About Dr. Steven Teitelbaum
Dr. Teitelbaum is an internationally recognized board-certified plastic surgeon known for his specific expertise in breast augmentation. He has extensive experience working with both saline and silicone implants, having helped design and test the most current models, and he lectures and teaches other surgeons how to perform breast augmentation surgery and achieve the best results with minimal pain and recovery time.
• Expertise. Dr. Teitelbaum is the only surgeon in the state of California, and perhaps the only in the United States to have participated in the clinical studies of the newest generation of breast implants (also known as “cohesive,” “gummy-bear,” or “form-stable” implants) for all three implant manufacturers—Mentor, McGhan (now Allergan), and Silimed (now Sientra.) He also testified at the FDA hearings on silicone gel breast implants. As a result, he has among the most clinical research experience of any physician in the U.S. with these implants, and he is frequently asked to teach plastic surgeons around the world about the differences between various cohesive gel implants, as well as the advantages and disadvantages for each in different patient profiles.
In the past few years, Dr. Teitelbaum has given over fifty lectures to other plastic surgeons on breast augmentation and breast implant revision surgery—including talks across the U.S. and in Brazil, England, Israel, Mexico, Morocco, and Sweden. He is also recognized locally, as one of just a few Los Angeles cosmetic surgeons to have been asked to join the esteemed teaching faculty of UCLA Medical School, where he is Assistant Clinical Professor of Plastic Surgery.
Dr. Teitelbaum has published several recent articles on breast augmentation in the prestigious journal Plastic and Reconstructive Surgery—including, among others, a landmark paper on reducing the need for patients to have multiple operations, and a roundtable discussion on breast augmentation he led with the most elite names in cosmetic surgery. He has written recent textbook chapters on both initial and revision breast augmentation surgery.
Dr. Teitelbaum is a principal figure in creating the curricula used to teach other surgeons how to select the proper implants for each patient and achieve the most-natural results, as well as a lead instructor in the breast augmentation course offered to plastic surgeons at the annual meeting of the American Society of Aesthetic Plastic Surgery—the largest aesthetic plastic surgery meeting in the world.
• Patients. Dr. Teitelbaum is cosmetic surgeon to a number of influential people, models, and celebrities, but he is most proud of the fact that he is often chosen by other physicians for their own surgeries or those of their family members. Dr. Teitelbaum is also frequently referred difficult cases from other top surgeons in the U.S. and around the world. Finally, Dr. Teitelbaum is often chosen by employees of breast-implant manufacturers—people who observe many plastic surgeons and have access to the results achieved with their products. Following a 2007 review of his clinical trial results by a two-person evaluation team that travels countrywide to review all surgical results for a particular implant—Dr. Teitelbaum received this note: “Jennifer is not given to false praise—what she told you about your work was truly from the heart, and I agree with her. You have that very unique gift which enables you to produce spectacular results over and over again. Keep making the world a more beautiful place.”
Philosophy of Breast Augmentation
Dr. Teitelbaum’s approach to breast augmentation is a direct result of years of studying, writing, and lecturing on the subject. He’d like to share with you a few of the points that distinguish him from other aesthetic surgeons:
“Augmentation affects your breasts for the rest of your life—a responsibility I take very seriously. Every surgical decision we make together—from the incision site to the pocket location to the type and size of implant—should further the goal of making your breasts look their absolute best, in the safest way possible. We should make choices that give you a beautiful breast not just this year and next, but for many years beyond that.
My personal aesthetic gravitates toward breasts that are beautiful and natural, and my patients generally share this approach. Most of them specifically say that they do not want to look “fake”; unless a patient specifically requests otherwise, this is always my goal. I tell patients what I believe will look best for them and be best for their bodies, but ultimately you – the patient – is the one who decides what will be done. I will work hard to make sure that I understand what you want before proceeding with any surgery.
Here’s what you can expect from me. First, an unparalleled consultation experience. Many plastic surgeons actually pass you off to a patient coordinator, or they may spend only a few moments with you. I schedule a large block of time for each prospective patient, and will take as much time as you need to discuss how you’ve always wanted your breasts to look, and any concerns you may have. Whether you have the surgery done by me, by someone else, or not at all, you will be sure to leave my office with a dramatically enhanced understanding of how an augmentation could change how you look.
This dialogue will continue throughout our entire relationship as doctor and patient. Far too often I hear other surgeons’ patients complain that their augmentation didn’t give them the results they wanted or expected. This is unacceptable to me, which is why I will explain the implications and consequences of each decision we make together, and stay in constant contact to make sure you know exactly what to expect.
I put an enormous amount of effort into keeping up to date with medical advances, and am proud to have my own state-of-the-art surgical facility. And while I don’t rush to embrace every innovation, through my own research, I have been able to improve upon breast augmentation techniques. In fact, I instruct other surgeons in how to minimize recovery time and pain in initial breast augmentation based on my own clinical studies.
Finally, I think it is important to stay in close contact with a patient after surgery. No matter how busy our office gets, you can expect regular follow-ups and the kind of top-notch postoperative care I consider necessary to ensure the best possible results, and I give out my cell phone number to all surgical patients so that I am easily within reach. I’m honored when any patient chooses me to be her surgeon, and I strive to make sure my conduct always reflects that feeling.”
Steven Teitelbaum MD FACS
What to Expect at Your Consultation
There are four steps to your breast consultation with Dr. Teitelbaum:
1 Communicate to Dr. Teitelbaum exactly how you want to look. Think about overall size, shape, and proportion. Natural or fake? Large, balanced, or small relative to your shoulders and hips? Do you want the implant to be visible through your skin or do you want it to blend imperceptibly into your body? Do you like an upper bulge or do you prefer a straight or even empty upper breast? A look that’s just enough to fill out your breast so you look womanly and feminine or something that even without a bra “pops” and is eye-catching? Whatever it is you want, don’t hesitate to tell Dr. Teitelbaum your wishes—there are no wrong wishes.
2 Dr. Teitelbaum will examine and measure you in order to determine if your wishes can be fulfilled exactly as you hope. Every woman’s breast skin has a certain volume that it can hold. If you fill it up beyond that point, the edges of the implant will be visible through your skin and the top will bulge. In time, the pressure will stretch your skin and may cause sagging. If you underfill the breasts, they will not look full, the upper part may be concave, and they may not be proportionally shaped. A breast that is already full, firm, and tight will have less capacity to be enlarged without looking augmented. A breast that is loose, empty, and soft has a greater capacity to be augmented while still looking natural. The thinner you are, the more likely it is that your implant could be seen or felt, while the thicker your tissue, the more your body will hide the implant.
3 This is the critical step, in which together you and Dr. Teitelbaum reconcile your “wishes” with your “tissues.” Most of the time, women intuitively know what will work on their body. But sometimes there are conflicts: there are patients that want to be a lot bigger and still look natural, yet an implant large enough to achieve that breast size would overfill their tight breasts, rendering them looking round and fake. They must choose: they can go larger and look less natural, or go smaller and look more natural. So too are there patients that just want to be full and only a little larger, yet an implant of adequate size to fill their loose breasts would make them much larger than they hoped to be. These women must choose between being the size they want and accepting being less filled, or being filled but larger than they ideally want. Dr. Teitelbaum has very specific expertise in this type of evaluation, and he excels at helping patients wade through these difficult decisions. He will never mislead you about your outcome; he will always tell you the truth about what your tissues will allow you to achieve.
4 In the final step, he will help you to visualize what you will look like after surgery. Dr. Teitelbaum wants you to know ahead of time how you will look with the implants you have selected; he doesn’t want a patient to ever wake up bigger or smaller than they were expecting. The doctor will take a 3D photo of you, then use his state-of-the-art breast-imaging system to simulate the size that you’ve decided on—so you can see on a computer screen how it would look in your body. (You can do this undressed or with a bra on.) Second, he will give you a “sizer implant’ to put inside an unpadded bra—so you can assess how your new breast size will appear under different clothes. Third, he will show you photos of patients of similar size and weight to yourself. None of these methods is precise, but taken in combination, they will help to give you some indication of how various implant sizes will look on your body.
3-D Simulation of Augmentation Results
Every woman considering breast augmentation shares the same concern: How do I choose an implant that’s the right size for me?
While Dr. Teitelbaum is known for his skill in intuiting exactly what volume will satisfy his patient’s wishes and look most balanced on her body, it’s understandable that you will want to visualize precisely how different options will look on you. It’s for this reason that Dr. Teitelbaum became the first aesthetic surgeon in the country to use the Axis Three digital breast imaging system. He has now used this state-of-the-art technology to help hundreds of satisfied patients forecast how they will look after their procedure.
After taking three-dimensional digital images of the breasts, the Axis Three software then calculates precise measurements and determines the exact volume of the breast tissue present. The system can then be used to simulate what various sizes of implants would look like when placed in your existing frame. Because any size implant can be simulated on your body, the machine presents you with an unprecedented opportunity to visualize approximately how you will look ahead of time, allowing you and Dr. Teitelbaum to more precisely select the implant that is right for you.
Of course, like any simulation, Axis Three can’t give a 100 percent precise prediction of the outcome. But Dr. Teitelbaum has found it to be far and away the most helpful forecasting tool available—and his patients agree. Many say that the digital imaging played a big role in reducing their concerns about their implant size, and gave them more confidence that they would be happy with their outcome.
All surgical consultations with Dr. Teitelbaum include a visual imaging session using the Axis Three at no additional charge.
Cohesive Implants
Many of Dr. Teitelbaum’s patients choose him to be their surgeon specifically because of his expertise with cohesive gel implants (also known as “gummy-bear implants” because the gel has a consistency similar to that of the candy). Widely popular in Europe because of their natural-looking and -feeling results, these implants are now available from just a few surgeons in the United States. Dr. Teitelbaum has been using them in studies since 2000 and is one of the most experienced providers in the country. He is the only surgeon in the state of California who was asked to participate in the clinical trials of all three cohesive implant manufacturers. And because of his extensive, excellent results, Dr. Teitelbaum is one of the most frequently requested lecturers on this topic in the United States,, and he has traveled to places as far away as Asia, Europe and Africa to share his cohesive breast implant expertise with other surgeons.
Cohesive gel implants offer a soft and supple feel with the added benefit of being relatively leak-free due to the nature of the silicone. It is this consistency that allows the implants to maintain the commonly requested teardrop shape. While the edges of the implant blend gradually into the surrounding tissue, the thinner top of the implant slopes gently down to a fuller bottom half, creating the most natural possible breast contour. Plus, clinical studies have demonstrated that cohesive implants have the lowest rate of capsular contracture (hardening of the breasts) and leakage of any implant ever studied.
Dr. Teitelbaum is an enthusiastic supporter of this new technology, and is developing the educational material that one implant manufacturer will use to credential surgeons who wish to use them following FDA approval. As excited as he is about these implants, he does not believe they are ideal for everyone. He always works with each patient to determine exactly what size and type of implant is right for her, and would never automatically recommend cohesive implants. When you come in for your consultation, you and Dr. Teitelbaum can explore if they might be right for you. In the meantime, we encourage you to visit Dr. Teitelbaum’s special website, www.cohesiveimplants.com, to learn more about this exciting new technology and all it has to offer.
24-Hour Recovery
Does the idea of a virtually pain-free breast augmentation seem too good to be true?
As remarkable as it sounds, recent developments have allowed over 90 percent of our breast augmentation patients to return to normal activities within 24 hours, without the need for narcotics, bed rest, or special bandages or bras. Bruising is minimal or nonexistent, and pain is controlled with ordinary Advil. In fact, Dr. Teitelbaum’s patients routinely go out to dinner the night of surgery, drive the next day, and need no more than a few days off work.
This is no exaggeration—and it’s also no accident. Your easy recovery will be the result of Dr. Teitelbaum’s commitment to meticulous preoperative planning, state-of-the-art anesthesia procedures, and the surgeon’s detailed understanding of finer points of anatomy, which allows each operation to proceed smoothly and with a minimum of trauma. His state-of-the-art surgery suite also offers the latest advances in anesthesia protocols, which significantly minimizes postoperative nausea.
Because of rough or imprecise technique, some surgeons tightly bandage patients or make them wear a special bra in the hopes of forcing the implant into a particular position or to act as a tourniquet to prevent bleeding. Dr. Teitelbaum’s precise and gentle surgical technique, conversely, allows his patients to move their arms in the recovery room right after surgery—and the result is less pain, a shorter recovery, and a lower chance of hardening of the breasts.
There’s a reason why Dr. Teitelbaum has been asked to teach other doctors how to achieve this kind of pain-free recovery at the largest annual plastic surgery meeting in the world. He’s made a believer out of hundreds of patients as well as many surgeons; feel free to ask as many questions as you like about how he can do the same for you.
Getting the Best Results
The natural, beautiful results Dr. Teitelbaum is known for are no accident—they are a direct result of the principles that have guided him since he opened his practice in 1995, and have made him one of the country’s premier breast surgeons. Here, he shares his advice for making smart decisions that will yield the best possible outcome.
It’s critical that you select an implant size and shape that fits your breasts. If an implant is too big, the breast looks round, shiny, and bulging on top in the short term. In the long term, the skin will stretch, the tissue will compress and thin, and the breast will sag. If an implant is too small, it will fail to proportionally fill out the breast. There is a narrow range of ideal sizes for each woman’s breast, and your surgeon will help you to understand what is realistic for you.
When considering the choice of incision, the resulting scar isn’t the only factor to consider. It seems like the most important thing before surgery, but no matter where the incision is, it is usually inconspicuous. What ends up being more important are issues such as pain, recovery time, sensation, ability to breast feed, accuracy, symmetry, avoiding implant hardening (capsular contracture), and putting off any revision surgery as far into the future as possible. Keep an open mind, and listen carefully to the logic behind any incision suggested to you.
If you are thin and can see your breastbone and ribs, don’t expect augmentation to correct a wide gap between your breasts. Some patients and plastic surgeons have the mistaken assumption that larger implants will fill in that space: They will not. Placing an implant under the extremely thin skin close to the sternum will result in fake-looking breasts that could migrate so close together that they form what is commonly referred to as a “uniboob.” (The medical term for this is symmastia.) A breast augmentation only augments the breast itself; it will not add tissue over a bony upper chest. And since your implants are obviously in front of your ribs, if you can see them, you most likely will be able to see your breast implant.
All breasts are a little asymmetrical—even after augmentation. Dr. Teitelbaum will do everything he can to make sure both breasts are as even as possible, and can adjust the implant size to correct major asymmetry when necessary. But it’s important to be realistic and accept that a tiny amount of variation will always be present—and almost never be noticeable to anyone but you.
Remember that skin stretches. If your tissue is thin, the implant will be visible no matter what the size. And, just as we have all seen with natural breasts, the larger they are, the more all breasts fall with age. It should come as no surprise that the additional weight of augmented breasts will similarly cause the skin to stretch and sag over time. A good cosmetic surgeon will help you assess what implant will best fit your natural breast pocket as well as examine your skin quality.
Don’t automatically dismiss the idea of a breast lift. If your skin is thinned, sun-damaged, or already stretched, adding additional weight can often cause the breasts to sag more quickly. This seems to be especially common in women who have stretch marks on their breasts, have had babies, or lost a lot of weight. Your surgeon will take measurements of your breast skin under maximal stretch. If the measurements are greater than a certain amount, your surgeon may recommend a breast lift. Heed his or her advice—or do no surgery at all. Proceeding with an augmentation in breasts that really need a lift rarely produces the results desired, and may ultimately just postpone the inevitable and necessitate an even more extensive lift down the road.
Once you’ve taken the above factors into consideration, weighed your options, and heard what your surgeon recommends, you should find yourself in an excellent position to make the critical surgical decisions that will determine the outcome of your breast augmentation surgery.
For more information please visit our website at www.drteitelbaum.com www.cohesiveimplants.com
Board Certifications & Society Memberships
Certified : American Board of Plastic Surgery
Certified : American Board of Surgery
Member : American Society of Plastic Surgeons
Member : American Society for Aesthetic Plastic Surgery
Member : California Society of Plastic Surgeons
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