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Things You MUST Know Before Getting Top Surgery

Top surgery is the term used to describe any procedure designed to alter the shape, size and/or appearance of the chest area. Today, one of the most common reasons top surgery is performed is to assist with the process of gender reassignment.

According to Healthline, top surgery can be performed to masculinize the chest or to feminize the chest in a way that reassigns gender from male to female, female to male or non-binary.

For most patients, having top surgery is one of the most transformative experiences of their life. However, if you or someone you love is seeking information about top surgery, there are also some things you must know before you start down this potentially life-changing path. 

In this article, learn about the key things you must know before getting top surgery, including how to prepare, how to select your surgeon, what your surgeon needs to know about you and more.

1. Be Prepared to Do Research - LOTS of Research

The first rule of thumb in plastic surgery is this: every patient is different. What looks great on one person may not look great on another person. 

You want to select a plastic surgeon who will treat you as the unique individual that you are, factoring in your natural anatomy as a pathway to get to your ultimate goal.

Here, the more research you can do, finding photographs of successful top surgery for patients whose natural build and body structure is similar to your own, the more you can hone in on exactly the look you want to achieve.

Bring your portfolio of pictures with you to your initial consultation so you don't have to rely on words along to share with your surgeon what you want to look like after your top surgery. 

2. Top Surgery Isn't an Overnight Procedure - It Is a Process

Depending on the type and extent of your top surgery procedure, you may need to do some preparatory work to experience the most favorable results.

For example, if you are currently taking hormone therapy as part of your transition, you may need to finish out that therapy before pursuing top surgery. This is especially likely to be the case if you are seeking insurance reimbursement for your top surgery procedure.

If you use tobacco products or drink alcohol regularly, you may need to stop these habits for a while both before and after your procedure. This will give your body the best chance to heal quickly and completely. This is so important for healing that some plastic surgeons even make this a requirement before scheduling the procedure.

It may also be necessary to go through some type of psychological counseling before scheduling your top surgery. Some plastic surgeons require this while others do not. 

In the same way, some surgeons will require that the patient be at least 18 years of age before agreeing to perform top surgery. Other surgeons will perform top surgery on younger patients as long as the parents consent to the procedure.

If you are also actively involved in a weight loss program, you should finish your program and achieve your ideal body weight before undergoing top surgery. Similarly, if you are under a doctor's care for any serious health issues, your surgeon may want you to work to resolve those before pursuing top surgery.

Finally, it is important to know that there will be an extended period of recovery following your top surgery. The average time away from work after a top surgery procedure is three to four weeks.

3. With Top Surgery, the Surgeon You Choose Really Matters

Top surgery requires a great many choices on the part of both the patient and their surgeon. This makes your choice of surgeon integral to the success of your procedure - truly, the two of you will partner to ensure your outcome is a stunning success.

The first thing you want to verify is that your surgeon follows the World Professional Association for Transgender Health (WPATH) standards of health care.

According to top surgery expert, Pramit Malhotra, only surgeons who adhere strictly to the WPATH standards of care should be permitted to perform top surgery on patients.

The second thing you need to discuss with your surgeon is the many surgical options that could potentially deliver the desired results. For example, there are a variety of incision patterns and techniques based on your desired outcome. 

As well, there are potential pitfalls only a truly experienced and skilled surgeon will have the expertise to avoid. One example here is "dog ears," a result that leaves extra skin and fat poking out at the sides of the chest. Dog ears represent one of the top reasons patients seek revision surgery following a top surgery procedure.

The chance of experiencing dog ears is greatly reduced when you choose a plastic surgeon who has special expertise with doing top surgery.

4. Be Sure to Get the Exact Cost Estimate Up Front

There is no sugar-coating this part: top surgery can be expensive. In some cases, health insurance may cover all or part of the costs. In other cases, you may contact your insurer only to find you are on your own to find funding.

The earlier you know the exact cost of your top surgery, the more time you have to figure out your finances and save for your procedure if that is a necessity. In planning for funding your procedure, also remember to factor in the need to take up to three or four weeks away from work to recover fully from your procedure.

Don't be afraid to gather several estimates (although be sure the plastic surgeons you are considering adhere to WPATH standards and are board-certified)! 

5. Ask for Support - You Will Be Glad You Did!

Finally, it is no secret that many people who dream about having top surgery are reluctant to talk to their loved ones about what they are going through.

But top surgery is a major surgical procedure and you will need help during the surgery and during your convalescence. 

It can be especially helpful to connect with others who have had top surgery to learn from their experiences and receive their support.

On the day of your top surgery, you will be so glad you have support to see you through this life-changing process.

6. About Ann Arbor Plastic Surgery 

Dr. Pramit Malhotra, MD, is one of just a handful of surgeons nationwide who is double board-certified in plastic surgery and otolaryngology. 

Dr. Malhotra has recently been selected by a committee of his peers to be inducted into the American Society of Plastic Surgeons as an honorary member.

To date, Dr. Malhotra has performed more than 6,000 procedures, giving him a truly fine eye and a steady hand to pursue his mission as a surgeon to achieve natural, elegant results that meet and exceed patient expectations. 

To learn more and schedule your initial consultation with Dr. Malhotra, top surgery expert in Ann Arbor, MI, visit us online.

Sinuplasty vs. Rhinoplasty: Which is Right For You?

A surprising number of patients who come to our offices for rhinoplasty are told that they have something a little wrong with their sinuses or some other structure inside the nose. This defect affects their breathing and makes it less efficient.

A deviated septum is sometimes a shock to a patient who has lived their whole life thinking their breathing was perfectly fine and just wanted to change the shape of their nose, according to New Jersey rhinoplasty expert, Daniel G. Becker.

People who wonder if they have to choose between sinuplasty, or sinuplasty and rhinoplasty should know that they don’t have to choose one over the other. Indeed, they are often performed at the same time. This is true of other nose surgeries such as septoplasty and turbinoplasty.

Doctors recommend that the sinuplasty or any other surgery to correct a medical issue be done before the cosmetic rhinoplasty but during the same session.

About the Nose

Besides being the most prominent part of the face, the nose is a complex structure, which makes rhinoplasty a challenging skill to master. There are four pairs of sinuses among many other parts of the nose that need to be taken into consideration during nose surgery.

Sinuses are spaces around the nasal cavity that are filled with air and take up a surprising amount of space. 

The frontal sinuses are above the person’s eyes. The ethmoid sinuses are between the eyes, and the sphenoid sinuses lie behind a person’s eyes.

Finally, the maxillary sinuses are found beneath the eyes. These sinuses appear at various stages in a child’s development.

People are born with the ethmoid and maxillary sinuses, though there’s no air in them at first. The other sinuses arrive later and keep developing throughout the person’s life.

Because they’re hollow, the sinuses make a person’s skull lighter, but they also keep the inside of the nose moist by producing mucus. The mucus traps pollutants and pathogens.

Why Do People Choose Sinuplasty?

The most common reason people get sinuplasty is that they have chronic inflammation of their sinuses, or sinusitis that doesn’t respond to more conservative treatments.

Though traditional sinuplasty involves cutting through tissue and bone to enlarge the sinuses, a new technique called balloon sinuplasty does not require this type of trauma.

During balloon sinuplasty, the surgeon threads a balloon catheter into the sinus then inflates it to force the opening to expand.

When this is done, the enlarged sinus is flushed with saline solution to remove debris such as pus. Then, the balloon is withdrawn, leaving the sinus open and cleared.


There are two basic rhinoplasty techniques: open or closed. In an open rhinoplasty, the surgeon makes an incision through the columella  (the strip of cartilage between the nostrils) and opens the nose up to operate.

According to studies, surgeons prefer the transcolumellar gull wing, where an upside-down V incision is made in the tissue.

In a closed procedure, the surgeon operates from inside the nose. Most surgeons use open rhinoplasty, though surgeons whose patients want them to improve the look of the tip of their nose or the top of their nose used closed rhinoplasty.

Most patients seek rhinoplasty because they have a bump in their nose that they find unattractive.

Other reasons include a nose that’s crooked, either because it’s been injured or the patient was simply born with it, a saddle nose that has a dip in the middle then turns upward at the tip, or a nose tip that’s too bulbous or has some other aspect about it that the patient finds unsightly. 

Many plastic surgeons find fixing the tip of the nose to be the most challenging type of rhinoplasty.

In some cases, the tip of the patient’s nose can’t be fixed because the skin there is too thick and the cartilage beneath it is too thin. The plastic surgeon should let the patient know this during the consultation after they’ve examined the nose.

Other people find their nose too large or too small in proportion to the rest of their face, their nose is too wide, or their nostrils are too narrow or too flared.

Who’s a Good Candidate for Nose Surgery?

A candidate for rhinoplasty is in good overall health both physically and mentally and has specific and realistic goals when it comes to their nose surgery. Their facial growth should also be completed.

Since this happens when people are about 13, plastic surgeons sometimes have consultations with teenagers who hate their nose but aren’t completely sure about what they want to be done with it. This can also make rhinoplasty more daunting than other types of cosmetic surgery.

A candidate should come to the consultation with a list of questions and be able to answer the questions that the plastic surgeon puts to them. The doctor will also tell them the best options for their nose surgery or if the surgery can be performed at all.

Though a sinuplasty can be performed at the same time as rhinoplasty, the patient must not have any infections in their upper respiratory system such as a cold or flu.

They’ll need to quit smoking at least two weeks before the surgery, and they’ll need to fast the night before their surgery. This is because most nose surgeries are done under general anesthesia.

The patient also needs to discontinue anti-inflammatory or anticoagulant medicines before their surgery, and they’ll need someone to drive them home and stay with them at least overnight.

It’s also a good idea to prepare the home for the patient’s convalescence. Needful things should be in reach of the bed, and meals should be cooked beforehand.

Since the patient will need to sleep with their head elevated for a few nights, a husband pillow and a neck pillow are good to have.

Rhinoplasty takes about one to two hours and may take more time if sinuplasty is performed at the same time.

The improvements brought by sinuplasty or septoplasty can be felt quickly, and the nose will heal into its new shape after about a year. The great majority of patients are very pleased with their rhinoplasty surgery.

A Doctor’s Guide to a Healthy Skin: Five Tips to Remember

The skincare industry is projected to grow to $180 billion by 2025. Experts point out that more people are becoming interested in buying skincare products because of the influence of celebrities and internet stars.

Additionally, the industry can sell a lot of products because of their effective marketing campaign, and more people are becoming interested in using different beauty products because of its positive effect on the skin.

Since ancient times, people have valued those who have youthful skin, and this is what the beauty product manufacturers are doing – they are telling the public to buy their products so that they too can have youthful-looking skin.

The beauty product manufacturers are also saying that more innovation will be introduced in the years to come. There are so many trends in skincare that is now being adopted by different companies, and the promotion of these services online is influencing the public to try it out.

The future of skincare is bright, and more businesses will benefit from the industry’s unstoppable growth. Aside from using skincare products, there are also a handful of ways on how you can retain a healthy and beautiful looking skin.

The following information will show you how to achieve healthy skin, through the guidelines given by dermatologists.

1. Protecting your skin from the harmful sun rays

Morning sunlight gives off Vitamin D, an essential vitamin needed by humans. Dermatologists encourage the public to bathe under the morning sun because it is a great source of Vitamin D.

However, they are also warning the public about the potential threat that can be experienced by those who are staying under the sun for too long, especially between 10:00 AM and 4:00 PM, when the sun is at its highest. 

These people are susceptible to different skin diseases, and their risk of acquiring skin cancer is also increased. Aside from Vitamin D, the sun is also known for emitting ultraviolet rays, and it can be deadly if someone decided to stay under the sun for too long.

Dermatologists and skincare experts advise the public to use protection whenever they wanted to go outside when the sun is out. The most recommended product to be used when going outside are sunscreens that have an SPF of 15 or better.

When applied to the skin, sunscreens produce a thin layer of protection that eliminates the effects of ultraviolet rays. When going outside for extended periods, people are advised to apply sunscreen every two hours.

People should also apply sunscreen frequently, especially if they are swimming or perspiring a lot because the liquid can take off the protective layer provided by the sunscreen. Wearing hats, long sleeves, pants, and shoes can also be an alternative. 

2. Avoid smoking cigarettes

Excessive smoking is bad for health. It can damage the lungs, and it can cause lung cancer. Another side effect of excessive smoking is skin damage, and you would notice that your skin becomes more wrinkled if you decided to smoke multiple pieces of cigarettes a day.

What happens inside the body when you smoke is that the tiny blood vessels found on the outer layer of the skin starts to narrow, and it will decrease the amount of blood flowing in this area.

This will make your skin paler, and it will also prevent more oxygen to reach these areas. The less oxygen your body has, the more susceptible you are to different skin problems.

The collagen and elastin in your skin are also affected when you smoke. This is the fiber that enables the skin to be elastic. If the amount of collagen and elastin in your skin starts to decrease, you will experience a drier skin that is prone to more damage.

According to a recent study conducted by the Department of Plastic Surgery at the Case Western Reserve University, people who smoke frequently look older than those who don’t.

Because of the negative effects of smoking on the skin, more skincare experts are encouraging the public to quit this habit.

3. Gently treat your skin when taking care of it

To ensure that your skin will keep its youthful look, make sure that you are treating it gently. Skincare experts are saying that cleaning and shaving the skin daily can damage it over time.

They advise people to be more gently when performing a cleaning routine, and some of their recommendations are the following:

People should limit their bath time because it can remove natural oils from the skin. If using hot water for taking a shower, make sure that it will be quick. Staying in hot water for extended periods can cause skin damage and irritation.

Avoid using strong soaps when taking a bath because it has a high level of chemicals that can strip the natural oils found on the skin. Dermatologists recommend using mild cleansers instead.

Use lubricants when shaving. The skin can be damaged if the razor is applied on the skin without any lubrication. Use lotion or shaving cream as a lubricant.

Pat your skin after bathing to dry it while retaining moisture. Use moisturizers if you have dry skin. Ask your dermatologist about the best brands that you can use for your skin.

4. Eat a balanced and nutritional diet

If you want to achieve healthy-looking skin, dermatologists recommend eating a balanced and nutritional diet. It can make you feel good, and it can also contribute to better-looking skin. You need to add more fruits and vegetables to your diet, as well as lean proteins and whole grains.

According to some researchers, people who are eating lots of foods rich in cholesterol can result in several skin problems, including excessive acne.

If you wanted to ensure a healthy=looking skin, you should start eating fruits that are rich in Vitamin C. This vitamin helps the immune system fight off diseases, and it can easily destroy any bacteria that can pose a threat to healthy skin.

People should also eat foods rich in Vitamin E because it promotes healthy-looking skin. Healthy fats are also a must when someone wanted to achieve beautiful and youthful skin.

Finally, make sure that you are well hydrated. People who are drinking eight to ten glasses of water a day will notice changes in their body if they are constantly hydrated. They will notice that the skin will look better, and they can also look younger. Many celebrities are already trying a diet rich in fluids, and the results are satisfying.

5. Visit skincare experts that will ensure you youthful-looking skin

If you wanted to achieve youthful-looking skin, you can visit your dermatologist and ask for treatments and skincare procedures that you can avail.

Microdermabrasion is a trending skincare procedure wherein a dermatologist will use a tool filled with small diamonds that will scratch off the outer layer of the skin, exposing a newer skin underneath. Virginia Beach skincare expert Dr. Kyle S. Choe stated that this procedure is safe, and people will notice changes in their skin instantly.

The procedure will remove an old and damaged skin that has been subjected to different elements. Many people who have visited the clinic owned by Dr. Kyle S. Choe are saying that they are satisfied with the results of the treatment.

Secrets to Applying Makeup like a Pro

Makeup is an art and expression form. When correctly done, it has the power to uplift your mood and change the way everyone looks at you.

With the right technique, and a great kit as reviewed here; you can achieve Hollywood glam at a fraction of the cost. 

While everyone has unique facial features, style preferences, and lifestyles, these steps can make a massive difference in nailing the perfect look. The secret to flawless makeup application lies in the preparation, application stage sequencing, and finally, the magical final touch.

1. Moisturize First

Before you can even think of applying your makeup, it is crucial to prepare your skin by moisturizing. Learning how to apply moisturizer correctly is just as important as the type of moisturizer you choose.

A great tip is to use small amounts, and gently working it with your fingers first around your forehead, on to your nose and then your cheeks.

Ensure that you get the moisturizer evenly spread across your skin to avoid clogging your pores. Once you’ve applied enough moisturizer, give it a few minutes to dry before moving onto the next step.

Whether you opt for face mists, serums, lotions, creams, or oils, the quality of moisturizer is critical. 

2. Foundation and Primer

After properly moisturizing, it is essential to prep your skin regardless of whether you intend to go for a full face makeup or a lighter touch up. Primer and foundation are a critical first step before applying makeup as they will make it last longer. 

Primer is essentially a base to lay your foundation. Typically in silky smooth cream or gel form, priming fills in the pores on your face and evens out skin texture, creating the perfect canvas for your makeup.

Once primed, your skin is now ready for foundation. This step is critical as it can make all the difference. When it comes to foundation, picking the right shade for your skin is your number one priority. Always test foundation colors against your jawline first. 

Liquid Foundation application tools, while a matter of personal preference also needs careful consideration. Sometimes, your fingers may be all you need, like when going for a light coverage look.

However, when you want to glam up, your best bet would be an applicator brush or beauty blender. 

Foundation powdering isn’t quite as straight forward. If you dab on too little it doesn’t work; too much and you end up with the dreaded cake look. A great tip we can recommend is light dusting using a larger brush. 

3. Highlight and Define

Now comes the fun part. Here we can get a little more creative. Firstly, apply concealer in a triangular shape right below your eyes. This technique works wonders in ensuring natural-looking coverage and drawing attention to your eyes.

Next, you can apply highlighter along the top of your cheekbones, between the brows and on your chin.Follow this up by contour powdering along the sides of your nose, cheekbones and forehead areas. Once done, your blush can go on to the apples of your cheeks extending towards the temples.

Want to look like a star? It’s all in the eyes. Apply a light gold, shimmery shadow to the area of your lids just below the eyelash line. Next, using a blending brush, dust a soft brown shade as you blend outward. 

For your brows, fill in with a brow pencil for a more defined look. Add some mascara, and you have aced your eye makeup!

Final Thoughts

Using a lip brush, swipe on a natural, rosy pink lipstick and your makeup is complete. With these makeup applications tips, it’s easy to create a Hollywood beauty look.

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