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Month: January 2013

New Year, New You: 5 Plastic Surgery Procedures to Start the New Year

· Abdominoplasty/Tummy Tuck, Body Contouring, Breast, Breast Augmentation, Breast Implants, Choosing the Best, Eyelids, Face and Neck, Safety · No Comments

            It’s resolution time again. Exercise, weight reduction and improving our appearance are always high on the list of objectives for the new year. Here are 5 popular plastic surgery procedures that produce a valuable, big-bang-for-the-buck change to begin the journey. The procedures featured here are very popular and offer a significant change with a high degree of patient satisfaction.

 

Eyelid Tuck

 

            The first place aging becomes evident is around the eyes. If the eyes are the windows of the soul, then the eyelids are the curtains that allow us enjoy the view. The upper lids develop excess skin causing hooding.  The puffy bags on the lower lids create a tired look.

 

The procedure of choice to correct tired eyelids is the eyelid tuck or blepharoplasty. It is one of my personal favorites to perform and is the most commonly performed aging procedure for men. The procedure takes 45 minutes and patients soon enjoy a refreshed and less tired look.

 

 

Face/Neck Lift

 

Facelift territory includes the area of the cheeks, jawline and neck. As we age the skin and other tissues sag from the underlying bony structures. Although highly advertised under many catchy terms, surgical facelift procedures generally fall into two categories, mini and full. A mini-facelift is best suited for patients in their 40’s or younger who just want to freshen the cheek and jawline.

 

The patient for traditional face and necklift is in her late 40’s and older with laxity of the jawline and neck, often with turkey-like banding. Combined with eyelid surgery, the procedure often produces dramatic results and can reduce the aging appearance by decades.

 

 

Breast Augmentation or Breast Reduction

 

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. Women choosing breast implant surgery want to achieve greater fullness and cleavage and fit their clothing more naturally. Many implant options exist and attention to detail is important. Breast augmentation is also one of the most commonly re-done procedures so women should carefully choose a compatible surgeon based upon credentials and experience.

 

Women who experience neck and back pain from heavy pendulous breasts can achieve a significant lifestyle improvement with breast reduction. Breast reduction can improve exercise tolerance, as well as lead to weight reduction and greater overall fitness.

 

Tummy Tuck

 

 

            Pregnancy or weight loss can create changes in a woman’s abdominal skin and muscles. In these cases, the procedure of choice is an abdominoplasty, also known as a tummy tuck. Tummy tuck surgery results in a substantial removal of excess skin and stretch marks, as well as tightening of the muscles. The result is a remarkable improvement in the belly with a very high degree of satisfaction.

 

Regardless of where you choose to start, these procedures, in the hands of a skilled surgeon, can produce dramatic results and patients who are among the happiest in plastic surgery. Bon voyage.

 

About the Doctor:

 

Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. He has lectured internationally and been featured as a plastic surgery expert for major news outlets. Dr. Perez is a member of the National Council of Leaders in Breast Aesthetics and was selected as a principal investigator for a national FDA-approved study on abdominoplasty. For more information call (954) 351-2200 or visit www.PerezPlasticSurgery.com.

 

It’s Thanksgiving: Time To Deal With The Turkey…Neck

· Face and Neck, Safety · No Comments

Jorge A. Perez, M.D., F.A.C.S.

            One of the most common areas requested for plastic surgery improvement by both women and men is the neck. Youth and attractiveness are defined by a strong jawline and a firm, clean neckline.

 

The aging process in the neck usually starts by age 40 and is affected by several components: the skin, bones and cartilage, and the underlying soft tissue, including the muscles and fat. Treatment options will depend upon the correct evaluation of each of these elements.

 

Jaw surgery or chin implants can help compensate for a bony profile deficiency. These procedures however can be complicated and should be approached cautiously with experienced surgeons.

 

Younger patients with excess neck fat alone and good skin tone may benefit from liposuction. Ultrasonic lipoplasty is an advanced liposuction technique that will also stimulate neck skin tightening.

 

The most common aging change affecting the neck is hanging skin, affectionately known as the “turkey neck”. In addition, loose muscles can contribute to the “gobbler” or wattle.

 

A muscular sling in the neck that is tight in youth but begins to separate as we age is called the platysma. The separation in this muscle causes two ridges that define the neck bands of age. A common treatment to correct this separation is to sew these bands together with a small incision under the chin.

 

A unique, less invasive, operation performed by our office is to combine neck muscle repair with ultrasonic lipoplasty for skin tightening in carefully selected patients. We were privileged to present this procedure last year to plastic surgeons in the U.S., Europe and Asia.

 

The gold standard for neck rejuvenation however, continues to be the conventional face and neck lift. The procedure allows for redraping of the cheeks, jawline jowls and neck in a more even and complete fashion. The anatomy of this area is complex, therefore a thorough consultation with a plastic surgeon experienced in face and neck surgery is required.

 

Many options exist for rejuvenation of the neck and lower face. The procedures can be safe and effective in proper hands. The plastic surgeon, facility and anesthesia all play an important role in the outcome. Cost should never outweigh quality, experience and safety. Happy Thanksgiving.

 

 

About the Doctor:

 

Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors. He has lectured internationally on face and neck rejuvenation surgery and has been featured as a plastic surgery expert for major media outlets. Surgery is performed at the Broward Health Weston facility with physician anesthesiologists.

To schedule a consultation with Dr. Perez call (954) 351-2200. To learn more about any of these procedures visit www.PerezPlasticSurgery.com.

 

The 5 Steps of Breast Cancer Reconstruction

· Breast, Breast Augmentation, Breast Implants, Breast Reconstruction · No Comments

 

October is breast cancer awareness month as it continues to be one of the most common disorders affecting women. However, great strides have been made in both cancer diagnosis and treatment. In addition, many options exist for reconstruction following breast lumpectomy or mastectomy that allow these women to enjoy a greater quality of life.

 

There are several important and timely decisions for women to consider in achieving an optimal outcome. These choices can be overwhelming, though, so here are 5 steps to help women work through this difficult time.

 

Step 1: The Cancer Operation

 

Following the diagnosis of breast carcinoma a woman’s first consultation should be with a general surgeon experienced in all of the options for removal of the cancer. Together they should decide upon mastectomy or less radical surgery such as lumpectomy, as well as the role of adjuvant treatment such as chemotherapy and radiation. Based upon these plans a referral to a plastic surgeon with expertise in breast surgery is in order.

 

Step 2: Immediate vs. Delayed Reconstruction

 

The initial consultation with a plastic surgeon includes a thorough medical history and directed physical examination. The first decision will be whether to delay the breast reconstruction or begin at the time of mastectomy. The latter is regarded as an “immediate” reconstruction. Coordinated surgery offers the advantage of a single operation and fresh tissue planes for a cleaner and faster reconstruction, although delayed breast reconstruction can also be safely performed years after a mastectomy.

 

Step 3: Autologous Tissue vs. Prosthesis Reconstruction

 

The detailed plastic surgery discussion should include the types of reconstruction. There are several procedures available for creation of a new breast mound ranging from simple implant placement to microsurgery. The choice will depend upon several variables including the patient’s desires and body type. Autologous reconstruction is performed using the woman’s own body fat from the belly, back or buttocks. These can be lengthy and more complicated procedures. Breast implants, with or without expansion of the chest skin is called prosthesis reconstruction.

 

Step 4: The Other Breast

 

The opposite, healthy breast can be reshaped as well. Breast augmentation, lift or reduction for the purpose of achieving symmetry to the reconstructed breast may be necessary and should be included in the reconstructive planning.

 

Step 5: Nipple and Areolar Reconstruction

 

Once a new breast mound has been formed the final phase is the optional creation of a nipple and/or areola. Many procedures exist for this purpose. Although these are not mandatory, the results can be amazing.

 

Finally, and fortunately, laws exist to protect women from insurance companies during this vulnerable time. Florida law mandates coverage for both the reconstructed breast as well as the other healthy breast, if necessary, to achieve symmetry.

 

About the Author:

 

Dr. Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan), leading breast implant manufacturers. Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. Our office aggressively advocates only on behalf of patients, not insurance plans. More information is available at www.PerezPlasticSurgery.com or call (954) 351-2200. Visit our website blog to learn about The 10 Questions Every Plastic Surgery Should Ask.

Sientra: The New FDA-Approved Shaped Gel Breast Implant

· Breast, Breast Augmentation, Breast Implants, Choosing the Best, Safety · No Comments

Breast augmentation surgery is the most commonly performed surgical procedure in plastic surgery. Following the breast implant lawsuit crisis of the early 1990’s most silicone gel manufacturers fled the U.S. market. Only two companies, Allergan (formerly McGhan/Inamed) and Mentor/J&J, remained and have dominated the market for the past 20 years. One consequence of this implant duopoly is that the cost of breast implants increased from hundreds to thousands of dollars since the 1980’s.

 

Earlier this year the U.S. F.D.A. which regulates medical devices approved a third breast implant manufacturer. Santa Barbara based Sientra was approved to offer silicone gel prostheses for sale in the U.S.  Allergan and Mentor are also based in Santa Barbara, leading to the affectionate term of “Silicone Alley” for the Southern California region.

 

Dozens of breast implant companies exist throughout the world. Many of these brands are sold in Latin America. Sientra’s parent manufacturer has sold implants internationally, but of course U.S. approval is a highly coveted achievement.

 

A Good Thing…and a New Thing

 

The arrival of a third player to the U.S. breast implant market is expected to be a good thing for American women. In addition to providing greater competition, Sientra offers a unique line of shaped gel implants. These “teardrop” or “anatomical” breast prostheses are commonly used in Europe and Latin America. A saline-water filled version has been available for years in the U.S. However, Sientra is the only manufacturer granted F.D.A approval for the gel filled type.

Shaped implants offer greater options for both cosmetic and reconstructive breast surgery. The prostheses come in a variety of shapes, sizes, base diameters and projections giving both the patient and surgeon greater versatility in body contouring.

 

The augmentation procedure using shaped implants is different from the traditional round prosthesis insertion. Therefore it is advisable that patients choosing these implants consult with experienced breast plastic surgeons. As a corporate philosophy, Sientra will only sell and warranty implants placed by plastic surgeons recognized by the American Board of Plastic Surgery.

 

Editor’s Note: Dr. Perez can be seen on ABC News in Miami discussing the Sientra implant at:

www.Youtube.com/user/PerezPlasticSurgery

 

 

About the Author:

 

Dr. Perez is a member of the NOVO National Council of Leaders in Breast Aesthetics. He has served as a consultant for both Mentor (J&J) and Inamed (Allergan). Dr. Perez has lectured internationally on the subject of breast surgery and has been selected among the Castle Connolly (U.S. News & World Report) America’s Top Doctors. More information is available at

The Forty-Something Facial Freshen-up: Are You Ready?

· Choosing the Best, Eyelids, Face and Neck, Safety · No Comments

The appeal of plastic surgery spans age groups from teens to seniors. Although not always the case, certain procedures such as nose reshaping and breast surgery apply to younger patients. Older candidates typically seek procedures to address aging issues.

 

Forty is a magic number for many of us. In our practice, one of the most common reasons listed for seeking plastic surgery consultation is “turning 40”. Legendary comedian Jack Benny remained at his trademark “39” for decades!

 

Patients in their forties present a unique and interesting demographic subset. Breast and body contouring procedures are popular among the “Mommy Makeover” group (that’s next month’s column).   In addition, forty is the age when many patients begin to first notice the signs of facial aging. Skin care. facial lasers and injectables are very popular.

 

Among the more common surgical procedures that appeal to forty-somethings are eyelid tucks, cheek lift and neck firming. These 3 procedures, each performed by us in under an hour, can offer a natural, fresher look with a rapid recovery and a high degree of patient satisfaction.

 

 

The Eyes Have It

Eyelid changes by age 40 may include extra upper lid skin and lower lid bags. The eyelid tuck procedure known as a cosmetic blepharoplasty, popular among both men and women, address these problems effectively. The results are usually a more rested, less angry and tired look, to the face. Blepharoplasty is the most common facial surgical procedure.

 

Face Time

Full face and neck lift remains the gold standard for facial rejuvenation. Nationally, most of these patients are in their mid-40’s-mid-60’s, although in South Florida we see patients well into their 70’s and 80’s.

 

A less invasive alternative to full face lift that appeals to the forty-somethings is the isolated cheek firming. Lifting the cheek and jawline can be done with a small incision “mini” face lift. Although they come by many catchy names, including the “lunchtime” lift, and others, these “mini” or mid-face lift procedures effectively freshen the cheek and jawline with natural, not pulled, results.

 

Up To Your Neck Yet?

A third area of rejuvenation is the neck. Some patients first notice the effects of aging when they can pinch the skin under the neck. For these patients, an isolated neck tightening procedure is a great option. Loose skin, fat and muscle can contribute to the extra wattle. They can all be addressed through a small incision under the chin.

 

Our preference is to add advanced ultrasonic treatment to achieve greater tightening of the neck skin. We were recently honored to present our unique isolated neck rejuvenation technique at international plastic surgery congresses in Greece and Korea.

 

 

Turning 40 may be a major milestone but with the many skin care and surgical options available today at least the signs of aging can be delayed. The three surgical procedures we’ve outlined here take relatively little time and offer a rapid recovery with a high degree of satisfaction when patients fully understand the risks and benefits. However, as with all plastic surgery, a skilled surgeon, a safe facility, and a competent anesthesiologist are key to a successful outcome.

 

About the Doctor:

 

Dr. Perez has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctors (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. Surgery is performed at the Broward Health Weston facility.

To schedule a consultation with Dr. Perez call (954) 351-2200. To learn more about any of these procedures, or to view our recent ABC News “Seniors and Cosmetic Surgery” segment, featuring Dr. Perez visit www.PerezPlasticSurgery.com.

 

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