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Cosmetic and Plastic Surgery-SanFrancisco Bay Area|Marin County

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.

What is a Keller Funnel?

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

Keller Funnel

Dr. Delgado has been using the Keller Funnel for his San Francisco Bay Area patients for quite some time now. Always wanting the best possible results for all of his cosmetic surgery patients, he is on top of all new procedures and devices.

The Keller Funnel was brought to market in August 2009. It is a device designed for easier insertion of silicone breast implants for cosmetic plastic surgeons performing breast augmentation surgery. Patients seem to heal faster and adjust to their implants easier.

The funnel is a nylon pouch shaped like an icing bag with an interior coating of a special lubricant, allowing any style or size implant up to 800cc’s to be inserted. The narrow end is placed into the incision, and the surgeon squeezes the implant into the breast. The traditional delivery system for augmentation mammoplasty,  the surgeon uses his finger tip to guide the implant through the incision into the pocket.

The Keller funnel is a one use “no touch” disposable device. It allows the surgeon to make a smaller incision with less stress on the implant; in fact an independent study claims the method reduces force applied on an implant by 95%.

Another advantage of a “no touch” technique is that it greatly reduces possible contamination. The breast is not a sterile organ; there is colonized bacteria living in the nipple ducts. Even with proper surgical preparation there is no guarantee of a completely sterile surgical field. Bacterial contamination is believed to be one of the leading causes of capsular contracture.

Facelift Procedures up 6% in 2012

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

American Society of Plastic Surgeons
2012 Annual Statistics


The latest statistics on cosmetic plastic surgery procedures for 2012 were released by the American Society of Plastic Surgeons (ASPS). Surprisingly breast augmentation is not the fastest growing procedure as it has been in the past. Cosmetic plastic surgery procedures show a 5% increase over 2011. This increase is fueled by the significant uptick in minimally-invasive procedures enjoyed by many San Francisco Bay Area patients such as; Botox, Dysport, Juvederm, Restylane and Radiesse.

Facelifts increased by 6%, and eyelid surgery was up 4%. There are several different theories as to why facial rejuvenation is seeing such an increase. Some believe that facelifts became less popular during the economic downturn, but people seem to be feeling better about the economy and are more optimistic about the future. Also, it is believed as the “baby boomer” generation is growing older many are opting for methods to maintain their youth. They are staying active longer and remaining in a competitive work place much longer than even a decade ago.

The top 5 procedures were:
•    Breast augmentation (286,000 procedures, down 7 percent)
•    Nose reshaping (243,000 procedures, no change)
•    Liposuction (202,000 procedures, down 1 percent)
•    Eyelid surgery (204,000 procedures, up 4 percent)
•    Facelift (126,000 procedures, up 6 percent)

Note that while breast augmentation remains the #1 procedure, it was down 7% from 2011. Interestingly for men, male breast reduction surgery increased by 5%, this is believed to be attributed to increased awareness and acceptance of the procedure.

New Study Shows Evidence of Lasting Weight Loss After Tummy Tuck Surgery

February 28th, 2013 Miguel A. Delgado Jr, MD

Before and After Tummy Tuck

The February issue of Plastic and Reconstructive Surgery, which is the official medical journal of the American Society of Plastic Surgeons (ASPS), states that a pilot study shows that patients who have had an abdominoplasty (tummy tuck)may have significant lasting weight loss. This is particularly true of those Marin County patients who were overweight or obese prior to surgery.

This may be due to increased satiety, feeling full after eating. The researchers also discuss possible changes in the “neuroendocrine system” by removing fat cells from the abdomen; it may reduce the levels of hormones affecting the appetite which are secreted by fatty tissues. More studies will be needed to confirm this hypothesis.

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.

Lateral Browpexy Done With Upper Eyelid Surgery

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




Excess skin at the lateral brow is a common complaint of patients that have had upper eyelid surgery. Having a lateral Browpexy at the same time as upper eyelid surgery addresses this issue. This combination of procedures rejuvenates not only the upper eyelid but the outer aspect of the brow. The lateral Browpexy does not lift the entire brow, only the outer third. For those Marin County patients that would be a candidate for the Browpexy, it is a great procedure as it is less invasive than traditional brow lifts with a faster healing time.

San Francisco Bay Area women love this procedure; they like to combine it with “corrugator muscle excision”, this is the muscle that allows the eyebrows to squeeze together forming frown lines between the eyes. With excision of this muscle, the effect is similar to Botox treatments, except the results are permanent.

Vitamins Speed Healing

December 14th, 2012 Miguel A. Delgado Jr, MD

Getting San Francisco patients back to normal life as quickly and safely as possible after cosmetic plastic  surgery, has always been a goal of Dr. Delgado’s. In observing patients for many years, Dr. Delgado noted that his patients that followed his advice in taking high quality vitamin supplements healed faster and had less discomfort than those who did not.

It then became a high priority for Dr. Delgado to find the best available product to recommend to his patients. After extensive research, he discovered that his patients who took VitaMedica healed the best after cosmetic plastic surgery procedures such as; liposuction, breast surgery, facelift, tummy tuck, and gynecomastia.

VitaMedica offers many high quality products; Dr. Delgado found their “Surgery Program” exceeded his expectations. It is difficult to find a good multi-vitamin that does not contain any vitamin E, vitamin E acts as a blood thinner and can be dangerous during surgery. VitaMedica superior multi- vitamin “Clinical Support” both for AM and PM does not contain any vitamin E and contains extra vitamin C which aids in healing. VitaMedica Surgery Program includes both the Clinical Support for AM and PM along with Arnica Montana and Bromelain with Quercetin which reduces inflammation and bruising.

Due to the exceptional healing results that Dr. Delgado noted in his post-operative patients, he includes the VitaMedica Surgery Program for all his surgery patients.

How to Prepare for Facelift Surgery to Expedite Healing

November 30th, 2012 Miguel A. Delgado Jr, MD

Before and After Facelift Surgery

The pro-active rhytidectomy (face lift) patient can speed up the healing process by following a few before and after surgery recommendations.

Decide if you are at your goal weight or close to it. You do not need to lose weight prior to surgery if you are at a weight you can comfortably maintain. It is not a good idea to try to lose a significant amount of weight after surgery as you may end up with loose skin on your neck and jowls.

It is mandatory to stop smoking 2 to 4 weeks prior to surgery.  Studies show that smoking increases inflammation which increases the risk of infection, cardiac arrest, heart attack and stroke. Smokers also usually suffer with a higher level of pain. You must wait 2 to 4 weeks after surgery to resume smoking. If you have managed to quit for 8 weeks, one of the best things you can do for your health and skin is never start smoking again.

If you color your hair, try to do that prior to face lift surgery or you will need to wait 4 weeks after surgery.

Eat healthy foods, lots of fruits, vegetables, fiber and protein. Drink lots of fresh water. Dr. Delgado encourages his patients to take a high quality multivitamin, both before and after surgery. Dr. Delgado has found Vitamedica to be a superior vitamin supplement that does not contain vitamin E, which must be avoided due to its blood thinning qualities.

Many Marin County patients begin a good skin care regime before surgery and continue it for life. To maintain their rejuvenated new face, they get products and maintenance skin care from the esthetician at cosmetic plastic surgery specialist, Dr. Miguel Delgado’s office at 165 Rowland Way Suite 300 Novato, CA, by calling (415) 898-4161 for an appointment.

Melting the “Muffin Top”

October 23rd, 2012 Miguel A. Delgado Jr, MD

Have you ever put on a tight pair of jeans or pants only to have some flab hang over the waistband? Sort of like a muffin top? It is easy to see how the term became popular. For many Marin County patients it seems no matter how many different diets or extreme exercises one does, that stubborn roll just won’t disappear.



Liposuction remains one of the most popular cosmetic plastic surgery procedures done, it is excellent for getting rid of trouble spots such as the love handles or muffin top. The younger patient with good elasticity will get the best result. However, the older patient will benefit, as well. If there is a lot of excess loose skin, it can be excised. This is a great procedure to include with a tummy tuck.

It is important to remember that if you don’t maintain a healthy diet and exercise, fat can come back to a different area.


Why is Massage Necessary After Breast Augmentation?

September 29th, 2012 Miguel A. Delgado Jr, MD

After breast augmentation surgery, Dr. Delgado has his patient begin breast massage exercises. This may be uncomfortable for a few days but is a very important step to soften and relax the breast implant pocket. Being vigilant with the massaging will greatly help in the prevention of a possible capsular contracture from forming around the implant which would prevent it from moving freely. 

The body’s natural response to a foreign body (in this case the breast implant) is to form a lining around it by your own living tissue. This is referred to as the “capsule”. For some Marin County women, the capsule may tighten and squeeze the breast implant making it feel hard. Capsular contracture can happen at any time for anyone but seems more common after the first few months of surgery.

The degree of contracture is graded on what is called the Baker Grading system. Baker Grade 1 is where the breast is normally soft and looks natural. Everyone is at least Grade 1 as everyone has a capsule form. If it starts shrinking/contracting, the implant will feel more firm going from a grade 2 to grade 4, grade 4 being the most severe, causing pain and distortion.

The cause of capsular contracture is still not clear. It is believed that infection, hematoma or a seroma may put a woman at greater risk. Some women may develop a capsular contracture for no known reason.

Studies have shown that massaging seems to reduce the likelihood of forming a capsular contracture. Dr. Delgado will give detailed instructions on how to do this at the first post operative appointment usually three days after surgery. The exercises are to be done hourly for three months and then daily.