• Our Testimonials

    Learn more about Dr. Bermudez and the services offered at our practice by reading through testimonials written by current and former patients.

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  • Meet The Doctor

    Kenneth Bermudez, MD, is a board-certified plastic surgeon with more than 20 years of experience. He is committed to helping his San Francisco cosmetic and reconstructive surgery patients achieve — and often exceed — their cosmetic goals.

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  • Awards & Recognition

    Dr. Bermudez has been honored numerous times for his surgical excellence. Most recently, he was selected as one of the Best Plastic Surgeons by Marin Magazine for 2018, 2015, 2014, 2013, 2012 in a peer to peer survey asking doctors in San Francisco and Marin counties to vote for the doctors they would go to or recommend to friends and family.

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  • Photo Gallery

    To get a clearer idea of the high-quality work Dr. Bermudez performs, please browse through our before-and-after plastic surgery photo gallery.

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Monthly Archives: March 2013

Breast reduction or breast lift with implants?

A patient came in this week with complaints of neck and shoulder pain, bra strap grooving and a rash underneath her breasts. She was a petite and 38DD. Her breasts were heavy and dense.

2 weeks ago I saw a woman who also said she was a 38DD cup, however, she had recently undergone massive weight loss (losing over 150 lbs. in 18 months) and felt that she lost shape and fullness to her breasts.

Same size, 2 very different problems.

The first patient is a classic example of someone who is a candidate for a breast reduction, which will reduce the size of her breasts and lift them to a most aesthetically pleasing shape.

The second patient needs a breast lift (mastopexy) with or without augmentation, depending on the patient’s wishes. Including an implant may improve the fullness which is lacking in many of these patients.

The best way to know whether to get a breast lift with implants, or breast reduction is to consult with a professional. Contact Dr. Bermudez, a trusted San Francisco breast surgeon today for a no-obligation consultation.

Breast Implants: How Long Do They Last? Are there any alternatives to breast augmentation.

Breast implants, like all medical devices, do not last forever. The manufacturers quote anywhere from 10-15 years. Most patients will require replacement of their implants at that interval. The most common reasons to have implants exchanges are patient’s desires to change the size of their implants (usually larger), capsular contracture and/or implant leak.

Imaging studies, like MRI , can be used to detect “silent leaks” and are recommended every 3 years (FDA). Some studies have showed that high resolution ultrasound can be as effective in diagnosis of a leaking implant. At our breast health center, we routinely screen with ultrasound as it is a cheaper and easier alternative than MRI. Your medical insurance carrier may or may not cover this expense.

Saline implants do not require the regular imaging. If they leak, your body will absorb the saline (salt water) and the breast volume on that side will decrease. You’ll probably figure out that you have a leak before you see your surgeon.

Both saline and silicone implants have a rubberized silicone shell. Both are prone to leak, roughly at the same rate. Silicone has a higher rate of capsular contracture than saline. We are not sure why, but probably due to the absorption of the saline….

Silicone implants feel and look better, especially in women who have very little breast tissue.

Think of the the silicone implant as a high maintenance luxury vehicle (i.e. Ferrari), where the saline is like a good solid lower maintenance luxury car (think Acura). Not as hot as the Ferrari, but still a really nice ride!

Another option for breast augmentation is fat grafting and the BRAVA device. This avoids the use of implants.

In this procedure, fat is harvested from your body and transferred to your breasts. Prior to surgery, you wear a BRAVA device to enlarge the tissue prior to grafting. You wear the BRAVA device for 2-4 weeks. The surgery is longer and requires more preoperative preparation, but if you are a candidate, can average about 250-300cc augmentation. I am currently enrolled in the FDA study.

Here are a couple of videos on the procedure:

All the best.