Actual patient with corrected breast asymmetry.

According to the statistics in Plastic Surgery, 88% of all women have different size breasts, also known as breast asymmetry. This includes breasts that are different shapes and sizes, nipples and inframammary creases at different levels, and variability in cleavages. When I see a woman in consultation, it is very important that I relate these anatomical features to her. Because it is impossible to correct all these differences, a surgical plan is developoed according to the woman’s priorities. I have found a careful and well thought out surgical plan enables my patients to have excellent results and an improvement in their preoperative asymmetries.  Please contact our office with any questions or concerns, or to schedule a complimentary consultation.

Please contact our office with any questions or concerns, or to schedule a complimentary consultation.

Dr. Robert Wald

Skin cancer today is quite prevalent. We are all exposed constantly to the sun. Many of us as teenagers and adults enjoy the benefits of a body that is tan and radiant. However, the sun damages our skin from its ultraviolet radiation and can cause skin cancer.

Black/brown lesions with irregular borders are suspicious for early cancer. Lesions that change in color or size are also of concern. When these types of lesions are seen, a biopsy is required. This is a simple procedure performed in the office. If the biopsy returns atypia, a excision of the area will be necessary. By early detection, lives may be saved and deformity minimized.

For additional information or to schedule a complimentary consultation, please contact our office, 714-738-4282

Dr. Robert Wald

Most of my patients think about using Botox in their mid to late 40′s or 50′s. This is the time facial wrinkles are quite prominent.  Even though Botox minimizes fine lines in the forehead, in the upper nose and crows feet, these lines are now permanent. I have found that by injecting these facial wrinkles earlier in their aging process (early to mid 30′s) this will delay and possibly prevent the deep wrinkles we develop later in life.  By paralyzing those muscles early, our skin will continue to stay youthful. NeuroToxins (Botox, Dysport) temporarily paralyze facial muscles.  Some of my patients have very strong muscles which accentuate the aging process. This can cause a scowling or angry appearance between the eyebrows and deep forehead wrinkles.  When I see a patient in their 30′s who have these types of muscles, I strongly suggest Botox for the reasons mentioned. This treatment plan may also delay fillers for the prominent lines that develop.  Please contact my practice with any questions or to schedule a complimentary consultation.

Dr. Robert M. Wald, Jr., MD

After performing facial rejuvenation procedures for over 20 years, I have now found fat injections to be a wonderful adjunct to improve my results.  Not only does fat improve volume, but it appears to have a regenerating effect on tissue adjacent to where the fat is injected.  Fat contains “adult stem cells” that are believed to elaborate growth factors and other as yet not clearly defined cellular mediators.  Numerous anecdotal and a growing number of scientific reports now support this idea.  It is my clinical opinion that fat improves skin quality and further enhances my results.

It is important that the patient realizes that more bruising will occur with fat injections versus fillers such as Juvederm or Restylane.  This procedure can be done under local or general anesthesia.  The length of time that fat lasts is also not exactly known but it can last for years.

Because fat is taken from the abdomen, thighs, flanks, or buttocks, a nice improvement in those areas is also obtained.

For additional information or to schedule a complimentary consultation, please contact our office, 714-738-4282

Dr. Robert Wald

Breast Reconstruction Surgery Images

Plastic surgeons for the last few years have human tissue (Acellular Dermis) available that enhances our breast reconstruction results.  This material (Alloderm), made by Life Cell, gives extra coverage and support in selected patients.  By placing this material under the breast skin and subcutaneous tissue we are able to help prevent rippling of an underlying breast implant.  This also is true for a very thin cosmetic patient.  Recent articles suggest that ACD may also help prevent capsular contracture.  Even though the results with ACD are still early, it appears that this material will continue to enhance our results.

Breast Revision procedures for post-breast reconstruction and post-breast augmentation are also enhanced by ACD.  Problems such as bottoming out, inframammary fold malposition and breast asymmetries can be corrected using this material.  There appears to be very few problems associated with ACD and it has been found to be extremely safe.  I have found ACD to be very helpful in problem cases.

Dr. Robert Wald

Today, most patients want facial improvement and a youthful appearance without surgery, discomfort or prolonged swelling and bruising. This can be accomplished with facial fillers (Juvederm, Radiesse).

As we age, the underlying facial soft tissue atrophies and we begin to hallow out. Laugh lines, crow’s feet and other facial wrinkles develop causing us to look older and less vibrant than we feel. Today, natural and biocompatible substances such as hyaluronic acid (Restylane, hylaform), calcium hydroxylapatite (Radiesse) and fat are helping to restore a more youthful appearance for millions of women and men. Research is ongoing, and new products are constantly being developed that further expand the choices available to physicians and patients.

Fillers are used to fill lines, wrinkles and lips. They may also be used to reduce the appearance of scarring caused by acne, chicken pox or injury. We also use them to augment cheeks and chins. One of the ways I am using fillers if for facial shaping. By building up the cheekbones and using hylaform to fill the indent in front of the jowls, disguising it, I can give the face a younger shape.

In my practice, a lot of patients point out to me red spots located on their faces and body. It is important to realize that some of these red areas may be early or actual skin cancer. The most common types of red spots are actinic keratosis (premalignant) and basal cell carcinomas.

It is very difficult for a patient to determine what these lesions represent. Typically, a red lesion that is present for many months, that itches, is scaly and flakes, is of concern. A strong history of sun exposure and a fair skinned individual are at high risk for developing these lesions.

When I see these lesions, a biopsy must be done to determine a diagnosis. In most cases, various anticancer creams can be applied to non-cancerous lesions. If a basal cell cancer is found, a minor surgery or radiation therapy is used to treat these cancers. It is important to realize that these cancers are not life threatening as long as they are caught early and treated. It is my advice that everyone examine their selves regularly and see their doctor for any suspicious lesions.

The cardinal feature observed in a skin lesion that proves to be melanoma is a change observed over a period of months. The time scale of the observed change is important. If a lesion grows so that it doubles its size within 10 days, it is usually an inflammatory (irritant) condition. If the lesion grows slowly that the patient or his relatives are unsure of any change, the lesion is often benign. However, medical advice should be sought regarding a lesion that doubles its size in 3 to 8 months. These symptoms may include growth in the diameter or contour of the mole, a change in color, bleeding, itching, ulceration, or the development of a palpable lymph node.

Growth (increased size) and color change (usually darker) are the symptoms most commonly seen first. They occur in over 70% of early, curable melanomas. Most lesions arise from a pre-existing mole, either on the trunk or leg. Please note that these facts and see your doctor immediately if you see these types of dark lesions.

Some people are born with noses that are quite large. Patients describe to me that their nose is like Pinocchio. What they mean is that their nose has a large bump and projects outward from their face. These people are very self conscious about their nose and would like their nose smaller and more shapely.

As a specialist in nose surgery I have treated hundreds of noses. By removing bone and cartilage from their noses, the nose is reduced in size and becomes much more pleasing and natural. The goal for this surgery is to make their nose fit their face and blend with the other parts of their facial anatomy. This surgery is very successful and allows these patients to develop a new self confidence.

There are multiple methods to improve our facial appearance. Today, we see many TV commercials and magazine ads showing wonderful results of facelifts that are inexpensive and require minimal surgery. I would caution consumers about surgeries that promise these great results. Good surgery requires time, expense and good surgical skill. Remember, it is your face that you are improving. Bad results can occur that may not be correctable. Your financial investment in your face will be worth every dollar you spend. Please do your research well.