Wednesday, December 24, 2008

Laser Skin Resurfacing can help ease the effects of sun damage, aging, and acne on facial skin

Laser skin resurfacing is a cosmetic surgery procedure that can help ease the effects of sun damage, aging, and acne on facial skin. Laser skin resurfacing works by removing the outer layers of skin where the problems are located and stimulating the production of collagen and new skin cells in the underlying layers. Laser skin resurfacing is popular because it is relatively safe and effective and is often done as an outpatient procedure. The result is usually smoother, younger, healthier looking skin.

Laser Skin Resurfacing Candidates

Laser skin resurfacing is appropriate for patients who want to diminish discoloration as well as wrinkles, sun damage, acne marks, or other types of scarring. Laser resurfacing can often effectively treat skin that is uneven in color or texture. Still, those with severe scarring may need to use additional scar revision techniques in order to achieve the best results possible. Also, if skin is loose, a facelift may be needed to fully improve its appearance. The best candidates are those who have realistic expectations and who discuss their questions and concerns with the physician beforehand. An initial consultation with the cosmetic surgeon can help to ensure optimal results are achieved.

How is Laser Skin Resurfacing Performed?

Before laser skin resurfacing is performed, the cosmetic surgeon administers a local numbing treatment, a mild sedative, or general anesthesia. The choice depends on the individual patient and his or her specific needs.

Once the necessary medication has been administered, the cosmetic surgeon uses a special laser to resurface the skin. Using a precise and controlled beam of light, the outer layers of skin are vaporized, revealing the smooth, unblemished skin beneath. While the old, damaged layers are removed, the growth of new skin cells is stimulated.

Currently, carbon dioxide and erbium lasers are the two types of lasers most commonly used for laser skin resurfacing. Both lasers allow for quick procedures. They also help to minimize the risks for the patient by limiting the amount of heat that the skin absorbs and offering the cosmetic surgeon a high level of precision.

Botox Injections – Treatments for the Reduction of Wrinkles

Botox injections utilize Botulinum Toxin Type A to treat wrinkles. Botox was originally slated to treat neurological disorders; today, it is widely and successfully used to remove facial lines, especially frown lines, "crow's feet," and forehead lines.

Who is the Best Candidate for Botox Injections?

Good candidates for Botox injections include younger people with facial wrinkles and those who cannot undergo a more extensive plastic surgery procedure such as a facelift. Certain medications may alter the potency of Botox injections, increasing the likelihood of bruising and bleeding. These include some antibiotics, anti-inflammatories, and aspirin, as well as some vitamins and herbs. People with neurological disorders should avoid having Botox injections. Also, women who are pregnant or nursing should not have Botox injections, because the effects on the fetus and on breast milk are unknown.

How are Botox Injections Administered?

Botox is injected directly into the muscle surrounding the wrinkle with a very small needle. If patients experience any discomfort, it is usually minimal and only lasts a few seconds. Once injected, Botox works by preventing nerve impulses from reaching the muscle, allowing it to relax. The effects of the procedure are usually noticeable within a few days. Although the results are not permanent, they usually last for a number of months. Botox injections are performed on an outpatient basis and may be repeated when the results diminish.

Botox Side Effects

Botox injections are relatively safe for most patients. The most common side effects of Botox injections are mild numbness, swelling, bruising, or tingling in the area. Most of these do not occur when the procedure is performed correctly. The patient can help prevent bruising and numbness by refraining from rubbing or touching the treated area for the first day after the procedure is done. A small number of patients report no improvement following their Botox injections. Patients should be screened for allergy to Botox before the procedure is undergone.

If you are interested in learning more about Botox injections, contact a plastic surgeon in your local area.

Abdominoplasty or Tummy Tucks

Abdominoplasty, also known as "tummy tuck" surgery, is a procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. This surgery is helpful to women who, through multiple pregnancies or significant weight loss, have stretched their abdominal muscles and skin beyond the point where that skin will be able to naturally return to normal.

Sometimes fat deposits are limited to the area below the navel and may require a less complex procedure called a partial Abdominoplasty or "mini tuck." You may benefit more from a partial or a full Abdominoplasty, done in conjunction with liposuction to remove fat deposits from the hips for a better and more pleasant body contour.

Regular smokers should plan to quit at least 2 weeks before surgery and not resume for at least two weeks after surgery. Avoid over exposure to the sun before your surgery, especially to your abdomen. It is also important to maintain a regular eating schedule (no strict dieting) prior to the procedure. The primary incision is made along the bikini line, just above the pubic area, and a second incision may be required to free the navel from surrounding tissue.

Abdominoplasty typically takes four hours, depending on the extent of the tuck required. You will need someone to drive you home from the hospital. You may wish to arrange help for two to three days following your surgery.

After your surgery, you may have a small drain inserted to release fluid from the surgical site. This drain will be removed when drainage has slowed or stopped. For the first few days your abdomen will probably be swollen. Any pain or discomfort you have will be controlled by medication. You will usually have gauze dressing on your abdomen covered by an abdominal binder. This will remain in place until you visit your physician post operatively. Sutures are typically removed in about ten days and your abdominal dressing will be replaced by a support garment.

You may expect to go back to work within one to two weeks. During the first three to six months, your incision will be pink and raised. Expect it to take nine months before your scars flatten out and lighten in color.

Tuesday, October 28, 2008

Q & A: Nasal Refinement, Will my voice change after rhinoplasty?

Your nose is so much about who you are, that if you are not on good terms with it, life seems somehow out of balance.

The nose is also the last organ on your body to stop growing as you get older. So even if your nose was a point of pride as a teenager, it may not have kept pace with your adult life, or it could be telling your age to all who see it.

Rhinoplasty, the surgical term for nasal refinement, is among the most performed cosmetic procedures in the world. And it is one of the few that is often covered by insurance because it’s so involved with your general health. When you consult with surgeon about changing your facial profile, your nose is the first area he will look at, because little changes can have a huge effect.

Improving your appearance through nasal surgery can reduce or increase the size of your nose, change the shape of its tip or bridge, or narrow the span of your nostrils. It may also correct an injury or birth defect, or alleviate some breathing problems.

A procedure as simple as raising the tip can take years off your appearance. Changing the angle between the bottom of the nose and the upper lip can balance the entire lower part of your face. The next time people see you, all they’re likely to notice is that your smile seems somehow more "full of life."

Surgeon may also recommend changes to your chin or cheeks at the same time, so that the individual parts of your face will work in better concert as a whole. You can count on surgeons’ long experience and aesthetic judgment to do what it takes to create the well-proportioned image you’ll carry confidently wherever you go.

Through nasal refinement procedures, surgeon will help you define the profile that can enhance your appearance and self confidence. Your nose will always be the part of you that focuses your entire face, and it can be the nose that truly represents who you are.

Q. Will my voice change after rhinoplasty?
A. No. Such changes will only occur if major sinus work is performed at the same time. This does not include septoplasty or turbinectomy.

Q. How long is the recovery period?
A. The splint is removed within five to seven days after surgery. There is mild to moderate swelling with slight bruising. This dissolves within 1-1/2 to 2 weeks. Small amounts of cover makeup will conceal this. Most people can return to work within 2 weeks, some sooner after rhinoplasty.

Q. Is there more bruising and pain if the nose is fractured?
A. There seems to be a lot of misinformation about whether nasal infracture is necessary. Certain surgeons who are performing removal of the hump with replacement of artificial materials are actually causing irreversible damage to the patient. The infracture should not be feared. It is neither painful nor is there any further bruising. It is only a small bone less than a centimeter in length, and only a millimeter or less in thickness, that is fractured. People assume that a fracture means pain but this is not true when it comes to the nose.

Q. How long does the nose take to heal?
A. Noses tend to look pretty good at one month and are about 90% healed at four months. But it will take as long as two years for all the swelling to go down and changes to occur.

Cosmetic nasal surgery: Incisions, Recovery

Nose Surgery

Cosmetic nasal surgery is more popular than ever. People are seeking cosmetic nasal surgery for a wide range of reasons. It can help people who feel that their nose is too small, too large, too long, too short, too wide, too narrow, too prominent, too flat, or crooked.

The potential for cosmetic nasal surgery seems boundless. Because each nose is different, the surgical plan for refining the nose is highly specialized according to the patient’s anatomy, desires, and other facial features. It involves a combination of refining, rearranging, augmenting, or reducing the underlying bones and cartilage of the nose to achieve the desired refinement.


Most of the incisions are inside the nose and are, therefore, not visible. In some cases, your plastic surgeon may recommend a small incision under the nose to facilitate the surgery and optimize your result. When this small incision is used, the surgery is referred to as "open rhinoplasty". Even though this incision involves a small scar under the nose, it is minimally visible.


Cosmetic nose surgery, or rhinoplasty, is most commonly performed as an outpatient procedure. You may be awake or asleep during the procedure, depending on the preference of you and your plastic surgeon. Light packing may be placed in your nostrils to prevent bleeding following surgery and is usually removed with a day or two. Discomfort is mild to moderate and is controlled with prescribed pain medication. Swelling is variable and can last from one week to one month or longer. Sleeping with your head elevated for the first several nights following surgery will significantly diminish the swelling. Bruising usually resolves within one to two weeks. Most are able to return to work within one to two weeks and resume exercise within a month.

African Americans Rhinoplasty (Nose Job, Nose Refinement)

Rhinoplasty helps to refine the nose and brings it into harmony with the rest of the face. I will emphasize at this early stage that there are no structural defects in the black nose. The difference between an African and a Caucasian nose may be due to adaptation to their unique environments.

There is great reluctance amongst African Americans about doing any type of cosmetic surgery, however it has become increasingly popular in the last 10-15 years as a result of well publicized successful surgeries in prominent African American entertainers.

Good results in Black rhinoplasty are greatly increased with a better understanding of the cultural diversity of the Black nose. Following the works of prominent Black plastic surgeons, the Black nose has been classified into three main groups:

Afro-American Afro-Caucasian Afro-Indian

A typical Afro-American nose has a nasal bridge that is wide, short, flat or saddle shaped. The tip of the nose is bulbous with no significant projection. Nostrils are wide, height is short and the skin envelope is thick and oily.

Low or concave dorsum is corrected by dorsal augmentation. Augmentation can be accomplished by cranial, rib or iliac bone graft, cartilage graft or silastic implant. The silastic implants are employed only in primary rhinoplasty, when the skin is thick, and preferably when a cartilage tip graft is in place. The cartilage tip graft ensures that the caudal end of the implant does not press directly into the skin and therefore reduces the possibility of skin erosion and implant extrusion.

Dorsal augmentation can be accomplished without breaking and putting together (osteotomy and infracture) the nasal bones. The dorsal graft not only raises the dorsum, but also creates the illusion of narrowness.

The main concern of patients with African type noses is the bulbosity of the nasal tip. This bulbosity arises from the thick oily skin and the extensive fibro-fatty tissue covering the alar cartilage and attached to the overlying skin. Correction of bulbosity therefore involves defatting of the alar cartilages, the space between the domes, and sometimes the surrounding skin. The alar cartilages are smaller and thinner, excision of the upper portion of the cartilage is limited in order to avoid alar collapse. Poor tip projection is corrected usually by tip grafts using septal or conchal (ear) cartilage.

Another major concern with African type noses is the width of the nostrils. These are narrowed by excision of the alar rims and reduction of the nostril floor. Sometimes in patients with very wide nostrils, there is a limit to which this can be reduced in order to avoid a pinched look.

Afro-Caucasian Nose

The Afro-Caucasian nose is longer and the bridge is narrower with a hump. The tip is thinner and projects. The nose is higher and nostrils are narrower.

In the Afro-Caucasian nose, dorsum can be narrowed by separating the nasal bones from each other, as well as their attachments, and compressing these bones together in order to narrow the dorsum of the nose. Dorsal augmentation may not be necessary to narrow the nasal bridge, but if required it is usually thin.

Management of the tip in the Afro-Caucasian includes generous excision of the alar cartilages because they are usually big and thick. The domes of the alar cartilages can be sutured together with non-absorbable sutures to further narrow the tip.

The width of the nose is usually smaller than the Afro-American nose, therefore nasal floor reduction is not usually necessary.

Afro-Indian Nose

Afro-Indian noses are long and straight. The bridge is wide with a big hump, with a bulbous tip and wide nostrils.

The management of the dorsum in the Afro-Indian type of nose is very similar to the Afro-Caucasian. The nasal bones are usually broken from their attachments and pushed together to narrow the nasal bridge. In addition, the Afro-Indian nose usually has a hump that needs to be shaved down. There is less frequent need for an augmentation.

The management of the nasal tip involves more generous resection of the alar cartilages, like in the Afro-Caucasian nose, as well as an extensive defatting, as in the Afro-American nose. Better tip projection is also achieved by suturing the alar cartilages together until the desired result is achieved. The nostril are usually wide in the Afro-Indian nose and nostril floor reduction is usually indicated.

What patients should know

Other important information to let patients know, prior to surgery, includes the need for nasal packings for a couple of days and drainage from the nostrils for about the same length of time after surgery.

The nose is swollen for up to six months following surgery, and patients will need to wait for the swelling to go down to fully appreciate their new features.

As pointed out earlier, there is nothing wrong with the Black nose, provided it is well proportioned to the face. Corrections are needed in parts of the nose where there may be excesses or inadequacies. The ultimate correction depends on what the individual patient wants, within the capability of the surgeon to make the changes.

Middle-aged affluent Blacks want refinement with maintenance of their ethnicity. These patients generally have good results. Problems generally occur with patients who desire Caucasianization of their noses, but do not request it at the time of their initial surgery. Overall, rhinoplasty can be dramatically positive with a proper pre-surgical evaluation and appropriate surgery.

Q & A: What Can I Reasonably Expect From Plastic Surgery? What Are The Risks, Cost?

How do I choose a Physician?
You should be aware that in California, ANY medically licensed physician can legally claim to be a plastic surgeon. So, you'll need to ensure that your doctor is trained in plastic surgery, and is certified by the American Board of Plastic Surgery. Physician who are certified by the American Board of Plastic Surgery have received specialized residency training and have successfully completed a rigorous oral and written examination in this specially.

Should I have plastic surgery?
This is a very personal decision, and one that should always be discussed with a certified plastic surgeon. The surgeon will be able to explain exactly what is involved, and what kind of changes in your appearance you can reasonably expect. While plastic surgery cannot completely change a person's appearance, significant improvement can often be achieved through reconstructive or cosmetic surgery. Use the following questions in assessing if cosmetic surgery is right for you:

What is it that I want changed?
This could be anything from losing pounds of unwanted fat, to losing the "crow's feet" by your eyes. If you're unhappy with some part of your appearance, it's worth looking into. Is this just a passing whim, or do I really want this changed? Most cosmetic surgery patients have wanted a change for some time.

Is this just a passing whim, or do I really want this changed?
Most cosmetic surgery patients have wanted a change for some time.

What can I reasonably expect?
Your surgeon will help you determine if your surgery goals are reasonable and attainable. It could be that the way you see yourself after having surgery is not a realistic picture. Your surgeon can help you understand how much of a change will be made, and what the final result will look like.

How much will this cost?
Besides telling you the cost of the surgery, if your goal is to have a number of different surgeries (perhaps having your nose and lips done), your surgeon will be able to help you best use your surgery dollars. It may be possible to have a few procedures performed at the same time and save some money.

You should also note that most insurance does not cover plastic surgery unless it is deemed medically necessary for health or well-being. Check with your insurance company to see if your operation will be covered, and what conditions may be required for coverage.

Procedures` Average Cost

Breast augmentation $3,000.00

Breast lift $3,500.00

Breast reconstruction Implants $2,500.00 to 3,000.00
Flaps $5,000.00 to 7,000.00

Breast reduction $5,000.00

Buttock lift $3,500.00

Cheek implants $2,000.00

Chemical peel (full face) $1,600.00

Dermabrasion $1,600.00

Ear surgery $2,500.00

Eyelid surgery (upper) $1,500.00

Facelift $4,700.00

Laser skin resurfacing (full face) $2,700.00

Liposuction - a single site $1,800.00

Nose reshaping $3,000.00

Tummy tuck $4,000.00

Retin-A treatment - per visit $ 100.00 t0 $300.00

Is it safe?
It's important to realize that, like any other surgery, there are risks associated with plastic surgery. Discuss in detail the risks of your desired procedure with your surgeon. Find out what complications are possible, how likely they are. Also find out what physical limitations you may have immediately after your surgery. By selecting a qualified plastic surgeon, one who is board certified in plastic surgery risks can be minimized.

Where will the surgery take. place?
Plastic surgery generally takes place in a hospital or your surgeon's facility. Simpler operations can be performed at your surgeon's facility, while more complex surgeries may require a hospital setting.

What kind of information your surgeon will need in planning your surgery?
Be sure to tell your surgeon if have any underlying medical condition that my cause problems during or after surgery such as uncontrolled high blood pressure, bleeding disorders, or tendency to form excessive scars.

If you taking any medications, herbal supplements, specially drugs that affect bleeding.

What kind of anesthesia is needed?
You may receive a local anesthetic to numb the area to be worked on, or be given a general anesthetic where you'll sleep through your surgery.

What preparation will you need for your surgery?
Instructions will be given to you by your surgeon on how to prepare for surgery, including guidelines on taking or avoiding certain medications and vitamins, eating, drinking and smoking. If you smoke, it is specially important to avoid it at least 10 days before your surgery. After surgery, smoking inhibits blood flow to the skin, and can interfere with the healing of your incision areas.

Is it painful? How long will it take me to recover?
This will depend on the type of surgery you choose. In general, the more invasive the procedure is (i.e. bone reconstruction, internal sutures) the longer the recovery time can be and the more recovery time may be needed. Of course, these will all vary by how MUCH is done, age of patient, etc, but you can say that as well.

Most patients will require assistance for the first two days. Then most patients are able to care for themselves, but may still need assistance if they have small children to care for. The specific lengths of disability are outlined below by procedure. These are approximations, and do not include return to exercise.

Eyelid Surgery - Usually can get around independently by the second day. With the use of sunglasses, may feel comfortable going to the store by day 3-4, and with make-up could return to work by 5-7 days.

Facelift Surgery - Usually can get around independently by the second day. Usually do not feel comfortable going out in public for 5-7 days. Requires 10-14 days before returning to work if in the public eye.

Breast Surgery - Usually can get around independently by the second day. May return to work at 5-7 days if not required to lift more than 15 pounds.

Liposuction - Usually can get around independently by the second day, earlier if smaller number of areas treated. One can return to work and normal activities in 5-7 days.

Abdominoplasty - Patients may take between 2-4 days before getting around independently. The recovery is almost identical to C-section. One can return to a desk job at 5-7 days, other jobs 10-14 days.

When can I resume normal exercise?

The time a patient resumes regular exercises varies based on the operation performed. All patients are encouraged to start a slow walking routine on the second postoperative day. Regular aerobic and more vigorous activities are not allowed during the first 2 weeks in order to decrease the risks of bleeding, swelling, and bruising. Weight lifting and contact sports are allowed at 1 month in most cases.

Does plastic surgery leave scars?
All surgery leaves scars. The type of procedure performed and an individuals ability to heal both play a part in type of scar that results. Some scars eventually become a fine line that scarcely noticeable. A plastic surgeon is trained to close wounds in a way that makes the scars asinconspicous as possible.

What is the most common plastic surgery procedure?
The most common plastic surgery procedure overall is tumor removal (for skin lesions such as skin cancers). The most common cosmetic surgery procedure is liposuction, followed by blepharoplasty (eyeled surgery), rhytidectomy (face lift), rhinoplasty (cosmetic nose surgery), breast augmentation (enlargement),
and abdominoplasty (tummy tuck).

Is it true that the numbers of cosmetic surgery procedure have increased dramatically?
A study by the American Society of Plastic Surgeons revealed during the past 5 years all cosmetic surgery procedures have increased by more than 50%, and more than tripling with liposuction and breast augmentation (enlargement).

Which plastic surgery procedure do men have performed most often?
Men most often have the nose reshaped, followed by eyelid surgery.

How much cosmetic surgery is performed on teenagers?
About 3% of all cosmetic surgery is performed on people 18 years old or younger. The top procedure is nose reshaping.

How old are most people when they choose to have cosmetic surgery?
Usually about 35-50 years of age is the primary category for cosmetic surgery. In 1992 and 1994, this group accounted for more than 40% of all cosmetic surgery.

In which state is cosmetic surgery most popular?
1 out of 5 cosmetic surgery patients reside in California.

What is a facelift?
A facelift or "rhytidectomy" is a surgical procedure designed to improve the most visible signs of the aging process by eliminating excess fat, tightening the muscles beneath the skin of the neck, and removing sagging skin. It doesn't stop the aging process but merely "sets the clock back".

Who would be the best candidate for a facelift?
Most patients are in their 40s to 65s. A man or woman whose face and neck have begun loose some elasticity of the skin and begun to sag, and whose bone structure is strong and well-defined.

What is the Submusclar Aponeurotic System?
The SMAS is a layer beneath the skin which invests the facial muscles. By tightening the SMAS, the jowls are lifted, the neck is tightened, the cheeks are elevated. This "deep" or "2-layer" facelift is an improvement over earlier skin-only techniques.

How long does a facelift last?
No one can say for sure. The clock is turned back, but keeps on running. Ten years later, you will look better than if you never had facelift plastic surgery. Many patients never have a second facelift, while others may desire further plastic surgery seven to 15 years later.

Can facelift plastic surgery be done without scars?
The scars from facelift plastic surgery usually fade and are barely perceptible. In some patients, especially younger ones, endoscopic surgery can be used to lift the eyebrows, remove frown lines, elevate the cheek and jowls, and tighten the neck. This endoscopic surgery can be done with tiny scars. However, if there is excessive skin, it must be removed for the best results through standard facelift incisions.

How long will I be out of work after facelift plastic surgery?
Most patients are able to return to work in two to three weeks after facelift plastic surgery. You should allow four to eight weeks before major social engagements.

How can I hide things during the time until I return to normal?
Your plastic surgeon will discuss post-operative camouflage techniques with you prior to your surgery, but be assured that while almost everyone has some sort of temporary side effect such as bruising and swelling, there are makeup techniques that both men and women can use almost immediately to disguise them.Generally speaking, makeup techniques can be used soon after facelift plastic surgery to cover discolorations, and to hide incision lines after the stitches have been removed and the incision is completely closed. Camouflage cosmetics include three basic types of products: Concealers to hide incision lines and discolorations; contour shadows to disguise swelling; and color correctors to neutralize color in reddened skin.

What is liposuction?
Liposuction is the surgical vacuuming of fat from beneath the surface of the skin. It is used to reduce fullness in any area of the body. It is an excellent method of spot reduction but is not an effective method of weight loss.

What is the tumescent liposuction technique?
The tumescent technique involves injection beneath the skin of large volumes of salt water containing lidocaine, a local anesthetic and small amounts of adrenaline, a naturally occurring hormone which shrinks blood vessels. By injecting this solution to the fat prior to performing liposuction the plastic surgeon numbs the tissues and shrinks the blood vessels thereby eliminating pain and reducing and minimizing bleeding, bruising, and swelling. The tumescent technique permits some patients who were previously treated under general anesthesia to be treated under local anesthesia with sedation.

Who is a candidate for liposuction?
Generally people who have localized areas of protruding fat achieve the most dramatic results. Patients who are slightly overweight can benefit from liposuction. It is best to be at or near your normal weight. Good skin elasticity permits the skin to shrink easily to the reduced contour. There are no absolute age limits for liposuction.

What areas are most frequently treated?
In women, the single most frequently treated areas are the outer thighs, followed by the stomach. In men, the flank area or "love handles" are treated most frequently.

Can liposuction tighten up a loose neck?
If there is excess fat in the area under the chin and the skin is taught, liposuction alone can produce a more sculpted, angular, and youthful jaw line. If, however, the skin of the neck is loose, hanging, or crepey, even if there is excess fat, liposuction alone will not produce the desired result. Patients with loose skin usually require a face and neck lift in addition to or instead of liposuction. In general, most patients who benefit from liposuction of the neck are under 40. Most patients over 40 will require some surgical skin tightening.

Liposuction seems very simple and safe. Are there any dangers associated with liposuction plastic surgery?
Although liposuction is very safe and effective, it is a surgical procedure and can cause complications such as infection, bleeding, and nerve damage. In addition, aesthetic complications such as skin irregularity or waviness can occur if too much fat has been removed. Fortunately, complications are uncommon and most patients are satisfied with their results.

What will my nose look like after surgery?
In general, rhinoplasty, cosmetic nose surgery, is designed to reduce excess cartilage and bone in the nose, removing irregularities and bumps to give a straightened, smooth and, usually, smaller appearance. Adding tissue to enhance certain features of the nose can also occur. The overall trend in modern rhinoplasty is away from over-reduction of tissue which can reduce the ability to breath through the nose and towards individualized treatment of each segment of the nose to give a balanced and refined look without compromising function.

How long does nose plastic surgery take and what kind of anesthesia is used?
Usually, rhinoplasty takes from one to three hours depending on the complexity of the condition of the nose. Most patients have sedation prior to and during the procedure while some patients request a general anesthesia. Nearly all rhinoplasty operations are done as outpatient surgeries.

Is there a lot of bruising after nose plastic surgery and how long will it last?
This depends again on how complex the procedure is, but in general most patients
experience five to seven days of purple discoloration and swelling around the eyes and upper cheeks. The nose itself will be swollen for around ten to fourteen days or longer, but subtle resolution of the swelling at the tip of the nose can take many months after surgery to go away.

If you have trouble breathing through my nose and have terrible sinus problems. Will my insurance policy pay for nose plastic surgery (rhinoplasty)?
The condition described is usually associated with a deviated septum or a bent internal framework of the nose. Most of the time this results from trauma such as a broken nose but many patients with this condition cannot recall an episode where this might have occurred. The condition described in this question however, could also result from allergies or the two conditions can exist simultaneously. Careful examination is needed before surgery to separate the two conditions. While individual insurance policies can vary, in general, functional surgery to improve breathing is considered a covered benefit in many group policies. If additional correction of a cosmetic deformity of the nose is done at the same time the cost of this part of the procedure is usually not covered by insurance.

Where are the incisions placed during nose plastic surgery?
In general, most or all of the incisions in rhinoplasty are hidden in the inside of the nostril. While external incisions hidden in the creases where the nose meets the cheek can be used to narrow the nose, incisions on the bridge or tip are not usually used in cosmetic surgery of the nose.

Will my nose grow after surgery?
In general, our noses tend to elongate as we enter the middle years of our life and
drooping of the tip of the nose can occur in the later years as elasticity disappears from the body. While undergoing a cosmetic rhinoplasty as a teenager or young adult will not prevent the effects of aging on the nose, the final shape that results from this surgery is expected to last a lifetime and regrowth of bumps and deformities corrected by the operation is a rare occurrence.

What is a blepharoplasty?
Blepharoplasty offers to eyelid surgery and is designed to remove the excess fat, along with skin and muscle, from the upper and lower eyelids. It is the second most common aesthetic procedure performed by plastic surgeons.

How is the eyelid plastic surgery performed?
Eyelid plastic surgery is usually performed using local anesthesia and light intravenous sedation. It is commonly done in a doctor's office, outpatient surgical center or, in some cases, in a hospital. Eyelid plastic surgery is most often performed on an outpatient basis.

Are there scars from the eyelid plastic surgery procedure?
Scars are a result of any surgical procedure. The incisions made to accomplish the goals of plastic surgery of the eyelids are barely visible after several months as they are placed within the normal creases and folds of the upper and lower eyelids. In patients who only need removal of fat from the lower eyelids, the incision can be made on the inside of the eyelid, and will therefore result in an invisible scar.

Will the fine wrinkles around my eyes go away after eyelid plastic surgery? What about my sagging eyebrows and dark circles under my eyes?
The blepharoplasty procedure will not eradicate the wrinkles around the eyes (crow s feet) nor will it elevate droopy eyebrow. There are other procedures designed for these purposes. Dark circles under the eyes may improve a bit if this is related to large bags, but most often the dark appearance of the lower eyelid skin remains.

Can anyone have eyelid plastic surgery?
The best patients are those who are healthy, psychologically stable and well motivated. Some medical conditions may increase the risk of blepharoplasty surgery such as thyroid disease, high blood pressure, and patients who do not make sufficient tears to keep their eyes well lubricated.

What are the risks involved with eyelid plastic surgery?
Fortunately, when performed by a competent plastic surgeon, complications are infrequent and minor. All patients will experience some bruising and swelling for a few days after the surgery. In addition, a temporary problem with closure of the eyelids is usually seen. Some may have temporary blurring of their vision, usually due to the ointments applied to the incisions post operatively.

In rare instances, the lower eyelid may be pulled down causing an ectropion. If this does not resolve on its own, further surgery may be necessary. The theoretical complications of any surgical procedure, such as bleeding, infection, wound disruption and heavy scarring are also possible, but rare

Saturday, October 11, 2008

Laser Skin Surgery: What you need to know

Laser for Skin Rejuvenation - Laser Resurfacing Surgery

Cosmetic laser surgery has come to the forefront of facial rejuvenation surgical procedures. This has actually occurred over many years and it is most recently due to significant changes in technology with the application of the CO2 laser. While the CO2 laser has been used in medicine for almost two decades, recent advances including the superpulse CO2 laser mode and higher power of CO2 lasers, have made cosmetic facial rejuvenation more viable and the results more predictable and desirable. It is for this reason that laser resurfacing has become a most popular and effective method of treatment of sundamaged skin or photoaging, lax or aging skin, wrinkles and facial scarring such as that due to acne. It is also useful for other conditions.

Laser surgery is carried out on an outpatient basis under "twilight anesthesia." The surgical procedure takes from 45 minutes for resurfacing of the mouth region to approximately two hours for resurfacing of the full face. Following laser resurfacing, the skin appears pink, moist and usually quite smooth. The outer layers have been removed during the surgical procedure and after the anesthetic wears off, the skin will be somewhat tender and some swelling is expected for the first two to three days. A burning sensation may be present but will be helped by the medication provided. It is important to keep the head elevated as much as possible for two days following the surgical procedure. A recliner is most helpful since it allows one to be able to sleep on his/her back. While the ability to work is not impaired, most patients may return to work and social activities within seven to 10 days, depending on the extent of treatment. The skin at that point will look red and sunburned in appearance; however, makeup is available for both men and women. Exercises may be resumed within one to four weeks. Extremes of heat, cold and wind should be avoided for several months.

Once the skin has healed, it is imperative to avoid sun exposure for at least six weeks; otherwise, sunburn, hyperpigmentation and other complications may occur. Laser areas should be protected by using wide-brimmed hats and potent sunscreen products for at least six weeks. This office provides two types of kits for laser procedures. The pre-laser surgery kit is extremely important since preparation of the skin prior to laser procedures is essential. Preparation of the skin consists of the use of glycolic acid products and bleaching agents containing hydroquinone and cogic acid. These products are utilized for a minimum of two weeks; however, in most patients we prefer to use them for at least six weeks prior to surgery. Following surgery, a post-laser kit is provided which allows for the use of the proper products to protect the skin from sun rays and to promote complete healing of all laser areas.

Laser Skin Surgery for Pigmented Lesions and Skin Blemishes

The development of laser treatment for port wine stains, broken blood vessels (whether they are the result of birth marks or whether they are acquired in later life), hemangiomas, tattoos and other skin lesions, is a wonderful advance in medicine. Laser treatments are possible because high intensity laser light is produced by the laser and focused on unwanted tissues, blood vessels or pigments to destroy them. In this manner, the normal portions of the skin are damaged less by laser than other traditional treatments.

This form of laser therapy involves the use of the Surgica K-1 laser, a device that produces an intense burst of yellow-green laser light that is specially optimized to treat vascular-pigmented lesions (broken blood vessels, dark spots, the so called liver spots and skin lesions). The light from the Surgica K-1 laser is absorbed mostly by the blood vessels in the lesions and passes harmless through the surrounding tissue and skin. Some lesions require only a few pulses and can be treated in one session, while larger lesions like port wine stains require multiple patient visits with multiple treatments. The treatment is carried out strictly on an outpatient basis and under topical (surface) local anesthesia. Work can be resumed immediately after treatment. Sun exposure should be avoided in the treated areas for a few weeks after surgery to prevent the skin from healing with a darker or lighter tone.

About Risks

Like any other treatment, there are some risks inherent to laser surgery, pertaining mostly to scarring and pigmentation of the skin. These complications are quite rare.

What Can Be Treated

Some birthmarks, port wine stains, hemangiomas (especially strawberry hemangiomas), telangiectasia (vascular spiders) and broken veins of the face, scars, tattoos, brown freckles and light brown birthmarks, skin cancers, warts and numerous other skin lesions.


Many, but not all, insurance companies will pay for laser surgery. Generally, we obtain prior determination and authorization for payment of the treatment. As with most of our cosmetic treatments, laser treatments must be paid for in advance.

Typical Laser (Ultrapulse) Pricing (full facial):

Champaign/Bloomington Facilities: Facility: $900.00 Surgeon's Fee: $2600.00
Procedural Fee for Lids Only, OR Included: $800.00
Procedural Fee for Mouth Only, OR Included: $900.00

Elmhurst Facility: Facility: $900.00 Surgeon's Fee: $2700.00
Procedural Fee for Lids Only, OR Included: $1000.00
Procedural Fee for Mouth Only, OR Included: $1100.00

Nose surgery (Rhinoplasty): Surgery and Risks

Rhinoplasty is the most common of all plastic surgery procedures. It can reduce or increase the size of your nose, change the shape of the tip or bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.

Who’s a Candidate?

The best candidates are people who are looking for improvement in the way they look. Age may also be a consideration. Many plastic surgeons prefer not to operate on teenagers until after they’ve completed their growth spurt.

What Are the Risks?

After surgery, small burst blood vessels may appear as tiny red spots on the skin’s surface. These are usually minor but may be permanent. As for scarring, when rhinoplasty is performed from inside the nose, there is no visible scarring. When an "open" technique is used, there will be small scars at the base of the nose.

Preparing for Surgery

The surgeon will ask you what you’d like your nose to look like, evaluate the structure of your nose and face and discuss the possibilities with you. He or she will also explain the factors that can influence the procedure and the results, including the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age and expectations.

Be sure to tell your surgeon if you’ve had previous nose surgery or an injury to your nose, even if it was quite some time ago. You should also inform him or her about any allergies or breathing difficulties you may have.

The Surgery

Rhinoplasty is usually performed on an outpatient basis under local anesthesia, depending on the extent of the procedure.

During the surgery, the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on the nature of your problem and your surgeon’s preferred technique. The skin is then redraped over the new framework.

Many plastic surgeons perform rhinoplasty from within the nose, making the incisions inside the nostrils. The "open" procedure is often used in more complicated cases.

Once the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

After Your Surgery

After surgery, particularly during the first 24 hours, your face will feel puffy, your nose will ache and you may have a dull headache. Plan on staying in bed with your head elevated for the first day.

You’ll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. You may apply a cold compress to reduce the swelling. Most of the swelling and bruising should disappear within two weeks. Some subtle swelling may remain for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.

A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Your surgeon may ask you not to blow your nose for a week or so while the tissues heal.

If you have nasal packing, it will be removed after a few days. All dressings, splints and stitches should be removed within one or two weeks. You can wear contact lenses as soon as you feel like it; however, if you wear glasses, they will have to be taped to your forehead or propped on your checks until your nose is completely healed in approximately seven weeks.

Tuesday, October 7, 2008

How to Choose the Facelift That Is Right for You

A layperson using the term "face lift" usually means surgery that rejuvenates the entire area from the top of the forehead to the bottom of the neck, including every structure in between. But to the plastic surgeon, there are probably half a dozen different surgeries to improve that territory, including: brow/forehead lift; upper and lower eyelid lift; face lift; neck lift; chin and cheek implants; and various peels or laser treatments. What surgery or treatment do you really need to get you where you want to go? To know what you need, start with taking a "facial inventory". In a facial inventory, you take stock of your various facial features. All of the steps are done while sitting upright and looking in a full-size mirror.

STEP 1: Think of the face as being divided into three zones or areas:
    Zone 1 - forehead, eyebrow line and upper and lower eyelids.

    Zone 2 - nose, cheeks, nasolabial folds (the lines from the corner of the nostril to the corner of the mouth) and the upper lip.

    Zone 3 - lower lip, chin and neck.

STEP 2: Examine each of these zones separately and evaluate the aging process:
    Zone 1 - forehead wrinkles; low, drooping brows with loss of natural arch; puffiness, drooping, excess skin of upper and lower eyelids.

    The area around the eyes says the most about our age, health and state of mind. When your face is totally passive, do you have deep wrinkles in your forehead and at the corners of your eyes? Do your eyebrows have a natural, youthful arch or are they level or inverted? Do your upper eyelids touch or almost touch your eyelashes? Look at your lower eyelids. Is there puffiness that is worse on some days and better on others but always there, especially when you rotate your eyes upward?

    Zone 2 - drooping nose and tip of nose; deep nasolabial folds; thinning of upper lip; deep vertical lines of upper lip.

    Place your fingers on your cheekbones and gently lift upward. Does it improve your appearance or make you look more youthful? When you look at yourself with only overhead lighting, is there a deep shadow from the corner of your nose to the corner of your mouth? Also, is there jowling at the corner of your mouth where the cheek tissue is creating a fold that may extend down toward your chin?

    Zone 3 - thinning of lower lip; small chin with loss of projection; deep vertical lines of lower lip; loose neck tissue (turkey waddle).

    Now look at your neck. Is it smooth and tight? Have you lost the natural almost right angle from the chin to the neck? Does your neck have an area of loose flesh, or have the muscles separated into two distinct bands?
Not all areas of the face necessarily age at the same rate. Some people will find that they have aging characteristics in each of the three zones and therefore may need to have a more comprehensive, corrective procedure. However, many others will find that their problems or changes are limited to just one or two areas.

Modern rejuvenation techniques allow the plastic surgeon to accomplish significant improvement with more limited operations than were required just a few years ago. Together, you and your plastic surgeon can decide on the area or areas of your face and particular aesthetic surgery that can help you achieve a more youthful or attractive appearance.

If you think aesthetic surgery is right for you, there are only two other considerations - the fear factor and the wallet factor. Aesthetic surgery, like all surgeries, carries a degree of risk. However, understanding those risks, you also recognize that they are generally uncommon and treatable if they do occur. Regarding cost, aesthetic surgery is elective. Insurance companies do not cover it.

Now that you may possibly know a little more about aesthetic surgery, and are still interested, it is time to talk to a board-certified plastic surgeon. Together, you and your surgeon can discuss how best to meet your expectations.

Getting Started
If you are considering a cosmetic medical procedure, consult a board-certified plastic surgeon about the process, risks, recovery time and costs.

What to Know About Surgery in Your Doctor's Office

Surgery, once upon a time, was almost solely confined to the hospital operating room. Today, many surgeries are being performed in ambulatory or "outpatient" settings-and a growing number are taking place right in the doctor's office. In many cases, office-based surgery is more affordable and more convenient for the patient.

A recent television broadcast focused on this trend, leading off with the tragic report of a nine-year-old girl who died on the doctor's operating table while undergoing relatively simple ear tube surgery. Out-dated and malfunctioning anesthesia equipment in the doctor's office was identified as a cause.

Is surgery in the doctor's office risky? What's hype-what's truth? And what do you need to know before consenting to a surgical procedure in your doctor's office?

Regulation of Office Surgical Facilities

State regulation
In-office surgery is not regulated in most states. In fact, only four states currently have comprehensive laws covering surgeries and anesthesia in doctor's offices-New Jersey, California, Florida and Texas.

Voluntary regulation
But doctor's offices that do surgery can voluntarily have their surgery practice accredited, licensed or certified - an assurance that the facility meets high standards for patient safety and complies with local, state, and federal codes.

The American Association for Accreditation For Ambulatory Surgery Facilities (AAAASF) is a voluntary program of inspection and accreditation in surgery facilities. Surgeons working in AAAASF-accredited facilities must be board-certified and have equivalent hospital surgical privileges.

What's the safety record of these accredited office surgical facilities? "Excellent," concludes research commissioned by the AAAASF. What's more, the study shows that overall risk is comparable to a free-standing or hospital ambulatory surgical facility.

The experts Dateline spoke to recommended that if you are going to have surgery in an office, ask if it meets one of the following standards:

  • Accredited by an accrediting organization such as the Joint Commission on Accreditation of HealthCare Organizations (JCAHO); or Accreditation Association for Ambulatory Health Care (AAAHC); or American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF)
  • Licensed as an ambulatory surgical center by the state
  • Certified as an ambulatory surgical center by the Medicare program

Know Your Doctor's Credentials
What about your surgeon's qualifications? If you are unsure, ask him, or direct your inquiries to your local or state medical society, advises the American College of Surgeons. Take note: Any doctor can call himself a plastic, facial plastic, or cosmetic surgeon. Find out whether he is board-certified or board-eligible and in what specialty. "One good sign of a surgeon's competence is certification by a national surgical board approved by the American Board of Medical Specialties. All board-certified surgeons have satisfactorily completed an approved residency training program and have passed a rigorous specialty examination," according to the American College of Surgeons.

What about anesthesia in doctor's-office surgery? The American Society of Anesthesiologists takes the position that ambulatory (or outpatient) anesthesia and surgical care "has been proven to be safe, convenient and cost-effective."

Talk to your doctor about the kind of anesthesia you will need and the risks associated with it. The person giving you anesthesia should be an anesthesiologist, a certified nurse anesthetist, or a physician with credentials in anesthesia. Ask questions about the doctor's office surgical room: Is a heart monitor used? How close is the nearest hospital? Is the anesthesia equipment inspected, calibrated and regularly maintained? Is it equipped with the latest safety devices? In LASIK eye surgery procedures, what kind of microkeratome is used and how often is the microkeratome blade changed? How often are the laser and microkeratome serviced? (You can check with the manufacturer for recommendations.) How many nurses work with the surgeon? Who assists? Is there a recovery room? Are emergency procedures in place? Is the surgeon trained in ACLS, Advanced-Cardiac Life Support? Who runs the operating room? Ask to see the room; is it tidy, clean and organized?

Don't be intimidated about asking questions. A caring, competent surgeon will understand that you are being thorough and will be willing to address your concerns.

Believe Your Instincts
Trust your first impression and trust your surgeon, writes Elizabeth Morgan, M.D., F.A.C.S., in "The Complete Book of Cosmetic Surgery: A Candid Guide for Men, Women & Teens." Ask to see the operating facility. "If the operating room doesn't look right, say that you prefer a hospital or surgery center," cautions Dr. Morgan.

"If you have a good surgeon, trust him. Good surgeons take good care of their patients. A conscientious surgeon will do your surgery where it is safe for you. You can't be an office accreditation committee."

More to Know

  • The AAAASF research project set out to identify complications and deaths related to in-office surgery and compare data with other outpatient surgery data. A questionnaire was sent to 418 accredited facilities; 241 (or 57 percent) responded. The study found that significant complications (hematoma, hypertensive episode, wound infection, sepsis, hypotension) were infrequent, occurring in 1 in every 213 cases. A death occurred in 1 in 57,000 cases (0.0017 percent). "This study documents an excellent safety record for plastic surgery done in accredited office surgical facilities by board-certified plastic surgeons," the report concluded.
  • Dateline NBC queried medical boards in all 50 states. The District of Columbia and 43 states reported that they have no rules specifically regulating surgeries in a private doctor's office. Three states-Virginia, Illinois, and Missouri-reported some kind of regulation. Four states currently have comprehensive laws covering surgeries and anesthesia in doctor's offices-New Jersey, California, Florida and Texas.
  • According to the AAAASF, studies have shown that costs to a patient in a single-specialty facility, such as an accredited surgery facility, are only one-third to one-half those charged by a hospital for the same procedure.
  • The American Society for Aesthetic Plastic Surgery (ASAPS) 1999 Statistics show that 53 percent of cosmetic procedures were performed in an office-based surgical facility.

Getting Started
If you are considering a cosmetic medical procedure, consult a board-certified plastic surgeon about the process, risks, recovery time and costs.

Breast Uplift Specific Risks

In any discussion or recitation of risks, not every conceivable risk or potential consequence can be mentioned. The ones that are touched on are those that occur with some relative frequency.

Besides the general risks associated with any surgical procedure, there are the risks that are unique to that surgery. In the case of Mastopexy (breast uplift), among the specific risks are:

Unfavorable Scarring – Regardless of which mastopexy pattern or design is used, thick, wide, or raised scarring can occur. The causes are not clear, although hereditary predisposition plays a role, & some people are more prone to this kind of scarring than others. The scars can be treated in a number of ways to try to improve them, including scar revision surgery.

Skin Loss/Slough – A problem with blood supply to an area of skin, including the nipple, can occur. The reasons are not always clear. However, it is far more likely to occur in smokers!

Asymmetry – Breasts, like most paired structures of the human body, are not naturally exactly the same (not mirror-images of one another). Surgery cannot make them exactly the same, although the surgeon may try to improve symmetry. Patients should expect some degree of asymmetry.

Interference with Breast-Feeding – If you have breast-fed before, breast implants should not interfere with breast-feeding in the future.

Residual Drooping – While the goal of mastopexy is to lift the breasts, patients should expect some degree of drooping to remain. This issue should be discussed before surgery, so that expectations are realistic.

When implants are used, the risks are the same as for breast enlargement (augmentation mammaplasty), namely:

Capsular Contracture (Hardening/Encapsulation) – A veil of scar tissue naturally forms around the breast implant after surgery. If that scar tissue thickens and tightens, it is called “capsular contracture”. It can result in a breast that feels hard and may look distorted. If this does not respond to non-surgical methods of treatment such as regular breast massage and compression, surgical release may be necessary.

Interference with Mammography – The position of the breast implant may make interpretation of a standard screening mammogram more difficult. Therefore, with breast implants, it is important to go to an experienced mammography center where the needed special mammogram views can be done, and where ultrasound examinations are available as well. There is, however, no evidence of a relationship between implants and breast cancer!

Leak or Rupture – Like any man-made device, breast implants can and do break. How often is not exactly known, but one manufacturer studied saline-inflatable implant breakage over the past 13 years and found the incidence to be less than 1%. And silicone-gel implants break less frequently than the saline. If a saline-inflatable implant breaks or leaks, the breast will "go flat", usually over a period of about a week. The saline (sterile salt-water) is absorbed into your system. If a silicone-gel implant breaks, and the silicone stays within the scar capsule that has been formed, you may not be aware that it has broken until it is discovered in a mammogram or ultrasound exam. If, however, the scar capsule breaks as well, the silicone can move into the adjacent tissue or even migrate to other contiguous areas, where the body surrounds it with scar tissue. Broken implants should be removed and replaced. Sometimes with silicone gel, it is not possible to remove all of it.

Rippling – This phenomenon is palpable and even visible ripples (seen as lines or grooves of the breast) appear to be most prominent in textured (rough surface) implants – especially those that are saline-inflatable – but also silicone-gel filled ones, as well. It is probably a function of the thickness of the implant shell. In an attempt to avoid this visibly unpleasant phenomenon, we prefer implants with a smooth surface. They tend to ripple much less.

Autoimmune Effects – Beginning in the early 1990's, there was some concern about a possible causal relationship between silicone and a group of disorders of the immune system called "connective tissue disorders". Since that time, however, major scientific studies undertaken to examine any possible relationship have consistently not shown any. They concluded that silicone gel either in implants or that which escapes from a broken implant is unrelated to autoimmune disorders and symptoms.

For additional information concerning risks specific to breast uplift, please consult with your own plastic surgeon, or the websites for ASPS (The American Society of Plastic Surgeons) or ASAPS (The American Society for Aesthetic Plastic Surgery).

Liposuction: Suction Assisted Lipectomy (SAL) Procedure and FAQ

Synonym: liposuction, suction assisted lipolysis, "fat suctioning", and "fat sucking"

Currently, and for a number of years, liposuction – the most commonly performed aesthetic (cosmetic) surgery (ASPS 1998 National Clearinghouse of Plastic Surgery Statistics) – has produced almost instant gratification and fulfillment of dreamlike wishes. Although intended as a method of sculpting and shaping areas of the body, its use as a weight loss alternative has opened it to potential abuse. These abuses may take the form of massive liposuctions in unsuitable candidates; poor patient selection in general; advertising-generated and misleading expectations; and non-plastic surgeons performing cosmetic surgery. Some of these abuses have resulted in spectacular complications and have generated lurid exposés in the media. This adverse publicity, unfortunately, places blame on the operation as opposed to the operators.This is regrettable, since liposuction is such a valuable cosmetic procedure. Anyone considering liposuction surgery needs to seriously examine both motives and expectations. What do you really hope to gain through liposuction surgery? Can it actually be accomplished by a combination of moderate weight loss and toning through exercise? Should you invest in a meeting with a nutritionist and a trainer instead of a plastic surgeon? Are your expectations for what surgery can do realistic? If your answers to these questions still lead you to want liposuction, you should prepare for your consultation carefully, armed with further questions.


Ideally this surgical technique would be reserved for people who:

  • Are at or near ideal weight
  • Have localized areas of abnormal or disproportionate fat deposits
  • Have regional fat deposits that are unresponsive to a program of reduced dietary intake and exercise
  • Have reasonably good elastic skin tone that will "shrink to fit" when excess fat is removed
  • Have reasonable expectations
  • Are looking for improvement, not perfection
  • Are in good health both physically and emotionally

However, it is not surprising that the criteria have been expanded to include a broad segment of people with problems of body shape and proportion. Among women, the most common areas requested for reshaping are thighs, hips, buttocks, abdomen, and face and neck. For men, the more common needs are for the abdomen, love handles, and neck. But virtually any area where "fat comes to rest" may be the object of liposuction.

The basic science of fat metabolism that allows liposuction to work is interesting. Suffice it to say, removed fat doesn't "grow back". But this doesn't prevent post-liposuction patients from gaining weight. Patients wishing to get and maintain the best results from liposuction continue to sustain a healthy lifestyle including dietary discretion and regular exercise.

Objectives & Facts

  • Shaping and sculpting areas of localized fat
  • Not meant for weight reduction
  • Will not tighten skin
  • Will not eliminate "cellulite"

Before Surgery

Whether at the time of consultation or later, once you have made up your mind to go ahead, you will need to take measures to ready yourself for surgery. While many of these measures will be at your plastic surgeon's request, others will be a matter of laying the mental groundwork for surgery, both for yourself and your family.

From a medical perspective, in preparing for any cosmetic surgery, there are certain steps that need to be taken. While each plastic surgeon may differ somewhat in the preparations they recommend, the basic objectives will be the same:

  • That you are in good physical and mental health
  • That you are not taking medications or over-the-counter supplements that could interfere with surgery or anesthesia
  • That transportation to and from surgery and homecare arrangements have been made

When surgery is scheduled, you usually will receive instructions from the staff covering all of the necessary pre-surgical planning. These instructions will include:

  • A list of drugs, medications, and food supplements that you will need to avoid because of their negative effect on surgery
  • Information about smoking cessation and the additional risks of surgery and smoking
  • Do's and don'ts in the weeks before surgery
  • Reporting any colds or infections that arise which may force surgery to be delayed
  • Making arrangements for transportation and assistance for post-operative care
  • Forms for your doctor for medical history and physical examination

The Surgical Procedure

Location – When the volume of liposuction is very small and/or the number of areas few, the procedure is usually performed as a day-patient. Under some circumstances, however – even with these criteria – we will recommend an overnight stay. For larger volume liposuctions, where many areas are involved, or when other surgical procedures are performed simultaneously, we advise staying overnight or even several nights.

Anesthesia – There are various anesthetic techniques that are used in liposuction surgery. However, for most liposuctions (except for very small areas), surgeons uses general anesthesia (complete sleep) exclusively. It is administered by a physician anesthesiologist in order to provide the safest, most controlled form of anesthesia.

Surgery Techniques – Once you are asleep, the first step in the process of liposuction – is the injection of the large amounts of fluid into the fat. In this "tumescent" or superwet technique, the fluid reduces the amount of bleeding and provides some anesthesia to the areas. It also separates the compartments of fat and makes the extraction easier. Then, surgeons uses both standard "tumescent" liposuction [SAL] and "ultrasonic-assisted liposuction" [UAL]. In the standard technique, a number of tiny incisions (so small that when they heal, they are barely perceptible) are made, through which hollow metal tubes or cannulas attached to suction are inserted. These cannulas vary in size with the largest being about the diameter of a pencil and the smaller ones the diameter of spaghetti. As the cannula is moved in-and-out of the fat, it removes cores of fat until the desired shape has been attained.

Where the fatty area is very tough and fibrous – such as in the back, flanks, breasts, and hips (especially in men) – or where there are very large volumes to be removed, ultrasonic-assisted liposuction (UAL) may be used. In this technique, there are special cannulas attached to a device that emits ultrasonic waves that rupture the fat cells before they are suctioned away. It is believed that this method may result in less bleeding and bruising and may create some degree of skin shrinkage. It, however, has its own set of risks and is used as an adjunct to standard tumescent liposuction, not a replacement.

Risks & Complications – All surgeries are associated with some risks. These relate to the potential for complications and untoward events during or after a surgical procedure. We can think of these in two groups:

1. General Risks – Risks that are common to all operations and
2. Specific Risks – Those that are unique to a particular surgery.

General Risks include:

  • Bleeding
  • Infection
  • Scarring
  • Swelling
  • Bruising
  • Anesthetic risks

Specific Risks include:

  • Unfavorable scarring
  • Skin loss/slough
  • Asymmetry
  • Alterations in skin sensitivity
  • Lumpiness
  • Waviness
  • Irregularities
  • Loose skin
  • Areas of hard scar tissue
  • Discoloration (permanent or temporary)
  • Injury to deeper structures (very rare)

After Surgery

Following discharge from the recovery area, you will either be sent directly home or spend the night and be discharged the next day. As mentioned earlier, there are numerous reasons for staying overnight, including: personal preference, number of areas and amount of fat removed, other surgeries performed simultaneously, and so on.

Everyone has some degree of pain after any surgery. The amount and the way you deal with it are very individual. You will receive medication to control the pain.

Surgeons encourage his patients to be physically active as soon after surgery as is practical. This is particularly true of liposuction. You will be wearing various elastic garments and girdles for 3-6 weeks. These both control the amount of post-operative swelling and help to shape the new contours. You will be able to change these daily (or more often, if necessary). The timing of normal showering and bathing will depend on a number of factors.

Most people recover sufficiently to return to work in about 1 week. You will be encouraged to quickly resume full, normal physical activities and exercise. Your new shape should be a motivator to resume or begin a regimen of exercise, shaping, and toning.

Suture removal is generally not required. The small scars will take months to soften and decolorize from red-to-pink-to-white. The results will be evident within several weeks. Still, where the fat has been removed, the tissues will be firm and even somewhat swollen for weeks to months. Staff will instruct you in the appropriate method of massaging these areas to speed the softening.

Conclusions and Patient Acceptance

Because the resulting new shape is often so dramatic, liposuction is among the most satisfying cosmetic procedures. Please refer to FAQ (frequently asked questions) below to review the details and concerns of many patients.

Liposuction FAQ

Will the fat come back?
You are born with essentially a fixed number of fat cells that increase or decrease in size based upon weight gain or loss. When cells are removed, they do not grow back. However, that does not mean that you can't gain weight! You can and will, if you overindulge. But the excess fat will be deposited predominantly in areas other than those that have been liposuctioned. That means other areas will get fat. And you may not be pleased with which areas they are!

How long does it take to heal?
We encourage patients to be physically active as soon after surgery as is practical. This is particularly true of liposuction. You will be wearing various elastic garments and girdles for 3-6 weeks. These both control the amount of post-operative swelling and help to shape the new contours. You will be able to change these daily (or more often, if necessary). The timing of normal showering and bathing will depend on a number of factors.

Most people recover sufficiently to return to work in about 1 week. You will be encouraged to quickly resume full, normal physical activities and exercise. Your new shape should be a motivator to resume or begin a regimen of exercise, shaping, and toning.

Suture removal is generally not required. The small scars will take months to soften and decolorize from re-to-pink-to-white. The results will be evident within several weeks. Still, where the fat has been removed, the tissues will be firm and even somewhat swollen for weeks to months. Massaging these areas will help to soften them more rapidly. You can combine professional massage (as long as it is gentle) and lymphatic drainage techniques in these areas with your own self-massage. Staff will instruct you in the appropriate method of massaging these areas to speed the softening.

Should I apply heat or ice to the areas?
Absolutely not! Both cold and heat can severely injure the skin in the liposuctioned areas. The skin will not tolerate these.

How long will the results last?
The results are permanent. But this doesn't mean that you can't gain weight! It just means that the fat cells that were removed will not grow back. If you gain weight, very little of it will be deposited in the remaining cells in the liposuctioned areas. It will tend to find its way to other areas which will then enlarge in size and become unattractive. See "Will the fat come back?"

Is this surgery covered by my insurance?
Generally, no. This is a cosmetic operation and is not covered by health insurance. Very infrequently, when there is a functional problem such as a large fatty tumor – a lipoma for example – or when a breast reduction is being performed using liposuction, some insurances may cover this procedure.

When can I start jogging and lifting weights?
As soon as you are comfortable. Everyone's pain tolerance is different. But you will probably find that within a few days, you are able to resume brisk walking and within a week or so, jogging. Weight lifting probably almost immediately.

Will I have bandages?
There will be little adhesive clear plastic dressings over each incision. The general areas of liposuction will be covered with a girdle or compressive garment. Other than these, there will probably not be any dressings.

When can I bathe and shower?
It depends on whether liposuction has been combined with other surgeries, as well as, other factors. However, assuming just liposuction has been performed, you will be able to shower — but not take a bath — beginning at about 48 hours after surgery. When you do shower, you will need to keep in mind:

  • No hot water on the liposuctioned areas; they will burn very easily!
  • No rubbing the liposuctioned areas
  • Blot or pat the areas dry
  • Reapply your girdle or garment as soon as you are dry after completing your shower

Does someone have to be with me at home after surgery?
Unless you have had only a small area liposuctioned under a local anesthetic, you should plan to have someone with you for the remainder of the day and night of surgery.

Could I really get the same results if I just dieted and exercised?
If it's a matter of becoming thinner and more toned that you're after, yes, diet and exercise is the answer, not liposuction. On the other hand, if there are shapes, bulges, and contours that don't seem to change much regardless of your weight or level of fitness, liposuction is the solution. We cannot "spot weight reduce"; we can't change the unattractive shapes that we have inherited, like full "saddlebags" or love handles and so forth. But liposuction can sculpt away these unpleasant shapes that dieting won't remove.

Can I drive myself home after surgery?
No. Even if you have had a very limited liposuction under local anesthesia, the surgical experience may make you weak, shaky, or distracted enough that it is dangerous to drive. You should have someone bring you to surgery and take you back home. If you have had a general anesthetic, driving is out of the question.

Will Endermologie help?
Don't waste your time or money. Endermologie has not been demonstrated to produce any long-term change or improvement, in spite of what the advertisements say.

Can I have my surgery with a local anesthetic like I saw on TV?
No. We really don't believe that this particular method as shown on TV is safe, useful, or effective for our patients. As presented, it really was a gimmick that doesn't provide a safe and controlled surgical environment for the performance of good liposuction.

Will liposuction lift my butt?
No. In fact, liposuctioning the buttocks under most circumstances has the opposite effect and makes the buttocks flat and sagging.

Will my skin be looser after surgery?
It depends on a number of factors including: your skin tone, elasticity, and the amount of fat removed. If the elasticity is fair- to- poor, you may have some degree of looser skin after liposuction. It's not always possible to be sure about the amount of laxity that will be present after surgery. To an extent, the surgery will cause the skin to shrink a bit, even where skin tone is only fair. In making your decision to have liposuction surgery, this may be one of the considerations. We will try to inform you to the best of our ability how much skin laxity, if any, to expect.

Should I lose weight before the surgery?
I don't recommend losing weight specifically for the liposuction surgery. If you were to go on a major short-term diet and lose weight, it might give an unrealistic picture of the locations and amounts of surgical sculpting that are needed. Then, after surgery, you might gain back the weight and create new problems. It is preferable to save the weight loss and toning exercise for after the surgery.

See "How Long Does It Take To Heal"

How many scars will I have?
We won't know for sure in advance. The number of scars will be determined at surgery by the number of access incisions necessary to get to the fat that needs to be sculpted. In any case, they will likely heal well with minimal visibility.

When will the results be complete?
It will probably take up to 6 months or more for all of the normal scar tissue to soften and for all swelling to be completely gone. Nevertheless, your new shape will be clearly present and enjoyable in about one to three months.

Can I continue my vitamins and supplements up until surgery?
It depends on just what those are. Please give the staff a complete list of these well in advance of the surgery date (at least 2 weeks) so that ones that interfere with surgery or anesthesia can be discontinued in time. Vitamin E and supplements that are intended to assist in weight loss or contain stimulants must be discontinued by at least 2 weeks prior to surgery.

When can I resume my vitamins and supplements?
Probably by 2 weeks after surgery. But speak with the staff to be sure.

When can I begin having sex again?
As with exercise, in the case of liposuction, we encourage resuming sex when you are comfortable and as long as no pressure or trauma is applied to the areas that have been liposuctioned. You will find, however, that especially if the abdomen has been liposuctioned, the genital area may be very swollen and bruised for a while. Don't be concerned. It will eventually disappear and look normal again.

Do I have to sleep in a special position?

Do I have to stop smoking or should I use the nicotine patches or gum instead?
The nicotine in cigarettes as well as the nicotine replacement medications have a very bad effect on the skin following surgery and can result in poor healing with areas of skin loss. Therefore, no smoking, nicotine replacements, or supplements following surgery for at least 1 week. Drugs that suppress the desire to smoke, such as Zybanâ can be used. Our staff will prescribe this for you if you wish. See also "Effects of Smoking".

Should I be on a special diet before surgery?
No. We suggest that you be on a well-balanced diet. Avoid radical or weight-reducing diets prior to surgery. You may take vitamin and mineral supplements, but avoid health-food supplements the ingredients of which are uncommon and may have drug effects.

Are there special medicines that I should take before surgery?
Our staff will provide you with preoperative instructions that include any medicines or supplements that we wish you to take. You should, of course, inform us of any medications that you are taking regularly or which your own doctor has prescribed. If those will not interfere with surgery or anesthesia, we will allow you to continue to take them. Otherwise, supplements such as iron, vitamin K, Vitamin C, Beta Carotene are all right. But Vitamin E needs to be eliminated beginning 2 weeks prior to surgery, as it causes prolonged bleeding.

Will I need any special tests before surgery?
Yes. You will be asked to have a complete pre-operative medical history, physical examination, and laboratory tests before surgery. Especially as this is elective surgery, we need to be sure that you are in good health. These can be performed either by your own physician or our staff will recommend a physician or a Physician Assistant to complete these for you.

How soon can I lie in the sun or use a tanning bed?
You need to protect the areas that have been liposuctioned from the sun until all bruising has completely disappeared. Otherwise, you will find that the skin will take-on a pigmentation that looks as if the skin is "dirty". This is from iron pigment being deposited and fixed in the skin by the sun-tanning effect. In addition, early on in the healing course, when the skin doesn't have normal "feeling" (is a little numb), you could get a severe burn from sun exposure without being aware of it. Otherwise, (disregarding the skin cancer risks) as long as you protect the liposuctioned skin zones, you can be in the sun or tan other areas to your heart's content.

Will both sides of my body be completely even?
No. The body is not symmetrical to begin with. You are probably aware that your shoes don't fit exactly the same on both feet, and gloves don't fit exactly the same, as well. A woman will find that her breasts are not exactly the same either. This is normal human asymmetry. Liposuction will not be able to create perfect symmetry; you shouldn't expect it.

What about touch-ups?
It's not uncommon to need to perform a little adjustment to the final result. This probably wouldn't be for many months or even a year after the original surgery. It should be a minor bit of "tailoring" but would not include any additional fat that you gained (obviously, this should be avoided) in the interim.

Can you put the fat that you take out somewhere else?
Some small amounts of fat can be transplanted to areas such as the face or certain other small spots or divots and indentations. Such fat transplants, if done in a way that layers small quantities in various places, will have a good chance of "taking" and remaining for a prolonged period of time, though not permanently. However, large volumes can't be transplanted with any success. Transplanting fat to the breasts is contraindicated, as it becomes calcified and on a mammogram looks like a cancer.

Is there anything to be done if my skin is loose after the liposuction?
Depending on the area of loose skin, sometimes it's possible later on to remove excess skin and tighten the location. This is true of the abdomen, upper-inner thighs, and back of thighs in particular.

How much weight will I lose?
Remember, this is not a weight loss surgery. We have no idea as to how much weight will be lost. And, this is not as important as contour changes. A small weight loss can produce a major contour change.

Friday, August 29, 2008

Cosmetic Laser Surgery Procedures 101


If you have wrinkles on your face, especially around the mouth or eyes that can be seen by others across the dinner table, you most likely will benefit from facial resurfacing, also called laserbrasion, laser abrasion, or a laser peel.

On the other hand, if your wrinkles, or the beginning of them, can only be seen when you study your face in a triple-magnification mirror, you're probably a candidate for alphahydroxy acids, Renova, and other beauty-before-the-beam measures, and not a laser peel - just yet.

Facial resurfacing is not a face lift! A face lift is a surgical procedure that has more to do with lifting the cheeks and recontouring the neck to counteract the effects of gravity. It is a "nip and tuck" that removes sagging, unwanted skin and extra fat deposits. No laser peel can correct these problems but it can improve the appearance of lines and wrinkles on the face. After a laser peel, in fact, it is not uncommon for people to appear ten to twenty years younger than their actual age!

In truth, lasers cannot make you look "light years" younger, but ten or twenty is another story. There is also no guarantee that your new face will "launch a thousand ships," but who wants to launch ships anyway!

If wrinkling is only in a limited area of the face, a person may opt for a perioral laser peel, which removes the fine lines in the "mustache" area of the upper lip as well as lipstick "bleed lines," and/or a periorbital laser peel, which removes the fine lines around the eyes (in the area covered by ordinary eyeglasses). In addition, there is the laser peel of the nose, which eliminates many effects of sun damage, or a laser peel of the earlobes, which improves the wrinkles on and dramatically shrinks their size.


Also called upper blepharoplasty, this laser procedure removes a crescent of skin and some underlying fat from the upper eyelids to correct their drooping or sagging. Anyone with droopy, overhanging upper lids that diminish the appearance, seem to impair vision, or obscure the area where eye shadow is applied, is a good candidate for this procedure.

A laser-assisted transconjunctival lower-lid blepharoplasty is a procedure that removes excess fat from the lower eyelid. Anyone with "bags" or puffy lower lids is most likely a candidate for this procedure.


Candidates for this procedure have depressed acne or chickenpox scars that indent the skin. After resurfacing, when the skin heals, a new band of horizontal collagen forms in the upper layers of the skin, greatly improving the skin's contour and tightening its overall appearance. While this procedure can erase years of heartache, it involves a warning: anyone who has taken Accutane for cystic acne must not have laser treatment for one to two years after discontinuing the medication.


Remember the bulbous red nose of W.C. Fields? He suffered from rhinophyma, a condition that is characterized by a gradually enlarging, reddened, and misshapen nose with enlarged pores. This is a condition that makes people very self-conscious but with laser resurfacing it vanishes within minutes.

Resurfacing lasers also treat a variety of other skin conditions:

* Seborrheic keratoses, the common wart-like brown growths that appear to be "stuck on" to the surface of the skin.

* Warts ~These common and often distressing flesh-colored bumps are caused by the human papilloma virus and have the potential to spread and persist for years.

* Scars and keloids.


In this condition tiny blood vessels under the skin "break," dilate and, increase in number, causing flushing in the central portion of the face around the cheeks and nose. Quite common in women, it is often (but mistakenly) called "adult acne." It affects thirteen-million Americans. The problem is eliminated with laser treatment, but it may return, requiring follow-up treatments.


It is always distressing when a baby is born with a port-wine stain, particularly one that covers a beneath portion of the face. This dense network of blood vessels the surface of the skin enlarges as the child gets bigger and never goes away on its own.

Laser surgery, performed in several sessions, is tremendously effective in eliminating port-winestains. But before such surgery is undertaken, a child must be fully evaluated to rule out other, rare conditions that might account for the stain.

The laser(s) that is used for red problems also treats a variety of other skin conditions:

* Hemangiomas ~ These "strawberry marks" usually disappear on their own. However, if they interfere with a vital function, laser treatment can help them disappear safely and more quickly.

* Scars, keloids, warts, spider veins, psoriasis, Kaposi's sarcoma, and miscellaneous vascular lumps and bumps can also be treated with the laser that treats red problems.


Typically, stretch marks occur as a result of pregnancy, adolescent growth spurts, weight lifting, or rapid weight gain in areas that have undergone extensive stretching such as the hips, tummy, and breasts. The hormone estrogen seems to play a role in their development.

Cocoa butter and other "potions" that promise to firm the slackened skin and prevent or heal stretch marks do little to improve their appearance. However, they may diminish slightly with the daily application of Retin-A or alphahydroxy acids. Laser treatment is highly effective.


Also known as sun spots, liver spots, or large freckles, these blemishes are largely the result of life-long sun damage. Sometimes, topical medications, bleaching creams, or alphahydroxy acids can lighten the spots, but the appropriate laser eliminates them in one easy treatment.

The laser(s) that is used to treat these brown problems also treats a variety of other skin conditions:

* Cafe-au-lait spots are flat, light brown, or tannish lesions - which are the color of coffee with milk and always benign. They are, however, a cosmetic nuisance and often respond to the laser.

* Dark circles ~ Many people hate the raccoon-like appearance that the dark circles under their eyes create. Again, laser can improve them.

* Beauty marks are really moles that, for the most part, are not beautiful. These, along with other large and small nevi, can often be improved with laser surgery. But sometimes laser surgery is not the best way to remove these spots. Beauty and the Beam explains why.

* Melasma (or chloasma) ~ Commonly called "the mask of pregnancy," this discoloration of the skin often disappears after childbirth but can also be treated safely with the appropriate laser, as can a variety of other conditions which are covered in Beauty and the Beam.


An estimated ten million people in the United States have at least one tattoo. Female college students account for the application of fifty-thousand to one-hundred thousand tattoos a year, while ten percent of adult males sport at least one. Yet, more than half of all people with tattoos eventually regret having them and many want them removed.

If a tattoo is comprised of different colors, several lasers are commonly used to remove it, each one targeting different-colored tattoo inks. While the procedure only takes a few minutes, several treatment sessions may be required. The good news is that the result will last forever, although in some cases trace pigments of the tattoo may be visible.


There are a variety of reasons why women seek out physicians or paraprofessionals trained in micropigmentation - the art of depositing small amounts of colored pigments into the skin. Whether they choose permanent make-up to add color to their eyebrows or to create eye liners, lip liners, or even rouge for their cheeks, the goal is the same: cosmetic enhancement. But sometimes women change their minds and want the "permanent" make-up removed. The same laser methods used to remove body tattoos are used to remove permanent make-up. For both, however, risks exist, which are spelled out in Beauty and the Beam.


Varicose and spider veins have a great deal to do with family inheritance. Simply, genes play a big role in who does and does not get them. But inheritance is not the only risk factor. Women who are overweight, have frequent pregnancies, or take birth control pills or estrogen and progesterone replacement are also vulnerable to varicosities and to the little spider veins that have such a rude and unexpected way of making themselves apparent. The situation is aggravated as well by wearing clothing that is tight around the waist, standing in one place for long periods, prolonged sitting, the habitual crossing of one leg over the other, and straining from constipation.

Many women try compression stockings to improve circulation and reduce discomfort, although they don't eliminate the veins. Others opt for sclerotherapy, which involves injecting a chemical solution into a vein, which causes the vein to collapse and disappear. Lasers or light sources are the newest, non-invasive way to zap these unsightly veins.


Photorefractive keratectomy, or PRK, is the surgery performed with the excimer laser that, since FDA approval in 1996, has been allowing nearsighted Americans to throw away their eyeglasses!

Nearsightedness occurs when light enters the eye and focuses at a point in front of the retina, causing close-up vision to be clear and distant objects blurry. In just a few minutes, the excimer laser changes the shape of the eyeball and often restores vision to 20/20! (Read a detailed description of this exciting laser procedure in Beauty and the Beam.)


Dentists who practice cosmetic dentistry can now recontour overgrown gums and give their patients the smiles they always dreamed of. Although not every one with gingival (gum) overgrowth is eligible, many are. (Read a detailed description of this laser procedure in Beauty and the Beam.)


In the same way, tooth whitening has been revolutionized by laser technology. Some people even find that their childhood tetracycline stains and adult nicotine stains are removed. (Read a detailed description of this laser procedure in Beauty and the Beam.)


In a recent study, nineteen percent of subjects described themselves as habitual snorers, while twenty-four percent of males and fifteen percent of females said they sometimes had a problem with snoring. Snorers don't enjoy peaceful sleeps; they usually find it hard to wake up and go through the day feeling uncharacteristically fatigued. And anyone who sleeps with a snorer suffers from both sleep deprivation and aggravation. Occasionally, snoring may be a sign of a more serious condition known as sleep apnea, a momentary cessation of breathing. Laser surgery, specifically the LAUP procedure (or, more complicatedly, laser-assisted uvulopalatoplasty) can eliminate snoring! (Read a detailed description of this laser procedure in Beauty and the Beam.)


Most women are enslaved to their tweezers, bleaching creams, razors, and depilatories, or to the aestheticians who perform electrolysis or waxing on the hair of their upper lips, eyebrows, arms, legs, and bikini areas. Every week they must attend this ritual, week in and week out, year in and year out, over a lifetime.

In contrast, laser hair removal is so efficient and rapid that small areas can be treated in seconds and large areas can be treated in minutes without the risk of contamination or scarring; electrolysis of the same areas would take months of weekly visits. However, the jury is still out about how "long-lasting" or "enduring" the resuls will be. (Read a detailed description of this laser procedure in Beauty and the Beam.)


Women may have an interest in removing body hair, but men, by and large, are the ones who are interested in adding it - particularly to the head. Most men, when they find themselves losing hair, "try everything" to bring it back, from toupees and wigs to special shampoos and conditioners to hair thickeners and even vibrating hair brushes that promised to "stimulate" hair growth. Others try Rogaine (minoxidil), a topical, over-the-counter drug that promises to retain or restore the hair that seems destined for the shower floor.

Laser-assisted hair transplants seem better than all these methods but, again, the jury is still out about whether the laser offers any advantage over a traditional hair transplant. With this procedure, the experience of the laser surgeon is paramount; he or she must have a good cosmetic eye for achieving a natural hairline. (Read a detailed description of this laser procedure in Beauty and the Beam.)