Each year Castle Connolly puts together a list of the nation’s “Top Doctors” as judged by the doctors’ peers. A doctor is selected based solely on a survey completed by other doctors, making this the most exclusive and sought-after list of medical elite. For years, this list has served as the go to list for patients seeking exceptional medical care.

Dr. Schulman continues to strengthen his reputation as one of the nation’s top plastic surgeons. He has been featured on FOX, NBC, CBS, ABC, and the emmy-award-winning show “The Doctors”. He routinely appears in the pages of In Touch, Life & Style, Star Magazine, and Globe. The New York Daily News called him an “anti-aging expert.”

Dr. Schulman Specializes in all aspects of cosmetic plastic surgery, such as breast augmentation, breast lift, facelift, eyelid surgery, nose surgery, tummy tuck and his very own procedure called Smooth Tuck™, a less invasive body contouring procedure of plastic surgery.

Again, congratulations to Dr. Schulman for being included in this list, only the top 1% of all physicians nationwide receive this award.

If you are interested in learning more about a procedure, contact Dr. Schulman’s office to schedule a consultation at his office in New York City.

Let’s look at some of the more common procedures:

Rhinoplasty: This is the number one requested procedure among young teens and has become almost a rite-of-passage among high school students in some communities. Young girls usually begin requesting a nose job at 13 or 14 years of age. This is too young for several reasons. Psychologically they are not prepared to make “body image” decisions about themselves, and also physically, the nose is usually still growing. The more appropriate age is 16-17 years old. This is why rhinoplasty is commonly performed on high school students between Junior and Senior year or after graduation.

Liposuction: The surgical removal of fat is a good tool for body shaping and can get rid of those “problem areas”. In this regard, it is never appropriate for young men or women and best reserved for those over 18 years old. In the case of weight reduction, high volume liposuction has recently been shown to be very beneficial in reducing weight and reducing the risk of obesity related illness such as diabetes and high blood pressure. Again, it is best reserved for those over 18 years old, but it may be appropriate for teenagers that meet very strict criteria. If a teenager is obese despite good compliance with diet and exercise, and has shown signs of obesity-related illness, then high volume liposuction may be indicated for medical reasons.

Breast Augmentation: The placement of breast implants is best reserved for women over 18 years old. The one exception is in the case of Poland Syndrome in which one breast fails to develop. Research has shown that the placement of a breast implant on the underdeveloped side to help achieve a more “normal” appearance has significant psychological advantages, even at an age as young as 13 years old.

So, as you can see, while most elective cosmetic surgery is reserved for people over 18 years old, there are some situations where it is appropriate for younger teens. Remember, children under 18 years old need to be accompanied by a parent during the consultation and a parent must give permission for any procedure.

To learn more about the cosmetic surgery procedure you are interested in, or to schedule your consultation, contact us or call 212-289-1851

Peri-Areolar
Advantages: well-hidden incision
Disadvantagous: not possible if areolas are very small, possible disruption of milk ducts which can lead to infection and interference with breast feeding, more technically challenging for the surgeon, higher capsular contracture rate than some other approaches, risk for decreased nipple sensation.

Inframammary
Advantages: well hidden incision, technically easier approach for surgeon, no disruption of milk ducts or breast tissue so virtually no risk for interference with breast feeding, lowest risk of infection and capsular contracture
Disadvantages: scar can be visible on underside of breast.

Trans-Axillary
Advantages: hidden scar, no disruption of ilk ducts or breast gland so virtually no risk for interference with breast feeding.
Disadvantages: challenging approach for the plastic surgeon and usually requires use of endoscopic camera equipment, highest risk for infection and capsular contracture, scar may be irritated when shaving underarms, high rate of implant malposition.

As you can see, there are several different approaches for placement of breast implants. Your surgeon will be able to discuss which approach is best for you. It will depend on your preference, type of implant selected, implant size selected, and your body shape and size.

To learn more about breast implants and breast augmentation, or to schedule your consultation with Dr. Schulman, contact us or call 212-289-1851.

For a very long time, Plastic Surgeons told patients something like this – “capsular contracture is abnormal scar tissue that some people’s body makes. There is no way of knowing if it will happen and really depends on your body”. This was a great way to not take any responsibility for this dreaded complication that can occur in around 7% of women. My opinion is that this is an inaccurate way of portraying CC and is nothing more than a cop-out so that the surgeon does not have to take responsibility if CC develops. It also totally disregards current scientific evidence.

CC is an inflammatory response to some stimulus. This may be a small amount of bacteria and infection, blood from poor control of bleeding during surgery, powder from surgical gloves, or even lint from operating room towels. Basically, anything that irritates the body during breast implant insertion can make CC more likely. In fact, many of us believe that 80% of CC is the direct result of these causes, which means that 80% of the cases of CC should be avoidable. This leaves the other 20% to the mysterious “some-people’s-body-makes-bad-scar-tissue” theory.

There are some very specific techniques that some surgeons employ during surgery to minimize the chance of developing CC – “no-touch” technique, Keller Funnel, triple antibiotic implant irrigation, avoiding towels with lint, and using powder-free surgical gloves. I think that the data will eventually show a dramatic reduction in CC rates among those surgeons using these techniques. The bottom line is that is your surgeon tells you that CC is something that happens and cannot be predicted or prevented, then he/she clearly is not using these advanced breast implant insertion techniques.

To learn more about Breast Implant Augmentation with Dr. Schulman using the latest techniques to reduce complications, contact us or call 212-289-1851.

The mother tends to persuade a smaller sized breast implant. Perhaps this is the mother’s maternal instinct to “protect” and she feels that large breast implants will portray an image that is not “daughterly”. I have watched many battles occur in my office between mother and daughter about implant size.

On the contrary, the husband tends to recommend larger implants. This is probably due to man’s attraction to large breasts. Husbands can at times attempt to mold their wives into their ideal image, and if that husband is a “breast-man”, than he will suggest larger implants. It can be quite interesting when I see a woman alone in consultation and we select a small-moderate sized implant, but when she returns with her husband, she is suddenly trying on large sized implants.

Implant size is a matter of personal taste. You need to choose and implant size that you will be happy with. Of course, the person who helps you in the decision process may have a different opinion about which implant size is best, but you need to ultimately make your own decision.

To learn more about breast implant augmentation in New York City with Dr. Schulman, contact me or call 212-289-1851.

This has several advantages. First, it allows women to see the breast augmentation results before they even have surgery. This allows us both to be confident in choosing out implant size. The software is specifically programmed with all the dimensions of every possible breast implant, so that the computer generated “after” pictures are accurate. I can quickly show what a 300cc versus 400cc implant will look like. My particular system also allows me to place 3D virtual clothing on the image so that you can see your “after” in a dress, bikini, or t-shirt.

Also, the software can precisely measure the pre-operative volume of your breasts. This is important in helping my patients see pre-existing asymmetries. It then allows me to determine the appropriate volume of breast implants. If the software measures your right breast as 50cc smaller than the left, we will know to choose and implant for the right that is 50cc bigger than the implant for the left breast.

3D computer imaging is just another tool to help perform breast augmentation more consistently. My patients are more comfortable choosing implant sizes and there is no more second guessing after the surgery.

To learn more about breast augmentation and to schedule your consultation and 3D breast imaging, contact me or call 212-289-1851.

Certainly, the women who have very large asymmetries (such as a C cup on one side and a small B cup on the other) come to my office aware of the difference. However, most women with smaller differences seem surprised when I point them out. I find it hard to believe that a woman had never noticed that her left nipple is 1 inch higher than the right, or that her left fold is 2 inches lower than the other side. It amazes each time, but I have come to expect it. These asymmetries are pointed out by using a large mirror and also taking pre-operative photographs.

Pointing out the asymmetries serves a few different purposes. First it protects me. If breasts are asymmetric before surgery, then they will remain asymmetric after surgery (hopefully less asymmetric, but asymmetric nonetheless). After cosmetic breast surgery, women will stare all day long at their breasts and I can guarantee that the asymmetry that was not obvious to them before surgery will be painfully obvious to them after surgery. Pointing it out beforehand helps to establish realistic expectations about the results.

Second, it helps me and my patient get on the same page regarding the surgical plan. If I need to raise a fold or lower a nipple, I want them to understand the specific surgical techniques involved so that they can appreciate the complexities of the scheduled surgery. In some cases, I need to perform a totally different operation on the left and right breast. For example, sometimes one side needs a lift, while the other does not. Also, sometimes I place different size implants in order to account for volume asymmetries. If different operations are needed on each breast, my patients must understand that this may result in different scars and different recoveries.

So breast asymmetries are almost a given. Cosmetic breast surgery is designed to minimize the difference, but achieving 100% symmetry is impossible and my patients need to understand this.

To learn more about cosmetic breast surgery such as breast augmentation, breast lift, and breast reductions, Contact me or call 212-289-1851.

Both implants are composed of a solid silicone outer shell and it is the “filling” that makes each different. Saline implants are filled with saline salt water. Silicone implants are filled with a cohesive silicone gel. If you cut a silicone gel implant in half, the gel will not ooze out – think of the consistency of the inside of a gummy bear. This is a tremendous improvement over the earlier generations of silicone implants that were composed of liquid silicone oil that would run out freely from a ruptured implant.

Saline implants are packaged unfilled. This means that the empty implant is placed in the breast and the surgeon fills the implant with saline fluid to the desired volume through a small fill tube. There are several advantages to this. Because the empty implant can be rolled up like a cigar, it can be placed through an incision smaller than the incision required for a silicone implant. Another advantage of saline implants is that the surgeon has some latitude in the amount of volume that can be added. The implants can generally hold a 30cc range of fluid. This means that a 300cc implant can be filled to anywhere between 300cc and 330cc. This allows for intra-operative adjustment of volume to help achieve symmetry of the breasts. This has a specific advantage when performing breast augmentation on women with pre-existing breast asymmetries. We can sit the patient up in the operating room and can look at the breasts and fine tune the volumes – maybe add a little to the right or take a little from the left.

Silicone gel implants come pre-filled. This means that the volume is pre-determined and cannot be adjusted in the operating room, therefore the pre-operative examination and implant size selection is paramount. In addition, the pre-filled silicone gel implants require a longer incision to inert. This longer incision means a longer scar. It also means that some incisions location choices may not be an option. For example, it may be impossible to place large silicone gel implants through a peri-areolar (around the nipple) incision in women with very small areolas.

In terms of the look and feel of the implant, no one will dispute that silicone gel implants look and feel more natural. They are soft and feel very similar to natural breast tissue. Saline implants tend to be firmer and may show visible rippling around the edges. There can also be visible folds, especially during movement or bending over. Placing the implants under the muscle can reduce some of this, but a saline implant will never look or feel as natural as a silicone gel implant.

Studies show that the rupture or leak rate of both implants is the same. However, the ability to detect a leak is quite different between the two implant types. When a saline implant leaks, it is obvious. Your breast will be deflated in a few days or weeks depending on the size of the leak. When a silicone gel implant breaks, the gel will not leak out. This means the breast will not change size. Rather, it will change very slightly in shape. These changes can be subtle and an MRI is needed to detect a silicone gel implant rupture. Studies do not show any connection between systemic sickness and a silicone implant rupture. Silicone gel will not get into the blood and travel throughout the body and cause cancer, Lupus, arthritis, or any other illness.

As you can see, there are advantages and disadvantages to each type of breast implant. To learn more about your options for breast augmentation and implant selection, visit a board certified plastic surgeon. Contact us to schedule your appointment with Dr. Schulman, by calling 212-289-1851.

So, how do you avoid becoming one of those “I wish I went bigger” with my breast impants? It is all about proper selection of the implant size. This means an in-depth discussion with your surgeon about your expectations. You should bring a photograph to demonstrate what you want to look like. This is important because I have had several women who have come to me saying things like “I want to be natural looking” or “I just want to be fuller, but I don’t want people to notice”. This all sounds reasonable until they whip out a picture of Pamela Anderson to show me what they want! Clearly in this case there is a disconnect between what they want and what they say. Do you want to be BIG, do you want to be just a little fuller? These are things you should be clear about before you even arrive for your first consultation.

Next, your plastic surgeon should give you implants to try on. You should see how you look and feel with the new look. Sometimes, your surgeon will even let you take the implants home for a few days so that you can “test drive” your new breasts. Trying on the implants is a million times better than any expensive imaging program that your surgeon may use.

Also important is to understand how the implant will look after it is “inside”. Breast implants tend to look slightly smaller after they are inserted during surgery. I notice that the implants look about 10% smaller. This means that if you like the way a 350 cc implant looks when you try it on, it may appear more like a 325 cc implant after surgery. In this case, you should consider having a 375 cc implant placed.

So, as you can see, a good discussion between you and your surgeon about implant size should prevent you from being unhappy with your size. Breast Augmentations are a major component of my practice, and I pay particular attention to sizing the implant so that my patients are happy afterwards. During our first visit, we discuss the surgery, the risks, and implant size. There is a lot to think about so I do not make anybody commit to the implant size. If there is any doubt about size, my patients will return again specifically to discuss implant size and not be distracted by all the other details about surgery that we go over. I also allow my patients to return as many times as they want to try on implants before surgery.

To date, I have had no woman return for reoperation purely because she thinks she is “too small” after her breast augmentation.

To learn more about breast augmentation with Dr. Schulman, including his Rapid-Recovery Breast Augmentation using the Keller Funnel, contact us by calling 212-289-1851.

My Rapid-Recovery technique involves four specific components:
1. Long-acting local anesthetics injected into pain nerves of the breast
2. Injection of Botox into the pectoralis muscle
3. Insertion of the breast implant using a Keller Funnel
4. Post-operative application of LED lights to reduce bruising and swelling

My breast augmentations are performed under general anesthesia – you are completely asleep. However, I also inject long-acting local anesthetics into the nerves of the breast. The medicine is specifically injected into the sensory nerves of the breast. The result is less pain during the first 8 hours after the surgery which is usually when most patients are most uncomfortable. This prevents the buildup of severe pain that can make a recovery difficult.

The majority of breast implants are placed under the pectoralis muscle. When implants are placed under the muscle, it requires that the surgeon cut the pectoralis muscles in order to place the implant. During the months after the surgery, this cut pectoralis muscle can have painful spasms. This can result in pain that can persist for weeks and months after surgery. Also, the implant can stretch the muscle, causing pain. More importantly, the implants commonly remain “high” for several months after surgery because they are being held by the pectoralis muscle and need to “drop” into a natural position. This often takes up to 6 months after plastic surgery. The solution for all these things is Botox! I inject Botox into the pectoralis muscle at the time of surgery. This causes paralysis of the muscle for 4 months, decreasing painful spasms as the muscle heals and allows the breast implant to drop into the desired position in just a few weeks instead of 6 months.

Next, I use a special device for insertion of the breast implant. This device, called a Keller Funnel, allows non-traumatic insertion of the implant through a very small incision. Less trauma and a smaller incision equals less pain.

The final component of the “Rapid-Recovery” Breast Augmentation in New York City is the use of LED lights. LED, or Light Emitting Diodes, are colored lights. Studies have shown the red and blue rays of light can decrease inflammation and bruising. My patients are given these hand-held lights to take home and apply it to the breasts several times a day. The use of these lights reduces the bruising, swelling, and pain.

Using this technique, I find that my patients have less pain, less bruising, less swelling, and a faster final result.

Contact Dr. Schulman’s practice of plastic surgery in New York City to schedule a free consultation and learn more about Dr. Schulman’s Rapid-Recovery Breast Augmentation.