Monday, June 13, 2016

How do you decide what size to be after breast reduction surgery? Does the doctor choose or does the patient get to decide? Dr. Suzman Answers a Common Plastic Surgery Question

Women who choose to have breast reduction surgery are typically extremely happy with the results.  Most patients feel that they are much more comfortable, fit in clothes better, and can exercise much more easily.   For all these reasons, patient often see tremendous gains in self esteem, fitness,  health, and appearance.

  Choosing a size after surgery depends on each patient's goals, desires, 
starting size and shape. 

For example, a young, fit  woman who is an active athlete who is a D cup starting out, may wish to be a small B cup afterwards.  And this may suit her frame and sports endeavors.  This breast size after surgery may be inappropriate, indeed impossible, for a patient with a much larger size and significant skin droop. For many patients who are exceptionally large, anything smaller than what they have is an improvement, even if that means ending up a D or DD cup size.

It is difficult to predict cup sizes after surgery for a number of reasons.  Bra cup sizes are not standardized between manufacturers, so a C cup in one company may be a D in another.  So instead of focusing on cup sizes, most plastic surgeons consider skin measurements in centimeters as a better way to size patients. We measure from the base of the neck (what we call the "sternal notch" to the nipple distance).  We then measure from the nipple to the bottom of the breast- the "infra mammary fold".  Now we have real numbers to compare among patients.  

Regardless of a patient's height or weight, we find that as long as the nipple height is near the height of the  infra mammary fold, and the distance  from the nipple to the fold is not more than 10-12cm, then patients are pretty comfortable with their breast size.  With these measurements, a woman's bra straps do not have to work very hard to keep the breast in a centered position.  We would rarely see such measurements in patients seeking reduction surgery unless they were in the active athlete category and wanted the benefit of a smaller size so they could more easily takes part in their profession or hobby, such as tennis, gymnastics, golf, or running.  ( The "sports reduction", as I call it, is a fantastic procedure in the right patient).

So if, for example, a patient comes in to the office with a starting breast measurement of 35 cm nipple to neck, and 15 cm to the fold under the breast (very common starting size),
Dr. Suzman Breast Reduction Patient with 35 cm nipple to sternal notch distance and 15 cm to inframammary crease(left)  and result after reduction surgery 24 cm/8cm)
then we can be VERY sure that our final result will be MUCH more comfortable.  If we raise the nipple height to the level,of the fold under the breast 24 cm is likely in this patient) and define a distance from the nipple to the fold of 8 cm, then in most cases this patient will be a small D cup after surgery.  For a very wide and heavier patient, the bra size may still be a DD, though a more slender patient may end up with a C cup with these same measurements.  but most all patients will end up very happy!  

On, an online website devoted to patients interested in sometime surgery procedures, over 98% of patients day going through breast reduction surgery thought it was worth it.  This is a very high number for a surgical procedure!

For patients who want to be smaller--  some just have suffered too long with very large breasts and want to be as small as possible--  more tissue can be removed to make a smaller size.  In a larger , heavier patient, this means that the breast will be quite flat and not at all "perky".  Though this is not typically a concern of such patients who just want comfort.  For smaller and more petite patients who want a very small breast size, this can also be accomplished with breast reduction surgery, though they do run a increased risk of numbness or inability to breast feed after surgery.  Each patient must balance these pluses and minuses of surgery to make the best  decision for themselves.

Dr Suzman Sports Breast Reduction from D cup to B cup bra size
At our WESTMED plastic surgery practice,  I personally perform about 2 breast reductions a week, so it is a very common surgery.  If you want to learn more about breast reduction or our "sports reduction", come and meet us in person in our Westchester office (Only 30 minutes from Manhattan NYC) or our Greenwich CT office.  

Dr. Michael Suzman is one of the country''s busiest plastic surgeons who has been honored to have patient satisfaction rates in the top 1% of doctors in the country according to the Press Gainey Survey.  
New York Magazine, U.S. News and WORLD report and Westchester magazine have all listed him of a top doctor for Plastic Surgery.  

Breast reduction surgery involves many choices. The first and most important is selecting a member of the American Society of Plastic Surgeons (ASPS) surgeon you can trust.
Do not be confused by other official sounding boards and certifications.
The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with “cosmetic surgery” in its name.
By choosing a member of the American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.

Monday, May 30, 2016

Dr. Michael Suzman’s Advice for Finding the Best Physician or Surgeon

What makes a great doctor?  How useful are online reviews and “Best Doctor” lists?  Dr. Michael Suzman’s Tips for finding the best physician or surgeon.

When the I was honored this month by being included on the “Top Doctors” list in New York Magazine and Westchester Magazine,  I was particularly proud because we were one of the only practices featured outside of New York City.  After 13 years in practice in Westchester County and Greenwich, it was very nice for me and our entire staff to be recognized.  We have truly dedicated all our efforts to make each patient interaction one of caring and excellence.

But does making a list or having a strong online presence on Google searches guarantee a great doctor for you?  The answer is maybe.  Online advertising dollars and strong efforts to getting happy patients to vote go a long way to making a polished images. Often the first doctors to come up on  web searches seem to have the highest advertising budgets, and are not necessarily the doctors who have published or innovated in their fields.  For this reason, a strong recommendation from you primary care physician or other doctor is also very helpful. Of course, some doctors on the first page of Google searched might be ideal for you. Balancing reviews with physician and friend recommendations is very important.   In fact, the Castle Connolly Guide to top doctors, is based on physician voting of their peers. The only way to get listed is to take care of hundreds if not thousands of patients referred from many different doctors, and provide great outcomes.  

From a doctor’s perspective, many of us were taught in our training, with a bit of humor, that the a good doctor must have the “ three A’s”:  Availability, Affability and Ability-- in that order!  There is a lot of wisdom in this saying.  Many of us grow up thinking that the very best best doctor has a brilliant mind with superior diagnostic skills or surgical wizardry-- so we can forgive an arrogant manner, gruff attitude, or impossibility of actually reaching them when you need to.  All things being equal, if you find a brilliant doctor who is kind and caring and makes time for you as well-- isn’t that truly the “BEST DOCTOR” ?

You can rely on online reviews if you keep an open mind  (a few negatives is not a bad thing-  when it comes to treating human health, there are always some less-than-ideal outcomes).  You can trust reputable best doctors lists, if you know that some great doctors are not on the list , and some on the list might not be the best fit for you and your specific problem.  Balance the online information with your doctor's recommendation (nurses' recommendations are vital too!).  Ask you friends and colleagues who they might have used and how their experience was. Now take all this information, and make an appointment or two.  At this point you should be meeting with a highly trained and regarded doctor, so now it's all about your feelings and instincts.  Ask yourself how comfortable you are with their style, communication, office staff and general office environment.  

In our current healthcare system, we should add an additional “A” to the three A’s of Availability, Affability, and Ability.  And that is A for AFFORDABILITY.  Healthcare is expensive.  Amazing technological advances require high tech machinery, software, expert staff and facilities.  These modern essentials allow a physician to keep you healthy and extend life meaningfully, but with significant financial investment (and because of our very litigious environment,  costly liability insurance).  Because healthcare is expensive, it is essential for each patient to understand their health insurance benefits, and this is not always easy.  The most affordable options will be seeing doctors who participate with your plan (in-network). They are paid more affordable rates by your insurance. There can be OUTSTANDING physicians who are in your network.  In many cases they work for larger medical groups or hospital centers or medical schools.  There are some practices that take the lower reimbursements of insurance networks, and run overly busy practices to make up for the revenue shortfalls.  Finding a practice that strikes the balance between really busy and personal attention is ideal.  

Hopefully you now have the keys to finding a doctor you are very comfortable with-- and  we wish you best of health!

Michael Suzman, MD is a  NY plastic surgeon with WESTMED Medical Group, a leading multi-specialty group in Westchester County, just north of Manhattan, He specializes in Plastic and Reconstructive surgery, including skin and breast cancer care, facial, breast and body surgery.

Sunday, February 7, 2016

Dr. Suzman Plastic Surgeon Q&A: What does a facelift really do?

My @Quora answer to What does a face lift really do?

  • A facelift is a broad, somewhat old fashioned term , which describes plastic surgery techniques used to correct significant signs if facial aging
  • The best candidates for surgery are typically aged 50-70, sometimes younger or older, and have some noticeable loose skin and loss of facial fat volume
  • The technique requires hiding the incisions around the ears, and often under the chin.  Using anesthesia, the skin is carefully separated from the underlying fat/muscle/soft tissue layer.  The loose deeper tissues (the SMAS layer- supra muscular aponeurotic system, for those who want to know the surgeon's terms). This deeper tissue plane is tightened and elevated using sutures, resulting in a restored neck and jawline contour.  Excess skin is the trimmed to reduce looseness and large wrinkles

  • Additional maneuvers such as fat grafting to the cheek region, skin resurfacing with chemical peels or laser, botox, and eyelid surgery are typically done at the same time
  • Patients are still swollen or bruised for 7-10 days, then start to look and feel better.  In three weeks, moat can be out in public without anyone noticing they had surgery, though final softening if the skin and scar fading take months.
  • Results last for years, though aging continues, so some ongoing skin care or office treatments are required. 
  • Risks are more common with less experienced doctors or those with less than 5-6 years of plastic surgery residency training.  Nerve or muscle injury, bleeding, bad scaring or poor aesthetic results are most common risks, though should be relatively unlikely with a skilled plastic surgeon.  Not meeting a patient's expectations of a result can be common, and consulting with a great doctor who can honestly discuss what to expect is key
  • A facelift is not for everyone, but in the right patient, results are great and patients are delighted.  And NO ONE should notice that they had surgery! Just that they look great.

Sunday, January 31, 2016

Most Recent Reviews of Dr. Michael Suzman, Plastic Surgeon, on

Here are what some of our recent patients are saying 
about their experiences at WESTMED Plastic Surgery
 with Dr. Michael Suzman:

RHINOPLASTY"I struggled with confidence through out my life being so self conscious about my nose. From as earliest as I can remember, I always said how I wanted to correct the appearance of my nose through plastic surgery. Like many of you reading this post, I would constantly find myself researching into rhinoplasty. One day I spontaneously decided to take action and have a consultation with a doctor. I met with a few doctors before meeting with Dr. Suzman. It was his professionalism and adequate that stood out to me. Dr Suzman's PA, Heather, was also so caring and intelligent! Dr. Suzman is truly amazing at what he does. You can tell how passionate he is about his profession from just meeting him. I am so happy I chose him as my doctor, because I am now in love with my perfect nose that he created! My recovery period went so smoothly as well, which just further proves how great of a surgeon Dr. Suzman is. Due to emergency circumstances, I was out in public two days after my surgery, and felt great! By the time I took my cast off I had little to no bruising and minimal swelling on my actual nose. I was expecting MUCH worse. I still can't believe I actually went through with this surgery. It was worth EVERY penny!!! I would recommend Dr Suzman to anyone and everyone!:

I had my procedudure performed by Dr Suzman . It was following an injury which effected the bridge of my nose , my septum and turbinates . I was having terrible headaches previous to having the surgery as a result of the injury . I had relief instantly from the headaches from the same day after the surgery . As a Muslim woman , I felt very comfortable with the respect and expertise of Dr Suzman and his team . Their follow up care was outstanding , friendly and professional with any questions that I had . Already , I am very pleased with the aesthetic outcome as my nose now looks refined , natural and feminine . Dr Suzman is not only an outstanding surgeon with a high standard of curtosy and professionalism , but I swear he is like a fine and detailed sculptor with a true passion for what he does . He is EXCELLENT . Thank you so much , Dr Suzman , Heather , Kate and all of the team who assisted me :)

Dr. Michael Suzman and Staff are amazing!!! I am so happy with his work, I can't even believe what they look like now. My breast were huge and hung down so low and were so painful. Now, they look young and perky but the best part is that I have no more back and neck pain. I can't give him enough stars. From the bottom of my heart, I am so thankful!

BLEPHAROPLASTY This is my fifth day after blepharoplasty surgery and already I am very pleased with the results . I just have mild swelling that most likely wouldn't be noticeable to anyone and bruising is just a little yellow under my eyes now . My results are excellent and there is no visible scarring . For anyone considering this surgery , it is a very easy surgery and the recovery is painless . I was a little swollen on the first and second day after surgery and felt somewhat disteessed , but Dr Suzman reassured me that it would only get better and he was 100% right . TRUST HIM in his knowledge , experience and his advise as he is truly an excellent Dr . I had another procedure with Dr Suzman for septorhinoplasty only 8 weeks ago to correct an injury and by ONLY 3 weeks after the surgery , aesthetically it had totally healed and looked very natural . It was also a painless recovery . I didnt need any pain medication when I came home for either procedure . Really , he is an EXCELLENT surgeon with a gentle and polite manner .

He is the best!!! He made me feel so comfortable and safe. The surgery was simple, quick and flawless. I had no fears. Naturally im in pain now, 4 hours after the surgery. But that is very normal. I have pain meds too. 

I would recommend Dr. Suzman to anyone!!! If you've been thinking about it for a long time- take the plunge. I finally did and I know I made the right choice. 

FACELIFT NECK LIFT  Dr. Suzman performed my surgical lower third lift and I loved it. However, I wasn't quite prepared for the after effects when the swelling fully decreased. Coupled with a lid lift, my face looked incomplete in mid-face sagging due to loss of volume at my cheeks. Dr. Suzman had administered Juverderm to my upper lip line in a way that restored volume without giving me giant bee-stung lips. I trusted him with injectables, so I sought out Juvederm Voluma for my mid-face. I can't rave about the results enough. Dr. Suzman is a magician with injectables. You may find yourself growing a little impatient with his conservative approach at first (as I did). Trust him. He knows what he's doing. When the full effect of the injectables comes in, you will not be disappointed in the least.

RHINOPLASTY SEPTOPLASTY I was 20 when I had surgery with Dr. Suzman. I was not happy with my appearance and had trouble breathing. Dr. Suzman was the first doctor that I saw and I immediately chose him because he made me feel comfortable as well as his PA, Heather. The surgery center was clean, and the nurses were by my side post surgery ensuring that I was comfortable. I could not be happier with the outcome of my rhinoplasty and septoplasty and I would suggest Dr. Suzman to anyone!

FACELIFT FAT, GRAFTING, TCA PEELI was tired of looking so tired. I wanted a more youthful appearance to match the energy I felt inside. The facial rejuvenation did just the trick. I feel as if I look ten years younger. The chin implant was a procedure I'd wanted done for a very long time, but was apprehensive. Dr. Suzman put my mind at ease by answering all of my questions clearly and even providing very specific statistics to allow me to assess my own level of risk. My look change has been striking, yet subtle.

Breast Lift with Implants  From my first appointment, the team working with Dr. Suzman made me feel comfortable and at ease. Dr. Suzman answered all of my questions honestly and it was clear that he genuinely cares about his patients and their results. I never had a moment of doubt through the entire process. I am so pleased with my results and I can't believe I waited so long to do this. A great, supportive and professional team! 

Breast Reduction  One of the best procedures. Dr Suzman created wonderful results. He reduced me to a D cup. This was determined based on my body type. The procedure was relatively quick and there was not much pain. He was able to perform this surgery using less incisions than expected, what scarring I do have is minimal.

Michael Suzman MD is a plastic surgeon with offices in Greenwich CT and Westchester County NY.  He is certified by the American Board of Plastic Surgeons and a member of the American Society of Plastic Surgeons. He performs both cosmetic and reconstructive surgery of the face, breast and body, including breast and skin cancer reconstruction.  Some of the best known plastic surgery procedures her performs are rhinoplasty, breast implants, face and neck lift and abdominoplasty.   914-848-8880
3030 Westchester Ave Purchase NY  
644 West Putnum Ave  Greenwich CT 

Thursday, January 21, 2016

Fixing Broken Noses: How to Manage Nasal Fractures and When to do Rhinoplasty Surgery

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I recently got a Sunday morning call from a neighbor who happens to be one of the country’s leading cancer surgeons.  He caught an elbow in the nose playing basketball and knew it was broken- it was severely twisted to the left.  Fortunately he did not lose consciousness, had stopped bleeding and was able to breathe through the nose.   In his kitchen, I was able to put the broken bone back in place with the back of a fork handle-- not a move for the faint of heart!.  He ended up doing great, but not everyone has plastic surgeon living down the street.  What should you do when you, a friend or family member, or patient if you are a doctor, do about a significant nose injury?

The good news is that  most nasal injuries do not require surgery and get better with a little ice and time.  Even most fractures of the nasal bones are not very deforming and do not need surgical correction. The fractures are more like a crack in a china plate, causing swelling and bruising, but not otherwise deforming.  The upper 1/3 of the nose is made of bone, and that is where broken noses occur. The middle third of the nose is made of bendable cartilage (the septum).  It can bend or shift to the side but is less  likely to actually break.  In the case of a shifted or deviated septum,  it is best to wait a few weeks to see if there is lasting airway blockage or curvature, and it can be corrected with surgery, if needed.   The only time to rush to the operating room for a fracture is a severely broken nasal bone or septum with active bleeding or major, obvious deformity.  It is tough to properly align the nasal bones and shape when the soft tissues overlying the nose are very bruised and swollen, so I tell patients another procedure may be needed down road.

When I am asked to treat a nasal fracture, it's important to start by evaluating the whole patient, and not just the nose.  Anyone who a has learned basic CPR knows about the ABC’s-- airway, breathing, circulation. These are the first key things to consider in keeping a patient alive in severe illness or injury.  In the case of nasal injuries, the airway can be kept open by stopping nasal  bleeding with packing in the nose.  The treating doctor should briefly survey the patient for more extensive injuries that could result in continued bleeding or inability to breathe.  A severely deformed and bleeding nose is alarming to patients and medical staff alike, but one should not get distracted from a complete exam. It would be dangerous to overlook other injuries that are not so obvious-- punctured lungs, ruptured spleens, skull fractures, bleeding in the brain, or stress on the heart can be excluded with a proper history, physical exam and simple testing. If there is any thought of other associated injuries, CT scans and other studies can lead to a diagnosis.

When the patient's history and physical DO NOT point to other injuries, such as a direct elbow to the nose in an otherwise stable and healthy patient, then extra testing such as x-rays and CT scans are not needed. They are often done as a matter of routine in Emergency Departments, but are often not necessary and just run up expenses and expose patients to radiation.  Fear of lawsuits and the rare miss certainly contribute to over testing in these cases.  The diagnosis of a clinically relevant nasal fracture can be done with physical examination alone.  And if a doctor is not sure (and sometimes I am not certain about a fracture), it is never wrong to wait 4-5 week for swelling to resolve and re-evaluate the nose for problems and fix it then.

Only a small percentage of patients require immediate surgical treatment.  When is is obvious that a nasal bone is displaced, then it is quite simple to put it back in place , or“reduce the fracture” as doctors say, by using pressure on the nasal bone from within.  Unlike my brave friend who had this done in the kitchen, most require some form of anesthesia to tolerate this procedure. Even when the bone is successfully popped in place, over time,  some minor lasting curvatures can persist. These can be corrected in the future if a patient desires.  
Severe left deviation and indentation after injury, corrected with surgery

Nasal fracture with severe left shift of bones, corrected with surgery  (Picture on right)

While the initial correction of a nasal bone fracture is quick and relatively easy for experienced surgeon, correcting lasting curvatures and breathing blockages requires more detailed surgery. In these cases, the surgeon needs to make sure the nose is straighter from the outside and has open breathing passages. This often requirescorrection of the bone, septum, and upper lateral cartilages.  Often patients request other cosmetic changes  such as tip narrowing or support, chin augmentation with an implant.
Injury cases are more difficult than a regular rhinoplasty, and patients should expect the results to be an improvement, but never “perfect”.  None-the-less, most patients are extremely pleased after repair of a broken nose, both in appearance and improved breathing.  Ask your doctor for a referral to an American Society of Plastic Surgeons Member Surgeon if you have any concerns about your nasal shape.

Dr. Michael Suzman is one of the country’s busiest plastic surgeons, focusing of both reconstructive and cosmetic plastic surgery. He has treated thousands of patients for facial injuries, deformities and cosmetic concerns. He is based in Purchase NY and Greenwich CT and maintains a teaching position at Weill Medical College of Cornell University in New York City. He is certified by the American Board of Plastic Surgery and can be reached at 914-848-8880 or

Friday, January 15, 2016

Why We Recommend Incision Plus Lipid-Peptide Complex Scar Gel for Treatment After Surgery and Injury

Over 15 million Americans undergo some sort of a surgical procedure
  each year, and countless others suffer cuts, burns or other injuries that causeredness or scarring.

 For those seeking a scar treatment, many treatments of variable effectiveness are found on pharmacy shelves, such as Mederma, Scar Fade etc.  What these treatments have in common is silicone gel, a well-tolerated , inert clear product that insulates and protects skin. Some studies show that redness can go away faster in certain patients.In our busy practice, treating nearly 5,000 patients a year, our leading plastic surgeons started a search for the best scar cream treatment available.  We wanted all natural ingredients, one that is safe for surgery patients as well as patients with bites, burns, acne and other scars, and is safe for children.  We hired experts to search the world over for leading cosmetic products that could help out patients more than the current best selling products.

ingredient: amino-acid complex.  Amino acids are the building blocks of all proteins and are the base compound in  collagen.  Our skin (dermis) is essentially a blanket of collagen fibers, carefully arranged.  When a patient scars badly, it is usually because the collagen in the scar is created in excess amounts or is poorly organized.  The theory of providing the amino acid peptides that form collagen directly to the skin has led to the development of  the most advanced and high-end skin creams in the world.

The only problem with using some  of these creams on all scar patients in the prohibitively high cost.  Most retail  for $200 and over for small containers.  By partnering  with a high end cosmetics manufacturer in Canada, we were able to provide an amino acid peptide complex in the form of Collaxyl (TM) - a leading french skin support product.  With addition of cosmetic grade silicone (dimethicone) and an all botanical antioxidant source of vitamins A, C and E, Incision Plus was created.  All natural moisturizers allantoin and panthenol were added for the healing and protective qualities.  The result is a smooth formulation that goes on comfortably.  Out patients have largely been incredibly impressed.
3 days of Incision Plus treatment 
Burn injury to hand, bright red scar

6 months later- no scar at all!
Initial research in 200 consecutive patients shows no skin rashes or reactions from the product.  10 breast reduction patients who used the product all felt the scar massage, moisturizer and skin support effects helped.  (see the study results at

 We provide the product for sale in our offices, or at can be purchased online  (

The challenge in scar treatment is that every individual heals differently. Some will heal amazingly well with no treatment, others will heal with dark or thick scars regardless of treatment. It is everyone else in the middle who may show some variability in healing.  
  It is for this majority of patients that a topical scar gel may really help.

Sunday, December 13, 2015

WESTMED Plastic Surgery Year in Review- It's Been A Great Year. Here is a look at the numbers!

Screen Shot 2015-12-13 at 1.48.53 PM.png1  Percent -- Our patient satisfaction scores placed us in the top 1% all off doctors in the country according to the Press-Gainey survey.  We are very proud of our dedication to each and every patient-- to deliver care with the  highest caliber of kindness, technical expertise, scientific rigor, and safety.  We thank our patients for their kind reviews of Dr. Suzman on such websites as, Google, Facebook, and

2 Offices-- We opened not one but, TWO new offices this year! Dr. Suzman sees patients at the WESTMED Plastic Surgery Greenwich office a few days a month to better serve our Connecticut and eastern Westchester patients.   Our main office is at 3030 Westchester Avenue in Purchase, NY.  The brand new building has gorgeous floor to ceiling windows, making it a beautiful and calming environment.  Plastic surgeons Dr. Michael Suzman and Dr. Brenon Abernathie both see patients in Purchase.
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3 Prominent Magazines--  listed Dr. Michael Suzman, Plastic Surgeon, on their best doctors list:  New York Magazine, Westchester Magazine, and US News and World Report. In addition, Castle Connolly, the leading guide to top  doctors lists, named Dr. Suzman as a best doctor for plastic surgery. 
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4 Thousand-- Number of patient visits during 2015.  Treating everything from accidents and injuries, complex wounds, to the plastic surgery we are most known for, Dr. Suzman performed as much plastic surgery as the busiest surgeons in the world!

5 Hundred-- Number of cosmetic injectable procedures for cosmetic treatments,  including Botox, Dysport, Juvederm and Radiesse.  A safe, natural and lasting result is the hallmark of Dr. Suzman’s Injectable treatments.   “Dr. Suzman is a wizard with injectables” one reviewer wrote in an online review!”
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Call, email or visit our website for more info and come see us in Greenwich or Purchase!