Many years of research and development and scrutiny by the FDA has resulted in a modern cohesive silicone gel implant with a non-bleeding shell that is a safe and FDA approved. Older silicone gel implants had problems with silicone bleed and gel migration after rupturing that has been corrected with the current generation of breast implant. Choosing an implant that is FDA approved is crucial as the same safety guidelines may not have been imposed on implant manufacturers from other countries. The recent problems with the PIP implants in Europe have created devastating issues for patients who have had breast augmentation in various countries in Europe. In the United States, Mentor (made by Johnson & Johnson) and Natrelle (made by Allergan) are excellent implants with well researched literature that illustrates safety in long term studies. Starting in 2012, patients will have another option for silicone breast implants from a third company, Silimed. Patients can choose an implant from Sientra (Silimed) or Mentor or Natrelle. The FDA has approved this implant which means that it is a safe product equal to the standard for Mentor and Natrelle.

For most patients, the effect of Botox takes between 4 and 7 days.  Bruising may occur but this is typically rare.  Each Botox treatment that Dr Monaco administers is tailored to a patient’s specific needs and concerns whether this involves making crows feet more subtle or treating the dreaded number “11”s in between the eyebrows.  Botox is used for diminishing the appearance of wrinkles without going overboard and making a patient look frozen.  The amount of time that Botox will last varies from patient to patient.  Some patients need Botox every three months and others only opt for it once a year.  Typically, the results last between three and six months.

I am so glad to have found Doctor Monaco.  She is a caring and knowledgeable doctor that listens to her patient’s needs.  She listened, advised, explained my options and I could not be happier.  I had vertical lines between my brows and always looked angry…no matter how happy I was.  Now I look happy and relaxed.  She treated me with botox and I love it!  He staff is friendly and very helpful.  The office is immaculate…..another big plus!  Will never go elsewhere.

J.R.
Jamaica, NY

In an age of instant gratitude, women and new moms are often feeling the crunch to fit back into their pre-pregnancy clothes within weeks of delivering their babies. Reality TV and popular magazines are constantly showing pictures of celebrities who are in their bikinis within days of delivering their infants and let’s face it… they always look fantastic. It’s the celebrity mom who goes into hiding to take the weight off at the gym with proper food choices and lifestyle choices that never really gets the press of the instant bikini moms. So, are these celebrities having a little plastic surgery on the side when delivering their babies? It’s possible and no one but the patient can really confirm this but is it optimal? The simple answer is “yes” it’s possible to have a tummy tuck or liposuction done at the time of a c-section but “NO!” it’s not optimal.

Many women come to my office in their third trimester of pregnancy seeking a tummy tuck at the time of their c-section and I always tell these patients to wait. The focus on a c-section is to safely deliver an infant while keeping the mother safe in the peri-operative period. Performing an elective procedure at the time of a medically necessary one is an option that comes with greater risks for blood clots and infection than is worth undertaking. In an age of instant gratification, I still tell these women to wait and I do not perform their requested procedures at the time of their delivery! Sometimes I lose a patient to the plastic surgeon who is willing to take this risk…but my goal is safety first before anything else.

Women who take the extra pounds of pregnancy off with diet, exercise and conventional means then seek consultation for liposuction or a tummy tuck will have a much better cosmetic result than women who have a combined procedure at the time of a c-section. The uterus needs several weeks to contract back down to a non-pregnancy state as do the skin and muscles of the abdomen. The stretch and strain on the abdomen and the water retention from pregnancy make performing a tummy tuck at the same very difficult to estimate how much extra skin can come off versus how much will contract back on its own. If there’s an ugly scar on the abdomen from a previous C-section, that scar can safely be removed at the time of a second (or third) C-section but that’s a far cry from considering a tummy tuck during this setting. It’s also difficult to tighten the muscles of the abdomen when the uterus is still enlarged from the pregnancy, as it’s much easier to get them tighter when there isn’t a physical roadblock like the uterus to get around.

The bottom line from this plastic surgeon is for a mom to wait until her body has recovered from the strain of pregnancy. The best results come when a mom feels that she has reached as close to her pre-pregnancy shape or weight and is ready to take care of herself with whatever “mom-job” she chooses for her to look and feel fantastic. When needed, it’s a procedure that is truly deserved after the miracle of childbirth…and one that is worth the wait.