Why Is Generation X Having More Cosmetic Procedures Than Any Other Age Group?

As each decade goes by at warp speed, plastic surgery has become a more widely acceptable option for aesthetic improvement, even for the youngest generation. Gone are the days of waiting until your golden years to visit the plastic surgeon.

For Generation Xers, whose previous trip to the cosmetic surgeon may have been for a post-adolescence nose job or breast implants, the types of procedures they’re seeking now are helping them to turn back the clock and keep up with the selfie-obsessed generation.

According to statistical data released by The American Society for Aesthetic Plastic Surgery (ASAPS) in 2014, adults between the ages of 35 and 50 account for the most cosmetic surgical and nonsurgical procedures—more than 40 percent of all procedures performed. That adds up to more than 4.2 million procedures, beating out Baby Boomers and Millennials for all the nips, tucks and injections happening in the U.S.

LIPS, HIPS AND CUP SIZES, OH MY! 3 THINGS TO THINK ABOUT WHEN CONSIDERING COSMETIC SURGERY

“You know what I wish?” My neighbor and new mother confided over lunch. “I wish I wasn’t so ashamed of my body.”

 

 

My neighbor is a beautiful person with four healthy and adoring children, yet I understood. Many women would empathize with her desire to feel more beautiful and be more confident about their appearance.

It isn’t a matter of vanity. For many, it’s celebrating the family they brought into this world but wishing that sacrifice hadn’t taken such a physical toll on their bodies.

Cosmetic surgery. The very topic has a polarizing effect on most social circles. But in today’s world, the perimeter of aesthetic medicine and plastic surgery reach beyond going “under the knife.” Although there is plenty of that, too. When facing sagging breasts or a jowly jawline, how can we know if seeking cosmetic surgery is the best option? Here are 3 things to think about.

Are you looking for a better version of yourself or the copy version of someone else?

Often a patient’s disappointment stems from expectations placed too high on the outcome. Kate Middleton has a fantastic nose, but not everyone can successfully pull off that same feature.

“Understanding what can be done given your personal situation is something you need to talk to your surgeon about.” Wrote Christina Haller in the article, The pros and cons of plastic surgery. “If you walked in with Sarah Jessica Parker's nose expecting to walk out with Natalie Portman's and instead ended up with Anne Hathaway's, you have to be alright with that.”

Another thing to consider is what is truly motivating this desire for change. Would this procedure bring about an inner confidence that is lacking due to a physical condition or is this desire motivated by a need to be accepted?

“Having low self-esteem as a result of a physical attribute you’re not happy with can affect all areas of your life,” wrote Haller. “There’s nothing wrong with thinking you could be happier, as a result of being more confident, if you could put your best face forward. Remember though, surgery is not a cure for deeper issues such as depression or jealousy. Be sure you are working through the root of the problem before going under the knife.”

The idea of pursuing plastic surgery is to improve what already exists. Don’t expect to come out of surgery looking like a Victoria Secret model with tons of friends and a trouble-free life. Instead, your goal should be attaining a younger, firmer version of yourself that enhances a stronger inner self.

Do you need a procedure or just some pampering?As new technology in aesthetic medicine is being introduced, many women are finding satisfaction in “treatments” instead of “procedures.”

For example, a local company called Venus Concept has perfected a technique that offers patients a non-invasive treatment using a Multi-Polar Radio frequency that delivers fast, homogenous heating deep in the dermis where collagen is located without damaging the epidermis. This “massage” performs deep penetration, lymphatic drainage and stimulates both fibroblasts and circulation. In layman’s terms, this means 30 minutes in a chair creates softened laugh lines and wrinkles, tighter skin, contoured upper arms and abdomen.

“It created subtle changes,” explained KUTV Channel 2 media personality Shauna Lake. “Changes that made people say, ‘You look great and well-rested.’ Or, ‘Have you lost weight?’ After the first day I noticed results. That was really the only assurance I needed.” According to the American Society for Aesthetic Plastic Surgery, doctors are seeing the biggest increase in nonsurgical procedures with Botox leading the list followed by chemical peels (Hyaluronic acid), hair removal, microdermabrasion, and photo rejuvenation.

If you are feeling dissatisfied with how you feel or look, rather than focusing on major surgical procedures, first consider less committed options such as regular massages or non-invasive techniques that improve your appearance.

The cost.

Because most procedures are considered an elective surgery, that bill is yours to pay in full. For example, breast augmentation can cost upwards of $4000 to $10,000.Liposuction can reach totals of $11,000.

According to the American Society for Aesthetic Plastic Surgery, Americans spent 12 billion dollars on cosmetic procedures. “Of that total, more than 7 billion was spent on surgical procedures and more than 5 billion was spent on nonsurgical procedures.”

What was the most popular surgical procedure this year? Liposuction replaced breast augmentation as the top procedure with eyelid surgery, tummy tuck, and nose surgery completing the list.

“In 2013, more than 2.5 billion dollars was spent on injectables alone. In addition, nearly 1.9 billion was spent on skin rejuvenation, a fast-growing sector of the aesthetic nonsurgical industry.”

“A significant increase in the number of both cosmetic surgical and non-surgical procedures suggests that people are once again investing in their appearance and perhaps have more disposable income to do so,” notes Michael Edwards, MD, President-Elect of ASAPS. “Given the state of the economy and the competitiveness of the job market, we expect to see the numbers for anti-aging procedures continue to increase.”

Keep in mind, this isn’t the time to settle on the cheapest bidder. Be sure to consult with a board- certified doctor who understands your desire, has experience in that type of procedure and can be someone you trust to handle the surgery well.

The “face” of cosmetic surgery is definitely changing. It brings with it exciting and affordable new options that are changing the way women view themselves. By considering your expectations, your motivations and the financial impact this decision may place on your family, you can consider whether or not cosmetic surgery is the right choice for you.

Five Ways to Save Money on Plastic Surgery

Nowadays, plastic surgery is enjoying an unprecedented level of popularity. Unfortunately, while cosmetic surgery access and options are more abundant than ever, plastic surgery is still prohibitively expensive for a number of people. If you're looking for ways to get the cosmetic enhancement you've been dreaming about without draining your bank account, take a look at the list below to see ways that you can save money on plastic surgery.

 

Talk to Your Doctor

One of the easiest ways to make cosmetic surgery more affordable is to talk to your doctor. Many plastic surgeons run their own private practices, which allows them to be flexible when it comes to pricing. So during your consultation, talk with the doctor or his staff about short­-term discounts or a price reduction for paying cash up front. A simple conversation could save you some money.

 

Schedule Smartly

Since insurance companies usually consider cosmetic enhancement to be an elective surgery, they typically don't cover any part of it, including your lab work. An easy way around this problem, however, is to schedule your surgery for around the same time as your annual physical. Your surgeon can use the insurance-­paid lab work from your physical, so you don't have to cover that cost out of pocket.

 

Agree to Give a Testimonial

Cosmetic surgery relies on word­ of ­mouth endorsement and stunning before and after photos. And when a cosmetic surgeon is just beginning to build his or her practice, they need patients to give testimonials and and to act as spokesmodels for their company in both online and printed materials. If you agree to let your doctor use your pictures or endorsement, maybe they'll knock some money off the cost of your procedure.

Use Reward Points

Believe it or not, there are actually rewards clubs for cosmetic surgery. Through rewards programs such as Brilliant Distinctions or CosmetiCare, you can actually accrue points and put them towards a wide array of cosmetic procedures. There are a number of reward programs out there, so do your research and find out which one works best for your needs.

 

Do More Than One Procedure

When it comes to cosmetic surgery, a large portion of the cost comes from lab work and anesthesia (And if you've been paying attention, you already know how to save on lab work.). If you're considering getting more than one procedure done in the next few years anyway, then bundle them together into one operation and save on your anesthesia cost as well.

If you're dissatisfied with some aspect of your appearance, then you shouldn't let money stop you from fixing it. With a little creativity and ingenuity, you can drastically cut down on the cost of cosmetic enhancement.

If you or someone you know would like more information about plastic surgery, please feel free to schedule a consultation or contact one of our representatives today!

PLASTIC SURGERY PRICING – WHAT IS IT WORTH?

One of the basic tenents of pricing is supply and demand. As supply goes up, the price goes down. I read an interesting article about pricing of Plastic Surgery procedures written by a Dr. Gupta and it appeared in a recent issue of the Aesthetic Journal.

 What he found after surveying 10 practices in 15 U.S. cities was that there was NO association between the cost of the procedure and the number of plastic surgeons in that population area. Things such as regional culture, ease of acquiring the said services and social perceptions played a role. But another big factor - non plastic surgeons entering the market place providing cosmetic procedures at discount prices. This has created deviation in the supply and demand curve.

LASERS FOR BREAST CAPSULES

Of all the complications Implant Capsular Contracture remains the most problematic in plastic surgery. These capsules can be hard, tender and cause breast asymmetry. A study was done by 3 physicians in the Philadelphia area. 

 They took 33 patients who had grade III or grade IV encapsulation. For 6 weeks patients were treated once a week for 10 minutes with a 904 nm. laser over a 2 cm. grid pattern at one minute per area. 

The physicians found they were able to avoid surgical intervention on 93.9% of the patients. Stiffness and discomfort were improved about 43%. More work remains to define a treatment protocol and also long term follow up.

IS THERE SUCH A THING AS A “NON-SURGICAL FACELIFT”

It seems everytime I read the paper I hear/read more and more about “non-surgical facelifts”. No downtime – short time to perform – using only local anesthesia – minimal bruising. Is there such a creature? At the aesthetic meeting they had a panel of “experts” chiming in on how best to answer this. The first to offer an opinion was Dr. Barry DiBernardo. He said there is and it depends on how you define a face and it’s intended consequences. 

 A facelift is intended to make a face look younger and address skin blemishes, wrinkles, loose skin, atrophy of soft tissue, muscle bands in the neck. Now if you do these surgically fine, but many can be done in a non-surgical way. But they both can do it to different degrees. The moderator Dr. Laurie Casas offered a different opinion. 

 So at the end of the day, in MY opinion, it depends on what the patient wants – what does the patient perceive to be their problem(s). I see my purpose is to listen to the patient and then, with my 35 years of experience, decide on a treatment plan whether it is Surgical or Non-surgical or maybe a little of both.

BUTTOCK LIFT – BBL – BRAZILIAN BUTTOCK LIFT

One of the most requested new procedures centers on buttock augmentation or contouring. This can be done very much like a breast augmentation where an implant can be placed or as I perform it, I augment the patients buttock area with their own fat. 

It must be remembered – the patient must have sufficient fat stores to augment the buttock area. Also the size of the existing buttock will help determine the amount of fat we can inject. Another way we can contour the “buttock” area is to perform judicious liposuction to areas that are associated with buttock such as the hips or saddle bags – also the love handle area. 

This is a great procedure and the patient gets areas suctioned with too much fat and then transplants it to their buttocks. Simply put it is a win win.

IMPLANT REVISION IN OLD SALINE IMPLANTS

The number of women who present to my practice with “old” saline implants is small. But many who do have them want them revised because they are hard and un-natural. I recently read an article concerning a new technique to improve the outcome in these patients. Patients with saline implants had their implants deflated 4 weeks before Revisional Surgery and the volume of saline removed was recorded. 

 One week before the final surgery patients were evaluated as to what they wanted next – new implant – smaller or larger – a breast lift or just simply removal and perhaps some fat grafting. By delaying the final procedure you allow the breast tissue/ligaments to contract. Also it affords the patients some time to evaluate their “new look” and this helps them make a decision going forward.

HOLISTIC PLASTIC SURGERY

I recently read some comments by a Dr. Adam Howawy. His practice is in Princeton N.J. He does his cosmetic procedures and then tries to engage patients into adopting a healthier lifestyle. This will involve diet and exercise counseling – I guess it goes to the heart of Cosmetic Surgery – how we want to look better – more youthful – healthier. 

 Many of my patients ask me about weight loss and in the end we want our patients to be at their ideal weight but many are not. I have 4 simple principles – you have to be motivated; it is a lifestyle change – set a goal, and finally incorporate some form if exercise. A survey of hundreds of liposuction patients done in 2004 came to the conclusion that successful body contouring requires a patient to enbrace a healthy lifestyle.

What Celebrity Body Parts Are the Most Requested By Plastic Surgery Patients?

 When it comes to plastic surgery, some patients simply describe the look that they're hoping to achieve to their doctors. Maybe they want a smoother nose or a rounder backside, and following a consultation, their doctors have a strong understanding of their expectations. The majority of patients, however, come into their consultations with a celebrity-inspired ideal in mind. In fact, for many of these patients, it was the hope that they could emulate a certain celebrity that inspired them to pursue cosmetic enhancement in the first place.

As you can imagine, doctors hear the same celebrity comparisons come up for certain body parts time and time again. So what are the most requested celebrity body parts?

Most Requested For Women

Over the last few years, there has been a trend of women looking to increase the size of their backsides. When it comes to butts, the celebrity ideals are Kim Khardashian, Nicki Minaj and Beyonce. And not surprisingly, Beyonce has more than one enviable body part. Her cheekbones are some of the most requested as well, along with Jennifer Garner’s and January Jones’s. When it comes to noses, the celebrity ideals are Kate Middleton, Natalie Portman and Jennifer Aniston. And for lips, one of the most requested cosmetic procedures, the most popular references are Scarlett Johansson and Kylie Jenner.

Most Requested For Men

Women aren't the only ones going under the knife to replicate a certain celebrity look. In fact, as plastic surgery has become more popular, an increasing number of men are turning to cosmetic enhancement to improve their looks.

For men, one of the most common requests is Will Smith's cheeks, which are big and full and play a large part in Mr. Smith's room-illuminating smile. When it comes to the body, more and more men want to look like Channing Tatum, whose impressive pecs and abs have been on full display in the Magic Mike movies and plastered across magazine covers. And for overall appearance, a lot of men turn to Hugh Jackman for inspiration. Not only does Mr. Jackman have an enviable body, but his cheekbones and jawline are also highly coveted.

When it comes to plastic surgery, it's a good idea to have celebrity ideals to use as reference points, but most plastic surgeons are quick to caution that not every look is easily achievable. If you're thinking about undergoing plastic surgery, make sure you have an open conversation with your doctor about keeping your expectations grounded and reasonable.

If you or someone you know would like to learn more about plastic surgery, please feel free to schedule a consultation or contact one of our representatives today!

HAIR LOSS AND DIET

Hair loss effects a lot of people. In fact over 60 million people are struggling with hair loss and of that number 20 million are women. I have quietly accepted my fate but for others it may be hard and the answer to their hair loss maybe simple – a mere change in their diet. So many people today are becoming vegans or vegetarians which can lead to hair loss. 

 Many people want to restrict calories so they eat more fruits and vegetables but as you cut back , you may be depriving your hair of much needed nutrients. People on diets will often limit the amount of meat they eat which is rich in iron. This iron is essential to maintain your hair and to grow new follicles. The good thing is diet induced hair loss is easily reversible with a change in diet.

BLOOD CLOT PREVENTION IN TUMMY TUCK PATIENTS

One of the most feared complications following a tummy tuck is the formation of blood clots which can be fatal. The risk is low (0.07%) but it can have devastating consequences. Many plastic surgeons are hesitant to chemo-prophylaxis with drugs because of the risk of bleeding. 

 In this new study involving 450 patients over a 37 year span they focused DVT prophylaxis on hydration and elevation of the legs post op. Fluids were given to maintain a urine output of 40-50 cc per hour. After fluids and elevation they had NO symptomatic emboli or deaths.

MARAJUANA – GOOD?

I recently returned from Colorado where the progressives in that state want to begin a petition drive to legalize marijuana in restaurants and bars. It seems we spent decades and billions on getting cigarettes banned now they want to allow smoking pot in these same bars and restaurant? Where is our country headed! The liberal media said it would help my grandmother with advanced Parkinsons or my young child with Tourettes but when asked for scientific or medical evidence, none was forthcoming. Their honesty and integrity was enough and so many of our nations young people will have greater access to its mind numbing effects.

A new research study from of all places Yale (a very conservative institution of higher learning – ha!) said they analyzed medical studies involving almost 6500 people and the Yale researchers found NO reliable evidence that marijuana could help treat this smorgasbord of medical conditions (depression, nausea/vomiting, anorexia, etc.) The drug MAY help alleviate some muscle spasms in multiple sclerosis (there are many drugs available for this now). What are the side effects of marijuana – vomiting, confusion, disorientation, depression and hallucination. The passage of these laws are based more on public opinion than scientific fact. Of course since it is legal - nothing wrong with a little weed before beginning my days work whether you’re a doctor, heavy equipment operator, bus driver, pilot – the list goes on. What a sad day in America.

ARE SALINE IMPLANTS BACK?

Recently the FDA approved a new line of Implants called “Ideal Implants”. What is different is that these are saline not silicone. These new implants are different from traditional saline implants in that there are 2 lumens within 2 shells that are attached at the back patch of the implant. These implants were developed by Dr. Robert Homan, a board certified plastic surgeon. These supposedly are soft like silicone. He says this will help to eliminate concerns about silent rupture of silicone implants. When a saline implant ruptures or leaks it becomes readily apparent. With silicone implants they recommend an MRI every 2 years but most of my patients never get them and do fine. I do many implant exchanges and I am sure many women who have had silicone implants in for 20 years have implants contained in the capsule that have been ruptured for years. There does not seem to be any adverse effects from this.

Patients with Ideal Implants (502 study patients) had complication rates after 2 years of 42.2% for primary augmentation and 50.5% from revision. Saline rupture rates may be higher than silicone because “water” has no lubrication properties compared to silicone.

It gives women another option but I still prefer the feel of silicone but perhaps the Ideal Implant will feel more natural. The vast majority of women (90%) prefer silicone to saline. Another point will be the cost of the new Ideal Implant.

IMPLANT REMOVAL AND REPLACEMENT WITH LARGE VOLUME FAT GRAFTING

Silicone Implants remain very very popular. For sure one of my more common cosmetic procedures. But now women who have hard, painful implants have a new alternative. Before choices were exchange or removal. I just read a recent article out of Belgium where some plastic surgeons removed the women’s implants and did simultaneous fat grafting.

 The volume of fat injected ranged from 300 to 600 cc’s per side. Implants normally are measured in cc’s. I have done autologous fat grafting to the breast to enhance an augmentation. It also is a great option for someone who wants a “more” natural breast, sort of like antibiotic free range chicken. Also when I do fat grafting to the breast or buttock area (Brazilian butt lift) it is important for the patient to understand my limitation is based on the availability of their fat stores.

 This means suction your abdomen or flanks or hips and rather than throw the fat away you put into the patients breasts. This is a win-win. So now women with implants have a new option to exchange them.

VIAGRA FOR WOMEN

It took a while but there finally is a Viagra for women. But questions remain as to how effective it actually will be but the FDA after tossing and turning gave the new medication it’s blessing. The new drug is called flibanserin and it always amazes me where these names come from. 

 Unlike the male Viagra this medicine works directly on a woman’s brain to increase libido. Originally this drug was developed as an antidepressant and it must be taken DAILY – not just when the mood suits you. The effects were modest but maybe that’s all one wants and can hope for. The cost is yet to be determined but if I were a betting man – it will be pricier than aspirin.

FLUID COLLECTION POST TUMMY TUCK

Abdominoplasty or tummy tucks are a very popular operation.  One of the risks associated with this procedure is development of a collection of fluid called a seroma.  What a group of Plastic Surgeons did was to do a series of ultrasounds at 4,11,18,25 and 32 days.

The lowest incidence of seroma occurred on post op day 4.  The highest rate was on day 11!  The area with the greatest collection was the left iliac fossa.  If a surgeon suspects a seroma then maybe an ultrasound would be beneficial and it may need to be aspirated.

ARTOURA – NEW TISSUE EXPANDER FOR BREAST RECONSTRUCTION

This is a new tissue expander by Mentor.  This new expander is designed to control pocket formation during the first stage of breast reconstruction when the expander is placed.  This new expander has internal structural elements that provide more precise expansion.

This expander will supposedly allow more controlled expansion to create a more natural look. This new expander will limit expansion laterally AND superiorly.  The expander has 2 projections available.  So who knows this may be a step forward in creating a more natural look with breast reconstruction.

GALDERMA – NEW RESTYLANE LYFT

Galderma just introduced and received FDA approval for a competition to Allergans Voluma. Restylane Lyft is for augmentation of the cheek and midface.

This use to be marketed as Perlane-L.  It also can be used to fill deep nasolabial folds.

HEARING LOSS – PREVENTABLE

I am sensitive to people with hearing loss since I have lost a lot of my hearing due to nerve damage by mumps and measles I had as a young boy. But much of it is preventable. There are many jobs that pre-dispose to hearing loss and in an article I read recently which one profession has a high degree of hearing loss? 

 I was dumb founded – farmers. The noise from the tractor and farm equiptment plus the sounds of farm animals predispose farmers to significant hearing loss. In our ears we have tiny hair cells that are susceptile to trauma caused by excessive noises. 

 As the hair cells are destroyed our hearing activity declines. Think of all the young people today losing their hearing with excessively loud music. This is totally preventable with ear plugs. We only have one set of ears.

FDA – ALERT AND FILLERS

The FDA just released an alert warning for injectable fillers such as collagen or hyaluronic filler like Juvederm and Restylane. The warning stems from the inadvertent injection of these products into blood vessels potentially causing serious side effects. This can lead to visual impairment or even loss of vision or stroke.  It also can lead to tissue necrosis leaving significant scarring.

The FDA warns people to go to qualified Healthcare Professionals who are knowledgeable about the anatomy and are trained in proper injection technique.

HAND REJUVENATION – NEW PLAYER

An area that is sometimes forgotten in our quest for beauty are our hands.  As we age like other parts of our body we lose volume and our hands look thin, shelotonized tendons become prominent.  Now Radiesse has been given FDA approval for hand rejuvenation.

In a randomized controlled study 75% of patients treated with Radiesse at 3 months showed improvement in the appearance of their hands.  I am somewhat surprised more women don’t seek hand rejuvenation because like your face, your hands are there for the world to see.

My preferred method?  Autologous fat grafting.  Great procedure and again using your own tissue. Doesn’t get any better than that!

FAT GRAFTING – HOW TO HARVEST

Researchers at MD Anderson were trying to decide what method was the best to use to get the best fat to re-implant.  Success of a fat graft depends on adypose derived stem cells and the stromal vascular faction.

They found that direct excision of fat from the abdomen or using Coleman’s technique with a centrifugation yielded the most ASC and SUF cells.  Also the abdomen was a better site to harvest from than the flanks or axillae.  I am still not sold totally on centrifugation.

FAT GRAFT SURVIVAL AND PRP (PROTEIN RICH PLASMA)

I have always felt that when I do fat grafting that adding PRP improved results.  The addition of PRP improved proliferation.

The net result was that fat grafting with 20% PRP and adult stem cells caused increased graft survival.

FAT – WHERE CAN IT BE?

So many times we jump on the scale to see how much we weigh but in reality we really want to know how much fat we gained or lost.  It is elusive to say the least.  But now we can track “our body fat”.

The new device is a process called Dual-Energy X-ray Absorptometry – or simply DXA for short. With this device you can actually see how your fat stores are doing or not doing.  The test takes about 3-12 minutes depending on the machine and your body size.  The cost ranges from about $45.00 to $350.00 and insurance does not cover it.  Great way to see how your “crunches” are doing.

FACIAL COSMETIC SURGERY – WHAT RELLY MATTERS?

An interesting survey was conducted by researchers online to see what areas on the face mattered most to women undergoing facial cosmetic procedures.  There were 603 participants ages 30-65 years of age.  The women rated their aestietic concerns on a scale of 1-6 for 14 facial areas.

The areas likely to be treated first were the crows feet (82%) oral commissures (74%) tear troughs (72%) forehead lines (66%) glabellar lines (65%) nasolabial folds (56%) marionette (50%) and peri-oral lines (49%).  Women younger than 45 years of age wanted their upper face treated first where as older women (50+) wanted the lower face treated.

FACELIFTS AND SUPERWET TECHNIQUES

I recently read an article about a variation of one of my favorite procedures……the facelift.  It was a retrospective study of 1089 consecutive facelifts performed by Dr. Rod Rohrich.  Of these patients 587 received platelet-rich plasma (PRP) and 926 underwent a superwet technique.  

The hematoma rate was 0.9%.  The use of superwet technique has benefits of improving visualization and  hemostasis.  PRP decreased edema and ecchymosis.  These are important to the outcome, but control of blood pressure is also critical. 

FACELIFT SATISFACTION – WHAT TO LOOK FOR

I recently read an article in the white journal that was a review of 27 articles on what factor affects a patients satisfaction with their facelift.  There were several factors identified that led to a patients increased likelihhood of disatisfaction.

What do you think they are?  Male sex, young age, unrealistic expectations, minimal deformities, demanding patients, surgiholics, relational or familial disturbances, obessive personality and narcissiim.

In my 35 years of practicing Plastic Surgery I found that many of these same characteristics can lead to an unhappy patient regardless of the cosmetic procedure being done.

DEEP PLANE RHYTIDECTOMY – VERTICAL VECTOR

I guesss what is great about Plastic Surgery is there is no single way to achieve a final result.  When I read articles in the White Journal I read it with a discerning eye along with my collective 35+ years of experience and look to see what can I learn and take away.  

In many cases I feel what the other doctor is doing maybe over kill or a simplier, easier, safer method maybe employed to achieve the end result.  In one article the doctor did this deep plane vertical lift on 43 patients to see if this procedure would enhance mid face volume in these patients.  They found that they were able to add about 2-3 cm. of volume to the mid face with this technique.  

A quicker and safer technique would be to do some autologous fat frafting.  Why go into the tissue planes of the face and risk injury to the facial nerve branches when you can simply add some of the patients own fat -  not to mention it would take LESS operating room time saving money and hopefully less morbidity.

CHOLESTEROL- NEW KID ON THE BLOCK

We all know that heart disease is the leading killer in America.  High cholesterol also leads to strokes and peripheral vascular disease.  When they came on the scene decades ago, statins were a game changer.  Now there is a new and exciting breakthrough drug when it comes to fighting cholesterol.  These new drugs are expected to receive FDA approval sometime this summer.

These new drugs are known as PCSK9 inhibitors.  These new injectable antibodies will limit the production of LDL – the bad cholesterol.  Two recent studies found that these new drugs reduced bad cholesterol by as much as 60%.  This would greatly lower a persons chance of developing a stroke or heart attack.

CHIN SYMMETRY – DOES IT EXIST?

I guess we are resigned to the fact we are not symmetrical.  I tell all my patients in 35 years of practice, I have not met a perfectly symmetrical person.  I just read an interesting article in the Plastic and Reconstructive Surgery journal.

It had to do with symmetry in our face.  After analysis of thousands of facial photos they noticed that the left side of the chin is weaker or less prominent than  the right side.  Why is this so?  No one knows but it may come into play when doing a chin augmentation or a Rhinoplasty.

BODY CONTOURING – WHAT REALLY WORKS?

Body Contouring is popular – next to Breast Augmentation it is the second most common procedure.  As body contouring climbs in popularity so do non-invasive forms of body contouring.  But in the end what really works?  Good question.  I read a really good article by Dr. Reza Nassak who did an online review using Medline.  He searched all the popular terms of non-invasive contouring, endermologie, ultrasound, Cool Sculpt – and the list goes on and on.

ENGERMOLOGIE:

This is a mechanical suction device developed in France in the 70’s.  The most recent study of 118 patients showed 99% had reduction in body circumference with mean reduction of 2.9 cm.  Big question is this permanent or do you have to go back all the time for more treatments?

TRACTIVE:

This device uses a low energy diode laser with suction cooling and massage.  The main indication is for the treatment of cellulite – everyone’s dreaded nemesis.  This is similar to Vela Smooth.  The treatment protocol is treatments twice weekly for six weeks.  Results – 30% of patients saw improvement in upper thigh circumference and 37% improvement in their lower thighs.  Their appearance was improved by only 20%.

SMOOTH SHAPES:

This is a laser-suction and massage device.  In this study there were 20 patients who had 2 sessions per week for four weeks on lateral thighs.  Patients were evaluated at 1,3 and 6 months post treatment.  76% saw improvement in cellulite and 84 cc. loss of volume.

RADIOFREQUENCY:

These are probably the most popular non-invasive technologies.  This device delivers heat to the epidermis/dermis with the hopes of skin tightening down the road.

VELASMOOTH/VELASHAPE:

These are combination devices using infra-red radiofrequency and mechanical suction.  The results are mixed – one study showed a reduction in thigh circumference in 71.9% of patients at 4 weeks with VelaSmooth however follow up at 8 weeks showed NO improvement.  Other studies showed better results.

THERMAGE:

For a while this was the hot ticket item.  This is a monopolar radiofrequency device.  This is used more for face and areas around the eye.  Patient selection is key here – but I think it is true for all procedures.  In a 12 patient blinded study for abdominal laxity they found decrease laxity of 1.4, 1.7, 0.2 and 0.9 cm. at 1,2,4, and 6 months.  Note the farther out you go, the less effect there is.  The message – come back for more treatments.

In general radiofrequency shows mixed results.  Bipolar devices like VelaSmooth/VelaShape require more sessions and results show modest short term improvement in cellulite and fat reduction.  Monopolar devices like Thermage show fat reduction in 60-80% of patients.

EXTERNAL ULTRASOUND

There are 2 types - low intensity/low frequency and high intensity focused ultrasound.  Low frequency have not been shown to be effective.  Hi frequency devices are Ultrashape and Liposonix.

ULTRASHAPE:

Ultrashape produces ultrasonic waves at a controlled depth.  A study of 25 patients showed 63% of patients showed improvement in body shape.  In a study of 53 Asian patients results showed a slight decrease in abdominal circumference after one treatment but an INCREASE  after subsequent treatments.

LIPOSONIX:

Liposonix is a another high frequency ultrasound.  In a study of 85 patients, there was a reduction of 4.6 cm. after one treatment at 3 months.  After 3 months, 70% were satisfied.  Although these devices are well used and marketed there is little evidence to support their effectiveness.

CRYOLIPOLYSIS:

These devices depend on freezing the fat.  The largest study involved 518 patients.  Caliper measurement showed 94% had SOME reduction in fat thickness but the average was about 23%.  These devices are good for patients who have small deposits of fat on their flanks or abdomen.  The average reduction of fat ranges from 14% to 25.5%.

LLLT:

This stands for low level laser therapy.  This therapy causes no increase in the temperature of the tissues being treated.  The machine is Zerona.  There have been multiple studies done to show significant circumferential reduction in fat following LLLT.  Some studies also showed a reduction in cholesterol and triglyceriedes.

AUSTRALIA & PLASTIC SURGERY

It seems one can’t go a day without hearing, reading or seeing a story about Plastic Surgery and how it affects our lives. As its popularity grows more and more people are wanting it and with that more “practitioners are practicing plastic surgery. 

 This creates many problems because many of these practitioners are NOT plastic surgeons and they practice in non accredited facilities. In Australia they are trying to put the lid on unqualified people doing Plastic Surgery as well as where they perform it. 

 Medical tourism is popular but unfortunately most people decide to travel abroad based on one reason – cost. Many countries do not have the same standards as we have in the United States so as Australia fights to gain control of this we too in America face many challenges as well. Buyers need to be SMART consumers – choice should be based on more that dollar signs.

AESTHETI PEDIA – WHAT IS IT?

 This is a website that was launched by an Israeli firm that manufactures medical devices like Lumenis.  It provides information on skin care treatments, hair removal, rejuvenation and Hyperpigmentation.

Also there are discussions on acne, fine lines, wrinkles – just one aspect of aging.  This is another resource patients can go to when searching for more information about particular procedures.

ARE YOU HAPPY WITH YOUR FACELIFT?

There really has been no study to answer this question until some researchers in New York surveyed 105 facelift patients.  53 patients completed the questionares.  Patients were highly satisfied with their facial appearance (80.7%) – over 90% were satisfied with their decision to undergo a facelift.

The patients said on average they were 6.9% years younger.  The areas patients were most satisfied with were the nasolabial folds followed by the lower jawline.

AUSTRALIA & PLASTIC SURGERY

It seems one can’t go a day without hearing, reading or seeing a story about Plastic Surgery and how it affects our lives.  As its popularity grows more and more people are wanting it and with that more “practitioners are practicing plastic surgery.

This creates many problems because many of these practitioners are NOT Plastic Surgeons and they practice in non accredited facilities.  In Australia they are trying to put the lid on unqualified people doing plastic surgery as well as where they perform it.  Medical tourism is popular but unfortunately most people decide to travel abroad based on one reason – cost.

Many countries do not have the same standards as we have in the United States so as Australia fights to gain control of this we too in America face many challenges as well.  Buyers need to be SMART consumers – choice should be based on more that dollar signs.

BREAST IMPLANT AND LARGE CELL LYMPHOMAS (ALCL)

There has been some concern raised about Breast Implants and ALCL.  An article reviewed 83 published cases associated with implants.  The majority were ALCL.  There was no particular association with any particular type of implant.

Presenting symptoms could be a breast mass or an effusion or collection of fluid.  The death rate is very low when one considers the enormous amount of implant procedures performed every year.

DIET AND PROTECTING YOUR SKIN FORM THE SUN

We all know about sunscreens and their benefits to protecting our skin from the harmful effects of sun damage.  But now there are foods we can eat that will protect our skin form the inside out.  These foods can help thwart the harmful effects of UVA rays.

Three of these foods are carrots, tomatoes and onions.  Carrots have Vitamin A & C.  Tomatoes have lycopene.  Onions help our liver function and immune system.  Two other healthy foods are spinach and kale.  The famous cartoon character knew what he was talking about.  For those with a sweet tooth try apples and berries.

Apples have an antioxidant called quercetin.  The berries are a good source of Vitamin C.  And if you’re thirsty try some green tea.  So between these foods and some good sunblock – you can play 36 holes of golf.

BOTOX AND SKIN

We all know the effects of Botox on muscles, but what if any are it’s effects on a person’s skin. It seems there is a lessening of the wrinkles with repeated injections of Botox. So does Botox affect the elastic properties of skin? 

 Two researchers from Canada set out to answer that question. They took 48 women and injected the glabella, supraorbital area and the lateral orbits. They found a significant effect of the Botox on the elasticity of the skin. These improvements in the visco-elastic properties of the skin can last up to 3-4 months past injection.

BOTOX – WHAT’S NEW?

I used to think that every week a new laser came on the market, now it is whatever the latest “use” for Botox. How is this new miracle use done? They are now injecting Botox to block smokers from inhaling. 

By injecting Botox in your lips you can no longer purse your lips to draw in on a cigarette. It limits one’s ability to drink out of a straw. The treatments are about $100-$150 per session and can cause an individual to cease smoking or greatly cut down on the number of cigarettes.

BREAST AUG – HOW BIG IS TOO BIG?

One of the key questions women ask when undergoing Breast Augmentation is how big should I be.  Large implants (400 cc +) can put a strain on your back.  A recent Italian study involved 40 volunteers who were asked to wear 800, 400 and 300 cc. implants in a sports bra for 6 ½ hours, 1 day for every implant size.  The volunteers were then evaluated by a physiatrist.

They noted a significant increase in cervical lordoses when the women wore the 400 and 800 cc. prosthesis.  So one may have to sound a word of  caution with the much bigger implants.  This study was done in Povia  Italy.

CHEMICAL BLEPHAROPLASTY – POSSIBLE?

How many people know what bimatoprost is? No, it is not a new exotic food or a new disease but many women know it as Latisse – a drug used to treat hypotrichosis or deficient eyelashes. By using this drug “off label” one may be able to achieve a “chemical” blepharoplasty. 

A dermatologist at New York University, Dr. Sarnoff published her experience with Latisse beyond it’s use for eyelashes. Dr. Sarnoff in conjunction with Dr. Gotkin, a Plastic Surgeon applied Latisse topically to the upper eyelids. It was a 0.03% opthalmic solution. 

Dr. Sarnoff treated herself. She treated her upper eyelids daily for 3 months, then reduced it to 2-3 times weekly. She noticed less hooding in her upper eyelids and less fat bulging from her lower eyelids as well as lower lid Skin Tightening. It is promising but more controlled, double blind studies need to be conducted.

Chemical Peels, Microdermabrasion, Dermabrasion - What's The Difference?

Moving into summer, we want to shed the pounds, the layers of clothes, and, most especially, dull, wrinkled skin. Am I right or am I right?

Now is the perfect time to research and book a procedure that can diminish scars, wrinkles, blackheads and brown spots.

Personally, I've been noticing the results of a dry winter and past sun exposure, leaving my skin lacking in "freshness." That, and some tiny clogged pores plus not-so-tiny fine lines (getting more noticeable by the day!) have me thinking about what I can do to rejuvenate my skin and overall appearance.

As a lifelong chemical peel devotee, I immediately thought that another peel was in order, maybe a stronger one this time.

But looking into a few non-invasive procedures, I realized that I might be a better candidate for a different option.

Let's take a look at three of the most popular Skin Rejuvenation procedures – chemical peels, Microdermabrasion and dermabrasion and see which one I should pursue.

CHEMICAL PEELS

Best for:

• Lighter peels are great for exfoliating dead skin to improve texture, lines, acne and sun damage.
• Deeper peels can tackle wrinkles and uneven skin tone.

Types of peels:

Light

• Alpha-hydroxy acid peel (AHA)
• Trichloroacetic acid peel (TCA)

Deep

• Phenol peel
• Croton oil peel
• Trichloroacetic acid peel (TCA)

Procedure:
The liquid of the peel is brushed, swabbed or rubbed on to the skin and allowed to sit for a period of time. The longer the peel is on, the more intense the effect.
After a light peel, there is little downtime, though you will be more sensitive to the sun, so stay away from the rays!

Following a deeper peel, a protective ointment is applied to protect and moisten the crust that will form. The ointment should stay on for up to 2 days. (Follow doctor’s orders!) For severe peels, bandages may be applied and will require a longer recovery period.

Cost:
$574 Average Cost* (Varies by peel)

Recovery Time:
1-7 Days (7-8 Days for a deep peel)

Results:
The more intense the peel, the longer the results will last; a few months for lighter peels, up to years for deep peels.

MICRODERMABRASION

• Best for non-invasively resurfacing the skin to remove dead skin, which:
• Produces a healthy glow.
• Diminishes blackheads and whiteheads.
• Reverses sun damage, acne scars and fine lines.

Procedure:
You may remember an earlier method for microdermabrasion, which was essentially a small sandblaster for your skin, shooting tiny aluminum oxide crystals to remove the epidermis. Then the process evolved to use a wand or pen to shoot the crystals on to the skin in a more controlled fashion.

Now the diamond-tip method uses a diamond-tip hand device to gently loosen and exfoliate dead skin cells. Like crystal microdermabrasion, the dead skin is suctioned off after it is mechanically removed.

Other options include HydraFacial or DermaSweep which is a non-particle microdermabrasion which is usually done monthly.

Exfoliating the dead skin stimulates collagen growth for healthier looking skin that also feels smoother. Skin regenerates more slowly as we age, so mechanically removing the top layers is a way to kick up collagen production. Regular treatments will likely improve fine lines, blemishes, dull skin and sun spots. And--bonus!--once the dead skin has been removed, it allows moisturizers and lotions to more effectively and easily absorb into the skin.

Cost:
$127 per visit average cost *

Recovery Time:
1-2 days.

Results:
Can last for six to twelve months with diamond tip.

Depending on your desired results, it might be recommended to combine microdermabrasion with a light chemical peel to increase the effect. Immediately after your treatments, moisturize with SPF of 30 or higher.

DERMABRASION

Best for deeper skin scars and marks, such as:
Lines around eyes, nose or cheeks.
Facial scars from acne, chicken pox or another injury.
Blotchy skin or brown spots.



Procedure:
Dermabrasion purposefully "injures" the skin because good scar tissue can replace the bad scar tissue, which will reduce blemishes and wrinkles. (If that sounds freaky, all the more reason to seek an expert {link to: www.smartbeautyguide.com} for the best care.) A rough, small spinning wheel rubbed on the skin physically removes the outer layers of skin. Just like skinning our knees (I did that all the time), the skin that is removed is replaced by new, fresh and smoother skin.

Cost:
$1,611 average cost*

Recovery Time:
In 7-10 days, new skin begins to form. The skin may remain pinker than normal for up to a month (longer for some). Within six weeks you can begin to see the positive results of the procedure.

Make sure to understand the recovery period associated with the location of the dermabrasion, as anything close to the mouth (for those fine lines that cause lipstick to bleed) will affect eating and drinking routines. Also inquire about what other activities may be affected during recuperation.

Results:
Dermabrasion produces more significant results and the effects will last years or permanently. Yay!

Given my skin and my desired results, I think diamond-tipped microdermabrasion is calling my name!

Join me in saying hello to summer fun and good bye to blah and dreary winter skin.

*Based on Surgeon fees per Smart Beauty Guide.

ANTIBIOTICS AND PLASTIC SURGERY

Every so often a patient will ask me if they need antibiotics before their surgery.  I think part of it is out of fear of getting an infection which can be devastating.  The rules have changed.  There was a recent article in the white journal that was a review of 4300 articles.  The results of this exhaustive review was that in the majority of cases NO antibiotics are needed.

Clean surgery with the exception of Cosmetic Breast Surgery do not benefit from antibiotics. Contaminated cases II, III and IV benefit from antibiotics.  Usually, the antibiotic was given as a single dose pre-operatively.

Who Is Administering Your Botox? Why Credentials Matter.

NBC's recent story, about the major consequences of seemingly minor facial treatments calls our attention to a scary but true scenario- doctors you trust for significant care in certain areas of your life --from dentistry to internal medicine--are not likely the best option to administer facial Fillers or Botox. But until you know what qualifications to look for, you may be swayed to get an enhancement at the hands of a Botox novice.

To gain some perspective on what we should look for when considering Botox and other facial fillers, Michael C. Edwards, MD, FACS, the president of the American Society for Aesthetic Plastic Surgery gives us the basics on why credentials matter, even for routine aesthetic enhancements.

Mary Joan Cunningham: What have you seen as the most common negative results when someone receives Botox from an unqualified medical professional?

Dr. Edwards: The goal of Botox treatment is to relax the specific facial muscles in a manner to soften lines from muscle action and even lift the eyebrows a bit with proper placement. Treatment by an unqualified injector can lead to dropping the eyebrows, one or both sides, making some patients feel they look worse than they did before. Also, treating too close to the mid eyebrow can lead to a sagging or lazy eyelid called ptosis. These things can happen in the hands of a qualified injector, but I think you can feel confident the incidence will be rare.

Mary Joan Cunningham: Dr. Edwards, in your post about the difference between cosmetic and plastic surgeons, you explained that Plastic Surgeons receive far more training and have a deep knowledge of their specialization. While we understand why that is important when undergoing major surgery, does that carry a benefit for those only seeking Botox or fillers?

Dr. Edwards: Botox treatment should not be equated with surgery and although the laws differ state to state, there are differing levels of injectors (nurses to physicians of different specialties). If a doctor goes to a weekend course to bring this into their practice as a financial supplement, they should have a solid knowledge of the anatomy and action of the treatment administered. They should also have an understanding of potential risks and possible complications so they can recognize and treat these if they were to occur.

Mary Joan Cunningham: With that in mind, should patients seek out a member of ASAPS when choosing who to administer Botox injections?

Dr. Edwards: They can be rest assured that members of ASAPS have a detailed and comprehensive training about facial anatomy. Patients should feel confident seeking care from a board-certified plastic surgeon, facial plastic surgeon, occuloplastic surgeon and dermatologist.

Mary Joan Cunningham: What do you hope that those curious about Botox will take away from this interview?

Dr. Edwards: That they will realize Botox is a medication with intended positive effects. There are virtually millions of very happy and satisfied patients who undergo treatment every 3-6 months. Everyone should do their homework and seek out care from a properly trained and credentialed board-certified plastic surgeon, facial plastic surgeon, occuloplastic surgeon or dermatologist.

Want to know what specific questions to ask? Check out my interview with Miami's Dr. Adam Rubinstein

Not all health care professionals administering Botox have the same credentials and experience with facial muscles. Remember, this is the only face you have. Choose wisely.

CELLULITE – WHAT’S THE ANSWER

Cellulite is a perplexing problem that affects millions of women. It is a genetic condition that affects the connective tissue of the individual that pulls down on the skin creating divots or dimples. At the 11th annual Las Vegas Cosmetic Surgery show Dr. Jason Emer, a Dermatologist from Beverly Hills, echoed what so many of us have said – at this moment in time there is NO real cure for cellulite. 

There are non-invasive technologies such as radio frequency that can improve the appearance of cellulite but none are curative. These non-invasive technologies manipulate the soft tissues whether through radio frequency, heat, suction, rolling, whatever. Some current treatment modalities include cellulaze or cellfina but I think people need to understand going into it, it is expensive and temporary. But in the end it is I guess kind of like Botox.

EMERGING TRENDS IN COSMETIC SURGERY

It is so ironic how trends change – whether it is in fashion – skinny tie trends then fat ties – short hemlines then longer hemlines –  liposuction and fat removal were the craze but now that’s reversed.  When I went to the Cosmetic Surgery meeting in Montreal, fat grafting and fat augmentation were the “hot” new procedure.

We are now adding fat to the face, the breasts and the buttocks.  Another new procedure on the horizon is labioplasty which is the removal of excess labial tissue.  Old standbys such as Breast Augmentation still are very popular.

GALACTORRHEA AND BREAST AUGMENTATION

There was a recent study done to investigate the incidence of galactorrhea and galactocoel following Breast Augmentation.  The study involved 832 patients.  In this group 8 patient’s experienced galactorrhea.  They all wre bilateral and 3 presented with a galactocoele.  Using a peri-aerolar incision increased the incidence.

The average time from surgery to occurrence was about 18 days.  The main culprit is increased production of prolactis which is a hormone that leads to increased milk production.  If there is an increase in prolactin levels use a dopomine agonist such as bromocriptine.  Usually galactorrhea is bilateral with a milky discharge.  Aspiration of a galactocoele may be necessary.  Usually with appropriate therapy patients return to normal in a matter of weeks.

FACE LIFTS AND ANTI COAGULANTS

Often times I’m faced the dilema in a patient who wants a facelift or ANY Cosmetic Procedure but are on blood thinners like Plavix or Coumadin. I read an interesting study designed to answer the question; do patient’s on blood thinners experience a higher rate of complications following a face lift versus patient’s who do not. The study looked at over 9200 Surgical Procedures.

They looked at patients who received peri-operative anti coagulants such as Plavix or Coumadin versus those who received none. Patients on ASA had no ill effects while patients on coumadin did show some increased peri-operative bleeding and post op infection. However, serious complications such as flap necrosis or wound separation did not occur which would require a return to the operating room. But in my opinion if they can safely be discontinued before surgery than I think they probably should.

COMPOSITE BREAST AUGMENTATION

What is a Composite Breast Augmentation?  It is placement of an implant - silicone or saline - with transplantation of the patients own fatty tissue.  I have done this now several times and it really does make a difference in that the result is more natural.  The added benefit is you get a little extra fat taken off another area.  Like a two for one!

I recently read an article from a Dr. Francisco Bravo in Madrid Spain who wrote about sternal fat placement.  One of the things women want in a breast aug is nice natural cleavage.  By adding fat to the space between the two Implants, this transition zone can be  made to be more natural.  I have done this several times and it is a nice adjustment to breast augmentation.

BOTOX AND BREAST RECONSTRUCTION

I would say the lion’s share of Breast Reconstruction today involves the placement of tissue expanders, followed by their removal and the replacement of permanent prosthesis.  Since these expanders are placed under the muscle the amount of expansion can be limited due the tension and pain experienced by patients undergoing expansion.

A recent study of 30 patients was done with 15 patients receiving 40 units of Botox in 4 injection sites and 15 patients receiving saline injections.  Those patients receiving Botox had less pain associated with their injections and also they had greater volumes injected at each sitting. Also after 7 days the rise of narcotics was less in the group receiving Botox.

BOTOX - A NEW ANGLE

It seems like every time I turn around there is a new indication for Botox. A recent study showed injections of botox could lessen the production of sebum. The study was conducted by Italian and Chinese researchers and involved 42 female subjects. 

The sebum production returned to normal after 16 weeks. So it may be that Botox may be a new treatment modality for acne. This may be a new role in the therapy of patients who have acne that is refractive to normal therapy. However, at this point more questions remain and more studies are needed.

ANTIAFING AND FACIAL SKIN

When we look at anti-aging for the face we need to look at the skin, it’s texture, sun spots, wrinkles and loss of soft tissue. If there is mark redundancy of the skin, then some type of lift is in order. One of the nuances in face lifting procedures today is the addition of fat grafting with stem cells and PRP or protein rich plasma. I recently read a study by a well known Plastic Surgeon in Italy by the name of Dr. Gino Rigotti.

He studied 6 consecutive patients and placed them in 2 groups. One group received injections of fat and stromal vascular fraction while the second group received expanded mesenchymal stem cells to set which subset would effect anti-aging. The results showed BOTH categories showed increased regeneration of their skin that is an increase in collagen and a decrease in elastin fibers (elastosis or loose skin).

Should children have plastic surgery?

I recently read that a New York Plastic Surgeon would ask his younger patients (children & teens) to draw a picture of how they see themselves.

This self portrait may be revealing to a child’s self-image – a view into his or her world.

Many times young children will be brought into my Fort Myers Plastic Surgery practice for ear surgery, ie. their ears protrude too much. In these cases I will ask the parents to leave the room and ask the child how they feel about their ears.

In other words, am I doing the surgery for the child and their self esteem – their image or their parents? It is important to make this distinction. Many times a physical deformity can be damaging to a child’s self esteem.

I remember when I was in high school and had to wear glasses. Wow! What a shock – what an eye opener – no pun intended. I was now 4 eyes. Pretty devastating to one’s ego and self esteem.

A child becomes the brunt of jokes, ridicule or as we like to now call it now, a victim of bullying. In many cases surgery can go a long way to helping correct not only the physical problem but, more important, the child’s psyche or self esteem.

Plastic Surgery in Fort Myers

I practice in a state-of-the-art, sterile surgery facility in Fort Myers, Florida. It incorporates the most advanced Cosmetic Surgery technologies and the latest Plastic Surgery treatment therapies available. I tell patients, “My passion is to provide you with the very best in surgical and non-surgical results.” I also have an office in Cape Coral, if it is more convenient for you. And a new office in Punta Gorda.