Your face often portrays the first signs of aging, leaving many people feeling like they look older than they feel.

By Carolynn Grimes
ThePlasticSurgeryChannel.com

Upper facial rejuvenation may be something you want to explore if you’re looking older than you feel.

Dr. Patrick Sullivan, a board-certified plastic surgeon and Chair of the Facial Cosmetic Surgery section of the Plastic Surgery Channel says, “whether you’re young or you’re old, you may feel that looking tired or sad is a problem for you at your job, or a problem socially.”

For some people, only Botox is needed to help with lines in the forehead or crow’s feet.  However, Dr. Sullivan says others may need to take a surgical approach.  If you’re bothered by either asymmetrical brows, or the overhang at your brow that crowds in on the eye making someone look tired, you may be a candidate for upper facial rejuvenation. Dr. Sullivan uses endoscopic incisions that are very small and hidden to elevate the upper face.  Sullivan’s main goal is to give the patient a nice shape to their face that looks natural and never surgical or artificial.

After the surgical portion, Sullivan says many patients can really benefit from some of the non-surgical procedures.  “It might be Botox or Dysport for the crows feet, or even Latisse to help enhance their eyelashes. When you put all of these techniques together is has brought about some very happy patients who seem to really love the results,” states Sullivan.

How do I know if I need surgical or non-surgical facial rejuvenation?

According to the American Society of Aesthetic Plastic Surgeons (ASAPS), during your physical examination with your plastic surgeon, your facial bone structure, underlying skin structure, skin thickness, texture, and elasticity as well as the extent of facial wrinkles and folds will be assessed. Your surgeon will use all of this information to formulate a plan to obtain the best outcome for you.

By Carolynn Grimes
ThePlasticSurgeryChannel.com

If you have a drooping jawline or jowls that needs correction, there is a  procedure that uses a patient’s own fat to fill in deflated areas.

They’ll say, “I don’t mind being forty or fifty years old, but I don’t want to be forty or fifty with jowls.” Dr. Patrick Sullivan, a board certified plastic surgeon in Providence, Rhode Island says sometimes this can be a condition that is inherited from your mother or father and there’s very little that can be done about a drooping jawline other than plastic surgery and sometimes weight loss.

Dr. Sullivan is a specialist in facial plastic surgery procedures and says people need to be very careful who they choose as their doctor for plastic surgery. Recently he consulted with a woman in her forties who was left with significant scars along both sides of her face along the jawline. Sullivan says the placement of those scars were not necessary for the result that she was looking for.

Dr. Sullivan uses a lifting procedure that is an extended inner lift with multiple layers, instead of just stretching the skin. He says he also looks at the chin region because often times people will have areas of deflation at the side, in front of the jowl. “These areas start getting more and more deflated causing the chin to look bigger,” says Sullivan, “and filling in this area with fat gives the jawline a smoother appearance.”

Many times he uses a patient’s own fat to fill in behind the jowl to give a better contour to the jawline. This procedure is particularly common in men who want their deflated jawline to look more masculine. For this procedure, Sullivan says, “rather than using a synthetic material that might get infected, if you use your own fat you’re using your own cells, which helps to keep the fat alive.” According to Sullivan, younger patients are the best candidates for this procedure. “We’ve done this in young people who want more of a chin. We put in fat along the chin area and maybe a little liposuction in the neck region to give a more artistic appearance to the lower face so it matches the nice features of their upper face,” says Sullivan. He says, “it’s all about artistic balance.”

Sullivan says the jawline is an area where he can help people of all ages.

“Sometimes it can be a very minimal procedure or it can be a more extensive procedure where we need to remove excess skin.” He says, “we are re-positioning tissue to solve the gravity problem.” Sullivan uses permanent stitches to lift the tissue and reshape the lower face. Using this procedure he brings out the cheekbones which he says “is really their own tissue rather than cheek implants.” Sullivan says “it gives a very nice jaw line with a balanced face that is no longer square but more oval shape, which tends to be much more enhancing in giving them a more natural and youthful look.”

Dr. Sullivan advises patients to bring in photos from their earlier years. “When patients bring in pictures of them in their 20’s, it is so helpful for me to see what they looked like.” He uses the photos as a gauge to help restore what time has slowly changed.

By Carolynn Grimes
ThePlasticSurgeryChannel.com

Plastic Surgeons from ThePlasticSurgeryChannel.com react to the arrest today of the faulty French breast implant founder. Claude Mas, the 72-year-old head of PIP was taken into custody this morning at his home in the south of France. Mas has been charged with deceptive business practices and fraud and now faces a potential charge of manslaughter after a French women with the PIP implants died of cancer.

Texas based, board certified plastic surgeon, Dr. Bill Adams, says fortunately, the implants were never approved here in the United States.

According to Adams there are stricter regulations here in the U.S., involving health and the products that are used in health care. The PIP scandal has caused a huge health scare among thousands of women across Europe and South America. PIP was shut down last year in March 2010 after it was discovered that the company was using industrial grade silicone in their breast implants instead of medical grade silicone that is used here in the U.S.

“The silicone implants that are presently used in the United States are manufactured by Allergan, Mentor and Silimed/Sientra (FDA clinical trials only), and must all meet the strict requirements of our Food and Drug Administration (FDA)” says Board certified plastic surgeon, Dr. Caroline Glicksman from New Jersey.

It’s been reported the faulty implants have a high percentage rate of rupturing among many of the women who had the implants inserted. It’s estimated that 300,000 women in 65 countries received breast implants from the company.  PIP exported 80 percent of its products, many of them to Britain, Spain and Latin America, causing worry and confusion for women all over the globe wondering if they too have the implants.

Dr. Adams says if a woman from the U.S traveled to another country for breast augmentation options, she could have received these defective implants. Adams, who specializes in breast augmentation, says “if you’re going across the world or going to other places that don’t have certain regulations, you could run into problems.”  See PSC Mediawire on Medical Tourism for more information.

Currently Over 2,000 French women have filed legal complaints against PIP and their complaints will be investigated case by case.

By Carolynn Grimes
ThePlasticSurgeryChannel.com

Plastic Surgery is often needed after massive weight loss

If you’ve been left with sagging skin and tissue due to weight loss, aging, child birth and pregnancy, a lower body lift procedure may be for you. The lower body lift is an operation that combines a tummy tuck with a lifting of the outer thighs and the buttocks.

Dr. Peter Rubin, a board certified plastic surgeon and leader in the the field of body contouring after weight loss says, “This operation is very effective for patients who have lost a lot of weight either after weight loss surgery or just their natural dieting and exercise.” Rubin says, patients can expect a very dramatic change with the lifting of the outer thighs and the buttock combined with a shaping of the tummy or the abdomen. “This combination procedure works very well to shape the whole lower body in one stage. Of course, it’s a bigger operation, the recovery is longer, and there’s always a bit more risk associated,” he says.

Dr. Rubin states because of the higher risks, you want to get properly evaluated by a board certified plastic plastic surgeon who has experience performing lower body lift procedures. He says, “At our center in Pittsburgh, we focus very much on safety as we evaluate our patients to make sure we’re matching the right operation to the right patient.”

Before a lower body lift, patients should be close to their ideal body weight

When is the best time to have the surgery? According to the American Society for Aesthetic Plastic Surgery (ASAPS), “The lower body lift should be performed when the patient is as close to their desired or ideal body weight as possible. If, for example, the patient has tightening of their lower body and then loses weight, the tightened skin will loosen and become saggy.  Conversely, post operative weight gain will either stretch the skin which has been tightened or undo the improvements of the body lift.”

Patients who might be a good candidate for a lower body lift:

1. Patients who have had massive weight loss
2. Loose skin in their buttocks and back of thighs
3. Loose skin in their hips and side of thighs
4. Loose skin in the front of their thighs
5. Loose abdominal skin or in their inner thighs
6. Acceptance of scars around the waist

By Carolynn Grimes
ThePlasticSurgeryChannel.com

Whatever you want to call it, “Bro-tox” or Botox, men are now learning what women have know for years; that Botox injections can help them look younger and more refreshed, taking years off the aging process.

The number of men getting Botox and cosmetic procedures has doubled in the last 15 years.

Doctors verify that they are seeing more men come into their office, many times at their wife’s or girlfriends prompting. But also to gain a professional edge in the workplace. Dr. Caroline Glicksman a board certified plastic surgeon and board member for ThePlasticSurgeryChannel.com says, “In my practice, one of the leading drivers of men trying Botox is the positive influence of their wives and girlfriends. Although their personal reasons may vary, a man who has the emotional support and encouragement of his wife or girlfriend, is more likely to try Botox for themselves, and continue using throughout the year. ”

Some men consider Botox because they want to look their best and compete in the workplace.

Another reason Glicksman says is men want that competitive edge  in the workplace.  “One of the things I’m seeing more recently with the economy, a lot of men have to go through job interviews, they are competing a little bit, so it helps them feel a little bit better about themselves for an interview,” states Glicksman.

Botox is now the number one plastic surgery procedure for men. According to the American Society of Aesthetic Plastic Surgery (ASAPS), more than 2.4 million individuals underwent these procedures in 2010.

Dr. Robert Grant a board certified plastic surgeon says when men get a little older into their 30’s and 40’s they should start thinking about the use of fillers and neurotoxins like Botox and Dysport to keep them looking their best.  Grant says, “These can help very subtly restore some of the age related changes in volume of the face and the lines and wrinkles that make us look older before our time.

Dr. Glicksman says the ideal candidate is someone who wants to see how much better they can look without having surgery and taking time away from work. She states, neurotoxin injections have no down or recovery time, are inexpensive compared to surgical alternatives and are relatively low-risk.

However, Glicksman warns that “men should take Botox injections seriously and be evaluated by a board certified doctor before getting the procedure.”

By Carolynn Grimes
ThePlasticSurgeryChannel.com

It’s a serious question to consider because many women find after having surgery they wished they had gone either a little bigger or smaller.

Dr. John Gross, a board certified plastic surgeon from Pasadena, California, says the size and type of breast implant you choose should be a decision made between you and your surgeon based on the patients size and existing breast tissue.

Fortunately, says Gross, “the options for breast augmentation and the devices (implants) available have markedly improved over the last decade.”  According to Dr. Gross, there are currently two implants approved by the Food and Drug Administration (FDA) which include saline and silicone filled implants both with a silicone outer envelopes.

Gross points out, that there’s a third implant available not yet approved by the FDA, but may be a great option for some patients.

It’s a highly cohesive gel that’s called style 410, referred to as the Gummy Bear implant. “Where it may have particular advantages is with patients who are very thin in their breast tissue, yet want a very natural result,” says Gross.  “Because of its shape and the fact that it tends not to wrinkle or ripple as much as some of the other devices, it may be a great option” says Gross.

Gross says when explaining the decision making process to patients, you’ll hear him frequently use the word, trade-offs.  He says, “all the choices whether they are saline filled, traditional silicone gel filled or the style 410 gummy bear, they each have different benefits.”

According to Gross you should carefully consider your options following a thorough examination and consultation with a board certified surgeon.  Dr. Gross say’s he encourages all his patients to take as much time as they need to think it over.  “When the patient has had time to absorb the information, discuss options with a friend or family member and come to a solid resolution they feel more comfortable moving forward.” He also supplies his patients with detailed information and encourages them to check out his web-site to help answer all their questions.

By Carolynn Grimes and  Peter Rubin MD
ThePlasticsurgeryChannel.com

Sagging skin and plump thighs are among the more common aesthetic concerns for women. Age, gravity and weight loss are the usual culprits according to board certified plastic surgeon, Dr. Peter Rubin. He says, “there are operations that will correct those issues, including thigh lift operations.”

A thigh lift reshapes the thighs by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the thigh.

Dr. Rubin is director of the Life After Weight Loss program, a clinical center at the University of Pittsburgh dedicated to the care of patients after weight loss. Dr. Rubin says there is usually a lengthy scar involved in this procedure and “the patient needs to realize the scar is in exchange for the removal of excess skin.”  According to Rubin, there are some versions of these operations where the scar can be minimized.  He says, “you may qualify for a minimal incision medial thigh lift which involves an incision only in the groin area.”

The timing and planning for one of these procedures is critical and many patients are excited to have some of their loose skin removed after weight loss.  One of the first questions many patients ask is, “when is the right time for a body contouring procedure?”

Dr. Rubin says a patient should ask themselves the following questions:

Has my weight been stable for the last three months?
Have I reached or am I close to my goal weight?
Am I committed to the lifestyle changes that are going to help me be successful with long-term weight loss success?

Once a patient feels the timing is right for surgery, patients need to know that recovery from a thigh lift can be fairly extensive.

Rubin says, “these are major operations and recovery time has to be accounted for when you’re planning for these procedures.” “Each operation is tailored to an individual’s specific body type,” says Rubin, “and your surgeon will determine what’s appropriate.” Dr. Rubin advises that these operations should be performed by a board certified plastic surgeon with experience in patients who have lost a substantial amount of weight.

By: Carolynn Grimes
ThePlasticSurgeryChannel.com

Unapproved and potentially dangerous breast implants sold overseas stir debate over the safety and risks associated with aesthetic plastic surgery.

According to the author Alexander Edmonds, the recent scandal involving unapproved and potential dangerous breast implants sold by a French manufacturer should raise questions about the safety and risks surrounding all aesthetic surgery.  Edmonds received a PhD in anthropology from Princeton and has written on the social dimensions of plastic surgery.  He is the author of “Pretty Modern: Beauty, Sex and Plastic Surgery in Brazil,” and is assistant professor of anthropology at the University of Amsterdam. Edmonds says, “With most surgeries, the risks are weighed against expected health improvements. But aesthetic procedures, by definition, do not improve health.”

Dr. Jeffery Kenkel, President of the American Society of Aesthetic Plastic Surgery (ASAPS) disagrees. “What would be next? Will physicians be banned from performing procedures on cleft lip children because it doesn’t prevent or cure disease?”

According to reports, the recent breast implant scandal could affect up to 300 thousand women world wide.  The French manufacturer, Poly Implants Protheses (PIP) has admitted to authorities it was producing and distributing breast implants with a cheaper industrial grade silicone instead of a medical grade silicone which could be harmful according to officials. The implants have also shown to have a high rate of rupture. Edmonds says, “The fact that a surgeon is putting in implants sends a subtle message that they are safe.”

Edmonds points out that one response to the PIP scandal is a ban on doctors performing cosmetic breast augmentation altogether. He says, “It’s well known that breast implants of many types can cause burning pain, loss of sensation, hardening of breast tissue and serious infection.”     Breast implant expert, scientist and  Vice President of  The Aesthetic Society Education and Research Foundation (ASERF) ,  William P. Adams, Jr, MD says he  does not  agree with this conclusion,  “it  appears he is  quoting the  exceptions and not the rule, in fact the science and data says when implants are used with modern techniques that outcomes are optimized, patients have very few issues and have  an extremely high degree of satisfaction.”

The FDA says both saline and silicone breast implants in the U.S. are safe.

He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.” But Kenkel says, “That’s not true.”  Last year the FDA (Food and Drug Administration) concluded that the silicone-gel implants are safe as long as women understand they come with complications.  According to Kenkel, “Breast implants are one of the most studied medical devices in the history of the FDA. Both saline and silicone implants that are manufactured in the U.S. are safe.”

However, Edmonds says the FDA made clear that local complications are not uncommon. He quotes the FDA’s 2011 ‘Update on the safety of silicone gel-filled breast implants’, which states that: “Frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others.”

Kenkel says Edmonds is confusing the issue of an unethical manufacturer using non-medical grade silicone and the legitimacy of plastic surgery. “When surgery involves a medical device that was fraudulently manufactured, it’s more logical to question the manufacturer than question the patient’s motivation for wanting the surgery.”

Dr. Leo McCafferty, President Elect for ASAPS says, “Cosmetic Surgery, if performed by a board certified plastic surgeon in a properly licensed and accredited facility has never been more safe.”   Dr.  Adams  agrees. He says, “If we look at the benefits of cosmetic and plastic surgery procedures to patients, it’s very well documented that patients have incredible elevation of their quality of life, and there’s data to support that.”

From 2009-2010, there was almost a 9% increase in the total number of cosmetic surgical procedures, with over 1.6 million surgical procedures this year, according to ASAPS. It is also reported that the number of breast augmentations alone have tripled during that same time frame with a 90% plus satisfaction rate.

Edmonds says his goal in the piece was to add to the already extensive debate about the risks of cosmetic procedures and whether consumers are adequately informed about them.  Drs. Kenkel and Adams , both Board Certified Plastic Surgeons in Dallas, Texas,  agree that patients need to be more educated on procedures and say patient education by qualified Board Certified Plastic Surgeons is a top priority in their practices.  In the end, they say,  an informed and educated plastic surgery patient results in a better outcome for the patient.

McCafferty states that anyone considering plastic surgery should “seek properly trained Plastic Surgeons certified by the American Board of Plastic Surgery and members of ASAPS and ASPS (American Society Plastic Surgeons). These surgeons operate in accredited, licensed facilities using safe effective FDA approved products, devices, implants and equipment.