Tuesday, November 27, 2012

The Woodlands Plastic Surgeon

Emmanuel De La Cruz MD, PLLC
Plastic & Reconstructive Surgeon
The Woodlands Plastic Surgeon

Sunday, November 18, 2012

Plastic Surgeon in The Woodlands

Emmanuel De La Cruz MD, PLLC
Plastic & Reconstructive Surgeon
The Woodlands Plastic Surgeon

Tuesday, October 2, 2012

Friday, May 25, 2012

Houston Tummy Tuck

Tummy Tuck, Tummy Tuck, Tummy Tuck.... What Do You Need to Know about Tummy Tuck?
(Photograph courtesy of twentyythreex.tumblr.com)
 What is the Perfect Body? 
  • Having an hour-glass figure is considered to be extremely attractive by men throughout human history.
    The hour-glass figure is the equivalent of having a 36-inch hips and a 23-inch waist.
    The perfect hip-to-waist ratio (hour-glass figure) is the best way to assess women to be fertile.  Universally, men find "fertile women" to be attractive.

The "Belly Button" or Umbilicoplasty Involved in a Tummy Tuck
  • A tummy tuck procedure almost always involves repositioning of your belly button (procedure is called umbilicoplasty.)The only time when the umbilicus is not repositioned is when your plastic surgeon performs a mini-tummy tuck, which has very limited indications (very few are candidates for a mini-tummy tuck.)There are several methods of doing an umbilicoplasty performed by different plastic surgeons.

The Ideal "Belly Button" or Umbilicus
  • Although the ideal shape of the "belly button" has been debated, studies have shown that in a young thin female, the umbilicus tends to have a small, vertically oriented umbilicus.
  • As the young attractive woman ages, the hooding of the "belly button" and deepening of the stalk develops.
  • With weight gain and after pregnancy, the umbilicus widens and deepens resulting to an unattractive "belly button."
  • A wide umbilicus and the presence of an outward protrusion called an "outie" are considered to be unappealing.
  • An ideal "belly button" according to studies of young women with an attractive abdomen shows desirable characteristics that is small in size, vertically oriented, and the presence of a superior hood.

Before & After Photos of a Tummy Tuck Procedure with VASER Liposculpture performed by Emmanuel De La Cruz MD, PLLC

Pregnancy and Abdominoplasty
  • —Some of the benefits of abdominoplasty may be reduced or eliminated by pregnancy. 
    Thus it is wise to postpone the procedure if a pregnancy is anticipated in the near future.

Stay tuned for more information about Tummy Tuck....
Emmanuel De La Cruz MD, PLLC

Craig et al.   In search of the ideal female umbilicus. Plastic & Reconstructive Surgery. 105(1) Jan" 389-392, 2000.
El-Sharkawy, etl al. A study of the Aesthetic Patterns of the umbilicus among Egyptians with a ew Technique for Umbilical Reconstruction de Novo.
De La Cruz, et al.  The Celtic-Cross Technique for Immediate Umbilical Reconstruction.  Journal of Plastic, Aesthetic & Reconstructive Surgery.
Baroudi R. Umbilicoplasty. Clinics of PLastic Surgery. 2 (3) July: 431-48, 1975.
Hodgkinson DJ.  Umbilicoplasty: Conversion of a "ouie" to "inneie".  Aesthetic Plastic Surgery7(4):221-2, 1983.

Thursday, May 10, 2012

The Perfect Breast | Houston Breast Augmentation

Engineering the Perfect Breasts

In today's society, women are subconsciously bombarded with images of larger breasts overflowing out of low-cut dresses.  These images are reflected from magazines, reality TV shows and celebrities with enlarged breasts.  Because of our society's infatuation with large breasts, the tendency toward favoring larger breast volume with breast augmentation may result to a deviation from the natural shape of the breasts.  When the breast is excessively augmented with breast implants, the tear drop shape of the breast becomes more round which is not harmonious and looks unnatural.  But then again, the ideal breast is different for every woman.
Photograph Courtesy of http://celebrity-stuff.popsugar.com


Breast Symmetry
Ideally the perfect breasts would be symmetric.  Although this seldom comes to mind, perfect breasts aren't what one would expect. One study showed that breast asymmetry in women is a commonality amongst the population. Nearly 80 % of women have asymmetric breasts.  Breast asymmetry is measured by several parameters, such as nipple areolar complex size & position, breast size/breast mound volume, breast/chest wall shape, degree of ptosis (sagging), and inframammary fold location. With this in mind, when one seeks a breast augmentation, any subtle difference of the breast may become more obvious after surgery.

What is the Ideal Breast Shape?
  • The nipple should be pointed outwards and parallel to the ground.
  • The upper pole of the breast should be full and not "deflated" as found in a "swooping breast."  The upper pole of the breast typically becomes "deflated" with aging, pregnancy or even with significant weight loss as seen in athletic women.
  •  The lower pole of the breast should be fuller than the upper pole of the breast.  The lower pole should also have a round shape.
  • The upper pole should have a slope from the upper chest down to the level of the nipple. 
(Photograph Courtesy of MedIndia.net)
Breast Ratio (Photograph Courtesy of dailymail.co.uk)

Ideal Breast Dimension
  • According to a recent British Study by Dr. Malluci, the proportion of the upper to the lower pole should have a 45:55 ratio 
  • The angulation of the nipple should be pointing upwards at a mean angle of 20° from the nipple meridian
  • According to the study, the upper pole slope should be linear or slightly concave, and the lower pole should be convex.
With the advent and popularity of larger breasts, like Pamela Anderson in Baywatch, the perception of the perfect and ideal breasts have changed.  Mild to moderate fullness of the upper pole will produce a more youthful and more beautiful breasts as seen after a breast augmentation.  Excessive upper pole fullness due to an overly-sized breast implant will look unnatural, and thus will have an appearance of a more obvious "boob job."
Before & After Photos of Breast Augmentation using the Dual-Plane Technique performed by Emmanuel De La Cruz MD, PLLC. Natural slope achieved after breast augmentation.

With this in mind, what is the perfect breast?  The perception of the perfect breasts may vary from culture to culture and may vary individually.  The unnatural appearance of an overly-sized breast augmentation may be perceived as more beautiful.  Women who wants a "more natural look" may want the ideal "traditional" perfect breasts with a natural slope.  Regardless of what one perceives the perfect breasts to be, you should communicate with your plastic surgeon the ideal breast shape that you would want to achieve after your breast enlargement.

Taylor Swift recent Breast Augmentation? (Photo courtesy of Hollywoodlife.com)

Emmanuel De La Cruz MD, PLLC
Plastic Surgeon in The Woodlands

Malluci, et al.  Concepts in Aesthetic breast dimensions: analysis of the ideal breast.  Journal of Plastic, Reconstructive & Aesthetic Surgery.  2012 Jan;65(1):8-16. Epub 2011 Aug 24.

Smith et al.  Breast volume and anthropomorphic measurements: normal values.  Plastic & Reconstructive Surgery.  1986. 78(3):331-335
Stark et al. Breast asymmetry: An objective analysis of posteperative results. European Journal of Plastic Surgery. 1991; 147: 173

Sunday, April 8, 2012

Dr. Emmanuel De La Cruz Reviews

Plastic Surgeon in The Woodlands | Houston Plastic Surgeon | Tomball Plastic Surgeon | The Woodlands Plastic Surgeon

To my patients, 

Thank You for your Testimonials!

Emmanuel De La Cruz MD, PLLC
The Woodlands Plastic Surgeon
Visit us at Plastic Surgeon in The Woodlands

Monday, April 2, 2012

Breast Massage after Breast Augmentation

Breast Massage after Breast Augmentation ~ Houston Breast Augmentation

Purpose of Breast Massage after Breast Augmentation
  • To keep the implant pocket soft and open, resulting in a natural looking breasts.
  •  Some plastic surgeons believe that breast massage may reduce capsular contracture.   However, currently there's no clinical studies showing that it reduces capsular contracture.

Breast Massage (Photograph Courtesy of prplastic.com)  Note: The implant stabilizer on the far lower right is not part of the breast massage.  Not all patients will require an implant stabilizer.

Breast Implant Massage Recommendations
  • Breast massage may be started 3 to 5 days after your breast augmentation surgery.
  •  Perform this 3 times per day
Prior to massaging your breasts after breast augmentation, I recommend consulting your plastic surgeon.  

Emmanuel De La Cruz MD, PLLC
The Woodlands Plastic Surgeon

Friday, March 30, 2012

The Secret to a Beautiful Lip

The Secret to a Beautiful Lip

Having fuller lips, like that of Angelina Jolie, have been considered a desirable trait.   A study has shown that female models who are selected in the fashion industry, in general, have fuller lips (upper and lower) than ordinary women.  Several studies have also shown that men prefer women with thick and prominent lips.  Over the past several years, there have been an increasing number of women seeking lip augmentation to achieve that sought after voluptuous lip.    
Angelina Jolie's Beautiful Lips (Image from Alex-Scheffer.com)
Features that Decrease the Perceived Age in Women
  • Big eyes
  • Short nose
  • Small chin
  • Thick lips
  • Thin eyebrows
With aging, the upper lip undergoes several changes which range from atrophy of the fatty tissue of the lips to thinning and a less pronounced vermilion border.  Thus, augmentation of the lip may decrease the perceived age in women desiring a sensual and youthful lip. 
    Photograph Courtesy of http://celebrity-stuff.popsugar.com

    Common Changes in the Aging Upper Lip
    • Fatty tissue atrophy of the upper lip
    • Thinning and less pronounced vermilion border
    • Flattening of the philtrum
    • Widening of the Cupid's bow
    • Loss of the natural "pout" of the lip

      Ideal Lip (Photograph by Rachael Ashe; Courtesy of Wikimedia Commons)
      So what is the secret of a beautiful lip?  Nearly every fashion model has full and plump lips.  Does having a lip augmentation of one's upper lip sufficient to have that sought after voluptuous lip? Studies have shown that the ideal lip has an upper to lower lip ratio of 1.0 : 1.6.  If this ratio is altered, as found in women with excessive augmentation of only the upper lip, the lip may look unnatural. This would not be as attractive as the natural upper lip.  The upper lip may predominate the discourse in aged lip, but the lower lip may need augmentation as well due to the development of lip ptosis with aging.  Moreover, lower lip augmentation may be needed to maintain the upper to lower lip ratio in order to achieve "natural" and beautiful lips.
        Lips of a famous actress after lip augmentation.  Overcorrection of the upper lip augmentation resulted in a deviation from the ideal upper to lower lip ratio.  Thus, the lips look unnatural.

        Reasons Some Women Desire a Lip Augmentation
        • Desire to have more fullness of the lips
        • Those with genetically thin lips
        • Those with poor definition of the vermillion border
        • Atrophic lips due to advancing age
        Non-Surgical & Surgical Options for Lip Augmentation
        • Implant material, such as Goretex, Alloderm, PTFE, Silicone
        • Fat grafts 
        • Dermal-fat grafts from patient's own tissue, especially after a facelift procedure
        • Dermal filler lip injections 
        Before & After Photos of Lip Augmentation using Dermal Fat Graft by  Emmanuel De La Cruz, MD, PLLC

        In most cultures, having a full lip is associated with female beauty and youthfulness. Young women may want to achieve sensual lips like that of Angelina Jolie or Jessica Alba. The older and refined woman may want to look younger with fuller and sensual lips. Whatever their reason maybe to obtain the ideal lip, one needs to be aware of the secret of the beautiful lip before one undergoes plastic surgery.
          Kara Dioguardi was included in  PEOPLE's Most Beautiful List (Photo courtesy of Wikimedia Commons)
          So is there a secret to a beautiful face?   
          Stay tuned....

          Emmanuel De La Cruz M.D.
          Houston Plastic Surgeon


          Anderson, Richard. Alloplastic Lip Enhancement. Aesthetic Surgery Journal. 2001. September, 21: 5: 445-449
          Bisson M, Grobbelaar A. The esthetic properties of lips: a comparison of models and nonmodels. Angle Orthod 2004;74:162-166. 
          Giddon, D. Orthodontic applications of psychological and perceptual studies of facial esthetics.  Semin. Orthod. 1995. (1)82-93
          Koscinki, K.  Facial attractiveness: General patterns of facial preferences. Anthropological Review. 2007. (70):45-79
          Lemperle, et al.  An Index for Quantitative Assessment of Lip Augmentation. Aesthetic Surgery Journal. 2010. May. 30(3) 301–31
          Narsete, et al. Lip Augmentation in Conjunction With Facelift: Preliminary Experience With A New Permanent Implant.  Aesthetic Surgery Journal. 2009. September295: 356-359
          Rohrich, et al. The anatomy and clinical implications of of perioral submuscular fat.  Plastic & Reconstructive Surgery. 2009;124:266-271.
          Scott, et al. Influence of lips on the perception of malocclusion,
          Am. J. Orthod. Dentofacial Orthop. 2006. (130)152-162
          Turkkahraman, et al. Facial profile preferences among various layers of Turkish population. Angle Orthod. 2004. (74)640-647

          Sunday, March 25, 2012

          Venous Freeze in The Woodlands

          Venous Freeze in The Woodlands | Houston

          Cellulite reduction?  Is Venous Freeze the potential solution?

          Cellulite Reduction
          •  Venous Freeze has been known to reduce cellulite.
          Potential Complications from Venous Freeze
          • Burning of skin 
          • Recurrence of poor skin tone (no long term studies are currently available.)
           Stay tuned for more information....

          Emmanuel De La Cruz MD, PLLC
          The Woodlands Plastic Surgeon

          Saturday, February 25, 2012

          VASER Liposuction in The Woodlands | Houston

          What is VASER Liposuction?

          Ultrasonic liposuction for body contouring began in the late 1980's and early 1990s.  The VASER system was developed in the late 1990s to reduce complications, reduce physician fatigue, and allow for faster patient recovery.

          So What is the VASER?
          • VASER stands for Vibration Amplification of Sound Energy
            at Resonance
          • This liposuction system employs mechanical and acoustic forces to emulsify fat within a targeted area, while preserving other
            important tissue structures.

            • "VASER Lipo utilizes acoustic forces to safely dislodge fat cells while protecting surrounding tissues, ultimately producing a clean, smooth aspirate with excellent cell viability."
          • The fat deposits emulsified from a VASER system are then removed from the body by aspiration (liposuction.)
          • The individual fat cells remain intact after emulsification from VASER.  Thus,  fat collected during the VASER Liposuction may be harvested for autologous fat transfer. 
          VASER Liposuction by Dr. Emmanuel De La Cruz (Before & After VASER Liposuction 1 Month)
          Before and after liposuction:  VASER Liposuction by Dr. Emmanuel De La Cruz

          What are the potential complications from VASER Liposuction?
          •  Burning of the skin
          •  Contour irregularities (less with the VASER when compared with traditional liposuction.)
          ADVANTAGES of VASER Liposuction?
          • Improved skin retraction according to reports by physician users
          • "No serious complications reported related to VASER technology in more than 70,000 procedures." 
          • "No complications, burns, contour irregularities or prolonged swelling in a study of 77 patients, no revisions needed in a multi-center pilot study."

          New technology in plastic surgery is exciting.  VASER Liposuction may improve one's body contour, but not everyone would be a candidate.  It is essential to see your plastic surgeon if one would be a candidate for a liposuction, whether it be VASER, Smart Lipo or traditional suction lipectomy.  Further procedures, such as a tummy tuck, may be needed to achieve the ideal body that one would want.

          Emmanuel De La Cruz MD PLLC

          Jewell, Fodor et al. ibid. pp 137–140; Garcia, Proven Safety of the VASER, ibid, pp 2–3
          Jewell, Fodor et al. Clinical application of VASER-assisted lipoplasty, ibid. pp 131–145 
          Mark Shafer, PhD.  Principles of Ultrasound for Body Contouring: The VASER® System. 
          EB De Souza Pinto, MD, R. Federico MD, et Al. Lipomioplasty with VASER: A New Approach to Body Contouring. In: Innovations in Plastic and Aesthetic Surgery, Editors M. Eisenmann-Klein and C. Neuhann-Lorenz, Springer-Verlag, Berlin, Germany, 2008, p. 433-442.
          Onelio Garcia, et al. Comparative Analysis of Blood Loss in SAL and Third-Generation Internal UAL. The American Society for Aesthetic Plastic Surgery, Inc. Volume 28, Number 4, July/August 2008
          Prado A, et al. A Prospective, Randomized, Double-Blind, Controlled Clinical Trial Comparing Laser-Assisted Lipoplasty with Suction-Assisted Lipoplasty. Plast. Reconstr. Surg. 118(4):1032–1045, September 15, 2006.

          Silicone Gel Breast Implant or Saline Breast Implant?