Phone : 864.214.5232

“What is the Size Range Available for the Gummy Bear Type Implants?”

A prospective patient asks Dr. Birchenough: “What is the size range available for the gummy bear type implants? And cost of a revision breast augmentation from saline under the muscle to the gummy bear?”


Thanks for contacting me about breast revision surgery.


The gummy bear implants now come in a huge variety of shapes and size, something like 200 different ones! So I’m sure there would be something that would work well for you.


Revision breast surgery encompasses a very broad range of possible techniques and methods, which translates into more or less time in the OR (and therefore more or less cost).
Also, the materials that may need to be used (including acellular dermal matrix) and the higher cost of the gummy bear implants contributes to a range of potential fees to the patient.


I cannot provide a general fee quote for these types of surgeries given the vast difference of technique and materials, each patient has a unique situation and considerations. (Is a breast lift needed? Does the existing capsule need revision to support and properly place the new implants? How many hours of surgeon time & OR time are required? Etc.)


Please schedule a consultation appointment by calling 864.849.9330 so I can meet you, do an examination, and fully discuss what might be done to improve your situation.

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“What is Your Price Range for Gynecomastia (Male Breast Reduction) Surgery?”

A prospective patient asks Dr. Birchenough: “What is your price range for gynecomastia (male breast reduction) surgery?”


Thank you for your question regarding gynecomastia.


As you may know, gynecomastia surgery can vary widely depending on the extent of extra male breast tissue, skin, and the amount of ptosis (sagginess.)


The length of surgery drives the cost. Sometimes I use liposuction and small incisions, sometimes larger incisions are needed.


So the total cost (with OR costs, anesthesia fees and surgeon fee) can run between $5,000-$7,000.


We are able to give patients a firm quote once I’ve seen you in consultation, and we talk in detail.

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“Do You Offer ‘Short Scar’ Breast Reduction?

A prospective patient asks, “Do you offer ‘short scar’ breast reduction?”


Thanks for asking about breast reduction and “short scar” surgery.


The type and length of the scar in a breast reduction surgery (or breast lift surgery, for that matter) has to do with how much breast tissue needs to be removed and what the size and shape of the breasts are before surgery. I also discuss your expectations about the size and shape of the resulting breast.


All of these things will influence the resulting scar.


I’d be happy to discuss your specific options with you during a consultation. As you know, insurance companies may have very strict requirements for covering breast reduction surgery, so that may influence what surgery (and therefore what type of resulting scar) I can offer you.


Many patients are opting to cover the surgery out of pocket, because their insurance company explicitly excludes coverage for it, or because they want more control over the amount of breast tissue that is to be removed.


Come in for a consultation to discuss it. Thanks for your question.

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“What are My Options for Breast Reconstruction after Breast Cancer Surgery?”

Many patients come in to see me after being diagnosed with breast cancer. While there are many types of breast cancer, and different modalities of treatment, one of the critical components to treating breast cancer is with surgery. This typically includes either removal of a portion of the breast, called a lumpectomy, or removal of the entire breast, called a mastectomy.

Reconstruction of the breasts can occur at the time of the breast cancer surgery called immediate reconstruction, or after other types of treatment have been administered (like chemotherapy or radiation), called delayed reconstruction. These are factors that are discussed with the patient and the other treating doctors after the diagnosis of breast cancer has been determined.

For breast reconstruction after mastectomy, the options are broken into 2 basic categories: implant reconstruction and tissue (flap) reconstruction. Sometimes the 2 modalities need to be combined to improve the overall outcome.

With implant reconstruction, this is sometimes done in more than one stage–starting with a tissue expander to help stretch the skin and accommodate the eventual breast implant. Some patients are candidates for immediate, direct to implant reconstruction, which means that they can get an implant at the time of their mastectomy. For flap or tissue reconstruction, typical places where tissue is transferred from includes the abdomen and the back.

Other procedures may be necessary down the road, including fat grafting which takes fat from the abdomen or inner thighs and transfers it up to the reconstructed breast to help improve the aesthetic outcome of the reconstruction. Also, nipple and areola reconstruction can be performed with a combination of skin rearrangement and tattoos–some of which are remarkable 3-D representations. These are almost always outpatient procedures.

After a lumpectomy, or partial breast removal, other procedures may be done to help improve the size and shape of the breast if necessary. These include fat grafting, and tissue flaps. Most patients who have a lumpectomy require radiation treatment, which must be taken into account during the discussion of breast reconstruction.

Working together as a team is an important concept for breast cancer treatment and reconstruction. If you get diagnosed with breast cancer, it is best to discuss your options with all of the treatment team members prior to proceeding to make sure that you and your entire team have a good strategy.

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Breast Augmentation Consultation

A patient visited for a breast augmentation consultation. After reviewing similar case studies, she had questions regarding recommended breast implant size.

After discussion with each patient, I determine the best range of implant sizes based on their chest size, the current amount of breast tissue and the dimensions of the breast.

need to be able to “hide” the implant as much as possible behind the breast tissue and muscle or else the implant may be too visible and too obvious (and other issues can develop such as rippling or implant exposure.)

So there is a tradeoff given a patient’s current breast size. To be safe and still provide a great shape and size, I order the implants in a particular range. I am able to “test” the implants in the operating room to see how they look, etc. prior to putting in the final size.

The difference of 30cc is only an ounce! So we strive to improve patients’ breast shape and size, while maintaining safety and longevity for the procedure!

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Ptosis – Breast Lift? Or Implants Needed Too?

“My breasts are quite droopy. Can you just do a breast lift on me? Or do I need an implant too?”

Women who have breast sagginess (ptosis) often ask this question. They think that they have enough breast volume, it’s just in the wrong the place! They demonstrate that by taking their breasts and lifting them up to where they would like them to be!

After pregnancies or weight loss, or just from aging, the breasts tend to stretch and fill out the bottom part of the breast less than the top. Overall, the breast tissue can change and shrink, as well as become less elastic. This can be very apparent from the “ski slope” appearance of the upper portion of the breast between the collar bone and the nipple. Sometimes bras can “push-up” the lower part of the breast to fill this more.

The typical surgical correction for ptosis is to do a breast lift, or mastopexy. There are many ways to do a mastopexies, that all involve different technical aspects. The resulting scar pattern, size and locations are the tradeoffs for varying amounts of “lift” – the more lift needed, typically the more extension the scars have to be to achieve a particular aesthetic look to the breast.

There are times when I recommend an implant to help fill in the top, or upper pole, of the breast. Even with a significant lift, this upper area can be difficult to round out or fill in sufficiently. Placing the implant behind the muscle can give even more boost to this upper pole. Also, the size, shape, and volume of the implant will influence this area. If patients want a more rounded upper pole shape, then an implant is typically needed.

The best way to find out is to call and make a consultation appointment! I’ll discuss your options with you, tailored to your particular anatomy and expectations. See you soon.

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Dr Shawn Birchenough Men Body Specialties and Surgeries

Early 50’s Male: “Anything I Can Do to Keep from Looking Older Than I Am?”

“I’m a guy in my early 50’s, and I’m wondering if there’s anything I can do to keep from looking older than I am?”


I am glad to hear from and treat male patients! Men of all ages are asking about plastic surgery, to the point where men represent the fastest growing population of those receiving plastic surgery over the past 5 years!


Men want to look younger (just like our female companions!) and have more confidence in our lives. Many men work hard to stay in shape physically, and eat healthfully, but have areas of concern.


I want men to know that I will discuss their issues with them personally, professionally, and discretely.


Here are a few things to think about…

Men are prone to lines and wrinkles in the forehead and between the eyebrows because of the strong action of the muscles in this area. Botox is a great way to soften some of that “mean” or “scowling” look.


For further facial rejuvenation, upper eyelid surgery is a common procedure that can significantly improve the “tired” or “droopy” eyelid look. This surgery could possibly be done in the office with oral sedation only. Lower eyelid rejuvenation is a bit more difficult, but there are ways to treat that too.


“Love handles” are a guy’s nemesis! Especially if you have been working out at the gym and watching what you eat, this can be a frustrating area that stays after other fat deposits go away! These areas of fat deposit are more prominent on men than women, typically. Liposuction can contour these areas to help you match the rest of your abdomen.


Similarly, male breasts can be treated with liposuction if diet and exercise just aren’t doing it. For men that have undergone significant weight loss through diet or surgery, and have significant excess skin, this needs to be removed in the OR with procedures like abdominoplasty, thigh-plasty, or brachioplasty (upper arm skin excision). While more involved, these surgeries greatly improve the fit of clothes, and the overall body contour.


So come in to discuss what Dr. Birchenough can do for you guys too!

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What is a Mommy Makeover? (Am I a Candidate for One?)

“Mommy makeover” is a term used generically for a number of different combined surgical procedures. There is no single mommy makeover surgery, but a general concept of helping regain some of the shape you had before pregnancy. The surgeries may be done in combination, or over more than one setting.

Typically, I am addressing concerns women have with changes they have from pregnancy and breast feeding. However, it can extend to facial changes that women go through due to the stresses of raising kids!

For the breasts, one changes that many women see is deflation, or drooping and flattening of the breasts after pregnancy or when breast feeding stops. This occurs because the enlarged breast ducts start to shrink back down, causing the breasts to get smaller. The constant stretching of the breast skin and breast tissue over the many months of pregnancy and breast feeding eventually leave the tissue very lax (stretch marks are one sign of this).

Most of the time the skin and breast tissue won’t have the same elasticity or “snap back” it used to have. For some women, a breast augmentation (implant enlargement of the breast) is enough to restore the lost volume, shape, and contour of the breast. Sometimes a mastopexy, or breast lift, is needed in addition to the implants. A breast lift can mean any one of a number of different specific surgeries and can involve any one of a number of different incisions and approaches, tailored to you. At a minimum, a breast lift will help relocate the nipple-areola to a more aesthetically pleasing location on the breast mound. Typically, a breast lift will also help round out the entire breast and more the breast tissue back up on the chest.

The belly is another area that goes through a lot of changes too. Stretched, lax skin and additional fat deposits can be a long term issue after pregnancy. Also, many women have diastasis recti – a term for stretched muscle and fascia in the lower abdomen. This is the “bulge” or “pot belly” or “beer belly” of the lower abdomen you may see, even if you are very thin and back to your pre-pregnancy weight. These areas can be helped with a mini-abdominoplasty (mini-tummy tuck) or a regular tummy tuck. These surgeries will address the lax muscle and remove the lower abdominal skin and fat (and stretch marks if they are low on your belly). Liposuction of the flanks / love handles can help contour the waist in addition.

Some women only need liposuction to remove the excess fat of lower abdomen, without removing skin, because their skin has enough elasticity to snap back after removing the extra fat.

Facial lines and wrinkles become more prominent and noticeable after pregnancy, long sleepless nights, and many stressed-out days! Botox and Juvederm filler can help restore some of the look of the face, and reduce those lines and wrinkles.

So! What can I do to help “mommy”? Breast implants and/or lift? Tummy tuck or liposuction? Botox? There are many options depending on which areas concern you the most. Come in to discuss what I can help you with!

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