Author Archives: Traci Temmen

Am I Too Skinny for a BBL?

As everyone celebrates the beginning of the new year, many people may feel like now is the perfect time to take a step towards getting the body of their dreams! And while living a healthy lifestyle can certainly go a long way, sometimes you need a little bit of extra help to overcome genetics or aging, and finally get the appearance you want. One option that many people are interested in learning more about is the Brazilian Butt Lift, a procedure that sculpts a rounder, more attractive butt using fat transfer performed by a highly skilled board-certified plastic surgeon.

A substantial subset of this population has concerns about being “too skinny” to undergo this procedure, and are worried that they might not have enough body fat available to transfer to the buttocks. In this blog post, I will answer the question “Am I too skinny for a BBL?” and put this worry to rest. The short answer to this question is: Probably not! Generally, even women who are very slim can achieve a safe and stunning result from the Brazilian Butt Lift procedure when performed by a Board-Certified Plastic Surgeon like Dr. Traci Temmen. Read on for more information!

The first step of the BBL procedure is to gently remove unwanted fat from the midsection via liposuction. This step serves two purposes: One, to provide a supply of fat for later fat transfer. Two, to eliminate stubborn fat from problem areas, smoothing and slimming the midsection. In the second step of the BBL, the fat that was harvested during liposuction is transferred to the butt and sculpted into the desired shape. Dr. Traci Temmen meets extensively one-on-one with her patients to ensure that each BBL is personalized for each unique patient, resulting in a beautiful, seamless shape that is tailored perfectly for your body.

An advantage of the BBL procedure is that since it uses fat harvested from your own body, the results look and feel very natural – no foreign material is inserted, just your own fat in a different place! Furthermore, very precise volumes of fat can be transferred to different aspects of the buttocks to create the most attractive shape. When working with a thin patient, a small amount – even just a few hundred cc’s – of properly transferred fat can go a long way! Generally, slender women do not desire a really large butt, but are mainly interested in creating a rounder and more voluptuous shape by adding a little bit of volume in just the right places. The BBL procedure is ideal for enhancing gluteal shape by decreasing sagginess, filling in stubborn “hip dips”, and increasing projection through precisely targeted fat transfer. In the rare instance that an extremely thin woman desires a very large butt, this may not be a realistic goal for a BBL due to there simply not being enough fat available to create the desired volume. In these cases, gluteal implants, or combined gluteal implants with a BBL, may be better suited to realizing the patient’s aesthetic desires. However, the vast majority of the time, the round and attractive shape that slim women are looking for does not require a high volume of fat to create, and is very achievable at their normal weight.

Dr. Traci Temmen frequently performs BBLs on thin patients with beautiful results! To see some real examples of patients who chose to have their BBL performed by Board-Certified Plastic Surgeon Dr. Traci Temmen, please explore the “Before and After” section of this website, and select the “Skinny Brazilian Butt Lift” tab.

If you are interested in seeing if you are a candidate for a Brazilian Butt Lift, or any other cosmetic surgery procedure you are interested in, book a one-on-one consultation with Board-Certified Plastic Surgeon Traci Temmen, MD: 813-771-6393.

How do you choose the best plastic surgeon for breast augmentation or breast implant surgery?

The decision to undergo breast augmentation or breast implant surgery is a big one for many patients, and it’s important to find a plastic surgeon that is a perfect fit for you! In this post, I will discuss some key things to look for when choosing a plastic surgeon.

First and foremost, it is extremely important to choose someone to perform your procedure who is board-certified by the American Board of Plastic Surgery. This ensures that your surgeon has undergone rigorous training, and is fully licensed and approved to perform plastic surgery. This is critical not just to maximize your chances of getting a great result, but also to ensure that your surgery is performed safely, and by someone who is extensively trained in the specific field of plastic surgery.

In addition to choosing a board-certified plastic surgeon, it is also important to choose a surgeon who frequently performs breast augmentation or breast implant surgery, and consistently produces beautiful results. A good way to assess this is to explore their website and look at the “Gallery” or “Before and After” section for examples of previous patients who have had the procedures you are most interested in. Pay special attention to examples that best illustrate your goals – preferably of patients who had a similar starting appearance to you, and who got a great result that reflects how you want to look. After you have chosen a surgeon, these pictures may also be helpful to share a few of the best examples of the appearance you are hoping for with your practitioner. Board-certified plastic surgeon Dr. Traci Temmen has performed numerous breast augmentation and implant procedures on a diverse array of patients with stunning results. She often encourages her patients to identify a few “wish pics” from the website to show her during the one-on-one consultation so she can fully understand and fulfill her patients’ desires. Some beautiful examples of past patients who chose to have their breast augmentation procedure performed by Dr. Temmen can be viewed under the “Breast Augmentation” tab of the “Before and After” section of this website.

Another key factor to consider when choosing a plastic surgeon is picking someone who makes you can communicate easily with and makes you feel listened to. Most women have lots of questions and concerns about breast augmentation, and it is important to select a surgeon who is going to take the time to fully unpack each one. Dr. Traci Temmen treats every patient like she would want a family member to be treated, and ensures that all of their fears and worries are addressed at each clinic visit. Furthermore, as a female plastic surgeon, Dr. Temmen has a unique understanding of her patients’ concerns and desires when considering a cosmetic procedure such as breast augmentation. Dr. Temmen gives compassionate care to her patients every step of the way, and makes a special effort to ensure that each and every patient feels comfortable, safe, and happy from initial consultation to post-op care.

A final factor to consider when choosing a plastic surgeon for breast augmentation is the clinic environment. Pay attention when you go to a consultation, and make a note of the setting. Is it clean and tidy? Are the staff who greet you friendly and polite? A dirty or chaotic clinic is certainly a red flag, as is interacting with staff who are rude or poorly trained. From the moment you enter the door at Temmen Plastic Surgery for your one-on-one consultation with Dr. Temmen, you are welcomed warmly into a private boutique surgical setting that places the utmost importance on your comfort and wellbeing.

If you are interested in finding out if you are a candidate for breast augmentation or any other cosmetic surgery procedure you are interested in, book a one-on-one consultation with Board-Certified Plastic Surgeon Traci Temmen, MD: 813-771-6393.

 

What is the Difference Between En Bloc Implant Removal, Total Capsulectomy, and Partial Capsulectomy in Breast Implant Removal Surgery

For many reasons, I am seeing an increased number of patients for consultation on breast implant removal, also known as explant surgery. Some of these women are concerned about breast implant illness, others simply prefer to avoid the future ‘maintenance’ associated with breast implants, and some women and interested in breast implant removal for cosmetic or lifestyle issues. Either way, it is clear that there is confusion surrounding the terminology associated with breast implant removal or explant surgery.

To date, there are few agreed upon surgical indications for the removal of breast implants and the capsule surrounding the breast implant other than severe capsular contracture and ALCL (a rare lymphoma that can be associated with textured implants). Some large, online breast implant illness support groups strongly advocate for implant removal and total or en bloc capsulectomy as the treatment of choice for breast implant illness. However, the American Society of Plastic Surgeons as well as the American Society of Aesthetic Plastic Surgeons cautions against widespread en bloc capsule removal or total capsulectomy for patients worried about breast implant illness but without other clear surgical indications. Currently, these large plastic surgery organizations, as well as the online breast implant illness support groups, do agree, however, that there is no guarantee that implant removal with or without removal of the capsule will “cure” symptoms thought to be associated with breast implant illness. To see more information about breast implant illness, please see my previous blog posts or return frequently for more posts on this evolving topic.

Thus, I would like to clear up the confusion around the terms used for discussing breast implants, the capsules, and their partial or complete removal.

Capsule- The scar tissue that naturally forms around any foreign object placed inside the body. Any object not naturally found inside the body, such as a splinter, prosthetic knee, or breast implant, will cause the formation of a layer of scar tissue, or capsule, to form and encase the foreign body. When discussing breast implants, the capsule is the layer of scar tissue that forms around the breast implant, analogous to a baby enclosed in a placenta inside the mother’s body.

Simple Breast Implant Removal- A simple breast implant removal involves an incision down to and through the implant capsule in order to remove the unwanted breast implant. During this surgery, the capsule is left in place and not removed. The capsule will then shrink in size and often times be “broken down” and “dissolved” by the body naturally.

Breast Implant Removal and Partial Capsulectomy- A partial capsulectomy is performed when in addition to breast implant removal, small portions of the capsule are removed as well. The areas of capsule removal are often used to treat capsular contracture or to provide a tissue sample for pathological evaluation. Similar to a simple breast implant removal, the remaining capsule will then later shrink in size or possibly be incorporated by the body.

Breast Implant Removal and Total Capsulectomy- A total capsulectomy is performed when the entire capsule is removed after removal of the breast implant. In this case, I usually dissect the superficial surface of the capsule, open the capsule and remove the breast implant, then continue dissection of the deep surface of the capsule. The entire capsule is removed either in one piece, or multiple pieces, depending on the ease of surgery, and is thus called a total capsulectomy. This is analogous to delivering a baby after the placenta has broken, then delivering the placenta once the baby is safely delivered.

Breast Implant Removal and En Bloc Capsulectomy- An en bloc capsulectomy is performed when the capsule is removed in one piece with the breast implant contained inside the capsule. This is analogous to delivering a baby still encased in an intact placenta. Those active on social media breast implant illness sites advocate en bloc removal of breast implants to prevent further “contamination” of surrounding tissues during removal of intact or ruptured breast implants. However, it is not possible to guarantee en bloc removal of breast implants, particularly when the breast implants have been placed under the pectoralis muscle. When implants are placed under the muscle, it can be difficult, if not impossible, to remove a breast implant with en bloc capsulectomy because the backside of the capsule is attached to the ribs and intercostal muscles. Attempts to remove the capsule en bloc can prove disastrous if injury to the underlying ribcage and lungs then occurs during dissection. Because of this, I always tell my patients requesting an en bloc capsulectomy and removal of breast implants that I will do everything in my power to remove their implants en bloc, but I will not risk their life or injury to the ribcage or lungs. In these cases where an en bloc capsulectomy cannot be performed due to safety concerns, I then convert an en bloc capsulectomy to a total capsulectomy. The breast implant and all capsule material is removed as planned, but it is removed as separate pieces, not in one, intact unit.

If you are interested in breast implant removal or explant surgery, please call today for a complimentary consultation with me, Dr. Traci Temmen. I will do everything I can to educate, help you feel comfortable with the surgical plan, and provide peace during this potentially stressful time. My staff and I are experienced in dealing with all types of breast implant removal and capsulectomy cases, and we will treat you the way we would want our family to be treated.

Traci Temmen, M.D.
Female, Board Certified Plastic Surgeon
Tampa, Florida
813-771-6393

Female Plastic Surgeons – Traci Temmen, M.D. Tampa, Florida

I grew up on a working farm in rural Missouri.  My father was a row-crop farmer, and before that, a truck driver that hauled hazardous materials.  To say that I grew up in a male-dominated, masculine environment is an understatement.  I was usually the only girl in the feed store ordering soybeans and the only woman picking up a fertilizer buggy at the local Missouri Farmer’s Association.  This was how I grew up, all I knew, and it never seemed out of the ordinary or uncomfortable at the time.

I sometimes think this is one of the reasons that I had no hesitancy when applying to medical school and pursuing a male-dominated surgical specialty.  I had been surrounded by “big, aggressive men” my whole life and surgery seemed no different.  I often tell the story of my first surgical rotation in medical school.  I had requested a cardiac surgery rotation and gotten it, only to realize later than I got my first choice only because no one else had wanted it!  At that time, the cardiac surgeons at my medical school were known for being “mean,” throwing instruments, and constantly yelling at everyone in the room.  My first day in the cardiac OR was no different- while that cardiac surgeon was an excellent technician and did a perfect operation for his patient, he did yell, throw Debakey’s, and generally petrify everyone in the room.  Afterwards, a friend asked me how my first day in the cardiac OR went.  I said, “Great!”  She said, “But didn’t the cardiac surgeon yell at you?!”  I responded, “Yeah, I guess so, but my dad and his friends were worse!  Cardiac surgery is not so bad!”

In the almost 20 years since I started medical school, operating room culture, and the medical culture in general, has changed a lot.  The operating room is a much more collaborative space and “disruptive physicians” are greatly frowned upon.  However, there is still a gender gap in medicine, plastic surgery, and surgery in general.  I can’t say, nor can anyone, exactly say why this is, but I assume the presumed more aggressive nature of surgeons and demanding lifestyle may have something to do with it.

With that said, as recently reported in the journal Plastic and Reconstructive Surgery- Global Open, while nearly half of current graduating medical students are female, only about 12-13% of surgeons are female.  Among practicing plastic surgeons, nearly 20% are female plastic surgeons; the percentage for women in plastic surgery training programs is slightly higher.  However, in the more male-dominated surgical specialties like neurosurgery, orthopedic surgery, and cardiothoracic surgery, female surgeons only account for 10% or less of practicing surgeons.  These numbers are slowly rising for women in surgery, but there is no doubt that women plastic surgeons still work in a male-dominated field.

Perhaps surprising to some, I do not recall every being discriminated against for being a woman while in college, medical school, or plastic surgery residency.  Sure, there were the older veteran patients that always thought I was the nurse or thought women had to go to nursing school before going to medical school (seriously!!), but nothing that I found overly offensive, hurtful, or discriminatory.  I don’t know if these actions truly never happened or if I had just been desensitized to such “offenses” through my childhood.  Either way, I never noticed it.  Unfortunately, this has certainly not been the case for most other female plastic surgeons that I’m friends with or the other women surgeons I know.

In summary, while the gender gap is narrowing in medicine and in surgery, women are still underrepresented in most specialties, including plastic surgery, and particularly in the more “male” specialties like orthopedic, neurosurgery, and cardiac surgery.  The cause for this gender difference is unknown, and while it is decreasing, we have years to go before there is an equal playing field for women plastic surgeons and female surgeons, in general.

I love being a woman plastic surgeon!  I feel I am able to better understand, communicate with, and connect with my patients than my male counterparts.  I also know that some women patients prefer a female plastic surgeon when discussing their personal insecurities or desires.  My message to anyone considering a career in surgery is DO IT!  Surgery, and especially plastic surgery is fun, fulfilling, and gives me a sense of accomplishment every day!  I routinely mentor female medical students or women considering a career in medicine.  For more information on female plastic surgeons, feel free to contact me by email.

Labiaplasty vs. Vaginal Rejuvenation

While labiaplasty and vaginal rejuvenation are both surgical procedures of the female genitalia, they differ in several ways. Labiaplasty surgery is designed to reduce the size of the labia minora in order to decrease discomfort and improve cosmesis.  Vaginal rejuvenation surgery is a reconstructive procedure that tightens the vaginal opening and vaginal canal.

Labiaplasty

The labia minora are located inside the labia majora and consists of two folds of tissue surrounding the opening of the vagina. Just like breast size or height, the labia minora can be enlarged or asymmetric from birth or may develop these changes gradually over time.   Regardless of the reason, an enlarged or asymmetric labia minora can result in painful intercourse, difficulty finding comfortable exercise clothing, irritation of the groin area, and dissatisfaction with the overall external appearance.  Labiaplasty is the surgical reduction in size or adjustment of appearance of the labia minora. It is used to improve external appearance, correct asymmetries, and/or address discomfort experienced during exercise, sex, walking, sitting, and other activities of daily living.

Dr. Traci Temmen usually performs labiaplasty surgery under local anesthesia as in in-office procedure.  Patients can drive themselves to the office, drive home, and the surgery itself takes about 30-45 minutes.  Clitoral hood reduction, double fold excisions, perineoplasty, labia majora reduction, and fat transfer to the labia majora can often be done at the same time.  The recovery time for labiaplasty is relatively quick; patients can resume normal activities and return to school or work after approximately 2-3 days and sexual activity after 6 weeks.

Vaginal Rejuvenation – Vaginoplasty – Vaginal Tightening

 Vaginal rejuvenation, also known as vaginal tightening or vaginoplasty, is a surgical procedure that tightens the muscles of the vaginal wall and decreases the size of the vaginal opening.  Many women seek this procedure after vaginal deliveries or the natural effects of aging on the pelvic floor.  These patients often complain of a lack of friction during sex, tampons “falling out,” and a sensation of vaginal gaping or widening.   After undergoing vaginal tightening patients note increased sensation and friction during sex as well as a feeling of greater core tone.

Dr. Traci Temmen performs vaginal rejuvenation under general anesthesia in the operating room and takes about one to one and a half hours to perform.  Patients go home the same day, may return to work within two to three days, and can resume exercise and sexual activity after six weeks.

The cost of labiaplasty procedures typically start at $3,900 while vaginal tightening starts at $6,900; these prices may vary depending on the level of difficulty, any associated procedures, and anticipated time in the operating room. Most health insurance plans do not cover either procedure but Dr. Temmen has a variety of payment options to accommodate your financial needs. Regardless of your areas of concern or discomfort, Dr. Traci Temmen will strive to achieve the results you desire, both functionally and aesthetically.