Functional Blepharoplasty Improves Quality of Life

Sunday, January 15th, 2012

A new study by the American Academy of Ophthalmology takes a closer look at eyelid surgery for ptosis repair, a procedure that has functional and aesthetic benefits – improving the patient’s vision, appearance, and quality of life.

Ptosis, a condition characterized by drooping upper eyelids, can interfere with vision, cause discomfort and detract from your appearance. Through upper eyelid surgery and blepharoptosis repair, these problems may be corrected.

Multiple Studies Confirm Outcomes

The new study published in Ophthalmology journal analyzed the results of 13 other studies, looking at the reported outcomes of these surgeries.

“As oculoplastic surgeons, we see the visual improvement and comfort that patients obtain from the surgical correction of upper lid ptosis and dermatochalasis,” said Kenneth V. Cahill, MD; “this study was performed to analyze the scientific data available to substantiate this.”

An Elective Procedure?

Sometimes, Dr. Cahill says, patients are denied functional blepharoplasty and ptosis repair surgery by third party payors because of “arbitrary and/or incorrect policies regarding the functional indications for these procedures.”

Although eyelid surgery is frequently performed as an elective cosmetic procedure, ptosis repair improves vision and should be characterized as such.

The procedure helps address problems such as:

• Ptosis, drooping of the upper eyelid due to paralysis or disease, and
• Dermatochalasis, loose, redundant skin on the eyelids

Dr. Tamara R. Fountain, an American Academy of Ophthalmology clinical consultant, was not involved in the study. But said she is always amazed at how life-changing the surgery can be for patients who suffer from ptosis.

“For my patients who have been denied coverage and then choose to pay out of pocket, they often tell me it was the best investment they’d ever made and only wish they’d done it sooner,” Dr. Fountain said.

Read more from Medscape Medical News or view the abstract from ophsource.org

Tags: blepharoplasty, eyelid surgery
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Maintenance Face Lift: The Key to Looking Younger, Longer?

Wednesday, December 21st, 2011

Study shows good long-term face lift results in patients younger than 50.

People with early signs of aging can achieve good results and high satisfaction 10 years or more after their face lift, according to a new study in the January edition of Plastic and Reconstructive Surgery journal.

A previous study found that older patients were more likely to have lower satisfaction scores, with varying facelift results.

This new study by Doctors Liu and Owsley (at California Pacific Medical Center) involved comparisons of long-term and short-term patient satisfaction scores, combined with analysis of long-term results using photo analysis. Three age groups were selected: younger than 50, 50 to 60, and over age 60.

“Remarkable Maintenance of Youthful Appearance”

Patients who had a facelift before age 50 showed “remarkable maintenance of their youthful appearance,” according to the authors. At both short and long-term follow-up, younger patients reported higher satisfaction scores. Their scores were further supported by photo analysis.

The study results support the idea of performing “maintenance” facelifts for patients who don’t have significant signs of aging. “Younger patients who have facelifts (<50 years old) have longest lasting results with less noticeable postoperative changes,” Drs. Liu and Owsley say. Because at 50, the visible signs of aging represent “the tip of the iceberg” in relation to changes beneath the skin that come later.

Many patients in this age group are likely to treat facial wrinkles and other localized signs using injectables. For a long-lasting result, it may be a better idea to undergo a face lift.

Compared to a facelift at age 60 or older, the surgery results will also be more subtle, so patients can be modest about having cosmetic surgery.

Read more on plasticsurgery.org

Tags: facelift at age 50
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Liposuction for Neck Contouring

Wednesday, November 16th, 2011

If you’re bothered by extra neck fat that hides your jawline, a neck liposuction procedure may be the right solution. This ABC news segment, filmed in San Francisco, briefly documents one patient’s experience with the procedure.

“My neck bothered me, because I was getting this long sort of fat part of it here I didn’t care for,” says Terry Herrell, a patient of Dr. Randall Weil.

“Extra weight in the neck can make a patient’s face appear heavier than it his,” according to Weil. “In someone that has a fatty neck, the angle is what we like to have a right angle, is obscured,” he explains.

Neck liposuction is performed with an incision below your chin or on each side of the neck. A thin tube called a cannula is inserted through the incisions, which will remove a conservative amount of fat. The surgeon sculpts the lower facial contours to remove fat and create a more youthful, angular appearance.

Read more on ABC7 News

Tags: neck liposuction
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Injectable Drug Studied as Remedy for Excess Chin Fat

Monday, November 14th, 2011

A new injectable product currently known as ATX-101 could offer a non-surgical method for double chin reduction. Clinical investigators say the drug could reduce excess fat beneath the chin, creating better definition of the lower face.

According to KYTHERA Biopharmaceuticals, the maker of ATX-101, 80 percent of participants in studies experienced significant reduction of chin fat after the first two years of the five-year trial.

“Treatment results with ATX-101 appear to be sustained and well-tolerated, which illustrates its potential as a novel, non-surgical approach to reducing submental fat,” said Kevin C. Smith, a Canadian dermatologist who was an investigator in Phase 2A and long-term follow up studies.

ATX-101 is a formulation of deoxycholate, which is a natural compound that breaks down dietary fat.

The procedure is done over several sessions, during which the patient gets around 50 small injections of the treatment into the chin area. The injections are said to eliminate fat beneath the skin’s surface.

“While these results are still preliminary, they support our expectation that ATX-101 may result in a long-term aesthetic correction,” said KYTHERA’s chief medical officer Patricia Walker, MD, PhD.

Traditional approaches to double chin reduction include neck lift surgery and neck liposuction.

During a neck lift, the skin is lifted and muscle tissue is removed as necessary to make the transition between the chin, neck and lower face more defined.

Neck liposuction gets rid of the persistent fatty tissue residing below the chin, and is a less invasive option than a neck lift.

Tags: neck lift
Posted in Facial Plastic Surgery | 6 Comments »

Blepharoplasty Can Improve Both Form and Function

Thursday, October 27th, 2011

Some eyelid surgery patients experience vision improvements combined with a rejuvenated look.

If you have droopy upper eyelids that impair your vision, a functional blepharoplasty procedure may be able to improve your vision. As an additional benefit, you’ll look younger and more rested.

Tampabay.com tells the story of one such patient, Mary Lou Lueders, 74, who says she never considered cosmetic surgery. “I just thought I would grow old gracefully,” she said.

However, when she found out that upper eyelid surgery would improve her vision, she decided to have the procedure and was happy with not only the functional results, but the changes to her appearance as well.

“People told me I looked 10, 20 years younger,” said Lueders after the operation. “Now I understand why women do this sort of thing. It makes them feel better and look better.”

“The face communicates so much,” said Tampa surgeon Adam Scheiner, who performed Lueders’ surgery. “The natural course of aging may make us look sleepy, tired or sick all the time. That’s not fair to those people who feel great but their face sends a different message.”

In Lueders’ case, her eyelid procedure was considered medically necessary and was covered by Medicare. She also had a laser procedure to remove festoons under her eyes, which was considered a cosmetic procedure.

For a total upper face rejuvenation, eyelid surgery can be combined with a brow lift or performed in addition to skin resurfacing around the eyes with a laser resurfacing treatment.

Read more about blepharoplasty in New Jersey

Tags: blepharoplasty new jersey
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More Couples Choose Plastic Surgery Together

Friday, July 1st, 2011

As more men choose cosmetic procedures, a new phenomenon among the plastic surgery clientele has been on the rise: more couples are appearing together in surgeons’ offices across the country.

America’s recovery from the recession has seen a modest resurgence of cosmetic surgery procedures. While women still make up about 80 percent of plastic surgery patients, the number of men has jumped 88 percent since 1997. The most popular choices among men include procedures like Botox, liposuction, and rhinoplasty.

The Pittsburgh Tribune Review recently told the story of Marsha and Mike Gavula, a couple from Evans City, PA, who do just about everything together. Recently, the 50-year-olds both stepped into a plastic surgeon’s office.

Marsha has undergone chemical peels, dermabrasion, and other minimally invasive procedures, while Mike opted for Botox and wrinkle-filling injections for the first time on his fiftieth birthday.

One medical spa with three offices in the Pittsburgh area reports that it offers cosmetic procedures for nearly 30 couples annually, compared with a half-dozen couples in the mid-2000s.

What could be driving this increase in couples’ procedures?

• Cosmetic surgery no longer carries a stigma among men, particularly as the baby boomer generation ages.
• More non-invasive options for those who don’t want a surgical procedure
• Men desire a more youthful appearance in order to compete in a younger workplace. .
• Reduced recovery times for many procedures, thanks to cutting-edge techniques
• Couples having surgery around the same time can “leapfrog” their procedures, alternating care and recovery.

Tags: couples get plastic surgery
Posted in Facial Plastic Surgery, Injectable Fillers | 5 Comments »

Plastic Surgeon Anthony Youn on Good Morning America

Wednesday, June 22nd, 2011

Are there important differences between male and female cosmetic surgery? Doctor Anthony Youn, author of the book In Stitches, recently appeared on Good Morning America Health to discuss this question.

For men, the most popular cosmetic procedure is probably nose reshaping, he says. Dr. Youn explains the way he does rhinoplasty, with incisions inside the nose and scars that are well-hidden. He says surgery takes only about 2 hours, and recovery is about one week or so.

Eyelid surgery is popular for aging women and men. The procedure is typically done to remove puffy bags below the eyes. Dr. Youn explains his technique that takes out the unwanted lower eyelid fat without scars. It heals fast because it is mucosa, he says. It heals quickly, in a similar manner to a wound inside your mouth. The surgery requires about one an hour and 15 minutes, and healing requires about one week.

Women wear bangs to cover up wrinkles, while men wear a goatee to cover up weak chin, Dr. Youn explains. He goes on to shows a chin implant and explains his in-mouth chin augmentation technique. One of the benefits – It’s reversible if you don’t like it. For a more defined jawline, there are also implants and fat grafting.

In women, body contouring surgeries are designed to slim down and create a slender shape, while men want enhanced muscle definition. That’s where VASER liposuction comes in. Using an ultrasonic liposuction system, the doctor sculpts the fat on the tummy to create a six-pack appearance, actually enhancing the definition of the patient’s abdomen. As Dr. Youn states, this is an advanced technique that not all surgeons will offer.

Using the special ultrasonic cannula, Dr. Youn uses crisco to demonstrate the “melting” ability of VASER ultrasonic lipo. Because the fat is liquified, you can really improve the results achieved with liposuction.

Tags: plastic surgery for men, vaser lipo
Posted in Body Sculpting, Facial Plastic Surgery | 4 Comments »

What is the Best Age For Facelift Surgery?

Tuesday, June 7th, 2011

Can facelifts be performed for elderly patients? A new study from Cleveland Clinic explores that question, and it shows that with proper screening, a facelift after the age of 65 can be just as safe as one performed for younger patients.

Researchers followed 216 women for three years, comparing their facelift results based on their varying age. 148 of the patients were under the age of sixty-five, while 68 of them were over the age of sixty-five. They tracked their progress, including results, complications and other facelift outcomes.

“Facelift surgery in the elderly has always been perceived to carry more post-operative risk,” says Dr. James Zins, Cleveland Clinic chairman of plastic surgery. [But] “according to our study and pre-operative screenings, patients over 65 had no statistically significant increase in complications.”

The best age for a facelift varies

For most patients, the best age for a facelift is some time between ages 40 to 60, when wrinkles and folds begin to appear on the lower face and neck. While younger people might address cosmetic problems in this area with neck liposuction or a chin implant, an older patient typically has loose skin that needs to be tightened.

Age alone should not be considered a predictor of facelift risk, the study suggests. The authors stress that good screening is a critical aspect of the procedure. Many older men and women considering facelift surgery may not be good candidates because of health problems. “Careful screening of the elderly patients, and excluding those with significant co-morbidities, led to the low complication rate, ” explains Dr. Zins.

“More important factors include; general health of the patient, skin quality, wrinkles, laxity of the face, jowls, environmental damage, genetics, realistic expectations about what a facelift can and cannot accomplish,” said Michigan plastic surgeon Steven Ringler M.D., in a recent blog post about the study.

According to the authors of “The Safety of Rhytidectomy in the Elderly,” more research is needed to determine if there should be an age limit for facelift in patients over 65 years of age. The average age of their elderly group was 70 years.

View Facelift Pictures from NJ Plastic Surgery

Tags: best facelift age, elderly patients get facelift, what is best age for facelift
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7 Reasons Men of Today Choose Plastic Surgery

Tuesday, May 31st, 2011

The news is currently buzzing about the topic of cosmetic surgery for men. “Why are men getting cosmetic surgery?” people ask. The answer always varies depending on the man, but here are seven reasons your brother, father or son may be considering a cosmetic procedure.

1. He’s Growing Tired of Those Tired Eyes

“The cosmetic surgery procedure men want the most these days is lower eyelid surgery,” writes Dr. Pat McMenamin of Sacramento. According to the American Society of Plastic Surgeons, more than 30, 000 eyelid surgery procedures were done for men in 2010, showing an increase of 4 percent over 2009. The numbers suggest that plenty of men are not too thrilled about looking like “the walking dead,” as Brennan, a male surgery patient describes himself on Youtube.

Brennan chose to undergo eyelid surgery in Beverly Hills. “I’m going to get my eyes done,” he says as he walks into the office of plastic surgeon Dr. Gerald Minniti. After eyelid surgery he says his eye bags and dark circles are resolved: “it’s gone, so every time I look in the mirror that is eliminated,” he confidently explains.

2. For a Refined, But Still Masculine Nose

Since ancient times, the appearance of one’s nose has been a vital, even symbolic, part of a man’s face. The earliest nasal surgeries were most likely performed on men, including the Byzantine emperor Justinian II in the eighth century.

One scholar and surgeon writes:

Known as the Rhinometus or “the one with the amputated nose,” Justinian II was overthrown and his nose mutilated so that his disfigured appearance would prohibit him from regaining the status of emperor. These efforts were futile, as he subsequently returned to power after benefiting from nasal reconstruction.

Today, rhinoplasty remains one of the most popular cosmetic surgery procedures. “For both men and women, rhinoplasty has increased significantly in the last 2 years,” says Dr. Cuzalina of Tulsa, Oklahoma.

But the procedure isn’t identical for either gender. A man’s rhinoplasty should always preserve a masculine appearance. In men, it is generally considered inappropriate to significantly reduce nasal size or excessively refine the nasal tip.

Instead, surgeons focus on making small changes, such as reduction of the dorsal hump, narrowing of the nasal base or subtle refinement of the nasal tip. “Men typically want a hump removed or a smaller nasal tip, but we also see men who want revision surgeries from a previous rhinoplasty,” explains Cuzalina. In some cases, men also choose rhinoplasty to change ethnic features or address the signs of aging.

3. Undoing Obesity Brings Unexpected Changes

As physicians and other experts implement solutions for the obesity problem in America, more men are experiencing the after-effects of major weight loss. Roughly one third of the U.S. male population is obese (with BMI greater than 30). Some are turning to bariatric surgery, while others are hitting the gym with greater intensity. Unfortunately either weight loss method can leave you with folds of loose hanging skin on your body.

In this situation, a guy can turn to his cosmetic or plastic surgeon for body contouring. On the website of Dr. Jagdev Heir, Matt from Sacramento explains his post-weight loss procedure:

“After losing so much weight, I was left with a lot of excess, hanging skin on my stomach and abdominal areas. I was at a good weight, but I looked pretty bad. I thought I’d just have to learn to live with it. When I discussed it with my regular doctor, he recommended abdominoplasty surgery…”

Post-weight loss issues are showing up more in media as more celebrities undergo bariatric surgery. Rapper Paul Wall was the latest to comment on his gastric bypass. “I lost 100 pounds, so I’m back at my fight weight. I’m ready. The champ is back,” he says in an interview for Ballerstatus.com.

4. Chest Concerns: Gynecomastia, Pectoral Implants and Pectoral Etching

Although it is quite exaggerated in size, an idealized male chest is highly sought after by body-conscious men. Enhancing the chest can mean different things for different men; some want to reduce excess chest fat while others want to pump up the pectoral muscles.

In 2010, more than 18,000 American men had a breast reduction to remove excess tissue (Gynecomastia). “Many of these young men are well built and in great physical condition, but just have excess fat and glandular tissue in the chest,” observes cosmetic surgeon Dr. Jacob Haiavy of southern California.

A smaller, but still significant group of men (more than 200) chose to augment their chests with pectoral implants.

One more option exists for chest contouring, that few people know about. Some surgeons are offering a procedure called “pectoral etching,” which involves lipo-sculpting the chest tissue to create the appearance of muscle definition.

An article in PRS Journal introduced this technique a few years ago:

“Non-athletes are requesting pectoral etching to add palpable pectoral inscriptions to their chests, particularly in conjunction with upper and lower body lipectomy. It is among our most popular procedures for men because the puncture scars are virtually undetectable, there are no rejection issues associated, and the result is permanent, resulting in a physique that often remains elusive even after routine strength training.”

5. More and Better Options in Hair Restoration

By the age of thirty-five two-thirds of American men will experience some degree of appreciable hair loss, and by the age of fifty approximately 85% of men have significantly thinning hair.

– American Hair Loss Association

In 2010, more than 13,000 men chose a hair transplantation procedure from a plastic surgeon. New hair restoration methods are continually being developed.

One of the latest hair restoration advancement is the introduction of bio-stimulation lasers. The iGrow system, for example, is a helmet that contains laser and LED diodes, which deliver energy to the scalp for hair restoration at home. Some plastic surgeons, including Dr. Barry DiBernardo of New Jersey Plastic Surgery, have added the iGrow to their list of non-surgical treatments.

6. Male Boomers Staying Competitive Through the Recession

“Men are the victims of two thirds of the 11 million jobs lost since the recession began in 2007.”

- Newsweek

During the recession, male-dominant industries were hit disproportionately hard with layoffs. In the current economic recovery, it shouldn’t be surprising to hear that men are seeking a competitive advantage over their (often younger) peers.

“A lot of these guys think that in order to compete in the workplace – to compete with younger guys – that they need to look better,” said clinical psychologist Jeff Gardere, on a recent CBS Early Show appearance.

“In our tough economic environment, men want to look more youthful so they can compete for and retain jobs that younger people are competing for,” comments Indiana plastic surgeon David Robinson, and “plastic surgery is playing an increasingly important role for these men.”

Dr. Richard Rand of Bellevue Washington shared a similar view: “With companies downsizing their senior executive pool in the struggling economy, many have found it critical to look as young and robust as possible,” says the Seattle area doctor. “As facial rejuvenation techniques have evolved, with a very natural and un-operated look that retains masculinity, more men are having facelifts and eyelid surgery,” he further explains.

A large number of practicing cosmetic surgeons are men in the very same age group, so they understand the desire to keep up appearances. “As a boomer myself, I identify with men my age who exercise, act young, and feel young,” remarks Philadelphia plastic surgeon Bruce Genter.

7. Influential Men, Like Politicians and Celebrities, Are Doing It

Tabloid speculation about politicians, celebrities and other influential men “having work done” has put the spotlight on cosmetic surgery options. Even for men who don’t pay attention to Hollywood, these examples are nearly impossible to ignore.

“Media, Hollywood and advertising have all influenced men regarding what looks good and why cosmetic surgery may be an option,” says Tulsa cosmetic surgeon Angelo Cuzalina.

Last week, the Boston Herald wrote an article claiming that John Kerry looked “better than he did a decade ago.” As hard-hitting journalists should, they asked local experts for their opinions. Boston plastic surgeon Dr. Fouad Samaha observed that Kerry “looked his age in 2002, with the loss of facial volume resulting in hollow cheeks and deepening of the folds around the nose and mouth.” But now in 2011, Kerry’s appearance is visibly improved.

Dr. Samaha explains: “Although this can happen naturally, it is likely that these areas were ‘enhanced’ and that volume was added. Many techniques are available to achieve this result, and it would be difficult to say which was done here.” He also adds, “if Senator Kerry had any ‘work’ done, it was done very tastefully, enhancing his features without creating something that looks artificial.”

Tags: alopecia, cosmetic procedure for man, gynecomastia, more men getting plastic surgery
Posted in Body Sculpting, Facial Plastic Surgery, Hair Transplant Surgery | 3 Comments »

Medical Organizations Unite to Promote Patient Safety in Aesthetic Medicine

Wednesday, February 23rd, 2011

According to a press release by the American Society for Aesthetic Plastic Surgery, this nationally-recognized medical specialty organization has joined three others in forming the Physicians Aesthetic Coalition, new, multi-specialty group focused on promoting patient safety and education in aesthetic medicine.

Each of the organizations involved in the Coalition, including the American Society for Aesthetic Plastic Surgery (ASAPS), the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) and the American Society for Dermatologic Surgery (ASDS), has a long history of championing patient education and safety initiatives, however this is the first time these groups have worked cooperatively toward the goal of helping the public get better informed about cosmetic plastic and dermatologic surgery.

Dr. Felmont Eaves, III, president of the ASAPS, cites the increasing popularity of aesthetic surgery and non-surgical cosmetic treatments, as well as the rising number of unqualified practitioners and unproven technologies in the industry, as the motivating force behind the formation of the Physicians Aesthetic Coalition.

“This is a significant patient safety issue,” said Dr. Eaves. “Through the Coalition, we can address these issues on a stronger platform than we could individually, using credible medical evidence to help patients make informed decisions.”

ASDS President Dr. Jeffery Dover also added that one of the primary objectives of the Physicians Aesthetic Coalition will be to provide patients undergoing popular surgical procedures such as blepharoplasty, liposuction and breast augmentation or new, non-surgical cosmetic treatments with reliable, unbiased educational resources.

“One of the Coalition’s founding principles is to develop educational forums for the public and media, transparent and free of commercial bias,” said Dr. Dover. “Over the next several months we will be announcing new resources to help [patients] differentiate fact from fiction.”

According to Dr. Jonathan Sykes, president of the AAFPRS, the Coalition represents the unified voices of more than 8,000 board certified physicians specializing in plastic and reconstructive surgery of the face, body, eyes and skin. And at a time when the news seems dominated by awful plastic surgery stories and gimmicks galore, prospective patients can certainly rest easier knowing that there are physicians out there who really care about their well-being, not just making a buck.

“Nothing is more important to us, both as a medical society and as individual physicians, than keeping our patients safe,” says ASOPRS President Dr. Jeffrey A. Nerad. “We are hopeful that this new Coalition will help us in achieving this end.”

Tags: blepharoplasty, breast implants, liposuction, safety in plastic surgery
Posted in Facial Plastic Surgery, Plastic Surgery | 21 Comments »