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Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon
15757 N. 78th St., Suite A, Scottsdale, Arizona
5 | 21 Reviews
9 Questions Answered
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Before and After Photos

QUESTIONS ANSWERED

Your surgery was performed about 2 months ago.  This is early in the postoperative phase for a lift.  The deep sutures are just now dissolving.  Some implants take  longer to "drop" especially if its on the dominant side?  Moving the implant and possible use of an upper pole band may help.  If you are right handed, try using the left side more if lifting. The flatness on the left will relax with time.  Scars change and mature over the first year.  As I said, a lot of the sutures are just now dissolving.  Massaging the scar will help expedite this.

I perform a hand tailored lift to the implant chosen.  It takes time for the final results to appear.  Patients and time and good communication with your surgeon is usually all it takes.  I would wait at least 5-6 months to even consider revision.  During this time, you will also see changes.

I hope this was helpful.  Good luck.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
You are less than a week from surgery.  The results will change significantly as the swelling resolves and the skin relaxes.  At this point, your muscles are still in spasm and may be pushing the implants "flat" and out.  The "lumpiness" is likely due to the lift and the incisions.  This will settle out with time  as the tissue relaxes.  The lift has to be "tight", otherwise you may need more skin removed, once the skin relaxes.    When your surgeon allows you to, begin to massage scars, this will help with the irregularities.


I perform this surgery regularly, and when performed correctly the implant will settle into the pocket and the skin will relax.  At 4 days after surgery, it is too early to tell final results.  Patience and communication with you surgeon is the best treatment at this time. 


I hope this was helpful.  Good luck.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
There are several factors to consider including volume as you mentioned.  Going down in volume alone may not be the answer.  If this in done by itself, the "pocket" will likely need to be adjusted (capsulorrhaphy).  Otherwise, the smaller implant will move in the pocket and to the side.  This will be very apparent when lying on your back.  There are different Profiles of implants, each producing a different look.  As far as upper pole fullness is concerned "projection" and "diameter" is important.  The more projection and wider the diameter will produce more upper pole fullness "fake look".  The wider diameter of the implant will produce more "side boob".  The most important factor is choosing the right implant for desired outcome.  Using a "tear drop" gummy-bear implant is an option, this will decrease the upper pole fullness.  However, these implants are more firm, and are not designed to move.  If they do, the can become oriented in the wrong position. 
The most important thing is to have good communication with your surgeon, so both of you have a clear picture of the desired outcome.  The other, is choosing the right implant (projection, diameter, shape) to achieve your goal.


I hope this helps.  Good luck.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
It appeared that the right side was smaller after the mastitis.  Though you didn't mention the implants placed, but I will assume they are different sizes to compensate for the difference.  As far as needing another augment, that will depend on several factors.  If you have more children and breast feed:  The important factor is 1) How big the breasts get 2)  More important is how long they stay that way.  If they stay engorged for 8-12 + months, then the real issue will be  skin laxity.  Then a lift may be necessary. Of course other factors play role such as recurrent mastitis or leak of implant.  Remember, the risk of leak for an implant is 1% per year and accumulates.  For example 10% risk of leak at 10 years.  If there is any question an MRI is recommended. 
So the question is what the "skin envelope" does with more children.  Then the question will be not so much as needing another augment but weather a lift (mastopexy) is needed.

I hope that helps.  Of course following up with your surgeon is paramount.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
The incisions and bruising appear normal, they are longer than expected for augmentation, however, more may have been done.  The important issue is to support the breasts and implants while its healing.  I usually recommend a sports bra.  If there is any irritation, padding the crease with gauze may help.  It will be important to take care of the incisions once they are healed (massage, sunblock) to allow them to heal light and flat.  Once healed, its "you" who can help achieve the best results.  Following up with your surgeon is also paramount. 


I hope this helps decrease any worry.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
The most important thing is to communicate with your surgeon and have the same goal in mind.  When exchanging implants, there are several factors to address.  The reason why you changed out the 600cc implants?  Were they too wide, too much projection, or both?  In my experience, the majority of the time, it's because the implants are too wide (most of my patients like the projection).  If that's the case, going from a 600 Hp to 400cc moderate profile is a large change (approx. 2+cm projection), and excess skin, skin laxity would need to be taken into account?  Even possible need for "lift".  Breast width (implant diameter) is critical when choosing implant, if the implant is too wide:  It will extend up to collar bone and out under arm, if too narrow, breast tends to droop over it.  Once, width has been measured, then projection is addressed:  Moderate profile, Moderate plus, High, Extra high profile. These factors will help with what implant to choose and ultimately the volume (cc).
Going to a 500cc Hp implant will help with projection, roughly .5cm difference in projection.  The width of the breast should be taken into account too because the 500cc implant will be narrower?  Which may be good, if that's the reason why you changed out the 600cc? 
So the key: be specific with your surgeon, communicate, so your goals can be accomplished.

I hope this helps.   Good luck.

provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
It's difficult to evaluate without pre-augment pictures.  The left breast appears larger than the right which if present prior to surgery, there may be a need for different size or "fill" ( saline) of implants.  If the breasts were the same size, shape, skin envelope, etc.,  preop, then implant position is the issue.  Even immediately postop the Right side appears slightly higher, the post op 5 picture the implant is higher and "rounder", this suggests a "tighter" capsule?  Not necessarily a "capsular contracture" just tighter than the left.  At times, in order to drop the implant (inframammary fold) releasing (capsulotomy)  the IMF may not be enough.  A tight capsule, can hold or prevent the implant from dropping and keep it "rounder".  Releasing the capsule itself (radial pattern) or removing capsule (capsulectomy) may be necessary.  The important factor in revision is making sure all factors contributing to the issue are accounted for and revised.


I see patients from all over the country, what I've found is that  usually more than one aspect needs to be taken into account.  I hope that helps.  Good luck.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews

Issues after strattice. Any suggestions?

Asked By:AnonymousANSWERS (1)
Without a picture, its difficult to see what exactly is happening.  Going from a 800cc to a 550cc implant (even though the projection may be close (depends on what profile the 800cc implant was) the width of the implant went down.  The skin has been "stretched out"  from larger implant, the Stratice may help support the implant, but the pocket and skin may still be too large, which essentially produces a "bottomed out" or inferiorly displaced implant.  this in turn causes the nipples to point up as more volume is in the lower breast.  Tightening the pocket may help, it depends on the skin, if there is skin excess, may need mastopexy (lift) or skin removal.  As far as the lumps, they can be benign fibroadenomas or cysts.  Also the incorporation of the Stratice can be the cause.  I agree with follow up in a 6 months, unless there is a high risk of breast cancer in family, then follow study sooner.

I see a lot of patients from around the country.  I use a lot of Alloderm, Stratice, and SERI, each has its own unique properties, but all are good.  The important issue is the skin envelope and the pocket?


I hope this helps.  Good luck.
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews
Yes, the implants have "bottomed out".  This can occur at anytime, and is more common if you work out, especially high impact exercise or arm/chest work outs.  It's important to wear high impact/ high support bra when working out (usually not comfortable) and gives a lot of support.  I usually recommend repair of the pocket (capsulorrhaphy) if this occurs.  If it occurs again, there are options of placing different materials (Alloderm, Stratice, SERI) that act like a "sling" or internal bra.  The reason I don't place this on first occurrence is that these materials are expensive.  Going up in size, is an option.  I would recommend on looking at all options not just going up in volume.  There are different profiles of implants which can influence "projection" and "width".  Just remember, the larger and heavier the implant, the more chance of "bottoming out". 

In my practice, I see a lot of patients from around the country.  Repairing it correctly is important for lasting results.  Even more important is preventing its occurrence. 


I hope this is helpful.  Good luck!. 
provider-Ryan B. Tsujimura, MD-photo

Ryan B. Tsujimura, MD

Board Certified Plastic Surgeon

5 | 21 reviews

Ryan B. Tsujimura, MD reviews

Ryan B. Tsujimura, MD

RATING DETAILS

5.0
21 reviews

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Ryan B. Tsujimura, MD
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10 Results
$11,000Breast Implant Revision
Cute172121

Cute172121

495 Cc to 750 Cc Revision. Best Decision Ever!

Boob greed...I went BIGGER!!! Revision surgery: 11/19/24 The photo on the left is my original "wish pic" I shared with my doctor back in January before my first surgery. He recommended 495cc implants (under the muscle), saying they should achieve the look I wanted. But they didn’t quite get me there. I started to get boob greed after reviewing my original wish pics and comparing them to my 495cc results. Fast forward to October—I did a ton of research, met with my doctor again, and decided to go bigger with 750cc silicone gel (under the muscle). I'm now one month post-surgery, and let me tell you, I finally got the results I was dreaming of! I couldn’t be happier. Looking back, I wish I had known that I’d lose about 15% of the initial volume once the swelling went down around the 6-month mark from my first surgery. And I didn't know just how big you have to go in order to achieve the look of most wish pics you see online. And that realization was a big factor in deciding to go larger this time. So when I sat down with my surgeon last month, he measured my base breast width at 12.5 cm. He had some initial concerns that 750cc implants might be too wide for me. I told him I didn't care if I had some side boob, so we proceeded with the surgery just before Thanksgiving. Well, let me tell you, ladies—I could have gone even bigger! I barely feel any side boob at all. For reference, I’m 5’7” with a long torso, so this size is practically perfect for my frame. Many doctors will advise against going this big, often because they don’t want to deal with complaints down the road or the potential risks that come with larger implants. But as long as you find a skilled, board-certified plastic surgeon (not a cosmetic surgeon—there is a difference!), your plastic surgeon can help determine the best size for your anatomy. Don’t be afraid to get ultra-high-profile implants like I did. They’ll drop and fluff slightly over time, so having that full upper pole makes a big difference in keeping their shape over time. Also, don’t let anyone scare you with the myth that larger implants significantly increase your risk of capsular contracture. That’s outdated information! Recent studies show the risk only increases by about 2%, and other factors—like smoking or a history of cancer—play a much bigger role. Capsular contracture is now known to be more about post-op infections due to improper sanitation and poor operating room practices, not implant size. So here’s my advice: do your research, find a board-certified plastic surgeon who knows what they’re doing, and don’t let fear hold you back from getting the results you truly want. I’m so glad I took the plunge, and now I’m absolutely in love with my results!

Mommy Makeover

mama299

Blown Away - Skill, Talent, Experience, Bedside Manner - 10/10 Amazing Experience

Do you want a TikTok doc who takes great before/after pics but has zero bedside manner, rushes through your appointments, and makes you look like a one-size-fits-all blow up doll? Or do you want a true surgeon and artist who works with your body, spends time connecting with you and setting your mind at ease, and meticulously restores you to your unique self? When you are under anesthesia and any one of a million things can go wrong, who do you want as your teammate, someone without board certifications or experience, who is more concerned with how the "after" photo will look on his instagram, than doing things properly and ensuring you are safe and proportional? Or a surgeon who has two board certifications, multiple hospital privileges, experience as an ER doctor, vascular surgeon-turned-plastic-surgeon, and decades and tens of thousands of surgeries under his belt? For me, as the mom of four, three with special needs, the choice was made based on ensuring I'd open my eyes again to see my kids. My safety was number one. But what surprised me most, is that Dr. Tsujimura is actually an artist and alchemist. He is truly talented and skilled at what he does. You get the best of both worlds: experience and artistry. First, I don't write reviews. Not a fan of reviews in general. However, I feel compelled to tell my story because I understand how stressful this decision is (or was for me) and how I painstakingly researched for months and months to make my decision. If this review can help someone make their decision, then it was worth it. Deciding to do an elective non-essential surgery for me took some soul-searching. After four kids, full-size 7.5lb each twins, pumping/breast-feeding for multiple years, and my weight fluctuating, I had tons of loose skin, an extreme separation in my abs, hernias (which were found during surgery and stitched up), and just an overall "sad" looking body from everything I'd gone through. I couldn't wear pants normally because of the apron of skin. My belly button even frowned. Even after diet and exercise, it was impossible for my skin to snap back from all the stretch marks and laxity. And to be upfront, I am not a small woman. I am 5'11" and close to 225 lbs. I was not looking to be thin and Kardashian-like. I just wanted to be restored to who I used to be before my body had done so much hard work. I was ready to put it behind me and move on to the next phase of life with no regrets. I decided to do this for me, and it was 100% the best decision I've ever made. I am only 3 weeks post op and still swollen, but I would do it again in a heartbeat. Was the recovery brutal and one of the hardest things I've ever done? YES. Was the result what I expected? NO. The result WELL EXCEEDED my expectations. Honestly, the result surprised me so much, there is a photo of my bandages coming off with my mouth literally agape and my jaw dropped open and I cried. I also threw up on one of the nurses and she went on business as usual without missing a beat. THIS is Dr. Tsujimura's team and they are STELLAR. From the top down, everyone has been sweet, gracious, down-to-earth, skilled, and treated me with respect and dignity. Even when I went in about a small question I had, Dr. T took probably one hour to answer all of my questions and personally walk me through my concerns. What strikes me as most important about Dr. T is his heart and soul. He wants to be there. He has a twinkle in his eye and a smile on his face EVERY. TIME. I. SEE. HIM. I have had experiences with different doctors where they would would talk golf over my gurney as I was being wheeled into the cold operating room, and who would walk in after I was put under. It's honestly terrifying to be put under, and even more anxiety inducing when nobody connects with you. Your final thoughts are of being scared. Of note, Dr. T sat at my side and locked eyes with me, making me smile and feel at-ease as the anesthetic kicked in. This really stuck with me. I told him at my last appointment how touched I was by that and his answer was that he did it because he had been on the other end and understood the importance of those small personal connections throughout the process. This is who you are getting. Someone whose mission in life - even to a spiritual level - is making people feel better about themselves. He's in it for the right reasons. During my consult, Dr. T also had some recommendations that I had questions about. Rather than dismissing my opinion, he was firm but spoke to me as an equal. He has a way of setting you at ease with his ability to answer any questions from a scientific and experience-driven perspective. You never feel hustled, rushed, or dismissed. You feel educated, empowered, and confident. I will reiterate that Dr. Tsujimura has beyond exceeded my expectations. He has taken a very emotionally- and anxiety-charged life event and made it feel safe, positive, and valuable. This is a big investment - monetarily, emotionally, physically - and you are setting aside the time and the energy to do something for you. I would 10/10 recommend Dr. Tsujimura, no questions asked. I am blown away.

Breast Implants

AZmamaof4

Absolutely happy with Dr. Tsujimura! He gave me exactly what I wanted

Dr. Ryan Tsujimura was the first PS that I had consulted for a BA and after meeting with him, I felt completely comfortable and confident in him, so I knew I didn't need to keep looking for the right doctor. It was a few months after my consultation until I was able to save the money to schedule my pre-op and surgery. At my pre-op we talked about the actual size of implant and I had expected the biggest size to be 330cc, so when Dr. Tsujimura said 415cc I couldn't believe it!!! Today I am 5 days post-op and SO HAPPY with my results!!! So glad I trusted him on the size and type of implant, he definitely knows what he's doing. He is such a nice guy and easy to talk to, totally not judgemental, and has always made me feel completely comfortable. His experience made my surgery go so smooth with no complications and minimal pain. Honestly, i have not a one complaint about Dr. Tsujimura and highly recommend him.

$6,500Arm Lift

jauga36

No More"wings", but I'm Still an Angel

Dr Tsujimura and Dr Holden work together in perfect harmony. Dr Tsujimura does the body and Dr Holden does the face. What a great thing. Two doctors for the price of one. They specialize in their area. Dr Tsujimura worked on me for 3 hours and Dr Holden for 7 hours. When I came in for my consult Dr Tsujimura knew what I wanted and help me to understand the process. I'm one week and one day after surgery. My arms are half the size. I can't believe I am going to spend my first Arizona summer in short sleeves instead of three-quarter sleeve. Dr Tsujimura has a soft spoken, fun, personality. You meet him and you feel instantly that you could be friends. He is so complimentary of staff members and Dr. Holden. Whatever is stopping you from doing something that makes YOU feel good, DON'T. I know this sounds stupid and maybe petty, but I am so excited. I'm 56. Life is way too short. My grandkids won't be able to play with my arms anymore, but I'll hold them just a little tighter

Mommy Makeover

Coconutquads

Best Surgeon!!

I can not say enough about this doctor Dr.Tsujimura and his GREAT STAFF!! This office is by far TOP NOTCH, Number #1!! The professionalism of Dr. Tsujimura and his staff make you comfortable from the minute you walk in the door. Results are beyond expectation, I would recommend this office to ANYONE. A truly gifted surgeon.

Breast Augmentation

jlhousto

Dr. Tsujimura is an amazing doctor.

Dr. Tsujimura is an amazing doctor. He takes the time to understand what you want, and then executes it. I had my (second) beast augment done by him and the results were so great, it made me wonder how I lived with my original implants as long as I did (which I previously thought I loved until I got my new ones). I could not have asked for better results, and would recommend this skilled surgeon to anyone!

Tummy Tuck

ReDoMe

Loved my tummy tuck

I got a full tummy tuck and lipo with Dr. T back in 2015. I loved my results! He truly took the time to answer my question, I never felt rushed or stupid for asking a question. I Totally trusted him and he really did a great job. Amazing doctor!

Tummy Tuck
amandapvaz

amandapvaz

Got a model bikini body from Dr. T

I had a full tummy tuck in 2013. At first I wasn't sure if I was a candidate, but Tsujimura's bedside manner was such a selling point for me to get this procedure. He is competent, easy to talk to, attentive, and confident. He never made me feel like he was rushing me out the door. What I loved most was that he seemed genuinely excited to do my tummy tuck and the results he thought he could acheive. He truly revels in his own work. Dr. T delivered on every promise and now I have the tummy beyond my dreams, complete with ab definition that he promised I could get after working out a bit. I am small and lean but never had a nice tummy or curves, and that got even worse after a few kids. I now have tight skin, tight ab muscles, and a figure! I would do this procedure 100 times over and trust this man completely!

Breast Augmentation

sthrnbrunette

He gave me exactly what I was wanting - Scottsdale, AZ

I have wanted to get a breast augmentation for quite sometime but was apprehensive, I'm so happy I was referred to Dr.Tsujimura. He was very professional and attentive. I went in to him being very nervous and particular with what I wanted and expected. He gave me his professional and expert option on what I needed exactly for the look I was going for. He listen to my wants and concerns. He in the end gave me exactly what I asked for and I'm so well pleased. I have referred him many of times and will continue you to do so.