Cosmeticsurg Blog

Is Liposuction to the hips for everybody? Recently, a patient came to me for a second opinion. She was an attractive, dark skin Hispanic female who had had Liposuction to the saddlebag area along with a tummy tuck and a breast lift. The result was great, but the patient was unhappy. She had a small waist, and a nicely defined hourglass figure. Her hips were curvy. Now why would a patient be unhappy with a ‘good’ result?

For forehead wrinkles, a cosmetic dermatologist will tend to recommend “therapy”, or facial fillers such as Restylane, or BOTOX. All of these injectables have to be repeated over time, with the full knowledge that if therapy is stopped, the wrinkles will come back. The plastic surgeon, on the other hand, will think of a more permanent solution, such as lifting the muscles that cause those wrinkles in the first place. Thus he may recommend an endoscopic forehead lift.

In 2006, I gave a lecture on the Body lift procedure to other surgeons in my hospital. In gathering the information for my talk, two things struck me when reviewing the literature published by other physicians. In summary, the current literature concluded that: 1) Surgeons are still reporting complications with the Body lift procedure. These complications include wound separations and seromas 2) Plastic Surgeons are still “learning about the procedure” My impression is that surgeons are having these problems because they do not use the Lockwood technique of body lifting. I use the Lockwood technique and feel very confident with the procedure and my results. Let me give you a brief history about the Body lift procedure, and how Dr. Ted Lockwood evolved the procedure.

As a senior (a little over 60 years old) I had given continued thought and prayer to having Breast reduction surgery for a number of years (at least 30 or more). In the past few years the thought and prayers became more and more on my mind and approximately 2 years ago I went as far as having a consultation with a plastic surgeon. I don’t know if it was my frame of mind or exactly what all the reasons were, but I was not comfortable with the surgeon, his staff, or even the thought of continuing on with this surgery. I didn’t go back for a 2nd visit…

Several people have asked me if fat grafts are permanent. They keep reading from other sources that fat grafts are not permanent or that they may need another procedure. In my experience, when done correctly, fat grafts are permanent, and I have yet to do a second procedure to add more fat in any of my patients. This is because of the way fat is harvested and the choice of sites for harvesting fat are crucial to the success of the Brazilian butt lift or any other fat injection procedure. In this blog entry I will detail how I harvest fat, process it, inject it, and care for the graft after surgery. In a subsequent entry I will describe how choice of harvest site matters.

In my last blog post, I went over briefly how the silicone implant moratorium came about. This week I’ll tell you why it is such a good thing that silicone implants are back as a choice for all breast augmentation patients. Remember, silicon implants weren’t really banned, as we have been using silicone implants for cancer patients, those with congenital defects, and patients needing a breast lift. Over the past 14 years they were just not available for cosmetic surgery patients. However, now all patients will have the choice to use saline or silicone implants.

Silicone breast implants are back! The truth always comes out in the end. In the case of silicone breast implants, it took 14 years! How can it be that implants are supposed to be so bad yet they’re back in the market? Well, because silicone breast implants were never really ‘bad.’

Since several patients have called recently inquiring about the “Lifestyle Lift,” I just had to put my thoughts online about the XYZ-lift phenomenon. Patients and surgeons are intensely curious about procedures that promise to deliver great results with minimal discomfort and downtime. After all, what could be better?– great looks, minimal bother! As with everything in life, if it looks to good to be true, it probably is not. But every once in a while, something does come up that is both much better than what was previously available, and true. It’s called innovation.

Patients are asking for specific procedures because they have been reached by the marketing efforts of Plastic Surgeons. Since surgeons are trained to do procedures, they market procedures as their product. In order to differentiate themselves in the marketplace, they come up with these catchy names to create a “unique” presence for themselves in the marketplace. Alternately, if there is a particular buzzword or catchphrase that is getting media attention, the surgeon will use it in his marketing pitch, to benefit from the attention generated by that particular “product-lift”.

Yesterday I did a Lip lift. My patient was a young woman, which is unusual for this procedure. Most women that need a Lip lift are older, and they have noticed the upper lip getting “thinner” as they age. Since the “red” part of the lip is getting thinner, they assume this is the part that needs to be augmented. So when a woman comes to me for lip enhancement, most of the time she is thinking…

Cosmetic surgery is not just for your face, breast, and body. Your hands age too. As we grow older, there is a change of fat distribution in the body. For example, the face tends to lose some volume in certain areas, and the midsection of the body tends to gain fat. Another one of the areas which loses fat is the hand.

Since the advent of thread lifts over the last couple of years, I keep hearing from patients wanting to know if they need a Thread lift or a face lift. A few years ago the question used to be whether they needed a laser treatment or a Facelift. The answer to either question is: It depends on what your goal is.

A British study was quoted in the news with the following teaser, “Is Botox addictive”? Here’s the short answer: no, breathe easy, it’s OK. The actual data quoted is that “up to 40% of patients feel a compulsion to have additional treatments”. Well, of course!! What else can, at such a low relative price point, for such little inconvenience, wipe years off your face? So you have it once. Hmm, that was easy! You become used to your new face because in three days, those wrinkles are g-o-n-e. Life is great, nobody is telling you you look tired, and when you look in the mirror, that’s what you’re supposed to look like!

Collagen, fascian, Restylane, etc., are wonderful options for tissue fillers, but their effect seems to be measured in months. If a patient repeats the procedure enough, the costs soon approach those of surgery. I found myself suggesting to more and more patients that they should just have surgery and make the result more permanent. Fat injections in the facial area do provide a longer lasting result than most fillers. However, fat injections are more of a surgical procedure rather than a quick injection. With fat injections, I use the patient’s own fat as a filler. The results can be dramatic and long lasting. Fat injections can be used in areas besides the face. I use a special type of fat injection is to fill out areas we never thought could benefit from large volume injections, such as the butt. I love doing fat injections, but there are a certain amount of pre and post op issues associated with it. So I look upon fat injections as a surgical procedure with a recovery time.

The question of whether to have a Tummy tuck or liposuction is a very common one. The two procedures address different problems. Liposuction deals only with fatty tissues, whereas Tummy tuck deals with muscle, skin, and fat. Some patients are candidates for lipo only, some for Tummy tuck only, and some could have either procedure, depending on their priorities. A candidate for liposuction only should have good skin tone. The skin will retract nicely after taking out the fat. Recovery time will be minimal, 7-10 days and you’re back to work. I like doing the procedure with a super fine cannula, and after surgery I apply foam pads to the skin to create the best possible smooth contour.