CosmeticSurg blog: Expert insights from Dr. Ricardo L. Rodriguez

Exparel is a long acting local anesthetic which is injected into the operative area at the end of the procedure. Like the pain pump, it focuses just on the operative area, and does not disseminate to the entire body like a narcotic does. The function of the Exparel is to numb the area of surgery so you do not feel pain. With cosmetic surgery, patients only need the one injection, and the pain control lasts for about 3 days. Similar to the pain pump, patients take fewer narcotics post operatively, because the pain is more controlled.

I asked the patient if he be interested in a procedure to tighten the muscles that was not described anywhere in the literature (this was early 90’s!) but that I could perform a surgery using techniques I was comfortable with? He agreed, signed the informed consent, and I did the procedure by making an incision around the belly button for access to the deeper tissues. The procedure went so well I immediately felt bad for all those patients on whom I had done a traditional incision to treat this problem. So if I could do this going above the belly button, why not do it for muscle separations below the belly button?

Plastic surgery doesn’t have to be painful. If you are having a cosmetic surgery procedure ask your plastic surgeon about pain pumps. These types of pumps use local anesthetics, not narcotics. Pain pumps eliminate pain, reduce nausea, and result in much quicker recovery.  

How do you achieve a flat stomach? Do you need more exercise or a Tummy tuck? Find out about the rectus abdominis muscle and how to perform a self examination of this muscle.

The question of whether to have a Tummy tuck or Liposuction is a very common one from my Baltimore patients. The two procedures address different problems. Liposuction deals only with fatty tissues, whereas Tummy tuck deals with muscle, skin, and fat. If you have loose skin,  liposuction will not address this. Some patients are candidates for liposuction only, some for Tummy tuck only, and some could have either procedure, depending on their priorities.

If you are considering a Tummy Tuck you should find out exactly where the surgeon will place the incisions.  The incision will determine what the scar looks like. Two types of incisions are made for the Tummy tuck: 1) horizontal and 2) belly button. The horizontal incision should be as low as possible ,and the belly button incision should be more similar to an inverted “U”. 

Many patients are afraid of the Tummy tuck procedure because they have seen friends’ scars or pictures of scars on the internet. Some patients including Hispanic, Asians, or African Americans think they are bound to get thick scars simply based on their ethnic background. This is just not so. Thick or unsightly scars following abdominoplasty can be easily avoided. In addition , your incision can be placed well below the panty line.

One of the biggest concerns patients have with any surgery is the amount of pain they will have to endure afterwards. This is especially true in cases of Breast augmentation and other cosmetic surgery procedures since the patient is undergoing elective surgery and wants the best experience possible. Pain itself can have a negative impact following surgery. In fact, it’s the main cause for readmission to a hospital after cosmetic surgery. When patients are in pain, they tend to breathe in short, shallow gasps which results in poor oxygen delivery tot he tissues that, in turn, affects healing. Besides, when the lungs don’t fully expand, patients are more prone to additional complications such as pneumonia. To prevent this, patients need pain relief. The traditional way is pain pills but there’s a better, less nauseating method for treating post-op pain.

Patients today are doing a lot of research about the upper Lip lift,. One of the most frequent questions I get is if the surgery involves the muscle of the upper lip. Patients want to know if my technique involves only the skin, or if I lift the muscle in any way. My Lip lift technique involves lifting the skin only, and I do not involve the muscle. It seems one of the biggest proponents of technique incorporating the muscle is Dr. Randall Heyworth in California. In 2008, he and I met on a trip to China representing the American Society of Plastic Surgeons, and I enjoyed his company. But I have a different approach to the upper lip lift and I will explain why.

We get quite a lot of questions regarding Lip lifts, so here’s a quick video of me talking about what techniques I consider to be the key for getting the most successful Lip lift. The goal of the upper lip lift procedure is to raise the upper lip to a more youthful.

Since the 1990’s Plastic Surgeons have reliably used fat grafting as a way to improve and enhance the cosmetic appearance of the face, breast, hands, feet, hips, and buttocks. However, more recently, clinicians have documented the therapeutic benefits of fat grafting in the healing of wounds and scars, as well as fat’s ability to repair damage to breast tissue following radiation treatment.

Following surgery, in an effort to repair damage to your dermis, your body forms new collagen fibers – which results in a scar. This new scar tissue will look and feel different than the surrounding tissue. A normal scar will generally appear somewhat flat and pale and will typically fade with time. In fact, many scars eventually become undetectable to the naked eye. However, some scars follow a more disruptive path, and can even get worse as time goes on. When the body produces too much collagen in an effort to repair the damage it can result in a ‘raised’ scar. These are considered ‘bad scars’ or ‘adverse scar conditions’ and they can unfold following any incision, including an incision made during a Plastic Surgery procedure.

 In the Liposuction procedure, the cannula is the long slender rod which is used to extract fat from unwanted area. I will explore the evolution of the liposuction cannula and discuss why cannula size is important to get a good Liposuction result.

Adipose tissue has a higher population of stem cells than bone marrow. Enough said. The tissue which has the highest population wins. Read more about this in Dr. Rodriguez’s CosmeticSurg blog.

Many young women come to my office when they start noticing a little bit of ‘extra skin’ on their eyelids, or sagging upper eyelids. They have heard about Eye lifts (blepharoplasty), and how easily it can be performed under local anesthesia. Naturally, they are very interested because the procedure is performed in the office and takes only 1-2 hours. However, the Upper eyelid lift is not an ideal procedure. I don’t think the results are as good as a brow lift. Furthermore, if too much skin is taken off, the eye lids will have a had time closing and the patient can suffer with dry eye syndrome. In fact, I usually prefer to perform a Brow Lift instead of an Eyelift in order to achieve a better result. The Brow Lift will elevate the brow to it’s youthful position, and in the process it will lift the upper eyelids. The result is a refreshed natural appearance.