Eye bags vs. Festoons

Do you have some swelling around your eyes and wondering what it could be from and how to get rid of them? Well first step is to understand if you have eyebags or festoons. A plastic surgeon would be the best person to accurately diagnose which one you have.

Eyebags are swelling and puffiness right under the water lines. Festoons are swelling and puffiness under the eyelids and the cheek area. Doctors are finding that the reasons for eyebags are mostly due to aging. Fats under the eyes become bulging, ligaments and muscles support these fats are loosening. Surgery will help to remove, rearrange fat, tighten muscle and ligaments and remove excess skin. All swelling and puffiness under the eyelids in the cheek area are termed malar bags.

Some patients have systemic disease like lupus, thyroid, etc…that cause retained water and swelling in the under eyes and cheeks. This is called malar edema. These patients can be best treated with diuretics and addressing their underlying diseases.

Some patients are born with festoons where they have extra fat under the eyes muscles that retain fluid, laxity of muscle around the eyes and very prominent ligaments or attachment of muscles and fats to the bone. These cases are called congenital festoons or malar mounds. These cases are treated with surgery (remove excess fat, skin, tighten muscle, remove ligaments).

Lastly but also the most common is acquired festoons or puffiness in the cheeks due to aging, filler injections, etc. These patients need surgery as mentioned above in congenital festoons. Not all festoons are created equal. Patients with this problem need to find a specialist to be accurately diagnosed and treated accordingly. There is no one solution to all malar bags.

The plastic surgeons at Napa Solano Plastic Surgery are available to set up a consultation if you are looking to talk about your options for the different facial procedures they offer.

Check out our Facial Procedures and Request Your Consultation

New recommendation for implant screening imaging

Breast implants are medical devices placed under breast tissue or muscle to increase breast size or to replace breast tissue that have been removed from cancer. There are two types of implants approved for used in the U.S.: saline and silicone. Both shells are made up of silicone and can be smooth or textured. Because of the recent link between breast implant-associated anaplastic large cell lymphoma (BIA- ALCL) and textured implants, the FDA has recommended against the use of textured implants.

BIA-ALCL presents as swelling and accumulation of fluids after many years of implant placement. It is associated with textured implants with extremely rare incidence 1 out of 30, 000 patients. It is a type of non-Hodgkin lymphoma but is more local and can be treated successfully with removal of breast implants and scar tissue around it. No chemoradiation is needed. 

Breast Implant Illnesses is described as fatigue, memory loss, rash, “brain fog,” and joint pain by some patients with implants. The exact relationship is unclear at this time.

Patient who are considering having breast implants should be aware of these rare potential risks associated with implants. To ensure that patients have all necessary information to make an informed decision about having implants, plastic surgeons should provide patients with a boxed warning, a patient decision checklist, and a patient information booklet/brochure specific to the breast implant prior to implantation. For those patients who decide to have breast implants, a patient device card should also be provided to patients after surgery. 

Patients should have their first ultrasound or MRI at 5-6 years after initial implant surgery and then every 2-3 years thereafter. If patients have symptoms at any time or uncertain ultrasound results for breast implant rupture, an MRI is recommended.

Boxed warning includes

  • Breast implants are not considered lifetime devices
  • The chance of developing complications increases over time
  • Some complications will require more surgery
  • Breast implants have been associated with the development of a cancer of the immune system called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
  • BIA-ALCL occurs more commonly in patients with textured breast implants than smooth implants, and deaths have occurred from BIA-ALCL
  • Breast implants have been associated with systemic symptoms

Patient Decision Checklist 

  • Situations in which the device should not be used or implanted
  • Considerations for a successful breast implant candidate
  • Risks of undergoing breast implant surgery
  • Importance of appropriate physician education, training and experience
  • Risk of BIA-ALCL
  • Risk of systemic symptoms
  • Discussion of options other than breast implants, as appropriate

1 For more information, see https://www.fda.gov/medical-devices/implants-and-prosthetics/breast-implants.
2 For more information and meeting materials, see https://www.fda.gov/advisory-committees/advisory-committee- calendar/march-25-26-2019-general-and-plastic-surgery-devices-panel-medical-devices-advisory-committee.
3 Ibid.

Considering breast implants? Reach out to the doctors at Napa Solano Plastic Surgery and schedule your consult to discuss your options today.

Breast Implant Illnesses, What does the evidence show?

Breast implant illness (BII) is a collection of symptoms reported by some patients which they attribute to breast implants. These symptoms may include joint and muscle pain or weakness, memory and concentration problems, chronic pain, depression, fatigue, chronic flu-like symptoms, migraines or rashes and skin problems.

No causal link between BII and breast implants has been identified. Some potential etiologies that have been hypothesized to be associated with BII include heavy metals, microbes, microbial toxins, cytokines, alternate causation (vitamin D deficiency, thy­roid issues, heavy metals from previous tattoos or diet, and preexisting anxiety or depression or connective tissue disease). Although women who develop these symptoms can’t be certain that their symptoms were caused by breast implants, several studies indicate that some women see most of their symptoms improve partially or completely after having their implants and capsules (scars around implants) removed.

Studies look at patient reported symptoms and biospecimens did not find a link between BII and implants. Specifically, a recent series study compares breast implant women with symptoms to those with implants and no symptoms and women who have no implants but undergo breast lift showed that

  • Patients who self-report BII show improvement in symptoms after removal regardless of the type of capsulectomy (scar surrounds implants) performed.
  • There is not a significant risk of heavy metal exposure from breast implants, either saline or silicone.
  1. American Society of Plastic Surgeons. https://www.plasticsurgery.org/patient-safety/breast-implant-safety
  2. Glicksman C, McGuire P, Kadin M, et al. Part 1: Impact of capsulectomy type on post-explantation systemic symptom improvement: Findings from the ASERF systemic symptoms in women-biospecimen analysis study. Aesth Surg J.2021 Dec. DOI.org/10.1093/asj/sjab417
  3. Wixtrom R, Glicksman C, Kadin M, Lawrence M, Haws M, Ferenz S, Sung J, McGuire P. Heavy Metals in Breast Implant Capsules and Breast Tissue: Findings from the Systemic Symptoms in Women-Biospecimen Analysis Study: Part 2. Aesthet Surg J. 2022 Apr 26:sjac106. doi: 10.1093/asj/sjac106. Epub ahead of print. PMID: 35474526.


Patients with these symptoms are recommended to discuss with their surgeons about a full work up and the need for implant removal.

If you have any questions, the doctors at Napa Solano Plastic Surgery are happy to set up a consult with you to discuss your options, concerns and questions.

Meet Our New Doctor Coming Soon: Dr Tran

Electing to undergo plastic surgery is a highly personal journey. Whether you’re interested in breast augmentation or another body procedure, you deserve to work with a surgeon who shares your passion for looking as good as you feel.

Dr. Bao Tran of Napa Solano Plastic Surgery is a skilled plastic surgeon with training from experts in the field. Her compassion and care for her patients provide a warm and caring environment that focuses on your comfort, privacy, and satisfaction. Like all of our surgeons, Dr. Tran wants you to feel secure with whatever procedure you choose. As a Bay Area native, Dr. Tran is excited to return home for this next chapter in her life, and we’re thrilled she has chosen to join the team at Napa Solano!

Meet Dr. Bao Tran

Dr. Tran graduated with honors from UCLA, where she double majored in Physiological Science and Anthropology and received her M.D. degree from UCLA’s David Geffen School of Medicine in 2014. An Integrated Plastic Surgery Residency at Rutgers New Jersey Medical School followed her surgical internship at New York-Presbyterian.

Dr. Tran was also an NIH research fellow at the prestigious Harvard Beth Israel Deaconess Medical Center, where she conducted projects in Breast Reconstruction and Lymphedema under the mentorship of Drs. Dhruv Singhal and Bernie Lee. She contributed to the development of the Boston Lymphatic Center, which is now designated a Comprehensive Center of Excellence in lymphatic care.

Dr. Tran was mentored by world-renown expert Dr. Mokhtar Asaadi during her training. Her deep interest in aesthetic surgery, particularly facial aesthetics, led Dr. Tran to seek out further training and mentorship from field experts, including Dr. Tim Marten in San Francisco, CA, and Dr. Bahman Guyuron in Cleveland, OH.

A Passion for Innovation

Dr. Tran considers innovation and research essential to delivering exceptional plastic surgery results for her patients. She has published more than 40 peer-reviewed book chapters and is an ad hoc reviewer for the plastic surgery journal ePlasty, which provides original research from world experts in multiple fields, including plastic and reconstructive surgery.

Above all else, Dr. Tran is committed to helping her patients find the confidence they seek through restorative surgical techniques and thoughtful care. She carefully listens to her patients’ concerns and values their aesthetic goals, which enables her to deliver highly-personalized care.

Plastic Surgery with Your Well-Being in Mind

Dr. Trans’s compassion, surgical skills, and zest for innovation combine to leave her patients feeling confident they’ve found the plastic surgery provider they’ve dreamed of.  

To learn more about all the plastic surgery procedures offered by Napa Solano Plastic Surgery, including breast augmentation and body lifts, or to schedule a consultation with Dr. Tran, get in touch with us today.

Frequently Asked Questions About Vaginal Tightening

As women age, declining estrogen levels sometimes leads to thinning of the vaginal walls, a decrease in natural lubrication, and tissue inflammation. The result is often dryness and discomfort that inhibits women from enjoying intimacy. Menopause is the most common reason for these changes, but they also occur from childbirth, breastfeeding, chemotherapy, and hysterectomies.

Non-surgical treatments for vaginal tightening have grown in popularity, with the global market size now estimated at over $4 billion. Napa Solano Plastic Surgery uses the Votiva FormaV and FractoraV systems to address unwanted changes to your vaginal area due to aging and childbirth.

What Is Vaginal Tightening?

Sometimes referred to as vaginal rejuvenation, vaginal tightening addresses various changes to the vagina’s inner lining. It can:

  • Increase collagen levels
  • Relieve dryness and irritation
  • Address vaginal skin laxity
  • Ease mild urinary incontinence
  • Diminish excess tissue
  • Tighten the area outside the vaginal opening

FDA-approved, Votiva vaginal rejuvenation systems are safe and comfortable treatments that avoid all the risks and stigma attached to similar vaginal procedures.

How Long Does Vaginal Tightening at Napa Solano Plastic Surgery Take?

Votiva treatments at Napa Solano Plastic Surgery offer women a fast and gentle way to deal with common feminine health and wellness concerns. The total treatment time varies from six to 30 minutes, depending on various factors. On average, you can expect a session to take about 15 minutes.

There is no downtime or recovery period after a Votiva procedure, and you can resume your daily activities immediately after leaving our facility.

Are Votiva Treatments Painful?

Votiva is entirely painless, though you might feel a “warming sensation” during each session.

How Soon Can You Expect to See Results?

Significant vaginal tightening and external tissue restoration can occur in as little as two weeks after initial treatment. Many patients report results lasting up to 18 months, while others might need to receive three sessions spaced a month apart before seeing the same outcome. In any case, it’s best to maintain your results with yearly or semi-annual maintenance treatments.

Is Vaginal Tightening Right for You?

Any woman experiencing symptoms like vaginal laxity, stretching, or discomfort can benefit from Votiva treatments. The groundbreaking, non-invasive solution is extremely safe, has no side effects, and poses little risk.

If you think Votiva vaginal tightening treatments could be right for you, or if you have more questions about the procedure, contact Napa Solano Plastic Surgery today to schedule a consultation.

Are You Considering CoolSculpting?

For people looking for a safe, nonsurgical fat reduction procedure, CoolSculpting offers them a way to contour their bodies without surgery or anesthesia. If you’re considering CoolSculpting as an alternative to other fat reduction treatments, here’s what you need to know.

What is CoolSculpting?

Nearly four million CoolSculpting procedures have been conducted worldwide. In the U.S., the treatment was cleared by the Food and Drug Administration (FDA) in 2012. It works by freezing and killing fat cells in a process known as “cryolipolysis.”

CoolSculpting has been shown to reduce stubborn fat in different areas of the body by up to 25 percent. The procedure is not a weight-loss treatment. Rather, it’s designed for people near or at their ideal body weight who want to reduce fat in one or more FDA-cleared treatment areas:

  • Chin and jawline
  • Thighs
  • Abdomen
  • Flanks
  • Back
  • Underneath the buttocks
  • Upper arms

One of the greatest benefits of choosing CoolSculpting is that it’s less invasive than traditional fat reduction methods like liposuction, body lifts, and tummy tucks. The procedure takes about 35 to 60 minutes, depending on the areas you want to target. There’s no recovery, as there’s no damage to tissue or skin. Once completed, it can take up to six months for the fat cells to entirely leave your body.

How to Prepare for CoolSculpting

Five simple steps will help you prepare for your CoolSculpting treatment:

  1. Lose any extra weight. CoolSculpting does not help you lose weight; it sculpts your body by removing subcutaneous fat just below the skin.
  2. Stop taking certain supplements and medicines as they can interfere with blood flow and increase the risk of bruising.
  3. Take care of your skin. Avoid sun exposure or tanning beds. And postpone treatment if you have cuts or bruises in the areas being treated.
  4. Choose a distraction during treatment. Since a CoolSculpting session can take up to an hour to complete, you might want to bring along a book or your digital device to catch up on a favorite show or movie.
  5. Have a post-treatment exercise and diet plan. It can take up to 16 weeks for fat to completely go away and a final outcome to be seen. Create a diet and exercise plan to follow during that time and stick with it afterward to maintain results.

Book Your CoolSculpting Procedure Today!

Ready to address those stubborn fat areas that don’t respond to diet and exercise? Talk with one of the doctors at Napa Solano Plastic Surgery. We’ll discuss whether CoolSculpting is right for you and answer any questions you might have about what to expect. We’re committed to ensuring your CoolSculpting treatment experience at our medical spa is a comfortable and positive one!

We invite you to schedule an appointment today to learn more about CoolSculpting and all the cosmetic surgery procedures we offer.