Louisville
13125 Eastpoint Park Blvd.
Suite 102
Louisville KY, 40223

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Weight Gain after Contouring Surgery

This past week one of my most favorite patients from this past year came back in with her husband and was worried because her tummy seemed to pooch out more. She had a tummy tuck just about a year ago. She had called and said her tummy was getting bigger. This sounded a bit unusual to me so I asked them to come back in so I could examine her and help find a solution. When I examined her the tummy was still nice and flat, her muscle repair was still intact and her skin was still tight. But…she was definitely a bit more full. When we looked back at her chart from her initial visit and after some discussion it looked like she might have gained some weight over the past year. So she hopped on the scale and sure enough, she had picked up about 15 pounds since surgery.

Weight gain after body contouring surgery usually shows itself as described above. When we do a tummy tuck or liposuction we are not only shedding excess skin and fatty tissue, we are sculpting and re-contouring the body. Now, if you maintain your pre-surgical weight you should maintain your results in the long term. If however, you do add weight what tends to happen is that the beneficial shape changes that resulted from your surgery maintain but you are just a bit larger. As in this patient, her tummy is still flat, her skin still taught, her muscle repair still intact, she is just a bit thicker at her current weight. What does not happen, and I hear this all the time, is that other body parts become disproportionately large. In other words, for example, your tush and thighs will not get extra large with weight gain if you’ve had your tummy liposuctioned or a tummy tuck. You will simply get larger but maintain your shape proportions.

As for my patient, after a good laugh was had by all three of us, we agreed her best option was to get back on her exercise regimen that had her at her lower weight to begin with!

Nipple Sensation after breast augmentation

I saw a new patient just yesterday who is going to have a breast augmentation and she had a good question. Her nipples are overly sensitive and she was hoping that after her breast implants were placed her nipples might be less sensitive. She asked if this was likely.

The answer is that it is possible but not likely. With any breast surgery, whether we are doing a lift, a reduction, or an implant, the nerve that give the nipple are its feeling is at risk. As a rule the ‘deeper’ into the breast we go the more this becomes a possibility because the nerve in question enters the breast from its under surface and then branches come up to the skin level. So, if we are just on the surface, as in a lift, yes some of the tiny nerve branches will be cut resulting in some temporary sensory loss but the dominant nerve supply is intact and full sensation should return within a few weeks. That’s why when we make a circular incision around the nipple it doesn’t mean you will be numb afterwards. With a breast reduction, as this is a bit more invasive than a lift, the chances for sensory changes are higher and thus more common. It’s simply a matter of the surgeon being deeper into the breast to remove the excess tissue. Now with implants the risk is highest as we are placing the implant right at the level of the nerve, which is called the 4th Intercostal nerve. This nerve enters the breast from the side and moves towards the midline (your breast bone). Now as your surgeon, I know where this nerve lives and so when I get into that area I change how I develop the pocket for the implant in an effort to preserve full sensation. That being said, if you look at the implant manufacturers data, the rate of sensory disturbance after an augmentation is about 8% and when this happens it tends to be an all or none deal. So, my answer to the patient referenced above is that “No, your nipple sensation probably wont change and if it does lessen I have no way to control how much or how little.

Lee E. Corbett, MD

Medical Director, Corbett Cosmetic Aesthetic Surgery and MediSpa

Longer Lashes and Latisse

This was taken from Dr. L Gibson’s blog. Well written and I couldn’t say it better!

The medication bimatoprost — marketed under the brand name Latisse — is approved by the Food and Drug Administration (FDA) to treat inadequate eyelashes (hypotrichosis). Bimatoprost is also marketed under the brand name Lumigan, which is used in prescription eyedrops to treat glaucoma. Eyelash growth was an unexpected side effect of Lumigan, which led to the creation and marketing of Latisse.

With regular applications along the lash line of the upper eyelid, Latisse gradually encourages growth of longer, thicker and darker eyelashes. Latisse isn’t meant to be applied to the lower eyelid. For full results, you must use the medication daily for at least two months. Eyelash improvements remain as long as you continue to use the medication. When you stop using Latisse, your eyelashes will eventually return to their original appearance.

Potential side effects of Latisse include:

Itchy, red eyes
Dry eyes
Darkened eyelids
Darkened brown pigmentation in the colored part of the eye (iris)
Hair growth around the eyes if the medication regularly runs or drips off the eyelids

Although darkened eyelids might fade when the medication is stopped, any changes in iris color are likely to be permanent.

In one small study of people who have eyelash loss due to alopecia areata — a medical condition that causes temporary hair loss — Latisse triggered moderate eyelash growth for more than 40 percent of participants. Research isn’t conclusive, however. In another small study of people who have alopecia areata, Latisse wasn’t an effective treatment for eyelash growth.

Latisse is available at Corbett Cosmetic Aesthetic Surgery and MediSpa

What happened to Cheek Implants?

When I was a Plastic Surgery resident in the mid 90’s we often used silicone cheek implants to restore mid facial volume (cheek area). These were relatively short and fairly easy operations and gave nice results. The problem is the implants could migrate causing facial asymmetry and the need for more surgery. They were also a bit firm. Plus, placement meant a trip to the operating room and anesthesia. In 2014 these implants have all but been replaced by injectable fillers. These fillers are usually composed of Hyaluronic Acid which is a protein that is already found in the skin and our joint surfaces. Think of the HA’s as the 2014 version of the old collagen injections but they last much, much longer. The treatments are done in the office with just topical anesthesia and other than the chance of a bruise and some mild swelling there really is no down time and the risk of complications is very, very low.

Lee Corbett, MD

Medical Director, Corbett Cosmetic Aesthetic Surgery and MediSpa

Butt Implants

We get called fairly frequently with the request for Butt Implants. For full disclosure, I don’t do butt implant operations. The reason is that the complication and re-operation rate are very high. In the Plastic Surgery literature, even in experienced hands, the re-operation rates for the surgery range from 13 to 25%. Risks include bleeding, infection, implant migration, chronic pain, numbness and extrusion. If someone is truly seeking a surgical option for a flat butt we recommend fat grafting, which has risks of its’ own. Otherwise, it’s lots of lunges and squats and step ups!

Lee E. Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

What’s a Vampire Facelift?

The “Vampire Facelift” appeared back in 2009 as an alternative to a true surgical facelift. In fact, it is not a facelift at all. The procedure involves taking your own blood and spinning it down to separate out the red blood cells from the plasma. The plasma contains growth factors that are thought to promote new collagen formation. The orthopedic surgeons use this technology to help with joint surgery. In any case, the plasma is then re-injected back into the face to promote collagen formation and help with wrinkles. The problem is a lot of times the doctor also injects a hyaluronic acid filler at the same time (think Juvederm or Restylane) to restore facial volume. So, the true value of the plasma is unknown and there have been no studies proving it’s effectiveness. It also lacks FDA approval. Is it worth trying? Well there should be no harm in having your own plasma re-injected into your face, but I’m also not sure its any better than just using traditional fillers.

Lee E. Corbett, MD

Medical Director for Corbett Cosmetic Aesthetic Surgery and MediSpa

Are prescrition strength skin care products really better?

Yes, absolutely.

With a prescription strength product what you are getting are much higher concentrations of the active ingredients that you’re buying the product for in the first place. For instance, if you buy a product at a department store that has glycolic acid in it the highest concentration they can sell is 2.5%. Most of the prescrition strength lines start at 5%. Fade creams use hydroquinone. Again, the most the department stores can sell is 2%. The prescription products have 4%. And ironically, the prescription products are usually no more expensive!

Lee E Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

Breast Implants: Saline vs Silicone

When I meet a new patient who is considering Breast Implants, a common question is “Which is better, saline vs silicone?”. Click on the link above to see information from Mentor, one of the two implant manufacturers. It’s a nice, concise list and may help. In my opinion, and I am biased towards the gel/silicone implants, the differences between the two devices are cost, feel, placement options and deflation detection. Gel implants cost more, almost twice as much, and this is purely the implant cost. Gel feels better/more natural in my opinion. They wrinkle and ripple less than saline and for a smaller breasted, slender woman that is an issue. Gel can be placed above or below the muscle depending on a woman’s starting point, though I prefer going below the muscle. Finally, if a saline implant leaks you get a ‘flat tire’ so detection is rather simple. If a gel implant fails, the breast will look the same so detection is more difficult and may require an MRI. Overall the ratio of gel to saline being used nationally is about 75:25. Ultimately, the best choice is the implant that the patient is most comfortable with.

Lee E. Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

How long do breast implants last?

This is a good question and honestly, I don’t know that answer. I’m not sure anyone really does at this point. When I meet with patients considering breast augmentation a significant number of them are under the impression that they have to have the surgery re done every 10 years. That is completely false! The “scheduled maintenance” concept is simply wrong. The silicone implant technology we are currently using has been in place since the early 1990’s. At this point, almost 22 years later, I have yet to see a significant number of failed implants at a given age and the failure rate at the 10 year mark is quite low, less than 1%. So while there is no guarantee a given implant won’t fail early on, I think it is reasonable to assume you can get twenty-something years out of your implants. Only time will tell.

Lee E. Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

Lower Eyelids: Surgery vs Filler

More and more we are meeting patients who are dissatisfied with their lower lids. Commonly the complaint is what we call a “tear trough” deformity. It is the result of the shrinkage and descent of the cheek fat pad where the cheek and lower lid meet as is demonstrated in the photo. Many patients present assuming that they need surgery when in reality we can completely correct this problem with the use of Injectible fillers such as Restylane, Juvederm, and Perlane. This treatment is done in the office with topical anesthesia and while a bruise and some mild swelling may result there is no true recovery. If you have any interest or have questions about this procedure please e mail our nurse injector Lyzah at lyzah@corbettcosmeticsurgery.com

Lee E. Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and Medi Spa

Weight Gain after Contouring Surgery

Monthly Archives: January 2014