Total Body Surgical Blog

I hope everyone had a great 4th....time to get back at it. 

One of my friends asked me to address those unsightly veins that show up on the face.

  Here is a good example of what I'm talking about.  These are from a condition called rosacea that causes inflammation and eventually the larger veins that appear on the cheeks and around the nose.  The problem is usually made worse with heat (i.e. working in the yard during summer) or consumption of red wine.  It can occur in all ethnic groups but is much more visible in the lighter skinned groups. Rosacea is treated with topical medications, oral medications, and light therapy which will be covered later. 

 Rosacea can also have a deleterious effect on the color and shape of the nose.  Known as "rhinophima", the nose becomes red with acne like lesions that eventually cause the nose to become misshapen.  It can also cause very large veins to become visible.

 The veins that appear at the base of the nose are very common as we age.  Some people have them worse than others of course, but lighter skin tends to allow them to show up more prominently.  They can occur with or without rosacea.

 Here is another example of a facial vein that sometimes bothers people.  This is known as a facial reticular vein.  They can occur around the eye and temporal area.  They are present in young and old alike.

 In some instances, instead of visible veins, just a "redness" is seen.  This probably is just early rosacea and should be treated as such.

How do we treat these problems?  The treatment depends on what the cause is and how severe the problem has become.  With rosacea, we treat it topically and sometimes with low dose antibiotics when it is early and large venous areas are not present yet.  Once outbreaks are controlled, the redness usually subsides.  If it does not, the next step would be to use Intense Pulsed Light treatments to close the small capillaries that are flushing and causing the skin to turn red.  These treatments (also known as IPL) use bright flashes of light of a certain wave length to damage and close the small vessels that are causing the problem.  Usually several treatments are required, sometimes up to 5.  These treatments will controll the problem for some time after, but usually not permanently, so treatments may be required every few years or so.

For the larger veins, in the cheek, nose, and base of the nasal area, we use the vascular setting of the Cutera 1064 YAG laser.  Using a very small spot size, the veins can be closed and they are no longer visible.  In some cases, we will use both the laser, and the IPL in combination.  This treats the redness that is generalized and the larger veins that are too large.  The treatments are generally pretty quick and the discomfort is tolerable.  We use numbing cream for most as well as the Zimmer chiller that blows cold air over the treated areas.  For larger treatments we will call in Valium if needed.

Reticular veins around the temples or eyes are also treated with the YAG laser.  They may be a little sore after treatment for a few weeks until the body resorbs the vein and some bruising is possible though not very common.

The nasal effects of rosacea can be severe if left untreated.  The laser is used to control the venous problem and it helps with the sebaceous problem as well.  Left alone, the nose can turn into a trunk so treatment is necessary.

All of these treatments are done in the office with little or no sedation.  The treatments alone are fairly quick, taking only a few minutes.  Usually there is only a mild amount of redness after, though there can be some areas of ulceration or skin slough.  These areas usually heal very well.  Ideally, you come in and have the treatment done, leave with a little redness, after that resolves, the veins and redness are gone or greatly diminished.  As I said before, more than one treatment is usually required and are done 4-6 weeks apart to allow for healing.

So, if any of these things are bothering you, give us a call at 918-786-7780 or 877weight0 toll free.  If you have any questions, fill out a contact form and I will try to answer it for you.

I hope this helped some of you understand a very common problem.

That is the question we hear daily.  Do I NEED a breast lift??  With this being one of the last installments on breast for a while, I thought a little knowledge in this area would be helpful. 

Before we start, let me remind you that we have 20 days left on the spring time breast augmentation special pricing....click below to see how you can get breast augmentation surgery, ALL INCLUSIVE, for as little as $3500.00!!

Now for the burning question...do I need a breast lift??  The answer to that question is, in some cases, a little fuzzy.  There are instances where the decision is easy.  If you have no breast tissue, or very little, and the nipple position is high, obviously, you do not need anything to enhance the breast except volume, i.e. implants. 

 In this picture, the nipple position is great, the skin is tight, and only an implant is necessary.  After implant placement, the skin will stretch to accomidate the implant and the breast will take on a nice and natural shape.  This is the perfect patient for implants alone.  As discussed in earlier blogs, the incision placement options, size, and type of implants are variable according to taste. At your consult, all of this will be discussed and you can decide.

The second presentation that is fairly easy is the patient that has significant drop in the nipple position

If the nipple has fallen below the fold under the breast (inframammary fold) then a lift is always needed.  Some select an implant and some do not.  That is a personal choice, but if fullness is desired in the upper chest, it is difficult to create, and maintain, without an implant.

This picture depicts one of the "easy" decisions.  Obvious drooping of the breast and nipple complex below the lower fold of the breast where it attaches to the chest.  If we were to just place an implant in this situation, there would be a nice implant present with a sagging breast hanging off with the nipple still pointing at the floor.  Several procedures are used to lift the breast.  We usually use the Weiss pattern lift (anchor incision) for larger lifts and the vertical (lolly pop) lift.  Both types of lift raise the nipple into a more normal position, remove excess skin below the breast and move remaining breast tissue into a higher position.  In the picture above, we call this the "rocks in socks" breast.  There is some breast tissue hanging around the nipple (rocks), and skin (socks).  If lifted only, this will be a very small and flat breast.  This is when an implant can really be beneficial to give the breast some volume.  Others have a sagging nipple and breast but still have a good amount of volume.  A lift alone, or with implants are both choices.

This is a photo of a breast lift alone. The shape is nice and nipple position is good, however, the upper pole remains flat.  This can only be fixed, long term, with an implant.  Implants, however, can be placed after a lift so you can decide later if you want them or not.

As you can see, a lift with an augmentation can be done simultaneously with good results.  This gives good fullness to the upper pole of the breast with the added benefit of only one procedure.

Now for the harder ones.  Many women have breasts that have fallen some but not to the extent we have discussed.  When the nipple is just above the lower breast fold or even with it...now what??  When the nipple is above the fold but there is significant breast tissue below, this is called pseudo-ptosis or false droop.  We have more than one option at this point.  One is to put large implants above the muscle, preferably silicone.  This is actually not a bad option for the right person.  The breast will still remain a little low, not filling the upper pole as much as if a lift were also done. Also, need for a lift later is still a real possibility. This is good for those who do not want scars on the breast and are willing to accept a breast that is not quite as "perky".  The other option for this group is to go ahead and bite the bullet and do the lift with or without implants.  This will generally fix the problem long term, give you a nice fullness to the upper breast and move the nipple into a more normal position.

Breast pseudoptosis with implants.  Looks pretty good, but upper pole is somewhat flat.  If this is acceptable, it is a great choice.

Well that about does it for this week.  I will try to move on to something else next time.  Remember our breast special pricing and call today....918-786-7780 or 1-866-weight0.  Cosmetic consults are complimentary!!

Tired of hearing about the breast???  This week I want to talk about the less than perfect breast that some women develop.  I know many of you women are tired of hearing about the perfect breast that is just a little small and can be made better by implants.  What about the breast, due to genetics, or abnormal development, cannot be helped by implants alone??  Let's talk about that today to give you a break!  However, I don't want you to forget about our breast enhancement special...it only lasts until April 30 so you have to act quickly.  Click the button below to get the details!!

Let's see how the breast develops normally, then we'll have a better appreciation for how these deformities can occur.  Then we will cover how we fix them to make the breast look more normal.  The normal breast is stimulated to form by female hormones that begin production at menarche or the start of menstruation. The picture below shows the normal progression of the breast as it grows from a bud that men AND women have.  Again, it is the female hormonal soup that causes them to form.

Of course it is very rare for both breast to form exactly the same.  Perfect symmetry in the body is rare, so each breast is different, even in the same person.  This is why some women have difficulty finding a properly fitting bra.  There may be a half cup difference between sides.....this is not abnormal....just aggravating!  Here is a picture of different breast shapes and sizes.  This does not include all types of course, but it gives you an idea of how many variations of normal there are and also includes some of the abnormal breast shapes.

 (the "perfect" breast shape is a misnomer of course)

As you can see from the first picture, the breast bud starts first and develops concentrically, widening to form the breast mound.  If this concentric expansion is retarded, the breast forms as a tube, making the very constricted and abnormal looking.  The function of the breast is also retarded and in most cases, breast feeding later in life is not possible.

 This picture is a depiction of tubular breasts of different severities.  It is the mound of the breast that is constricted and does not spread out, therefore, the tubular shape of the breast. 

The other feature of the tubular breast deformity is a herniation of the nipple.  Normally, as the nipple and areola develop, they are "puffy".  The nipple is puffy until the breast mound spreads out.  As this happens, the nipple-areolar complex flattens to create the more "normal" appearing breast as a whole.

 Herniated "puffy" nipple.

So now that we know what a tubular breast deformity is.....what can be done about it?  To fix this problem properly, we must address several issues.  First, is the nipple herniation.  Fortunately, fixing the nipple also gives us access to the rest of the problem and allows the entire fix to be done through one incision.  We use the peri-areolar incision to make the nipple smaller and to allow access to the tubular, constricted, breast tissue below.

 This incision allows us to reduce the nipple size and when closed it flattens the nipple and areola into a more normal appearance.  The constricted breast is broken up below so that it is no longer in a tube shape and lays flatter. 

The last step is augmentation.  Since the breast only formed centrally, there is generally very little volume.  This can only be corrected by adding volume with an implant.  We place the implant below the muscle and through the same incision.  Saline implants or silicone implants are used as there is no difference in the result...again...it is personal preference.

The results are generally very good.  It does take some time for the skin to stretch and accomidate the new volume.  There also may be some creasing of the skin, usually the lower part of the breast, due to its tight adherence to the chest wall, that may take some time to stretch.  This skin may never stretch fully.  The goal is to get as near a normal appearing breast as possible.  This is not always achievable but any improvement is usually greatly appreciated.  The incisions heal nicely and the recovery time is about that of a breast augmentation.

 Good representation of tubular breast deformity repair.

Come see us today for all of your Cosmetic surgery, Vein surgery, Obesity surgery, and General surgery needs.  All Cosmetic Surgery Consults are complimentary, call 918-786-7780 or call toll free 1-877-weight0.  Be sure to take advantage of our breast augmentation special through April 30!!!!!

It's VERY close to spring (thank God) and summer is right around the corner.  I wanted to blog today about something very special.  If you have ever considered breast enhancement surgery, you MUST pay attention.  Dr Miller and I have a special offer for you and it is limited, so you will need to act quickly if you want to take advantage of it.  Click on the button below to see the offer, then continue.

Breast enhancement is a very personal choice.  Many women, who are not well endowed, have breast augmentation, in the back of their mind, but due to life in general, or cost, they put it off.  Our goal is to remove the cost issue.  If you can get around the "life in general" part, we can help with the rest.

Here is the thing about the cost....in many cases, when you get a quote for an augmentation, they neglect to inform you of the facility fee, anesthesia fee, and in some cases, the cost of the implant.  Our quotes have no hidden fees, it is all out there so you know what you are going to spend.

Here is what you get.  First, you set up your appointment, you can request either Dr Miller or Dr Swetnam.  (If you are healthy and live further away, much of the preparation can be done by email. Just send an email and we can talk there) The consult is complimentary of course.  We talk about what you want, size, implant selection, saline vs. silicone, etc.  The consult will take about 30-40 minutes.  We want you to bring shirts that you want to fill out and when you try on implants, you will have an idea of what you will look like.  We will also discuss the approach (how the implants will be placed).  Of course the size and approach are personal choices but we will help guide you.  Lastly, we will review before and after pictures so you can see our work. We don't play the "trust me" game where you are not involved in the selection process.  You will then get a quote that includes everything.  The fees we charge include the facility fee, professional fee, anesthesia, and implants.  The only other fees will be for the post operative bra, post operative medications which are generally less than $100.

We then pick your surgery day.  You show up, the procedure is performed...takes less than an hour.  With recovery and pre op, about 3-4 hours total time.  When you wake up you will have your post op bra on and you will wear it for about a week.  Of course you can take breaks from the bra, shower, walk around, do most of your normal activity, within limits.  We like to see you soon after the procedure, within the first week (if far away, we have you send some pictures by email) to make sure everything is OK.  We then usually see you at a month and at about 3 months to get pictures for YOUR before and afters.  We will email them to you if you like.  The post operative visits are also included in the fee.

So there you have it.  At Total Body Surgical we are trying to remove the barriers.  All of us worry about cost these days (except Washington..ha) and we understand that.  This is a rock bottom offer that you will find hard to beat so take advantage.  There is only so much operating time between now and April 30 so make sure you get yours!

Call 918-786-7780 TODAY to book YOUR time for YOUR enhancement.  Don't live with regret, this offer may not happen again 918-786-7780, CALL TODAY!!

Breast augmentation....is it too early to get ready for summer 2013???  NOOOOOOOOO!!!  In fact, now is the perfect time.

For most women, the surgery is only the beginning.  It usually takes about 2-3 months for implants to settle and skin to stretch to accomidate the implants.  Why??  Well, let's get into that.

  This young lady is a good example to discuss.  For women who have never had children have tighter skin than those who have not...in most cases.  This makes sense in that their breasts have not enlarged gradually over nine months, then shrunk down after.  When the skin is tight and implants are placed, it takes a little bit of time for the skin to stretch to accomidate them, in some cases, up to three months or so.  The other thing to consider is the distance between the nipple and the fold under the breast.  If you look at this picture, in the 45 degree view, you can see the natural fold under the breast that delineates the breast from the chest wall.  This is the nipple to fold distance.  In women with small breasts, who have not had children, this distance is usually very short.  If you can imagine placing an implant in this breast, the implant will ride high until this skin stretches to accomidate the new and extra thickness of the implant.  After the skin stretches, the implant drops into place giving the more natural look that most women want.

As you can see in this picture, the nipple to fold distance in the first photo is essentially non-existant, in the after photo, 3 months later, the implant has settled, the skin has stretched, giving a nice result.  Again, 3 months later!!

For women who have had children, AND those who have not, when we put implants in below the muscle (the more popular way to place them to decrease creasing and rippling of the implant and skin) the muscle does not like to stretch.  Think about it, when you stretch your muscles, it can be uncomfortable until you put the muscle back into the resting position.  The pectoral muscle is no different.  It contracts in an attempt to resume its resting position as well.  This contraction pulls the implant up on the chest wall making it ride high.  It also takes time for the muscle to stretch and allow the implant to drop.  It seems that the bigger the muscle, the longer the implants lose this battle.  We use massage and a velcro strap to help the process proceed quicker, but it still takes time.

Implants can only be placed one way....through the skin.  Whether they are placed through the arm pit, below the breast, through the nipple, through the belly button, or through a tummy tuck incision, there is still an incision.  For saline implants, about 2 cm (less than an inch) and for silicone, 4 cm (a little less than 2 inches).  It takes a little time for these small incisions to heal.  When summer arrives, with enough time, they are barely noticed.  Not enough time, they can be seen. 

It is now January.  At Total Body Surgical, we always have great pricing on breast augmentation, AND the pricing is all inclusive.  This means that the price includes anesthesia, implants, physician, and facility fees.  The only other costs are for medications, and for the post operative bra that is needed...about one hundred dollars.  If you've been thinking about it, NOW is the time to proceed.  You will look great by March, before the summer outfits are even coming out of the closet.  The implants will have settled, incisions will have healed, and you'll be ready for summer fun.

Come in today or call for an appointment 918-786-7780.  Operating time is filling up quickly so act today!!

Get ready for summer???  What!!  That's right, this summer for all intents and purposes is OVER, it is now the time to consider what changes YOU want, and do them before it is too late for the next go around.  There are things that you can do in fall and winter to be ready for lake, swim suit, and beach wear.

The first thing to consider working on are things you have a hard time hiding.  Spider veins or varicose veins are two of the big things.  I will talk more about options for treatment in the coming weeks, but, to have a great result and be ready for shorts and skirts, it takes time.  The areas have to heal and may require several treatments.  During fall and winter, long pants conceal treatment in progress....now is the time to start.  Call to schedule..918-786-7780.

The second thing to consider is your complexion.  Now is the time to get started on a good skin care regimen to reverse summer sun damage and keep that skin glowing through the winter.  We love the results we see with the Obagi line of skin care and for those that need an extra kick, we use the Pearl laser and IPL to get rid of dark spots, fine lines, and wrinkles.  The Pearl laser is fantastic for fine lines, wrinkles, and improving skin tone, color, and texture.  It also comes with one of the shortest recovery time of all ablative laser treatments.  Treatments in the winter will get you ready for next year...call today 918-786-7780.

The third thing, the second concerning lasers, is hair removal.  With the lowest prices in the 4 state area, now is the time to get that unwanted hair GONE.  Start now and stop shaving those sensative swim suit areas for good.  With our pricing, you'll make money not buying those expensive razors....call today 918-786-7780.

Fourth...breast augmentation.  Even though recovery time is fairly short for an augmentation, it is nice to get that over in the less active winter time.  We can get you the look you want at a very fair price with short booking times.  Call today for your consultation and book your time early.  Restore your confidence next summer in swim wear...918-786-7780.

Fifth...liposuction.  Have that abdominal pooch, love handles, or are you unhappy with your thighs?  For the right people, liposuction is life changing.  Problem areas that won't go away with exercise and diet can be sculpted into the form you are looking for.  We have laser technology that can tighten skin as well.  It takes time for the skin to tighten after laser liposuction so now is the time to get going.  Consults are complimentary so call today..918-786-7780.

Sixth...toe nails.  Many people are embarassed by their feet....toe nails in particular.  Many of us have nail fungus that makes the nails thick, yellow, brittle, and discolored.  Medications are 50% at best for curing the problem but come with many risks your liver.  Laser Genesis has been FDA approved to treat the problem and is over 80% effective with only two treatments.  It does take time for the sick nail to grow out.  Do it now and get your two treatments out of the way, new nails...next summer....sandals!!!  Call today 918-786-7780.

Of course there are many other things that you can do and it is always better to recover in the winter, tummy tucks, eyelids, facelifts, and more.  The other thing that you can do to re-invent yourself is the lap band.  If you are overweight and diets continue to fail, the lap band may be for you.  If you do it soon, you could be fifty or more pounds lighter by next summer...would that be amazing or what!!!  Book today 918-786-7780.

So there you have it!!  My advice is to start preparing for next summer NOW.  Don't wait or you'll miss it.  We want to help and we have the skills and people to make it happen.

Call today 918-786-7780!!

Breast disease for men???  What the heck you say.  Well, it does happen even though breast problems and Cosmetic breast surgery IS much more common for women. What kind of problems would a guy have is a question you might ask.  Well, there are several, but today I want to address a problem called gynecomastia.  Gynecomastia is a word that means puffy nipples.  Gynecomastia normally occurs during hormonal changes in the life of infants, adolescents, and men.  The first time in life it occurs is in infancy.  After birth, estrogen from the mother is high in the infant and breast tissue develops that rapidly disappears.  It also occurs in elderly males as the hormonal changes of aging take hold.  Many medications can also cause the breast tissue to increase.  Other causes are beyond the scope of this installment.  I mostly want to focus on the adolescent occurrence.  In adolescent males, gynecomastia can develop in as high as 80% of individuals.  Again, its the hormones that occur normally and in those who use anabolic steroids.  Unfortunately, in up to 30%, it doesn't go away this time.  Gynecomastia during adolescence is made of fatty tissue with a bud of breast tissue under the nipple.  By the early 20's it should be gone, if not, it may become a real problem.  The problems it causes are not generally physical but psychological.  Wearing normal clothing becomes an uncomfortable situation for a guy that has breast tissue and makes one very self conscious.  Working out to develop pectoral muscles can often times only make things worse...so what's a guy to do??  First of all, be patient.  It is hard to do but fortunately, in a majority of cases the problem resolves after hormone changes settle down.  In cases that don't resolve, we can take care of the problem.  Usually, in the normal case, I will liposuction the chest and remove the "bud" of breast tissue.  I do this through a small incision in the arm pit to liposuction the chest of excess fatty tissue.  I then make an incision through the nipple to remove the small bud of breast tissue.  We do this in the office procedure room using some IV sedation and tumescent local.  It takes less than an hour and can be life changing.  We have you wear a compression shirt for about 3 weeks and from that point on, normal clothes can be worn without the worry of those two little reminders poking through.  The incisions heal very well and go unnoticed after a healing time of a few months.

If you or someone you know has this problem, come see us!  We can help.  Call 918-786-7780 for an appointment.  Don't forget our other specials as well...laser hair removal, breast augmentation, nail fungus eradication, and great pricing on Obagi skin care products.

Now is the time!!!  Time for what you ask??  Time to get a jump on summer!

There is a lot that can be done to get ready for a new look this summer.  Probably the biggest thing (no pun intended) is a breast augmentation.  Many women think about doing this when summer is already here.  Then, it is too late in many cases to enjoy them.  It does take a few weeks to recover and regain normal activity.  So in reality, now is the time.  Do it in the winter, recover in the winter, and unveil in the spring and summer.  Spending time at the pool or lake in your new suit with new assets will be great fun for you after an augmentation. 

Whether you want saline implants or silicone gel implants, we, at Total Body Surgical can take care of your needs.  We are here to please.  I will personally listen to your desires, we will discuss the pros and cons of different implants, placement options, and especially sizes.  Most women are worried that I will choose the size and you will be stuck with it.  At our facility I will give you a range of sizes based on your measurements and we will try them on in your clothes and YOU decide so you can get the look you want.  Our special pricing for this summer is $3899.00 for saline implants and $5099.00 for silicone implants.  This includes all fees with the exception of medications that you will get from the pharmacy.  It includes the pre op and all post op care. 

The other big thing we have discussed recently that can make a huge difference is liposuction.  Many women have small areas (hips, thighs, saddle bags) that are unsightly.  These areas are difficult to get rid of even is you are in great shape and exercise regularly.  This is when liposuction shines!  For small areas we can do them in the office with or without sedation and it is very affordable.  Recovery time for a single small area is very short (a weekend or so) and when using the laser the skin contracts well over the next few weeks and looks great.

Our pricing for liposuction is fantastic and we have bookings available now.  As summer approaches, spring break, etc. get closer, the operating times get tight. 

Come now and get these special prices and book your time before it is gone!!

Don't forget our amazing hair removal offer as well!  Just $50. per treatment (an average of $300 per area).

Choosing Breast implants 2.0....

Very funny huh!! Problem is, most women stress about how to pick implants. There are many questions that must be answered before making a life altering decision. Questions that you should ask are:

1. Saline or silicone, what are the risks and benefits?

2. Approach, how should I have the implants placed?

3. Size and how they will look IN me?

4. Price, how much can I afford?

5. Recovery, how long will it take?

6. Implant warranties....what are they?

7. Should I place the implants above or below the muscle?

8. Do I need a Breast lift? 

At Total Body Surgical we have a check list that we cover with every patient to cover all of these questions and more. I will answer the questions in a short fashion here but you should ask your Doctor as his or her opinions may differ.

1. Saline or Silicone....I like them both. Some women prefer the feel of silicone as they think they look and feel "more Natural". Some women have a fear of silicone. I let them feel both, explain the cost difference and let them decide. I cover what I have discussed in previous blogs about the implants.

2. Approach.....we do them all. Silicone can be placed around the nipple, under the breast, through the arm pit. Saline can be placed through all of these approaches and through the belly button as well. I prefer the arm pit as I can use creases in the skin that heal well and are concealed leaving no scar on the breast. I let you decide however.

3. Size. As explained before, we let you help choose. I will give you a range based on the size of your chest and let you try them on. My bias is this...if a Doctor tells you he will decide based on experience what looks best for you....don't walk....run from his office. This is an important decision that you should be involved in. You try on clothes don't you????

4. Price. Saline implants are usually about $1000 cheaper than saline. This is because they are more expensive to make, and carry more liability for the manufacturer. In my office, it is up to you to choose. I explain the benefits of each and you try them on. Unless you want a high profile implant, you decide based on look and feel. High profile implants are a bit different as I feel that the silicone have a far superior look.

5. Recovery. Recovery is usually a few days. I like for you to be careful lifting or raising your arms for around 2 weeks but pain is minimal after the first 3 days if you have any at all. The implants will find their home after about 1-3 months if under the muscle and shorter if above.

6.  Implant warranties, what about them?  Both of the major manufacturers will cover the cost of the implant if there is a mechanical failure due to a manufacturers defect.  This does not pay for the surgery to replace them.  They both do have a very inexpensive insurance policy that will cover this cost for 10 years.  The implants are also covered for 10 years.

7. Above or below the muscle. I usually put them below the muscle. I put them below with saline, always to avoid seeing the implant or ripples in the implant. I put silicone above the muscle in women with a slight bit of droop of the nipple.

8. Do I need a lift?? The answer to that question is complicated. Usually if you look at the fold under the breast where it attaches to the chest wall and the nipple is above this fold, you probably won't need a lift, if below, you may. However, there are other factors involved that you will need to consult your physician about.

These are the most commonly asked questions.  Hope this helps.  Breast augmentation is a very personal event.  You should have a big say in how it is done.  One of the biggest problems I see is when a girl comes in with a centerfold picture and her body is very different.  This is an expectation that cannot be fulfilled.  BE REALISTIC!! 

Come see me at INTEGRIS Total Body Surgical.  Our spring introductory offer is:

Call 918-786-7780 now for and appointment.