Dr. Bhupesh Vasisht

This is perhaps the most fun part of the procedure. The goal of the augmentation is to restore volume and projection to the breast. During a consultation, patients can "try on" different sized implants to see which size gives the most natural appearance. Being attentive to a patient's wishes and desires is extremely crucial in finalizing the correct size.

The patient's height and body shape, along with the pre-surgical dimensions of her breast plays a prominent role in determining the size to acheive a natural look. The pre- operative tissue stretch and existing volume will determine the size of the implant that is chosen. Implants come in various dimensions and profiles and implants that are too large can often distort the anatomy. The surgeon will guide you in making the best choice to suite your individual goals.

Most of my patients want a natural look that fits their body. This is desirable in my opinion. Often when we hear that there is a problem, it is usually related to the implant being too large for a patient's frame. The other issue is that the implant should not be too small either. I usually give patients a range of sizes and often pick the size that best fits their body.

Everyone knows the ill-effects of smoking. Media coverage is abundant when it comes to the detrimental effects of smoking. We know that it causes all sorts of cancers, but lets explore how smoking affects plastic surgery.
Smoking affects the microcirculation in the body. It causes the smallest blood vessels to constrict even more. This prevents blood from flowing into areas that are important during healing process. After plastic surgical procedures, whether big or small, we are relying on your ability to heal wounds. Smoking affects this process.
Another affect of smoking occurs with each puff of the cigarette. With each puff, instead of oxygen, carbon monoxide is delivered into the lungs. This same carbon monoxide is then delivered to a wound during the healing process. Now the wound, which needs oxygen to heal, is getting poisoned by the carbon monoxide.
The combination of constricting blood vessels and the absence of oxygen being delivered to a wound adversely affects wound healing. Most of the procedures that are performed in plastic surgery rely on wound healing to occur correctly and effectively. Smoking adversely affects how a wound heals.
The general recommendation of American Society of Plastic Surgery is for patients to quit smoking about 2 weeks prior to the procedure and to remain smoke free at least 4 weeks post surgery.

Anti-aging medicine is a catch term that has become very popular in the last decade. The skin is the first manifestation of the aging process. There are a number of factors that have been shown to speed up aging of the skin. Fortunately, these are factors that are within your control. Any steps that you take to adjust these factors will help to slow down aging of the skin. Remember these seven factors and make adjustments in your life as needed!

1. Sun Exposure
2. Smoking
3. Dry Extreme Cold Weather
4. Lack of a Sleep
5. Stress
6. Lack of Exercise
7. Too much Alcohol

Hyperhidrosis (excessive palmer and underarm sweating) is a real problem faced by many patients in the United States. It affects patients both on a personal social level and even professional level. This can have a profound effect on productivity at work.

Although, there are many solutions to this problem, Botox injections are very effective in helping control the hyperhidrosis. Botox works to block the neurotransmitter that results in the excessive sweating. It is injected directly into the affected area. This can be done in the office setting under local anesthesia. There is little to no downtime. It takes a few days for the Botox to start working. Once it takes effect, it will temporarily stop the excessive sweating.

One of the aspects of our healthcare that does not get noticed is that of the commitment of US surgeons to provide healthcare in many parts of the third world.  There are thousands of MD's in this country who take the time to travel to another country to provide their expertise to those in need.  In particular, plastic surgeons from the US routinely travel to countries like Philippines, Thailand, India, and many African nations to provide cleft lip and palate repair to those patients who do not have access to healthcare.  As most of my patients know, I have been traveling annually with a group of my colleagues to the Philippines to perform cleft lip and palate surgery.

In 2007, the FDA approved the use of cohesive gel (silicone) implants for the purpose of cosmetic enhancement of the breast.  Since then, the use of silicone gel implants has really increased in popularity.  The question that I get asked is whether they are safe.  The simple answer is "yes".  There are many factors that need to be considered when evaluating patients for breast augmentation using these gel implants.  Most of these issues should be discussed by the surgeon in the office during the initial consultation.