By: Wandra Miles, MD

After years of ignoring warnings from doctors about lung cancer, emphysema, and heart disease, most smokers are quick to ignore a surgeon’s disclaimer that you need to toss those cigarettes well before your cosmetic surgery. With both health and surgical results at stake, smoking cessation prior to surgery is vitally important. I believe that, if more patients understood the connection between smoking and surgery, the warnings would not be so frequently ignored.

Results at Risk

Recovery after Seattle cosmetic surgery is incredibly important; the most attractive results can only be accomplished when the body is allowed to recover and heal. Smoking can jeopardize this healing process by:

• Increasing the level of carbon monoxide and decreasing the level of oxygen in your blood.
• Reducing blood flow to the cells.
• Overloading your system with nicotine.
• Increasing the risk of infection.

A Perfect Time to Quit

Cigarettes are incredibly addictive, so in order for people to successfully quit, they must be quitting for their own reasons. Sometimes cosmetic surgery provides the extra motivation that is needed because, for many men and women, the desire to look their best is more important than their desire to smoke. In addition, the American Board of Anesthesiologists has found that the time of surgery is an ideal time to kick the habit because some of the medications used during and after surgery can actually reduce withdrawal symptoms.

Free From Wrinkles, Free From Cigarettes

Many people who come to me considering a Seattle face lift have been lifelong smokers. No one disputes that smoking can cause facial wrinkling and poor skin quality. At the same time smoking can also jeopardize the surgery that improves facial wrinkling and other skin concerns. Cosmetic surgery requires and investment of time and money, so if you’re ready to make the effort to improve your appearance, make the effort to quit smoking as well.

By: Wandra Miles, MD

A new study indicates that men and women who suffer from migraines may find lasting relief from the pain while, at the same time, rejuvenating their appearance with a procedure quite similar to a face lift.

There are many different theories about the cause of migraines; however, it is well-established that there are distinct trigger points in the forehead, cheek, and the back of the head that contribute. Dr. Bahman Guyuron, lead author of the study, found that a majority of patients who received BOTOX® injections into the trigger points and then had surgery to remove the trigger points experienced a reduction in their migraines. These surgeries also had the added benefit of reducing wrinkles and improving appearance.

It’s a bit too soon to tell whether this new surgical treatment for migraines will be effective for a wide range of patients. Before Seattle face lift patients rush into surgeons’ offices thinking they can both look better and relieve severe headaches with facial surgery, I think several additional studies with larger patient groups are needed. Of course the possibilities raised by Dr. Guyuron’s research are exciting and remind us that there is always room to explore and develop new methods; however, breaking new ground should never compromise safety or an honest discussion of what surgery can accomplish.

By: Wandra Miles, MD

As with many ethical plastic surgeons devoted to the best possible practice of medicine, I am disturbed by news of a “quick” and “inexpensive” facelift company posting bogus reviews to online review sites in an effort to boost business. According to recent news reports, the management of Lifestyle Lift, Inc. instructed employees to post reviews, comments and testimonials as “satisfied clients” who have had procedures. Company representatives flooded the internet with glowing reports about a procedure that they did not actually have. The company also aggressively fought to have posts removed from legitimate customers who were NOT so pleased with their Lifestyle Lift.

Public criticism and legal action, not to mention a widely-reported $300,000 fine, against Lifestyle Lift should act as a deterrent against similar activities in the future; however, it is important to take patient reviews you see on the internet with a grain of salt. For men and women considering plastic surgery in Seattle or anywhere else, an in-person consultation with a board-certified plastic surgeon and a careful review of the surgeon’s certifications and credentials is the only way to determine if you should trust them with your health and your appearance.

By: Wandra Miles, MD

Most women dream of their perfect wedding from the time they are little girls – the veil, the flowers, and, most importantly, the dress. To look their best for that special time, from the ceremony to the honeymoon, many brides (and even some grooms) are turning to plastic surgery.

Brides and grooms-to-be are choosing Seattle liposuction, BOTOX® Cosmetic injections, and even breast augmentation to get wedding-ready. While you may decide that plastic surgery is just what’s needed to boost your confidence in that gown or tux, it’s important to plan ahead. Many procedures require a recovery period that, ideally, should be completed well before your Big Day. If you’re planning to tie the knot in the next year and are considering plastic surgery in Seattle, you should get in to see a board-certified plastic surgeon at least several months before your wedding date, so you can look and feel your absolute best for that walk down the aisle.

By: Wandra Miles, M.D.

With the economy so tight, a lot of surgeons and patients are focusing on “injectable” facelift procedures as an effective substitute for the traditional approach.

I offer both types of Seattle facelift options from my plastic surgery offices in Washington and Southern Alaska, so I understand the benefits of each. At the same time, though, I have seen an increasing number of misstatements about the purpose of and level of results that can be achieved from injectable treatments. I’d like to take a moment to clarify some of their most important differences.

Which is Which?

“Traditional” or “surgical” facelift uses any of a variety of approaches to facial plastic surgery in Seattle to pull facial skin back into a tightened position, and in the process give a much smoother contour to the mid-face area. Different types of incisions can focus the procedure for different effects. Some approaches also will re-drape some of the facial muscles that shift position most significantly as you age, and/or address slightly loose neck tissue.

“Injectable” or “liquid” facelift can mean a few different things:

• Injectable fillers like Restylane® and JUVÉDERM® Injectable Gel
• BOTOX® Cosmetic
• A combination of either of the above with each other or with another noninvasive procedure, for example lip augmentation or a physician-quality facial

From a qualified Seattle plastic surgery professional, these procedures can have benefits, but that all depends on the type and extent of the wrinkles you have.

• Static wrinkles form as a result of sun damage, smoking, or other factors that compromise the firmness and elasticity of your skin. They are present even when your face is at rest, and most commonly form a network of fine lines most visible in the delicate areas surrounding the lips and eyes.
• Dynamic wrinkles result from repeated movements of facial muscles. These are the deep lines you see around your eyes, forehead, and mouth when you smile or frown.

Sometimes, even if you have good-quality skin, you may still appear to have wrinkly or sagging skin texture if weight loss or pregnancy has left you with patchy areas of excess fat, or depleted the fat and firming proteins that normally smooth skin.

Long-Term Effects

While Seattle facelift surgery corrects both static and dynamic wrinkles in the long term, different injectable options tend to focus on one or the other, and have a much shorter timetable.

• BOTOX corrects dynamic wrinkles, but has a minimal effect on static wrinkles and will require re-treatment in 4 to 6 month intervals.
• Hyaluronic acid fillers like JUVÉDERM and Restylane are more effective for static wrinkles, partly because they help stimulate firming collagen in the skin. Like BOTOX, these fillers need to be renewed between 6 to 12 months after the initial procedure.
• Combination treatments can improve the appearance of both kinds of wrinkles, but are all less effective than surgical approaches for excess skin, fatty pockets, or laxity in the facial muscles, and in the long term will not help slow the appearance of further signs of age.

In the end, either surgical or liquid facelift may be effective for your needs and goals, but you have to understand the differences before you sign on for a procedure that may not yield the results you expect.

By: Wandra Miles, M.D.

The latest clinical research shows that breast reconstruction after mastectomy has many benefits, but the fact remains that only about 20% of women who lose their breasts to mastectomy choose to undergo breast reconstruction. Why aren’t more women choosing reconstruction?

I’d like to explain the benefits of breast reconstruction, and address a number of misconceptions that in my experience cause many women to discount the potential benefits of this procedure.

Common Misconceptions

As a Seattle breast reconstruction surgeon, I see many women opt out of reconstruction because:

• Their mastectomy surgeon neglected to discuss the option at all, and/or failed to mention that the cost is generally covered by insurance
• The patient thinks she is too old for surgery
• The patient initially delayed reconstruction, and thinks that after years without breasts, reconstruction would have minimal benefits
• They dislike the idea of breast enhancement using implants

Over the years, I’ve seen better awareness of the benefits of reconstruction among mastectomy surgeons like the ones I work with. Some are even developing enhanced techniques to preserve more of the original breast curve by using more vertical mastectomy incisions.

While some patients have other health concerns that make them less eligible for surgery, in my experience most women who forego reconstruction because of age, time since mastectomy, or aversion to implants do not have accurate information about the procedure.

Seattle Breast Reconstruction: Options and Impact

There are actually two main options for breast reconstruction:

• Expander and Implant (typically more appropriate for larger-breasted women): The surgeon uses a tissue expander to stretch the chest skin gradually before replacing the expander with a breast implant.
• Flap Method: The surgeon reconstructs the breast mound using your own tissues from your abdomen or back.

While immediate reconstruction patients tend to experience greater benefits to their mood, both immediate- and delayed-reconstruction patients generally see significant positive effects on their:

• Self esteem and mood; specifically, incidence of depression and anxiety can be reduced
• Body image and how feminine a woman feels
• Sexuality, including both how attractive a woman feels and her degree of sexual satisfaction

Self-image is complex, so these benefits will be different for each woman. However, in general, women who choose not to undergo reconstruction tend to experience higher levels of depression and anxiety than women who do. Many patients find breast loss hampers personal relationships and everyday activities like clothes shopping.

In the end, many of my patients see their reconstructive plastic surgery in Seattle as part of the healing and recovery process. Better self-confidence and feelings of normalcy can accomplish a great deal to help a patient regain a sense of physical and emotional wholeness, and alleviate some of the fears that persistent after a cancer diagnosis. Many psychologists see breast reconstruction as “positive coping” because it requires a patient to initiate a decision about her body and assume control of her own wellbeing.