Body Procedures

Dr. Miranda firmly believes that a well proportioned body with attractive, gender-appropriate contours is the most aesthetically pleasing in both women and men. Dr. Miranda uses a large variety of techniques to improve the body contour including advanced liposuction and modern lifting techniques alone and in combination to achieve the patient’s aesthetic goals

Liposculpture & Liposuction

Liposculpture is the term used for the meticulous sculpting of the body using liposuction techniques. The ideal patient for liposculpture is one that has one or more persistent problem areas where fat will not go away. Typically ideal candidates have relatively good skin tone, although this is not a requirement. Body areas commonly treated with liposuction includes the belly, flanks, hips, buttocks, inner and outer thighs, back, upper arms, neck and chin. From as little as a few ounces of fat in the wrong place to as much as 10 pounds can be removed in one session depending on the patient and his/her goals. For patients with loose or excessive skin, Dr. Miranda may recommend liposculpture combined with a lift (e.g. tummy-tuck for the abdomen).

Tumescent Liposuction vs. Ultrasonic Liposuction (Vaser)

There are two major techniques that Dr. Miranda prefers. Dr. Miranda uses Tumescent liposuction with or without Ultrasonic (Vaser) assistance. When using the tumescent technique, Dr. Miranda gently uses anesthetic solution to numb the areas to be treated and to minimize bleeding and bruising before sculpting the problem areas. If Dr. Miranda decides to use Ultrasonic Liposuction, after using the anesthetic solution, he pre-treats the fat to be removed with the Vaser device which gently melts difficult fat using ultrasound. The ultrasound can make difficult areas easier to sculpt.

Recovery

Dr. Miranda can perform liposculpture either with or without general anesthesia depending on patient preferences and the amount of liposuction to be done. Each patient will have a compression garment that will be placed on immediately after the procedure to optimize the results and minimize swelling. The garment is generally worn for 2 weeks. Bruising and swelling often occurs and depending on how much liposculpture is done, patients can generally return to work within 1 week and most bruising is gone after 1-2 weeks. Improvement is generally seen as soon as swelling goes away over the next few weeks. In some cases, patients can see continued improvement as far out as three months.

Abdominoplasty (Tummy-Tuck)

After pregnancy, weight-loss or simply with the aging process, excess skin and fat may accumulate around the abdomen. Often the excess hangs in an unattractive manner and is persistent despite exercise. For patients who cannot be treated with liposculpture alone, Dr. Miranda recommends a tummy-tuck (abdominoplasty). In a tummy tuck, Dr. Miranda removes the excess skin and fat through an incision that is placed low on the abdomen, just above the pubic hair line (hidden by underwear and similar in location to a C-section scar). Dr. Miranda has found that in many cases, not only do fat and skin contribute to poor contour in the abdominal area, but weakness of the abdominal muscles can give a “pooch” or “pot-belly” appearance. Dr. Miranda also will tighten and reinforce the abdominal muscles to give a more youthful hour-glass appearance in women and a more “cut” appearance in men.

Depending on the patient and the extent of the problem area, Dr. Miranda will either recommend a mini-abdominoplasty or a full tummy-tuck which may be combined with liposculpture for optimal control of the results.

“Mommy Make-Over”

Dr. Miranda believes that the Tummy-tuck is an important component of the “Mommy Make-Over” which is the combination of procedures custom designed to return women to their pre-pregnancy bodies. Dr. Miranda commonly combines the tummy-tuck with a breast lift or breast reduction and liposuction for the “Mommy Make-Over.”

Recovery

Abdominoplasty is performed under general anesthesia and generally requires 1-2 weeks off from work, depending on the occupation, extent of the procedure and patient tolerance. Dr. Miranda offers the use of pain-pumps in all of his patients as this can significantly reduce pain after the operation. Patients generally wear an abdominal compression garment under their clothes for several weeks after the procedure.

Arms, Thighs, Buttocks

Dr. Miranda can also lift and restore the contours of the arms, thighs and buttocks. These areas are often left loose after weight-loss or with the aging process. Significant improvement can be achieved in each of these areas. There has been growing interest in the augmentation of the buttocks in combination of narrowing of the waist particularly in Latin America in order to give a more ideal waist to hip/buttock ration of 0.7. Dr. Miranda is pleased to offer the “Brazilian Butt Lift” in which, in select patients, he will remove fat from the abdomen and transfer it to buttocks.

Labioplasty (Vaginal Surgery)

Many women are concerned about the external appearance of the labia. Dr. Miranda can gently improve the appearance and reduce extra-tissue in the vaginal area, while minimizing recovery time.

After Massive Weight Loss or Gastric Bypass

Both non-surgical (e.g. dieting) and bariatric surgical procedures (including gastric-bypass, gastric stapling, the LapBand and others) have allowed many patients to lose large amounts of weight (e.g. 70 pounds or much more) and return to healthier lives. However, after massive weight loss, problems remain—particularly the presence of residual excess skin which can lead to hygiene problems, poorly fitting clothes, the limitation of exercise and an unattractive appearance.

Dr. Miranda has considerable experience in body contouring after bariatric surgery and massive weight loss. Although it is patient dependent, Dr. Miranda generally recommends starting work on the abdominal area first and then follow with treatment of other areas as needed (breasts, thighs, arms, face, neck, etc).

For treatment of the abdomen Dr. Miranda offers a variety of procedures which will be custom tailored to each individual’s particular case. Dr. Miranda offers both Belt Lipectomy and the Lower Body Lift which can provide comprehensive restoration of the abdomen, trunk, buttocks and thighs. Smaller procedures offered include panniculectomy (removal of the excess skin on the abdomen only) and modified vertical abdominoplasty (fleur-de-lis abdominoplasty), which can be used in certain patients who already have a scar in the middle of their abdomen.

Edward P. Miranda, M.D.
A Medical Corporation

3838 California Street, Suite 404
San Francisco, CA 94118
(415) 379-9015

Info@MirandaPlasticSurgery.com

Board Certified by the American Board of Plastic Surgery