Thursday, December 27, 2012

Facial Feminization Surgery - Forehead and Jaw Contouring Reshaping

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Historically differentiation between male and female skulls was performed by anthropologists and medical examiners by analyzing nose, chin and forehead bone shapes in cadavers. Today it is common knowledge that faces contain secondary sex characteristics that develop during puberty and make male faces easily distinguishable from female faces. The female chin is more rounded or pointed than the square male chin and their less prominent noses have less angular tips . The male forehead has a prominence of bone, a horizontal ridge of bone, running across the forehead just above the eyebrows (bossing), followed by a concave area and then slopes upward and backward. The female forehead lacks bossing and the concave area above it and rises vertically rather than sloping upward and backward.
Additionally as is evident in these photos the angle of the lower jaw in front of and below the ears is more prominent in males

Tuesday, December 4, 2012

How Long Does A Facelift Last?

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This a question most patients have going into facelift surgery and my usual answer was 5 to 10 years depending on genetics, age at surgery (it lasts longer in younger patients), exposure to extreme climates and active or passive smoking. Now a long study out of the UK shows that more than five years after facelift surgery, three-fourths of patients still look younger than they did before surgery. The researchers looked at photographs of 50 patients who had undergone facelift surgery an average of 5½ years previously. Surgical changes in the lines around the nose and mouth had the greatest longevity while the angle of chin to neck (the neck outline) changes deteriorated the most during this time frame. This is probably why neck revisions after facelift surgery are more common than revisions above the jaw line. The study does not tell us how long all of the changes last only that they last to some degree for more than 5 years.
One of my male facelift patients in his 60s did not require anything but a laser resurfacing a few years after facelift surgery and sculptra dermal filler injections 8 years after facelift surgery to maintain his results.

Male Facelift
Face and Neck Lift1
Face and Neck Lift2
Mini Facelift-Lifestyle Lift-Quick Lift

Aaron Stone MD - twitter
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Monday, December 3, 2012

Genital Cosmetic Surgery - Designer Vagina

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Researchers at the UCL Elizabeth Garrett Anderson Institute of Women’s Health, University College Hospital in London, England looked at the first 5 websites that appeared on Google searches for female genital cosmetic surgery in the US and the UK. They then assessed the content of those sites for different criteria including what and how procedures were carried out, success rates, potential risks, terms used to describe the procedures.

Tuesday, November 20, 2012

Reconstruction After Breast Cancer Surgery

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Breast cancer forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and/or lobules (glands that make milk).

It existence was acknowledged thousands of years ago. The ancient Egyptians in 1600BC described it as a “coagulum of black bile” within the breast and thought that getting rid of the excess bile¬ — through surgery, special diets, purging or even attaching leeches to draw out the bad blood— could cure the disease. In 1889, American surgeon William Halsted, a founder of renowned Baltimore teaching hospital Johns Hopkins, performed the first radical mastectomy removing the breast and underlying chest muscle in an attempt to cure the disease. It was not until the introduction of breast implants in 1963 that any reasonable breast reconstruction could be performed.

Monday, October 15, 2012

Rhinophyma - Acne Rosacea

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Rhinophymas have been observed for centuries but the term rhinophyma (from the Greek rhis for nose and phyma for growth) was first used in 1845 by Hebra. It was initially thought to be due to chronic alcohol consumption but is currently thought to be a severe form of acne rosacea. Rosacea is a chronic inflammation and vascular condition that affects the face which in turn generates redness and visible blood vessels. There is bulbous enlargement of the nose with a ruddy complexion and numerous pits along the surface. The sebaceous glands of the nose increase in size and number with each surface pit being the mouth of a gland. Although the disease is benign superficial skin infections are characteristic with drainage of foul smelling material. It is 12 times more common in men than women.

Tuesday, October 2, 2012

Remove Stretched Ear Piercing

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The stretching of body piercings has been practiced for thousands of years presumably beginning shortly after humans started wearing jewelry. Mummified bodies with stretched earlobes have been discovered, including the oldest mummified body discovered to date: Ötzi the Iceman (3300BC). Gautama Buddha, an aristocratic and wealthy prince, had long stretched ears. He wore heavy gold earrings or precious stones as a status symbol, and the weight stretched his ear lobes dramatically. When he finally renounced his wealth and discarded his jewelry, his ear lobes were permanently stretched. As a way of remembering Buddha's act of personal self-sacrifice in walking away from his wealth, all succeeding images of Gautama Buddha show his stretched ear lobes without jewellery. Ancient Egyptian pharaoh King Tutankhamen is of one of the earliest known to have stretched ear lobes. It can clearly be seen in one of his more famous images on his sarcophagus. African, Eurasian and American indigenous peoples did and do so for cultural, religious and traditional purposes.

Modern day teens and 20 somethings are also stretching their ear piercings in vast numbers.

Monday, October 1, 2012

Plastic Surgery in South Korea

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According to a International Society of Aesthetic Plastic Surgeons survey the top 3 countries in the world in terms of the number of people in the country having plastic surgery are the United States, Brazil and China. Over 3.3 million plastic surgery procedures were performed in the US, 2.5 million in Brazil and 1.27 million in China in 2010. When you look at plastic surgery per capita to correct for the size of the population the picture is quite different. South Korea had the most per capita in 2010 with 16 procedures per 1,000 people. Half of them had non-invasive treatment including botox and facial peels. Next came Greece with 14 procedures per 1,000 population, followed by Italy, Brazil, Colombia, the U.S., Taiwan, and Japan.

Sunday, September 23, 2012

Laser Tattoo Removal

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Tattoos have been applied to human skin for thousands of years. In 12,000 B.C. ash rubbed into skin cuts at bereavement ceremonies. Tattoo pigment bowls and needles have been found in Western Europe dating back to 8,000 B.C. Egyptian mummies have been found dating back to 4,000 B.C. that have tattoos as well as evidence of attempted removal. In 543 A.D. the Greek Aetius first documented the attempt at tattoo removal using salabrasion (abrasion of the skin with salt).

Monday, September 17, 2012

New Type of Breast Implant - The Ideal Breast Implant

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The 2 main types of breast implants available for decades have been the saline filled an silicone gel filled breast implants. Each has its pros and cons. Silicone gel implants have a more natural feel and look. Unlike silicone gel, implants containing only saline do not blend well with surrounding tissues at the edges of the implants. This is due to the chemical properties of salt water which is chemically charged as positive and negative charges that attract each other as opposed to silicone gel which does not carry a charge. Thus saline is more cohesive than silicone. What this means in clinical terms is that saline implant margins are more visible than silicone gel implant margins, especially when the soft tissue (breast gland and fat) between the outside world and the implant is thinner. Thus, in those patients with smaller breasts (less glandular tissue and/or fat) it is preferable to place saline implants under the chest muscle.

Wednesday, August 29, 2012

Finding a Breast Augmentation or Related Procedure that Works for You

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This is a guest post by&nbspPeter Samberg, writer forAssociates For Plastic Surgery- A Leader in San Diego Breast Augmentation.

Every year hundreds of thousands of women undergo breast surgery. Many of these are cosmetic procedures that utilize breast implants. The surgeries are performed by plastic surgeons. Generally, breast augmentation surgery is designed to increase the size of small and underdeveloped breasts.

Pregnancy and breast feeding can decrease breast volume
Breast surgery can also restore or enhance breast volume. The size of a woman's breast will sometimes decrease as a result of pregnancy or breast feeding. Additionally, breast implants can serve numerous other purposes.

Monday, August 27, 2012

Systemic Lupus Erythematosus (SLE) and Cosmetic Surgery

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Lupus is a rheumatic condition which affects the muscles, joints, and connective tissue. About 1.5 million people in the US have lupus which includes as many as 10,000 children. Nearly 90% of those diagnosed with lupus are female. It's an autoimmune disease. A healthy immune system produces special proteins or antibodies and these normally protect the body against bacteria and viruses that cause infections. In the case of lupus, the immune system confuses the body's healthy cells and sees them instead as if they were a bacteria or a virus, and the result is that our antibodies then attack some of our own body's healthy cells. You become allergic to yourself.

Friday, July 20, 2012

Mini Facelifts - LifeStyle Lift, QuickLift...

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Anyone watching television lately has been exposed to a mass marketing blitz by Lifestyle Lift. The infomercials claim over 150,000 completed surgeries and are filled with satisfied customers who in before vs. after photos look remarkably younger and happier after surgery. In 2012, Grammy®-winning singer, author, and television personality Debby Boone, best known for her 1977 RIAA Platinum-selling #1 hit "Theme from You Light Up My Life," became the spokesperson for the company in its television commercials and its half-hour infomercial; the song is well-represented in both the commercials and in the infomercial.

Tuesday, July 17, 2012

Groupon and Discount Coupons for Cosmetic Surgery

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Social media coupon sites such as Groupon and Living Social entice consumers to buy online coupons for products, services and procedures offered by a provider at a reduced price with the addition of a viral component in terms of likes and comments that appear on users facebook timelines.
These social media sites receive payment based on the number of consumer participants, and the arrangement generally brings higher-than-normal customer volume to the providers - in this case, plastic surgeons. However, some elements of this marketing should raise red flags with surgeons as well as patients, including:
  • Exaggerated language in the offering: Numerous sites use extreme exaggerations to garner attention
  • Lack of medical review: The only requirement the customer must meet is to purchase the coupon, which means that services or procedures are offered to potential patients without regard to medical suitability

Friday, July 6, 2012

Botox May Help Cancer Patients Recover Their Voice

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This is a guest post by Rod Kelly, a content writer for Cosmetic Surgery. You can follow Rod at @thefreshhealth :)

The botulinum toxin is widely recognized for its ability to decrease the appearance of wrinkles in cosmetic surgery. What many people may not know is that it also has a number of health benefits as well. Hospitals in India are currently using the drug as a treatment for cancer patients who have lost their voice due to throat cancer. Patients undergoing cancer treatment undergo a removal of the voice box as a part of the treatment necessary to remove the cancer.

Sunday, June 24, 2012

Vampire Facelift is Really a Face Fill

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A google search on Vampire Facelift yielded 1,020,000 results. The term was first used by the press in a July 2010 ABC News report on the use of Selphyl for facelifting. Selphyl first became available in 2009 and involves taking a small sample of blood from the patient mixing it in a test tube to separate blood components, which takes about 20 minutes and then injecting some of the components (platelets) into the area to be filled. Your body then makes collagen to fill the depression or fold. The process takes about 3 weeks from the date of injection to become visible. Because the result was rejuvenating and the material came from one's own blood the term Vampire Facelift was employed. Although hyaluronate injectable fillers like Restylane had been around for 7 years at this point the injection of hyaluronate together with this platelet material began around this time.

Wednesday, June 6, 2012

The Dangers of Sun Exposure

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In today's world the dangers of sun exposure as they relate to skin cancers and aging of the skin are common knowledge. The aging side of the issue was further supported by a case study published in the April edition of the New England Journal of Medicine. A patient seen at Northwestern Medical Center in Chicago was 66 years old on the right side of his face and 86 years old on the left side.

Monday, June 4, 2012

Nerve Freezing Alternative to Botox

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Botox has been available for decades to treat fine wrinkles on the face but this involves injecting minute amounts of a poison to temporarily paralyze the nerves. An estimated six million doses of botox are now given every year so it is now the single most popular cosmetic treatment in the United States. Now a revolutionary new concept is being developed to replace botox. It involves freezing the nerve so it is temporarily damaged and therefore paralyzed for an equivalent amount of time as the botox injection.

Thursday, May 31, 2012

Controlling Pain After Cosmetic Surgery

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Pain control during surgery has been quite good for a number of decades. Refinements in recovery from anesthesia to lower the incidence of nausea, shaking etc. after surgery have been accomplished by adjusting the mix of anesthetics used and employing newer medications like propofol, toradol, zofran etc. More recently the focus has been on controlling pain after surgery to lessen the need for narcotics, shorten recovery times after surgery and improve surgical results in general. The opioid narcotic medications commonly used can become addictive, have small windows between effective and overdosing quantities that affect breathing and tend to be constipating.

Wednesday, May 16, 2012

Liposuction Can Result in More Fat Around Internal Organs

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Plastic Surgeon researchers at the University of Sao Paulo in Brazil followed 36 normal-weight women who had liposuction to take away a small amount of superficial tummy fat. Beginning 2 months after surgery half of these women were placed on an exercise program (walking on a treadmill and doing light strength training 3 times a week), while the rest stuck with their usual lifestyle. None exercised regularly before surgery.

Four months later the women who did not exercise still had flatter tummies, but they had 10% more fat around the organs inside the abdomen. The women who did exercise had no such gain in this visceral fat. This the the first study showing increases in visceral fat after liposuction if you do not exercise.

Thursday, March 22, 2012

Botox, Xeomin and Corporate Espionage

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On Friday, March 9, US District Judge Andrew Guilford entered an injunction against Merz Pharmaceuticals in his Santa Ana, California court chambers. This prohibits Merz from selling filler products or Xeomin or soliciting the purchase of filler products or Xeomin in the facial aesthetic market for 10 months from the date of the order, except in limited circumstances. Merz has to also do a number of other things and report on these to the court in 6 month intervals for the next year in a half. This took place about a week before Merz was supposed to introduce Xeomin, a new direct competitor to Botox, at a major medical meeting in the US.

Saturday, March 17, 2012

Treatment of Aging Hands

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As you get older your hands lose fat and muscle volume. The skin develops brown spots (liver spots also know as sun spots), becomes more translucent and shriveled, thins and loses its elasticity. The skin doesn’t bounce back when you pinch it. The underlying veins, tendons and bones then become more visible.

Although we have botox, injectable fillers and facelifts to make our faces look younger as we age the hands frequently look much older than our treated faces. Joan Rivers, no stranger to plastic surgery, suggested to The Huffington Post after Madonna’s recent Super Bowl performance that she favored fingerless gloves because “she’s trying to hide those wrinkly old hands.” Madonna now usually makes public appearances wearing gloves.

Tuesday, February 28, 2012

Documentary of Plastic Surgeon Volunteer Treatment of Acid Burn Victims Wins Academy Award

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Sharmeen Obaid-Chinoy was born in Karachi Pakistan, emigrated to Toronto, Canada and this passed weekend won an academy award here in Los Angeles for her short documentary film Saving Face. The film documents the plight of Pakistani women who are disfigured by having acid poured on them usually by relatives, husbands or rejected suitors. The acid damages the skin, sometimes exposes the underlying bones and often times causes blindness in one or both eyes. The film chronicles the efforts of a Pakistani born British plastic surgeon, Mohammad Jawad,  to reconstruct their faces and restore their dignity. It is the first win for a Pakistani film. A win that instills pride and shame at the same time. Over 100 such attacks occur in Pakistan each year. Most go unreported and the women live secluded lives due to the circumstances surrounding these attacks (in the case of husband attackers they do so out of fear for their children) so the number of victims could even be double that. In the course of the film a girl describes being burned at age 13 for rejecting the advances of her teacher. In the Western world that teacher would have been prosecuted. Although it is rare a female Pakistani lawyer took up the legal case of one of the victims in the film and successfully managed to have the perpetrator convicted. Sadly these women require multiple operations to regain some resemblance of normal appearance. There is a report of a New Delhi India girl who underwent 25 reconstructive operations to treat disfiguring from acid burns.

Saturday, February 18, 2012

Woman's Body Swallows Breast Implant

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A report from Johns Hopkins University in the December 2011 New England Journal of Medicine describes the swallowing of a breast implant into a woman's chest cavity. The patient had reconstruction of both breasts after mastectomy for breast cancer. She subsequently had minimally invasive heart surgery via the right mastectomy scar. Some time later while partaking in a Pilates class the right implant was swallowed by her body during a stretching exercise. The intact implant squeezed through a small hole between her ribs left from the heart surgery and ended up on top of her right diaphragm. It must have been scary to look down and see the implant disappear into her chest.
The implant was retrieved, the hole in the chest was closed with a mesh patch and the implant was put back in its original position. Now I assume she is back doing Pilates. This is one thing you don't see everyday.

Aaron Stone MD - twitter
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Tuesday, January 31, 2012

Home Laser and Cosmetic Devices

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A Google search on "home laser" yielded 154,000,000 website links overseas and 48,000,000 when searched in the US. Most of the initial listings are for hair removal devices but there are also ones for treating acne and for facial rejuvenation and others treat skin conditions like psoriasis, vitiligo and dermatitis. Many of these home laser and light or ultrasonic devices can be purchased on the Internet. Sellers tout the benefits of these products in treating acne, age spots, large pores, wrinkles, sagging skin, puffy eyes, rosacea, cold sores, and many other skin conditions. However, few of the devices have been studied or approved by the Food and Drug Administration. Some of them sound sort of scary and could be a waste of money or at worst harmful. Sales of home cosmetic devices totaled $500 million last year, and are expected to nearly double to $950 million in 2015. Women have been removing hair from their legs for quite some time. Now it is a multibillion dollar per year industry.

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