Monday, December 19, 2016

Non-Surgical Treatments Cannot Replace Facelift Surgery

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157 patients under the age of 50 who underwent their first face lift at the New York Center for Facial Plastic and Laser Surgery between January 1, 2003, and December 31, 2013 showed that prior to that facelift each patient spent on average a total of $7,000 on nonsurgical treatments. These included fillers, laser, radiofrequency and botox treatments. The patients reported that they appeared 4 years younger after their nonsurgical treatments, but appeared 8 years younger after their facelift. The take home lesson is that nonsurgical treatments are not a replacement for facelift surgery and that is even more true of patients in their 60s and 70s.


Despite that and correcting for the 2008-2009 recession between 2007 and 2015 the population increased by 6.3% while the number of facelifts per year increased by only 6.1%. The percentage of the population undergoing facelift surgery appears to be a relative constant.

How Long Does A Facelift Last?
Face and Neck Lift 1
Face and Neck Lift 2
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Sunday, December 11, 2016

Pilonidal Cyst - Pilonidal Sinus

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Pilonidal cysts or abscess are located over the tailbone where the buttocks meet on the lower back. The cause is believed to be ingrown hair(s) and/or a congenital pilonidal dimple. Pilonidal is Latin for nest of hair. Excessive sitting or pressure on the area is thought to be a predisposing factor. They cause pain and tenderness over the area with itching and opaque yellow (purulent) or bloody drainage. It was first described by the Mayo brothers in 1833. The disease affects 70,000 people in the United States each year, most of them young men between 15 and 35 years of age. It is 7 times more common in dark skinned individuals, though every patient I have ever treated for pilonidal disease was white. It has historically been associated with the military and even earned the nickname "Jeep-rider's disease" in World War II as it was thought to be due to prolonged jeep rides in bumpy vehicles irritating the tailbone area.



A 2013 study of 151 military personnel afflicted with pilonidal disease revealed that the recurrence rate of the disease is related to the type of surgery used to treat it.


# Type of Surgery Complication Rate
45 excision and suture closure 62%
22 excision and suturing wound edges down  27%
69 excision and left open to heal 24.6%
15 incision and drainage20%

A 2008 study of over 1000 Israeli soldiers had a recurrence rate of only 16% using the trephine technique and 9 year follow up. Almost 90% were healed at 4 weeks after surgery vs. the months required for healing if left open to heal or the edges are sutured down. Other advantages of the trephine technique are less pain after surgery and a quicker return to work. The best options are therefore excision and flap closure or the trephine technique.

Negative Pressure Wound Therapy

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Thursday, November 24, 2016

4 Types of People Who Should Not Have Plastic Surgery

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  1. Nothing left to fill or do 
  2. Those who have already had so much done that it is impossible to inject more filler or place  even larger breast implants in the current skin envelope. Those who have had so much botox that nothing moves yet they ask for more botox.
  3. Copycats 
  4. Those who want to look like someone, usually a celebrity or model, with completely different features, proportions and/or ethnicity. The goal of Plastic Surgery should be to turn back father time but not mess with mother nature.
  5. Doctor shoppers 
  6. Those who hop from one doctor to the next in order to get various treatments and procedures that may not normally be allowed by one doctor. They have typically seen too many doctors and are unsatisfied with what they were told or what has been done. The have unrealistic expectations and behave like patients visiting pain pill mills.
  7. Fit specific profiles
  8. These include the Body Dysmorphic Disorder (BDD) types who exaggerate perceived flaws and become dysfunctional because of these perceived flaws, the Single, Immature, Male, Overconfident and Narcissistic (SIMON) who are never satisfied with their rhinoplasties and those who have undergone numerous other procedures before but are continually unhappy despite having had acceptable outcomes.
Body Dysmorphic Disorder (BDD) and Plastic Surgery

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Tuesday, August 30, 2016

Skin Aging and Wrinkling by City and State

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Skincare, maker of topical anti-aging skin care products, partners with , an analyzer of American city demographics, to produce a yearly ranking of US cities with respect to skin aging and wrinkling. In their analyses the top 5 factors contributing to skin aging/wrinkling are low winter temperatures, extreme weather temperatures, commuter times, sunny days (UV exposure), and elevation. Other contributors are stressful living, dry heat, ozone pollution, sleep deprivation and smoking rates. Although UVB is blocked by glass up to 72% of the UVA radiation of the sun, that which damages and ages the skin, still penetrates ordinary glass. So those with long commutes have significant sun exposure. The risks for skin wrinkles obviously overlaps with skin cancer risks. In 2015 New York was the most wrinkle prone and Alaska was the least most wrinkle prone state. California came in at 36th , Texas at 38th and Florida at 32nd.




Thursday, August 25, 2016

Plastic Surgery Around the World in 2015

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The International Society of Aesthetic Plastic Surgeons released its worldwide statistics for 2015 which are interesting for the following reasons.
world population 2015
In 2015 the USA, Brazil, Mexico and South Korea accounted for 9.6% of the world’s population.
total world breast implants saline 2015

total world breast implants silicone 2015
Yet the USA accounted for 75% of the world’s total breast implant placement and 56% of its saline breast implant placements.


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