Wrinkle correction used to mean either small improvements with creams or major improvements with surgery. The ground betwen is now covered with the introduction of wrinkle fillers, like Restylane, Juvederm, Perlane and Radiesse, and wrinkle relaxers, like Botox, Dysport and Xeomin.
San Francisco Bay Area – Leaders in Wrinkle Reduction
San Francisco Bay Area Plastic Surgery patients have always been at the forefront of facial wrinkle correction with fillers. It began in the 70′s with the local development of Collagen, and carries on today with its replacement, hyaluronic acid or HA.
Like collagen, HA is a normal component of the skin, and is also found in our joints. HA dermal fillers are sold under many brands names, with the most popular being Restylane, Juvederm and Perlane. These clear gels allow for the correction of moderate to deep facial rhytids (lines) with minimal down time and quick improvement.
Wrinkle Relaxers – Botox, Dysport & Xeomin
Botulinum toxins have been used for years for the treatment of blepharospasm, a disabling chronic spasm of the muscles around the eyes causing functional blindness. For many years it was the plastic surgeons “secret” weapon, and used off-label, but a few years ago Allergan received approval for a new indication – the cosmetic treatment of frown lines. BOTOX Cosmetic was born. Others have followed with similar approval and results including Dysport and Xeomin.
Facial Wrinkle Correction Video
Today’s video is from a recent appearance on KRON‘s Body Beautiful during which I discuss how to use minimally invasive procedures to achieve maximum results. The discussion includes the use of fillers like Restylane, Juvederm, Perlane and Radiesse, and wrinkle relaxers, like Botox, Dysport and Xeomin. The (415) number in this video was for viewers to call during the live broadcast. If you have questions about dermal fillers or botox, give us a call at (925) 943-6353.
This Facial Wrinkle Correction Video includes:
Freshening up for special occasions
The best areas to treat with fillers
The best areas to treat with neuromodulators
Who is a good candidate for wrinkle reduction treatments?
As a Board Certified Plastic Surgeon in private practice in the San Francisco Bay Area city of Walnut Creek, California, for 15 years, the development of injectable therapies has revolutionized the way facial rejuvenation is approached. While no substitute for real plastic surgery, they allow for real improvement in appearance of facial lines and wrinkles, in ways that were just not possible before.
More Wrinkle Correction Information
Information on facial wrinkle reduction is available in English and Español. Please follow the links below:
It made headlines in 2004 when New Jersey, in a misguided effort to raise state taxes, levied a 6% excise tax on Cosmetic Surgery. Now the nip-tuck tax is getting the axe.
Read My Lips … No Cosmetic Taxes
Today, New Jersey Governor Chris Christie signed legislation calling for the elimination of the state’s 6 percent tax on cosmetic surgery procedures. Medical procedures, like food, have always been tax free, but in 2004, New Jersey enacted the New Jersey Cosmetic Medical Procedures Gross Receipts Tax. A 6% gross receipts tax was required on all cosmetic surgery, hair transplants, cosmetic injections, cosmetic soft tissue fillers, dermabrasion and chemical peels, laser hair removal, laser skin resurfacing, laser treatment of leg veins, sclerotherapy, and cosmetic dentistry. All providers were required to register, report gross receipts and pay the tax quarterly.
This type of tax is called an excise tax. Excise taxes are taxes paid when purchases are made on a specific good. Excise taxes are often included in the price of the product, such as gasoline, alcohol and tobacco. There are also excise taxes on certain activities, such as taxes on wagering or taxes on highway usage by trucks.
Excise taxes are indirect, because the government does not collect the tax. Instead, and intermediary, like the producer or the merchant, is charged and they in turn pay the government. These types of taxes are inefficient and costly to regulate, and this is likely the reason the tax is being withdrawn. In the case of New Jersey, the annual tax collected was half of what was expected, about 10 million dollars. Furthermore, this was more than offset by an annual loss to the state of about 34 million dollars. This, among other facts, lead Joseph Cryan, the sponsor of the 2004 bill, to lead the repeal.
Who Decides What is Cosmetic Surgery?
There is not always a clear division between cosmetic and reconstructive surgery, and this makes this type of tax arbitrary and difficult to administer. The decision of medical necessity was left to those collecting the tax. This led to the taxation of cosmetic surgeries like those used to improve appearance after disfiguring accidents, port wine stain removal and even keloid scar removal.
A Tax on the Middle Class
With cosmetic procedures becoming more acceptable, it is no longer the exclusive realm of the rich and famous. Research by the American Society of Plastic Surgery found that 71 percent of plastic surgeries were for individuals earning less than $60,000 a year; moreover, only 10 percent of respondents reported household income over $90,000.
A Tax on Women
Research from the American Society for Dermatologic Surgery finds that 83 percent of its members’ minimally invasive cosmetic medical procedure patients are women. The percentage of women accounting for cosmetic surgery procedures approaches 90% in the yearly surgical statistics published by the American Society of Plastic Surgery.
Connecticut’s Cosmetic Taxes
Six months ago, Connecticut passed a 6.35% sales tax on all cosmetic medical procedures. Time will tell if the state suffers the same fate as New Jersey. It seems likely. With Connecticut being a small state, it is estimated that as many as half of Connecticut’s cosmetic patients will seek their care out of state to avoid the tax. This will have a significant negative impact on the state’s corporate tax revenue.
California’s Cosmetic Taxes
California considered a cosmetic tax a few years back, but with a greater appreciation of the complexities involved, the bill was withdrawn and exchanged for a 10% tax on tanning salons. This tax revenue should be reduced a little more this year thanks to a bill signed by Governor Jerry Brown that went into effect on Jan. 1, that bans indoor tanning for anyone under 18.
Breast Augmentation with Breast Implants remains one of the most popular cosmetic plastic surgery procedures in the San Francisco Bay Area, but breast enhancement comes in all shapes and sizes. As a Board Certified Plastic Surgeon in the East San Francisco Bay Area City of Walnut Creek, a large part of my private practice is dedicated to the numerous aspects of breast enhancement, including:
The simplest way to decide what to do to achieve the optimal results in Breast Enhancement Surgery is to independently evaluate what needs to be done to the size of the breast and what needs to be done to the shape of the breast. While intimately related, size and shape often need to be addressed separately.
The Best Breast Size
The best size for your breasts depends on you. The best breast size will vary, and depends on the size of your body (preoperative breast size, the dimensions of the chest wall, height, weight); your level of activity (couch potato, gym enthusiast, serious athlete, Olympian); and most importantly, your comfort level with your desired cup size. This is a simplification, but a good sampling of what I am considering during every breast enhancement consultation. Whether increasing the size of the breasts with breast augmentation or decreasing the size of the breast with Breast Reduction, there is a range of aesthetic outcomes determined by physical parameters. In the vast majority of cases, this range includes what my patient has pictured in her own mind. On the other hand, the imagination has no bounds, and occasionally it outstrips what is possible.
The Best Breast Shape
The ideal breast is perky, with the nipple centered over the most projecting aspect of the breast. Changes in shape solely due to absent or lost volume, like that seen after pregnancy or weight loss, can often be improved with breast implants alone. Changes in shape due to increasing breast volume, whether due to genetics, pregnancy or weight gain, are addressed with breast reduction.
It may seem like breast reduction is the opposite of Breast Augmentation. If you are considering only breast size, it is. However, when we consider breast shape, just removing volume is not sufficient. The result would be a deflated, saggy breast. Breast reduction surgery includes a breast lift as an integral part of the procedure.
The Best Breast Lift
Breast Lifts, like breasts themselves, come in different sizes. Small breast lifts are effective for small amounts of sagging, while big breast lifts are necessary to correct large amounts of sagging. The topic is too large to cover in a paragraph, or even a web page, but more general information is available on San Francisco Breast.
The important part about breast lifts is that they help enhance the shape of the breast. Whether you are born with tubular breasts, have breast asymmetry or your breasts are ptotic (saggy), a breast lift can reshape the breasts into a more attractive form. Unlike breast augmentation, which simply magnifies the existing shape of the breast, a breast lift can remove excess skin and elevate the nipple’s position on the breast mound.
Breast Enhancement Consultations
If you are considering breast augmentation, breast lift or breast reduction surgery, be certain to find a qualified Board Certified Plastic Surgeon. It is important to remember that while there may be several ways to accomplish your desired goals, the method is not as important as the person you choose to do your surgery. Choose a Board Certified Plastic Surgeon, who is an active member of the American Society of Plastic Surgeons (ASPS). If you are considering cosmetic plastic surgery, members of the American Society for Aesthetic Plastic Surgery (ASAPS) are ASPS members who have shown a special interest in the cosmetic side of plastic surgery. For those truly dedicated to Cosmetic Plastic Surgery, the ASAPS also offers a Certificate of Advanced Education in Cosmetic Surgery. Mine is pictured below, as evidence that I am dedicated to providing you with the best that Cosmetic Plastic Surgery has to offer.
Dr. Mele's Certificate of Advanced Education in Cosmetic Surgery
If you are in the Greater San Francisco Bay Area, and would like to take the next step and schedule a personalized consultation appointment, please give us a call at (925) 943-6353, or use the contact form to the left.
The Tummy Tuck remains one of the most requested cosmetic plastic surgery procedures in my San Francisco Bay Area plastic surgery office. Walnut Creek is a growing community with excellent schools. It’s a great area for raising children, so I see lots of mommies from Walnut Creek and the surrounding areas.
Tummy Tuck, Abdominoplasty, Panniculectomy, it doesn't matter what you want to call it, the result is a flatter, firmer stomach.
What Does a Tummy Tuck (Abdominoplasty) Do?
Tummy tucks are designed to fix abdominal wall laxity. Abdominoplasty can repair stretched abdominal wall muscles. The tummy tuck removes the excess skin and fat that accumulates on the lower belly. This part of the abdominoplasty is sometimes called a Panniculectomy. Whatever the name, the result is a firmer, flatter abdominal wall.
Tummy Tuck Timing – When to Get Your Abdominoplasty
There are several reasons for abdominal wall laxity, but having children tops the list. Pregnancy stretches the abdominal muscles and skin. Often the stretching is irreversible, and the skin and muscle remain loose, despite weight loss and working out. It may take several months for your abdomen to recover from child birth. Normally, maximum shrinkage is seen by your newborns first birthday. The best time to get a tummy tuck is after your are done having children. For more information about abdominoplasty, click on San Francisco Tummy Tucks
Another common reason for a tummy tuck is a history of being overweight. Weight gain, like pregnancy, stretches the abdominal wall. When the weight is lost, loose skin and stretched muscle may continue to be a problem. This occurs in more areas than the abdomen. Loose skin may affect the breasts, face, arms and thighs too. The best time to have a tummy tuck after Weight Loss, is when you have reached your goal weight. If you have had bariatric surgery for weight loss, it is recommended to wait one year after your weight loss surgery. This allows you to reach a stable weight, and gives your body time to adjust to its new physiology. For more information on plastic surgery that can help improve your appearance after weight loss, click on Post-Bariatric Plastic Surgery.
The Mommy Makeover is a combination of Tummy Tuck and Breast Enhancement. Since pregnancy affects the breast and abdomen, the mommy makeover is one of the most common combination surgeries I perform. Most commonly, Breast Augmentation, with or without a Breast Lift, is added to the tummy tuck. But sometimes, just a breast lift (mastopexy) or even breast reduction is needed. A mommy makeover may involve a smaller abdominal procedure when appropriate, so liposuction and mini tummy tucks (mini abdominoplasty) are always considered. For more information on Mommy Makeovers, click on San Francisco Mommy Makeover.
If you would like more information about the mommy makeover, tummy tuck, mini tummy tuck, liposuction, Breast Augmentation, breast lift, breast reduction or post-bariatric plastic surgery, make an appointment for a personal, private plastic surgery consultation. Give us a call at (925) 943-6353, or use the contact form on this page.