Facial Implants

Facial re-contouring for aesthetic purposes is a critical part of the overall process of aesthetic enhancement and rejuvenation. Weak chins, best viagra case absence of cheekbone definition, viagra salve flattened jaw bones and other areas of facial loss of contour, check volume and definition greatly impact on the overall aesthetic appearance. The early implants were either rib, bone or cartilage, harvested from the patient and carved meticulously into the desired and individualized shape. Some synthetic materials such as paraffin were also used but were problematic and much less desirable.

In the early 70′s, silicone implants became available, mostly for chin implants. There was a limited selection, and the implant configurations were less than ideal. Blocks of silicon rubber were also available, and many doctors found it more desirable to carve their own implants. Over time the selection of implant types exploded and the implants were computer designed into anatomically desirable shapes. Other non silicon materials were also used.

Today, there is an abundance of commercially available implants , anatomically designed in myriad sizes and configurations. They have made facial re-contouring a more predictable and less complicated process.

Chin Implants: The most widely used of the facial implants and used to correct the weakened chin, Lengthen the shortened chin if necessary, help correct jowl deformities. These implants, most are made of soft silicone, are inserted either through the inner aspect of the lower lip or from a small incision under the chin. They are extremely valuable in nasal surgery to balance out the facial profile and also in facelift surgery where a weakened chin contributes to the appearance of aging and detracts from a youthful neck.

Cheek Implants: Absence of cheekbone definition is of concern to many patients. There are a wide variety of sizes and they are made of silicone rubber. There are many other types of cheek implants available to address different needs and some are made of different forms of synthetic material. The cheek implants are mostly inserted from an incision inside of the upper lip but can also be inserted from a lower eyelid incision or through a facelift incision.

Jaw (Mandibular) Implants: Much less widely used but very valuable in those cases where the lower jawbone is too narrow. They are inserted through the mouth and most are made, again, of silicone rubber, although other materials are used.

Other Areas: For other areas of facial depression such as the forehead or temporal area, implants are available. Although, for these areas, custom carved implants may be more desirable.

It is important to note that today there are many injectable materials available which have a definite and growing role in facial re-contouring. They are not permanent, however, and repeat injections will be necessary at some point. That said, most patients are very satisfied and of course there is no surgery, no anesthesia and little if any downtime.

Breast Augmentation

Breast augmentation is today, sildenafil cialis as it has been for many years, viagra the number one operation performed on women. Last year, view over 350,000 breast augmentations were performed in America. Even during the worst economic period of the last 10 years, this number did not waver. Breast implants have come a long way since the development of the modern silicone implant by Doctors Cronin, Biggs and Gerow in Houston, Texas in the early 1960s. We now have the fifth generation of silicone implants which are more natural, highly cohesive, and have thinner, stronger and nonporous shells. Today there are only three companies that can sell implants in the United States: Sientra, Mentor and Natrelle. All of the products are equally good.

Breast augmentation procedures are routinely performed on an outpatient basis, most frequently under sedation, and takes between one and two hours to perform. Implants are most frequently placed through an incision in the lower half of the areolar or through an incision in the lower portion of the breast. The final implant position can either be completely under the breast or partially submuscular with the upper portion of the implant under the pectoralis major muscle.

While there is always a risk of bleeding, infection and nerve damage, these complication are of a low order. The most common problem since the inception has been capsular contracture where the implants feel hard and at times move out of position. This problem is well on its way to being resolved and patient satisfaction is very high.

Bra Fat, Where It’s At

Many of my patients complain about the fat that bulges out around the bra like rising loaves of bread. It shows below the bra, best cialis unhealthy above the bra and surrounds the bra straps. Clearly visible through most garments it is another sign of the aging process. Fortunately it can be treated with liposuction using power assisted technology. The fat of the back is more difficult to remove than, for example, the fat of the hips, or love handles or knees.. There is usually more bruising associated with removal of the bra bulge fat. It normally takes three weeks to see the result and about the same time for the bruising to be largely gone. These factors, not withstanding, the patient satisfaction level is very time. There is minimal down time. One is back to full activity the next day in most cases.

Beauty On the Inside Out

My mother was committed to finding the perfect dates for me but when she added, generic viagra viagra as she frequently did, viagra sales treat her infamous disclaimer, purchase “and she is beautiful on the inside” I knew immediately that, the “outside” was not quite right. It was for me, at that time, the ultimate deal breaker. Of course, my mother turned out to be right, because beauty on the inside is forever and beauty on the outside is a fifty billion dollar a year business.

People have divergent views on what beauty really is but it is unquestionably societal and cultural and mystical. And let us start out by dispelling the rumor that plastic surgeons create the standards for beauty and have the power to establish beauty fads and trends. We excel at making dinner reservations and planning elaborate trips but establishing the ground rules for beauty, not even close. Beauty standards are established and nurtured by television, the movies and the media. They decide what is acceptable for presentation and publication. It has been shown in multiple studies that you have a much better chance to be hired if you are taller, thinner and more attractive. Look who presents the news on local and national TV. Handsome guys and beautiful ladies. You mean no short fat balding man can get a handle on the news and there is not a heavyset woman who understands what’s going on in the world? No, these people are chosen because they have the greatest appeal to the audience and this converts to advertising dollars.

So, where does the plastic surgeon fit in? Well, we are first and foremost, great technicians , master techno-artists, who can transform a this to a that. We are the levelers of the playing field and this is our greatest contribution. Parents can tell a young 16 year old daughter, who hates having a big nose, how intelligent she is and what a good a person she is (I have been there and done that) and they are right, but she is dreading going to the school dance nonetheless. But following a well done nose job, you can see the life and energy jump back into her life. Does this make her less intelligent, less good, less loving? Absolutely not! It can, however, make her feel much better about herself. Now if this same young lady loved her looks and loved her nose, then none of this applies to her. We are there for those who don’t look the way they would like, don’t age they way they would like and feel that societies aesthetic standards have passed them by. That is where we fit in. No, we don’t create or sustain standards of beauty. We just make it available for those whose genetics has denied them this reality.

Vaginal rejuvenation , Labioplasty and Buttock Augmentation

Statistics just published by the American Society for Aesthetic Plastic Surgery for 2013 show that two operations had far and away the biggest percentage increase in popularity over the past year (2012 to 2013).  The number of buttock augmentations performed went up by 58.2% and the number of labioplasties (vaginal rejuvenations) went up by 44%.  This is clearly reflected in my practice.  Buttock augmentations using mostly fat autografts (the patient’s own fat) has become a very much desired procedure.  It involves harvesting fat from a donor site on the body and injecting this fat into the buttocks providing not only an increase in volume but also a more youthful contour.

Vaginal rejuvenation procedures  include shortening of elongated labia minora, viagra sales illness revision and rejuvenation of the aging and often hanging labia majora and revision and shortening of the overhanging clitoral hood.   The interest in these procedures has grown exponentially over the last several years and the patients run in age from women in their early twenties to ladies in their late fifties and sixties.

Technology in Aesthetic Surgery

Percy Bysshe Shelley and Steven Jobs worked at opposite ends of the spectrum, generic viagra buy viagra yet the world needed both of them. Shelley was an early 19th century romantic poet and Jobs, there through the creation of Apple, viagra became the personification of modern technological advancements. Each of them contributed to this world, making it a better place to live.

Aesthetic plastic surgery is a function of artistic perception and technology. They are, in fact, inseparable. The plastic surgeon must fully grasp the artistic and totally humanistic end point. The surgeon then uses all of his/her procedural and practical skills, employing all of the meaningful technology available, to achieve that goal, a goal which is the fusion of art and science.

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Going Under the Knife: A Plastic Surgeon’s Checklist of Things to Consider

Plastic surgery can be glamorized by the media, viagra sales thumb often making it appear to be an event nearly analogous to choosing new makeup or a new hair style.  Nothing could be further from the truth.  There are many factors that should go into one’s thought process when considering elective cosmetic surgery.  The first and most important consideration is to recognize that it is a surgical procedure.  Any surgery brings with it attendant risks and possible complications, as well as many benefits, and one should consider all of them carefully.

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Liposuction: The Institution that Works

shutterstock_90551683Liposculpture was first performed in France in 1929, best cialis site but the real renaissance, cialis sale sildenafil a veritable explosion really, there occurred in the mid 1970’s in, of course, France. I wrote a poem once on liposuction and the only line worth repeating from it is, “Liposuction simply that/In goes tube, out goes fat.”

Clearly e.e. cummings need not be concerned, but the description is valid. From the very beginning right up to the present time, this is the way it works and it works well. Liposuction is the most common cosmetic procedure performed in this country. Yet something happened along the way. People felt the need to improve upon something that was already working great. Early on there was internal ultrasonic liposuction and its cousin, external ultrasonic liposcupture, and then the real scientists got involved and there was laser, vaser, infrared, water jet, the use of freezing, heating, beating and depleting, and then new versions of the ultrasonic energy, HIFU (not a Japanese dish), and a liposuction device that actually comes with an IQ rating, Smart. Continue reading