Dr. Keith Paige
Dr. Keith Paige is a top plastic surgeon in Seattle. He received his undergraduate degree from Stanford University and his medical degree from Harvard Medical School. Dr. Paige completed his general surgical residency at Massachusetts General Hospital in Boston and his plastic and reconstructive surgery residency at Emory Affiliated Hospitals in Atlanta, Ga.
Areas of Focus
Dr. Keith Paige’s expertise includes all areas of plastic surgery with emphasis on the following areas
Breast reconstruction, including microsurgery
Facial Plastic Surgery
A face lift is performed in order to restore a person’s appearance to give a natural and rested look to your face. We use a multi-layer approach to reshape the muscles, skin and connective tissue. Our rejuvenating technique allows the muscles to heal better and more rapidly.
A face lift, also known as rhytidectomy, is the removal of facial wrinkles that result from aging, gravity, exposure to the sun, and the daily stresses of life. This procedure can help make you look younger and fresher, thereby enhancing your self- confidence. It is commonly performed after the age of 40, when skin starts to sag and deep creases may start to appear on cheeks and between the nose and mouth. At this time, you might also notice some folds and fat deposits around the neck, or a double chin forming.Facelift Procedure
A facelift is generally a fairly lengthy surgical procedure normally performed with a combination of local anesthesia and sedation that takes up to 2 to 5 hours. It typically begins at the temples right above the hairline, following a natural line in front of the ear, and continuing behind the earlobe to the lower scalp. If the neck requires some correction, a small incision may also be made under the chin. To improve the contour, fat may be trimmed from around the neck and chin.
Next is the tightening of the underlying muscle and membrane, and then the skin is pulled up and excess skin removed. After closing the incision, cotton dressing is used to bandage the face and head. This helps to prevent swelling and also to provide good support for 2 to 3 days. Bruising and swelling normally decrease to “socially acceptable levels” within 10 to 20 days. But remember, we all heal differently. Any significant discomfort can be reduced with some pain medication. You can expect some numbness, which normally disappears within a few weeks or months.Recovery and Final Result
Although a face lift cannot stop the clock of aging, most patients feel that their faces look up to 10 years younger. We use only the most advanced, cutting-edge techniques and technology. These advanced techniques ensure the highest possible quality for all our clients
Surgeons at the Polyclinic perform blepharoplasty, frequently referred to as eyelid surgery. Because eyes are often referred to as “the window to the soul,” and are typically the first thing we observe, it is essential that your eyes show just how you really feel. If your eyes have a tired and droopy appearance, they may not reflect your vibrant inner self or, indeed, your right age. As we grow older, the skin surrounding the eyelids stretches, muscles deteriorate, and fat collect over and under the eyes. This may result in drooping eyebrows and upper lids, swelling or circles.
This is simply a surgical process involving both the upper and lower eyelids, enabling individuals to correct any problems related to eyelids. Eyelid surgery is an impressive procedure that has allowed thousands of individuals to eradicate hooded eyelids.
Eyelid surgery can get rid of some of the signs of aging, leaving your facial appearance improved and rejuvenated.Are You A Good Candidate for Eyelid Surgery?
You may feel that the eyes looking back at you in the mirror seem worn out looking, or perhaps colleagues and family members are wondering if you actually had a good night’s rest because your eyes are puffy with bags and you have dark circles. Aging in this area can have a detrimental effect on your appearance and potentially your self-confidence.
Eyelid surgery is certainly not just a cosmetic procedure for older people, as numerous younger people are impacted with sagging eyelids as well. The competent team at Polyclinic Plastic Surgery Center can surely assist you with any questions.
With the expertise at Polyclinic Plastic Surgery, you can attain dramatically more radiant eyes and also improve your overall look.
The breast is often identified as the feature that makes a woman feel feminine. Many factors affect the size and shape of the breast including genetics, weight, child-bearing, and age. There are many different reasons that a woman might seek breast enhancement surgery.
At Polyclinic Plastic Surgery we believe that a beautiful breast is one that is subtly enhanced and fits the proportion of a woman’s frame. We focus on providing natural, full cleavage and making sure that the nipple is positioned on the most projecting portion of the breast. Our providers are experts in breast augmentation surgery utilizing saline or silicone implants as well as breast lifts and the all-natural augmentation utilizing the patient’s own fat cells to restore fullness.
When considering breast augmentation surgery the first decision is whether you would prefer to utilize your own fat cells, an implant, or a combination. Fat transfer augmentation provides only a modest increase in size, but is wonderful for restoring cleavage and can be used in combination with an implant if a greater volume is desired. It can also be used to reduce asymmetry between two different sized breasts by increasing the size of the smaller breast. Liposuction is performed in order to harvest a patient’s own fat and then injected through tiny incisions to reshape the breast. These injected fat cells become incorporated into the tissue over the following weeks to permanently enhance the breast. Size is limited by available fat cells to relocate as well as the initial size of the breast. Sometimes multiple sessions are required to achieve the desired result.Let’s talk implants:
There are many different types of implants (saline, silicone, round, shaped, textured, smooth…) and it is best to have a detailed discussion with your doctor about which specific implant would be best for you. That said, the most basic difference is saline (a silicone shell filled with salt water) versus silicone. Both are safe and effective and each type has pluses and minuses. Saline is a good choice when there is adequate breast tissue to cover the implant and a large size is not desired. Silicone is a better choice when there is very little native breast tissue or a bigger size change is desired. Your doctor will go over the options in detail with you so that you can make the right decision to meet your goals and body.
The next decision is placement of the implant- either above the pectoralis major muscle (subglandular) or below it (submuscular). The sub glandular position has a higher chance of implant hardening over time (known as capsular contracture), but lower chance of “animation” (meaning the implant looks distorted when the pectoralis muscle is engaged). Again, depending on your anatomy, activities, and goals the right position is a decision made on an individual basis with your surgeon.
The last major decision is incision position. The most common incisions are in the crease under the breast (inframammary fold), at the edge of the areola (infra-areolar), or in the armpit (axillary). All of these incisions are concealed in some way- the inframammary fold incision by the breast itself, the infra-areolar incision by the color change between the areola and the breast skin, and the armpit by the location away from the breast. Discuss with your surgeon which incision would be best for you.When should you consider a lift and when will just implants do the trick?
Implants will give a very slight lift to the nipple due to the “swingset effect” (the implant provides volume behind the nipple allowing the tissue to swing out and the nipple to look slightly raised). This is very modest and works for only very slight cases of sagging (or breast ptosis). Implants mainly address the volume of the breast whereas a lift addresses nipple position and overall breast shape. A breast lift is a trade off between scars and improved breast shape and nipple position.What is the downtime?
Most patients are back to work in a week and back to all their normal activities at four to six weeks. Narcotic pain medications are prescribed post-operatively, but generally not necessary beyond the first week or two.Where would I have surgery?
This is an outpatient (meaning you can go home the same day) procedure performed in our fully accredited operating rooms attached to the office. A board certified anesthesia provider will deliver deep sedation and monitor you during the procedure. This method of anesthesia known as monitored anesthesia care decreases the risk of post-operative nausea and vomiting from the anesthesia and shortens overall recovery time. Your safety is our first priority. All of our providers are board certified by the American Board of Plastic Surgery and our operating rooms adhere to the strictest safety standards as noted by our Medicare accreditation.
The surgery to reduce the size and improve the shape of a woman’s breasts is consistently found to be the single plastic surgery procedure with the highest satisfaction rating. Most of the women who choose to use this as a means of ending musculo-skeletal pain and soreness report near complete to complete reversal of symptoms such as chronic shoulder, neck and back pain. Also reduced or eliminated are tensions headaches, skin rashes below the breast, numbness and tingling in the hands and forearms and breast pain itself.
The operation itself removes a significant amount of breast tissue while preserving the nipple and establishing most of the remaining breast on the chest wall above the breast fold. A breast “lift” is always incorporated into this procedure. Over time, this can settle in and drop but never to the extreme that women present with when needing this procedure.WILL INSURANCE COVER THIS PROCEDURE?
Insurance coverage varies by policy and company but most insurance plans have included this benefit if a woman meets certain criteria. Commonly this includes six months or more of failed conservative measures to reduce the musclo-skeletal symptoms common to women with large breasts. In addition, the plastic surgeon seeking pre-authorization for these procedures must submit an estimate of the weight in grams of the amount of tissue to be removed to be a curative rather than a cosmetic procedure. This is based on the patient’s height and weight at the time of the request.HOW IS THE PROCEDURE PERFORMED?
There are many different ways to perform this procedure but the most common way reduces the areola with a ring scar around it, and in most cases preserving enough tissue connected to the nipple to nourish it and possibly maintain the ability to eventually breast-feed from this nipple. Almost all the types of breast reductions then result in a vertical scar from the new nipple location down to the breast fold. Additional incisions along the fold are also very common depending on the size of the breast being reduced. Sensation to the breast returns in most cases and many women report improved nipple sensitivity.
Occasionally very large breasted women will require that the nipple be grafted onto the breast like a common skin graft. The new smaller nipple usually does not have sensation and the ability to breast feed in the future is eliminated with this technique.ARE THERE ANY RISKS?
Risks include bleeding, occasionally requiring that the woman be returned to the operating room to stop the source of bleeding. Delayed incisional healing can occur and may also require retuning to the operating room to close an opening in the scar.
Most small openings heal themselves in a few weeks. Infections can occur as with any large procedure but are not life threatening when this happens. Other risks include asymmetry, chronic pain and heavier than normal scarring.
If a woman goes on to gain a very large amount of weight after surgery it is possible she will incur increases in her breast size again. Breast re-growth without this weight gain is very rare and usually happens in younger patients who had early rapid breast growth in their early teen years.
Denial of coverage by an insurance company does occur for various reasons but the plastic surgeons at the Polyclinic can still perform the procedure by private payment. This results in a fixed price including anesthesia and facility costs. At times women whose insurance coverage requires removing more breast tissue than she would allow can also privately pay for the procedure with the surgeon and patient agreeing on how much tissue to remove that is far less than would have been required by the insurance company.WHAT IS THE RECOVERY TIME?
Recovery varies by patient but most women return to work between seven to fourteen days after surgery. Most breast reduction patients are off of pain medication by seven days post operatively. Activity restrictions vary by surgeon but most commonly include a month or more before women can return to vigorous exercising, yoga or running.
The final appearance of the breast scars can take up to a year to finally fade, but all scars, regardless of the type of reduction preformed, should be well hidden in a bikini, bra or dresses.
Male Breast Augmentation
Male breast development can occur naturally around puberty. In about 5 to 8 % of males it can persist into adulthood. Persistent adult breast enlargement has also been associated with body building steroids, hormone imbalances, pituitary tumors and other conditions.
The vast majority of gynecomastia cases have no association with any other external or systemic source and arise spontaneously; they usually do not diminish with age. In obese males who lose large amounts of weight it may continue since the glandular component is not reduced with weight loss.
There is a long list of medications thought to stimulate male breast enlargement. Currently there is little evidence to clearly support or refute the link between THC, marijuana, and gynecomastia. The evidence for this is mostly anecdotal, not scientific.
There are usually two components to gynecomastia, fat and gland. Enlargement or widening of the nipple can also occur. Microscopic examination of the male breast gland reveals no significant architectural difference from that of the female breast gland. Gynecomastia is graded, I, II III and IV.
- In Grade I there is modest glandular enlargement but the skin envelope remains tight.
- In Grade II there is larger glandular enlargement but without loose skin.
- In Grade III there is glandular enlargement and modest loosening of the skin envelope
- In Grade IV there is significant glandular enlargement with loosening of the skin envelope allowing the entire gland to sag, usually with lowering of the nipple.
Men with gynecomastia are quite uniformly affected psychologically by the feminization of their chests. They report longstanding embarrassment at their appearance, which significantly impacts their choice of clothing and activity. Many are reluctant to appear in public at all without a shirt. These means they avoid beaches, pools and any social situation in which removing their shirt might occur in public. Many report being ridiculed over their appearance in school and team situations, as well as locker rooms. Surgery can quickly remove the stigma of feminization of the male chest.
Surgery is considered elective and most insurance companies deny coverage for the majority of these cases claiming that surgery for male breast enlargement is purely cosmetic and non-functional.
If a patient wants to pursue insurance coverage significant testing for the source of gynecomastia by an endocrinologist will be required. Many insurance companies require a regimen of medical treatment such as daily usage of oral tamoxifin for up to a year, and then if there has been a failure of conservative treatment they will address pre-authorization. Some companies also require a letter from a psychiatrist stating what impact the condition has had on male self esteem.
Surgical treatment is highly effective in eliminating male breast enlargement. For Grades I and II a small incision around the nipple may be the only incision required. That scar incorporates into the edge of the nipple quickly and can be difficult to detect by just six months after the operation.
No skin removal is needed for Grades I and II but often the surgery will include liposuction of the adjacent fat as well as direct glandular removal in a technique called “en bloc” or total glandular excision. Liposuction alone rarely works for any grade of gynecomastia.
For Grades II and IV some skin removal will be needed in addition toe gland and fate removal. The location and extent of the scar is dependent on both the amount of skin removal needed and surgeon preference for one type or another. In extreme cases the nipple may need to reduced and grafted into the correct position but with no significant negative impact on the visual aspects of the final result.
Recovery from most male breast reductions is quick. Surgery is done as an outpatient with sedation or general anesthesia. Most men require pain medication for 3 to 7 days and can return to work in one week. Most surgeons require the patient to wear a tight compression vest after surgery for up to four weeks.
Exercise and all type of workouts and sports participation are discontinued after surgery usually for three to four weeks.
The risks of male breast reduction include bruising, pain and infection. Collections of blood inside the surgical site called hematomas are rare but may require secondary surgery to remove them. Chronic pain is very rare. Secondary surgery is rare as well but may be required to adjust asymmetrical results or persistent nipple enlargement or skin redundancy after six or more months.
Men who have undergone this surgery report huge increases in their self-esteem. They change their clothing styles to include more tailored shirts and discontinue wearing multiple shirts to disguise their breasts. They report being excited to go to vacations where they will be at the beach or pool with no hesitance to expose their chest.
The surgeons at the Polyclinic Plastic Surgery have extensive experience with male breast reductions at all Grade levels. Their success with these patients has lead to many referrals by other men seeking the same result as their friends or relatives. Please visit the photo section on this web site to see relative examples of what this surgery has done for other Polyclinic patients.
Best in Class
About Dr. Paige
Dr. Keith Paige is a top plastic surgeon in Seattle. He received his undergraduate degree from Stanford University and his medical degree from Harvard Medical School. Dr. Paige completed his general surgical residency at Massachusetts General Hospital in Boston and his plastic and reconstructive surgery residency at Emory Affiliated Hospitals in Atlanta, Ga. He completed a postgraduate fellowship at the Children’s Hospital of Philadelphia and the University of Pennsylvania.
Dr. Keith Paige’s practice includes all areas of plastic surgery with emphasis on breast reconstruction, including microsurgery; Cosmetic surgery, and Body contouring.
Working in partnership with his patients, Dr. Keith Paige finds great satisfaction combining art and technique to achieve profound and lasting results from plastic surgery.
- American Board of Plastic Surgery Certified
- Seattle Met Top Doctor
In the Media
- American Board of Plastic Surgery Certified
- Seattle Met Top Doctor
In the Media
Profound and Lasting Results
Working in partnership with his patients, Dr. Keith Paige finds great satisfaction combining art and technique to achieve profound and lasting results from plastic surgery. He is currently accepting new patients to his practice at Nordstrom Tower.
Best in Class
Expertise & Results
- Highly skilled
- Loved by his patients
- Terrific results
Everything went wonderfully. I'm very happy with the results and Dr Paige is awesome and his entire staff, everybody from the financial planner to the nurses to the surgical staff - everybody was wonderful. Thank you guys very much.
"Your customer service is top notch!!! Jennifer was courteous in scheduling an appointment with Dr Paige and his nurse was so patient and explained everything so well. Thank you - I am so excited about my results."