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ScottSattler JoshuaCooper (Sound Plastic Surgery)
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For women and teenage girls, excessively large breasts may cause back pain, shoulder pain, and neck pain, as well as bra strap grooving and skin irritation. 
Teenage women may feel self conscious and socially inhibited by their unusually large breasts. Some women may feel the need to hide the size of their breasts and may choose clothing to hide their appearance. Some women are prevented from participating in exercise or are physically inactive due to the large size of their breasts. Breast reduction surgery may also be performed solely for cosmetic reasons for women who desire a smaller, more proportioned breast, or a breast lift.

Breast reduction can be performed at any age, but it is advisable to wait until the breasts have stopped developing. Some plastic surgeons, pediatricians and parents are hesitant when it comes to breast reductions for teens. For younger girls, one concern is the potential for regrowth.
Women who plan to have children and breast-feed should discuss this with their plastic surgeon because breast reduction surgery may impact the ability to breast feed, and changes are likely to occur to the breasts as a result of pregnancy and childbirth.

In general, breast reduction patients are among some of the happiest patients. They see the results of the procedure immediately and feel a huge weight off their shoulders, along with improved posture. Making the breasts smaller, firmer, lighter, and more evenly proportioned relieves the pain caused by large breasts.

Is This a Good Option For You?
Breast Reduction surgery may be a good option for you if:
• Your breasts are disproportionate to your body
• Your breasts are different sized
• You have back, neck and shoulder pain
• You have indentations from tight bra straps
• Your breasts limit your physical activity
• Your breasts cause self-image problems
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Don’t Neglect Your Neck!

We all know by now how important it is to take proper of the skin on our face, but what about the neck?
It may surprise you to learn that the area where signs of aging most commonly appear first is the neck. The skin on your neck can be thinner and more sensitive than the skin on your face, but just as prone to changes in pigment, elasticity, and texture―and, yes, to wrinkles.

As a result of the aging process, many people seek cosmetic surgery to effectively reduce the signs of aging on their neck and regain a more youthful appearance. With this in mind, here are some ways that you can improve the appearance of your neck:

It’s no surprise that wearing sunscreen is one of the most important and effective ways to protect your skin. A broad-spectrum sunscreen with an SPF of at least 30 should be worn every day to keep your neck looking youthful. Lotions and revitalization creams that contain alpha hydroxy acids are also effective at keeping the skin smooth and supple.

The quickest and most effective way achieve a more youthful neck is through cosmetic treatment. Neck lift surgery, along with neck liposuction, might be the procedure that’s most appropriate for you. The two surgeries are typically performed together to improve the appearance of the neck.

Botox is commonly used to ease the appearance of crows’ feet and frown lines, but can also be used on the muscles of the neck.

Call TODAY to make a complimentary consultation to discuss which options are best for YOU! 

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We will be holding a seminar on "mommy makeovers" on Tuesday, November 11th at 6:30 pm at our Sound Plastic Surgery office by University Village.  We will be discussing breast augmentations, breast lifts, tummy tucks, and liposuction.  Lots of before and after photos and plenty of time for your questions! 

Erin Keane, LME, Sound Plastic Surgery's esthetician, will be talking about skin care tips for the autumn and winter months.  Skin care samples for all!

Drinks and appetizers provided, and as always, free underground parking!

RSVP: or call (206) 729-2248
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Scott and Josh discuss surgical and post operative risk and recovery for breast augmentation patients

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Considering Breast Augmentation Surgery?  Part I

Some women think about breast enhancement with implants for months, or even years, before they finally decide to meet with a plastic surgeon to find out more information.  At first, breast augmentation surgery can seem overwhelming, or even scary, for healthy women who have never considered elective surgery before. 

Today’s post, Part I, will go over some of the basic questions that many women we meet have about their breast augmentation operation. 

Is the breast augmentation procedure safe?  
Breast augmentation surgery is indeed a very safe procedure, if performed by a board certified plastic surgeon who is experienced and performs this operation in an accredited surgical center.  Additionally, we perform all of our breast augmentations with patients asleep, using a general anesthetic or IV sedation administered by board certified anesthesiologists.  

Which type of breast implant should I use, saline or silicone, and are they safe?    
Breast implants, both saline and silicone, are safe although they do differ from one another.  

Saline implants are basically super specialized silicone bags that we fill with saline (salt water) at the time of breast augmentation and insert under the breast tissue to enlarge the breast and give the breast a nice new contour.  Saline implants are round, and come in various sizes.  If a saline implant leaks, your body will reabsorb the saline, and when you look at or feel that affected breast, you will notice that the breast will be smaller.  

Silicone implants are super specialized silicone bags that contain very viscous silicone gel.  Currently, there are both round and shaped silicone implants on the market for augmentation.   Depending on your anatomy and your desired appearance, the shaped implant might be advantageous.  (We will discuss more about this topic later! Stay tuned for “Considering Breast Augmentation Surgery? Part II”….)  If a silicone implant leaks, chances are you may not notice a difference in the affected breast because silicone is not reabsorbed by your body like saline is.  

Both saline and silicone implants are very safe, but complications can occur (We will discuss more about complications in “Considering Breast Augmentation Surgery? Part II” as well….)  The main differences between saline and silicone implants, and the reasons that the vast majority of women choose silicone are:
1. Silicone tends to feel softer and more natural than saline
2. Silicone implants are less likely to produce visible rippling/wrinkling under the skin.  
3. Shaped silicone implants may sometimes offer a benefit in some situations. 

Downsides of silicone implants:
1. They are more expensive than saline implants. 
2. If a silicone implant leaks, it may be contained within the normal scar tissue that surrounds the implant, called the “capsule.”   This is also known as a “silent rupture” because this is usually asymptomatic, and the breast continues to look the same.   With time, however, this “silent rupture” can eventually break through the scar tissue (“capsule”) surrounding the implant, and the breast tissue may become inflamed causing a palpable lump, swelling, or soreness that needs to be addressed.

Silicone implants do not cause any systemic diseases or health problems.  Interestingly, silicone implants are one of the most studied “medical devices” out there!  From 1992-2006, due to health concerns, the FDA decided that silicone implants could not be used for cosmetic breast augmentation surgery, and only patients undergoing breast reconstruction for cancer could have silicone implants placed.  

During this time, thousands of women in the U.S. who had silicone implants were studied.   Numerous advisory panels concluded that silicone implants do not cause health issues such as rheumatoid arthritis or autoimmune disorders, and they were indeed safe to use for breast augmentation.  Thus, in 2006 the FDA granted permission to bring silicone implants back on the market for cosmetic breast augmentation use.   

Stay tuned for “Considering Breast Augmentation Surgery? Part II” which will discuss the differences between shaped and round silicone implants, the intra-operative steps of the procedure, and recovery….”

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Have him in circles
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Scott Sattler MD FACS's profile photo
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This is the age of the “Selfie Generation.” Everyday, millions of people of all ages document their every move with self-portraits taken on cellphones, iPads, and other devices.  (Ever opened your front camera when you weren’t expecting it?)

Unfortunately, when those pictures are uploaded to social media, people don’t always like what they see- jowls, or maybe a double chin?

If you are one of the many people affected by the dreaded jowls or double chin, chances are you are not happy with your profile. Liposuction has traditionally been recommended for shrinking a double chin, but another option known as Kybella, is now available. 

How can you tell whether you will get better results with Kybella vs liposuction, and which is better for you? 

Neck Liposuction vs Kybella 

In office neck liposuction has minimal downtime and maximal results. During neck liposuction, excess fat under the chin and neck is removed. Neck liposuction will sculpt and contour the neck area. 

Liposuction in this area produces consistently good results, and has a particularly high satisfaction rate

Kybella is an injectable treatment that has been clinically proven to effectively treat localized deposits of fat under the chin. It is a synthetic form of deoxycholic acid and dissolves under-chin fat.

Kybella is a non invasive fat reduction procedure which requires multiple, up to 6 series, of injections each done under local anesthesia. Kybella destroys the fat but it can also destroy nerves, muscles etc. The results are not immediate and you have to wait months to see the potential results. 

Lastly, the cost of Kybella will be similar to in-office liposuction of the same area.

Call us today for a complimentary consultation!

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Dr. Scott Sattler is listed as a 'Top Doctor' in the August 2015 Seattle Met magazine survey of physicians. This annual survey queries Seattle area physicians who they would send a friend or relative to if that individual needed care from a Plastic Surgeon, in the case of Dr. Sattler.

Both surgeons at Sound Plastic Surgery in Seattle have been recognized by Seattle Met magazine as Top Doctor physicians in past years.

Here is a link to Dr. Sattler's 2015 Seattle Met Top Doctor listing
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Intra-Operative Steps of Breast Augmentation

We perform our breast augmentation procedures with an anesthesiologist who provides a general anesthetic to our patients.  Prior to our patients falling asleep, they receive intravenous antibiotics to help prevent an infection.  

After local anesthetic is given to help with post-operative pain, an incision is made, most commonly in the crease under the breast called the infra-mammary fold.  Next, a pocket is made to accommodate the implant.  Most commonly, the implant is placed in the dual plane position.  This means that a portion of the pectoralis major muscle is divided where it inserts onto the chest wall.  Dual plane refers to the fact that most of the implant will be covered by the muscle to help give a more natural look to the breast, and the inferior and lateral most part of the implant will be covered by breast tissue only.  

We take special care, and use specialized instrumentation, to create a pocket that involves hardly any bleeding.  After the pocket has been created, it is washed with a triple antibiotic solution, and the implant is then placed.  Special sutures are placed to help prevent the implant from migrating too far downward, and then the incision is closed.

Sometimes the crease below the breast, the infra-mammary fold, needs to be lowered to accommodate the appropriate sized implant.   If this is not performed the implant will not end up in the appropriate position, centered behind the nipple and areola.  If the crease is surgically lowered, it will be reinforced with internal sutures as well. 

When using shaped implants, a small drain is usually left in place as well to prevent fluid build up and rotation of the implant.  This is removed a week later, and is painless when removed.  

All absorbable sutures are used (no sutures need to be removed after your operation), and steri-strips (specialized band-aids) are placed over the incision, as well as a gauze dressing and surgical support bra and “pec strap.” 

Post-Op Care
We ask our patients to wear their surgical support bra day and night, and they may shower the next day.  Often times we also have patients where a “pec strap” which goes around the chest and helps keep the implants in the correct position. 

There are no special exercises that we recommend. 

We do ask our patients to take it easy for a few days, avoiding any really strenuous lifting or activities as this may prolong swelling and cause pain. 

We see our patients back one week later, but we are always happy to see our patients back any time before that if desired, and of course we are always available by cell phone after hours. 

What to Expect Right After the Breast Augmentation Operation

Pain is usually not as severe as a lot of women expect, and most patients will take prescribed narcotic medication for a few days as well as Ibuprofen.  Most of our patients return to work a few days later.  If your job entails a lot of heavy lifting, you may wish to wait longer before returning to your full duties.   

Nausea from the general anesthetic or pain medication can occasionally occur, but our anesthesiologists will provide you with medication to prevent this. 

Nipple sensation may be altered right after the operation, with some women having numbness for a few days, and others having nipples that are very sensitive.  Within a few days to a week, this usually resolves. 

What About the Size of My new Breasts?
It is not uncommon for patients to question the size of their new breasts!  Some women may feel that their implants are too big, and others may feel that they are not big enough.  There are a few causes for patients to be anxious about the size of their new breasts during the first few weeks after breast augmentation.  

Sometimes this is related to swelling or the position of the implants.  With time swelling fades away, and the implants do also settle a bit meaning that almost always the shape improves over the first few months.   Additionally, the pectoralis muscle that covers most of the implant may be in spasm causing the implants to ride a little higher than they will once everything relaxes. 

Lastly, some women, who have had small breasts their whole lives, and suddenly have much larger breasts, go through a period of adjustment.  This isn’t really that surprising because your new breast shape and size can really have a big impact on your body image.  It can take a little while for your mind, which is perceiving the new implants as something large and foreign in your chest, to accept them as your own. 

We ask you to remain patient and wait several months for everything to heal, the implants to settle, swelling to resolve, and your mind and body to work again in tandem before worrying about your size!  In almost all cases, women are extremely happy with the choice they made several months after the breast augmentation operation.  
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The 'ideal' female form changes periodically - if you have been paying attention to the media, you've noticed the buttocks has taken a more 'prominent' role in shaping the ideal female form. 
Brazilian Butt Lift by Sound Plastic Surgery in Seattle
The posterior view of the female form is composed of the waist area, which extends from the lower rib level to the crest of the pelvis. From there, the hips begin and end at the outside of the thigh.
This cascade of anatomic zones frames the buttocks.
By liposuctioning the waist, hips and lateral thighs, we can create the illusion of a more prominent buttock - this is the 'subtraction' principle.
We can then take the large volume of fat obtained from liposuction and process it to remove all fibrous, oil and other liquid components.
With fat grafting techniques, we can enhance the prominence, shape and volume of the buttock to create a 'Brazilian Butt Lift'
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The team at Sound Plastic Surgery in Seattle - from left to right - Julie, Lindsey, Erin, Dr. Cooper and Dr. Sattler
Our experienced team is ready to see you for cosmetic surgery, skin care and cosmetic facial injections.
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Great beer selection !
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