Removing Old Scars

There are several cosmetic surgery procedures that can leave a patient with scars, especially if the procedure was performed decades ago, prior to the smaller incision technology that is available today.  However, an individual has several available options to diminish old scars, below are some of the most effective:

• Scar gels
• Scar creams
• Silicone sheeting
• All of the above

Silicon sheeting consists of a pre-cut shape meant for long term treatment, however it is not suggested for individuals who perform strenuous exercise on a regular basis.  If you do have a more active lifestyle, a high performance gel or cream may be the best option for you.

Whichever remedy you choose, the key to success is staying consistent with the treatment!

A Guide to Otoplasty

Regardless of age, having enlarged or misshaped ears can have a negative effect on an individual’s self-esteem. Typically this procedure can be performed from ages 5 and up, once the ears have reached full maturity.

Otoplasty was first developed by Sushruta, a physician often regarded as the “father of surgery”. He lived in ancient India circa 600 BC, which he first described in his text Susrutha Samhita. He and his later students and disciples used otoplasty to reconstruct ears that were amputated as a punishment for crimes. The techniques of otoplasty he developed form the basis of surgical procedures that are practiced to this day. This knowledge of plastic surgery existed in India up to the late 18th century.

It is important to realize that otoplasty surgery will not affect hearing ability in any way, it is purely an aesthetic procedure. Otoplasty can take many forms, such as bringing the ears closer to the head (often called ear pinning), reducing the size of very big ears, or reshaping various bends in the cartilage. Other reconstructive procedures deal with the deformed, or abscent-microtic ears. Otoplasty surgery can involve a combination of moving, reshaping, adding, or removing structural ear elements.

If you would like information on Otoplasty or to set up a consultation with Dr. Bruck, please click here.

Minorities Continue to Adopt Cosmetic Surgery

The longer that plastic surgery is around, the deeper it becomes embedded in our culture. And one of the fastest growing adopters of cosmetic surgery procedures are ethnic groups. The American Society of Plastic Surgeons revealed that in 2004, well over 1 million procedures were performed on minorities in the US, with Hispanics being the leading group, followed by African American’s and Asians.

Also of note, in a survey a year later, in 2005, it was revealed that the majority of of plastic surgery procedures was actually performed on the middle-class income bracket. The full breakdown is below:

• 30% with an income level of $30,000 or less
  
• 41% at $31,000 to $60,000
  
• 16% at $61,000 to $90,000
  
• 13% at $90,000 or more

It’s great to see, with all the changes happening on the social level across the country, that the plastic surgery industry is continually evolving and helping to meet the needs of Americans everywhere!

Is It Time for a Tummy Tuck?

If you haven’t been able to lose inches off your waist from dieting and exercise, an abdominoplasty, more commonly known as a tummy tuck, might be the right procedure for you. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. This type of surgery is usually sought by patients with loose tissues after pregnancy or individuals with sagging skin after major weight loss.

Abdominoplasty operations vary in magnitude ranging from a mini-tuck where a short incison is made above the pubic area (location of a c-section scar), the muscle is tightened from the belly button to the pubic area and fat of is removed by liposuction to a complete tummy tuck which involves a hip to hip incision (see below). (eliminate from and to sessions) and are frequently subdivided into different procedure sessions. Depending on the extent of the surgery, a complete abdominoplasty can take 1 to 5 hours. A partial abdominoplasty (Mini-Tuck Abdominoplasty) can be completed between 1 to 2 hours.

Typically a complete abdominoplasty follows these steps:

1. An incision is made from hip to hip just above the pubic area.
2. Another incision is within the navel to free the navel from the surrounding skin.
3. The skin and fat is lifted from the abdominal wall, exposing the underlying muscles and fascia that are tightened with sutures. (delete to end of sentenceskin is detached from the abdominal wall to reveal the muscles and fascia to be tightened. The muscle fascia wall is tightened with sutures.
4. The excess skin and fat is removed and the remaining skin and fat are tightened by connecting and closing the incision.
5. The old belly button stalk is brought out through a new hole and sutured into place.
6. Liposuction is often used to refine the transition zones of the abdominal sculpture.
7. A dressing and sometimes a compression garment are applied and any excess fluid from the site is drained.

During the immediate recovery period, it is vital that you prepare to take off 1-4 weeks from intense movement or stress to the body. You should also be prepared for bruising and discomfort during this time, however an abdominal binder can help minimize the swelling and bruising. The full recovery process typically takes 3-6 months, depending on how extensive the procedure was.

If you would like information on Tummy Tucks or to set up a consultation with Dr. Bruck, please click here.

Areola Enhancement Guide
Despite the fact that breast augmentation is one of the most popular forms of cosmetic surgery, there are many cases in which the woman simply wants to alter the appearance of the nipple/areola. A number of women have nipples that either protrude too far or are inverted, and you will be pleased to know that with a simple procedure both of these issues can be corrected.

The most common form of nipple enhancement surgery is the areola reduction procedure, in which the areola, the skin surrounding the nipple, is reduced to fit proportionately with the breast. The areola, which is the darkly pigmented skin surrounding the nipple, can grow due to age and breast feeding.

This procedure is fairly commonplace, with most patients returning to normal activity within 24-48 hours. Due to the exposure of this region of the body, the surgery requires only a small incision, to reduce the outward appearance of scarring.

If you would like information on Areola Enhancement or to set up a consultation with Dr. Bruck, please click here.

Minorities Continue to Adopt Cosmetic Surgery
The longer that plastic surgery is around, the deeper it becomes embedded in our culture. And one of the fastest growing adopters of cosmetic surgery procedures are ethnic groups. The American Society of Plastic Surgeons revealed that in 2004, well over 1 million procedures were performed on minorities in the US, with Hispanics being the leading group, followed by African American’s and Asians.

Also of note, in a survey a year later, in 2005, it was revealed that the majority of plastic surgery procedures was actually performed on the middle-class income bracket. The full breakdown is below:

30% with an income level of $30,000 or less
41% at $31,000 to $60,000
16% at $61,000 to $90,000
13% at $90,000 or more

It’s great to see, with all the changes happening on the social level across the country, that the plastic surgery industry is continually evolving and helping to meet the needs of Americans everywhere!

If you would like information on Tummy Tucks or to set up a consultation with Dr. Bruck, please click here.

Laser Tattoo Removal

Are you regretting the tattoo you received a few years or even decades ago? It is important to know that complete laser tattoo removal requires as many as 8 to 12 treatments, typically spaced at least 8 weeks apart. At each session, some but not all of the tattoo pigment particles are effectively fragmented, and the body removes the smallest fragments over the course of several weeks. The result is that the tattoo is lightened. Remaining large particles of tattoo pigment are then targeted at subsequent treatment sessions, causing further lightening. The number of sessions and spacing between treatments depends on various parameters, including the area of the body treated and skin color. Forearm and ankle tattoos generally take longest.

The amount of time required for the removal of a tattoo and the success of the removal varies with each individual. It is often difficult to predict the number of treatments required. Factors influencing this include: skin type, location, color, amount of ink, scarring or tissue change, and layering.

Laser tattoo removal when performed with local anesthesia is painless. Prescription strength topical anesthetic creams or injections of anesthetic solutions are usually used to manage pain, although some patients forgo any type of anesthesia.

Depending on the patient’s pain threshold, and while some patients may forgo anesthesia altogether, most patients will require some form of local anesthesia. Laser tattoo removal for small or moderate size areas can be formed with local anesthesia and is painless. When treating large areas, pre-treatment might include the application of an anesthetic cream under occlusion for 45 to 90 minutes prior to the laser treatment session. If complete anesthesia is desired, it can be administered locally by injections of 1% to 2% lidocaine with epinephrine.

Multiple factors contribute to the success of laser tattoo removal one of which is a patient’s own immune system. A healthy patient will get the best results. Adequate hydration, eight hours of sleep a night, maintaining a healthy weight, eating a well balanced diet.

If you would like information on Laser Tattoo Removal or to set up a consultation with Dr. Bruck, please click here.

Hand Rejuvenation

Over the years, due to sun exposure, dryness and other causes, and individual’s hands tend to show the signs of aging: Loss of volume (fat) making veins, tendons and bones prominent, sun spots and rough skin texture.However, through recent cosmetic therapy techniques, you will be pleased to discover that your hands can begin to return to their natural youthfulness. This can be accomplished by the hand rejuvenation method.

The most common approaches for hand rejuvenation are below:

1. Injectable Fillers

2. Fat Transfer

3. Laser treatments

4.Chemical Peels

5. Microdermabrasion

A detailed summary of each procedure is below:

Injectable Fillers –The most commonly used injectables for hand rejuvenation are Radiesse, and Sculptra. Radiesse is a calcium based product that has an immediate effect as the material plumps up the tissues and a long term effect as it stimulates the skin to thicken by making new collagen. Sculptra requires 2 to 3 treatments and works by stimulating the skin to make new collagen. While it may take several weeks to see , the results can last up to 2 years. Both treatments correct the ‘bony’ appearance that aging can cause.

Fat Transfer – The patient’s own fat is taken from another body area, usually the abdomen, hip rolls, or thighs, and “injected” to plump-up the hands giving a youthful appearance. The results can last up to several years.

Laser Treatments– A laser that specifically targets melanin, the pigment causing brown spots can be used to eliminate or lightening them. Another type of laser, such as a C02 Affirm laser can be used to treat not only brown spots but lines and wrinkles as well. . (Eliminate this sentenceis procedure is a technique used during laser surgery wherein the molecular bonds are dissolved by laser.) Lasers can be used to treat sun damage–wrinkles, solar lentigenes(brown spots), scars, stretch marks, actinic keratoses and telangiectasias or “spider veins”.

Chemical Peel – A chemical peel is a treatment technique used to improve and smooth the texture of skin using a chemical solution that causes the dead skin to slough off and eventually peel off. The regenerated skin is usually smoother and less wrinkled than the old skin and brown spots are reduced or eliminated.

Microdermabrasion – Microdermabrasion is the process in which the stratum corneum (dead outermost surface of the skin) is partially or completely removed by light abrasion, to improve the appearance of sun-damaged skin. Dark spots are removed or lightened, skin texture is improved and scars minimized.

Is an Arm Lift Right for You?

An arm lift, known as a Brachioplasty, until recently was the procedure of choice to correct loose skin in the upper arm. Loose skin is typically the result of aging and weight gain or weight fluctuations earlier in life as well as genetics and sun exposure. Until now, patients had legitimate concerns about the scarring associated with conventional arm-lifts.  Now with the new Smartlipo arm-lift, excess fat can be melted away and skin tightened all under local anesthesia through an inconspicuous tiny incision.  Patients return to work after a few days and can resume most activities after 2 weeks. For patients who have a more pronounced degree of excess skin, a mini “nip-and–tuck” , a mini-Brachioplasty ,where the scar is limited to the arm-pit can be combined with the Smartlipo arm-lift.   Only in patients who have extreme excess of skin is a conventional brachioplasty necessary where the scar runs from the armpit  midway down on the inside of the arm.      When a brachioplasty is indicated, your physician can help you decide on whether a general anesthetic or sedation is appropriate for your situation. After surgery, you can expect approximately 2 weeks of swelling and mild discomfort while the body goes through the healing process. Usually moderate exercise can be performed around 14-21 days following the procedure.

If you would like information on Arm Lifts or to set up a consultation with Dr. Bruck, please click here.

Protect Yourself: Find a Qualified Plastic Surgeon

The federal Centers for Disease Control and Prevention (CDC) is warning consumers against undergoing cosmetic surgery by unlicensed providers.

An article in the May 2nd issue of the Morbidity and Mortality Weekly Report details the cases of three women in North Carolina who developed kidney failure after they received soft-tissue filler injections in their buttocks of what they were told was liquid silicone. The women received the injections from an unlicensed provider at a single facility.

In December 2007, the North Carolina Division of Public Health was notified of the three kidney (renal) failure cases. All of the injections were administered by an unlicensed provider, whose only medical training was as a radiology or x-ray technician. Investigators were not able to definitively identify the substances injected, but records indicated that the injections contained liquid silicone.

Potentially fatal, acute renal failure occurs when the kidneys suddenly stop working, The kidneys are charged with removing waste products and helping to balance water and salt, as well as other minerals known as electrolytes, in the blood. When your kidneys stop working, waste products, fluids and electrolytes build up, causing potentially fatal problems.

According to records, the women all had large volumes of silicone oil and saline injected in their buttocks. Renal failure has not previously been linked to silicone injections, but since the contents of the syringes were not verified, it is unknown whether silicone oil or another substance in the injections caused the problem. All three women recovered. The practitioner was arrested and charged with practicing medicine without a license.

“These findings underscore the risks posed by cosmetic injections administered by unlicensed practitioners,” the researchers write.

The bottom line is that soft-tissue filler injections should be administered only by licensed providers with appropriate medical training, the CDC warns.

Think it can’t happen to you? Think again. Any person can claim to be a plastic surgeon. Safeguard yourself by doing the right research and asking the right questions before you choose a plastic surgeon or procedure.

Sources:

CDC, Morbidity and Mortality Weekly Report, May 2, 2008; vol 57: pp 453-456.
American Society for Aesthetic Plastic Surgery website. “Credentials: How to Check”

A Guide to Eyelid Surgery

If you feel that you have an excess amount of skin in your upper eyelid region or possibly are suffering from bags and dark circles under your eyes, eyelid surgery might be for you. Typically the results from an aesthetic eyelid procedure will help you appear more rested and youthful. For individuals with high-stress jobs, you may be a good candidate for this surgery.

Eyelid surgery is also called Blepharoplasty. A Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes apparent. Most patients can return to work after one week. Depending upon the scope of the procedure, the operation takes one to three hours to complete.

The anatomy of the eyelids, skin quality, brow position, age, and the adjacent tissues all affect the cosmetic and functional outcomes. Recognition of factors which are known to cause complications such as dry eyes, looseness of the lower lid edge and prominence of the eye relation to the cheek prior to surgery can eliminate problems after surgery. Be sure to choose a board certified plastic surgeon, facial plastic surgeon or an occuloplastic surgeon.