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Liposuction Q&A Part 2

Wednesday, July 6, 2011
I am not very overweight but I have bulges on my thighs and hips. Even if I lose some weight, I can’t seem to make some of these areas go away.
You might be an ideal candidate for liposuction. Liposuction is at its best when it is used for sculpturing and contouring those stubborn areas that seem to be resistant to diet and exercise. Women tend to deposit fat around their pelvis, including lower tummy, hips, and thighs. And despite exercise and good eating habits, some of these areas are seemingly diet and exercise resistant. Liposuction can refine your body contour, restore your waistline, slim down your waist, hips and thighs, and help you to feel more confident in clothes.

Liposuction is the number one cosmetic plastic surgery procedure performed. It should be performed in a hospital, ambulatory surgery center, or an accredited surgical facility. Be leery of liposuction preformed in a doctor's office and check credentials of the surgeon.

The key to achieving a patient's desired look is understanding what the patient is hoping for and designing a sound surgical procedure. If you want to know if your surgeon is a Board Certified Plastic Surgeon and a member of the American Society of Plastic Surgeons, call 1-888-4-PLASTIC.

 

Liposuction Q&A Part 1

What is the difference between tumescent liposuction and ultrasound liposuction? Is one better than the other?
The standard principle of liposuction involves using a cannula to suction out fat from an area of fat burden. Some years ago, tumescent liposuction was developed, which involves instilling the tumescent fluid under pressure into the area to be suctioned. This technique not only improved the results from liposuction but also allowed for larger volumes of fat to be removed.

The ultrasound liposuction technique still involves a variation of the standard cannula and the tumescent technique, but also adds an ultrasound current to the tip of the cannula. The ultrasound current further dissolves fat and probably improves results for certain areas.

What are even more important in liposuction are the skills, experience and artistic judgment of the plastic surgeon performing the procedure. Understanding male vs. female fat distribution, recognizing end points, utilizing different cannula techniques, and sculpturing are far more important issues.

The key to achieving a patient's desired look is understanding what the patient is hoping for and designing a sound surgical procedure. If you want to know if your surgeon is a Board Certified Plastic Surgeon and a member of the American Society of Plastic Surgeons, call 1-888-4-PLASTIC.

 

Facelift Q&A

When should I consider a facelift?
Although the average age of when a person might undergo a facelift is about 60 or older, more and more people are beginning to consider a facelift in their 50s. Perhaps not surprisingly, many people do not want to wait until the skin is droopy and wrinkly and there are a number of signs of aging before they get a facelift.

Persons who undergo plastic surgery before time and gravity causes signs of aging appear to age more slowly. A facelift, which includes the neck, will lessen deeper folds, give a stronger jaw line without the jowls, and provide for a more youthful neck. Plus, performing a face lift early a person is able to enjoy the benefits of youthfulness during their 50s and 60s, rather than waiting to their 60s or 70s to turn back the clock. An eyelid lift added to a facelift, plus an advanced skin care program, is often an ideal way to turn that clock back 10 or 20 years.

The key to achieving a patient's desired look is understanding what the patient is hoping for and designing a sound surgical procedure. If you want to know if your surgeon is a Board Certified Plastic Surgeon and a member of the American Society of Plastic Surgeons, call 1-888-4-PLASTIC.

 

Eye Surgery Q&A

My eyes look tired and old and have dark circles. What can I do?
Part of the tired look is when the upper eyelids have excess skin that hangs there. The eyelid fold is poorly defined and it is difficult to place eye makeup. The lower eyelids can bulge due to fat pockets under the skin and the lower lid skin can be wrinkled, with skin that appears dark.

An eyelid lift can help improve most of these findings. An upper lift can remove excess skin and some fat, giving a smoother, youthful look with a better-defined eyelid fold. On the lower eyelid, removal of fat pockets and tightening of the skin can greatly improve the tired, bag look. The dark circles, which are partly due to shadowing are improved with removal of the bags and wrinkles. Some pigmentation changes can be further lightened with skin care products.

The key to achieving a patient's desired look, is understanding what the patient is hoping for and designing a sound surgical procedure. If you want to know if your surgeon is a Board Certified Plastic Surgeon and a member of the American Society of Plastic Surgeons, call 1-888-4-PLASTIC.

 

Breast Augmentation Q&A

A lot of my girlfriends have had their breasts enlarged. Some look good while others look too round and fake.
Breast augmentation is called an "augmentation" because it "augments" the existing anatomy more so than it actually creates it. Other factors come into play, such as the patient’s desire for size, pre-existing anatomy, and where the implant is placed.

The roundness in the upper half of the breasts that is often considered undesirable can be due to several factors including placement of the saline implant on top of the muscle, placing very large implants, or not making the implant pocket big enough to accommodate the implant. Saline implants tend to be rigid so softening of the contour is achieved by going under the muscle.

The key to achieving a patient's desired look, and this holds true with any cosmetic surgery procedure, is understanding what the patient is hoping for and designing a sound surgical procedure. If you want to know if your surgeon is a Board Certified Plastic Surgeon and a member of the American Society of Plastic Surgeons, call 1-888-4-PLASTIC.

 

Liposuction

You may be interested to know that liposuction is the number one cosmetic procedure performed in the United States for both men and women. Women commonly have liposuction performed on the hips, thighs and stomach. For men, liposuction is often done around the waist especially the "love-handles" and the stomach. Liposuction can be performed around the neck and is often combined with a facelift or necklift.

Liposuction is not a good method for weight reduction and it does not take the place of appropriate diet and exercise. Liposuction is an excellent procedure for sculpturing and slimming areas resistant to exercise and dieting. Most plastic surgeons feel that the best candidate for liposuction are those who are close to their ideal body weight and physically healthy, but have fatty deposits in particular areas.

The standard principle of liposuction involves using a cannula to suction out fat from an area of fat burden. Some years ago, tumescent liposuction was developed, which involves instilling the tumescent fluid under pressure into the area to be suctioned. This technique not only improved the results from liposuction but also allowed for larger volumes of fat to be removed.

The ultrasound liposuction technique still involves a variation of the standard cannula and the tumescent technique, but also adds an ultrasound current to the tip of the cannula. The ultrasound current further dissolves fat and probably improves results for certain areas.

What are even more important in liposuction are the skill, experience and artistic judgment of the plastic surgeon performing the procedure. Understanding male vs. female fat distribution anatomy, recognizing end points, utilizing different cannula techniques, and sculpturing are equally or more important issues. Don't get caught up in the latest technology buzz; there is no substitute for a skilled and experienced surgeon.

Liposuction is performed on an outpatient basis with local anesthesia and IV sedation or with general anesthesia. Some patients stay over night in the hospital, especially if they have larger volumes of fat removed. Healing after liposuction is gradual but most patients return to work within one week and can resume full activities within one month. Although the results of liposuction are seen immediately, there is swelling that can take up to three months to resolve. In fact, the initial swelling and bruising resolves within several weeks and the final new body contour will continue to improve.

If you want to know if your surgeon is certified by The American Board of Plastic Surgery, call 1-888-4-PLASTIC.

 

How to Pick a Plastic Surgeon

plastic surgeon has trained in a two to three year residency in a plastic surgery program approved by the American Board of Medical Specialists (ABMS). The ABMS is an organization of 24 approved medical specialty boards. The intent of the ABMS is to provide assurance to the public that those residencies certified by the ABMS have an approved training program and an established certification process assessing ability to provide quality patient care within that specialty.

Step 1. Go to www.abms.org. Click on Member Boards. There are 24 member boards of the ABMS in the United States. Your surgeon should be certified by The American Board of Plastic Surgery, which is one of the 24 member boards of the ABMS. If a different board that's on the ABMS list certifies your surgeon, they may be board certified BUT they're not a board-certified plastic surgeon. And if the surgeons supposed board does not even appear on the ABMS list, it is not a recognized board, sometimes referred to in the industry as bogus boards.

After training in an ABMS approved residency training program, a plastic surgeon usually enters practice and begins a 2-3 year process of becoming certified by The American Board of Plastic Surgery (ABPS). The mission of The American Board of Plastic Surgery is to promote safe, ethical, efficacious plastic surgery to the public by maintaining high standards for the education, examination and certification of plastic surgeons as specialists.

Step 3. Go to www.plasticsurgery.org. You can also call toll free the American Society of Plastic Surgeons at 1-888-4-PLASTIC. From the web site or from the phone call, you can ask if the surgeon in question is a plastic surgeon and whether or not that surgeon is certified by The American Board of Plastic Surgery. If they're not on the certified list by calling 1-888-4-PLASTIC, they're not a board-certified plastic surgeon.

There is also a great deal of useful information at www.plasticsurgery.org. Make sure you go to dot ORG (.org) not dot COM (.com).

Summary:
Plastic surgery residency approved by the American Board of Medical Specialists Certification by The American Board of Plastic Surgery Membership in the American Society of Plastic Surgeons.

Step 4. Buyer Beware! The Yellow Pages, Newspaper, TV, and Radio perform absolutely no screening of whom they allow to market themselves as plastic surgeons. Anybody can list themselves as a plastic surgeon under that heading in the Yellow Pages and anybody can place an ad in the Newspaper appearing as if they're a plastic surgeon or cosmetic surgeon. You would think there would be some accountability in the media but there isn't.

Step 5. At your Consultation, it is okay to ask a plastic surgeon how many of a particular procedure they have done. But don't get hung-up on numbers; they're only part of the equation. Ask to see Before and After pictures and be suspicious if there are few if any pictures to show. Make sure the pictures being shown are of that surgeons own work and not some other plastic surgeons results. Also ask for references, that is, the first name and a phone number of patients to call whom have had that operation performed by that surgeon.

Step 6. Hospital Based vs. Office Based Surgery. Be suspicious if a surgeon performs surgery out of their office. Although many good plastic surgeons have an office based operating room, its also a loophole for non-plastic surgeons. In most places in the US, there is absolutely no supervision of office-based surgery. A doctor who was practicing general medicine one week can take a weekend course and start performing liposuction that next week in their office.

With hospital based operating rooms, however, there is a credential process, peer review, and oversight. Hospitals do not allow surgeons to perform procedures in their hospital that's not part of their specialty.

In conclusion, verify if the doctor is certified by The American Board of Plastic Surgery by calling 1-888-4-PLASTIC or going to www.plasticsurgery.org. Don't base your decision solely on advertising but solicit referrals from friends or family. Look at Before and After pictures. Call a few patient references. Be leery of office based plastic surgery.

 

Breast Augmentation Part 2

There are three choices for breast augmentation incisions: nipple, breast crease and armpit. Each approach has its advantages and disadvantages. When you look at the entire scope of breast augmentation, such as size, shape, and symmetry, where the incision is placed is less important.

Because of the inherent ripples that can occur with saline implants, most plastic surgeons place saline implants under the chest muscle in order to hide the ripples and also hide any unnatural roundness to the implant.

So-called teardrop implants sounds good in theory but that theory doesn't translate into reality. Be leery of advertisements claiming to use anatomic, teardrop or biodimensional implants; their use is very limited in augmentation surgery.

Textured implants were originally invented in an attempt to reduce scar contracture around silicone gel implants. However, saline implants enjoy a much lower contracture rate and also, going underneath the muscle reduces contracture rate, too. Therefore, there is often no derived benefit in adding textured saline implants into the mix. In fact, textured implants likely have a higher ripple rate and rupture rate than smooth implants, and because of their texture, don't move as naturally as a smooth implant. Textured implants might be used for women who have recurrent contractures.

Final breast size is ultimately up to the woman although an experienced surgeon can help guide that decision. Most women often augment near the C-cup range, from a full B to a full C or small D.

The operation is called augmentation precisely because it augments the woman's given anatomy. Implants don't create the anatomy as much as they augment it. Most women have suitable anatomy such that simply making the breasts fuller; paying attention to anatomic landmarks, and filling out lost volume will achieve a great result. Some women need adjustment to the anatomy, such as a breast lift, in order to improve shape. A plastic surgeon conversant with breast augmentations can help a woman decide what her options are.

Breast augmentations should be performed only by plastic surgeons certified by The American Board of Plastic Surgery (call 1-888-4-PLASTIC). Be leery of office-based surgeries. Despite what the public thinks, any doctor can perform a breast augmentation in their office, whether or not they're a plastic surgeon. There is no government regulation. Hospitals and outpatient surgery centers at least credential their medical staff adding a level of security for the public.

 

Breast Augmentation Part 1

Reasons a woman might desire a breast enhancement operation include small breasts, sagging breasts, loss of breast fullness after breast feeding, and to fit better in clothes, strapless dresses and swimming suits. A woman should only undertake a breast augmentation, or for that matter any cosmetic plastic surgery operation for herself.

Breast augmentation is almost always performed in a hospital or outpatient surgery center, where general anesthesia is available. If it is being performed in a doctor's office or in an office operating room attached to a doctor's office, be suspicious of the surgeon's credentials since office based surgery is totally unsupervised from peer and government regulation and scrutiny. However, some plastic surgeons have accredited office-based operating rooms.

A breast augmentation takes about 2 hours to perform, is usually performed under general anesthesia, requires several hours of recovery, and most patients go home the same day of surgery. Although post-operative instructions vary from plastic surgeon to plastic surgeon, in general, women are very limited in activities during the first week, return to work at 5-7 days, allowed to perform light non-arm activities in the first month, and return to most physical activities after one month. Don't plan to have a breast augmentation and then go on a beach vacation two weeks later. Plan ahead.

Although there are some risks to the operation they are uncommon. Such risks include bleeding, infection, numbness, inability to breast feed, asymmetry, unhappiness with size and/or shape, implant ripples, implant leaks or ruptures, and scar. Almost all patients who undergo breast augmentation are happy and few experience risks or complications.

The only implant that is available for first-time breast augmentations are the saline implants. Saline implants are made of silicone rubber on the outside and are filled with saline at the time of surgery. Saline implants tend to have more ripples than silicone gel implants and tend to be rounder appearing. Saline implants can also rupture or leak, resulting in complete loss of volume necessitating a replacement operation. If the leak or rupture is within 5-10 years, the implant manufacturers will often provide a new implant free of charge and some money towards a 2nd operation. Silicone gel implants are only available through an FDA study for women undergoing breast cancer reconstruction, redo breast augmentations, and if a breast lift is also being performed alongside the augmentation, provided the woman meets the indications.

Breast augmentations should be performed only by plastic surgeons certified by The American Board of Plastic Surgery (call 1-888-4-PLASTIC).