Dr. Hartog and the staff at Bougainvillea Clinique were so welcoming and helpful during my entire experience, and so were the nurses at the Surgery Center right next door where my procedures took place. Bronwyn answered every question I had & accommodated my complicated schedule. Eric was amazing to have by my side helping Dr. Hartog perform the procedures, and the anesthesiologist was wonderful as well. They all made me feel so at ease. I had a recessed chin which caused my submental area to look fat & I also had a hooked nose. Dr. Hartog is an artist. He reconstructed my facial structure, removed the fat under my chin, & straightened out my nose & septum allowing me to breathe better. The results are truly nothing short of a miracle & I'll be forever thankful I chose Dr. Hartog.
Dr. Jeffrey Hartog is an excellent surgeon. I have had multiple surgical procedures performed by him over three decades and have always been delighted with the results. Though Dr. Hartog is an expert in multiple types a procedures, he is an extraordinary choice for any facial procedure as in addition to being a plastic surgeon he is also trained maxillofacial surgeon. Most patients are unaware of the fact that Dr. Hartog has done significant charity work as a surgeon, repairing facial deformations and cleft palettes for improvised children in third world countries. It is an added bonus to have found a great surgeon who is also a compassionate human being making a difference.
Having tuberous breasts affected my self esteem and made me feel less than. And as a result I settled for less in relationships. I finally had the means to correct my breasts and after literally years of research and weighing the pros and cons I contacted Dr. Jeffrey Hartog's office and set up a consult. I originally wanted breast implants but he explained to me that I had insufficient breast tissue to accomodate an implant and he suggested a donut lift with fat transfer. Size was not the issue for me, I just wanted perky symmetrical breasts with a proportionate areola so I took his suggestion and had the surgery yesterday. He harvested fat from my tummy, thighs, flanks and back via lipsuction gave me a lift and filled my breast with as much fat as he felt comfortable with. The pain in the breast area is tolerable, the worse is the lipo. It feels like I had the toughest workout and then got beat up and then fell down a flight of stairs. I am sore and bruised and I have to wear a compression garment and hose. I had my post op today and it went well. They look a little scary but I am pleased with them so far. I will post an update next week with more pics. Updated on 18 Jul 2019: So I had my one week post op. My boobs have gone down significantly so I am afraid I won't retain much. But they are still 100 percent improved from my before. I was told my healing is right on schedule. No need for the compression hose, but I still need to wear the girdle. Pain is really tolerable but still some discomfort. I am only taking the pain pills at night. Still aches from lipo but the bruises are not as bad as they look. He didn't take much from my tummy and I am sad about that. I am just using the surgical tape now on the aereolas. They stay on for 5 to 7 days. Had I known I would have taken pics before so you all could see the nipple incision. Not gonna lie they look bad. Frankenboob bad, but she said that was normal and that the puckering will smooth out and I can discuss scar therapy at my one month post op.
Work out every day, but was not happy with stubborn fat on flanks and stomach. Consulted Dr. Hartog about lipo, but he gave me an honest advice, about the options I had. He said lipo will give you faster results, but that I was a good candidate for coolscupting which was less envasive. I chose coolscupting and are very happy with my results!
I try to workout 4-5 times a week and relatively eat healthy but I still had this area of stubborn fat on my lower stomach that always bothered me. I decided to try CoolSculpting and was so impressed by my results! CoolSculpting got rid of the bulge on my stomach that diet and exercise couldn’t. I would recommend CoolSculpting to all of my friends.
I have to say my hole experience from day one until now and I’m 1 week 4 day post op has been great the staff r really nice and the surgical team was phenomenal and the anesthesiologist was the best ...dr was great just love him I’m so glad I went to him my hole experience was very great if I had to do it all over again he would be the dr I go to thank you all for everything ????
I am SO happy I chose Dr. Hartog to perform my breast augmentation! I'm just over 6 weeks post-op and I'm so in love with my new breasts. I flew in from Vancouver, Canada, because I read so many great reviews on him and loved his before and after photos and I was not disappointed. His staff and nurse, Karen, made me feel so at ease the entire process and always answered any questions that I had in a timely manner. They were very professional and the facility was extremely clean. I found Dr Hartog to be very kind and patient, and he provided me with great advice on sizing. They have followed up with me twice since my surgery to check in on how I'm healing and I am blown away by the service they've provided me with - very caring and attentive. I would HIGHLY recommend Dr Hartog to anyone who's looking to get a breast augmentation - he is amazing! Thank you Dr Hartog!
I have consulted with 2 other plastic surgeons before decided on Dr. Hartog. He addressed the concerns I had and didn't "sell" me on anything else other than what I came in to discuss. He gave me the realistic low-down, which I appreciated and anticipated. We were on the "same page." I am a 46 year old mom of 6 children, including a set of full term twins born when I was 39. My concerns are the thigh/flank fat pockets that were not present before the twins. I simply want my jeans/skirts to fit better. I feel confident they will when these small pockets of fat are removed via lip with Dr. Hartog. To note: my stomach has stretch marks but no sagging of skin, and certainly no apron of excess skin. There is no need for a tummy tuck, with added risk, long incision, and recovery process. Other surgeons brought the subject up, which did not sit well with me. I am athletic to an extent. I run 15 miles each week, use arms weights, and do squats. I was afraid these fat pockets were here to stay, until I research liposuction options. I look forward to my surgery with Dr. Hartog on November 13th. My preop is scheduled for October 30th, and will update with my progress and final review in good time. So far, Dr. Hartog is 5 stars for me, just with the the consultation and plan presented. Staff was amazing and informative. Updated on 28 Nov 2018: Inner and outer thigh and flank/sides (waist as well). Lots of bruising of course, but already loving results at 2 weeks post! The added pictures have spanned across these last two weeks. I’ve added in order. I included another before picture. Lots of soreness of course. Wearing compression 23/7 Dr. Hartog addressed the flanks and even upper waist side to blend. I’m very pleased so far. The day of surgery was the worst, post anesthesia was brutal. IV and gas sedation. Pain was very tolerable. I had quite a bit a of back pain (one spot in back towards side) up until 2 weeks post. I’m thinking it was related to a muscle issue. It was annoying because I felt pretty good everywhere else. Now, I have some “pulling” sensation in my inner thighs area. It’s more intense after sitting for a few minutes, then standing. Massaging and stretching has helped a bit. I’m hoping it resolves soon. I’m a teacher and took the 4 days off before Thanksgiving break, which gave me a full 13 days off work for recovery. So far, so good. I will make updates from time to time, and include a final before/after. Updated on 20 Dec 2018: I will add a current after in another update. Updated on 20 Dec 2018: Updated on 20 Dec 2018: I plan on using my wooden roller massagers and firming cream to improve skin tone and reduce appearance of cellulite. I just don’t have the time (working twin-mom), and I’m not sure how effective endermologie is, but will do more research. I did enjoy the process and the massage lady; she’s fabulous. I loved chatting with her. I’m 5 weeks post lipo on my outer/inner thighs and flanks (entire side waist). Updated on 2 Jan 2019: After researching Endermologie online, I came to learn more about cupping massage. From what I learned, I can acheive the same results as the Endermologie, without the hefty price tag and having to make appointments. I bought my cup set and grapeseed massage oil on Amazon. I think both together were about $15. Cheap! I have just added this to my routine, every couple days. I am focusing on my thighs (outer, inner, front, and back...the whole dang thigh). I am hoping that this will help a bit with the cellulite I have, and make my skin as good as it can be at 46 years old. So far, I am pleased. I have also started cupping my face and love the results so far. It has now become a part of my routine. Time will tell if there are any real benefits to cupping. Lipo update: I am scheduled for my final post op, 3 months post, on February 13. I plan to provide my final before and after pictures here. I am over the moon with my results! My saddlebags are gone and my waist is much smaller (that was a bonus). I should have done this 5 years ago! Thank you for reading! Please feel free to inbox me questions, should you have any. I try to check back when I think of it. I know that I appreciated the experiences shared here and on the Tube. It was helpful to know what to expect. XOXO Updated on 2 Mar 2019: I started doing more squats and already see my bum rounding out some (see the side view). I didn’t have any fat added or removed from my bum. Lipo was done on saddlebags, inner thigh and flanks. Squats work, and this was just after 4 weeks of doing 25 squats in the morning and 25 at night. I’ve now added weights. Squats make a difference! I continue I run about 15 miles every weekend. I really need to work on my diet :-/ I would like lose 10lbs. For those interested. I was 156 prelipo and 147 now. I think 5lbs was from lipo and the rest from small improvements with exercise and diet. I just love junk food. Updated on 17 Jan 2022: Here we are, 3 years later....I am seeing an othopedic surgeon in hopes of getting this rib pain resolved. Within a couple months post lipo, I visited plastic surgeon with rib concern, no resolution. Researched broken rib, no real treatment. Moved forward with only occasional discomfort but improvement. Here is the timeline I am sharing with my orthopedic doctor this Friday: September 2019- pilates October 2019 Hamstring pain (thinking Pilates related-muscle pull) Remained constant with mild ups and downs for over 18 months March 2021- Jewitt Ortho- possible Bursitis (hip X-ray fine-no break). Anti inflammatory meds and PT. No change. August 2021 - new Dr. Gideon (referral from runner colleague) MRI ordered of right hip/buttock. IFI, hamstring tendinitis, Quadratus femorus atrophy. NEW PT. Mild improvement through modifications in Pilates moves. No first position, etc. dry needling, exercises. better, but not great. December 2021 pulling heavy garden soil into car, hurt my right back side area. Painful for several days-used heat pad for relief. ***this garden soil incident brought attention to rib pain post lipo from November 2018. Pain upon awakening and lasted months. Discomfort upon palpitations. Now I can feel a hard boney area on that side. December 2021 PT- discussed rib, concern that rib is connected with hamstring pain. Concerns about upper iliac pain with stretching and protruding “bone” in right/back/rib area. Could the QL muscle (or other muscle attached to the 12th rib and hip) be involved-causing shift in pelvis, resulting in IFI narrowing and hamstring pain? PT suggested QL stretches along with other side area muscle stretching. This helped improve my hip issue, hamstring pain decreases. Today 1-17-2021 Lower back pain when standing for a while. Discomfort when driving and leaning on the center console...on rib/back side area. It feels like something is stuck under my rib. Sitting on couch and leaning, even slightly results in discomfort and need to purposeful lean to other side. Dull Ache deep hamstring tendon sometimes, not constant Upper iliac crest soreness Sore areas along side when stretching. Bladder issues (could be unrelated to injury) That's my update. I hope to get an x-ray of my ribcage this Friday. The boney protrusion is unmistakeable. Something is not right. It all began with the lipo.
I had a tummy tuck, muscle repair and lipo. Dr.Hartog did an amazing job. After 4 kids including twins, I have my shape back. The doctor and staff was great with all my questions and needs. I couldn't be more pleased!
It had my BA on June 5th 2018. I will be very honest with you I was so excited that when I taken to the OR I just freaked out I was so scared and wanted to cry but I wanted the procedure so bad that I stuck it out and I’m so HAPPY I did. Dr. Hartog is the greatest. Yes he is very serious and might not be like other Dr’s that make you feel comfortable but underneath it all he is the GREATEST. I LOVE him. I would recommend him to anyone. My nurse Jennifer ( I hope I have her name right as I am so bad with names ) was great. The staff are great. My recovery has been an experience that I would not forgot nor will I regret. I am still feeling a bit tight and soreness but I’m healing.
I am always amused at the fact that plastic surgeons differentiate between subglandular and subfascial when I have always performed subglandular augmentation subfascially. So for me they are essentially the same. In the past, when plastic surgeons frequently performed breast augmentation using a technique called blunt dissection, then it is likely that they were not under the fascia. Today most plastic surgeons perform breast augmentation using electrocautery dissection, so they should normally be lifting the fascia off the top of the muscle. Unfortunately the fascia is extremely thin, so in fact does not give you much additional tissue thickness and this is the key to whether your result will be satisfactory or not. Unfortunately, if you are extremely slim, you really have to choose between risking more implant visibility, particularly in the upper and medial parts of the breast, and likely a higher risk of capsular contracture, versus some degree of animation and more separation of the implants. It's not a straightforward decision. In general, I nudge my slimmer, narrower patients toward submuscular placement, and heavier, broader patients towards subglandular (subfascial). Unfortunately there is no one perfect approach for every patient, and you have to decide based on your priorities. All this is based on 25 years of observing my breast augmentation patients.
Two of the disadvantages of sub muscular augmentation that are rarely addressed, are that the implants will tend to be displaced a little more to the side when under the muscle, and in some cases the extra padding of the muscle may actually result in loss of definition of of the implant and thus the augmented breast. Contrary to many peoples beliefs, under the muscle does not always look better than over the muscle. Looking at your photographs, this appears to me to be the case. I believe your breasts are already naturally somewhat far apart, and in your case the implants under the muscle does not help. Over the muscle will allow the implants to be placed a little closer together, the muscle will no displace the implants, and you will likely have better breast definition towards the cleavage area. Unfortunately there are also potential disadvantages of sub glandular augmentation such as increased risk of capsular contracture, and possibly increased visible rippling particularly with saline implants. There is no right and wrong, just pros and cons that you should discuss with your surgeon.Often I recommend fat grafting towards the middle to help augment the cleavage - know as composite breast augmentation - but from the pictures it is hard to assess whether that would be appropriate for you because of the poor breast definition.
Adipose Derived Stem Cells are some of the small cells that live around the tiny blood vessels in fat, and help regulate the day to day survival of fat in your body and changes as you gain or lose weight. They are essentially the healing cells found around small blood vessels everywhere in your body, but they are much easier to isolate in larger numbers from fat stores with liposuction. They help regulate the survival of fat when it is transferred and as you say support the transferred fat. There is evidence that adding extra stem cells to a fat graft by isolating them from a separate sample of fat can help the survival of a fat graft, but for the most part this is not practical in large volume fat grafting like the breast, because a lot of fat volume is wasted when separating additional stem cells to add. These cells are likely the cells that help restore normal tissue in scarred areas, and work in conjunction with the actual fat cells (adipose cells) to help replace scar tissue with normal tissue which contains fat. Te changes in the ADRC's, differentiation etc is a complex, still incompletely understood process, but it is well accepted that they are essential to the survival of a fat transfer. The cells already exist at the time of transfer, so there is not time lag, nevertheless they will differentiate to different functional cells at different times depending on what they are needed for - this is the essential property of these cells that allows them to change into whatever is needed, such as cells to build new blood vessels, or cells to make new fat cells.Various factors cause these cells to essentially differentiate and go to work when fat transfer is done, primarily things like low oxygen supply to the newly transferred fat etc.
There is a lot of misunderstanding about the concept of a double bubble. Most likely there is a slight discrepancy between your original breast shape and the shape of the implant with your own breast being a little narrower in the area of concern than the round base of the implant. This is a common problem as breast implants are made to fit an ideal breast shape, not all variations of breast shape, particularly breasts with what we call a narrow lower pole, or sometimes what we call a mild moderate or severe tubular breast shape. So what you are seeing is a step off between the edge of your original breast, and the new edge of the implant which extends further out. In most cases this step off improves over time as the implant stretches the tissues, but sometimes a perceptible step persists as in your case. I am almost always able to counsel my patients ahead of time that this may result by evaluating their original breast shape and explaining to them this mismatch that may occur. My approach to the problem is to discuss the possibility of fat transfer in the area, either at the time of the original procedure or as a second procedure. In this way we can build up the area where the breast is deficient to smooth out this step and create a rounder breast shape. This is known as composite breast augmentation.
I always remind breast implant patients, that breast pain is not necessarily related to their implants and frequently is due to the breast tissue itself. Mastodynia, or breast pain, occurs in women who do not have implants as well. The most common cause is simply the size and weight of the breasts. In your case, you describe your breasts as not feeling hard or firm so it is not likely that you have pain due to capsular contracture. It is important that you get a comprehensive breast exam by your Ob/Gyn or primary care provider, and possibly additional studies like a mammogram, ultrasound or MRI as they recommend. Of course also see your plastic surgeon for an evaluation of the implants. Once this evaluation is complete and all the various issues relating to the breasts themselves, even things like hormonal changes, and nerve irritation, have been ruled out - then one can consider further consideration of the implants themselves. Assuming none of the evaluations above have established any defects of the implants, or rupture, it then becomes a process of elimination. Once all these considerations relating to the breast tissue itself have been ruled out, and if patients still have pain, I offer my patients the option to retain their implants, or remove or downsize the implants (which loosens the capsule around the implant). I also stress simple things like wearing good breast support, as the weight of the breasts can cause pain, and even occasional use of medications like Advil if they find these helpful. Many patients still choose to keep the implants, depending on how much discomfort they have, and depending on how important it is to them to retain their breast size with implants. I have also removed the implants and substituted breast size to some degree with fat transfer.
