All Frequently Asked Questions

Cosmetic surgery can help patients quit smoking

Q:

I read somewhere that cosmetic surgery can help patients quit smoking; is that true?

A:

If you’re a smoker considering cosmetic surgery, your plastic surgeon will likely require you to stop smoking for at least two weeks before your procedure because smoking can result in serious complications.

A long-term follow-up study reported on in the September issue of Plastic and Reconstructive Surgery® finds that many patients receiving instructions to stop smoking from a plastic surgeon will quit smoking, or at least smoke less, in the years after cosmetic surgery.

To see a video about cosmetic surgery patients and the rate of smoking cessation from the editor of Plastic and Reconstructive Surgery CLICK HERE.

Study findings

The study shows an association between cosmetic surgery and smoking cessation at long-term follow-up, which suggests that surgeons who request preoperative smoking cessation are clearly influencing the long-term smoking status of their patients.

As part of the study, 85 patients who were previously labeled as smokers, were required to refrain from smoking for at least two weeks before their procedures.

Five years after cosmetic surgery, 42 patients who were previously daily smokers, responded to a follow-up survey. Most of the patients were women; the average age was 40 years. The most common procedures were tummy tuck (abdominoplasty), breast lift (mastopexy), and facelift.

40 percent of the patients who responded to the follow-up survey said they no longer smoked cigarettes on a daily basis. Nearly one-fourth had not smoked even one cigarette since their cosmetic surgery procedure.

Seventy percent of the respondents agreed that discussing their increased surgical risks with the plastic surgeon influenced their ability to quit or reduce smoking.

The results suggest that patients were more motivated to quit by targeted messaging provided by the surgeons who gave them specific examples of the negative effects of smoking, instead of just an overview of general health benefits from smoking cessation. Previous research had confirmed that patients who undergo cosmetic surgery are more motivated in general to sustain positive lifestyle changes.

How does smoking negatively affect surgical results?

Everyone knows that smoking is dangerous, but the effects of tobacco use impact far more than just our lungs. Carbon monoxide introduced during smoking affects the tissue, and the nicotine found in tobacco products can cause blood vessels to restrict, limiting the amount of oxygen that can get to the rest of the body.
If patients continue to smoke right up until surgery it can result in complications and issues after surgery including:

  • Compromised circulation, which can cause the skin to breakdown
  • A higher rate of post-op infection
  • Impeded healing
  • Impaired healing can lead to scarring, necrosis and skin loss

Facelifts can be very adversely affected by smoking. And as a result many surgeons will not perform facelift procedures on smokers; other surgeons will require that patients quit smoking for a longer time period pre-surgery. This is because the effects of smoking greatly restrict blood flow, and a good blood flow in the tiny capillaries of the face is essential in a facelift. In this procedure the facial tissue is lifted up from the surface, and if the capillaries have been impaired due to smoking, it can make healing much harder and in some cases can result in unsightly scars.

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Men get the same benefits

Q:

Can a man get the same benefits from a tummy tuck as a woman?

A:

A tummy tuck, which is also called an abdominoplasty, is one of the most common body contouring procedures performed by the board-certified plastic surgeons at Edina Plastic Surgery.

The procedure involves the removal of excess skin and fat from the abdomen and a repair or joining of the separated abdominal muscles. Tummy tucks can be as effective for men as they are for women. Plastic procedures overall are becoming more and more popular with the male demographic and a growing number of men are choosing to have tummy tucks.

Weight loss surgeries are on the rise for both men and women and they are another reason why tummy tucks for men are gaining in popularity; men are choosing the procedure to tighten and tone their midsection.

CLICK HERE to see our tummy tuck before and after photos.

The ideal candidate for a tummy tuck is in good medical health and has realistic expectations of what the procedure can and cannot accomplish. He should also be at his ideal body weight. One of the reasons for this is that a tummy tuck will not improve the appearance of the mid-section on men with large amounts of intra-abdominal fat located around their organs. Men who fit this description need to diet and exercise before they would be a good surgical candidate.

There are several techniques to perform tummy tuck surgery on both males and females, and our board-certified plastic surgeons will decide the best technique for each patient based on their anatomy and aesthetic goals. In most tummy tuck procedures, the surgeon will tighten the abdominal muscles as well as removing the excess skin and fat. The incision made during a tummy tuck is in the lower part of the abdomen, typically below the belt line. In some cases the surgeon will suggest that the male patient have additional liposuction to the waist at the same time the tummy tuck is performed to improve the love handles and the overall result.

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At Edina Plastic Surgery, tummy tuck procedures are done in our modern and accredited outpatient surgery center which is attached to our clinic. The surgery can take anywhere between one and five hours depending on the exact procedure. No overnight stay is required; however, in rare cases complications can require admission to a hospital.

Most body contouring procedures are done under general anesthesia. Patients will need someone to drive them home and care for them for at least 24 hours after the surgery; assistance with daily activities may also be necessary during the next few days.

Of the many procedures performed by our surgeons, tummy tucks can provide the best results and the most satisfied patients. Men have been delighted with their new taut waistlines and torsos. Post-procedure, all men and women are encouraged to control their weight and to exercise after recovery to maintain the surgical results and an improved state of wellness.

Top procedures performed before the holidays

Q:

What are the top procedures performed before the holidays and what are the recovery timeframes?

A:

Now that the summer is over, people start thinking ahead to the holidays; and who doesn’t want to look their best during the holiday season? A refreshed and rejuvenated appearance makes people feel more youthful and confident but it requires some planning, and now is a good time to begin that process. While some techniques can provide immediate results, most take weeks or months for the full benefits to become apparent.

Below is a list of some of the top procedures that patients choose to undergo:

Liposuction: Plan 2-3 months ahead

Liposuction is one of the most frequently performed procedures for fat removal. At Edina Plastic Surgery our board-certified surgeons can do this procedure as a stand-alone or we can perform it in conjunction with a tummy tuck or even a facelift. It has tremendous potential to shape the body, but there are some limitations based on the skin quality and planned volume retrieval. Typically the liposuction procedure can be done on the neck, arms, back, abdomen, thighs, knees or ankles. Sometimes patients request to have it performed on a combination of areas. Recovery from liposuction varies but a return to normal full activity will occur around four to six weeks.

CLICK HERE to request a free consultation to look your holiday best or call us at 952-925-1765.

Breast augmentation: Plan 2-3 months ahead

Breast augmentation is one of the most popular procedures with patients at Edina Plastic Surgery. All three of our board-certified surgeons have special expertise in breast augmentation. Because of our expertise our clinic was selected to participate in the FDA’s clinical trials for silicone breast implants. Breast augmentation can increase self-esteem and confidence, improve the fit of clothing and make women look and feel more youthful. Edina Plastic Surgery is the only practice in the Twin cities using the Vectra XT 3D camera which allows patients to see “virtual before and after photos” on their own bodies. Although most women are back to their daily routine in about a week, it takes three to six months for the implants to completely settle into position and for the residual swelling to subside.

Blepharoplasty: Plan 1 month ahead

Your eyes convey so much information and emotion, which is why you don’t want your eyes to appear tired or aged. Eyelid surgery can help patients project a more youthful, rejuvenated and refreshed appearance. A blepharoplasty can help make your eyes your most beautiful accessory for the holiday season and beyond.  An eyelid lift can be conducted on the upper and/or lower eyelids to improve appearance by removing excess fat pads or skin. The swelling and bruising post-surgery generally resolves in one to three weeks.

Botox: Plan 3-4 weeks ahead

Botox is a well-known and popular anti-aging treatment that can provide quick and amazing results to patients who want to diminish wrinkles around the eyes and on the forehead. It is so quick it can work within just one treatment so it is a very popular pre-holiday procedure. It targets dynamic facials lines; those caused by repetitive expressions including crows’ feet, forehead creases and frown lines. The treatment takes only a few minutes and requires no down time. The early benefits can be seen within two weeks but many times patients see improvement even after that time period. For best results plan about three weeks before your holiday celebration.

Dermal fillers: Plan 1-2 weeks ahead

There are many well-known fillers that patients request to give them a beauty perk-up before the holidays including Juvederm, Restylane, Radiesse and Voluma. Dermal fillers promote hydration of the skin, and they also restore volume to the skin and its underlying foundations. The expert skin injectors at Skin Artisans of Edina Plastic Surgery apply injectable gel under the skin to provide a smooth, natural look and feel. Areas that can benefit from filler treatments include: temples, around the eyes, mid-face, lip rejuvenation and jowl correction. Mild bruising and swelling can sometimes occur after treatments so give yourself a week or two before any holiday events.

CLICK HERE to request a free consultation to look your holiday best or call us at 952-925-1765.

Breast Implant Surgery Misconceptions

Q:

What are the most popular misconceptions about breast implant surgery?

A:

There are many common assumptions about breast implants that are not based on scientific fact but rather on public lore. On behalf of all women considering breast augmentation surgery, we have listed some myths about the operation that need to be dispelled, as well as the actual facts.

1.  All implants need to be replaced after 10 years

There is no absolute indication to remove or replace breast implants at the 10-year mark. Breast implant removal with or without replacement should be considered if and when complications occur.

Breast implants are prosthetic devices that are not expected to last forever, and there are known complications that are associated with breast implants. Routine follow-up is essential in detecting any issues with the implants and determining appropriate therapeutic intervention, if any.

The most common reasons implants may need to be replaced include:

A. Rupture or leakage. If saline implants leak, the saline is reabsorbed by the body, whereas if silicone gel implants leak, the extruded silicone gel will need to be surgically removed. The chance of an implant leaking or rupturing increases with the implant’s age. However, rupture or leakage may occur at any time subsequent to surgery.

B. Capsular contracture. Capsular contracture describes an abnormal scar formation around the implant that usually presents with pain and hardening in the breast. This condition is usually progressive, resulting in distortion of the breast and displacement of the implant. Women may develop capsular contracture in either one or both breasts at any point following implantation.

CLICK HERE TO SEE OUR BREAST AUGMENTATION BEFORE AND AFTER PHOTOS

2. It’s impossible to get a good idea of what the implant will look like pre-surgery

There are hundreds of types and sizes of breast implants currently on the market, and therefore an enormous range of possible results from breast augmentation. Edina Plastic Surgery is the only clinic in the Twin Cities area with high tech imaging equipment called the Vectra XT 3D camera that shows breast augmentation patients “virtual before and after photos” of implant options on their own bodies.

CLICK HERE TO LEARN MORE ABOUT OUR VECTRA 3D CAMERA

In addition to using the Vectra XT 3D camera, the surgeons at Edina Plastic Surgery are experts in helping patients choose implants that match the patient’s own breast dimensions and characteristics in terms of breast width, diameter and position on the chest wall. For instance, placing a very large implant under a small, narrow breast will most likely result in an implant that may be palpable or whose edges may be visible at the top or sides of the breast. The surgeons also take the actual weight of the implants into consideration, and the progressive stretch of the tissues due to the effects of pressure from the implants and the downward pull of gravity.

3. A hospital stay is required for breast implant surgery

At Edina Plastic Surgery breast augmentation surgery is performed at our in-house AAAASF-approved surgical facility. This facility is state-licensed and staffed with the finest specialty-trained personnel. The surgical process itself takes about 1½ hours, and patients are in our recovery room for approximately 2 hours. An adult is required to give you a ride home and spend the first 24 hours with you, but no actual hospitalization is required.

4. Breast implants cause autoimmune diseases

The media has highlighted many anecdotal reports of patients who claim to have developed a number of health problems and diseases as a result of their breast implants. The association between implants and systemic or autoimmune diseases has been refuted in many scientific studies that included hundreds of thousands of women with implants. There is also no proven increased risk of breast cancer in patients with breast implants.

It is also important to note that the implants that are currently available in the US, including all silicone gel, saline and structured saline implants, are all FDA cleared. Implants of the previous generation used in procedures as early as the 1960’s did not undergo the extensive testing and data collection that implants are currently subjected to in order to ascertain their safety and effectiveness.

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Top ten questions to ask about liposuction

Q:

What facts are important to know about liposuction before scheduling a procedure?

A:

More than 400,000 patients had liposuction in 2016 according to the American Society of Aesthetic Plastic Surgeons, making it the most popular surgical cosmetic procedure in the United States.

There is a good reason that so many patients are interested in liposuction; it can provide the individually tailored body sculpting results that people truly appreciate. Patients also appreciate that this minimally invasive technique is done on an outpatient basis and requires a very short recovery time.

The best way to get optimum results is to make sure that you are an informed and educated patient before your consultation. Asking your plastic surgeon the following ten questions will help you make the right decision.

1. Are you board certified by the American Board of Plastic Surgery?

This is a question you should ask even before you schedule a liposuction consult. Do some research online and make sure that the plastic surgeon you choose for a consultation is board-certified by the ABPS. If they are board-certified it means that they have undergone extensive training in their specialty and that they routinely pass rigorous board certification exams. The three surgeons at Edina Plastic Surgery are all board-certified.

2. Who is a good candidate for liposuction?

Liposuction should not be considered as a treatment for obesity; it is best used to treat stubborn, excess fat deposits that cannot be resolved by diet and exercise. The best candidates are patients who are healthy, exercise regularly and have realistic expectations of the procedures’ results.

3. What are the benefits of liposuction?

With continued healthy eating and diet, the effects of the liposuction procedure can be permanent. This procedure helps to smooth and contour the skin; and it can result in a dramatic improvement in appearance.

4. What type of liposuction will be performed?

When your doctor meets with you they will suggest the type of liposuction that is best suited for your particular needs. The right technique for your situation may depend on several factors, including treatment location, the extent of correction desired, and your doctor’s personal protocols. Ask your surgeon which type of liposuction they perform on a routine basis; a skilled doctor will be experienced in a variety of techniques.

5. Can I have liposuction at the same time as another cosmetic procedure?

It is very common for patients to have liposuction at the same time as another procedure such as a tummy tuck or a breast augmentation or lift. Your doctor will be able to tell you whether you are a good candidate for multiple procedures.

6. If I choose to have liposuction will the results be permanent?

When liposuction is performed, the fat cells that are removed do not return. However, if the patient experiences future weight gain, the surrounding fatty tissue can still expand. Ask your surgeon for ideas on how to best maintain your liposuction results for the long-term. They will have advice on how to best retain your newly refined physical contours.

7. Where will my liposuction procedure be performed?

Because liposuction is normally performed as an outpatient procedure, you will need to arrange for a ride home after the procedure. At Edina Plastic Surgery we perform liposuction procedures at our own state-of-the-art accredited surgical center which is located within our clinic. Some surgeons use an off-site day surgery facility that can be miles from their clinic location, so make sure you are familiar with that location and that it is convenient for you.

8. What type of anesthesia will be used?

Liposuction surgery is typically done under adequate anesthesia to allow your surgeon to do the very best job possible. For larger areas, this will be a general anesthetic. While local anesthesia can be used for smaller areas, there are limits to the area that can be done safely with this technique.

9. How long does the liposuction procedure take?

Traditional liposuction typically takes approximately three hours or less to complete. In some cases where large areas or multiple areas are being treated at the same time, the procedure can take longer.

10. Is there anything I need to do beforehand to prepare for my surgery?

First and foremost, patients are advised to quit smoking before the liposuction procedure. Smoking can prolong healing of wounds. You may also need to discontinue certain medications as they can cause bleeding issues during surgery. Ask your doctor for pre-procedure instructions.

Breast Implant Revision Surgery

Q:

When should you consider a breast revision? What are the benefits of having a breast implant revision surgery? How do you tell if you are you a good candidate for breast revision? How is a breast revision procedure performed?

A:

Breast implant revision surgery, (also known as breast implant replacement) commonly involves removal and/or replacement of saline or silicone breast implants. This surgery is performed to change the size or type of a patient’s implants and to correct any complications from a primary breast augmentation. Restoring a youthful breast contour and appearance is one of the benefits of this procedure.

The following are suggested guidelines:

  • If your saline breast implants have deflated or an X-ray or MRI suggests that your silicone implant has a shell leak.
  • If you want to change your implant/breast size
  • If you have tightening of the scar tissue around the implant (capsular contracture) or your breast implants have shifted in position.
  • If your breast tissue has changed as a result of skin stretching or weight loss/gain.

These are some of the benefits that patients have experienced:

  • Your breasts will regain a youthful shape.
  • You have the ability to increase or decrease your breast size.
  • Your breast symmetry will be improved.

Even if your breast implant surgery was perfectly planned and beautifully executed, changes can occur over time. If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

The exact procedure your surgeon will use for breast implant removal and replacement varies depending on the reason for your breast revision.

Change in implant size: If you decide to change your implant size, your surgeon will frequently use your original incision for implant removal and replacement. If you want a larger implant, your doctor will surgically enlarge the “pocket,” or space in the breast, surrounding your implant to accommodate a larger implant. If you want smaller implants, your doctor may surgically reduce the size of the pocket with sutures to properly fit smaller sized implants. A breast lift may be done at the same time.

Capsular contracture (hardening of the capsule and implant): Your doctor will probably use the same incision used to insert the original implants to remove the hardened capsule and implant. He or she will then insert a new implant.

Implant rippling: When the edges of saline breast implants are visible and palpable (able to be felt), your surgeon may use the same incision to remove or reposition the implants as was used to originally insert them. Other options include using a different type of implant or placing the new implant into a different breast pocket that either has thicker muscle coverage or uses other tissues to cover the implant edge.

Implant malposition: Sometimes implant pockets are created too far apart or too close together, resulting in poorly positioned breasts. To correct this, using the prior incision, your surgeon will manipulate the scar tissue from the capsule surrounding the implant and reconstruct the pocket in the appropriate position using suturing techniques. Your surgeon may need to utilize other tissues to reinforce this new implant pocket and may recommend using a cellular dermal matrix product to add additional support.

Implant removal: If your implants are large and your skin has stretched, your surgeon may recommend a breast lift in addition to implant removal, but implant removal alone may suffice. The original incision created to insert the implant will almost always be the same one used to remove it. The lining around the implant, or “capsule,” is often surgically removed at the same time to facilitate rapid healing.

Elevation of nipple and areola position: If it is necessary to elevate the position of your nipples and areolas (pigmented skin surrounding the nipples), you will need additional incisions. Incisions around the upper portion of the areola will be adequate in cases where not much elevation is needed. When more lifting and tightening is necessary, an incision all the way around the areola, including a vertical scar extending down from the areola to the crease under the breast, may be necessary. For cases where significant excess skin needs to be removed (such as in women who have had massive weight loss), a third incision may be necessary that will extend horizontally beneath the breast, following the natural curve of the breast crease. If your nipples need lifting, the nipples and areolas remain attached to underlying mounds of tissue and this usually allows for the preservation of sensation and the ability to breastfeed.

The goal of the board-certified plastic surgeons at Edina Plastic Surgery and our entire staff is to help you achieve the most beautiful and natural-looking results, as well as making your surgical experience as easy and comfortable as possible.

Liposuction and The Ideal Female Silhouette

Q:

I’m considering having liposuction on my hips and buttocks. How do the surgeons decide how much fat to remove during the procedure?

A:

Despite what most people may believe, the main goal of liposuction is not really about removing as much fat as possible. The most important thing that plastic surgeons consider is whether the fat that is left behind will artfully preserve the natural contours of the body.

“There is a true art in performing liposuction,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “Removing too much fat can not only destroy the natural contours of the body, but it can also lead to skin irregularities that may be hard or impossible to completely correct in the future. A good surgeon will take many different factors into account to achieve the best result in the overall silhouette. That is why it is so important to consult with a board certified plastic surgeon who is very experienced in this area.”

When surgeons perform liposuction of the hips, it typically also involves the flanks in order to create a smoother, more natural transition. When the fat rolls, also referred to as love handles or muffin tops, are removed or reduced the buttocks area will appear more voluptuous.

Liposuction is not a procedure that is commonly performed on the butt cheek due to the increased risk of skin asymmetries and the possibility of a sagging appearance. This is particularly true when performing liposuction on the lower half of the buttocks.

Rather than doing liposuction on the actual buttock cheek, the vast majority of patients benefit from liposuction of the upper/outer butt, outer thigh and hip-flank area.

Excess fat in the upper-outer buttock makes it appear flatter and wider. For this reason, contouring the area with liposuction can provide a dramatic improvement for the butt appearance even without the use of silicone implants or Brazilian butt lift (fat transfer).

It is important to note that the amount of fat removed via liposuction must not only be determined by the patient’s desired post-op size but balanced with the consideration of the patient’s skin elasticity and ability to re-drape to the new contour.

If a surgeon removes more fat volume than the skin can handle, a wide variety of problems can result including visible and palpable rippling or a sagging appearance. While skin asymmetries can be improved by fat transfer, which in essence is a liposuction procedure in “reverse,” patients can only expect some level of improvement, as opposed to a complete remedy.

“To put it simply,” says Dr. Robert Wilke, “the goal of liposuction in the hips and buttocks is to remove just the right amount of fat while leaving behind enough fatty tissue to preserve the natural contours of the body and maintain a smooth skin surface and a feminine silhouette.”

Breast Implant Considerations

Q:

I am considering getting breast implants. What are the steps involved in deciding what size implant will look most appropriate?

A:

Breast implant preferences vary substantially from woman to woman and the size choice can be influenced by factors such as lifestyle, goal appearance, and modern trends.

Past trends/future trends.

In the past, the larger, more obvious breast implants were a popular look. While a full, high, and round silhouette will always have some popularity, many women today are leaning towards a more modest, natural-looking breast enhancement.

Bigger Isn’t Always Better.

Dr. Robert Wilke, a board-certified plastic surgeon from Edina Plastic Surgery shares his thoughts on this topic. “When patients come in for a breast augmentation, we listen carefully to their goals. What is the type of look that they are hoping to achieve?” Dr. Wilke emphasizes the importance of the consultation. “We devote a lot of time during the consultation to implant sizing. We have the patient try implant sizes in a bra to see how this looks, then proceed to using computer imaging on our Vectra XT 3D Camera to determine the optimal size for each patient.”

Trends in breast augmentations: “The Brazilian B”.

While the United States consistently performs a high number of cosmetic surgeries compared to most other countries, Brazil is a solid competitor for the most annual cosmetic surgeries. Breast augmentation is one of the most commonly performed surgeries in both countries, but it’s the Brazilians who have popularized the modern trend toward smaller implants, dubbed the Brazilian B. The trend has since gained traction in the United States as iconic Brazilian models such as Gisele Bündchen showcase how sexy a perkier breast size can be.

One Size Does Not Fit All In Breast Implants.

When deciding which implant will provide a patient with her desired appearance, the surgeon must account for many factors besides size. For example, different implant profiles involve varying levels of height from the chest with corresponding base widths. The implant profile you choose can influence your breast shape as well as how natural your chosen size appears on your body frame. Additionally, chest proportions, breast shape, and the amount of pre-existing breast tissue can all impact the end results of the augmentation; which means that the same implant volume can deliver a variety of different looks on different patients.

The Vectra XT 3D camera at Edina Plastic Surgery is a high tech tool to help determine the appropriate implant size for each patient.

Patients love it that they can see the virtual results of breast augmentations on their very own bodies. Here is just one of many testimonials we’ve received about this incredible technology.

“I am 57 years old and giddy with joy at the results of my breast augmentation. I credit the Vectra 3D camera with giving me the courage to “go for” the size implants that I chose. I have always been a small-breasted woman and am quite petite so it was difficult for me to imagine myself with larger breasts. When I tried on the implants with a “demo bra” I thought I looked ridiculous but when I saw myself on the Vectra 3D camera it made all the difference. I looked great! Thank you Edina Plastic Surgery for my new beautiful breast and for having this technology.”

Pre-pregnancy body procedure

Q:

I waited until I was 36 to have my first child. Can a mommy makeover help me regain my pre-pregnancy body?

A:

Mommy makeovers have become increasingly popular over the past 10 years. This is at least partly due to so many women having children later in life; many are over 35. As such, their bodies may be less resilient than those of their younger counterparts, and the after-effects of pregnancy can be loose abdominal skin, separated abdominal muscles, fat deposits in areas that are resistant to diet and exercise, and droopy breasts. And while diet and exercise can be helpful, in many cases for these patients, plastic surgery is needed to get the kind of improvement that they’re looking for.

“Many of the patients that come to us for mommy makeovers are over 35,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “Healthy women who are done having children can be excellent candidates for abdominoplasty, liposuction and a breast lift, reduction or augmentation. The overall satisfaction rate for mommy makeovers is very high. Many women have told us that they are delighted with the transformation and their only regret is that they wish they had come in to see us sooner.”

For a typical “mommy makeover”, the board certified surgeons at Edina Plastic Surgery often perform abdominoplasty combined with liposuction, and very frequently the patient also has a breast lift, reduction, or augmentation. Mommy makeover procedures remove extra skin, minimize stretch marks and lift the breasts and body to regain a comparable figure to pre-pregnancy form. Our surgeons listen carefully to each patient and advise them on the most appropriate procedures.

Women are having babies later when their bodies aren’t as resilient.

According to the National Center for Health Statistics, in 2000 the average age of a first time mother was 24.9 years. In 2014, that age had risen to 26.3. And although that may not seem to be a big change, it is representative of a trend that women are waiting longer to have children due to a combination of factors including improved birth control, improved fertility treatments and other socioeconomic reasons.

For many mothers; especially those over 35, one of the most challenging aspects of giving birth is regaining their pre-pregnancy bodies. Many plastic surgery procedures are aimed at providing assistance for those looking to regain their svelte physique. Due in part to the popularity of television shows that focus on plastic surgery procedures, requests for multiple procedures done at one time are rising each year.

Multiple procedures; just one recovery period.

Patients appreciate the fact that when having a mommy makeover, they can have multiple procedures performed at once, thereby having a single recovery vs. three separate ones. With the advent of much-improved anesthesia techniques that allow a safer anesthetic with fewer after-effects, combined with the popularity of such shows as “Extreme Makeover”, requests for multiple procedures at one setting are increasing rapidly.

Recovery time for mothers with children must be considered carefully, and the doctors at Edina Plastic Surgery suggest that patients have a support plan in place to make sure that supplemental help is available for household chores and childcare post-surgery for one to two weeks.

Breast lift surgery

Q:

After having two children I am very unhappy with how my breasts look. Is a breast lift a good option for someone like me?

A:

Statistics released by the American Society of Plastic Surgeons (ASPS) show that breast lift procedures are growing at twice the rate of breast implant surgeries. Since 2000, breast lifts have grown by 75 percent. Breast implants are still by far the most-performed cosmetic surgery in women, but lifts are steadily gaining. In 2014, more than 90,000 breast lift procedures were performed by ASPS member surgeons.

Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery says, “Many women develop droop in their breasts over time, often due to the effects of pregnancies and breastfeeding. Some really like the idea of achieving a more optimal breast shape by using the tissue they already have, while some choose to restore breast volume with an implant in addition to a lift. Breast lifts can help them look and feel younger, which is why this procedure has such a high satisfaction rate.”

According to the statistics, women between the ages of 30-54 made up nearly 70 percent of the breast lift procedures performed. More women who have had children and whose breast volume has decreased are consulting plastic surgeons.

Over the years, pregnancy, nursing and the force of gravity take their toll on a woman’s breasts. As the skin loses its elasticity, the breasts often lose their shape and firmness and begin to sag. Patients want a solution for the excess skin and want to see their breasts “back up where they are supposed to be”.

Women often ask if they are good candidates for a breast lift. The ideal candidates for a breast lift are healthy women who are realistic about what the surgery can accomplish. The best results are usually achieved in women with small, sagging breasts. Breasts of any size can be lifted, but the results may not last as long in heavy breasts.

A simple home test can help determine whether a breast lift may be appropriate. To perform the pencil test, a woman simply places a pencil under her breast. If the breast tissue holds the pencil in place against the chest, this can imply that there’s a hanging nature to the breast that can be fixed with a lift.

Patients who had had breast lifts often say that they feel more confident after having the procedure. Many say that they are delighted to be able to wear clothing that would either have not fit correctly, or not looked appropriate before their surgery.

Breast augmentation remains the most popular plastic surgery procedure for women. In 2014, there were 286,254 breast augmentation surgeries performed by ASPS member surgeons. That represents a growth of 35% since 2000, less than half the rate of the statistical growth of breast lifts (75%).

Body contouring post-bariatric surgery

Q:

I had bariatric surgery and have lost a great deal of weight. I am considering having body contouring surgery. Are there any studies that show that this surgery helps patients like me keep the weight off?

A:

According to a new study by Henry Ford Hospital researchers, patients who have plastic surgery to reshape their bodies after bariatric procedures are able to maintain “significantly greater” weight loss than those who do not have surgery.

Many previously obese patients opt for plastic surgery. The types and extent of the surgeries can vary widely; but tummy tucks, arm lifts, breast and body lifts are very common. These procedures can be very effective in removing inelastic excess skin and tissue after substantial weight loss and to reshape or recontour bodies.

The results of the study are encouraging to the plastic surgery community. When improved body image translates into better long-term maintenance of a healthier weight it also translates into a better quality of life for these patients. This improved aesthetic combined with better health is the kind of end result that is very satisfying to both plastic surgeons and their patients.

The study followed patients who underwent bariatric surgery at Henry Ford Hospital. Study results were presented at the annual conference of the American Society of Plastic Surgeons. Of the patients studied 47 subsequently underwent body recontouring procedures.

The Henry Ford researchers recorded each patient’s Body Mass Index, or BMI – a weight-to-height ratio used to determine degrees of obesity – both before their bariatric surgery and 2.5 years after the procedure. Of the patients who underwent contouring surgery, the average decrease in BMI was 18.24 at 2.5 years, compared to 12.45 at 2.5 years for those who did not have further surgery.

These findings suggest that aesthetic procedures following bariatric surgeries may well contribute to improving the long-term results.

Bariatric surgery is used to help obese patients lose weight and includes several types of procedures that limit the amount of food the stomach can hold, including removal of a portion of the stomach or constricting it with a gastric band. Such weight loss can be significant, and result in a lower risk of diabetes and heart disease. This type of surgery can have a significant positive impact on obese patients, but long-term success still depends on patients changing their eating habits post-surgery. There is currently a high incidence of patients who regain weight after the surgery, so procedures that help incent patients to keep the weight off are a positive step in long-term maintenance.

Facial Aesthetic Surgery

Q:

I had a friend who had fat grafting in her face. Is this a popular procedure and if so why?

A:

According to a recent survey of Plastic Surgeons, facial fat grafting is increasing in popularity.

The practice of transplanting fat by injecting abdominal or other fat to fill out cheeks, creases and areas that are sagging has become more widely embraced by plastic surgeons in the past few years. According to results of a survey by NYU Langone Medical Center researchers, the process of fat grafting is gaining in popularity.

The American Society of Plastic Surgeons is the largest plastic surgery specialty group worldwide, and 309 randomly-selected members were asked to complete the survey.

Surgeons were asked about their methods of harvesting, processing, and injecting fat, the most commonly selected injection sites, and their opinions on the overall efficacy of grafting as a facelift procedure. They were also surveyed as to how often they used fat grafting in facelifts.

85 percent of the 309 facial aesthetic surgeons surveyed use fat grafting as a technique to enhance the results of facelift procedures designed to smooth wrinkles and creases, and eliminate sagging. Of this group, over 70 percent reported adopting the method within the past 10 years.

The survey results show that a majority of plastic surgeons across the country are adopting fat grafting as a standard technique to optimize the results of facelift procedures.

Researchers say the survey is believed to be the first of its kind to determine the frequency and extent of plastic surgeons’ use of the injectable fat-grafting method for facelifts. The survey results are summarized in the journal Plastic and Reconstructive Surgery.

As part of the survey, the ways in which plastic surgeons practice fat grafting were analyzed. The most popular sources of fat were from the patient’s abdomen (over 80 percent of the respondents’ cases) and from the hips (10 percent of cases). The amount of fat injected into the face to replace volume loss from aging ranged from 11 cubic centimeters to 25 cubic centimeters (about 3 to 5 teaspoons).

Surgeons typically add extra fat to compensate for the amount of fat likely to be reabsorbed by the body, about 40 percent of the initial injection. The rest remains indefinitely. By contrast, synthetic/commercial dermal fillers, an alternative to injected fat, last only nine months to a year and require repeated injections.

According to the survey group, the most commonly injected areas of the face are the cheek, the region below the lower eyelid, and the nasolabial folds, or creases between the nose and corners of the mouth.

Fat grafting is currently the only widely used method able to counter so-called volume deflation in the face, or loss of fat over time. The results of fat grafting procedures have improved dramatically in the past 10 years. Initial results were sometimes unpredictable and inconsistent. A deeper understanding of the facial anatomy in regards to fat compartments has led to refinements in fat grafting, along with more consistent and longer-lasting results. Reports of complications are rare.

Breast Augmentation Satisfaction Rate

Q:

I’ve heard that the satisfaction rate for breast augmentation surgery is very high, but how high is it?

A:

According to a study published in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, ninety-eight percent of women undergoing breast augmentation surgery say the results met or exceeded their expectations.

The women surveyed in the study also reported improvements in self-esteem and quality of life after breast augmentation.

“So many patients tell me that their breast augmentations have changed their lives for the better,” says Dr. Robert Wilke, a board certified plastic surgeon at Edina Plastic Surgery. “For many women it improves their confidence and makes them feel much more comfortable to wear all types of clothing. Breast augmentation is the most common procedure that we perform. We do see an increased demand in the springtime, however, as people are thinking about shedding the winter clothes and getting ready for swimsuit season.”

225 consecutive women who returned for interviews at least one month after breast augmentation over a five-year period were interviewed for this study. Interviews included questions about the recovery, results, complications and psychological effects.

The average patient age was 34 years old, and the majority of women received saline-filled breast implants placed under the muscle. The average implant volume was 390cc.

Eighty-five percent of women rated their new breast size “just right.” Thirteen percent would have preferred a larger size and less than two percent a smaller size. Only one percent expressed dissatisfaction with their scars, which were usually located in the crease under the breast. Seventy-five percent of women rated their breast firmness “just right.” When asked to rate the result, over half of the patients gave it a perfect 10 on a scale of 1 to 10. Almost all patients (98 percent) reported that the results met or exceeded their expectations.

Increased Self-Esteem and Other Psychological Benefits.

When asked about psychological effects, 92 percent of women reported improved self-esteem after breast augmentation and 64 percent reported an improved quality of life. Before surgery, the majority of women (86 percent) were self-conscious about their breasts. After surgery, only 13 percent were self-conscious about them.

Breast augmentation is the most popular cosmetic surgery procedure in the United States-approximately 286,000 operations were performed in 2014, according to ASPS statistics. The study results provide new information for women considering breast augmentation, particularly in terms of their expectations of the recovery and results.

Candidate for eyelid surgery?

Q:

Who is a good candidate for eyelid surgery?

A:

In general, good candidates for eyelid surgery are:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for eyelid surgery
  • Individuals without serious eye conditions
  • Excess skin and fine wrinkles of the lower eyelid

Remember that the eyelids are part of the face. The appearance of a drooping upper lid may also be due to relaxation of the forehead skin and eyebrow. Sometimes a drooping eyelid is caused by stretching of one of the upper eyelid muscles, the levator.

The board-certified plastic surgeons at Edina Plastic Surgery specialize in cosmetic procedures including blepharoplasty. We welcome you to come in for a free consultation.

They will evaluate your anatomy thoroughly to determine the causes of your eyelid appearance, and what procedures might best remedy them.

Eyelids are getting droopier?

Q:

I feel like my eyelids are getting droopier every day. What is a good solution?

A:

Eyelid surgery is one of the most popular types of plastic surgery procedures, and patients say they look more youthful and refreshed.

Eyelid surgery, or blepharoplasty, is a surgical procedure to improve the appearance of the eyelids. This is a very popular procedure. In 2014, more than 200,000 blepharoplasties were performed in the United States.

A blepharoplasty can be performed on your upper eyelids, lower eyelids, or both. Based on a preoperative evaluation of factors such as your underlying facial muscle structure, bone structure, and the symmetry of your eyebrows, the surgeon will decide how much skin, muscle, and/or fat to remove.

“I was 51 years old when I had a blepharoplasty (eyelid surgery) at Edina Plastic Surgery. I was delighted with the very natural-looking results. I look more ‘awake and rested’ and it is more fun to apply eye makeup now that my eyes look so much more youthful. There was very little discomfort following the procedure. I have recommended this procedure and Edina Plastic Surgery to many friends of mine.”

Whether you want to improve your appearance or are experiencing functional problems with your eyelids, eyelid surgery can rejuvenate the area surrounding your eyes.

SPECIFICALLY, EYELID SURGERY CAN TREAT:

  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision
  • Excess fatty deposits that appear as puffiness in the eyelids
  • Bags under the eyes
  • Drooping lower eyelids that reveal white below the iris
  • Excess skin and fine wrinkles of the lower eyelid

Where else can Botox® be used?

Q:

I know that Botox® is very versatile; but besides the forehead where else can it be used?

A:

Botox® can be effective on many areas of the face, neck and even the upper chest.

LOWER EYELID:

The jelly roll area which is under some people’s eyelid area is another area where Botox® can be effective. This area is most evident when patients smile really big. When Botox® is injected into the middle of the lower eyelid it makes the eye look more open and youthful.

EYEBROW (LATERAL):

Botox® can be injected to reduce eyelid hooding to produce some of the benefits of a lateral brow lift.

CORNERS OF THE MOUTH/MARIONETTE LINES:

As some people age the corners of their mouths become downturned, giving them a “crabby look”. We can inject Botox® to relax the muscles and help make the corners more upturned. Patients can achieve a look that is friendlier and more approachable.

CHIN:

To reduce dimpling or “orange peel skin” on the chin, Botox® can be effective. It relaxes the muscle in the chin to help diminish the dimply look.

NECK (VERTICAL BANDS):

Botox® is also used in the neck to treat the vertical platysmal bands. These bands may become prominent as we age because the skin progressively loses elasticity and soft tissue support weakens. Botox® injections help to make these bands and lines less pronounced.

DECOLLETAGE:

We use Botox® in the décollete area to diminish the fine wrinkling.

Facelifts for Men

Q:

Are facelifts for men a rising trend?

A:

One of the latest trends in plastic surgery is that a record number of men are getting on board and telling plastic surgeons that they want a facelift, seeking the benefits that the procedure can offer.

In today’s culture, youth and appearance are equated with success for both women and for men. Facelift procedures are very common in the world of cosmetic surgery. They have historically been popular with women who want to look and feel younger and more refreshed.
According to The American Society for Aesthetic Plastic Surgery, in the past five years there has been a dramatic 43% increase in the number of nonsurgical and surgical cosmetic procedures for men. Starting in 1997, when the organization began collecting statistical data, the increase in the number of procedures performed on men has risen by a whopping 273%.

Many men look at cosmetic procedures as a way to gain confidence and enhance their careers. In a marketplace where looking fit, younger, and more masculine is imperative, the better you look, the better your chances of climbing the corporate ladder.

“The best facelifts for men are the ones that look very natural and distinguished,” says board certified plastic surgeon Dr. Robert Wilke.

“Many men consider that the investment they make on a facelift is good for business. They are successful and feel young and confident but may be worried that they don’t look that way. We can help them look more refreshed and extremely natural.”

A facelift can also include a neck lift, eyelift, jawline recontouring, and possibly liposuction. It is not just older men who are opting for cosmetic surgery. Many younger men who want to refresh their appearance are opting to get rid of unwanted wrinkles, bags under the eyes, drooping eyelids and double chins. Rhinoplasty is still the top cosmetic surgical procedure for men.

HydraFacial™ for winter weather

Q:

The skin on my face gets so dry in the winter months. What is a good professional moisturizing treatment?

A:

Winter is on its way. Along with the cold temperatures and wind, it also brings seasonal problems such as skin dryness and irritation. Cold temperatures can create poor blood circulation with widened capillaries and as a result, the skin suffers. However, the drop in temperature isn’t solely responsible for these issues. The drop in humidity and the use of indoor heating systems are also culprits in making the sky feel dry.

Our $180 HydraFacial treatment is a non-invasive, liquid skin resurfacing system with no downtime. It instantaneously hydrates the skin, helping you achieve smooth, well-cleansed, hydrated, moisturized skin in a matter of minutes.

The HydraFacial resurfacing procedure addresses all aspects of your skin’s health. It is the trifecta of effective facial treatments that combines the following:

  • The exfoliation and resurfacing of microdermabrasion;
  • The skin renewal of a chemical peel; and
  • The hydration and extractions of a deep-cleansing facial.

This is the ideal treatment before a big event because it improves clarity, color, and skin texture while tightening the skin, creating an overall youthful, fresh look. The HydraFacial procedure is soothing, moisturizing, non-irritating and is immediately effective.

BENEFITS

  • Exfoliates dead skin cells and extracts impurities
  • Helps to visually retexturize the skin
  • Restores skin’s hydration leaving skin more supple and vibrant
  • Hydrates, plumps and firms the skin
  • Exfoliation of the skin’s upper layers allows improved absorption of active ingredients
  • Improves clarity and helps restore radiance to the complexion

The HydraFacial uses a unique five-step approach.

  1. Vortex-Cleaning—The patented HydroPeel tip hydrates the skin with a nutrient-rich solution that deeply cleanses the pores and softens and lifts away impurities.
  2. HydroPeel Exfoliation—The HydroPeel tip uses its multiple abrasive edges to exfoliate the skin several times with each pass to achieve better, more even skin resurfacing without irritation.
  3. Painless Vortex-Extraction—The vortex (powerful circulation of liquid) effect easily dislodges and removes blackheads, whiteheads, and sebum for quick and painless extractions.
  4. Vortex-Fusion of Antioxidants—The unique spiral tip employs a patented method for infusing hydrating skin solutions and potent antioxidants into the skin, improving the appearance of fine lines, wrinkles, oily skin, and hyper pigmentation.
  5. LED Light Therapy—Light therapy provides additional benefits after the HydraFacial treatment. LED light therapy uses specific types of light, which give off energy that stimulates your cells, thereby increasing your skin’s production of collagen and elastin. In turn, your skin becomes firmer, less wrinkled and younger looking. The treatment’s red LED light helps improve the appearance of skin firmness and resilience, while reducing the appearance of fine lines and wrinkles, hyperpigmentation and other signs of aging. The blue LED light is extremely beneficial for people who suffer from oily skin or breakouts. And the combination of red and blue LED lights is helpful in reducing the appearance of rosacea.

Plastic surgery for people over 50?

Q:

Is plastic surgery becoming more of an accepted practice for people over 50 years of age?

A:

Seniors are turning to plastic surgery in record numbers. It may be a current trend for the “more mature” to let their hair color go to a natural silver, but those same seniors are clamoring to have plastic surgeons erase other marks of aging like sagging breasts, wrinkles and droopy eyelids.

No matter how hard they look, these men and women know that there are no creams, potions or drugstore remedies that can completely erase the effects of aging. There is no such thing as an over-the-counter miracle cure. The former head of Revlon, Charles Revson was quoted as saying “I am selling hope in a jar.” Today older Americans are often finding that hope is in the hands of board-certified plastic surgeons.

A record number of senior citizens are electing to undergo plastic surgery. In 2014, women and men from the ages of 51 – 64 accounted for 25% of the surgical and 32.9 percent of the non-surgical cosmetic procedures. The total of those procedures for the year was more than 10 million. Add to that the number of people 65 and over who made up 8% of the total of yearly surgeries and 11% of the non-surgical procedures and you have got some very significant numbers of people over the age of 50 opting for cosmetic procedures. And the numbers are increasing every year, so the trend is clearly growing.

It’s not that hard to answer the question “Why are cosmetic procedures becoming more popular for people 50 and older?” Medical technologies are ever-advancing. This means that people are living longer and living more healthy lifestyles. They feel good and they want to look just as good as they feel.

If they are still in the work environment these patients often feel the pressures of the work environment and want to “continue to fit in”. Many have returned to the dating world and want to look their best to meet new people.

When asked about this trend, Dr. Robert Wilke, a plastic surgeon board certified by The American Board of Plastic Surgery said, “Every year we see more patients that are over 50, and the over-65 patient base is growing as well. My partners and I perform procedures that make people look and feel more youthful, but in a very natural way. Most people want a natural looking result. They still want to look like themselves, just a more refreshed and rejuvenated version of themselves.” The surgeons at Edina Plastic Surgery are experts in performing these procedures, as evidenced by all three of them being named as Top Doctors.

Seniors are asking for all types of surgeries and cosmetic procedures, but the most commonly requested surgeries are: facelifts, eyelid lifts, breast lift, tummy tucks and liposuction. These are followed in popularity by breast augmentation, breast reduction, lower body lifts and forehead lifts.

Do the risks increase as the age does?

“Many people are under the impression that advanced age automatically increases the surgical risk for patients,” says Dr. Wilke, “but that is not necessarily the case. Age does not have to be a limitation, but any co-morbidities and extenuating medical conditions that the patients are experiencing can play a part as to whether they are a good candidate for plastic surgery. Every patient needs a full medical evaluation preoperatively, and we, along with their primary physician, need to assess their surgical risk to determine if elective surgery is appropriate for them.”

Dr. Wilke goes on to say, “Because of advances in medical technology and techniques, plastic surgery is not only safer than ever, the results are better than ever as well. With our refinements in surgical techniques, as well as better and safer anesthesia, it all adds up to make it easier for these more mature patients to enjoy the benefits of plastic surgery.”

And with social mores and opinions on plastic surgery becoming more accepting, the social stigma of having “something done” has been all but erased. Surgeries are no longer considered a mark of vanity and they are no longer limited to Hollywood divas and jet-setting executives. The vast majority of people electing to have procedures are middle class wage earners who have saved up to get plastic surgery because it is important to them.

Looking more youthful with non-surgical alternatives.

For the maturing population who want to avoid or postpone a surgical option, the non-surgical alternatives are also very popular. Seniors are flocking to the offices of plastic surgeons and to skin clinics for all kinds of treatments including Botox® to erase wrinkles and facial fillers to plump up hands and face. They are also trying skin rejuvenation in record numbers. These include chemical peels, dermabrasion, skin-tightening lasers and laser skin resurfacing.

“At Edina Plastic Surgery we have a great skin clinic,” says Dr. Wilke. “So our patients have the option of any type of surgical or non-surgical procedure in their pursuit of looking more youthful. As people go through life transitions they want to look good; and no matter what avenue they choose we are there to help them reach their goals.”

What is KYBELLA?

Q:

I have a double chin that I’d like to get taken care of. I’ve heard that there is a new injectable called Kybella® that melts away that type of fat. How does it work?

A:

The single biggest breakthrough in treating double chins has been approved by the FDA and is now available at Skin Artisans at Edina Plastic Surgery.

Kybella is a non-surgical injectable for reducing moderate to severe fat on the upper neck, otherwise known as a “double chin.” The injection contains a naturally occurring molecule which eats away at fat. In short, Kybella is billed as a double-chin eraser that comes in a syringe.

Kybella is identical to the deoxycholic acid that is produced in the body. Deoxycholic acid produced in the body helps the body absorb fats. Kybella is a cytolytic drug, which when injected into tissue physically destroys the cell membrane. When properly injected into submental fat, the drug destroys fat cells occurring below the chin.

And unlike most of the injectable procedures offered, because it is so unique, this new fat-dissolving injection treatment is as popular with men as it is with women. Some plastic surgeons across the country are reporting that 40% of their Kybella patients are men.

How does it work?

Basically what Kybella does is that it disrupts the fat cell membrane. As soon as it hits, it causes lysis—or destroys the cell membrane. After that, the fat cell releases its fatty contents and the body metabolizes the fatty contents as normal.

How many rounds of treatment do you need, and what results should you expect?

In general, patients will need a series of 12-20 injections per visit. Patients may need two to three total visits, spaced a month apart. Each treatment takes about 15 minutes.

Some people may get up to 50 injections in a single treatment, with up to six single treatments no less than a month apart. Many people saw results in two to four treatments, according to Kybella’s manufacturer, Kythera®.

Before approving the drug, the FDA looked at the results of two U.S. trials that included more than 1,000 people. Those who got the drug more often saw less fat under the chin. More than 80% of those getting the drug said they noticed some improvement in their chin fat.

How long do the results last?

Depending on the patient, the results may last several years.

Could the drug help destroy fat cells in other areas of the body?

Currently the drug is only approved for injection below the chin. Kybella works best on small areas so it is not appropriate for areas like love handles.

What will it cost? And will insurance cover it?

The cost of Kybella varies from patient to patient but the costs will be similar to other dermal fillers such as Juvederm or Restylane. Kybella requires more than one treatment. Because it is a cosmetic procedure insurers will not cover the costs.

Is everyone a candidate for Kybella?

Almost everyone is a candidate for Kybella, except for patients under the age of 18. It is recommended that doctors screen patients carefully to make sure that their submental fullness is indeed fat and not the result of something else, such as thyromegaly (enlargement of the thyroid) or cervical lymphadenopathy (enlargement of cervical lymph nodes in the neck).

What are the potential side effects?

The most common side effects are bruising, swelling, pain, numbness, and small, firm areas around the injection sites. There can also be a bit of numbness at the site which resolves over time.

A possible serious side effect is an injury to the marginal mandibular nerve, which helps control facial expressions, causing an off-balance smile. This likely happens when shots are given too close to this nerve.

In trials including more than 5,000 people, this side effect happened in 4% of patients, according to a report from the FDA advisory panel. It eventually went away in all of them.

Loose and Sagging Skin?

Q:

After having gastric bypass surgery I have lost a great deal of weight and have a large amount of loose and sagging skin. Can you tell me what options plastic surgery can give me?

A:

Dramatic weight loss has many benefits. But after weight reduction surgery, or any substantial amount of weight loss achieved naturally, the skin and tissues often lack the elasticity to conform to the reduced body size.

Surgical body contouring following major weight loss removes excess sagging fat and skin while improving the shape of the underlying support tissue. The result is a more normal appearance with smoother contours. These procedures below are also very effective in improving appearance in patients experiencing normal aging or a small amount of weight loss.

Body contouring procedures may include:

  • Facelift: sagging of the mid-face, jowls, and neck
  • Breast lift: sagging, flattened breasts
  • Tummy tuck: apron of excess skin hanging over the abdomen
  • Lower body lifts: sagging of the abdomen, buttocks, groin and outer thighs
  • Medial thigh lift: sagging of the inner, outer and mid-thigh
  • Arm lift: sagging of the upper arms

If you are considering body-contouring surgery, here is what the surgeons at Edina Plastic Surgery suggest you should do first:

  • Choose a surgeon who is board-certified in plastic surgery — not just a board-certified doctor. All three surgeons at Edina Plastic Surgery are board-certified by The American Board of Plastic Surgery.
  • Stabilize your weight — at your goal — for at least three months, and be sure to correct all nutritional deficiencies (which are common after weight loss surgery).
  • Establish a reliable support network of family and friends to help you during recovery.
  • Make sure you can get enough time off from work to recover.
  • Prior to surgery, stop smoking. This is a must to speed healing and reduce complications.

My Hands Look So Old

Q:

My hands are full of veins and look so old. What procedures are available to help make them look younger?

A:

Radiesse® recently received FDA approval as an injectable to rejuvenate aging hands.

The hands don’t lie. Even with a more youthful appearance of the face, your age can easily be given away by the appearance of your hands. In early June, Merz North America, the maker of Radiesse®, announced that they have received regulatory approval to sell the nation’s first injectable “filler” to improve the appearance of bony, aging hands and to correct volume loss in the dorsum of the hands. The nurse injectors at The Skin Clinic at Edina Plastic surgery are experts in these injections and have helped many patients achieve smoother, younger-looking hands.

Radiesse® is the first and only FDA-approved product for hand augmentation to correct volume loss in the hands and reduce the prominence of tendons and veins in the hands. This filler restores volume to the hands while providing smooth, natural-looking results that can be seen immediately and can last up to 1 year.

But it’s not just older women who want in: Young women are getting hand rejuvenation so they can take engagement ring selfies without shame, the Daily News reported in August. Women who’ve recently added “rocks” to their left ring fingers are getting Radiesse® injections to beef up the appearance of their hands for the engagement ring photos.

In clinical trials, 75 percent of evaluators said Radiesse® improved hand appearance three months after injection, Merz said. The evaluators didn’t know which patients had received Radiesse® and which ones were injected with a placebo.

Here is a quote from a patient who had her hands rejuvenated using Radiesse®:

“I wasn’t happy with the way my hands were looking — the veins were showing and the skin didn’t have its youthful vibrancy,” says Margareta C., 66, who had the procedure. “It filled in all those pockets and the veins are not noticeable now.”

The Ideal Implant

Q:

I’ve heard about a new saline breast implant called the “Ideal Implant”. What makes it different?

A:

Edina Plastic Surgery has the exclusive rights in Minnesota to use the new Ideal Implants recently approved by the FDA. We know that when it comes to breast augmentation, women appreciate having options, and the more options the better. At EPS we offer patients the very latest in breast augmentation advancements.

The Ideal Implant is a revolutionary new design in saline-filled implant. It has a baffle structure, two lumens and a series of shells of increasing size nested together to control saline movement; making it behave much like a silicone implant

Many women don’t like the look and feel of the typical saline-filled breast implant which can wrinkle or “scallop” over time. However, these same women may not be comfortable with the silicone gel options.

This new saline breast has recently been approved by the FDA and offers women a great new option. It has two valves that fill the device with saline. This revolutionary new design controls the saline movement to prevent bouncing and provides a more natural result than current single-lumen saline implants. The structured design also provides internal support to the implant edge, while minimizing scalloping and wrinkling. Study results have found this new implant to have a high rate of patient and surgeon satisfaction along with a low rate of capsular contracture compared to current, single-lumen, saline-filled implants.

“The saline-filled implants that we have used to this point were essentially balloons filled with freely-moving fluid,” says Dr. Nathan Leigh of Edina Plastic Surgery. “They can result in an unnatural feel and sometimes the aesthetic results are not as pleasing as we’d like them to be. I believe that the Ideal Implant has the promise to be an excellent alternative to current saline options and some silicone gel-filled implants options, especially in view of the low rate of capsular contracture shown in the studies.”

The IDEAL IMPLANT meets a clear need for saline-filled implants that offer a more natural result for patients who don’t want silicone gel-filled devices.

Tips Pre-Facelift

Q:

Are there tips for patients to do pre-procedure when having a facelift?

A:

The surgeons at Edina Plastic Surgery know that the best results from any facial plastic surgery procedure look extremely natural. The facelifts we perform do not look “fake”, but are done so well that others really don’t notice. The most common responses that our patients receive are; “Did you get a new hairstyle?” or simply “You look so good!”

A good recommendation for patients that don’t want to call attention to the results of their facelift is to change their hairstyle or hair color before their procedure. This way people commenting on how great they look often refer to the hairstyle change.

Plastic Surgery in the Cold Months

Q:

Friends have said that the cold weather months are great for having plastic surgery procedures; why is that?

A:

Just like there are good seasons for sporting activities there are seasons that can greatly benefit patients considering plastic surgery procedures. The cold months of winter/early spring can have their benefits

The months from February through April can be the ideal time to undergo just about any type of cosmetic surgery from facelifts to breast augmentations to tummy tucks and liposuction.

  • There is less direct sunlight during these months which is advantageous when having any facial cosmetic surgery or laser treatments.
  • Turtlenecks, scarves and hats can help hide the temporary bruising/discoloration from a facelift, laser resurfacing or brow/eyelid lift.
  • The cooler weather allows patients to conceal any temporary swelling/bruising or bandages with seasonally appropriate bulky clothing such as heavy sweaters and winter weight slacks.
  • Many patients find it easier to “take it easy” after a surgery during the colder months when most everyone tends to be less active.
  • Usually the months immediately after the holidays are simply “less social” so there are fewer events to be missed with post-surgery downtime.

Liquid Facelift

Q:

What is a “liquid facelift” and how effective is it in making people look more youthful?

A:

Our nurse injectors soften lines with Botox® and add back youthful volume with fillers like Voluma® XC. By using a combination of injectable fillers and/or muscle immobilizing products, lines can be minimized or erased, and sagging skin lifted and filled out.

Patients can see noticeable improvements from these liquid facelifts without the downtime of surgery. Middle-aged people who have mild jowls, volume loss, vertical lip lines, crow’s feet, lines along the side of the nose and chin — sometimes called marionette lines — can benefit greatly. Also, injectable products can correct asymmetries and even those bands in the neck below the chin that become prominent with age.

It is important to note that a “liquid facelift” is not permanent and must be repeated every few months with shorter-acting products, or every couple of years with more long-lasting products. The goal is to make patients look “better” and not “different” and our nurse injectors are experts in achieving these results.

Which procedure is the most popular?

Q:

Are plastic surgery procedures still on the rise and which procedure is the most popular?

 

A:

Dr. Nathan Leigh, Dr. Robert Wilke and Dr. Michael Philbin are all members of The American Society of Plastic Surgeons. This group which is the largest organization of board-certified plastic surgeons in the world, published their annual results on plastic surgery procedures in the U.S. The report shows that 15.1 million cosmetic procedures were performed in 2013, a 3% increase from the previous year.

Some of the findings were not surprising. Breast implants, for instance, remain the top cosmetic surgical procedure. The top minimally invasive procedure was once again Botox®. Facelifts and eye surgeries were both up 6% from the year before.

Interestingly, two procedures that are gaining a great deal of popularity among American patients are buttock augmentation and neck lifts.

 

Best way to get rid of smile lines

Q:

What is the best way to get rid of smile lines?

A:

Dermal fillers are FDA approved prescription products that are typically injected into the dermis and used to fill skin that has lost volume. The fillers we inject are made of natural ingredients such as calcium and hyaluronic acid. Fillers normally last 6-18 months depending on the individual and require no downtime. Our three “master nurse injectors” have over 30 years combined experience in using dermal fillers and will assess your needs and consult with you to decide which filler best suits you.

Fillers can be used on many areas of the body to treat trouble spots. The most common areas are:

  • Facial wrinkles
  • Cheeks
  • Corners of mouth
  • Nasolabial Folds
  • Cellulite
  • Hands
  • Knees
  • Lips
  • Marionette lines
  • Tear Troughs
  • Temples

Our skin care experts can give you more information when you schedule a free consultation.

NanoLaser Peel

Q:

Are there any lasers that do a good job resurfacing the skin but require little to no downtime?

A:

Patients often ask about solutions that require no downtime, especially when they want to schedule treatments before parties and special events.

The NanoLaser Peel is a fast, comfortable laser resurfacing treatment with the shortest downtime. If your skin looks old and tired you may be a great candidate for the NanoLaser peel. This procedure uses laser energy to instantly remove the top layer of the skin at a depth that stimulates the skin’s own renewal process while activating special messenger cells. Only the NanoLaser from Sciton has the precision to work at just the right depth to treat fine lines, scars, sun damage and more to create beautifully smooth, luminous skin. All these benefits with little to no downtime.

Price for a full face resurfacing is $200.

Different types of silicone implants?

Q:

How are modern silicone gel implants different from silicone implants of the past? What is a “Highly Cohesive/Form Stable Implant?” Where did the name “Gummy Bear Implant” come from?

A:

The modern silicone gel implants are much different than the earlier generation implants used prior to 1992, and vastly improved. The silicone gel used today has a greater viscosity compared to saline, so the implant feels a bit more like natural breast tissue. The outer shell is stronger and the gel itself is much more cohesive. At Edina Plastic Surgery, all the gel implants that we use in our practice contain a cohesive gel that will not freely leak out of the shell if it is ruptured.

In the past year, a new form-stable, teardrop-shaped silicone gel implant has been approved for use by the FDA. This implant is made with a more highly cohesive gel that allows it to maintain its shape and have a firmer feel. The form-stable implant may be the best choice for certain patients due to their natural shape and anatomy. The surgeons at Edina Plastic Surgery still agree that the round, standard silicone implants produce the best result for many types of anatomies.

Many patients ask about the “Gummy Bear” implants because they’ve heard about them through the media or on the internet.

This is a colloquial term that doesn’t apply directly to any specific implant, but was originally coined to describe the more highly cohesive, form-stable shaped implants.

There is an interesting story about how the name “Gummy Bear” was coined. The name was started by the president of a breast implant company to describe the characteristics of the highly cohesive silicone. He was in a meeting and was biting the heads off of gummy bears and came up with what he thought would be a good and catchy term.