Archive for September, 2009

They’re really totally different options. Thermage can help if there’s a minimal amount of tightening expected, such as lower lids maybe. Sometimes the pre and postop photos on some of the new technologies out there are really difficult to reproduce. If you’ve seen Thermage results on an abdomen, I’d be pretty hesitant to expect much. It just has been really underpowered in those areas.

If your ABPS board certified plastic surgeon has told you that you are a candidate for a tummy tuck, then you should consider that and not thermage. There are different variations in tummy tuck (such as mini tucks or float abdominoplasties) for those that have very little extra skin. Those may be more worth your while to look into with more detail.

As with everything else in rhinoplasty, all you need to do is describe the top three things you want improved in the appearance of your nose. Your ABPS Board Certified Plastic Surgeon will then help you decide if you need this done to achieve what you want out of the operation.

It makes a big difference if you do it or not for your recovery. I find this step in the operation to be one of the major determinants of how your recovery will be. Without breaking the bones, the recovery is a breeze. With breaking them, you may have a mild case of black eyes, a splint on your nose for up to a couple of weeks, a little more swelling and thus discomfort, etcetera. That being said, I find myself doing it very often — because the patients anatomy needs it to achieve the goal.

Some reasons to break the bones of the nose are if they are too wide at the base.  If they’re not too wide but there is a significant bump on the bridge of the nose that you’re going to have reduced then we need to break them to bring them together once the bump is shaved off. Another reason could be if the nose is really crooked.  There’s a bunch of reasons, fortunately you don’t need to worry about them. Your rhinoplasty doctor should be able to explain to you if you’re going to need it or not…and sometimes he won’t know until during the actual operation. I wouldn’t suggest restricting your surgeon in this regard, he may need it to get you what you desire in your look for your new nose.

Can a Face Lift help my disproportionately fat face?

Fullness in your lower cheeks is a very common trait that is quite difficult to correct completely, however improvement can be made surgically. Without seeing your photos, I’ll answer the question in general terms. You are very young to have a Face Lift, but assuming this is what you’re interested in exploring I’m going to address to the question of what surgical option is most likely to be effective.

There are few surgeon’s that resect Bichat’s fat pad during a Face Lift since it is in a territory referred to as tiger country because of the high concentration of facial nerve branches. You should find the ABPS BOARD CERTIFIED PLASTIC SURGEON in your area that is comfortable with this and has photos to share his experience with you.

Yes, once the fat pad is decompressed/reduced there will be sagging cheek tissues. These will need to be lifted and re-suspended, thus requiring a Face Lift.

Some resect this tissue with a tiny suction cannula but I think that’s not a safe way of doing it since there are so many facial nerves there that control the movement in the corner of your mouth, suctioning is a blind technique and not my favorite way of doing it for that reason.

Lastly, I would warn you against your initial hunch of just tugging the skin laterally showing a significant improvement. There’s plenty of people out there that would do that for a small fee. The tension will be there with a Face Lift but it will not fully correct the problem in the long term.

Eventually, the tissues from the pull will relax, the Face Lift scar will widen (over the years), and the cheek will bulge back through an unnatural “lateral sweep,” where the wrinkles on your cheek sweep in the shape of a Nike swoosh! It is potentially a pretty unnatural look. If you only lift up on your jawline and don’t lift up your cheek, how will it look later on when your cheek continues to descend and your jawline didn’t? My intent isn’t to pose more problems, it is simply to reinforce the fact that your anatomy requires the skill of an ABPS Board Certified Plastic Surgeon that does Aesthetic Surgery.

The marionette lines can be improved with fillers, not a biggie. The turned down corners of your mouth is a little trickier but I’ve seen great great results just by using fillers causing some really nice optical illusions that show drastic improvements.

I’ll continue the conversation further by adding a definition differentiating the two surgeries. The difference between an umbilical float abdominoplasty and a mini tummy tuck is that the minitummy tuck is a smaller incision (just longer than a c-section) and just skin removal usually. The umbilical float is done to release the skin underneath the belly button and muscle tightening followed by fairly minor skin removal.

Your belly button should be slightly high or you need to have a long torso, otherwise your result will be somewhat unaesthetic.  It’ll depend on the artistic eye of the board certified plastic surgeon that you go to (this the ultimate US qualification for a plastic surgeon).

10 days should be fine.

As everything, there’s a spectrum of possibilities in the recovery for this surgery. There are many varying techniques in performing a full abdominoplasty that your ABPS Board Certified Plastic Surgeon will be familiar with.  If you discuss return to work at this deadline, I believe that it will in fact help your recovery since you are so motivated to get out of bed and mover around.  A technique of internal suturing can help get your drains out sooner than usual (typically a week).

Even if you go back to work with your drains, depending on what you do at your work, it is achievable. Your recovery will depend greatly on your anatomy, your stamina, tolerance and the actual operation performed. The plan you’ve made thus far is reasonable.

I’d hold off until you’ve had your last child.

You’re not fat so forget liposuction –  those lipo-tightening machines will work on your stretch marks about as well as the microdermabrasion you’ve had.

It’s tough to see how long your scar will need to be. Just sit down and look down .. that’s how long the scar needs to be for your tummy tuck. It’s nice to have a scarless abdomen, but not so nice if when you crouch or sit it’s full of rolls. In that case, there’s a bunch of lines on your abdomen anyway.

Save your money on all those treatments people keep selling you for stretchmarks… none of them work. Instead of  save up for your tummy tuck, once you get it done you’re gonna be so glad that you did.

You’re a great candidate and you’ll be even better after another child but make sure that you’ve gotten used to the scar that’s involved. Sounds like you’ve not basted in the idea long enough just yet. When that day comes, you should go for it.