Body Contouring in San Diego & La Jolla

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Body Contouring at True Beauty with Dr. Brian Reagan

Dr. Reagan is a true expert in Body Contouring.  He is a graduate of the Plastic Surgery Residency Program  at The University of Texas at SouthWestern in Dallas (2000). This program was recently voted #1 Training Program in the country by other Plastic Surgeons (The US News and World Report, 2014).  Be assured that Dr. Reagan worked intensely  with some of the top body contouring surgeons in the world before starting his San Diego private practice in 2000.  Dr. Reagan created True Beauty to provide a complete array of services to achieve outstanding body contouring results.  Dr. Reagan has lectured nationally on new techniques in body contouring (see CV) .

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What is Body Contouring?

Body Contouring encompasses all the technology and surgical techniques designed to improve the contour of the body.  Breast procedures will be discussed separately under BREAST.

 

Why True Beauty with Dr. Brian Reagan is a great place to do Body Contouring

Dr. Reagan is a board certified Plastic & Reconstructive Surgeon with the American Board of Plastic Surgery.  When it comes to body contouring , the type of board certification means a lot!  Other boards may not reflect the breadth of training in body contouring.  Dr. Reagan  developed his surgical skill and judgement over an intense 9 yr training period at some of the finest institutions in the country.  Other boards entail only a few years in training.  And Dr. Reagan is a member of ASAPS, a society of plastic surgeons with a focus on aesthetics.   Dr. Reagan offers a full breadth of  non-invasive, minimally invasive, and surgical body contouring techniques.  You can be confident that the advice you receive will be thorough and unbiased.  Without limitations, True Beauty can offer what is best for you!

NON-INVASIVE BODY CONTOURING

There are several different non-invasive body contouring technologies available.  The common thread among these devices is the delivery of some form of energy across the skin towards the underlying fat or muscle.  The limitations pertain to the avoidance of injury to the skin.  Too much energy can lead to too much pain and ultimately skin injury.  Too little energy can lead to insufficient result.  Given that these technologies do not require direct physician supervision, it is important to go to a reputable practice with sufficient clinical experience.  Below are some examples of currently available non-invasive technologies.

CoolSculpting(Cryolysis) – Fat cells are more fragile to cold than normal skin cells. Cryolysis or freezing of fat leads to breakdown and ultimate absorption of fat cells. Applicators are designed for each body area. The coolsculpting reatment takes 1-2 hours. Areas commonly treated include the abdomen and flanks. Treatment pain is mild to moderate. Treatment areas may feel firm for a few weeks as the fat is reabsorbed. Final results will be achieved after several months. Multiple treatments to same site may be necessary to get optimal results.

Thermage(radiofrequency)- Thermage applies radiofrequency across the skin to the deep dermis and muscle.  Treatment areas are typically jowls and neck.  Treatment can be painful, and results are minimal at best.  Multiple treatments are typically necessary.  Managing patient expectations is critical to achieving success with use of Thermage.

Ulthera/Ultrashape(focused ultrasound)-Ulthera delivers focused ultrasound to the subcutaneous fat.  Treatment pain can be significant necessitating oral or local anesthesia.  Bruising is possible.  Treatment areas typically include face, neck, abdomen and flanks.  Results seem to be better in the body than the face.  Multiple treatments are likely necessary to yield optimal results.

iLipo- This is a non-invasive system that combines several modalities to achieve fat reduction.  The technology combines a visible red and infra-red light with radiofrequency to “stimulate” the fat cells to release their contents and shrink.  The radiofrequency attempts to stimulate collagen formation.  Lymphatic massage and vacuum treatment (aka endermologie)  are then employed to enhance results and improve cellulite.   It is simply too early to comment on the effectiveness of iLipo, though results are likely minimal at best.

TICKLE LIPO LESS INVASIVE BODY CONTOURING

DSCN0956Dr. Reagan appreciates that some patients are looking for a less invasive approach to body contouring.  The avoidance of general anesthesia and a shorter recovery time are common requests.  The answer is Tickle Lipo (Infrasonic nutational liposculpture).  By vibrating in a specific manner,  Tickle lipo is less painful than traditional liposuction.  Thus, use of oral analgesia (percocet)  along with local tumescence is sufficient to perform Tickle Lipo.  And it is Dr. Reagan’s opinion that Tickle Lipo causes less bruising with subsequent less pain and recovery.  Results are immediate!  Special compression garments are worn for 2 weeks.  Patients can return to work after 1-2 days compared to a 1 week recovery for traditional liposuction. The harvested fat is healthy and can be re-injected into the face (autologous fat grafting)during the same procedure.  Dr. Reagan limits the amount of fat removed at any one procedure to 2 liters, a volume considered moderate by most surgeons.  The most common areas treated include the abdomen, flanks, neck, and thighs.  Gynecomastia can be treated effectively for most patients.  Dr. Reagan will stage the procedure in cases of anticipated volumes of fat aspiration greater than 2 liters.  Please see some of our amazing results with Tickle Lipo and call for an appointment today!

SURGICAL BODY CONTOURING – The Gold Standard!!!!!!

Sometimes it is necessary to “do more” to get great results.  When it comes to body contouring, getting transformational results usually means surgery under general anesthesia.  Dr. Reagan performs all his general anesthesia cases with a board-certified anesthesiologist at a AAAASF-certified facility.

Abdominoplasty

An abdominoplasty or tummy-tuck involves a few basic maneuvers to achieve a flat, contoured abdomen. First, the skin is released off the abdominal wall exposing the underlying fascia and musculature. Second, the laxity of the abdominal wall is then tightened using permanent sutures. Finally, the skin is redraped, redundancy is trimmed, and the incision is closed. The umbilicus (belly button) is brought through at its new site to complete the procedure. Often liposuction is performed to the flanks to achieve best results. How each of these steps is performed is highly surgeon-dependant and ultimately determines the outcome. Drains may or may not be used depending on the patient.

At True Beauty, Dr. Reagan is a true expert in performing abdominoplasty. The procedure takes 2-3 hrs. Recovery is 2-3 weeks, gym activity at 4 weeks, and no restrictions at 6 weeks. Scar management will be utilized to achieve the best possible scars.

Mommy-Makeover

The term “Mommy Make-Over” gets used often, but patients are often confused as to what it actually means. While any procedure that makes Mom look younger could essentially be included, a true Mommy Make-Over more specifically applies to those procedures designed to correct the changes that occur with childbirth. The two areas of the body that change the most are the abdomen and the breasts. So let’s start there.

A Tummy-Tuck or Abdominoplasty is a surgical procedure designed to restore a flat abdomen.  Two things happen with child birth.  First, the skin gets stretched, often resulting in stretch

marks.  Second, the space between the abdominal muscles (rectus adominus) gets wider to accommodate the fetus.  After delivery, the skin laxity often remains, and bulging of the muscles persist.  Contrary to patients wishes, there exists no good treatment to remove stretch marks or tighten the skin laxity other than a tummy-tuck.  And sit ups will not restore or shorten the stretched muscles, only suturing them together will restore the flatness.  A tummy tuck addresses the two main issues:  extra skin is removed, and the abdominal wall is tightened.  Of course a scar will result, but I keep it below the bikini line.  All of my patients get scar therapy to ensure the best looking scar possible.  Recovery is about 3 wks, and varies with each patient.

For patients that lose breast volume after having children, a Breast Augmentation can effectively restore the desired shape and size. This is performed in approximately one hour  at the same time as the tummy tuck under general anesthesia.  Either silicone or saline implants can be used.  I will discuss the advantages of each at your consultation, and together we will make the decision which is best for you. Recently Anatomic Shaped Implants have become available.  Again, we will discuss the merits of using this type of implant at your consultation. The implant will be placed under the chest muscle (pectoralis muscle) to minimize capsular contraction (hardening) or rippling.  The incision utilized will most likely be at the breast crease (inframammary fold) or along the junction of the inferior areola.  I perform the procedure so that  the breasts look great immediately.  There is no “waiting for the implants to drop”, but I do have you wear a special breast band for two weeks to keep the implants in the right space.

A Mastopexy (Breast Lift) can be performed at the same time as the augmentation if the breast tissue is droopy. The nipple should be positioned so that it is centered over the breast mound. I typically perform a Vertical Mastopexy that results in a lolli-pop type scar. But the real surgery lies in reshaping the actual breast tissue so that the skin is passively redraped. This leads to no tension on the skin closure and results in the best possible scars. I utilize breast pillars as described by the French surgeons Lajoure and Lassus. I find this technique to yield the best, most reproducible results.

Finally, Liposuction of the Flanks, Bra-Line, or Thighs can be performed at the same time if necessary.  But if we decide to do this later, it can be performed under local anesthesia only in my office utilizing Tickle Lipo.  Otherwise known as Infrasonic Nutational Liposculpture, Tickle Lipo vibrates in a way that allows it to be less painful.  In my experience, Tickle Lipo causes less bruising, and therefore less recovering than traditional liposuction.  The procedure takes about two hours.  A garment will be worn after surgery for two weeks, and it will take a few months to see the final results.  The fat can be washed and injected into the face (Autologous Fat Transfers) to restore or enhance a youthful facial appearance.

The best time to perform a mommy-makeover is after the changes to the body have stabilized.  Lactation should be discontinued for at least 3 months.  Post-pregnancy weight should be stabilized.  Emotional stability is also critical when undergoing any type of surgery.

The surgery itself usually takes 5-6 hours if all the procedures are performed.  Recovery is 3 weeks, back to the gym at 4 weeks, no restrictions at 6 weeks.  Patients can go home with help, or a care-giver and hotel can be arranged.

  • Tickle Lipo or custom acoustic liposuction as it is also known, is an innovative, new form of liposuction. It effectively reduces pain and recovery time by its revolutionary new technique and is also safer than most lipo treatments available today. Liposculputure is an advanced form of liposuction combined with micro fat graft techniques which allows significant improvements in bodily lines and curves and re-establishment of a youthful appearance not otherwise achievable with traditional surgical techniques.
  • Liposuction is a surgical technique that removes excess fat from areas of the body such as the abdomen, hips, buttocks, thighs, flanks, back, knees, upper arms, chin, cheeks, and neck. This technique allows the surgeon to artistically contour the body resulting in deeper curves and a shapelier body.
  • Tummy tuck surgery, or abdominoplasty, is a surgical procedure that removes excess skin and tissue from the abdomen while tightening the abdominal muscles. A tummy tuck can be performed as either a mini tummy tuck, regular tummy tuck, or extended tummy tuck, all dependent on the amount of excess skin presented by each patient.
  • Post bariatric plastic surgery is performed on patients who have undergone extreme weight loss, generally following gastric bypass surgery. Procedures done can include lower body lift, tummy tuck, leg, thigh and buttock lift, breast lift and/or augmentation, upper arm lift, and face and/or neck lifts.
  • Mommy makeover is a surgical procedure done for woman to reverse the undesirable effects of pregnancy. This includes a combination of surgical procedures including breast augmentation, lift or reduction, tummy tuck, and liposuction. Each mommy makeover is specially tailored to fit the individual needs of each patient.

Circumferential Body Lift
There will be occasions when a frontal abdominoplasty is not sufficient for obtaining optimal results. More needs to be done. Specifically, in instances of significant weight loss, the lateral thighs and posterior buttocks will droop with noticeable tissue laxity. To correct this deformity, a Circumferential or Full Body Lift will be necessary. The incision is carried around the back, meeting in the midline. Positioning the scars low allow maximum direct elevation of the buttock. Clothing should cover the scars, allowing the mid-waist to be exposed. Recovery is slightly more difficult with a Circumferential Body Lift, and a full 3-4 weeks should be allotted.

Arm Lift (Brachioplasty)
Significant laxity of the posterior arm, sometimes referred to as a “bat wing”, is treated with excision of skin and subcutaneous fat. The excision is carried the length of the posterior arm, ending just above or below the elbow. Liposuction around the elbow may be added. Dr. Reagan feels that excising a wedge in the armpit alone is insufficient and will lead to less optimal results. Scars from a brachioplasty are more likely to be raised and red, so scar management with prolonged steri-strips, silicone sheeting, and scar cream are all recommended. In cases of significant laxity of tissue around the armpit, an Extended Brachioplasty onto the chest wall may be necessary.

Thigh Lift
As with an Arm Lift, significant laxity of the thigh requires excision of skin and subcutaneous fat. The excision is carried out on the inner portion of the thigh and typically courses from groin to inner knee. Liposuction is often performed around the knee. Dr. Reagan feels that a wedge excision of the inner groin is insufficient and will lead to less optimal results. Scars from a thigh lift are treated with scar management to achieve best outcomes. Recovery is approximately 2 weeks, with light walking after 3 weeks and a return to the gym after 4 weeks.

Direct Bra-line Excision
Laxity of upper back skin can be noticeable as a “role” above and below the bra. Liposuction alone may be sufficient in cases of good skin quality and significant subcutaneous lipodystropy. Otherwise, is cases of significant skin laxity, direct bra-line excision will be necessary. The scar is hidden by a bra or bikini top. Recovery is 2 weeks, back in the gym at 4 weeks, no restrictions at 6 weeks.

Suction-Assisted Lipoplasty
Liposuction, otherwise known as suction-assisted lipoplasty, is the most common aesthetic surgery performed in the United States. In its simplest form, liposuction involves removal of fat using a cannula and suction system. SAL or suction-assisted lipoplasty is still a very common means to body contouring. Much confusion arises from the multiple terms and technology that exists to assist with liposuction. Below are some common terms and systems employed when performing liposuction. Note that the systems have evolved to either reduce the effort of the surgeon (surgeon fatigue), or improve the efficiency of fat removal. Many claims are made purporting the advantages of one system or another. In reality, it is the quality of the surgeon performing the procedure which most determines the outcome of a liposuction procedure!

Tumescence-Tumescence refers to the fluid which is introduced into an area prior to removing the fat. The fluid typically contains lidocaine for pain control and epinephrine to minimize bruising/blood loss. Currently all forms of invasive fat removal use some form of tumescence.

Vaser- Vaser is ultrasound – assisted liposuction. General anesthesia is typically necessary. The system moves easily through the fatty tissue, thus reducing the effort by the surgeon. Heat is created and can lead to burn injuries. The port sites are larger than with other systems. The main advantage of Vaser is in redo liposuction where fibrous scar tissue may be present, or possibly with gynecomastia (excessive male breast tissue). Dr. Reagan has experience with Vaser and utilizes it selectively in his patients.

Smart-Lipo(laser lipolysis) – Laser lipolysis, branded Smart Lipo, utilizes a laser to essentially melt the fat in question. A suction-assisted cannula is then introduced to remove the liquefied fat. The main advantage of Smart-Lipo is the ability to perform it without general anesthesia. As with Tickle Lipo, only tumescence and oral pain medication is necessary. A second purported advantage to Smart Lipo is an enhanced ability to cause skin contraction. Theoretically this would allow treatment of areas with poor skin quality that otherwise should not be treated.

Post-Bariatric Surgery Body Contouring– At True Beauty, Dr. Reagan is honored to help patients who have undergone massive weight loss to achieve their body contouring goals. It is a true pleasure to see these patients become their new confident selves! Please read some interesting patient journeys in Dr. Reagan’s article “The Final Step”. Body contour surgery in these patients can present very unique challenges. The degree of skin laxity is significant. True surgical judgement and outstanding surgical skill is necessary in order to correctly remove and reposition the correct amount of tissue. Undertreatment leads to unsatisfactory results. Overly aggressive resection can lead to wound healing problems. Dr. Reagan will combine surgeries during your transformation to get your endpoint sooner. A typical approach is to doing the truncal work(abdominoplasty or circumferential body lift) with an arm lift or breast surgery. A thigh lift is performed 3-4 months later, possibly with more breast surgery. And finally a facelift of often performed to complete the transformation. Dr. Reagan will be by your side the entire time!

Dr. Reagan Performs Tickle Lipo