operative photographs need to be taken. I have observed that my patients are less concerned about their visible breasts and more concerned about covering the stretch marks and their post pregnancy abdomens. This fact had a great deal to do with my setting up the Mommy Makeover Institute of Hawaii.

The Mommy Makeover surgery is not a collection of separate procedures, but is a holistic approach to the rejuvenation of the female body after pregnancy. Please feel free to visit my websites,

www.mauibody.com
www.breastimplantcenterofhawaii.com
www.liquidfacelifthawaii.com

Dr. Schlesinger’s Philosophy on the Mommy Makeover

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Dr. Schlesinger’s Philosophy on the Mommy Makeover

As a male, it never occurred to me what havoc is reeked on so many young women’s bodies by pregnancy. As a plastic surgeon, each of the five elements of a Mommy Makeover are things I have done in my practice for years, but I truly believe putting these separate elements together and looking at the Mommy Makeover as an entity rather than a collection of parts helps the surgeon and the patient. My surgical technique has changed to allow multiple surgeries done at the same time, and a better understanding of recovery from these multiple surgeries. When it comes to the Mommy Makeover, the whole is truly greater than the sum of its parts. I find that women after a Mommy Makeover are some of the happiest patients that I have ever interacted with. I know the surgery helps my patient’s self esteem, and being able to do these surgeries well gives me a sense of personal satisfaction.

The field of the Mommy Makeover has given me a surgical raison d’etre. I really never knew that I was searching for a field within cosmetic surgery to specialize in. I enjoy being a plastic surgeon and helping people, but the Mommy Makeover, the great people I get a chance to help restore their self esteem, the outstanding surgical crew that I work with at my brand new surgery center (the Mommy Makeover Institute of Hawaii), all of the above make it a true pleasure to get up every morning. WOW – this is what it’s all about!

Check back often for more blogs from Dr. Larry Schlesinger and the Mommy Makeover Institute of Hawaii.

To View More Before & After Photo’s of Mommy Makeovers Please Visit Breast Implant Center Of Hawaii