Category Archives: plastic surgery news

Kybella Non-Surgical Injectable Now Available

The Pearl Plastic Surgery Center is pleased to announce an exciting new addition to our non-shutterstock_161758796-2surgical treatments: Kybella injectable treatment. This revolutionary FDA-approved treatment is used to dissolve extra fat under the chin (i.e., a “double chin”). Learn more about this exciting and safe new treatment, performed by both Dr. Samuel Pearl and Dr. Alexander Ereso, in this post.

What Causes a “Double Chin”?

Many factors can contribute to a person having a “double chin,” including being overweight or obese. However, a person who is otherwise slim may still have extra fat below their jaw line as a result of genetics or aging, which causes the skin in the area to droop over time and create this unattractive effect.

How Can Kybella Help?

Kybella is made from a naturally occurring molecule in the body called deoxycholic acid. Upon injection into the chin area, Kybella targets and then destroys the fat cells in the area. Once these fat cells are eliminated and then absorbed naturally by the body after treatment, new fat cells cannot rejuvenate and store fat in the area. The result of treatment, then, is a slimmer, more well-defined jaw line — and without any incisions, stitches or scarring!

What is a Kybella Treatment Like?

A Kybella treatment plan usually consists of two to six sessions of injections, depending on the needs of the patient. Each session, which typically lasts 15 minutes, is spaced between four and eight weeks apart. To start off your treatment, Dr. Pearl or Dr. Ereso will apply a topical numbing agent on the chin and jaw area, so that you do not feel the injection. The doctor will use a small syringe to inject Kybella into the fattiest areas of the chin for the best aesthetic outcome.

Once the Kybella session is done, a small amount of redness and irritation in your chin area is expected, though minor. There will also be some mild swelling in the area, which usually subsides after a couple of days. Downtime is minimal after treatment; you can expect to return to normal daily life, including going to work and exercising, after a day or two.

The Best Part: The Results!

You should expect to see a noticeable improvement in your chin and jaw line appearance after about a month of treatment. The results, though gradual, are marked, with chin fat that appears to dissolve slowly before your very eyes! Final results can be expected after three to four months, or after about three or four treatment sessions. And the best part is that these beautiful, natural-looking results can last a lifetime!*

*Kybella results are permanent. However, fat can return to the chin area if a patient gains weight after being treated. But since a Kybella treatment permanently destroys and removes fat cells in the chin area, these cells cannot rejuvenate to store fat. Any added weight, therefore, will be more evenly distributed throughout the face and neck area.

Find Out if Kybella is Right for You

Are you ready to learn more about the innovative Kybella treatment? One of our doctors at the Pearl Plastic Surgery Center would be happy to answer your questions. To schedule a consultation with Dr. Pearl or Dr. Ereso, contact the Pearl Plastic Surgery Center by calling (650) 964-6600.

Improving Breast Augmentation/Tummy Tuck Recovery with EXPAREL

Pretty adult girl with perfect legsIt’s common for Mountain View plastic surgeon Dr. Samuel Pearl’s breast augmentation and tummy tuck candidates to be worried about the surgical recovery period: specifically, what it entails, and whether they will be uncomfortable while healing from surgery. Certain individuals even postpone or avoid having breast augmentation or tummy tuck surgery because they are nervous about pain or discomfort during recovery.

Traditionally, the first three days after surgery are the most challenging and uncomfortable. Patients typically manage pain with intravenous or oral narcotics, which can have a highly sedative effect, hamper range of motion and cause uncomfortable gastrointestinal, genitourinary and respiratory side effects.

Dr. Samuel Pearl is pleased to offer his patients a new aid for post-operative pain management. EXPAREL is a single-dose local analgesic that controls pain without the need for catheters, pain pumps or other delivery devices.

Approved by the U.S. Food and Drug Administration in 2011, EXPAREL combines bupivacaine, which causes numbness or a loss of feeling, with DepoFoam, a type of technology that breaks down the medication over time to prolong its effect.

“We followed the development of EXPAREL very closely and were very excited when it became FDA approved,” said Dr. Pearl. We have been using EXPAREL at the Pearl Plastic Surgery Center for more than two years and have been very happy with the reduction in post-operative pain noted by our patients.

EXPAREL is injected around the surgical incisions as well as into and below the pectoral muscle during breast surgery and into the rectus muscle when performing muscle repair during tummy tuck surgery.  It can be used in any type of breast or abdominal surgery with good results. Post-operative pain and discomfort are reduced for up to three days after surgery. “This is a game changer.”

It’s important for Dr. Pearl to have a firm grasp on the medical history of any patient considering EXPAREL. He needs to know about the existing chronic medical conditions, as well as over-the-counter or prescription medications the patient takes or has taken, in order to avoid any complications.

Results of EXCLAIM Study Show Great Outcomes with EXPAREL

At last year’s meeting of the American Society for Aesthetic Plastic Surgery, Pacira Pharmaceuticals presented the compelling results of a study on patients treated with EXPAREL. The EXCLAIM study looked at nearly 50 patients undergoing four common plastic surgery procedures: breast augmentation, breast reduction, abdominoplasty and a combination abdominoplasty/breast surgery. Patients reported low pain scores, high satisfaction with pain control and minimal use of opioid medication.

“Based on our findings, use of EXPAREL helps to effectively manage pain during the critically important 72 hours after surgery while reducing the need for opioid medications, which can result in a host of unwanted side effects,” said Dr. Stephan Finical, an EXCLAIM study investigator.

Learn More about Reducing Post-Operative Pain and Discomfort

EXPAREL could help make your breast surgery or tummy tuck recovery a much more comfortable and pleasant experience. If you would like more information about the surgical procedures or EXPAREL, please contact Dr. Pearl today. Call our office at (650) 964-6600 or send us an email at

The Non-Surgical Shoelace Breast Cast Technique

Shoelace Breast CastIn the July 2014 issue of Aesthetic Surgery Journal (ASJ), Dr. Daniel Mills and Dr. Alexander Ereso describe an innovative technique that nonsurgically treats breast asymmetry and double bubble-deformities that may appear after implant-based breast augmentation in the early post-operative period. Previously, the only methods that could fix these types of problems involved undergoing revision surgery, which is not without its risks, including the risks of surgery and anesthesia. Furthermore, revision surgery may involve further financial costs to patients. The Shoelace Breast Cast is a technique that effectively treats the asymmetry while eliminating those factors that accompany revision surgery. When worn continuously, the shoelaces act as an external breast cast that allows the inframammary fold to be set and heal in the correct position.

The technique utilizes the placement of shoelaces around the breast in a manner that acts as a “cast” to allow the inframammary fold of the breast to heal in the correct position. Two wide-bodied, flat shoelaces are tied together and then wrapped around the neck, under the breast, around the back, and then tied together and worn for a prescribed length of time. The shoelaces effectively create a new inframammary fold in the location on the chest that will yield symmetry with the opposite breast. The shoelace breast cast, if placed and worn properly, has been shown to be a cheap and effective technique that solves a significant potential complication. Furthermore, the technique can be utilized to raise the inframammary fold on both breasts if the implants are considered to be placed too low. Based on almost 20 years of results, the shoelace breast cast has a success rate above 90%, meaning the vast majority of patients can have their asymmetry or double-bubble deformity corrected without the need for undergoing revision surgery.

About Alexander Ereso, MD

Dr. Ereso graduated from the University of California at Berkeley before earning his medical degree from Meharry Medical College, School of Medicine. He then completed a full residency in general surgery at UCSF-East Bay followed by a residency in plastic and reconstructive surgery at Wayne State University. Dr. Ereso received further subspecialty training completing a fellowship in reconstructive microvascular surgery at the University of Pittsburgh and an aesthetic surgery fellowship with Dr. Daniel Mills in Laguna Beach, CA. Dr. Ereso is available for interview upon request.