BEFORE	AFTER

Breast augmentation is a very popular procedure for women and among the most commonly performed cosmetic surgery procedures. Most often, a saline-filled implant is placed under the breast tissue or beneath the chest wall muscle.  After surgery, breasts will appear fuller and more shapely in contour.  Incision scars can be placed in the armpit, around the areola, or under the breast. 

Dr. Medalie typically performs breast augmentation as an outpatient procedure.  The average cost including anesthesia, facility and implants is $4900.

For more of Dr. Medalie's patient photos, please visit his web site. 

For more information about Breast Augmentation, please visit the American Society of Plastic Surgery site, by clicking on  this link, or Looking Your Best, by clicking on this link.

		BEFORE	AFTER

Over time, the effects of gravity along with the loss of the skin's natural elasticity begins to have an effect on the appearance of a woman's breasts.  These factors, combined with pregnancies and nursing will often cause the breasts to lose their youthful shape and firmness.

A breastlift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts.  The procedure can also reduce the size of the areola (the darker skin surrounding the nipple).  Breast implants inserted in conjunction with a mastopexy procedure can increase both firmness and size.

Dr. Medalie typically performs breast lift as an outpatient procedure.  The average cost including anesthesia and facility fee is $4700.

For more of Dr. Medalie's patient photos, please visit his web site. 

For more information about Breast Lift, please visit the American Society of Plastic Surgery site, by clicking on  this link.

BEFORE	AFTER

Large, pendulous breasts may cause a woman to potentially experience various medical problems caused by the excessive weight of the breast tissue.  Problems with posture, skeletal deformities, back and neck pain, skin irritations and nerve irritations of the fingers are common with this condition.  Bra straps often leave indentations in the shoulder area.  Many women, especially teenage girls, are very self-conscious if they have unusually large breasts.  With breast reduction surgery, women of all ages are able to have breasts that are better shaped and in proportion. 

Breast reduction (reduction mammoplasty) removes fat, glandular tissue, and excessive skin, resulting in smaller, lighter and firmer breasts that are better-shaped in proportion to rest of the body.

For more information about Breast Reduction, please visit the American Society of Plastic Surgery site, by clicking on  this link.

For more of Dr. Medalie's patient photos, please visit his web site. 

		BEFORE	AFTER

Reconstruction of the breast after a mastectomy due to cancer or other disease is quite possible with today's surgical procedures.  It is now a Federal law that after Breast Cancer surgery, all insurance companies are required to cover Breast Reconstruction as well as opposite side breast symmetry procedures.   Using the newest medical techniques, a plastic surgeon is often able to create a breast that is similar in form and appearance to that of the natural breast.  A consultation will provide you with information on the many available options for post-mastectomy breast reconstruction.

For more information about Breast Reconstruction, please visit the American Society of Plastic Surgery site, by clicking on  this link.

For more of Dr. Medalie's patient photos, please visit his web site. 

BEFORE	AFTER

Dr. Medalie is a specialist in the surgical treatment of gynecomastia or male breast enlargement. Although rarely discussed, male breast enlargement is a common condition. There is no specific cause for gynecomastia, although there has been some correlation with various medical conditions or drugs (anabolic steroids, some heart medications, marijuana, etc.).
Men who feel self-conscious about their appearance are helped with breast-reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.
If excess glandular tissue is the primary cause of the breast enlargement, it typically requires sharp excision. The excision may be performed alone or in conjunction with liposuction. Dr. Medalie prefers ultrasonic liposuction because it has greater efficacy in the dense fibrous tissue under the nipple. In a typical procedure, an incision is made at the skin -areola junction in the 4-8 o'clock position. Working through the incision, Dr. Medalie removes the excess glandular and fatty tissue from beneath and around the nipple. The remaining excess tissue is contoured via liposuction to blend smoothly with the rest of the chest wall. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars. When liposuction is used to remove excess fat, the cannula is usually inserted through the existing incisions or in an inconspicuous location under the arm.

Dr. Medalie typically performs male breast reduction as an outpatient procedure.  The average cost including anesthesia and faciltiy fee is $3500-$4500 (depending on the extent of the procedure).

For more information about Male Breast Reduction, please visit the American Society of Plastic Surgery site, by clicking on  this link.

Due to the private nature of these surgeries, Dr. Medalie has chosen to limit the extent of the discussion on his web site. Please contact him for more information which can be e-mailed to you. He would also be more than happy to provide a free online evaluation of photos e-mailed to him.

Dr. Medalie adheres to the same guidelines and principles of the Harry Benjamin International Gender Dysphoria Association. Prior to any surgical procedure, the prospective patients must fulfill the criteria established by the Benjamin Society and have letters of referral from a therapist (psychiatrist, psychologist or psychiatric social worker) who has had a long-term relationship with the patient.

FtM Chest Surgery
The procedure is based on the following: size and shape of breast and nipple-areola complex, elasticity of skin and patient's needs and preferences.
In general, patients who have smaller breasts can have the entire surgery performed with ultrasonic liposuction alone or in combination with surgical removal through an incision at the skin-areola junction. It is also possible to remove larger breasts using this technique, if the skin of the breast is thicker, more elastic, and not damaged or stretched out. In these patients with good skin tone, the excess skin and the areola will shrink by a fair degree. If the skin does not shrink enough, it may be necessary to have a secondary procedure to remove the excess skin by making a complete incision around the areola and then closing the defect with a "purse-string" suture. The advantage of a multi-stage procedure is that it also enables me to perfectly size the nipple and areola. If the patient is willing to return for an additional procedure, I think this is an excellent approach that minimizes scarring.

In those patients with a large amount of breast tissue with excessive skin of poor quality and droop, I usually recommend an elliptical skin excision mastectomy with removal of the excess skin and breast tissue in the crease of the pectoralis muscles. The nipples are removed during the excision and replaced as skin grafts. The advantage of this procedure is that it provides me with absolute control of the chest contour and nipple/areola size. The disadvantages are the large scars across the chest and the loss of nipple sensation.

Breast removal can be performed on an outpatient basis for approximately $3500-5000 (depending upon the extent of the surgery and duration of the procedure).

BEFORE	AFTER

MtF Chest Surgery
In those male patients who desire female breasts the first treatment that can be of benefit is the female hormone, estrogen. The results are extremely variable, but almost all patients have some growth of breast tissues. The more definitive and predictable way to achieve female breasts is through implant surgery. This surgery is no different for genetically male patients than genetically female patients. I encourage readers to see my breast augmentation section as well as examine the information at the American Society of Plastic Surgery at www.plasticsurgery.org. Breast augmentation can be performed on an outpatient basis for approximately $4900 (implants included).