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Cosmetic and Plastic Surgery-SanFrancisco Bay Area|Marin County

The Different Types of Breast Lifts (Mastopexy)

September 2nd, 2013 Miguel A. Delgado Jr, MD

San Francisco, CA-Women may lose fullness and shape of their breasts due to pregnancy, breast feeding, aging, and weight fluctuations. In order to regain a youthful looking breast, many women consider a breast lift. There are different types of breast lifts (also known as mastopexy) to address different issues women may have. Breast lift surgery costs can vary as there are different ways of doing the procedure depending on the patients amount of breast droop.

There are generally 3 degrees of breast sagging or ptosis.

             Minor ptosis is where the areola lies even or slightly above at the inframmary fold of the breast.

             Moderate ptosis is where the areola is 1 to 2 centimeters below the inframmary fold.

             Severe ptosis is where the areola is 2 to 3 centimeters below the fold.

Peri=areolar Lift

This is a 37-year-old, female resident of San Francisco, California who presented for evaluation for a breast lift. She is 5 feet 8 inches tall and weighs 165 pounds. She is the mother of two children. She underwent a peri-areolar augmentation breast lift with 275 cc Mentor normal-saline breast implants inflated up to 300 ccs. The procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. The approach was peri-areolar with the implants being placed sub-muscular. She went from an A+ size to a C+. Note the larger right breast having asymmetry before surgery and, postoperatively, an improved balance.

With minor ptosis, the peri-areolar mastopexy is a great technique as the incision heals to almost invisible. The incision goes around the areola, and a doughnut shaped piece of skin is removed and is closed with a purse string type suture. Since this procedure tends to flatten the breast and not reshape the underlying breast tissue, many women choose to have a breast implant to give fullness to the breast. This is a very desirable procedure, but not all women are candidates for this as the amount of ptosis to be corrected needs to be minor.

For the woman with moderate ptosis, the vertical mastopexy, also known as the short scar or lollipop breast lift is a good choice and widely used. The nipple/areola complex is repositioned, and the incision extends down to the breast crease giving a youthful conical shape. With the vertical mastopexy, an implant is not needed unless there isn’t enough breast tissue.

Vertical Breast Lift

This is a 29-year-old, female resident of Sonoma, California who presented to the Novato office in Marin County for evaluation for a breast lift. She is 5 feet 3 inches tall and weighs 135 pounds. She underwent a short-scar vertical breast lift at the Marin Cosmetic Surgery Center in Marin County, California. She also underwent a full tummy tuck and liposuction of her flanks.

The patient pictured here that had the vertical breast lift agreed to have her procedure documented. The BBC had contacted Dr. Delgado as a Board Certified breast surgery specialist, to see if he would be interested in collaborating in the production of a video showing the journey of a patient going through a Mommy Makeover procedure, a Mommy Makeover is a combination of procedures including a full tummy tuck, breast surgery and usually some liposuction.  Dr. Delgado agreed to the venture and the BBC brought a full production company to film at Dr. Delgado’s private Marin Cosmetic Surgery Center. The video was hosted by Louise Rednapp, a British pop star and the video focused on the stages one goes through for Mommy Makeover surgery; before, during and after the recovery. In addition to her breast lift, she had a full tummy tuck and liposuction of the flanks. Notice the beautiful result of her vertical breast lift that was achieved without the need of an implant. You can see the BBC video here.

The woman that has severe ptosis will most likely need the Inverted T or the Anchor Mastopexy. This procedure has been around the longest and is considered the Gold Standard with a high success rate. The Inverted T allows for the greatest removal of skin and reshaping of the breasts, with maximum lift. The incisions, however, are the most visible, with the addition of an incision that follows the natural curve of the breast crease, thus referred to as an Inverted T or Anchor. The incisions of the Inverted T usually heal well over time.

At the time of a breast surgery consultation at either the San Francisco, California or Marin County, California office, Dr. Delgado will be able to make recommendations as to which procedure will give the best outcome.

Do Breast Implants Have to be Replaced After 10 Years?

July 15th, 2013 Miguel A. Delgado Jr, MD

Mentor Implants

San Francisco, Mentor Implants

San Francisco, CA-Breast augmentation has been the number one cosmetic surgical procedure since 2006, according to the American Society of Plastic Surgeons. The evolution of the breast implant has changed dramatically since it was first introduced about 50 years ago in the 1960’s.

The first generation of breast implants introduced was a Cronin-Gerow implant in 1963. It was a tear drop shaped implant filling a silicone rubber envelope with a viscous silicone gel.

The 1970’s brought the second generation of breast implants, which had a thinner shell and low cohesion silicone gel filler, improving the size, look and feel of the implant. The second generation implants proved to be fragile with high rates of rupture and “gel bleed” where the silicone actually leaked through the shell, causing increased incidents of medical complications.

In the second technological stage, a polyurethane foam coating was used on the implant to reduce the incidence of capsular contracture. The third technological development was the double lumen implant which as a silicone implant inside a saline implant but the complex design proved to have a greater failure rate than the single lumen implant.

The 1980’s brought the third and 4th generation of implants with continued advances in technology that further reduced gel bleed and increased the cohesive gel.

The mid 1990’s brought the fifth generation of silicone breast implants that were made of a semi-solid gel practically eliminating filler leakage, with improved safety and lower rates of capsular contracture and device shell rupture.

In 1992, the FDA placed a moratorium on silicone implants allowing only women needing breast reconstruction or breast revision surgery to have them until further studies could prove their safety.

The breast implant manufacturers conducted many clinical trials, and in 2006, the FDA lifted its restrictions on silicone implants for women 22 years of age and older. The FDA does recommend that women have periodic MRI screenings to rule out “silent leaks”.

The manufacturers give a lifetime warranty on their implants should they deflate or rupture due to a malfunction of the implant. If this should happen within 10 years of the implantation, the manufacturers also give some monetary compensation to the patient to help offset the breast implant costs of surgery. This warranty has caused some confusion for women as to the life of their implants. Some believe that, after 10 years, they must have their implants replaced. This is not the case.

Napa, California - A 35-year-old resident of Napa, California who presents to the Novato office in Marin County for breast revision surgery. Her initial breast augmentation was with 300cc normal saline implants and developed early breast contracture and mal-position on her

Napa, California – A 35-year-old resident of Napa, California who presents to the Novato office in Marin County for breast revision surgery. Her initial breast augmentation was with 300cc normal saline implants and developed early breast contracture and mal-position on her.

It is true that breast implants are not lifetime devices and most women will have to have them replaced once and maybe more in their lifetime. As a general rule of thumb, 10 years is the average that women may need to have some type of revision surgery.

There are several different scenarios where a woman may need to have breast revision surgery, most commonly it may be a deflation or a rupture or capsular contracture. Sometimes revision is needed if the implant has shifted its position or a woman may desire to change the size of her implants. In addition, a need for revision could be the development of a “double bubble” where the implants rests below the natural crease of the breast or the implant has “bottomed out” where the nipple is sitting too high on the breast. Women’s breasts change after pregnancy and childbirth and/or with weight fluctuations causing many to need a breast lift. See before and after pictures of breast implant revision surgery cases of Dr. Delgado’s here.

Women who are not having complications do not need to have their implants replaced, and for some lucky women this may never happen. Women who are planning on having breast augmentation need to assume that they will need revision surgery at least once in their life. It is strongly recommended that women have periodic visits with their plastic surgeon to maintain the health of their breasts.

Haute MD Brings Dr. Miguel Delgado on Board as Their Newest Member of Select Doctors

April 30th, 2013 Miguel A. Delgado Jr, MD


San Francisco, California-Dr. Delgado was selected by Haute MD  to join their prestigious directory of top physicians. Haute MD is an upscale internet publication with informative stories on the latest health and beauty trends. The online publication offers readers access to premiere cosmetic specialists around the country.

Due to his exceptional reputation and skills, Haute MD has featured Dr. Delgado as their newest member as a specialist in plastic surgery for the body, including such procedures as; breast augmentation, breast revision, tummy tuck, mommy makeover and gynecomastia or male breast reduction.

Besides having a directory for top physicians, Haute MD also gives the readers a detailed profile of the doctor’s with before and after pictures of actual patients, videos the doctors may have produced and patient testimonials.

The exclusive website delivers San Francisco Bay Area men and women intriguing articles like:
•    “Auriculotherapy Beads for Celebrity Wellness”
•    “Cupping Celebrity Health Fad: Groundbreaking or Totally Useless?”
•    “Benefits of Dead Sea Salt”
•    “Power Juice and How it Helps You”

“Haute MD connects the most trusted doctors and specialists with the country’s most discerning affluent audience. The network is an exclusive, invite only membership circle with only one representative per market for each of the nine medical specialties.”

What is the Cost of a Tummy Tuck?

April 15th, 2013 Miguel A. Delgado Jr, MD

This is a 45-year-old woman resident of Marin County who is 5 feet 5 inches tall and weighs 135 pounds. She is a mother of two children. She underwent a full tummy tuck and tumescent liposuction of her flanks.


San Francisco, California – One of the most popular cosmetic surgical procedures for San Francisco Bay Area patients is the tummy tuck. For some patients who have lost a lot of weight, men and women alike, a tummy tuck removes excess skin and fat for a smoother and flatter stomach.

For women who are finished having children, the abdominoplasty is a remarkable procedure to help them achieve their pre-pregnancy figure. In addition to the tummy tuck, a waist enhancement procedure can be added to give more definition to the waist. An extremely popular procedure adds breast surgery to the tummy tuck. This is known as the mommy makeover. The breast surgery could be a breast lift with or without implants and in some cases a breast reduction.

A standard tummy tuck usually takes 4 hours and the fee for Dr. Delgado would be about $6800. The fee for Marin Cosmetic Surgery Center would be $2800. The anesthesiologist fee is $1200. The supplies run about $1050, including a pain pump, surgical garments, VitaMedica vitamins and various other supplies. These fees are just to give an estimate of costs involved; at the time of the initial consultation each patient will be given a personalized quote.

For many it seems no matter how much dieting and exercising are done, it is not possible to get a flat, smooth abdomen that the tummy tuck procedure can provide, thereby making it one of the most patient pleasing procedures available.

How to Choose a Cosmetic Plastic Surgeon

February 15th, 2013 Miguel A. Delgado Jr, MD

San Francisco Bay area patients often ask “how does one go about finding a good qualified plastic surgeon?” The internet is a good source of information, but most surgeons sound good if you look at their website. What exactly is one to look for that determines the qualifications of a surgeon? Whether you are looking to have a facelift, mommy makeover or breast reduction you want to make sure your surgeon is Board Certified in Plastic Surgery. You may ask, “What does Board Certified mean?”

According to the American Society for Aesthetic Plastic Surgery (ASAPS) one of the most prestigious plastic surgery societies in the United States, a Board Certified Plastic Surgeon is one who is certified by the American Board of Plastic Surgery (ABPS), the only board recognized by the American Board of Medical Specialties (ABMS). To be certified by the ABPS, a physician must have at least 5 years of approved surgical training, including a residency in plastic surgery.

ASAPS states further that physicians who call themselves “cosmetic surgeons” could be trained in any specialty, including a non-surgical specialty, because anyone who has a medical license can legally call him or herself a surgeon even if they have no formal surgical training. ASAPS warns: state laws permit any licensed physician to call him  or herself a “plastic” or “cosmetic” surgeon – even if he or she has not been trained as a plastic surgeon or has had no surgical training at all – prospective patients must select their doctor carefully.

Marin County patients should not be hesitant to ask their surgeon during consultation if he or she is Board Certified in Plastic Surgery, the only doctor that might be offended would be one that is not.

Ask friends who are happy with their plastic surgery results for a referral. Be sure to see many before and after pictures of the surgeon’s patients.

Is 60 Too Old For a Mommy Makeover?

November 17th, 2012 Miguel A. Delgado Jr, MD

62 year old Before and After Mommy Makeover

The popular term Mommy Makeover is a combination of an abdominoplasty (tummy tuck) with breast surgery, usually a breast reduction or a breast lift with or without breast implants. Both procedures are complex and extensive.

The patient’s chronological age is not as important as the physiologic age. If the patient receives medical clearance from their doctor, making sure that heart and lung functions are good, and there are no other medical issues, the patient should be able to proceed with surgery. If there is any concern, it is possible to stage the procedures, doing them one at a time. Safety for the patient is of utmost concern, and all aspects need to be evaluated by a Board Certified Plastic Surgeon.

Pictured above is a 62 year old San Francisco Bay Area patient that had her Mommy Makeover staged. She had a tummy tuck first, then a year later had her breast reduction surgery.

Mommy Makeover: Body Rejuvenation for a Post-Pregnancy Figure

October 11th, 2010 Miguel A. Delgado Jr, MD

The Mommy Makeover is a procedure made popular by many  California celebrities, that entails breast surgery, tummy tuck and some degree of liposuction.  It has been popularized over the past year-and-a-half to two years due to the increasing demand for women wanting to regain their shape, body image and self-esteem.  The technique involves either a breast lift or a breast lift with a breast augmentation.  On some occasions, the patient may require a breast reduction.  However, in most cases women lose a fair amount of volume in their breasts and require either a lift or a lift with breast enhancement using an implant. At your consultation in San Francisco or Marin, Dr. Delgado will help you decide the best procedure for you.

The tummy tuck is a key note of this procedure in which the pregnancy has changed the abdomen, both in the abdominal wall as well as the skin.  For a pre-pregnancy look, the procedure entails tightening the abdominal wall and stretching the skin down to a nice, taut, contoured figure.  Liposuction of the flanks is an added bonus which gives a nice waistline.  The Mommy Makeover is a significant procedure which takes approximately two weeks to recover, but the results are amazing.  Dr. Delgado performs numerous Mommy Makeover procedures at his Marin Cosmetic Surgery Center,with beautiful results and very happy patients. Please click here to view a Mommy Makeover video of Dr. Delgado’s patients.