Category: Uncategorized

An Update on Implant Position in Breast Augmentation

This is an update to a blog post that I made last year on whether patients undergoing breast augmentation should place the implants above or below the pectoralis major muscle. In conjunction with the study that I mentioned in that prior blog, we now have another, recently published study from one of my dear colleagues and associates in the Journal of the American Society of Plastic Surgeons.

In their study, they found that several things increased the risk of problems following breast augmentation. To quote the article, “In the primary augmentation cohort, subglandular placement of the device was the strongest univariate risk factor for development of capsular contracture”. This means that women who have their breast implants placed on top of the muscle are at greater risk for development of a tight scar around the implant. Positioning the implant in that location is the highest risk of all risks for this complication.

My nearly 30 years of surgical experience and my practical experience as a plastic surgeon confirm the findings of these colleagues. There are many unexplained factors that create risk of any surgical procedure, but we certainly need to do our best to minimize those odds when and where we can. I hope you’ll give us a chance to evaluate any concerns you have about a prior procedure or any anticipated future surgeries.

If you want to take a look at the previous blog that I mentioned, you can find it here:

The Plastic Surgery Channel Rocks!

In 2012, a plastic surgery colleague of mine founded The Plastic Surgery Channel to showcase important stories for plastic surgery patients and provide legitimate, board certified plastic surgeons a platform to present valuable patient educational materials.

Two years ago, and after careful consideration, I decided to join this group. My experience with these amazingly brilliant, dedicated, and conscientious colleagues of mine has been phenomenal. I’ve had many opportunities to interact with them, assist in producing educational videos with them, and we’ve spent many hours discussing issues important to patients and the specialty of plastic surgery.

This past weekend, I was fortunate enough to attend one of the many video production sessions at The Plastic Surgery Channel’s film studios in Dallas, TX. During this visit, I moderated panel discussions on Fat Grafting and bizarre Cases. Furthermore, I was on panels that talked about scar management, surgeon review sites and awake surgical cases.

Independently, I filmed shots about having the right size breast (#therightsizematters), what the priorities are in breast augmentation, and the associations/societies that patients should look to see that their surgeon is a member of. Keep your eyes open for the videos to be added to my video gallery in the near future.

You’ll also notice that my video gallery will include videos from my colleagues at The Plastic Surgery Channel. Because these are trusted, respectable colleagues, I am grateful to share their opinions with you. It is nearly impossible for me to individually create videos on every topic of potential interest to you all, so I’m publishing these for you to learn from.

Thanks for taking the time to support us and your fellow patients.

By: Brian Brzowski Categories:Body, Breast, Breast Augmentation, Uncategorized

What’s the Difference Between Implant Warranties?

All of the implant manufacturers offer great warranties. They compete with each other so vigorously that you’ll likely find the company with “the best” warranty will have their warranty matched word for word very soon after it becomes known. You simply can’t chase the warranty rabbit.

The most important part of this to understand is that no matter which implant company your surgeon uses, you have unprecedented choices at this point in time. Breast implants today are more durable, more pleasing, and have far fewer complications such as capsular contracture and rippling. Even more reassuring is that if a company warranties their product for life (which they all do), you know that the company really doesn’t think that they’ll be giving out free implants very often. Like us, they understand that a breast implant rupture is becoming a very rare event.

You should spend your time considering the surgeon first and foremost. There are few true differences in implants, but HUGE differences in the training, experience and personalities of the surgeons you could utilize. Just like a lot goes into picking the person you choose to cut your hair, choosing where to go based on what type of hair clipper they use is, shall we say, misapplying your priorities.

Nonetheless, here is a great breakdown of warranties and how they vary from manufacturer to manufacturer. In my office we use all of these manufacturers and will select from all of these choices the implant that we think will provide our patients with the best result. Trust us to make the best decision for you and the one that will lead to the highest likelihood of a safe and long-lasting pleasing result.

By: Brian Brzowski Categories:Breast, Breast Augmentation, Breast Implants, Uncategorized

Even the Brits know there’s a problem

The attached news article is a real awakening to the pervasive problem across the globe of unqualified persons (often not surgeons or even MD’s) performing surgical procedures that are only traditionally taught in approved residency training programs.

When looking for a breast augmentation or any other elective cosmetic surgical procedure, your first stop should be to search for a board certified plastic surgeon who is a member of his or her state plastic surgery society. Once you have verified the surgeon’s memberships and professional affiliations, you should consult with friends and visit reputable sites that contain reviews from real patients. One of the most truthful and educational of these websites is Contributors are vetted for their legitimacy and reviews are carefully scrutinized for honesty.

We welcome a thorough review of our backgrounds and experience. A visit here in our offices in Ogden, UT will help you learn more about us and let you make a truly informed decision about who should be doing your elective cosmetic surgery.

Give us a call to schedule your consultation at 801-479-5722.

By: Brian Brzowski Categories:Breast, Breast Augmentation, Trends, Uncategorized

Why the square face?

Have a square face? Not having a tapered or more oval shaped face can take away from one’s attractiveness. In years past, it often took major surgical procedures in order to improve this issue. Luckily, we now have many good non-surgical options that allow us to make very nice changes in the shape of a patient’s face.

As a surgeon and experienced injectables physician, I’m able to fully assess and consider the wide range of options for a patient to consider when deciding how to make an improvement in his or her appearance. The variety and number of products continues to grow, and the advances in this area of non-surgical treatment are rapidly changing how we approach problems in facial appearance.

If you are interested in seeing how we can help you address any issues that you may be experiencing with your appearance, facial or otherwise, please contact our office via email ( or phone us at 801-479-5722.

By: Brian Brzowski Categories:Botox, Face, Injectibles, Juvaderm, Voluma

Which Implants Should I Choose?

I’m often asked what breast implant is the “best”. Here’s my usual answer.

Silicone implants are better for thin patients without much of their own breast tissue. For heavier chested women, the difference is minimal. These advantages are because silicone implants are softer and show less rippling; with the newer (5th generation silicone gel implants) that have been released in the last few months, this improvement is even more noticeable.

In years past, it was felt that silicone implants had a higher contracture (tight scar around the implant) rate than saline, but it really seems to not be as much the case anymore, so we really don’t need to give that a lot of worry.

The implants will behave differently when they rupture – saline implants deflate like a balloon – silicone implants generally don’t change at all (plus there is overall no health worries with a silicone rupture).

Saline implants do allow for more “on the table” adjustments in volume so, for patients with a lot of volume differences between the breast, that might equate to a small advantage. However, with our years of experience, we’re usually able to give the same improvement in breast symmetry using a silicone implant.

Lastly, silicone breast implants will cost more than saline. When factored out over the many years you can expect to get from your silicone implant, the increased cost is minimal.

The optimal way to find out the “best” implant for you is to come in and let us show you these differences and give you our opinion based on your specific situation. Every patient is different… so not every answer is the same.

By: Brian Brzowski Categories:Breast, Breast Augmentation, Breast Implants, Uncategorized

Cosmetic Surgery For Seniors Shows Equal Success

There’s good news for older men and women who are interested in improving their appearance with cosmetic surgery: A new study shows that plastic surgery is just as safe for seniors as it is for younger patients.

Motivated by the aging U.S. population, researchers wondered whether older patients are at greater risk of complications. Their results show that seniors can proceed with physical rejuvenation without added worry: “Our study demonstrated that patients over 65 years old can safely undergo cosmetic procedures with a complications rate similar to younger patients when surgery is performed by board certified plastic surgeon,” explains study author Dr. Max Yezhelyev.

According to statistics from 2008 to 2013, younger patients (mean age 39.2 years) experience postoperative complications at a rate of 1.84 percent. For seniors (mean age 69.1 years), the rate was just 1.94 percent — a statistically insignificant difference. The post-surgical complication rate was 2.2 percent for patients aged 80 years or older — also statistically insignificant.

These results are somewhat surpising, considering seniors have higher risk factors, such as a higher incidence of diabetes and a slightly higher average Body Mass Index. But, older patients are less likely to smoke.

The most common postoperative complications in older patients were hematoma, infection and problems with the healing of wounds.

The study, Safety of Cosmetic Procedures in Elderly and Octogenarian Patients, was presented at the annual scientific meeting of the American Society of Plastic Surgeons in Chicago and was published in October’s issue of the journal Plastic and Reconstructive Surgery.

For cosmetic surgery in Salt Lake City and South Ogden, Utah, visit board-certified plastic surgeon Dr. Brian Brzowski.

By: Anita Brzowski Categories:Uncategorized

“Flexing Moves My Implant”

On occasion I have a patient who tells me that their implant moves around and looks funny when they flex their chest muscle. They forget that the implant is under the muscle and is naturally pressed by the pectoralis major muscle when it is flexed.

The muscle temporarily compresses the implant a little bit, causing the implant to move around and develop a momentary crease across it. This completely resolves when the active contraction of the muscle ends.

Since we are only talking about the small span of time- such as those isolated incidents when flexing nude in front of the mirror- the significant upside of having the implant underneath the muscle outweighs this small concern. The major benefits include a smoother appearance, improved visibility during mammogram and reduction in the risk of a tight contracture development.

As always, we welcome questions about any procedure that we perform and are happy to educate all patients regarding our recommendations and the best possible outcome that they can achieve.

By: Brian Brzowski Categories:Breast, Breast Augmentation, Breast Implants, Uncategorized

Safe Navigation

As an introduction to my upcoming posts (that I hope you will find engaging), I want to share a few heartfelt thoughts.

Those of you who keep up with our Facebook, Twitter, and blog writings may recall that I recently posted lessons extracted from a speech by Admiral William McRaven. He is the former Commander, Joint Special Operations Command, and the architect of the raid by Navy Seal Team Six that resulted in the death of Osama Bin Laden. Of the points that he stressed in his commencement address for the graduating class of 2014 at the University of Texas, Austin, a few were especially meaningful to me.

McRaven’s recognition of the extraordinary importance of hard work was reflected in his statement, “measure people by the size of their heart (his effort, his work ethic, his determination), not the size of their flippers (status in society, income, appearance).”

This quote illustrates how absolutely critical it is for us all to push to succeed and excel at everything we do. Talent is over rated as they say, and genius is no guarantee of results.
A brilliant example of this truism and triumph of work over innate ability is seen in the thoughts of Jordan Ellenberg. Dr. (PhD) Ellenberg is a professor of Mathematics and author at the University of Wisconsin. At the age of 12, he scored a perfect 800 on the math SAT. He describes how it is easy to be caught up in the glare of ability and genius, ignoring where real achievement comes from. “The cult of genius tends to undervalue hard work and the productive persistence that psychologists nowadays like to call ‘grit’”.

The second personally relevant lesson from the Admiral that he wanted to [...]

By: Brian Brzowski Categories:Mark Twain, Musings, Plastic Surgery, Uncategorized

How Much Does a Painting Cost?

I recently posted on an answer to a question about “how much_______ costs?” That is such a hard question to answer and, honestly, is not the right question to ask.

My response was framed around me answering a similar question, “how much does a painting cost?”  The comparison in the query reveals that the variation in costs between surgical services is precisely like that between costs of paintings.

If a local painter, or your neighbor’s child listed an object of their creation for sale, you’d likely be stunned if they charged a fee similar to what you would pay if you could buy the Mona Lisa. You’re really getting a different product/service, although they’re both “paintings”.

I could draw another easy analogy by asking, “how much does court time cost if I want to rent out a basketball court?”. If I’m renting time at the home court for the Miami Heat, I would surely not expect to pay the same for time at the local YMCA. The are different and are priced differently.

Although breast augmentation costs or tummy tuck costs are important considerations, you should consider any surgical procedure such as a tummy tuck or breast augmentation to be a variable product or service.  Outcomes are different from surgeon to surgeon and from office to office.  Because you are purchasing an “experience” and not just a commodity like a pair of implants, it’s important to realize you are indeed comparing apples to oranges when using price or cost as a determining factor.

We know how vitally important the first surgical procedure is for patient happiness and success. It makes perfect sense (and is probably rather illogical to do otherwise) to invest time on the frond-end and carefully [...]

By: Brian Brzowski Categories:Cost, Musings, Uncategorized