Facial Surgery
What is sun damage?
Mar 2nd
Model showing signs of sun damage.
Scottsdale – Many patients ask what is sun damage? Here’s a quick and short version of what happens.
Sun damage occurs as a result of your skin being exposed to ultraviolet (UV) rays. As UV rays are absorbed, they may cause cells to enter into photo-excited states, which may lead to the formation of free radicals in some skin cells. Free radicals lead to oxidation and cellular damage to occur. UV rays can also produce changes or mutations in the DNA (your genetic information) within the skin cells. Depending on which changes occur, the cells to may malfunction and act differently than normal cells.
With repeated exposure to UV rays, the skin is continually abused, and over time it struggles to repair the signs of sun damage. As the cells begin cellular replication and keratinization, the DNA changes caused by the UV rays are copied into new cells.
Eventually, visual changes on your skin surface may appear including hyper-pigmentation, uneven skin tone, fine lines and wrinkles. More serious conditions like actinic keratosis and even skin cancer could result when your DNA is damaged.
Lifting the corner of the mouth.
Feb 3rd
Scottsdale – When the corner of mouth sags, the individual can look sad, angry and aged.
There are several ways of lifting the corner of the mouth.
The non-surgical method includes the application of Botox to the Depressor Anguli Oris (DAO) muscle. This is the simplest approach to the problem with the down-turned corner of the mouth. It is a nice, quick and relatively pain-free approach. The down side is that results only last about 3 to 4 months. The treatment has to be repeated to maintain the results. Adding dermal filler, like Juvederm or Restylane, can make the results more impressive and longer lasting.
The DAO can also be surgically manipulated. Direct surgical manipulation can lift the corners and create a more permanent result. This can be performed during facelift surgery. This procedure, however, is relatively new and results will vary depending on surgeon experience.
Another approach includes the direct lift of the corner of the mouth. This is performed with the excision of a small sliver of skin right above the corner of the mouth. With the closure of the incision that is created, the corner of the mouth comes up to a normal level and the patient loses that scowling downward turn of the mouth. This is a procedure that has a long history and is more predictable.
Cheek Augmentation: Indications.
Jan 29th
Scottsdale – Indications for Cheek Augmentation.
Cheek implants increase the projection of the cheekbones. They add volume to areas which may be deficient or flat.
Inadequate cheek volume that requires cheek augmentation may be genetic. In other words, you were born with small cheeks that need a cheek implant to give you a normal appearance. Cosmetic cheek surgery to give your cheeks the appropriate shape and volume. Cheek implants may be required to restore volume that was lost during a traumatic event. Injuries are not uncommon in car accidents.
Cheeks may be asymmetric with only one cheek requiring augmentation. Cheek implants are not meant to fully correct these asymmetries. Cheek implants can give your cheeks a more aesthetic size and shape while improving the symmetry. Inadequate cheek volume is a result of the natural aging process. Aging causes the fat tissue and bones of the face to atrophy creating inadequate cheek volume. Adding volume to your cheeks in this situation, increases the ability of facelift surgery to make you look younger.
Chin Augmentation: Indications.
Jan 28th
Scottsdale - Indications for chin augmentation.
Cosmetic chin surgery, which is also known as mentoplasty, is a plastic surgery procedure to reshape the chin either by augmentation, reduction or other type of shape change. The most common method for chin augmentation includes placement of an implant to add size and volume. Some chin implants are shaped to give patients a certain look. Occasionally, when the chin is too large for the face, a reduction surgery on the bone, can improve the situation.
A plastic surgeon may recommend chin surgery to a patient having rhinoplasty in order to achieve better facial harmony, as the size of the chin may magnify or minimize the perceived size of the nose. A chin implant may also be recommended in patients having facial plastic surgery to reverse the changes of natural aging. When we get old, the chin bone atrophies and becomes smaller. Adding volume to the chin in this situation, increases the ability of facelift surgery to make you look younger.
A chin augmentation helps people with short fatty necks achieve a thinner facial appearance. The procedure may be combined with neck liposuction to achieve better results. Cosmetic chin surgery helps to provide a harmonious balance to your facial features so that you feel better about the way you look.
Lip Augmentation: Indications.
Jan 26th
Lip Augmentation
Scottsdale – Indications for Lip Augmentation.
The most common reason to perform lip enhancement is to increase the size and improve the shape of the lips. In other words, the vast majority of patients seeking this type of plastic surgery request bigger, fuller lips. A small percentage of patients may request plastic surgery to reduce the size of the lip or for a lip lift. There are various lip shapes that are important to take into account. Lips are different from person to person and from side to side. No two lips are exactly alike.
Lip augmentation is a plastic surgery procedure used to enhance the size and appearance of your lips. For a lip augmentation, your plastic surgeon will discuss several options. Some of these options, including dermal fillers, can be performed in the office under local anesthesia only. Dermal filler injections can be performed quickly and easily. Dermal fillers can provide a nice lip augmentation with results lasting between 3 to 9 months, depending on the product used. The procedure can be repeated when desired by the patient.
Longevity of the results is the main advantage of plastic surgery over non-surgical options. During surgical lip augmentation, the plastic surgeon can insert materials like fat, silicone implants, and/or biological products to achieve a better looking lip. These types of materials usually outlast any result achieved through the injection of dermal fillers. It is impossible to predict how long the results of lip augmentation will last on any particular patient. The new FDA-approved silicone lip implants are likely to provide the most long-lasting results achievable (model used in illustration).
Dermal fillers in rhinoplasty?
Jan 21st
Dermal fillers for Rhinoplasty?
Scottsdale – Dermal fillers are not FDA approved for rhinoplasty or post-rhinoplasty correction. However, because of their potential reversibility, low risks and ease of use, these are used in the nose with high frequency, especially for correction of minor defects after rhinoplasty.
The latest issue of the Aesthetic Surgery Journal discusses the use of dermal fillers to correct post-rhinoplasty deformities in the nose. The article was published through the University of Illinois Medical Center in Chicago.
The authors point out that dermal fillers are minimally invasive and can reduce the financial expense, anesthetic risks, or downtime associated with revision nose surgery. The researchers discussed these options and give some sound advice.
The authors like hyaluronic acid (HA) derivatives, such as Restylane and Juvederm, and calcium hydroxylapatite gel, such as Radiesse. Tips on patient selection and injection technique in the article are important, including:
1. Nasal injection includes sub-SMAS placement to reduce visible or palpable nodules.
2. Restricting the use of fillers to the nasal dorsum and sidewalls.
3. Avoiding injections to the tip and alae, which carry more adverse risks with injections.
4. Radiesse is an acceptable treatment for post-rhinoplasty deformities, but patients must be carefully selected to minimize risks.
5. Avoid silicone altogether because of severe granulomatous reactions, infection, thinning of the skin, and necrosis.
I found the article to be quite useful. I do agree with the authors, patients who are treated with dermal fillers must be followed closely for complications. The use of any soft tissue filler must be carefully considered by the patient. An explanation of the risks and the off-label use must be clearly explained to patients before any non-surgical plastic surgery procedure is administered (model used in illustration).
Plastic Surgery for special occasions.
Jan 19th
Tips on plastic surgery before weddings.
Scottsdale – Plastic surgery for special occasions? I blogged about cosmetic surgery for the holidays last year.
With the wedding season fast approaching, I decided it was a good time to write about surgical and non-surgical options before the big day.
We classified cosmetic surgery procedures into those which are quick and easy to recover (hours & days) from, and those which take longer to (weeks & months) recover from.
This information should be helpful for most people planning for that certain procedure. With this information, you can plan ahead so you are fully recovered and ready on a particular date, for the big day.
The simple and easy: Botox, dermal fillers, and microdermabrasion.
We can classify Botox and dermal filler injections as the simplest and easiest of all the options. Many brides-to-be, mothers-of-the-bride and (and fathers too), or just anyone that wants to look their best in front of family and friends should know about these non-surgical options.
These medical office procedures are performed quickly and recovery is just a few days. My advice is to have these types of injections 1 or 2 weeks before the event. To avoid bruising, you should not use Aspirin or other medications affecting your platelets before injections.
Botox Cosmetic and dermal fillers, like Restylane and Juvederm, are approved for the treatment of facial wrinkles. Botox is also approved for severe underarm sweating, which can be really helpful to any nervous bride or groom!
Facials and microdermabrasion, involving a spray of tiny crystals on the skin blasting away dead skin cells, reducing fine lines, brown spots, and small scars can be useful as a last minute enhancement for a wedding. Be careful if acne is an issue for you, because facials can sometimes trigger a breakout.
The just a little bit more involved: Skin care & IPL.
Laser therapy with intense pulse light photorejuvenation (IPL) performed a month before the big day can really help the facial skin to form a healthy glow for the wedding. IPL offers a quick recovery, but multiple treatments over several weeks are usually necessary to achieve the best results.
Some skin regiments may also take a few weeks to achieve the maximal effect. Obagi and prescription strength Retin-A may take up to 6 weeks before you start seeing smaller pores, smoother skin and a healthy glow. It is recommended you do not wax if you are taking Retin-A.
The longer recovery procedures: Facelift, Breast Augmentation, and Lipo.
Plastic surgery is real surgery and requires an appropriate amount of time for a full recovery. Many mothers and fathers-of-the-bride may choose eyelid surgery or even facelift to remove flabby skin in these areas. Eyelid surgery usually heals nicely by 6 weeks. A facelift may require a few weeks longer to recover. My advice is to give yourself plenty of time to recover from facial surgery.
Patients should realize, however, that with most plastic surgery procedures a full year is required before we consider you have reached your final result.
Breast Implants.
Breast augmentation is very popular before weddings. It takes about 6 weeks for most implants to settle into the right place. I recommend breast augmentation 3 to 4 months before weddings, to give your wedding dress maker time to size you up correctly. Once your breast implants have settled, it is fine to get measured. Be sure there is enough time before the wedding to order your dress for a timely arrival.
Breast lift is popular too, but require just a few more weeks to be ready for wedding dress measurements.
Lipo for a wedding!
Liposuction is also very popular before weddings. The same issues with dress size measurements and wedding dress orders apply to those thinking about lipo before a wedding. Six weeks after lipo you will likely be ready to try on your new wedding dress. Liposuction recovery is tied to the amount of fat that is removed during the procedure. The more lipo you have, the longer your recovery and the farther ahead you should plan for your procedure.
Tummy tuck before weddings?
We have seen brides, bridesmaids, and mothers-of-the-brides, get tummy tuck plastic surgery before weddings quite frequently. Other procedures like belt lipectomy, lower body lift, arm tuck and thigh lift are less popular before weddings.
Patients will really have to plan ahead before having one of the more involved procedures. For tummy tuck we recommend surgery at least two months before the planned wedding day. For belt lipectomy and thigh lift, we recommend, 3 to 4 months of recovery before the wedding date, might be better. An arm tuck should be performed 2 to 3 months before a wedding.
The final results of any surgery are not achieved until one full year after the plastic surgery date.
Some Thoughts on Rhinoplasty.
Jan 15th
Scottsdale – Here are some basic thoughts on rhinoplasty:
1. The goal of nasal surgery is to achieve a natural-looking nose as opposed to one that appears operated upon.
2. Each nose is shaped to fit in with the distinctive features of the patient’s face.
3. The shape of the nose should be improved, and importantly, the appearance of the entire face should be enhanced. There are limitations on what can be done.
4. Medical grade photographs will be taken to be analyzed in planning for surgery and to define the unique characteristics of your nose and face.
5. Dr. Guerra will discuss the steps involved in your rhinoplasty, using detailed diagrams which are easy to understand. When both parties agree on the plan, we will schedule surgery.
This discussion includes a disclosure of risks, benefits, imponderables and expected outcomes after surgery. There are no guarantees with rhinoplasty. Across the nation, re-operations from rhinoplasty are very common.
Considering rhinoplasty or a nose job in the Scottsdale and Phoenix, Arizona area? Please call (480) 970-2580 or use our contact form today to schedule a complimentary consultation.
IMCAS: Big aesthetic meeting brings good news.
Jan 10th
Aesthetic Plastic Surgery on the rise!
Scottsdale – The International Master Course on Aging Skin (IMCAS) is being held this week in Paris, France. This is one of the biggest aesthetic meetings in the world and important economic news are coming from the presentation platform. According to the international experts, beauty therapies including laser treatments, breast enlargements and wrinkle-filling injections should grow 5 to 10 percent a year worldwide until 2013 (Source: Reuters).
The financial crisis had a significant effect on the number of aesthetic surgeries performed in 2009, with a drop of about 15% on average. In Europe, revenues in the medical aesthetic industry fell 15 percent to 3 billion euros (4.30 billion dollars) due to fewer surgical procedures and a 40 percent decrease in energy-based therapy equipments like ultrasound massages and laser treatments.
“Among patients it’s increasingly fashionable to want to keep one’s facial expressions intact rather than opt for a more drastic change in looks through surgery,” said plastic surgeon and IMCAS director Benjamin Ascher. “Medicalized beauty treatments can no longer be seen as a pure luxury,” Laurent Brones, business development manager at Symatese Biomaterials, a French maker of collagen.
Medical spas still have ample room for development in Europe. “Europe lags behind compared to the United States,” Dr. Ascher said. “The potential is huge.” According to this article, revenues from breast surgery should recover again, growing between 5 and 10 percent annually through 2013, after a decline of 15 percent last year.
Women represented 91 percent of plastic surgery patients in 2008, according to the American Society of Aesthetic Plastic Surgeons. IMCAS meets every year in Paris, gathering aesthetic surgeons and dermatologists. The four-day conference began Friday.
10 Tips for healing after facelift.
Jan 7th
Scottsdale – These are our recovery tips for after the first week after facelift:
1. Mild bruising can be covered up. We carry a specially formulated brand of makeup for facelift surgery patients. You can begin applying this 7 days after surgery.
2. Numbness is normal. It is normal for sensory nerves of the face to have been disrupted during surgery. When applying make up, numbness in certain areas, close to incisions, may be noted.
3. Take it easy for several weeks after surgery. Do not bend over or lift heavy objects or run or do any activity that raises your blood pressure or heart rate (above 100) for 2 weeks after surgery.
4. High blood pressure is related to a higher risk of bleeding after facelift surgery. Do not participate in contact sports for at least 6 weeks. We recommend you avoid steam rooms, saunas, steam face masks, or any product that promotes flushing of the skin. You should avoid supplements containing niacin, which can also cause flushing until 12 weeks since surgery.
5. Avoid alcohol and products containing aspirin or ibuprofen for several weeks.
6. Smoking impairs your circulation and decreases your ability to heal. You should avoid smoking, first and second-hand, for as long as possible.
7. It is normal for you to notice a change in your smile, sensations of tightness, tingling, occasional sharp shooting pains, pulling, burning, and even cold sensations during the recovery period. These symptoms are usually mild and subside within the first 6 weeks.
8. A gentle massage with an Arnica-based ointment is extremely helpful in reducing these symptoms.
9. As the swelling subsides, a more youthful version of yourself will be revealed. This takes time and you should prepare yourself emotionally.
10. It is normal for some patients become depressed during the recovery period. Maintaining a positive attitude, eating a sensible diet, concentrating on re-establishing your normal routine, and beginning outdoor activities as soon as you feel up to it, will help you to get through the recovery period.
