How do I know my grade of Gynecomastia?

Gynecomastia is a condition that can occur in men of all ages. Fat is trapped and intermixed with firm breast tissue with any amount of Gynecomastia. With diet and exercise, the firm breast tissue (Gynecomastia) makes it very hard to lose. This unusually dense breast tissue can distort the chest and lead to unwanted aesthetic changes. Some patients can have considerable breast tissue, and their skin can sag. Gynecomastia is graded according to skin elasticity and the amount of firm breast tissue.

A highly skilled plastic surgeon can diagnose, grade, and treat Gynecomastia in all age groups. Dallas Plastic Surgeons Dr. David Azouz and Dr. Solomon Azouz are known for their techniques to correct Gynecomastia in primary and revision gynecomastia surgery in Dallas, Texas, for men of all ages and body types.

Determining the grade of Gynecomastia

 Board-certified Dr. Azouz explains what Gynecomastia of varying grades looks like below.

Gynecomastia, Grade, Determining Scale,

Grade one: “mild” Gynecomastia without sagging

In mild cases, the chest looks normal and does not have excess skin. Some grading scales quantify the amount of Gynecomastia in grams, but this isn’t easy to do before the time of surgery. Therefore, most plastic surgeons define Grade one Gynecomastia as a slight or “mild” enlargement of the breast glands without skin excess. 

Grade 1, Gycomastia, Dr. Azouz, Dallas, TX

Grade two: “moderate” Gynecomastia with or without some sagging

When a patient has moderate Gynecomastia but still does not have skin excess, they are usually deemed a grade 2.   This means they have more breast tissue than a mild grade one but do not have breast sag. Some plastic surgeons break upgrade twos into 2a and 2b, which means that 2bs have a minor skin excess. Regardless of the grading system, most plastic surgeons label a grade 2 as those with a “moderate” amount of Gynecomastia.

Grade 2, Gycomastia, Dr. Azouz, Dallas, TX

Grade three: “severe” gynecomastia with mild sagging

When a patient has a severe amount of Gynecomastia but still does not have extreme skin excess, they are usually deemed a grade 3.   This usually means they have more than 500 grams of fat and breast tissue within their chest.

Grade 3, Gycomastia, Dr. Azouz, Dallas, TX

Grade four: “severe” gynecomastia with “severe” sagging

When a patient has a severe amount of Gynecomastia and sagging usually deemed a grade 4, this usually means their breasts sag as a women’s would when she had large sagging breasts. A patient with grade four gynecomastia would usually have severely enlarged areolas pointing towards the floor.

Grade 4, Gycomastia, Dr. Azouz, Dallas, TX

How Can I Tell If I Have a Gynecomastia?

Early signs may include a firm or fatty tissue in the breast or a feminine appearance to the breast or areola. As the condition progresses, some patients may notice sagging to their breasts with contours that resemble a woman’s breast. Men who are dissatisfied with the look or feel of their chest should seek evaluation and treatment by a board-certified plastic surgeon who performs a high volume of gynecomastia surgery, such as Dr. Azouz.

How Common is Gynecomastia?

Overall, research shows that Gynecomastia is very common and may affect as much as seventy percent of men at some point in their lives. There are different levels of severity ranging from almost unnoticeable to severe with sagging of the breast and female appearance. Regardless of age, gynecomastia surgery can be beneficial to patients of all body types and severity.

Can I Prevent Gynecomastia?

In many patients, Gynecomastia is unavoidable and genetically inherited. Avoiding the triggers of Gynecomastia is essential even after surgery to prevent a recurrence. 

What Causes Gynecomastia?

The cause of Gynecomastia varies from person to person. There are several accepted theories on what causes Gynecomastia.

The most common cause is usually genetics. When patients think of their family history, they often recognize a family member with a similar body type who also had Gynecomastia.

There are many different drugs and medications that can cause and contribute to Gynecomastia. These include:

  • Anabolic Steroids
  • Antiandrogens (Finasteride)
  • Antimicrobials (Isoniazid, Ketoconazole, Flagyl)
  • Antireflex drugs (Cimetidine, Omeprazole)
  • Cardiac Drugs (Calcium channel blockers, Captopril, Digoxin, Methyldopa, Reserpine, Spironolactone)
  • Psychiatric Drugs (Diazepam, Thioridazine, Tricyclic antidepressants)
  • Illicit Drugs (Alcohol, Amphetamines, Anabolic steroids, Opioids, Heroin, Methadone, Marijuana)
  • Drugs for HIV/AIDS (Antiretrovirals)

Medical conditions can also cause Gynecomastia. These include

  • Medical problems:
  • Androgen resistance syndrome
  • Klinefelter’s syndrome
  • Hyperthyroidism
  • Hyperprolactinemia
  • Kidney Disease
  • Obesity
  • Cancer

Some cases, however, do not seem to have a genetic link or identifiable risk factor.

Even in patients with no risk factors, some patients will still have Gynecomastia.

What Does Gynecomastia Feel Like?

Depending on the severity, Gynecomastia usually presents as firm, spongey or lumpy tissue underneath the areola. Gynecomastia can cause a lack of confidence and poor aesthetics in men at various severities.

How Can I Get Rid of My Gynecomastia?

Gynecomastia surgery is the most effective treatment to get rid of Gynecomastia. This procedure involves liposuction and removal of the thick breast and fatty tissue.

Gynecomastia can be very frustrating as many patients report having it for many years, beginning in puberty. Most patients report being unable to improve their Gynecomastia despite effective workouts and dieting. 

Gynecomastia Specialists in Dallas,TX

If you are worried about the appearance of your breasts, the first step is to schedule a consultation with Dr. David Azouz and Dr. Solomon Azouz, leading plastic surgeons in Dallas, Texas. Expertly trained, both board-certified plastic surgeons are highly skilled in the correction of Gynecomastia.

After a thorough evaluation and discussion of your goals, Dr. Azouz will develop a plan of care to restore and rejuvenate your chest to a more sculpted appearance free from Gynecomastia. If you consider gynecomastia or revision gynecomastia surgery, Dr. Azouz can assist you in his Dallas office through an in-person or virtual consultation. Schedule your consultation by calling at 972 702 8888.

Why you might need to remove your breast implants?

Have you had a breast augmentation with implants in the past, but are considering having them removed? If so, you may be able to benefit from breast implant removal with Dr. Azouz. Our team of board-certified plastic surgeons is dedicated to providing the best natural-looking and beautiful results to each of our patients. With many breast implants banned in the United States or recalled by the FDA, many patients are turning to plastic surgeons to remove their breast implants and capsules. 

Why Breast Implant Removal?

Breast implants removed | Dr. Azouz | Dallas & Plano

Breast implants that have been present for many years can have silent leaks, ruptures, and capsules.  Dr. Azouz often finds leaked and free-floating silicone which causes severe capsules and scar tissue.  Capsular contracture, can be painful or distort the look of the breast.

Breast implants can be removed through a variety of incision lines and in combination with many other plastic surgery procedures including breast lifts, liposuction, and in conjunction with a tummy tuck.

Breast implant removal:

During this procedure, incisions can be created in the same places they were during breast implant surgery, to reduce the need to create more scarring.  A total capsulectomy is routinely performed at the same time as the implants are removed.  If a lift is performed in conjunction with breast implant removal, a separate incision may or may not be necessary.

Breast implant removal with a breast lift:

If desired, a breast lift can be performed at the same time as your breast implant removal. This can help to lift your breasts to a perkier position. The areolas can also be resized to fit your new, smaller breast shape.

How do you prevent sag after breast implant removal?

Breast surgery Dallas | Dr. Azouz

Breast implant removal with a lift is the best way to prevent sag after a breast implant removal.  Many patients elect to have liposuction of the lateral breast (side boob) and/or the axilla (armpit fat) at the same time as their breast implant removal.

Contact Dr. Azouz for breast implants removal

For more information regarding breast implant removal, please contact Azouz Plastic and Cosmetic Surgery in Dallas, TX today to schedule a consultation with Dr. David Azouz or Dr. Solomon Azouz. You can also fill out an online contact form for a prompt reply or call at 972 702 8888.

What to Know About Breast Reconstruction

Breast reconstruction refers to surgery performed to correct acquired or congenital disorders of the breast or chest.   Most people define breast reconstruction as recreating the breast after mastectomy for breast cancer.  However, breast reconstruction can be performed for a multitude of different indications. 

Breast reconstruction can also refer to the reconstruction of the breast or chest for congenital disorders of the breast including Poland syndrome in men and women, pectus deformity in men and women, and extra nipples in men and women.

Breast reconstruction can be performed after massive weight loss, after trauma or work injury, and for revision of cosmetic surgery. 

All causes of breast loss in men and women take a heavy toll on a patient’s body confidence. For this reason, breast reconstruction can be an integral part of treatment for many men and women even when the patient has associated functional problems. Fortunately, many reconstructive options are available by board-certified plastic and reconstructive surgeon like Dr. Azouz in Dallas. 

Here’s what to know about your options for breast reconstruction and how Dr. Azouz can help.

What is Breast Reconstruction?

Breast reconstruction is a procedure that aims to restore the shape, look, and feel of the breasts after they’ve been partially or fully removed during mastectomy, from trauma, or for a patient who is born without a breast. There are a few different ways that breast reconstruction can be achieved. In some cases, breast reconstruction includes surgical techniques to rebuild and recreate the nipples, areolas, and breasts mounds. Breast reconstruction surgery with Dallas-based board-certified plastic surgeon Dr. Azouz can occur at the same time as mastectomy, or months to years later. 

Indications for Breast Reconstruction

  • Post-mastectomy
  • After trauma or work injury
  • Poland syndrome
  • Chest wall deformity (Pectus)
  • Breast/chest asymmetry 
  • Extra nipples (Polythelia)
  •  To revise cosmetic breast surgery
  • Gender confirmation surgery
  • Gynecomastia (male breasts)

How Does Breast Reconstruction with Implants Work?

Breast reconstruction with implants can occur in two different ways:

  1. Using tissue expanders that are placed under the skin. The tissue expanders are inflated and gradually stretch tissues to accommodate implants which are placed later in a different surgical procedure. 
  2. Breast implants are placed above, in the place of or below the pectoralis musculature.

Implants can be customized according to your desired goals. Breast implants come in a variety of shapes and sizes. Breast implants with or without tissue expanders are a good option for women who have undergone a mastectomy and would like to regain their feminine shape.  Pectoral implants are a good option in men who want the appearance of bigger pectoral muscles or who are missing a pectoral muscle (Poland syndrome).  

Dr. Azouz is known for his ability to perform directly to implant breast reconstruction in men and women with a drainless minimally invasive technique.

How Does Breast Reconstruction with a Tissue Flap Work?


Breast reconstruction with a tissue flap is also called autologous tissue grafting or flap reconstruction. This surgical procedure uses a section of tissue or muscle taken from another area of the body (either with or without the connected blood vessels) to create a natural breast mound out of the skin, muscle, and fatty tissue. Areas where flaps can be taken from include:

·           The abdomen (DIEP flap) which does not include muscle

·           The latissimus dorsi (LD flap), or the middle and side of the back

·           The lower abdomen (TRAM flap) which does include muscle

Additionally, some women can opt for fat grafting from areas around the thighs or buttocks if they’ve previously undergone major abdominal surgery (or don’t have enough tissue in the torso for reconstruction). For some women, a combination of tissue flaps and implants is the most effective reconstruction technique.

How Does Nipple and Areola Reconstruction Work?

After recovery from breast reconstruction, many women and men opt for nipple and areola reconstruction. This can be performed by grafting small pieces of skin to the breast mound in combination with medical tattooing. The goal of nipple and areola reconstruction surgery is to create a more natural-looking breast, nipple, and areola. Some mastectomies can be performed while sparing the nipple and areola, preventing the need for nipple reconstruction at a later time.

Schedule an appointment

The best way to achieve life-changing and confidence-boosting reconstruction results is by partnering with an experienced reconstructive breast surgeon. To meet with board-certified Dallas Plastic surgeons Dr. David Azouz and Dr. Solomon Azouz, we invite you to contact our office or call 972 702 8888.

How to fix Breast Asymmetry with plastic surgery?

Breast asymmetry is extremely common, and most women will naturally have some degree of mild asymmetry. However, some women may have asymmetry that is quite noticeable and causes self-consciousness or difficulty finding clothing that fits properly. This asymmetry may be in the shape, position, or volume of the breasts. Whatever the case, plastic surgery can restore a symmetrical and balanced appearance that boosts confidence.

Breast Asymmetry Correction Surgery

Different breast surgeries can address breast asymmetry, find out more about each alternative below:

Breast Augmentation for Asymmetry

Breast Asymmetry correction surgery with Dr. Azouz | Dallas & Plano

A breast augmentation is one of the most commonly performed breast surgery in general, so it makes sense that it is also a common choice to address asymmetry. In a breast augmentation, saline or silicone breast implants are placed to add volume and create a preferable shape in the breasts.

Patients who have asymmetrical breasts frequently choose to use two different-sized implants to create balanced sizes in their final results. Either round or teardrop-shaped breast implants can also be used to create a dramatic or natural look. During a consultation, Dr. Azouz can review all of your breast implant options and create a plan for a symmetrical and proportionate result that meets your aesthetic goals.

In addition to implants, a natural breast augmentation—also known as a fat transfer augmentation—may be a good option for many patients. This involves removing fat from another area of the body, such as the abdomen, flanks, back, or thighs, and injecting it into the smaller breast to create natural-looking fullness. This is beneficial both for restoring symmetry in the breasts and contouring the body for many patients.

Breast Reduction for Asymmetry

Breast plastic surgery Dallas Dr. Azouz

Some patients may prefer the size of their smaller breasts, making breast reduction a preferable option to address their asymmetry. In a breast reduction surgery, Dr. Azouz will remove tissue from the larger breast and reshape the remaining tissue to match the smaller breast.

This can be achieved through liposuction for some patients, while more extensive excision may be required for others. Dr. Azouz can explain the best surgical plan to achieve your ideal results during your consultation.

Breast Lift for Asymmetry

Breast lift for Assymetry Dr. Azouz | Dallas & Plano

While differences in size are often the first type of asymmetry many think of, patients may also find a significant difference in the position of the breasts. For a range of reasons, one breast may have significantly more sagging than the other, creating an asymmetrical look.

A breast lift, also known as mastopexy, is the best option to restore a balanced look. In breast lift surgery, Dr. Azouz will reshape the natural breast tissue to restore a youthful position and symmetrical appearance. For many patients, a combination of a breast lift with either a reduction or augmentation can be beneficial to change both the shape or size and position of the breast.

Schedule a Consultation with Dr. Azouz

To learn more about your options for correcting asymmetrical breasts, schedule a consultation with Dr. Azouz. During your consultation, Dr. Azouz can assess the asymmetry and suggest a surgical plan that will create a more balanced look and meet your aesthetic goals. Call our Dallas, TX office at (972) 702-8888 or contact us online.

Explore Breast Implants Options and Breast Augmentation Surgery

If you are considering breast augmentation surgery (placement of breast implants), it is recommended to start exploring the different breast implants options with a board-certified plastic surgeon in your area to help you to determine what is the best choice for you and fulfill your aesthetic expectations. With that being said, it is helpful to go into your first appointment knowing some of the basics about breast implants and breast augmentation surgery and address with your surgeon any doubts or concerns. Here we share the basic information you need to know about breast implants and breast augmentation surgery.

Breast Implants Options for Breast Augmentation

Before going to your first appointment, spend some time thinking about what you want your new silhouette to look like. When you are ready schedule your appointment with a breast augmentation plastic surgeon to explore the different breast implants options available. Dallas Plastic Surgeon Dr. Azouz is a great resource to help you to find the best breast implants for you and create a surgical plan to achieve your aesthetic goals.

Anesthesia used for Breast Augmentation

Breast augmentation procedures can be performed under either general anesthesia or IV sedation. In nearly all cases, Dr. Azouz will use a combination of local anesthetic and IV sedation. This means that you are asleep but do not have a machine that is breathing for you.  Sedation is often considered much safer than general anesthesia.  Dr. Azouz has found that the recovery period is much quicker and patients report less nausea when local and sedation are used compared to a general anesthetic. 

Breast Augmentation Incisions

There are several incision placements that may be used to complete a breast augmentation procedure. The goal is to minimize scarring after healing is complete.  Dallas plastic surgeon Dr. Azouz will explain these options and which one is best for your procedure during a consultation. Generally speaking, a breast augmentation can be completed using one of the following incisions:

Breast Augmentation with Dr. Azouz | Dallas & Plano
  • Periareolar incisions are made in a semi-circular pattern around the nipple and areola. Any resulting scarring is camouflaged within the areola.
  • Inframammary incisions are made just below the breast crease. 
  • Transaxillary incisions are made within the armpit.This is more common with saline implants which can be filled after placing them within the breast pocket.

Inserting and Placing Breast Implants

Once incisions have been made, Dr. Azouz is ready to place the breast implants. The technique for this step will again vary depending on the type of implants you have chosen and your desired results. Breast implants can be placed either below the pectoral muscle, known as a submuscular placement, or between the muscle and natural breast tissue, known as a submammary or subglandular placement. Submuscular placements typically create a more natural result, especially for those who have a smaller amount of natural breast tissue. This placement is also associated with a lower rate of capsular contracture or rippling in the case of saline implants. Subglandular placement is beneficial for those who do not have a pectoral muscle especially in cases of Poland Syndrome. During a consultation, Dr. Azouz will help you choose the best option according to the results you are looking for.

Closing Breast Augmentation Incisions

After successfully placing the breast implants, Dr. Azouz will then close the incisions. This is typically done with a combination of sutures and skin adhesive or surgical tape. After closing incisions, dressings and bandages will be placed over the incisions, and you will wear a compression bra to keep the breasts in place as you heal. When surgery is complete, you will be given detailed instructions on caring for the incision sites.  At times a breast augmentation can be combined with a mini lift or full lift (mastopexy).

Recovery and Results After Breast Augmentation

Immediately after a breast augmentation, you can expect to feel tired and sore and should prioritize rest, especially for the first 48 hours. Swelling and redness at incision sites can both be normal.  Dr. Azouz uses a variety of techniques for minimal pain and rapid recovery after breast implants are placed.

Through your recovery period, Dr. Azouz will explain exercises you should perform to help avoid capsular contracture and maintain soft breast tissue. He will also outline when you can safely return to all normal activities, such as your exercise routine. Most patients are ready to return to work and non-strenuous activity within a few days after a breast augmentation.

Schedule a Consultation with Dr. Azouz

To learn more about the breast augmentation procedure, schedule a consultation with Dr. David Azouz or Dr. Solomon Azouz by calling our Dallas office at (972) 702-8888 or contacting us online.

Breast Augmentation: Which breast implant is best for me?

According to The Aesthetic Society, Breast Augmentation is one of the top breast plastic surgery procedures for women in the United States. Breast Augmentation is a procedure performed by plastic surgeons that helps women to resize and reshape their breasts. Women interested in Breast Augmentation in Dallas can enhance their breasts with fat transfer or implants. Breast Implants are devices that can help women to go from a subtle change to a dramatic difference or a modest enlargement. If you are not sure yet which breast implant to choose, Dallas Plastic Surgeon Dr. Azouz will guide you to make an informed decision and select the best implants for your breast augmentation.

Dallas & Plano Breast Augmentation Dr. Azouz

Breast Implants Types

Cosmetic breast augmentation offers two main categories of breast implants. What type is suitable for you depends on your cosmetic goals, implants cost, and reason to get the implants (cosmetic or breast reconstruction surgery). Dr. Azouz explains the pros and cons of each one, so you know which one can provide the best result for your body structure.

Saline Breast Implant:

  • Saline-filled implants are approved for women at least 18 years old.
  • They are inserted empty and filled with sterile salt water.
  • Saline implants can last from 10 to 15 years or even longer.
  • The incision site is smaller and less noticeable.
  • Saline implants can enhance and project a patient’s natural breast tissue.
  • In case of rupture, the saline is absorbed by the body and the implant shell needs to be removed.

Silicone Breast Implants:

  • Silicone implants are approved for women at least 22 years old.
  • The fill of silicone impants is meant to mimic the feel of the breast.
  • There are regular silicone implants and more cohesive silicone implants known as gummy bear.
  • Gummy bear implants can be formed into an anatomical shape and are cohesive in case of a rupture.
  • Silicone implants’ rupture can go undetected. A MRI is recommended to check for ruptures.
  • If a rupture occurs, silicone implants need to be removed.

Which breast implant is best for me?

Breast Implants Dr. Azouz Dallas & Plano

Both Saline and Silicone Breast Implants are made to last and enhance the breast. To know which breast implant is best to reach your goals, it is essential to consult a plastic surgeon. If you are located in the Dallas metroplex, request your first breast augmentation consultation with Dr. Azouz, a board-certified plastic surgeon specializing in breast surgery and breast reconstruction. 

In your first consultation, you will have the opportunity to explore your options for breast augmentation, discuss the pros and cons of implants, and decide which breast implant is best to help you achieve your new breast’s shape and volume.

Schedule a consultation with Dr. Azouz

Dr. Azouz, a board-certified plastic surgeon in Dallas, has helped patients in their journey to find the best implants for their patients according to their body structure, lifestyle, and expectations. Request your initial consultation with Dr. Azouz in Dallas by calling 972 702 8888 or filling out our contact form.

Breast Surgery Dallas: Top procedure options

Breast augmentation, breast lift, and other breast procedures help women of all shapes and sizes get the curves and figure they want. And with modern technology extending the limits of what results you can achieve through breast implants and other devices, there’s never been a better time to consider going under breast surgery for significant improvement. No matter your current anatomy, it is always best to check with a board-certified plastic surgeon to evaluate your options. If you consider breast surgery to enhance your figure, contact Dr. Azouz in Dallas by calling 972 702 8888.

Breast Augmentation With Fat Transfer

Breast procedures | Dr. Azouz | Dallas & Plano

The most popular plastic surgery in the United States every year is consistently breast augmentation.  But did you know that there’s another procedure that doesn’t use breast implants but rather your own body’s tissue?

Fat transfer breast augmentation is certainly not capable of achieving the significant enlargement possible with implants, but it does have its advantages. Primarily, the procedure creates permanent results, with no need to worry about poor implant placement, infection, or a noticeable scar. Fat is harvested from problem areas in the body, such as your abdomen, waist, or thighs, and then processed for re-injection in the breasts.

Most people who undergo this procedure end up with a one-cup bra size enhancement, as not all of the fat injected will survive the transfer process. However, reducing fat in other areas and enhancing the volume of the breasts can be a great way to get a natural, albeit conservative, body contour. If you are interested in having a major change in your breast area, check our breast augmentation with implants procedure site to learn more about all the options provided by Dr. Azouz.

Areola Reduction

A less well-known procedure doesn’t involve reducing or enhancing the size of the breasts but simply addressing issues of areola appearance. The nipple and areola are significantly affected by changes in the body such as weight fluctuations, pregnancy, or breastfeeding, and can become unsatisfying for some. Others are just naturally large, and people want them to be smaller.

In areola reduction surgery, Dr. Azouz can reduce the size of the areola in patients with stretched, enlarged, or puffy nipples to achieve a more youthful look and feel, without the need for more invasive techniques. If you’re not happy with the way your nipple and areola look but are satisfied with the shape and size of your breasts in general, this could be the perfect procedure for you.

Breast Lift

Another highly requested procedure is the breast lift. Often complementary to breast augmentation, a breast lift helps people with sagging or downward-pointing breasts achieve a perkier, more youthful look. In this procedure, Dr. Azouz will make a predetermined incision to remove excess skin that’s causing sagging, as well as excess tissue (though not as much as a breast reduction) to surgically lift the breasts and help the nipples point straight ahead.

Reach Top-Rated Breast Plastic Surgeons in Dallas, Texas

If you are looking for an experienced, highly trained, and board-certified plastic surgeon in Dallas whose patients’ reviews confirm their competence in delivering dramatic results, contact Dr. Azouz to schedule your consultation by calling 972 702 8888. During a consultation, Dr. Azouz will examine you, listen to your concerns, and recommend one or more breast procedures to help you achieve your ideal figure. He can also let you know which techniques produce the most satisfied patients, as well as what’s new in the world of breast surgery. Get the conversation started today by calling us or filling out our online contact form.

Combination Plastic Surgery: Face, Breast, and Body

What cosmetic procedures can be combined and why would that be beneficial?

Combining plastic surgery procedures is extremely popular and involves a plastic surgeon performing multiple plastic or cosmetic surgeries in one day.  This is a great option for patients who have many different concerns they would like to address. Dr. David Azouz is a board-certified plastic and reconstructive surgeon in Dallas, TX who performs many combination procedures to help his patients reach their goals in a safe, efficient, and effective manner. Dr. Azouz is highly experienced and offers patients the benefits of a natural-appearing look with minimal scarring from his combination procedures. The most well-known combination procedure is the mommy makeover, but there are many procedures that can be combined. Facelifts, tummy tucks, liposuction, and breast surgeries are all popular surgeries that can be done together.

Benefits of Combination Plastic Surgeries

There are many different benefits that come from performing two or more surgeries simultaneously. Mainly, it cuts down on the need for multiple surgery days which allows a patient one recovery. Additionally, combining procedures often cuts down on the cost of surgery and anesthesia.

Candidates for Combination Plastic and Cosmetic Surgery

The best candidates for combination surgery:

  • Require moderate improvement of the areas to be treated
  • Are in good overall health
  • Are non-smokers
  • Have realistic expectations

Dr. Azouz recommends that patients with areas that require significant skin and soft tissue resection stage their procedures rather than have them done on the same day.  The right combination of procedures can achieve the results a patient desires and this is best achieved through expressing your goals with Dr. Azouz.  Dr. Azouz is committed to performing plastic and cosmetic surgery as safely and efficiently as possible.

Combining Plastic Surgery with other non-plastic surgery procedures

Patients often desire to combine cosmetic and plastic surgery operations with other types of surgery including:

  • Hysterectomy
  • Removal of gallbladder
  • Functional rhinoplasty
  • Hernia repair

Dr. Azouz is able to coordinate performing cosmetic surgery with other noncosmetic surgeries with a variety of different surgeons.  Often Dr. Azouz will work with an OBGYN to perform a hysterectomy and tummy tuck together.  Hernia repairs are often performed at the same time as a panniculectomy (tummy tuck).

Recovery Time

One of the main questions Dr. Azouz is asked during his consultations with patients is how much recovery time they will need for their procedure. If a patient has multiple concerns and requires multiple procedures, this adds to time spent recovering from surgery. With a combination procedure, you get one recovery time.  A mommy makeover may involve a drain-less abdominoplasty or mini-tummy tuck, liposuction, and breast augmentation in the same day.   Men often desire liposuction of the abdomen to be done concurrently with liposuction and removal of gynecomastia of the chest.  The recovery time for each procedure is about four to six weeks until a patient can return to heavy exercise. Instead of having to heal for four to six weeks to or three different times, patients can get surgeries done on the same day so that they only go through one recovery.

How soon can you have cosmetic surgery after massive weight loss surgery (gastric bypass)?

Gastric bypass induces weight loss by both restrictive and absorptive methods.   This means that a patient will eat less food and less food will be absorbed through the patient’s digestive tract.  Patients will generally have their weight fluctuate for six months after surgery.  Dr. Azouz typically recommends having a stable weight for six months prior to surgery as well.  Patients who have had bariatric surgery (gastric sleeve or bypass) are typically excellent candidates for post-bariatric body contouring.  Combination procedures are often possible and include a variety of cosmetic surgeries of the body, breast, and face.

Possible combination surgery after bariatric procedures include:

Mommy makeover

Body lift with liposuction

Tummy tuck with liposuction

Facelift with eyelid surgery (blepharoplasty)

Breast lift with breast augmentation

Liposuction and removal of gynecomastia

Cost and Recovery

Along with the cut down on recovery time, combination procedures also cut down the cost. The cost of each individual procedure varies greatly. You have to add in the surgical facility, anesthesia, and medical devices to the total cost. By getting multiple procedures done in one surgery, this cuts down on the time spent in the operating room and anesthesia costs being repeated. Dr. Azouz will give you an estimated cost of your unique combination procedure during your in-person consultation.

Popular Combination Plastic Surgeries

To help his patients save on recovery time and cost, Dr. Azouz performs many of his procedures in combination with others. Due to the drain-less technique accompanying his procedures, patients can enjoy a less complex healing period. One of his most popular procedures is the Drainless abdominoplasty. Other popular combination procedures are:

  • Mommy Makeover (breast and abdomen)
  • Liposuction and Removal of gynecomastia
  • Liposuction and Abdominoplasty
  • Breast Lift and Reduction
  • Rhinoplasty and Eyelid surgery (blepharoplasty)
  • Facelift and Eyelid surgery
  • Mini Abdominoplasty and liposuction
  • Tummy tuck and labiaplasty

Schedule a Consultation

If you have multiple body concerns that you would like to address, then talk to Dr. Azouz about combination procedures. These are excellent options to get your ideal look in a quick, effective manner. You can request a consultation with our online form or give us a call at 972-702-8888.

How Do I Know Which Breast Surgery is Right for Me?

Many women are insecure about the size, shape, and overall look of their breasts. In some patients, the breasts are too large, too small, or sagging, whatever the issue, there is a Plastic Surgical operation which can offer a solution. In Dallas, Texas Dr. David Azouz performs various breast surgeries on women who are looking for a change. Dr. David Azouz is a Board-Certified Plastic Surgeon specializing in drainless, rapid recovery of breast surgery. Dr. Azouz offers an individualized approach to breast surgery and thoroughly explains the benefits and drawbacks of each surgery. Dr. David Azouz is highly experienced and offers many minimally invasive approaches to breast surgery that allows for minimal scarring with a natural look.

Why does a woman’s breast empty?  There are many reasons including:


The most common reason for a woman’s breast to be empty is hereditary.  Some women inherit poor skin elasticity which causes their breasts to sag over time.  Other women lose their breasts when they lose weight.  There are some women who never develop breast tissue.


Pregnancy can cause enlargement of the breasts.  Some women find that when they are finished breast feeding they no longer have the breast tissue they started with.

Weight Loss

Massive weight loss with diet and exercise or with bariatric surgery can cause the breasts to be emptied and are often associated with sagging breasts.


As some women age, they are left with sagging or empty breasts.

Breast Augmentation

Breast augmentation is a surgery that is done to increase the size of the breasts, correct asymmetrical breasts, and improve breast contour. This is a good option for women who wish to increase the size and improve the shape of their breasts. This surgery alone will may correct slightly sagging or drooping breasts. Patients who have more significant sagging or drooping of the breasts will require a lift or a lift in addition to an augmentation. Candidates for this surgery are women who are physically healthy, have fully developed breasts, and are not currently pregnant or breastfeeding.

Recovery Time for Breast Augmentation

Recovery time from a breast augmentation varies for each patient. Dr. Azouz will give you a list of detailed postoperative instructions to follow to help the recovery be smooth and easy. It is important to rest and relax for the first 48 hours following your surgery. Most patients can return to most daily activities within a week. More strenuous activity such as contact sports, marathon running and crossfit may still need to be paused for a few weeks.

Cost of Breast Augmentation

Each patient’s breast augmentation cost will vary. At your consultation with Dr. Azouz, he will give you an estimated cost based on your customized procedure. Costs vary due to implant type, size, and placement. If any other procedures are performed in combination such as a breast lift or liposuction, that will also affect the cost. If you have any questions regarding cost and payment, feel free to contact our Dallas office at 972-702-8888.

Breast Lift

A breast lift, also called mastopexy, is a surgical procedure that is performed to lift sagging, loose breasts. Often women’s breasts start to lose volume and elasticity after pregnancy or weight loss. This breast surgery also repositions the nipple and areola to a more youthful position. Women who seek breast lifts want to get higher, fuller appearing breasts without increasing the actual size through augmentation.

Recovery Time for Breast Lift

The recovery from breast lift surgery is relatively quick. Dr. Azouz will provide detailed instructions for your post-operative care. These will help to make recovery smooth and easy for you.

Cost of Breast Lift

The cost of breast lift procedures varies for every patient. It is highly dependent on the amount of change desired, techniques used, and any combination procedures. There are three main approaches to a breast lift which include a lollipop incision, anchor lift or a mini lift.  Dr. Azouz will give you an estimated cost during your consultation appointment and identify which breast lift is best for you.

Breast Reduction

Breast reduction, also known as reduction mammaplasty, is a surgical procedure that helps to reduce the size of large and/or sagging breasts. Dr. Azouz can also reduce the size of the areola during this procedure to make the breasts look more natural. This procedure is great for women who have large breasts that are causing them pain, discomfort, and even lowering their self-confidence. Breast reductions help to aesthetically improve the look of the breasts and alleviate discomfort associated with large breasts. Dr. Azouz utilizes liposuction with a breast reduction to remove lateral breast tissue and fat.   Liposuction allows for a more sculpted look.

Recovery Time for Breast Reduction

You will notice an immediate improvement in the look and feel of the breasts. Most patients return to work within one week of the procedure. Dr. Azouz will provide specific aftercare instructions for you to follow.

Cost of Breast Reduction

Each breast reduction procedure has a varied cost. The cost depends on the amount of change desired and any combination procedures that are done. During your consultation with Dr. Azouz, he will give you an estimated cost for your breast reduction.

Breast Reconstruction

Breast reconstruction is a procedure that is done to help restore breasts for women who have undergone surgery for breast cancer, have altered breasts from previous surgery, or have altered breasts due to trauma. Dr. Azouz works with each woman individually to find the best breast reconstruction method and to help them feel comfortable. Dr. Azouz will strive to make sure that the results look natural.

Breast reconstruction can be done in multiple ways depending on the health, history, and goals of the patient.

Recovery Time for Breast Reconstruction

The recovery time for breast reconstruction varies for each patient. It is dependent on the type of breast reconstruction, the amount of breast tissue, the health of the patient, and medical history. Most patients return to work within one week following their surgery.

Cost of Breast Reconstruction

Each breast reconstruction will vary in cost. There are many factors playing into the cost of the surgery such as method, desired change, and more. Dr. Azouz will give you an estimated cost during the in-person consultation.

Removal of Implants

Many women decide to remove their breast implants for a variety of different reasons.  Some women do not want an augmented look as they age.  Other women are concerned as their specific type of breast implant may have been recalled by the FDA.   Dr. Azouz does not place textured implants which have been recalled by the FDA.  While there is not a recommendation for breast implant explantation of textured implants, many women feel more comfortable removing their textured implants.

Recovery Time for Removal of Implants

Recovery time for removal of breast implants is somewhat dependent on if a total capsulectomy is performed or not.  In general recovery from removal of implants is rapid with patients returning to work a few days after surgery.  It is not recommended to engage in heavy exercise activity for four to six weeks after surgery.

Cost of Breast Implant Removal

The cost of breast implant explantation is dependent on the type of implant and the need for a total capsulectomy.  Insurance coverage is possible for women with advanced capsules.  Many insurance companies deep breast implants to be cosmetic and therefore coverage is dependent on the insurance carrier and policy.

Breast Feeding After Breast Surgery

Breast feeding is possible after breast augmentation, breast implant removal, breast reduction, and  breast lift.  Patients who have undergone a mastectomy for breast cancer will be unable to breast feed as the breast glands, ducts and nipples may have been removed.

Drainless Breast Surgery

Surgical drains are used to evacuate fluid after surgery.  While they can be helpful to remove fluid, they involve additional scarring, are potentially painful and need to be continually emptied.  Dr. Azouz performs drain free breast surgery.  This allows patients to recover more quickly and to have a better postoperative experience.

Enhanced Recovery Breast Surgery

Dr. Azouz utilizes many surgical techniques to that provide an optimal post operative experience.  Dr. Azouz places long acting anaesthetics to minimize pain. Dr. Azouz avoids general anesthesia whenever possible to provide his paitents with a quick recovery.  He also utilizes compression garments,  which minimize pain and swelling after surgery.

Combining Liposuction with Breast Surgery

Liposuction can be used in almost all breast surgeries.  Liposuction provides a more defined and sculpted look by removing axillary adiposity, later breast tissue and by giving the breasts a more natural rounded look.  Many patients also decide to add liposuction to the abdomen with a breast surgery for a full body make over known as a “mommy makeover”.

Schedule a Consultation

Dr. Azouz will work with you to choose the best breast procedure, or combination procedures, for you. To make a consultation at his Dallas office, call Dr. Azouz at 972-702-8888 or fill out an online form.

Breast Augmentation Over Summer Break

Summer is here, which means more time to spent outdoors and by the pool. However, it can also be a great time to undergo a plastic surgery procedure! The most popular plastic surgery procedure to date is breast augmentation, which individuals across the U.S. benefiting from it! If you are interested in undergoing breast augmentation this summer, read on!

Why Undergo a Procedure Now?

During the summer, the weather is nicer, so you won’t have to be cooped up in the house during recovery. While this doesn’t mean that you can take part in exercise or activities, it does mean that if you wish to sit in a chair on your deck instead of sitting on the couch outside, you may do so.

Some individuals also have less work to do during the summer months, such as teachers, which makes this a great time to heal before autumn comes around. Plus, the kids are out of school now, so you won’t have to worry about driving them to and from school and activities.

Things to Consider Before the Procedure

Now, if you have decided that summer is a great time to undergo your breast augmentation- great! However, there are now some things you should consider before booking your surgery date.

The first is breast implant type. There are three main types of breast implants used today, including saline, silicone, and form stable. Saline implants are filled with a sterile salt water solution, and silicone implants are filled with a silicone gel. Form stable implants are similar to silicone implants, though they tend to hold their shape better.

Second, you will have to consider the incision pattern. During a breast augmentation, an incision is created in the breast, through which the implant can be placed. Patients can choose from the periareolar incision (around the nipples), the inframammary incision (in the breast crease), or the transaxillary incision (in the armpit).

Overall, these decisions can be discussed during your consultation with a board certified plastic surgeon in Dallas like Dr. Azouz. If you are interested in learning more about breast augmentation in Dallas, TX, contact us today to begin your plastic surgery journey!