Liposuction, or liposculpture is the most common cosmetic surgical procedure in the United States. Traditionally, liposuction was associated with an outpatient surgical setting, where excess fat was removed and patients experienced rapid recovery and gratifying results.
In recent years, procedures have become more ambitious with larger amounts of fat being removed. Though this progress frequently allows for more dramatic results, it has unfortunately been associated with serious complications, including death. Because liposuction remains an attractive cosmetic procedure, patients want to know if liposuction is fundamentally safe and, if so, how they can make sure their particular procedure is done safely.
Liposuction is conceptually simple. A healthy patient with areas of excess fat has these areas reduced by vacuuming the fat through small metal tubes called cannulas. This procedure is frequently done on an outpatient basis under general anesthesia in the hospital or accredited surgical facility.
Most liposuction begins with the surgeon infiltrating a special solution into the fatty tissues to be suctioned. This solution is mostly salt water, but also contains adrenaline to reduce blood loss and may contain a local anesthetic to reduce pain. Following the injection of this "tumescent" fluid, fat removal begins. In certain cases, the initial phase of liposuction involves ultrasound cannulas that loosen the fat to be removed. This is followed by standard liposuction, where a vacuum is employed to remove the excess fat.
At the end of the procedure, the patient is placed in a compression garment to reduce postoperative swelling. In most cases, the patient is discharged home the same day and returns to work in a few days. When more significant fat removal is performed (greater than 10 pounds), patients are usually observed overnight.
It sounds so simple, so how could anything go wrong? Easy – each factor in liposuction can be critical to a safe outcome. For instance, if the patient is not healthy, even liposuction can result in significant problems, such as a heart attack or trouble breathing. If the surgeon is overly aggressive in fat removal, excessive blood loss can occur. If the anesthesia is not administered properly, too much fluid can be given with serious consequences. If the surgical facility is poorly maintained, infections can be more frequent and lifesaving equipment might not be available in an emergency.
There Are a Few General Factors that Influence the Safety of Liposuction:
Patient: Liposuction is for healthy patients who are within about 40% or their ideal body weight. Liposuction is not intended to be a strategy for weight loss. Obese patients should be considered only rarely. Patients with significant heart or lung disease are not candidates.
Doctor: Ideally, liposuction should be done by surgeons familiar with all facets of liposuction, including the tumescent technique and ultrasound-assisted liposuction. Board certification, preferably by the American Board of Plastic Surgery, is mandatory. This ensures that a national organization feels this surgeon is competent and safe. Additionally, and equally as important, the surgeon should have privileges to perform the procedure in a local hospital. Such privileges mean the surgeon has demonstrated to his or her peers locally that he or she is capable of performing the procedure safely.
Anesthesiologist: Whether general anesthesia is being used or not, all patients undergoing liposuction should be monitored by someone other than their surgeon. This is preferably done by a board-certified anesthesiologist, but can also be done by an experienced, certified registered nurse anesthetist. Experience is essential as it can be difficult to manage liposuction patients, especially during a large volume liposuction.
Facility: Liposuction should always be performed in a hospital or accredited surgery center. The surgery center should be approved by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). This certifies that the facility is of the highest quality. Frequently, I hear of patients who have undergone liposuction done under local anesthesia without proper monitoring, who have done well. I try to point out that just because the surgery was successful, it does not mean it was performed safely. Since liposuction is a real operation with real risks, the conditions for the procedure should be the same as those for any other surgical procedure such as a hysterectomy. Accepting anything less is simply making liposuction more risky than it needs to be.
Liposuction is like any operation in cosmetic surgery in that it can have unsatisfactory results. Specifically, too much or too little fat can be removed, contour irregularities can develop and swelling can be prolonged. However, when adequate precautions as outlined above are taken, life-threatening complications should be exceptionally rare. When done properly by an experienced surgeon in an accredited facility, liposuction remains an extremely safe and effective way to improve one’s shape by fat removal.
Liposuction is real surgery and involves risks such as bleeding, infection and scarring. Results will vary.
Showing posts with label Surgery. Show all posts
Showing posts with label Surgery. Show all posts
Tuesday, January 6, 2009
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.
Insurance
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
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.
Insurance
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
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:
STEP 2: Examine each of these zones separately and evaluate the aging process:
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.
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?
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:
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.
Anesthesia
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
Getting Started
If you are considering a cosmetic medical procedure, consult a board-certified plastic surgeon about the process, risks, recovery time and costs.
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.
Anesthesia
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).
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).
Friday, August 29, 2008
Cosmetic Laser Surgery Procedures 101
LASER PEEL FOR WRINKLES
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.
EYELID SURGERY
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.
RESURFACING OF ACNE SCARS
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.
RED-NOSE SYNDROME (RHINOPHYMA)
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.
ROSACEA
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.
PORT-WINE STAINS
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.
STRETCH MARKS
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.
AGE SPOTS
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.
TATTOOS AND TATTOO REMOVAL
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.
PERMANENT MAKE-UP REMOVAL
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.
REMOVAL OF LEG VEINS
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.
NEARSIGHTEDNESS
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.)
GUM RECONTOURING
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.)
TOOTH WHITENING
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.)
SNORING
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.)
LASER HAIR REMOVAL
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.)
LASER HAIR TRANSPLANTATION
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.)
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.
EYELID SURGERY
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.
RESURFACING OF ACNE SCARS
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.
RED-NOSE SYNDROME (RHINOPHYMA)
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.
ROSACEA
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.
PORT-WINE STAINS
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.
STRETCH MARKS
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.
AGE SPOTS
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.
TATTOOS AND TATTOO REMOVAL
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.
PERMANENT MAKE-UP REMOVAL
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.
REMOVAL OF LEG VEINS
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.
NEARSIGHTEDNESS
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.)
GUM RECONTOURING
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.)
TOOTH WHITENING
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.)
SNORING
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.)
LASER HAIR REMOVAL
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.)
LASER HAIR TRANSPLANTATION
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.)
Monday, December 24, 2007
Choosing a Surgeon procedure can often be a long and difficult one
The process of choosing the correct surgeon for a cosmetic or plastic surgery procedure can often be a long and difficult one. There is no shortage of qualified doctors in almost every field of cosmetic surgery, yet there are also less scrupulous and less qualified individuals who are also competing for your business. Just because a doctor is offering a lower rate for services does not necessarily mean that he or she has less experience or is less skilled as a surgeon. However, an extraordinarily below market price for a particular procedure should be a warning sign to research the background of the physician extensively, setting up contact with previous patients whenever possible.
Of course, certain factors, such as geographic location, availability, and cost, are always going to be major influences on your decision to go with one surgeon over another. Yet, some of the others that should be given equal consideration are the facilities out of which the doctor is operating. Is the doctor affiliated with an accredited hospital? and if so, which one(s)? Will your procedure be performed in a hospital or ambulatory care center or will the surgery take place in the office of the doctor? These are all important and legitimate questions, which are often overlooked when cost considerations and techniques become the focus of the discussions.
It is always a good idea to focus on the individual patients that your prospective surgeon has handled in the past -- not simply before and after photographs. Ask about the entire procedure, from initial consultation through follow-up appointments. Cosmetic surgery is an especially sensitive area of surgical practice and often requires a higher level of patient care and re-assurance, since all of the work of the doctor is going to be readily visible on the body of the patient - permanently.
Of course, certain factors, such as geographic location, availability, and cost, are always going to be major influences on your decision to go with one surgeon over another. Yet, some of the others that should be given equal consideration are the facilities out of which the doctor is operating. Is the doctor affiliated with an accredited hospital? and if so, which one(s)? Will your procedure be performed in a hospital or ambulatory care center or will the surgery take place in the office of the doctor? These are all important and legitimate questions, which are often overlooked when cost considerations and techniques become the focus of the discussions.
It is always a good idea to focus on the individual patients that your prospective surgeon has handled in the past -- not simply before and after photographs. Ask about the entire procedure, from initial consultation through follow-up appointments. Cosmetic surgery is an especially sensitive area of surgical practice and often requires a higher level of patient care and re-assurance, since all of the work of the doctor is going to be readily visible on the body of the patient - permanently.
Thursday, January 6, 2005
Cosmetic Surgery is Increasing in Popularity
Is Everyone Doing It?
Cosmetic Surgery is Increasing in Popularity — for Some Very Good Reasons. Not so long ago, cosmetic plastic surgery was one of those "does she or doesn’t she?" topics. Except for obvious celebrity transformations such as Ivana Trump and Cher, many people couldn’t be sure why even a good friend looked so rested and relaxed after a recent trip to Manhattan or southern California. On the newsstand, articles about cosmetic plastic surgery were generally confined to magazines devoted to health. Today, however, cosmetic surgery has become a popular subject at suburban cocktail parties, coffee shops and in the workplace.
Articles about microdermabrasion ("Improve your complexion on your lunch hour!"), collagen injections ("Kiss your thin lips goodbye!") and other cosmetic surgery trends can be found every month in high profile fashion magazines such as Vogue, Harper’s Bazaar and Elle.
An Affordable Option for Millions of Americans
No longer the private domain of wealthy women, cosmetic surgery is rapidly becoming an affordable option for millions of Americans. Recently, a vibrant 73 year old woman approached a plastic surgeon at a Minneapolis cocktail party. Smiling, she said "I know who you are, I know what you do and I’ve been thinking about breast implants." As they chatted, she told him that she was a widow and that she felt it was time to do something that made her feel good about herself. She said "I could go out and buy a whole new wardrobe, but I want to do something more meaningful for myself. I realize there will be some risk, some pain and some recovery time associated with the surgery, but to me, it’s worth it." As the surgeon recounted their conversation, he smiled and said "This woman’s vitality, confidence and realistic expectations make her an ideal candidate for cosmetic surgery. I’d be honored and delighted if she chooses me to be her surgeon."
Over One million Procedures in 1998
According to statistics published by the American Society of Plastic and Reconstructive Surgeons (ASPRS), the number of cosmetic surgery procedures has increased 50 percent over the last two years and 153% over the last six years, to top the million mark at 1,045,815 in 1998. Liposuction, at 172,079 procedures, (a 57% increase since 1996 and a 264% increase since 1992) remains the most commonly performed cosmetic procedure in the United States, followed by breast augmentation at 132,378 procedures (a 51% increase since 1996 and a 306% increase since 1992), eyelid surgery (120,001 procedures), facelifts (70,947 procedures) and chemical peels (66,002 procedures).
Cosmetic Surgery for Aging Baby Boomers
The ASPS has identified a number of trends that account for these dramatic increases in the number of cosmetic surgery procedures, including the vast number of aging baby boomers, the increasingly competitive workplace and the general decrease in the cost of cosmetic surgery. According to American Demographics, over the next ten years, a baby boomer will turn 50 every 8 seconds. Since 1996, when the first boomer turned 50, the number of cosmetic surgery procedures in this age group rose from 164,662 (1996) to 242,427 (1998), an increase of 47%. Says Paul Schnur, MD, ASPRS president, "Due to healthier lifestyles, men and women age 50 and older are feeling good about themselves and want to maintain a youthful appearance. As this large segment of the U.S. population ages, we anticipate the increase in cosmetic surgery to continue."
Competitive Workplace Pressures
Increased pressures in the workplace are one reason that 9 percent of all cosmetic procedures are performed on men. In bold letters, the cover of Fortune magazine (February 1) declares that experienced executives are "Finished at 40." Inside, the article states that "…a new trend is emerging: In corporate America, 40 is starting to look old." To combat the painful reality of this trend, more and more men are choosing liposuction to eliminate their not so lovable love handles, blepharoplasty to adjust their drooping eyelids and facelifts to boost their sagging jowls. Wrinkles, crows feet and other tell-tale signs of aging are being erased with laser skin resurfacing and chemical peels. Says Dr. Schnur, "More and more men are having cosmetic surgery, not only to look and feel younger, but also to give themselves a competitive edge in the workplace."
"I don’t Want to Look Like my Mother!"
Another reason why cosmetic surgery appeals to the baby boom generation is the ability to minimize their resemblance to their parents. As the first generation to dramatically redefine adulthood in America, both men and women boomers are loathe to let Nature take its toll. Says John M., a successful 49 year old business owner, "I run and do push-ups every morning, even when I’m on the road. I watch what I eat and I just got some hip new eyeglasses. Despite my best efforts, whenever I look in the mirror, I see my dad staring back at me!"
Says Claire N., a striking woman in her early 40’s, "I’m comfortable with my age – I didn’t mind turning 40 at all. However, when someone tells me that I look like my mother, I feel like crying!" When asked if she’d consider cosmetic surgery, Claire admits that she’s already scheduled a cosmetic surgery consultation as a birthday gift to herself.
Active, youthful boomers are not the only ones choosing cosmetic surgery. More seniors age 65 and over are choosing to enhance their retirement years with cosmetic surgery. Like the boomers, the most popular procedures with seniors are eyelid surgery, facelifts, liposuction and laser resurfacing. While many Americans may question the decision to undergo surgery at an advanced age, thousands of others would no doubt agree with the vibrant 73 year old Minneapolis woman when she says "I just want to feel good about myself again."
Cosmetic Surgery is Increasing in Popularity — for Some Very Good Reasons. Not so long ago, cosmetic plastic surgery was one of those "does she or doesn’t she?" topics. Except for obvious celebrity transformations such as Ivana Trump and Cher, many people couldn’t be sure why even a good friend looked so rested and relaxed after a recent trip to Manhattan or southern California. On the newsstand, articles about cosmetic plastic surgery were generally confined to magazines devoted to health. Today, however, cosmetic surgery has become a popular subject at suburban cocktail parties, coffee shops and in the workplace.
Articles about microdermabrasion ("Improve your complexion on your lunch hour!"), collagen injections ("Kiss your thin lips goodbye!") and other cosmetic surgery trends can be found every month in high profile fashion magazines such as Vogue, Harper’s Bazaar and Elle.
An Affordable Option for Millions of Americans
No longer the private domain of wealthy women, cosmetic surgery is rapidly becoming an affordable option for millions of Americans. Recently, a vibrant 73 year old woman approached a plastic surgeon at a Minneapolis cocktail party. Smiling, she said "I know who you are, I know what you do and I’ve been thinking about breast implants." As they chatted, she told him that she was a widow and that she felt it was time to do something that made her feel good about herself. She said "I could go out and buy a whole new wardrobe, but I want to do something more meaningful for myself. I realize there will be some risk, some pain and some recovery time associated with the surgery, but to me, it’s worth it." As the surgeon recounted their conversation, he smiled and said "This woman’s vitality, confidence and realistic expectations make her an ideal candidate for cosmetic surgery. I’d be honored and delighted if she chooses me to be her surgeon."
Over One million Procedures in 1998
According to statistics published by the American Society of Plastic and Reconstructive Surgeons (ASPRS), the number of cosmetic surgery procedures has increased 50 percent over the last two years and 153% over the last six years, to top the million mark at 1,045,815 in 1998. Liposuction, at 172,079 procedures, (a 57% increase since 1996 and a 264% increase since 1992) remains the most commonly performed cosmetic procedure in the United States, followed by breast augmentation at 132,378 procedures (a 51% increase since 1996 and a 306% increase since 1992), eyelid surgery (120,001 procedures), facelifts (70,947 procedures) and chemical peels (66,002 procedures).
Cosmetic Surgery for Aging Baby Boomers
The ASPS has identified a number of trends that account for these dramatic increases in the number of cosmetic surgery procedures, including the vast number of aging baby boomers, the increasingly competitive workplace and the general decrease in the cost of cosmetic surgery. According to American Demographics, over the next ten years, a baby boomer will turn 50 every 8 seconds. Since 1996, when the first boomer turned 50, the number of cosmetic surgery procedures in this age group rose from 164,662 (1996) to 242,427 (1998), an increase of 47%. Says Paul Schnur, MD, ASPRS president, "Due to healthier lifestyles, men and women age 50 and older are feeling good about themselves and want to maintain a youthful appearance. As this large segment of the U.S. population ages, we anticipate the increase in cosmetic surgery to continue."
Competitive Workplace Pressures
Increased pressures in the workplace are one reason that 9 percent of all cosmetic procedures are performed on men. In bold letters, the cover of Fortune magazine (February 1) declares that experienced executives are "Finished at 40." Inside, the article states that "…a new trend is emerging: In corporate America, 40 is starting to look old." To combat the painful reality of this trend, more and more men are choosing liposuction to eliminate their not so lovable love handles, blepharoplasty to adjust their drooping eyelids and facelifts to boost their sagging jowls. Wrinkles, crows feet and other tell-tale signs of aging are being erased with laser skin resurfacing and chemical peels. Says Dr. Schnur, "More and more men are having cosmetic surgery, not only to look and feel younger, but also to give themselves a competitive edge in the workplace."
"I don’t Want to Look Like my Mother!"
Another reason why cosmetic surgery appeals to the baby boom generation is the ability to minimize their resemblance to their parents. As the first generation to dramatically redefine adulthood in America, both men and women boomers are loathe to let Nature take its toll. Says John M., a successful 49 year old business owner, "I run and do push-ups every morning, even when I’m on the road. I watch what I eat and I just got some hip new eyeglasses. Despite my best efforts, whenever I look in the mirror, I see my dad staring back at me!"
Says Claire N., a striking woman in her early 40’s, "I’m comfortable with my age – I didn’t mind turning 40 at all. However, when someone tells me that I look like my mother, I feel like crying!" When asked if she’d consider cosmetic surgery, Claire admits that she’s already scheduled a cosmetic surgery consultation as a birthday gift to herself.
Active, youthful boomers are not the only ones choosing cosmetic surgery. More seniors age 65 and over are choosing to enhance their retirement years with cosmetic surgery. Like the boomers, the most popular procedures with seniors are eyelid surgery, facelifts, liposuction and laser resurfacing. While many Americans may question the decision to undergo surgery at an advanced age, thousands of others would no doubt agree with the vibrant 73 year old Minneapolis woman when she says "I just want to feel good about myself again."
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