Is Breast Implant Removal Right for You?

( – Fresh Meadows, NY, July 2014 – Getting breast implants is a choice, but deciding to have them removed may be completely optional or due to medical necessity. Either way, women should know what to expect from the procedure and how to prepare for it, says Robert Kraft, MD, Plastic Surgeon with Advanced Dermatology, P.C.

About 20,000 breast implant removal surgeries are performed each year in the United States, according to the American Society of Plastic Surgeons. But 70 percent of those procedures stem from three main problems: the breast implant has leaked or ruptured; collagen fibers have grown around the implant, painfully squeezing it (called “capsular contraction”); or the woman’s breast has changed in shape or size.

“Most women who choose to have breast implants don’t consider that they may one day need to be removed,” Dr. Kraft explains, “but the procedure, while unusual, underscores the fact that breast implants are not designed to last forever. This means women should be informed about what’s involved.”

Reasons for breast implant removal

Changing our minds is natural, and women with breast implants may decide that they’re too big or small and want to exchange them for implants of a different size. Others may not like the “artificial” look of their breasts – or decide they’re too high or low – and want to return to having only their natural breast tissue, Dr. Kraft says.

But typically, medical reasons necessitate the removal of breast implants. Filled with silicone, gel or saline, the implants may eventually leak, and all breasts eventually change in shape and size. Other reasons for breast implant removal include:

  • Visible wrinkling or rippling of the implant
  • Hardening of the implant
  • Allergic reactions to the implant
  • Uneven appearance of breasts
  • Persistent breast pain following implant insertion

“Many factors explain why women would want or need to revise their breast implants, replace them or opt out of having implants at all,” Dr. Kraft says. “All motives are valid and should be handled seriously by a woman’s doctor.”

Undergoing the procedure

What’s involved with removing breast implants? The surgery is same-day, meaning you can go home shortly after the one- to two-hour procedure or in certain cases need to stay in the hospital overnight. Using intravenous sedation or general anesthesia, a surgeon typically removes the implants using an incision along the crease beneath the breast. Extra care will be taken if the breast implant has ruptured, and hard scar tissue that may have formed around the implant area will also be removed.

“After the implants are removed, the skin will look loose,” Dr. Kraft explains, “so another procedure is typically needed to lift the breasts and adjust the skin and tissue if the patient isn’t exchanging her implants for a fresh set. This can be done at the same time as the implant removal or at a later date.”

Before the breast implant removal is scheduled, women should talk with their surgeons about their expectations – including whether they desire new implants, and their type and size – and will need certain to follow certain pre-operative procedures, Dr. Kraft says. Blood and imaging tests may be scheduled, and the patient may be asked to stop taking some medicines and supplements up to a week beforehand.

Once home, breast implant removal patients are typically advised to use compression bandages or wear a special bra to lessen swelling along with avoiding heavy lifting and extensive reaching for several weeks.

“If your breast implants are intact and aren’t causing you any trouble, then there’s no need to remove them,” Dr. Kraft says. “But for some women, this surgery is exactly the right choice and the results leave them feeling better inside and out.”

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

Robert Kraft, M.D., is board certified and performs breast augmentation, reduction and lift; abdominoplasty and liposuction; and the full range of facial aesthetic procedures at Advanced Dermatology P.C., with 13 locations in New York and New Jersey.

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Get More Beautiful Arms for Summer

Plastic Surgeons Drs. Elan Singer and Joshua Fox With Advanced Dermatology PC Offer Tips About Upper Arm Lift Surgery

According to Dr. Elan B. Singer with Advanced Dermatology P.C., you don’t need to be famous to want to confidently wear short-sleeved and sleeveless fashions, especially in the summer heat, and an upper arm lift can help people achieve this ideal.

Roslyn, NY (PRWEB) June 04, 2014

Inspired by the toned arms of celebrities such as Michelle Obama, Kelly Ripa and Jennifer Aniston, upper arm lift procedures have exploded in popularity among women who want to bare their arms but have been held back by the dreaded “batwings” common to weight loss, aging or genetically loose skin, says Elan B. Singer, MD, of Advanced Dermatology P.C.

Known as brachioplasty, upper arm lifts – a surgical procedure sometimes incorporating liposuction – have increased by more than 4,378% since 2000, with more than 15,000 women undergoing arm lift procedures in 2012, according to the American Society of Plastic Surgeons (ASPS). A 2013 ASPS poll indicated the trend is fueled in part by heightened attention on strong-armed celebrities that also include actresses Jessica Biel and Demi Moore.

“But you don’t need to be famous to want to confidently wear short-sleeved and sleeveless fashions, especially in the summer heat, and an upper arm lift can help people achieve this ideal,” says Dr. Singer, whose practice has a particular emphasis on surgery of the breast and body. “

Adds Joshua Fox, MD, medical director of Advanced Dermatology P.C, “More people are becoming aware of the benefits of arm lift surgery and are seeking us out. (We were awarded best plastic surgery practice on Long Island in 2013.) They want to look and feel great and realize their options for doing so have expanded.”

What arm lift surgery entails

In a nutshell, upper arm lift surgery reshapes the upper arm from the underarm region to the elbow by trimming loose skin and fat from the area. The procedure may also incorporate liposuction to help remove additional fat. It’s an outpatient surgery that generally takes between 90 minutes and 2 hours to complete.

Who are optimal candidates for an arm lift? According to Dr. Singer, they include those:

  • At or near their desired weight
  • With loose upper arm skin that hasn’t responded to diet or exercise
  • Who lost large amounts of weight, often 80 pounds or more
  • Who are otherwise healthy and don’t smoke

The length of each incision required for arm lift surgery varies depending on the patient, but the procedure will leave a scar – albeit one on the underside of the arm that may prove barely noticeable six months or more afterward.

“While exercise can improve the upper arm’s muscle tone, it can’t effectively take care of excess skin that has lost its firmness due to age or weight loss, along with localized fat deposits that may be genetically programmed into an individual,” Dr. Singer explains. “People dealing with these factors may want to consider an upper arm lift as their solution.”

Complications minimal, benefits huge

Recovery from arm lift surgery occurs over days and weeks, and most patients will need to wear compression garments on their arms to minimize swelling and maximize the chances for a smooth, contoured result, Dr. Singer says. Most can return to work within a couple of weeks and will be able to exercise and lift heavier objects again four to six weeks after surgery.

While complications from arm lift surgery are possible – as with any surgery – a study in the journal Plastic & Reconstructive Surgery found that 95% of all complications are classified as minor, such as bruising and swelling. Patients can also help boost healing by keeping arms elevated while sleeping, limiting strenuous activities in the first weeks after surgery.

“It’s a trade-off: You have a scar, but you lose the loose skin,” Dr. Singer says. “Most patients consider the trade-off well worth it. The benefits aren’t merely cosmetic – they’re psychological as well. It’s great to feel self-assured in your own skin.”

For the people who do not want a linear scar but usually with less improvement, we have several non-invasive options: Thermage, Ulthera, Liposonix, all-offer no downtime with mild swelling. For a semi-invasive technique with no stitches the device is entered through a tiny hole, we have Smart-Lipo and ThermiRF, performed by Dr. Singer. These last 2 devices not only melt the fat, but they can tighten the arms.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

Elan Singer, M.D., is board certified and his practice has a particular emphasis on surgery of the breast and body. Joshua Fox, M.D., is board certified and specializes in dermatology at Advanced Dermatology P.C., with 13 locations in New York and New Jersey.

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Drs. Kraft and Fox on Breast Augmentation

Vast Majority of Women Thrilled with Breast Augmentation Results

Fresh Meadows, NY (PRWEB) May 15, 2014

What’s the most popular cosmetic surgery in the United States? Breast augmentation procedures significantly outpace surgical enhancements of other body areas, with recent research showing that nearly all women who’ve done it feel the results met or exceeded their expectations – echoing what patients of Advanced Dermatology P.C. are telling plastic surgeon Robert Kraft, MD.

“Women come to us unhappy with the small size of their breasts and say they feel self-conscious when wearing form-fitting tops or swimwear,” explains Dr. Kraft. According to Dr. Joshua Fox, founder of Advanced Dermatology, “after breast augmentation, their confidence level soars and they love their new shape.”

Research published in May 2013 in the journal Plastic and Reconstructive Surgery indicates that 98% of women undergoing breast augmentation – which soared by 35% since 2000, to 286,000 operations in 2012 – said the results met or surpassed their hopes. They also reported improvements in self-esteem and quality of life, with 85% rating their new breast size “just right.”

“Patient satisfaction tells us all we need to know about the success of breast augmentation surgery,” says Dr. Kraft, who’s board-certified and is a founding member of the New York State Association of Plastic Surgeons and is President of the Queens Medical Society. “Not only is it a highly safe procedure, but it helps women feel beautiful inside and out.”

What’s involved in breast augmentation?

Most people know that breast augmentation surgery, known medically as augmentation mammoplasty, results in bigger breasts. But many don’t know what’s involved in the procedure, Dr. Kraft says, or even all the reasons why it might be desirable. Breast augmentation used cosmetically to:

  • Enlarge small breasts that most commonly result from heredity
  • Restore breast volume lost after pregnancy, breast-feeding or weight loss
  • Achieve better symmetry when breasts are noticeably uneven in size and/or shape

What breast augmentation can’t do, Dr. Kraft notes, is correct badly drooping breasts, which require an operation called a breast lift – which can be done along with breast augmentation – to re-position them. Two types of breast implants are used in breast augmentations: saline or silicone gel. Each has pros and cons, but surgeons work with each patient to determine which choice is best for them. Once that’s decided, Dr. Kraft uses one of two incisions for the surgery:

  • Periareolar incision: Made around the edge of the areola, this incision leaves the least-visible scars but may affect a woman’s ability to breastfeed in the future.
  • Inframammary incision: Considered the fastest, simplest and most popular of the incision options, this incision is best for patients with fuller breasts that effectively cover the scar when standing but may be visible when lying down.

Implants may be placed either over or under the muscle depending on how thin the patient is.

Preparing for breast augmentation surgery

Before breast augmentation surgery, a plastic surgeon will examine the patient’s breasts, review their medical history and take medical photographs to compare pre- and post-surgery results. Beyond physical preparations for surgery, Dr. Kraft recommends that women also be psychologically prepared to understand that implants typically need to be replaced over time, since aging, gravity, hormonal factors and weight loss or gain can change the appearance of their breasts, or the implants may develop a leak.

Breast augmentation surgery is usually performed on an outpatient basis using general anesthesia to keep patients comfortable for the 1- to 2-hour procedure. Temporary pain, swelling and other surgical complications may occur, but the 2013 Plastic and Reconstructive Surgery study found that patients felt they were completely “back to normal” about 25 days after surgery.

“Best of all, the results are immediate,” Dr. Kraft says. “Women can tell right away after breast augmentation surgery how much bigger and fuller their breasts appear. It’s a feeling of satisfaction for them that’s like no other.”

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies.

Robert Kraft, M.D., is board certified and performs breast augmentation, reduction and lift; abdominoplasty and liposuction; and the full range of facial aesthetic procedures at Advanced Dermatology P.C., with 13 locations in New York and New Jersey.

Joshua L. Fox, M.D., F.A.A.D., is the founder and medical director at Advanced Dermatology P.C. He is a leading authority in the field of dermatology with expertise in skin cancer, cosmetic surgery and laser procedures and is program director of a fellowship in laser and cosmetic surgery.

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ThermiRF is now FDA Cleared





Thermi RF is now FDA Cleared!

ThermiRF is now FDA cleared for “thermistor‐regulated energy delivery for both micro-surgical and non-invasive aesthetic applications  for dermatological and general surgical applications in soft tissue and nerves” (see press release attached). This is a huge accomplishment for ThermiAesthetics and is actually a more comprehensive clearance than the original SmartLipo approval.

Click here for the official press release.

Skin Care in Your 40s


Skin Care in Your 40s

by team
As a 40-something, you might be noticing more lines around your eyes, mouth and forehead and your complexion might be looking dull and dry. Fortunately, there are simple adjustments you can make to boost your complexion. Here’s what you can do to achieve healthier, more radiant skin.
Skin Care in Your 40s

Switch up your skin care

Throughout the years, you’ve probably developed a good routine of cleansing, exfoliating and moisturizing. However, your 40s are a time to re-evaluate your skin and update your regimen. How much you’ll need to adjust your routine will depend on how you’ve treated your skin thus far.

Dermatologist Joshua Fox, M.D., tells WebMD, “If you wore sunscreen, if you did some preventive care, then you may not notice any major difference in your skin.” But, “If you didn’t do those things, then fine lines and wrinkles are definitely on the upswing once you hit 40,” he explains.

Whether you need to make major changes or just several tweaks here and there, consider these tips:


  • Add powerful products. If you aren’t using an anti-aging topical treatment, now is the time to start. Look into powerful ingredients such as alpha hydroxy acids and retinoids, both of which stimulate collagen synthesis, helping to reduce fine lines and wrinkles and attain a younger, more radiant complexion. Because retinoids are only available via prescription, consult your dermatologist. 


  • Reconsider your skin type. As we age, not only does skin experience a loss of collagen and firmness, but our skin type tends to change, too. Usually, the skin gets drier, so even though you might’ve spent your entire life with normal skin, you might need to shop for products for dry skin. Make the switch by looking for hydrating cleansers and thicker creams (instead of moisturizer or lotion). 


  • Address acne. To many women’s surprise, acne can become a regular problem during your 40s due to hormonal changes. If that’s the case, Dr. Fox suggests seeing a dermatologist and gynecologist — yes you read that correctly. That’s because adult acne could indicate a gynecological problem. 

    It’s also easy to mistake acne for rosacea, a skin condition marked by redness, swelling and bumps, which typically resemble pimples. Because your “acne” might not be acne after all, consider seeing a professional to receive an accurate diagnosis. Also, your dermatologist can prescribe effective treatments that you won’t find over the counter.

Streamline your beauty routine

As women get older, they typically apply more (and heavier) makeup to conceal imperfections. This actually has the opposite effect: Heavy foundation and too much powder create a cakey complexion and can even highlight fine lines by settling into the creases of your wrinkles.

Instead of hiding your features, here’s how to enhance them and look younger:


  • Be selective. Rather than applying a surplus of cosmetics, pick several key products. What might be your must-haves? “Moisturizer, concealer, tinted moisturizer, pot rouge for lip and cheeks, black mascara,” renowned makeup artist Bobbi Brown tells Newsday. 


  • Consider creamy, hydrating products. Makeup that has a creamy consistency doesn’t sink into fine lines and it helps the skin appear dewy and supple. To guarantee your beauty products have a “creamy consistency,” look for “sodium hyaluronate, petrolatum and glycerin,” on the label, writes Brown in Prevention


  • Go with lighter colors. Choose lighter blush (like peach and light rose) and light-colored eye shadow. Brown suggests using medium eye shadow on the lid and a light shade just below the brow bone. 


  • Define disappearing lips and brows. Brown suggests using a natural-colored lip liner to enhance thin lips, reports Newsday. For vanishing brows, use eye shadow to draw them in. Just make sure to choose the same color as your natural brows. Marie Claire also suggests using a “chunky brow pencil.” 

Consider in-office options

You might be considering more dramatic procedures to rejuvenate the face. Here are the specifics on two common options:

    Chemical peels can improve skin discoloration, sun damage and scarring, treat some acne and reduce fine lines. There are a variety of chemical peels, including mild (e.g., glycolic acid peel), medium (e.g., Jessner’s peel; trichloroacetic acid peel, or TCA) and deep peels (phenol peel). The medium and deep peels penetrate deep into the skin, delivering more dramatic results. For example, deep peels can reduce wrinkles considerably. But this also means a longer recovery period, greater risk for side effects and a much higher price tag. 

      A dermatologist applies a solution to your face, which causes the skin to peel off. This reveals a new layer of skin that looks fresher, younger and has fewer wrinkles. Depending on the strength of the solution, you might be given medication. For instance, with a phenol peel, you’ll receive general or heavy sedation. 

      The cost of chemical peels varies widely. Mild peels can run around $100, TCA peels about $2,000 and phenol peels about $4,000 (with some upwards of $6,000). As with any procedure, complications are possible. Some individuals might develop temporary or permanent abnormal pigmentation and redness. Though less common, scarring can occur, but it’s treatable. Make sure to discuss all concerns with your doctor.

      If you’d like to pass on chemical peels, consider at-home products. Though you won’t get the same results, these products are effective for removing dead skin and refreshing your complexion. Try Dr. Brandt Laser A Peel or MD Formulations My Personal Peel System . 

    • How chemical peels work:
    • At-home option:

    Many swear by Botox, or botulinum toxin type, known for visibly reducing wrinkles and fine lines. 

      Approved in 2002 for frown lines between the eye brows (elsewhere on the face is considered “off-label” use), Botox works by temporarily paralyzing the muscle — injecting a short-term wrinkle antidote to the respective area. 

      The average cost of Botox injections is roughly $400 with results lasting four to six months. According to the Mayo Clinic, your skin type, skin thickness and the degree of wrinkles all impact the effectiveness of Botox. Some side effects include headache, nausea and flu-like symptoms. Around the treated area, you might notice temporary redness, bruising and pain.

      Some experts disagree on whether women should get Botox. In an article in Marie Claire, prominent dermatologists Fredric Brandt, M.D., (known as the “Baron of Botox”) and Nicholas V. Perricone, M.D., debated the efficacy and safety of Botox. According to Dr. Brandt, Botox is medicine that’s excellent in reducing fine lines, especially horizontal forehead lines, frown lines, crow’s feet and lines on the neck. 

      On the other hand, Dr. Perricone believes that Botox is a neurotoxin that will actually accelerate the aging process, because Botox users lose volume in their faces.

      He steers his patients away from Botox.

      If you choose to have Botox injections, make sure you go to a reputable and experienced professional.

    • How Botox works:
    • Some debate:
  • Chemical peels:
  • Botox: