A Board Certified Plastic Surgeon in Scottsdale, AZ
AB Guerra, MD, FACS
Scottsdale Arizona plastic surgeon - Dr. Guerra, performs a broad range of cosmetic plastic surgery procedures including mommy makeovers, tummy tucks, breast augmentations, breast lifts, breast implant exchanges, liposuction, face lifts, eyelid surgery, rhinoplasty, plastic surgery after weight loss, body lifts, thigh lifts and more. He is known for having a graceful, gentle and meticulous touch in performing cosmetic enhancement procedures with great precision and elegance. Dr. Guerra prides himself in establishing long-term relationships with his patients and has a great bedside manner.
Homepage: http://www.myfaceandbody.com/?ref=wp
Posts by AB Guerra, MD, FACS
AB Guerra, MD, FACS. Surgery Training, 1997.
Aug 26th
Scottsdale – An unbelievable photograph taken at Harbor-UCLA Medical Center. This is during the my general surgery training years, before I was thinking about pursuing a career in plastic surgery. I was way too busy back then to care about photos, but I am glad an old friend had a camera handy! After so many years, I have learned to appreciate the value of old pics.
Breast Asymmetry: Causes and Treatments.
Aug 25th
Scottsdale – Breast development usually results in some unevenness of the breasts. Breast asymmetry, in fact, is normal and natural, but it is usually only acceptable to most patients when the difference is subtle. When examining the human shape, is is normal to visualize some differences in our bodies from side to side. Many patients request silicone breast implants to improve breast asymmetry.
The cause of breast asymmetry can be divided into two groups:
- Asymmetry may result from natural development, which includes pubescent growth, pregnancy, lactation and weight fluctuations.
- The second group of causes includes asymmetry caused by external factors such as disease, trauma, reconstructive or cosmetic surgery. During development, the female breasts increasing in size and projection, responding independently to hormonal and growth stimulation. For most women, the differences that exist at the end of this process are typically minor. Exceptions can occur when conditions such scoliosis and Poland’s syndrome.
The Developed Breast and Breast Implants:
The developed breasts have similar volumes with the infra-mammary folds in a similar position, nipple position is close to being at the same level, and the nipples are at the center of the breast and above the infra-mammary fold. Volume differences are very common and are often associated with differences in nipple position and diameter as well as differences in elevation of the IMF.
When the nipple position is below the ideal location the breast is said to be saggy. This is especially true when the nipples fall below the IMF. Breast augmentation and breast lift can improve the asymmetry in such cases. Perfection cannot be achieved. It is believed that breast should be like sisters but not identical twins.
Pregnancy and Weight Fluctuations and Breast Implants:
Pregnancy and weight fluctuations can lead to asymmetry. Pregnancy and lactation typically creates an increase in the size of the breasts. After the baby, there is a deflation and a loss of volume in the breasts. Usually, the breast shrink back to near pre-pregnancy size, although some experience an additional decrease in overall breast volume.
Similarly, significant weight changes can increase the saggy appearance and asymmetry. As weight increases, the fat portion of the breast increases and with the extra weight, the breast falls. This process can occur unevenly on each side leading to asymmetry which can also be compounded by the same stretching of the skin..
Breast augmentation may help those who are not very saggy, but a breast lift is better when the breasts are very saggy. As in cases involving other types of breast asymmetry, perfection cannot be achieved. Before and after plastic surgery, breasts are like sisters, not identical twins.
Update II. The 25th Breast Surgery and Body Contouring Symposium
Aug 22nd
Santa Fe, NM – Yesterday (Friday) was indeed another great day the 25th Annual Breast Surgery and Body Contouring Symposium. Saturday’s discussion and instructional plastic surgery courses were far better. I can easily say the meeting is a 10 out of 10.
I really came to this meeting to find any and many updates on the latest plastic surgery techniques. The topics for the day?
It all started with tummy tuck, lipo, and tummy tuck and liposuction. In the middle, we heard about bodylift after major weight loss, arm lift, and thigh lift. Then we finished the day with buttock augmentation and buttock lifting.
I have to tell all, this meeting was truly eye-opening. I saw wonderful results from techniques similar to those I use, but will likely begin fine-tuning my own cases to continue to achieve better and safer results with body contouring and cosmetic surgery.
Based on what I have learned, what am I going to add?
I am going to add a 5 mm liposuction cannula for my future plastic surgery cases. This size of cannula adds a little more fat for fat harvest and fat injection, especially when it come to buttock augmentation. I plan to use this in zone 4 of the back when I perform Brazillian Butt Lift. I have always been a strong advocate of small lipo cannulas, the biggest I routinely use is a 4 mm, because these improved the results. In fat grafting surgery, I clearly saw the advantage of having a 5 mm exploded basket tip cannula for fat harvest.
What else? I was impressed about incision location options for the lower body lift. I currently use an incision which is low. I prefer that because plastic surgery clients in Scottsdale, Arizona also prefer a lower incision which is easier to hide. The advantage of the higher incision relates to the contour which is achieved. A higher incision allows the patients to have more of an hour-glass contour, which is quite attractive.
It was another good day for the basic science and technique of fat harvest and fat injections. The discussion Saturday focused on the various techniques employed by different surgeons for fat grafting. It is easy to note that no one seems to use the same technique and everyone discussed was slightly different from the next.
The day in the main lecture area was wrapped up with buttock augmentation via fat grafting. The symposium was sponsored by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.
Update from the 25th Breast Surgery and Body Contouring Symposium
Aug 21st
Santa Fe, NM – I wanted to take this opportunity to let patients know about my experience at the 25th Annual Breast Surgery and Body Contouring Symposium. This is my first visit to this plastic surgery symposium which is sponsored by the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.
I arrived Thursday evening and missed all the live plastic surgery presentations. I was pleasantly surprised, however, to find the most invigorating discussion occurring on Friday. The schedule included an updated presentation on silicone gel breast implants, including some early numbers on the form-stable gel breast implants, currently undergoing FDA trials.
Thursday was also a good day for the basic science and technique of fat harvest, stem cells, and fat injections. The discussion was focused primarily on fat grafting as it applies in reconstruction of the breast after mastectomy. The portion of this medical conference involving the use of stem cells in the future was really quite exciting.
The day in the main lecture area was wrapped up between the component with liposuction and revision lipo with and without ultrasound. At the time, late in the day, I was looking forward to the body contouring instructional course I signed up for earlier. I chose to go with the brachioplasty after major weight loss course, as it peaked my interests the most. I certainly did get to see a different approach for arm lift than what I routinely use.
Overall, I gave my first day at this plastic and cosmetic surgery conference a 9 out of 10, so far…. I am indeed looking forward to hearing all the discussion about plastic surgery after major weight loss on Saturday!
Stem cells shown to repair damaged heart cells.
Aug 20th
Stem Cells in Medicine Today.
Scottsdale – Research at the Mayo Clinic in Rochester, MN along with Belgian collaborators, have demonstrated that “guided” human adult stem cells can effectively heal, repair and regenerate damaged heart tissue. The findings — called “landmark work” in an accompanying editorial — appear in today’s Journal of the American College of Cardiology.
According to the summary on Bio-Medicine.org, stem cells isolated from patients have normally a limited capacity to repair the heart. This innovative technology boosts the regenerative benefit by programming adult stem cells to acquire a cardiac-like profile. Primed by a cocktail of recombinant cardiogenic growth factors, mesenchymal stem cells (MSCs) harvested from the bone marrow of a cohort of patients with coronary artery disease showed “superior functional and structural benefit without adverse side effects” over a 1-year follow-up in a model of heart failure according to the study.
“These findings provide proof-of-principle that “smart” adult stem cells have added benefit in repairing the heart, providing the foundation for further clinical evaluation,” says Andre Terzic, M.D., Ph.D., Mayo Clinic researcher and senior investigator of the study. “The successful use of guided “lineage specified” human stem cells is based on natural cardiogenic cues” adds Atta Behfar, M.D., Ph.D. first author of the study. The pre-clinical data reported in this seminal paper have cleared the way for safety and feasibility trials in humans, which were recently conducted in Europe.
In their editorial, Eduardo Marban, M.D., Ph.D., and Konstantinos Malliaras, M.D., of Cedars-Sinai Heart Institute, in Los Angeles describe the Mayo approach as a “boot camp” for stem cells and also write that the study ” provides the first convincing evidence that MSCs, at least in vitro, can in fact become functional cardiomyocytes (heart cells) ”
I feel this study is really ground-breaking. Previously, regeneration of human heart cells was thought to be quite limited or impossible. In the future, perhaps stem cells for heart regeneration could help those with heart disease.
Medications for Breast Augmentation.
Aug 18th
Scottsdale – For your safety, comfort, and convenience we provide several important medications that you should understand and use after your breast augmentation. These medications will also help you to achieve a better result with breast implants. Taking your medications and following all the instructions for before and after your surgery, will improve your experience and the results of surgery.
Antibiotics for Plastic Surgery:
Antibiotics are important to reduce the risk of infection with all surgery. A short course of antibiotics is given to patients receiving breast implants after breast augmentation. Giving patients antibiotics for long periods could have potential side effects and are not recommended for longer than 3 days for the typical breast implant surgery.
Pain Medications for Breast Augmentation:
Your pain medications will help to keep you comfortable. Too much pain medication is not good for you. When too much pain medication is given serious side effects can occur, such as, dizziness, light-headedness, nausea, sedation, and vomiting. If you experience any of the following symptoms, call your doctor immediately: difficulty breathing, fever, rash, and weakness.
Muscle Relaxants for Breast Implants:
A muscle relaxant is a drug which affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. Taking too much muscle relaxant can cause serious side effects including, drowsiness, dizziness, clumsiness, headache, fast heart rate, upset stomach, vomiting, and skin rash. If you experience any of the following symptoms, call your doctor immediately: difficulty breathing, fever, weakness, and burning in the eyes.
Anti-Nausea Medications for Silicone Breast Implants:
Anti-nausea medications are important in reducing the risk of postoperative nausea and vomiting with anesthesia and cosmetic surgery. Taking too much anti-nausea medications can cause serious side effects including, drowsiness, dizziness, clumsiness, headache, and skin rash. Drowsiness is the most prominent effect of this drug. If you experience any of the following symptoms, call your doctor immediately: blurred vision, confusion, and disorientation.
Exciting Mommy Makeover Seminar – Tomorrow!
Aug 17th
Scottsdale – Dr. Aldo Guerra, a Board Certified Plastic Surgeon and Member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery is proud to announce the Scottsdale Mommy Makeover Seminar on August 18, 2010. That’s tomorrow evening!
Our topics for tomorrow’s Scottsdale Mommy Makeover Seminar?
We will discuss the 4 major variations of the mommy makeover offered in Scottsdale, Arizona:
- Tummy Tuck with Breast Augmentation
- Tummy Tuck with Breast Lift
- Tummy Tuck with Breast Reduction
- Tummy Tuck with Brazilian Butt Lift
What is a Mommy Makeover?
Mommy makeovers are combination plastic surgery operations used to treat the areas that change during pregnancy. The cosmetic surgery techniques improve the shape and size of the breasts, lift the breasts, tighten the tummy, remove stretchmarks and extra skin, reduce unwanted fat pads, and lift the pregnancy butt.
What Time is the Mommy Makeover Seminar?
August 18th at 6:00 PM
AB Guerra Plastic Surgery Center
8765 East Bell Road
Scottsdale, Arizona 85260
Learn More
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Plastic Surgery does not help with BDD.
Aug 16th
Scottsdale – I recently reviewed in Plastic Surgery Products, a summary of a new study that has examined the impact that cosmetic surgery on the correcting body dysmorphic disorder. The study has been originally published in the journal Annals of Plastic Surgery and found that only 2% of procedures actually reduced the severity of BDD.
“BDD is a psychiatric disorder characterized by preoccupation with an imagined or slight defect in appearance which causes clinically significant distress or functional impairment,” says Katharine A. Phillips, MD, director of the body image program at Rhode Island Hospital and a co-author of the paper. “A majority of these individuals believe they have an actual deformity that can be corrected by cosmetic treatments to fix these perceived defects rather than seeking psychiatric intervention,” she adds.
In the study, researchers report that in a small retrospective study of 200 individuals with BDD, 31% sought and 21% received surgical or minimally invasive treatment for BDD symptoms. Nearly all of these individuals continued to have BDD symptoms, and some actually developed new appearance preoccupations. They also note that in a survey of 265 cosmetic surgeons, 178 (65%) reported treating patients with BDD, yet only 1% of the cases resulted in BDD symptom improvement.
“These findings, coupled with reports of lawsuits and occasionally violence perpetrated by persons with BDD toward physicians, have led some to believe that BDD is a contraindication for cosmetic treatment,” says Phillips, who is also a professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University. In terms of long-term outcomes from procedures, only 25% of the patients showed an improvement in their appraisal of the treated body part and showed a longer-term decreased preoccupation.
“Only two percent of surgical or minimally invasive procedures led to longer-term improvement in overall BDD symptoms,” according to the authors. The researchers also found that when treatment was sought, 20% of the procedures were not received. Cost was the most common reason for not receiving the requested procedure (30%), followed by physician refusal to perform the procedure (26%).
In summary, BDD is a serious psychiatric disorder and cannot be successfully treated with plastic surgery.
Additional Facts for Buttock Augmenation with Fat Grafting.
Aug 13th
Buttock Augmentation with Fat Grafting (Model Used)
Scottsdale - Buttock Fat Transfer/Augmentation – More Quick Facts:
Average Length: 3 – 4 hours
Anesthesia: General
Location: Certified Outpatient Plastic Surgery Center or Specialty Hospital
Recovery: Back to work: Less than 2 weeks, full exercise in 6 weeks
Improving the Experience: Lymphatic Massage Therapy
Am I a Candidate? Yes, if you are….
Healthy
Non smoker
No medical conditions that reduce wound healing
Unhappy with size of buttocks
Have realistic goals and expectations
Also Known As: Brazilian Butt Lift, Gluteal Augmentation, Fat Grafting to the buttocks
Hot Topics: Composite Body Contouring.
Aug 10th
Scottsdale – Composite Body Contouring is a relatively new topic in plastic surgery. So, what is it?
A composite body contouring procedure is a combination plastic surgery operation. The Composite includes a tummy tuck, liposuction of the body, and fat injections to the buttocks. In many cases, the liposuction can be circumferential and may include lipo of the upper and lower back, love handles and extremities.
A special technique is used to perform the tummy tuck which preserves the oxygen supply to the skin and can reduce the risks of wound healing complications. Restoration of buttock contour with fat transfer can be used to give patients a better shape to the buttocks. The outer thighs are another popular location for fat grafting.
It is very important to provide the greatest amount of safety for our patients when performing Composite Body Contouring and the key to perform this cosmetic surgery operation only in a surgical facility that can admit patients for recovery and observation for at least 24 hours after surgery. I use a specialty surgery hospital that is specifically designed to meet the needs of cosmetic plastic surgery patients.
Also known as, “the composite”, this operation is a variation of the “mommy makeover” concept of combining multiple procedures to reverse the changes associated with pregnancy. Published studies demonstrate that the combination of cosmetic breast surgery and tummy tuck is safe when performed in an appropriate environment by qualified physicians. That combination of surgery is the classic “mommy makeover” duo I have performed since 2003.
On the other hand, “the composite” typically excludes breast surgery, but targets different areas that can affect women either post-pregnancy or with weight gain or loss, including the tummy, back, thighs and buttocks. Before and after photos can be found on our main website.
