Archive for October, 2012

Choosing your Plastic Surgeon

Selecting your surgeon can be challenging at times, especially when there are so many to choose from.  First and foremost, you need a skilled surgeon and this can be confirmed through talking to patients and friends who have firsthand knowledge of outcomes and the hospital staff that have to work with him/her.  You need to like your surgeon and feel a special bond with and this is achieved through face to face consultation.  A good doctor will treat you with respect and also value your time.  Your doctor should have a clear revision policy so you know what may happen should your results require tweaking to achieve the best outcome.  The doctor’s staff should be friendly, accommodating and accessible to you should you have any questions or concerns.  Even better, you have direct access to your doctor where texts can be exchanged if needed.  Then there are the intangibles such as the doctor’s complication rate, timely response to your calls, and efficiency in completing any necessary paperwork like disability forms and excuses from work.  Do your homework and you should have a wonderful experience.

Body Contouring

There are many techniques and technologies available for contouring your body.  The gold standard remains traditional liposuction using the tumescent technique.  Many technologies have come and go and some variations of traditional liposuction have persisted such as power-assisted liposuction, water jet liposuction, ultrasonic liposuction and laser liposuction (better known as Smart Lipo).  These all work but the gold standard remains traditional liposuction.  Non-invasive methods of contouring such as Cellulaze and Endermologie claim remarkable results but the test of time has not been encouraging as these technologies produce temporary and subtle results that require repeated treatments (and costs) to simply maintain a subtle improvement.  A clear revision policy should be understood before embarking on a costly series of non-invasive technologies or you should at least have a very clear understanding of just what results you should expect.

What is the Lifestyle Lift?

You may have seen those television ads about the ‘Lifestyle Lift™’, showing amazing results from a procedure done in the office under local, often over the ‘’lunch hour”.  The Lifestyle Lift™ is a variation of a mini-facelift.  This is provided by surgeons of all specialty backgrounds that take their training class.  What is deceiving is they do not tell you all of the other add-on procedures the advertised patient had to achieve her remarkable and stunning results.  Mini-facelifts can be done in the office safely but my preference is to have it done in the operating room (yes, it does add costs to the overall procedure).  When considering facial rejuvenation, it is worth it to obtain a consultation with doctors you are interested in having your procedure with.  Options for addressing your concerns should be reviewed with you in-depth at that time.  In general, the more extensive a procedure, the more enduring your results.

Brow Lifts

There are at least 3 distinct methods of elevating your drooping brows.  You can achieve this through the traditional coronal lift, the high tech endoscopic lift and the simple subcutaneous browlift.  In the best of hands, the endoscopic browlift was noted to have a relapse rate of 25% or more.  The coronal life leaves a scar going across your scalp from ear to ear as well as the risk for permanent numbness to your scalp behind the scar.  The subcutaneous browlift admittedly has a high relapse rate but it is the only lift that can be done under local anesthesia in the office setting.  With a good revision policy, this puts you at minimal financial risk.  The scar is hidden along the hairline and has healed quite well.   Because of this, the subcutaneous lift is my lift of choice.  Ultimately, my patients choose what is best for them after considering the risks and benefits of each technique.

Lip Enhancement

Many techniques are available for ‘plumping’ your lips.  When there are a multitude of procedures available in cosmetic surgery, it usually translates to unpredictable techniques as it is with lip enhancement.  Everyone has seen the overdone filled lip that result from excessive dermal fillers.  Fortunately, these monstrous lips eventually subside.  Fat grafting has also been used but the results are not predictable as fat take in lips is less than 25%.  Surgical procedures done at the lip border or inside the mouth have also been done but with less than satisfying long-term results.  Finally lip implants made out of silicone can be placed for a ‘permanent’ result from one procedure that can be done in the office under local.  The costs of this procedure for both upper and lower lips does not exceed $2000 (equivalent to 4 vials of Restylane) and can be easily reversed if you are not satisfied or become uncomfortable with the implant.  Of all the techniques out there, lip augmentation with implants is the most predictable and permanent.

Fat Grafting

Using your own fat to fill deficient areas has achieved a reliable level of effectiveness.  Using it in breast enlargement is controversial but accumulating evidence is supporting its safety.  The major risk of fat grafting, besides failure to take, is fat grafts will still behave as it did before harvest.  Translation means weight gains can lead to your grafts also increasing subtly in volume.  Microliposuction can always address this should it happen.  And if you have liposuction with me, I am more than happy to return it to you in selected areas.  Stem cell effects have been speculated on but at this time, it remains speculation.

Anatomic (teardrop) gel implants

They have been reintroduced and some are already advocating the return to them as the more ‘natural’ of implants.  Prior experience with saline anatomic implants revealed that the revision rate was much higher and this will probably be a persistent problem.  However if rippling is your problem, these highly cohesive, true ‘gummy bear’ implants can definitely help.  Other issues may arise but your appearance upright should be more than satisfying.