The Non-Surgical Shoelace Breast Cast Technique

In 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.

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Dr. Ereso Now Offering Improved Dermal Filler Treatment

At our practice, we’ve seen the incredible rejuvenating effects of dermal filler injectable treatment. However, one of the downsides of dermal filler treatment is that it often leads to bruising and swelling.

With the DermaSculpt Microcannula, we can now administer injections of dermal filler with 70-percent less bruising (and other added benefits!). We are pleased to offer this revolutionary treatment to our patients who want a younger and more vibrant-looking facial appearance, with minimal side effects.

What Is the DermaSculpt Microcannula?

The DermaSculpt Microcannula is a small, flexible tube with a rounded tip that we use to inject products such as JUVÉDERM™, Restylane®, Radiesse® and SCULPTRA® into areas of the face. Thanks to the Microcannula’s unique design, the filler is delivered into the treatment area via a single point of entry but can reach a wide range of coverage.

What Can the DermaSculpt Microcannula Treat?

The DermaSculpt Microcannula can be used for various dermal fillers applications, including treatment to:

  • Fill in smile lines
  • Smooth depressions around the sides of the mouth
  • Enhance the lips
  • Lift the brow
  • Fill in hollow temples
  • Improve the contours of the cheeks

Advantages of the DermaSculpt Microcannula

The DermaSculpt Microcannula causes minimal pain (if any) both during and after treatment. By nature, the Microcannula is significantly less traumatic on the blood vessels and nerves than traditional dermal filler treatment. It causes 70-percent less bruising and swelling, as well as minimal downtime and post-operative discomfort. Treatment with the Microcannula is optimal for patients who are on-the-go and don’t have a lot of time to recover from injectable treatment.

Additionally, the Microcannula enhances the precision and accuracy of dermal filler treatment. With the Microcannula, we are able to target two – and sometimes three – treatment areas through a single injection port. Also, the overall time of treatment is significantly reduced with the Microcannula.

Learn More About Dermal Filler Treatment With the DermaSculpt Microcannula

If you’re interested in having your dermal filler treatment performed with the Microcannula technique, please contact Dr. Ereso’s office by calling (650) 964-6600.

5 Advantages of Using the Keller Funnel

Dr. Ereso is continually looking for techniques and technology to improve his patients’ plastic surgery experiences. An instrument that has monumentally helped improve breast augmentation surgery is the Keller Funnel, an FDA-approved device that helps Dr. Ereso place silicone gel implants.

To use the device, Dr. Ereso places the tip of the soft, conical-shaped nylon device through the surgical incision, and places the pre-filled implant in the funnel. Then, he uses a gentle pushing/squeezing motion to coax the implant through the funnel and into place within the breast pocket. The Keller Funnel can safely be used with periareolar, transaxillary and inframammary surgical incision patterns.

Let’s look at five ways that using the Keller Funnel improves the delivery of silicone breast implants.

1.     Requires Shorter Incisions

Dr. Ereso is able to make smaller surgical incisions, similar to those used in saline implant placement. Smaller incisions produce less visible post-operative scarring (especially helpful for women who are prone to scarring).

2.     Reduces the Risk of Infection

Using the Keller Funnel involves a no-touch sterile approach that reduces the risk of bacteria contaminating the implant shell and causing an infection. This is also believed to reduce capsular contracture, a painful implant-related complication in which the capsule contracts and hardens.

3.     Faster Healing

Placing implants with the Kennel Funnel technique reduces the amount of trauma on the breast tissue; this lends itself to a quicker, easier recovery with less post-operative pain.

4.     Less Stress/Force on the Implant Shell

The funnel’s slippery coating allows Dr. Ereso to use a minimal amount of force when positioning and placing the breast implant. This puts less stress on the implant shell and reduces the risk of the implant weakening or rupturing (which would require another surgery to remove or replace the implants). The Keller Funnel can prolong the life of the breast implants.

5.     Quicker Procedure

The Keller Funnel generally makes the entire surgery proceed more quickly.

Learn More About Breast Augmentation Using the Keller Funnel

For more information about the Keller Funnel technique, or to schedule a breast implants consultation, please contact Dr. Ereso by calling (650) 964-6600.

Protecting Your Skin With TNS by SkinMedica

Dr. Ereso and our skin care team are pleased to offer a range of luxurious skin care products, including the SkinMedica TNS line. These products are specially formulated to repair skin damage, promote healthy cellular function and protect the skin from harmful elements.

TNS products rely on growth factor technology to erase visible signs of aging around the face. Growth factors are special proteins that trigger the production of new cells, collagen and elastin – all of which are vital to improving the appearance of the skin. They also contain traditional anti-aging ingredients, proteins and collagen. The combination of these ingredients changes the quality of the skin from the inside out, making it stronger and less susceptible to outside elements such as the sun.

What Does SkinMedica Treat?

SkinMedica products can be used to improve the appearance of the following:

  • Fine lines
  • Deep creases and lines
  • Dark spots and patches
  • Loss of skin firmness
  • Uneven skin tone

Product Examples

SkinMedica’s TNS product line includes the following options:

  • Essential Serum to smooth wrinkles, brighten spots and patches, and firm and tone the skin
  • Recovery Complex cream to give the skin a firmer, more elastic quality and address discoloration and uneven/rough skin texture
  • Eye Repair cream to nourish, smooth, firm and plump the eye area; to reduce crow’s feet; to tone sagging eyelids; and to brighten dark circles

Your Partner in Skin Care

SkinMedica products are not sold in retail locations like Sephora or Ulta; they are only available through an approved physician’s office. Dr. Ereso and our aesthetician, Carol McDonald, have a unique understanding of the body’s healing and restructuring processes and use their expertise to recommend suitable SkinMedica products for your needs.

We will analyze your current skin care routine and skin condition, and ask you about your skin care goals (e.g., fewer wrinkles, more even skin tone). Based on this information and information about certain lifestyle factors, we will put together a customized product regimen to help you achieve and maintain your best skin yet.

Explore Your Skin Care Options

If you’d like more information about TNS by SkinMedica, or you would like to schedule a skin care analysis with our aesthetician and skin care specialist, Carol McDonald, please contact our office at (650) 964-6600.