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Plastic Surgery Articles

  • IPL vs Laser Hair Removal

    Alternatives to shaving and waxing, IPL and laser are two very effective procedures for long-term hair removal. In addition to preventing hair from re-growing, both treatment methods reduce growth speed and thickness of remaining hair. They work in similar ways: Light energy heats and damages the hair follicle, slowing down and eventually preventing hair growth. Multiple treatments are usually necessary. The main difference is the light source.

    Lasers are single beams of intense, one-color light that can be focussed into small areas. Lasers penetrate individual pores, and blast a concentrated beam of heat on the hair follicle.

    IPL stands for Intense Pulsed Light and uses broad-spectrum, visible light. Its effectiveness is optimized, targeting specific chemicals by emitting just the right combination of wavelengths. For hair removal,  IPL targets the melanin pigment in hair. Where the light energy is absorbed, it transforms into heat, causing damage to the target.

    Except in lasers, light naturally spreads out. The coverage in IPL devices is therefore greater than in laser hair removal devices. Treatment times can be quicker, and larger areas can be treated at once. IPL can be considerably cheaper per session, but they are less intense—more sessions are typically required.

    IPL uses a broad spectrum of light, so it can be put to multiple uses including hair removal, photorejuvenation, treatment of skin pigmentation, sun damage, thread veins, as well as to alleviate dermatologic diseases such as acne. It can be altered to match different skin and hair types. Not only do different skin tones have different requirements for light-based hair removal devices, but different areas of the body, like the course bikini line hair will require different settings than thinner hair on the arms.

  • Natural Effects Of Aging: Forehead Wrinkles

    The forehead is especially susceptible to signs of aging, simply because it’s so expressive. Surprise, concern, interest, disbelief, anger, joy and the majority of other human emotions all transform the brow and shift the eyebrows. Repetitive expressions over many years eventually become wrinkles, and wrinkles eventually become deep creases. These “memory lines” in the forehead have a tendency to make a person look concerned, stern, or just older than they actually are.

    TREATMENT

    Muscles tend to work in opposing directions. In the brow, one set of muscles pulls the forehead up while depressor muscles are pulling down. We use Botox to treat various muscle groups, relaxing them, and rebalancing the amount of upward and downward pulling forces. After just one treatment, patients often look noticeably less angry, less serious, and more relaxed.

    Care must be taken not to over-treat the forehead muscles. Too much lift can result in an unattractive, surprised expression. Some inexperienced doctors will over-relax the muscles, leaving the face with hardly any expression at all! An expert injector who has comprehensive training in facial anatomy can appropriately relax the muscles without paralyzing them, and treat the depressor groups to create just the right amount of lift, creating noticeable improvements with a natural appearance.

    With regular treatments, lines can dissipate and the patient can develop a smoother forehead. After a few years, muscles adjust to the new balance, and treatments can become less frequent and even more refined.

  • Crows Feet Eye Wrinkles

    A powerful and protective muscle surrounds the eye. In a split-second, it can squeeze the area shut, completely closing and shielding the pupil from harm. It’s also a very expressive muscle. Squinting, smiling and other facial emotions engage this area of the face hundreds of times per day. With decades of folding and refolding skin can develop noticeable wrinkles. Crows feet are wrinkles that radiate from the corners of the eyes. They are harmless and completely natural, but can make us appear older than we are, and more tired than we actually feel.

    Eye cremes, peels and cleansers can improve the outer layers of the skin, while collagen-inducing skin care treatments like Pelevé radio frequency treatments and SkinPen micro-needling treatments can improve deeper layers of the dermis.

    A somewhat more aggressive approach is to address the underlying muscles themselves. When correctly applied, Botox injections relax the muscle around the eye, softening our expressions, to create a younger and more pleasant appearance. Botox is highly versatile; you can treat different areas, add more or less, and fine-tune the results over time. With the muscles relaxed, wrinkles are less pronounced and expression lines begin to fade. Botox is not permanent, and follow-up treatments will need to be scheduled every 3–4 months. A Botox treatment averages $350–700, depending on how much of the serum is used.

    It’s important not to over-treat any area with Botox. The goal is to only soften expressions. An over-application of Botox can leave us with an unnatural lack of expression, which will look far worse than a few wrinkles. This is one of the primary reasons Botox should only be applied by expert injectors with surgical experience and in-depth knowledge of facial anatomy.

    Some doctors offer surgical solutions, sometimes referred to as “permanent Botox.” We discourage patients for taking this route for a number of reasons, it’s expensive, involves greater risk, has a longer recovery time and is difficult to get right. The procedure involves surgically removing certain muscle fibers to permanently imitate the effect of Botox. But unlike Botox injections, if there’s a bad result, the problem will not fade over time. If the appearance looks under-treated or asymmetrical, another surgery would be required. If the effect looks over-treated, that can be difficult or even impossible to reverse.

    For optimal results, we recommend using Botox to soften expressions, and combining skin care to improve the health, elasticity, tone and texture of the skin around the eyes.

  • Addressing Problems With Breast Implants

    It’s important to understand that breast implants are not permanent. Given enough time, things in the body change, and additional surgery may be required. Time isn’t the only cause of implant problems; we occasionally treat patients who have received less-than-perfect augmentations and need help to improve or correct any issues, or we see people who have been in accidents that have caused damage to their implants. The three most common issues are: capsule hardening, implant rupturing, and implant displacement.

    Capsule Hardening

    When a saline or gel implant is placed in the body, it responds by building a protective capsule of tissue around that implant. This is a remarkable thing that the body does: it isolates the implant in its own chamber, increasing strength, safety and stability. Some women naturally produce soft capsules, and others produce capsules that can grow to become thicker and harder. The most common problem women have with breast implants is a hardening of the tissues (the “capsule”) that the body forms around the implant itself. This is known as “capsular contracture,” and when it occurs, the implants can begin to look too round, or irregular, and can eventually become painful. Most women who experience this problem have had their implants for 10–15 years. One solution is to surgically open the capsule, releasing the tension. More often, it’s better to remove the capsule altogether. In both cases, the body naturally repairs itself, growing a new capsule around the implant, which should remain soft for many years to come.

    Leaking or Ruptured Implants

    Implant manufacturing standards are constantly improving. We rarely encounter leaking or ruptured implants; however, it does happen occasionally. The implant manufacturer, Allergen, covers the implants for life and will replace them free of charge, although they will not cover the cost of surgery to replace the old implant with the new one. Though, in some cases, they will cover part of the surgeon’s cost.

    Under- or overfilling a saline implant beyond the manufacturer’s specifications can cause problems. Underfilling the implant can cause it to have folds in its surface that a properly filled implant does not have. These folds can rub together as we move around, creating friction that can eventually weaken or damage the implant. Overfilling can cause the implant to stretch too much, thinning the wall of the implant, and therefore making it more vulnerable to rupturing. Accidental trauma to the breast can sometimes cause an implant to rupture and slowly leak fluid or gel. And though in the past there were many fears around silicone implants, it’s important to understand that saline or gel/silicone implant leakage is not toxic, and extensive tests have found no long-term health hazards due to breast implant leaks.

    Displacement

    Breast implant displacement means that the implant moved or shifted after breast augmentation surgery. An improperly secured implant may shift upward, downward, in toward the breastbone or out toward the armpit. In our opinion, the techniques for fixing these problems in the past were only marginally effective. Typically, a surgeon would open the breast capsule and attempt to suture (stitch) in order to relocate the implants in a better position. These corrections had a tendency to fail quickly; the sutures would not hold, or the implant might simply migrate around the correction or to a new area. We are pleased to say that today we have a much better way of addressing implant displacement.

    The technical name is “the neo-subpectoral pocket technique,” and it differs from older methods. Instead of trying to suture the implant into a better position, we open the natural capsule and remove the saline or gel implant. Then, we separate the natural capsule from the breast, and collapse it flat against the chest wall, changing it from a round, globelike shape to a sort of flattened pad. This pad of natural tissue is very strong and useful. We position it where we need to and replace the implant into the desired position. As the body heals, it forms a new capsule around the implant. The tissue below supports the correction, making it strong and long-lasting. It’s a really great technique.

    In all of the cases above, it is rare that we will reinsert the same implant; typically, we will replace them with brand-new ones. This is an opportunity to discuss if the size was just right, perhaps a little too large or too small, and make any desired size adjustments while fixing a problem implant.

  • Plastic Surgery: Truth vs Marketing

    It’s our goal to get to the truth behind the hype, and to help patients make the best decisions for their health, appearance and well-being. Patients usually choose to have cosmetic surgery because they want, not because they need, the procedure. These personal choices are often influenced by stereotypes and aggressive marketing that can contain confusing and misleading information.

    For example: the “latest and greatest” in medicine is actually an oxymoron, because the newest things are always the least proven. What makes us able to understand if something is good or not is how it performs over time. If the product or procedure is just entering the market, it needs to be carefully assessed before we consider it for our practice.

    We’re not talking about fashion, we’re talking about medicine. If you are considering plastic surgery, you shouldn’t have to figure out what the right medical approach is all by yourself. You need a qualified physician to help you navigate available options and set appropriate expectations.

    This becomes more problematic when people present themselves as experts who are not. Some practitioners offer plastic surgery or skin care without sufficient background: dentists, pediatricians, family practitioners, and OB/GYNs. They might have attended a few clinics or seminars, but lack the surgical background and in-depth training.

    We cannot emphasize it enough: this is medicine, this is science. As physicians, we are entrusted to protect bodies and lives. At the Santa Fe Plastic Surgery Center, we are exceptionally well qualified and motivated to help our patients make the best possible decisions concerning skin care, injectables and elective surgery.

    We believe it’s extremely important to provide consultations for cosmetic procedures. Patients need to be able to confidentially discuss what they hope to achieve, ask questions, and receive expert guidance in a professional, no-pressure environment. Only then cane they become fully informed about the benefits, risks and appropriate expectations. Everybody has different physical characteristics and medical histories and a consultation can help determine if you are a good candidate for specific cosmetic products and procedures.

  • Recovering From Breast Augmentation/Implant Surgery

    After your operation, it’s important to let your body rest for at least 48 hours to avoid bleeding or increased swelling. Don’t do any overhead lifting for 3 to 4 weeks. Drink plenty of water, and slowly progress to other clear liquids such as tea or juice. Drinking ginger ale is good for nausea. Eat light foods as you can tolerate, and resume your regular diet after 2 days.

    Take medications according to the instructions on the bottle. If you’re taking strong narcotics, or if other pain medications make you feel “spacey” or drowsy, have a responsible adult administer your medicines according to proper time intervals. Under such circumstances there is a risk of accidental overdose, should you forget how much you’ve already taken. Advil or Ibuprofen may be taken between the prescription doses to help with inflammation and pain.

    You may wear a soft cotton bra with a formed cup—sports bras are not recommended. You can expect moderate discomfort and burning sensations, a gradual increase in swelling, black and blue discoloration, and slight signs of pink to red discharge from incision sites.

    Please call the office immediately if you are experiencing:

    • Severe pain that does not respond to medication
    • Dramatically increased swelling on either side
    • Bright red spots on the bandages which continue to enlarge
    • Uncontrollable nausea and vomiting
    • Fever above 101 degrees
    • If your bandages seem extremely tight

    Avoid smoking or contact with smoke after your operation to prevent coughing, the possibility of bleeding, and delayed healing. Do not drink any alcohol for at least four days after surgery — it increases swelling and the possibility of bleeding.

    For 2-4 weeks, avoid exercising and any strenuous activity. Even heavy housework will deprive you of the rest you need to fully recover, and exertion will also aggravate swelling. Wait two weeks to resume an active social life. Avoid aerobics, dancing, and other strenuous activities for about a month. Start these activities slowly and always wear a supportive bra. Avoid prolonged exposure to sun and heat for three months to avoid swelling and burns, and always use sunscreen.

    You may shower after 1-2 days if you feel like it, but do not let the water directly hit your surgical area. We prefer Bacitracin ointment on the incisions. Please do not use Vitamin E because it slows down wound healing. Do not use anything that your friends and family think will help with wound healing or scaring. Only use what your doctor prescribes. As you are healing, we will continue to help you with the scars.

    Your breasts will be sensitive to stimulation for approximately two weeks, so you might want to avoid sexual arousal during that time. Postoperative visits will be determined by your surgeon. We usually take stitches out the next week. Feel free to call us at any time — we want you to be as comfortable as possible during the healing period.

  • Recovering From Facial Surgery

    It is very critical that you do not perform any maneuvers that will generate a sudden rise in blood pressure the day after surgery. Examples are a constipated bowel movement, sudden coughing fit, or bending over and reaching down to tie a shoelace.

    Keep your head elevated for the first two days after surgery. An easy way to do this would be using two pillows or a rolled blanket under the head of the mattress. Keep your head in a natural and straight position. Do not hyperextend your head back or have your chin too close to your chest. You must lie on your back — do not lie on either side. If you bend over, or even let your head drop forward, the force of gravity may aggravate swelling, so keep your head up as much as possible.

    It is important to let your face rest after surgery. Keeping your head and face immobile as much as possible will greatly aid the healing process. Avoid talking, laughing or chewing. Start with water and if tolerated, progress to other clear liquids such as tea and juice. Ginger ale is good for nausea. Eating light for the first few days and sticking to a liquid/soft-food diet will help to keep your face still. Avoid very hot or cold liquid, and any foods that are high in sodium – as they will increase swelling.

    Take medication according to instructions on the bottle. If taking strong narcotics, or if other pain medications make you feel “spacey” or drowsy, have a responsible adult administer your medications according to proper time intervals. Failure to properly monitor these time intervals may result in accidental overdose. You may take Advil or ibuprofen between the prescription doses to help with inflammation and pain. Do not apply hot/warm/cold compresses to your face.

    Please immediately fill your anti-nausea prescription. You must use this medication as soon as you notice the onset of nausea. It is important to avoid vomiting because it may cause bleeding in your face. Call our office immediately if you are unable to control your nausea.

    After surgery, it is typical to experience moderate discomfort, gradual increases in swelling, black and blue discoloration, bloodshot eyes, and small amounts of blood on the bandages.

    Let us know if you experience any of the following:

    • Severe pain that does not respond to medication
    • Large amounts of increased swelling on either side
    • Significant blood loss evident on your bandages
    • Uncontrollable nausea and vomiting
    • Fever above 101 degrees
    • Bandages seeming too tight

    Avoid smoking or contact with smoke after your operation to prevent coughing, possible bleeding and delayed healing. Do not drink any alcohol for at least four days after surgery, as it increases the probability of swelling.

    Avoid sports and strenuous activity for one month. Even heavy housework will deprive you of the rest you need to fully recover. Exertion also aggravates facial swelling that may pull on the stitches or increase scaring. Avoid prolonged exposure to the sun and heat for three months to avoid swelling, and always use sunscreen.

    Feel free to call us at any time — we want you to be as comfortable as possible during your healing period. Stitches will be removed 3 to 7 days after your surgery, depending on the type of procedure and the location of the stitches. Additional visits will be determined by your physician.

    You may color or bleach your hair up to, but no later than, one day before surgery. No further coloring is allowed until one month after surgery. It is not recommended to invest in an expensive hairstyle shortly before surgery. Using a mild shampoo on your hair is okay, but only after the bandages have been removed and you have received your physician’s approval. Be sure the water is not too hot. Check with our office before applying any make-up.

Crows Feet Eye Wrinkles

A powerful and protective muscle surrounds the eye. In a split-second, it can squeeze the area shut, completely closing and shielding the pupil from harm. It’s also a very expressive muscle. Squinting, smiling and other facial emotions engage this area of the face hundreds of times per day. With decades of folding and refolding skin can develop noticeable wrinkles. Crows feet are wrinkles that radiate from the corners of the eyes. They are harmless and completely natural, but can make…

Natural Effects Of Aging: Forehead Wrinkles

The forehead is especially susceptible to signs of aging, simply because it’s so expressive. Surprise, concern, interest, disbelief, anger, joy and the majority of other human emotions all transform the brow and shift the eyebrows. Repetitive expressions over many years eventually become wrinkles, and wrinkles eventually become deep creases. These “memory lines” in the forehead have a tendency to make a person look concerned, stern, or just older than they actually are. TREATMENT Muscles tend to work in opposing directions…

Addressing Problems With Breast Implants

It’s important to understand that breast implants are not permanent. Given enough time, things in the body change, and additional surgery may be required. Time isn’t the only cause of implant problems; we occasionally treat patients who have received less-than-perfect augmentations and need help to improve or correct any issues, or we see people who have been in accidents that have caused damage to their implants. The three most common issues are: capsule hardening, implant rupturing, and implant displacement. Capsule Hardening… 

Plastic Surgery: Truth vs Marketing

It’s our goal to get to the truth behind the hype, and to help patients make the best decisions for their health, appearance and well-being. Patients usually choose to have cosmetic surgery because they want, not because they need, the procedure. These personal choices are often influenced by stereotypes and aggressive marketing that can contain confusing and misleading information. For example: the “latest and greatest” in medicine is actually an oxymoron, because the newest things are always the least proven. What makes us able to understand if something is…

Recovering From Breast Augmentation/Implant Surgery

After your operation, it’s important to let your body rest for at least 48 hours to avoid bleeding or increased swelling. Don’t do any overhead lifting for 3 to 4 weeks. Drink plenty of water, and slowly progress to other clear liquids such as tea or juice. Drinking ginger ale is good for nausea. Eat light foods as you can tolerate, and resume your regular diet after 2 days. Take medications according to the instructions on the bottle. If you’re…

Recovering From Facial Surgery

It is very critical that you do not perform any maneuvers that will generate a sudden rise in blood pressure the day after surgery. Examples are a constipated bowel movement, sudden coughing fit, or bending over and reaching down to tie a shoelace. Keep your head elevated for the first two days after surgery. An easy way to do this would be using two pillows or a rolled blanket under the head of the mattress. Keep your head in a…

IPL vs Laser Hair Removal

Alternatives to shaving and waxing, IPL and laser are two very effective procedures for long-term hair removal. In addition to preventing hair from re-growing, both treatment methods reduce growth speed and thickness of remaining hair. They work in similar ways: Light energy heats and damages the hair follicle, slowing down and eventually preventing hair growth. Multiple treatments are usually necessary. The main difference is the light source. Lasers are single beams of intense, one-color light that can be focussed into…