Logo Roy Kim, MD
San Francisco Plastic Surgery

call us at 415.362.1846

220 Montgomery Street, suite 348
San Francisco CA - 94104

Is It Possible to Get Silicone Breast Implants Through an Underarm Incision?


YES- it is possible to get a silicone gel breast implant augmentation through an underarm incision.

The underarm or axilla approach for breast augmentation surgery is a popular alternative to the breast fold or nipple/ areolar incision. Your surgeon makes an incision in your underarm, then creates a tunnel under the muscle. With special surgical instruments, a circular pocket is created for your breast implant. The breast implant is then placed into the tunnel, and then placed under the breast tissue. The end result should be a breast enhancement procedure without any incisions on your breasts.

Many plastic surgeons have a difficult time placing silicone breast implant through an underarm incision, but I have found that it is possible, with careful surgical technique, to place them through this incision for my patients.

The main disadvantages for the underarm incision are that it generates more swelling and takes longer to heal. The tunnel created under the muscle tends to generate more swelling than the breast fold or nipple incisions, and the pectoralis muscle commonly takes 2-4 months for the swelling to fully go away. Also, the breast implant may occasionally wish to go into the tunnel the surgeon has created, so you may have to do more breast implant massage for a longer period of time to ensure that your breast implants maintain an excellent position after your breast augmentation procedure.

The time in the surgery is about the same compared to other procedures, and the post-op pain control is also similar. You may experience a little more pain or soreness over the pectoralis muscle, since more surgery needs to be done to accommodate the surgical tunnel and swelling after your breast augmentation procedure. You should still be able to get a pain pump after surgery as well to help reduce your need for pain medications after your procedure.

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com or (415)362-1846.

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What is the Best Age for an Eyelid Lift?


An eyelid lift or blepharoplasty is an aesthetic procedure performed to repair saggy or droopy eyelids. Advancing age primarily accounts for loose eyelid skin and eyelid bags, but some people are born with circles under their eyes. Some diseases may also cause eyelids to sag prematurely.

Assuming you are in good health, technically anyone can get an eyelid lift. However, for cosmetic reasons, I would recommend that any potential patient be at least 18 years old. In general, I would not recommend a teen ager undergo an eyelid lift.

An eyelid lift, or a blepharoplasty, is a surgical procedure that will rejuvenate lower eyelid excess skin and bags, and puffy, tired-looking eyelids. The results of a cosmetic eyelid surgery are usually long-term and very fulfilling with respect to your appearance and self-esteem, especially if you have realistic expectations of the outcome.

People who have loose skin, excess fat, bags under the eyes, or simply want to have rejuvenation, should discuss with a board-certified plastic surgeon about getting eyelid lift surgery. This is normally done as an outpatient procedure, and you can leave the recovery room shortly after the surgery. An eyelid lift is typically carried out with some anesthesia given through an IV to ensure drowsiness, and we make sure that you do not feel pain during the surgery.

Depending on what modifications you need, your plastic surgeon will tighten loose skin, remove excess fat, and tighten the loose structures around the eyelid . A few stitches will be required to close most of the small incisions. Initial discomfort and swelling can be alleviated with pain medication, ice and cold compresses, and head elevation.

Scars may be slightly visible after the surgery but should eventually fade to an almost invisible white line. A more youthful, fresher, and enhanced appearance awaits those who undergo this procedure. There is no need to wait until “a certain age” to rejuvenate your eyes.


Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com or (415)362-1846.

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How Long do Breast Implants Last?


Breast Implants, whether they are saline or silicone, are medical devices, and theoretically will not last forever. However, they should last for many years, and certainly beyond their current warranties.

In the US, Mentor and Allergan implants have similar warranties. Saline breast implants are warrantied for 5 years, and silicone breast implants are warrantied for 10 years. These warranties are through the manufacturer, and are not dependent on your plastic surgeon.

There is a misconception among some of my patients that if your implant is older than 5 or 10 years, then you need to change them. That is actually not true. As long as your breast implants are fine, you do not have to change them. There is no need to change them every 5-10 years. In fact, there is no specified mandatory change or replacement that you must make.

In general, many patients considering changing breast implants if they want to increase volume. Some patients eventually need a breast lift, and they may wish to change the volume of their breasts.

Assuming normal activities and exercise, your breast implants should last longer than the warranties, and may last for years or decades.

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Why Do Insurance Companies Not Pay for Cosmetic Plastic Surgery?


A great question asked on my Dr. Roy Kim Facebook Page: “Explain why insurance companies do not pay for elective cosmetic plastic surgery and what have you done to help your patients understand. Would your answer be different if obama-care paid for this procedure?”


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Merry Christmas!

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Merry Christmas- Santa Tracking by NORAD


Father Christmas on Holiday Holding a Surfboard

NORAD Tracks Santa

Courtesy of www.noradsanta.org

Normally, NORAD tracks flying objects north of Canada and the US. However, to prove to children worldwide that Santa exists, NORAD tracks Santa around Christmas time.

Please go to their web page,www.noradsanta.org, and watch Santa's travels over the Earth. There's also an Iphone app. to track his travels.

From NORAD-    Santa’s Sleigh Technical Data

Designer & Builder: K. Kringle & Elves, Inc.

Probable First Flight: Dec. 24, 343 A.D.

Home Base: North Pole

Length: 75 cc (candy canes) / 150 lp (lollipops)

Width: 40 cc / 80 lp

Height: 55 cc / 110 lp

Weight at takeoff: 75,000 gd (gumdrops)

Passenger weight at takeoff: Santa Claus 260 pounds

Weight of gifts at takeoff: 60,000 tons

Weight at landing: 80,000 gd (ice & snow accumulation)

Passenger weight at landing: 1,260 pounds

Propulsion: Nine (9) rp (reindeer power)

Armament: Antlers (purely defensive)

Fuel: Hay, oats and carrots (for reindeer)

Emissions: Classified

Climbing speed: One “T” (Twinkle of an eye)

Max speed: Faster than starlight

*Note: Length, width and height are without reindeer*

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How Long Will the Results from an Eyelid Lift Last?


The results from an eyelid lift depend on how much surgery you undergo, as well as the overall tightness of your skin. Typically, an eyelid lift should last 7-15 years, and this is  variable from person to person.


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Saturday Shout Out- Mr and Mrs Miscellaneous


Today's Saturday Shout Out goes to Mr. and Mrs. Miscellaneous.  This is a newer place that makes ice cream from scratch, along with the sauces.  The flavors are unique, and taste great.  They're located in Dogpatch, an industrial neighborhood that's becoming gentrified, and right on the 3rd Street Rail Line.

Here's their address and Facebook link.  Check them out!

699 22nd St

(between Illinois St & 3rd St)

San Francisco, CA 94107

(415) 970-0750


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Do You Need An Eyelid Lift?


Close-up of a young womans eye Horizontal

An eyelid lift is a procedure that can rejuvenate the upper and lower eyelids, so that you have tighter skin, reduction or elimination of bags under your eyes, and a more youthful appearance. Depending on your appearance, and whether you’re concerned about your upper eyelids, lower eyelids, or both, you may have various concerns addressed before getting an eyelid lift.

The most common finding that patients want eliminated is excess skin of the upper or lower eyelid. If you can pinch extra skin above or below your eye, but the shape of your eye does not change, then you may be a candidate for an eyelid lift.

Puffy eyes in the upper or lower eyelid may be a sign of excess fat in the fat pockets of the eyelids, and can be removed during an eyelid lift. Everyone has small fat deposits in the upper and lower eyelids, but as you get older, they may become more prominent and visible, resulting in circles, bags, or eyelids that droop and hood. While the skin is being tightened during an eyelid lift, your plastic surgeon can also remove this small amount of excess fat.

Circles under the eyes can also be addressed with an eyelid lift. Your eyelid fat may need to be removed or repositioned to reduce and eliminate the dark circles underneath your eyelids.

If you have very droopy lower eyelids, then you may need a tarsal strip procedure. The tarsus is the white hard strip of tissue that your lower eyelashes come out from. If this is loose, then you may need to have the tarsus tightened to prevent continued aging.


Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com or (415)362-1846.

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How to Avoid Gaining Weight over the Holidays


Christmas dinner with ham

Normally, as a plastic surgeon, I would suggest eating as much as you can, and then making an appointment to see me in early January for some liposuction. However, since I’m in a giving mood, and since I am a MD/ Medical Doctor, here are my hints to avoid gaining weight over the holiday season.  Basically, these hints come down to diet and exercise. I hope you can put them to good use.

In terms of diet, drinking more water and fluids in general will help with maintaining your weight. Sometimes you may feel hungry, but your body may actually simply want some water. Try drinking water first before you eat something- you may be pleasantly surprised to feel your hunger go away.

Eating smaller portions of fatty food may help avoid weight loss. Please feel free to indulge in your holiday foods, but consider taking fewer bites or smaller portions. Maybe you won’t gain any weight, and at least you’ll be able to try more kinds of food!

Avoid too much alcohol, since any alcoholic drink has calories in it. Also, any clear alcohol (vodka, white wine, etc.) tends to not generate as big of a hangover as colored alcohol (brandy, whiskey, red wine, etc.)

Doing more walking may help you maintain your weight. If you have plans on shopping, try parking far away from the entrance, using stairs in the mall, and just doing laps in the shopping mall while waiting for your family and friends. Any extra movement will help you maintain or lose weight.

If you still need liposuction after the holidays or should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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  • American Board of Plastic Surgery
  • American Aesthetic Society of Plastic Surgery
  • American Society of Plastic Surgeons
  • Real Self