Questions
Answers to Ten (Most) Frequently Asked Questions In Plastic Surgery
Q: If I have liposuction will the fat come back?
A: No the fat will not “come back” after liposuction. However, that doesn’t mean you can eat without discretion. While the fat cells that have been removed will not come back, the fat cells left behind can enlarge or hypertrophy. So If you have a nice svelte abdomen after liposuction, keep it that way through moderate exercise and sensible eating habits. The formula is simple calories in vs. calories out.
When you take in more calories than you burn, fat cells enlarge. When you burn more calories than you take in, fat cells shrink.
Q: If I have liposuction will the fat go to some other area(s) other than where I had liposuction done?
A: No the fat will not preferentially go to other areas. Once an area is reduced by liposuction, there will be less fat cells in that area but the remaining fat cells can still enlarge. Likewise fat cells in other body areas can get enlarge as well.
Q: Are Silicone breast implants really safe?
A: In 1992 the FDA banned the use of silicone-gel breast implants due to reports, albeit unsubstantiated, that silicone implants were causing autoimmune disorders and connective tissue diseases such as rheumatoid arthritis, lupus and fibromyalgia. Over the next 14 years the FDA reviewed an extensive amount of data from clinical trials and an extensive body of scientific information. The FDA determined silicone implants to be safe. The FDA will continue to monitor the use of silicone breast implants by requiring each of the manufactures to conduct post-approval follow-up studies monitoring women who undergo breast augmentation for 10 years after receiving breast implants.
Q: What can I do about the brown spots on my face?
A: There are a variety of effective treatments that can reduce or eliminate the brown spots on your face. Which treatment you choose depends on a variety of factors. Are the brown spots superficial and confined to the epidermis, the superficial layer of the skin, or are they situated in the dermis, the deeper layer of the skin. Brown spots confined to the epidermis can be effectively treated with topical creams such as Retin-A, chemical peels, microdermabrasion, or superficial laser treatments. Brown spots located in the dermis require more aggressive treatment. These usually respond best to laser treatments. Our state-of-the-art lasers at the Juva Skin and Laser Center effectively treat brown spots in the dermis. The Accolade laser targets individual brown spots while the C02 Affirm laser treats not only brown spots but improves lines and wrinkles, reduces pore size and tightens skin as well.
Q: My face looks pretty good but I have these brown spots on my hands that make me look old. What can I do about them?
A: Brown spots on your hands can be treated most effectively with a laser. At Juva Skin and Laser Center we have the state-of-the-art Accolade laser by Cynosure that specifically targets the pigment causing brown spots. A topical anesthetic cream is applied prior to the treatment which is painless and takes only a few minutes. By adding volume to the hands and restoring youthful contours, rejuvenation of the hands can be further enhanced minimizing the appearance of prominent veins and tendons. This can be achieved by adding fat, or with injectables like Sculptra or Radiesse.
Q: Can Botox help with my laugh lines?
A: Laugh lines refer to the lines that extend from the nose to the mouth and are also known as the nasolabial folds. These folds become more prominent with age as skin elasticity decreases and tissues of the cheeks descend giving a tired appearance to the face. I use a variety of fillers including Juvederm, Restylane, Perlane, and Radiesse to “plump-up” the area restoring a more youthful, energized appearance. Which filler I use depends on the depth of the folds and other special needs of the patient. Botox works by relaxing muscles and is great for treating, crow’s feet, frown lines, and forehead creases but it is not used to treat laugh lines.
Q: What’s the difference between Botox and a filler?
A: Botox works by blocking the release of a chemical, acetylcholine, that is necessary for muscles to contract. Several small injections are made into muscles that cause lines and wrinkles to appear. By relaxing these muscles that cause the frown lines, forehead lines, or crows’ feet, these lines and wrinkles are eliminated or softened. A filler, on the other hand, “plumps-up” folds, lines, and wrinkles, but does not relaxed the muscles that cause them. Fillers are generally injected into the dermis or just beneath the dermis while Botox is injected directly into the muscles causing lines and wrinkles.
Until now there’s been nothing better than Botox to temporarily reduce wrinkles. In fact Botox has been the number one non-surgical cosmetic procedure many years. According to the American Society of Plastic Surgeons, over 4 million Botox procedures were performed last year. The new wrinkle to fight aging is Dysport which was FDA approved July 1, 2009. Like botox, when it inhibits facial muscle contractions that over time lead to frown lines, crow’s feet and forehead lines. Dysport has been used in Europe for years with a similar safety profile and effectiveness as Botox. While Botox can take several days before it starts working, Dysport’s effect has been noted in as little as 12 hours. There are reports that Dysport may last longer–up to six months compared to four months for Botox. The longer-lasting effects could make Dysport more affordable.
Q: Can I breast feed after breast augmentation surgery?
A: There is no definitive answer to this question. There is a greater likelihood of being able to breast feed after augmentation surgery if your implants are placed under the muscle rather than over the muscle. Implant placement rather than where the incision is made has a greater effect on whether or not a woman can breast feed after surgery.
Q: How long will (whatever the particular filler happens to be) last?
A: Fillers are injectable products that restore a more youthful, rested appearance by smoothing-out lines, wrinkles, and restoring youthful contours. How long a filler lasts depends on several factors. These include the composition of the filler, where the filler is injected, and how quickly the filler is absorbed or metabolized. Hyaluronic acid fillers (Restylane Perlane, Juvaderm) usually last 6 to 9 months while Radiesse, composed of calcium based microspheres, lasts from 9 to 18 months. Sculptra which stimulates the production of new collagen can last up to 2 years. The greater the muscle movement in an area, the faster the filler is degraded. However, if Botox or Dysport is used to relax the muscle in an area, the faster the filler is degraded. However if Botox or Dysport is used to relax the muscles in an area, the filler can last twice as long. There are some patients in whom a particular filler just won’t last. For these patients a different type of filler can be used.
Q: Will I have bruising after I’m injected with a filler? Can I conceal the bruising?
A: Bruising can occur after injecting with a filler. It is somewhat more likely with a thicker filler like Radiesse that with a less viscous filler like Restylane. However it also depends on the area injected, and the quality of the patient’s skin. Bruising is more likely, for example, in the area of the lower eyelids than it is in the laugh lines and it is more common in patients with poorer elasticity and less collagen than in thicker more resilient skin.
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