Welcome to the Blog of Dr. Brian S. Glatt, a Premier Plastic Surgeon based in Morristown, New Jersey

Stretch Marks After Pregnancy

By drglatt on June 9, 2009

As a board certified plastic surgeon who sees a great number of young moms seeking to rejuvenate their bodies after childbirth, the issue of stretch marks comes up quite often.  The key to managing stretch marks is all about prevention.  I have many patients who wound up without a single stretch mark that swear it was because they lathered up their skin with cocoa butter twice a day every day of their pregnancy.  With that being said, there is definitely a genetic basis regarding who will develop stretch marks (and how bad they will be) and who won’t.  Some women are just lucky and based on their physical make-up, will never develop one stretch mark – whether they use products for prevention or not.  Others will use everything on the shelf imaginable, yet still be left with severe stretch marks on their abdomen, sides (flanks), and even their breasts.  Even though there is some genetic basis for this, it is thought that stretch marks can at least be minimized with regular moisturizing treatment of the skin.  This is especially true for women who are carrying multiples (e.g. twins or triplets) and for those women who gain a lot of weight very quickly.  Gaining weight more gradually may help in prevention of stretch marks, as will consumption of foods with high content of vitamins A, C, D, E, zinc, omega 3, essential fatty acids and protein.  This will help your skin produce more elasticity and aid in extra healthy collagen production.  In addition, staying adequately hydrated during pregnancy is thought to enhance the moisture content of the skin and may also contribute to the prevention of stretch mark formation. 

Some say stretch marks are somewhat preventable, and this is probably partly true.  Regular use of a moisturizing product during pregnancy is thought to help keep stretch marks away or at least at bay.  One of the most popular of these treatments by far, and the one I favor the most, is straight forward cocoa butter.  My favorite is Palmer’s brand, and you want to stay with the pure cocoa butter stick or cocoa butter in the tub – not the creams with cocoa butter content.  Generally, one should really rub it in to the entire abdomen, flanks, and breasts twice a day – and rub it into the skin quite aggressively.  Another brand which is gaining popularity recently is Mama Mio, which has two aptly named products to prevent stretch marks:  Boob Tube and Tummy Rub.  Regardless of which product you use, the key is to keep the skin well moisturized – dry skin is more prone to sustaining damage from stretching.  Providing sufficient moisture can increase the elasticity of the skin, so moisturizing creams made from aloe vera, cocoa butter, grape seed, squalene oil, vitamin E, collagen, pro-vitamin B5, germ oil, aroma oil or essential oil can help to prevent the formation of stretch marks. The above ingredients will moisture the skin, increase the elasticity of skin, and protect the skin from damage. However, creams that consist of any exfoliating ingredient like alpha-hydroxy acids AHA , glycolic Acid, Retin-A, vitamin D3 are not suitable to use during pregnancy and breast feeding and should be avoided. The truth is that as long as the product you are using is very lubricating, safe, and feels good to you, then you should go with it!  The thought is to keep your skin as well hydrated as possible as the severe stretching action on your skin can severely damage the underlying collagen and elastin fibers and also cause your skin to dry out significantly.   

Once stretch marks are present, they are notoriously hard to treat definitively.  An important point to keep in mind is that stretch marks can never be removed 100%.  For marks that are light in color, there is little one can do to improve them.  Occasionally, the marks can be somewhat red or pink in color.  If such marks do not fade to a lighter shade, they can sometimes be improved with laser treatments using a Candela laser, which is a type of laser used to also treat spider veins or hemangiomas.  Typically laser treatments for stretch marks are easily tolerated, last only several minutes, and require little to no downtime with some possible bruising or temporary darkening of the area being the worst of it.  Each session should cost anywhere from $200 – $750 depending on the doctor you go to and the part of the country you live in.  Laser treatments will rarely work with one treatment, so you may expect to undergo at least 2-3 separate sessions, and some doctors may sell you a package of treatments for a better price.  If there is no improvement after several treatment sessions, then the chances of success are minimal and you may not want to continue with this modality.  There are no proven topical remedies which exist that will “erase” or even significantly improve your stretch marks after pregnancy, despite all the fancy ads out there.  Prevention is key!

Of course, depending on where the marks are located, they may be surgically removed if within an area of resection such as during a tummy tuck or breast lift.  If considering any of these kinds of surgeries, you should discuss your expectations concerning eradication of your stretch marks beforehand with Dr. Glatt

Posted in Abdominoplasty, Body, Special Topics |

Saline versus silicone gel breast implants

By drglatt on June 2, 2009

Brian S. Glatt MD, a board certified plastic surgeon in Morristown, New Jersey performs a great deal of breast implant surgery using both saline as well as silicone gel implants.  While there were a number of years in which saline filled breast implants were the only option for those who desired cosmetic breast augmentation surgery, women now have the choice of receiving silicone gel filled implants as well.  There are advantages and disadvantages of each kind of implant and these will be fully discussed with you during your consultation with Dr. Glatt.  He views an important part of his job as educating you as much as possible in order to help you make the right decision for you.  Dr. Glatt will never pick an implant type (saline versus silicone) for you – this important choice is always made by his patients.  Regardless of your choice, excellent results can be obtained with either type of implant.

Saline filled implants contain a sterile salt water (saline) solution which comes straight out of an IV bag.  These implants are placed into the breast implant pocket empty and are able to be rolled up for easy, non-traumatic insertion and then get filled in the operating room, so the incision length can be slightly smaller than that required for silicone gel implants.  Saline implants feel and look slightly less natural than silicone gel implants.  There is also a higher chance of developing “rippling” with saline implants, especially in very thin women, which can make the implants look more obvious.   No implant will last forever, and all of them have a chance of rupturing some time in the future.  One of the features of saline implants is that if they rupture, it is usually quite obvious as your breast will “deflate”.  This requires a small operation to replace the ruptured implant with a new one.

Silicone gel filled breast implants were reapproved by the FDA in 2006 for use in all cosmetic and reconstructive breast surgery.  This decision came after plastic surgeons collected data based on a nationwide study which tracked women who received these implants for approximately 15 years. It may be interesting to know that the silicone gel breast implant is the most studied device in the history of our country!  These breast implants feel much more natural and softer than saline filled implants and most seem to think that they feel more like a natural breast does.

Silicone gel breast implants have never been made better – the gel inside is extremely cohesive and maintains its structure upon compression.  One point to keep in mind though is that these breast implants are made so well that if a silicone gel breast implant were to rupture, it may not be noticeable and you might not be aware that the implant has ruptured!  Breast implant rupture may be detected on physical examination by your doctor or you may notice a difference in your breast feel or shape.  The gold standard and most definitive way to know if they have ruptured or not is to undergo radiographic studies, such as an ultrasound or an MRI.   Thankfully, if they are found to be ruptured there is no harm that will come to you.  Although people seem to believe that the gel will “leak” or ”spread” in their body or make them sick, none of these things happen.  In reality, medical studies have proven that breast implant rupture is not associated with autoimmune disease or other syndromes.  Also, your body forms a wall of protective tissue, called a capsule, which keeps implant material from coming in contact with any other part of your body or tissues.

The hear more about breast implant surgery click here and be sure to watch Dr. Glatt discuss this procedure in the video portion of our website.  

Posted in Breast Surgery |

Recovery after breast implant surgery at the Premier Plastic Surgery Center of New Jersey

By drglatt on June 2, 2009

Breast augmentation surgery remains the number one most popular cosmetic procedure performed in the United States.  Board certified plastic surgeon Brian S Glatt explains that although most people think that recovery will take a long time, in truth, recovery is quite surgeon as well as patient dependent. By paying particular attention to meticulous technique in the operating room and by treating the tissues as delicately as possible, Dr Glatt can help patients achieve a faster recovery and enhanced long lasting results.

Most of Dr. Glatt’s patients at the Premier Plastic Surgery Center of New Jersey require postoperative pain medicine for only 2-3 days, but many may continue taking a muscle relaxant such as Valium for several days longer.  Breast augmentation patients are generally finished taking any postoperative medication by about 6-7 days. 

What are my restrictions after breast implant surgery?  Most of your restrictions after breast augmentation surgery are physical, and involve a decrease in overall activity as well as avoidance of heavy (greater than 20 lbs) lifting.  Your pectoralis muscles will be somewhat weaker during the time immediately following surgery and the tissues will need time to heal and recover.  We like our patients to avoid any kind of heavy lifting or strenuous exercise for three weeks.  After three weeks, most patients are healed well enough to resume most activity.  Full unrestricted activity can be resumed after 5-6 weeks. 

When can you drive after breast implant surgery?  Patients are allowed to drive when they are not taking any medicines that can affect their coordination or decision making ability and when they can move their arms well enough to swerve away if someone were to stop short in front of them.  A majority of our patients are moving their arms freely within twenty-four hours and driving without difficulty within 5-6 days.

When can you go back to work after breast augmentation surgery?  Of course the answer to this highly depends on what you do for a living.  If your job is less physical, then most of the time you may return to work after one week.  If your work is more physically demanding, then you may want to take an additional week off postoperatively to give your body a chance to more fully recover.  Too much activity or too much stress on the body too early can cause small amounts of trauma to your inner tissues and compromise your healing and your ultimate result! 

When will my breast augmentation scars be fully healed?  Most people do not realize that any scar on the body takes almost a full year to completely heal!  With that being said, a majority of your scar wound healing will be complete by about three months.  Most of the time, your scar will start to fade by this time and will continue to do so.  Dr. Glatt will advise you on postoperative scar care and management during your postoperative visits.

Do I have to massage my breast implants?  Whether you have silicone gel filled breast implants or saline filled breast implants placed, Dr. Glatt feels it is very important to move the implants around in their pockets, or “massage” them.  You will be instructed on how to do this properly about a week after surgery.  It is good practice to continue this on a regular basis for as long as possible to help keep your implants soft, mobile and natural looking and feeling.

All of our patients at the Premier Plastic Surgery Center of New Jersey in Morristown, New Jersey receive their postoperative instructions in advance of their breast implant surgery and Dr. Glatt will spend a great deal of time discussing everything you have just read in a lot more detail during your consultation as well as during your dedicated preoperative visit.

Click on the appropriate term for more information about breast implant surgery with silicone gel breast implants, breast implant surgery with saline breast implants or breast lift or breast reduction surgery.   Also be sure to view our video of Dr. Glatt discussing breast implant surgery.

Posted in Breast Surgery |