How to Prepare for Your Tummy Tuck

If you’ve already scheduled your tummy tuck appointment, we understand that you may be overwhelmed about your upcoming surgery. With all of the processes you’ve gone through to get to this point, you want to make sure the procedure goes smoothly.

So what can you expect in the upcoming weeks leading up to the event? If you’re curious about the lifestyle choices you can make to ensure optimal recovery after the surgery is complete, here’s what you can do.

Clean up Your Lifestyle

The first tactic you can begin taking today is cleaning up various parts of your life. Do you smoke, drink, or have an unhealthy vice? By reducing the amount of time you partake in these activities, you increase your odds of having a healthy system when the surgery happens.

If you had to focus on the number-one habit that you can eliminate before your surgery date, it’s smoking. Smokers who undergo surgery are more likely to have wounds that will not close or heal after the surgeon finishes their job.

We understand that eliminating smoking from your life can be a challenging task, so we’ve established a list of go-to tactics to help you:

  • Nicotine-replacement therapy
  • Vaporizers with no nicotine
  • Chewing low-sugar candy
  • Establishing a support group
  • Massage therapy
  • Meditation and yoga

These tricks, when used in conjunction with one another, can greatly increase your odds of dropping the habit of smoking.

Get Rid of Anti-Inflammatory Drugs and Aspirin

Although it may sound somewhat graphic, for post-surgery wounds to heal correctly, the blood needs to clot and seal properly. When you rely on aspirin and other anti-inflammatory drugs daily, you can create excess bleeding during surgery.

While you may need to take these medications to stay healthy, talk with your physician about your upcoming surgery. They may provide an alternative treatment plan that can be used in the weeks leading up until the procedure.

Get Close To Your Ideal Weight

Perhaps the most critical step that you can take to ensure a safe tummy tuck is getting as close to your goal weight as possible. When you consult with your doctor or surgeon, define the weight that you desire to be in the future. Once you have this number, it’s time to get to work!

Much like smoking, getting into shape can seem like a daunting task. Knowing this, we advise you to approach the subject slowly. Through a combination of cardiovascular routines and smart dietary choices, your goal can become a reality.

Be Positive

Lastly, we want to encourage you to stay optimistic and hopeful for your procedure. While it may seem intimidating and scary, it’s a new start for your life! From here on out, you’ll be able to look into the mirror and feel confident and proud of your figure. Never again will you let a little bit of weight hold you back from experiencing the life you desire!

Schedule a Consultation

To get started with your tummy tuck journey, schedule a consultation with Dr. Hetal Fichadia. To request your appointment, complete our online form.

Understanding Liposuction: What to Expect

Liposuction is one of the best options for removing stubborn fat that’s left from events like weight loss or pregnancy. However, it’s important to make sure your expectations are in line with a successful and safe procedure. There are a lot of misconceptions about liposuction and what it can do, so you should be sure and discuss your expectations with Dr. Fichadia during a consultation. Here are some things to know about liposuction and what you can expect from your results.

Liposuction Will Not Fix Sag

One common accompaniment to rapid weight gain or loss is stretched skin. Unfortunately, liposuction can’t fix this concern and can even worsen it if more excess fat is removed. If lax skin is a concern, then make sure to discuss your options for a lift procedure with Dr. Fichadia.

Liposuction Is Not For Weight Loss

Liposuction isn’t meant to be a weight-loss method. In fact, you should be at or near your ideal weight before opting for liposuction. It’s also important that your weight be stable so that fluctuations don’t affect your results. The amount of fat removed by liposuction isn’t often substantial, meaning liposuction won’t drastically change the number on the scale. Rather, it can positively affect your figure and overall look.

Liposuction Is Not The Same As Bariatrics

In the same vein, liposuction will not induce weight loss like bariatric surgery. If you still need to lose weight, it’s important to discuss your plan with Dr. Fichadia so you can plan the right timeframe for your liposuction procedure and ensure you’re successful. If your BMI is above a certain threshold, bariatric surgery may be more beneficial for you.

Schedule a Consultation

Liposuction is an excellent option for refining your weight loss results and improving your figure after you reach your weight loss goals. To discuss your options for stubborn fat, contact our Portland office by calling or filling out our online form.

Everything you need to know about a mommy makeover

A Makeover Specially Designed for Moms?

What is a mommy makeover and why would a mother be interested in having one in the first place? It’s no surprise that the secret behind the trim and fit bodies of celebrity moms is more than just a good diet and exercise plan. While it is necessary to combine a healthy body type with these two things, at the same time there is no mystery as to what the extra boost to vibrant looks comes from. It’s more than only celebrities that are seeking makeovers that extend even further than face makeup or a new hair cut. Everyday, ordinary mothers are just as likely to seek certain procedures to revert their bodies back to the glory that existed before introducing the world to a new member of the family.

Achieving Your Desired Results

Due, in part, to the influence of celebrity mothers, there is a great demand for “mommy makeover” plans. These plans include a series of procedures that are specially designed to help restore a woman’s body by repairing the natural damage that it has undergone throughout their pregnancy. Even though this series of procedures can help individuals in reaching their physical goals, it is important for patients to be realistic in their expectations. Clear communication between doctor and patient can help everyone involved in getting to where they need to be to understand what can and cannot be achieved. Great things can be done with cosmetic and corrective surgery. However, what can be done and when will depend on each individual case.

While it may seem as if celebrities who lose a ton of weight and achieve a toned body soon after giving birth do so with some sort of surgical miracle, that is not necessarily the case. Since all mothers go through extreme stress throughout their pregnancy and while giving birth, it is not realistic to be prepared for major corrective surgeries right off the bat. It may take weeks or even months of recovery before a patient will be fully ready for the physical healing demands that certain cosmetic procedures will require of them. Dr. Fichadia will be able to go over all of the important details pertaining to an individual’s needs during your consultation.

What Does This Makeover Include?

Even though a mommy makeover is a very personal thing, there area few common types of surgeries that are usually included in a customized plan. When a woman undergoes months of pregnancy, her body tends to go through changes that differ depending on the woman. For some, certain areas of the body may be much more affected than for others. For example, one mother may see an extreme gain in weight in all areas of her body, while another mother may only experience significant weight gain in a few areas.

For this reason a tummy tuck is one of the absolute most common types of cosmetic procedures for recently pregnant women to undergo. Since pregnancy is renown for extending the stomach, there is a good reason for this. In the same vein, some individuals may seek liposuction, breast lifts, and labiaplasty to help in repairing damage experienced while giving birth.

After Liposuction, Can Fat Pockets Return?

Liposuction is a popular form of cosmetic surgery in the US. The beauty of getting liposuction is that the results are immediate as it instantly gets rid of unwanted and excess body fat. This dramatically improves the body contour and shape. Liposuction is an especially effective method for removing stubborn fat that seems resistant to shrinking, even with regular exercise and dieting. Other than the near immediate results that this procedure provides, most patients are concerned about its long-term results. One of the common questions that candidates ask is whether fat will return after having liposuction.

Liposuction for fat removal

The main aim of undergoing liposuction is to remove fat cells from a targeted or localized area on your body. Dr. Hetal Fichadia is a double board-certified plastic surgeon that is experienced in performing liposuction. As a cosmetic surgeon, she closely evaluates every case to ensure that all her patients are satisfied with their results. Several techniques are used in liposuction, but all have the goal of eliminating excess fat. In contrast to dieting, which makes fat cells shrink, liposuction uses a hollow tube called a cannula, to suction out the fatty tissue. Thus, liposuction permanently removes excess fat from localized areas in your body.

Can this fat return?

The best way to maintain your liposuction results is to have it done when you are at a stable, healthy weight that you can maintain. Any increase in weight after the surgery will hinder its results, as they will be less dramatic. The patient needs to maintain their “post-lipo weight” to preserve the results and to maximize the body contour achieved after liposuction. It is still possible to gain fat in other areas of the body not touched by liposuction. A small or moderate weight gain may diminish the results of liposuction, but the improved body shape will still be visible. This is because the areas targeted by liposuction have fewer fat deposits than the rest of the body. However, if you experience a significant weight gain, fat cells all around your body will enlarge and eventually proliferate, including those in the targeted areas for liposuction. The effect after significant weight gain will be more noticeable in the untreated areas but will ultimately affect the whole body. Thus, if you undergo liposuction and gain weight, you will still look better than having not done the surgery at all.

How to ensure your liposuction results last

The most vital aspect that can significantly affect your liposuction results is your weight. If you want long-term results, you will need to maintain a healthy weight after surgery. By incorporating regular exercise and a balanced diet, you can be sure that your results will be long-lasting.

Dr. Fichadia will provide you with post-procedure instructions to follow to get the best results.

Schedule a Consultation

To learn more about liposuction and how to get started on your journey to your ideal look, come into Dr. Fichadia’s office. Call 503 488 2344 to schedule a consultation with Dr. Fichadia to see if liposuction will be beneficial to you.



Common Reasons People Undergo Breast Surgery

Without a doubt, breast augmentation has become a well-known cosmetic procedure often performed in the United States. Despite differing opinions about this type of surgery, there are many reasons why women across the country choose breast augmentation, including the desire to improve the shape and volume of their breasts. Each patient holds a unique reason for wanting to enhance their breasts and it is important that they are guided by a board-certified plastic surgeon throughout their journey. Besides breast augmentation, there are many other breast surgeries available, even for men who are unhappy with the appearance of their chest! Let’s delve into some of the more common reasons why people undergo breast surgery, including some of the benefits associated with the surgery for both men and women.


People who have had breast cancer sometimes undergo a mastectomy, or removal of the breast tissue. This can happen in the case of both men and women. After a mastectomy, some patients choose to undergo reconstructive surgery, which often involves the placement of breast implants. Although breast reconstruction is different from a breast augmentation, they both share a similar end goal—to achieve fuller and better-shaped breasts to increase confidence in the patient. A breast reconstruction poses unique challenges for the surgeon, as the limited or absent amount of remaining natural tissue can hamper the achievement of a natural look. Breast reconstruction surgery after a mastectomy may also require skin or fat grafting, as well as nipple and areola reconstruction.

Post-Pregnancy Breast Volume changes

It’s not uncommon for women to experience a change in the volume of their breasts after having a baby. In an effort to achieve their pre-pregnancy physicality, some women choose breast augmentation with or without a breast lift. While it’s possible to get back to physical fitness through diet and exercise, that’s not the case when it comes to restoring breast volume. Breast volume can be increased using breast implants or using the patient’s own fat tissue. Depending on the goal size and the characteristics of the breasts, a board-certified plastic surgeon will be able to help you decide the option that works best for you.


Gynecomastia is an enlargement of the breast tissue in boys and men causing “man boobs”. An imbalance of estrogen and testosterone is usually the cause of this condition. Gynecomastia is a common reason for which males choose to undergo breast surgery, as the procedure reduces the size of the breast tissue that causes a feminine-like profile and restores the patient’s confidence.

Enhanced Youthfulness

Some women start to notice loss of volume and sagging of their breasts as they age. While this isn’t an issue for all women, some prefer the restoration of perky breasts that tend to have a more youthful appearance. A breast lift or mastopexy can help reshape and reposition the breasts, allowing them to have a firmer texture and sit at an optimal position on the chest. A breast lift can also correct the nipple enlargement that sometimes is present after pregnancies, or as a part of the natural aging process. A breast augmentation with or without implants can help restore the fullness of the breasts but it will typically not change the position of the nipples on the chest. A breast augmentation can be performed alone or in combination with a breast lift. Depending on your specific needs, your board-certified plastic surgeon will be able to help you choose the best path towards perkier and more youthful breasts.

Back and Neck Pain

Women with disproportionally large breasts often report back and neck pain, as well as other symptoms associated with the weight of their breasts. Although these symptoms can be caused by multiple reasons, reducing the size of the breasts has shown to help ameliorate the pain and discomfort in most patients. A breast reduction or reduction mammoplasty allows fat tissue and skin to be removed from the breasts. This results in proportionally sized breasts, which are also repositioned higher on the chest wall, resulting in more comfortable and aesthetically pleasing breasts.


A positive self-image and high self-esteem are important in life. It’s actually one of the reasons why some women choose breast surgery. Studies of individuals that have received breast augmentation often reveal a significant increase in confidence. Living with the self-consciousness of having a body part that is bothersome to the patient may weigh heavy on their mind. Discussing these issues with your doctor is the first step towards living a happier and healthier life.

Improved Fit of Clothing

Some women choose to have breast surgery because they would like their clothing to fit better. Whether they feel as though their breasts are too large, too small for their frame, or simply sitting too low on their chests, breast surgery can help women achieve the breast shape that maximizes their comfort, happiness, and health. A consultation with a board-certified plastic surgeon will shed light regarding the surgical intervention that best addresses any particular concerns.

We’re Here to Help You

Regardless of your situation, elective breast surgery is a decision that should be made thoughtfully. It’s also a decision that should be made in consultation with a qualified doctor. Dr. Hetal Fichadia is a double board-certified surgeon that has received comprehensive training in plastic and reconstructive surgery.

Dr. Fichadia has the knowledge and expertise to help you make a decision that best fits your needs. You’ll have an opportunity to ask any questions about breast surgery so that you can make an informed decision. Whether you are considering breast surgery because you are a cancer survivor or because you simply want to boost your self-confidence, Dr. Fichadia will guide you through the process.


5 Signs That You’re A Good Candidate For A Mommy

Giving birth is a magical time for every mother, but it’s also a huge change not only for your life but also your body. Pregnancy can leave your body looking very different. You may have noticed that your breasts have lost volume, stretch marks appear, and you have excess skin and tissue in different areas. Getting back to a proper diet and exercise plan can help fix the issues you are having, but they won’t always solve the whole problem. This can be extremely frustrating for a lot of women.

Double board-certified plastic surgeon, Dr. Fichadia, offers mothers the chance to rejuvenate their bodies with a mommy makeover. This type of makeover addresses the after-effects that occur from giving birth. It is a combination surgery that involves multiple procedures to address each woman’s specific concerns. It typically involves a tummy tuck, breast surgery with or without implants, and liposuction. The end goal of the mommy makeover is to make you feel good about your body again. While it is a great procedure for many women, it is not for everyone. That is why we always speak closely with every patient in order to make sure that the procedure is right for them.

Are you interested? Here are five signs to help you decide if a mommy makeover is the best option for you:

1. You’ve Already Tried to Lose Weight

A mommy makeover works best for patients who are healthy and within 10-15 pounds of their goal weight. If you are in your weight loss journey, it is recommended that you are approaching your target weight before considering surgery, as any dramatic postoperative weight loss may cause loose skin. Women who are overweight, smoke, or have conditions such as hemophilia are not typically good candidates for such an extensive procedure. For women who are trying to get back into shape after pregnancy, it is important to always seek the advice of a doctor. If you have worked hard at losing weight but are still dealing with excess skin and saggy breasts, a mommy makeover may be right for you.

2. You are Done Having Children

Sure, you can have a mommy makeover if you plan to have more children. However, once you get pregnant again you may lose all of the benefits you gained from the makeover itself and may need additional procedures to correct any damage done. In order to maximize the incredible results of a mommy makeover, we do recommend that most patients wait until they are done having children before they undergo the procedure.

3. You Had a C-Section

A cesarean section leaves a large scar on the lower third of your stomach, which can sometimes be associated with loose skin above the scar, resulting in a noticeable step off. A tummy tuck can correct this.  It is also a great option for women who have stretch marks, scars from previous surgeries, hernias, or diastasis recti—a separation of the rectus abdominal muscles that is fairly common after a pregnancy. Consult your doctor to discuss imperfections in the abdominal area that bother you, as many of them can be resolved with a mommy makeover.

4. Your Last Birth was Six or More Months Ago

Your body needs time to recover after giving birth, especially if you underwent a C-section. The tissue in your abdominal wall, skin, and breasts progressively stretch for months during pregnancy. It is recommended to give them time to shrink back and return to their baseline before considering surgery. You will always want to wait for a minimum of six months before you think about a mommy makeover.

5. It Has Been At Least Six Months Since You Breastfed

Breastfeeding is a great way to make sure your baby gets the nutrients they need. However, it can also change the way your breasts look. You will want to wait until you are through breastfeeding and they settle back into a more natural state before you consider getting a mommy makeover.

Dr. Fichadia will answer any of your questions or concerns. We want your experience to be the best you have ever had! Feel free to call our office at (503) 488-2344 for more information.



Important Things to Know About Breast Augmentation

Breast implants are an excellent way to replace lost volume, correct underdevelopment, and get a proportionate figure. The number of people electing cosmetic plastic surgery continues to rise each year. With over 300,000 performed in 2018 alone, breast augmentation remains one of the most popular cosmetic procedures.  Cosmetic surgery is a big decision with a lot of frequently asked questions. Here are some important things to know about breast augmentation to help you make an informed decision.

What Is Breast Augmentation?

This is a surgical procedure is to enhance the shape, and size of the breasts. The most common way to achieve this enhancement is with an implant. It can also help restore balance in cases of significant asymmetry.

Are All Breast Implants The Same?

Composition of a breast implant is a silicone outside shell that’s either filled with medical grade silicone gel or sterile salt water (saline.) The latest techniques in breast augmentation emphasize the importance of tissue based planning. This means selecting a breast implant that matches the footprint of the breast. Therefore, breast implants also come in different sizes and shapes to accommodate a preferred breast width, desired volume, and projection. Within these implants, there are choices with regards to round vs anatomically shaped (teardrop) implants and smooth vs textured implants. Dr. Fichadia will perform a detailed physical examination and recommend implants that will fit your body and achieve the desired cosmetic outcome.

What Questions Should Be Asked In Selecting A Plastic Surgeon?

Picking a qualified facility and plastic surgeon is very important to achieving a positive and safe breast augmentation outcome. You’ll want to know about the following areas before making a selection:

  • Is the surgeon certified by the American Board of Plastic Surgery?
  • Is the facility accredited by an accreditation organization such as the Joint Commission, AAAASF, AAAHC, or Medicare? Are the anesthesiologists experienced with this procedure?
  • Is the cleanliness of the facility, friendliness of staff, and overall level of comfort a match for your needs?
  • What’s the surgeon’s experience with this particular procedure?
  • What protocols and procedures does the facility and surgeon use to help ensure patient safety?
  • Are there any future considerations for breastfeeding, mammograms, scars, and revisions?
  • How will breast implants affect your lifestyle?

What are the different approaches to breast augmentation?

Dr. Fichadia offers the following approaches to breast augmentation:

Inframammary Incision

This incision is the most popular one among plastic surgeons in the United States. This incision is made along the breast crease under the breast.

The incision under the breast is generally recognized as the best approach for a number of reasons. It is very versatile, gives excellent access to the breast, and can be used for virtually all breast augmentation procedures, including challenging cases such as misshapen breasts, tight tissues, and revisions.

The incision is hidden in the crease of the breast, which is an important factor for many women. There is also less contamination with bacteria. More nerves are avoided, and the breast tissues are usually not cut so there may be less painful. This incision can also be used for revision procedures.

Nipple Incision (Peri-areolar)

The nipple incision is recommended for some patients who have underdeveloped or misshapen breasts, such as constricted or tuberous breasts. Since it requires cutting through the breast tissue, there are more pain, swelling, and changes to nipple sensation compared to other incisions.

The nipple incision is made around the lower part of the areola. The scar is barely visible on most Caucasians, but on patients of other races, the scars frequently pigment and thicken.

It’s important to note that this incision requires pushing the implant through the breast. Though we don’t really think about it, the ducts within the breast have bacteria within them. When the implant goes through the ducts, those bacteria can get on the implant. Low-grade infection/inflammation results in capsular contracture, which remains the leading cause of revision surgery after breast augmentation. Dr Fichadia makes it a top priority to reduce the possibility of capsular contracture. Therefore, while she offers this incision when needed, she prefers using the inframammary incision if otherwise indicated.

How to prepare for a breast augmentation surgery?

Before your breast augmentation:

A well prepared patient before surgery will make the recovery much quicker, easier and safer.  Here are some tips to ready yourself for implant surgery:

Stay off of all medications that thin your blood for 2 weeks prior to surgery (i.e., aspirin, Motrin, Advil, Alleve, ibuprofen, naprosyn, Anacin, Bufferin, etc.) and 2 days after surgery.

Arrange for transportation to and from the surgical facility as it is typically an outpatient surgery, and takes under 2 hours to perform.

Arrange for a responsible adult to be with you the day of surgery.

Fill all your prescriptions in advance and bring your pain pills with you to the surgery center.

Review and confirm with your doctor the choices you have made for your procedure regarding size of implants, type of implant, incision choice and location of implant.

Ice bags to breasts for 48 hours after surgery helps to reduce swelling and pain–arrange to have ice bags, gel packs or frozen vegetables ready for immediate placement after the procedure.

Review how to prevent thrombophlebitiis (DVT) in the post-op period

Report any sign of a cold or infection immediately to the doctor

Take a shower the night before surgery and the day of surgery and use a special surgical soap called Hibiclens, this can be provided by your doctor or purchased at a pharmacy.

Wear comfortable, loose-fitting clothes that do not have to be put on over your head the day of surgery.

Remove all earrings and body piercings the day of surgery, remove all makeup.

Do not eat or drink any food or water after midnight on the night before surgery.

Leave all your valuables and jewelry at home the day of surgery.

If there is any chance of pregnancy, perform a home pregnancy test and bring the results into the surgery center the day of surgery.

If you are experiencing your period, use an external sanitary napkin, tampons can cause toxic shock syndrome and need to be removed before surgery

What Does Recovery Look Like?

Recovery varies per patient since your overall health and lifestyle habits before the surgery can greatly impact your ability and speed of healing. Following applies for a standard breast augmentation under the muscle. Breast augmentation over the muscle has a slightly quicker recovery.

Rapid Return Stretches Following Breast Augmentation

Perform these exercises immediately in the recovery room and at least once circuit each hour while awake until your first post-operative visit. Although these are illustrated in the sitting position they can be performed in the standing position as well. Our goal is to progressively stretch the pectoralis muscle. If the exercises are not performed, the muscle tends to contract and shorten which may cause more discomfort (as is seen with a hamstring pull.) Remember: NO HEAVY LIFTING or SUDDEN MOVEMENTS.

Shoulder Roll

With your arms hanging straight down at your sides, pull your shoulders up toward your ears and roll your shoulders back slowly in a circular motion. Maintain an upright posture and sit at the front of the seat. Roll your shoulders for 10 to 15 repetitions in one direction before reversing direction for an additional 10 to 15 repetitions.

Arm Circles

While seated upright at the front of your seat, hold your arms straight out to each side and slowly rotate your hands in a small circular motion. Complete at least 10-15 revolutions in each direction, rotating forward, then backward.

Arm Stretch

This places the pectoralis muscle on full stretch. Place your arm over the head with your forearm resting on the top of your head while your hand reaches for the opposite ear. Avoid tilting your head. With the other hand, slowly pull on the elbow and hold it as you take a few slow breaths. Hold this position for 10 to 15 seconds with each arm.

Pain: In general, breast augmentation is tolerated very well. You will be sore the first 2-3 days. The primary reason for the pain is the muscle being elevated from the procedure. Take Tylenol and Celebrex on a schedule, staggering their doses alternately. It is possible that you will be taking narcotic medication for the pain in the first two days. Typical, by day 3-5 patients wean themselves off of narcotics and feel much better. There is a lot of variation patient to patient. Some may be done with narcotics by day 3, others continue on. After a week, there should be no more pain. If you experience any discomfort after one week, Tylenol should be sufficient to manage it.

Showering and Bathing – You may begin showering on the evening of surgery. Do not submerge yourself underwater (e.g., bath, pool, ocean) for the first three weeks after surgery.


Try to sleep on your back with your head slightly elevated after surgery. This will help with the swelling.

Activity –

Activity restrictions

Most women are able to return to desk-job type activities within 3-4 days, although things such as exercising and other strenuous activities should not be attempted for a minimum of 4 weeks, on average. No sexual activity for 2 weeks. At 2 weeks, it’s OK to get back to low impact cardio exercise.

For the first 6 weeks after breast augmentation, we advise against any activity that involves:

high impact activity (like jumping, jogging, martial arts)

big arm swinging (like tennis, golf)

lifting more than 15-20 pounds (lifting your baby is OK if you do it with your elbows close to your chest)

repetitive motions (sweeping, vacuuming, raking leaves)

How Long Do Results from a Breast Augmentation Last?

This is yet another question that’s highly individualistic and based on the style of implant chosen. While breast implants don’t come with an expiration date, they are not meant to be lifelong devices. It is possible to need another surgery around 10 – 15 years. The reasons for reoperation can range from size change, capsular contracture, implant leakage, weight gain or loss, asymmetry, or evolution of your personal aesthetic goals. Excessively large implants tend to have problems such as excess skin stretching and thinning, bottoming out, etc in the long run.

Schedule a Consultation

If you are interested in learning more about Breast Augmentation in Portland, Oregon, contact Dr. Fichadia. She is a double-board certified plastic surgeon known for delivering amazing results to her patients with excellent care. She can answer any and all questions you may have regarding breast augmentation and how it can benefit you. To make an appointment call her office today or fill out an online form.

Your Treatment Options For A Double Chin

Studies show that a vast majority of Americans are bothered by fullness under the chin, otherwise known as a double chin, or submental fullness in medical speak. Even with weight loss, this can be a difficult area to slim down. Sometimes, it can have a genetic component that makes it as much harder to treat on your own. Fortunately, we have very effective cosmetic treatments for a double chin. They range from non-invasive office procedure, to a surgical neck lift. The treatments are tailored to your specific concerns, and recovery time.


This unique injectable option is made specifically to remove fat from the chin area. It’s made from deoxycholic acid, which is found in the body’s digestive system and aids in the breakdown of fat cells. It involves a series of injections that can take a few months to fully address a double chin. On an average, patients require 2-3 treatment sessions.  It avoids invasive surgical techniques, and each 15-20 minute session can easily be fit into your busy schedule. Patients with mild to moderate fullness, and good skin tone are ideal candidates for this.  Side effects include swelling and numbness at the injection area. The swelling can last for 1-2 weeks, and it can take up to 6 weeks for full improvement to be apparent. The fat cells that are dissolved are permanently removed by your immune system. It is not indicated if loose skin is a greater concern than excess fat.  If you’re a busy professional looking for non-surgical options, Kybella might be for you.


This is another method for permanent treatment of addressing double chin. Chin liposuction can be done as an office procedure using numbing medicine (local anesthesia). Dr. Fichadia will make a small incision under the chin to gain access to pockets of fat. Once the fat is loosened using a thin metal tube, it’s suctioned out and the incisions are closed. Patients are generally prescribed anti-anxiety medicine to be taken before the procedure.  During recovery, you may need to wear a compression garment to prevent swelling for the first week. You can generally return to light office-work within a few days. Side effects include mild bruising, which can be concealed with make up after the first week. Its benefits over Kybella include the need for only a single treatment. Just like Kybella, patients with moderate fat excess and elastic skin are good candidates for this treatment. It doesn’t address any significant skin loosening.

Neck Lift

If you have loose skin in addition to excess fat in the chin, then Dr. Fichadia may recommend a neck lift. The neck lift specifically treats the lower face and neck area where excess fat and skin can cause a double chin and neck bands. This procedure requires general anesthesia. Dr. Fichadia makes incisions (under the chin and around the ear) to gain access to the underlying fat and loose skin, which is draped. Any extra skin can be trimmed, and this can tighten the neck and create a youthful contour. Your downtime will depend on the extent of your procedure, but it can take about 2 weeks for the incisions to heal and bruising to settle.

Some patients choose a direct excision neck lift where the incision is made in the front of the neck to address the excess skin directly. The benefits are quicker recovery and minimal bruising, but the tradeoff is a visible scar in the front of your neck.

Dr Fichadia strongly believes in individualizing treatment plan for each patient based on his or her anatomy, priorities and lifestyle. The best way to determine which treatment option is best for you is through a consultation with Dr. Fichadia. Contact our office at (503) 488-2344 or send us a message to get started

Your Most Common Liposuction Questions Answered

Liposuction is a highly popular fat reduction method that can help contour different parts of your body! There are several questions and myths that surround the procedure. Here are some of the myths I’ve come across during patient consultations:

Liposuction is a weight loss tool

While liposuction effectively removes pockets of stubborn fat that you can’t get rid of with diet and exercise, it is not a weight loss tool. Common problem areas treated with liposuction include the abdomen, flanks, hips, back, and thighs. For the best results from your liposuction procedure, you should be within your ideal weight range and be committed to a healthy lifestyle before and after the procedure.

Liposuction is only for women

Cosmetic procedures are popular among women, however, that doesn’t mean they’re not for men! Men can benefit from liposuction to recontour their figure and remove stubborn fat, just like women can. With liposuction for men, the male figure is taken into consideration to sculpt a masculine, toned physique.

Liposuction gets rid of cellulite, stretch marks or sagging skin

Despite popular belief, the presence of cellulite is not due to fat alone, but connective tissue causing dimpling in the skin. Liposuction is not meant to treat cellulite. Similarly, it is not effective at treating stretch marks or sagging skin. In fact, these problems may worsen after liposuction.

The fat will return after liposuction

Once fat cells are removed during the liposuction process, they are removed permanently. This means you can still gain weight in untreated areas, so maintaining a healthy weight after treatment is very important if you want to ensure long-lasting results. In addition, with a significant weight gain (over 10-20 lbs), the existing fat cells in the treated areas can become larger, reversing some of the benefits.

In addition, here are the most common questions about liposuction:

What does liposuction entail?

Liposuction is an invasive procedure that involves a series of small incisions less than one centimeter long. Most commonly, it is done using tumescent technique that reduces bruising and blood loss. First, a diluted fluid of numbing medicine (local anesthetic) and epinephrine (capillary constrictor) is injected into the area being treated. Thin metal tubes called cannulas are then inserted into the body through tiny incisions in the skin. The surgeon attaches the cannula to suction and remove the unwanted fat.

Is it right for me?

As discussed earlier, an ideal candidate is a healthy individual close to their ideal body weight who has stubborn pockets of fat that have not responded to diet and exercise. Although liposuction can improve body contour at any weight, those with a body mass index (BMI) over 30 are typically not good candidates for the treatment.

Another important thing to consider is your skin’s elasticity. In general, young patients, who are non-smokers with minimal sun damage, have the best elasticity. With aging, our skin loses its ability to bounce back after being stretched, so older patients or those removing a large amount of fat could be left with sagging skin following the procedure

What is the recovery like?

Unless it’s a very high volume liposuction, you should be able to go home the same day after liposuction. Pain and discomfort depends on the amount of liposuction performed. Usually, the significant pain lasts for the first 2-3 days, and mild pain may persist for several weeks. Patients may also experience tingling and numbness in the areas treated for a few weeks. Most doctors recommend taking at a week off from work and your regular routine. (Those who undergo a small amount of liposuction may only need a few days.) To prevent blood clots and discourage swelling, light walking is usually recommended starting the day of surgery. Heavy exercise and other strenuous activities should be avoided for two to three weeks.

You’ll likely see some results immediately after surgery, but swelling and bruising are normal and take weeks to resolve. Some residual swelling can persist for several months. It’s also common to have some weight gain due to swelling and the tumescent fluid that was injected. This resolves over time. Most people see final results six months after surgery, but you may continue to see improvements for up to a year.

The use of a compression garment is often recommended for anywhere from three to six weeks. These garments are beneficial for decreasing the amount of bruising and swelling, and helping loose skin to retract. The final result is achieved sooner with the use of these garments.

You will have a few small (less than a centimeter) incisions.  Just like any other scar, they will mature over the first year.  The scar can feel firm initially, but as it matures, it becomes soft, pale, flat, and less noticeable. Some people are prone to hypertrophic scars or keloids, which are abnormal scars that become prominent. If you or a family member has a tendency for these types of scars, please bring up this information at the time of your consultation.

What are the risks and trade-offs for liposuction?

Complications are infrequent with surgery performed by qualified surgeons for the right candidates. However, there are risks with any surgery. Bumpiness of the skin and contour irregularity can happen, especially after large volume liposuction. In addition, medical complications, such as blood clots to legs and lungs can occur, especially after prolonged surgery. Individuals with dark skin tone are also prone to dark pigmentation of the skin after liposuction.

If you are thinking about liposuction, or to schedule your consultation with Dr. Fichadia, contact our office today.


Taking Care of Breast Implants

Bra-fitting and Breast Massage after Augmentation

Let’s address some of the most frequently asked questions after initial recovery from breast augmentation.


The timing of when to start wearing a bra following breast surgery varies with different surgeries and individual patients. Dr. Fichadia or one of her staff will advise patients when to start wearing a bra. Some patients will be advised to start wearing a bra soon after surgery and others may be advised to wait a while for breast shaping to occur.

What to wear until you are ready for a bra:

A surgical bra or ACE wrap is used after surgery, but a tank top with adjustable straps and band bra can be used until you are ready to go bra shopping.


Some department stores have “certified” bra fitters who can help you find a correct fit. Once a person has been “fitted” properly, shopping in any lingerie or department store is much easier. Bra manufacturer’s size and shape can vary – if you find a style that fits well, buy several, as bra styles often change. Please remember that there is no standard for bra cup sizing and there is great variability within styles of bras, even by the same manufacturer.

Bra style

Underwire bras give the best support; this is due to the wire and bra cup construction. To begin with, a seamless, molded cup style works best. Look for bras that are seamless, have some slight padding, with molded feel. When breasts are still swollen after surgery, seams can indent skin. You may use a soft cup bra until comfortable with an underwire. Avoid “Miracle Bras”, “Wonder Bras” and “Push up bras” as they can displace implants to an abnormal position.

Breast Massage

Following breast surgery, and specifically breast augmentation with smooth-shell breast implants, it is important to maintain the soft feeling of your breasts. Implants are a foreign substance. Your body will naturally respond to an implant by creating scar tissue or a capsule. This capsule can become excessive; the results may include:

  • Reduced size of the implant pocket
  • Restricted movement of the implant within the implant pocket
  • An unnaturally firm feeling to the breasts
  • A misshapen appearance to the breasts

Regular breast massage in the first six months following surgery can reduce the potential for these conditions by manipulating your implants so that they can move freely within the implant pocket. Breast massage can also retain the contour and symmetry of your breasts, or to help gain breast symmetry where one implant may be slightly higher than the other.

Begin the exercises one week after breast surgery, when it becomes tolerable to do so. Perform the entire set of exercises at least two times each day for the first three months following surgery. While this may be uncomfortable when you first begin to perform the exercises, it is very important that you begin these exercises early.

After three months, if your breasts feel soft and implants are moving freely, you may perform your exercises one time per day.

After six months and every day the first year, if your breasts feel soft and implants are moving freely, you may perform your exercises once per day or every other day. Should you experience any sharp pain, severe tightening or hardness at any time with your breast implants, please consult our office as soon as possible.

Please note: In some cases, and with anatomical/teardrop shaped implants we do not recommend implant massage. If you have any questions, please ask us, and we will guide you through the exercises.