October, 2007

A Rhinoplasty or nose job is one of the most common plastic surgery procedures. It can effectively change the size of your nose, reshape the nose, resize the nostrils, or make other adjustments to match your nose to the shape of your face. The procedure can help to improve the appearance and balance of a face. Such factors may improve an individual’s confidence, leading them to seek their own Rhinoplasty surgery in San Francisco.

Rhinoplasty in the Bay Area can be performed through slightly different procedures. In each of the procedures, the nose and cartilage are reshaped to create the desired shape. Dr. Anthony accomplishes such effects by either removing the skin from the nose to reshape it or through an incision made through the nostrils. This not only helps to improve the physical appearance of the patient, but also restores self-confidence and respect to the patient.

A rhinoplasty is a very individualized procedure in which your goals should be realistically determined and discussed with your cosmetic surgeon in San Francisco. Together you will determine what specific procedures will be performed. A San Francisco nose surgery procedure can be performed in conjunction with other procedures such as a face lift to enhance the balance of the patient’s facial features. Once your goals have been determined, you will set a date for your nose surgery in San Francisco and will be given instructions about how to prepare.

The patient should remember to have realistic expectations about what a San Francisco rhinoplasty can accomplish. Your surgeon may instruct you regarding physical activity, medication, drinking, smoking, or washing your face in order to help you prepare for the surgery. You may need to find someone to help you for the first few days of your recovery since movement is initially discouraged.

When the date for your rhinoplasty in San Francisco has arrived, you should plan on the surgery taking several hours depending on which procedures you are having performed. When the procedure is finished, the nose will be secured in place and given a splint to help preserve its shape as it heals. Patients should plan on taking about two days of rest before being up and active. A week should be given before returning to work for office workers and a period of approximately three weeks will be needed for full recovery. All procedures are performed with anesthesia to minimize any discomfort or pain. Please visit our home page to learn more about rhinoplasty in San Francisco.

For Plastic Surgery in San Francisco Contact Board Certified Plastic Surgeon Dr. Anthony by Email or contact us by phone at 415.395.73. Dr. James Anthony  serves the San Francisco Bay Area, nand offers the best in Aethetic Procedures including Breast Augmentation, Face Lifts, Liposuction, Tummy Tucks, and Rhinoplasty(nose surgery). Contact us today to schedule a consultation.

 Patients who desire a Browlift in San Francisco may have noticed the effects of age, gravity, exposure to sunlight, and the stresses of life all taking their toll on a person’s face. Muscles and other tissues may slowly begin to droop, causing the patient to look tired or sad. Such factors may affect an individual’s confidence, leading them to seek their own Bay Area Browlift.

A brow lift can help such individuals restore youthful vibrance and energy to the face. The effects of time are virtually undone to restore an individual’s face and to remove many of the effects of time and aging. Dr. James Anthony accomplishes such effects by removing a portion of and tightening the muscles and other tissues that are causing the skin to droop. This not only helps to restore the physical appearance of the patient, but also restores self-confidence and self-respect to the patient.

A Bay Area Browlift is a very individualized procedure in which your goals should be realistically determined and discussed with your Cosmetic Surgeon. Together you will determine what specific procedures will be performed. A brow lift is often performed in conjunction with other procedures such as a face lift, nose job, or eye surgery. Once your goals have been determined you will set a date for your Browlift procedure in San Francisco and will be given instructions about how to prepare.

When the date for your San Francisco Browlift has arrived, you should plan on the surgery taking several hours or more depending on which procedures you are having performed. There is no set procedure for how a brow lift is performed, as each individual’s brow is different and may have different requirements. Plastic surgeons use either the classic method or the endoscopic method to tighten the brow. While these procedures differ slightly, both involve incisions placed in the hairline so they will be less visible.

The plastic surgeon will bring the brow skin upward and remove the excess tissues that previously caused drooping. The brow line is then set in place and secured so that it can heal. All procedures are performed with anesthesia to minimize any discomfort or pain.

Recovery will usually require a few days of rest before the patient is moving and a week to ten days should be allowed before returning to work. The endoscopic procedure usually has a quicker recovery time and less negative consequences than the classic method. Discuss with your cosmetic surgeon which procedure is best for you.

For Plastic Surgery in San Francisco Contact Board Certified Plastic Surgeon Dr. Anthony by Email or contact us by phone at 415.395.73. Dr. James Anthony  serves the San Francisco Bay Area, nand offers the best in Aethetic Procedures including Breast Augmentation, Face Lifts, Liposuction, Tummy Tucks, and Rhinoplasty(nose surgery). Contact us today to schedule a consultation.

AUTOGENOUS RECONSTRUCTION – TRAM

Autogenous means "one’s own". In autogenous reconstruction the patient’s tissue is used to create a breast. When tissue (not just skin) is moved from one part of the body to another it is called a "flap". There are several different flaps that are used for breast reconstruction. The most commonly performed is a "TRAM" flap. "TRAM" is an acronym for "transverse rectus abdominis myocutaneous". This refers to the transverse (or sideways) orientation of the skin and fat taken from the lower abdomen, supplied by blood vessels that come through the rectus abdominis muscle (see figure 1). A "pedicled" TRAM flap is when the skin and fat of the lower abdomen is elevated with the underlying rectus abdominis muscle, and transferred to the chest. The skin and fat are supplied by the "pedicle" of muscle, which carries and protects the blood vessels.

Figure 1

The TRAM flap has many advantages. The use of the skin and fat of the lower abdomen is similar to an abdominoplasty ("tummy tuck"). Most patients are pleased to have this tissue removed. A major benefit of the TRAM, and all types of autogenous breast reconstruction, is that such reconstruction avoids the disadvantages of implant reconstruction. Breasts that are reconstructed with the patient’s own tissues usually look and feel more natural, and act more like a normal breast over time.

The main disadvantages of the TRAM flap is that compared to implant reconstruction it is a longer operation, usually requiring a longer hospital stay. In addition the TRAM flap requires the sacrifice of part or all of the rectus abdominis muscle. Most patients have minimal side effects from the loss of this muscle, although occasionally it can result in abdominal weakness, bulging, or (rarely) hernia.

 This plastic surgeon in San Francisco serving the Bay Area offers all aspects of plastic surgery including tummy tucks, facelifts, nose surgery, breast reduction and more. Contact Dr Kind at 415-565-6884 or email us. View plastic surgery photos from this San Francisco plastic surgeon.

 An exciting development in microsurgical reconstruction is the increasing use of perforator flaps. These flaps preserve the underlying muscle by dissecting the blood vessels through or around the muscle. Theoretically any muscle flap that includes a paddle of skin can be harvested as a perforator flap. In practice there are several perforator flaps which have been used for various reconstructive needs around the body. A few of these include the lateral arm, the anterolateral thigh, and the thoracodorsal artery perforator flaps. These flaps generally provide good thin soft tissue coverage, and since they do not include muscle, the donor defect created results in minimal deformity and less pain than a muscle flap.

In the mid-1990′s it was recognized that the TRAM flap could be harvested without the rectus abdominis muscle by dissecting the blood vessels (the perforating vessels to the skin and fat) through the muscle (see figure 2). This flap, called the deep inferior epigastric perforator or DIEP flap (see figure 3), uses the same skin and fat of the lower abdomen as the TRAM to reconstruct a breast. There are several published series in the medical literature that show that patients who undergo this procedure have less pain and a faster recovery than patients who undergo TRAM flap reconstruction. There is also less risk of abdominal wall weakness and herniation. Finally, since the flap is taken from the low abdomen like a TRAM flap, there is the added benefit of a "tummy-tuck", with the abdomen nicely re-contoured.

Figure 2

Figure 3

The DIEP harvest is longer and more complicated than a TRAM flap, but for most patients this is more than offset by the benefits to the abdominal wall.

In approximately 15% of patients, there are no large perforators coming through the muscle. In these patients the skin and fat of the lower abdomen are supplied by a more superficial blood vessel, the superficial inferior epigastric artery. This blood vessel is a branch of the femoral artery, and courses through the tissues of the lower abdomen without going through the rectus abdominis muscle. In these patients breast reconstruction can be performed with a flap of fat and skin from the lower abdomen without having to dissect through the rectus abdominis muscle. This flap is called the superficial inferior epigastric artery or SIEA flap.

Each time that Dr. Kind dissects a DIEP flap, he carefully looks for and preserves the superficial inferior epigastric blood vessels. If these vessels are of sufficient size, the SIEA flap can be used.

Figure 4 – Left breast reconstruction with DIEP flap.
Note the intact rectus abdominis muscle. This plastic surgeon in San Francisco serving the Bay Area offers all aspects of plastic surgery including tummy tucks, facelifts, nose surgery, breast reduction and more. Contact Dr Kind at 415-565-6884 or email us. View plastic surgery photos from this San Francisco plastic surgeon.

 You may be a candidate for eyelid surgery in San Francisco if you have excessive, sagging, or wrinkled upper or lower eyelid skin. Eyelid lift can also be helpful if you have excess upper eyelid skin that interferes with vision or if you have lost your natural upper eyelid crease. Eyelid lift may also be indicated if you have puffy pouches of fat in the upper or lower lids that create a tired or aged appearance. The eyelid lift (blepharoplasty) procedure is intended to produce a more youthful and rested appearance of the eyes. The procedure may also widen your visual fields if excessive upper lid skin has partially blocked vision. Blepharoplasty is done on an outpatient basis under sedation and local or general anesthesia. The incisions are made where the natural crease should be in the upper lids and below the lash line in the lower lids. Excess fat and skin are removed. If only excess fat is present in the lower lids, it may be removed through an incision inside the lower lids with no external incision or scar (transconjunctival blepharoplasty).

This plastic surgeon in San Francisco serving the Bay Area offers all aspects of facial plastic surgery including facelifts, nose surgery and other facial plastic surgery procedures. Contact Dr Kind at 415-565-6884 or email us. View plastic surgery photos from this Bay Area plastic surgeon.

Dr. Malcolm Rude is board certified by the American Board of Plastic Surgery. He earned a Bachelor of Science degree at Texas A&M University, Class of ’93. He was a University Honors Fellow and was a Student Senator. He attended Texas Tech University for medical school. There he served as class Vice President and was elected as a Student Representative to the Texas Medical Association. Dr. Rude then went on to do his general surgery training at Scott and White Hospital in Temple, Texas. Following this, he accepted a Plastic Surgery residency position, under the direction of the former President of the American Society of Plastic Surgeons. He completed an additional year as chief resident in Plastic Surgery with expanded clinical duties.

Dr. Rude maintains a firm commitment to patient education and the advancement of plastic surgery. He has engaged in research at all levels of his education. He won the Senior Honor thesis award at Texas A&M. He went on to pursue research in medical school that led to publications in well-respected medical journals. During his three year plastic surgery residency, he conducted research in both cosmetic and reconstructive plastic surgery and presented his research at both state and national scientific meetings.

Dr. Rude has special interest in breast and body contouring. He has attended numerous courses throughout the nation on the latest techniques. His extended training in general plastics has afforded him the ability to diagnose and treat a wide variety of disorders, including hand surgery, facial cosmetic surgery, and all the reconstructive techniques of modern plastic surgery.

A dedicated and skillful surgeon, Malcolm Rude M.D. realizes that beauty is intensely personal. His recommendations and advice are the result of experience and thoughtful, professional judgment. He is committed to staying abreast of recent advancements and technologies, which keeps him and his techniques on the cutting edge of cosmetic surgery. Before prescribing or performing any surgery, treatment, or therapy, Dr. Rude meets with patients to educate them, discuss options and ensure informed decisions.

Dr. Rude is married to Stacie Rude, Class of ’92. They have been blessed with two children. When Dr. Rude is not doing plastic surgery he enjoys spending time with his family and golfing.

Bryan Texas Plastic Surgeon Dr. Malcolm Rude serves the Bryan Texas and College Station areas. Dr. Rude is board certified by the American Board of Plastic Surgery and focuses on all aspects of plastic surgery including breast augmentation, breast lifts, breast reduction, liposuction, tummy tucks, facelifts, rhinoplasty ( nose surgery ) and more. View breast augmentation before and after photos, learn more about these plastic surgery procedures and schedule a consultation via email or call us today at 979-776-8825. If you are considering plastic surgery in Bryan or College Station Texas learn more about this dedicated and skillful plastic surgeon.