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Is Timing Really Everything? Plastic Surgery Boston

January 16th, 2012

This winter so far has been much milder and less active with snow than last year.
In the cooler climates many potential patients wait until the spring thaw before they consult me about a body procedure such as Breast Augmentation or Liposuction. My advice is to try to plan ahead.

If you want to put yourself into that bathing suit you did not buy last year, allow enough time for you to recover from the procedure and feel comfortable with your new look.
For some that might be less time that others, but most patients like to give themselves a minimum of 4-6 weeks to help reduce any post operative swelling or bruising.

After breast augmentation, whether it is silicone gel or saline filled implants, most patients need several days to rest and relax.
I prefer to put the implants under the muscle which many feel gives a more natural look, especially for women with very little breast tissue. If you want to be comfortable on the beach at the Cape on 4th of July, do not wait till the end of June to have the surgery.

Liposuction is popular for both men and women in my office.
For men the excess fat in the breast area, also known as Gynecomastia, can be helped with liposuction. The often problem belly and hip rolls better known as the ‘spare tires” are also popular for male liposuction. Women often want to reduce the muffin tops, abdomen and the thigh area. For some women the knees are often done along with the thighs for a more contoured look.

Although I use ultrasonic tumescent liposuction for less bruising and swelling, there is still a time after the surgery that you will need to rest and relax.
Give yourself some time before you try that bathing suit or those jeans you could never wear before.

Consult a board certified plastic surgeon, weigh the benefits and risks of any procedure, and allow yourself enough time to get the most benefit from the procedure.

Define your Lips for 2012

December 29th, 2011

One of the hallmark signs of aging is thinning lips.

Take a look at an old photo of yourself and look at your lips, then look in the mirror. Many of you will not only see that your lips are thinner but there may be some fine lines as well.

Why are lip liners part of many women’s makeup routine?

Lip liners are intended to define the lip borders and give the appearance of larger lips.

Restylane, a hyaluronic acid, is now FDA approved for lip augmentation.

Restylane has been used for several years to treat facial lines and folds such as the lines running from the nose to the mouth. In my practice, one of the ways I use Restylane is to enhance the lips and define the lip borders. The result is more youthful looking lips.

By using a local anesthetic ,the in- office procedure is usually comfortable, easy and takes only a few minutes.

We immediately apply a soft gel ice pack to the lips and ask that the patient refrain from exercise and alcohol for 24 hours. The ice gel pack is applied at home by the patient after the procedure. Some swelling is expected although the results are seen immediately.

The goal of injecting restylane into the lips is to create an enhanced, younger, natural looking lip.

Many times the procedure is combined with adding volume to other parts of the face to treat facial folds and lines and to add youthful volume to the face. When several parts of the face are contoured with facial injectable fillers such as Restylane , Radiesse, Perlane and Juvederm, the procedure is often referred to as the liquid facelift.

A Twinkle in your Eyes

December 10th, 2011

Look into your eyes and what do you see? Many of my patients feel that the area around their eyes makes them look older or tired. The main complaints are:

  • Wrinkles
  • Dark circles and bags under the eyes
  • Excess skin hanging from the upper eyelids

Let us address each problem:

My top suggestion for refreshing the eye area is to be on a good skincare regime which includes Vitamin A in the form of Retinol or Retin A , a daily sunscreen with UVA and UVB protection, an antioxidant eye cream for the delicate skin around the eye area. For those patients with the dark circles under the eye a lightening cream should also be part of their skincare routine.

The wrinkles around the eyes, or what is commonly known as crow’s feet or smile lines, can be helped with a product such as Botox or Dysport. This injectable product can be done right in the office and its effects last anywhere form 2-4 months. To maintain the results most patients return 3-4 times a year.

Bags under the eyes can be treated a few different ways depending on the individual problem.

For some patients filling in the area with an injectable filler such as restylane or juvederm can improve the hollowed look under the eyes.

For others ,with excess amounts of under eye skin ,a surgical procedure may be needed. This is called a lower lid blepharoplasty.  The excess skin above the eyelids usually requires surgery which is called upper lid blepharoplasty. Non-surgically, some modest improvement can be achieved by filling in the eyebrow area with an injectable filler such as restylane or juvederm . This causes a mild lifting of that area which in turn improves the upper eyelid.

Each patient is unique and a careful evaluation by a board certified plastic surgeon is the best place to start when considering cosmetically improving your eye area.

Muffin tops are Great for Breakfast but not on your Hips

November 7th, 2011

Muffin TopMuffin Tops seem to be the latest word for “hip rolls” or “love handles”. The fashionable low rise jeans and pants have certainly contributed to more visibility of that sensitive area. Liposuction is the plastic surgeon’s tool for minimizing local areas of fat that are exercise and diet resistant.

For a select group of patients the “muffin tops” may be the only area of concern. However, for many patients, both male and female, the abdomen and waist areas may also be contributing factors.

A careful assessment of the patient’s body and the focus of their concern are key to making sure that both the Doctor and patient are on the same page.

Liposuction uses an instrument called a cannula to carefully remove fat cells from the areas being treated. I use external ultrasonic tumescent liposuction. . The external ultrasonic method uses ultrasound to alter fat deposits, making them easier to remove. In the tumescent liposuction technique, fat is injected with a physiologic solution before surgery. This causes the fat to swell and improves penetration of the ultrasound wave, leading to easier removal of the fatty tissue.

The liposuction surgery is an outpatient procedure with minimal downtime. Patients are asked to refrain from vigorous exercise for a few weeks after surgery. For those patients who have tried both exercise and diet and who have maintained a healthy lifestyle, liposuction of their muffin tops or any other areas may be a good solution.

Five Good Reasons for Cosmetic Surgery

October 25th, 2011

Cosmetic Surgery FaceWith an aging population, the number of people considering cosmetic surgery is growing dramatically. But, like any medical procedure, cosmetic surgery is not to be taken lightly.

Modern cosmetic surgery techniques have been proven safe and effective time and time again, but it is still surgery. It’s important for the patient to recognize that surgery does carry risks and they must assess those risks before deciding to move forward.

Researchers have found that those patients who base their decision to have cosmetic surgery on solid reasons are more likely to be satisfied with the outcome. Here are five reasons that might indicate someone can benefit from cosmetic surgery:

  1. You’ve thought about cosmetic surgery for a long time
  2. Cosmetic surgery is something you want to do for yourself
  3. You want to take charge of your life and appearance
  4. Cosmetic Surgery is part of a plan for self-improvement
  5. Cosmetic surgery can be a boost to one’s self-confidence

Cosmetic Surgery is a major decision. Make sure you have considered the consequences deeply enough. If you have been considering the same procedure for a while and have done research to make sure this is the proper solution; it might be time to move to the next step.

There should be only one person that you are trying to satisfy with cosmetic surgery – you. If you think cosmetic surgery will fix a bad relationship, help you win back a former lover or create jealousy with someone else, there are likely better solutions.

Cosmetic surgery alone won’t change your life. But it can be an important step that can bring positive changes in your life. It can give you a sense of control and it can spur you on to make further changes.

Cosmetic surgery will not cure depression, but it can be a step that will provide the self-confidence you need to make other changes.

Aging Gracefully

October 3rd, 2011

Aging gracefully may have different meanings for everyone. I can tell you what happens anatomically to the face as we age.  Simply put we lose facial volume as we age:

  • Thinning of fat around the eyes
  • Loss of soft tissue around the cheek bones
  • Sagging of skin which causes folds around the mouth or the folds that we see going from the nose to the mouth
  • Thinning of the lips and flattening of the area between the lips and the nose—loss of that “pout of youth”
  • Loss of definition in the jaw line better known as ‘Jowls”.

Before I perform a facial procedure I like to have my patients bring in a picture of them taken at least ten to twenty years ago. Usually it is an old wedding picture, graduation or family reunion.  The goal is never to make a fifty year old look like twenty one again, but we can turn back the clock significantly with the right choice of procedures:

Cosmetic Enhancements in the Golden Years

August 31st, 2011

As baby boomers now approach the Golden Years of sixty five and over, how good do they want to look? Is seventy really the new fifty?

According to the American Society for Aesthetic Plastic Surgery, in 2010 there were 84,685 surgical procedures among patients age 65 and older. They included 26,635 face-lifts; 24,783 cosmetic eyelid operations; 6,469 liposuctions; 5,874 breast reductions; 3,875 forehead lifts; 3,339 breast lifts and 2,414 breast augmentations.

Safety is the operative word when it comes to elective cosmetic procedures regardless of a patient’s age.

A healthy 70 year old will, generally speaking, be a better candidate than a 45 year old with risk factors such as diabetes, cardiac problems or bleeding abnormalities.

Realistic expectations are another key prerequisite for a successful outcome to a cosmetic procedure regardless of age.

Perhaps a 70 year old may desire liposuction so he or she would have better fitting pants. A facelift would correct the “turkey gobble” neck that makes him or her feel older and less fit than they really are. One of my older patients put it like this; “I am too young to look old”

All patients considering elective cosmetic procedures should be carefully screened prior to surgery.

A careful health history, any necessary pre operative tests and the choice of a well monitored facility are among the important preoperative considerations.

We should also remember that there are a number of non surgical procedures which are available to those patients who may not be good candidates for surgery for a variety of reasons.

Facial fillers for lines and wrinkles such as restylane, perlane , juvederm and radiesse are achieving great results. Botox or Dysport are very effective for frown lines. Lasers and light therapy can improve skin quality , texture and tone. 

Most important is to choose a board certified plastic surgeon and have realistic expectations.

Botox or Dysport for Frown Lines?

July 14th, 2011

Over two years ago the product Dysport was FDA approved for frown lines. In the US there are two FDA approved products that essentially do the same thing – Botox and Dysport.

What should patients know about these two similar products?

  1. Both products relax certain muscles of facial expression
  2. Both are injections that last approximately 2-4 months, depending on the individual
  3. Both can be used on women and men
  4. No recovery time
  5. Both have same active ingredients and work in a similar fashion
  6. Each is made by two different companies: Botox is distributed by Allergan which also distributes the injectable filler Juvederm. Dysport is distributed by Medicis Aesthetics which also distribute the injectable fillers Restylane and Perlane.
  7. Each product is dosed differently –that is the “units’ are not the same
  8. Pricing may vary depending on the Doctor’s practice and the company promotions
  9. Both products should be used by experienced injectors

Patients now have a choice in products that are equally effective. The most important thing is to find an injector who is experienced with both products, can answer any questions you may have and that has excellent credentials.

What’s SPF Got to do With it?

June 24th, 2011

SPF numbers only regulate the protection against the UVB rays or as I tell my patients the “burning” rays.  What are even more important in our concern with sun exposure are the UVA rays or the “aging” rays which the SPF does not address.

The FDA has recently come out with new label guidelines to address the issue of broad spectrum protection. They are targeted to appear in 2012.  Consumers should be careful when choosing their sunscreens because not all sunscreens are created equal.

In our office we advocate the physical sun blocks zinc oxide and titanium dioxide.  They are gentle to the skin and provide the needed Broad spectrum protection from both the UVB and the UVA rays.

If you are looking at the SPF number we suggest a 30+ and then read on to make sure they contain zinc or titanium or both, so that they can be considered broad spectrum (protections against both UVA and UVB rays)

Water resistant or water proof—always re-apply no matter what the label says.  You will find that water resistant sunscreens usually feel a bit thicker.  We suggest no matter what, if you are outside for extended periods, that you reapply your sunscreen at least every 2 hours.

Sunscreen is one of those products that you should never leave your home without applying, no matter the time of year. Beyond that, make sure the quality of your sunscreen is made to do the job.  While the new FDA labeling requirements will be helpful to consumers, do not wait another year to choose your sunscreen wisely.

Minimally Invasive Procedures Lead the Way – What is Right for You?

June 8th, 2011

Inject the frown lines, fill in the wrinkles, rejuvenate the skin and smooth out the appearance of cellulite.

That is just what Americans did last year and according to the American Society of Plastic Surgeons. These procedures were more popular than surgery. As a matter of fact, over the last decade minimally invasive procedures have gone up 110%. In contrast, over the last decade cosmetic surgical procedures have declined by 18%.

If you can look better and maintain that look with minimal or no down time then one can see the reason for such an overall increase in minimally invasive procedures. This is not to say that surgical procedures are being replaced. Clearly part of the reason for the decline has been the economy. More recently the stringent money lending policies have also contributed to the downturn in surgical procedures. Breast Augmentation, Nose reshaping, Eyelid Surgery, Liposuction, and Tummy Tuck round out the top five surgical procedures for 2010.

So what is right for you, surgery or a non-surgical procedure?

Maybe both. The Plastic Surgeon of this decade has both surgical and non surgical tools available to better help you to achieve your desired results and to maintain them over time. Seek the opinion of a Board Certified Plastic surgeon, think about what you are trying to achieve and afford yourself of all the wonderful tools available in today’s market.

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