Surgical Plastic Surgery

Posted May 06, 2017 in Botulinum Toxin (Botox Dysport Xeomin), Fillers (Restylane Juvederm Perlane Radiesse), Home, Wrinkle Reduction (Non-surgical)

Botox and Fillers are by far the most common cosmetic plastic surgery procedures in the United States, but operative plastic surgery procedures are also on the rise.

Botox and Fillers are by far the most common cosmetic plastic surgery procedures in the United States, but operative plastic surgery procedures are also on the rise.

There is always a lot of buzz around Non-Surgical Plastic Surgery. The appeal of plastic surgery results, without surgery, is undeniable. If we could truly reshape our bodies with a cream, a pill or a shot, it would seem … too good to be true.

Non-Surgical Cosmetic Procedures

The number of non-surgical cosmetic procedures performed each year out number surgical procedures by more than an order of magnitude. The two most common, Botulinum Injections (Botox and Dysport) and Dermal Fillers (Restylane and Juvederm), work very well to correct smaller cosmetic problems, and they can also provide improvement in the appearance of deeper wrinkles.

It’s Not Surgery

The appeal of these minimally invasive procedures stems from the fact that it is not surgery. The procedures are performed in-office, require minimal equipment and are easier to schedule. Per treatment, there is Less Downtime and a Shorter Recovery Period. These types of procedures appeal to our need for instant gratification.

And It’s Not Surgery

On the other hand, Non-Surgical Procedures require a lot more maintenance. Without surgery, the results will be less dramatic and the longevity of the results is reduced. The half-life of non-surgical interventions is months, so multiple treatments are needed each year. It adds up to additional expense and recovery with each treatment.

The Biggest Problem with Non-Surgical Treatments

Some cosmetic problems respond very well to non-surgical options. In fact, for non-surgical problems, non-surgical techniques work better. A good example is the Minimally Invasion Treatment of fine lines and wrinkles. Botox, fillers, chemical peels, lasers and dermabrasion all may work better than surgery for carefully selected individuals. On the other hand, if you are receiving fillers or botox from someone who only does these minimally invasion procedures, you may never learn what your longer lasting options are.

When Minimally Invasive Means Minimal Results

Non-surgical procedures are complimentary to what I do as a Board Certified Plastic Surgeon; however, when it comes to truly surgical problems, botox and fillers cannot equal surgical results. If your problem is loose skin, or you are interested in more significant augmentation, there is no replacement for surgery. After all, non-surgical surgery is by definition an oxymoron.

When To Get A Plastic Surgery Consultation

If you are interested in maintaining your youthful appearance, or correcting the outward signs of aging, it is never to early to consult an experienced, board certified plastic surgeon. Plastic Surgeons offer a wide range of treatments. From minimally invasive procedures like Botox and Fillers, to Facial Plastic Surgery like Eyelid Lifts and Face Lifts, a qualified board certified plastic surgeon can be your guide and confidant. If you are interested in learning what all your options are, call our San Francisco Bay Area plastic surgery clinic today at (925) 943-6353.

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Top Plastic Surgery Procedures – SF Bay Area

Posted March 05, 2017 in Brazilian Butt Lift, Breast Augmentation, Breast Augmentation Lift, Breast Lift (Mastopexy), Breast Reduction, Brow Lift, Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Home, Liposuction, Neck Lift (Rhytidectomy), Plastic Surgery Societies, Rhinoplasty (Nasal Surgery), Tummy Tuck (Abdominoplasty), Wrinkle Reduction (Non-surgical)

The 2016 ASPS National Plastic Surgery Statistic were released this week.

The 2016 ASPS National Plastic Surgery Statistic were released this week.

This week the American Society of Plastic Surgeons (ASPS) published the United States’ national Plastic Surgery Statistics for 2016. It is always interesting to me to see how the national statistics correlate with my own Cosmetic Plastic Surgery practice here in the San Francisco Bay Area. Last year, the correlation was pretty close.

Top Ten Cosmetic Plastic Surgery Procedures

As a group, surgical procedures grew 4% from 2015 to 2016. The top five Cosmetic Plastic Surgery procedures are almost the same. Facelifts edged out Tummy Tucks for the fifth spot, but the popularity of the two procedures remains very close. Here are the top five procedures as reported by the ASPS:

  1. Breast Augmentation (Augmentation Mammoplasty)
  2. Liposuction (Suction Assisted Lipectomy)
  3. Cosmetic Nasal Surgery (Rhinoplasty)
  4. Eyelid Lift (Blepharoplasty)
  5. Face Lift (Rhytidectomy)

The next five procedures, in order of popularity were: Tummy Tuck (Abdominoplasty), Breast Lift (Mastopexy), Neck Lift (Rhytidectomy), Forehead Lift (Brow Lifts) and Breast Reduction (Reduction Mammoplasty).

Brazilian Butt Lifts Grow The Fastest

The fastest growing procedure last year was the Brazilian Butt Lift (BBL). The BBL is not really a buttocks lifts, but more a buttocks enlargement. During the procedure, fat grafting is used to enlarge the buttocks and selectively enhance its shape. The results can be quite dramatic and the resultant shape is usually much nicer than that obtained from buttocks implants.

The Brazilian Buttocks Lifts is again the fastest growing cosmetic plastic surgery procedure. Significant improvement in the size and shape of the buttocks is possible by removing disproportionate fat from other areas, the lower back in this example, and selectively inserting the excess fat into the buttocks.

The Brazilian Buttocks Lifts is again the fastest growing cosmetic plastic surgery procedure. Significant improvement in the size and shape of the buttocks is possible by removing disproportionate fat from other areas, the lower back in this example, and selectively inserting the excess fat into the buttocks.

The number of Brazilian Butt Lifts increased 26%, from 14,705 to 18,489 in 2016. The procedure was also the fastest growing procedure of 2015 when it grew 28%, from 11,505 to 14,705. In fact, for the US population, the number of BBL’s has doubled from 2013 to 2016, and shows no signs of slowing in 2017.

Minimally Invasive Plastic Surgery Procedures

Minimally invasive plastic surgery procedures grew 3% in 2016. The top five procedures remain:

  1. Botulinum Toxin Type A (Botox®, Dysport®, Xeomin®)
  2. Soft Tissue Fillers (Restylane®, Juvederm®, Radiesse®)
  3. Chemical Peels (TCA, Phenol)
  4. Laser Hair Removal
  5. Microdermabrasion

Cosmetic Plastic Surgery Consultations

If you live near the San Francisco Bay Area and are considering Cosmetic Plastic Surgery, be certain to seek out an experienced and Board Certified Plastic Surgeon in your area. To schedule a private consultation, tailored to your specific needs, call (925) 943-6353, today.

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The Neck Lift – Opened Or Closed? – SF Bay Area

Posted May 01, 2016 in Facelift (Rhytidectomy), Home, Liposuction, Neck Lift (Rhytidectomy)

Natural Facial Rejuvenation  depends on selecting the best techniques to correct the natural signs of aging. The Neck Lift is usually combined with the Face Lift to maintain facial harmony, as is shown in the before and after pictures shown above..

Natural Facial Rejuvenation depends on selecting the best techniques to correct the natural signs of aging. The Neck Lift is usually combined with the Face Lift to maintain facial harmony, as is shown in the before and after pictures shown above.

Plastic Surgeons and Facial Plastic Surgeons alike have for decades debated the benefits of opened and closed approaches for Facial Rejuvenation. Most often, open vs. closed is debated for Rhinoplasty (Cosmetic Nasal Surgery), but at the most recent American Society for Aesthetic Plastic Surgery meeting in Las Vegas, the open vs. closed debate centered around Neck Lifts.

The Annual Aesthetic Meeting attracts thousands of Cosmetic Plastic Surgeons from around the world.

The Annual Aesthetic Meeting attracts thousands of Cosmetic Plastic Surgeons from around the world.

The American Society for Aesthetic Plastic Surgery

The American Society for Aesthetic Plastic Surgery (ASAPS) is over 2600 Plastic Surgeons strong. Most members are from the United States and Canada, but many countries are represented. Only about one-quarter of all American Board of Plastic Surgery certified surgeons have been accepted as ASAPS members. The ASAPS is the largest plastic surgery society dedicated exclusively to the Cosmetic side of Plastic Surgery. Most members, like myself, are also members of the American Society of Plastic Surgeons (ASPS). The ASPS represents both cosmetic and reconstructive plastic surgeons and has over 8000 members. The ASPS represents about 94% of all Board Certified Plastic Surgeons in the United States.

The Las Vegas Plastic Surgery Debates

The nice thing about a society dedicated to just the aesthetic aspects of plastic surgery is that we can focus on Cosmetic Surgery. There are many scientific sessions, expert panels and instructional courses offered over the week long meeting, each dedicated to a specific aspect of what Plastic Surgeons do. Every procedure is covered, often with multiple sessions exploring every aspect of every technique. Since there is often more than one way to do each procedure, lively debates are common, and some of these debates have been going on since long before I started my San Francisco Bay Area Plastic Surgery practice.

The Neck Debate – Open Vs. Closed

One such on going debate explores the various approaches to Neck Rejuvenation. Neck Lifts seem easy enough, but they are one of the more challenging areas to correct. Just about everyone over 40 has tried lifting their neck at least once or twice in the mirror, but making the change long lasting, without distortion, is the challenge. Several Neck Lift techniques exists, but they are usually divided into two main groupings – Closed Neck Lifts and Open Neck Lifts.

Closed Neck Lifts

There is a tremendous amount of crossover between Neck Lifts and Face Lifts, and since the face and neck age together, the Neck Lift and Face Lift are usually combined to maintain facial proportions and harmony. The term Rhytidectomy (literally wrinkle removal) is used for Neck Lifts, Face Lifts and even Brow Lifts.

When the neck has loose skin without platysmal bands, a Closed Neck Lift may be the best option. If disproportionate fat is present, Liposuction can be used to sculpt an even smoother contour.

When the neck has loose skin without platysmal bands, a Closed Neck Lift may be the best option. If disproportionate fat is present, Liposuction can be used to sculpt an even smoother contour.

Closed Neck Lifts are similar to what we do in the mirror. The skin is tightened in the direction of the jaw line, and the excess is removed to hold the smoothed skin in place. This reduces the loose skin under the chin (the waddle or turkey gobbler), reduces jowls and better defines the junction between the face and neck. For closed neck lifts, the skin is opened around the ears like for a Facelift, but the neck is left closed.

Open Neck Lifts

The platysma is a flat muscle that supports the neck skin.  Often it is separated in the midline. As we age, we see this separation as Platysmal Bands, the two cords running down the front of the neck. One goal of the Neck Lift is to diminish to appearance of these bands.

The platysma is a flat muscle that supports the neck skin. Often it is separated in the midline. As we age, we see this separation as Platysmal Bands, the two cords running down the front of the neck. One goal of the Neck Lift is to diminish to appearance of these bands.

Open Neck Lifts do everything a closed neck lift does, but also include an incision under the chin. The opening allows for direct adjustment of the superficial fat and muscles under the chin and down the front of the neck. When platysmal bands are present, the two cords of skin that run from under the chin down the front of the neck, they can be “repaired” through an open technique. Excess fat can also be removed, and we Plastic Surgeons debate how much and from which levels fat removal is most effective, yet still safe and predictable.

Minimally Open Neck Lifts

I add a third class of Neck Lift to my treatment algorithm: the Open-But-Just-A-Little-Bit Neck Lift. This is a combination of a Closed Neck Lift with Liposuction of the neck. It can accomplish much of the fat removal of the open technique through a much smaller incision. When disproportionate fat is present beneath the chin, Liposuction can be a useful adjunct to tightening up the skin. In this case a small incision is made under the chin to allow the fat to be suctioned, but not big enough to look through or repair the platysma muscle.

Most Plastic Surgeons Use Multiple Approaches

In our yearly ASAPS debates, Plastic Surgeons choose techniques and debate the pros and cons, but in reality most of us use multiple techniques. The choice depends on what our patients need. This month I have used techniques from all three categories of Neck Lifts listed above. I choose different techniques for different patients depending on what is broken, and what I have to fix.

How To Choose The Best Neck Lift For Your Neck

If you are considering a Neck Lift, it is helpful to have an idea of what your options are. Some problems respond better to specific techniques. If loose skin is the main problem, a closed technique may be the best. Platysmal bands may respond better to an open technique, while disproportionate fat may respond to liposuction.

The Internet provides lots of information, but trying to choose your own technique is a bit like trying to pick the wrench your plumber is going to use. Get a working knowledge of what is possible and get the help of a professional. Choosing the best Board Certified Plastic Surgeon is much more important than choosing the best technique. Getting multiple opinions can help, but you will likely learn that multiple approaches are possible. Having multiple choices can be a source of confusion, and this is why you need the best Plastic Surgeon.

Neck Lift Consultation

If you are in the greater San Francisco Bay Area, and would like to come into my Walnut Creek, CA, office for a Neck Lift evaluation, give me a call at (925) 943-6353. During your private consultation we will review your expectations and explore your options, so that the best Neck Lift for you can be selected.

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How to Help Your Face – San Francisco Bay Area

Posted January 24, 2016 in Botulinum Toxin (Botox Dysport Xeomin), Chemical Peels, Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Fillers (Restylane Juvederm Perlane Radiesse), Home, Rhinoplasty (Nasal Surgery), Smoking and Plastic Surgery, Wrinkle Reduction (Non-surgical)

If we are lucky, Facial Aging is something we all experience. It can present as changes in skin tone or coloration, fine lines or deeper wrinkles, and even loose or saggy skin. It happens, if we stick around long enough. While Facial Aging cannot be altogether prevented, how you look is influenced by how you treat your skin. Some of our normal daily activities help, while others hinder the effects of time.

Good Genes and Bad Habits

We all know someone who never wears sunscreen, drinks, smokes and whose skin looks great. It’s hard to beat youth and good genes, but you can if you try hard enough. Skin likes Protection, Hydration and Circulation, so here’s how to earn your PhC in beautiful skin:

  • Protect your skin. It protects you.Protection – Prevention is the best medicine, and this is true for your skin, too. While we need a small amount of sunlight to activate vitamin D, the amount we subject our skin to, especially when we are young, is excessive. The high-energy ultra-violet light in the sun’s rays breaks the DNA inside the skin cells. At a minimum, sunshine dehydrates the skin, but it also damages the elastic fibers that keep skin supple, reduces the skin’s ability to heal itself and if too much damage is done, leads to the development of skin cancer. We would all treat cancer after it’s found, but why not treat it before it starts, by protecting your skin?

    Skin cancer can occur even where the sun does not shine, but it is most commonly found in areas exposed to the sun. Moreover, the risk of Skin Cancer increases with the amount of sun exposure. Today, sunscreen is incorporated into many moisturizers, cosmetics and even fabrics. Hats and long sleeves help, but sunscreen is a must. Personally, I could not survive a trip to Hawaii without sunscreen, a hat and a swim shirt. When I was young, it may not have made me look cool, but it did allow me to have fun with my friends without a week of recovering from sunburns. Now, if you go to the beach, sunscreen and sun shirts are common, and using them shows that you care about your body.

  • Your skin likes being hydrated.Hydration – Our skin keeps us from drying out, but it is not impermeable. I remember a junior high school science project during which we placed a plastic bag over one hand. The water that is normally lost through the skin was trapped in the bag. It made it quite clear that we are constantly dehydrating.

    If you’ve ever watched Naked and Afraid, or any of the other survivor “reality” shows, you know that water is more important than food. Keeping hydrated keeps us healthy. It improves circulation and allows the body to rid itself of toxins. Alcohol, on the other hand, tends to dehydrate us, so all things in moderation.

    You can help your skin by using a moisturizer. Moisturizers do not supply moisture to the skin, but trap the normal water that is lost through the skin. Petroleum Jelly (Vaseline) is very effective. It certainly helps injured skin heal with better scars, but its sheen is a bit obvious and it greasiness makes using vaseline quite messy. Most moisturizers are not as good as Vaseline, but are easier to live with. It’s a compromise.

  • Good circulation makes for healthy skin.Circulation – Good hydration promotes good circulation. The blood is mostly water, and when we are dehydrated the skin suffers more than another other organ. Circulation is also effected by our habits. Good habits, like daily exercise, promotes increased circulation and may improve the look of our skin, too. Bad habits, like smoking, decreases circulation, and the skin is especially hard hit.

    As a Cosmetic Plastic Surgeon, I am operating on the skin, and I need healthy skin and circulation to get the best results. Several cosmetic operations are known to have increased risk in people who smoke. For procedures like Face Lifts, Breast Reduction and Tummy Tucks, smoking increases the risk of wound healing problems by six-fold. Because of this, Plastic Surgeons recommend smoking stop at least four weeks before and after any elective surgery. If you can quit smoking for surgery, you can quit for life, literally your life.

Good Genes and Good Sense

There are many simple actions we can take to keep our face and skin happy, and earn our skin a PhC. You have probably heard many of them before, like eating right and sleeping, but good advice only works if you act on it. I will share additional pearls in additional posts.

With the title How to Help Your Face, you might have thought I was going to review all the plastic surgery options for Facial Rejuvenation. That information is certainly available here on the the San Francisco Plastic Surgery Blog. The most common, Eyelid Surgery (Blepharoplasty), Face Lifts (Rhytidectomy), Nasal Surgery (Rhinoplasty), Chemical Peels, Fillers and even Botox, all work better with skin that is cared for.

If you would like to learn more about Facial Plastic Surgery procedures, feel free to follow the links in this post article to access more information, or give me a call at (925) 943-6353, to schedule a personal consultation appointment at our San Francisco Bay Area Plastic Surgery office in Walnut Creek, CA.

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U.S. Plastic Surgery Statistics – 2014

Posted March 14, 2015 in Botulinum Toxin (Botox Dysport Xeomin), Brazilian Butt Lift, Breast Augmentation, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Men), Breast Reduction (Women), Butt Lifts, Chemical Peels, Eyelid Lift (Blepharoplasty), Fillers (Restylane Juvederm Perlane Radiesse), Home, Liposuction, Rhinoplasty (Nasal Surgery), Tummy Tuck (Abdominoplasty), Wrinkle Reduction (Non-surgical)

The American Society for Aesthetic Plastic Surgery (ASAPS) has released its 2014 Cosmetic Plastic Surgery statistics. The United State’s premier professional society dedicated to the advancement of Aesthetic (Cosmetic) Plastic Surgery has compiled the procedures performed by its members and others last year, and here are the results:

The ASAPS has released last year's plastic surgery statistics.

The ASAPS has released last year’s plastic surgery statistics.

Plastic Surgery Procedures- Who had What?

More than ten million surgical and nonsurgical cosmetic procedures were performed in the United States last year.

Nonsurgical cosmetic procedures are easier, simpler and more frequently performed than surgical procedures.

Nonsurgical cosmetic procedures are easier, simpler and more frequently performed than surgical procedures.

As expected, nonsurgical procedures accounted for the majority of the total with 8.8 million procedures:

  • Botox – 3.6 million
  • Fillers (Restylane, Juvederm, Perlane, Radiesse – 1.9 million
  • Hair Removal – 0.8 million
  • Chemical Peels – 0.5 million
  • Microdermabrasion – 0.4 million

The top five cosmetic plastic surgery procedures are Liposuction, Breast Augmentation, Eyelid Surgery, Tummy Tuck and Nose Surgery.

The top five cosmetic plastic surgery procedures are Liposuction, Breast Augmentation, Eyelid Surgery, Tummy Tuck and Nose Surgery.

Surgical procedures accounted for 17% of all procedures with 1.8 million cosmetic surgeries:

Plastic Surgery Procedures – What’s the Cost?

Americans have spent more than 12 billion dollars during each of the last two calendar years on surgical and nonsurgical cosmetic plastic surgery procedures. While nonsurgical procedures outnumbered surgical procedures in frequency, surgical procedures accounted for 60% of the total expenditures.

The Fastest Growing Procedure in 2014

Liposuction, Breast Augmentation and Tummy Tucks have increased dramatically since I started my Walnut Creek Plastic Surgery practice in 1997, while Cosmetic Eyelid and Nasal Surgery have remained steady.

Liposuction, Breast Augmentation and Tummy Tucks have increased dramatically since I started my Walnut Creek Plastic Surgery practice in 1997, while Cosmetic Eyelid and Nasal Surgery have remained steady.

Since starting my San Francisco Bay Area Plastic Surgery practice in 1997, there has been a 274% increase in the total number of cosmetic procedures. Surgical procedures have increased by 82% and nonsurgical procedures increased by 508%. The fastest growing procedure in 2014 was Buttock Augmentation, aka the Brazilian Butt Lift (BBL). While the totals are still less than 10% of the number of breast augmentations, the growth was an impressive 86% last year. The BBL, with over 21,000 procedure performed in 2014, moved up steadily from 20th in 2004, and 18th in 2009 to 15th in 2014.

Breast Augmentation Trends

Breast Augmentation was passed by Liposuction again this year for the most popular procedure. The two are usually neck-and-neck for the top spot each year. With the introduction of breast implants 5.0, form-stable, high-strength, cohesive silicone gel, gummy bear or whatever the latest catch phrase is, 80% of breast implants used in 2014 were silicone and 20% were saline. Breast Implant Revision Surgery increased 30% last year, and may be the result of both the improved alternatives in breast implants currently available and the recognition that breast implants are not life-time devices.

The Ladies Have It

Since 1997, the number of cosmetic procedures for women increased over 429%. Women account for 90% of all cosmetic plastic surgery patients. With breast procedures, excluding breast reconstruction, accounting for over one-third of all cosmetic surgery, this is no surprise. 605,987 female breast procedures (breast augmentation, breast lift, breast reduction, breast revision) were performed in 2014. Comparing this with 24,234 male breast procedures (gynecomastia reduction), women account for over 96% of all cosmetic breast surgery.

Cosmetic Plastic Surgery Consultations

If you are considering Cosmetic Plastic Surgery, be certain to find a Board Certified Plastic Surgeon with experience in the procedure you are considering. If you are in the San Francisco Bay Area, give my office a call at (925) 943-6353. My friendly Plastic Surgery staff in Walnut Creek, CA, is available to take your call, and arrange your private consultation.

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FaceTime and Face Lifts (Rhytidectomies) | SF Bay Area

Posted December 27, 2014 in Facelift (Rhytidectomy), Home, Mini Facelift (Mini Rhytidectomy)

Media is buzzing about the Selfie leading to more Plastic Surgery. It is no secret that Selfies and FaceTime allow us to view ourselves and our faces in a new way. Perhaps we are seeing ourselves a little more often because of video chat services like FaceTime, Skype and Google Hangouts. On the other hand, mirrors, photographs and video have been around much longer. The ability to compare past and present in visual form has often provided the motivation for self improvement, and portable video chat technology is yet another way for us to see how we look to others.

Are Selfies and FaceTime driving a surge in Facelifts?

Are Selfies and FaceTime driving a surge in Facelifts?

Physiognomy

Physiognomy (from the Gk. physis meaning “nature” and gnomon meaning “judge” or “interpreter”) is the assessment of a person’s character or personality from his or her outer appearance, especially the face. Physiognomy is a double edged sword. It is part of forming a first impression when we meet someone new. It is a starting point that helps us to interpret whether someone is friend or foe. Study after study shows that initially we prefer attractive faces. This is not a learned behavior and can be demonstrated in infants as young as 6 months of age. While Physiognomy becomes less important for relationships after we get to know someone, it is an initial metric that is undeniably inherent in being human.

Facelifts and Job Opportunities

Studies of job interviews show that all other variables being equal, attractive people are more likely to get the job and to get the promotion. Attractive sales people are more likely to make the sale. Many of my San Francisco Bay Area Plastic Surgery patients mention the desire to maintain a successful career as part of the reason for getting Plastic Surgery. One of the more popular procedures as we get older is the Facelift or Rhytidectomy.

What Does the Face Lift Do?

Facelifts can reverse signs of aging and remove lines associated with worry, fatigue and even anger.

Facelifts can reverse signs of aging and remove lines associated with worry, fatigue and even anger.

The Facelift is unique in that it can reverse signs associated with aging and diminish facial animation lines associated with fatigue, disinterest, anger or worry.

Face Lift or Neck Lift?

Neck Lifts and Face Lifts both treat the neck. The procedures are very similar, and they are usually performed together, so really you don’t have to choose between the two. The difference in the names is more an indication of where the emphasis is placed, rather than a difference in techniques. Below is a view of the face not usually seen on FaceTime or in a Selfie, but is often seen in the photographs patients bring in as an illustration of what they want fixed. Often, pre-Facelift and pre-Rhinoplasty patients will purposefully avoid profile pictures until after their procedures.

Before and After Neck Lift as seen from the side. Loose skin under the chin is removed and the angle between the neck and chin is improved. Facelifts also improve jowls, clean-up the jawline and reduce the loose skin that accumulates around the mouth and sides of the nose as we age.

Before and After Neck Lift as seen from the side. Loose skin under the chin is removed and the angle between the neck and chin is improved. Facelifts also improve jowls, clean-up the jawline and reduce the loose skin that accumulates around the mouth and sides of the nose as we age.

Facial Rejuvenation Consultation

When considering a Face Lift, Neck Lift, Mini Facelift or any other Facial Plastic Surgery, be certain to get the advice of an experienced and Board Certified Plastic Surgeon. We Board Certified Plastic Surgeons dedicate our professional lives to learning and refining the techniques specific to Facial Rejuvenation and applying these techniques uniquely for each of our patients, and it’s a great job to have.

During your personal Face Lift Consultation, you can expect a frank discussion of not just the risks and benefits of the procedure, but more importantly the options available to correct the aspects of your appearance that you would like to see improved.

To schedule your private consultation, call (925) 943-6353, or use the contact form in the margin.

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Male Plastic Surgery – Happy Father’s Day

Posted June 14, 2014 in Botulinum Toxin (Botox Dysport Xeomin), Breast Reduction, Breast Reduction (Men), Brow Lift, Daddy Makeover, Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Facial Augmentation, Fillers (Restylane Juvederm Perlane Radiesse), Home, Liposuction, Wrinkle Reduction (Non-surgical)

Since I opened my San Francisco Bay Area Plastic Surgery office in 1997, the demand for Plastic Surgery Procedures has increased almost 300%. Both surgical and nonsurgical procedures have improved and advanced over the last 17 years. Women account for 90% of all plastic surgery patients, but men have kept up their demand, too. Plastic surgery procedures have adapted to allow women to achieve more feminine, and men more masculine, results. The Mommy Makeover has been well described, but for Father’s Day, I thought some Manly Makeover information might be appropriate. We will explore a new topic today, the Daddy Makeover.

Before and After Gynecomastia Reduction - A well defined masculine chest is hard work, but sometimes being in incredible shape is still not enough. This patient works very hard for his physique. He had small amounts of natural breast tissue (gynecomastia) behind the areolae, his left greater than right.

Before and After Gynecomastia Reduction – A well defined masculine chest is hard work, but sometimes being in incredible shape is still not enough. This patient works very hard for his physique. He had small amounts of natural breast tissue (gynecomastia) behind the areolae, his left greater than right.

Gynecomastia Reduction provided smaller areolae, improved symmetry, elevataion of the left nipple and removal of the stigma of possible steroid use. The difference in projection of the tissue beneath the nipple, before and after gynecomastia surgery, is best seen on the lateral view.

Gynecomastia Reduction provided smaller areolae, improved symmetry, elevation of the left nipple and removal of the stigma of possible steroid use. The difference in projection of the tissue beneath the nipple, before and after gynecomastia surgery, is best seen on the lateral view.

Gynecomastia Reduction is a uniquely male plastic surgery, and one of my specialties. The before and after pictures above show how plastic surgery can complement a good workout ethic. This gentleman works hard to look this good, but was still bothered by Gynecomastia. What looks like a small change is not simple to achieve, but it makes a big difference in how tight muscle shirts fit. With the workouts he puts in, he deserves to look great.

Nonsurgical Plastic Surgery

Many of the common non-surgical enhancements available today were either not approved or nonexistent in 1997. Now, you can’t walk down Main Street, USA, without seeing advertisements for Botox and Fillers. Botox was part of my training, but the use of Botox for wrinkles was an off-label use then. The first approved botulinum toxin was Botox Cosmetic (Onabotulinumtoxin A). Botox Cosmetic was approved by the FDA in April 2002, for the treatment of moderate to severe glabellar lines (frown lines) in men and women, ages 18 to 65. Any other treatments, while often safe and effective, are still considered off label.

Botox then and Now

Men often request Botox or Dysport treatments to reduce frown lines. These are the lines that form between our brows when we frown, concentrate or squint. No matter the reason, these lines make men look angry and less approachable. The treatment of these rhytids (wrinkles) involves an injection into the paired corrugator supercilii muscles and the procures muscle, to relax the central brow, and mute the ability to frown. Not frowning might make you feel better too, see: Darwin, Depression and Botox on the San Francisco Plastic Surgery Blog.

Filling Wrinkles

Fillers, like Restylane, Juvederm, Perlane and Radiesse were not around in 1997. Collagen ruled the world, and was the only available wrinkle filler. For the fine wrinkles in and around the lips, Collagen worked better, but it didn’t last long. Collagen would begin to absorb the minute it was injected. This was the main reason for overdone “Collagen Lips.” A ten percent “over correction” was normal to help prolong the results.

Current fillers last longer, are softer and give more natural results than Collagen. While not permanent, these fillers do not absorb immediately. Each provides a prolonged period of stable augmentation, after which it slowly absorbs. This eliminates the need for over correction. There is some swelling the first few days, however, so the “Trout Pout” has not been eliminated.

Dermal fillers, like Perlane, Restylane and Juvederm, are used to soften the naso-labial folds that extend from the sides of the nose around the corners of the mouth.

Dermal fillers, like Perlane, Restylane and Juvederm, are used to soften the naso-labial folds that extend from the sides of the nose around the corners of the mouth.

Dermal Fillers are most used to soften the lines that run from the nose to the lips, the naso-labial folds. Men and women have them, and they tend to be a more masculine trait. It is no surprise that most naso-labial fold treatments are done for women, but even for men, sometimes less is more. Deeper lines tend to age the face, so often the lines are reduced with a little filler. In Male Facial Plastic Surgery, deeper naso-labial folds may be more masculine, but softening them can often give a more relaxed and rested appearance. Fillers are also used to augment the face. Stronger cheeks, chins and noses, all more masculine features, can be created with the use of dermal fillers.

Surgical Plastic Surgery

All plastic surgery procedures share similarities; however, Male Plastic Surgery procedures are often modified to avoid feminizing the face and body. Common procedures that may require variations are Face Lifts, Eyelid Lifts, Brow Lifts, Nasal Surgery, Breast Reduction, Liposuction and even Tummy Tucks.

The Male Eyelid Lift (Male Blepharoplasty) above was performed to improve sight. Upper and lateral (outer) gaze was blocked by overhanging skin. The Blepharoplasty lifted the eyelids without distorting the eyebrows. Bags beneath the eyes were also reduced. Comparing the upper before and lower after pictures, he looks less angry and tired and more friendly and rested.

The Male Eyelid Lift (Male Blepharoplasty) above was performed to improve sight. Upper and lateral (outer) gaze was blocked by overhanging skin. Just look were his pupils are. The Upper Blepharoplasty lifts the eyelids without distorting the eyebrows. Bags beneath the eyes were also reduced with a Lower Blepharoplasty. Comparing the upper and lower (before and after) pictures, he looks less angry and tired and more friendly and rested, yet remains recognizably male.

For the face, men tend to have lower brows (Ladies, please no snickering), heavier upper eyelids, stronger chins and larger noses. These normal differences in male anatomy, and the difference in male hair patterns, need to be considered in all Facial Plastic Surgery Procedures.

Liposuction can enhance the male physique.

Above – Liposuction is used to remove the Male Muffin Top to create a more fit and masculine, inverted pyramid shape.

The male body is less curvy. The Liposuction before and after pictures above come from the recent San Francisco Plastic Surgery Blog article about treating the Male Muffin Top. In general, the masculine chest is a reversed pyramid, and below this it’s fairly straight down to the thighs. The male chest is wider, the breasts are smaller and even the nipples and areolae are in different positions with different shapes. The details are sometimes subtle, but always worth noting. For Male Body Shaping, the procedures are modified to better suit the ideal male shape.

Father’s Day

It’s another beautiful day in the San Francisco Bay Area, and my children are up to enjoy their first day of summer vacation. I hope you have the time and opportunity to enjoy your Father’s Day. If you have questions about plastic surgery, give me a call at (925) 943-6353 or use the contact form in the margin and I will be in touch.

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Eyelid Lifts – Blepharoplasty and Asian Eyelid Surgery

Posted April 05, 2014 in Asian Eyelid Lift (Asian Blepharoplasty), Eyelid Lift (Blepharoplasty), Home, Videos

Blepharoplasty (Cosmetic Eyelid Surgery) is the third most common Cosmetic Plastic Surgery. Only Breast Augmentation and Liposuction are performed more frequently.

Why is Blepharoplasty so Popular?

Blepharoplasty is popular with both men and women because not only does it reverse one of the most obvious signs of aging, it also makes us look more alert and interested. As we age, the eyelids tend to loosen and sag. Excess upper eyelid skin can block peripheral vision and cause a heavy sensation as it comes to rest on the eyelashes. Excess lower eyelid skin and fat can give lower eyelid bags, even festooning. This can shadow beneath the eyelids and compound any darkness already present due to pigmentation or vascular coloration. Both excess upper eyelid skin and lower eyelid bags make us look tired, even when we are well rested.

KRON4 Body Beautiful Television Presentation

Last month I had the opportunity to discuss how to improve the appearance and function of the eyelids on KRON4’s Body Beautiful. The show is broadcast live and gives San Francisco Bay Area viewers the opportunity to call in and ask questions. The (415) number used during the video was for the live show. If you have Blepharoplasty Questions call my Walnut Creek Plastic Surgery office directly at (925) 943-6353.

Blepharoplasty and Asian Eyelid Video

Eyelid Surgery Frequently Asked Questions

This Eyelid Surgery Video covers many of the frequently asked questions about blepharoplasty including the narration of multiple Blepharoplasty Before and After pictures:

  • What does Blepharoplasty mean?
  • How is Eyelid Surgery performed?
  • What is done during Upper Eyelid Surgery?
  • What is done during Lower Blepharoplasty?
  • Can the excess skin be removed from my Upper Eyelids?
  • Can the bags be removed from under my eyes?
  • Can all the fat be removed from around my eyes?
  • Before and After Pictures showing the removal of excess upper eyelid skin.
  • Before and After pictures showing the removal of excess lower eyelid fullness.
  • Before and After pictures showing the removal of excess lower eyelid skin.
  • Before and After pictures showing Asian Eyelid Surgery.
  • What is the recovery time after Eyelid Surgery?
  • What is the difference between Eyelid Surgery and a Chemical Peel of the Eyelid skin?
  • How can a distinct fold be made on the Asian Eyelid?
  • What is the difference between an Asian Eyelid and a Caucasian Eyelid?
  • What is the difference between Female Blepharoplasty and Male Blepharoplasty?

Schedule a Private Blepharoplasty Consultation

If you are considering Cosmetic Eyelid Surgery, whether to improve function or appearance, the best way to get your questions answered is with a private consultation. The specifics of what can be done, and what to expect will be explained, and you can get your questions answered fully. Give us a call at (925) 943-6353 to get started today. You can also contact us via the contact form in the left margin.

Dr. Joseph Mele is a Board Certified Plastic Surgeon who has been in private practice in the San Francisco Bay Area, East Bay city of Walnut Creek since 1997.

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Non-surgical Cheek Augmentation – San Francisco Bay Area – Walnut Creek, CA

Posted October 26, 2013 in Cheek Implants/Augmentation, Facial Augmentation, Fillers (Restylane Juvederm Perlane Radiesse), Home, Wrinkle Reduction (Non-surgical)

Cheek Augmentation is not the most frequently requested cosmetic plastic surgery procedure, but it is an excellent procedure for the right person. In cases where the cheeks are flat, narrow or even recessed behind the front of the eyeball, cheek enlargement can create a more harmonious balance for the face overall.

Allergan Announces a New Cheek Filler

Voluma XC - Allergan's new entry into the cheek enhancement arena.

Voluma XC – Allergan’s new entry into the cheek enhancement arena.

This week, Allergan released their latest answer to flat cheeks: Voluma XC. The XC stands for eXtra Comfort and alludes to the fact that Voluma is manufactured with a local anesthetic (Lidocaine) in it.

Voluma is related to Juvederm, another Hyaluronic Acid (HA) based filler. Where Juvederm is approved for filler facial wrinkles around the mouth, Voluma is FDA approved to provide volume to the apex, apple of the cheek and the hollow inferior to these. Like Juvederm, Voluma is injected into the area where augmentation is desired right in the office. The results are immediate, and the down time is minimal. Common side effects as listed on the Allergan website include temporary reactions at the treatment site such as: tenderness, swelling, firmness, lumps/bumps, bruising, pain, redness, discoloration, and itching.

Other Methods of Cheek Augmentation with Fillers

For years, HA’s have been used for Non-surgical Cheek Enlargement. The off-label use of Juvederm, Perlane and Restylane has been common practice. Voluma is the first HA that is FDA approved specifically for the cheeks.

Radiesse is not an HA filler. It is made of calcium hydroxyapatite (CaHA). Radiesse is FDA approved for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds, and it is also intended for restoration and/or correction of the signs of facial fat loss (lipoatrophy) in people with human immunodeficiency virus. Radiesse has also been used off label as a cheek filler for people without HIV also. I have used it for both cosmetic and reconstructive patients with good results.

Cheek Implants

Cheek Implants are the only “permanent” cheek fillers, and have been around longer than any of the facial fillers. The insertion of Cheek Implants is a surgical procedure and requires meticulous attention to detail and sterile technique. I use cheek implants to balance the face when a long term solution is desired.

Frequently, I combine Cheek Implants with lower eyelid lifts in patients with a recessed cheek, to help prevent ectropion (drooping of the eyelid). Cheek implants also can improve the results of a Facelift when the volume of the cheek is deficient, as seen below.

Facelift with Cheek Implants

Facelift with Cheek Implants to balance the more youthful face.

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Facelift San Francisco Bay Area | Rhytidectomy Walnut Creek, CA

Posted September 21, 2013 in Cheek Implants/Augmentation, Eyelid Lift (Blepharoplasty), Facelift (Rhytidectomy), Facial Augmentation, Home, Videos

The quintessential plastic surgery procedure is the Facelift. Others may claim that Breast Augmentation more typifies cosmetic plastic surgery. Breast augmentation is more popular than facelifts (3:1); however, unlike breast augmentation, facelifts are not hidden by clothing. We all see directly the results of every facelift, down to the smallest detail. All the more reason to make certain your Facial Plastic Surgeon is a member of the American Society for Aesthetic Plastic Surgery and Board Certified by the American Board of Plastic Surgery.

Rhytidectomy aka Facelift Video Presentation

Dr. Joseph Mele appears on KRON4's Body Beautiful to talk about Facelifts (Rhytidectomies).

Dr. Joseph Mele appears on KRON4’s Body Beautiful to talk about Facelifts (Rhytidectomies).

This month I had the opportunity to discuss face lifts on KRON4’s Body Beautiful with Janelle Marie. Before and after pictures were provided, as well as many of the options available for today’s San Francisco Bay Are Facelift patients. Facelifts, eyelid lifts, cheek implants and other techniques used to reduce facial wrinkles and restore a more youthful face were all reviewed.

Body Beautiful is a live show, so anyone watching can call in and have their questions answered. The (415) number shown during the broadcast is only for the live show, but if you have Rhytidectomy (Facelift) Questions, call my San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353.

Facelifts (Rhytidectomy) as seen on TV

Frequently Asked Facelift Questions

The Face Lift Video embedded above answers many of the most frequently asked questions about Rhytidectomies (Facelifts). Some of the information discussed includes:

  • When is a Mini Face Lift enough?
  • When should a full Facelift be performed?
  • What are the differences between a Mini Facelift and a full Face Lift?
  • Facelift Before and After pictures
  • Can a Brow Lift be added to a Facelift?
  • Can Blepharoplasty (Eyelid Lift) be added to a Rhytidectomy?
  • Can Chemical Peels or Dermabrasion be added to a Facelift?
  • Can a Neck Lift be added to a Rhytidectomy?
  • Can Cheek Implants or Chin Augmentation be added to a Facelift?
  • What is a Platysmaplasty?
  • What are Dermal Grafts?
  • Can Fillers be used during a Facelift?
  • What is the recovery time for Rhytidectomies?

More Facelift and Facial Plastic Surgery Information

More information about Facelifts and other Facial plastic surgery is available by clicking on the area of interest in the column to the left, or by visiting my main website’s Face Page

Other Segments from This Month’s Body Beautiful

To view other plastic surgery video segments from this month’s show, click on the following links:

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