It seems that every day brings news about a treatment that is supposedly going to “revolutionize” cosmetic surgery. Sometimes it’s true. Sometimes it’s not. I’ve just added a treatment to my practice that is truly a game-changer: Ultherapy™.

Here are the most important things you should know:

• Ultherapy is a treatment for sagging skin on the face and neck.
• It is completely non-surgical.
• The procedure is performed right in the office, and takes about 60 minutes.
• No anesthesia is required.
• No downtime is required.
• Ultherapy is FDA approved.

I explain Ultherapy to my patients in Detroit as a non-surgical face lift. While it can’t achieve the same results as surgery, I’ve actually seen improvement that is very close. The best results are usually for the jaw, neck, cheeks, and upper eyelids.

Unlike some laser treatments that are used to tighten skin, Ultherapy uses an ultrasound device. First, ultrasound is used to image the treatment area. Next, the ultrasound energy targets the area of concern and triggers the body’s own regenerative response. This natural response results in a gradual firming and tightening of tissue.

How it Works
Laser skin tightening delivers energy to targeted areas of the skin to heat the underlying tissue. This initiates the body to generate new tissue, tightening the skin almost immediately. The body then starts producing new collagen to replace the damaged collagen, leading to further tightening in the months following treatment.

One of the most popular skin tightening technologies is the StarLux® 500, which is what we use at our clinic.  The StarLux® 500 is considered to be the “gold standard” of lasers, emitting pulsed light at a wavelength of 850 – 1350 nm. This infrared energy tightens the skin by gently coagulating the tissue in the dermis and hypodermis to initiate the generation of  healthy new tissue. Several areas of the body and face can be targeted with the device, including lax skin and stretchmarks on the arms, legs, buttocks and stomach. Loose skin on the face, particularly along the jawline, can also be treated.

The effects of laser skin tightening are noticeable immediately after treatment. Many patients notice that the tone and condition of their skin improves after the first treatment. However, the full results of laser skin tightening cannot be seen until 90 to 180 days after the initial treatment because that is about how long it takes for new collagen growth to take place.

There may be some warmth, redness, and tightness in the targeted areas following treatment but it will fade within a few hours. Typically, you can resume your daily activities immediately after treatment. Some people see excellent results after one treatment session but most need at least two treatments for optimal results. Those who have severely loose skin may need up to three treatments or more. Further maintenance treatments every one and a half to two years following the initial treatment may be required.

The Advantages of Laser Skin Tightening
Laser skin tightening in Toronto is becoming an increasingly popular solution to treat loose skin and stretch marks. It is a non-invasive procedure that dramatically firms the skin. It is effective in reducing fine lines, wrinkles, and loose skin on all parts of the body but unlike surgery, there is little risk of serious side effects and no downtime or discomfort.

By: Michele Cooper, MD

You don’t need to be told all the benefits of losing weight. They’re practically immeasurable – improved health, a more active lifestyle, and an enhanced self image. But what about those few downsides of weight loss, specifically the loose skin and flab that may still be left behind around your midsection and lower body? What can you do about those?

If you’ve lost a fair amount of weight and you schedule a time to talk with a plastic surgeon about your body contouring options, chances are good that both liposuction and a body lift may be presented as ways to improve your appearance. Oftentimes, a combination of these procedures, and even other procedures such as thigh lifts and arm lifts, is necessary to achieve your ideal look.

Liposuction

This procedure is the “gold standard” for body contouring. It’s chosen by thousands of people each year both for subtle contouring and more dramatic reshaping. My New Orleans liposuction patients generally have good skin tone overall but have stubborn pockets of fat that won’t respond to diet and exercise.

If you are considering this procedure, keep in mind that not all approaches are equally appropriate for every patient. Laser-assisted liposuction can get very good results for certain patients, but depending on your tissue quality and the location of your problem areas, you might be better off with a more traditional approach.

Body Lift

This is a much more extensive procedure than liposuction, but the results are also far more dramatic. A body lift involves re-sculpting the abdominal area, flanks, and thighs to slim down the mid-body and re-tighten loose skin.

In many cases, liposuction will be performed as part of a body lift. I always recommend the least invasive option possible to achieve my patients’ plastic surgery goals. If you are unhappy with the way your body looks after weight loss, it’s important to know your plastic surgery options and talk with a well-qualified plastic surgeon who can give you a better sense of which procedures make most sense for you.

By: Thomas McNemar, MD

After weight loss surgery, most San Francisco Bay Area women are very eager to start enjoying their new shape. Slimmer clothing, swimsuits, and physical activities are just a few of the many things that women look forward to after they have lost weight, but loose, sagging skin can compromise a woman’s happiness with her weight loss results. Breast sagginess can be especially frustrating, which is why many women choose post weight loss breast surgery in Walnut Creek to help accomplish their goals.

Post Weight Loss Breast Lift Surgery: Goals

After weight loss surgery, Walnut Creek and Bay Area women typically want to improve their breast shape in 2 ways:

• Position: After weight loss, breasts that sag severely create a longer, less attractive cleavage line and make some women hesitate to wear revealing clothing or exercise strenuously, because of the way their breasts make them feel. By improving the breasts’ position, an Oakland area post bariatric surgeon can often help patients reverse both of these problems.
• Shape and volume: Often, stretched-out skin causes the breast tissues to spread apart and flatten, creating a “pancake” look. A firmer, rounder breast shape gives a younger and more vibrant look to the whole body.

Post Weight Loss Breast Lift Surgery: Techniques

Unlike the “average” cosmetic surgery patient, post-weight loss breast lift patients have special characteristics that need to be addressed specifically. In the typical breast lift procedure, the surgeon elevates the breast simply by removing excess tissue (usually from below and around the nipple), then closing the incision. When I perform breast lift for post weight loss surgery patients in Walnut Creek, I take the time to discuss a few approaches designed for the postbariatric shape specifically in order to help the patient evaluate which option offers the most complete results. Typical approaches may also adjust:

• Sagging skin between the breast and the arm
• Severely downward-pointing nipples
• Loose upper-arm tissues
• “Bra rolls”

Because each patient is different, no procedure or set of procedures is “ideal” for all, and each decision depends on the kinds of changes the patient expects to accomplish. When you talk with your surgeon, be clear about the kind of improvements you want to accomplish, and ask questions to make sure you understand your options clearly. Your Oakland area bariatric surgeon ought to be able to explain why a given approach makes sense, and adapt his or her procedures to create the changes you want to see.

By: Thomas McNemar, MD

Weight loss is a big accomplishment, but sometimes patients who have lost a large amount of weight need extra help to reach their goals. Significant weight loss often leaves behind loose, flabby areas in typical “problem spots” like the lower and upper belly, hips, flanks, and thighs. In the lower abdominal area, particularly, loose skin and muscles can create an illusion of heaviness even when a person has little excess fat.

A normal tummy tuck (abdominoplasty) can tighten loose muscles very effectively, but for many post weight loss patients, large amounts of loose skin create problems that a tummy tuck alone cannot fix. To add to the problem, excess skin can often cause post weight loss patients to experience puckering and unevenness along the incision if their surgeon performs only “standard” tummy tucks. As an Oakland-area post bariatric surgeon, I perform many tummy tucks and I would like to outline briefly how post bariatric patients can adapt their procedures to accomplish their goals and enjoy more attractive results.

Post Weight Loss Tummy Tucks: Why the Special Approaches?

Postbariatric cosmetic surgeons have developed two main approaches to post weight loss surgery to help Walnut Creek tummy tuck patients:

Bi-Directional Abdominoplasty

What is it? Normal abdominoplasty involves just one horizontal incision that extends from hip to hip below the patient’s “bikini” line, but for weight loss patients who are seeing excess skin in their upper abdomen as well, this lower incision is not enough to create a smooth result. Bi-directional abdominoplasty adds a second, vertical incision that runs perpendicular to the first one, allowing the surgeon to remove the excess skin.

Is it right for me? Bi-directional abdominoplasty is effective for post bariatric surgery patients in the Bay Area who have reached a stable weight and practice healthy habits, but want to correct excess skin that gives their abdomen a puckered look.

Circumferential Abdominoplasty

What is it? Circumferential abdominoplasty also requires an additional incision to tighten and remove loose skin and fat. In this version, the surgeon will extend the initial incision all the way around the patient’s hips and along their upper buttocks, removing excess skin and fat (through liposuction) in the process. This tightens the hips and lower abdomen significantly, while slightly lifting the buttocks.

Is it right for me? Circumferential abdominoplasty is effective for post bariatric patients who have maintained a healthy weight for at least 6 months and exercise faithfully, but dislike the loose, flabby areas along their hips, lower belly, and buttocks.

As with any cosmetic surgery procedure, tummy tucks offer the best results when the surgeon can customize the procedure for you, personally. When you meet with a potential Oakland-area post bariatric surgeon, take the time to find out whether he or she has the personal focus to go beyond the “standard” approach and create results that match your needs.

By: Thomas McNemar, MD

Men tend to build muscle quickly, so after significant weight loss, many men enjoy a better physique to match their healthy new lifestyle. However, after weight loss surgery in San Francisco, areas of loose, sagging skin can be very frustrating for men in particular. This is why I perform post weight loss cosmetic surgery – to help men achieve a body contour that more accurately reflects their hard work.

Some of the top goals and procedures options for male body cosmetic surgery after weight loss include:

Firmer Upper Body: Pectoral-Area Liposuction

Most men want a firmer, flatter chest area, but unfortunately weight loss often leaves loose skin or fat. A surgeon may need to remove excess skin and tissue through a series of incisions, but in many cases liposuction surgery tightens up this area very well, giving a firmer and more defined appearance to the pectoral muscles.

Flatter Mid Body: Abdominoplasty and Body Lift

Ideally, the midsection will look flatter and firmer after weight loss surgery, but in reality weight loss surgery often leaves San Francisco area men with a large amount of excess abdominal tissue. Abdominoplasty (tummy tucks) are used to correct this problem by tightening stretched-out abdominal muscles and trimming away loose skin from the lower belly. For very large amounts of excess skin, a body lift may be necessary to retighten the hips, upper and lower abdomen, flanks, belly, and thighs.

Tighter Lower Body: Inner Thigh Lift, Liposuction

The hips and thighs are typically less of a problem for men than for the women who need post weight loss surgery in Walnut Creek, but depending on your physiology these areas can still pose problems. Loose, wrinkled skin on the lower thighs and small, isolated patches of fat on the flanks and lower belly can look and feel awkward, so many men choose to correct these areas with liposuction or lift procedures. Typically, I will perform these as a combination procedure that may integrate abdominoplasty or body lift, but they can also be performed as single procedures.

By: Thomas McNemar, MD

Most women have no trouble finding a Walnut Creek or Danville area breast reduction surgeon – the difficulty is in finding one who offers results that flatter their body contour. When I’ve talked with women considering breast reduction, I’ve found that sometimes it can be difficult for them to translate their personal priorities – results, cost, and healthy healing – into specific questions to ask about potential surgeons.

Here are five characteristics that you should factor into your choice of surgeon:

1 – Training: Board certification by the American Board of Plastic Surgery is an absolute must for a qualified surgeon, but it is not a total guarantee that your surgeon knows the ins and outs of cosmetic breast surgery. A skilled Walnut Creek or Danville area breast reduction plastic surgeon will have expanded his or her knowledge base through participation in additional research fellowships, extensive training seminars, or active involvement in accredited surgical training programs.

2 – Safety standards: Many plastic surgeons perform some procedures in their own surgical care facilities, and while some surgeons use this independence as an opportunity to establish particularly high standards for safety and patient comfort, others are less attentive to the safety and quality of the experience they provide. Be wary of surgeons whose staff or surgical centers demonstrate carelessness.

3 – “Feminine,” natural-looking results: Some patients mistakenly believe that all breast reductions will be performed the same way, but because each patient’s existing anatomy is unique, care and attention are necessary to ensure a more “round” shape. For certain Danville area breast reduction patients, some “spreading” of the breast tissues is natural and unavoidable, but when you look at your surgeon’s breast reduction photos, evaluate for yourself whether he or she seems capable of creating a result that is not only “better,” but also feminine, natural, and attractive.

4 – Nipple-sparing techniques: For Walnut Creek and Danville area breast reduction, breast lift, and breast augmentation, good nipple position is extremely important for attractive results. For very large breasts that sag severely, your surgeon may need to remove and reposition the nipple, but this diminishes nipple sensation and in many cases is not necessary, even if it is a faster and “easier” approach.

5 – Honest feedback about your goals: A surgeon who is committed to your wellbeing will pay attention to factors beyond the technical aspects of your surgery itself and spend some time to get to know you and your goals. It takes effort to help patients formulate expectations that respect the limitations of their procedure along with its benefits, but an honest surgeon will be straightforward and specific about both.

By: Dr. Jon Harrell

A recent news story reports that a woman in Illinois claims she got less than she bargained for with regard to results, and too much in medical bills, after her surgeon allegedly removed more than double the agreed amount of tissue during a breast lift procedure.

Now, it’s true that a surgeon’s opinion sometimes has to take precedence over the patient’s. For example if a very small-framed woman wants a high-volume, high-profile breast augmentation in Miami, I would encourage her to rethink her options, for her overall wellness as well as for the sake of her happiness with her surgical outcome.

That said, areas of concern such as how much breast tissue will be removed during a procedure need to be addressed and fully clarified in the consultation. I firmly believe that my breast reduction patients in Fort Lauderdale and Miami need to understand how their procedure works in order to enjoy their results. At the same time, I also have to understand their desires fully so that I know we are working together toward a goal that is not only realistic, but genuinely benefits the patient.

I think this unfortunate case of a woman being disappointed with her breast surgery results underscores the need to watch out for surgeons who are unwilling to address your questions, explain their procedures personally, and/or put you in contact with past patients. Be sure you know just what will happen during surgery and just what to expect when you see your results.

A few of my patients lately have heard about media stories on the so-called “BOTOX® Breast Lift.” Basically, this procedure is supposed to temporarily create some of the effects of the typical breast lift in Tampa. I have to say that from a medical and technical standpoint this idea seems a little far-fetched.

BOTOX® Cosmetic, of course, minimizes dynamic facial wrinkles by contracting facial muscles. A few cosmetic surgeons in the UK are injecting BOTOX® into the rhomboid muscle of the chest, supposedly lifting the breast.

The problem with this idea is that the chest muscles really have very little to do with breast position. Normally, breast sag (ptosis) results from a combination of volume change and loss of skin elasticity, most commonly after pregnancy or weight loss. When I perform breast enhancement surgery in Tampa, I lift the breasts by removing precise amounts of excess skin and tissue, allowing each breast to sit in a more elevated position with a more flattering contour. Muscle treatments would fail to address the source of the problem or to help prevent additional sagging in the future. At the same time, the depth of the muscles means that the person injecting the BOTOX® would need to be very cautious to avoid accidentally injecting the ribs or the pleura (lung sac) instead of muscle tissue.

When you factor in the cost of the large amounts of product that need to be used to achieve a noticeable effect, and the fact that treatments are required every 6 months to maintain results, the procedure is hardly cost effective. In my opinion, patients would do better to opt for long-lasting results and go for the traditional surgical procedure.

A few recent news stories suggest that celebrities like Madonna and Keira Knightley are sporting one of the hottest new looks: ultrathin shoulders. Allegedly, more than a few women are using liposuction to slim their shoulders for this “celebrity” look. But as a plastic surgeon performing liposuction in Las Vegas, I can tell you that this kind of celebrity-inspired trend is far from the best solution for great-looking shoulders – and I can offer some better alternatives.

Liposuction in Las Vegas: How It Works

This procedure helps men and women tighten and tone the loose, flabby areas that resist diet and exercise. Excess fatty deposits may be created by genetics, rapid weight loss, or hormonal imbalance, and I target them through surgery by first breaking down and then removing the unwanted fat cells.

Good candidates for liposuction in Las Vegas work hard to keep fit already – the procedure is not meant to achieve weight loss but instead creates a better body tone and shape. Often, women find that the upper arms are a particularly challenging area to tone because loose skin and excess fat serves to hide any muscle that would create an attractive contour.

Clearly, many women could benefit from cosmetic enhancement of the upper arm and shoulder area. However, speaking as a board-certified Las Vegas plastic surgeon who understands how different factors contribute to your aesthetic appeal, I can say that shoulder liposuction alone will only provide minimal benefit for most women looking for a slimmer upper arm and shoulder appearance.

Procedures to Slim Your Shoulders

If you have only a very small area of fat on your upper arm or shoulder, liposuction alone may be able to create a slimmer contour. But for a large number of my patients, only performing liposuction would cause an unflattering result. This is because the skin and tissue of the upper arm is susceptible to sagging and in most cases will not easily “shrink to fit” the slimmer arm after liposuction. No fashion magazine is going to point to sagging, deflated upper arms as the new hot trend.

The solution for many women is arm lift, a procedure that eliminates fat and tightens flabby skin on the upper arm to highlight existing muscle tone. By eliminating excess skin and fatty deposits, you can trade in your loose, rounded shoulder shape for a more sculpted contour.

Women looking into liposuction in Las Vegas should remember that Keira’s and Madonna’s shoulders are so thin because these celebrities are remarkably (some would say abnormally) thin all over. Liposuction provides an excellent means for your plastic surgeon to help you achieve your aesthetic goals, but this and other plastic surgery procedures should be performed to compliment your existing figure, not to try to turn you into someone else.