Four days ago, the roles were reversed — it was my turn to be the patient.

Growing up, we didn’t have much. I was a fast-growing kid, and my shoe size seemed to change every few months. I wore my shoes until they were beyond worn out, and my parents only bought a new pair when absolutely necessary. By the time I was 20, I had developed significant hammer toe deformities on both feet. While my feet weren’t the most attractive, they didn’t slow me down. I was an avid runner well into my early 60s — until my knees told me it was time to switch to lower-impact exercise.

About eight months ago, the extensor tendons of my right 2nd, 3rd, and 4th toes shifted around the first joints, making the joints stick up even more. That’s when the pain began, especially in shoes. I turned to a talented foot surgeon, Dr. Nicholas Wegner, to fix the problem. The procedure took place at Hoag Orthopedic Institute last Thursday, and I was thoroughly impressed with every member of the team — from the receptionist, to the nurses, to my anesthesiologist, and of course Dr. Wegner.

What stood out most was the approach to pain control. For the last 25 years, I’ve avoided prescribing narcotics for my own patients, instead relying on pain pumps or, more recently, Exparel® — a long-acting local anesthetic that provides about three days of excellent pain relief. It costs roughly $500, but in my opinion, it’s worth every penny. Patients remain clear-headed, avoid constipation, and steer clear of the risks of narcotic addiction.

For my own surgery, I asked the anesthesiologist to go light on intraoperative narcotics and to use Exparel® at the surgical site. The result? I left the facility within an hour, clear-headed and pain-free. Our office manager, Jo, drove me to the office, where I propped my foot up higher than my chest and worked the rest of the day. The next day was spent working with my foot elevated (getting up for short walks to prevent blood clots), and by day three, I was functioning normally around the house — still without pain.

This morning, I was back on my stationary bike (no forefoot pressure) and back in the operating room performing surgery — yes, still with Exparel® to keep my patients comfortable as well.

Sometimes, walking a mile in your patient’s shoes — or in my case, limping a few steps — reinforces just how effective thoughtful pain control should be.

Taking the time to catch up on some old accounting issues dating back to my home purchase, that I have not had time to focus on without this forced down time – foot elevated as instructed!

Let’s continue this week’s article with a quiz:

Which of the following is the most commonly performed cosmetic surgical procedure in the United States?
A) Breast augmentation
B) Rhinoplasty
C) Liposuction
D) Eyelid surgery

✔ Correct answer: A Breast augmentation
(Consistently the most common cosmetic surgical procedure in the U.S.)

Breast enhancement remains the most popular aesthetic plastic surgery procedure in the United States — and in my own practice here at Orange County Plastic Surgery in Corona Del Mar/Newport Beach, CA. Many women come to see me because they want to restore volume lost after pregnancy, weight loss, or aging, or because they have always wished for fuller breasts.

While breast augmentation with implants is an excellent way to increase cup size, it does not correct droopiness (ptosis). If your goal is not only to have larger breasts, but also to have them sit higher and look perkier, we may need to discuss a mastopexy, or breast lift, in addition to augmentation.

Here’s a simple way to assess if a lift will be advisable: Stand in front of a mirror without a bra. If your nipples are at the same level as the crease beneath your breast (the inframammary fold) or lower, a lift will likely be necessary to achieve a youthful, well-proportioned result.

A mastopexy reshapes and repositions the breast tissue and nipple for a perkier look but does not change cup size. Augmentation increases volume but does not lift the nipple or improve droopiness. For women with both volume loss and sagging, combining augmentation with a lift provides the most satisfying, natural-looking results.

There are also different options for augmentation — saline or silicone implants, different shapes, and varying projection profiles — all chosen to match your anatomy, goals, and lifestyle. I take the time to discuss all these choices with each patient to ensure we create a result that fits your body and your vision.

One of my hallmarks is my minimal discomfort, rapid recovery breast augmentation technique. I use Exparel®, a long-acting local anesthetic that keeps the surgical area numb for about three days. This approach helps my patients avoid or minimize narcotic pain medication, stay clear-headed, and get back to normal activities faster.

Special Offer — Through September Only

Any patient who books a breast augmentation procedure with me before September 30 will receive their breast implants at no cost — a $2,500 savings. If you have been considering breast enhancement, this is the perfect time to take the next step.

Call Orange County Plastic Surgery today to schedule your consultation. Let’s create the beautiful, confident look you’ve been dreaming about.

Interested in improving your breasts?

Schedule your consultation today!

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