This is an article taken from Cosmetic Surgery Times.
Lifestyle Lift’s dirty little secret
September 10, 2009
This is an article taken from Cosmetic Surgery Times.
Lifestyle Lift’s dirty little secret
September 10, 2009
Taking these steps before scheduling a consultation with a cosmetic surgeon will ensure that you find a plastic surgeon with the highest qualifications.
Many patients have asked me if they can smoke cigarettes up to the time of their cosmetic surgery. The procedures most often in question are breast lifts with or without implants, breast reductions, tummy tucks and facelifts. Simply put, smoking and these procedures can be recipes for disaster. I strongly encourage smokers to quit smoking before these surgeries, as tobacco, nicotine, and carbon monoxide, all of which are within cigarettes, can impede wound healing. In operations which involve lifting and tightening large amounts of skin, this can result in skin separation, or worse yet, skin loss.
Most board-certified plastic surgeons are selective in the procedures that they will offer to tobacco users. Some procedures that do not require a significant amount of skin lifting, such as rhinoplasty, liposuction and breast augmentation, are thought to be somewhat safer to perform in smokers than procedures that require more skin manipulation. For that reason, most plastic surgeons will perform these surgeries in smokers, but will still extend significant disclaimers and warnings.
Virtually everyone knows that smoking can cause pulmonary problems, heart disease and lung cancer. For those reasons alone, I encourage all patients to quit using tobacco products. In regards to cosmetic surgery, tobacco usage can cause significant problems with healing. Because cosmetic surgery is elective, it only makes sense to quit tobacco usage prior to surgery to minimize this potential risk.
Many of my patients ask how I choose the optimal size for a breast implant. Some women are very concerned about choosing too large of an implant, as they know this can make their breasts look unnatural. Other women are afraid that they won’t choose a large enough implant to see a discernible difference. There are a variety of tools that I use to help my patients select the best breast implant size:
In the past couple of weeks, I’ve had some patients engage me in conversations about breast implant profiles. They had seen pictures on the Internet of patients with breast augmentation results they liked and wanted the same style implants as in the pictures. These patients had a limited understanding as to what breast implant profile refers, prompting this blog entry.
The naming for implant profiles predominantly refers to smooth, round implants, which are the most common type of implants used for cosmetic breast augmentation. The two major breast implant manufactures have different names for their implants. Allergan refers to its saline implants as low, moderate, and high profile and its silicone implants as moderate, midrange and high profile. Mentor has similar names, but also has a moderate profile plus implant, which is between its moderate and high profile implants.
The profile of an implant equates to the projection of that implant. For a given volume, the higher the profile, the fatter and narrower an implant is. As a result, higher profile implants tend to provide more fullness and a rounder appearance to the upper portions of the breast. Higher profile implants tend to be really useful in women with relatively narrow breasts who want significant enlargement of the breasts; in these women, if a low or moderate profile implant were selected, to achieve the desired volume may entail the implant riding into the underarm region. In contrast, a patient with a wider build or wider breasts may find that high profile implants may fail to adequately fill their entire breast; they often times benefit from implants with lesser projection. Higher profile implants also tend to be useful in women who desire a small breast lift without the incisions associated with a formal lift.
Almost no patients choose low profile implants for aesthetic breast augmentation; the limited amount of projection provided with these implants does not coincide with their aesthetic goals. Generally speaking, women looking to maximize their cleavage and perkiness often times opt for high profile implants. Ultimately, though, the best implant profile for a patient can only be determined after a careful examination by a board certified plastic surgeon, taking into account the specifics of a patient’s breast anatomy, as well as their desired appearance.
Treatments with injectable fillers, such as Juvederm, Restylane, Radiesse, and Evolence, not to mention others, can restore a youthful appearance to the lips, nasolabial folds, marionette lines, midface, jowls and lower eyelids, with minimal to no downtime. Many patients avoid these treatments, though, because they have heard horror stories from friends or colleagues about the pain associated with these treatments. Suffice it to say, this needn’t be the case – there are steps your plastic surgeon can take to make these treatments more comfortable.
Recently, BioForm Medical, Inc., makers of Radiesse, received approval from the Food and Drug Administration to mix the filler with lidocaine, an injectable local anesthetic, prior to injection into the skin. This approval was based on a large study of patients, in which 100% of patients reported feeling less pain when Radiesse was pre-mixed with lidocaine. Many plastic surgeons, including me, have begun to pre-mix lidocaine with all fillers, including Juvederm, Restylane, and Evolence, not to mention Radiesse, prior to injecting into patients. The results of treatment are still great, but patients are significantly more comfortable during treatment.
Others things your plastic surgeon can do to make your treatment with injectable fillers more comfortable include:
• Using topical anesthetic gel for at least 30 minutes prior to commencing any injections.
• Augmenting treatment with topical anesthetic gel with injections of local anesthetic into nerves above and below the lips.
• Using small gauge needles and slow injection techniques
Combining all of these treatments can ensure that you’ll not only look fantastic after your treatment with injectable fillers, but you’ll feel pretty good during the treatment too!