April 21st, 2009 Robert Wald M.D.
Most breast reductions are performed at a hospital. However, breast reductions may also be performed in outpatient surgicenters.
The advantages of an outpatient facility is the privacy and personal care one gets when performing this surgery in this setting. The infections rate is less because in the hospital patients are sick and germs may spread. The surgical team is also the same providing consistent, expert care to the patient.
In my care, I only utilize Mesa SurgiCenter for these surgeries. This facility provides the advantages as described and gives the best possible patient care. Being associated with this facility, allows me the comfort and assurance that my patients will receive excellent care.
Dr. Robert Wald
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April 15th, 2009 Robert Wald M.D.
Patients who are faced with breast cancer and require a mastectomy, have many options for reconstruction. Our techniques continue to improve. One of the newest techniques is the use of alloderm or strattice dermal sheets of prepared tissue. By using these materials at the time of mastectomy with tissue expanders, a more natural breast shape and contour can be achieved. Immediate expansion of the overlying breast skin is accomplished. In patients that are candidates for skin sparring and nipple/areola preservation, a breast implant may be placed immediately and avoid the need for prolonged expansion.
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These regenerative tissues help mask implant palpability and visibility and bottoming out of the implant. In my experience, I have found these new tissues to be beneficial and improve my results in breast reconstruction.
Dr. Robert Wald
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April 15th, 2009 Robert Wald M.D.
The Miracles of Breast Reduction
In our society, large breasts are quite fashionable and emotionally uplifting to the patient. However, breasts can be too large causing multiple problems. The problems include shoulder strap grooving, back, neck and shoulder pain, headaches and occasionally shortness of breath. Some patients complain of poor posture and an inability to exercise because of the pain in their chest areas.
With breast reduction surgery, most of the symptoms disappear or are markedly diminished. This surgery is covered by most insurance companies when there is evidence of these problems. This surgery is performed as an outpatient and the patient is back to work within two weeks.
The patient must must accept scars on her breasts but these scars fade nicely over one year. I am amazed how much this surgery changes a woman life. These patients are now able to exercise, fit in normal size bras, and live their daily life without pain. It is for this reason, that I have found this surgery to be one of my most gratifying procedures.
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Dr. Robert Wald
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April 14th, 2009 Robert Wald M.D.
Women following childbirth develop aesthetic problems in their breasts, abdomen, and thighs. With pregnancy, women’s bodies stretch causing thinning of tissue, sagginess and stretch marks. Unfortunately, despite diet and exercise, the stretched and loose skin can only be corrected with surgery. Breasts also deflate following nursing which causes a decrease in breast size.
In order to correct these problems, breast augmentation, tummy tuck and liposuction may be indicated. All of these procedures may be done at the same time minimizing recovery time and cost.
Recovery time for all these procedures is approximately 2 weeks. Exercise may be resumed at 4 weeks. Women with young children should have help for one week. After this surgery, women are back to their pre pregnancy appearance.
Dr. Wald
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April 2nd, 2009 Robert Wald M.D.
Depending on the patients desire, a small amount of surgery can be performed to correct the aging skin of our face. With age, we develop loose skin of the cheeks with the development of prominent folds at the cheek-lip border. Some people prefer fillers to soften these indentations, other individuals prefer a tightening of the cheek skin which also improves the jowls.
Under local anesthetic, a small incision is made in the hairline. The skin is then freed from the underlying tissue. The tissue under the skin is then tightened and pulled toward the ear. The procedure takes one hour. There is minimal bruising and swelling and the person is back to work after 3 days. In the individual that has realistic expections, this procedure can be extremely satisfying.
Dr. Wald
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February 11th, 2009 Robert Wald M.D.
With the current economic conditions, people are afraid to spend a lot of money on plastic surgery. However, people continue to age and the lines, wrinkles and loose skin progress. A simplified face procedure can be done under local anesthesia and a weekend of downtime. This involves a tightening of the facial skin with a small incision in the hairline and lines of the preauricular area.
The results of this procedure along with facial fillers are quite pleasing. This approach allows the patient to enhance their appearance, feel better and with minimal cost and downtime.
Dr. Wald
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February 9th, 2009 Robert Wald M.D.
Many patients think that recovery from breast augmentation is 4-6 weeks. My patients, in most cases, can return to work in 3 to 5 days. The key to a fast recovery is the surgeons technique. By a meticulous, bloodless dissection, a pain pump postoperatively, and intraoperative marcaine in the breast pocket, patients have minimal pain and bruising. Ice packs over the breasts after surgery minimize the swelling and discomfort. Most patients are amazed by their fast recovery and minimal pain.
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December 11th, 2008 Robert Wald M.D.
The first thing the patient notices in the aging process is the neck. Most commonly in older patients, loose skin is produced in the lower neck area. In younger patients, excess fat is usually located throughout the neck area.
In order to correct these problems, either liposuction or neck lift would be required. Younger patients will require only liposuction to reduce the fullness or fat located throughout the neck. Skin contraction following this procedure will produce a nice contour. Older patients will require a neck lift. This will require small incisions behind the ear and in the hair line. Excellent results are accomplished in both procedures. Minimal down time is required for both procedures. Most patients need 3-5 days before going back to work.
Robert Wald
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December 11th, 2008 Robert Wald M.D.
Many people think that plastic surgery is best performed in highly affluent areas such as Beverly Hills, Newport Beach, and New York City. Perspective cosmetic patients have preconceived ideas that these cities are the hot beds for this type of surgery. What they don’t understand is that their local community plastic surgeons may perform cosmetic surgery as well, or better than surgeons located in these areas.
Patients should do the appropriate research for their cosmetic surgeons. There are many surgeons right in their communities that are extremely qualified to perform their cosmetic surgery. Board Certified Plastic Surgeons are all trained well and have the expertise to perform these surgeries.
Patients should do the homework prior to selecting their surgeon. Patients should evaluate their doctor’s credentials, their Board Certification and their experience. By visiting the surgeon, the patient must be comfortable with the surgeon. Prices will vary depending on location. An experienced competent surgeon will not be the cheapest in town.
Robert Wald
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November 24th, 2008 Robert Wald M.D.
Today skin cancer is very frequent. This is due to a large degree from excess sun exposure we have growing up. Occasionally these cancers can be herefitary. Most patients believe that their dermatologists are the best doctors for treating these problems. However when one realizes the extensive surgical training a plastic surgeon receives, it is easy to understand that the quality of surgical care is superior.
Not all plastic surgeons trat skin cancers. For this reason, the patient must inquire of that doctor before making an appointment.
In my practice I see several patients a day for facial and body lesions. My first step is to determine whether a biopsy needs to be done. If the lesion appears to be suspicious for skin cancer, a shave biopsy is performed and the ledion is sent to the lab. After the pathologist examines the lesion and the diagnosis is skin cancer, treatment options are discussed. In most cases, minor surgery is required to remove the lesion. Frozen sections or immediate pathological examination is performed to insure free margins around the tumor. At this time, reconstruction using skin flaps or skin graft is performed. After several months of healing, these surgical scars blend well with minimal, if any deformity. The doctors in my community realize the superior cosmetic appearance following a plastic surgeons care and treatment of these problems. It is important that the patient realizes the advantages of a plastic surgeon performing skin cancer excision and reconstruction.
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