An umbilical hernia is an opening in the abdominal wall and results in the protrusion of fat or intestine. This appears like an “outie” that can be pushed in. These hernias are extremely common in infants and usually close on their own by age 2 or 3 years old. Hernias that fail to close may require a surgical procedure to close the opening, preventing potential complications in the future. The most serious complication can be a piece of the intestine getting stuck in the opening causing bowel obstruction, partial death of the intestine, and septic shock.

So, if his hernia was repaired, why does his belly button look like that? This is probably because the surgeon closed the opening with sutures, which is the appropriate thing. But what the surgeon probably failed to do is remove any fat that was trapped outside the opening, or trim the excess skin of the belly button. This may be the reason why he has a bulging belly button with overhanging skin. Essentially, the hernia was repaired, but little consideration was given to the cosmetic portion of the procedure. As a plastic surgeon, I have trained in BOTH general surgery AND plastic surgery. This means that I am able to repair the hernia AND make the belly button look better!

But don’t worry if you have had your hernia fixed and you belly button still doesn’t look good. You can still have a cosmetic belly button procedure that improves the appearance. Cosmetic surgery of the belly button, or umbilicoplasty, has become one of the most common in-office procedures that I perform. In fact, I have been nicknamed “Dr. Belly Button” by many of my patients who come great distances for the procedure. It takes anywhere from 30-60 minutes and is done using only local anesthesia. The recovery time is rapid.

So John, if you are reading this (if you are not, then you are really missing out on a great blog), give me a call so I can correct your only flaw.

If you would like to learn more about cosmetic surgery of the belly button, call 212-289-1851 or contact me to request a consultation

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.

#3 – Umbilicoplasty
    The demand for cosmetic surgery of the belly button has continued to increase over the past several years. Common requests are to make an “outie” into an “inne”, remove that overhanging “hood” of skin, or remove the remnants of a belly button piercing. The beauty of this procedure is that I can perform a significant improvement in the comfort of my office, using only local anesthetic and under 45 minutes. My patients complain of only a small amount of soreness that lasts for 1-2 days afterwards, making this an extremely easy recovery as far as plastic surgery procedures go. In 2011, I performed several belly button surgeries per week, and drew patients from all over the tri-state area and as far away as London. I have basically become known as “the belly button plastic surgeon” because I perform a large number of this very uncommon procedure.

#2 – Brazilian Butt Lift
    2011 was definitely the year of the booty. With continued media focus on Beyonce, JLo, and Pippa Middleton, request for a lifted and fuller backside was through the roof. To improve the shape of the buttock, I use a technique that combines liposuction and fat injection. Commonly known as the Brazilian Butt Lift, this technique involves removing fat from the areas around the buttock (the outer thighs and lower back), processing this fat, and reinjecting it into the buttock. The result is a rounder, fuller, and more lifted backside. While there are many surgeons performing this procedure, I have added several techniques to the procedure that I think improves my results and increases fat survival. In addition to meticulous liposuction and fat harvesting techniques, I add specialized growth factors to the fat before I reinject it. This addition of growth factors is unique to my practice and it is one of the reasons why people are choosing me over the numerous other surgeons offering Brazilian Butt Lifts.

#1 – Smooth Tuck®
    2011 was another enormous year for Smooth Tuck®. I first created this procedure in 2009 as an abdominal contouring procedure for the patient too obese for the traditional tummy tuck. This was extremely well-received and I had numerous media appearances for this procedures including being named a “Hot New Procedure” by Life & Style Magazine. As time went on, I was able to expand the indications for this procedure. I began performing this procedure on morbidly obese people, resulting in some of the most dramatic transformations I have ever seen from any procedure. I also adapted Smooth Tuck® to the ideal tummy tuck candidate who desires a less invasive procedure with a more rapid recovery. Instead of the 6-8 weeks recovery that is required after a tummy tuck, my Smooth Tuck® patients are returning to work in 7-10 days and have completely unrestricted activities at 3 weeks. I now have performed a few hundred Smooth Tuck® procedures and have modified my techniques to reduce the recovery and also to safely perform it on even the largest patients. The media exposure this past year was huge, with Smooth Tuck® featured on CBS, NBC, ABC, FOX, The Doctors TV, and Dr. Steve. Because Smooth Tuck® is exclusive, people continue to come to me for this procedure from all over the country and the world. This past year, I performed Smooth Tuck® on people from as far away as Thailand, Ireland, Afghanistan, Bermuda, Alaska, Texas, and Florida.

To learn more about Smooth Tuck®, Brazilian Butt Lifts, cosmetic belly button surgery, or any other procedure, contact us or call 212-289-1851.

So what is gynecomastia and what is the cause? It is the enlargement of the male chest as a result of breast tissue growth. Yes, it is actual breast tissue, not simply fat. All men have some small amount of breast tissue normally. Hormonal imbalances can cause an increase in the level of estrogen (also normally found in men but in much lower levels than women) to rise, signaling breast tissue to enlarge. The hormonal imbalance can occur from prescription medication such as many anti-depressants, psychiatric medications, and weight loss medicines. It can also occur from anabolic steroid use of chronic marijuana smoking. Interestingly enough, when the offending medication or drug is eliminated, the chest may decrease in size but rarely goes away entirely. Obesity triggers the conversion of testosterone to estrogen and can result in male chest enlargement. A more rare cause of male chest reduction is tumors, such as testicular cancer that can secrete abnormal hormones. Enlargement of both sides is most common, although one may become larger than the other. If there is enlargement of only one side, the possibility of male breast cancer must be considered although it is rare.

If you suffer from male chest enlargement, you should be evaluated by a physician. Your physician will perform a history to determine the possible causes. This will include a detailed history of all drug use, both legal and illegal. Also, a physical exam may help determine whether tumors or cancer is a cause. Your physician will also test your blood for hormone levels and possibly have you seen by an endocrinologist. Approximately 80% of the time, there is no detected cause for this and it is termed “idiopathic” – a fancy medical term for “we have no idea why”.

After treating any underlying medical condition or in the case of “idiopathic gynecomastia”, you may be referred to a plastic surgeon for discussion of the options for correction. Gynecomastia reduction surgery is one of the most common procedures among my male patients.

The treatment will revolve around removing the excess tissue. This may be done with liposuction to suction out the breast tissue and fat. Often, there is a hard lump of breast tissue that is felt under the nipple and areola. This is called the “breast bud” and is very resistant to liposuction. The tissue is just too dense to be removed by suctioning alone and needs to be removed through an incision around the areola. In severe cases, there is excess skin as well as underlying breast tissue. In these cases, reduction usually involves removal of breast tissue with a combination of liposuction and excision, as well as removal of the excess skin.

Gynecomastia is extremely common and a major source of embarrassment, no matter what the age. There are many options for correction. You should see a board certified plastic surgeon to learn about these options. To see some of my before and after gynecomastia pictures Click Here.

To learn more, or to schedule your consultation, contact me or call 212-289-1851.

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.

I hear this scenario (or something very similar) several times a day in my New York City Office an I have a solution for you – cosmetic belly button surgery.

Cosmetic Belly Button Surgery, or umbilicoplasty, is a procedure designed to improve the appearance of the belly button. Most commonly, it is done to convert an “outie” into an “innie”. But in recent years, patients have been increasingly requesting removal of an old belly piercing. This specific request now makes up about 30% of my umbilicoplasty cases. Removing the old piercing is more than just simply removing the hole. It usually also involves removing the skin “hood” that develops along the top of the belly button, especially after weight changes and pregnancies.

This procedure is done in the comfort of my office, using only local anesthesia. It takes approximately 45 minutes and there is virtually no pain afterwards. The sutures all dissolve on their own and you can be back to normal unrestricted activities in 1 or 2 days.

To learn more about cosmetic belly button surgery, or umbilicoplasty, or to schedule your appointment with Dr. Schulman, contact us or call 212-289-1851

Whether we choose to admit it or not, looks do matter. Many studies demonstrate that beautiful women and handsome men have a social advantage. It is what is called a “halo effect”. Strangers view attractive people in a more positive way than they view his or her unattractive counterpart – attractive people seem to have a “halo”. This has been observed in schools, in interactions with law-enforcement, on the street among strangers, and in the workplace.

You may be reading this and would insist that you treat everyone the same, irrespective of their appearance. But do you really? When you see a thin, attractive female next to an overweight, disheveled female, what are your assumptions about their work ethic? Who would you hire to work at your business? Who do you think portrays the image that you think your company best represents?

While we would like to believe that there is not a bias against unattractive people, multiple studies have demonstrated that there is, even if it seems to go against our own personal beliefs. Therefore, we must recognize that people do think this way, and we need to understand how looks can affect our position in the job market and our own “marketability”.

Looking youthful, refreshed, and “put together” may be one of your best tools to get that job or that promotion. While it won’t be found on your resume, employers and hiring managers find it crucial. They see a person who takes pride in their own appearance as someone who will take the same pride in representing their company. There is not an official category for appearance when evaluating a job applicant, but it definitely comes into play. Anyone who says differently either hasn’t hired or been hired recently, or is just naïve.

This may explain why there has been an increase in cosmetic procedures over the past years, despite the fact that more people are out of work and almost everyone is watching their spending and eliminating non-essential expenditures. It also helps explain why the largest growing group of people undergoing cosmetic surgery is men. Men have traditionally been immune to this appearance bias – hasn’t it been said that an aging man is not older, he is more “distinguished”? Aging men are now competing with younger men in the workplace. All of a sudden, those bags under the eyes or the lines on the forehead are seen as signs of weakness.

Cosmetic procedues can help someone look more youthful, more rested, and more attractive. While it is not “politically correct” to say, this may make them more competitive in a very tight job market. A variety of procedures are available, from non-surgical treatments for the skin such as lasers, Botox, and fillers to surgical procedures for the face such as eyelid surgery, facelifts, and necklifts.

To learn more about what procedures may be available for you ,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.

Let’s look at some examples of implants. A 300cc Low Profile implant is wider and flatter than a 300cc High Profile implant which is narrower and projects more. A Moderate Profile 300cc implant has a width and projection that is in between the other two profiles.

So, what does this mean and how do you know which type of breast implant is best. In general, a person with a narrow torso may be better suited with a High Profile Implant. This is because the other profiles may be too wide for a narrow torso, resulting in implants that are too close in the center (“uni-boob”) or hanging off the side (“side-boob”). However, if a woman has a wide torso, than a wider implant is needed so that the implants help to fill out the chest. In this situation a Low or Moderate profile implant may be better. A High Profile implant will be likely leave too much space in between the breasts.

Your surgeon will play the key role in determining which breast implant profile is best for you. This is done by using specific measurements such as the width of your breast (base diameter), the size of your torso (band width), and the nipple-to-nipple distance. Your surgeon must also factor in your specific desires about implant volume and the desires “look” of your augmentation.

The bottom line is that you should not stress about which implant profile is best. This is a job left to your surgeon. I tell my patients that they should only focus on the volume they desire and then I will recommend a profile type based on multiple factors that were discussed above.

For more information about breast augmentation in New York City, contact Dr. Schulman or call 212-289-1851 to schedule your consultation.