Smoking & Cosmetic Surgery Do Not Mix

Clearly, smoking is an unhealthy habit. Still, it is estimated that a staggering 40 million American adults currently smoke cigarettes. While aware of smoking’s obvious health risks, patients at Seattle Plastic Surgery Centerare surprised that to learn of the impact that smoking has on both the safety and success of their chosen cosmetic surgery. Doubly as bad, smoking affects more than the surgery alone, also hindering and delaying one’s recovery.

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What You Need to Know About Breast Implant Revision Surgery

What You Need to Know About Breast Implant Revision Surgery

If you had a breast augmentation years ago and are wanting to maintain the youthful appearance of your breasts, you may be a great candidate for breast implant revision surgery. Most women who have breast implants will need to have the implants replaced at some point during their lifetime they are not intended to last forever. Also, if you underwent breast augmentation surgery several years ago, you may not have had the option to get cohesive gel (gummy bear) implants that are becoming increasingly popular today. Dr. Jonov can perform breast implant revision surgery with gummy bear implants or silicone implants to restore your silhouette and enhance your figure.
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Improve Your Body Image with a Seattle Breast Reduction Procedure

 Do you struggle with body image issues because of very large breasts? Even though breast augmentation is still one of the most sought-after procedures among women, many women are actually looking to reduce the size of their breasts. A breast reduction can improve quality of life by balancing out your figure and alleviating any physical pain or discomfort you’ve been experiencing. Dr. Jonov can provide you with more information about the breast augmentation procedure during your consultation. Continue Reading

New Study Shows Half of Cosmetic Surgery Patients Use Herbal Supplements

According to a new study in The Wall Street Journal, a near majority of men and women having cosmetic procedures are taking herbal supplements, which may have an impact on their procedure. The findings of the study were reported in the July issue of Plastic and Reconstructive Surgery, and included the warning that herbal supplements may have a negative effect on cosmetic surgery procedures. In the words of Dr. Bahman Guyuron, one of the study authors, “It is extremely important to investigate the use of herbal medicines, as many of these supplements can put the surgical patient at risk.”

Possible Risks from Herbal Supplements

Though herbal supplements and nutrition additives are often thought to be harmless, many of them can elicit side effects which may have a negative impact on any surgical procedure. One of the most commonly noted potential side effects is excess bleeding, in which the body cannot naturally slow the blood flow as a result of chemicals released by these supplements. Though not all herbal supplements cause this response, some of the supplements which have been most clearly linked to this problem include:

  • Bilberry
  • Bromelain
  • Fish Oil
  • Flaxseed Oil
  • Garlic
  • MSM
  • Selenium
  • Vitamin A

Other supplements with different potential adverse effects may include St. John’s Wort, echinacea, ginseng, ginger and feverfew. Those taking any of these supplements may need to discontinue them for a specific period of time prior to their procedure for the best results. In this study, 17.5% of patients were taking supplements with potentially negative surgical side effects. For this reason, the authors of the study note that, “These high risk supplements… are quite commonly used and the surgeon must elicit a complete history in order to avoid the known adverse consequences of supplement use on surgical outcome.” Whether having minimally invasive procedures like Botox Cosmetic and facial fillers, or a more involved procedure like a tummy tuck or breast surgery, giving a full list of your supplements at the consultation is a crucial part of a healthy result. Photo by L. Bernhardt, Resident Loon on Flickr.

How Long Will My Cosmetic Procedures Last?

cosmetic surgery injections timeline

One important factor for many people considering a cosmetic procedure is the expected length of the results.

While many cosmetic surgeries may provide patients with lifelong results, others are performed with the expectation that they will need to be repeated or updated in a certain amount of time. In some cases, such as with certain dermal fillers, the best results may be achieved by maintaining regular treatment intervals.

Determining Your Re-Treatment or Update Timeline

Major cosmetic surgeries, such as breast lifts, breast augmentations and tummy tucks, often provide satisfactory results for the life of the patient. In fact, the first silicone breast implants are still in place with satisfactory results more than fifty years later. However, the natural aging process may mean that some future revision could become necessary for the best possible results. This is impacted by a number of factors, including genetics, lifestyle, dramatic weight changes and major physical changes such as pregnancy, childbirth and menopause.

With more short-term cosmetic procedures, such as dermal fillers or Botox, injections can be performed every three months to two years. This range depends on the specific type of injection and the way it interacts with your body specifically. One advantage to using repeat treatments is that you become very used to the way that the treatment impacts your body, giving you an advantage when it comes to scheduling these treatments to line up perfectly with major events like weddings and vacations.

During your consultation, you will discuss these various timelines in detail, with projected results that are specifically tailored to your unique situation. Whether undergoing a cosmetic surgery or a facial injection, you will be able to make an excellent estimation of how long your results will last based on the length of previous patients.

Photo by linh.ngan on Flickr.

More Moms Receiving Plastic Surgery Gifts for Mother’s Day

When it’s hard to find the perfect gift for the perfect mom in your life, many more gift givers are now choosing to give the gift of cosmetic surgical and non-surgical procedures. As cosmetic procedures become more mainstream, and discussion of these treatments becomes more common, satisfied customers are more likely than ever before to give these procedures as gifts to their loved ones and friends. This annual holiday celebrating mothers is a perfect opportunity for this kind of gift giving.

Mothers Frequently Choose Injectables, Breast Procedures

With the increasing popularity of these unique gifts, some cosmetic surgeon’s offices have begun encouraging this trend, offering cosmetic surgery specials for Mother’s Day gifts and mothers who schedule procedures around Mother’s Day. Some of the most popular cosmetic procedures that are given to mothers are non-surgical procedures, such as injectables and various skin treatments. Affordable, fast, and requiring almost no recovery time, injectable treatments like Botox and dermal fillers may be ideal treatments for the busy lifestyles of mothers. These procedures give dramatic results without the larger commitment of surgery. They can also be an excellent option for those who have not used cosmetic procedures before, but have always wanted to get a taste of its possibilities. Many gift givers will purchase a gift certificate in a certain amount, and then let the recipient pick their chosen procedure. For those who know exactly what the mother in their life is looking for, the financial details may be taken care of beforehand, improving the surprise of the gift experience. For mothers who are more familiar with the options available through plastic surgery, and have a clear idea of what they are looking for, there are a number of these surgeries that make popular gifts. Popular plastic surgeries chosen by mothers include breast procedures such as a breast lift or breast augmentation, as well as body contouring procedures like tummy tucks and arm lifts. Photo by mikebaird on Flickr.

Tummy Tucks: Mini, Full, and Beyond (How does one choose?)

I am frequently asked whether a patient can have just a mini tummy tuck rather than a full in order to tighten loose tummy skin.  I thought it might be useful to discuss what a tummy tuck does (and what it does NOT do), and how we decide who may be able to get by with something less than a full tummy tuck procedure.

A tummy tuck refers to a procedure where an incision is made in the lower tummy beneath a swimsuit line, placed just above the pubic hairline and curving up towards each hip.

Since we will be freeing up under the skin and releasing the skin attachments so that we can re-drape the loose skin downwards and trim the excess that overlaps the incision, how long the incision will be depends upon how much loose skin there is to be removed and how far to the sides the laxity extends.

Full vs. mini

If the loose skin is only located below the belly button, the undermining or freeing up beneath the skin would stop at the belly button.  The skin would be pulled down and trimmed, and the only scar would be at the lower tummy under a swimsuit line.

This is referred to as a mini or lower tummy tuck.  There is no tightening of skin above the belly button.  If the patient has a stretched out belly button or loose or wrinkled skin above the belly button, these problems would not be corrected.

If loose skin at and above the belly button is present, a full tummy tuck is required.  The attachment of the tummy skin to the belly button needs to be released so that the upper tummy skin is not tethered at the belly button. Then pulling downward on the skin will tighten the upper as well as the lower tummy skin.

So, the main determining factor in deciding between mini and full tummy tucks are whether the belly button itself and the upper tummy skin above the belly button are stretched and loose.  If so, only a full tummy tuck will correct this.  If not, and the loose skin is entirely in the lower tummy, a mini alone is the answer.

The appearance of scarring

In a full tummy tuck, there is, in addition to the lower tummy scar, a small scar around the belly button where it is reinserted through the upper tummy skin that is tightened and pulled over it.  In this way, a stretched out and overly large belly button can be made to look much better.

I work hard to make a small, natural-appearing belly button with the scar mostly hidden in the shadow lines.  What happens to the hole where the belly button used to be attached  It is pulled down with the surrounding loose skin.

If there is enough loose skin above the belly button, unfurling this skin and advancing it will cause the old hole to move below the incision line and it will be removed.  If there is not quite enough laxity to remove this hole, it will be closed as a short vertical scar in the lower tummy.

Some plastic surgeons, trying to avoid this short vertical scar resulting from closing the old belly button hole, will raise the entire lower tummy scar to a higher location.  This allows the hole to be advanced past the incision line and removed.

I believe that this is a mistake.  The lower tummy scar may end up too high, and the pubic hair may be pulled up too high as well.  The distance from belly button to pubic hair may be abnormally short.  This just seems like a high price to pay in order to avoid a short vertical scar.

Tummy tucks and muscle tightening

There are some other factors to consider.  Oftentimes after pregnancies the abdominal wall fascia giving support to the abdominal muscles is stretched, the rectus (sit up) muscles are separated (this is known as diastasis recti), and when a woman stands up her tummy protrudes forward. Her abdominal wall is not properly supporting her bowel’s  That is why, in most full tummy tucks, we usually are tightening the fascia and muscles prior to tightening the skin.

Certainly there are some situations where this is not required. There are also some patients in whom this is the main problem causing them to seek treatment; sometimes this protruding fascia fills out their loose skin so that they are more aware of the protrusion than of the problem of skin laxity.

However, in most of these patients, once the fascia is tightened and pushed back where it belongs, the overlying looseness of the skin becomes more noticeable and the need for a full tummy tuck more apparent.

If the fascia and muscles are protruding both above and below the level of the belly button, a full tummy tuck with release of the belly button is needed to gain access to repair the upper abdominal wall.

If only mild fascial laxity is noted in the lower tummy at the time of a mini tummy tuck, this can be repaired, but one must be careful: over-tightening the lower fascia without tightening the upper fascia can lead to bulging of the upper tummyâ?¦just like pushing in on one part of a balloon will cause another part to bulge out.

Tummy tucks and fat reduction

There is some controversy about removing fat at the time of a tummy tuck.  Certainly the fat of the lower tummy will be advanced with the loose skin and whatever portion advances past the incision line will be removed.

But what about fat that remains in the mid- to upper tummy? It is tightened downward, but it is not removed.  Although some surgeons will perform liposuction of the tummy at the same time as a full tummy tuck, there are dangers involved: there is a higher risk that the skin loses its blood supply and dies due to the trauma of liposuction.

Many of us, in order to avoid these serious risks, prefer to not liposuction the central tummy, the same area where the skin is undermined, at the time of a tummy tuck.  It can be safely done at an earlier stage a few months before a tummy tuck or some months after.  And some patients have so much thick tummy fat that they are just not good candidates for a tummy tuck unless they experience significant weight loss first.

Somewhere in between a mini and full tummy tuck

Just for the sake of completeness, there is one variation of tummy tuck that lies somewhere between a mini and a full, and that is a modified tummy tuck with an umbilical float.   If someone has very mild laxity above the belly button, one can release the belly button from underneath, dividing the stalk where it attaches to the fascia, free up the skin above that point, repair the muscles if needed, and then advance the skin down and reinsert the belly button stalk to the fascia perhaps an inch lower.

This will allow some mild tightening of the skin above the belly button with no belly button scar and no small vertical scar below it.  Unfortunately, most women are not candidates for this operation¦they need to have belly buttons that are high to begin with, not stretched out, and only very mild skin laxity above the belly button.

If lowering the belly button about an inch makes its location look too low on your tummy, you are not a candidate!  I have seen patients who have had an umbilical float procedure whose belly buttons are about one inch above their pubic hair; this is not a good look and is very difficult to correct.

– Dr. Craig Jonov, Seattle Plastic Surgery

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