Sun 11 Oct 2009
single incision mommy makeover. what is this new gimmick?
Posted by Lauren Greenberg, M.D. under Breast , post baby breast[2] Comments
Some plastic surgeons seem more focused on marketing than on their patients.
I guess I am an old fashioned girl. I like honest and real. I don’t try to sell my patients a rainbow. I don’t try to lure them into my office with promises of scarless surgeries, only to tell them it isn’t possible for them. (Kind of reminds me of those teaser car lease rates. In the fine fine print you’ll see only one is available at the special advertised rate, and oh yes, we forgot to mention the thousands of dollars down for registration and drive off…)
Anyhow, I recently saw an article by two young plastic surgeons advocating a single incision, single scar mommy makeover. (Forgetting all tummy tucks have two scars, so the name is misleading from the start…) But love it. Sign me up! What is it?
It basically is for women who need
- Breast augmentation, in front of the muscle.
- Tummy tuck.
Now I have many patients who benefit from a tummy tuck and breast augmentation. It is a common combination for mommy makeover. I find these dual surgeries safe in most of my Bay Area healthy patients. Most of my Palo Alto moms don’t have time to do two surgeries, the cost is lower, and it is one recovery. And I am all for reducing the number of scars. Plastic surgery is about innovation. What I do today is not what I did a decade ago. And with new advances and refinements, I expect what I do in the future will be different as well.
My issue is with this procedure is it has been tried before, with some poor results. It is tough to position the implant well when going from the abdomen. You create an opening which connects the breast pocket with the abdominal pocket. There are many many issues with placing the implant in front of the muscle, particularly in thin women. (Please see my page on breast augmentation for more information.) And with implants my greatest concern is always what happens down the road. Does it move? infection? hardening? And if you put it through the abdominal incision how are these addressed?
This is being spearheaded by two young guys just out of residency. I don’t know how many they have done, what they look like (no photos were shown in the article, or on their website), or what the technique really is.
But it is a great marketing play. It has gotten them an article written about them which I read, and I am sure it will attract patients to their new practice. They have many sayings which could apply here: Buyer beware. If it seems too good to be true, it usually is. Show me, don’t tell me.
Until then, I will continue to keep my breast implants separate from my abdominal incision. The breast augmentation scar at the areola on most of my patients fades to nothingness, I like the submuscular placement of the implant, and I like knowing I did everything I could to insure they have a beautiful, natural, soft result. Unfortunately for me, good solid plastic surgery technique isn’t catchy. Alas, no splashy article about me today.
December 1st, 2009 at 12:18 am
Dr. Greenberg,
I recently came across your article, refuting the “gimmick,” A.K.A. the “Single-Incision Mommy Makeover.”
I wanted to personally address your questions and concerns. Although I agree, it IS a catchy title, I do NOT agree with your reasoning: How can someone refute a procedure without ever having performed it? When you say that this procedure “has been tried before, with poor results” I believe you are mistakenly referring to the TUBA (transumbilical breast augmentation). For those plastic surgeons who have never performed – let alone even witnessed – this procedure, one cannot comprehend the surgical exposure offered by the SIMM. Indeed, although technically more difficult, the results can be spectacular.
I also wanted to clarify a few things:
1. In your blog article, are you saying that subglandular or subfascial breast augmentation in selected patients do not have good results? I can assure you that John Tebbetts, Scott Spear, Dennis Hammond, Maurice Nahabedian, or Foad Nahai would disagree…
2. We can also place the implants through a submuscular approach, under direct vision, and yes, through one major incision.
3. I can assure you, PSP (Plastic Surgery Practice) did NOT write an article about us because of the Single-Incision Mommy Makeover. Nor did we pay to have it written. We were accomplished enough in residency that someone alerted the editor, so I feel it was earned.
4. As far as the SIMM being “spearheaded by two young guys out of residency,” this is correct. Everybody’s training is different. We happened to be fortunate enough to train with the single largest group of Plastic Surgeons in America – Long Island Plastic Surgical Group. It was there that we were pushed to improve, excel and transform current dogmas in Plastic Surgery – much as our past leaders of our specialty have done.
I do agree with you on one thing, however: Good, solid plastic surgery technique isn’t catchy. Unfortunately, many surgeons equate “newer” techniques with “catchy.” That’s what general surgeons thought when the laparoscopic cholecystectomy was developed. We’re not claiming to be visionaries; we just wish to grow as “pioneers” in this field of having 20 ways to “skin a cat.”
And lastly, with the utmost sincerity, if you DO wish to observe this procedure, we would be happy to teach you. Please refer to our website: http://www.bhpsg.com.
Sincerely,
John and Payman
Beverly Hills Plastic Surgery Group
March 16th, 2010 at 8:35 pm
I still find it interesting that my previous comment was not posted; or, even more interesting, perhaps, that this post still exists. We don’t need to negatively write about our colleagues because our work speaks for itself…newer in practice or not. Again, I open the invitation to you to come and witness a SIMM Procedure…no one is above learning new techniques.