Planning Your Breast Augmentation Consultation

October 15, 2018 sieberps

Your first step in a breast augmentation procedure is a one-on-one consultation with Dr. Sieber so that you can discuss what you hope to achieve from your results. You can expect this to be an in-depth conversation that has many different facets, but there are a few things that are most important when it comes to your consultation. Here are some things to be prepared for as you schedule your appointment.

Your Results

The most important part of your procedure is coming to an understanding with Dr. Sieber about what you hope to achieve from your breast augmentation. This can include deciding on your implants, techniques, and intended results. Dr. Sieber uses Vectra 3D to assist with this process, giving you a virtual idea of what results you can expect with your chosen factors. This technology can be invaluable when trying to get on the same page and describe exactly what you would like your new breasts to look like.

Your Candidacy

Breast implant surgery is one of the most popular plastic surgery procedures from year to year, but it might not be for everyone. Dr. Sieber will thoroughly examine your medical history to make sure there are no factors that could compromise your results or put you at risk. Another consideration is whether your results are achieveable, and your outlook on your recovery and long-term results. This discussion of candidacy is not used to prevent you from undergoing the surgery, but rather to professionally recommend the best procedure for you and your intended results.

Your Procedure

After establishing these two points, Dr. Sieber will plan an ideal surgical process for you and your preferred outcomes. This can include decisions about implant placement, incisions, and any additional steps that can benefit your results from breast augmentation. Because every patient is unique, so is their breast implant surgery. Dr. Sieber can recommend the best surgical technique that fits your implant type and intended outcome, as well as make sure that you understand each step of the surgical procedure.

Beginning your breast augmentation process can be an exciting time, but it’s important to be prepared for the important conversations that take place during a consultation. Be sure to keep in mind the above points and ask any and all questions you may have, so that Dr. Sieber can reassure any concerns and understand your anxieties. To schedule your consultation, contact our office by calling or filling out our online form.

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What You Can Gain with A Tummy Tuck Procedure

August 21, 2018 sieberps

Although the tummy tuck is one of the most popular plastic surgery procedures, there can still be a lot of misinformation about what it is and what it does. The good news is that patients can gain a lot with a tummy tuck. This procedure is one of the best ways to overhaul the abdominal area through surgical techniques that have a lot of benefits. Here’s what you should know about what a tummy tuck procedure can do for you.

Cosmetic Benefits

Most otherwise-healthy people have a little extra fat and skin around their stomach and would most likely get rid of it if they could. A tummy tuck is very effective at removing extra skin and fat that can most commonly be the results of pregnancy and childbirth for women. A tummy tuck procedure can surgically remove fat and excise any extra, baggy skin, and some stretch marks can even be removed if they’re below the belly button. Tummy tuck techniques have come a long way, and any scarring can usually be hidden with clothing or within the natural folds of the skin. That means you’re left with a new, slim, contoured abdomen that can leave people guessing.

Medical Benefits

What most people don’t realize is that tummy tucks can do a lot for your body’s function as well. In the case of pregnancy and childbirth, the abdominal muscles can become stretched and ineffective during the process, meaning they can’t be restored with just diet and exercise. A tummy tuck can tighten these muscles with sutures, which can have many medical benefits. For example, many postpartum women suffer from urinary incontinence or back pain because of a weakened abdomen which leaves the core muscles with less support. Tummy tucks have been shown to lead to a large improvement in these conditions.

The best way to see what a tummy tuck can do for you is through a consultation with Dr. Sieber, a top plastic surgeon in the San Francisco Bay area with many years of experience helping his patients achieve great results. Contact us to schedule your appointment at our San Francisco office.

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Neuromodulators vs. Fillers: What’s the Difference?

August 1, 2018 sieberps

If you’re new to the world of cosmetic treatments, it might seem like there are tons of injectable options. It can become a little overwhelming, but it’s important to know that there are two major types of injectables and that they accomplish different things. Here’s a guide to consider while you look at your treatment options with Dr. Sieber.

What are neuromodulators?

These injectable options commonly go by their brand names like Botox®, Dysport®, or Xeomin®. While there are slight differences that might make one a better option for you, they all function in virtually the same way. They’re called neuromodulators because they block the receptors in muscles that receive signals from the brain for movement. These injectables are derived from the bacteria that causes botulism, but they’re perfectly safe in the hands of a professional and highly effective at preventing unwanted movement. This can be a great cosmetic treatment because it can relax muscles that cause frown lines or crow’s feet over a lifetime, smoothing out the areas prone to frequent movement or contraction. Neuromodulators also have many medical uses, like treatment for migraines, muscle spasms, and overactive sweat glands.

What are dermal fillers?

These injectables are a little more varied in their technique and composition, but they generally fall under a handful of popular families like Restylane® or Juvéderm®. These brands and others have many different injectable options that are formulated for different areas of the face, hands, or other areas, and can be made of substances like hyaluronic acid, poly-L-lactic acid, or calcium hydroxylapatite. Dermal fillers use these substances to create volume underneath the skin, which can effectively smooth out wrinkles and sagging that is usually caused by a loss of volume over the course of aging. Dermal fillers can have just as many creative, off-label uses as neuromodulators, including “liquid” rhinoplasties or chin augmentation.

Which is best for me?

As a very general rule, neuromodulators most benefit the upper face (forehead, glabelal, crow’s feet) while dermal fillers most benefit the lower face (cheeks, tear troughs, lips, etc), but each can be tailored to your unique needs. The best way to determine which injectable will benefit you best is through a consultation with Dr. Sieber, who can examine your treatment area and aesthetic goals to recommend the right product for you. There are many that exist, but Dr. Sieber can ensure you’re educated about your options and treatment plan.

To consult with Dr. Sieber and see which options are best for you, contact our San Francisco office and schedule your appointment at our state-of-the-art aesthetic facilities.

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What You Should Know About the Mommy Makeover

May 7, 2018 sieberps

Today, the mommy makeover is one of the most popular combination plastic surgery techniques, created to address common physical issues faced by women who have experienced pregnancy. This personalized combination of procedures can help to improve the physical changes that linger after pregnancy, which can include sagging breasts, excess fat deposits, and lax skin. Read on to learn more about this procedure, and if it’s right for you.

Components of a Mommy Makeover

During pregnancy, the body goes through many changes. The areas that are most commonly affected include the breasts and the abdominal region. A mommy makeover can include a number of plastic surgery procedures to help address your “problem” areas, and may include the following procedures:

  • Breast Augmentation– can restore fullness and lost volume to the breasts using implants.
  • Breast Lift– help to lift sagging skin and the breasts to a more youthful position.
  • Breast Reduction– can create smaller breasts for those with disproportionately large, uncomfortable breasts.
  • Tummy Tuck– removes excess abdominal skin and tightens abdominal muscles for a flat midsection.
  • Liposuction– removes excess, stubborn fat deposits from anywhere on the body.

The mommy makeover is highly individualized, so no two mommy makeovers will be the same. During your consultation, you can discuss your personal aesthetic goals, and Dr. Sieber will create a customized mommy makeover treatment plan just for you.

Are You a Candidate?

Women who are healthy and wish to restore their pre-baby figure can often benefit from a mommy makeover. The best time to undergo this procedure is when you are done having children, and at least six months after you have finished breastfeeding. This is because future pregnancies can undo the results of your mommy makeover. A consultation with Dr. Sieber can help to best determine if a mommy makeover is right for you.

If you are interested in learning more about the mommy makeover for a boost in confidence, contact our San Francisco office today to schedule a consultation with Dr. Sieber.

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Get Silky Smooth Skin Just in Time for Summer

March 28, 2018 sieberps

Summer is just around the corner, which means more time spent in swimsuits! However, this also requires showing more skin, and those with unwanted body hair are stuck with taking the time to remove it with shaving or waxing. However, there is another option that can save patients overall time and money with long-term results: laser hair removal! Read on for some things you should know about this treatment.

More than One Treatment is Needed

Laser hair removal usually requires 4-8 treatments spaced 3-6 weeks apart. Because hair follicles have different growth cycles, treatments must be regularly scheduled to see best results. A noticeable reduction in hair growth can often be seen after 2-3 treatment sessions.

It Works Best with Darker Hair

Lasers target pigment or color in the hair follicles, so white or blonde hair might not respond as well to treatment as darker hair colors. Skin color can also play a role in specific lasers, however, modern lasers can deliver good results to people with all skin tones.

Side Effects are Temporary

Possible side effects of laser hair removal include mild swelling at the treatment site, slight redness, and temporary skin irritation and pigment changes in those with darker skin. An ice pack or cool compress can help with irritation.

Keep Out of the Sun

Following laser hair removal, it is very important to avoid sunbathing or tanning beds. Sunscreen must be worn after each treatment to help protect the skin.

Laser hair removal is an easy and effective option for removing unwanted body hair for both men and women. If you are interested in scheduling a laser hair removal consultation, contact our San Francisco Plastic Surgery office today.

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Your Mommy Makeover Questions Answered

February 20, 2018 sieberps

Mommy makeover procedures have become popular with women who are unhappy with their post-pregnancy bodies. Pregnancy and childbearing can take a transformative toll on a woman’s body, and sometimes diet and exercise just aren’t enough. You might have heard from mommies who have undergone a makeover and have questions of your own. Here are some common ones.

What is a Mommy Makeover?

A mommy makeover is just that— a makeover. It’s a catch-all term for a set of surgical procedures that have the goal of restoring a woman’s post-pregnancy body and are often done all at once or within a couple sessions. This makeover is customized to fit the needs of your post-pregnancy body, which can vary since pregnancy and childbearing affect every woman’s body differently.

What can be fixed with a Mommy Makeover?

The most common areas treated with a mommy makeover are those that take the hardest impact during pregnancy. This includes the stomach, breasts, and lower body. The procedures which correct these include:

  • A tummy tuck, which can tighten the underlying abdominal muscles and remove fat, excess skin, and stretch marks.
  • A breast augmentation, reduction, or lift, which can restore the breasts to their pre-pregnancy shape and size.
  • Liposuction procedures, which can remove excess fat from various areas that is stored during childbearing and can be resistant to diet and exercise.

These various procedures can often be completed within one session by a skilled surgeon, meaning your downtime and recovery will be reduced. Many mommies also undergo nonsurgical procedures as part of their makeover process if they are beginning to feel the effects of aging or stress.

What should I consider before I undergo a Mommy Makeover?

Your overall health is the most important thing to consider before you commit to your procedures. It’s very important that you’re able to undergo invasive surgery and successfully heal from it, as this will have the most impact on your results. You should also consider your reasons for pursuing a mommy makeover, and be ready to discuss them during your consultation with Dr. Sieber. To make sure you get the best out of your results, you should make sure you have no further plans for pregnancy, as this means you might require another procedure.

What is the recovery from a Mommy Makeover like?

Your recovery time will depend on how extensive your makeover is. Healing your incisions might require maintenance of any drains that are placed to help collect fluid that builds up, and wearing compression garments to aid blood flow. You’ll need to refrain from certain activities that might agitate the surgical sites, and any pain can be managed with prescribed medications. Be sure to follow any instructions given by Dr. Sieber after your procedure.

If you have any further questions and would like to discuss them, contact our office for a consultation with Dr. Sieber.

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Three Ways to Rejuvenate Your Hands

February 20, 2018 sieberps

Hands can show a lot about a person. We use them constantly, and they are often the first thing to show signs of aging. They can lose volume over time and become ropey, with visible veins and tendons. They are often left to the drying elements if you don’t wear gloves regularly in cold weather. They can also be subject to more sun damage than other parts of the body, since many people forget to put sunscreen on their hands or it washes off. Whatever the cause, these options for hand rejuvenation can help restore youthful, beautiful hands.

Dermal Fillers

These injectables use natural or synthetic substances to add volume back to areas that have lost it. The most common filler used on the hands is Radiesse, which uses calcium hydroxylapatite, a compound found in the bones. Although it lasts up to a year and then is naturally absorbed into the body, it’s well known to produce a natural and subtly-voluminous result. If you would like to try something noninvasive, a filler might be a good option.

Surgical Fat Transfer

For a longer-lasting result, fat transfer can be used. This is usually done by removing fat through Liposuction from a fatty area of the body, like the abdomen, buttocks, or thighs. The fat is then optimized, meaning that any excess fluid or tissue is removed from the fat, and is then carefully injected into the hand where volume has been lost. While not all of the new fat is taken in by the body, it will exist in the hand long-term, and the cells will change with weight loss or gain. Since a Liposuction procedure is necessary, this option is preferable for patients seeking other fat removal procedures that can be done in conjunction.

Laser Skin Treatments

Along with volume restoration, skin treatments can give your hands new life. Laser treatments with BBL (Broadband Light) target the pigment in the skin, removing age spots and sun damage. While fillers and fat transfer can restore volume, they can’t remove the damaged, aging skin that can also contribute to aesthetically unpleasing hands. Laser treatments might take multiple sessions before the best results begin to show, but are quick, easy, and require no downtime.

Our hands can take a beating over the course of a lifetime, so be good to them! Moisturize regularly, and contact our office if you would like to schedule a consultation with Dr. Sieber to discuss rejuvenating your hands.


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Men, Plastic Surgery, and Gynecomastia

February 9, 2018 sieberps

While many men have opted for cosmetic procedures in the past, they have made up a small percentage of the statistics until now. While it’s no surprise that men are subject to the same poor self-image and process of aging as women, it is a surprise just how quickly men are trending towards being a substantial demographic of patients. According to the American Society of Plastic Surgeons, men made up 72% of the total number of hair transplants performed in 2016, along with 55% of chin augmentations, and 25% of rhinoplasties.

Many non-surgical procedures, like injectables or chemical peels, can be specifically tailored to men due to differences in skin and aesthetic goals. Some surgeons even offer male-specific procedures like calf or pectoral implants, and— perhaps the most popular selection— gynecomastia treatments.

What is Gynecomastia?

Just like women, men can be subject to change in their fat and breast tissue for many reasons. Age, genetics, hormone changes, weight, and certain medications can cause male breasts to develop in unwanted ways. Many men experience this during puberty and early development but grow out of it. Many don’t. Unfortunately, it can be extremely difficult to get rid of through diet and exercise, because often the cause is within the breast tissue which can’t be naturally reduced like fat. Otherwise healthy, fit men often struggle with breast tissue that protrudes or appears large and fatty.

How is it treated?

Treatment for gynecomastia is dependent on the cause. If it’s the result of fat, then a Liposuction procedure will be beneficial. Breast tissue, however, is denser and more fibrous than fat and has to be surgically removed. If extra skin is present, it will need to be surgically removed as well. Puffy or large nipples can also be fixed through surgery. Different incision options exist to best suit the anatomy being treated.

What are the results like?

Since the fat and breast tissue that causes gynecomastia are removed during the treatment, the results are long-lasting. The cells that store the fat are absent and can no longer swell with weight gain, meaning the breast region is now contoured over only muscle and underlying tissue.

This procedure can be life-changing for men who struggle with feeling like they have “man-boobs” and can’t get rid of them. Thanks to changing ideas about what plastic surgery can do for men, more patients are pursuing these procedures that can change their self-image and overall profile.

If you are considering a gynecomastia treatment and would like to schedule a consultation, contact our office today!

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Who Needs Drains? The Drain Less Tummy Tuck Is Here to Stay!

October 31, 2017 sieberps

If you’ve been considering a tummy tuck or mommy makeover, it is very likely that you have come across information about drains during your research, or saw photos on RealSelf or Instagram show patients after tummy tucks hauling around their drains. Well those days are gone! If you’re thinking about getting a tummy tuck but don’t like the idea of drains, then keep reading!

For many procedures, surgeons commonly put temporary drains in to collect fluid which may accumulate under the skin after the surgery. The reason they do this is because the body does not like to have spaces filled with air, so instead it produces fluid to fill that area. Anything that is removed from the body, whether it’s a lung or some fat, is immediately replaced by fluid to fill in the empty space. Most of the time the fluid just occupies the space until the body is able to remove it and replace the fluid with scar tissue during the healing process. Sometimes there is too much fluid for the body to remove quickly and it gets trapped in the tissue resulting in something called a seroma. A seroma is simply a collection of fluid the body placed there to fill a space during the healing process. To avoid this from happening, surgeons started using drains to collect excess fluid so that it didn’t get trapped underneath the skin. Having drains works great for removing unwanted fluid, but they are a bit of a nuisance for the patient!

In order to reduce the amount of space left after a tummy tuck, something called a progressive tension suture (or quilting sutures) was invented. This suture acts like an internal tuft and results in less space into which fluid can collect. In most patients, when these progressive tension sutures are used during a tummy tuck, drains are no longer needed. Studies have shown that by adding these sutures, the incidence of seromas is drastically reduced whether or not drains are used.

Putting in the progressive tension sutures does add a little bit of time to the surgery, but in my opinion the benefits are worth it. The progressive tension sutures can also be placed in a very precise fashion to re-create the peaks and valleys of an aesthetically pleasing mid-section!

So if progressive tension sutures are so good, why are so many surgeons still using drains? This is in part is because surgeons tend to operate in ways that they feel are most reliable and predictable, and are slow and cautious to implement new techniques. I believe that it is important to be at the forefront of medicine and to adopt proven techniques which have been developed to improve the recovery process and optimize the surgical outcome.

If you’re thinking about getting a tummy tuck or a mommy makeover, ask if you’d be a good candidate for a drain-less tummy tuck. For more information or to schedule a consultation give us a call at 415-915-9000.

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Do Breast Implants Cause Cancer?

October 17, 2017 sieberps

The short answer: possibly, but the long answer is much more involved and not nearly as simple.

Although breast implants have been around since 1961, it wasn’t until 1997 that a woman was found to have developed a rare lymphoma called anaplastic large cell lymphoma (ALCL) related to her breast implants. Today this lymphoma is called breast implant associated anaplastic large cell lymphoma (BIA-ALCL). Reports in the recent media of breast implants causing breast cancer are referring to BIA-ALCL, not related to primary breast cancer. It’s very important that patients understand the difference between BIA-ALCL and breast cancer as they are two totally different entities with very different prognosis and treatments.

There are several factors which make the two cancers very different. The first is that because BIA-ALCL is a lymphoma, it is a disease originating from the immune cells in the body and not from the breast tissue.

To date there have been a little over 300 reported cases of BIA-ALCL worldwide in over 50,000,000 women with breast implants and they all have one thing in common: they all had breast augmentations with textured breast implants. As far as we know there has never been a case of BIA-ALCL in a woman who had smooth breast implants. So, what is it about textured breast implants that makes BIA-ALCL only occur in those patients? We believe the texturing on the breast implant allows for bacteria to hideout within the nooks and crannies within the silicone shell. Bacteria is smart and it knows that as soon as it’s in the body, the immune system will be looking for it. So is does something very unique, the few bacteria cells make a covering over the cells called a biofilm. This biofilm acts like a barrier between the bacteria and the immune system. So even though the body knows the bacteria is there, despite its best efforts, it can’t get to it to destroy it. What happens over time is that the normal immune cells get frustrated trying day and night to get to these bacteria so the immune cells mutate. This mutation then prevents the cells from acting as they normally do and over a long period of time can eventually lead to the formation of a lymphoma. Most women presenting with BIA-ACLC have had breast implants for 10-15 years before any symptoms appeared because the cellular transformation takes a very long time.

The promising news about BIA-ALCL is that it is a very treatable disease. Current studies recommend removing the breast implants as well as the capsule around the implants. This procedure is curative in the vast majority of cases.

So what is your actual risk of dying from BIA-ALCL if you have textured breast implants for your entire life? In order to understand this question we need to introduce a term called a micromort. 1 micromort is a 1 in a 1,000,000 chance of dying from a certain activity. The concept of micromorts was originally developed to help evaluate high risk activities such as mountaineering or skydiving, as well as other common everyday activities. For instance, drinking 0.5L of wine, living 2 days in NYC, riding a bicycle for 17 miles, riding in a car for 230 miles, or traveling by plane for 1000 miles all increase your risk of dying by 1 micromort. In terms of BIA-ALCL, the micromort risk for a woman with bilateral breast implants over her lifetime is only 0.4 micromorts. That means you’re 5 times more likely to die every time you drink a bottle of wine or every 4 days you’re in New York city than you are from BIA-ALCL related to textured breast implants!

So the short answer is although there are reports of breast implants causing cancer, the incidence of BIA-ALCL is extremely low and if a woman is diagnosed early, the disease is very treatable.

For more information on BIA-ALCL please read my article in the Aesthetic Surgery Journal as featured in Allure and Refinery29 entitled “What’s your Micromort? A Patient-Oriented Analysis of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).”

For more information on breast implants or breast augmentation surgery, give us a call at 415-915-9000 or send an email to

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