ASPS Medical Tourism Alert, Facelift Longevity, Indian Rhinoplasty

The American Society of Plastic Surgeons cautions consumers on medical tourism; research looks at the longevity of the facelift; and more Indian Americans are opting for nose surgery.

What is the best tummy tuck?

It can get confusing when coming in for a consultation about your tummy.  Assuming you are not a good candidate for liposuction or a minituck, you are now looking at a full tummy tuck.  The traditional way was to simply undermine your skin all the way to the ribs and then sew the muscles together as snugly as possible in the midline then pull the skin down as much as possible.  The newest way is to employ liposuction to diminish the thickness of the fat layer then employ discontinuous undermining to maximize the blood supply and diminish risks.  The muscles are sutured together but not as tightly as in a traditional tuck.  If you are thin, the traditional will work well but if you have any excess of fat, the newer method, called lipoabdominoplasty will work better for you and with less risks.  Talk to your doctor about what is best for you when you are given your options.

Versatility of Injectables

Fillers and Botox have emerged as very effective way of temporarily creating desired improvements.  Here is a laundry list of what they can do for you.  Ask your doctor about it!  For the face, they can elevate your brows, diminish frown lines, fill frown lines, smoothen your forehead, prevent crow’s fee, fill crow’s feet, fill hollows under the eyes, fill in earlobe creases; plump up cheeks, lift a droopy nose or diminish a gummy smile, plump up lips, lift corners of mouth, fill creases and depressions, round out pointy chin or soften chin cleft, fix neck bands and fill a jowl line.  For the hands, revive the effects of aging on the dorsum of your hands and stop sweaty palms.  For the body, it can dry up armpits, fill dimples in the skin, and mildly boost your breasts.  For the legs, it can cushion soles and eliminate sweaty feet.  But remember, with fillers and Botox, your results are temporary.  Fat grafting can give you permanent results.

Beauty Myths Exposed

The following was obtained from New Beauty magazine:

1) You do not need to use sunscreen every time you’re exposed to the sun – FALSE  [experts agree that you should always apply sunscreen when exposed to the sun – I personally have not yet been able to do this myself]

2) If dermal fillers are not repeated, your tissue will deflate once the fillers wear off – FALSE  [your tissue will revert back to the pre-filled stage and will continue to age, though some studies suggest stimulation of collagen from repeated injections]

3) Baldness is inherited from the maternal grandfather – FALSE  [though long held thought, there are other conditions that contribute to hair loss beside genetics alone]

4) Acne scars and pock marks fade with time – FALSE  [they do not but fractional laser resurfacing as well as dermal fillers show promise in helping diminish the scar]

5) The nose is always broken during rhinoplasty – FALSE  [the underlying structures are altered to achieve the goals, sometimes requiring fracturing of the nasal bones]

6) Liposuction removes cellulite – FALSE  [cellulite is caused from fibrous structures in the skin and liposuction alone does not do anything for that]

7) There is a ‘best’ doctor for specific procedures – FALSE  [though some doctors specialize in only one procedure, it does not make them the best – research your doctors credentials and results and you can find great surgeons in your own neighborhood]

8) Spider veins and varicose veins are caused by crossing your legs – FALSE  [where do they get this stuff from?]

9) Skin becomes ‘addicted’ to treatments like moisturizer and lip balm so that the more you use them, the more you will need them – FALSE  [the natural aging of skin may make it seem like you need more products but that is from the natural aging process alone]

10) Older women shouldn’t have longer hair – FALSE  [I love long hair and experts agree that older women can wear it well too]

Topics to review with your plastic surgeon

When you are considering plastic surgery, you should make sure the following questions are addressed.  Is your doctor board certified in Plastic Surgery (and not simply board certified in some other specialty)?  Can he/she show you pre and post-op photos of his/her work?  Are there any alternatives to what you are considering?  What procedure is recommended and why?  Is the operating room an accredited facility with licensed anesthesia providers?  Your doctor should be able to say YES to every one of these.

When to walk when considering cosmetic surgery

If you see any of the following, consider finding another surgeon…

No informed consent

Surgery is scheduled without your doctor evaluating you and reviewing your health history

The cost is not clearly stated prior to the procedure, or unbelievable pricing to induce you to schedule today

Promises and guarantees are made to you – if so, get it in writing

Additional procedures are encouraged despite being unrelated to your goals

Your doctor has an awful record of infections and complications with standard procedures (friends or those that work in health care will know)

How do you know you are ready for plastic surgery?

You know you are a serious candidate for plastic surgery when you want to do it for yourself, you are realistic about what can be accomplished, you accept that surgery will not change your life but only your appearances, you accept the risks of surgery, your health is good, and this is an affordable option for you.  If you can say yes to all of the above, you are a good candidate for cosmetic procedures.

Dinosaurs become extinct

and I’m referring to doctors who do not keep up with the latest, proven technologies and techniques.  If you doctor only has one way of doing a breast reduction or lift, its best to avoid them.  If they refuse to do what is best in your interests, despite the newest evidence about ‘no-touch’ techniques when inserting implants and biofilms, you need to ask why they don’t embrace what is best for you.  With this mentality, that dinosaur doctor should be looking at retiring in the near future as they all eventually become extinct.  I need to retire when I choose to stop learning.

Sientra Textured Anatomic Cohesive Gel Implants

We are developing an experience using their textured anatomic “gummy bear’ implant in reconstructions and cosmetic augmenations.  The early results have been more than satisfying, achieving shapes and looks that could not be accomplished with the traditional round implant.  These implants will always have a place in breast reconstructions and I’m glad I have another alternative to offer my patients.

Vaginal Rejuvenation

According to the December 13, 2012 issue of Cosmetic Surgery Times, on-line information about vaginal rejuventaion (aka labiaplasty) can be misleading and inaccurate.  From what I have seen on-line. there are several doctors that should not be doing this kind of surgery.  Don’t be mislead but what some doctors may say are special techniques because there really are none.  There are 2 basic ways of labiaplasty and one has much less risk than the other.  See results from your doctor and see if you’re comfortable with him/her and their protocols and costs.  Regardless, this procedure will not improve the physical aspect of your intimacy.