Quicklift is here

The "Quicklift" is an exciting addition to our practice that allows us to offer a safe, long lasting facial rejuvenation procedure that can be done in our office under local anesthesia in only a few hours. We are currently promoting the procedure on television and look forward to seeing many new patients.

Dean Jabs, MD, PhD, FACS

Breast Capsule after Augmentation

Breast augmentation is a safe procedure with high patient satisfaction rates. But, like all surgeries, it does carry some risk of complication. Possible complications include changes in nipple sensation, a noticeable scar, infection and capsule formation. All are rare but can occur.

Capsule formation is due to inflammation leading to scar (capsule) formation around the implant. This is usually due to some form of bleeding that occurs after the surgery. The capsule that is formed can distort the breast and make it misshaped. Correction involves some form of capsule modification. This can take the form of scoring, partial excision or complete excision. I have had good luck with partial and complete excision. Sometimes this isn't enough though and the capsule can return for whatever reason.

In these cases, and they are few and far between, after removing the capsule, a tissue matrix is placed where the capsule used to be in the the lower portion of the breast and the implants replaced. This has led to a soft breast with good shape. It can be done on one or both breasts to better match the result.

If you are having this problem, I would be happy to see you. You can also send photos to my personal attention at jabs@cosmeticplastics.com

All the Best,

Dr. J

Redoing a Nose

Correcting deficiencies after a rhinoplasty (secondary rhinoplasty) can be difficult. Depending on what was done in the first surgery correction can require simple rearranging of misshaped cartilage to a complete redo where cartilage is harvested from the nasal septum or the external ear and grafted in to place. Bones may even need to be reset. In some extreme cases where there is little cartilage to harvest or the nose is markedly depressed rib and even synthetic bone may be needed to achieve an acceptable result. All of this is done through an open approach where a small incision is made in the columella (little column) between the nostrils and then carried in to the inside of the nose to allow adequate exposure of the internal structures of the nose. The resulting scar is minimal and the results that can be achieved are more predictable than doing the procedure "closed" where the only incisions are on the inside of the nose.

One of the more interesting cases I've had through the years involved a young man who might be described as a 'street pugilist'. His nose had been hit several times and the last altercation had resulted in the nose being very crooked and pushed to the right side of his face. I started the operation and after opening the nose and seeing how badly the septum (the wall that separates the nostril passages internally and supplies the support for the nose) was twisted I knew something more than the standard scoring and suturing would have to be done. I elected to separate the mucosa from the wall from above and completely remove the septum. I cut is out and put it on the sterile surgical table to try to straighten it. It allowed me access to parts of the septum that I otherwise couldn't get to and allowed me to reshape it with incisions and stitches. When I was done I put it back in place but it still wasn't good enough. I noticed the bottom half was much straighter than the top so I flipped it over and put it in upside down. The nose looked great. I sewed it in to position with the other cartilage and closed the soft tissue over it holding the mucosa (and blood supply) to it with sutures. The patient healed uneventfully and the nose was markedly improved with better function (he could breath) and a straight appearance.

If you have a nose that needs redoing I would be happy to see you.

All the Best,

Dr. J

Bad 'Nose Jobs'

Ever notice a bad 'nose job'? Have you stopped to think what it is that makes it look bad? Often it is overdone, meaning it looks as if too much has been changed, amplifying certain aspects while juxtaposing one ethnicity's traits next to another that you would never see in the general population. A good example was Michael Jackson's nose. It just didn't fit his face or features. You see this sometimes in celebrities. They want something that just doesn't conform to their face and they have the influence and money that can sway some surgeon to give them what they want, even if doesn't look right.

If you don't like the way your nose looks, the best thing you can do is to spend some time with a mirror to figure out exactly what it is that bother's you about it and then look at people with a similar ethnic background to find pleasing noses. They may not be an exact fit for your face but at least you will be starting in the right direction. Once you have an idea of what you would like to change then visit a board certified plastic surgeon or E.N.T. to determine if it is even possible and to have an imaging session to see how you might turn out.

Remember, plastic surgeons are human and can make substantial positive changes but they don't have a magic wand and some things are just not possible, and in some cases not desirable.

Have a great Thanksgiving Holiday.

All the Best,

Dr. J

Compassionate Doctor Award

I have been notified that I was selected by patients as a "most compassionate Doctor".
Evidently of the 720,000 active United States physicians, only 3% were accorded this honor. It is the most important recognition a doctor can receive: the recognition of our patients.

I am thrilled to receive the honor and rededicate myself to patient care.

All the Best,

Dr. J

Life Changing Plastic Surgery

So often plastic surgery is thought of as "fluff" or "vanity" surgery that is not needed and selfish. The truth is changing one's appearance, especially a trait that causes embarrassment, can have profound effects on how you see yourself and your ability to deal with society.

I had a patient today return after treatment for gynecomastia. The man had lost over 80 lbs and the resultant excess skin and floppy breasts were a big embarrassment to him. He didn't feel confident taking his shirt off in front of anyone. The feelings had profound effects on his feelings of self worth. He didn't like undressing in front of his girlfriend, at the beach, or in the gym.

Today he told me I had changed his life. When I asked how so he told me he was now a full time student in Physical Therapy. One of the requirements is for the students to practice their art on each other. He now has the confidence to remove his shirt in front of his fellow students and not feel bad about himself.

So much for "fluff" surgery.


All the Best

Dr. Jabs

Satisfied patients

I came to work today and was delighted to find a note from a recent patient. She made my day.
She writes:

Dr. Jabs, I could not have wished for a better surgeon! You are so personable and your results are exactly what I wanted. Words can not express how pleased I am with the liposuction of my inner thighs and my breast augmentation. I never would have guessed that I would feel so relaxed going into surgery but I did-thanks to you. I recommend you fully and without reservation!

Just a reminder that we should all compliment the people in our lives that please us. It doesn't take a lot of time and it can make such a difference in that person's life.

Dr. J

How are bioidentical hormones administered?

How are bioidentical hormones taken?

Four hormones are typically replaced when a woman goes on HRT (hormone replacement therapy). They are Estrogen (two types), Progesterone, Testosterone and DHEA a precursor to many hormones.

Typically women begin by taking a mixture of two estrogens (Estriol and Estradiol) in a transdermal gel that is rubbed on the skin in the morning after showering. It literally takes two minutes.

Progesterone is taken at night in the form of a pill that slowly dissolves, the products of which are breast and uterus protective as well as aid in sleep induction and maintenance.

DHEA (a hormone precursor) is taken orally as well. Some of the DHEA becomes testosterone. If the testosterone level is low after a few months then low dose testosterone may be added as well.

The effects of hormone replacement are felt within a week and the benefits continue as you take them. Adjustments are made once or twice per year as your body becomes accustomed to the normalization of your hormones.

Breast Reduction

In our society's focus on a woman's shape we often think only of breast augmentation when we think of breast procedures. Naturally this gets the most attention from our media because it is "sexy". But what about those women who have the opposite problem? Our ability to reduce too large a breast with less scarring has improved greatly over the last 20 years. We can now do the procedure with less than half the scarring that it used to entail.

A breast reduction can have several beneficial effects. It decreases the weight borne by shoulders as well as the stress that weight places on the lower back. It solves problems of skin irritation in the breast fold and often improves nipple sensation. By using a short scar technique we reshape the nipple/areola complex and usually maintain the ability to breast feed by not interrupting the ducts that carry milk from the breast tissue. To learn more please visit our website and be sure to check out our before and after photos.

Women's Bioidentical Hormone Safety

Is Hormone Replacement Safe?

We not only want to alleviate the suffering of menopause and give a woman her energy and femininity back, but we want to do it in a safe manner. It is of no use if the side effects of the treatment are worse than the disease.

Many people (including physicians) erroneously associate hormone replacement therapy with the medications used in the Women's Health Initiative (WHI) study from 2002 that led to the wholesale cessation of hormone replacement by many doctors due to the findings that the drugs that were being used were leading to blood clots, strokes and breast cancer increases in the test subjects. The medications that were used were estrogen and progestin (not progesterone). The synthetic progestin led to the problems associated with the hormone replacement. When estrogen alone was evaluated there was a decrease in breast cancer, heart disease, stroke and dementia. There was no change in mortality compared to controls.

A French study of 54, 548 women for 3 years put on different forms of hormone replacement found little to or no increase in risk in breast cancer when estrogens were used alone or with extended release progesterone.

The answer to the problem of safety is to use an estrogen and progesterone that is exactly like the ones found in your body. Bio identical.

Bio identical hormones have been studied extensively and found to be safe.