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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 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.

 

The Dirty Little Secrets of Plastic Surgery…Part 2 “Free” Consultations: You Get What You Pay For (Original Article)

· Choosing the Best, Safety · No Comments

 

Plastic surgery is booming. A combination of an aging baby boomer demographic, greater disposable income, affordable surgery and greater awareness, have all contributed to an increase in both surgical and non-surgical enhancements.

 

Patients are able to enjoy improvements to their face and body appearance like never before. However, along with the highly publicized successes of plastic surgery, there exist pitfalls and drawbacks that patients need to avoid. We call these the dirty little secrets of plastic surgery.

 

Part 2: The “Free” Consultation: You Get What You Pay For

 

The first step towards self-improvement through plastic surgery starts with the consultation. Some plastic surgeons offer “free consultations” in order to keep their waiting rooms and surgical schedules full. These usually go hand-in-hand with heavy advertising, phony car dealer-type “discounts” and a slick sales pitch. Ironically, places that lure patients with free consultations often charge more for surgery than honest, reputable plastic surgeons.

 

The problem with free consultations is that the patient usually gets what they pay for, nothing. Although there are exceptions, it is difficult to have a thorough and meaningful consultation with a plastic surgeon when dozens of other patients are also waiting for their brief “free” consultation. Patients typically complain that they felt like they were taking a number at the supermarket deli counter. I recall one patient who told us that her free consultation consisted of the doctor shaking her breasts and remarking, “Yup, you could use a boob job”!

 

Our office policy is to charge a modest cosmetic consultation fee. However, even though our fee is modest, it serves as a sufficient screening method. Amazing as it might seem, since plastic surgery is such an important, life-changing process that typically costs thousands of dollars, some patients quibble over paying even a modest fee for a consultation. We’re happy to refer them elsewhere for their freebies.

 

The decision to have plastic surgery is an important one that should be given the time, effort and seriousness that it deserves. The patient should invest in a thorough, honest and meaningful consultation. We have heard no greater regret than the patient who fell for a free consultation and slick sales pitch only to need to have the surgery redone.

 

Remember, unlike bad food, bad plastic surgery can’t be cured the next morning. So take your time, avoid “free” consultations, see several reputable doctors, and choose wisely. Remember, it’s your face and your body, don’t compromise.

 

About the Author:

 

Dr. Perez is a graduate of The Albert Einstein College of Medicine. He has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. A limited number of personalized consultations are offered by appointment only.

The Dirty Little Secrets of Plastic Surgery…Part 1 Choosing the “Best” Plastic Surgeon (Original Article)

· Choosing the Best, Safety · No Comments

Plastic surgery is booming. A combination of an aging baby boomer demographic, greater disposable income, affordable surgery and greater awareness, have all contributed to an increase in both surgical and non-surgical enhancements.

 

Patients are able to enjoy improvements to their face and body appearance like never before. However, along with the highly publicized successes of plastic surgery, there exist pitfalls and drawbacks that patients need to avoid. We call these the dirty little secrets of plastic surgery.

 

Part 1: Choosing the “Best” Plastic Surgeon

 

The relationship between patient and plastic surgeon is unique. It is different from any other doctor-patient relationship. Plastic surgery patients choose to have elective, medically unnecessary surgery. However, even elective surgery can carry risks and potential complications. Therefore, selecting the right surgeon is the first step towards self improvement. I like to define the “right” plastic surgeon in terms of 3 components; training, experience and personal compatibility.

 

Training at a top medical school and university residency program is a valuable foundation for any physician in practice. Plastic surgery training is broad and diverse and includes birth deformities, burn care, hand surgery, trauma and cancer reconstruction, as well as, of course, cosmetic surgery.

 

Plastic surgeons may focus their practices on any of these areas. However, only a small percentage of doctors are able to sustain a successful word of mouth, cosmetic surgery practice. Many must rely on heavy advertising, “free consultations” (more about that later) and cheesy car dealer-type “discounts” in order to keep their waiting rooms and surgical schedules full.

 

Another accolade some offices rely upon to lure patients is a “Voted the Best” designation. However, these doctors are usually “Voted the Best” by the very magazine they are advertising in. Cute, but plastic surgeons are not like pizzerias. Patients don’t usually have a facelift with every surgeon in town just to see who’s “the Best”.

 

Castle Connolly/U.S. News & World Report conducts a nationally recognized survey each year to identify Americas Top Doctors. This survey seeks the opinions of physicians and healthcare leaders to choose the top 1% of physicians in each specialty. It is an independent, blinded survey, so doctors do not, and cannot, buy their way onto the list.

 

Finally, it is important for a patient to choose a plastic surgeon who takes the time to listen and perform a thorough and honest consultation. It is often difficult to get that kind of personalized attention in factory style plastic surgery centers. However, unlike bad pizza, bad plastic surgery can’t be cured the next morning. So take your time, have multiple consultations, and choose wisely. Remember, it’s your face and your body, don’t compromise.

 

About the Author:

 

Dr. Perez is a graduate of The Albert Einstein College of Medicine. He has been selected among Castle Connolly/U.S. News and World Report’s America’s Top Doctorsevery year since 2000 (again for 2012-2013). He has lectured internationally and been featured as a plastic surgery expert for major media outlets. A limited number of personalized consultations are offered by appointment only.

10 Questions Every Plastic Surgery Patient Should Ask

· Safety · No Comments

About the Surgeon:

Question 1: Are you certified by The American Board of Plastic Surgery? Then call the Board to verify at 1-800-635-0635 or visit www.PlasticSurgery.org to confirm.

Question 2: Where did you obtain your plastic surgery training? Training programs in plastic surgery affiliated with medical schools are generally regarded as the best.

Question 3: What percentage of your practice is dedicated to aesthetic surgery? Many plastic surgeons concentrate on other areas of specialization, such as burns, reconstruction, or hand surgery. Also, plastic surgeons who focus on lasers, injectables and fillers often do so because their surgical procedure practice is not busy.

Question 4: How many times per year do you perform this operation?

Question 5: At which local hospitals to you have privileges to perform this procedure? Even if surgery is performed in the office, the surgeon should have at least one hospital as a backup. Then call the hospital’s medical staff office to verify the privileges.

Question 6: Who responds to patients’ questions or problems after hours and on weekends? Does someone else answer the page? The relationship with your plastic surgeon only starts on the day of surgery. You want to know that you can reach the doctor if an emergency arises. Try calling on a Saturday afternoon before surgery to see how difficult it is to get through.

About the Facility:

 

Question 7: Where will the operation be performed? (Hospital? Outpatient Surgical Center? Office?) Many reputable surgeons choose to operate in their office. However, sometimes this is a tip off that the doctor does not have hospital privileges.

Question 8: If the operation is done right in the office, what happens if there is a problem during surgery? Is there enough backup staff and equipment? There is no mandatory certification of office surgery in Florida. It is up to the facility to maintain its staff, equipment and procedures up-to-date in case of emergency.

Question 9: May I see the operating room? If it is not possible right now, make an appointment to come back when it is convenient. Don’t take no for an answer. It if doesn’t look safe, run, don’t walk, to the exit.

Note: Plastic surgery clinicsoften boasta “Certified Facility”, even though they are merely on-the-premises office operating rooms. They are cheaper and more convenient for the surgeon/owner. However, the problem with these facilities is: 1) Backup (see Question 8) and 2) Accountability (independent ambulatory surgery centers have strict peer review processes that ensure quality care. Private offices typically have no such patient safeguards.)

About the Anesthesia:

Question 10: Who will be administering the anesthesia and what are his/her credentials? (A doctor, a nurse, the plastic surgeon?) The anesthetist is an important and integral part of the safety and comfort the patient will experience during the surgery.

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