Archive for the ‘Blog’ Category

Firm and Fabulous: How to Fix Sagging Breasts

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Saggy breasts can be a common concern for many women, impacting their self-esteem and overall body confidence. If you’re wondering how to fix sagging breasts and regain a more youthful, full and perky appearance, you’re not alone! As well as wearing a really good bra, there are effective solutions that can bring you life-changing results. But first, let’s discuss what causes sagging breasts and if we can fix them to achieve the firm and fabulous breasts you desire.

What causes sagging breasts?

Let’s explore what causes saggy breasts. Over time, factors like aging, pregnancy, weight fluctuations, genetics and, of course, gravity can lead to a loss of skin elasticity and breast tissue volume. This can result in breasts that appear less firm and saggy. This may lead to discomfort, reduced self-confidence and choices of preferred clothing.

Common causes: breast sagging after breastfeeding

Breastfeeding is a natural and nurturing experience for mothers and infants, offering numerous health benefits. However, it’s common for women to wonder if breastfeeding can lead to sagging of the breasts. The changes primarily result from the stretching of skin and ligaments during pregnancy and breastfeeding, affecting breast firmness. Hormonal levels also affect the density and fullness of breasts. These effects vary from person to person.

Common causes: sagging breast after weight loss

Significant weight loss is an amazing achievement with numerous health benefits, but it can sometimes result in concerns about sagging breasts. The changes primarily occur due to the reduction of fatty tissue in the breasts and its impact on breast volume. Supporting ligaments can also be affected. With weight loss, the skin elasticity also diminishes leading to more saggy, flat breasts.

However, it’s crucial to remember that weight loss’s positive effects on overall well-being usually far outweigh any aesthetic concerns. The choice to address breast changes with surgery is a personal decision that can be safely achieved after weight loss. Celebrate your achievements and embrace your journey to feeling fabulous in your dream body.

So, can you fix saggy breasts? The answer is YES!

The good news is that yes, you can fix saggy breasts! There are several breast surgery options that can help you regain your confidence and feel amazing in your own skin.

Breast Augmentation

For those looking to restore lost volume or enhance their breast size, breast augmentation with implants is a popular choice. This procedure allows you to customize the size and shape of your implants, providing you with beautiful, natural-looking, more youthful breasts. After the surgery, your breasts will no longer be sagging, leaving you with a renewed sense of confidence.

Breast Augmentation with a Breast Lift

This combined procedure is the go-to option for those seeking both increased volume and lifted contours. Breast augmentation enhances size, while the breast lift addresses sagging by removing excess skin and reshaping the breast tissue. The result is a fuller, lifted bustline. You surgeon will discuss the possibility of a combined procedure with you.

Browse our gallery of breast augmentation and implant before and after photos.

Breast Lifts

If your concern is primarily sagging without a loss of volume, a breast lift procedure may be the ideal solution. This surgery raises and reshapes sagging breasts, repositioning the nipples to a more youthful height. The result is firmer and more youthful-looking breasts, enhancing both your appearance and self-confidence.

Browse our gallery of breast lift before and after photos.

Breast Reduction

For those with overly large breasts causing discomfort and sagging, a breast reduction can provide relief. This procedure not only lifts and reshapes the breasts but also reduces their size, leading to an improved quality of life. After a breast reduction, you can enjoy a more balanced and harmonized figure, free from the burdens of sagging and discomfort.

Browse our gallery of breast reduction before and after photos.

Schedule a Consultation with Dr. Michele Koo for Your Breast Transformation

To achieve your dream breasts, it’s crucial to choose a board-certified plastic surgeon with a proven track record of delivering exceptional results. Dr. Michele Koo in St. Louis, Missouri, is a compassionate and skilled surgeon with extensive experience in breast surgery.

If you’re ready to address your concerns about sagging breasts, take the first step towards renewed confidence by scheduling a consultation with Dr. Michele Koo. You may also call 314-984-8331 with any of your questions prior to your consultation. Her expertise and commitment to patient satisfaction will guide you through your journey to your perfect breasts.

Breast Implant Sizes Chart: Implant & Cup Sizes for Your Perfect Look

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Your breast enhancement is an exciting journey, and we’re here to help you every step of the way. Choosing the ideal breast implant size is a pivotal and very personal decision, and we’re here to make it an empowering experience. We understand that achieving the results you desire, while ensuring a comfortable and natural fit, is so important. In this blog, we’ll explore your options and provide a useful breast implant size chart to help you find your perfect fit.

Understanding breast implant sizes

Breast implants come in a great range of sizes, measured in cubic centimeters (cc). The size of the implant directly influences your final cup size and the overall appearance of your breasts. Cup sizes, on the other hand, are more commonly recognized and range from AA to DD and beyond. Understanding the harmony between these two measurements is key when selecting your dream breast implant size.

Small, medium and large: What’s the difference?

What is considered a small breast implant?

When it comes to small breast implants, you’re looking at a subtle, natural enhancement that typically ranges from 100 cc to 300 cc. This choice is perfect for those of you who seek a modest change, providing a confidence boost while maintaining a harmonious look. You may simply want to replace the fullness and roundedness of your breasts prior to pregnancy or breastfeeding. You may simply want to replace the firmness of your breasts prior to weight loss or hormonal changes.

What is considered a medium breast implant?

A medium breast implant, usually ranging from around 300 cc to 450 cc, offers a noticeable yet natural enhancement. It’s the preferred choice for individuals looking to add or return fullness and proportion, resulting in a balanced and confident appearance.

What’s considered a large breast implant?

For those considering large breast implants, typically 450 cc and beyond, you’re stepping into a category that offers a more dramatic transformation. Whether it’s for a curvier figure or to restore lost volume, these implants, when carefully selected, can provide a striking yet natural change that aligns with your individual preferences and goals. A larger implant may be perfect for a tall, lengthy torso or take up the slack of extra breast skin.

What is the most common breast implant size?

The most common breast implant size usually falls in the range of 300 cc to 400 cc, offering a noticeable yet natural enhancement, resulting in an increase of approximately 1 1/2 to 2 cup sizes. This size choice provides a balanced and harmonious appearance without an overly ‘in your face’ dramatic change! However, finding the perfect fit for your unique goals is essential.

Implant CC Sizes and Corresponding Cup Sizes

Our breast implant size chart provides you with a more detailed and enlightening guide to breast implant cc sizes and their corresponding approximate cup sizes. But remember, these are approximate values. The real outcome may vary due to factors like your unique body type and your choice of implant shape. These factors are discussed with you during consultation visits.

Implant CC Size Approximate Cup Size Increase
100-175 cc 1/2 cup size increase
200-275 cc 1 cup size increase
300-375 cc 1 1/2 cup size increase
400-475 cc 2 cup size increase
500-575 cc 2 1/2 cup size increase
600-675 cc 3 cup size increase
700+ cc 3+ cup size increase

Call us on (314) 984-8331 or schedule a consultation to learn more.

Selecting the right implant size

Selecting the appropriate breast implant size involves careful consideration of your desired results and your body. Here are some essential steps to help you make an informed decision:

Consult with a Board-Certified Plastic Surgeon: A consultation with an experienced plastic surgeon is the first step. They will assess your body type, discuss your goals, and recommend implant sizes based on your unique circumstances.

Dream Big, Dream Beautiful: Be crystal clear about the look you want to achieve. Whether it’s a subtle enhancement or a more dramatic transformation, YOUR VISION matters!

Think About Proportion: Your chosen implant size should beautifully complement your body’s proportions. What suits one person may not be the right fit for another.

Discuss Implant Types: In addition to size, breast implant type plays a role in the final result. Discuss options like saline, silicone and their specific projection height to circumference ratio and its suitability for your breasts and rib cage with your plastic surgeon.

Consider Your Lifestyle: Think about your daily activities, fitness routine, and clothing choices. Your implant size should complement your lifestyle and what you want to wear, and your comfort level and desire to show cleavage. Your profession may be a significant factor in the choice of your type and size of breast implant.

Trust the Expertise: Your plastic surgeon is your trusted partner on this journey. They will provide expert guidance, considering your goals and anatomy and guide you to the perfect breast implants. It is extremely important you are on the same visual page. I always recommend bringing pictures of your ‘perfect world’ breasts to the consultation in addition to discussing your preferred ultimate cup size.

Ready to discuss breast implant sizes?

Choosing the perfect breast implant size for your breast augmentation surgery is a deeply personal journey that should harmonize with your unique vision and body type. Schedule a consultation with Dr. Michele Koo, our board-certified plastic surgeon. With her expertise and your dreams, together, you can confidently select the ideal breast implant size and cup size, ensuring you feel comfortable and beautiful. It’s your beauty, your journey, and your choice – and we’re here to support you every step of the way.

Types of Breast Implants for Your Perfect Look

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When considering breast augmentation surgery, one of the most crucial decisions you’ll make is between the different types of breast implant. You’re probably wondering, “what are the different types of breast implants?!”. The world of breast implants is diverse, offering options to suit various preferences and body types, including choices from popular brands available in the US. In this blog, we’ll delve into the different kinds of breast implants, exploring the technical aspects and helping you understand which one might be the perfect fit for your aesthetic goals.

The wide world of breast implants

Breast implants have come a long way over the years, offering various options from reputable brands in the US market. Whether you’re looking for a natural feel or a particular look, there’s a breast implant that may be the perfect type for you. Let’s delve into the different types of breast implants available, considering both the technical and aesthetic aspects.

Silicone breast implants

Silicone breast implants have been a popular choice for many years and come in various options from reputable brands like Mentor, Allergan/Abbvie, and Sientra. These implants are composed of a silicone shell filled with cohesive silicone gel. The cohesive gel in these implants is designed to mimic the natural feel of breast tissue and maintain its shape. The gel also reduces the risk of rippling and provides a realistic appearance and feel. Silicone breast implants tend to be more forgiving of natural breast contour deficits and come in a large variety of shapes, profiles (projections), and sizes. The form stable cohesive gel that is currently available has a lower capsular contracture rate than the older silicone implants which were more liquid in nature. The current form stable cohesive gel silicone resembles a jello firmness.

Saline breast implants

Saline breast implants, available from brands like Mentor, Allergan/Abbvie, consist of a silicone shell filled with a sterile saltwater solution. These implants are adjustable, making them suitable for fine-tuning the size particularly in the case of asymmetry. In the event of implant rupture, the body safely absorbs the saline, making it a safe and easily detectable option. Saline implants however tend to cause palpable ripples with time which can sometimes be also visible.

Gummy bear implants (highly cohesive gel)

Gummy bear implants, offered by reputable brands like Allergan/Abbvie, Mentor, and Sientra, as well as other smaller companies such as Implantech, are filled with a highly cohesive silicone gel. This gel is designed to maintain its shape, providing a natural look and feel. Even if the implant shell were to rupture, the cohesive gel stays intact. These implants are a suitable choice for those looking for natural and long-term results. Think of the inside resembling a gummy bear candy.

The Allergan Natrelle 410 highly cohesive gel implants have been voluntarily recalled due to its textured outside shell being associated in a rare instance with Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA ALCL).

BIA ALCL is a rare disease seen in the capsule formed around textured implants. The disease is curable with surgical excision of the entire capsule. In the very rare instance, chemotherapy or radiation may be required in a late stage BIA ALCL.

To learn more about the different breast implants available, schedule a consultation with Dr. Michele Koo today.

Breast implant considerations and comparisons

Choosing between the different breast implants involves comparing various technical factors. Factors to consider include:

  • Filler material
  • Implant shell texture
  • Implant size
  • Implant shape
  • Placement options
  • Incision techniques used for the placement

Each type of breast implant, whether silicone, saline or ‘Gummy bear’, has its own set of technical features, advantages, pros and cons, making it important to find the one that aligns with your goals. Your plastic surgeon will guide you through the decision process to optimize your outcome based on your body and aesthetic preferences.

Choosing the right breast implant type for you

Selecting the right kind of breast implant is a personal decision that should take into account both your technical preferences and aesthetic goals. At Dr. Koo’s Private Practice, we discuss this breast implant selection with our patients during in-depth pre-consultations. We can help you assess your goals, understand your options, suitable brands, and make an informed choice that aligns with your vision for the perfect look.

The variety and range of breast implants available ensures that you can achieve your perfect look while preserving your comfort and confidence. The decision may feel overwhelming, but with the right guidance, you can confidently select the ideal breast implant type to enhance your appearance.

Begin your journey to the perfect you with Dr. Michele Koo

If you’re considering breast augmentation in St. Louis, Missouri, and need personalized guidance, don’t hesitate to contact us. Our experienced team is here to help you achieve your desired look while prioritizing your comfort and well-being. You can contact us on or (314) 984-8331.

Real Boobs Vs Fake Boobs: An Ultimate Guide

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I am asked every day if breast implants can lift the breasts and keep them on the chest and not the tummy, especially after having children and breastfeeding. But more importantly, will they look and feel natural? When it comes to breast enhancement, it’s essential to separate the facts from fiction. There’s a lot of chatter about real vs. augmented breasts, and it’s important to make an informed decision if you’re considering breast augmentation surgery. I’ll delve into the world of breast augmentation, discussing the key differences between real and augmented, enlarged breasts, dispelling myths, helping you understand the differences and your choices, and answering your questions about what can and cannot be achieved through breast augmentation with breast implants.

Real vs. fake: what’s the difference?

Characteristics of real breasts:

  • Completely squish-able
  • Usually hang slightly lower and are not as full on the upper pole of the breast
  • Fall off to the sides of chest or armpits when lying down
  • Aging and gravity affect them over time
  • Hormonal and weight changes affect breast density. With time and loss of hormones, breast sag

Characteristics of augmented breasts:

  • Firmer more dense feel due to breast implants (resembles younger pre-kids breast)
  • Typically more voluminous and round especially at upper breast portion (upper pole)
  • Will not typically fall off into the armpits with time
  • Generally maintain their shape over time
  • Hormonal & weight changes WILL affect breasts. Augmented breasts WILL still change and drop with time and gravity but more slowly

Debunking common myths about augmented breasts (AKA fake boobs)

Myth 1: fake breasts always look unnatural

Not true! Modern breast augmentation techniques, including SILICONE and SALINE BREAST IMPLANTS, have come a long way. Skilled surgeons can create a natural look and feel that complements your body shape without anyone ever knowing.

Browse through our breast surgery, before and after gallery.

Myth 2: fake breasts feel hard and unpleasant

Not true! While some individuals may prefer the natural feel of real breasts, today’s implants are designed to mimic the texture and softness of natural breast tissue. Most people can’t tell the difference by look or touch.

Myth 3: fake breasts don’t need maintenance

With aging, weight and lifestyle changes, the actual breast tissue overlying the augmented SILICONE or SALINE BREAST IMPLANTS can lose volume and firmness. The natural breasts will continue to age and change and therefore the overall breast appearance changes even with breast implants in place. Your augmented breasts will continue to have more fullness and roundness from the implants but the shape will continue to change.

Myth 4: fake breasts are forever

Not true, both saline and silicone augmented breasts will tend to firm over time. The breast implants themselves whether they are silicone or saline implants have a lifetime of 10-25 years and will need to be replaced. They only need to changing if there is a change in shape, feel (firmness), or on an incidental mammographic finding. There is NO emergency to having the breast implants replaced or removed. They can be changed at your convenience. However, if you have a leak or an intra-capsular leak of the implants, the longer you wait to replace your silicone breast implants, the messier it is for your plastic surgeon.

If you have any questions about breast implant maintenance, contact Dr Michele Koo today.

Myth 5: fake breasts are perfect and completely symmetrically identical

NOT TRUE! Both saline and silicone breast implants can help even out breasts that are quite asymmetric but you will always have sisters and not twin breasts. The roundedness of your own breasts, your rib cage, the inframammary fold distance from your nipple, placement of the inframammary fold to name a few variables all affect the overall symmetry of your breasts. these variables are NOT all corrected with breast implants.

Myth 6: fake breast will have tight perfect cleavage

Not true! Cleavage can be improved but if you have breasts that are naturally far apart without any breast tissue or fat between your breasts, it will be difficult or near impossible to achieve a tight full cleavage.

Making the choice

Factors to consider

Your Body Type

Consider your overall body proportions. In my private practice, I help you choose implants that complement your physique and that fulfill your ‘perfect world’ breasts on YOUR body for YOUR lifestyle. Everyone is different, and I guide your choices solely based on your desires, safety and body type.

Your lifestyle

Think about your daily activities and the impact of breast size on your lifestyle. For example, larger breasts may affect your exercise routine. Its also important to consider is your choice of clothing. Do you wear clothing that reveals your breasts, that show cleavage? Are you in a profession where you prefer not to show any breasts and want to conceal the breast augmentation entirely? Do you only want your breasts to appear full, pushed up with cleavage when you’re intimate with your significant other or during a function when you are wearing a more revealing outfit?

Your style

Its also important to consider is your choice of clothing. Do you wear clothing that reveals your breasts, that show cleavage? Are you in a profession where you prefer not to show any breasts and want to conceal the breast augmentation entirely? Do you only want your breasts to appear full, pushed up with cleavage when you’re intimate with your significant other or during a function when you are wearing a more revealing outfit? Do you have young children, adolescent boys?

Your long-term goals

How do you envision your breasts in the future? Discuss your long-term goals with your surgeon to choose the right option. Are you planning to have more children? Will you want to replace your implants in 10-25 years? Will you have the time and resources to have another operation?

All the above are very important questions that you need to answer prior to your choice of the perfect size breast implants. I go through all the questions and issues that will come up with newly augmented breasts and we will take our time choosing the perfect breasts for your physique.

Real-Life experiences

Many individuals have chosen breast enhancement for various reasons.

Here are some common experiences:

Boosted Confidence: Some people find increased self-confidence and a more positive self-image after breast augmentation.

Reconstruction After Surgery: Breast implants are often used in breast reconstruction procedures after mastectomy or injury.

Body Harmony: For some, breast augmentation helps them feel more in harmony with their bodies.

Feeling More Feminine: It can enhance the sense of femininity for those who have felt less feminine due to breast size.

Replacing Lost Breast Volume: After breast feeding and pregnancy, breast can sag and atrophy. Breast implants can lift and replace the lost tissue if you don’t have too much excess skin. A lift is also required if the breasts are too low however.

Real vs. Augmented Breasts: a personal choice

Ultimately, the choice between real and augmented breasts is deeply personal. It’s essential to consult with an experienced plastic surgeon who can discuss your goals, assess your body type, and help you make an informed decision.

Remember that there’s no right or wrong choice, just the one that feels right for you! In the end, what matters most is how you feel about your body and your confidence. Whether real or fake, your breasts should make you feel comfortable and empowered in your own skin.

If you’re considering breast surgery, consult with our board-certified plastic surgeon Dr Michele Koo in St. Louis, Missouri, to discuss your options and get personalized advice. You can schedule a consultation or contact our private practice on 314-984-8331.

Let This New Year Inspire You to Take Better Care of Your Health

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Are you determined to make a fresh start in prioritizing your health this New Year? Begin with your skin! As they say, ‘First Impressions are Everything.’ Maintaining New Year’s resolutions becomes easier when you turn them into simple, sustainable habits. It’s not about viewing your resolution as a one-off task; instead, it’s about embedding it into your routine, so it sticks. Even if you miss a week, don’t let a small setback turn into months of inaction.

This year, let your focus be on better health. It can mean making smarter food choices, controlling portion sizes, reducing starches/carbs, committing to a 20-minute walk each week, or attending one weekly workout class. These are simple yet effective steps to transform healthy choices into HABITS.

And remember, consistent daily skincare is not just about aesthetics – it’s a crucial component of your overall health. The right medical skincare regimen tailored to your specific needs and skin type can lead to not only healthier skin but also a healthier you.

What are the correct products for YOUR skin?

1. An anti-oxidant serum, such as Dr. Koo’s GLOSS Vitamin Serum, that protects against the formation and the penetration of super-oxide free radicals that damage skin (wrinkles and uneven pigmentation) and go on to cause skin cancers. Pollution and UV rays are the greatest producers of free radicals in our skin. Layer the anti-oxidant serum under daily sunscreen, makeup, and all other products EVERY DAY, TWICE A DAY.

2. Use the appropriate skin cleanser to remove dead skin cells. This does not mean using harsh cleansers or brushes which will irritate and redden the skin. Harsh detergent cleansers or too frequent washing will strip your own skin’s natural oils thereby stimulating your oil glands to overproduce oil. This will lead to the opposite of what you want; it will create breakouts, clogged pores, and even more oily, rough, and irritated skin.

  • Use gentle GOOD quality cleansers for your skin needs.
  • Dry/Very Dry Skin: use a creamy cleanser
  • Oily/Acne Prone Skin: use either a clarifying or exfoliating cleanser
  • Congested Pores/Rough Skin: use a gentle cleanser with TINY ORGANIC  crystals (Dr Koo POLISHING CLEANSER) to cleanse the pores without aggravating them with harsh scrubs
  • The appropriate cleanser will allow the actives you use to penetrate and fulfill their purpose.

3. Use the correct level of moisturizer your skin craves. If you have dry to very dry skin, you will need a cream AND perhaps a more rich dense serum. Your own skin’s level of moisture will determine the level of moisture product (Dr Koo BOOST) required. Moisturizers should be applied twice daily, under makeup and with the GLOSS Vitamin Serum.

The weather and temperature will determine the frequency of use. If you are in a high altitude in a dry climate, you may need to moisturize even more than twice a day. If you are in a temperate, humid climate such as Florida, you may only need to moisturize at night.

The season and how your skin responds to the products will guide you to the frequency of use.

The above 3 products are the most basic and most important products you must use. If you are in your 20’s or 30’s, those are the ONLY products you need (anti-oxidant sunscreen of course also)!

If you have pigment, wrinkles, and thin skin concerns, you will also need an anti-pigment and retinol product such as Dr. Koo’s REJUVENATE & GLOW products.

The correct level of Retinol/REJUVENATE product is used at night only and will increase the thickness (plumpness) of your skin. REJUVENATE will lessen the appearance of the fine and deep wrinkles. In combination with the correct PIGMENT product (Dr Koo’s GLOW), your blotchiness/pigmentation will lessen and the skin tone will appear milkier, smoother, and more even.

5 products plus a sunscreen is the maximum amount of products you honestly need. Additional products are only if you have particular concerns of redness/ruddiness, thin crepe-like eyelid skin, significant acne, or very sun damaged skin.

Your skin is a dynamic changing organ. In fact, your skin is the largest organ of your body and deserves continued care due to its constant exposure. You will help your own systemic health AND the health of your children if you take care of yours and their skin CONSISTENTLY and early-on!

The beauty will follow the functional care of your face.

I haven’t even started on the protection of your neck, chest and knees!!! Stay tuned for the next BLOG!

xo Happy New Year, let the intrinsic reward of healthier and therefore more fresh looking skin and health motivate you to continue the routine!!!

Dr Koo Skincare for Health

How Do I Choose the Perfect Breast Implant for Me?

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My patients ask me this question during every consultation. There are many different types of breast implants, so its a perfectly understandable question.

My reply is: it has taken me 25 years of experience to really understand, to truly “see” how an implant will fit a patient’s breast, chest wall, rib cage, lifestyle, clothing choices, comfort level…let me be your expert and I will pick the perfect implant with you depending on what you want, your body, and your lifestyle.

I say don’t worry about the size or shape of the implant, simply look at pictures of your perfect world breasts, and “shop the look.” Bring me the pictures of the size, and “look” of the breasts you love, and I will match that  “look” for your body size, breast shape and desires!

The most important point for you is, what look are you going for? What is your comfort level with the amount of attention your breasts will receive? What type of neckline do you like to wear? Do you simply want to have some fullness and firmness in a swimsuit? Do you not want anyone to notice? Do you want a little or a lot of curves?

Everyone is different. Every breast and rib cage is different even from one side to the other. These tiny nuances and details are what I pay particular attention to in order to achieve YOUR perfect breasts.

YOU only have to “shop the look” and ask yourself what you want!


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  • Hyaluronic Acid microsomes diminish eyelid wrinkles, puffiness, and dark circles. Rejuvenates and restores the delicate upper and lower eyelid skin. Squalene, Arginine, & Proline enrich and penetrate the skin cells to smooth the eyelid skin. Prevention and maintenance are your best anti-aging solutions!


  • Intensely concentrated Tocopherol, Jojoba Esters, & intense anti-oxidants diffuse and lighten photodamaged pigmented skin spots. Excellent for the very stubborn pigment age spots. Precise application tip targets pigment spots.


  • Prevents and calms hormonal acne breakouts. Alpha Lipoic Acid & Buffered Salicylic Acid extract toxins, blackheads and oils to shorten acne breakout without overly drying or irritating blemish prone skin. Quiets the angry red stage to help prevent long-term scarring.

To view and learn about all of Dr. Koo’s Skin care products visit Dr. Koo Premier Skincare site

Too Much Sun When You Were Young…Do You Look Older than Your Chronological Age?

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Many of my patients tell me they look so much older than their actual age. What is the reason for this? Let’s start with the basics:

  1. Too much sun exposure during the teen and young adult years and continued lack of sun protection.
  2. Years of smoking.
  3. Early loss of one’s own hormones (early menopause).
  4. Poor skin regimen with ineffective skin products.
  5. Poor nutritional choices.

The number one offender is too much sun exposure. The sun damages the skin cells (keratinocytes) and the arrangement of the collagen and shape of the cells. All of this damage leads to rough, unevenly pigmented skin that is leathery and crepey appearing.  Inhaling nicotine and various toxins associated with smoking also causes direct damage to the cells and the blood vessels that supply the entire body as well as the skin. The loss of hormones can also profoundly affect the quality of skin also. Your choice of foods can also be a factor if you already have trouble prone skin i.e., acne oily prone skin. Drinking more water, and cutting out sugary carbonated sodas can lessen this last offense. The more green the choice of your vegetable the healthier it will be for your skin.

The best advice for your food choices: try to avoid any food that you have to open a can or unwrap a wrapper to consume. The fresher the food, the more natural the state of the food, meaning having to cook it yourself, the better nutritional value it will have and the healthier it will be for you.

Your best weapon to undo the previous wrongs committed against your skin is to start using sun protection EVERY day and cut down (or quit) smoking. I am not a fan of taking exogenous (supplemental) hormones after menopause, but I am a strong proponent of taking vitamin supplements to make our cells more efficient and be able to perform as previously (produce more normal collagen, more tiny capillaries, normal pigment).

I also believe that medical quality skin products can make a significant difference in the skin quality, color, and texture. These products need to contain true tested pharmaceutical active components NOT simply COSMETIC ingredients you can purchase at the drugstore or mall.

I have technologically engineered skin products formulated specifically by my formulating pharmacist and myself! The natural products and their derivatives are blended in a proprietary technique to drive the actives much more effectively into the actual skin cells to stimulate the cells to return to normal function. This translates to healthier, more brilliant appearing skin erasing much of the damage.

The catch: you have to use it on a regular basis! That part isn’t rocket science. This is truly the best value for your money spent. You spend more money at Walgreen’s, CVS, and Target on products that fill your bathroom cabinets that do nothing for your skin. The products have little penetration and the ingredients that do penetrate do nothing to actually change your skin quality.

If you start on the products and don’t see any change after CONSISTENTLY using them following my instructions in 8 weeks, I will refund your money. You may need to add or change one of the products but my office and I will get the correct combination of products for your skin type! We also will continue to progress your skin to more concentrated and intense components as your skin improves to make sure you are achieving the most you can from your medical skin care.

Do Breast Augmentations have to look big and… fake?

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The answer is no! A breast augmentation with breast implants can simply fill in your skin envelope and take up the slack in your breast skin.

If you see yourself as an athletic person, and you’ve always had smaller breasts but now after children, you don’t have any roundness or shape to your breasts, you can have a breast augmentation and still have small but now rounded, more firm and more pleasing breasts.

The key to remember is that breast augmentations are not always about size! It is about the look!! Some of my patients do want very large “fake” breasts and they are very comfortable with that look and I make sure I achieve their perfect world desires.

For those who want a change in shape but not much of an increase in size I feel it is important to address the following issues with your plastic surgeon:

  • How much roundness you want
  • How high on your chest wall you want your breasts to start, how full on top
  • How much “side boob” curvature you want
  • How much cleavage you want
  • And especially important is how noticeable you want your breasts to be on your body

A small volume breast implant with the appropriate projection and fill ratio (firmness) can create soft, natural, well proportioned breasts that are well balanced and elegant for your body size and compatible with your lifestyle.

I try to discuss all of these points with my patients and try to understand your lifestyle to help direct your ultimate decision for the size, shape and LOOK you want. I find it much more important to discuss the look rather than the size. There is too much variability in bra cup sizes to finalize a breast augmentation based solely on cup size. In my communication with my patients, it is imperative I understand the LOOK of your breasts you want to achieve.

Furthermore, if you haven’t finalized the shape and look that you want, it would be impossible for your plastic surgeon to pinpoint it for you at the time of surgery. This must be discussed and agreed upon prior to your surgery.

Take home point: breast augmentations are very safe and you should be able to achieve whatever size and look you desire, but you must have that LOOK well defined in your mind and show your plastic surgeon that LOOK before the surgery!

Ready to achieve your ideal look?

If you’re considering breast augmentation or have questions about the options available, our board certified plastic surgeon in St. Louis, Dr Michele Koo, is here to guide you through the process. She dedicated to helping you achieve the look that makes you feel confident and comfortable in your own skin.

Contact us today to schedule a consultation and start your journey toward the perfect aesthetic for you.

How Do you Find the Right Breast Implant for Your Breast Augmentation??

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You’ve wanted a breast augmentation for such a long time, you’ve read about different types of breast implants, and now you’re at least ready to start the interviewing process for the right plastic surgeon. Now the real question is how do you know what the right breast implant is?

I feel it is extremely important that you tell your plastic surgeon about your lifestyle, profession and activity level. If you are a teacher and really don’t want your friends and pupils to notice your new breasts or make ANY comment at all, you may want a lower profile softer sitting implants that allow some fall and roundness.

If you are a Mom of young children and teenagers, you may especially be self conscience of being noticed. You want some sexiness and fullness but above all you want your breasts to look natural and in proportion to your body. In this case you will want a full implant but one that is perhaps smaller in width and a little more firm to give your breasts a slight lift in addition to the volume.

If you are in your 20’s and you’re looking for a breast augmentation, the sky is the limit. The choices will truly be only limited by the anatomy of your breasts and your desires. If you want to rock full, sexy, up in your face breasts, you should have them with a full profile, firm, wide breast implant.  You can also choose to have a slightly softer fill implant if you want to only have them in your face when YOU want to show them off with a push up bra or in a swim suit. The exact type and size of breast implant will be determined by your plastic surgeon. Don’t make the mistake of dictating the actual cc size of the breast implant. Your plastic surgeon will place sizers in to determine the perfect fit.

The take home message is have many conversations with your plastic surgeon and ask many questions. Tell her/him about your concerns, if you are planning to have children, breast cancer history, the type of skin you have, the amount of time you spend in the sun, your profession, exercise routine, etc etc etc, in essence everything about your life you think is important actually.

If your plastic surgeon doesn’t want to hear all of your concerns or someone other than your surgeon is talking to you, run for the door. Take the time and make the effort to know the quality of the person your plastic surgeon is!

Breast augmentations are extremely safe and you should have a wonderful experience obtaining the perfect breast enhancement for YOU!!

Enjoy the process—

CELLULITE….What the …. is it? How Do I Get Rid of it?

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If you have cellulite you are certainly NOT alone. Most women and many men have the same problem. Some have a very mild case of it so it is not very noticeable and some have severe cases of it that they do not feel they can wear shorts or even tighter clothing for fear that the cellulite will show through the clothes.

Some researchers and physicians believe cellulite is a normal fat distribution that occurs more in women than men and can be linked (not necessarily caused by) to hormones, genetics, diet, and lifestyle choices (such as smoking, obesity, dehydration and lack of exercise).

Cellulite is an enlargement of normal adipose cells in the superficial layer of our skin. Everyone has these fat cells but when they enlarge and stretch the skin and tether the normal intermittent fibrous bands in our skin, the end result is a dimpling appearance in our skin.

Cellulite typically becomes noticeable during adolescence during weight gain and increase in circulating hormones. This does not occur in everyone and even occurs in people who are thin.

Unfortunately, there is nothing you can do to prevent cellulite specifically if you are predisposed to it with the genetics of your body type and fat cell type. However,….sensible lifestyle choices of regular exercise, not smoking tobacco, adequate hydration, and healthier food choices of dark green vegetables and fewer carbohydrates will all help to deter and minimize the sometimes inevitable development of cellulite. Maintaining a healthy (not thin but healthy for your genetics) weight is key.

The treatment options are varied and many, and again unfortunately not very effective. There is currently an FDA approved laser for the treatment of cellulite but the results are minimal and subjective in my opinion. Liposuction while it improves the contour and shape to perhaps make cellulite appear less noticeable, it can actually also worsen the appearance of cellulite! Mesotherapy, injection of various medications and vitamins have not been proven to reduce cellulite and fat and can cause more irregularities, swelling, skin changes, and infection.

Spa treatments and external massage and wraps are temporary. The results are most likely due to temporary removal of the water content of the superficial and deep skin and fat layers.

Creams and lotions are extremely tempting but costly and a waste of your money!

What lies ahead for cellulite treatment? I know I sound like a skeptic and a naysayer, but the truth is there is ongoing research for certain wavelengths of light (lasers) that may disrupt fat cells and cause them to shrink but these are only at the research stages.

DR KOO’S ADVICE: Try to prevent cellulite from worsening by staying within your ideal weight zone to begin with; make healthy food choices and engage in regular aerobic exercise with weight training incorporated. This doesn’t mean you can’t occasionally eat or drink what you like, but key concepts are limits, portions, and continue to make the right choice EVERYDAY NOT JUST WHEN YOU FEEL LIKE DIETING.

Does Plastic Surgery of the Face Always Look Peculiar and “Done”?

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When I am performing facial aesthetic surgery, I respect the natural architecture of the entire face. I respect the natural lines that are the patient’s unique look. I replace the skin and tissues to where they were previously; I don’t change the inherent structure.

Mickey Rourke or Renee Zellweger illustrate exactly my point. Their unique facial structures have been obliterated by their plastic surgery. Whether they’ve been overfilled or over pulled, it’s not a good look.

I recreate the natural and individual beauty of my patients’ former youth by replenishing and repositioning. This is the key to looking rested and not “done”. I completely understand and respect the soft tissue AND skeletal anatomy.

Meticulous attention to the positioning of the eyes, nose, and mouth within the face is imperative. I balance the face in its entirety therefore my patients never look odd or incongruous. For instance, addressing the neck without attention to its relation to the rest of the face creates a mismatch and a “done” pulled look.

A layered comprehensive approach with filler, BOTOX, skin care, and mini office eye and face-lifts can continue to keep the aging process in check. You can continue to look better and better without creating a significant one-time change. Again the key is regular maintenance. The subtle layered approach is especially important for MEN. As men age, their eyes narrow and brow drops and that becomes a sexy distinguished look that can be enhanced and tweaked but not entirely changed. Men especially do not look appealing with the “wide eyed surprised doe in headlights” look.

The maintenance should start as early as the teen years with acne prevention and sun protection. This will prevent long term scarring and the irreparable deep creases from sun damage. The pigment changes of aging skin can also be prevented and reversed with early intervention and regular maintenance. Medical strength products will achieve far more than any over the counter “feel and smell good” lotions. This is the only way to truly prevent skin damage and restore the luster and sheen of youthful skin.

Bottom line: See your Board Certified Plastic Surgeon early and often. It is better to do a little at a time than too much at once.

If I Have Plastic Surgery On My Face Will I Still Look Like Me?

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facephotoThis is a question I often hear during my office consultations for facial rejuvenation. My philosophy is that well-done plastic surgery makes you look rested, with softer smoother features not create a face and eyes that look pulled and “done.”

This is especially true for male plastic surgery. If you’ve seen pictures of Kenny Rogers or Mickey Rourke, you’ll know exactly what I’m talking about. They’ve lost the natural architecture of their faces and are not recognizable. You can see that result also if you Google Uma Thurman and Renee Zellweger.

So what happened to them? Did they not know where to go to get the best possible results? I don’t know what these celebrities requested during their consultation with their plastic surgeons but I feel it is my job to guide you as to what the best approach is to achieve an extremely natural improved look that allows you to completely keep your own features. I replace the tissues to their previous positions to achieve the very natural rested look.

‘LESS IS MORE’ is my approach when addressing the face, especially for men!

My job is to advise you what can and cannot be achieved and the best way to do it. I respect the natural contours of the face and eyes. Sometimes it is better to do a little at a time during the rejuvenation process. I term this the layering effect. This technique allows you to continue to improve slowly to achieve an unaffected look.

The answer to the question is, of course, yes you can look unaffected if you take the layered approach to rejuvenation. You can always do more but it is really difficult to correct what is overdone!! You don’t need to do it ALL at one time and the mission is NOT to make it as TIGHT as possible.

Plastic Surgery and Weight Loss

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If you’re hoping that plastic surgery will produce weight loss, you are wrong! What…? Are you kidding me, the title of this blog is plastic surgery and weight loss!!

Plastic surgery is NOT where you START your weight loss program. I CAN, however, help you get started and I can help you STAY on track with your weight loss either before or after your plastic procedure intervention!

I could simply take your money and do your tummy tuck or liposuction or breast reduction/lift and send you on your way only to have you bounce back to have more body contouring procedures. That would be great for my pocket book but it really wouldn’t help you at all.

My goal is to help you sustain a HEALTHIER LIFESTYLE through diet and activity intervention before and after your plastic surgery procedures. That is the ONLY way to keep the shape I give you and for you to keep the weight off!

Here are your FIRST most valuable tips to help you get started:

  1. Cut back on the Fruit — you’re pounding tons of fruit because everyone says it’s so healthy and this will help you lose weight. Many food and nutrition guides are now just starting to get the word out that most of the fruits you love are too high in fruit sugar content. Sugar is sugar. Berries are lower in sugar and of course more tart and most people don’t choose the strawberries, raspberries, blackberries and blueberries as their fruit of choice. You go straight for the watermelon, bananas, cantaloupe, and honeydew, etc. These fruit are very high in sugar content and will only stay your hunger for a short few hours and send you craving and starving for more food when your sugar levels plummet and your insulin is still scavenging through your body looking for more sugar. THIS ALSO APPLIES TO THE FRUIT/PROTEIN SMOOTHIES which tend to be too high in sugar.
  1. Cut back on the Carbohydrates — cut WAY back on all breads, pasta, cereal, oatmeal, and rice. It doesn’t mean you can’t have any, it means you shouldn’t have it with every meal or with every dinner. The portions also should be measured and STEP AWAY FROM THE TABLE when you are done eating. Do NOT get seconds.
  1. Increase your protein — protein in the form of fish, meat, and chicken/turkey. You may think that being a vegetarian is healthier and will reduce your fat and caloric intake but actually you may indeed be consuming not only more calories in your rice and grains but the wrong kind of calories in the form of carbohydrates. You need more protein. Protein will stay your hunger longer and level out your insulin levels and hence your blood sugar. This will help minimize the up and down cravings you may be currently suffering. This may also help your constant hunger you tend to feel when you try to “diet.”
  1. Snack on nuts and beef/turkey jerky—if you are a grazer and feel the need to crunch and eat between meals or if you don’t have time for a meal, choose nuts and the dried meat jerkys of your choice. This is also a good way to stay away from sweets or protein bars/snack bars, which tend to be high in carbohydrates.

More to come in next blog….On How to Stay Motivated on Your Weight Loss Journey…

REJUVENATION – Rick Stoff, Town & Style St. Louis

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Town & Style – St. Louis featured Dr. Koo in an article detailing ‘combo surgeries’ such as the Mommy Makeover and why they are growing in popularity. Here’s an excerpt from the article:

The appeal of cosmetic surgery probably increases with the number of candles blazing on your birthday cake. After blowing out the latest inferno—and viewing the celebratory pictures—many a celebrant will decide it’s time for some self-improvement. But where to start?

combo surgeries
Especially popular with young moms and the more matronly (or patronly) alike, combo surgeries are the proverbial two-fer. They may not exactly offer ‘two-for-one,’ but they do come with other attractive features. For one thing, you can tackle two related problem areas at the same time.

And there are indeed some cost- and time-cutting benefits. “Combining operations may allow for fewer down times and less time off work, so it is more cost-effective,” says Dr. Judith Gurley of Judith Gurley Plastic Surgery and Medical Spa.

“It saves recovery time and operating room and anesthesia costs,” adds Dr. Michele Koo. “Any combination of surgeries is possible. It depends upon what the patient requests and whether it makes sense and is safe. Often an insurance-covered procedure is combined with a cosmetic one.” …

have it your way
“There really isn’t a combination that cannot be done together,” says Koo. “The ‘makes sense’ part is the location of the surgery. Combination brow-lift, eye-lift and face-lift makes sense since I address the rejuvenation of the entire face. A complete face rejuvenation also can be performed with a breast lift or a breast augmentation.”

Combined facial procedures can bring enhanced outcomes, Gurley adds. “A combined approach can avoid the ‘operated on’ look. This involves maneuvers such as lasers for tightening, fat injections and fillers for plumping, and eyelid lifts for removing extra skin. These techniques can be done under anesthesia so there is no pain.”

Breast procedures are often scheduled with arm reductions or tummy tucks—the removal of excess fat and skin. “Breast reductions and tummy tucks are an excellent combination,” Koo says. “Breast reductions often are covered under insurance, along with an overnight hospital stay. The overnight stay can be used in conjunction with the tummy tuck, which is an elective procedure not covered by insurance.”

Read the full article at

Botox for Men

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There’s a reason why BOTOX has been given the nickname “BRO-TOX!”

Men love the quick fix for looking younger and better but not different. No downtime, no evidence, and most importantly it takes 5-15 in the doctor’s office.

So why wouldn’t you do that? Many men do receive BOTOX to smooth the lines across the forehead, the crows feet or the angry “11’s” between the eyebrow.

One caution is don’t go to a spa that has a different aesthetician inject each time and not see you in follow up in a few weeks to insure a consistent & reproducible result.

Another caution is not all Botox injections are the same. Make sure your (preferably) doctor does this frequently, and is using the true BOTOX product at the appropriate dilution.

Happy Bro-toxing!

Schedule a consultation to learn more about Botox!

Frustrated with Fat Tummy and Thighs?

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Tummy and Thigh Fat - St. Louis Plastic SurgeryMany of my patients become quite frustrated with the rolls of tummy fat and saddlebags after pregnancy. By the time they see me, a plastic surgeon, they are depressed, exasperated, and another 35 lbs overweight.

If you fall into the category of “look at my belly, nothing I do is going to change it, so I’m going to eat that cake for dessert,” then it’s time to drastically change your eating and exercise habits. It may even be time to see a plastic surgeon and ask what the options are for removing that skin, or at least thinning out your waist and thighs.

The key is not to fall into the despair mode and stop caring about yourself. That is a negative feedback loop of further frustration and weight gain. Break the cycle.

But HOW? Start with a few very simple tricks.

  1. DO NOT BUY THE FOODS YOU CAN’T RESIST – e.g., ice cream, cookies, potato chips, pastries, etc.  If they are not within reach and you can’t see them, then you won’t have to resist. You simply will not have them readily available.
  2. INCREASE YOUR PROTEIN – eggs, fish, meat, Greek yogurt.
  3. DO NOT SUBSTITUTE FRUIT for your sweets, sugar is sugar and fruit is full of sugar. The common mistake is to eat as much fruit as you would chips and cookies and wonder why you are not losing weight. Carbohydrates are sugar and fruit is still considered in my opinion in the carbohydrate category.
  4. SNACK ON LIGHTLY SALTED NUTS for your need to munch and snack. Nuts are very filling and will satisfy the nervous bored need to eat with a healthy nutritious snack.

Let’s start with the above and next we’ll go on to the activity level to get you started on a happier more self controlled lifestyle. Contact our office for more information!

Can Men Actually Have Breasts?

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The answer is yes and I know this is extremely embarrassing for both adolescent and adult men.

The male breast development may have started as a teenager when you may have been a little chubby. As you started to look around and notice other guys and become aware of young women, you became more and more self-conscience of your developing male breasts. You became more and more embarrassed and became less and less willing to participate in sports and activities hence worsening the weight gain and noticeable breasts.

As you then started a radical weight loss program and mission to weight lift and take supplements you noticed that you certainly became skinnier and more cut up but your breasts didn’t go away. You forgot about it or you started to take even more supplements.

This may not have been your exact scenario but there are parts of it that may resonate with you. Gynecomastia or the benign development of male breasts is extremely common and normal. Up to half of adolescent boys may develop some breast tissue. While 75% of gynecomastia will resolve within 2 or 3 years of onset, there more often than not is a residual hint of a “knot” of firm breast tissue that remains beneath the nipple areolar complex that simply never resolves.

This manifests as “prominent nipples” or “breasts” in tight shirts or when shirtless and is often a source of jokes, “man boobs”, etc. This firm tissue is actually true breast tissue and will NOT go away with any changes in weight and actually has to be removed with direct surgical excision rather than liposuction, which can remove the remainder of the excess fatty breast tissue.

I want you to know that you are not alone. We don’t know if the increasing hormone enriched foods we consume or other additives in our diet has increased the incidence of gynecomastia, but it does seem to me that I have seen more and more men of all ages wanting to have intervention for the removal of the excess breast tissue.

As long as your male development has been normal, you’re not on any medications or supplements that is causing or exacerbating the condition, and you do not have a medical condition that may be causing the gynecomastia, the majority of the gynecomastia will resolve as I mentioned in 2-3 years. During this time, you may even feel like your breasts feel more swollen and larger at times and may even be tender. If your gynecomastia does not resolve, a combination of direct surgical excision and liposuction will remedy the contour deformity that has plagued you since your teen years. The surgery is very safe and is performed in 1-3 hours as an outpatient procedure.

I want you to first know that the majority of cases of male breasts are benign. twenty-five percent may be from medications or some underlying medical condition, which should not be ignored. A simple history and physical should determine whether this is a likely cause. Male breast reductions are becoming more and more frequently performed and are safe!

MOMMY MAKEOVER…I’m sick of these saggy breasts and stretched tummy…

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What is a Mommy Makeover and can I possibly get my flat pre-baby tummy and perky breasts back? The answer is yes. You’ve had your baby(ies), you’ve lost as much weight as you can, but you now have saggy scooped breasts and tummy skin with all sorts of stretch marks, and a wicked alien looking belly button…HELP.

A St. Louis Mommy Makeover can consist of a tummy tuck, liposuction, breast lift, and breast augmentation or any combination of the above. You decide what bothers you the most or what you want to achieve. The breasts and tummy can be fixed all in one surgery.

A tummy tuck will repair your split abdominal muscles, remove all the stretch marks below and just above your belly button and can even give your upper thighs a lifted slimmer look. The breast lift will remove the excess skin and reposition your nipples so they look out from your chest and NOT DOWN at your toes. If you want to regain fullness and firmness, you will need a breast implant at the same time as the breast lift.

Take home message: do not despair! First, eat healthy and make time for at least 15 minutes of walking or exercise at least twice a week. Try to cut down on the carbs and portions and then consult a plastic surgeon of your choice who will really hear what you want. Someone who GETS IT.

Don’t be discouraged by your body. Stop your unhealthy eating habits now, before you gain more weight and are even more frustrated with your appearance. That extra skin and lax belly can all be fixed safely.

If you are interested in learning more about Mommy Makeover procedures and what combination of procedure will suit you best, schedule a consultation with Dr. Michele Koo!

I Really Want to Improve my Face… But Do I Need to Have Surgery?

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The answer is NO. I tell my patients to start simple. The thing many people forget about is their SKIN! The first thing one sees on your face is your skin quality, the texture, and pigmentation. Taking care of your skin with medical products that truly improve the cellular components will significantly improve the overall appearance of your face without spending beaucoup bucks!

All Skin Care Products are not the same and just because you buy it at a high-end department store does not guarantee that the products will be effective.

There are ingredients that will improve the fine wrinkles and are anti-aging but honestly they’re not available over the counter. Most of the truly effective products are by prescription or available through a medical office. The reason is that the concentration of the effective ingredients cannot be sold in over the counter makeup or skin products. These ingredients can sometimes damage and harm skin and must be monitored by a trained personnel. Unfortunately, you might have to pay an office visit but typically you should only have a ONE-time fee and can start your entire skin regimen that will put off surgery perhaps forever.

A few basic products you MUST have:

  1. Sun Block – look for products that are tinted for extra protection. A minimum SPF 30 is what you want for your face. The products I love the best don’t feel greasy, stay on and apply like a foundation. I often use a tinted sun block instead of any foundation at all and I use it absolutely everyday!
  2. Face Wash – look for a wash that is free of the sulfates and sulfites that can be skin irritating and one that is specific for your skin type and needs. If you want anti-aging, anti-wrinkle results, look for lactic acid, trichloro-acetic acid, phytic acid, ascorbic, and perhaps even some estrogen. There are ingredients for every type of skin need from acne to pigment.
  3. Moisturizer – even if your skin is oily, you need moisture. Many of my patients wash their skin with such harsh ingredients to control the oil and acne that they actually cause their skin to produce MORE oil and create more breakouts.

Again, all of your Skin Care products should contain the ingredients targeted specifically for your skin needs. That is the most effective way to have get the most out of your dollars spent rejuvenating your face. You may buy products from the drug and grocery store, and online, but the key is to have an experienced trained medical personnel diagnose yours skin’s needs and address those needs with the best products available. Sometimes the filler ingredients (non active ingredients) can irritate your skin and care should be taken that your products are not working against each other.

MORE TO FOLLOW… In the meantime, if you have any questions or would like to discuss your St. Louis Skin Care needs with Dr. Koo, Schedule a Consultation today!

How Often Will I Need to Change My Breast Implants…and WHY?

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One of the first questions my patients ask when considering a breast augmentation in St. Louis is how long will my breast implants last? When I tell them the breast enhancement using breast implants, whether saline or silicone implants will NOT be a ONE and DONE surgery, they are disappointed and worried about future costs.

Let’s go over why your breast implants will need to be replaced.

First, your breasts will continue to change with age, especially if you gain, lose weight, or become pregnant. Even if you don’t breast feed, your breasts will change with pregnancy! Your breast may become saggy and you may lose more breast volume. When this happens your skin will “slide off” the breast implants and your breasts will appear to have fullness on top with the rest of the breast and nipple at a lower position.

If this happens, you can change the size of the implant to create the size of breast you desire and remove any excess skin to reposition the nipple into a “perky” position.

Second, the breast implant has a lifespan of 10-20 years. Saline implants may begin to lose volume at 10-15 years or may appear to “ripple” if you have very little breast tissue of your own overlying the saline breast implant. After 10 years, your breasts may also become more firm and eventually actually feel hard and become misshapen. This is also an indication you will need an implant replacement.  Some patients keep the same silicone implants for more than 20-25 years without a problem.

Typically, the breasts will become firm and change shape after 10-20 years. When this happens you will need to remove the implants, the existing scar capsule, and any excess skin. You may or may not wish to have the implants replaced. Most of my patients do want to retain full breasts and opt to have new implants.

The initial surgery as well as the subsequent replacement surgeries are very safe and are performed as an outpatient with a minor recovery.

If you would like to learn more about a breast augmentation in St. Louis, schedule a consultation with Dr. Koo today!

What is Botox?

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Botox! Yikes, isn’t that a very deadly poison? The answer is no. That would be Botulism, a serious and life-threatening illness. But they come from the same source: Botulinum toxin.

Botulinum toxin is a protein and neuro-toxin produced by a bacterium called Clostridium botulinum. It can cause botulism, a deadly disease. Another form of it, with the popular trade name Botox, is what is used today for cosmetic purposes.

Justinus Kerner, a 19th century German poet and medical writer called Clostridium botulinum the “sausage bacteria” because it was found on improperly handled or prepared meat and sausage. It was in 1895 that Emile P. Van Ermengem isolated the microbe and discovered that it produced a toxin from a piece of ham that had poisoned 34 people.

The modern therapeutic form of Botox (BTX-A) was used by Professor Edward Schanks who began working with the bacterium in 1944 while working for the US Army at Fort Detrick, Maryland investigating germ warfare. In the 1960′s, ophthalmologist Alan Scott collaborated with Schantz and by 1973 began injecting it into monkeys. In 1978 he got government approval to inject it into humans.

The secret to Botox is that it causes the controlled weakening of the muscles near the injection site. Results of the treatment can be seen within 3-4 days with the peak effect at 10-14 days. The effects last for four to six months, and must then be repeated.

In 1988, the company Allergen bought the rights to sell BTX-A (Oculinum, as it was called) and shortly after received approval to use it for crossed-eyes and facial spasms. In the early 1990′s, Canadian Ophthalmologists Jean Carruthers was using it on patients to relieve eyelid spasms and noticed that some of the patients were losing their frown lines. She and her husband published a study in a medical journal reporting that though temporary treatment with Botox was a safe and simple procedure for reducing brow wrinkles. Cosmetic surgeons and other practitioners took notice. By 1997, it’s use took off.

In April 2002, the FDA approved Botox for use in reducing frown lines between the eyebrows. Botox is an incredibly useful tool for reducing wrinkles for forehead, crow’s feet, and between the eyes. It can also be used on smoker’s wrinkles and the chin. Botox can help make the eyes much more attractive. It has also been useful for the treatment of muscle pain and is now commonly used to treat migraine headaches.

To repeat, Botox treatments are safe and delay the signs of aging. At the end of 2006, the sales of this treatment passed one billion dollars with over half for cosmetic purposes. As of 2007 Botox injection is the most common cosmetic operation.

New Trends in Plastic Surgery – When First Impressions Count

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Often times, a person decides to undergo some form of plastic surgery to boost their self-esteem and enhance their self-image. But new studies based out of New York City boasts that plastic surgery can actually boost a person’s chance of gaining employment.

Surgical procedures such as chin augmentations can create a favorable impression on the general public. It seems as though strong jaw lines and chins are linked to trustworthiness, dependability, and other positive and desirable characteristics in the workplace. People subconsciously associate a stronger chin with more authority, self-confidence, and trustworthiness. Therefore, chin augmentations are among the newest trends in plastic surgery.

Professionals, both men and women over the age of 40, seem to crave that strong jaw line that they feel will give them the upper hand in the workplace and are turning the plastic surgery procedure of chin augmentation to achieve it. This three hour plastic surgery procedure, which has been coined “the chinplant,” has become popular among Americans and has increased in the US roughly 71% in the last two years. One of the highest rates of increase is seen in women in corporate America.  Could it be that this sudden urge for plastic surgery could be linked to the everyday use of video conferencing in the business world? Business executives often find themselves “face to face” with people of important statuses from all over the world via video conferencing. It is these interactions that have people thinking of their appearance and how important that first impression can be.  A promotion, an added responsibility, a significant contact can be made all based on the impact of a person’s appearance.  Therefore, the desire to use plastic surgery to enhance their looks seems to be a possible way to also enhance their resume.

Plastic surgery is undoubtedly a booming business, with chin implants gaining popularity in competitive work environments because of their seemingly enchanting ability to give an edge to the willing recipient.  Whether this is a real or perceived notion, it seems as though the “chinplant” will continue to be among one of the leading trends in plastic surgery.

Does it help to have ideal result photos during a rhinoplasty consultation?

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A very common question when considering rhinoplasty is whether example photos help during the consultation process. Pictures to illustrate a desired result can help a board certified plastic surgeon to understand patient expectations and a desired result.

Most patients considering plastic surgery have an excellent idea as to what changes they want to see as a result of their rhinoplasty procedure and pictures help to give a plastic surgeon a visual representation of these changes.

There are some things that should be considered when bringing photos to a plastic surgeon during a rhinoplasty consultation.  Consultations and examinations should be an open process where patients feel comfortable sharing their goals and expectations. But patients should also be open to discussion since no tall results are possible given the underlying structure of the nose. During a rhinoplasty consultation, a board certified plastic surgeon may suggest the image example isn’t realistic because of the patient’s facial structure.

It is easy to idealize a photo and the structures possessed by celebrities, but it is important to note that photos of celebrities are often best case scenarios and may not actually work for a patient’s personal facial balance.  Photos of celebrities are often “touched up”or edited to make celebrities look their very best.  The final result is a photo of a perfectly shaped nose that may not be possible given the limitations of a rhinoplasty procedure. Tricky camera angles and lighting can obscure the real structure of the nose. Board certified plastic surgeons often prefer photos of family members as their facial structure and nose can be very similar and make the desired results much more likely.

It is also important to note that not all rhinoplasty procedures fit all facial shapes and contours.  In most cases, an idealized nasal shape and size can simply mean facial balance and harmony.  One nose does not fit all.  What looks good on someone else may not look good on you.

Rhinoplasty is a highly personalized procedure and a consultation should be seen in that light. While photos provide excellent examples for a board certified plastic surgeon to gain further understanding in the overall outcome of a rhinoplasty, there may be issues with the photo that make the results impossible or improbable to achieve. A rhinoplasty consultation should be an open conversation between patients and surgeons and this will increase the patient satisfaction following a rhinoplasty.

Plastic Surgery Popularity Growing Among Men

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Let’s be honest, plastic surgery has always had a stigma attached to it. While good plastic surgery often goes unnoticed, the horror stories often create and attach a negative stigma. As more positive results have been publicized in Hollywood and among social circles, plastic surgery is growing rapidly in popularity among women.

As plastic surgery has become more socially acceptable for women, men have often looked the other way and never considered having plastic surgery for themselves. Since men have largely avoided going under the knife, the procedures and techniques that have been developed over the years have largely favored women. A sit did with women over the years, plastic surgery is now growing in popularity among men, and plastic surgeons are beginning to create more effective ways to rejuvenate and refresh the appearance of their male patients.

According to a recent report in the L.A. Times, more than twice as many men are choosing plastic surgery now, compared to just 15 years ago. While men still make up less than 10% of all patients in plastic surgery, this is a positive sign that men are beginning to ignore any negative stigmas that may have prevented them from undergoing procedures in the past.

While it is difficult to show what has changed the social perception of plastic surgery among men, it is clear that more men in Hollywood are choosing to have surgery to appear younger and more refreshed.  With Botox leading the way, a term was recently used on Nightline ABC to characterize the procedure done on men.  They dubbed it… “Brotox”. While many of the procedures performed on men are less-invasive like Blepharoplasty (eyelid surgery) or “Brotox,” some men are choosing to appear more youthful with a facelift or tummy tuck. While women still hold the title for most likely to undergo plastic surgery, this recent shift has shown that men are making a move toward appearing more youthful and refreshed with the help of plastic surgery.

Can Breast Implants Give Me Fuller, Natural-Looking, and Shapely Breasts?

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You may want fuller breasts but may be asking yourself, is it possible to have breast implants that fit your body?  Is it possible for breast implants to look natural and shapely as well as make your breasts larger?

Breast enhancement with saline or silicone breast implants is very safe. Both types of breast implants are FDA approved for elective breast augmentation.

While general anesthesia is required, the surgery itself should only take 30-45 minutes. You can drive the next day and return to routine daily activities. It will take two weeks before you are able to exercise.

The most common questions I am asked by my patients is, can you make my breasts look natural, still sloped, and “tear drop” shaped? Can you make them proportionate to my body? Will people be able to tell I have breast implants?

Yes, people will be able to tell if you have breast implants because they will be too perfect to be real. If you are over the age of 23 and have had children and your breasts are perfect, people will guess that they are not real but they will never know for sure until you tell them.That’s how real breast augmentations can look and feel.

As far as the look of the breast, the majority of my patients most want beautifully shaped breasts, with size as a secondary priority. Shapely, beautiful but still tear dropped and sloped.If you want to hide them, you will be able to by wearing looser clothes. If you want to show them, you can wear tighter clothes and use a push up bra.

Yes, all your goals can be met, but it is up to you to convey those wishes and to make sure your plastic surgeon understands what you want.Bring breast photographs you like to your consultation and make sure your surgeon understands the look you want to achieve. It is also important that your surgeon is very honest with you and educates you as to what can be achieved given your starting breast anatomy.

I believe that your “perfect” breast enhancement can be achieved. It’s a matter of communicating with your plastic surgeon and seeing her previous results of similar breasts. Most importantly, breast augmentation with breast implants is very safe and considered relatively non-invasive! Go achieve your “perfect” breasts!

I’ve Seen Videos of Liposuction…it Really Looks Painful and Scares Me…Is That Truth or Myth?

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The videos you’ve seen of liposuction are probably all real and do in fact look pretty brutal. However, you should know that liposuction recovery is actually very minimal and NOT very painful. Could you call it completely non-invasive?

I wouldn’t go quite that far because the type of liposuction that really works requires the fat to be removed. For fat to be removed you have to have surgery, and for safe surgery you should be in an operating room. For complete removal of a significant amount of fat you probably should have general anesthesia.

General anesthesia under a controlled operating room setting performed by an anesthetist or anesthesiologist is extremely safe and preferred. I feel I have complete control of the operating situation and can do what I need to do to give the most complete and best results possible. I never compromise  my patient’s safety or well-being. I am therefore blatantly honest with what is required and will tell you what you NEED to hear, not what you may WANT to hear.

If you want to hear that you can have liposuction during your lunch hour under local anesthesia or have an external device applied to your skin and walk away inches smaller with no cellulite, FORGET IT. Those are gimmicks that will waste your hard earned money. If you want something meaningful done that will change your shape, get the appropriate surgery or don’t do anything at all.

I will tell you though that ultrasonic liposuction, whether you want to call it VASER LIPOSUCTION, TUMESCENT LIPOSUCTION, ULTRASONIC LIPOSUCTION, all work. You just have to be careful what your surgeon means when they are using these terms.

If you want true results that removes the fat, you will need the application of cannulas under your skin to physically remove the fat. The recovery is amazingly short with very little pain depending completely on the VOLUME that is removed. The more volume of fat removed, the more the recovery. Don’t let any doctor tell you otherwise no matter how much you want that one-hour liposuction. Get the right liposuction procedure for you and that procedure depends on what you want to achieve.  Don’t be afraid of how invasive liposuction is because it really can have very little downtime and pain.

Do You Want Nice, Smooth Skin With Fewer Wrinkles and Less Pigmentation?

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You would be surprised how little you have to do to get smoother and livelier looking skin. However, it does require maintenance. The only maintenance required  is daily skin products and a little bit of intervention.

I formulate medical pharmaceutical grade products with my pharmacist that will be less expensive than the unproductive, over-the-counter products you spend a fortune purchasing.

Yes, of course, you should stop smoking and protect your skin from the sun. I even have pharmaceutical grade sunblock that is specially formulated. All those skin products you spend a fortune purchasing that clutter up your entire bathroom can’t compare to using as few as three of my specially formulated products designed for your problem and skin type.

These formulated products can often be covered by insurance.  In combination with an office peel, BOTOX or filler, such as Juvederm these products can make your skin look years younger with less discoloration and wrinkles. You would be shocked at how little the costs are compared to what you currently spend. The key is to use the appropriate products for your skin and that the products are doing what they actually say they should be doing. But how would you know? You see the ads, you read the back of the bottles and jars, and you listen to your friends.

The truth is none of the over-the-counter products will change your skin at the cell level to generate new collagen or get rid of the brown spots. None of the products that work can be sold over the counter. You need prescription strength products to achieve the desired changes.

The key is to have your skin medically evaluated and have the products tailored to your needs. It is important that the person evaluating your skin truly knows the science and the medicine behind skin and the products necessary to make the changes. I love seeing my patients transform their skin over a period as short as three months!

Why Do I Have Flattened, Stretched Out Breasts After My Pregnancy…and What can I can do about it?

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These are very common questions women ask during a consultation for breast rejuvenation. Everyone thinks breast implants are only to make breasts bigger. This is only one aspect of what breast rejuvenation can achieve with a mastopexy (breast lift) and breast augmentation.

Silicone or saline breast implants can reshape breasts and also make them more symmetric. After pregnancy, weight gain and loss, breasts can appear deflated, stretched, and elongated.

A breast lift with a breast enhancement can completely reshape the breast. The nipple is lifted to the center of the breast mound and the breast implant fills the deflated skin envelope, recreating the volume of a very natural sexy looking breast.Asymmetry of the breasts can be almost completely corrected and the enlarged areola can also be reduced. The breasts can regain a soft, very natural looks natural as with with the rest of the body.

One does not have to live with the unpleasant results of aging or pregnancy. The saggy, flat breasts that make you feel unsexy, with NO desire to wear a swimsuit or be seen naked can safely be remedied.

The surgery requires about 1½ hours of general anesthesia but the recovery is very quick. You are able to drive the next day and can do simple household chores, perform office duties, and take care of your children in approximately two days. Returning to light exercise will take about two weeks, and four weeks for strenuous boot camp work outs.

Breast enhancement and rejuvenation is all about achieving natural beautiful breast shape and is safe and very achievable!! It’s not just about the size but it is about YOU liking yourself and the way you look!

Schedule a consultation today with Dr. Michele Koo.

Why do women get breast implants?

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This may seem like a very obvious question with a very obvious answer. The decision to undergo breast augmentation surgery is often perceived as a straightforward desire for larger breasts. However, delving deeper into the motivations reveals a more nuanced and meaningful journey.

Reasons why women get breast implants

For Women in Their 20s:

Prior to significant life milestones, such as having children or perhaps a significant other, women seeking breast enhancement are often doing so for personal reasons. Beyond the pursuit of larger breasts, the primary goal is to boost self-confidence and achieve a sense of balance in their bodies. It’s not merely about attracting attention or flaunting sexuality, neither of which are bad, but rather about feeling comfortable and assured within one’s skin.

As a female plastic surgeon, I truly understand the intricate dynamics of female body image that take root in a woman’s head, starting at a very young age. The pursuit of beauty and balance becomes a personal journey, and breast augmentation emerges as a viable option to attain the desired sense of self. We are vain but don’t want to be thought of as vain. We can’t increase the length of our legs (which is what we truly want) so this is the next best thing!

For Mothers Reclaiming Their Confidence:

Post-pregnancy, some women experience changes in their breasts that can affect their self-esteem. Issues like sagging, stretch marks, and volume loss (the breasts may even look like the old Playboy’s cartoon caricatures of grandma’s with extra long bananas for breasts) may contribute to feelings of dissatisfaction with one’s appearance. This dissatisfaction can extend beyond physical discomfort. These women hate their breasts and do not want to be seen naked or in a swimsuit. They feel their breasts are ugly and therefore the rest of their body is ugly. These women don’t want to go out, don’t enjoy shopping for clothes, and don’t feel motivated to eat healthy and stay fit. impacting daily activities and overall well-being.

A breast lift and augmentation can be transformative, not just physically but also emotionally. Repositioning the breasts and restoring volume can significantly enhance a woman’s outlook, motivating her to embrace a healthier lifestyle and regain confidence in her body.

The Psychology of Self-Image and Confidence

I have learned from my patients and from my own insecurities growing up that my self confidence or “happiness” is often tied into my perception of how good or bad I look. While this may seem very shallow, it really isn’t. Our outer appearance is more than just a superficial projection—it reflects our inner selves. A well-groomed, put-together exterior often translates to inner peace, balance, and harmony. Conversely, a disheveled appearance can project inner chaos and a feeling of being “out of control.”

Our outward appearance tells the world whether we care about ourselves or not. In my opinion, women opting for breast enhancement aren’t solely chasing an idealized beauty standard; they are expressing a deep care for themselves and their overall well-being. By taking charge of their appearance, they strive to make a positive impression, radiating balance, harmony, and beauty.

The Importance of Self-Care

While some may view cosmetic surgery as trivial or superficial, it is, in fact, a commitment to personal growth and happiness. The decision to enhance oneself isn’t about changing the world overnight; it’s about fostering happiness, confidence, and productivity. In the grand scheme of life, prioritizing our own well-being can have a ripple effect, potentially transforming our lives and, by extension, the lives of those around us.

In essence, the choice to undergo cosmetic surgery is a declaration of self-care—a recognition that investing in our own happiness can be a catalyst for positive change. As we navigate life’s journey, striving to be the best version of ourselves can be a powerful and empowering endeavor.

Your Journey Begins Here

If you find yourself resonating with the stories shared here and are considering breast augmentation, we invite you to explore further. Our dedicated team in St. Louis is here to guide you through every step of your journey. Schedule a consultation or contact us on or (314) 984-8331.

Your Ultimate Guide to Breast Augmentation

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Have you been considering a breast augmentation or enlargement procedure to achieve the fuller and shapelier breasts you’ve always wanted? Perhaps you’ve been considering this for as long as you can remember?! While visiting with women considering breast implants in our St. Louis plastic surgery office, we often hear the same concerns. Whilst these concerns are completely legitimate, being able to make an informed decision is crucial. This comprehensive guide to Breast Augmentation will help you navigate the important aspects of the procedure. Learn more about breast augmentation before taking the next step.

Read on to learn more about:

  1. What is breast augmentation?
  2. Who is a good candidate for breast augmentation surgery?
  3. What results can you expect?
  4. What not to expect from breast augmentation
  5. Choosing the right surgeon
  6. Implant decisions
  7. Understanding your vision – size and shape
  8. Personal factors to consider
  9. Ensuring effective communication with your surgeon
  10. What are the risks?

What is Breast Augmentation?

Breast augmentation is a surgical procedure that increases or enhances the size of breasts. It is one of the most commonly performed plastic surgery procedures and also known as an augmentation mammoplasty. It’s also commonly referred to as a “boob job”. Beast augmentation is accomplished by either using breast implants or transferring fat from other parts of one’s own body to the breast.

Who is a good candidate for Breast Augmentation Surgery?

If you are unsatisfied with the size of your breast, are a non-smoker and in overall good health, you are likely an excellent candidate for breast augmentation. Candidates often have a variety of reasons why they choose breast augmentation.

Some common reasons include:

  • To increase the size of naturally small breasts
  • Restore volume depleted by pregnancy, age or weight loss
  • Reconstruction after mastectomy
  • To correct uneven or oddly shaped breasts

What Results Can You Expect from Breast Augmentation?

This popular cosmetic surgery option helps achieve:

  • Larger or fuller breasts
  • Restored breast volume lost due to factors like pregnancy, weight loss, or aging
  • Enhanced harmony between breast and hip shape
  • Improved self-image and confidence

What does Breast Augmentation not do?

A breast augmentation does not reduce the size of the breast. This is a separate surgical procedure known as breast reduction surgery. Breast augmentation procedures also do not address severely sagging or drooping breasts. However, sagging or drooping breasts can be corrected by a breast lift procedure, which is often carried out at the same time as an augmentation. Your plastic surgeon can help advise you on these procedures.

To learn more or get personalized advice, schedule a consultation with Dr Michele Koo today!

Choosing the right surgeon for your Breast Augmentation

One of the first and most critical decisions is choosing the right plastic surgeon for your breast augmentation journey. To ensure you’re in capable hands, consider these questions:

Is your plastic surgeon BOARD CERTIFIED?

This is important because surgeons who are certified by the American Board of Plastic Surgery must meet rigorous qualifications and standards to receive their certification after completing four years of medical school and several more years of residency. Be wary of physicians who are certified by medical boards other than plastic surgery as they do not have the same extensive training.

Is your plastic surgeon a member of the Aesthetic Surgery Society?

Choosing a plastic surgeon who is a member of the Aesthetic Surgery Society or a similar professional organization is a fantastic decision! It shows that your surgeon is dedicated to the art and science of aesthetic surgery, constantly learning and staying up-to-date with the latest techniques.

Does your plastic surgeon have a portfolio of before and after pictures?

Your plastic surgeon having a substantial portfolio of before and after breast augmentation photos is fantastic news for you! These photos give you a clear view of their skills and results, helping you set realistic expectations and enhancing your communication during consultations. It’s all about trust, confidence, and peace of mind, knowing you’re in the hands of an experienced and transparent expert.

Does your plastic surgeon have testimonials or patients willing to share their experiences with you?

Reading through your breast augmentation surgeon’s reviews and testimonials is a must! They help show real success stories, empowering you to make a confident choice. It’s like getting advice from friends who’ve been there, and it’s all about ensuring your journey to your best self is a positive and informed one.

Dr. Koo is truly an artist and she is a perfectionist. She guided me through selecting the perfect implants that fit my body type and lifestyle. She exceeded my expectations. I’m extremely pleased and now more self- confident in every way. Joanne is so accommodating and full of great information; she is amazing!

Implant decisions

Now that you’ve found a qualified surgeon, you’ll need to make important implant-related decisions. But don’t worry, your surgeon will advise you every step of the way!

  • Silicone vs. Saline: Understand the differences between silicone and saline breast implants. Your surgeon should explain the positives and negatives associated with each type.
  • Implant Placement: Decide whether you want the implant placed under your breast tissue or under the muscle.
  • Breast Lift: A breast lift in addition to a breast augmentation may be required for the desired result. Breast lift procedures can be done at the same time as the breast augmentation if that is something you and your surgeon decide is the best option for you.

Understanding Your Vision

Your breast augmentation journey is not just about size; it’s about achieving the shape and look you desire.

  • Describing Your Vision: You’ll need to educate yourself on the look and size of your future breasts. The most important point is that you effectively communicate and accurately convey your ideal breast appearance to your surgeon. Bring visual references, such as pictures of what you want and don’t want.
  • Natural Appearance: Consider how you want your breasts to look. Do you prefer a natural slope so no one will guess you have breast implants, or do you want them to appear rounder and fuller?
  • Size Preferences: Reflect on your comfort level and how noticeable you want your new breasts to be. Consider when you want them to stand out and when you prefer a more subtle look.

Personal factors

Various personal factors will impact your breast augmentation journey:

  • Lifestyle and Activity: Your exercise routine, daily activities, and personal style can influence your implant size and shape choices.
  • Body Characteristics: Your height, weight, and whether you’ve had children or plan to in the future all play a role in determining the best approach for your breast augmentation.

Other Factors

When contemplating your breast augmentation journey, it’s essential to take into account additional factors that can influence your decision, particularly before determining the ideal cup size:

  • Future Mammograms: Consider how breast implants may impact future mammograms. It’s crucial to discuss this with your surgeon and ensure that you’ll be able to undergo routine breast screenings without interference or complications.
  • Family History of Breast Cancer: If you have a family history of breast cancer, it’s vital to communicate this with your surgeon. Your breast augmentation plan should align with any recommendations or precautions related to breast health and cancer risk.
  • Implant Longevity: Understanding how often you may need to replace your breast implants is essential. Discuss the expected lifespan of your chosen implants and any factors that could affect their longevity.
  • Long-Term Appearance: Consider how full you want your breasts to be and how long that desired look will last. Discuss this with your surgeon to ensure your expectations align with the results you can realistically achieve.

By considering the factors above alongside your personal preferences and lifestyle, you can make a well-informed decision that leads to the results you desire while safeguarding your long-term breast health.

Effective communication

Your surgeon should completely understand your vision for your body and articulate it back to you. You can help facilitate this by:

  • Building a Breast Vocabulary: Educate yourself on breast terminology, which will enable you to ask more informed questions and describe your goals more effectively.
  • Patient-Doctor Connection: You need to feel comfortable with your surgeon and truly feel that you have connected. Establishing a strong rapport with your plastic surgeon is one of THE most important elements of achieving your perfect breasts and crucial for a successful outcome.

What are the risks of Breast Augmentation Surgery?

Like any medical procedure, breast augmentation surgery carries potential risks. However, understanding these risks empowers you to make informed decisions that align with your goals. During your consultation, your surgeon will discuss the specific risks tailored to your situation. In general, some potential risks associated with breast augmentation surgery may include:

  • Infection
  • Temporary or permanent alterations in skin sensation
  • Temporary bleeding or bruising
  • Minimal risk of blood clots
  • Possible skin discoloration due to scarring or bruising
  • Temporary challenges with breastfeeding (if applicable)
  • The rare possibility of chronic pain
  • Adverse reactions to anesthesia or sedation medications

It’s important to remember that these risks are manageable with the guidance of a skilled surgeon, and countless individuals have successfully undergone breast augmentation with satisfying results. Your surgeon will prioritize your safety and provide you with the best care possible throughout the process.

Ready to take the next step?

Breast augmentation is a personal journey that should be both seamless and life-enhancing. By asking the right questions, doing your homework, and connecting with your surgeon, you can achieve your vision for the perfect breasts. Follow the information and insights in this Breast Augmentation Guide and you’ll be thrilled with the results! If you want to learn more about our Breast Augmentation procedures in St Louis or need further guidance, feel free to reach out. We’d be more than happy to help you out and answer your questions of concern.

Do something for yourself and make yourself feel better

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So you’re thinking about plastic surgery for those stubborn areas of fat, flat chest, or excess left over baby skin… First of all, I want you to know plastic surgery procedures are safe. Second, stop feeling guilty and start taking care of yourself. You’re so busy running around doing things for your kids and husband, you forget about yourself and you feel guilty if you even buy yourself a little lipstick.

I know, I get it. As women, we are brought up to do for others first, especially for our children, husbands and family members.I go through the same daily stresses as you, perhaps with a little variation: my Mother who I am extremely close to is very sick, I’m passionately devoted and feel very obligated to making my patients happy, I have teenagers, two of which are girls, and a very busy husband. Need I say more?

We all go through the daily grind of the bleary sand in the eyes when you wake up feeling like you’re so tired you can’t get through the day. The feeling of being so overwhelmed you have chest pain. But, we do it everyday and we get through the obstacles and we move on. I want you to know we are all in it together. It is OK to do something for yourself. Really it is.

You don’t have to go straight to a plastic surgery procedure, but you should start with something that makes you feel healthier. Take an exercise class. Sign up for the class on a regular basis; pay for it upfront and lock yourself in so you can’t make excuses. You’ll be amazed how much better you feel with a little regular sweating and exercise. As you continue to this, you’ll actually see results which will motivate you to go to the next step.

Choose your foods more wisely. Carbohydrates are NOT your friend. Even eating a lot of fruit is NOT healthy. Lightly salted nuts or raw nuts are the best solutions to satisfy the need to munch. You don’t need crazy diets, you need to choose your foods wisely and step AWAY from food when you are NOT hungry. Keep in mind, my philosophy is that I am here for YOU. I want to make your life better by empowering YOU. Whether you choose to have a breast augmentation, liposuction, or tummy tuck is not the point. It is about making you feel better about yourself so you will take better care of yourself and ultimately be better for those around you. 

I will not suggest anything for you that I wouldn’t do myself. I ONLY suggest the minimal intervention necessary to achieve the great natural look. I DON’T want you to look “DONE.” I will also steer you away from anything that is dangerous and not in your best interest, no matter how much you ask for it.

Begin today, TAKE CARE OF YOURSELF AND FEEL BETTER AND MORE CONFIDENT… and go buy that lipstick!

Are Breast Implants Stupid? Why Augment Your Breasts…?

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You may think using breast implants to enhance a woman’s breasts are ridiculous and fake… but ask any woman who has had her breasts enhanced and you’ll get quite a different answer.

Nearly all women have their breasts enlarged for themselves. They want to feel that their breasts and body are in proportion. They want to feel balanced, be able to wear a swim suit, feel less self conscious, and to feel sexier in and out of clothes. Truthfully they just want to feel a better about their own body.

Is that wrong? The public condemns woman seeking breast augmentation and implants

as being vain, vapid, and “slutty” for the reason of wanting attention for themselves in an unbecoming manner. Really, that couldn’t be further from the truth.

Woman want to be more comfortable with their own bodies. They want to feel comfortable being seen naked. If they don’t like how they look naked, they will never want to be seen naked or in any type of clothing that shows anything!

Breast implants are safe and the surgery itself takes less than an hour with 1-2 days recovery time. Yes, there is maintenance since the implants will need to be replaced in 10-20 years and mammograms may be more difficult. However, it is minimal maintenance and your plastic surgeon should see you every year after you have your breast augmentation as a courtesy for you.

What do you think, let me know your opinion. My opinion? Brest augmentation is very safe and very uplifting for any woman who hates what nature gave them. Don’t let nature own you, go out and take control!!

Liposuction what is the “skinny”, non-invasive vs invasive?

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High intensity external ultrasound liposuction, laser liposuction, external sound waves, smart lipo… what next? We’ve seen the demise of Lipodissolve because it simply didn’t work. Or I should say the results were minimal, with prolonged discomfort and swelling. Everyone truly is looking for the quick fix, but my question to you is, what in life worth having is without some amount of work or payment?

If you want something fixed you have to approach the problem with the right tools. You can’t tie your plastic surgeons hands, take away their tool box and expect the outcome you are seeking.
According to an article by Jennifer Capra and Peter Rubin in the latest PRS Journal, July 2011, noninvasive liposuction still has a long way to go. The following article is available through the ASPS free public access.

“Will liposuction become obsolete? Fueled by the success of effective minimally invasive and noninvasive treatments for aesthetic management of the face, the quest for effective nonsurgical body contouring technology continues at a robust pace. To date, no noninvasive body contouring treatment has assumed a prominent role in plastic surgery practice. Jewell et al. present data from a randomized controlled trial to demonstrate the efficacy of a high-intensity focused ultrasound device for reducing subcutaneous fat deposits. This study is a thorough investigation of the LipoSonix high-intensity focused ultrasound technology (Medicis Technologies Corp., Scottsdale, Ariz.), demonstrating both safety and efficacy in a blinded prospective trial. The authors are to be commended for collecting well-controlled data to test the effect of this device.

According to the 2010 report of plastic surgery statistics from the American Society of Plastic Surgeons, the number of patients seeking cosmetic minimally invasive procedures has increased from 5,500,446 in 2000 to 11,561,449 in 2010.1 This 110 percent increase is indicative of patients seeking the “quick fix” that allows them to improve areas of concern with decreased downtime and minimal risk. At 203,106 cases, liposuction is still one of the top five cosmetic surgical procedures performed in 2010, and while it is touted as “minimally invasive,” many technologies have been explored in an effort to improve body contour and tighten skin with less recovery and risk.

In Jewell et al.’s article, we see data from a multicenter, randomized, sham-controlled, single-blinded trial of 180 patients designed to determine the effectiveness of high-intensity focused ultrasound on trunk aesthetics. The primary outcome measure was reduction in waist circumference at 12 weeks. In patients treated at the highest energy level (59 J/cm2) in the “per protocol” group, in which maximal effect was seen, there was a statistically significant decrease in waist circumference of 2.52 cm compared with a decrease in the sham control group of 1.21 cm. One potential source of error in this study is the use of a standard measuring tape to determine waist circumference.2 Other modalities, such as three-dimensional photography or magnetic resonance imaging assessment, may be considered for future studies.3 In particular, magnetic resonance imaging will show precise changes in the thickness of the abdominal subcutaneous tissues after treatment. A major challenge in the evaluation of noninvasive body contouring treatments is establishing standard methods of assessment that can provide accurate and reproducible results. One other variable that may affect the results presented in this article is that the patients in this study population did not respond as well as other patients might have. Indeed, a prior high-intensity focused ultrasound study of 282 patients by Fatemi, one of the current authors, revealed an average circumference reduction in the abdomen and waist of 4 to 5 cm.4

While effective, the change in waist circumference induced by high-intensity focused ultrasound is relatively small compared with that in the sham-treated patients. This leads to two important questions. First, why does the sham group have a waist reduction of 1.21 cm? Second, how does high-intensity focused ultrasound fit into our aesthetic armamentarium?

With regard to the changes in the sham group, the authors stated that patients agreed to maintain their current diet and exercise regimens without any changes during the study period. In their Discussion, the authors do suggest that this decrease in waist circumference in control subjects may be related to unintended consequences of asking patients to pay attention to their diet and exercise habits. Despite our best efforts in asking our patients to comply with requests not to change their lifestyle, the placebo effect may be strong enough to induce subconscious changes in activity that favor tightening of the trunk muscles. It may have become a self-fulfilling prophecy that our patients, once treated with a device intended to improve their waistline, will adjust their lifestyle in accordance with the image they desire. Although it is impossible to regulate a patient’s lifestyle changes during a study period of 12 weeks, a diary of diet and exercise habits implemented both before and after treatment might have provided some insights into the changes seen in the sham group.

How high-intensity focused ultrasound fits into our aesthetic practice depends on whether patients will consider that it is worthwhile to undergo a safe 45-minute office treatment, followed by 7 to 10 days of mild discomfort and up to 16 days of edema and bruising, to achieve a decrease in waist circumference of a little more than a centimeter. The authors performed a patient satisfaction survey at week 12 that revealed interesting points. In evaluating the change in abdominal contour in the group that received the higher-energy LipoSonix treatment, 68.4 percent rated an improved or much improved score, compared with 23.4 percent of the sham group subjects. Clearly, patients within the treatment group noticed a change, but only 50 percent of this treatment group reported being satisfied with the results. Although not evaluated in this study, it is possible that repeated treatment with this device may lead to further improvement.

This technology, in its current form, will not make liposuction obsolete. It may, however, meet the demands of well-selected patients seeking less invasive procedures that can help with their “trouble spots.” Rather than take away from the pool of patients undergoing liposuction, this technology may bring a new group of patients to the plastic surgeon’s office who would not ordinarily have presented for evaluation and treatment. Because many patients presenting with a request for high-intensity focused ultrasound may be candidates for liposuction (even after their initial ultrasound treatment), it is imperative that board-certified plastic surgeons embrace noninvasive body contouring technology. Most assuredly, noncore aesthetic practitioners will be interested in this technology and may use this as a gateway to offering more invasive body contouring procedures.”