I had the privilege of volunteering at Maria Shriver’s Modern House Call as part of her 2010 Women’s conference this Saturday and Sunday. It was truly a pleasure working with all the other volunteers who shared my passion for helping women with their health care needs. The majority of the women I saw in the health care clinic hadn’t seen a doctor for years and were completely removed from any health care system. Most of them had no insurance and told me that they didn’t know where to go to see a physician.
I took care of a woman who was in her early 50’s who had a very strong family history of breast cancer. Her maternal aunt and sister both had breastcancer. She had not had a mammogram in over ten years! Being a plastic and reconstructive surgeon and taking care of many breast cancer patients, I am especially passionate about early breast cancer detection. To have participated in the emotional and physical struggle of women undergoing surgery and treatment for this disease, I continually stress to women the importance of getting an annual mammogram and physical exam, as well as performing self breast exams. The fact that there was an on-site mammography station at the Modern House Call was truly a blessing for these patients. The women who attended the Modern House Call were able to get screening mammography immediately.
I truly believe that myself and the other volunteers were able to make a difference in the lives of many women who had no access to even the most basic health care. I was glad to be able to assist in providing basic health care screening that most of us take for granted. I feel blessed to have participated in this event and thank all the people who donated resources and time to help women who are truly in need.
I’ve attached a link to a video clip of me on the Woman’s Conference Website. http://www.womensconference.org/the-modern-house-call/
Dr. Catherine Huang Begovic
Posted in: Plastic surgery and Pregnancy | October 17, 2010 | Comments Off
As a female plastic surgeon, many of my girlfriends who have recently had children ask me how they can “get their body back.” I’m planning on having a baby within the next few years and as a fitness model, I am super body conscious…so trust me ladies – I understand your concerns. Most of the changes that moms want to correct are the result of the weight gain and loss associated with their pregnancy. Some of the common complaints are sagging breasts and excess skin and fat around the abdominal area. Additionally some women feel that they have redundant tissue in their vaginal area, namely increased labial show.
The term “mommy makeover” is often used in the media. What needs to be “made over” varies from person to person but involves cosmetic surgery to restore some of the changes that occur with pregnancy.
A breast lift or “mastopexy” helps with sagging breasts. In this surgery, the skin is lifted off the breasts and the any extra skin or fat is removed. The breast and nipple is then repositioned into a more youthful position and then the skin closed around it. Sometimes with deflated breasts, an implant is also placed to restore volume. Each surgery is tailored to the patients’ individual needs. The scars from this surgery range from being just around the nipple to a “lollipop” or “anchor” depending on the amount of skin that needs to be adjusted. The scars usually heal well and patients are extremely happy with their new shape.
For excess abdominal skin and fat, a tummy tuck or “abdominoplasty” helps. In this surgery, the skin and fat is raised off the abdominal wall, pulled down tight, and excess fat and skin removed. The abdominal wall is tightened. Liposuction at the sides of the belly and flank is also commonly performed to improve the over all shape. In many cases, patients only need a “mini-tuck” where there is less elevation of the abdominal tissue. The scar from this surgery is usually a low horizontal incision that can be concealed by underwear or bikini bottom. It can be small with the “mini-tuck” or extend from hip to hip if extensive amounts of tissue need to be removed.
Finally, one of the least talked about surgeries is vaginal cosmetic surgery. A “labiaplasty” involves trimming some of the excessive labia that shows. Some women complain that the extra labia that hangs causes embarrassment when wearing leggings or tight pants and sometimes discomfort with walking or riding a bike. The suture line is hidden along the inner edge of the labia. Post operatively patients are instructed to refrain from sexual intercourse for about a month.
From a physician’s point of view, I always encourage a healthy diet and exercise first before turning to surgery. I know that after I have my baby, I’m hitting the gym double time! But if there are a few things that can’t be fixed with diet and exercise, new moms also have some surgical options that can help them regain confidence and help them get back into their pre-baby clothes.
Dr. Cat Begovic
Gynecomastia, enlarged breast tissue in males, can be very emotionally devastating. My patients tell me they feel embarrassed by their “man boobs” and have to wear oversized clothing. They wear t-shirts in the pool and at the beach. Overall their enlarged breast tissue makes them extremely self-conscious.
1. Who does it affect?
Gyencomastia is most frequently seen in teenage boys and in older men because of hormonal changes. In more than 90% of young boys, the condition resolves spontaneously. However, up to 40% of ADULT men are affected to by some degree of gynecomastia.
You will likely be referred to an endocrinologist “hormone specialist” to rule out conditions that can cause gynecomastia. These include diseases like hepatitis, various cancers, or thyroid and testosterone imbalance. Street drugs like marijuana and heroin, as well as many prescription drugs, have been associated with gynecomastia. Steroid can also cause gynecomastia. Your physician must always rule out the possibility of breast cancer. Obesity causes enlarged breasts from the accumulation of fatty tissue. Once the serious medical conditions have been eliminated, many patients choose to proceed with surgery.
3. Surgical options
The goals of surgery are 1) to reduce the volume of the breast and 2) to remove and shape the redundant skin as needed.
To reduce volume, I start with liposuction. If there is firm fibrous breast tissue, I use power-assisted liposuction or PALS. This is where the liposuction cannula has a vibrating tip that helps break up thicker tissues. If there is residual tissue under the breast, I may also perform a “direct excision.” I make a small crescent shaped incision placed at the edge of the areola. Through this incision, the remaining breast tissue is removed. The scar usually heals nicely. For younger patients with good skin elasticity, this is usually all they need. The skin slowly tightens and forms a nice flat contour. Patients should know that this process of skin tightening takes time, and for many months they may have skin bagging or wrinkling.
In a few cases – usually older patients with poor skin elasticity, or in cases where a large volume of breast tissue or fat is removed, there is excess skin that needs to be removed. The safest way is to first perform liposuction to remove the volume, and then several months later perform the skin excision. The skin excision is tailored to the patient’s individual anatomy but can consist of removing a circle around the areola, removing a vertical section of skin under the nipple, removing an ellipse of skin near the armpit where the skin folds, or removing a large section of skin and moving the nipple as a free graft. All patients undergoing surgery should understand that they will have a significant improvement in their breast appearance but that there can be visible scars, skin depressions, and persistent skin wrinkling.
Overall my patients have been extremely happy with their results. They feel comfortable going to the beach or wearing a t-shirt for the first time. Gynecomastia surgery can often improve a man’s quality of life and help him feel more confident.