A Board Certified Plastic Surgeon in Scottsdale
Facial Rejuvenation
Fat Grafting Fab(ulous) Five Facts.
02 years ago
Human Fat Cells: The ideal filler?
Scottsdale – What makes fat grafting so attractive to many people planning to undergo facial plastic surgery? These are the top 5 reasons many people are choosing fat transfer:
1. Fat is readily available in most plastic surgery patients.
2. Fat is easily obtained using reliable cosmetic surgery techniques for harvesting fat.
3. Fat is inexpensive.
4. Fat is bio-compatible with the donor.
5. Fat can be harvested and re-injected repeatedly, as needed.
Neck lift – some details…
02 years ago
Neck Lift Before After Photo, Actual Patient
Scottsdale – A neck lift or platysmaplasty is the ideal procedure for rejuvenation of the neck. A neck lift can be part of a facelift in Scottsdale procedure, as recommended for your situation, or may be carried out alone or with liposuction of the neck.
The operation begins with a small incision under your chin and those in front of and behind the ears. The incision is carried into the hairy scalp towards the back of the neck. The incisions allow access to the paired platysma muscles and the fat layer of the neck.
The neck muscles are tightened and any excess fat removed or contoured. The neck muscles are tightened in the front and the back, effectively creating a supportive sling that holds up the neck tissue in a more youthful position.
The fat may be reduced with lipo or by direct removal. Once the muscles are tightened and the fat contoured, the skin is redraped over the neck and lower face. Any excess skin is gently removed and the incisions are closed with sutures.
A special compression bandage that you will have to wear to help reduce post-operative swelling is applied. This is usually worn night and day for at least 5 days and then only at night for a longer period of time. It is important for you to follow instructions in order to optimize a proper recovery.
Age 50: 5 recommendations for your face.
02 years ago
Top 5 for 50 Facial Plastic Surgery procedures recommended.
Scottsdale – The AB Guerra Plastic Surgery Center recommends that patients in their 50′s take a look at our suggestions list. We see hundreds of patients interested in plastic surgery every year. These are the recommended facial plastic surgery procedures can help you to feel and look younger.
The top 5 procedures for 50, in the face include:
The eyes: The eyes can easily give you away! Heavy eyelids can make you looked tired, aged and uninterested. In some cases, the upper eyelids can become so heavy at 50, they may actually block your vision. In contrast, after eyelid rejuvenation surgery, you can look youthful, bright and beautiful.
The face: The face is the centerpiece of all facial plastic surgery rejuvenation. Aging of the face at 50 results in deep laugh lines, sagging skin and jowls. A facelift offers all patients, men and women, the opportunity to turn back the clock on aging. Face lift can be performed as a mini, which treats only the face and has shorter incisions, or a full facelift, incorporating part of a neck lift, as well.
The forehead: Aging lines and wrinkles in your forehead and frown area are typical in persons younger than 50. Deep frown lines, in particular, evoke feelings of anger or unhappiness to your face. By the time 50 rolls around, most persons are tired of those age lines to the point of doing something about it. The forehead lift, is an operation that can smooth out the forehead and the frown lines in one procedure and make you look younger, well-rested and happy.
The neck: Loose and elastic skin of the neck can make you very self-conscious. In addition, the neck is sometimes difficult to hide in Arizona. A neck lift is a great procedure that can be done by itself or with a face lift and can rejuvenate your neck area by reducing loose and wrinkly neck skin. The incision is easily hidden behind your ear. Liposuction can sometimes be used alone or in combination with a lift in neck rejuvenation. An examination by Dr. Guerra can help you decide which procedure is best for you.
The wrinkles: Exposure to sun, wind and the elements can increase the number of lines and wrinkles on you face. Lasers, chemical peels and a sensible skin care regiment will help to reduce the number of wrinkles and reverse some of the changes that occur with aging.
For more information on plastic surgery in Arizona or to make a consultation with Dr. Guerra call (480) 970-2580, schedule an appointment online. You may also want to review the facial surgery section on The AB Guerra Plastic Surgery Blog for more information on facial plastic surgery.
Ironing out forehead wrinkles with forehead lift surgery.
02 years ago
Ironing out forehead wrinkles with forehead lift surgery.
Scottsdale – A forehead lift can be performed using various techniques. The procedure has changed over the years from an open technique to more sophisticated short incisions and even endoscopic techniques, utilizing a camera to visualize the surgery steps.
A forehead lift usually involves incisions in the scalp. Incisions may also be performed in the forehead and the upper eyelids. Once incisions are made, undermining (lifting) of the skin is performed, and the deeper layers of the forehead are lifted.
Importantly, muscles that depress the eyebrows and create wrinkles in the frown area can be treated. The surgery can modify or remove parts of the muscles that cause wrinkling and frown lines, remove excess skin, and lift your eyebrows to a more pleasing level.
The results of forehead lift are a reversal of the effects of gravity and aging. Tightening of soft tissues of the forehead to restore a more youthful appearance to the upper face is an additional benefit (model used in illustration).
Perma Lip Implant: Report of Initial Experience.
02 years ago
Lip augmentation alternatives.
Scottsdale – An interesting permanent silicone implant for lip augmentation was recently approved by the FDA. It is called, the Perma Lip implant and its use has been recently reported in the Aesthetic Surgery Journal. The implant is manufactured by SurgiSil in Plano, TX. The silicone implants are designed and approved for lip augmentation and are available in three thickness levels at 3, 4, and 5 mm and variable lengths of 55, 60, and 65 mm to fit any adult lip.
The authors point out that the upper lip is longer, so longer implants are typically used in this location. When planning the augmentation, the authors suggest that the lower lip should be twice as full as the upper lip and it can be altered with thicker implants. The key in the design with this implant occurs at the ends. The ends are tapered to match the thinner ends of your lips. This makes the results appear very natural.
The implants were placed at the time of face lift and were done under twilight sleep using ketamine and valium plus local anesthesia. After nerve blocks were applied, additional local anesthesia is introduced into the lips, along the course of the moist and dry lip. The implants were then easily threaded in the correct position. The surgeon can confirm proper position before closing incisions. The authors placed nearly 100 implants in this study with a follow-up of six months. Patients expressed satisfaction with the treatment.
I think this is an interesting method that could be useful in some patients. Patients should be aware that a lot of swelling and bruising has been seen in using this technique. This is the first published article on this subject. The FDA-approved, Perma Lip implant is available at the AB Guerra Plastic Surgery Center.
What does a facelift do?
02 years ago
Reduce facial aging with face lift.
Scottsdale – A facelift is a form of facial plastic surgery that offers a technique used to improve visible signs of aging in the face and neck.
What it will do:
- Restores the sagging face into a more youthful position.
- Reduces deep creases below the lower eyelids.
- Reduces deep creases along the nose extending to the corner of the mouth (laugh lines).
- Reduces lower face jowls and deep creases from the corners of the mouth.
- Tightens loose skin and reduces fat deposits under the chin.
- Reduces a double chin.
What it won’t do:
- A facelift does not change your fundamental appearance.
- A facelift cannot stop the aging process.
- A facelift can only be performed surgically.
- Non-surgical rejuvenation cannot achieve the same results as a face lift.
- Non-surgical procedures may complement the results of surgery.
(model used in illustration).
Is all fat grafting the same?
02 years ago
Fat cells take better when they are closer to oxygen and nutrient supply.
Scottsdale – Is all fat grafting the same? No. The simple answer is that not all fat grafting techniques are the same. There are many variations. Some surgeons place large volumes per injection. Others place medium-sized volumes, and yet other surgeons may use micro-volume techniques for their procedures. I use a a micro-volume technique and place tiny amounts of fat per injection. This allows for the most predictable and improved long-term results.
This micro technique allows for the fat cells to have better “take” and to establish a better oxygen and nutrient supply. The closer the injected fat cells are to a nutrient source, the better the chances these fat cells will survive the transfer from one part of the body to another. Our technique is gentle and optimizes the outcome of fat grafting for facial rejuvenation, buttock augmentation and post-liposuction correction.
At the AB Guerra Plastic Surgery Center, we use a sophisticated system to harvest and graft the fat cells using a method that works extremely well and reduces the risk of fat reabsorption.
Fat grafting can be safely combined with traditional techniques to enhance your appearance after face lift. Fat grafting can also be used alone, in some cases, and can deliver very good results in rejuvenation of the face for reduction of the laugh lines, augmentation of the cheeks and chin, and general filling of any “hollowed” areas.
For more information of fat harvest and grafting please go to www.MyFaceAndBody.com.
A Comparison of popular Short Scar Facelift Techniques.
02 years ago
Facelift Surgery
Scottsdale – Short scar facelift is very popular among younger women seeking facial rejuvenation. The procedure has several advantages including reducing the length of the scar. With this procedure, the scar is limited to an area front of the ear and patients avoid an extensive scar in the hairline behind the ear. Additionally, short scar facelift is performed with less surgical dissection and is noteworthy because patients experience less pain and swelling and a faster recovery with minimal bruising.
Several short scar techniques have been developed. The two most popular include the Minimal Access Cranial Suspension (MACS-Lift) and the Lateral SMASectomy techniques. An article has been published in the journal Plastic and Reconstructive Surgery, which examines these two surgical options and gauges the outcome at 1 month and 24 months after surgery. The researchers enrolled 97 patients who had short scar facelift using either of the techniques mentioned earlier that were followed for a total of 24 months.
The results of the study demonstrated that MACS-Lift takes significantly less time to perform when compared to Lateral SMASectomy. Patients after Lateral SMASectomy experience significantly less pain than those having MACS-lift. There was no statistical difference in the aesthetic outcome of the operations at 1 and 24 months after surgery between the two techniques. At 24 months some patients had recurrence of the jowling and did not appear as improved in the neck area.
It is not unexpected to see some laxity in the neck after short scar facelift. This area does not respond particularly well to the short scar techniques which are designed to treat early aging signs in the face, but generally do not treat serious laxity in the neck. When a patient requires more lift in the neck I prefer to use a full facelift technique which addresses the neck issues better. The results of the study are impressive, however, and the before and after photos in the article show some very nice results of the surgery.
The article is important as it attempts to identify how long the results of short scar facelift results actually last. More research will be needed to see the actual time the results will last, but given the findings it is likely that short scar results do not last as long as results from full facelift techniques. What is important to note from this article is that the techniques are comparable with regards to the results and low level complications.
I have used both of these techniques and have been happy with the results. I find that patients do well regardless of technique and have a nice aesthetic improvement (model used in illustration).
New Study: Fat grafting shown to improve skin quality.
02 years ago
Scottsdale – Fat grafting in plastic surgery is not new, but a new study published in the September issue of Plastic and Reconstructive Surgery outlines results which demonstrate a positive effect of fat grafting on human skin. The study was conducted in France. According to the researchers, the aim of this study was to investigate the histologic modifications of the skin after fat tissue grafting on an animal model.
In the study 30 nude mice, divided into three groups, were used. All 30 mice received human fat tissue on one side. On the opposite side, 10 mice received nothing (negative control group), 10 mice received cell proliferation medium, and the remaining 10 mice received only subcutaneous tunneling. After 8 weeks the investigators analyzed the tissues via biopsy of the skin and subcutaneous tissue. Dermis thickness was measured. To differentiate human from mice collagen fibers, human and murine (mice) collagen type I antibodies were used.
The results found human fat tissue was in all animals and appeared normal, with abundant peripheral neo-vascularization (establishing a new blood supply). Examination under the microscope, showed abundant extracellular matrix around the injected human fat tissue. This was primarily type I collagen fibers of mice origin as a result of the murine fibroblast stimulation by the grafted human fat tissue. Dermal thickness after fat grafting was significantly greater. The researchers excluded inflammation as a cause of the increased thickness because no modification was detected in our control groups.
For years, plastic surgeons have been reporting improved skin quality after fat grafting. However, a biologic mechanism has not been fully elucidated to account for these observations. This study demonstrates the biologic steps which lead to improved skin quality. Based on the findings, it is safe to say that the generation of collagen in the overlying skin produces several positive effects. Overall, this study shows that fat tissue grafting stimulates a neo-synthesis of collagen fibers at the recipient site and makes the dermis thicker. However, I agree with the investigators that long-term effects remain undetermined and need further investigation.
