Repair CO2 Fraxel

A little over a year ago we did a press release on "Repair CO2 Fraxel". Since it's appearance on the plastic surgery horizon, it has become one of the most utilized additions to a large number of our facial surgery/rejuvenation cases. As an active professor at UTSW Medical School here in Dallas, I see any number of "new", "improved" and sometimes "re-cycled" surgical procedures with various claims of success. With over 25 years of cosmetic surgery experience, there have been some truly revolutionary treatments, approaches and products introduced during my career. Repair Fraxel is one of the products that has met expectations.

Repair Fraxel is a one-time treatment requiring general anesthesia which is done on the same floor as my office at the Dallas Day Surgery Center. The recovery period is five to seven days at home before resuming normal daily activities. Post-op patients usually experience a severe sunburn appearance, which heals and fades into a smoother, and regenerated skin surface. When done in conjunction with a facelift procedure, the Fraxel Laser magnifies the resultant skin rejuvenation by addressing the fine lines, wrinkles and skin discoloration that are not intended to be the primary focus of most face lift procedures. Men who have spent years in the sun playing golf, and basketball, or fishing and hunting may have extremely damaged skin. Fraxel has proven to be very effective in restoring a more youthful complexion.

Zeltiq

Zeltiq is a new non-invasive, no downtime procedure which targets and then eliminates fat cells. Currently, it is being used on the abdomen, flank and back, with anticipated expanded usage in the future. Zeltiq has some of the same results as liposuction without requiring anesthesia of any kind and no downtime. After the roughly one hour treatment, patients can immediately return to work, home or the gym with no side effects. The full results are apparent in two to four months as the size and number of fat cells dissipate.

Zeltiq has many advantages for men looking to lose some extra belly fat that may have creeped up on them silently over the course of years, or the love handles that may be the result of some recent holiday over-indulging. The first step is a consultation to determine if you're an appropriate candidate for Zeltiq. If you qualify, you will be taken to the the fifth floor of our building to the EpiCentre Skin Care and Laser Center. You'll then set up an appointment to come in for an hour treatment, and that's it. There are no post-procedure pain medications, no downtime, no scarring, and when the procedure is done, you're ready to resume the rest of your day.

The most important thing for men to know is that there are options available to them that range from these two new, innovative procedures, to the established liposuction and facelift procedures, and the other procedures we've discussed as part of this series. If you're not happy with your appearance, make an appointment for a consultation and get the information you need. An e-mail or phone call is all that's necessary to start the process and get a consultation appointment. Take the time, make the call, and then look at your options - we'll be happy to help you in anyway we can.

Rhinoplasty surgery is one of the most requested procedures, and one of the most complicated surgeries to do. Rhinoplasty, or "nose jobs" can be done for purely aesthetic reasons however, in the case of many males, they may come in for a consultation knowing that their nose has been broken at least once in the past, and that it's no longer straight or the same size it used to be, but rarely do they realize how much damage has been done internally. Men who are active in sports; baseball, football, basketball, soccer, and/or hockey, are accustomed to playing injured. When they initially injure their nose, the damaged cartilage and the associated tissue swelling restrict breathing. Eventually the swelling goes away and breathing becomes significantly easier, but often the airway is still partially blocked due to the damaged cartilage. Over time these men got used to getting a smaller amount of oxygen than they were intended to get, and they adjusted their expectations lower than they should have.

Many male athletes, both the professional and the weekend varieties, decide to wait until the end of their careers before having anything done to correct their damaged, broken nose. The reasoning is that as long as they're participating in sports it's possible that their nose will get broken again, so why waste the time and money to repair it now. They often decide to wait until after 'retirement' before fixing the nose. That does make sense if you're really only dealing with a cosmetic issue. It would be worthwhile though, to check with a plastic surgeon experienced in rhinoplasty to determine if there is internal valve damage, a deviated septum or other injuries that are impinging on the air passageway. If your breathing is being restricted by as little as 10 - 20%, that could make a fairly significant difference in your fitness and performance levels. Fixing internal damage at the end of any athletic career being measured by performance, would be waiting too long to get the full value of the rhinoplasty surgery. Rhinoplasty isn't just about fixing the way a nose looks. It's often about fixing how well you breathe and how it looks.

While rhinoplasty can be a complicated and demanding surgery, chin augmentation is very different. Using a plastic implant to build up the chin is clearly an aesthetic/cosmetic procedure. You're not going to breathe, eat, or speak better with a bigger chin, but there are few procedures that have a bigger impact on a patient's self-image than chin augmentation.

It's not unusual for male post-op chin augmentation patients to stand a bit taller, and to carry themselves with more confidence. It's not just about patients seeing themselves differently; it's also about the people around them perceiving them differently as well. While it's unfair and untrue, men who have small/receding chins are often seen as weak, lacking self-confidence and leadership abilities. It is still surprising that a few ounces of plastic expertly placed can make an enormous difference in the way a man is perceived by himself and others. Don't wait! Make an appointment today to determine where and what type of damage you might have taken with you off the court, the field, or the ice. Get it fixed now and breathe easier.

As mentioned in earlier posts, men are having plastic surgery procedures in record numbers in part due to the need to remain competitive with younger workers. While liposuction can help refresh and renew the body, an aging face can unfairly give recruiters, potential employers and co-workers a reason to overlook your qualifications by assuming you're simply too old to do the job effectively.

The first area of the face to show age is usually around the eyes. Dark circles, and bags under the eyes, as well as heavily hooded upper eyelids, are often genetic "gifts" from our parents. These gifts can add years to the face, making patients look tired, and unfortunately, old. Blepharoplasty is the surgical procedure used to address the creases, bags under the eyes, and heavily hooded upper lids. Occasionally the upper lids can become so heavily hooded that they interfere with vision. The good news about that is that in some of these cases insurance will cover correcting that vision impairment. Working together closely with an experienced Opthamologist, the surgical procedures we do together will correct the cosmetic problems as well as improve the restricted vision.

Every time we animate our face by laughing or smiling we cause creases and furrows to develop. As long as we have reasons to smile, we'll have causes to form wrinkles. That's just the price of a life well lived. Many people are content with that and if they are, so am I. However, if a patient is bothered by those creases for whatever reason, Botox is a very safe, effective treatment to stop the muscles from animating which in turn reduces the visible creases, and temporarily stops the development of new lines. There is no one right answer for every single patient, and you have to determine what bothers you and what doesn't. That's the only answer that matters.

One of the most important things you'll do in connection with any cosmetic treatment is to find an experienced, board certified Plastic Surgeon who will listen and then address the things that are important to you. It doesn't stop there. It's also critically important that you have a rapport and trust in the entire staff. In my Dallas practice, all of our injectable procedures, Botox, Sculptra, Restylane, etc., are done by my nurse of 20+ years, Lisa. She and I work together in developing a comprehensive program that will strive to achieve whatever your goals are. If you start with Botox and Sculptra injections, and find over time, that they're not achieving the results you want, then it's time re-evaluate to determine if you are ready to move to the next step - a surgical procedure.

The Endoscopic Brow Midface lift (EBMF) is often the foundation procedure at this point. It can be combined with the Blepharoplasty and/or a Mini Lower Facelift, but every patient is different, so it's advisable to keep an open mind. The endoscopic approach requires only a few small incisions behind the hairline, which are used to insert the endoscope and the instruments necessary to rebuild or refresh the facial foundation. Using the endoscopic approach means that there's less risk of infection, less sutures required, a shorter recovery, and there's less trauma to the facial tissue. Because there is no ear-to-ear incision over the top of the head as there is in "traditional" facelifts, there's also less chance of hair loss, which for many men is a very key issue. The EBMF will last for about 10 -15 years in most cases and the result is a more rested, elegant appearance.

There are many options available to men, and fortunately we're able to choose as much or as little as we want. Whatever anyone of us decides to do, whatever answer we find for ourselves is the right answer and that is progress.

Although it may not be talked about in the locker room, at the football game, or in the executive's corner office, more men than ever are having plastic surgery. It's estimated that 13% of all cosmetic surgery patients are men, which is a significant increase. In many ways, the reasons for choosing to have cosmetic surgery are the same regardless of the sex of the patient. As we age, men, and women decide they want to look better, younger, less tired, and more confident. Men tend to make the move to surgery later than women do, but they reap the same rewards:

a renewed self-confidence
better self-image
improved body image

Nationally the most requested surgery for both sexes continues to be liposuction. There are two main reasons that inspire men to finally make the decision to have plastic surgery:

Competition in the Workplace - Baby boomers are competing sometimes with much younger adults, many of whom don't know a world without cell phones, laptops and being constantly connected to the internet. During much of my medical career I would never have envisioned advertising on the internet, and the term "blog" hadn't even been invented yet. Staying up with the ever changing technology is only part of the struggle men face in whatever career path they've chosen, and if they look too much like their colleagues' father or heaven forbid, even their grandfather, they may be unfairly perceived as less savvy, resistant to change and outdated. In this job market, that's a black mark no one wants.

Divorce - While divorce is painful and disrupting at any age, when it happens later in life, it can have a devastating impact on self-image. Again, remaining competitive is an important factor when re-entering the dating world sometimes after a decade or more of marriage. More than that is rebuilding a self-confidence that may have taken a beating during the process of dissolving a marriage. Regaining a physical assurance can assist a newly single man when he begins dating again.

Liposuction is not a weight loss tool, but used appropriately, it can be effectively used in removing isolated pockets of fat that are resistant to diet and exercise. "Love handles", "beer bellies" and "double chins" are all areas where liposuction combined with a low fat diet and exercise can be very effective in achieving a trim, athletic build. Men who are completely frustrated come in to my office after they have spent hundreds of hours in the gym doing all kinds of core/abdominal exercises trying to achieve that elusive "six pack" shown so often in magazines of all types. The problem may not be that the muscles aren't developed enough, but that there's a layer of fat and tissue that is covering the muscles. Using a small cannula, that layer of fat can be removed and within a few weeks after all the surgery induced swelling has dissipated, the true musculature is visible. If the patient continues to keep their weight in check and their fitness level fairly constant, they can forget about the love handles and beer belly permanently.

There are areas of our bodies where no exercise is going to make any difference. Men who are very fit and completely happy with their appearance otherwise, may still have to deal with jowls, double chin, and/or turkey neck. Often I'll hear that one morning the patient looked in the mirror and saw their father's neck and chin where it wasn't wanted. Some patients are genetically predisposed to very early on develop crepey skin on the neck that can severely age any man's appearance. While the face and body may not announce your true age, if your neck looks old, you look old. A short two-hour surgical procedure, including liposuction, can remove the excess fat and skin. This one procedure alone can dramatically improve the patient's profile and overall look.

While liposuction is the procedure most often selected by men, there are other procedures men are choosing which we'll be discussing in this series over the next few days. Check back with us to see the changes underway in men's health.

Most people have never heard the term "Gynecomastia". This condition is sometimes insensitively referred to as "man boobs" which just adds insult and injury to the embarrassment the man who suffers from Gynecomastia deals with on a daily basis. In about 75% of the cases of Gynecomastia, the cause is thought to be a decrease in the hormone testosterone compared to estrogen. All men and women have varying amounts of estrogen and testosterone hormones, and when that balance becomes skewed, sometimes the result is Gynecomastia in men.

Swelling of the male's breast tissue can develop at birth when the mother's increased estrogen causes the infant's breasts to swell. Without treatment, this swelling usually goes away within two to three weeks. Hormonal changes in puberty can also cause enlarged breast tissue, and this too sometimes resolves itself within a few years even if left untreated. One quarter of those with Gynecomastia don't develop symptoms until the ages of 50 - 80. The most highly affected groups are adolescent boys and middle age/older men. Medications, chromosome disorders, poor diet, lack of exercise, obesity, and thyroid issues are all suspects in the development of excessive breast tissue in men, but many times the causal factors remain unidentified.

We often see men who have not gone to a pool party or to the beach for years because they didn't want to risk the potential cutting and damaging remarks. Sufferers often resort to wearing two or three t-shirts, or multiple layers of clothing in an attempt to mask the swelling of the breast tissue. Many will have worn binders and compression garments of all types as concealment efforts. They will also adeptly avoid locker room and communal shower situations at all costs. It's not uncommon for these men to have given up dating and for teenagers to not ever start dating at all in an effort to avoid the inevitable awkward situations. Sufferers will develop a whole cadre of coping mechanisms to avoid embarrassment, and by the time they come in to see me, they've simply tired of the avoidance dance.

Gynecomastia can be treated very successfully with surgery and liposuction, which removes any glandular tissue as well as any remaining excess fat. The surgery, when done by a board certified plastic surgeon, is a relatively simple procedure lasting about two hours. A scalpel is used to excise the breast tissue much like a mastectomy procedure to treat breast cancer. Liposuction is then used to remove any remaining fatty tissue on the outer margin of the chest. If the suspected cause is obesity, it's important that the patient initiates and maintains a calorie appropriate, low fat diet to avoid recurrence.

Surgery is not right for every Gynecomastia patient, and that's one of the critical reasons it's important to talk to someone who has experience in treating the disorder. It's essential that the right patient have the surgery done at the right time. As with every decision, it's important to consider risk versus reward. It may be very difficult for the Gynecomastia sufferer to take that first step and talk about this. If you're a male and find yourself suffering from enlarged and swollen breasts, please call and make an appointment so we can work together to find a solution that will give you back the portions of your life you've perhaps put on hold for many years. Gynecomastia is treatable and this summer you could be at the pool, comfortably, by calling us now for a consultation.