Our Surgeons' Blog

Dr. Friedman, Dr. Huang, Dr. Forman and Dr. Kulkarni

Small Sagging Breasts Need Augmentation Mastopexy

Published on January 15, 2019

Have you ever wanted firmer and larger breasts? To get both of these results, you’ll need a breast lift with implants. This procedure is a combination of two breast-enhancement surgeries: a breast lift and a breast augmentation with implants.

What Is a Breast Lift?

A breast lift, clinically known as mastopexy, is a surgical procedure used to lift sagging breasts and firm them up. It can also eliminate asymmetry. This procedure does not increase the size of the breasts, though a firmer pair may look slightly bigger.

Pregnancy and breastfeeding are the most common reasons for sagging breasts, apart from age. The continuous change in the size of the breasts during pregnancy and after breastfeeding leads the skin and muscles to loosen and sag. In other cases, the issue is the result of genetics.

What Is Breast Augmentation with Implants?

Breast augmentation, clinically known as augmentation mammaplasty, uses prosthetic breast implants to increase the size of your breasts, to restore the original size lost due to pregnancy or weight loss, or to create better symmetry.

The breast implant is a silicone rubber shell filled with either silicone gel or a saline solution. Implants are inserted into the breasts through incisions, which can be made in several locations, including the armpit, the breast crease, and on the border of the areola.

A Breast Lift with Implants

Many women who have given birth or experienced sudden weight loss experience sagging and loss of breast volume. A breast lift with implants is often the best solution to both issues. During the combination procedure, the breasts are lifted to be firmer and implants are added to restore the lost volume.

Choosing the Right Size

Breast implants are measured in cubic centimeters. Since everyone has a different body shape and different expectations for the breast size they want, size goals must be discussed with Dr. Forman before the procedure can be scheduled. This occurs during a consultation.

Dr. Forman may show you digitized version of how different sizes would look for you. Implant sizers may also be used to help you see how they would look. These sizers are placed in your bra.

The Procedure

First, the incisions are made for the breast augmentation. After the implants are placed, the lift aspect of the procedure is performed – excess skin is removed and the tissues are reshaped. Finally, the incisions are closed with stitches. You will typically be able to go home on the day of the surgery.

One of the major benefits of combining these two procedures is that only a single recovery period will be needed afterwards. This means you’ll be able to get back to your everyday schedule sooner.

Arrange an Informative Consultation

A breast lift with implants is a great combination to consider if you’re unhappy with the size and shape of your breasts. To find out more about the procedure, you can contact our office for a consultation. Doctors Roger Friedman, Douglas Forman, Kathy Huang, and Anita Kulkarni are all board-certified plastic surgeons who will be happy to help you achieve your aesthetic goals.

Precise Injections of Restylane Fill In Wrinkles

Published on November 27, 2018

Wrinkles and fine lines are a part of growing older – unless you have located the Fountain of Youth, you cannot avoid them. However, there are ways to keep them at bay. One popular treatment for wrinkles is Restylane. This innovative treatment has become a global phenomenon thanks to its effective long-lasting results and thousands of happy customers.

What Is Restylane?

Restylane is a type of facial filler that is made of hyaluronic acid, a compound that occurs naturally in your skin’s connective tissues. This filler is used in lip enhancement, smoothing away wrinkles and lines, adding volume to cheeks, and reducing dark circles under the eyes. Restylane is FDA-approved and is suitable for anyone looking to improve their looks.

The hyaluronic acid in Restylane helps boost collagen production in your skin. As you grow older, your skin loses collagen and elastin. This makes your skin become weak and dry, leading to the formation of fine lines and wrinkles. Hyaluronic acid provides your skin with hydration and volume. This makes your skin soft and plump, erasing wrinkles and lines.

People are choosing Restylane injections more and more frequently because of their amazing results. You get to enjoy smooth wrinkle-free skin for six months or even longer. You will not see these kinds of results with many of the other available anti-wrinkle treatments.

How Is Restylane Administered?

This cosmetic procedure is only minimally invasive and is fairly easy to perform. It requires no incisions and takes minimal time. Since Restylane does not contain lidocaine, a local anesthetic is administered before these injections are given to eliminate any potential discomfort.

Depending on your desired results, Dr. Forman will determine the best injection sites. After determining the treatment areas on your face, the doctor will administer the local anesthesia. Once the anesthesia has taken effect, Restylane is injected under the skin at specific areas. These will ensure that all your wrinkles and lines are taken care of.

What Can You Expect from Restylane Injections?

One of the best things about Restylane injections is that there is almost no downtime. You can return to your daily schedule after your session.

Post-treatment care differs from patient to patient and also depends on the number of injections administered. There will be some swelling and redness that will disappear within a day or two.

The best results are evident after a week, but you can notice changes almost immediately after the procedure. The skin appears smoother and softer. With wrinkles and lines gone, a more youthful look can be achieved.

The results of Restylane injections last for about six months. To maintain your appearance, your doctor will advise periodic sessions.

Is Restylane Right for You?

To find out whether or not Restylane is the right filler option to correct your signs of aging, contact our office and schedule an informative consultation. Doctors Roger Friedman, Douglas Forman, Kathy Huang, and Anita Kulkarni are board-certified plastic surgeons with years of experience and will be happy to help you achieve your beauty goals safely and comfortably.

Tired of Having a Flat Butt?

Published on October 19, 2018

The Brazilian butt lift, also known as the BBL, is increasingly becoming one of the most popular cosmetic procedures. There are quite a lot of patients who are dissatisfied with the size and shape of their buttocks or have developed sagging due to age. A Brazilian butt lift can help them achieve their desired rear-end shape and contours.

A typical Brazilian butt lift is an autologous fat-transfer process that augments the buttocks to a particular size and shape according to the patient’s wishes. Autologous means that the fat that is used for reshaping comes from the patient’s own body. The fat is usually taken from sources such as the stomach, hips, and thighs.

During the procedure, the donor fat is extracted, appropriately processed, and then evenly injected directly into the butt cheeks for augmentation.

Differences Between Buttocks Augmentation with Implants and a Brazilian Butt Lift

Traditional butt augmentation involves placement of silicone implants to make the buttocks firmer and more contoured. Brazilian butt lifts instead use the fat from the patient’s own body.

Because the fat used comes from the patient’s body, the procedure is completely safe from any kind of rejection issues or misalignments. The Brazilian butt lift is also free from the risk of many potential post-operative conditions.

Recovery Time for the Brazilian Butt Lift

The complete recovery time for the BBL procedure is three weeks. During this time, it is important to not put any pressure on the buttocks. A special pillow is usually provided for sitting on for these three weeks.

After the first 48 hours of the operation, the patient can bathe. They must wear a special compression garment for two to three weeks of recovery. There is little to no post-operative pain, and the patient may be able to take painkillers as prescribed.

The results of a Brazilian butt lift are permanent as long as the fat is properly processed and carefully injected. Transferred fat cells that connect with the blood supply can thrive in their new location.

Candidacy for the BBL Procedure

While Brazilian butt lifts are suitable for most patients, there are certain basic criteria for candidacy. The patient needs to be in a healthy and fit condition prior to the operation. This ensures proper recovery from anesthesia.

There is no smoking allowed in the weeks prior to the surgery, and the same goes for drinking alcohol. These activities can slow down the healing of tissues. The patient must also maintain a proper diet, as it aids in recovery.

The patient needs to have clinically realistic expectations from the process. They must be aware that the new size and shape of their buttocks must be in proper proportion with the rest of their body.

Taking the Next Step

If you’ve decided that you’re ready to enhance the curves and volume of your rear end, it’s time to take the next step – contact our office and schedule a consultation with one of our skilled plastic surgeons.

Doctors Roger Friedman, Douglas Forman, Kathy Huang, and Anita Kulkarni are all board-certified plastic surgeons with years of experience. They will be happy to answer any questions you may have.

Don’t Let Your Crow’s Feet Win

Published on September 28, 2018

Who doesn’t hate crow’s feet? From telling people you’ve aged to showing them you have a poor sleep schedule, crow’s feet can be extremely frustrating. If left untreated, crow’s feet can become even worse and ruin the beauty and youthfulness of your face.

Thankfully, we now have a cosmetic solution to crow’s feet: Botox. Botox is an incredibly popular injectable option for dealing with those embarrassing fine lines.


Botox is a chemical product made from Botulinum toxin type A. It can be injected into the skin to reduce the appearance of a number of fine lines and wrinkles, including crow’s feet, glabellar lines, horizontal forehead lines, and chin wrinkles. It can also be used to address vertical neck bands.

Unlike other dermal injectables, Botox doesn’t fill in the skin tissues to reduce the appearance of folds. Instead, Botox has neuroinhibitory properties to relax the contracted muscles in the areas of the face that have wrinkles.

Once Botox is injected into the areas where you have crow’s feet, the underlying muscles stop receiving the signals that tell them to contract. They relax, thereby allowing the skin to lie flat, reducing the appearance of crow’s feet.

The Botox Procedure

The Botox treatment starts with a consultation with Dr. Forman at his office. He evaluates the extensiveness of your crow’s feet and advises you about the quantity of Botox that needs to be used. He will help you set realistic expectations regarding results and will chart a treatment plan for you.

Botox isn’t designed to be used by expecting or lactating women. If you are pregnant or lactating, it’s best that you inform the doctor so that he can create an alternative treatment plan for you. If you’re on any medications, this is also the right time to tell the doctor.

The Botox treatment takes around 15 minutes to complete and can be done without any preparation beforehand. Botox doesn’t contain any anesthetic as an ingredient, and the doctor may offer a local anesthetic or other numbing agent if required.

Next, Dr. Forman takes a syringe of Botox and injects it into the contracted muscles. He uses small quantities and injects the Botox at various points.

Post-Treatment Care

After the Botox injection, you may notice minor swelling and bruising in the treatment areas. These will fade away in a day or two.

You are advised not to use makeup, contacts, or any undereye creams for 24 to 48 hours. You also need to stay away from alcohol for a day and avoid direct sunlight for a few days.

Stunning Results

The effects of the Botox won’t be visible for at least 24 hours. When they do appear, you will notice a significant reduction in the number of crow’s feet under your eyes.

The results of the Botox will be apparent for three to four months, after which you will need to schedule a follow-up session.

Your Botox Consultation

Doctors Roger Friedman, Douglas Forman, Kathy Huang, and Anita Kulkarni are board-certified plastic surgeons with a wide variety of skills in aesthetic procedures. Contact our office to arrange a Botox consultation.

Tighten Sagging Muscles and Loose Skin Using Abdominoplasty

Published on August 23, 2018

Abdominoplasty is a cosmetic surgical procedure that results in a more youthful and firm abdomen. While diet and exercise are traditional methods of achieving a better-looking abdomen, they are often ineffective with certain body types. Additionally, major body changes such as pregnancy or excessive fluctuations in weight are extremely difficult to recover from with these traditional methods.

Abdominoplasty is a safe and simple plastic-surgery option that involves the elimination of excess fat and loose skin from the abdominal region, particularly the middle and lower abdomen. The muscle tissues are also tightened using internal sutures.

Candidates for Abdominoplasty

People who are fit and free from serious diseases or chronic conditions are fit for a tummy-tuck operation. The goal of the operation is not to help with obesity or to offer weight-reduction solutions. Techniques like liposuction are far more effective for such purposes.

Instead, abdominoplasty is strictly meant to improve the aesthetics of the abdomen and as such is fit for candidates with a good overall figure. Liposuction may be combined with a tummy tuck to perform a more intensive treatment.

Women with multiple pregnancies often find their skin stretched and sagging. The muscles around the stomach lose their rigidity and strength. The tummy tuck can get rid of the loose skin and tighten the muscles around the abdomen to bring back the shape and contours of days past.

An Overview of the Procedure

Depending upon the nature and intensity of tissue alteration, an abdominoplasty can last from one to five hours. A typical abdominoplasty has the following basic steps:

1. Delivering Anesthesia: Depending upon the intensity of the surgery, local or general anesthesia can be used. The choice of anesthesia also depends on the preferences of the surgeon and the patient. Intravenous sedation is a popular form of anesthesia for this procedure.

2. Making the incision: A horizontal incision is made in the area between the pubic region and the bellybutton. The length and shape of the incision are governed by the amount of skin and fat that is to be removed. After making the incision, the skin is lifted right up to the belly button, revealing the fat deposits and weakened muscles. The excess fat deposits are cleared and the muscles are strengthened. Subsequently, a second incision is made around the bellybutton in order to work on the excess skin and sagging. The upper abdominal skin is stretched downwards like a drape and the excess skin is removed. The upper skin is then tightly stitched together and the new orifice for the bellybutton is made.

3. Closing the incisions: After the alterations are complete, the incisions are sutured back together. The results of an abdominoplasty are visible almost immediately, and the patient is advised against any physically intensive activity for over a week.

Ready to Get the Stomach You’ve Been Dreaming Of?

If you’re feeling ready to take the next step towards a beautifully contoured abdomen, it’s time to contact our office for a consultation. Doctors Roger Friedman, Douglas Forman, Kathy Huang, and Anita Kulkarni are board-certified plastic surgeons and will be happy to help.

New York Magazine Explores Ethnic Plastic Surgery

Published on August 16, 2018

Image Courtesy of Witthaya Phonsawat/ FreeDigitalPhotos.net

In the latest issue of New York Magazine, Maureen O’Connor explores ethnic plastic surgery in an article titled “Is Race Plastic? My Trip Into the Ethnic Plastic Surgery Minefield.” She starts out in the office of a New York plastic surgeon who specializes in Asian eyelid surgery, and weaves us through a series of clinics promoting different ethnic plastic surgery procedures from Asian facial reshaping to African-American rhinoplasty. All through the article, she debates whether ethnic plastic surgery is designed to specifically “deracinate” or whether universal beauty ideals have simply been influenced by Caucasian features.

From a plastic surgeon’s perspective, I think the modern trend is to embrace ethnically and culturally diverse features. Minority patients who come to me for plastic surgery nearly universally express a desire to maintain their ethnic appearance. They usually want to refine a particular feature, but almost always insist that they don’t want to lose their racial identity. I think this is the result of a changing media landscape that now routinely includes mixed-race and ethnically diverse role models. When I was growing up, there were no Indian-Americans in mainstream media. Now, I can name a handful off the top of my head (Mindy Kaling of The Mindy Project, Kal Penn from the White Castle movies, Padma Lakshmi of Top Chef, Sanjay Gupta on CNN, and M. Night Shyamalan from The Sixth Sense). It’s not a large group, but it is a vast improvement from a television landscape that used to be completely whitewashed. Given the weighty influence of media on cultural standards of beauty, it stands to reason that people are more interested in embracing their uniquely ethnic features.

Breast Reconstruction Using Tissue Expanders

Published on August 6, 2018

Having a single or double mastectomy can be a very emotional experience for a woman. With breast-reconstruction surgery, you can have your breasts back and start feeling more comfortable with your body again.

Breast reconstruction using tissue expanders is one of the ways in which a new pair of breasts can be surgically constructed. The process takes some time to complete but has been found to be safe with excellent results.

How Does the Procedure Work?

Before the surgery, you will be given general anesthesia so that you can be comfortable and asleep during the procedure. Next, a small incision will be made around the area of the breast and an empty prosthetic called a tissue expander will be inserted under the skin and chest muscles. The skin will be sutured closed and drains will be fitted to allow the removal of fluid that collects at the site of the incision. The incision will be dressed with gauze.

Over a course of the next four weeks or so, the tissue expanders will gradually be filled with saline until they expand enough to reach the desired size. The gradual increase in the size of the expander helps to stretch out the skin and muscles, preparing them for the insertion of permanent implants.

Once this stage is complete, you will undergo a second surgery to remove the saline-filled tissue expanders and replace them with the breast implants. Reconstruction of the nipples and areolae will be done a few weeks later.

After the surgeries, you might feel a bit of stinging at the sites of the incisions; this sensation is normal and will pass in a few days. While the expansion process is going on, you will experience some tightness and heaviness in your chest. This is because the skin and muscles are being stretched out to form the new breasts.

Post-Surgical Care Directions

You will be advised to rest at home after the surgeries. The nurses will teach you how to care for the drains at the incision sites, which will be in place for the next week or two before they are removed.

Following the placement of the breast implants, you will need to wear a compression bra for a time. Wear the bra as instructed by your plastic surgeon to help with the healing process and to help the new breasts hold their shape.

If you have to undergo chemotherapy or radiation, your doctor will keep you informed regarding the timeline for the second surgery, which might be delayed slightly.

Schedule a Consultation

Removal of the breasts because of breast cancer no longer needs to leave you feeling incomplete. With breast reconstruction using tissue expansion, you can have a new pair of breasts that look and feel natural. With everything you have already been through, you deserve the chance to feel your best.

Doctors Roger Friedman, Douglas Forman, and Kathy Huang are board-certified plastic surgeons with years of experience. During a consultation, you will be given all the details of the procedure and can ask any questions you may have. Contact us today to schedule your consultation.

Breast-Augmentation Incision Options

Published on June 20, 2018

When it comes to breast augmentation, all the hours of preparation and doctor consultations are incredibly important. While most consultations are devoted to envisioning the patient’s goals for the surgery, another key topic of discussion is the type of incision that will be used.

The incision type and pattern used for your breast augmentation will be chosen based on Dr. Forman’s preference and your goals. Because you’ll be discussing your options beforehand, it is important that you know the uses and limitations of each incision pattern.

Incisions and Implants

The primary purpose of incisions during breast augmentation is to facilitate proper and safe placement of the breast implants. Through these incisions, surgeons create tissue pockets – spaces in the breasts for the implants – and the shape and size of the pockets influences the final outcome.

To better understand the reasons why incisions are chosen, you must first understand a key difference between saline and silicone implants. Silicone implants come pre-filled to their intended size, meaning their size cannot be changed. Saline implants, on the other hand, do not come pre-filled. Instead, they are filled to their intended size during the procedure.

Because saline implants are inserted empty into the breast pocket, they are much smaller than silicone implants when inserted. This makes them more versatile. They can be inserted into a much smaller incision that is a longer distance from their intended position in the breasts.

Incision Types

In general, one of these three incisions is made:

Periareolar: This option is a common approach in breast augmentation. As the name suggests, the incision is made along the lower circumference of the areola. Any post-surgical marks resulting from this incision are expertly hidden along the areola’s border. People sometimes think that this incision leads to loss of nipple sensation, but in reality, loss of nipple sensation is the consequence of choosing the wrong implant size. This incision option works well with silicone and saline implants.

Inframammary: The inframammary incision is made along the crease of the breast or right above the crease. Many surgeons prefer this incision option, since it offers easy access for breast-implant insertion and provides an unparalleled view of the internal tissues. Any post-surgical marks resulting from this incision are camouflaged in the breast fold. This incision pattern can accommodate silicone and saline implants of any size.

Transaxillary: This incision is quite small and is made in the armpit crease. Because it is created in this area, post-surgical marks are well hidden. Since it is farther away from the final implant location than the other options, it is best suited to saline implants. The size of the incision made is quite small in comparison to the periareolar and inframammary incisions.

Arranging a Consultation

During a consultation at our office, you will discuss your breast-augmentation incision options with a skilled medical professional. Doctors Roger Friedman, Douglas Forman, and Kathy Huang are all board-certified plastic surgeons with years of experience.

Together, you and your plastic surgeon will decide on the right incision option for you. To schedule your consultation with one of our experienced plastic surgeons, contact our office today.

Your Skin Can Look Revitalized and Fresh with Microdermabrasion Treatment

Published on June 1, 2018

Exfoliation is a well-known technique used to remove dead skin cells from the face. There are many techniques that are commonly used for exfoliation. Facials and scrubs are common exfoliation techniques, but these are ineffective for deep exfoliation and skin rejuvenation.

Microdermabrasion is a technique of exfoliation wherein dead cells are mechanically scrubbed off the skin and vacuumed away, revealing radiant youthful skin beneath. Although the word “microdermabrasion” may sound intimidating, microdermabrasion is one of the gentlest and fastest non-invasive anti-aging treatments currently available on the market.

This exfoliation treatment is suitable for all skin types. For those candidates with skin conditions like widespread acne, lupus, active sunburn, herpes, psoriasis, open sores, and fragile capillaries, a thorough medical report may need to be conducted before a microdermabrasion treatment can be recommended.

The Microdermabrasion Procedure

If it’s your first microdermabrasion treatment and you’re not sure what to expect from the procedure, here is a breakdown of the steps involved.

To get an idea of how the procedure works, imagine smoothing down a rough edge with sandpaper. Don’t jump to conclusions and assume that the process is painful, though – it’s actually quite gentle.

In general, there are two variations of the treatment. The first option involves the use of a handheld machine that targets the skin’s surface with a stream of miniscule crystals. The machine contains an attached vacuum that suctions away the loosened skin cells.

The second option – and also the most widely used – involves using a diamond-tipped wand. The wand is gently moved over the surface of the skin, causing dead skin cells to be loosened and removed. Apart from removing dead skin cells, the wand also massages the treated region to improve blood circulation.

Microdermabrasion or a Chemical Peel?

The end results of microdermabrasion and a chemical peel can be quite similar, depending on the type of peel chosen. After either of these procedures, the patient can enjoy radiant younger-looking skin free of blemishes.

However, the mechanism of action is quite different. Chemical peels rely on chemicals to remove the outermost layer of the skin. Rashes and severe redness are potential side effects of a chemical peel.

With microdermabrasion, on the other hand, since no chemicals are used, the skin exfoliation is gentler and the pink tinge left behind heals faster.

Microdermabrasion Aftercare

Removal of the outermost layers of dead skin reveals new skin cells. These new skin cells are quite sensitive and are not yet ready to withstand harsh sunlight. Aestheticians recommend avoiding direct sunlight soon after the treatment to ensure that the cells are not injured. If you do need to step out, sunscreen is mandatory to protect the skin. The key to speed up healing after a session of microdermabrasion is to moisturize daily.

Try Microdermabrasion for Yourself!

If you’re interested in trying microdermabrasion treatment for yourself, set up an appointment for a consultation by contacting our office. Doctors Roger Friedman, Douglas Forman, and Kathy Huang are experienced board-certified plastic surgeons and will be happy to answer your questions regarding the procedures we offer.

A Breast-Reduction Procedure Can Dramatically Improve Your Quality of Life

Published on April 26, 2018

To many who were unhappy with the shape and size of their breasts, augmentation and lift procedures came as a major blessing. Breast reduction is another breast procedure that has brought comfort to those who are unsatisfied with the proportions of their breasts. For patients who want to decrease the size of their overly large busts, this surgery is an excellent choice.

Breast Reduction

Breast reduction, also called reduction mammoplasty, is a plastic-surgery option that aims to reduce the size of a person’s breasts through the removal of excess fat, glandular tissue, and skin tissue. This not only reduces the volume but also the weight of the breasts, helping the patients live normal and comfortable lives.

Plastic surgeons use different approaches to breast reduction depending on the size of the breasts and the degree of breast sag. Here are some of the main breast-reduction techniques:

Liposuction – Patients who have breasts with excess fat in them may require only minor volume reduction without any need for sag correction. In these cases, liposuction alone would suffice.

Donut (Benelli) technique – This technique is useful for making minor size corrections. An incision is made around the perimeter of the areola, and another concentric circle is made around this incision.

Lollipop (vertical) technique – This option is ideal for removal of small to moderate volumes of excess tissues. A circular incision is made around the areola and a vertical incision is made that travels down from this to the crease of the breast.

Inferior pedicle (anchor) technique – Also called the inverted-T or wise pattern technique, this surgery is used when the size of the breasts is extremely excessive. With this, sagging can also be corrected. Three incisions are made: one around the areola, one vertically from the areola to the crease of the breast, and one along the crease. This resembles the appearance of an anchor. After the excess tissue is removed, the nipple-areolar complex is moved up to achieve an even appearance.

How Breast Reduction Helps

For women who are encumbered with breasts that are large or asymmetrical, reduction surgery can do a world of good:

Physical – The weight of large breasts often causes neck, back, and shoulder aches, not to mention the pain of bra straps cutting into the skin. Sweating and rashes under the breasts are common problems for these patients. Exercise also becomes difficult. Breast reduction gives them freedom from physical pain and improves their mobility.

Aesthetic – Breast reduction can bring symmetry to the breasts and improve them aesthetically. The size and shape can be reduced so that it is more proportional to the body.

Emotional – Women with larger breasts than normal for their body shape often struggle with low self-esteem. This can also mean unwanted sexual attention. Breast reduction restores proper proportion to patients’ bodies. Patients don’t look overweight anymore, clothes fit them better, and in many cases, they feel more confident.

Arrange a Helpful Consultation

Doctors Roger Friedman, Douglas Forman, and Kathy Huang are board-certified plastic surgeons who will be happy to help you reach your aesthetic goals. Contact our office to schedule your breast-reduction consultation.

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