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All posts by Timothy Janiga

Four Things to Expect During Your Breast Surgery Recovery

Whether you’re having breast cancer reconstruction or breast augmentation, you’re likely to experience four common factors in your recovery. Let’s take a closer look at the typical stages of recovery once you’ve undergone surgery.

Breast Surgery Recovery

  1. Soreness

Regardless of the type of surgery you have, you should expect to feel at least a little sore. How much soreness you experience will vary depending on how involved your procedure is, though even localized procedures such as a breast augmentation come with some discomfort afterward. In the days right after your procedure, you’ll usually be prescribed a course of pain medication, which will be tapered down to ibuprofen or Tylenol as you return to normal. It’s not unusual to experience some mild discomfort for up to six weeks after surgery, but it varies from case to case. As part of the post-op consultation, we’ll discuss how long it will take you to get back on your feet. This way, you’ll know generally what to expect as you recover.

  1. Activity Restrictions

Based on the type of operation you’ve undergone, there will likely be some restrictions on your activity. When we operate on breasts, the muscle and skin can often become disturbed. This necessitates a break from vigorous activity for a few weeks after your procedure. Your downtime could range from three to eight weeks, but I’ve found the average is between four and six weeks. Within three weeks of your surgery, you should be able to take moderate walks, but I’ll strongly advise you to avoid weightlifting, moving furniture or generally lifting more than 20 pounds until you’re about six weeks removed from your operation.

  1. Fatigue

There’s no getting around the fact that you’ll simply be tired after an operation. This partly comes from being administered anesthesia, but other factors come into play. For one, you’ve probably worried about the procedure beforehand, which takes a toll on your mental and physical strength. Also, your body is pooling its resources to help you heal, which requires a lot of energy. Rest assured, this fatigue usually subsides after three weeks.

  1. Follow-Ups

Naturally, there will be a couple of follow-up appointments after surgery. If you’ve had drains placed, we will remove them anywhere between a day to two weeks after surgery. If you’ve been given stitches, we’ll likely remove them one to three weeks later, depending on where they are on your body. After that, I like to see you roughly three months later for an additional follow-up. I do this to ensure that everything is healing as it should. Most of my breast surgery patients then see me once a year thereafter, or sooner if needed.

As you can see, each type of breast surgery is unique, and so is its associated recovery.  Because everyone is different, I will walk you through what to expect as you start on the road to recovery. After you’ve had your operation, we will tailor a set of instructions specific to you and your procedure so that you can get back to the most important things – and people – in your life.

Ready for a consultation? Contact Dr. Timothy Janiga today to learn about your surgical options.

This post was last updated on .

Forget the Dad Bod. Let’s Have a Do-Over.

Actor Leonardo DiCaprio made headlines last year for his so-called “Dad Bod,” a physique that features a prominent beer belly and a generally softer, plumper look. For a short time, the Dad Bod was all the rage on social media, but it soon became clear that the usually svelte DiCaprio had intentionally beefed up for his role in “The Revenant.” Once filming was over, Leo quickly returned to his thinner, healthier form, and the Dad Bod fad was over almost before it began.

Dad Bod

For the rest of us who don’t have Hollywood fitness instructors at our beck and call, it’s not quite so easy. Years of sedentary office work, the stress of raising children and the grinding effects of middle age all combine to give many men a natural Dad Bod along with other normal signs of aging.

Fortunately, it’s becoming increasingly acceptable for men to go under the knife for plastic surgery procedures meant to improve their appearance. According to the American Society of Plastic Surgery, men now account for 13 percent of cosmetic surgical procedures, with some procedures rising as much as 30 percent since 2000. Two of the more popular procedures are pectoral implants and male breast reduction (Gynecomastia).

At Janiga MDs, we’ve performed many Mommy Makeovers throughout the years. These include breast lift and augmentations with tummy tucks. Now, we’d like to introduce the Daddy Do-Over. Tailored for men seeking to keep their competitive edge in the workplace and to those simply hoping to look as young as they feel, the Daddy Do Over consists of any combination of the following: jawline and neck reshaping, rhinoplasty, facelift, pectoral implants, male breast reduction, liposuction and/or tummy tuck.

Let’s look at some of these procedures a little more closely.

Pectoral Implants: We insert the implants through an incision in the skin, around the areola or through the armpit. We then carefully place them through the incision to create more definition in the male chest wall.

Male Breast Reduction: This is usually performed in a man with a history of a significant weight loss. In these cases, there is a lot of excess skin to be removed, but once it’s gone, shape is restored.

High Definition Liposuction: This is done to combat love handles and to create definition in the abdominal muscles. Liposuction is particularly useful in men who are close to their ideal weight and would like some additional definition in the abdominal muscles.

Tummy Tuck: This is performed in both men and women. For men, tummy tucks are usually performed after weight loss surgery where there is a significant amount of redundant skin and tissue to be removed.

Jawline and Neck Reshaping: We find many men seek improvement in the appearance of their necks. As men age, laxity increases in the neck, resulting in a double chin. We often perform neck lifts or liposuction to help restore the neck to its original appearance.

The Daddy Do-Over is quickly becoming a common procedure. Whether you’re a CEO at the top of your game, a man who has lost a significant amount of weight or a man trying to get that promotion, Dr. Timothy Janiga will evaluate your concerns and goals and help you choose the best combination of procedures for you. Schedule a consultation today and start kicking that Dad Bod to the curb for good.

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Couple’s Plastic Surgery: Going Under The Knife To Bring You Closer Together

There’s no doubt couples share a lot with each other: bank accounts, cars, parenting responsibilities and countless journeys together; but what about the joint experience of plastic surgery? Could going under the knife together be the key ingredient that’s missing in your love life? A new trend in plastic surgery suggests that it just might be.

couples-plastic-surgery

Here at Janiga MDs, we have quite a few couples that come in together considering joint procedures. Those who decide to take on this joint venture will usually have their respective surgeries a couple of days apart so they can take care of the other, while allowing themselves to heal during the same time. Many couples plan a staycation around these procedures.

You can’t be blamed for a healthy dose of skepticism here. After all, isn’t plastic surgery largely performed on women? The truth is, we’re seeing this old stereotype crumble as large numbers of men are seeking plastic surgery. While 90 percent of cosmetic surgery procedures are still performed on women, that number is quickly shrinking as more men are taking the plunge and opting for everything from rhinoplasties to breast reductions. As we mentioned in a November blog post, the top five cosmetic surgical procedures for men in 2014 were nose reshapingeyelid surgery, breast reductionliposuction and facelift. We’ve also seen a growing number of men choosing to have breast reduction surgery.

As men increasingly embrace plastic surgery, the number of couples going in for joint procedures is also growing. In our experience, having surgery together helps these couples understand what each partner is going through. The shared experience gives each person a better understanding of their partner’s concerns about a specific part of the body. As a bonus, it seems to make post-surgery recovery a better overall experience.

How does it work? Honestly, any way you want it to. Sometimes the couple has their consult at the same time and then one person has their procedure first. After the first partner is happy and overjoyed with their results, the other then follows. In my practice, facelift is the most common procedure that couples have together, but it is also common for a man to have rhinoplasty while his other half is interested in a body procedure such as breast augmentation or tummy tuck.

In the end, it just makes sense that couples would want to support each other during consultation and recovery, as well as age gracefully together. So, go ahead, embrace the new.

Set up your complimentary combined couples consult with Dr. Timothy Janiga and start a new journey with your significant other today.

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Best of 2015: Plastic Surgeries of the Year

plastic-surgery-consultation

As we near the end of 2015, let’s take a closer look at the three most common cosmetic procedures I performed for patients this year: breast augmentation, facelift and rhinoplasty.

These three are some of the most commonly performed surgical procedures in the United States. Here at Janiga MDs, we seem to follow the national trend with these procedures outpacing most others.

The national numbers for 2015 won’t be out for a couple of months, but breast augmentation was one of the most popular procedures in 2014 according to the American Society of Plastic Surgeons (ASPS), with almost 300,000 augmentations performed across the country. This number is even greater when you include those women who have a breast lift along with augmentation, which is one of the most common procedures we performed at Janiga MDs in 2015. Breast augmentation is a procedure that places either saline or silicone implants in the chest wall to increase breast size. The implant can be placed either above or below the muscle, depending on the patient’s anatomy. The procedure can enhance a naturally smaller breast to make a woman feel more symmetrical. Also, the procedure can help women’s clothes fit nicer and increase overall self-esteem. Breast augmentation can improve breast appearance after pregnancy, nursing or weight loss. Overall, breast augmentation is a very high satisfaction procedure and this is reflected in the feedback we get from patients who elect for these types of services from Janiga MDs.

The next top procedure is the facelift. In 2014, ASPS reported nearly 150,000 facelifts were performed nationally. This number has remained mostly stable for 15 years, and it remains one of the most common procedures I perform. There are two main types of facelifts in my practice; one is the in-office facelift or mini facelift, and the other is the full facelift performed in a surgical center. In my practice, I perform an equal number of each type of facelift. The in-office facelift/mini facelift is performed under local anesthesia, which means you’re not put to sleep. This procedure is for women with excess skin around the jowl and neck area who are not ready for a full facelift in the operating room.

When under general anesthesia, you have more options, including a more extensive facelift and neck lift. Liposuction of the neck, brow lift or eyelid procedures can be performed at the same time. In some cases, body procedures such as breast augmentation can be performed in the same surgical session.

The last of the three most popular procedures is rhinoplasty. Rhinoplasty is one of my favorite procedures to perform. It is done to reduce the size of the nose, change the angle of the tip, remove a hump on the nose’s dorsal surface or any combination of the three. If done well, rhinoplasty can provide tremendous satisfaction to patients.

As we reflect back on 2015, we would like to say thank you to all of our patients. It has been a great year. As always, feel free to reach out to us for a free consultation at our Reno office.

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Considering a Mommy Makeover?

Give yourself the gift of confidence this holiday season with a mommy makeover.mommy-makeover

As parents, we give our children every ounce of our time and energy around the holidays, just as we give them all throughout the year. One of the most common obstacles to having surgery is finding the time to devote to yourself. Although this is a problem for both men and women, the data shows women do the majority of the caretaking of the household and of the children, so it doesn’t surprise me (or probably you as the reader) that finding time for surgery is very difficult for mothers. If you are like my wife, it’s “go-go-go” from sunup to sundown. I am encouraging you – as I encourage her – to take time for yourself. Schedule it and find a way to do it, because it’s worth the effort.

A mommy makeover entails two main procedures, with one involving the breasts and the second involving the stomach. For the breast portion of the surgery, some women need breast augmentation while others need a lift or lift with augmentation. This depends on the anatomy and how the breast has changed with pregnancy and/or nursing. You can opt for a mini tummy tuck or a full tummy tuck, but I’ve found that a majority of women choose the full tuck after pregnancy. The mommy makeover must be performed in a surgical center under general anesthesia. The surgery takes between three and five hours. The downtime associated with the mommy makeover is between one and three weeks, depending on the procedures performed. Additionally, you should refrain from lifting anything greater than 20 pounds for six weeks afterward.

While it is true that a mommy makeover requires some downtime, it is our experience that the amount of help needed in those first few weeks after surgery is far outweighed by the boost in self-esteem and confidence that the women in my practice gain after a mommy makeover.

This year, make some “me time” and boost your self-confidence so you have more to give of yourself in the years to come. As always,

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Breast Reduction for Males – Learn More About Gynecomastia

In November, I am focusing on the cosmetic procedures that are most utilized by men. One of the most common is gynecomastia surgery.

gynecomastia

Gynecomastia in men occurs in two main forms. The first is in younger men, where a small amount of breast tissue develops as a result of hormones. This usually does not bring any medical consequences, but becomes cosmetically unacceptable in its appearance. The second type of gynecomastia surgery in men is for excess skin or fatty tissue after weight loss or gain. When performed surgically, both procedures are similar, but the hormonal type of gynecomastia is usually performed on younger patients and is a smaller procedure then the post-weight loss or gain type of gynecomastia surgery.

Most of my gynecomastia patients come in saying that they don’t like the way the chest area looks with their shirt off, and some even have what they consider to be an unacceptable appearance while clothed. The goal of gynecomastia surgery is to remove the excess breast tissue, fat or skin to give the male chest a more masculine appearance.

The procedure takes approximately one to two hours in the operating room depending on how extensive, and the recovery is one to three weeks.

Please call my office to schedule your complimentary consultation if you are interested and cosmetic gynecomastia surgery.

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Growing Popularity in Plastic Surgery for Men – What Are the Trends?

According to a report from the American Society of plastic surgeons, there were 15.6 million cosmetic procedures in 2014. Of these procedures, 1.7 million were surgical and 13.9 million were considered minimally invasive. We talk a lot about cosmetic procedures for women, but for November, we’re going to focus some attention on the other half of the population: men.

The top five cosmetic surgical procedures for men in 2014 were nose reshaping, eyelid surgery, breast reduction, liposuction and facelift. The top five minimally invasive procedures include Botulinum Toxin Type A (Botox, Dysport, or Xeomin), laser hair removal, microdermabrasion, chemical peels and fillers.

facelift-for-men

tummy-tuck-for-men

From a surgical perspective, nose reshaping or rhinoplasty can be performed in most age groups and is usually a procedure done to improve the overall contour or size of the nose. The width length or a type of dorsal hump can be improved with rhinoplasty. Eyelid surgery candidates are usually a more mature population, who seek help with laxity in the skin on the upper eyelid or bags or laxity on the lower eyelid. Breast reduction in men can be performed after massive weight loss or in men with abnormal tissue called gynecomastia. Liposuction is the fourth most common procedure performed on men. It can be performed on the flanks or abdomen to reduce fat deposits. Rounding out the top five is facelift, which is a similar procedure for men and women, but special care must be taken in men because of their hairline.

For minimally invasive procedures, the overwhelming top spots goes to the botulinum toxin type A with more than 400,000 men receiving this procedure in 2014. Botulinum toxin inhibits muscle movement and is commonly performed to decrease lines in the area between the eyes, the forehead and around the eyes on the sides. Other areas that can be treated include the jaw muscles, which can be prominent in men. Botulism toxin can be used to inhibit some of the muscle contraction in this area, thereby decreasing the thickness of the muscle improving the contour of the face. Laser hair removal is usually performed on the beard area or other areas such as the back where hair is undesirably located. Microdermabrasion and chemical peels are usually performed by an esthetician associated with a plastic surgeon or dermatologist. Rounding out the top five are soft tissue fillers. Men with a desire for improving the lines around the mouth, or giving a lift to the cheek area are interested in soft tissue augmentation such as Juvéderm, Restylane or Voluma.

I’ve included a few before and after pictures specifically for men, but if you would like a consultation for any of these surgical or minimally invasive procedures, please call our office at 775-398-4600 and make an appointment for your complementary consultation.

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Are you a good candidate for breast revision surgery?

breast-surgery

There are many reasons to have revisional surgery for the breasts. Having previous breast augmentation, breast lift, breast reduction, or surgical procedure such as breast biopsy or lumpectomy may make you a candidate for a revision.

Breast augmentation revision can be performed for patients who would like a different size implant or a switch between saline and silicone. These procedures can also be performed for someone who may want to switch out a silicone implant for one of the new gummy bear silicone implants. Over time, the concept of ideal breast appearance can change for an individual. As women mature, their bodies change. Additionally, women may decide they want the breast to be smaller or larger. This is the most common reason for breast revision surgery after breast augmentation.

If you have had a previous breast lift, you may choose to have revisional surgery years later. As gravity has a continued effect on the breast itself, some people want to have their breasts lifted again. As women mature, have children, breast feed, have hormone changes and gain or lose weight, the breasts go through significant changes. Additionally, as women go through menopause, the dense breast tissue changes to a less firm fatty tissue adding to the sagginess of the breast. Another reason for revisional surgery after breast lift may be to improve unwanted scarring. With surgery, there is always a scar. At times, we can improve upon the look of a scar by revising it.

Breast reduction is another reason to have revisional breast surgery. There are many cases of women who have had breast reduction and, as the body changes with pregnancy, nursing, or maturing, they may have enlargement of the breasts again. This is usually related to weight gain or loss but may be a natural hormonal change for some women. A revisional breast reduction can also be performed if there is asymmetry in the breast from a previous procedure. If one breast is larger than the other or one is slightly higher, it can be made smaller or lifted higher.

People will also visit us for breast revision surgery after medical procedures that have been done to or around the breast which cause abnormalities in the contour. Revisional breast surgery can be done to improve the contour irregularities after breast biopsy, lumpectomy or from removal of other skin cancers on the breast.

If you have any questions or concerns regarding revisional breast surgery, please contact me, Dr. Timothy Janiga for your complementary cosmetic consultation.

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Breast Reconstruction Options Explained

In honor of October, which is Breast Cancer Awareness Month, I thought we would review a little bit about breast cancer reconstruction. My practice is about 30 percent breast cancer reconstruction, and I do most types that are available.

breast-reconstruction

Breast cancer reconstruction is the general term for reconstruction of the breast after cancer. It can come in many forms which we will review here.

First, there can be small abnormalities of the shape of the breast after a Lumpectomy. Lumpectomy is done when there is a small focus of breast cancer that needs to be removed. In this case, the entire breast does not have to be removed. Radiation may or may not follow. Lumpectomy scars can be indented or make the breast appear smaller on one side than the other. We use different techniques to give the breast a more natural shape after surgery. Sometimes an implant is needed, but at times we can take fat from another location on the body and graft the lumpectomy area for a more rounded shape. At times, we need only scar revision after lumpectomy to regain a more natural shape.

Breast reconstruction is commonly done after mastectomy on one or both sides. There are multiple techniques for mastectomy and reconstruction. Let’s first discuss the mastectomy. A mastectomy is when the breast tissue is removed either for an occurrence of breast cancer or for the prevention of breast cancer (in genetically susceptible individuals). The overlying skin is left intact and is called the skin flap, but most of the time the nipple/areolar complex needs to be removed as it contains breast tissue. Once your breast surgeon/general surgeon performs the mastectomy, I will usually come in on the same day and perform part of the reconstruction. Please be aware there are times where we are unable to do reconstruction at the same time; this will be determined by you and your doctors.

With most breast cancer reconstruction, a temporary expander is placed under the skin flaps during surgery. The expander is then gradually inflated with saline over multiple weeks after your surgery to stretch the skin out to allow for a larger permanent implant to be placed later. The expansions are done in the office approximately every two weeks. Once the desired size is reached using the expander, you will return to the operating room and have the expanders removed and permanent implants placed. Some women decide this is where they would like to stop, but other women proceed with grafting and tattooing for nipple areolar reconstruction, and sometimes fat grafting for contouring of the breast.

Sometimes, more involved procedures need to be performed for reconstruction that include a latissimus flap where the latissimus dorsi muscle from the back is moved around toward the front to give more volume or coverage. This is particularly needed after a mastectomy that is accompanied by radiation. Radiated tissue is thinner and, at times, we will need more tissue to help maintain as natural of a reconstruction as possible.

Less commonly, but also possible is a TRAM flap for breast cancer reconstruction. This is where tissue from the abdomen is used instead of the back. Your surgeon will have different reasons based on your anatomy for using each type of procedure.

The government has mandated that breast cancer reconstruction be covered under all health insurance plans. This is been in effect for many years. If you have breast cancer in one breast, insurance companies are also mandated to cover a “matching procedure” on the other side to decrease or increase volume so that the reconstructed and natural breast are as close as humanly possible to each other in their appearance.

If you or a loved one has questions about breast cancer reconstruction please make an appointment with me and your breast surgeon to discuss.

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The beauty of a mommy makeover

Mommy-Makeover

The mommy makeover is one of the most common procedures plastic surgeons – including myself -perform. The mommy makeover is a combination of breast surgery and tummy tuck to restore the shape of the breasts and stomach to their pre-pregnancy states.

The breast surgery can either be a lift, a lift with implants placed or can involve surgery to the nipple areolar complex if needed. Some women only need the breasts repositioned after pregnancy. The milk engorgement, nursing, hormones and changes that occur for the breasts during pregnancy and nursing can make the breasts feel and look flatter and lower than prior to pregnancy. This is also something that naturally happens as we age, so there can be a combination of factors at play. In this case, a breast lift alone may be the only breast surgery needed.

Sometimes, projection of the breast is the major issue and an implant can be placed under the muscle or on top of the muscle to regain some of the projection of the more youthful breast. There are times when both a lift and augmentation are needed to achieve desired result.

One area that we do not talk about as much is the nipple areolar complex. The nipple itself can become elongated from nursing and hormone changes, and the areola itself can look larger once the breast has been stretched with pregnancy or weight gain. The areola itself can be reduced in size, as can the nipple. This can be done in combination with either a breast lift or a breast lift with augmentation, and can be performed alone also.

For the tummy tuck portion of the mommy makeover, there are also a couple of different options. The first is a mini tummy tuck that can be performed through a smaller incision like a C-section scar. This can be performed for women who have had C-sections or for women who have not. This is less invasive than a full tummy tuck, but not everyone is a candidate. A full tummy tuck is a longer incision than the mini tummy tuck incision and can incorporate an old C-section scar and revise it. Both of these surgery options can be performed in women with and without C-sections and both involve removing the excess skin on the abdomen. One area of the tummy tuck that most people are not aware of that I commonly do is a diastasis repair. The diastasis is the longitudinal fibrous tissue of the abdomen that separates the “six pack” of the abdominal muscles, and has commonly been spread by the stretching of the abdomen with pregnancy. When women say they cannot get their waist back after pregnancy, this is usually why. The fibrous tissue between the abdominal muscles has been spread out, and no amount of sit-ups will return the fibrous tissue to its original state. With a tummy tuck, I can go in and repair the diastases, essentially cinching the waste back down to give women back their natural hourglass curve.

The mommy makeover is one of our highest satisfaction procedures. To see what type of breast and abdominal surgery combination is right for you, please come in for your complimentary consultation with Dr. Timothy Janiga.

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