It’s a subject that has been covered several times: how do you pick a plastic surgeon? There are many appropriate answers to this question. I’d like to present what I’ve found can be one of the best ways: a referral from your family doctor.

You trust your general practitioner to have thorough medical knowledge and your best interests in mind. So who better to trust when you’re picking a surgeon for a cosmetic procedure such as a face lift, liposuction, or breast implants in Detroit?

I’d also suggest that you consider referrals from the medical staff at your GP’s office. Nurses and physician assistants have a great deal of personal contact with patients and with other medical professionals. Perhaps even more often than doctors, they hear what others have to say about plastic surgeons. They’ll know who has a positive reputation – and who does not.

This is just a brief note about one possible resource. There are plenty of other options. Have YOU had success in finding a plastic surgeon? How did you make your choice?

You’ve probably heard about toning shoes – the shoes with a distinct curved sole that are meant to help build leg muscles and increase calorie burn. Like thousands of people in the Bay Area, you may even own a pair. I’ve had a few patients recently asking about whether these shoes can help them avoid a body contouring procedure in Walnut Creek such as abdominoplasty, liposuction or a body lift. While I always support a person’s effort to lead a healthier and more active lifestyle, I doubt that these shoes will contribute much to a person’s overall level of fitness.

Fancy Footwork

Toning shoes supposedly increase calorie burn and muscle toning by keeping people a little off-balance with their “rocker-bottom” soles. While this makes some sense in theory, potential drawbacks of the rocker-bottom shoes include higher risk of falling for people with balance problems (potentially causing fractures), as well as back and knee pain. The shoes change your stride; it’s what they’re intended to do, but those changes could have unpleasant results.

Ultimately, even if the shoes are safe and they help you exercise more and lose weight, a body contouring procedure may still be needed to create your ideal look. Pockets of unwanted fat may still remain, and if you lose a significant amount of fat, you may need to reduce excess skin as well. For that kind of improvement, surgery really is the only option.

If the Shoe Fits

If you really want to look and feel your best, exercise more and watch your diet carefully. If you get a pair of toning shoes and they help you raise your level of fitness, stick with them. And, when you’re sure that you’ve tried every possible solution, but you’re still not happy with the way you look, it might be time to revisit your surgical options.

With childhood and adult obesity rates continuing to rise, it’s no wonder that some people are beginning to recommend weight-loss surgery for teenagers. It should go without saying, but these procedures, and the body contouring procedures that are often required afterwards to remove excess skin, are not an ideal option for most overweight or obese teens. Here’s why:

Weight Loss Surgery

The first option for weight loss should always be diet and exercise. But even when diet and exercise fail, going under the knife presents a few problems. Gastric bypass surgery permanently limits the amount of food a person can consume, which for young people means a lifetime of small portions and diet supplements even after they have lost weight.

Gastric banding procedures are reversible, but this procedure raises other concerns. Right now, there is very little data showing the long-term effectiveness of the bands. Living with the bands also requires a great deal of motivation and self-discipline and it may be hard for teens to find the internal motivation required to continue the routine after surgery.

The health risks and complications following weight loss surgery for younger patients are not well understood, and at this time non-surgical weight loss methods are still essential for this patient group.

Body Contouring

The first thing to understand about procedures like liposuction and tummy tuck is that they are not weight loss surgeries. Liposuction is used to treat areas of fat that are resistant to diet and exercise for patients who are close to their ideal body weight, and tummy tuck (abdominoplasty) procedures are performed to treat sagging skin and loose muscle from things like weight loss and pregnancy. Very few liposuction and tummy tuck procedures are performed for teens, and with good reason. For a young person who has lost a significant amount of weight, I would want to see them maintain that weight loss for an extended period before performing a body contouring procedure.

Designed by LPG Systems of France more than two decades ago, Endermologie® was the first method approved by the FDA to temporarily reduce the appearance of cellulite without invasive surgery. It is a 35-45 minute procedure that is an essentially deep tissue massage which reduces subcutaneous fat viscosity in the target area and promote circulation. This allows trapped fluids and toxins to be released and facilitate lymphatic drainage. This deep tissue massage, performed by a device that gently kneads and suctions the skin in the desired area, is what assists the body to minimize the presence of cellulite. Typical of many nonsurgical cosmetic procedure, a series of sessions is required to achieve results. As the body reacts to treatment, results appear gradually.

There is no anesthesia or pain medication required during or following the procedure, although a body stocking, called Endermowear, is worn during a session for sanitary reasons and to provide a smoother surface for the Endermologie® device to operate.

For the best results, it is recommend that Endermologie® sessions are scheduled twice weekly. Patients should drink plenty of fluids throughout the course of their treatment to help the body eliminate released toxins.

A Note About Liposuction
Some still believe that liposuction can effectively remove cellulite. Unfortunately, liposuction is not an effective way to get rid of cellulite. Although some methods of liposuction, particularly those that are laser assisted such as Smartlipo, can tighten the skin and smooth it out, results may often be far from desirable. Currently, lifts and full tummy tucks are generally the most effective ways to reduce dimpled skin surgically.

The Consumer Guide to Plastic Surgery® recently revealed their predictions for plastic surgery in 2010. I’m going to share some of their predictions here and weigh-in on some of the hotter topics. I’ll also give you some resources if you want to learn more.

1) More BOTOX® Cosmetic alternatives will become available.

As most of you know, BOTOX has been used for a long time in a variety of uses, including the cosmetic enhancement of dynamic wrinkles. In 2009, an alternative called DYSPORT® emerged on the scene. The Consumer Guide to Plastic Surgery predicts that both a topical form of the treatment and a few cousins (such as PurTox) will gain FDA approval.

Learn more about DYSPORT from my Las Vegas plastic surgery Web site.

2) Fat injections will be used for breast augmentation.

Although I try to stay on the leading edge of breast augmentation methods, I’m skeptical of this development. The Consumer Guide admits that there are “some kinks” to work out, but I believe that’s putting it too mildly. There may be some use for fat transfer if only small amounts are necessary, but it is not currently suitable for larger-scale augmentation. As it stands now, injected fat can die, change position, or get reabsorbed by your body. It’s definitely not something I recommend for my patients at the moment.

Learn more about fat injection for breast augmentation from Dr. John Sampson on his blog post.

3) Surgeons will “invent” and “perfect” body contouring procedures for post weight loss patients.

Wait a minute – we’ve already developed highly effective methods of slimming and tightening the post bariatric shape. Apparently the Consumer Guide is referring to “corset trunkplasty,” a new procedure to target fat above the belly button, an area that the Consumer Guide claims has been ignored. However, an incision around the belly button can be and often is added during a tummy tuck to address the upper abdomen. A body lift might do the trick as well.

4) Fat freezing will prove an effective method for reducing unwanted fat.

Now this is exciting. Keep in mind, liposuction can be an excellent way to remove unwanted fat. However, this new method could provide yet another good option for some patients. Currently in clinical trials for fat removal, Zeltiq™ Cryolipolysis™ is FDA-approved only for skin cooling during dermatologic treatments. However, early indications are that the Zeltiq technology just might be the next big thing in fat removal.

Learn more about Zeltiq at www.zeltiq.com.

5) “Gummy Bear” breast implants will gain FDA-approval.

“Gummy Bear” breast implants are leak resistant and made with cohesive silicone. If the implants should rupture, the silicone inside won’t leak into surrounding tissue. They’re currently being studied in the United States. Approval of and the use of gummy bear breast implants could improve the safety and results of breast augmentation.

What types of cosmetic treatments would you want to see become available in 2010 and beyond? Post your “wish list” here and let’s see what’s on most people’s minds.

The case of the Argentinean beauty queen who passed away after cosmetic surgery has garnered international attention. A vibrant life cut short is always a tragedy. If you haven’t read about it, here are the details: Solange Magnano went in for a gluteoplasty (buttock enhancement) and died from a pulmonary embolism.

Besides the sympathy and sadness many people feel, there are also probably a lot of people considering cosmetic surgery who wonder, “Could that be me?” In particular, if you are considering liposuction, you may have heard that pulmonary embolism is one risk following surgery. I’d like to explain a little more about this news tragedy especially for my liposuction patients in Lexington and Louisville.

Although the risk of death after liposuction is low, pulmonary embolism is the leading cause of death following this procedure. The way it works is this: alteration in blood flow causes deep vein thrombosis (blood clots in the deep veins of the legs). In the case of the pulmonary embolism, a clot travels to the main artery of the lung, where it blocks flow of blood to the lung, which can stop respiration and lead to death. Studies have suggested that liposuction may be among the cosmetic procedures most likely to lead to pulmonary embolism.

While it’s important to know and understand the risks of liposuction, keep in mind that U.S. surgeons are trained to take steps to minimize the formation of blood clots following surgery, including:

• Administration of anticoagulants such as heparin
• Compression
• Physical activity soon after surgery

An experienced, board-certified plastic surgeon will take every precaution to minimize complications associated with liposuction and will thoroughly discuss the risks with you. When performed correctly and with proper follow-up care, your liposuction procedure can be very safe and produce beautiful results.

The Technology

Nonsurgical treatments have historically focused heavily on skin care in San Jose, California. With the Accent system, however, nonsurgical treatments have entered a whole new arena: body contouring. Using two different radiofrequencies, and without anesthesia or a single incision, the Accent can achieve improvements in cellulite, excess fat and skin laxity. During treatment, a handheld device delivers radiofrequency energy to deep tissue layers and surface skin to contract connective tissue, drain fat, improve circulation, and encourage collagen growth. The treatments are brief, virtually painless, and have very limited side effects or recovery time.

Get Systematic

With the Accent System, radiofrequency technology is just a piece of the puzzle. In order to ensure positive and long-lasting results, I also suggest a personal trainer for my patients who offers a customized diet and exercise program. It’s important for people to understand that cosmetic surgery can get you only partly there, and to get the long-lasting, transformational results you want, you need to look at your entire lifestyle. This is as true for surgical procedures (such as liposuction or a tummy tuck) as it is with the Accent System.