Cosmetic surgery is no longer just about women. Men are getting in on the action to look better and feel good about themselves. For many men it’s a must in today’s youth obsessed world, where a younger-looking appearance can give a man the edge in a competitive business environment or even in a dating relationship. Dr. Kevin Smith explains that in today’s atmosphere, men have plenty of options to improve on appearance and look more masculine.

By Dawn Tongish
and Kevin Smith, MD

The Fountain of  Youth For Men

The numbers don’t lie. The American Society for Aesthetic Plastic Surgery reports that MEN spent more than $12 billion on an array of plastic surgery procedures in 2014. It’s because the male sex wants to look good, just like women want to feel good about the reflection in the mirror. It isn’t surprising to Dr. Kevin Smith, a plastic surgeon who operates the Charlotte Plastic Surgery Center. “Guys are spending a lot of time in the gym and they are watching what they eat, but that still doesn’t help with the old look, so they feel they need to do something about it.” Smith has seen an uptick in the number of men seeking procedures at his office in Charlotte, North Carolina. He says that men want the end result to not only get rid of the problem, but to look natural, not noticeable.

“It happens to guys too. We lose volume in the face and we get saggy skin and jowly stuff, but men are afraid that with surgery they will end up looking obvious or overdone.” Smith says he likes to assure his male patients that the best outcome is have a friend notice a “refreshed appearance”. Smith says any surgical procedure shouldn’t make the patient look different, it should make the patient look better.

Cozy Up To Botox

It isn’t just rich and famous men turning to cosmetic surgery. Men from all socio-economic walks are seeking to turn back the clock and the stats prove it. The number of procedures increased by more than 106 percent between 1997 and 2012, according to some reports. That’s staggering, but so are some of the images of bad cosmetic procedures. It can be downright scary for men to see Hollywood macho men, overdone with fillers and facelifts. “There’s a lot of bad plastic surgery out there and it scares a lot of men,” says Dr. Smith. He says that men tend to take it slowly at first and should consider non-invasive procedures, like Botox to smooth out facial wrinkles. “I think that more men should be accepting of the fillers. Botox is an excellent way to get rid of that intense look between the brows,” says Smith.

Smith says there may be a misconception that fillers are used predominately on women, but he says they are effective on men too, especially for erasing dark patches that can make a person look exhausted. “For men, we can use Botox in that hollowness underneath the eyes that makes us look tired.”

Nip and Tuck to Command the Boardroom

The marketing trends have begun to entice the corporate male to plastic surgery, with labels like “Forbes Facelift” for the man who wants just the right touch of trustworthy wrinkles, with a mix of youthful restoration. It is the new reality that a younger appearance helps for those looking to climb the corporate ladder, or those wanting to maintain a position of leadership in the marketplace. Many men are turning to plastic surgery for a leg up on the next guy with a resume. “I tell my clients that you can’t be managing that hefty portfolio and looking like you are an old soul. Your face needs to reflect the youthful you,” says Smith.

Those searching for the fountain of youth are finding an answer in eyelid surgery or blepharoplasty. Smith says it is a common first step for men. “We get those heavy upper eyelids and its a function of vision. It is like wearing a ball cap and you can’t see with all of that heavy eyelid skin.” He says repairing the puffiness under the eyes and eliminating dark circles can make the face look less tired. Whether it is body contouring to get rid of love handles that don’t’ seem to disappear even with countless hours in the gym, or a surgical fix — men do have options to repair and restore. After all, why should women be the only ones to bask in a renewed glow? Men are realizing they can opt for change, without seeing BIG change and that’s just the way they want it. “The changes are subtle and the procedure solves the problem without looking different, just better,” Smith says.

The post Man’s Best Friend May Be Plastic Surgery appeared first on The Plastic Surgery Channel.

Board certified plastic surgeons of The Plastic Surgery Channel field a common question for new patients: “What’s the best, fillers or Botox?”

For a large percentage of would-be fillers and Botox patients, many are engaging in plastic surgery for the first time. They’re testing the waters and want to try one of these injectable treatments that are low risk and inexpensive. When they hear from their friends how great fillers are, or how Botox has made a big change in their life, it’s hard to separate the two without knowledge. Is one better than the other? Is one safer? Can you have both?

Rest assured, this episode of No Spin News clears the air on two of the most popular – and powerful – non-surgical treatments in plastic surgery and how their union is the centerpiece of non-surgical facial rejuvenation..

The post No Spin Live… What’s The Best, Fillers or Botox? appeared first on The Plastic Surgery Channel.

Six months after surgery, Dr. Bruce Van Natta of Indianapolis hears an identical chorus from almost every breast lift patient. “I really like my result, it’s SO much better than before. But I loved it in the first month or two when it had such fullness. Then it settled a little bit.”

A common occurrence in a standard mastopexy (breast lift) is that it initially pushes up the breast tissue, creating upper-pole or top-of-the-breast fullness while elevating the lower pole or bottom of the breast. Eventually gravity takes over and the first place the volume leaves is the top of the breast, followed by a bit of a drop on the bottom. “The challenge,” says Dr. Van Natta, “is rejuvenating a breast and keeping it there.” Two new devices he is using on his breast lift patients are showing incredible results. In fact, you could say gravity’s force is no longer a foregone conclusion. And neither is wearing a bra.

by Isabel Bolt
and Bruce Van Natta, MD

The 411 on Standard Breast Lifts

Age, hormones, significant weight loss and multiple pregnancies can all contribute to sagging breasts. Though your breasts may be of good size, they may droop (ptosis) and lack firmness or substance. Breasts may appear pendulous and nipples may point downward below the breast crease. To determine whether you need a breast lift, the location of the nipple relative to the inframammary fold (IMF) is the most important factor. When you have gland and/or the nipple below the IMF, then you may need a breast lift. A breast lift will reshape sagging breasts to a more naturally rounded shape and reposition the breast tissue and nipple to a more youthful height and projection. According to Dr. Van Natta, a breast lift literally lifts sagging breasts without major removal of tissues. Until now, patients had to accept that the initial result and final result would be influenced by gravity. “We always “over lift” the breasts a bit, but gravity always wins. Skin elasticity and the amount of weight will determine how much (the breasts) settle. But they settle in everybody. There is however, good news. Today, I am using two new devices that are giving us a means of trumping gravity.”

Refine® for the Upper Pole

Dr. Van Natta is the medical advisor for a company called Refine Medical that has a device made of a permanent suture. It is placed to provide added support and lift to the upper breast tissue. “I now have over 2 years of follow up and over 100 patients using this device and am really impressed with the results.” In essence, the device is placed in the breast, the tissue is lifted to the degree necessary for optimal positioning and then secured. Think “internal suspenders.” The result is permanent upper pole fullness. In fact, small implants are often recommended in a lift to round out the upper pole, but Refine® gives the breast real, natural, lasting fullness many patients desire without an implant. An added bonus is there are no telltale signs that the “suspenders” exist. Although the suture will not dissolve, it cannot be felt or seen in/on the breast, nor does it show up in a mammogram. Even women who are considered quite active are not restricted in any way.

GalaFLEX® for the Lower Pole

Dr. Van Natta describes GalaFLEX® as a “game changer.” GalaFLEX is a mesh support material made from naturally derived material which acts as a scaffold, encouraging patient’s own tissue to grow because it provides a platform for new collagen and elastin. Simply put, it creates a “sling” to help keep breast tissue “up.” According to Dr. Van Natta, while lift or reduction procedures go south after a little while, GalaFLEX is keeping women perky, longer. “It gives a boost to breast tissues to the point that it allows women to ditch their bra, if they like.” The mesh dissolves in 12-18 months and is replaced by scar tissue. “We put in the mesh material at the time we’re doing the breast lift…tightening that skin brassiere. It tricks the body into making the collagen and then after the mesh disappears you’ve got this little internal sling almost like an internal bra,” say Dr. Van Natta who has been performing this procedure for over 2 years on 90 women with great success.

The Physician as a Magician

Initially Dr. Van Natta would use one or the other device during lifts, but as the results continued to improve he had an epiphany. “They each do different things, but they both work and keep things where we put them, so why not use both?” The improvements speak for themselves in the before and after gallery. One of the most memorable patients is shown here–a 65 year old lady whose main objective was to never wear a bra again. “A couple years ago, says Dr. Van Natta, “I would have said, “Ma’am I’m a physician, not a magician.” But I looked at her and said, let me use all my tools and you won’t have to wear a bra again.” A combination procedure using GalaFLEX® and Refine® yielded a 6 month result demonstrating roundness at the top of the breast and support underneath with no recurrent drooping–astonishing for the stretchy skin that is classic at her age. The Refine® actually mimics the appearance of a small implant.

Not “Settling” for Less    

In his practice going forward Dr. Van Natta is using both devices as standard in his breast lift patients. Compared with results 5 years ago, he describes this option as “very liberating and exciting.” “We are maintaining much more upper pole fullness than with the standard mastopexy, and in most cases won’t require an implant to achieve that result. No more disappointment with breasts settling and dropping. The patients love the fact that they can enjoy a more youthful appearance, and results are long lasting–bras optional.”

Dr. Van Natta is in the process of publishing some papers on the devices and procedure for peer review and speaks at society meetings making colleagues aware of these new devices. “This is going to be a big deal.”

The post Breast Lifts: Defying Gravity with 2 New Devices appeared first on The Plastic Surgery Channel.

The barbed wire bicep. The so-called tramp stamp. How about your boyfriend’s or girlfriend’s name? Millions of us love our tattoos, but life and circumstances and people change.  And sometimes that means the body art we had inscribed on our various body parts needs to change… or disappear altogether.

By John Hammarley

THE ONLY CONSTANT IN LIFE IS CHANGE ….

We don’t forget our first love, but who wants to be reminded of their ex’s everyday? Johnny Depp’s solution: he turned his Winona tattoo into Wino. That’s one way to deal with people who literally get under, and onto, your skin. Tattoo artists say they are often asked to rework old tattoos to obscure names, but if you’re really intent on a clean slate, other options exist. Be warned, however, few are cheap, most are painful, and none guarantee complete success.

A LOT DEPENDS ON WHO DID THE ‘TAT IN THE FIRST PLACE

Dr. William P. Adams, Jr., a Dallas-based plastic surgeon, says it’s easier (and more effective) to remove a tattoo if it was first administered by a professional tattoo artist. The dyes used as well as how they’re delivered makes a big difference if and when it comes to removing the tattooed image.

BRACE YOURSELF… IN MORE WAYS THAN ONE

If you thought getting the tattoo was painful, brace yourself.  Even with a topical anesthetic, laser tattoo removal is more painful, and the process typically requires six to eight treatments, if not more, over the course of at least as many months to give skin time to heal between each procedure. The price of removal is based on the size of the tattoo, but it’s not cheap. A tattoo that cost less than $100 could cost thousands to remove.

CAN TATTOOS AND PLASTIC SURGERY PROCEDURES CO-EXIST?

Dr. Brad Calobrace, a plastic surgeon in Louisville, KY., says when he has a tattooed patient who’s come in for some type of plastic surgery procedure, he has to consider several factors. Can he completely remove the tattoo? If he’s partially going to alter the image, how can he best accomplish that? If you are considering both a plastic surgery treatment AND a tattoo removal, plastic surgeons recommend you wait until after your surgery to start your removal process.

SUCCESS IN A TUBE? BEWARE

Some say the easiest, most affordable (but probably least effective) tattoo removal process comes in a tube. All tattoos fade to some degree over time if exposed to sunlight. Topical creams aim to speed and maximize fading by bringing the tattooed layer of skin closer to the surface and prevent the pigment from spreading to new layers of skin.

After extensive product testing, the Tattoo Removal Association ranked Tat-Med, Profade, Wrecking Balm, Tat B Gone and Tattoo Fading (in that order) as the most effective and safest products on the market. But watch out. Many of these creams contain harmful chemicals, such as Hydroquinone (a carcinogen that has been banned in a number of countries) and Trichloroacetic Acid, which literally burns off layers of skin.

LASER REMOVAL

Both Drs. Adams and Calobrace say using several different lasers, with different strengths, is the best way to remove tattoos. Black, blue, and red colors are the easiest to disperse while yellow and green have staying power that makes them harder to eliminate.

In 2007, New York-based company Freedom2 produced a new tattoo ink made of smaller molecules encased in polymers that could be dissolved and dispersed completely after just one laser treatment. The product, called Infinitink, hasn’t really caught on yet by tattoo artists, however, who prefer to think of their art as permanent.

The post Regret the tattoo? Here are some options appeared first on The Plastic Surgery Channel.

When it comes to the impact of our overall expression, no feature can rival our eyes. They communicate without our saying a word. What do your eyes say about you? “Bright”, “alert”, and “rested”? Or, “tired”, “sad”, and “old”? Both age and heredity can play a role in the shape and proportion of your upper and lower lids. You may be beginning to notice your upper eyelid has an overhang, is droopy, or has a hooded appearance. Perhaps your eyes turn down and look sad with frown lines deepening between the brows. Or there may also be puffiness or “pillows” under the lower lid. Hollowness, first seen as a circle of mild depression under the eye may deepen over time and create a chronically tired appearance.

In any of these circumstances, you may be a candidate for one of the simplest but dramatic aesthetic procedures called a blepharoplasty, also known as an eyelid lift. 

by Isabel Bolt
and Shaun Parson, MD

When the ‘Windows to the Soul’ Need an Update

Dr. Shaun Parson who practices in Scottsdale, Arizona says patients often ask his advice on facial rejuvenation. “My answer many times is to focus on the eyes. It’s the first and last thing people notice about a person, and rejuvenating the eye area can turn the clock back 10 to 15 years. If a surgeon is really good at doing eyes you cannot tell anything was “done”, except to notice a rested appearance is restored.”

In upper lid surgery, excess skin and fatty tissue are removed through an incision placed in the natural crease of the eye. The fold of skin between the eyelash and eyebrow is removed. Scars heal rapidly and are barely visible. The result is an alert, more youthful expression.

A combination of approaches is used for lower lids. If the appearance can be improved simply by removing fatty tissue, an internal incision is made inside the lower eyelid. If both fatty tissue and excess skin are involved, a small incision is made close to the lower lashes and extends into a natural wrinkle line to hide the scar. Fat may be reduced, redistributed or added. In the case of “sad eyes” an additional procedure called Canthoplasty or Cantopexy may be involved.  This repositions and reinforces the tendons at the outer corner of the eye to support the lower eyelid.  Although this does not require any additional incisions, it is a procedure that leaves little room for error and must be performed by a skilled, board certified surgeon.

Upper and lower eyelid surgery can be performed independently or together and can be performed under local or general anesthesia.

The Brow/Eyelid Connection

The perceived shape of the eye is sometimes associated with brow ptosis (droop.) Dr. Parson addresses this at consultation and will explain what eyelid surgery alone will or will not accomplish. Patients with true brow descent or who want a higher position of the brow may have to consider a browlift.

Countdown to the Great Reveal

According to Dr. Parson, the whole procedure takes a little over an hour. Your lids will be tight at first and then relax. There will be some discomfort at the incision site for one or two days but is easily controlled. You may experience blurry vision due to temporary swelling. Bruising is usually minimal. Sunglasses may help with dry eyes. Elevating your head and using cold compresses the first 24 hours alleviates some discomfort. Special drops and ointments will be prescribed.

Contact lenses are discouraged for 2 weeks following surgery. Dry eyes that temporarily accompany this procedure could make wearing them any sooner uncomfortable. Stitches are removed 5 to 7 days after surgery and you can expect to return to work and normal activities within 7 days. While not permanent, eyelid surgery usually lasts 10 to 20 years.

Simple, but not Easy

Dr. Parson emphasizes the point that eyelid lifts are simple, but not easy. There is a difference. Old fashioned blepharoplasties that removed fat, muscle and skin, often altered the shape or “character” of the eye and changed a person’s “look”. “The procedure should never fundamentally change the shape of the eye. It’s very difficult to revise eyes that have been overcorrected due to an aggressive approach. There is a lot of finesse involved in preserving, yet improving the eye area.” Different eye shapes age differently so it is imperative that any treatment be tailored to the individual’s eye and eyelid shape. The main priority is to have a blepharoplasty based on the unique shape of the eye, eyelid shape and on how the eyes have aged. “It fundamentally resets the clock on how you look and how you feel about yourself.”

The post Eyes on You – The Prescription for Resetting the Clock appeared first on The Plastic Surgery Channel.

Childbirth is a beautiful thing. But it does wreak havoc on many women’s abdominals, stretching and distorting the skin and muscle past the point where diet and exercise can help. For women who want their flat tummies back, an abdominoplasty or tummy tuck has long been the go to procedure. And though extremely effective, it does have one of the longer and more painful recoveries of any cosmetic procedure which, according to Dr. Christine Hamori of Duxbury, MA, has been a big deterrent for many of her patients. Particularly new moms who can not take two weeks off from raising their child. But now, there is the drainless tummy tuck procedure that not only drastically reduces post op pain, but actually helps to speed up recovery.

by Katherine Stuart
and Christine Hamori, MD

Drainless = Painless?

“The one deterrent to tummy tucks for most patients is the recovery.” says Dr. Hamori. Historically, surgeons would advise patients to stay in bed for the first 3-4 days, take at least two weeks off work and refrain from exercising for anywhere from 4-6 weeks. Which is a pretty scary proposition for many women especially new moms who are the ones really needing the tummy tuck. But now, there’s a new technique called the drainless tummy tuck that severely reduces a patient’s recovery time and her post op pain. It’s a combination of a long lasting anesthetic called Exparel with a new suturing technique that allows the surgeon to forgo using a drain.

During your drainless tummy tuck, Dr. Hamori will inject Exparal, a non narcotic anesthetic, about half way through your procedure. It will give you about 72 hours of pain control so that you are up and moving right away which helps to prevent blood clots, makes you feel better about yourself and causes your swelling to go down faster as it mobilizes your fluids. “When we usually do a tummy tuck the old fashioned way,” says Dr. Hamori, “we kind of just pull down the skin, and pop a drain in to prevent the skin from coming away from the tissues so fluid won’t form.”  The drain would be taken out after about 7 days, but during that time, the patient had to walk around with a plastic tube coming out of her skin that got caught on things and had to be hung up in the shower. It was a pain. But how does a surgeon avoid the drain without running the risk of a seroma developing? By using a new suturing technique called quilting or progressive tension.

Dr. Hamori describes it as being like a window shade: a surgeon lifts up the skin of the abdomen and then pulls it down little by little, placing sutures to attach each fold on the way down. “ The big advantage is that we can take more skin out because we can pull as we can go.  And it gives you a better waist, a better contour. And since there’s no space, what we call dead space, there’s no little area or pockets where fluid can form.” Which means that there’s no need for a drain.

Patients recover faster without the drain because they can move better. Dr. Hamori has been performing the drainless tummy tuck for about 5 years  and it has really changed her practice. Patients are so surprised and ecstatic about their speedy recovery that they’re telling their friends to get one. And through the surgery may take a bit longer than the traditional tummy tuck, cosmetically, the results look better. “It pulls everything down like a nice tight t-shirt.”

The post Is A Drainless Tummy Tuck A Painless Tummy Tuck? appeared first on The Plastic Surgery Channel.

It turns out that a whole lot of people are hating their double chin. According to a 2015 study by the American Society for Dermatologic Surgery (ASDA), over 67% of us are bothered by “under the chin fullness”. It’s even on par with the fine lines and wrinkles around the eyes in terms of how much it disturbs people. The fact that we are spending more and more time looking down at our phone, tablet and laptop screens, and talking with friends, family and colleagues on Facetime or Skype is definitely making us more aware of our chin fat than ever before. But unless you had the money and time for surgery, there really wasn’t anything that could be done about it. Until now. Kybella is the first minimally invasive FDA approved product to treat submental fat.

by Katherine Stuart
and Robert Whitfield, MD

Kybella Is The First Non-Surgical Option for Chin Fat

Under the chin fat impacts a broad range of patients, including both men and women. Although it can be exacerbated by age, and weight gain, many people’s double chin is actually resistant to diet and exercise alone. Up until just recently, the only option for getting rid of this stubborn pocket of fat was liposuction. Which is extremely effective, but which is also expensive and requires downtime from your daily routine or work that not everyone can take. But now, with the introduction of Kybella, there is a non-surgical option for treating your double chin. Dr. Robert Whitfield of Austin, Texas is finding Kybella to be an “excellent modality for someone who doesn’t have the time or inclination for surgery.”

Kybella Treatments Are Easy

During a Kybella treatment, Dr. Whitfield will make a series of marks on the patient, like a grid, and put small injections of the product into the subcutaneous fatty tissues. Deoxycholic acid, the active ingredient in Kybella, is a naturally occurring molecule in the body that assists in the breakdown and absorption of dietary fat. Once injected, “Kybella destroys the fat cells and they don’t return so the results are long lasting.”

Most patients will need to be treated at least twice, maybe three times, in order to obtain optimum results. The treatments are typically spaced out every two months. The injections, like filler and Botox injections, can be uncomfortable, but are not really painful. Afterwards, patients may experience post op swelling, skin irritation and redness, but this will go away within one to two weeks.

For people who are bothered by their fatty chin, Kybella could be a game changer. It’s performed in the office. It’s quick so a patient can easily schedule it during their lunch break. And it’s minimally invasive so patients can return to work immediately,  making it ideal for most of our busy lives.

The post Double Chin Be Gone With Kybella appeared first on The Plastic Surgery Channel.

There are multiple reasons why a woman may opt for breast implant revision surgery; it could be medical or cosmetic. Most of time a woman wants to change the size or type of implant replacing the saline or silicone implant. She could be electing to have the operation to correct a problem resulting from a previous breast augmentation. As Dr. Mark Pinsky explains, breast revision is becoming a popular procedure for women who want to update their look.

by Dawn Tongish
and Mark Pinsky, MD

The Breast Is New Again

Time changes everything and that includes breast implants. Even if your breast augmentation was performed without any complications, there can be changes that happen. Sometimes a woman’s body isn’t the same and there is a need for a little ‘updating’, according to the experts. “One of the more common reasons that women seek out a breast implant revision is that their figure is different than it was 10-15 years ago,” says Dr. Mark Pinsky. Pinsky is a sought-after plastic surgeon for breast revision in Palm Beach Gardens, Florida where he practices. He cites it as one of his favorite procedures. “It gives me a lot of delight to do a revision because it makes the patient feel renewed and restored. Pinsky says women often swap implants because their taste changes throughout the years.

“What they wanted way back when is not what they want today, so we want to make them happy.” He says women may opt for larger or smaller implants, depending on their lifestyle. “Maybe they have an old implant, an old saline implant that needs to come out and silicone implants have gotten so advanced, with all kinds of shapes and sizes.”

New and Different

There can be medical reasons to seek out breast implant revision surgery. One condition involves breast implants that have dropped on the chest, making the implants look very low. “Sometimes a patient comes in because where the breasts used to be perky, now they aren’t so perky and they have dropped down over time.” Pinsky says sometimes the implants are swapped out and sometimes they aren’t. Weight gain through the years can also be another factor that impacts breast augmentation. “If the breasts have gotten too large with weight gain, perhaps the patient wants smaller implants.”

Pinsky says often the patient just has a different lifestyle and the breast size that was convenient or suitable isn’t anymore. “Sometimes patients are motivated to come to the office because they are now a sophisticated woman, instead of a young lady and the look that is desired is different.”

Need To Know: Breast Revision

There are times when a patient must have breast revision surgery due to a complication from a prior surgery. “It is sad when a woman comes into my office needing to have breast revision because of a complication,” says Pinsky. “I feel terrible for those patients because they have gone down a path and the dream didn’t happen, it turned out worse.” He says he always works to make sure the patient has an outcome that restores a youthful appearance. The goal is to correct the look and allow the patient to walk away feeling good about their new look. “I feel happy when that happens.” Patients should know that general anesthesia is usually required and recovery time can be prolonged. There may not be a return to work for 1-2 weeks and full recovery can take up to 3 weeks.

Experts agree, augmentation-mastopexy can be a difficult operation to perform, so it’s important for a patient to do their homework and find a qualified surgeon. “Look for a surgeon with a great deal of experience,” says Pinsky. “It is not for the casual surgeon. He calls it a ‘challenging’ surgery, but still one of the most rewarding because of the end result he sees for so many patients who leave with a renewed sense of self-confidence. “I really get to feel like Santa Claus just about every day.”

The post It May Be Time For a Breast Implant ‘Re-Do’ appeared first on The Plastic Surgery Channel.

The things we notice most as we climb up in years are those unwanted signs of aging: wrinkles, sun spots, loose or sagging skin or pockets of fat.  Often these are the very things that bring us to our plastic surgeon’s office – seeking Botox, facial fillers or plastic surgery.  However, a regular visit to your plastic surgeon’s office can do more than just reverse the signs of aging – it could also save your life. 

by Anne Meyer
and Caroline Glicksman, MD

Sun Damage Can Result in More than Wrinkles or Brown Spots

New Jersey based plastic surgeon Dr. Caroline Glicksman uses consultations for age related concerns as an opportunity to screen her patients for early signs of skin cancer, and educate them about the importance of skin cancer screening.  “Where we live, most of the residents enjoy sun and the outdoor activities of the Jersey Shore,” says Glicksman.  “A lot of patients will come into my office seeking care for their sun damaged skin: lines, wrinkles and brown spots.  As a board certified plastic surgeon, I trained at Memorial Sloan Kettering Hospital, covering a lot of the skin cancer clinics.  It’s almost more important to me that I check my patient’s skin for early skin cancers.”  

Types of Skin Cancer

According to the Skin Cancer Foundation, each year there are more new cases of skin cancer than cases of breast, lung, prostate and colon cancer combined.  There are three types of skin cancer: basal cell carcinoma, squamous cell carcinoma and melanomas. The most treatable types of skin cancer resulting from sun damage are basal cell carcinoma and squamous cell carcinoma.  The third, more deadly type of skin cancer is melanoma.  “Melanomas have a genetic component, so any patient who has a family history of a relative with a melanoma really needs to be screened on an annual basis,” stresses Dr. Glicksman.

Benefits of Seeing a Plastic Surgeon for Skin Cancer Screening

If you thought only a dermatologist monitored and treated skin cancer, you were wrong.  Some skin cancers are obvious in appearance to a well-trained plastic surgeon, and others require a biopsy.  “I’m going to screen you adequately, take off only what we need to take off, and have a small biopsy that doesn’t leave a significant scar,” explains Dr. Glicksman.  Once a skin cancer has been identified, a plastic surgeon is best trained to close up the wound in a way that achieves minimal scarring, using a combination of special techniques to place the least amount of tension on the top layer of stitches.  Plastic surgeons are uniquely qualified to close incisions in a manner that leaves the best looking result.

Early Detection Saves Lives

“Most skin cancers are 95-100% curable when found small and early,” shares Glicksman.

Annual Screening

Dr. Glicksman strongly recommends all patients have a screening at least once each year to monitor the skin for any signs of new cancers.  This visit, when done with your plastic surgeon, can also be combined with a consultation for other age-related concerns or a regular surgical follow up.  

The post Treating Wrinkles & Saving Lives: When Plastic Surgeons Screen for Skin Cancer appeared first on The Plastic Surgery Channel.

Breast surgery, including reductions, lifts, and implant revision surgery is a big part of many plastic surgery practices.  The most common cause for breast reductions and lifts is the excess weight in the breasts and associated sagging, technically known as ptosis. Many factors including pregnancy, breast-feeding, and weight gain and loss, can have an impact on your breasts. In addition, many women with breast implants look to plastic surgeons to correct implant related problems, such as “bottoming-out” especially if you had large or heavy implants.

By Carolynn Grimes

When you need additional support to hold up your breasts…

Dr. Brad Bengtson a board certified plastic surgeon from Grand Rapids, Michigan often uses surgical scaffolds to support the soft tissue in his breast lift and implant revision procedures. “There are several scaffolds on the market and each one has slightly different properties. GalaFLEX® is a resorbable microfilament and SERI™ Surgical Scaffold is a silk-derived product, both are eventually replaced by your own tissue and absorbed. SERI™ Scaffold is very good for deep support, or implant malposition repairs and those kinds of things. What I like about GalaFLEX® is that being a monofilament or without braids and weaves in it, there’s a little bit less material but it’s equally strong.” Dr. Bengtson says his practice is about 25 percent breast implant revision, and in these types of surgeries, many of the patients require additional internal support to hold up their breasts.

“For larger breasts undergoing a lifts or a reduction, or in patients with large breast implants, it really unloads the skin and that’s the long term benefit,” states Bengtson.  “Without the GalaFLEX®, there’s a lack of support and the lower breast stretches and bottoms out over time.”

Dr. Caroline Glicksman, a board certified plastic surgeon from Sea Girt, New Jersey, specializes in breast surgery including reductions, lifts, and breast augmentation. She has used these scaffolds for many difficult reduction or breast lift procedures. “These materials can provide strong, long-lasting support especially for women who have poor quality skin after weight loss or multiple pregnancies,” says Glicksman. The GalaFLEX® scaffold eventually breaks down and becomes part of the patient’s own tissue in about 9 months to a year. “The clinical studies have shown us that at one year of follow up with ultrasound and mammogram, there’s no visibility of the product.  It has integrated well into the tissues and is usually not detected by the radiologist.”

Breast Lift Results Measured with State-of-the-Art Technology

“The other thing we’re doing that’s really exciting with the Vectra 3D imaging is that we can bring a virtual cut right through the nipple plane and we can measure the percent of breast tissue above and below that plane,” says Bengtson. These measurements can then be repeated after surgery to evaluate how long the lift maintains its post-operative result.

“Classically with breast reduction patients or mastopexy patients, the results are dependent on the weight of the breast and the skin stretch over time. These internal supports seem to give us much longer lasting outcomes,” says Glicksman.

Surgical scaffolds are now being used more and more to optimize a patient’s augmentation, reduction, and lift results by improving not only the shape of the breasts but the position and the long-term outcomes. “Whoever controls the lower pole of the breast – controls the outcome,” says Bengtson.

The post Internal Scaffolds Offer Longer Lasting Breast Lifts for Patients appeared first on The Plastic Surgery Channel.

Dr. Ashley Gordon of Austin, Texas sat down with her colleagues Dr. Camille Cash of Houston and Dr. Richard Baxter of Seattle to discuss whether or not they’ve found regional differences when it comes to plastic surgery. Are Los Angeles, New York and Dallas really the epicenters of plastic surgery? Do patients in Houston or Austin want the same procedures or look as patients in Washington or Miami?

by Katherine Stuart
The Plastic Surgery Channel

Which Cities are Top Dog?

Dr. Gordon questioned her colleagues about “Tri-Coastal” plastic surgery: Are Los Angeles, New York and Dallas really the epicenters of plastic surgery? Not any longer, according to Dr. Cash. “I think as more and more Americans are embracing plastic surgery then you’re finding that plastic surgery is happening throughout the entire country.”

New York and LA have historically been the birth place of certain trends in plastic surgery since New York is the center for the fashion industry and LA is home to Hollywood. But now, “you’re finding that cities like Houston, Seattle and Atlanta are becoming major hubs as well for plastic surgery.” Dr. Baxter agrees:“I think people on the coast and sun belt states are more open about their procedures.” People in the northwest are definitely getting plastic surgery, but they’re more reserved. They prefer a more natural look than, say, a patient in Miami.

Are There Regional Trends in Types of Procedures?

When it comes to breast augmentations in particular, there are definitely regional differences when it comes to sizing. The Northeast is a little more conservative with the average size being between 200-300cc while Dallas is a bit larger at 400-500cc. But neither holds a candle to Las Vegas where the average implant size is probably around 600cc. “Well, I think each city has a little bit of it’s own flavor.” says Dr. Cash. But she’s also found that in her practice in Houston, which is in the great state of Texas where bigger is usually better, that her patients are all over the map in terms of the look they want. Some like that very augmented, big, round “fake” look while others want a more natural look which she’s achieving with the anatomic implants. So, really, there’s a wide range just within her own geographic area.

Dr. Gordon is finding the same thing with her patients in Austin. In fact, she’s seeing a lot of patients who are in their 50’s or 60’s who’ve always wanted breast implants, and waited until now thanks to more natural looking results. “I think it’s the overdone ones that get talked about so much.” says Dr. Baxter. When people talk about implants always being so big and obvious that’s because they’re not seeing the other 90% that look natural and proportionate. Bottom line, it’s the surgeon’s job to give the patient her desired outcome, within the restrictions of her anatomy, when it comes to breast implants.

The post Tri-Coastal Plastic Surgery appeared first on The Plastic Surgery Channel.

Plastic surgery and breasts go hand in hand.  Everyone is familiar with procedures that enhance the shape of the female chest, but many people are not aware of the many men who would benefit from the confidence-boosting surgical treatment of overdeveloped breast tissue; a condition known as gynecomastia.  It’s a devastating problem for a man, causing him to feel uncomfortable in tight fitting clothes.  Men with gynecomastia are also very uncomfortable being seen in public without their shirts on, so they often spend their lives avoiding any time spent by a pool or at a beach.

by Anne Meyer
and Richard Zienowicz, MD

Causes

At puberty, hormones cause as many as 60-75% of adolescent boys to experience some amount of gynecomastia.  Fortunately, most of those cases resolve on their own as the boys continue to mature.  If gynecomastia persists after several years, a surgeon may consider using surgery to treat the overdeveloped breasts of a teenager.

Dr. Richard Zienowicz, a board certified plastic surgeon in Rhode Island, sees far less adolescent males in his office for gynecomastia surgery than adult males.   “Late twenties to late forties is one of the more prevalent age groups,” he says.  Athletes and bodybuilders who take steroids may experience gynecomastia as a side effect. Steroids, which are natural or synthetic hormones taken to stimulate muscle growth, often end up stimulating permanent breast tissue growth.  There are other prescription drugs on the market that can affect a man’s hormones, giving them the possible added side effect of enlarged breasts.   “Gynecomastia can also be associated with pot smoking,” adds Dr. Zienowicz.  “Cannabis will initiate the tissue growth, and that’s a prevalent situation in our society today.” Not all causes of enlarged male breasts are hormone related.  After massive weight loss, many men are left with extra sagging skin and some extra tissue in the chest that can cause them to feel self conscious, but that no amount of exercise can get rid of. 

Surgery & Recovery

The excess fullness removed during surgery for gynecomastia is taken from above the chest muscles, below the skin.  This means that the recovery is an easy one, with minimal swelling.  Most patients wear a special compression garment for a few weeks after surgery to assist with healing, and are back to work within a week.   The incisions are camouflaged by being placed in the pink area around the nipple.  

When Dr. Zienowicz is explaining the procedure to his patients, he points out that it’s important to realize that the goal of surgery is not to “flatten” the chest entirely. “We want to preserve a male chest, which has got some muscularity to it.”  

Surgery to treat gynecomastia is a life changing procedure for many men.  If a man in your life is struggling from self esteem issues stemming from enlarged breasts, encourage him to take the first step and learn more about the surgical treatments that are available to safely and quickly solve the problem.  “Once this change has been made,” says Zienowicz, “It’s just amazing what happens in terms of the transformation.”  

The post Getting It Off His Chest: Plastic Surgery for Men appeared first on The Plastic Surgery Channel.

The two biggest post-pregnancy body image complaints that bring patients in to see a plastic surgeon are sagging breasts and a loose tummy.  As a result, the Mommy Makeover was developed as a surgical approach to address multiple post-pregnancy body issues at the same time.  It typically combines a breast lift or augmentation with a tummy tuck and/or liposuction, restoring mom’s perky breasts and smooth abdomen. 

by Anne Meyer
and Mark Pinsky, MD

Restoring Mom’s Figure

“Most of the patients in my practice are moms,” shares Dr. Mark Pinsky of Palm Beach, Florida. “They spend considerable amounts of time, energy and effort sacrificing for their family and their children, running all over the place, taking little time for themselves. They once enjoyed putting on “that dress” and “that outfit”, looking fabulous.  Afterwards, after all that sacrifice and time, going through pregnancy, weight gain, weight loss, not getting enough sleep, always sacrificing – now it’s their time.  Their turn.  I love doing this operation, the Mommy Makeover.”

Mommy Makeover Part I: A Mother’s Breasts

“When a woman becomes pregnant, her breasts engorge; they get much larger with milk.  Whether they breastfeed or not, it creates significant impact upon the breast, to the point where breasts begin to drop,” explains Dr. Pinsky.  “The breasts get smaller after pregnancy as well.  The thought process behind re-creating a woman’s breasts following pregnancy is to give her back that upper pole fullness that she once enjoyed, and maybe even make it better than it ever was before.”

Lifting Breasts Also Lengthens Torso

“It’s an interesting perspective,” says Pinsky. “As the breasts come down and the tummy fills out, a woman looks heavier because the trunk gets shortened.  When you lift the breasts and you bring them up on the chest, the trunk gets longer and by relative proportions looks much thinner – whether or not you did anything to the tummy.” 

Mommy Makeover Part II: Post Baby Belly

“When it comes to the body contouring part of the mommy makeover, it can be multiple different things,” Pinsky discloses.  “Sometimes it’s just excess skin that we remove and some patients require a tummy tuck.”  The tummy tuck removes skin, removes fat and also addresses the layers underneath the skin and fat: the muscles.  By stitching the muscles together that were stretched apart during childbearing, mom’s can achieve a flat tummy.  A third common option to improve a tummy after babies is liposuction – which can address extra fat when there isn’t sagging skin or loose muscles.

Reclaim Your Figure

Just as a mommy makeover can sometimes provide women with even better breasts than they had prior to babies, it can also sometimes offer a patient an even flatter stomach than they ever enjoyed before having children.  “Lots of beautiful things come with babies,” acknowledges Pinsky, who has a child himself. “But, it takes a toll on a woman’s figure.  We have to do procedures to restore that figure, so that a woman can get into that dress they once enjoyed getting into, that bathing suit they used to look fabulous in.”

The post Moms, Get Your Body Back appeared first on The Plastic Surgery Channel.

The typical combination procedure addressing post-pregnancy woes usually includes a tummy tuck and breast enhancement to tighten abs and lift and/or augment breasts. Dr. Ned Snyder, whose practice is based in Austin, Texas recently performed a mommy makeover with a twist. The prospective patient’s tummy was fine, thank you. But her thighs were XL and heavy, while her breasts were XS and sagging…and the age old question was posed–“Can’t we take some from down here and put it up there?” Dr. Snyder said, “Yes.” The surgical plan included a three step procedure: circumferential thigh reduction, breast lift, and fat grafting to the breast. The result? Thinner thighs, perkier breasts and an extra cup size.

by Isabel Bolt
and Ned Snyder IV, MD

Lifting the Breasts

A breast lift, also known as mastopexy is one of the most frequently requested procedures in plastic surgery. According to the latest statistics from the American Society of Plastic Surgeons, breast lifts have grown 70% since 2000, outpacing breast implants 2-to-1. A woman’s breast shape, size and firmness is compromised over time and is particularly influenced by pregnancy and nursing, but can also be due to heredity, aging and weight fluctuations. The exact techniques used to lift the breasts is determined by the size of the breasts, amount of ptosis (sagging) and the position of the nipple. A mastopexy raises the breasts by removing the excess skin, tightening the surrounding tissue to reshape the new breast contour, and in some cases, reposition the nipple. Keep in mind, the purpose of a breast lift is to reposition the breast. It does not address size.

Thinning the Thighs

Most women are not in love with their thighs. Thighs are a problem: they are among the most fat-concentrated parts of a woman’s body. Heavy thighs can be an issue for adults of all ages, even young and generally fit people. Liposuction targets those deposits of fat on thighs that never seem to go away regardless of diet and exercise. If you are within 10-20 pounds of your ideal body weight but are still frustrated by large thighs, liposuction could be the answer. Dr. Snyder performed a circumferential thigh reduction with liposuction to remove deposits of excess fat from various parts of the patient’s upper legs, tightening the skin left behind. “I was able to improve both contour and proportion. She now has a nice overall reduction of tissue in her thighs.”

Liposuction is surgery. Depending upon the total area or areas and volume of fat to be removed, either local or general anesthesia is used. Combination procedures almost always require general anesthesia. A cannula (a hollow metal rod device) is inserted into small incisions and in simple terms, the fat is melted, dissolved and removed via suction. Excess skin around the incisions is tightened and sutures are applied. Compression garments are worn for several weeks to discourage bruising and swelling. Scarring is eventually invisible and final results a usually evident at the 3 month mark.

The firmer and more elastic the skin, the better the results. It will not get rid of cellulite. Liposuction gets rid of some fat cells for good, leaving less to expand and contract and so reducing fat levels permanently.

Fat: The Beauty of Recycling

Our relationship with fat is schizophrenic. Condemned on one body part. Celebrated on another. Dr. Snyder’s patient wanted smaller thighs, but a bit more in the breast area. He explained to her that since she commented that she didn’t want implants, but just a bit more volume to her breasts, she was a great candidate for lipo augmentation. “The fat I was going to take from her thighs would typically be discarded. She indicated that an increase of one cup size was all she wanted, so why not save the fat from her thighs and inject it into her breasts?” Since a breast lift does not significantly change the size of a woman’s breasts or round out the upper pole of the breast, fat grafting is a great alternative for those who want a modest increase without the maintenance of an implant.

The methods for harvest and injection have also been refined over time but fat grafting remains one of the most technique dependent procedures in plastic surgery. It should never be done by any physician other than a board certified plastic surgeon if you want the fat to remain over time. Dr. Snyder is experienced in both liposuction and fat transfer. “In the case of this mom, we used 120ccs (about 24 teaspoons) of lipo filling in each breast.”

Augmenting the breast with the body’s own fat first became popular in the 1980s. ASAPS initially cautioned its members because of potential side effects which could potentially make mammograms difficult to interpret. However, digital mammography, especially when examining dense breast tissue has greatly improved interpretation. In addition, recently published studies suggest that radiologists are able to distinguish between the changes seen after surgical procedures to the breast and changes that are suspicious for cancer.

A Happy Ending

“This was a lady who came to us with two concerns,” says Dr. Snyder. “Excess weight around her thighs and breast rejuvenation after breastfeeding two kids. We were able to get her to her target goal and she looks just great. She’s thrilled.”

The post Double Dipping: Thigh Reduction and Breast Enhancement appeared first on The Plastic Surgery Channel.

During the middle years of our journey through life, age begins to show itself in some unpleasant ways. Fat becomes harder to lose, muscle becomes harder to maintain, skin becomes loose and faces seemingly “fall”.  To combat the facial changes, many look to a plastic surgeon for a facelift.

But times are changing and new technologies are arriving almost monthly to bridge the gap between a youthful and aged adult. One such technology is ThermiTight.  It’s designed to provide skin tightening while being minimally invasive, meaning no general anesthesia and no operating room.

Dr. Tom Tzikas, a facial plastic surgeon from Florida, finds the device to fill a much needed role in facial aging; many patients could use some skin tightening, but do not yet need a facelift.  ThermiTight offers a way to tighten the skin and even melt some fat, providing a rejuvenation perfectly tuned to those patients who are not yet ready for surgery.

by Thomas Tzikas, MD
and Adam McMillon

The Power Behind ThermiTight

Areas especially suited for the procedure are the jawline and neck region. “It does a combination of fat melting and skin shrinking,” explains Dr. Tzikas. “It’s a great procedure for younger patients that don’t want a surgical facelift or necklift. It is a minimally invasive procedure, which means there is some local anesthesia injected under the skin.”

The device works by utilizing radiofrequency to heat up the tissue beneath the skin. Physicians carefully monitor the heat levels by way of a thermal camera, allowing for incredible precision and, as Dr. Tzikas notes, “You can actually see tissue tightening even as you’re performing the procedure.”  Minimally invasive is obviously not the same as non-invasive, so what does a patient need to know? For the probe to get under the skin, physicians create a small needle-hole near the ear for the probe to enter. Local anesthesia is used in regions where there might be discomfort.

Also different from some of the newer non-invasive treatments, ThermiTight is a one-time procedure. Because it is more invasive than some options, it can accomplish more at one time with longer-lasting results.

Are the Results Real?

Dr. Tzikas himself was surprised to find that the results keep getting better over time. Tzikas mentions one patient in particular and the progression of results from one ThermiTight procedure: “After 4 months she had a reasonably nice result. At 11 months, the result was significantly better. Then we took pictures at 18 months and the results were dramatically better than anything before.”

These findings reinforce the ability of minimally invasive procedures to have powerful, long-lasting effects for patients who are not yet ready for surgical procedures like a face or neck lift. “Results get better and better over time,” says Tzikas. “With one treatment, one procedure – that takes roughly 1 hour – and a 3-4 day recovery period… This is pretty significant for a non-surgical procedure.”

The post No Need for a Facelift (Yet) with ThermiTight appeared first on The Plastic Surgery Channel.

There comes a day when the mirror is no longer our friend. It starts slowly, but eventually there is no use denying that age is taking its toll. Getting older is written all over our face in the form of fine lines, wrinkles, poor skin quality, jowls and hollows. A consultation with a board certified plastic surgeon is a smart action step.  Dr. David Lickstein who practices in West Palm Beach, Florida sees patients of all ages interested in everything from basic skin care and correction of sun damage to full facelifts. “The true power lies in mixing, matching and combining modalities and techniques.”

by Isabel Bolt
and David Lickstein, MD

The Skinny on Skin

Great skin is the foundation of beauty. All the fillers and facelifts in the world won’t make up for poor skin quality. That is why it is essential to seek the opinion of a board certified dermatologist or plastic surgeon who has the tools to make the proper assessment of your skin.  “Rejuvenation, prevention, and protection” is the mantra at Dr. Lickstein’s med spa. Patients interested in counteracting sun damage are assessed with a special 3D Vectra camera at his practice that reveal specific areas affected below the skin’s surface. Intense Pulsed Light (IPL) therapy is a proven technology to quickly reverse signs of aging, breaking up brown spots, removing roughness, and allowing smooth even-toned skin to shine through. For those seeking to diminish age spots, hyperpigmentation or reduce fine lines, wrinkles and enlarged pores, microdermabrasion can be performed. It lightly buffs away damaged outer skin layers and replaces them with healthier skin cells. Dr. Lickstein comments: “With little downtime and a slow but steady improvement in appearance, these procedures are perfect for a wide demographic in our practice.”

A proper skin care regimen includes medical grade products not available in department stores, so step away from the cosmetics counter. The ingredients in skin care lines carried by plastic surgeons are much stronger than you can buy over the counter and work at the cellular level. Regimens are designed to work synergistically with your specific skin issues, so the results are more immediate and long lasting.

Noninvasive Chin and Neck Improvement

Of all the noninvasive tools at his disposal, Dr. Lickstein is particularly excited about two new procedures involving the chin and neck. “The neck is one of the least satisfying areas we treat as surgeons,” says Dr. Lickstein. “We can now offer improvements to a whole group of patients that might not want surgery through either injections or CoolSculpting®.” Until now, liposuction was the primary tool for eliminating fat at the chin and neck.

KYBELLA^™ has recently been approved by the FDA as a non-surgical injection for reducing the small fat pad under the chin, aka “double chin.” KYBELLA^™ contains deoxycholic acid, which is a substance that occurs in your body. When injected into areas of excess fat under the chin, KYBELLA^™ destroys the targeted fat cells, eliminating them from your body forever. Your chin/neck area will be “mapped” for where tiny injections will be placed. The procedure takes about an hour and there is no downtime associated with it. At least two treatments are often necessary for the best possible results. Patients with larger amounts of excess fat may require additional treatments.

CoolSculpting^® is a non-surgical alternative to liposuction that can freeze away and remove stubborn fat bulges. For the past few years CoolSculpting has primarily targeted abs, thighs, arms and hips.  The FDA has just cleared a new fat-freezing treatment for chin fat called the CoolMini^™. This miniature applicator is designed specifically to target excess fat cells that have collected under the chin. Using the same technique as CoolSculpting^®, the CoolMini^™ procedure can destroy the excess fat and cause it to filter out of the body through natural metabolic processes.  Like KYBELLA™, two sessions are often required for the best results and each treatment takes about an hour.

The Tipping Point: Graduating to Heavy Lifting

According to Dr. Lickstein, one of the most uncomfortable conversations he has with patients happens at the tipping point when surgery really is the best alternative. “Some patients are convinced they don’t need an operation, but I have to tell them that despite all these things we can do, the real answer is a facelift or necklift to accomplish what they desire and there is really no substitute.” In fact, injectables eventually reach a point of diminishing return both from the standpoint of appearance and budget. Dr. Lickstein understands it takes time to get accustomed to a recommendation for surgery. “It’s natural if someone is not ready to jump into surgery, so it’s nice to have other options available to at least allow patients to put it off for some time and wait for the right time, knowing there still is a surgical option.”

The fear of surgery is second only to the fear of looking “done,” says Dr. Lickstein. “Patients are looking for natural results and their greatest fear when we talk surgery is looking artificial, fake or even funny. We can deliver a very natural result where they will look well rested and others won’t even know they had a procedure done.”

Making the Most of your Consultation

A consultation for facial rejuvenation is multifaceted. Skin quality, volume and degree of skin sag will be evaluated. Dr. Lickstein starts from the forehead, down. “I look at the position of the brows, excess skin around the eyes, jowls, loose skin in the neck. All or some of these can be addressed. It is never one operation fits all.” Adding volume with fillers or fat, while taking away volume with liposuction may be necessary.  He cautions against having preconceived notions prior to the consultation. Sometimes it is not what you might expect. “As trained board certified plastic surgeons we know it is our job to explain…and most patients will come to the conclusion there is rationale behind the recommendation. Then they can make up their own mind if it fits into their life at that time.”

In any case, Dr. Lickstein points out that given the number of options available and the infinite ways of combining modalities, long lasting relationships are often formed with patients. “It can be tightening loose skin, resurfacing sun damage, maintenance with a laser, injectables, surgery, or just plain skincare for someone who has never put any effort into that before. It’s a very satisfying continuum of care.”

The post About Face: An Overview on Facial Rejuvenation appeared first on The Plastic Surgery Channel.

When you’re considering having breast augmentation, there’s a lot more to think about than just what cup size you want to be. Working with your surgeon, he or she should walk you through at least five important steps before the day of surgery.

by John Hammarley
and Mark Epstein, MD

How to Determine Size

Size does matter but there’s so much more to consider about size when contemplating a breast augmentation. One great thing about breast implant surgery these days are the options available to both the patient and surgeon. Certainly the ‘one size fits all’ approach has no place in today’s breast implant conversations.

It’s a decision with long-lasting consequences, so size is probably the best place to begin. One recent study showed three years after surgery, 15 percent of re-operations were due to a woman’s decision to select a different size or style. One of the best clinical methods of determining breast implant size is to use a tissue-based measurement system.

Which Type of Implant?

Talk about choices! When considering the type of implant, get ready to use both hands to count them all. Saline or silicone, smooth, textured or round, a large-than-ever contingent of implants are available for the discriminating patient. And, as the American Society of Plastic Surgery reminds us, implant manufacturers occasionally introduce new styles and types of breast implants, so there may be additional options available. Whether you choose saline or silicone implants, you’ll need to monitor your breast implants and follow-up with your plastic surgeon for appropriate checkups.

Like Real Estate, Pocket Location is Key

There are two main pocket locations for breast augmentation: sub-glandular placement is between your chest muscle and your breast tissue (under the gland) and partial sub-muscular placement, where your breast implants are placed partially under the pectoralis major chest muscle. Sub-glandular placements may help reduce your surgery and recovery time. It may be less painful than partial sub-muscular placement and may make your breast implants easier to access if reoperation is needed. To avoid partial sub-muscular implants resulting in a longer, more painful recovery than sub-glandular implants, surgeons now have the option of using a Dual Plane placement which allows partial muscle coverage without the negatives associated with traditional partial sub-muscular placement. Placing an implant partially under the muscle may reduce the risk of developing capsular contracture , as well as offer easier mammographic imaging of the breast.

Where the incision is made is important

Incisions vary based on the type of breast implant, how big of an implant, your particular anatomy and the agreement between you and your surgeon. The most common breast implant used today is silicone gel.  Since silicone implants are pre-filled, and the silicone is extremely thick and cohesive, the incision location is limited, usually,  to the inframammary fold location or underneath the breast.

How soon will i be back at full-strength?

Using special, precise surgical dissection techniques, Dr. Epstein can produce a better recovery for patients, allowing them to be up and returning to normal activity the day of surgery.   The American Society of Plastic Surgery recommends you be given specific instructions that may include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when you should follow-up with your plastic surgeon.

Dr. Epstein says you possibly can resume light, normal activities, including shopping and going out for dinner, the same day as surgery. Strenuous exercise, Dr. Epstein warns, shouldn’t be resumed for three weeks after your augmentation.

The post 5 Key Decisions in Breast Augmentation appeared first on The Plastic Surgery Channel.

Teenagers who get plastic surgery may have far different reasons for seeking a change, than adults. Teens often want cosmetic procedures to fit in with their age group, but adults often have surgery to standout in the crowd or look better. It isn’t uncommon for teenagers to want to correct flaws that make them feel ‘awkward’ or different from their peers. Longtime plastic surgeon, Dr. Mark Epstein supports plastic surgery for teenagers, if its done for the right reasons and in general for reconstructive purposes. Dr. Epstein lays out his TOP FOUR COSMETIC PROCEDURES FOR TEENAGERS and discusses why these surgeries are appropriate for children.

By Dawn Tongish

Plastic Surgery Is Right For Teens

Each year thousands of people have plastic surgery and of those, many are under age 18. It is estimated that in 2014, about 64,000 cosmetic surgery patients were between the ages of 13-19, according to the American Society of Plastic Surgeons. There are numerous reasons why teenagers seek out plastic surgery, but topping the list is a desire to stop feeling like an outsider. Many times, a child just wants to feel ‘normal’. Some top doctors agree that there are conditions that need to be surgically fixed before adulthood. “When we think about teens and plastic surgery we are all thinking teens and cosmetic surgery and we aren’t thinking that much that what we are doing is really about reconstructive procedures,” says Dr. Mark Epstein. Epstein, who practices in Stony Brook, New York thinks there should be more discussion about teens and plastic surgery to highlight an issue that too often is considered taboo or off limits. “It’s such an important topic that needs to be out in the open.”

Otoplasty – Prominent Ears

It is a condition that is often referred to as ‘Dumbo Ears’ and can lead to cruel taunting on the school playground. The surgery involves the correction of protruding ears, in which the ears are pinned back and may be performed after the age of five or so. This procedure makes up about 11 percent of all cosmetic procedures in children. Epstein says it is one surgery that is performed on the very young. “The reality is when a child is around six-years old the ear is fully grown and that kid can become a target for bullying at school. That is one reason why we will operate on a child so young.” The difference is remarkable and children often experience a big boost in self-esteem. “When you take the before pictures, they are never smiling and then you take the after pictures and the hair is pulled back and they are showing off their new ears. It does do a lot for their esteem.”

Breast Reduction

Enduring overly large breasts can be a physical and psychological burden for a teenage girl, according to many experts. Many teenagers can suffer back pain due to the size of their breasts. Dr. Epstein says the weight of having big breasts is often a mental strain for a teen girl. “When a young girl is being teased and she doesn’t feel good in her clothes and she can’t go to gym class and exercise with her friends, that is an awful thing to endure.” In recent years, the popularity of breast reduction for girls and young women has grown. About 4,600 of these surgeries were performed in 2010, an operation which Epstein performs. “These girls need relief just like any other woman. When I can do a procedure like this, it can be life-changing for a girl.”

Labiaplasty

It isn’t exactly a procedure that most people talk about, improving the looks of  ‘down there’, but teenage girls are seeking out labiaplasty. The surgical procedure removes excess tissue from the labia, making it smaller. Dr. Epstein says it is often done for hygienic reasons or cosmetic reasons. “The problems are often time appearance. The girls are self-conscious to the extent that when they stand up, the skin hangs over the outer lips and that is distressing.” Epstein says that unlike women, who are usually sexually active, teenage girls are not. It’s important to correct the issue before a girl becomes intimate. “This can cause problems later, so we usually try to perform the surgery about 16-years old, if she is done growing.”

Rhinoplasty

It is without a doubt, THE MOST SOUGHT AFTER PROCEDURE among teenagers. “The most common procedure that is done in teens, is the rhinoplasty,” says Epstein. Rhinoplasty accounts for about half of all plastic surgery procedures in the teenage age group. Epstein says there is a burning desire among young girls and boys to reshape the nose, to in general improve the look of the face. “This is a spot where most people are very self-conscious. The nose is so important to the appearance of the face, and the face is so important in our society.” Usually, this surgery is not performed until the nose reaches its adult size. Epstein has rules that he follows. “I will ordinarily perform the surgery at about 15 in girls and 16 in boys. I wait until the facial skeleton is developed.” Overall, Epstein says he thinks teenagers who feel they can benefit with improved appearance and a boost in self-confidence should consider cosmetic surgery. “I don’t think there is a downside to that.”

The post Is Plastic Surgery Ever a Good Idea for Teens? appeared first on The Plastic Surgery Channel.

When it comes to beating Father Time or Mother Nature, the first thought comes in one word “Lift.” Whether we’re talking about our faces, or our breasts or our posteriors, lifting is almost always a way to fix and fight the weight of gravity and time.

Lifting our necks is no different.

by John Hammarley
and Peter Fodor, M.D.

When it comes to necks, there are options

Whether you’re considering a complete rhytidectomy, the surgical procedure that improves visible signs of aging in the jawline and neck, or liposuction or injectable drugs — sprucing up your neckline can be approached from many different aspects.

Some of them may be chosen because you may want to avoid the scalpel and some may be selected because of expense or need.

Dr. Fodor likes all the options he has. It gives him and his patients the freedom to choose what approach is going to work best, for the long- and short-run for each of his patients.

The Usual Suspects

When you’re looking for the culprits that conspired to turn your neck of years gone by into the one you’re not all that jazzed about when you look in the mirror, there aren’t many surprises.

According to the American Society of Plastic Surgeons — excess fat and skin relaxes in the lower face, creating jowls; similar excess fatty deposits under the chin; overall loose neck skin and muscle ‘banding’ all make good reasons to visit a plastic surgeon. Even environmental conditions and stress can sap your neck of its youthful appearance.

Those nicknames…

“Turkey wattle.” “Double chin.” “Jiggly jowls.” You may not be ready for a full face lift, and, in fact, you may not need one. But the neck? That may be a different story. And if it is, you may feel it’s time to get those stories to match up a bit better.

Not Ready for a Full Neck Lift?

About this time last year, the U.S. Food and Drug Administration  approved Kybella (deoxycholic acid), a treatment for adults with moderate-to-severe fat below the chin. It’s identical to the deoxycholic acid that we naturally produce in the body, which helps the body absorb fats. When it’s injected into the fat, the drug destroys fat cells. Kybella is administered as an injection into the fat tissue multiple times. You may receive up to 50 injections in a single treatment, with up to six treatments administered no less than one month apart.

LIPOSUCTION removes excess fat, but can’t significantly improve sagging skin. A good candidate for successful neck liposuction will be younger, in his or her 20’s through early 50’s. Their skin is fairly elastic, which is necessary for the skin to contract smoothly and evenly after liposuction.

For most patients, neck liposuction is fairly quick and many times it can be done with local anesthesia. Through one or two tiny incisions, concealed beneath the chin or behind the ears, a plastic surgeon inserts small liposuction cannula, removing excess fat and sculpting a natural contour to the chin and neck. Following the procedure, patients typically wear a special supportive chin strap for about three or four days, will return to work within a week, and be ready to return to full activity after about two weeks. It’s typical to experience some swelling and bruising after neck liposuction, but it should disappear with two weeks of your surgery.

The post Go Ahead, Stick your Neck Out! Help is Here! appeared first on The Plastic Surgery Channel.

On the surface, it’s a simple question… What is a full C cup? It represents a long-standing challenge for patients and their plastic surgeons as a ‘full C cup’ to one person may be significantly different for another.

by John Hammarley
and The Plastic Surgery Channel

One Person’s “C” May Be Another’s “D”

You’d think since we’ve already taken a solid step into the 21st century, it wouldn’t be a problem agreeing on something as seemingly straightforward as a cup size for a woman’s breast.

Think again. 

“Not a day goes by when someone comes into my office and says ‘I want to have a full C cup’ when we’re talking about breast augmentation,” says William P. Adams Jr., MD, a Dallas plastic surgeon. “The problem is there’s not even a bra that’s a full C cup bra.”

It’s a lot like clothing sizes. Today’s size six in a woman’s dress most likely is a far cry from how big (or small) a size six was just a decade ago. It’s called the same thing, but the actual size can vary by the manufacturer, the generation is was made and who’s describing it.

Who knows?

An estimated 70 percent of women don’t know their proper bra measurements. Without knowing these measurements, it can be very difficult to buy fashionable and well fitting clothes, let alone estimate a different size breast they may like through augmentation.  Many women’s clothing items use bra or cup size measurements to distinguish differences in fit, so these measurements can be extremely important.

Additionally, a woman’s breasts change significantly over time, particularly during and after pregnancy. Weight loss, gain and monthly cycle variations can also have an effect on the size of your breasts. It is advised that you check your bra size once or twice a year or as necessary due to significant weight changes.

“I think there’s no topic greater than this one to find more differences of opinion in between plastic surgeons,” says Constantino Mendieta, MD, a Miami-based plastic surgeon. “You’re not going to find two people who agree on the same answer to this question.”

How to reach a concensus

Dr. Mendieta suggests three ways patients and doctors can come to an agreement on the size of any given breast size. First, measure. “So that your current breast will determine what’s the best implant that your body can accommodate,” he says.  The second way is for the patient to bring in a picture of the size of breast she’d like. A picture may be worth a thousand words as well as being an invaluable guide for both patient and doctor. And the third method would be to use so-called bra ‘sizers.’

Dr. Adams, in his practice, likes to steer women away from fixating on cup sizes and instead utilizes three dimensional imaging. By using this technology, Dr. Adams is able to employ scientific accuracy to show the patient exactly what any certain size implant will look like, instead of estimating with sizers or approximating with a photograph from a magazine.

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