• Liposuction
• Eyelifts / Blepharoplasty
• Laser Resurfacing
• Demi – Lift / Lower Face Lift
• Hair transplantation

Liposuction
The Tumescent Technique for Liposculpture by local anesthesia (instead of general anesthesia) is a safe and effective method of removing unwanted fat. This technique uses large volumes of a dilute solution of Lidocaine, a local anesthetic, in combination with the drug epinephrine, which temporarily shrinks capillaries and therefore, minimizes bleeding during the procedure. Mild sedation may be added to reduce a patient's anxiety. As a result, there is much less bruising and swelling with Tumescent Liposculpture as compared to Liposuction by general anesthesia.

After surgery, an elastic compression garment is worn for one week. Most patients can return to work and begin exercising again within a day or two after surgery. Discomfort after surgery is minimized since the local anesthesia remains in the treated areas for approximately 18 hours after the procedure. Patients often require nothing more than plain Tylenol for discomfort.  

About 90% of patients will see at least some improvement in their silhouette by one week after surgery. However, because of the slow resolution of post-surgical swelling, the ultimate results following liposculpture usually are not apparent for 6 months. The change in silhouette produced by liposculpture is equivalent to being able to focus the effects of dieting to specific areas of the body. Since the fat is removed by creating small "tunnels" through the fat, the skin remains intimately connected to the underlying muscles by multiple fibrous attachments. As healing occurs after surgery, these fibrous strands contract and pull the skin into close proximity with the muscles. It is this process that assures the skin will not hang in loose folds after liposculpture surgery. Because the surgeon is careful to leave a thin blanket of fat attached to the skin, the skin will look and feel soft and normal after the procedure.  

The fat cells that are removed by liposculpture do not grow back. Your new, more pleasing silhouette is permanent. If you gain or lose weight in the future, the change tends to be distributed proportionately over the entire body.   Although the results of liposculpture are often quite spectacular, it is not realistic to expect perfection. Liposculpture does not eliminate dimpling of the skin (often called "cellulite"). The degree of cellulite may be reduced, but is unlikely that it will be eliminated.

As with any surgical procedure, liposculpture is associated with certain expected side-effects such as bruising, swelling and temporary numbness. Although irregularities of the skin are possible following liposuction, this side-effect is minimized by the Tumescent Technique. As judged by current world-wide experience, liposculpture is amazingly safe. Serious complications such as blood clots, infection and allergic reactions are extremely rare. Most of the dangers associated with surgery are related to the type of anesthesia that is used. Surgery of the skin and subcutaneous fat is safest using local anesthesia with the patient awake.

CLICK HERE FOR COMMONLY ASKED QUESTIONS REGARDING THE LIPOSUCTION PROCEDURE

Eyelifts / Blepharoplasty
As we age, our upper eyelids can begin to sag, eventually obliterating the natural fold in the upper lid. Lower eyelids can develop wrinkles and may bulge as fat pushes its way up from beneath the orbit. Aging eyelids can be rejuvenated by blepharoplasty, which involves removing excess skin and fat in the upper and lower eyelids. This simple outpatient surgery can be performed under local anesthesia with mild sedation. Most patients feel good the day after surgery and are able to drive and do minor chores with their healing eyelids hidden by sunglasses.

An upper eyelid blepharoplasty involves removal of the sagging skin and suturing it to form a new upper lid crease.   Because the incision is placed in the natural crease it is barely perceptible. Often excess fat, particularly on the nasal edge of the eyelid, is also removed to improve the eyelid contours.

Lower eyelid blepharopalsty is performed through an incision on the inside of the eyelid. Excess fat is removed so the eyes appear less tired looking. Laser resurfacing of the lower lid can be done at the same time, tightening the skin of the lower lid and greatly reducing the fine lines and wrinkles.

Blepharoplasty before and after photos:

Demi – Lift / Lower Face Lift
At Skin Physicians and Surgeons we perform a minimally invasive, lower face and neck lift, also, known as a mini face lift or Demi-lift. A mini face lift improves and tightens the skin of the lower face (also known as the jowls) and the neck.   This is most often performed under local anesthesia with or without IV sedation (also known as twilight sedation). In other words, general anesthesia is avoided as is all the risks and the recovery time that is associated with general anesthesia. To begin the procedure, the area is numbed with local anesthesia and excess fat is removed (if there is excess fat present) using tumescent liposculpture. Superficial muscles of the neck and lower face are tightened and any excess skin is removed. Sutures are placed in front of the ear, but often times, well hidden inside the ear, and also behind the ear. Sutures are removed in 7-10 days. Patients will likely not want to appear in public for about a week, but are certainly able to work from home and do minor chores and housework. Oftentimes, some patients will go out during that first week after surgery to run minor errands, and just choose to wrap a scarf around their head to hide the sutures.  

Before and after demi-lift:

 

 

Laser Resurfacing
Laser resurfacing with the CO2 laser is a remarkable procedure which has the potential for taking many years off the age of your skin. It is used to smooth out and even eliminate facial wrinkles, improve acne scarring, and actually tighten the skin. It is particularly effective for lines around the mouth and the eyelids.   Long-lasting results can be obtained.   Recovery time is 7 to 10 days. During this time, most patients are comfortable to work from home and can exercise and do housework, but would not wish to appear in public. If only the eyelid area is treated, patients can venture out in public to complete minor chores, and hide the healing areas with sunglasses. After 10 days, women can wear makeup to cover up your skin which will still be pink to slightly red.

Before and after pics – laser resurfacing:

Hair transplantation
People lose hair for many reasons, but the most common is male pattern hair loss. Some females also exhibit a version of this as they age called female androgenetic alopecia. The cause for this type of hair loss is genetic. Most people have close relatives who have also lost hair in a similar fashion. Often beginning in the late teens, male pattern baldness manifests itself has as a patterned loss of hair in the crown and front of the scalp. As the balding crown widens and the hairline recedes men pass through stages of thinning hair and into baldness. Women generally exhibit genetic hair loss by diffuse thinning rather than in a patterned fashion as men do.

The first step for a person who is losing hair, is to be sure of its cause. Dermatologists are especially trained to diagnose and treat hair disorders. Hair loss may be due to internal factors such as those caused by thyroid disease, which must be diagnosed. If there is an internal problem present the hair loss is merely a symptom of a more important problem which needs to be addressed. Specific blood tests can be used to determine if the hair loss is part of a more important disorder. Many individuals presume that their hair loss comes from lack of vitamins, improper shampoos, or grooming techniques. These are very rare causes.

After a diagnosis of the type of hair loss is made, the proper treatment can be selected. Many individuals fall prey to clever advertising techniques, which promise restoration of hair by taking certain medications or applying certain lotions or shampoos to the scalp. These are fraudulent and have been going on for thousands of years.

There are only two medications which have been FDA approved for treating hair loss. One is Rogaine or minoxidil, which originally was developed as a blood pressure medication. When applied in a liquid form to the scalp this can reduce hair loss and occasionally grow small amounts of new hair. Propecia (finesteride) was specifically developed to block the enzyme which is presumed to lead to hair loss. Propecia can be effective in slowing down hair loss, and occasionally grows significant amounts of new hair. Propecia can only be prescribed to male patients.

If a person wishes to gain a noticeable amount of new hair he or she will either have to purchase a hairpiece or undergo hair transplantation. Hairpieces are sold under a variety of names. Consumers should be very careful because some companies advertise in a way that is quite deceptive. Hairpieces are fashioned of human hair, which is attached to the scalp. Hairpieces fall apart in time and must be replaced and this process can be quite expensive. Hairpieces are best suited for men or women with significant baldness who are poor candidates for hair transplantation.

Hair transplantation is a procedure that was developed by dermatologists in the late 1950's. This technique involves transplanting hair follicles from the back of the scalp where the hair is thicker into the front of the scalp and the crown where balding is present. Hair transplantation has gradually become a very refined procedure. In the early days large "plugs" of hair were transplanted which left an unrefined pluggy appearance to the transplanted hair. Modern techniques however are based on the use of very small or follicular grafts containing from 1-3 hair follicles. These small grafts are placed to resemble the growth of normal hair. Because the grafts are so small and the result is so subtle, it is very difficult to tell that a patient's hair has been transplanted. Often even the barber is unaware that the patient had undergone this procedure.

The hair to be transplanted is obtained from a strip of hair-bearing scalp obtained from the back of the head. Once the strip is removed, the area is carefully sutured leaving only a small hairline scar. This eventual scar is nearly impossible to see unless the head is shaved. This removed strip is then subdivided into tiny individual little grafts containing between 1-3 hairs. These are then placed into punctures in the scalp in a precise fashion. The grafts are held in by clotted blood. The process takes several hours but most patients are quite comfortable during hair transplantation due to advances in local anesthesia. Postoperatively, the patient wears a dressing for one day and can drive or do minor chores wearing a hat the following day. Anywhere from a few hundred to well over a thousand hairs can be transplanted effectively during one procedure. Although some doctors have advocated even larger transplantations, there is evidence that transplanting too many hairs at one time results in poor growth and loss of many of the grafts. A conservative approach limiting the amount of hairs transplanted to 1500 or less provides excellent growth with most grafts surviving.

Most men or women undergo hair transplantation at least two times to achieve the best results. Severe cases of baldness may require several procedures. Additionally men with significant loss of hair in the crown area may benefit from a scalp reduction in which some of the balding scalp is removed and the scalp is "reduced" in size. Once sufficiently reduced, hair transplantation can be used to cover the remaining balding scalp and the scar. Each person must be carefully evaluated according to the severity of baldness, the color and thickness of hair, and other factors in order to achieve the best results.

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