-Allyson, Licensed Aesthetician at The Medical Spa at Corbett Cosmetic
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A ‘double chin’ is a common problem as we age. In my Louisville Plastic Surgery practice I encounter this issue frequently. Usually it is a result of an accumulation of fatty tissue and skin laxity. Sometimes a lack of muscle tone factors in. If it is just a thickening of the fat pad, in office liposuction is an effective treatment with little or no downtime. This only takes about 15 minutes and is done under local anesthesia. If the problem is significant loose skin or muscle laxity a neck lift may be in order. This is typically done in the operating room under anesthesia.
Your Plastic Surgeon should be able to easily tell you which procedure will best suit your needs.
In my Louisville Cosmetic Surgery practice I see a lot of patients considering what we call an upper lid Blepharoplasty. This is an eyelid lift and what it does is remove the excess skin of the upper lid that hoods over the eye lashes.
The problem is, a lot patients really need a brow lift instead. Anatomically what we refer to as the ‘brow’ is basically your forehead. When the forehead droops it causes the skin of the upper eyelid to droop. So, a lot of the times if you lift the forehead, that will eliminate the ‘excess’ skin on the upper lid.
If you upper lids are making you look tired and you have been considering an eyelid lift, maybe it’s not your eyelids after all.
Folks, it has happened again, in my Louisville cosmetic surgery practice. The e mail requesting the “non-Invasive” facelift.
They go by several trade marked names. Quick Lift, Lunch Time lift, Life Style lift and they sound great. Quick, easy, minimal recovery and minimal expense.
There is no such thing as a non invasive facelift. Doesn’t exist. It is impossible to tighten the deep structures of the face to produce the lift effect without an incision and by definition an incision is invasive.
My advice would be to really look at these procedures, which all amount to variations on a typical mini facelift. You cannot get a maximum result if you are going to buy a minimum product. A couple of old expressions come to mind…”you get what you pay for” and “if it sounds too good to be true, it probably is”.
Drains are round or flat tubes that are placed in surgery. They exit through the skin and empty into some form of reservoir. Patients don’t like them at all but they are necessary “evils” following procedures like Louisville Tummy Tucks and Louisville Facelifts.
During surgery if we elevate the skin, as in a facelift, breast lift, or tummy tuck from the underlying muscles, our body will leak serum into that new space. Serum is basically the watery part of our blood. If there is no method to evacuate that fluid, it will form a collection called a seroma. Seroma can cause a variety of problems and so we do our best to avoid them. Thus, the drain. The drains are placed and serve as an exit route for the fluid. They stay in after surgery anywhere from 12 hours to a week or two depending on the procedure. They are typically removed not based on time but on output.
So, while they are not the most popular part of cosmetic surgery, they do serve a valuable purpose in helping you achieve a great surgical result.
My opinion on combining procedures is based on many factors. First, I look at your overall health status. Secondly, I look at the scope of the procedures we are planning and their physiological impact, and finally we need to consider how much time it will take to get you in and out of the O.R.
My advice is to come in for a consultation, let me see your “wish list”, then we’ll take a look at your starting point. I can then map out a plan and we can then decide the feasability. Our consultations are complimentary.
This is a tough one and my answer changes but today it’s an upper lid Louisville Blepharoplasty. I did a few this past week and am always amazed at what a great operation it is.
Why? Several reasons.
First, the operation requires the use of fine instrumentation, which I love! Second, everyone looks better and they look better immediately. You don’t have to wait a long time for the swelling to go down, bruising to go away etc… Third, the recovery isn’t bad. Most patients complain of little to no discomfort.
In addition, the operation is quick, the complication rate is very, very low and the patient satisfaction rate is very high.
Understandably, when patients are considering a facelift, they are concerned about the extent and placement of the scars.
A traditional facelift includes an incision that starts just above and in front of the ear. The incision comes down in front of the ear and loops around the earlobe to the back. Once there, we keep the incision in the crease behind the ear up to the level of the hairline, and then extend it outward along the hairline. This is your typical, classic incision and most facelifts follow some variation on this pattern.
In the last few years newer “mini” facelifts have become en vogue. There are a bunch of trade names for these like a “Quick Lift” or Lunch time Lift. These procedures use less incisions. Typically there is a transverse incision that runs just under the sideburn to the front of the ear and once there, it follows the crease in front of the ear down to the earlobe. There is no incision behind the ear with these operations.
From a scar perspective, these usually heal very well and are inconspicuous. They end up as a thin white line that is very easy to camouflauge with make-up or even your hair.
There are absorbable and non-absorbable sutures. Both can be used to re-approximate deep tissues under the skin or the skin itself. More often than not though, we use the non-absorbable kind to close the skin. The reason is that they tend to be a mono-filament, like fishing line. This type of suture elicits less of a scar reaction than a braided suture. Most absorbable ones are braided. So non-absorbable ones make for nicer scars, the goal of every Louisville plastic surgeon.
What I like to do is use a long lasting absorbable mono-filament suture for skin closure. I put one stitch outside the skin, tie a knot to anchor it, and then run it under the skin surface and when I get to the other end of the incision I tie another knot to secure the stitch. That way, all I have to do is clip the knot on either end the rest will dissolve. Plus, because the suture lasts several months, it continues to add strength to the stitch line to keep the scar from widening. So yes, most of the time I do have to remove sutures but I try to make it as user friendly as possible!
This is a very common question that I deal with almost on a daily basis. In general, it is perfectly fine to combine procedures and I do it all of the time. The advantages are one anesthetic, one recovery, and you will save some money. Facial procedures are often combined, like eyelids and facelifts. Breast and body procedures are commonly coupled as well.
But there are things I consider before I give a ‘yes’ or a ‘no’.
First is the time it all takes. Most surgeons will agree that about 6 or 7 hours is long enough to have someone asleep for an elective cosmetic procedure. After this time period your risks for post operative complications start to go up. So I will combine procedures if I can do my best work in less than about 6 hours.
Secondly, I take into consideration the type of procedures being performed. Though the incisions are very small, a large volume liposuction is a bigger shock to your system than combining an eyelid tuck and breast augmentation for instance. So we have to consider what we are planning and what kind of a toll this is going to take on you immediately after surgery and during your recovery.
Lastly, we have to look at your medical history. A 30 year old woman with no medical problems can safely have more surgery than a 60 year old over weight diabetic patient. And it’s not even the age that matters that much. My mother is 80 and other than some aches and pains, she is completely healthy. I could safely operate on her all day long. The bottom line is we need to step back and look at your whole picture before we develop some grand plan that may be too risky. So more often than not the answer I give is “Sure, that’s fine”. I even recommend it most of the time.