Saturday, October 30, 2010

Butt Augmentation

If your back-side just isn’t cutting it for you, maybe you’ve been thinking of a buttock augmentation. There are two types, the butt lift or implants.

The butt lift, often called the Brazilian butt lift, involves a combination of removing fat from certain areas around the butt and adding fat to certain areas. Often the fat that is injected back into the patient comes from the fat removed from the butt and other areas like the stomach or any other problem areas on the patient. The fat will be processed before it is re-injected. This process is like sculpting the patient’s buttocks—the doctor removes stuff from areas that it should be, while adding to areas that need more volume. Below are some examples of before and after for a Brazilian butt lift. As you can see, this procedure is great for giving the buttocks a younger, perkier appearance.

The other option is to have implants placed in. These implants are not like breast implants—they are made of a VERY strong material, which is what you would expect because they will have a great deal more force placed on them on a regular basis compared to breast implants. A small incision is made and the implant is inserted right above the muscle and underneath the layers of connective tissue material (called fascia). The scarring that results from this procedure is negligible and most often is not visible in the long term.

The recovery from this surgery is pretty serious, you are not supposed to sit on your butt directly for up to three weeks. This means that if you have a job or pretty much any other obligations, you’re going to need to make other arrangements. You may be a bit surprised when you hear the cost for a Brazilian butt lift, but make sure you keep in mind that not only are you getting a butt lift, you are also going to be getting liposuction. Below is an example of a patient who received butt implants.

This is one surgery where it is absolutely IMPERITIVE for you to pick the right doctor. These are delicate surgeries. I’m sure you’ve seen at least one news article about somebody who flew to South America to have a Brazilian butt lift performed and then died later from complications. Make sure your surgeon knows what he is doing! The process of purifying the fat after its removal from your body and before it is injected back into your butt is especially important, so make sure you speak with your doctor about how he does that.

Overall, deciding which of these methods is right for you is a tricky choice. Speak with a doctor who is well-practiced in both types of surgery and explain to him the results you desire. If you want to shape up that entire region, you will likely want to go with the butt lift; if you are just looking to add a bit more volume then perhaps implants are the better choice for you. One bonus for butt implants is that, many patients say, if you lose weight after the surgery it will not come off of your new butt. Either way, do your homework and find a reputable surgeon. Then, enjoy your new curves!

Image Source
Image Source

Thursday, October 28, 2010

Laser Hair Removal

Laser hair removal is all over the place right now. There are ads for it pretty much everywhere you look. It seems like an amazing procedure—painfree and permanent hair removal, who wouldn’t want to do it? However, it is not right for everybody. This procedure works best on those with light skin and dark hair. There are a variety of lasers on the market today and they are beginning to adapt to work on a wide range of skin and hair color combinations. These newer lasers are more effective at removing dark hair from patients with dark skin, so those of you with light hair will need to wait a bit longer (and keep your fingers crossed that they continue to make advancements in this field).

To start off with, laser hair removal works by targeting the melanin in your hair. Melanin in the hair follicle comes from melanocytes that are located in the lower layers of your skin. They produce melanin (a pigment) which then enters the growing hair. This is the same compound that gives people different skin colors. Minor genetic differences determine the location of the cells which is what makes hair (or skin) darker—if the melanocytes are located closer to the skin surface there is less time for the melanin to degrade and therefore the hair and skin will appear darker. The laser will target the hair follicle and destroy it which means it will no longer produce hair.

There are some choices to be made, and you will want to speak with several laser centers to find the best one for your hair/skin combo. An Alexandrite laser is often the laser of choice for those with pale skin—make sure that this is not the laser used if you have dark skin, it is NOT safe for dark-skinned patients! Patients with dark skin need a Nd:YAG laser (a neodymium-doped yttrium aluminium garnet laser) which is also effective on lighter tones. As a side note, the Nd:YAG laser is not only used for hair removal, but it can be effective in treating vascular problems like spider veins. The other option is a pulsed diode array laser which is best for pale or medium tones.

It may be scary to think that a laser will be used, but this procedure is painless. The laser will get warm, but they are always combined with a cooling system to prevent pain. This can be contact cooling (which is inside of the laser unit and will be touching your skin so it can keep the unit cool), air cooling (fored cold air that works in a similar manner), or a cryogen spray that is placed directly onto your skin.

Keep in mind that this is NOT a one-time thing. You will need multiple sessions; most people require 6-8 sessions for maximal results. With this being said, you will see immediate results after the first session. Your hair grows in cycles, not all of the follicles are active at the same time, so one treatment will kill all of the actively growing follicles but it will not get the ones that are inactive. This is why multiple treatments are necessary.

As with any procedure, it is important to find a skilled doctor to perform this. You may want to save money by finding the cheapest place possible, but make sure that they know what they are doing. The side effects if something goes wrong can be pretty rough and scarring is common among procedures that were done by inexperienced people.

The above image is to give you an idea of what a bad reaction can look like. Always make sure that the laser being used is the right type and at the right setting for your skin tone. Also, it is smart to have them do a test spot before treating your whole body.


Rhinoplasty, a nose job, is one of the most common procedures available today. This procedure is very delicate and even minor changes to your nose can drastically alter your appearance. Anything done on your face must be done very carefully simply because the face is the first thing people notice; nobody sees a few lumps on your thighs unless they are looking closely, but a hooked nose is definitely something people pick up. Rhinoplasty can be done for purely aesthetic reasons, or it can be done to improve functionality.

Reconstructive rhinoplasty often performed in conjunction with a septoplasty; this is designed to repair a damaged or uneven septum and restore your ability to breathe through your nose. Even a small trauma as a child could cause a deviation in your septum, and you may not even realize it is there until you get it fixed and realize how much better you can breathe. Other times, deviations can be accompanied by noticeable outer deformities (like bumps and crookedness). These problems can all be fixed in the same procedure. When you visit your doctor, make sure that you explain to him any troubles you have with your breathing. Oftentimes, insurance will pay for some (or even all, if you’re lucky) of the cost of the surgery if it repairs breathing ability. Overall, reconstructive and cosmetic procedures are quite similar. Unless you have had some severe trauma that has greatly damaged the underlying structure, they will all follow the same pattern.

A rhinoplasty may be open or closed. Open refers to having an incision across the skin between nostrils as well as inside the nostrils, while closed refers to incisions just inside the nostrils. Speak with your doctor about the results you would like to see, that is what will determine your incision type. Keep in mind that an open rhinoplasty will have a visible incision line, but it will not likely leave a noticeable scar. As you can see below, the scars in the nostril will be completely undetectable and there is only a tiny incision outside of the nose.

The first thing that your surgeon will do after he has made his incisions, will be to start working on removing the bump portion—if that is what you had discussed. Part of the bump is made of cartilage and part is made of bone. The cartilage portion can easily be removed with a scalpel but the bone section will require the use of a chisel like instrument. The doctor will then perfect the bridge of the nose using a file to fine-tune his work. Next, he will work to refine the tip of the nose. This can be done via a variety of methods, all depending on what you want altered and what is causing it. Common methods involve cutting out portions of cartilage from the tip or even suturing the tip closer together to make it narrower.

Here is the tricky part, if the bridge of the nose is too wide, or needs to be reshaped; the doctor will break the bones in order to reshape them properly. Below is a GREAT image that helps explain this without having to know a great deal of technical terminology. The bones on the outside will be broken which allows the doctor to move them into a position that makes the bridge smaller and places it in a better position.

If you are interested in altering the appearance of your nose but do not want to go the “full” surgery route, you can try for a modified rhinoplasty or a non-surgical one. A modified rhinoplasty is when the doctor one removes the bump portion of the nose and/or alters the tip. This process does NOT involve breaking any bones, simple filing or cutting away at the bone and cartilage. It will have a few days of soreness and bruising as a recovery period, but will provide a VERY natural result and is a great option for those who like their nose but want to change just a few small things.

Another option is called a non-surgical rhinoplasty—this procedure involves the injection of fillers to your nose to smooth out any bumps that you have. Keep in mind that it will NOT make your nose smaller, just remove bumps, so if a reduction in size is what you want you will need to go the surgical route. To give you an idea of what this procedure looks like, see the picture below. This type of procedure will not have the recovery time that the others do, although your nose will likely be a bit sort right afterwards.

Time to talk about the recovery process—a rhinoplasty can be a bit scary when you see recovery pictures since it results in a TON of bruising. Yes, you will be sore. Yes, you will be bruised. Yes, there will be swelling. And yes, there will be some discomfort—but the discomfort will last no more than 3 days and it’s really only going to be sore on day 2 or 3 if you spend time touching it or bump into something. The reason that you will experience all of these things is because your face has a fantastic blood supply. Any procedure will be recognized by your body as “trauma” and therefore your body will want to help heal from it. Increasing the blood supply (the swelling portion) will allow you to heal by rebuilding the bone that was broken and to finish closing where the incision was made. One major benefit of this is that since your face has such a good blood supply the healing time is fairly quick.

A typical rhinoplasty

Image sources:

Wednesday, October 27, 2010

More about breast augmentation

Although deciding which implant material you want for your breast augmentation is a big step, there are other important decisions to me made- like implant shape, incision type, and implant location.

To start with, there are different shapes of implants. Most people only think of the round ones but in fact there are more options available to you. Teardrop shaped implants are becoming quite popular, they have a sloping portion that is at the top which many feel makes the implant look more natural once inserted. These implants require a textured surface because if they rotate, the breast will look deformed (a problem that won’t occur with a round shaped implant since it is perfectly symmetrical).

Another aspect of implant shape is the profile you want. Most of the time, doctors assume that you want a medium profile- those are what the majority of people get. However, depending on the look you are trying to achieve a higher or lower profile might be appropriate. Basically this aspect is when you set and implant down on the table, how tall is it.

This is an example of a patient who has gotten high profile implants. Keep in mind, these look relatively new and therefore they have not fully settled yet, but they ARE high profile and are probably not going to drop down very much—they will continue to have that very full appearance at the top of the breast. On a related note, you should always remember that what you look like immediately post surgery is not what you will look like permanently. Breast implants often take a couple months to fully “settle”. The body is recovering from a trauma (the surgery) and is adjusting to a foreign body (the implants) so there will be swelling and adjustments that the body makes before everything reaches its final positioning.

Below, is a patient who got low profile implants. You can clearly see the difference between these two types. If you are on the smaller side to begin with and are aiming for a very natural look with a modest size increase, low profile implants might be right for you!

The next important thing to consider is the incision type. As I mentioned before, silicone implants are at a disadvantage to saline implants in that they require larger incision types. The implant comes pre-filled and so you require a large incision to provide the surgeon access to place the implant. I know that reducing scarring is one of the TOP priorities for you and your doctor, so it is important to weigh incision types before you decide implant material.
Periareolar incisions are right around the nipple. This incision can be used for silicone implants, but they would need to be small since that would be very difficult—however it is not unheard of, just uncommon. These scars will be less noticeable than other methods and often blend in with the areola. One major advantage of this type of incision is that it permits the doctor great accuracy in placing the implants. The image below gives you an idea of where this incision is located; the scarring will be quite light, and really only noticeable upon close inspection… if somebody’s that close to your boobs, I’m pretty sure they aren’t going to complain about a faint line.

Inframammary incisions are located in an area called the inframammary fold. This is pretty much the crease where the bottom of your breast meets your rib cage. This type of incision can leave pretty noticeable scars, but is the ideal type for silicone implants. Again, if you think you wan silicone implants, you need to decide if they are worth the additional scarring.

A transaxillary incision will be located in the armpit and placed through a tunnel that is made to the breast. This is a nice option for those who do not want any visible scars on their breasts, but will leave scarring in the armpit (it’s quite small though) and can NOT be done with a silicone implant. One disadvantage however, is that this incision type more often has issues with symmetry of implants.

Now I’m sure that most of you have come hear about “no scarring” breast augmentation. That is achieved using a transumbilical (often called TUBA) incision. Saying that this has NO scarring is a bit misleading, really it is simply placing the incision inside of an existing scar—your belly button. The doctor makes a small incision in the belly button, makes two tunnels up to the breasts and places the implants. There are no visible scars on the breasts, and usually the scar inside the belly button is completely invisible. This incision is ONLY for saline implants and you must find a specific doctor who has been trained in this, since it is a relatively new procedure and not all surgeons perform this type.

Finally, implant location is one more choice you can make. An implant may be complete submuscular, partial submuscular, or subglandular.

Complete submuscular is where the implant is located completely below the pectoralis. This is often the best option for those undergoing reconstructive surgery after a mastectomy since the muscle will add tissue between the implant and the skin and allow for a more natural appearance.

Partial submuscular is when the implant is placed mostly under the pectoralis with the bottom portion only covered by breast tissue, not muscle.

Subglandular is when the implant is located on top of the muscle and underneath of the breast tissues. Many feel that this is the ideal location for realistic results, however this placement type is thought to lead to a higher rate of capsular contracture than the other locations.

On the left is subglandular and on the right is complete submuscular.

This should cover most of the basics about breast augmentation. I’m going to start discussing other types of cosmetic surgeries and will come back later to address the potential complications that may arise from breast augmentation. In the meantime, let me know if there’s a particular surgery you would like to read about!

Monday, October 25, 2010

Breast Augmentation

“Boob jobs”, the bread and butter of a plastic surgeon; this is easily one of the most common procedures and it is definitely one of the first things people think of when you say “plastic surgery”. Since this is such a popular procedure, countless variations exist from what type of implant material you choose to the implant location to the incision types. For this reason, I will be posting a few articles on the topic so I am able to go in-depth enough on these topics to give you all of the information you really need. Keep in mind, I am not a plastic surgeon, just an enthusiast; I know my stuff, but since I don’t know you and each patient is different, make sure you discuss your options with your doctor.

Ok, to start with you are able to get saline or silicone breast implants.

Although silicone implants have a bad reputation, that applies to PAST implants. The FDA took older models off the market but newer, better versions are currently available and are completely safe for use. Back in the day, silicone implants were what everybody used. Then they had lots of problems with capsular contracture and leakage of the implants. Once the silicone got in to your body, it caused a heck of a problem. Doctors would have to go in and remove a big, sticky mess. For this reason, older models are no longer available.
This is what a ruptured implant looks like. The tissue material on the side (the red stuff) is a capsule that had formed in the patient, likely in response to the leakage.

However, in the late ‘90’s though, the FDA looked in to silicone implants and decided that there was no significant difference in side-effects for patients with silicone implants. Prior to this, silicone implants were only permitted for patients having reconstructive breast surgeries done (like after a mastectomy).

Now that you have a bit of background and understand that both types of implant are safe, let me explain the benefits of each type to you.

These are often called “gummy bear” implants. They are made up of a silicone gel inside of a silicone shell. These newest models are much better than their predecessors. They have lower rates of capsular contracture (a side effect that I will go in to in a later post) and do not rupture as much as the older versions did.
These implants are available in various shapes, sizes, and profiles. However, their sizes are NOT adjustable. The implant comes to the surgeon pre-filled in certain increments and that is it. If you had been hoping to get a 643cc implant, you are going to have to settle for a 650cc or a 600cc.

Silicone implants are generally considered to be more “realistic” feeling than saline and have a similar texture to that of your natural breast tissue. A drawback for these is that they are more likely to rupture than saline implants. Also, if they do rupture, it is harder to detect since they retain their shape; if a ruptured implant goes unnoticed, the silicone could leak to surrounding areas and cause health problems.

These implants are made of a silicone shell that is filled with a saline solution. They can be inserted into your body and then filled with saline; the doctor then closes the valve and stitches up incision. This means that these implants are available in virtually any size you want. A 600cc shell can be filled with 575cc or it can be over-filled with 625cc, for example. These will result in different appearances of the implant.

The drawback for these implants is that they have a higher rate of cosmetic side effects than silicone implants. There may be rippling or capsular contracture. One major benefit though, is if these rupture you will notice immediately. Saline solution is matched to your body’s saline levels and is similar to what you will find in an IV bag; because of this, if the implant leaks you will not have any problems from the saline entering your body. Your tissues will absorb the liquid and you only need to worry about getting in to have it fixed- unlike silicone ruptures which can lead to severe health problems.

Another benefit is that since these implants can be filled after they are placed in your body, the incision can be MUCH smaller than with silicone, and a smaller incision means a smaller and less noticeable scar. The “scar-less” techniques that you have heard about (and that I’ll talk about later) utilize saline implants.

Overall, you need to weigh what is important to you. You body type, desired results, and even your lifestyle can all affect which type of implant you want. Incision type is another important factor in picking the implant type, and I’ll discuss those later. Implant material is just one of a variety of choices that you can make to reach your ideal appearance and feel great about yourself.

Sunday, October 24, 2010

Choosing your doctor

Cosmetic surgery is a big decision. There are countless choices to be made once you decide you want a procedure, and your surgeon is the person who will help guide you through those decisions. Above all other things, picking the right doctor is critical. That choice can make the difference between whether you are happy with your procedure or not.

First things first, do NOT try to save money on ANY surgery of any kind, especially something as serious as breast augmentation. Find a licensed and accredited doctor. See if he has hospital privilege nearby. Ask to speak with previous patients. All of these are good ways to pick a competent surgeon. Picking a "back alley" doctor may save you money at first, but the cost of surgeries to repair whatever damage is done will far exceed the cost of picking a good doctor the first time around.

Feel free to "shop around" and meet with various doctors to see who you feel the most comfortable with, but do not let the price affect your choice. All reputable surgeons will charge pretty much the same amount. Whatever little variation there may be in the price, is worth it to be comfortable with your doctor.

Think about it, you are going to have this procedure for the rest of your life. What difference does $100 make when you spread it out over the next 30 years?? Bottom line, choose the surgeon who you are comfortable with and who is knowledgeable about the subject.

There are two important things to keep in mind to help you decide if the doctor you are meeting is decent. Your consultation should be free, if it is not then just hang up the phone and pick a new doctor. Also, if while you are at your consultation, the doctor (or any staff) try to talk you in to a procedure that you did not come in for and did not express any desire for, LEAVE. Nobody should tell you how you need to look, they are there to help you achieve YOUR desired look- not how they think you should look or what will line their pockets the most.

I'll be going though the various types of surgeries and procedures and explaining all of the details about them (average costs, how they are done, healing time, restrictions, etc.) so be sure to check back as I add more stuff!!

Also, if there is any specific procedure you want me to address, let me know and I'll add it to the top of my list!