Facial Trends – Buccal Fat Pad Extraction

Last week, on The Humanity Behind the Vanity, my wife, Betsy wanted to talk about a procedure I find myself doing more and more of: Buccal fat pad removal. Now, there are a lot of people who’ve never heard of this procedure, so I’ll give an introduction and let you hear our chat.

Buccal fat is the fat just under the cheekbone. If you’ve ever seen anyone with “chipmunk” looking cheeks or very round cheeks, that’s the buccal fat. So, many models back in the early 90’s would have a bit of the buccal fat removed for more enhanced and pronounced cheekbones.

Again, there aren’t many side effects besides a bit of swelling, which DOES go down after a few days. And there are alternatives to enhance the cheekbones as well, as Betsy describes. It’s all a matter of personal preference. If you’d like to know more or have any questions, send me an email or call my office at 505-988-8886…or let’s talk about it right here.

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Body Contouring – After Massive Weight Loss

Two weeks ago, on our radio show, The Humanity Behind the Vanity, we devoted the entire show to answering listener questions. In the first segment, we talked about cryolipolysis, or fat freezing. In this segment, we’re talking about body contouring after gastric procedures for weight loss, along with insurance questions.

One of the biggest issues people deal with after weight-loss surgery is excess skin. People who decide to go in and get serious about weight loss often don’t think about the after-effects. And in the past, it wasn’t something talked about during consultation with the weight-loss surgeon (nowadays they are better at preparing the patients for what to expect). In many cases, there have been some people who come out of the weight loss phase and are suffering just as much mentally because they weren’t prepared for the excess skin.

So, now that the weight has been lost after the gastric bypass, or lap band, or other procedure, what can be done with the excess skin? I typically don’t even think about body contouring on anyone until their weight has been stabilized for about three months, and this usually takes two years or so after the surgery. The only way to get rid of excess skin is to excise it…cut it off. The same goes for stretch marks. So, during this procedure, both are typically taken care of during the same surgery.

It’s not uncommon to combine procedures, two or sometimes three at a time (modern techniques have made this safe on most patients). Later on down the road, there can be another combo — popular ones are thighs and tummy, or breasts and arms, or tummy and breasts. We really wouldn’t know what would be best until we actually sat down and talked.

Concerning the insurance question, you’d have to ask your insurance company. Removal of excess tummy skin has been covered in the past, but not in all cases. Sometimes large-breasted women can have a reduction covered. Arms and thighs are not covered, unfortunately.

Questions?

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Be leery of the bandwagon

We’re all prone to the bandwagon. I don’t know many people who aren’t. Who doesn’t want something to magically work and take away fat without having to work quite as hard? It’s a natural tendency to want to believe a pill or procedure will work, and as technology is changing and shifting, there are going to be products, services or procedures that make hefty claims, but don’t do what they say in the long run.

That being said, my wife and I answered some listener questions on our radio show last week. I’m going to share the first part with you today and second part next week because both subject matters are worth a blog post.

We had a listener write in and ask about cryolipolysis…which is essentially a technique for dermal cooling. In other words, dermatologists use this to numb the skin before performing a procedure. Well, because it cooled the skin, some doctors thought it would have an impact on fat cells. Here’s a bit about it and here’s what they found.

It’s important to keep in mind that there are reasons for the time frame it takes to research procedures and products. And though PR is great, it can also cause a backlash in the future that isn’t expected. There are new procedures out there that DO work…for example, the Tickle Lipo™ procedure, but it took me over a year to decide what I was going to use. Again, these things take time.

My advice? Research the doctors you use and never be afraid to ask hard questions.
Speaking of…do you have any questions?

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Madonna’s Aging Hands

There’s been a lot of press going around about Madonna’s aging hands over the past few years. Blogs have been written, photos have been posted, and assumptions have been made. Some doctors have said her “vigorous exercise routine” is partially to blame, mainly because strenuous exercise does cause increased blood flow, which in turn, causes veins to appear more prominent. But hang aging is a natural thing. The question turns now to, ‘what can be done about it?’

Working out is essential to our overall health. I would never advise anyone to not work out because it could cause hand aging. Madonna has taken her fitness level to the extreme, and she’s always been on stage. There is pressure for entertainers to be fit.

Another thing to consider is that the skin on our hands is just as sensitive as the skin on our face. It’s very thin, and some of the first signs of sun damage can be seen in these areas. Sunscreen is just as important on your hands as it is on every other part of the body. Also, genes are genes, and can’t be changed – some people will be more prone to hand and neck aging than others. We all have to work with what we’ve got.

The good news is, if you’re self-conscious about the way your hands look, you can change that. We’ve been using fillers in to rejuvenate hands for years and have seen great results. My favorite hand filler is Artefill because it lasts longer than any of the other fillers, though it’s more of an investment up front. The patients who have had this procedure done have loved it. Radiesse is a great alternative, less expensive and less durable.

Hand rejuvenation is an in-office procedure that takes a short amount of time. A small wheal of numbing medicine is raised on the back of the hand with a little needle, and the filler is injected painlessly into the area. It is then massaged into position, and voila! Done in 5 minutes. You can drive off and go back to what you were doing before you came in. There is numbness on the back of the hands and sometimes the fingers for a few hours.

A great combination for those with sun damage is to get laser treatments for those brown spots and freckles. I have a combo package going with my laser expert, Marian Urban. If you have any questions about this, always feel free to call my office in Santa Fe, at 505-988-8886.

Questions?

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Exercise vs. Plastic Surgery

We’ve had some questions come up recently regarding exercise and plastic surgery. Although I’ve written on it before, I’d like to talk about it in a bit more depth . . . mainly because even though they both change the body, they’re not the same.

Here are a few scattered thoughts:

• Burning more calories than one consumes has always been the safest way to stay in a healthy weight range.

• Today, consumers have many “healthy”, “diet” food choices available to them that are not ideal for how our bodies were made. Low-calorie foods with artificial sweeteners are not recognized by our biochemical food processing system, and so we end up starving our bodies of nutrients.

• As technology has improved, laziness has increased. We do not walk anywhere any more.

• Most people are not dumb, they are simply not properly educated because their parents weren’t properly educated and their peers are not. There are many confusing nutritional authorities in the media.

• There is currently an obesity epidemic, especially among teens. Having said that, there are millions of people consumed with body image and how their bodies look. It is easy for them to be swayed by the success of a few people they know or a few photographs in an advertisement.

• Exercise is such a crucial part to maintaining a healthy BMI (Body Mass Index). Not only does it keep us in shape, it also has major physical and psychological benefits such as lowering depression and anxiety, and strengthening the heart, lungs, and immune system. Exercise can give us peace of mind.

• Every person is born with different genetics. Some are small by nature, others are bigger boned, causing them to naturally be bigger. There is no “normal”. We’re all so very different. Take pregnancy for example: I’ve known women that have had children and have bounced back within weeks of birth. It’s not that easy for others. For some, no matter how hard and often they work out, that extra belly fat or skin just won’t go away.

Here is where the psychological effects of plastic surgery play a role: body image is very real to those that have it . . . good, bad, or indifferent. When someone’s body image affects him or her negatively and it controls a big part of his or her day, something should be done. With our Whole Being Plan, we’re able to address the physical, the psychological, and the spiritual. Exercise is a key component. Plastic surgery is often not the “quick fix,” that many believe that it is. I want to help people be the best they can be and feel their best. Sometimes, it takes a little more than what we can do on our own.

Thoughts?

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Are people judgmental when plastic surgery is involved?

I tweeted and posted on my Facebook page a video of our radio show, The Humanity Behind the Vanity. The subject matter was centered on Julia Roberts and her announcement to not have plastic surgery.  This was on The View last week.  She has decided, for lack of a better expression, to “grow old gracefully.”

Julia Roberts is naturally beautiful. She’s been in the spotlight for decades, which may have played a role in her taking such great care of herself . . . that, and her biology.  Very few people are like her.  We “normal” looking people struggle with so many things that others can never understand, and often people are so quick to jump to conclusions or judgments.

This is an important topic because when a celebrity makes a pronouncement about plastic surgery, the buzz that follows is really about how we judge other people.

What a person chooses to do or not do to their body is entirely up to them.  There is nothing more satisfying than to see my patients post-op, and see a light in their eyes that may not have been there before because of the changes I was able to assist with. It’s one of the reasons we have the Whole Being Plan. It’s not just about how the outside looks, sometimes those outside changes affect how they feel inside . . . and vice versa.

Have you experienced different attitudes as a result of any procedure you’ve had done? Was it positive or negative? How did you handle it?

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Trunkplasty: Excess back skin removal

Before

Before

We’ve all seen it. Perhaps some of reading this blog post actually deal with it, or know someone else who does. Back fat. And for some people, no matter how much they exercise or work out, it doesn’t go away. This can be especially problematic for someone who is experiencing major excess skin after massive weight loss. There is a solution. It’s called Trunkplasty.

Trunkplasty is an excision procedure where the surgeon goes in and actually cuts the excess skin off. Many patients also incorporate liposuction in the lower back for shaping purposes.

After

After

Although it does cause a scarring, (Kris Wrede, our Aromatherapist can help with this issue), for women, the incision is hidden in the bra line. The down-time is about a week. The scar heals slowly in terms of redness and width – like arm and thigh scars, they take longer to remodel than do breast and abdominal scars. But eventually, with the scar hidden behind the bra, it looks great.

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Which 1 are you? Limited Time Botox Offer

We see them all the time…the older we get, the more prominent they become: Frown lines between the eyes. If you’ve been wondering if Botox could be a solution to these lines, here is your chance to get $50 off on your treatment.

Which 1 are you?

This is a limited-time offer and ends September 30, 2010.

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Who is getting plastic surgery?

Before Face, Neck and Browlift

After Face, Neck and Browlift

Those getting plastic surgery are not who you think they are. They’re not doing it for the reasons you might think. Since 2000, the number of cosmetic procedures performed in the United States has increased by almost 50% percent.

There were almost 10 million surgical and nonsurgical cosmetic procedures performed in the United States in 2009, as reported by the American Society for Aesthetic Plastic Surgery (ASAPS). Surgical procedures accounted for 15% of the total with nonsurgical procedures making up 85% of the total.

The top five cosmetic surgical procedures in 2009 were:

• Breast augmentation (311,957 procedures)
• Liposuction (283,735procedures)
• Eyelid surgery (149,943 procedures)
• Rhinoplasty (138,258 procedures)
• Abdominoplasty (127,923 procedures).

Women had over 9 million cosmetic procedures, over 90% percent of the total. The number of cosmetic procedures for women decreased over 3 percent from 2008, likely due to the poor economy.

The top five surgical procedures for women were:

• Breast augmentation
• Liposuction
• Eyelid surgery
• Abdominoplasty
• Breast reduction

Men had over 900,000 cosmetic procedures, over 9 percent of the total. The number of cosmetic procedures for men actually increased over 8 percent from 2008.

The top five surgical procedures for men were:

• Liposuction
• Rhinoplasty
• Eyelid surgery
• Breast reduction to treat enlarged male breasts
• Hair transplantation

So, what are some of the reasons why? Here are excerpts from some emails I have received from patients:
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“I’ve had 2 kids and I breastfed them both. I’ve been dieting, I go to the gym, and have even been using a personal trainer to tighten my abs. I just can’t get rid of the “baby fat” across my tummy and my breasts are too saggy. Help!”

The number of “mommy makeovers” is increasing: in this day and age, women are giving birth later, returning to their careers sooner, and have busier schedules than ever before. Many are finding cosmetic plastic surgery to be the answer to returning to a pre-pregnancy shape they are comfortable with. The “mommy makeover” procedures include breast augmentation, tummy tuck and breast lift. In fact, for the first time, breast augmentation has become the most popular plastic surgical procedure, followed by nose reshaping.
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“I’m 45 years old and was let go 6 months ago by my accounting firm. I’ve been going to job interviews but I am competing with men 10 years younger. Do you think a facelift will help?”

The reality is that our workplace society favors a more youthful look – those who look younger and fitter are generally more highly paid, etc etc

Baby boomers (44 – 61 years of age): as a group they are experiencing the loss of skin elasticity with age, and so the number of body lifting procedures, targeting the thighs, lower body, breasts, upper arms, and face, has increased significantly.

In the past year, men have typically looked to revitalize their aging faces with injectable fillers. In contrast to these minimally invasive procedures, they were also looking to tone their bodies with surgery, including tummy tucks, thigh lifts, and breast reduction procedures.

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Isn’t it vain to have plastic surgery?

The Latin origin of the word, “vanity” is vanus, meaning, “empty, without substance.” This does not apply to most people seeking plastic surgery. The typical patient either wants to refresh their appearance, to look as they did in years past, or to enhance their body to a state that corresponds to their image of themselves. An increase in self-esteem occurs, and rarely crosses the line into an excessive feeling of attractiveness or of one’s abilities. The increased self-confidence is profound and has many positive repercussions.

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Isn’t plastic surgery for the rich?

No longer! The relative cost of plastic surgery has decreased and has become available to a much larger segment of the population. There are financing plans available much like those for buying automobiles or appliances. Even some managed care insurance plans offer cosmetic surgery to their participants in a limited fashion. 48% of Americans with an income under $25K approve of plastic surgery according to the survey and would have a procedure done.

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How can people afford it?

Although some patients save up the entire cost of their plastic surgery, many are turning to finance companies that will lend them the money, often at reasonable rates. Financing provides the opportunity to have the surgery without having to wait — for many patients, the plastic surgery loan is just another bill, a way to build up frequent-flier miles if they put it on a credit card, or another check to write once a month.

My patients have included teachers, truck drivers, retirees, ranchers, and school-bus drivers.

Questions?

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Will the Real Aesthetic Surgeon Please Stand Up? The Difference between Board-Certified Plastic Surgeons and all Other ‘Cosmetic’ Surgeons

In July 2007, the Arizona Medical Board suspended the license of a physician who was board-certified in internal medicine, and had been performing cosmetic procedures. The Board took action after a third liposuction patient died under his care. The suspended physician was/is not board-certified in plastic surgery or in any surgical field.

Can anyone call themselves a plastic surgeon?

Yes, and there are an increasing number of doctors shifting their practices to include plastic surgery procedures – but calling yourself a plastic or cosmetic surgeon does not make you a qualified plastic surgeon. In most states, licensed physicians are not restricted from performing plastic surgery regardless of their training. Here are some questions we’ve heard.

My gynecologist is offering Restylane and Juvederm injections, and she is Board-Certified. What does that mean?

Just because a doctor is board-certified does not mean he or she is certified by the American Board of Plastic Surgery (ABPS). You probably would not take your car to an airplane mechanic, and you would not ask a brain surgeon to do a heart transplant. Although there are some well-qualified other doctors who can perform cosmetic surgery, many are inexperienced and poorly trained, performing services for which they are not experts.

To be ABPS-certified, a physician must meet these rigorous requirements:

• Graduate from an accredited medical school

• Complete a combination of at least five years of general surgery and plastic surgery residency training. At least two of these years involve aesthetic plastic surgery.

• Pass comprehensive oral and written exams

• Regularly attend continuing medical education courses

• Adhere to a strict code of ethics

• Perform surgery in accredited surgical facilities

There are other Boards that certify physicians to perform “aesthetic surgery”, but this can sometimes be meaningless. The American Board of Cosmetic Surgery, for example, will certify a dermatologist to perform cosmetic surgery after completing only a few weekend workshops!

I made an appointment with a facial plastic surgeon for an eyelid tuck– is that OK?

In addition to formal plastic surgery training, there is another qualified training program that teaches facial aesthetic surgery. Ear, nose, and throat doctors can train for an extra year in facial cosmetic surgery, and can call themselves “Facial Plastic Surgeons.” It would be safe to go to them for facelifts, nose jobs, Botox, wrinkle fillers, and eyelid surgery. Unlike true plastic surgeons, they are not trained in the surgery of other parts of the body, such as breast surgery, tummy tucks, or liposuction.

Everyone seems to be injecting Botox, even my Pediatrician. Isn’t that safe?

Botox is not just a cure for wrinkles, and can be used incorrectly if it is just injected into them. Plastic surgeons understand 3-D facial anatomy and use Botox to reshape the face by changing the balance of facial muscles. It takes this knowledge of facial anatomy, as well as skill and artistry, to prevent the frozen, paralyzed look. In fact , many patients come to me after having had Botox elsewhere because their faces are off balance, or their eyebrows are droopy.

How can I tell if I am going to the right doctor?

Before you even get to the doctor’s office, there are 3 questions you can ask to determine if it is even worth your while to have a consultation.

1. Be thorough in your research about the doctor’s credentials. You can start by asking if they are Board-Certified by the American Board of Plastic Surgery. If they are not, ask which Board did certify them.

2. Ask if the doctor has hospital privileges, which implies that they have some respect in the medical community.

3. Is the price significantly lower than other doctors’ prices for the same thing? Ask why.

This is a pretty intense subject. Let’s discuss it.

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