|Steven Teitelbaum, MD, FACS
California Plastic Surgeon
Santa Monica, CA
Double Board Certified Plastic Surgeon
Cosmetic Surgery Website
Santa Monica Office
Cohesive Breast Implants
"Your health first, plastic surgery second"
Article by Dr. Teitelbaum
by Site Visitors
|These are not testimonials submitted by the plastic surgeon or the plastic surgeon's office; these were sent to us directly by the patient through our surgeon survey.|
"Dr. Teitelbaum was the most caring, professional doctor I met with. He was so knowledgeable and was more than happy to answer all my questions. He listened to my wants then educated me on trying to meet my wants while doing what my body, breast tissues would allow and why this is the important factor in breast augmentation! He is big on a 24 hr recovery - which I thought was too good to be true but it wasn’t - I took only Advil and was at dinner the night of surgery - for real!! He is amazing!" ~Rebecca, Breast augmentation patient from Los Angeles, CA, May 05, 2008
"Truly the most skilled, personable, caring and ethical doctor I have ever met. From the moment I met him I knew I was in the best of hands. He has always taken the time to talk with me and to make sure all of my questions were answered. He made sure that I knew exactly what I could expect from my surgery. From the lengthy initial consult to the flowers he sent me after surgery to his willingness to come to the office on Saturday or Sunday to remove my drains he has gone above and beyond. I recommend Dr. Teitelbaum to anyone that not only wants a skilled doctor but a truly wonderful person taking care of them."~Lisa (Breast Augmentation & Site Visitor from Los Angeles, CA)
job. He was so caring, and they turned out extremely natural. He even
took care of my wrist (a 3rd degree burn incurred 2 days before my
surgery from a terrible car accident.) He has been the sweetest and
has been on top of every little request I've made and I think he's
just awesome!!!!"~Cat (Breast Augmentation Patient &
Site Visitor from Pasadena, CA)
"AWESOME. Very patient, Great Bedside Manners. He is very honest about what he feels best suits your body. Great office staff too." ~Cameo, Breast Augmentation Patient from Central Valley, CA
"Absolutely the most professional and capable doctor ever. Detail oriented, personable. An artist! Great post surgery care with honest concern. I have no reservations about recommending Dr. Teitelbaum to anyone. I am a very enthusiastic and happy patient!" ~Laurie Jo, Breast Augmentation Patient from San Clemente, CA
"Dr. Teitelbaum and his staff are truly wonderful! His care and attention to detail made me feel secure with my decision to have plastic surgery. The results I achieved with Dr. Teitelbaum exceeded my expectations and I highly recommend him." ~Unique, Breast Augmentation Patient from Los Angeles, CA
Dr. Teitelbaum is extremely skilled and very patient - perfect combination. My experience could not have been better! And my results are fantastic! Dr. Teitelbaum and his entire staff are wonderful! He is a true artist. He has continually been honest about all options and outcomes. I would highly recommend him to anyone wanting breast enhancement surgery! Email me to hear all about him and his wonderful staff! :-) ~Melissa, Breast Augmentation Patient from Santa Monica, CA - Los Angeles, CA
is very smart and has a keen aesthetic [skill]. He truly wants to
make you beautiful and not look disproportional. He's very personable
and informative and there for you at any time. He called after the
surgery and the next two days to find out how I was doing. He is a
very genuine person and during my follow-up visit showed true emotion
and gave me a hug--because it's pretty unbelievable how good I look
now from how bad I looked before with my semi-deformed old breast
implants--he knew how happy I was. The clincher as to why I chose
him was because he also volunteers for "Doctors Without Borders"
a group, which helps people in poor countries who have physical deformities
that can be surgically treated (i.e. cleft lips). He has a terrific
staff and I truly felt at ease and knew I was in good hands.
I highly recommend Dr. Teitelbaum. I had a breast revision surgery and an upper/lower eyelid surgery with him. He does excellent work and his staff is wonderful. His surgical center is like going to a spa. In fact, I encouraged Dr. T to contact you guys and become part of your web site. I told him how helpful and informative it was for me. All the best to everyone at Implant Forum. ~Lisa, Breast Augmentation Patient from Los Angeles, CA
Also Recommended by ~Gina (Breast Augmentation Patient & Site Visitor)
5'4" - 110 pounds - Mentor implants, smooth, saline, overs, areola 34B-34C/D
This is a partial list of cosmetic procedures offered by this plastic surgeon. Other cosmetic procedures may be available by this plastic surgeon, please ask when contacting the plastic surgeon's office.
Dr. Teitelbaum is an internationally recognized cosmetic surgeon known for his specific expertise in breast augmentation. He has extensive experience working with both saline and silicone implants, having helped design and test the most current models, and he lectures and teaches other surgeons how to perform breast augmentation surgery and achieve the best results with minimal pain and recovery time.
• Expertise. Dr. Teitelbaum is the only surgeon in the state of CA, and one of fewer than ten surgeons in the world, to have participated in the clinical studies for all three implant manufacturers—Mentor, McGhan (now Allergan), and Silimed (now Sientra)—and to have testified at FDA hearings on silicone gel breast implants (also known as “cohesive,” “gummy-bear,” or “form-stable” implants). As a result, he has among the most clinical research experience of any physician in the U.S. and is frequently asked to teach cosmetic surgeons around the world about the differences between various cohesive gel implants, as well as the advantages and disadvantages for each in different patient profiles.
In the past three years, Dr. Teitelbaum has given over fifty lectures to other plastic surgeons on breast augmentation and implant revision surgery—including talks across the U.S. and in Brazil, England, Israel, Mexico, Morocco, and Sweden. He is also recognized locally, as one of just a few Los Angeles cosmetic surgeons to have been asked to join the esteemed teaching faculty of UCLA Medical School, where he is Assistant Clinical Professor of Plastic Surgery.
Dr. Teitelbaum has published recent articles on breast augmentation in the prestigious journal Plastic and Reconstructive Surgery—including a landmark paper on reducing the need for patients to have multiple operations, and a roundtable discussion on breast augmentation he led with the most elite names in cosmetic surgery. He has written textbook chapters on breast augmentation, including how to revise unsatisfactory results.
Dr. Teitelbaum is a principal figure in creating the curricula used to teach other surgeons how to select the proper implants for each patient and achieve the most-natural results, as well as a lead instructor in the courses offered to cosmetic surgeons in Los Angeles and at the annual meeting of the American Society of Aesthetic Plastic Surgery—the largest aesthetic plastic surgery meeting in the world.
• Patients. Dr. Teitelbaum is cosmetic surgeon to a number of influential people, models, and celebrities, but he is most proud of the fact that he is often chosen by other physicians for their own surgeries or those of their family members. Dr. Teitelbaum is also frequently referred difficult cases from other top surgeons in the U.S. and around the world. Finally, Dr. Teitelbaum is one of the few surgeons chosen by employees of breast-implant manufacturers—people who have access to the results of thousands of clinical trials of their products. Following one 2007 case involving a manufacturer’s family member—this particular woman is a member of a two-person evaluation team that reviews all surgical results in the country for a particular implant—Dr. Teitelbaum received this note: “Jennifer is not given to false praise—what she told you about your work was truly from the heart, and I agree with her. You have that very unique gift which enables you to produce spectacular results over and over again. Keep making the world a more beautiful place.”
Philosophy of Breast Augmentation
Dr. Teitelbaum’s approach to breast augmentation is a direct result of years of studying, writing, and lecturing on the subject. He’d like to share with you a few of the points that distinguish him from other aesthetic surgeons:
“Augmentation affects your breasts for the rest of your life—a responsibility I take very seriously. Every surgical decision we make together—from the incision site to the pocket location to the type and size of implant—should further the goal of making your breasts look their absolute best, in the safest way possible.
My personal aesthetic gravitates toward breasts that are beautiful and natural, and my patients generally share this approach. Most of them specifically say that they do not want to look “fake”; unless a patient specifically requests otherwise, this is always my goal. Because I understand that my aesthetic sensibilities will not be shared by all prospective patients, I will work hard to make sure that they are compatible with your own before proceeding with any surgery.
Here’s what you can expect from me. First, an unparalleled consultation experience. Many plastic surgeons actually pass you off to a patient coordinator, or they may spend only a few moments with you. I schedule a large block of time for each prospective patient, and will take as much time as you need to discuss how you’ve always wanted your breasts to look, and any concerns you may have. Whether you have the surgery done by me, by someone else, or not at all, you will be sure to leave my office with a dramatically enhanced understanding of how an augmentation could change how you look.
This dialogue will continue throughout our entire relationship as doctor and patient. Far too often I hear other surgeons’ patients complain that their augmentation didn’t give them the results they wanted or expected. This is unacceptable to me, which is why I will explain the implications and consequences of each decision we make together, and stay in constant contact to make sure you know exactly what to expect.
I put an enormous amount of effort into keeping up to date with medical advances, and am proud to have one of the most state-of-the-art surgical facilities in the United States. And while I don’t rush to embrace every innovation, through my own research, I have been able to improve upon breast augmentation techniques. In fact, I instruct other surgeons in how to minimize recovery time and pain in initial breast augmentation based on my own clinical studies.
Finally, I think it is important to stay in close contact with a patient after surgery. No matter how busy our office gets, you can expect regular follow-ups and the kind of top-notch postoperative care I consider necessary to ensure the best possible results. I’m honored when any patient chooses me to be her surgeon, and I strive to make sure my conduct always reflects that feeling.”
Steven A. Teitelbaum, MD, FACS
Preparing for Your Consultation
There are four steps to your breast consultation with Dr. Teitelbaum:
2. Dr. Teitelbaum will examine and measure you in order to determine if your wishes can be fulfilled exactly as you hope. Every woman’s breast skin has a certain volume that it can hold. If you fill it up beyond that point, the edges of the implant will be visible through your skin, and will cause the top to bulge Over the long term, the pressure will make your skin stretch and lead to sagging. If you underfill the breasts, they will not look full, the upper part may be concave, and it may not be proportionally shaped. A breast that is already full, firm, and tight will have less capacity to be enlarged without looking augmented. A breast that is loose, empty, and soft has a greater capacity to be augmented while still looking natural. The thinner you are, the more likely it is that your implant could be seen or felt, while the thicker your tissue, the more your body will hide the implant.
4. In the final step, he will help you to visualize what you will look like after surgery. Dr. Teitelbaum wants you to know ahead of time how you will look with the implants you have selected; he doesn’t want a patient to ever wake up bigger or smaller than they were expecting. The doctor will take a 3D photo of you, then use his state-of-the-art breast-imaging system to simulate the size that you’ve decided on—so you can see on a computer screen how it would look in your body. (You can do this undressed or with a bra on.) Second, he will give you a “sizer implant’ to put inside an unpadded bra—so you can assess how your new breast size will appear under different clothes. Third, he will show you photos of patients of similar size and weight to yourself. None of these methods is precise, but taken in combination, they will give you an excellent indication of how various implant sizes will look on your body.
3-D Computer Simulation of Augmentation Results
Every woman considering breast augmentation shares the same concern: How do I choose an implant that’s the right size for me?
While Dr. Teitelbaum has a patent for a device that determines the best implant size for a breast and he is extremely experienced in helping patients find an implant that is best for them, it’s understandable that you will want to get some sense of how different options will look on you. It’s for this reason that Dr. Teitelbaum uses a state of the art digital breast imaging system. The Precision Light technology has helped hundreds of satisfied patients forecast how they will look after their procedure.
This device is new and not available to the public. While there are other 3-D devices on the market, none have the same sophisticated software engine that actually does a simulation rather than just a “morph,” thereby creating what seem to be much more realistic images. While the images are excellent and generally reliable, patients should understand that this is a new technology and only time will determine the accuracy of these images.
After taking three-dimensional digital images of the breasts, the Precision Light software then calculates precise measurements and determines the exact volume of the breast tissue present. The system can then be used to simulate how various implant sizes and types will look on you. Because any size implant can be simulated on your body, the machine presents you with an unprecedented opportunity to visualize approximately how you will look ahead of time, allowing you to get an idea of whether the implant Dr. Teitelbaum calculated for your breast gives you the overall size and balance that you wish.
Of course, like any simulation, Precision Light can’t give a 100 percent precise prediction of the outcome. But Dr. Teitelbaum has found it to be far and away the most helpful forecasting tool available—and his patients agree. Many say that the digital imaging played a big role in reducing their concerns about their implant size, and gave them more confidence that they would be happy with their outcome.
Many of Dr. Teitelbaum’s patients choose him to be their surgeon because of his expertise with cohesive gel implants (also known as “gummy-bear implants” because the gel has a consistency similar to that of the candy). These have been widely used in Europe since 1993. US clinical trials began in 2001, and finally approval of these implants is expected in 2012. Between 2001 and the approval, the implants are only available to patients and a select group of surgeons participating in clinical trials.
Dr. Teitelbaum is the only surgeon in the state of California who participated in the clinical trials of all three cohesive implant manufacturers. He has over a decade of experience and has implanted more than 1300 such implants. Because of his excellent results in a wide variety of breast types, Dr. Teitelbaum is one of the most frequently requested lecturers on this topic in the United States, and he has traveled to places as far away as Asia, Europe and Africa to share his cohesive breast implant expertise with other surgeons.
These implants have several advantages and disadvantages. While beautiful and natural results can be achieved with any breast implant, Dr. Teitelbaum believes he has greater control to create a more beautiful shape with these implants. They are more resistant to developing folds that can be either seen or felt. Studies show a lower rate of scar tissue formation, leakage, and chance of needing another operation than standard silicone gel implants. While many patients perceive these implants as “leak-free”, in fact it is possible for them to break, though the gel is so stiff that it does not appear to migrate.
They are slightly firmer than standard silicone implants, but it is that characteristic which allows them to maintain a shape and to have possibly enhanced durability. Since they are thin at the top and thick at the bottom, they must maintain their orientation. If a round implant rotates, then there is no change in appearance, but if a teardrop rotates then it can create a distortion. This is a risk that exists with these cohesive implants that does not exist with the round implants.
They work best in patients who wish to have a proportional augmentation, because they do not look as good when sized much above or below what is ideal for the breast. In loose and highly mobile breasts, they tend to feel more firm than they do in breasts that are already very firm.
Does the idea of a virtually pain-free breast augmentation seem too good to be true?
As remarkable as it sounds, recent developments have allowed over 90 percent of our breast augmentation patients to return to normal activities within 24 hours, without the need for narcotics, bed rest, or special bandages or bras. Bruising is minimal or nonexistent, and pain is controlled with ordinary Advil. In fact, Dr. Teitelbaum’s patients routinely go out to dinner the night of surgery, drive the next day, and need no more than a few days off work.
This is no exaggeration—and it’s also no accident. Your easy recovery will be the result of Dr. Teitelbaum’s commitment to meticulous preoperative planning, state-of-the-art anesthesia procedures, and the surgeon’s detailed understanding of finer points of anatomy, which allows each operation to proceed smoothly and with a minimum of trauma. His state-of-the-art surgery suite also offers the latest advances in anesthesia procedures, which significantly minimizes postoperative nausea.
Because of rough or imprecise technique, some surgeons tightly bandage patients or make them wear a special bra in the hopes of forcing the implant into a particular position or to act as a tourniquet to prevent bleeding. Dr. Teitelbaum’s precise and gentle surgical technique, conversely, allows his patients to move their arms in the recovery room right after surgery—and the result is less pain, a shorter recovery, and a lower chance of hardening of the breasts.
There’s a reason why Dr. Teitelbaum has been asked to teach other doctors how to achieve this kind of pain-free recovery at the largest annual plastic surgery meeting in the world. He’s made a believer out of thousands of other surgeons; feel free to ask as many questions as you like about how he can do the same for you.
Getting the Best Results
The natural, beautiful results Dr. Teitelbaum is known for are no accident—they are a direct result of the principles that have guided him since he opened his practice in 1995, and have made him one of the country’s premier breast surgeons. Here, he shares his advice for making smart decisions that will yield the best possible outcome.
It’s critical that you select an implant size and shape that fits your breasts. If an implant is too big, the breast looks round, shiny, and bulging on top in the short term. In the long term, the skin will stretch, the tissue will compress and thin, and the breast will sag. If an implant is too small, it will fail to proportionally fill out the breast. There is a narrow range of ideal sizes for each woman’s breast, and your surgeon will help you to understand what is realistic for you.
When considering the choice of incision, the resulting scar isn’t the only factor to consider. The most important thing is that your surgeon uses the incision that allows him to create a pocket into which the implant will sit in the most gentle, accurate, and consistent way. Keep an open mind, and listen to what your surgeon has to say about other relevant issues, such as pain, recovery, accuracy of placement, retention of sensation, and avoiding capsular contracture (hardening of the implants).
If you are thin and can see your breastbone and ribs, don’t expect augmentation to correct a wide gap between your breasts. Some patients and plastic surgeons have the mistaken assumption that larger implants will fill in that space: They will not. Placing an implant under the extremely thin skin close to the sternum will result in fake-looking breasts that could migrate so close together that they form what is commonly referred to as a “uniboob.” (The medical term for this is symmastia.)
All breasts are a little asymmetrical—even after augmentation. Dr. Teitelbaum will do everything he can to make sure both breasts are as even as possible, and can adjust the implant size to correct major asymmetry when necessary. But it’s important to be realistic and accept that a tiny amount of variation will always be present—and almost never be noticeable to anyone but you.
Remember that skin stretches. If your tissue is thin, the implant will be visible no matter what the size. And, just as we have all seen with natural breasts, the larger they are, the more all breasts fall with age. It should come as no surprise that the additional weight of augmented breasts will similarly cause the skin to stretch and sag over time. A good cosmetic surgeon will help you assess what implant will best fit your natural breast pocket as well as examine your skin quality.
Don’t automatically dismiss the idea of a breast lift. If your skin is thinned, sun-damaged, or already stretched, adding additional weight can often cause the breasts to sag more quickly. This seems to be especially common in women who have stretch marks on their breasts, have had babies, or lost a lot of weight. Your surgeon will take measurements of your breast skin under maximal stretch. If the measurements are greater than a certain amount, your surgeon may recommend a breast lift. Heed his or her advice—or do no surgery at all. Proceeding with an augmentation in breasts that really need a lift rarely produces the results desired, and may ultimately just postpone the inevitable and necessitate a lift down the road.
Once you’ve taken the above factors into consideration, weighed your options, and heard what your surgeon recommends, you should find yourself in an excellent position to get the best, most beautiful, and natural-looking breast augmentation results.
"Your health first, plastic surgery second"
Article by Dr. Teitelbaum
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