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Should I get a 2nd Opinion?

Yes but don’t go overboard.

I see a lot of patients who are considering cosmetic surgery and they have or are in the process of seeing 8, 10, even 12 different doctors for consultations. I think this is overkill.

If you are thinking about surgery, I think it is a good idea to see 2 to 4 doctors. This process will give you a good idea of what procedure is best suited to your situation, you will get a good idea of what to expect, the details about the surgery and your recovery, and finally, the cost of the surgery.

You can get all of this information from one doctor. But, what you will discover is Plastic Surgeons will each come up with a treatment plan that is slightly different. The reason is that there are a lot of ways to solve the problems we face and each of us will perfect their own blend of techniques. This creativity is what most of us like about the specialty. The problem is that it tends to confuse you, the patient.

If you see Dr. A and his plan is different from that of Dr. B, chances are both are correct. Each is just using a slightly different technique that they are familiar with and have with which they have become proficient. Both know what the other is doing and if you ask they will tell you the other doctors’ plan is solid. So, don’t be confused. It’s simply a matter of there being more than one way to solve a lot of the problems we see in Cosmetic Plastic Surgery.

Lee Corbett, MD

http://www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Kentucky Plastic Surgery Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

What are Fillers?

I meet a fair number of patients who don’t know what “Fillers” are or why they are used.

You are also probably seeing a lot of advertisements now for facial fillers. Restylane and Juvederm are the most commonly seen. Other brand names are Perlane, Sculptra, and Radiesse. These are not as commonly used and tend to be for specific isolated purposes. In any case, let me give you a crash course on the more common Hyaluronic Acid fillers.

The fillers used today are replacing collagen. Collagen was ‘ok’ but there was the potential for allergies and it didn’t last very long. The new fillers are predominantly Hyaluronic Acid (HA). Like collagen, HA is also a protein that we already have in our skin. The advantages of HA are that allergy to the products in not an issue and it typically lasts about a year or more.

The purpose of fillers it to fill in deep folds like the ones we all have separating our cheeks from our lips. They are also commonly used to plump shrinking lips, treat the corners of the mouth, or marionette lines. Additional uses are to fill the tear troughs, acne scars, or deeper wrinkles of the forehead.

The fillers are not ideally suited for smoothing out the fine surface lines we get around our eyes and mouth. They help smooth these out, but they are really intended to treat deeper lines and folds.

A final not, Fillers and Botox are not the same thing. Botox smoothes wrinkles by deactivating the muscle responsible for the wrinkle. Fillers fill. They can and frequently are used together to get the best results in facial rejuvenation.

Lee Corbett, MD
https://www.corbettcosmeticsurgery.com/
502.721.0330

All posts on this blog are authored by Louisville cosmetic plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery Botox, Juvederm, Restylane, and lasers.

Why you should choose Saline Implants.

My previous blog will championed the cause of silicone gel implants. Now, let’s talk about the virtues of saline.

Saline implants hit the market in 1992 when the silicone moratorium began. Today women are choosing saline implants about 50% of the time.

The advantages of saline implants are cost, adjustability, mammography related issues, and dealing with leakage.

Implants are less expensive than silicone gel by about a $1000. This is simply how they are priced by the manufacturers, Allergan and Mentor.

Because we fill saline implants in the OR, we are able to adjust volumes more specifically than silicone to better serve those patients with asymmetry.

Mammograms are easier for the Radiologist to interpret when an implant is under the muscle. Silicone implants typically go on top of the muscle and saline below, making mammograms easier to read when a sub-muscular saline is used.

Finally, if a saline leaks, you get a “flat tire”. It’s not hard to make the diagnosis. With silicone implants, the gel doesn’t absorb so we have to rely on an MRI to make the diagnosis.

Saline and Silicone are both good implants but each has its’ Pros and Cons.

Lee Corbett, MD

http://www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Louisville breast implant cosmetic plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

Why you should choose Silicone Gel Implants

My next blog will champion the cause of Louisville, Kentucky saline implants but for now, let’s talk about the virtues of silicone.

First and foremost, silicone filled implants are safe. The safety has been demonstrated via FDA studies conducted by both implant manufacturers Allergan and Mentor. The data shows no increase in the rate of connective tissue disorders between augmented and un-augmented women.

The advantages of silicone implants are feel, placement & recovery and possibly look. Silicone implants are softer and have a more natural feel than saline. That is my opinion but if you held them both I think you would agree. Silicone implants are typically placed above the muscle, which allows for a more comfortable recovery than implants placed below the muscle. Patients with silicone above the muscle report 3 to 4 day recoveries while those undergoing sub-muscular placement report discomfort more in the 5 to 7 day time frame.

Also my opinion, but I think silicone look slightly more natural than saline owing to the fact that they go on top of the muscle. This allows the implant to more directly affect the shape of the overlying breast. It just looks good.

Saline and Silicone are both good implants but each has its’ Pros and Cons.

Lee Corbett, MD
http://www.CorbettCosmeticSurgery.com
502.721.0330

All posts on this blog are authored by Louisville cosmetic plastic surgeon Dr. Lee Corbett.

Do I need a Tummy Tuck or will Liposuction work?

The answer depends on your starting point and your goals.

If all that you have is a little extra fluff you want to dump, say around your belly button or just above your backside, Louisville Liposuction is the answer.

If you have a lot of skin excess, stretch marks, extra fluff, and generalized laxity of the abdominal wall, a Louisville Tummy Tuck is the answer.

First, you should read my previous blog on abdominal wall laxity http://www.louisvillecosmeticsurgeryblog.com/?p=94

Liposuction is a great tool to decrease the amount of fat on the front of the tummy, hips, and flanks. But, it has no effect on abdominal muscular laxity and mild to moderate skin tightening abilities. So, if all you care about is decreasing the fat, this is a good choice. If you are bothered by loose skin, have a muffin top with certain clothes, or hate the laxity, you need to consider a tummy tuck.

Tummy Tucks are bigger operations but they also give a bigger result. This operation allows us to tighten your tummy muscles back up, de-fat the area, and remove the loose skin. The results are usually very dramatic.

So, my advice is to be very honest with yourself when you choose your procedure. If you really need a tummy tuck and try to get those results with Liposuction alone, you are going to be disappointed.

Lee Corbett, MD

http://www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Louisville, Kentucky cosmetic surgeon Dr. Lee Corbett.

You’ve had kids, you do a million crunches a day and your tummy still pooches! What gives?

The reason is because exercise only affects your muscles, it doesn’t do anything for loose skin or more importantly your fascia. I know, you have no idea what fascia is. So, I’m gonna tell ya. Every muscle in the human body is enveloped in fascia. Fascia is a whitish colored tissue that has the consistency of one of the white legal envelopes you can never tear open. It is a tough, sinewy tissue. In the picture, the fascia is the white stuff surrounding the 6 pack muscles. So, when you get pregnant, that fascia gets stretched out making your abdominal wall lax. Along your midline, the fascia from the right and left 6-pack muscles fuses in a line called the linea alba. Before kids, the linea alba is about 4 or 5 mm wide. But after, that line is stretched and thinned and can be a inch or two wide, so you get a midline bulge that looks like Alien is trying to escape! Here’s the bad news…fascia doesn’t respond to exercise and neither does skin. So all the situps in the world will tone the muscles but it can’t do a thing for the other two. But, there is still hope in the form of a Tummy Tuck or Abdominoplasty. A tummy tuck allows for fascial tightening thus muscle tightening, fat removal, and loose skin removal. In fact, it is part of a “Mommy Makeover”. It is usually coupled with Liposuction and is the procedure of choice for maximal abdominal wall rejuvenation.

Dr. Lee Corbett

http://www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Louisville liposuction surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

I have an Ugly Scar. Can you make it go away?

There are a few lessons I have learned after 10 years as a cosmetic plastic surgeon in Louisville, Kentucky.

First, a fact about wound healing. If your skin is injured or cut deep enough into the dermis, the deep layer of the skin, your body heals that injury by making scar tissue. Every cut heals by making a scar. Some scars are more noticeable than others but that is how the human body heals. Like it or not, that’s what nature stuck us with.

Factors that affect how your scar looks include your genes, age, skin color, skin thickness, scar location, how you were injured, and how the wound was repaired.

In general, though lasers are an option, most scars are revised by excision and re-closure.

Here are some things I consider when I look at your scar.

Location: Scars over joints are tough. The skin is constantly moving and the chances the scar will widen again are high. I usually shy away from these. Scars on the upper chest always heal poorly. Not open heart scars, but scars off the midline. These have a high chance of doing poorly with revision too.

Who repaired it: If the intern on the trauma service repaired your cut in the ER at 4 a.m. after being on call for 24 hours, well, brand me cocky, but I think I may be able to do better. With all due respect to interns, I was one too many years ago, I feel like an additional 18 years of experience are helpful. Contrast this with a scar that was repaired by an experienced surgeon in the OR. He was working in an ideal environment, the O.R., with the best light and the best instruments possible. Chances are, technically, he did what I would do. I would be less certain I could make an improvement.

What type of wound was it? If you had a dirty cut with dirt and grass or gravel in it that got infected afterward, I’m pretty optimistic a revision would help. Again, contrast this to a surgical incision repaired in the OR. Not so optimistic.

The bottom line is there are 3 possibilities when we revise scars. It can turn out the same, better, or worse. Your Plastic Surgeon can give you guidance on which one he expects but you MUST be willing to accept all three possibilities. If you can’t, don’t have the surgery. But in the end, remember, once you have a scar, you will always have a scar, hopefully a less noticeable one though.

Lee Corbett, MD
https://www.corbettcosmeticsurgery.com/

502.721.0330

All posts on this blog are authored by Louisville plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

Does Anything get rid of Stretch Marks?

Nope. Stretch marks, or striae, are where the skin has expanded so rapidly (pregnancy) or been exposed to such tension (obesity) that it has torn. So, a stretch mark is a tear of the deep layer of the skin called the dermis. The dermis tears and thins. Another way of thinking about them is that they are scars of the undersurface of the skin. Regardless of what the 2 a.m. infomercial says, there is no cream, lotion, potion or spa treatment that will get rid of stretch marks. Period. Save your money. At best you will get a slight improvement with any over the counter products. Whatever you see or hear about…it probably doesn’t work! Now, some things do improve their appearance. Lasers can help with the discoloration and can give some skin tightening. Chemical peels and microdermabrasion can help as well. Liposuction, because it results is skin tightening after the fat is removed, can also give an improvement. Surgical excision via a tummy tuck or breast reduction can permanently remove them if the stretch marks fall within the area of skin that is removed. This is most often the case when we do tummy tucks or body lifts. Short of surgical excision of the affected skin, in 2009 we still don’t have a definitive treatment for stretch marks. Lee Corbett, MD http://www.CorbettCosmeticSurgery.com 4121 Dutchmans Lane, Ste 305 Louisville, KY 40207 502.721.0330

All posts on this blog are authored by Louisville tuumy tuck expert Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

You are Unhappy after Cosmetic Surgery. Now what?

Overwhelmingly, after cosmetic surgery, patients are very happy. You had surgery, had an uneventful recovery, and can see a huge improvement. Everyone is happy. It’s all good. In fact, patient surveys show most procedures are accompanied by satisfaction rates in the 97 to 99% range.

Sometimes true complications occur, like bleeding or infection. These are rare, less than 1% in most cases, and are usually not the source of patient dissatisfaction. People understand this stuff can happen.

Sometimes in the first 3 to 6 months after surgery as swelling resolves and your tissues heal, it becomes apparent a little more could be done to maximize your results. In these cases a “touch up” procedure can be done to get everyone happy. Again, this isn’t really what I am hitting on.

I am talking about you being totally unhappy. So now what should you do? Patient dissatisfaction almost always stems from a lack of communication, which leads to unmet expectations. So, while you may be tempted to see a bunch of other Plastic Surgeons to see what your doctor “did wrong”, that’s not your best answer. Here are a few reasons. First, the other doctors aren’t thrilled about a mad patient in their office. They may hesitate to take you as a patient. Secondly, they weren’t there for your original surgery, so they are at a pretty big disadvantage. Third, another doctor is not going to be enthusiastic about dealing with someone who they may deem to be litigious. Finally, a new doctor is going to charge a lot more because revision surgery is always more difficult. Your best price will always come via your original doctor. So, though it may be counter-intuitive, your best option is to go back to your original surgeon. Why, because in all likelihood, you are unhappy because your surgeon didn’t fully understand what you told him/her pre-op or you might not have made yourself clear. It usually has nothing to do with technical skill or competence and once he or she knows exactly what you want, they can probably deliver. Or, maybe they can’t achieve what you are looking for, but they can now let you know before you have more surgery.

In most cases though, your issues can be worked out and chances are everyone ends up happy. Hopefully you never end up in this situation but if you do, start by meeting again with your doctor.

Lee Corbett, MD

http://www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are authored by Breast Augmentation expert Dr. Lee Corbett. Dr. Corbett specializes in cosmetic surgery of the face, breasts, and body.

Do I have to get New Breast Implants every 10 years?

This too is one of the most common plastic surgery myths I hear from patients. See my previous post for the other one. The answer is a resounding NO!! There is no validity to this at all. Zero, zilch, nada, none!

Here are the stats to explain the answer.

For Saline Implants, the reported deflation rates show numbers in the 3 to 4% range at 7 years. So at 7 years almost 95% of all implants are alive and well! Now, 7 years is not 10, but after doing this for 12 years and inheriting charts of thousands of implant patients I can confidently tell you there is no reason to change out an Implant just because of its age.

For Silicone Gel Implants the deflation rates are a bit higher, in the 7-8% range at 7 years. But still, that leaves over 90% of the women in good shape. Valid reasons to exchange implants are appearance related. You want a smaller/larger breasts, you had kids the breast shape and consistency has changed, you gained/lost weight and your breasts have gotten too large or too small. You want to go from saline to gel. These are reasons to exchange implants. Now, if you have a burning desire to pay me to take out perfectly normal implants every 10 years I will. I don’t get many takers on this option though…for good reason. So, forget the 10 year stuff and remember this, “if they ain’t broke, don’t fix ‘em”.

Lee Corbett, MD

https://www.corbettcosmeticsurgery.com/

502.721.0330

All posts on this blog are authored by Louisville, Kentucky cosmetic plastic surgeon Dr. Lee Corbett. Dr. Corbett specializes in cosmetic plastic surgery including facelifts, browlifts, blepharoplasy, Botox, Juvederm, Restylane, breast augmentation, breast lifts, breast reductions, body lifts, liposuction, and tummy tucks.

Should I get a 2nd Opinion?

Monthly Archives: April 2009