Dr. Ereso : De Maio Master Injector

Juvederm Voluma De Maio TrainingEarlier this month, Dr. Alexander Ereso completed an advanced master class on injection techniques for JUVÉDERM Voluma in San Francisco. Dr. Ereso is one of a few physicians who were handpicked to attend the course which was taught by the renowned Brazilian plastic surgeon, Dr. Mauricio de Maio. Dr. de Maio is considered a pioneer, and an expert in the field of injectable medicine, and he lectures around the world to his peers about JUVÉDERM Voluma. The course was sponsored by Allergan, the company that makes Botox, JUVÉDERM XC, Latisse, and JUVÉDERM Voluma. Dr. Ereso attended the event to not only further develop his considerable skills, knowledge and experience, but also, to incorporate these new and exciting techniques in his day-to-day treatments.

The all day course, which featured didactics as well as live injections featured Dr. de Maio’s innovative new injection technique designed to revolumize age-related volume loss, add structure to the midface, and provide balance to the whole face. By strategically injecting JUVÉDERM Voluma in a few key locations including the upper outer cheek, a subtle yet natural aesthetic lift can be achieved instantly.

JUVÉDERM Voluma is a facial filler that has been FDA approved for use in the U.S. with clinical trials showing that it lasts up to 2 years. It is the first and only FDA-approved Hyalronic Acid filler for the midface, designed to temporarily correct age-related volume loss in the cheek area, thereby restoring definition to the cheek area. As result of restoring volume to the mid check, you can see an immediate lift in the jowl area, resulting in a more youthful appearance.

Improving Tummy Tuck Results with Lipoabdominoplasty

The benefits of lipoabdominoplastyWhen performed as a standalone procedure, abdominoplasty (a.k.a., tummy tuck) can be incredibly transformative. The procedure is designed to treat excess belly fat, loose skin and weakened/separated muscles along the abdominal wall.

Drs. Samuel Pearl and Alexander Ereso, plastic surgeons in Mountain View, can improve upon the results of traditional tummy tuck by incorporating advanced liposuction techniques. This combination approach is known as lipoabdominoplasty, and produces an even sleeker and sexier looking body.

What Tummy Tuck Will Accomplish

Before we address the benefits of the combination approach, let’s remember what tummy tuck will accomplish on its own:

  • Remove surplus fat to reduce abdominal protrusion
  • Repair separated or weakened abdominal muscles
  • Remove loose skin
  • Tighten the remaining skin
  • Relocate the navel to a higher position on the abdomen

Tummy tuck is often requested by two types of patients: individuals that have lost a lot of weight but are left with a saggy or protruding belly, and women that have stretched skin and muscles from pregnancy.

More about Lipoabdominoplasty

Lipoabdominoplasty will produce results that are vastly superior to those achieved by traditional tummy tuck. It is designed for those that are deemed to be good candidates and desire dramatic improvement in the stomach, hip and flank area.

In the first stage of the operation, Drs. Pearl and Ereso will perform tummy tuck as normal. This involves making a horizontal incision from hipbone to hipbone right above the pubic area. Through the incision, the surgeon will remove fatty tissue and skin. He will repair the abdominal muscles, stitching them together into an internal corset.

During lipoabdominoplasty, the surgeon will continue with the operation with additional steps. He will use advanced liposuction techniques to remove excess fat from the flanks, hips and lower back. This gives the entire area a more sculpted, attractive shape. The mid- to lower body will look firmer, flatter and sexier.

Patients that seek a comprehensive body transformation may opt to include another procedure, depending on their personal cosmetic goals. Some women choose to have breast lift or breast augmentation. Men with excessive breast tissue may be interested in male breast reduction. Our surgeons will work with every patient on an individual basis to develop a customized surgical plan.

Contact Our Practice

For more information about lipoabdominoplasty, tummy tuck, liposuction or another plastic surgery procedure of your choice, please contact the practice of Dr. Samuel Pearl and Dr. Alexander Ereso. Call (650) 964-6600 or send us an email at pearlmd@pearlmd.com to make an appointment.

Computer Imaging Provides a Preview of Facial Plastic Surgery

stk212568rkeIt is normal for facial plastic surgery patients to feel hesitant or nervous about their results. Though Drs. Samuel Pearl and Alexander Ereso are skilled, experienced plastic surgeons any surgery performed by any surgeon involves an element of the unknown. Our doctors understand this, and offer special technology to help alleviate some of these patient concerns and improve the predictability of the surgical outcomes.

Computer imaging allows our facial plastic surgery patients to envision how they will look after surgery. This technology works for patients who are seeking to have a specific feature (e.g., nose, eyes) corrected, or have requested allover facial rejuvenation.

Computer imaging is a valuable part of the treatment planning process, as it improves the communication between doctor and patient. Also, it helps the patient develop realistic expectations of the surgical outcome. And, it is a helpful teaching tool for our doctors.

How Computer Imaging Works

First, a member of our team will take photographs of your face, likely from the front angle and the profile view. The images will then be loaded into our office computer and the special digital imaging program. Then, Dr. Pearl or Dr. Ereso will manipulate the image as you watch alongside them, to simulate what surgery will accomplish.

For example, if you have requested rhinoplasty to improve the look of your nose, the doctor may digitally tweak your nose to make it look thinner or straighter. Or, if you are planning eyelid surgery to remove wrinkles and bags underneath your eyes, he can digitally remove those imperfections.

As the doctor alters the photographs, you can provide your feedback and suggest changes or improvements.

When you and the doctor are happy with the modified digital image, it will be saved in your file, and emailed or printed out for you to take home. You are free to share the image with family or close friends to get their feedback.

Keep in mind that the digital images are not meant to be 100 percent accurate, in terms of how your results will look. It is impossible to predict with complete certainty what you will look like after surgery, but your digital images will be very close.

Preview Your Results

Are you interested in a facial plastic surgery procedure? Would you like to preview the possible results? If so, please contact the practice of Dr. Samuel Pearl and Alexander Ereso and schedule a consultation. Call (650) 964-6600 or send us an email at pearlmd@pearlmd.com.

The Use of Acellular Dermal Matrix and Biologic Scaffolds in Difficult Cosmetic Breast Surgery Revisions

What is acellular dermal matrix?Over the past 30 years, millions of women have had breast implants for cosmetic augmentation and lifting, as well as reconstruction after breast cancer excision. Difficult problems can arise that sometimes require sophisticated solutions that were not available previously. Breast revision has become a true sub-specialty in plastic surgery and, with more than 25 years of experience, Dr. Pearl has developed a keen interest and talent in the art of breast revision. Dr. Ereso’s recent modern training has had an additive effect on Dr. Pearl’s experience, helping to produce some outstanding results. Many patients are referred to Dr. Pearl and Dr. Ereso to treat these difficult problems, as well as treating their own patients that have developed complications.

When a breast augmentation patient develops a complication such as recurring capsular contracture, implant rippling, implant malposition, severe asymmetry or loss of either superior or inferior pole support, Dr. Pearl and Dr. Ereso will perform cosmetic breast surgery revision. In many cases, they can manage the problem with a very innovative solution: the use of a biomaterial called acellular dermal matrix.

What Is Acellular Dermal Matrix?

Acellular dermal matrix (ADM) is a skin graft from which the cells have been removed. Think of it like a lattice or scaffolding of sterile tissue that supports the natural breast tissue. Once placed, the patient’s own cells grow into the framework and in some instances, eventually replace the graft.

ADM has been used for more than a decade, and has yielded many favorable results with a low complication rate. Usually it is used for breast revision operations, although occasionally, ADM may be used in primary breast surgery (if Dr. Pearl or Dr. Ereso feels it would be medically appropriate).

How the Doctors Use These Biomaterials

Drs. Pearl and Ereso use Strattice® and AlloDerm® biomaterials (as well as Allergan’s SERI® Surgical Scaffold) to support the natural breast tissue, and improve the appearance of breast implants. They can use ADM to do any of the following:

  • Correct the inframammary fold (crease underneath the breast) when an implant has “bottomed out”
  • Stabilize the pocket of an implant
  • Provide support for the lower portion of the implant in augmentation or implant-based reconstruction cases
  • Decrease the appearance of implant wrinkling or rippling
  • Camouflage implant visibility in thin patients (particularly reconstruction patients)

ADM is particularly helpful in cases of capsular contracture, when scar tissue forms around the implant, squeezing it and distorting the shape/feel of the breasts. In these cases, Dr. Pearl or Dr. Ereso will place ADM over a portion of the implant to prevent the return of capsular contracture. The intention is that by covering the implant with ADM, the body won’t produce more scar tissue in that location. SERI® surgical scaffold, which is made of silk, is the latest innovation that can be used to treat these problems. SERI® has the unique property of allowing your own tissue to grow into the silk scaffold. After one to two years, your tissue entirely replaces the silk!

Learn More about Acellular Dermal Matrix

For more information about ADM, and how the biomaterial can be used to improve the results of breast implant surgery, please contact Dr. Pearl and Dr. Ereso today by calling (650) 964-6600.

Dr. Pearl’s Voluma Results

Details: Dr. Pearl had 3cc Voluma and 2cc Juvederm Ultra Plus injections over two treatment sessions, spaced six weeks apart. Both procedures were performed with topical anesthetic and a small amount of local anesthetic injected prior to the Voluma and Juvederm.

As you can see, Dr. Pearl noticed excellent improvement with rejuvenation of the malar cheekbone area.



















Learn More about Voluma

Would you like more information about Voluma or another non-surgical facial rejuvenation treatment? Please contact our office today by calling (650) 964-6600.


Improving Your Body Contour after Major Weight Loss

Post-Bariatric Body Contouring Surgery Losing a significant amount of weight has an undesirable side effect: excess loose skin. This skin can obscure the body’s new shape and make it difficult to feel attractive and confident. Sometimes, the skin can chafe or develop rashes or infections. Unlike fat, it cannot be eliminated through diet or exercise. It requires surgical removal.

Drs. Samuel Pearl and Alexander Ereso, plastic surgeons based in Mountain View, can help. They offer post-bariatric body contouring to remove the excess saggy skin and refine the body’s new contours.

After learning more about a patient’s specific needs and the areas of the body that need help, the plastic surgeon will draft a customized treatment plan, which could include any of the following procedures:

Lower Body Lift

Lower body lift improves the appearance of the outer thighs and buttocks. The plastic surgeon will first make an incision in the inner thigh and extend it around the hip/flanks. Then, he will remove excess unwanted fat, tissue and skin. Finally, he will smooth and tighten the remaining tissue and skin for a more attractive body contour.

Abdominoplasty (Tummy Tuck)

Abdominoplasty improves the appearance of a protruding or saggy midsection. Through a horizontal incision along the lower abdomen, the plastic surgeon will remove stubborn fat deposits, tighten the abdominal muscles and suture them into place. He will excise loose, saggy skin and re-drape the remaining skin more tightly over the abdomen for a flat, firm result.

Breast Lift

Breast lift restores saggy or drooping breasts to a more youthful position on the chest. The plastic surgeon will remove excess skin and tissue and sculpt the remaining tissue into a breast mound higher on the chest wall. He will move the nipple and areola to a higher position on the breast, and reduce the areola if needed.

Brachioplasty (Arm Lift)

Brachioplasty treats loose, flabby upper arms. The plastic surgeon will remove localized fat deposits using liposuction techniques, and excise loose skin and tissue. He will wrap the remaining skin more tightly around the upper arms to improve their shape and firmness.

Thigh Lift

Thigh lift is designed to improve the upper thighs (specifically the inner thighs). The plastic surgeon will remove excess skin and tissue, using liposuction if needed to target excess fat. Then, he will tighten the remaining skin to eliminate any sagging or laxity.

Learn More about Post-Bariatric Body Contouring

If you have recently lost a significant amount of weight and would like to explore your body contouring options, please contact Drs. Samuel Pearl and Alexander Ereso today and schedule a consultation. Call (650) 964-6600 or send us an email at pearlmd@pearlmd.com.

What Is Gynecomastia and How Is It Treated?

Treatment for GynecomastiaGynecomastia is a term that means “enlarged male breasts.” Studies show that nearly half of all men will experience gynecomastia during their lives. Physically, it is not a cause for concern; however, it can be psychologically difficult to accept. Many men with gynecomastia feel uncomfortable or self-conscious of their bodies. Luckily, plastic surgeons have developed a solution: male breast reduction surgery.

Dr. Samuel Pearl and Dr. Alexander Ereso treat gynecomastia at their Mountain View-based plastic surgery practice. Here, they explain what causes the condition, and what can be done about it.

Causes of Gynecomastia

Gynecomastia is primarily caused by a hormonal imbalance. If a man develops high estrogen levels, his body will start to produce more breast tissue and his chest will look larger. Other possible causes include:

  • Medications — e.g., anti-depressants, anti-anxiety medications
  • Drugs and alcohol — e.g., marijuana
  • Medical problems —e.g., kidney or liver disease, hyperthyroidism

Some men develop gynecomastia simply as the result of the aging process.

During your consultation, the plastic surgeon will take down a detailed health history to rule out any medical problems that could be causing excessive breast tissue. He will ask for a list of medications you currently take, including nutritional supplements and herbal remedies, and look for any drugs that could be contributing to the problem.

Certain cases of gynecomastia will resolve over time. If yours does not, and you are struggling with the appearance of enlarged breasts, you may opt for surgical treatment.

Gynecomastia Treatment

Gynecomastia surgery removes excess glandular and fatty tissue to produce a flatter, firmer and more masculine-looking chest.

Your treatment plan will be tailored to your unique needs, but generally, the surgical steps are as follows:

First, the plastic surgeon will make an incision along the lower edge of the nipple-areola complex. He will surgically excise excess glandular tissue to flatten the breasts. Then, he will use ultrasound-assisted liposuction techniques to remove localized fat deposits and “fine-tune” the results. Finally, he will close the incisions with sutures.

Swelling and mild discomfort are normal post-operative side effects, and will subside within a few weeks. The plastic surgeon will likely place a supportive garment around the chest to control the swelling.

While initial results are noticeable almost immediately after surgery, it can take several months for the full results to appear. Since the surgical incision is small, scarring is minimal.

Learn More about Gynecomastia Treatment

If you feel self-conscious about excessive breast tissue and desire a more masculine-looking chest, please contact our plastic surgeons, Drs. Samuel Pearl and Alexander Ereso, today and book a consultation. Call (650) 964-6600 or send us an email at pearlmd@pearlmd.com.

How Can I Tell If I Need Implants With My Breast Lift?

Do I Need Implants With My Breast Lift?Are you frustrated with sagging breasts, nipples that have migrated down the front of the breast, overly enlarged areolas (the darkly colored skin encircling the nipples) or deflated-looking breasts? If so, you might be a suitable candidate for breast lift surgery (with or without breast implants) with Dr. Samuel Pearl or Dr. Alexander Ereso. Keep reading to find out how to determine whether you need breast implants included with your breast lift surgery.

Why Breast Lift Becomes Necessary

Over time, the body gradually stops generating elastin and collagen, proteins that are essential for elastic, young-looking skin. Without these proteins, the skin — including breast skin — loses its elastic quality and begins to sag. This contributes to the look of sagging breasts.

In addition, pregnancy and breastfeeding, major weight loss or simply the effect of gravity can compound this aesthetic concern. They can also cause additional cosmetic issues, including downward-pointing nipples, excessively large areolas, breasts that appear flattened or perhaps breasts that are smaller in size than they were prior to having children or losing a substantial amount of weight.

Fortunately, undergoing breast lift surgery, with or without breast implants, can help improve these aesthetic concerns.

Whether Implants Should Be Included in Breast Lift

If you are concerned with sagging breasts, southward-pointing nipples or overly large areolas, but are happy with the size of your breasts, breast lift alone should address your aesthetic concerns. With breast lift surgery, Dr. Pearl or Dr. Ereso removes excess skin and reshapes the breast tissue mound while moving it to a higher, more youthful-looking position on the chest wall. He can also adjust the position of the nipples, so they are again in the center of the breasts and point forward instead of toward the ground. During breast lift surgery, Dr. Pearl or Dr. Ereso will reduce the size of the areolas, if necessary, as well.

If you are frustrated by both breast ptosis (sagginess) and flattened or small breasts, Dr. Pearl or Dr. Ereso can place breast implants while he performs breast lift surgery. Combination breast lift with implants will both lift the breasts and restore or enhance their volume, for a fuller, more voluptuous breast profile.

Visit Us for a Consultation

The best way to establish with certainty whether or not to include breast implants with your breast lift surgery is to visit Pearl Plastic Surgery for a consultation. During your personal consultation, Dr. Pearl or Dr. Ereso evaluates your breast anatomy, listens to your aesthetic concerns and recommends an appropriate treatment plan to satisfy your unique needs.

To schedule a private consultation with Dr. Pearl or Dr. Ereso and learn more about your cosmetic breast surgery treatment options, contact us by calling (659) 964-6600 today.

What Are My Nonsurgical Treatment Options?

How Can I Rejuvenate My Face Without Surgery?Over time, the body produces less and less collagen and elastin, two proteins that are vital for healthy, elastic skin. Without a sufficient amount of these proteins, the skin loses its elasticity and starts to sag. In addition, outside factors, including major weight loss, constant sun exposure, hereditary traits and certain lifestyle habits such as smoking, can contribute to sagging facial skin as well as other visible signs of aging and environmental damage on the face.

Thankfully, Dr. Samuel Pearl and Dr. Alexander Ereso offer a wide range of nonsurgical facial rejuvenation treatment options to help combat noticeable signs of aging and sun damage on the face. The following are a few of the most popular nonsurgical cosmetic treatments requested at Pearl Plastic Surgery.

BOTOX Cosmetic

BOTOX Cosmetic treatment continues to be one of our most requested nonsurgical treatments. When injected, BOTOX Cosmetic temporarily stops muscle activity in the treatment area, thereby relaxing and smoothing out the overlying wrinkles. BOTOX is great for use in smoothing out forehead furrows, frown lines in between the eyebrows and crow’s feet, among other uses. Results last about four months before an additional treatment is needed to maintain the rejuvenating results.

Dermal Fillers

There are several types of dermal fillers available at Pearl Plastic Surgery, including Juvéderm, Restylane, Perlane, Radiesse and Sculptra. They are used to fill in — and thus smooth out — wrinkles and lines on the face, including smile lines and frown lines. Dermal fillers can also be used to restore volume in areas of the face that lack fullness, such as the cheeks. Some of them can even be used to enhance certain facial features, including the lips.

Laser Skin Resurfacing

With Fraxel laser skin resurfacing treatment, patients can achieve improved skin texture, more even pigmentation, an improvement in the look of wrinkles and fine lines and a subtle skin tightening effect on the face, neck, chest and hands. This treatment option is especially beneficial for individuals who would like to improve the look of dark age or sun spots, freckling or areas of redness.

SilkPeel Dermalinfusion

SilkPeel Dermalinfusion treatment is performed to slough away the upper layer of dead, dull skin cells to reveal the fresher, healthier skin underneath. Its effects are similar to those of microdermabrasion treatment, but SilkPeel Dermalinfusion does not require the use of harsh abrasive particles like microdermabrasion does. In addition, SilkPeel Dermalinfusion treatment infuses the skin with a nourishing solution that leaves patients with refreshed, healthier-looking skin. This treatment is an effective way to improve the look of hyperpigmentation, dehydration, fine lines and wrinkles, uneven skin texture and acne scarring.

Find Out More

Our nonsurgical cosmetic treatments are a great way to rejuvenate the face and help stave off the need for cosmetic facial surgery. They can also be used to optimize the aesthetic benefits of cosmetic surgery. To schedule a consultation with Dr. Pearl or Dr. Ereso to find out more about your nonsurgical facial rejuvenation treatment options, please contact Pearl Plastic Surgery by calling (650) 964-6600.

Introducing the Liposuction S.A.F.E. Technique

iStock_000005834226SmallAre you frustrated because you consistently make healthy diet and exercise decisions, yet you aren’t seeing the fat reduction results you desire?

Unfortunately, some problem areas of the body simply won’t respond to lifestyle efforts. It might be time to explore a surgical alternative with liposuction. Traditional liposuction is generally a safe procedure, but it has its limitations. Dr. Samuel Pearl has discovered an advanced liposuction system that improves upon traditional liposuction and provides smoother, more natural-looking body contouring results. Dr. Pearl is pleased to offer SAFELipo to his Mountain View liposuction patients.

More about SAFELipo

S.A.F.E. Liposuction is a technique developed by Dr. Simeon Wall from Shreveport, La., and has truly improved Dr. Pearl’s results. S.A.F.E. stands for Separation, Aspiration and Fatty Equilibration!

SAFELipo can be used to remove excess fat around the thighs, knees, waist, upper arms and neck. It can also be combined with another body contouring procedure, such as abdominoplasty or breast enhancement surgery.

Treatment Steps

First, Dr. Pearl will use special power-assisted liposuction probes to carefully loosen the targeted fat and separate the cells from each other and the supporting framework, without damaging the delicate surrounding structures. No suctioning is used during this portion of the procedure and no fat is removed. SAFELipo does not use thermal energy, which means that there is no risk of any heat damage.

Then, Dr. Pearl will use gentle suction to remove the fat cells from the body. Because the targeted fat has already been separated from the surrounding structures in the previous stage, Dr. Pearl is usually able to remove the fat with less effort. The approach is less traumatic than traditional liposuction and reduces post-operative bruising, swelling and internal scarring.

The final, crucial step of the SAFELipo procedure is what differentiates it from other liposuction approaches. Dr. Pearl will treat the remaining thin layer of subcutaneous fat that remains in the body and is essential for smooth, natural-looking results. He will use special probes to equalize this fat, therefore preventing the skin from adhering to the underlying muscle layer. This helps to prevent contour irregularities (e.g., lumps, divots, “wavy” skin) that can compromise the cosmetic effects of traditional liposuction treatment.

Schedule a SAFELipo Consultation

If you would like more information about SAFELipo, please contact Dr. Pearl at our Mountain View plastic surgery practice. Call (650) 964-6600 or send us an email at pearlmd@pearlmd.com.

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