Plastic Surgery Channel Magazine Vol.2 by The Plastic Surgery Channel

VOL.02

LIFESTYLES

THE BEAUTY ISSUE

THE PLASTIC SURGERY CHANNEL MAGAZINE

AGE

DEFYING SECRETS

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VOL.02

LIFESTYLES

THE BEAUTY ISSUE

THE PLASTIC SURGERY CHANNEL MAGAZINE

PUBLISHER William P. Adams Jr., MD EDITOR IN CHIEF Carolynn Grimes MANAGING EDITOR Anne Meyer-Kaneko ASSOCIATE EDITOR Beverly Brooks CREATIVE + PRODUCTION Victoria Hulett-Gross / Venus Agency

WWW.THEPLASTICSURGERYCHANNEL.COM

LIFESTYLES MAGAZINE is published by The Plastic Surgery Channel, Dallas, Texas PRINTED IN THE U.S.A. Lifestyles Magazine is published and distributed through some of the most elite and experienced doctors in the country. All advertising is subject to publisher approval before acceptance. Lifestyles Magazine reserves the right to refuse any ad for any reason. Advertisers warrant and represent that the descriptions of the products and services advertised are true in all respects. Lifestyles Magazine assumes no responsibility for claims made by advertisers. Lifestyles Magazine, The Plastic Surgery Channel, its officers, directors, employees and agents make no recommendations as to the purchase or sale of any product, service, or other items. All views expressed in all articles are those of the authors and are not necessarily those of the Lifestyles Magazine and The Plastic Surgery Channel. Copyright ÂŠ2016 All rights reserved. Reprinting, in whole or in part, is expressly forbidden except by written permission of the publisher.

1 THEPLASTICSURGERYCHANNEL.COM

Lifestyles Magazine Shaun Parson, MD

James Namnoum, MD

Ned Snyder IV, MD

Peter B. Fodor, MD*

Bradley Calobrace, MD

Robert Whitfield, MD

Geoffrey R. Keyes, MD*

Simeon Wall Jr., MD

Mark A. Pinsky, MD

Michael R. Schwartz, MD

Michael Lee, MD

David A. Lickstein, MD

Grant Stevens, MD

Kevin Smith, MD

Jason N. Pozner, MD

Tiffany McCormack, MD

Stephan J. Finical, MD

Clifford P. Clark III, MD

Brian Brzowski, MD

Michael E. Beasley, MD

Christine Hamori, MD*

Richard A. Baxter, MD

Paul A. Watterson, MD

Caroline Glicksman, MD*

Laurie A. Casas, MD

Jarrod R. Daniel, MD

Stafford R. Broumand, MD

Bruce W. Van Natta, MD*

Mary Gingrass, MD

Daniel Y. Maman, MD

Brad Bengtson, MD

Melinda Haws, MD

Mark D. Epstein, MD

Ryan T. Mitchell, MD

William P. Adams Jr., MD*

Robert T. Grant, MD

Mark S. Elliott, MD*

Camille Cash, MD

Louis P. Bucky, MD*

Lee Thornton, MD

Ashley Gordon, MD

J. Peter Rubin, MD*

Patricia A. McGuire, MD

Dustin Reid, MD

Richard J. Zienowicz, MD

* Advisory Board Member of THE PSC

The Official Publication of The Plastic Surgery Channel™ 2 THEPLASTICSURGERYCHANNEL.COM

INVITATION ONLY INCLUSION The Plastic Surgery Channel™ (PSC) is a trusted resource for patients desiring credible and informative information. All of the surgeons highlighted in Lifestyles have been exclusively invited by PSC for their expertise and accomplishments in the field of plastic surgery.

“PSC is a unique ‘channel’ where information is exchanged between consumers, surgeons and industry.”

Typically traditional media is several years behind the real innovations that patients want to know about.

TIMELY AND CREDIBLE Nowhere else will you find the hottest topics in plastic surgery, delivered by the world’s most respected surgeons. We’ve featured the plastic surgeons who develop, evaluate, and refine trends in the field of plastic surgery! We hope you’ll enjoy reading this issue of Lifestyles magazine. Many physicians and non-physicians call themselves “cosmetic surgeons” and offer many types of procedures, both surgical and non-surgical without any real formal training in plastic surgery.

REAL PLASTIC SURGEONS REAL ANSWERS The Plastic Surgery Channel™ is owned and operated by board certified plastic surgeons. Using multi-media internet platforms, PSC presents trustworthy, timely and educational programming about cosmetic and reconstructive surgery. Every presentation is created by plastic surgeons at the peak of relevance - without the interference or interpretation of traditional news media. This is truly the voice of Plastic Surgery.

WHERE DO I FIND ON-GOING CONTENT? • ThePlasticSurgeryChannel.com • Youtube/PlasticSurgeryChannel • Facebook/ThePlasticSurgeryChannel • Twitter/PSChannel • Instagram/ThePlasticSurgeryChannel • Pinterest/SurgeryChannel • Roku Channel • PSC Newsletters 3 THEPLASTICSURGERYCHANNEL.COM

~ Peter B. Fodor, MD, FACS Chairman, PSC Medical Advisory Board

BREAST

THE BEAUTY ISSUE

LIFESTYLES/CONTENTS

Augmentation 10 Breast Implants: Forget Cup Size

22 A Tale of Two Surgeries

Interview with Mark A. Pinsky, MD

Interview with Patricia A. McGuire, MD

11 Boost Your Breasts, Boost Self Confidence

23 Top Five Things You Need to Know

Interview with Michael E. Beasley, MD

Interview with Ned Snyder IV, MD

12 One Day Recovery Breast Augmentation

24 Do I Need a Breast Lift or Implants?

Interview with Mark D. Epstein, MD

Interview with Kevin L. Smith, MD

13 Visualize Your Results in 3D

25 All in One Breast Surgery

Interview with Brad Bengtson, MD

Interview with Daniel Y. Maman, MD

Lifting, Reducing, Reconstructing

26 Seasons of Change: Are Your Implants Ready?

14 Younger Looking Breasts with No Down Time

Interview with Mary Gingrass, MD & Melinda Haws, MD

Interview with Peter B. Fodor, MD

15 Time to Revise

27 Lymphedema Treatment Following Breast Cancer

Interview with Shaun Parson, MD

Interview with Robert Whitfield, MD

16 Breast Lift Booms in Popularity Interview with Simeon Wall Jr., MD

17 Better Breasts the Second Time Around Interview with Louis P. Bucky, MD

The Plastic Surgery Channel™

18 Beautiful Imperfection Interview with Caroline Glicksman, MD

DOCTORS DIRECTORY

19 Taking the Weight Off Your Shoulders Interview with Mark S. Elliott, MD

96 - 97 PSC Doctors by Region

20 Reconstructing Beautiful Breasts after Cancer

98 - 175 Doctor Profiles

Interview with Robert T. Grant, MD

21 Disturbing Diagnosis, Positive Outcome Interview with David A. Lickstein, MD

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Surgery, Liposuction, Fat Transfer

44 Tired of Fat That’s Impossible to Lose? Interview with Stafford R. Broumand, MD

30 Mini vs. Full Tummy Tuck

45 Sculpting Your Waist

Interview with Tiffany McCormack, MD

Interview with Daniel Y. Maman, MD

31 Improvement All the Way Around

46 The Ultimate Mommy Makeover

Interview with Mark D. Epstein, MD

Interview with Richard J. Zienowicz, MD

47 ThermiVA: A Very Private Makeover

32 Arm Lift: A Life Changing Procedure Interview with J. Peter Rubin, MD

Interview with Camille Cash, MD

33 Sculpting a Beautiful Bottom

Face, Fillers, Eyes, Nose

Interview with Peter B. Fodor, MD

34 Body Contouring after Weight Loss Interview with Brian Brzowski, MD

35 The Tummy Tuck Designed for You Interview with David A. Lickstein, MD

FACE

BODY

THE BEAUTY ISSUE

50 Making Wrinkles Magically Disappear Interview with Bradley Calobrace, MD

51 Facelift vs. Fillers Interview with Lee Thornton, MD

36 Say Goodbye to Sagging Skin

52 A Younger Looking Neck

Interview with J. Peter Rubin, MD

Interview with Bradley Calobrace, MD

37 A Better Butt with Your Own Fat

53 The Halo™ Glow

Interview with Bruce W. Van Natta, MD

Interview with Ashley Gordon, MD

38 New Options for a Flatter Stomach

54 Perfecting The Nose

Interview with Caroline Glicksman, MD

Interview with Dustin Reid, MD

39 Moms, We’ve Got This

55 The Art of Rhinoplasty

Interview with Camille Cash, MD

Interview with Stephan J. Finical, MD

40 Delete Fat and Drop a Decade

56 It’s All in the Eyes

Interview with James D. Namnoum, MD

41 Baby’s Got Back

57 When is it Time for a Facelift?

Interview with Richard J. Zienowicz, MD

Interview with Clifford P. Clark III, MD

42 Look Sexy after Babies

58 Plump Up the Volume

Interview with Laurie A. Casas, MD

Interview with Mark S. Elliott, MD

43 A Tighter Tummy after Kids

59 Tech Neck: The New Turkey Neck

Interview with Mark A. Pinsky, MD

Interview with Paul A. Watterson, MD 5 THEPLASTICSURGERYCHANNEL.COM

LIFESTYLES/CONTENTS

Improving Appearance Without Surgery 62 New Alternatives to Botox速 Interview with Jason N. Pozner, MD

63 Chill Out, FAT Interview with Grant Stevens, MD

64 Placing Wrinkles on Pause Interview with Brian Brzowski, MD

TRENDING

NON SURGICAL

THE BEAUTY ISSUE

Advances in Plastic Surgery

72 Manly Surgical Solutions Interview with Louis P. Bucky, MD

73 Solutions for the Muffin Top Man Interview with Jarrod R. Daniel, MD

74 Have we Discovered the Cellulite Solution? Interview with Michael Lee, MD

65 Get the Look You Want Without Surgery

75 The No Pain, No Drain Tummy Tuck

Interview with Michael R. Schwartz, MD

66 Goodbye Deodorant

76 Building Confidence with Labiaplasty

Interview with Bruce W. Van Natta, MD

Interview with Laurie A. Casas, MD

67 Zapping Fat with Vanquish速

77 Labiaplasty and Beyond

Interview with Clifford P. Clark III, MD

Interview with Christine Hamori, MD

68 A Non-Surgical Facelift

78 Transgender Surgery

Interview with Christine Hamori, MD

Interview with Patricia A. McGuire, MD

69 Big Results, Little Downtime

79 Medical Spas Made Just for Men

Interview with Jason N. Pozner, MD

Interview with Grant Stevens, MD

80 No More Man Boobs Interview with Mary Gingrass, MD & Melinda Haws MD

81 Restoring Confidence in Men with Gynecomastia Interview with Shaun Parson, MD

82 FAST-TRAK Recovery Interview with William P. Adams Jr., MD

83 Stem Cell Research: Is the Verdict Still Out? Interview with Robert T. Grant, MD

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SURGEONS & SURGERY

THE BEAUTY ISSUE Advice for Patients from Top Surgeons 86 Safety First When it Comes to Surgery Interview with Geoffrey R. Keyes, MD

87 Before You Have Plastic Surgery Interview with Lee Thornton, MD

88 Turning OFF Nausea Interview with Richard A. Baxter, MD

89 Revision Surgery: What You Need to Know Interview with Richard A. Baxter, MD

90 Three Keys to Finding a Great Plastic Surgeon Interview with Geoffrey R. Keyes, MD

91 Leaders Share Knowledge Through Live Surgery The Plastic Surgery Channel

92 High Standards Equals Safety Interview with Tiffany McCormack, MD

93 Improving the Lives of Burned Children Interview with Stafford R. Broumand, MD

94 Whoâ&#x20AC;&#x2122;s Right for the Job? Interview with William P. Adams Jr., MD

Doctors Directory 96 - 97 PSC Doctors by Region 98 - 175 Doctors Profiles

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Breast Implants are supposed to feel as good as they look. Thatâ&#x20AC;&#x2122;s why Sientra breast implants are made with High-Strength Cohesive Silicone Gel to provide implant strength and integrity, while still feeling like a natural part of your body.

A remarkable difference you can see and feel.

Ask your Board-Certified Plastic Surgeon about Sientra Breast Implants!

Sientraâ&#x20AC;&#x2122;s Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old and for breast reconstruction. Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of primary breast augmentation surgery. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the results of a primary breast reconstruction surgery. Breast implant surgery is contraindicated in women with active infection anywhere in their bodies, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions and, who are pregnant or nursing. Key complications include capsular contracture, implant removal, rupture and reoperation. For more detailed information about the risks and benefits of Sientra breast implants, please visit www.sientra.com/resources or call Sientra at (888) 708-0808. Sientra breast implants with High-Strength silicone gel are only available through board-certified or board-eligible plastic surgeons.

FeelGood/sientra.com/SiliconeBreastImplants

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MDC-0118 R1

Breast Implants: Forget Cup Size Interview with Mark A. Pinsky, MD

Boost Your Breasts, Boost Self Confidence Interview with Michael E. Beasley, MD

One Day Recovery Breast Augmentationâ&#x201E;˘ Interview with Mark D. Epstein, MD

Visualize Your Results in 3D Interview with Brad Bengtson, MD

Younger Looking Breasts with No Down Time Interview with Peter B. Fodor, MD

Time to Revise Interview with Shaun Parson, MD

Breast Lift Booms in Popularity Interview with Simeon Wall Jr., MD

Better Breasts the Second Time Around Interview with Louis P. Bucky, MD

Beautiful Imperfection Interview with Caroline Glicksman, MD

Taking the Weight Off Your Shoulders Interview with Mark S. Elliott, MD

Reconstructing Beautiful Breasts after Cancer Interview with Robert T. Grant, MD

Disturbing Diagnosis, Positive Outcome Interview with David A. Lickstein, MD

A Tale of Two Surgeries Interview with Patricia McGuire, MD

Top Five Things You Need to Know Interview with Ned Snyder IV, MD

Do I Need a Breast Lift or Implants? Interview with Kevin L. Smith, MD

All in One Breast Surgery Interview with Daniel Y. Maman, MD

Seasons of Change: Are Your Implants Ready? Interview with Mary Gingrass, MD & Melinda Haws, MD

Lymphedema Treatment Following Breast Cancer Interview with Robert Whitfield, MD 9 THEPLASTICSURGERYCHANNEL.COM

BREAST

AUGMENTATION, LIFTING, REDUCING, RECONSTRUCTING

BREAST

F ORGET THE CUP SIZE

“We have patients who simply take Tylenol® and go out to dinner the day of their surgery; it’s remarkable.”

ion,” says Dr. Pinsky. “It also reduces the risk of complications and re-operations and that’s critical. We don’t want to make unnatural looking breasts, we want women to look beautiful.”

An Interview with Mark A. Pinsky, MD by THE PSC

hen it comes to beautiful breasts, it’s easy to get too hung up on cup size. Your friend is a 34C and it looks good on her. That doesn’t necessarily translate into the size that will look good on you. To make the situation more complicated, there is no standardization for bra cup sizes. Every brand and style fits and feels very different. We chatted with Dr. Mark Pinsky, who brings his artistic eye and years of experience into every augmentation consultation. “It’s not as much about the implant, as it is about the artistry.”

NOT ALL BREAST AUGMENTATIONS ARE THE SAME While the incision size or location may be similar, what happens below the skin can vary significantly. Dr. Pinsky lectures on, “fine, meticulous, bloodless dissection.” This is reflected in his nationally recognized surgical results and quick recovery times for patients. “We have patients who simply take Tylenol® and go out to dinner the day of their surgery; it’s remarkable,” says Dr. Pinsky.

IMAGING TECHNIQUES FOR SIZING “Bio-dimensional planning is critical. We take the dimensions of the implant and match it to the proportions of a woman’s figure so it ‘fits’ her. This makes for the prettiest, most natural appearing breasts in my opin10 THEPLASTICSURGERYCHANNEL.COM

Patients now have the unique opportunity to create and view a 3D simulation of their possible outcome. The images, taken by the Canfield Vectra™ 3D system, are very accurate and extremely helpful to women who want to see what they might look like after surgery. “This imaging system educates our patients so they can view the images at home and review them with a loved one, such as a spouse, relative or friend. It takes a lot of guesswork out of the decision making process.”

IMPLANT OPTIONS There are now a number of different types of breast implants available to patients. While that might initially be overwhelming to the patient researching options, it allows the truly sophisticated plastic surgeon to use the perfect implant for each individual patient. Dr. Pinsky believes that no two patients are alike and therefore a great deal of planning and thought are committed to selecting the perfect implant for each patient.

REDUCING REVISIONS Dr. Pinsky serves on the Allergan Executive Council for Breast Aesthetics, a distinguished advisory panel of ten nationally recognized leaders in breast surgery. The education initiative, called the “50 in 5 Challenge” is designed to provide aesthetic surgeons education on the best practices to help reduce the incidence of breast implant revision by 50% within five years.

B OOST YOUR BREASTS, BOOST

SELF CONFIDENCE “Women who undergo breast augmentation are some of our happiest patients.” An Interview with Michael E. Beasley, MD by THE PSC

hile superficially it may appear that these patients just want to be bustier, being unhappy with one’s breasts can take its toll on a woman’s self-confidence. We spoke with Dr. Michael Beasley of Charlotte Plastic Surgery who has a great wealth of information as to what women are truly asking for.

than 90% accuracy, so we have visual feedback to confirm what the patient is thinking,” says Dr. Beasley.

IMPLANT TYPE “The second thing we need to consider is the implant. We’ve had several advancements in implant technology over the years. Patients now have a choice between saline implants and silicone gel implants. Each has been proven to be safe and effective, and come in different sizes, shapes, and surface characteristics which can have advantages.” It is important to ask your surgeon what sizes, shapes and implant surfaces they recommend for you, and why.

THE DESIRE TO LOOK AND FEEL BETTER One way to look at plastic surgery and any elective procedure is to consider that at the core, it is people trying to better themselves. Breast augmentation is one of the most popular avenues for this with more than 300,000 procedures performed last year alone. Even though it is routinely requested and performed, it is still surgery.

INCISION LOCATION

YOUR TOP THREE QUESTIONS: ANSWERED

“The third important question is where they want the incision placed,” says Beasley. “There are a few different locations where we can place the incision, and each might be more or less beneficial to a patient depending on their lifestyle and their unique anatomy.”

Excellent planning and organization before surgery provides the foundation for a fabulous result. To assist in the planning, Dr. Beasley shares the top three questions a patient needs to answer with their surgeon in order to achieve a great breast augmentation.

CONFIDENCE-BOOSTING RESULTS It cannot be emphasized enough how important surgeon selection is when considering elective cosmetic surgery. Choosing a board certified plastic surgeon to guide you through the above questions will make you more comfortable, and allow for a fantastic result. “Women who undergo breast augmentation are some of our happiest patients,” says Dr. Beasley. “It seems to make them feel more confident with their bodies and the way they fit in clothes. I think that is also relayed in their personality and what they project to other people moving forward.”

SIZE A lot of women come in requesting a certain bra cup size. Different stores and different manufacturers have different standards for cup size, and all bras fit differently. Because of this range in sizing, cup size is not the most accurate way to choose an end goal. “To be accurate, we rely on technology. 3D imaging technology has proven to be very helpful. We can take a picture of a woman’s torso and do a 3D simulation of different types and sizes of breast implants, which show on her body on the screen. It’s proven to give us greater 11

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BREAST

O NE DAY RECOVERY BREAST AUGMENTATION “Seeking a board certified plastic sugeon who specializes in faster recovery is the first step.” started to produce a better experience for patients, he says, “they were in disbelief.” But after routinely producing One Day Recovery for patients, they started to tell their friends, who told their friends and then testimonials started appearing, touting the amazing recovery experiences patients were having after this fast recovery breast augmentation.

NORMAL ACTIVITY DAY OF SURGERY This new type of recovery allows women to raise their arms above their heads before they are even out of the recovery room. 98% of Dr. Epstein’s cosmetic breast surgery patients are able to resume all the normal activity of daily living, except for strenuous exercise, by the very next morning after surgery. Many of his patients go out to dinner the night of surgery and have been known to go shopping and to their kid’s soccer games.

RECOVERY SECRETS

“It is real,” says Dr. Mark Epstein, a board certified plastic surgeon in Stony Brook, New York. “98% of my patients don’t need anything more than Tylenol® or Advil® after surgery. One Day Recovery Breast Augmentation is a procedure I’ve been performing and perfecting since 2004. It allows patients to recover from breast implant surgery in dramatically less time.”

The secret literally lies in the hands of an expert surgeon like Epstein. “It actually comes from very delicate handling of tissues. There is absolutely no blunt dissection. All dissection is done using a cautery under direct visualization.” The precision used to develop the pocket for the implant, and the less traction placed on the tissues means less trauma to the patient and thus less pain after surgery, almost eliminating the need for post-operative narcotics. This is a huge benefit in returning patients to full, normal activity so quickly. Although advances have been made in long lasting local anesthetics, Dr. Epstein says he doesn’t need them.

NO MORE HORROR STORIES

BETTER RECOVERIES

Recovery from breast augmentation surgery can vary widely from surgeon to surgeon and patient to patient. Ask any of your girlfriends what their recovery from breast implant surgery was like and you will likely hear some horror stories. Complaints often include not being able to raise their arms above their heads for weeks, recovery bras, bandages, drains, bruising, missing work, no driving and even needing help to go to the bathroom. So common are these complaints that when Dr. Epstein first

“It is a whole change in paradigm about how a surgeon handles tissues and performs surgery. These techniques are applicable to many operations, like breast reduction and abdominoplasty, and we are seeing much quicker recoveries as a result.” Seeking a board certified plastic surgeon who specializes in faster recovery is the first step. Remember, whatever happens to the patient in the operating room, the patient pays for later in their living room.

An Interview with Mark D. Epstein, MD by THE PSC

ave breast augmentation surgery in the morning and go shopping in the afternoon. Are you kidding me?

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VISUALIZE YOUR

“Imaging allows us to show the patient their breasts in ways they have never seen them before.”

RESULTS IN

An Interview with Brad Bengtson, MD by THE PSC

f you ask women who are considering breast augmentation what their biggest fear is, they will almost all say they don’t want to be too big. However, they also want to be sure that if they’re going to get breast implants, the investment will be worth the money. Basically, they want to be able to see what their results will be before they have surgery. With recent advances in technology, Dr. Brad Bengtson, a board certified plastic surgeon in Grand Rapids, Michigan, says he can do just that for patients.

VIRTUAL RESULTS “I used to think of breast augmentation as an event, but it really is a process,” says Dr. Bengtson. The most important parts of the process are the assessment of the patient and breast implant selection. The Bengtson Center uses Vectra® 3D imaging, and it has transformed the entire assessment and consultation process.

CHOICES AND DECISIONS “Imaging allows us to show the patient their breasts in ways they have never seen them before,” says Bengtson.

The simulation is so incredibly accurate that it can show the patient how different sizes and shapes of implants will affect their result. Breast implants are not just round any more. There are shaped implants, like the Allergan Natrelle® 410, or variations in implant technology and fill, like the new Inspira® breast implant. With all these different choices, it’s important for patients to be able to visualize the difference their choices could make in their end result. Imaging makes the “after” result a reality at a critical decision making time for each patient. The projected result that imaging provides is so accurate that when compared to the real “after” result one year post-surgery, it essentially “ghosts” the computer simulated image. This type of accuracy in imaging makes it an incredibly reliable and accurate tool for both patients and surgeons.

RECONCILING WISHES WITH TISSUES Visualizing outcomes is important to patients, however, it’s important to remember that surgeons must work with the patient’s individual body shape. “The biggest indication to the outcome is what the individual patient breasts look like before,” says Bengtson. In the past, looking at other patient’s before and after photos never factored in the patient’s own body. “Life is all about expectations,” reminds Bengtson. “So the closer you can get to the actual expectation of not only size and look, but recovery and outcome, the better.” Dr. Bengtson hasn’t done a single revision due to size exchange in the last 600 breast augmentation surgeries he has performed. Historically, size exchange is the number one reason for re-operation in breast augmentation patients. He attributes this lack of need for size change to the virtues of 3D imaging and its ability to help patients visualize their results.

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BREAST

hen it comes to new techniques, double board certified plastic surgeon Dr. Peter Fodor is at the forefront. One of his areas of expertise is achieving younger looking breasts with minimal downtime through a procedure called Lipoplasty Only Breast Reduction (LOBR).

“The secret ingredient to lifting the breast, is not lifting the breast at all.”

WHAT IS LOBR? “The secret ingredient to lifting the breast, is not lifting the breast at all,” says Dr. Fodor. “In the right patient, Lipoplasty Only Breast Reduction (LOBR) works by removing the fatty portion of the breast specific to liposuction. As the skin shrinks during recovery, the nipples are automatically lifted to an aesthetically pleasing position, without any skin removal.” Weight gain, pregnancy and aging all take a toll on a woman’s body. Dr. Fodor seeks to provide his patients with less invasive options for a more youthful appearing chest. “It’s truly an underutilized technique with a very high satisfaction rate,” says Fodor. “There’s rapid recovery, virtually undetectable scars and no sensory changes.” LOBR serves especially well for an older patient group, many of whom may have health or recovery concerns.

YOUNGER

LOOKING BREASTS WITH NO DOWN TIME An Interview with Peter B. Fodor, MD by THE PSC

HOW MUCH FAT IS IN THE BREAST? A mammogram accurately reveals the fatty tissue composition of a patient’s breast, which allows the surgeon to determine if she is a good candidate for LOBR. In younger women, a breast ultrasound examination may be used for the same purpose. In general, most patients have at least 50% to 80% fat composition in their breasts. “This means we can reduce the size of the breast by at least 50%,” says Dr. Fodor. “The result of the fat removal becomes even more noticeable because of the simultaneous lifting effect. The well-hidden and small resulting scar is located in the tiny fold under the breast.” The procedure leaves the body’s framework of an internal brassiere intact, delaying the development of breast sagging in the years to come. It is important to only have this procedure done by an experienced, artistic and qualified surgeon, as suctioning with abandon can easily create a breast deformity.

DOES LOBR WORK FOR EVERYONE? “Yes,” if they are the right candidate, says Dr. Fodor, “Even if there is diminished skin elasticity, LOBR can reduce breast size with a limited lifting effect.” If a secondary procedure is done, the subsequent breast reduction or lift will result in shorter scars, because the breasts are smaller, ultimately helping the patient feel more comfortable and confident, while appearing natural.

14 THEPLASTICSURGERYCHANNEL.COM

“Today’s implants and technology are much more advanced than the implants that were available ten or twenty years ago.”

T IME TO REVISE An Interview with Shaun Parson, MD by THE PSC

ou had your breasts done, and you were thrilled with the results. You’re not alone, most women who have their breasts enhanced are extremely happy with their augmentation. In fact, according to a study by the American Society of Plastic Surgeons, 98% of women say breast augmentation surgery met or exceeded their expectations.

common with breast augmentation surgery, they can sometimes cause physical discomfort and pain, which can often be corrected through revision surgery. “It’s always fixable,” says Parson. “We want to be sure the woman does not have false expectations, but you can always improve on things.”

WHEN IS BREAST REVISION SURGERY NEEDED?

If your initial augmentation was years ago, you may be pleasantly surprised at how much times have changed. Technology and research have improved almost all areas of surgery, including changes that make breast surgery recovery very easy. Depending on the extent of surgery being done at the time of revision, most augmentation revision patients that have their surgery done on a Friday can be back to work by Monday.

RECOVERY TIME

Even if your breast implant surgery was perfectly planned and beautifully executed, changes happen over time that may require revision. As part of the normal aging process, you may notice changes in your breasts. Skin that was tight begins to sag and gravity takes its toll. Sometimes these changes are exaggerated as a result of pregnancy and breastfeeding. Dr. Shaun Parson of Scottsdale, Arizona sees many breast augmentation patients struggling with the changes that have developed since they first underwent breast augmentation. “Implants have a lifespan and eventually need to be removed or replaced,” says Dr. Parson. “A lot of the time, during your initial breast augmentation consult, surgeons won’t tell you this, but it’s true.”

HOW LONG WILL THE NEW IMPLANTS LAST? Today’s implants and technology are much more advanced than the implants that were available ten or twenty years ago. This means that the implants put in during your revision will last longer and feel more natural than the implants put in a decade or two ago.

Revision surgery is also used to correct problems that resulted from an initial surgery. Although complications are not 15

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BREAST

THEIN POPULARITY BREAST LIFT BOOMS B

An Interview with Simeon Wall Jr., MD by THE PSC

reast surgery is a big decision. It can involve implants, liposuction, fat transfer or even a lift. With the latest techniques, scarring can be minimized and virtually unnoticeable. The Wall Center in Shreveport, Louisiana encourages patients to consider all of their options prior to deciding on a procedure. “Many times women will come into our practice and take a strong stance against having a ‘lift’,” says Dr. Simeon Wall, Jr. “You may be concerned about a long recovery, however a breast lift doesn’t add much if any downtime; you can be active in a day or two.”

“The procedure outpaces implants by two to one.” “We really want to create long lasting results,” says Dr. Wall. “At our practice, combining a lift with an augmentation often reduces the need for revision surgery later on.”

HOW NOTICEABLE ARE THE SCARS? “Scarring has decreased so much in the past few years,” says Dr. Wall. “Scars are barely visible nine months after surgery.”

BREAST LIFT COMBINED WITH IMPLANT New statistics from the American Society of Plastic Surgeons (ASPS) show a 70% increase in breast lifts since the year 2000. The procedure outpaces implants by two to one. A breast lift, also known as a mastopexy, raises the breasts by removing excess skin, which tightens the surrounding tissue to reshape and support the new breast contour.

A ‘short scar’ breast lift technique, also called the vertical or lollipop lift, is often used. For this procedure, the incision is made around the areola and then straight down to the breast crease. This technique, with an exceptionally skilled surgeon, eliminates the scar that runs along the breast crease, and provides a more enhanced breast shape.

While a breast lift can help defy the signs of gravity, it doesn’t add volume. A breast lift combined with a breast augmentation adds volume while improving the shape, creating the most significant change in appearance.

WHEN CAN I GO BACK TO WORK? Recovery is on a case-by-case basis. Many patients return to office jobs within a few days of breast surgery. Those who need to do heavy lifting may require a bit more time off. It’s always best to consult with a board certified plastic surgeon for an accurate assessment and expectations specific to your surgery.

A woman’s breasts changes over time due to a variety of reasons including pregnancy, breastfeeding, weight fluctuations, aging and gravity. 16

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B ETTER BREASTS THE SECOND TIME AROUND

“The science of plastic surgery evolves over time, yet the human variable persists.”

An Interview with Louis P. Bucky, MD by THE PSC

“B

Alternatively, a patient’s surgery may have produced the expected result, and the patient may have been initially satisfied with the outcome. As the body continues to change over time, the patient may return to their surgeon to discuss a revision. Dr. Bucky says, “Revision patients in this category are often seen a decade or more after the original procedure. As the science and techniques in plastic surgery advance over time, these patients are re-entering the surgical discussion at a time when surgeons have better options and choices to offer their patients.”

alancing a patient’s wishes with reality is often the key to a successful primary breast surgery,” says Dr. Louis Bucky, a plastic surgeon in Philadelphia who specializes in breast surgery revisions. When it comes to revisions, he explains that most revision cases he sees fall in one of two categories: patients are either unhappy with the first attempt at augmentation, or, in other cases, it is simply time that brings revision patients into his office.

REASONS FOR REVISION “Even with the best patient education and surgical planning, surgery does not always produce the expected result,” says Dr. Bucky. The science of plastic surgery evolves over time, yet the human variable persists. Each body is unique and comes with its own challenges, some of which can’t be seen in a mirror. The surgeon will recognize those challenges and account for them in the operating room. The patient’s responsibility is to be reasonable and honest with their expectations. In those instances where expectations were not met, the possibility for revision surgery is discussed. Patients may return to the original surgeon or they may look for another. Surgeons recommend returning to the original surgeon for the revision, as they will be the one with the most intimate knowledge of what went on in the surgery and which revision technique is the best option.

These secondary augmentation patients may need to address with their surgeon how time and gravity have affected their skin envelopes. Often a breast revision will require not just new implants, but also a breast lift.

THE NEW REVISION Surgical techniques, device options and consultation methods have all improved over time. Many patients who have lived with heavy saline implants are returning a decade later to find lighter silicone implants. Also available to surgeons is a technique called Simultaneous Implant Exchange for Fat (SIEF). In this scenario, a surgeon combines the use of implants with the use of a patient’s own fat cells for a natural result. If the surgeon determines the patient has appropriate fat donor areas on their body, this may be a great option. Dr. Bucky uses measurements and 3D imaging to evaluate patients and best plan their unique revision. “With considerable advances in both surgical techniques, implants and fat grafting technology, much can be done today to assist patients in getting better breast results.” says Dr. Bucky.

Some patients will elect to find another surgeon. “This is a choice that shouldn’t be made lightly,” states Dr. Bucky. “The new surgeon will be a new face in an old scene and it’s important for breast revision surgery that any surgeon selected is board certified and specializes in breast surgery revisions.” 17

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BEAUTIFUL IMPERFECTION An Interview with Caroline Glicksman, MD by THE PSC

SHAPED IMPLANTS: NEW TOOLS FOR THE CORRECTION OF ASYMMETRICAL BREASTS

Where before there were only a few implant options for the widely varied physical make-up of women, modern breast augmentation provides many tools for surgeons to more precisely achieve patient goals. “For over a decade, my patients had to enroll in clinical trials to get these shaped implants. Today we have implants available where we can vary the width of the implant, and the projection, and the height, all independently,” says Dr. Glicksman. “What you put in on the right side doesn’t have to match what you put in on the left side. For years we had only round implants; you could create two different cup sizes, but you couldn’t fine-tune where you needed to add the gel. With the new implants, you can have a little more height on one side, more projection on the other side, and we’re finally able to really get better symmetry.”

aving perfectly symmetrical breasts is a rare thing. In an interview with Dr. Caroline Glicksman, a board certified plastic surgeon in New Jersey, she says, “For almost all women, their right breast and left breast aren’t exact. For the majority of women, the difference between the breasts is slight and chalked up as beautiful imperfection. For some women, however, the difference can be major, and it can be the root cause of self-esteem issues and problems with interpersonal relationships.” Dr. Glicksman has been using shaped, highly cohesive breast implants, with their varying dimensions, as a solution for such asymmetries in her practice since 2004.

DEALING WITH BREAST ABNORMALITIES Growing into adulthood with two different shaped or sized breasts is one disappointment; growing up with a chest wall deformity that further highlights the difference between your breasts is even worse. “We can now treat both simultaneously with shaped, highly cohesive gel breast implants, something we could rarely do in a single operation with round gel implants,” says Dr. Glicksman.

FINDING AN EXPERIENCED PLASTIC SURGEON While the options of available breast implants for surgeons has increased, so has the availability of information for patients. Armed with the Internet, curious women can research the devices and techniques available to them to fix their issues. Taking that information and seeking out a consultation with an experienced surgeon goes a long way in having a breast augmentation done correctly in an individualized way.

Some women are extremely self-conscious of their chest and often have complicated breast asymmetries, as well as chest wall deformities. It’s something that they’ve lived with and tried to hide since adolescence. “A lot of these young women have an associated scoliosis and one side of their chest may be more projecting than the other side. They can also have associated volume differences between the breasts, often more than one cup size apart.” You add all of these abnormalities together and you have young women with very poor self-esteem. “Often it takes great courage for these girls to bring up their concerns with their parents and family doctors,” says Dr. Glicksman.

Getting it right the first time is an important goal for an educated patient to have, “Women seeking correction of significant breast and chest wall asymmetries are becoming more Internet savvy and searching for an answer in the form of a single-stage solution,” says Dr. Glicksman. “With these shaped implants, that’s what we’re able to give them.” 18

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reast reduction is one of the most frequently performed procedures and has one of the highest rates of patient satisfaction. “The impact of breast reduction surgery on the quality of women’s lives is undeniable,” says Dr. Mark S. Elliott of Meridian Plastic Surgery in Mississippi.

“Breast reduction surgery is an operation that truly improves the quality of life and patients are always so glad they had it done.”

The women that walk through Dr. Elliott’s door looking for breast reductions have reached a point in their lives where they have become limited in what they can do. “Generally, women come to the office with complaints of neck pain, back pain and shoulder pain. If it’s a young person, it might be that they’re having a hard time participating in sports. As people get older it probably has something to do with their job; they can’t do their job, or by the end of the day their neck and shoulders are so sore they can have trouble sleeping at night. Some women even get numbness and tingling in their hands.”

NOT A COOKIE-CUTTER PROCEDURE There are a number of solutions available. Typically, younger women tend to respond well to excisions of tissue while older women may be better suited to liposuction. Often, women can require some delicate combination of these two techniques. Every woman is different and should undergo an exam and consultation with a board certified plastic surgeon before making plans.

WHEN TO CONSIDER BREAST REDUCTION There are several indications that you may be a good candidate for breast reduction surgery. Perhaps your breasts are extremely large and create neck, back and shoulder pain. Your breasts may feel very heavy and your nipples may point downward, or one breast may be significantly larger than the other.

WILL INSURANCE COVER THE PROCEDURE? Dr. Elliott says, “You shouldn’t do this for cosmetic reasons. You should do it to relieve your symptoms.” A majority of his patients are seeking serious health solutions and 90% of the breast reductions that he does are pre-certified and covered by insurance. Dr. Elliott has treated hundreds of satisfied breast reduction patients. “From the experience of seeing how women respond, breast reduction surgery is an operation that truly improves the quality of life and patients are always so glad they had it done.”

T AKINGTHE WEIGHT OFF YOUR SHOULDERS

An Interview with Mark S. Elliott, MD by THE PSC 19 THEPLASTICSURGERYCHANNEL.COM

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R ECONSTRUCTING BEAUTIFUL BREASTS AFTER CANCER

An Interview with Robert T. Grant, MD by THE PSC

breast cancer diagnosis is devastating. With medical advances and early diagnosis, even a bad situation can be manageable. “Plastic surgery is about quality of life,” says Dr. Grant. “It’s about a woman’s overall health and well-being. I partner with each and every one of my patients to identify and reach that balance of inner and outer beauty and to maintain that balance through every life stage.”

Every patient is unique, and that applies to the chest. The new shaped implants can help patients achieve naturally shaped breasts and achieve balanced breasts when the two sides may start out very different. Having many shapes and size options available is especially helpful for a post-mastectomy situation.

INTERNAL BRA

SOFTER SIDE OF CANCER DIAGNOSIS “Optimally, we hope you would never need to have an operation,” says Grant, “but the good news is that there are situations where we can enhance the way you look and feel, once you’ve gone through the reconstructive process of a double mastectomy.” You could consider this to be a silver lining of sorts. “A woman in her 30’s or 40’s who learns she has breast cancer may have noticed some droopiness from aging or breast feeding prior to the medical diagnosis,” says Grant. “And now, after the reconstructive process, beautiful cosmetic augmentation can improve the appearance of her breasts. This is truly an opportunity to make the best out of a bad situation.”

GAME-CHANGING ADVANCES IN IMPLANTS “New and improved styles of implants make it possible to individualize the procedure to the patient,” says Dr. Grant.

Engineered materials used during surgery give plastic surgeons another tool to help create internal support, sometimes referred to as an internal bra. The support these materials provide is a huge advantage in breast reconstruction, where the weight of the implants needs support if much of the natural supporting tissue has been removed.

FAT GRAFTING Areas the implant can’t fill may be noticeable and thin skin can contribute to an unnatural look and feel of a reconstructed breast. By utilizing fat grafting, surgeons can remove a patient’s fat from elsewhere on the body and use it to improve the problem areas during breast reconstruction. This seemingly small injection can make a huge impact on the breast’s shape and feel. Plastic surgeons today use all of the scientific advances available for breast reconstruction surgery to provide a patient who has undergone a mastectomy a new outlook on life and the best quality of life possible.

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DISTURBING DIAGNOSIS, POSITIVE OUTCOME

“Often we’re able to put an implant in at the time of the mastectomy.”

An Interview with David A. Lickstein, MD by THE PSC One of the most common requests heard by Dr. Lickstein is a woman’s desire to regain a sense of wholeness after a mastectomy or lumpectomy. While breast reconstruction is not a simple procedure, it can achieve beautiful, symmetrical, and enduring results with the potential to not only restore and uplift, but also empower the patient.

t’s the medical diagnosis everyone dreads: a potentially deadly disease has invaded your body. Maybe it’s your mother, sister or a beloved friend who has just received the bad news. When you learn about breast cancer, it can set you back in many ways - physically, emotionally and psychologically. Even with the best support network, the news that you may need a mastectomy is difficult to comprehend.

SAVING THE NIPPLE

In many situations, there can be a positive outcome, especially if you have a great medical team fighting along with you. Together you can rebuild what is surgically taken away.

There are a range of procedures that work together to rebuild the breasts. Dr. Lickstein uses the patient’s healthy body tissue, fat grafting, breast implants or a combination of treatments and devices. By utilizing advanced surgical techniques and innovative technologies, Dr. Lickstein can restore the breasts with some of the most natural-looking results possible. And yes, in some cases, that can mean saving the nipple. In a nipple-sparing mastectomy or areola-sparing mastectomy, the nipple and/or areola are left in place while the breast tissue under them is removed.

The surgical techniques used during a single stage mastectomy have come a long way in the past few years. A single stage mastectomy involves having the breasts removed and the implants inserted at the same time. This one step surgery can produce stunning results. “Often we’re able to put an implant in at the time of the mastectomy,” says Dr. Lickstein. “Our patients open their eyes after surgery and know the reconstruction is completed, with the added bonus of beautiful breasts. In the right cases, these results are better than the woman’s appearance before mastectomy.”

CONSULTATION Dr. Lickstein says, “The consultation with a physician offers the potential patient an opportunity to ask questions that are weighing heavy on their minds, such as, how do you know which implant is right for me? How will I feel when I wake up? What is the recovery like? What are my restrictions following this single stage procedure? What do the patients look like before and after? How do we deal with my insurance company? Is the surgeon board certified by the American Board of Plastic Surgery? How many years of experience does he have performing a single stage mastectomy? It is an opportunity to build confidence in both your treatment plan and in your surgeon.”

GUMMY BEAR IMPLANTS There are many tools and techniques available to recreate the breasts. Dr. Lickstein was one of the first plastic surgeons regionally to use Allergan’s new “gummy bear” implant as part of a single-stage reconstruction. He has become a key opinion leader on the procedure. Each individual’s unique circumstances and goals determine which approach and device provide the greatest opportunity for success. 21

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A TALE OF TWO SURGERIES An Interview with Patricia A. McGuire, MD by THE PSC

“What women need to hear is that pregnancy isn’t the end for their bodies. They don’t need to give up on their breasts; there are options.”

he joy of motherhood eclipses the concern women might have with their breasts following pregnancy. Loose skin and deflation can trample a mother’s self-confidence, motivating women to keep their chests hidden. “What women need to hear is that pregnancy isn’t the end for their bodies. They don’t need to give up on their breasts; there are options,” says Dr. Patricia McGuire, a board certified plastic surgeon in St. Louis. Dr. McGuire commits a large portion of her practice to rejuvenating patients following pregnancy and massive weight-loss, utilizing two separate surgeries to return a woman’s breasts back to where they once were.

BEST CANDIDATES “Childbirth keeps me in business,” says Dr. McGuire. “Pregnancy stretches the skin; sometimes we can simply give it a lift, but other times women benefit from an implant as well.” Weight loss patients are also often ideal candidates for a twostage mastopexy. Before surgery, you should be at or near your ideal weight. Eating a balanced, healthy diet, and having a relatively active lifestyle before surgery will also help to reduce any possible risks. Non-smokers have fewer complications after mastopexy. If you are a smoker you will be expected to quit smoking for several weeks before and after the procedure to reduce your risks of complications.

TWO-STAGE MASTOPEXY: ADVANTAGES We would all like a quick solution and to be able to limit the number of surgical procedures as much as possible. For the best results, however, many board certified plastic surgeons suggest having a breast lift and a breast augmentation performed separately. “A lot of patients are resistant to two procedures,” says Dr. McGuire. “But when I show them the beautiful results, they understand. I just want them to look good; and look good for a long time!” McGuire says there are many possible advantages to a twostage mastopexy. The scars may be less noticeable, the surgeon may have better control of nipple position and the patient has the opportunity to decide if a breast lift alone is enough change for them.

PAIN & RECOVERY Another positive aspect of having two procedures is that a breast lift alone is far less uncomfortable than most cosmetic surgeries since it is basically only a skin operation. “The lift isn’t that difficult,” says Dr. McGuire. “When we perform a lift, without an implant, our patients can have the procedure done on Thursday and be back to work on Monday.” 22

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TOP FIVE THINGS YOU NEED TO KNOW

#2 - WHAT BREAST IMPLANT SIZE IS BEST FOR ME?

If you polled most women considering breast augmentation, their goal wouldn’t be to stand out from the crowd. Experts say the desired result, for most, is to look better in a bathing suit and to fit most types of clothing with ease. “Most women don’t want everyone to know they have had augmentation. They just have a goal to look better in what they wear.” To help a woman decide what implant size is best, Dr. Snyder uses devices called, “sizers” and sports bras. “I have them sit in front of a mirror with this new look on and see how it looks. They might even bring in a girlfriend or a spouse to see if someone else likes the size on them.” Dr. Snyder says a photo is always helpful. “A picture can work great because that gives me an idea of what they want to look like. It is a starting point.”

#3 - WHO IS THE BEST CANDIDATE FOR A BREAST AUGMENTATION?

An Interview with Ned Snyder IV, MD by THE PSC

Women of all ages, shapes and sizes are seeking breast augmentations and experts say there are good candidates from nearly all walks of life. “Some are younger, like the 22-year old woman who has never been pregnant and just wants to look better in a bathing suit,” says Dr. Snyder. He says the majority of his clients are women who are a bit older, who are done having children. “They are past the pregnancy years. The childbirth has really taken a toll on their body and often the breast has deflated. They would like to get it fixed.” For these women, the breast augmentation might be a stand-alone procedure or part of a bigger Mommy Makeover, involving several procedures like a tummy tuck and liposuction.

f you gathered 25 women in a room, you might be surprised at how many of them have had breast implant surgery. It isn’t just for Hollywood starlets and top models. The neighbor next door may be part of a growing number of women who want to feel better about their look. More than 300,000 breast augmentation surgeries are performed in the United States and the numbers continue to climb each year. Still, women have questions about what to expect before and after the operation, along with concerns about size and shape. Dr. Ned Snyder of Austin, Texas guides us through the process, describing the top five things you need to know before a breast augmentation.

#4 - WHAT CAN I EXPECT DURING THE BREAST SURGERY?

You can expect relatively little downtime with breast augmentation. “Breast augmentation is a simple procedure. It takes about an hour or so and usually the patient goes home the same day,” says Dr. Snyder. The patient can be back to normal activities in 3-5 days, according to experts. More strenuous workouts, like jogging, could take longer to resume. New, long-acting pain medications injected into the muscle during the procedure help patients recover with greater ease.

#1 - WHICH TYPE OF BREAST IMPLANT IS BEST FOR ME? Women want to feel beautiful inside and out. To achieve that confidence, they are turning to breast augmentation, says Dr. Ned Snyder. “Breast augmentation is one of the top consultations that we see in our office. Women want to feel good in their clothes and boost their confidence in the workplace.” Once a woman has decided on breast augmentation, often her first question is about which breast implant is the best choice. Dr. Snyder explains the difference between the options available, but says he uses primarily round silicone gel implants. “There are saline, which are really just a bag of water and there are silicone gel implants. If someone has almost no breast tissue, there may be an advantage to putting in something that is shaped and has a natural feel, but if someone just wants to go up a cup size, it may be less important what it is shaped like.

#5 - WILL THERE BE A LOT OF DOWN TIME? WILL I HAVE TO MISS WORK OR SCHOOL?

“It really isn’t a lot of downtime and most women say they wished they hadn’t waited so long.” Women don’t have to feel embarrassed about wanting a new look. Insecurities or body image worries can be swept away for good. “If we do the procedure on Thursday, most people can be back to work by Monday or Wednesday at the latest. Our patients are usually feeling fairly good within a few days,” says Dr. Snyder. “Many times it is just about getting your body back to a place where it once was, where you feel better”. 23

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BREAST

An Interview with Kevin L. Smith, MD by THE PSC

DLIFT O I NEED A BREAST OR IMPLANTS? M

on the apex of the breast mound, just as the breast peaks,” says Dr. Smith. “As far as where the nipple areola complex belongs, it really depends on where it is in relation to the fold underneath the breast. If the nipple is above the fold, rarely do you need a lift. If the nipple is below the fold, more often than not you’ll need a lift.”

any women undergo major physical changes after pregnancy, specifically with their breasts. Hormonal changes, breast feeding and changing breast size before pregnancy and after can lead to deflation of the breasts and possibly a loss of volume. When considering surgical rejuvenation, the question becomes: do you need a breast lift, implants or a combination of both? Dr. Kevin Smith of Charlotte, North Carolina discusses the signs that can help you answer that question.

THE CONSULTATION IS IMPORTANT While you can guess at what you need to restore your breasts, a consultation with a board certified plastic surgeon will give you the most reliable information to help plan your surgery. “So many moms come in and say, ‘You know, my kids sucked the life out of these. I just want my old breasts back,’” says Dr. Smith. “Using our Vectra® 3D imaging device, it gives us a good idea of where you are and where you’d like your breasts to be.” By utilizing 3D imaging, Vectra can morph your breasts into a 3D image for you and your physician to study and discuss. The software can also add volume, simulating different sizes and shapes of implants, and give you an accurate view of what your results may be.

HOW TO TELL... AT HOME When contemplating whether or not you should look into breast surgery, there are a few questions you can ask yourself, to determine what it is you might need. “It really depends on whether or not you like your volume,” says Dr. Smith. “If your breasts are large enough, just not in the right place, then that means you may need a lift. If your breasts are not in the right place and you want to be bigger, that means you may need an augment and a lift. Finally, if your breasts have a nice shape but just have insufficient volume, and your nipple areola complex is in the right position, then all you need is an implant.”

“Breast surgery is all about elegance and subtlety,” says Dr. Smith. “That perfect size to me is when a woman feels a little bit big in a bikini top, and small when she’s dressed up. Ultimately, it all depends on if you like your volume, and whether you feel that your breasts are droopy or not. That’s how we always begin the process to restore your breasts back to where they used to be, which usually corresponds with a restoration of confidence.”

THE NIPPLE AREOLA COMPLEX: POSITION MATTERS While it’s easy to tell if you’re lacking volume or not, the lift question may be a bit trickier to answer. An attractive looking breast has a distinct location where the nipple and areola complex resides. “An attractive breast should have the nipple 24

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“We use our patients ‘own’ native breast tissue which allows us to implant a smaller implant, providing a more natural look.”

eing dissatisfied with your breast can be a combination of multiple issues, yet the solution can sometimes end up being quite simple. Dr. Daniel Maman at 740 Park Plastic Surgery in Manhattan helps many women lift and reshape their breasts. Here he defines what a lift and augmentation can accomplish and explains when and why a single surgery should be considered.

AUGMENTATION-MASTOPEXY DEFINED One procedure that combines a breast augmentation with a breast lift is called an augmentation-mastopexy. Dr. Maman removes saggy, excess skin, making the breast skin envelope smaller and perkier. Once lifted, he augments the breast with an appropriately sized breast implant to provide fullness in all the right places. “One of the beauties of this combined treatment plan is that we use our patients ‘own’ native breast tissue which allows us to implant a smaller implant, providing a more natural look,” says Maman. Because it is a challenging operation that combines what was originally two separate surgeries, patients should select a surgeon who is experienced with this procedure. “We do a lot of these procedures. Often women may think they need just a lift, or just an implant,” says Maman. By using 3D imaging, he is able to simulate the results of both the lift and the augmentation, showing the patient the combined results. “These patients are ecstatic with these results. Women are much happier with having both procedures done in the same surgery. Doing one procedure alone would not have given them as great a result.”

HOW LONG IS THE RECOVERY? Most patients return to work within about a week, allowing two to three weeks for a full recovery. “Since we’re combining the two operations, it may seem like there would be a longer recovery, however, the patient actually has the same recovery as you’d have with an augmentation or mastopexy alone; it’s remarkable.” 25 THEPLASTICSURGERYCHANNEL.COM

A LL IN ONE

BREAST SURGERY An Interview with Daniel Y. Maman, MD by THE PSC

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S EASONS OF CHANGE: ARE YOUR IMPLANTS READY?

An Interview with Mary Gingrass, MD and Melinda Haws, MD by THE PSC

ife’s biggest challenges often include change. No matter how exciting or difficult the transition, we all enter decades of our life where we may want things to feel and appear a little bit different. For some women, that can mean a new breast size through augmentation, a breast lift or even implant removal. We caught up with Plastic Surgery Center of Nashville surgeons, Dr. Mary Gingrass and Dr. Melinda Haws, who help women of all ages achieve their desired look, regardless of age or season in life.

I WANT A MORE NATURAL LOOK What a patient may have desired in her 20’s and 30’s may not be what she still desires in her older years. Decreasing size, or simply opting for a more natural look will often make patients feel their appearance is more age-appropriate. At the time of implant removal surgery, depending upon the amount of a patient’s natural breast tissue, they may or may not need a breast lift, also known as a mastopexy. This procedure brings the breasts back up to a youthful position, dialing back the wear and tear done by breastfeeding and gravity.

REASONS FOR IMPLANT REMOVAL What may have been a wonderful size in the beginning may be a much different story for a woman in her 40’s or 50’s. “A lot of our patients say, ‘These implants were great at one time, and now I’m not so sure I want them,’” says Dr. Gingrass. “They might want them removed along with a breast lift.”

AGING IMPLANTS Implants have been around since the 1960’s. Some women have had their implants for more than 20-30 years and their bodies have gone through significant changes. “New technology, whether it be 3D imaging or newer implants and more precise surgical procedures, all offer the best atmosphere to have breast surgery,” states Dr. Haws. “Most of these women relate a relatively happy relationship with their implants when they were younger and thinner,” says Dr. Gingrass. “Now they feel the added breast size makes them look ‘thick’ and no longer accentuates their figure.”

Many changes can occur over time that have a significant impact on an augmentation. “We do revisions all the time to make sure our patient’s implants match the stage in their life,” says Dr. Haws.

BODY CHANGES AFTER CHILDREN After child bearing and breastfeeding, breasts can deflate making the appearance of an augmentation appear different than it did pre-baby. Childbirth, the aging process, gaining/ losing weight, and the ever-present effects of gravity can all make implants appear less desirable than they used to. 26

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hen a patient receives the tragic news of cancer, protocols are immediately put into place. However, even following cancer recovery, there can be unforeseen post-traumatic medical problems. In the hands of plastic surgeon Dr. Robert Whitfield and his partner Dr. Ned Snyder of Breast and Body Center of Austin, patients who are coping with lymphedema are treated with the latest instruments and technology available.

LYMPHEDEMA

WHAT IS LYMPHEDEMA?

Lymphedema refers to swelling that generally occurs in one of your arms or legs. In some cases, there is swelling in both. The condition most commonly develops after the removal of, or damage to lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. “Lymphedema is incredibly debilitating, and we’re seeing this condition a lot from breast cancer patients treated in the 90’s,” says Dr. Whitfield. “The arm becomes heavy, with fat and fluid building up. It can add five to ten pounds to a person’s limb, making it a huge burden for the patient.” Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes, infection-fighting cells that live in your lymph nodes, and are ultimately flushed from your body.

TREATMENT FOLLOWING BREAST CANCER An Interview with Robert Whitfield, MD by THE PSC

LYMPHATIC SURGERY “The first step is to seek treatment. In many instances, early and aggressive lymphatic massage can control the edema. If it doesn’t, we have the instruments and microscope to perform the surgery. We now have one of the few microscopes in the United States called the Mitaka®. This high-resolution microscope allows you to operate on structures less than 1mm. It has 42X magnification, with 8:1 zoom. Patient selection is still key. The best candidates are those who we can perform a DIEP flap reconstruction on, as well as lymph node transfer and lymphaticovenous bypass.” Whitfield goes on to explain, “Once you’ve been evaluated for surgery and considered compliant, it can make a huge difference in your overall lifestyle and that’s our ultimate goal.”

TRADITIONAL VS. MODERN TREATMENT Typical treatment has always been massage, compression garments and sleeves. While there is no cure, standard care for lymphedema includes physical therapy to decrease pain and improve mobility as well as the use of pressure garments to keep lymph fluid moving. New developments include a product called Flexitouch®. “It’s remarkable, we are now at a point where we zoom in to connect lymphatic vessels, and ultimately drain fluid, decreasing swelling in the hand,” says Whitfield. 27

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Mini vs. Full Tummy Tuck Interview with Tiffany McCormack, MD

Improvement All the Way Around Interview with Mark D. Epstein, MD

Arm Lift: A Life Changing Procedure Interview with J. Peter Rubin, MD

Sculpting a Beautiful Bottom Interview with Peter B. Fodor, MD

Body Contouring after Weight Loss Interview with Brian Brzowski, MD

The Tummy Tuck Designed for You Interview with David A. Lickstein, MD

Say Goodbye to Sagging Skin Interview with J. Peter Rubin, MD

A Better Butt with Your Own Fat Interview with Bruce W. Van Natta, MD

New Options for a Flatter Stomach Interview with Caroline Glicksman, MD

Moms, We’ve Got This Interview with Camille Cash, MD

Delete Fat and Drop a Decade Interview with James D. Namnoum, MD

Baby’s Got Back Interview with Richard J. Zienowicz, MD

Look Sexy After Babies Interview with Laurie A. Casas, MD

A Tighter Tummy after Kids Interview with Mark A. Pinsky, MD

Tired of Fat That’s Impossible to Lose? Interview with Stafford R. Broumand, MD

Sculpting Your Waist Interview with Daniel Y. Maman, MD

The Ultimate Mommy Makeover Interview with Richard J. Zienowicz, MD

ThermiVA: A Very Private Makeover Interview with Camille Cash, MD

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BODY

SURGERY, LIPOSUCTION, FAT TRANSFER

BODY

INI VS. FULL TUMMY TUCK An Interview with Tiffany McCormack, MD by THE PSC

If you only have a small amount of excess skin and it is below your belly button, you may be a candidate for the mini tummy tuck. A smaller incision is used for a mini tummy tuck, and the recovery period is slightly shorter.

ummy tuck surgery, technically termed abdominoplasty, is a great option when you have loose skin, loose muscles and some extra fat in your midsection. “Tummy tucks are one of my favorite procedures, mostly because there’s such an immediate gratification,” says Dr. Tiffany McCormack, board certified plastic surgeon in Reno, Nevada. “It’s not like liposuction where you have to wait for the swelling to go down for several weeks.” Both full and mini tummy tucks address the loose skin, loose muscles and stretch marks. “This is a part of a woman’s body that hasn’t gotten better with exercise,” says Dr. McCormack. “All the sit-ups in the world aren’t helping to tighten the muscles that have been stretched. That’s where I come in, and I can tighten those muscles and take away that extra skin and hopefully a lot of those stretch marks too.” Depending on the amount of skin and your muscle laxity below the skin, you may be a candidate for a shorter-scar, shorter recovery surgery called a mini tummy tuck.

TUMMY TUCK SCARS Scarring is a common worry patients have after any surgery, and especially when it involves a scar across your abdomen. Regardless of if the tummy tuck is full or mini, your surgeon can work with you to decide where your scar should fall in order to be concealed by your favorite cut of underwear or your favorite swimsuit. With mini tummy tucks, the shorter incision is typically easier to cover up. Although a scar can be scary, it is often a trade-off that patients don’t mind making for the results they see after the procedure. By resting and limiting the strain on your mid-section, your scar should heal nicely and will become less visible over time. “Patients can see an immediate result when they come in for their first post-operative visit. It’s very rewarding,” says Dr. McCormack.

COMPARING FULL AND MINI TUMMY TUCKS A traditional full tummy tuck reconstructs the entire abdominal region, both above and below the belly button. Often times, liposuction is combined with the procedure to further sculpt the midsection. A mini tummy tuck is considered a less extensive variation of the full abdominoplasty.

WEIGHING YOUR OPTIONS The decision on whether you are a candidate for a mini or a full tummy tuck is one that will be made together with your surgeon during your consultation. 30

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ave you ever listened to your own voice on your voicemail recording and wondered if you really sound like that? What we think we see as the problem when we look in the mirror may not be what a surgeon would see. Dr. Mark Epstein, of Stony Brook, New York, says, “My focus, is not just on the area that is bothering a patient. Typically patients come in complaining about their stomach, but the abdomen blends with the anterior flanks, which is part of the posterior flanks, which then is contiguous with the back and the buttocks. I look at the patient from a 360 degree perspective.”

BREAKING SURGICAL TRADITION Advancements in technology and taking an artistic view of body contouring is a refreshing change from the traditional static approach to changing the torso with an “either - or” mentality. Liposuction and abdominoplasty procedures are staples in the plastic surgery menu of services. Combining them has been done for years; however, with new technology, like VASER® 4D liposuction, and a new surgical vision that seeks to improve total torso definition, the results in body contouring procedures are showing a much more blended, total change.

HOW IT IS DONE “Even though the procedure is quite detailed and extensive, it can be done in one day, within four to six hours depending on the patient,” says Dr. Epstein. The surgery begins with the patient lying face down on the operating table, which allows the surgeon to liposuction the back and upper arms, the flanks, the thighs and to fat graft the buttocks if needed. The patient is then turned over and the suctioning continues on the abdomen. Once the abdomen has been sculpted, the tummy tuck portion of the surgery begins with tightening muscle walls and removing excess skin. Having a sculpted, tailored abdominal area is crucial to being able to achieve a better, more refined shape and result.

TECHNOLOGY AND ART “You want a surgeon who is marrying technology to art. This is medicine and science but we are also looking into the aesthetic proportions, and coming up with an aesthetic plan to rejuvenate the body,” says Epstein. A surgeon must pay attention to the scientific and surgical principals so that the procedure is safe. “The most important factor is safety. The results are secondary.” Recovery from total body contouring has taken a turn towards dramatic improvement with the advent and use of Exparel®, a long lasting, local anesthetic. “Patients wake up with very little pain in the abdomen,” says Dr. Epstein. “We are seeing some very nice results with this approach to body contouring and patient satisfaction has been amazing.”

MPROVEMENT ALL THE WAY AROUND An Interview with Mark D. Epstein, MD by THE PSC

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BODY

RM LIFT: A LIFE CHANGING PROCEDURE

An Interview with J. Peter Rubin, MD by THE PSC

t’s a huggable body part and no one likes the uneasy feeling they get when a friend, colleague or acquaintance notices the loose skin and fat on their arm. Even worse, how does one hide all that loose, excess arm skin when the weather warms and it’s time for short sleeves? Diet and exercise only go so far when it comes to repairing loose skin, whether it’s the result of massive weight loss or simply caused by aging. To remove the excess skin, plastic surgeons can perform a brachioplasty procedure, commonly known as an arm lift. By removing skin from the arm, the area is tightened and patients can feel confident again in short sleeves.

others. Patients whose bodies are now healthier on the inside after massive weight loss want that inner confidence to reflect on their outer appearance.

GOOD CANDIDATES FOR BRACHIOPLASTY

Let’s be honest, there will be a scar, and it can be noticeable in some patients. It is indeed a trade-off, one that patients are more willing to accept now that scar therapies have greatly improved outcomes. With time, the obvious tell-tale signs are limited and within months you’ll be showing off those beautifully contoured arms.

“People are so bothered by their excess skin, no one wants others to feel our fat upon meeting someone, especially for the first time,” says Dr. Rubin. “What we’re noticing is that by removing that skin flab you’ll have a wonderful body image and improved self-esteem, it’s really interesting how this surgery has such a huge impact on people.”

ABOUT THOSE SCARS

“Good candidates for brachioplasty are patients who have excess skin; significant skin that won’t go away,” says Dr. Peter Rubin, a liaison between the American Society of Plastic Surgeons and the American Society of Metabolic and Bariatric Surgeons. He promotes safety and quality standards in plastic surgery after weight loss. “Perhaps you’ve had extensive weight loss, or even the aging patient may be candidates for this procedure.”

Limited scar operations are available, but surgeons are very selective about which patients are good candidates for shorter scars. Typically, those who have minimal fat and minimal skin to remove are the ideal candidates for a minimal scar.

You must be willing to accept a scar, which can be noticeable, in exchange for the improved shape. A scar will appear across or down the rear of the upper arm where the skin is removed. Scar placement varies based on the patient’s desires and the amount of skin to be removed, so it is important to discuss your goals and scar placement options during your consultation. In most people, the scarring fades and improves with time. The scar is a trade-off, one that many patients are willing to make after seeing the incredible results achieved by an accomplished surgeon.

WHEN CAN I GO BACK TO WORK? You can expect to need about two weeks of down time. Most patients are out of the office for ten to fifteen days, and when you return you’re advised to limit heavy lifting for about a month. An arm lift may seem like a drastic option, but board certified plastic surgeons experienced in the procedure can ease the concerns of their patients and safely guide them through the surgical process. With the results that can be achieved and modern therapies to reduce scarring, the final result will seem completely worth it to many. For some, it could even be the final step to getting their physical and mental image in the right place.

AN ARM LIFT CAN BOOST SELF ESTEEM Bingo arms, bat wings, flabby arms. A whole host of playful yet derogatory terms have been used to describe loose arm skin that plagues the aging and those who have defeated obesity. People suffering from loose skin can also suffer from self-confidence issues, often hesitant to reveal their arms to 32

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CULPTING A BEAUTIFUL

BOTTOM

ull, beautiful bottoms are a sign of youth and vitality. Enlargement procedures are becoming increasingly popular. Statistically, the American Society for Aesthetic Plastic Surgery notes that buttock augmentation took one of the top spots recently for the most significant increase in the number of procedures performed, by a whopping 58 percent.

An Interview with Peter B. Fodor, MD by THE PSC

This comes as no surprise to double board certified plastic surgeon, Dr. Peter Fodor, who perfected his technique of buttock augmentation during dozens of teaching trips to Rio de Janeiro and other areas of Brazil. “We’ve seen a significant increase in buttock augmentation in the U.S. It was slow catching on, but that’s no longer the case,” says Dr. Fodor. Celebrities with voluptuous bodies are often attributed with some of the recent buttock enlargement frenzy.

suctioned, leaving a more aesthetically pleasing contour. The fat is appropriately processed and injected into the buttock area, creating a beautiful overall figure.”

CANDIDATES FOR THE PROCEDURE Many patients seek buttock augmentation when their buttocks are too small for their body frame or when the buttock shape is too flat or square and they would like more curves and a more youthful appearance. Weight loss or the aging process may have left the buttocks loose, sagging and or flat.

SCULPTING THE ENTIRE BODY “Not only do we harvest fat to create a full beautiful bottom, we also sculpt the body,” says Dr. Fodor. “It’s a two-for-one procedure. Buttock augmentation gives you curves you never had and makes you feel sexier and more confident in clothing that you were never able to quite fill out.”

FAT IS A GOOD THING

Finding the right balance and ensuring your body is in proportion requires a lot of artistic sense, judgment and finesse. Dr. Fodor says, “When considering the procedure, the best results are from board certified plastic surgeons who are willing to devote ample time to assessing the appropriate hip to waist ratio.”

“When people think about fat, it’s often viewed as an ugly reminder to lose weight,” says Dr. Fodor. “It doesn’t need to be perceived that way. We are now able to harvest fat and successfully attach it to stem cells with a success rate that is phenomenal. Appropriate fat harvesting and the addition of stem cells, also isolated and derived from fat, has led to a phenomenal success rate. As it turns out in my practice, at least 80 percent of the fat transferred survives. What you see at three months is a permanent result,” states Fodor.

HOW A BUTTOCK AUGMENTATION IS PERFORMED Buttock augmentation reshapes and enhances your gluteal area, for an uplifted and shapelier buttock profile. Fat grafting with your own natural fatty tissue is frequently done, and is the preferred method of buttock augmentation at Dr. Fodor’s practice. “We can perform augmentation with an implant, however, the preferable method in my practice is to use a patient’s own tissues (fat) and occasionally combine it with an implant,” says Dr. Fodor. “First, we evaluate where there is sufficient donor fat on the patient. Those areas are then

RECOVERY There is initial swelling and some pain associated with buttock augmentation. This swelling and pain increases with implants, which is another reason Dr. Fodor urges his patients to consider augmenting with their own fat instead of relying on an implant. Most normal activities can be resumed within the first week and on average most people are back to work within a week or ten days. 33

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BODY

ODY CONTOURING AFTER WEIGHT LOSS W

An Interview with Brian Brzowski, MD by THE PSC

hether it’s a bundle of joy, genetics, hormones or poor diet there can reach a time in life where you just want a slim, trim body to emerge. Diet and exercise aren’t the only solutions obese patients utilize to lose weight. Sometimes they are assisted by surgical techniques in bariatric surgery.

Studies have shown that many associated diseases that accompany morbid obesity either improve or completely resolve with the weight loss that follows bariatric surgery. Although the bariatric procedure is able to help the patient move toward their previous weight, patients generally do not fully return to the condition and appearance that they had prior to their weight gain.

Bariatric surgery is a big step. Weight loss is achieved by reducing the size of your stomach with a gastric band or through removal of a portion of your stomach or by resecting and re-routing your small intestine to a small stomach pouch (gastric bypass surgery). Board certified plastic surgeon, Dr. Brian Brzowski of Salt Lake City, Utah, explains how body contouring can be the cherry on top of your bariatric procedure.

A belt lipectomy (often called a lower body lift), thigh and arm lifts, facelifts and breast lifts are commonly done for massive weight loss patients at Dr. Brzowski’s practice. All of these procedures involve some amount of skin removal and lifting of sagging tissues. Where appropriate, the lost volume can be augmented and the muscle layers tightened. The trade-offs for these improvements are the resulting scars and recovery.

WHAT HAPPENS TO YOUR SKIN AFTER BARIATRIC SURGERY? Although the bariatric procedure is able to help the patient move toward a healthy weight, patients are left with extra skin that resulted from the weight gain.

WHAT’S THE END GAME? Contouring the body after massive weight loss comes with the drawbacks of scars, significant recovery and expensive procedures. However, the patient satisfaction which comes with an improved body contour can be completely life altering. In some patients, self-esteem improvement is as noticeable as the physical improvement results of the procedure.

Changes in the skin and soft tissues occur to some extent in nearly every patient. These changes include looseness in the skin of the face, neck, arms, breasts, upper trunk, abdomen, buttocks and thighs. It’s not unusual for skin to remain stretched after a deflation in the fat volume of these areas, particularly in the breast and buttocks.

CREDENTIALS Do your homework, as always. Is your surgeon board certified? Do they have extensive experience with surgery performed for weight loss patients? These are questions you should have resolved prior to any surgical procedure.

“Once my patient has gone through weight loss, and attained a look to restore their body image, the next step of contouring allows them to see such a stunning result, they have a much stronger desire to KEEP the weight off,” says Dr. Brzowski. “The bottom line: we see a lot of success with the patients who opt for body contouring.” 34

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s women go through pregnancy, their bodies will no doubt go through quite a few changes. Once their families are complete, they often look at their bodies and see the physical toll pregnancy has taken. It’s common to have everything from loose skin to stretch marks. Plastic surgeons can now utilize new tools and science to tailor or individualize tummy tuck procedures for their patients, resulting in better outcomes. There are new options that don’t involve surgery for those women who do not want a surgical procedure and the recovery time. Dr. David Lickstein of Palm Beach Gardens, Florida explains how spending time with his patients to understand their concerns, helps to create a unique treatment plan to achieve their goals.

COULD I BENEFIT FROM A TUMMY TUCK? Weight gain and weight loss from pregnancy is evident on the body: stretch marks, a loose abdomen and sometimes new fat pockets reveal what the body has endured. Even if you only have one of these issues, there’s no reason to give up on having your pre-pregnancy body back.

T HE TUMMY

“I think the important thing to realize is that the approach is different for each patient,” says Dr. Lickstein. “Some women just have loose skin, some have extra skin and some fat that they haven’t been able to lose, and many have a combination of both.”

TAILORING A TREATMENT PLAN “The first thing is to have a consultation, examine the patient and take a careful look,” says Lickstein. “We have a variety of approaches now that can really be individualized to what a woman wants. Surgical techniques have been refined over the years and medical devices have evolved and improved. If a patient doesn’t have the time for surgery, then we may use CoolSculpting®, which is a non-surgical and non-invasive way to remove fat. It’s done in the office with no recovery. Sometimes liposuction is all they need. But if there’s extra skin, a surgical procedure may be the best modality to remove it.”

TUCK DESIGNED FOR YOU

IF YOU HAVE SURGERY The recovery process may last a few weeks with some discomfort, but modern surgery includes modern medicines that alleviate discomfort more than ever before. “It’s different now because the recovery is much easier with the use of pain pumps,” says Lickstein. “We place stitches in the muscle that create an internal girdle that helps shape the abdomen both vertically and obliquely.”

An Interview with David A. Lickstein, MD by THE PSC

“It’s probably one of the most fulfilling things that we do,” admits Lickstein. “The transformational change in such a brief period of time is incredible.”

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he quest to feel good in one’s own skin isn’t always easy, especially when it comes to the formerly obese. With the success of weight loss programs and bariatric surgery, people are shedding pounds and reclaiming their lives. It’s not enough to just lose the fat. Once the fat is gone, many weight-loss patients are left with sagging skin, most dramatically around the stomach, biceps and thighs, all of which may take a toll on the person’s self-esteem. “It can really help patients feel good about their body image and get rid of that daily reminder of excess skin that they really link to the ‘obese self’ that they once were,” says Peter Rubin, MD, board certified plastic surgeon, a leader in the field of plastic surgery after weight loss.

BODY CONTOURING AND PLASTIC SURGERY AFTER WEIGHT LOSS Fortunately for patients who want to complete their weightloss journey, there is a solution. Plastic surgery after weight loss has been evolving rapidly and offers many procedures to remove excess skin in the areas of the body that are left loose or sagging. Skin removal surgery goes by many different names, determined by the area of the body where the skin is removed. If the extra skin is in the stomach area, it is called an abdominoplasty or tummy tuck. In the arms it is called a brachioplasty or arm lift. Other common areas for skin removal after weight loss include the back, the chest and the thighs. While it may seem like a simple fix, that’s far from the case. Unlike minimally-invasive procedures where surgeons manipulate the gastrointestinal track to help facilitate weight loss, this surgery requires removing the leftover, unwanted skin and tissue. As such, the surgery comes with a few tradeoffs: scarring and recovery time. “We can achieve positive changes in shape and contour in different regions of the body, and patients need to be accepting of scars in exchange for removing and tightening skin. If patients are willing to make this trade, they are likely to be very satisfied with their new body shape,” says Rubin.

“It can really help patients feel good about their body image and get rid of that daily reminder of excess skin.”

AY GOODBYE TO SAGGING SKIN

An Interview with J. Peter Rubin, MD by THE PSC

recovery. For some that may be an option; though it boils down to many factors that need to be discussed with the surgeon, including the patient’s overall health.

“If we’re ever offering more than one procedure at a time, we want to make sure that the patients are very well screened, The location and pattern of scars can vary between patients, have a good medical profile, and understand all the risks and based on their body type, and it may be possible to achieve benefits involved,” says Dr. Rubin. powerful results with shorter scars in some patients. “Shorter scars can be used to correct milder problems with excess INNOVATING NEW PROCEDURES skin, but usually cannot accomplish the goals when the problem with excess skin is more severe,” says Rubin. “We put In order to properly address excess skin in all areas of the the scars in areas where there are normal lines and wrinkles; body, plastic surgeons have innovated new procedures to but the reality of it is, outside of clothing, it’s going to be ob- help patients after weight loss. In particular, Dr. Rubin has advanced new techniques for “upper body lifting” and for vious that you had an operation.” breast lift after weight loss. His “dermal suspension” mastopexy uses the natural tissue layers of the breast to create RECOVERY AND DOWN TIME an internal bra that restores breast shape and holds the new The recovery time is similar to the gastric bypass surgery shape in place. He has lectured widely about this procedure itself, which can range from four to twelve weeks. Patients and published numerous book chapters and scientific articles. may seek to do one area at a time or to combine two proce- Additionally, Dr. Rubin was recognized for this procedure dures at once to reduce the amount of surgeries and time for with the very first “Iron Surgeon” award by the American Society of Plastic Surgeons. 36 THEPLASTICSURGERYCHANNEL.COM

A BETTER BUTT WITH YOUR OWN

FAT

An Interview with Bruce W. Van Natta, MD by THE PSC

first carve out the waist with liposuction,” says Van Natta. “If we need to take some extra from the saddle bag and posterior thigh regions, we do that, too. Instead of throwing the removed fat away, we insert it into the areas of deficiency in the buttock, and create these really cute butts.”

ne of the hottest procedures in cosmetic surgery is fat grafting, which is the removal of fat from one area of the body and reinserting it in another area that is lacking volume. Many fat grafting procedures involve refilling lost volume in the face, supporting breast augmentation and even rejuvenating aging hands. Dr. Bruce Van Natta, a board certified plastic surgeon from Indianapolis, Indiana has found another area of the body that could use some fat: the buttocks. “What I’m noticing more and more is that some ladies have a deficiency in the buttocks,” says Van Natta. “A lot of people complain, ‘My butt is too big,’ but that’s not everybody! There are women who have deficiencies. After I’ve taken fat out from the waist or love handles, we can use that same fat for the buttocks.”

IS IT SAFE? “Using one’s own fat for enhancing buttock volume is very safe. The only previous solution was to use silicone implants to enhance buttock volume. The implants could have multiple problems including discomfort, capsular contracture, palpable edges and extrusion,” notes Van Natta. With fat grafting done by an experienced board certified plastic surgeon, the problems are minimal. “There can be some palpable lumps but these are not usually problematic for the patient. It is normal to lose anywhere from one third to one half of the grafted volume, so to account for this, the area treated is typically overfilled,” says Van Natta. “To date I have found patient satisfaction to be extremely high with this procedure.” It gives the surgeon an additional tool to significantly improve a person’s shape and achieve a beautiful buttock shape through fat grafting.

TAKING FAT FROM HERE AND PUTTING IT BACK THERE The benefits of fat grafting are many, but one thing that really sells the procedure to patients is that the fat is their own. It’s not a foreign material or chemical, it’s just fat from elsewhere on their body moved to a new location. “With fat grafting, we 37

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BODY

NEW OPTIONS FOR T

A FLATTER STOMACH

roubled by fat around your midsection? Plenty of patients feel the same way. Newer techniques and numerous choices are available for patients who want to eliminate fat in the midsection and achieve a better shape. “A lot of patients will come into the office and say they can’t stand their stomach, but they’re not sure if they’re a candidate for a tummy tuck, liposuction or a simple non-invasive procedure, like CoolSculpting®,” says Dr. Caroline Glicksman of New Jersey. “Really, it’s a question of the quality and quantity of their skin. A younger patient with just a small problem area might be a great candidate for some of the newer techniques that are non-invasive. For patients who have more fat, had more than one child or you’ve gained/lost a lot of weight, your skin may be stretchy and loose. You’re probably not a candidate for liposuction alone.”

LIPOSUCTION OR TUMMY TUCK Most patients looking for a better abdomen hope that liposuction or CoolSculpting alone will get the job done. Many worry that a more serious surgery such as a tummy tuck just isn’t worth the downtime involved. “The problem with this reasoning is that there are times when removing fat will not create a flat stomach,” explains Dr. Glicksman. Weight fluctuations and pregnancies add and subtract pounds, but they also stretch out the abdominal muscles and skin. Repairing these areas to achieve a flat stomach requires an abdominoplasty, also known as a tummy tuck. “I’ve seen more disasters from patients who were convinced that they just needed liposuction. They had a liposuction procedure, but should have had a tummy tuck,” says Dr. Glicksman. “Tummy tuck involves the removal of excess skin and typically the repair or tightening of the abdominal wall muscles.” There is good news. “If a patient is ready to have an abdominoplasty, they should know we have newer techniques. The way we did a tummy tuck twenty-five years ago is a lot different than the way we do the procedure now. We place more sutures inside to help reduce the need for drains, which allows us better results while also eliminating a lot of inconvenience for the patient,” states Dr. Glicksman.

WHAT ABOUT TUMMY TUCK SCARS?

An Interview with Caroline Glicksman, MD by THE PSC

The scar usually fades nicely with time and is hidden below the bikini line. “There is a trade-off when you get a tummy tuck; a new scar is created,” explains Dr. Glicksman. “We have wonderful new methods of scar management now. Overall, women are so thrilled with the flat stomach and the ability to wear low cut jeans that they deal with the scar while it goes through the healing process.” 38

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ost new moms are unhappy with the changes their bodies have gone through with pregnancy. Some of these changes can’t be fixed with diet and exercise alone. There’s never been a better time for all the moms out there that want to get their pre-pregnancy body back. From surgical to non-surgical procedures, there’s an explosion of new techniques and technologies. “Just as digital technology and social media evolve, so does everything within plastic surgery and medicine,” says Camille Cash, MD, a plastic surgeon in Houston, Texas. As a mother of three, she can relate to her patients. “The tools we have are rapidly expanding,” says Dr. Cash. “One of the newer trends utilizing the advances in technology is the ‘mommy makeover.”

MOMMY MAKEOVER By using a combination of surgical and nonsurgical procedures plastic surgeons can help women restore their bodies after babies. “There are areas of the body that take an extra beating during pregnancy and post pregnancy,” says Cash. “Oftentimes women are coming in looking for improvements.” Combining multiple procedures at the same time means that moms don’t have to take more time off from work or away from their family.

“Moms don’t have to take more time off from work or away from their family.”

WHAT PROCEDURE IS RIGHT FOR ME? The procedures for each mommy makeover vary slightly. After pregnancy and nursing, breasts may be smaller; a breast augmentation can restore fullness. A breast lift can restore the breasts to their pre-pregnancy position. In combination, these procedures can achieve a full breast makeover. If breasts are larger after pregnancy, patients may be experiencing neck, upper back and shoulder pain, and women can even develop rashes between their breasts or grooves on their shoulders from bra straps. “Breast reduction can bring relief,” says Cash. A tummy tuck is ideal for tightening stretched-out abdominal muscles and removing excess skin and fat on the belly. “A tummy tuck is usually the keystone procedure in a mommy makeover,” she says. Finally, liposuction is a great way to touch up areas, “Where the baby weight refuses to disappear,” says Cash. Liposuction in combination with a tummy tuck can also help slim a patient’s waistline, giving her a fit and youthful appearance. There is no one size fits all approach to a mommy makeover. “In my practice, we try to treat the patient as a whole,” says Cash. “That may mean everything from non-invasive procedures to diet, exercise and some degree of nutrition and wellness. Only then are you going to get the best surgical results.”

MOMS, WE’VE GOT THIS!

An Interview with Camille Cash, MD by THE PSC 39

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BODY

ouldn’t it be great if we could hit the delete button on our laptop and the fat would just disappear? Dr. James Namnoum with Atlanta Plastic Surgery has spent years researching fat removal. “With aging we all lose muscle and take on more body fat,” says Namnoum. “It doesn’t mean we have to settle though, it just means do your homework and lead a healthy lifestyle.”

BETTER NUTRITION AND MORE EXERCISE Fat generally accumulates around our hips, thighs, stomach and arms. “As we get older, if you want to stay the same, you will need to lose weight and constantly work on replacing fat with muscle. This calls for weight lifting, cardiovascular exercise, improved nutrition, and an overall healthier lifestyle,” says Dr. Namnoum. “It becomes much harder to retain muscle mass the older we get.” It’s more than just hitting the gym and spending time on a treadmill or elliptical. Many trainers suggest also working out with weights three to six times each week. The more muscle you have, the more calories you burn. Weight training also makes your body utilize more calories in the post workout period and even a couple days after your workout. Meanwhile, the cardiovascular exercise increases your blood flow, which helps your body recover and become leaner. Good nutrition is another key component when it comes to losing fat and building/retaining muscle.

DELETE FAT AND DROP A

WHEN DIET AND EXERCISE AREN’T ENOUGH “The challenge is helping people circumferentially, reducing and refining bodies, thus turning back the clock for an overall more youthful body,” says Namnoum. Even the back of the arms can be problematic, yet can resolve itself fairly quickly through liposuction.

DECADE An Interview with James D. Namnoum, MD by THE PSC

TYPES OF LIPOSUCTION You may have heard of a variety of liposuction procedures including laser liposuction, power assisted liposuction, water liposuction and ultrasound assisted liposuction. “I have used all of these types of liposuction and to me, nothing is better than well done conventional liposuction,” says Dr. Namnoum. At Atlanta Plastic Surgery, liposuction is done with a full-body approach, instead of simply targeting specific areas. Dr. Namnoum uses techniques created by Simeon Wall, Jr. of the Wall Center in Shreveport, Louisiana. “It’s really not that hard to do, but it is hard to do well.”

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BABY’S

GOT BACK

An Interview with Richard J. Zienowicz , MD by THE PSC

hat once began as an urban trend is now saturating mainstream America: buttock augmentation. We spoke with Dr. Richard Zienowicz, a plastic surgeon in Rhode Island and a leading expert in the field of buttock augmentation. “Surgical implants of the past are losing ground as using a person’s own body fat and transferring it to the buttocks is now the gold standard. It is a simpler and safer way to enhance and round out the buttock.”

USING FAT FOR BETTER BODY PROPORTIONS Michelangelo made countless drawings and measurements of the human body, including Greek and Roman statues, in order to understand its shape, proportions and variations. In modern times the ideal figure has changed with the buttock taking the lead even surpassing breast augmentation when it comes to erogenous zones. “Unwanted belly fat, thigh fat or arm fat can be harvested and transferred into the buttock for a well-proportioned appearance,” says Zienowicz.

HOW DID THE BUTTOCK CRAZE START? The media and social media have recently expanded the buttbuzz, but it’s really nothing new. In the 90’s, artist Sir Mix A Lot had his hit song ‘Baby Got Back’ and the theme has continued through today, with recent hits including Meghan Trainor’s ‘All About That Bass.’ The American Society of Aesthetic Plastic Surgery reported a 58% increase in the number of buttock augmentation procedures in 2013 compared to 2012. “It’s really catching on among urban white women in their 40’s,” says Dr. Richard Zienowicz. “Once they see their friends having the procedure and notice the perky backside, they say ‘wow’ I want that!”

FAT IS “TWO-FOLD” Buttock augmentation can actually serve two purposes. If you have fat in unwanted parts of your body, your surgeon can remove that fat, harvest it, and then redistribute it to your buttock to make it rounder and fuller. Using your own fat instead of an implant actually reduces risk and is considered ‘standard operating procedure’ when it comes to modern butt augmentations. 41 THEPLASTICSURGERYCHANNEL.COM

BODY

LOOK SEXY

AFTER BABIES “Fat can show up in places it never appeared before.”

An Interview with Laurie A. Casas, MD by THE PSC

urturing a child in the womb and bringing them into the world is a beautiful experience for a woman. With life as a mother underway, the newest enemy in a woman’s life is often times the mirror. The bodily changes caused by multiple pregnancies can be disappointing. Dr. Laurie Casas, a plastic surgeon in Chicago, knows full well the toll it can have on a woman’s body. It’s a story she is told by many patients who come to her office interested in a mommy makeover.

I WANT MY BODY BACK When child birth and breast feeding are over, women become very aware of all the ways in which their body is different, and not necessarily in a pleasing way. The breasts and stomach are the most obviously affected, but Dr. Casas points out that many women also notice new pockets of fat in places that were never problematic before.

WHAT TO DO Regardless of where the body has been affected, plastic surgeons are equipped with surgical and non-surgical options to help restore pre-pregnancy bodies. Dr. Casas says, “A combination of non-invasive, minimally-invasive or invasive procedures can even achieve a result that actually improves on the pre-pregnancy body.” Casas, in her thirty years of practice, has discovered that most women are capable of restoring their abdominal musculature on their own. With a strong core, plastic surgery can focus on the surface issues and build upon a solid foundation. Plans for re-contouring the body in its most affected areas will give shape to each woman’s unique mommy makeover. The most important question about breasts is usually one of volume. Babies can suck the life out of their mother’s breasts quite literally. The resulting breast is often depleted with less firm tissues.

A THREE-DIMENSIONAL ASSESSMENT Casas recognizes the body exists in three dimensions, “It’s not just a series of flat images on a screen.” She takes into account every angle of a woman’s body and considers her approach to be one not unlike a sculptor’s. The breasts and stomach may well be addressed in a more surgical nature, but there are many other areas where women may benefit from non-surgical procedures such as CoolSculpting®. Back fat, arm fat, hip fat, fat can show up in places it never appeared before. To address these areas, Casas’ holistic view of the woman’s body comes into play. She views the various body parts all in delicate connection with the whole, and is able to hone in on the problem areas, sculpting them in such a way that an overall balance and proportion are achieved. 42 THEPLASTICSURGERYCHANNEL.COM

A TIGHTER TUMMY AFTER

An Interview with Mark A. Pinsky, MD by THE PSC

“You can think of it like an internal corset that ties in the front and laces up from the inside.”

KIDS

stretches, it does not always retain its elasticity. Not only is the skin stretched, but also the muscle below is stretched and doesn’t always return to its previous location and tone. “Lots of times after a woman has a baby, the abdominal muscles stretch apart and stay separated,” says Dr. Pinsky. “No matter how much you tighten the muscles through exercise, you can’t get the muscles to come back together. In that situation, we stitch the muscles together from the top to bottom. You can think of it like an internal corset that ties in the front and laces up from the inside.”

veryone desires a flat stomach. While some people seem to be graced with god-like genetics, the rest of us have to watch what we eat and consistently exercise to stay in shape. Pregnancy can wreak havoc on a body that diet and exercise simply cannot address. There is hope to be found in plastic surgery. “There’s a progression in the way we manage a woman’s abdomen,” says Dr. Mark Pinsky, a plastic surgeon in Palm Beach Gardens, Florida who routinely restores post-pregnancy abdomens. “Some women come in with excess skin, some with excess fat, and still others with loose muscles.” Based on the existence and severity of these three issues, a treatment plan is designed to best restore a beautiful figure. An abdominoplasty, also known as a tummy tuck, works to correct the entire abdomen, including the muscles and skin that were stretched by an expanding uterus. Some patients only need skin removed, if the muscles were not stretched during childbirth. When a doctor only removes skin in the abdomen, the procedure is called a panniculectomy.

MINI TUMMY TUCK FOR MINI PROBLEMS Some women have a small pooch at the bottom of their abdomen. While the top half of their abdomen may look just fine and responds well to diet and exercise, the bottom part doesn’t respond. “Some women just have a bit of a bulge at the bottom. In these situations, we would consider a mini tummy tuck,” describes Dr. Pinsky. “The idea of a mini tummy tuck is to flatten the lower part of the abdomen so that it is just as smooth as the upper part of the abdomen.”

“Typically there is some excess skin on the lower abdomen,” describes Dr. Pinsky. “When we remove skin, there is a 3:1 ratio with the scar. If we remove one inch of skin vertically, the scar will be three inches long. The key is to place the scar low and stitch it in such a way that it heals pencil-thin and can be well concealed in most underwear and bathing suits.”

THE FINAL RESULT A tummy tuck can be a great benefit in restoring or even improving your pre-pregnancy shape. “In stitching the muscle together we actually redefine the waist-line to recreate a beautiful hourglass figure. With a super flat tummy, the skin is tight and the muscles are flat.”

INTERNAL CORSET It seems obvious that a mother’s skin stretches when making room for a growing child within her abdomen. When the skin 43

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BODY

TIRED OF

FAT THAT’S IMPOSSIBLE TO

LOSE? An Interview with Stafford R. Broumand, MD by THE PSC

s we age, there are changes in the body that simply can’t be avoided. Liposuction can be one of the most effective ways to wipe out fat for problem areas that are hard to eliminate, in particular for those patients who wants to reshape their body and balance their appearance. Plastic surgeons don’t recommend the procedure as a weight loss tool; it’s best used when there are areas that can’t be addressed through diet and exercise alone.

STUBBORN PROBLEM AREAS Maintaining a healthy diet and regular exercise is the gold standard when it comes to fighting fat. However, with aging, the problem areas become more prominent making it virtually impossible to lose “stubborn fat” through diet and exercise alone. “When I have a patient who works out at the gym and eats healthy food, they become frustrated when the fat around their outer thighs or abdomen won’t go away,” says Dr. Stafford Broumand, a busy plastic surgeon in New York City. “Thankfully we have an answer for them through liposuction.”

A POPULAR, MODERN AREA FOR LIPOSUCTION: THE NECK Liposuction of the neck is gaining in popularity among both men and women. It can be performed under ‘local anesthesia,’

meaning the patient is awake and the procedure has minimal downtime. An escort is no longer needed to assist the patient before or after the procedure. The recuperation is fast; patients can be up and about the next day. They will leave the office with a small head wrap and can be back at work between three to five days.

RECOVERY TIME The exact recovery time depends on the size of treatment area and the number of treatment areas. Many patients are able to resume normal daily activities after about one week; others may take up to two weeks. There will be some bruising and swelling, and post-operative discomfort can be relieved with medication. Results from the procedure will be noticed during the recovery period and become more apparent in the weeks following the procedure.

WILL THE FAT COME BACK? Many people are reluctant to have liposuction because they fear the fat will just come right back. The fat cells will continue to grow and expand if more calories are consumed than burned. Trouble areas can return. Plastic surgeons often recommend patients who undergo liposuction maintain their new physique with nutritional planning and a trainer at the gym. 44

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SCULPTING YOUR

WAIST “The outcomes that we get for abdominoplasty are one of the most dramatic of any procedures.”

An Interview with Daniel Y. Maman, MD by THE PSC

“Muscle separation occurs during pregnancy,” Maman explains. “There is no exercise in the world that is going to restore those muscles back to mid-line. A tummy tuck procedure allows us to bring those muscles back to the most functional position so that patients not only look better, but can exercise more efficiently.” Stubborn fat pockets may also appear after pregnancy that seem resistant to diet and exercise. “My operation involves two things: tailoring the skin and contouring the abdominal wall, in addition to liposuction,” says Maman.

fter pregnancy, a woman’s abdomen may not be quite the same as it was prior to childbirth. A mother would never trade her children for a great, youthful abdomen, but with the help of plastic surgery, mothers can have both. Dr. Daniel Maman considers the abdominoplasty procedure or tummy tuck to be a truly transformative operation, effectively reversing damage caused by pregnancies and massive weight loss. Maman seeks more than just the removal of skin and tightening of the muscles, his practice aims to improve contour. He feels the shape of the abdomen can define a woman’s entire figure.

BODY CONTOUR IS KING With loose skin removed and abdominal muscles repaired, a tummy tuck may appear to be complete. For many it would be, but Maman chooses to make sure that the contour of the abdomen is not only restored, but also improved. “Most of the abdominoplasty results that I’ve seen have a very flat, plain affect to them,” says Maman. “Our practice takes it to the next level by contouring the abdominal wall and adding liposculpting to certain parts of the procedure to provide that very defined, athletic look to the abdomen. The outcomes that we get for abdominoplasty are one of the most dramatic of any procedures,” explains Maman. “Our patients look better, feel stronger, and their contour is better.”

A TUMMY TUCK TREATS LOOSE SKIN AND MUSCLES Due in part to the fact that “tummy tuck” is a catchy phrase, the average person casually connects the procedure with weight-loss surgery. “I think a common misconception is that a tummy tuck, or abdominoplasty operation, is for weight reduction or overweight patients only,” explains Dr. Maman. “The ideal candidate is someone who has a lot of loose skin, particularly after bearing children.” Additionally, many women suffer from loss of strength in their abdomen, a condition caused by muscle separation during pregnancy. 45

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BODY

here’s no denying that the mommy makeover procedure, a combination of a breast augmentation with abdominoplasty to rejuvenate lost volume and contour following multiple pregnancies, is more popular than ever. Both abdominoplasty and breast augmentation consistently rank in the top five surgical procedures for cosmetic surgery each year, a statistic that shows these corrective surgeries are strongly desired by patients. Dr. Richard Zienowicz of Rhode Island employs a unique procedure that begins with a tummy tuck and then utilizes that procedure to place breast implants through the abdomen. By placing the implants through the abdomen, Zienowicz is able to perform a breast augmentation without any scars on the breast. This is what Dr. Zienowicz likes to call, “The Ultimate Mommy Makeover.”

THE

ULTIMATE MOMMY MAKEOVER

WHAT HAPPENED TO MY BREASTS AND ABDOMEN? With all the energy and life mothers give their children as they grow in the womb, areas of the body take abuse. The abdomen obviously stretches to accommodate the growing child, causing skin to stretch, often times leaving stretch marks and loose skin. The breasts also swell, grow and change shape due to hormones and breastfeeding.

RESTORATION OF BEAUTY Better science, technology and understanding culminate to offer patients a legitimate way to get their pre-pregnancy bodies back. Surgeons correct stretched abdominal muscles and remove loose skin, while restoring lost volume and contour in the breasts. Dr. Richard Zienowicz employs a single procedure known as Transabdominal Breast Augmentation, or TABA, to correct both issues. “TABA: you talk about the ultimate mommy makeover!” says Dr. Zienowicz. “You remove all the loose skin, and use that incision site to introduce the implants to the breast... so you augment them, but with no scars.” Because a surgeon already has the abdomen open in order to perform a tummy tuck, TABA involves running the implants up and through the abdomen, rather than creating an incision on the chest or armpit to insert the implants. In addition to offering a scar free breast augmentation, Zienowicz is able to alter the inframammary fold (where the bottom of the breast meets the chest) by having control of the abdominal tissue. “TABA allows you to have full control on the inframammary fold, so that by placing the implant through and pulling the abdominal tissues down, you redistribute all that tissue and reset the inframammary fold to where it needs to be,” explains Zienowicz. “It’s incredibly powerful.”

NEW IMPLANTS, EVEN BETTER RESULTS “True rejuvenation is possible with new implant choices. With the new shaped implants that we have, it allows you to capture that up-sweep of the lower pole so that you can lift the nipple-areola complex higher,” says Dr. Zienowicz. “With this technique you can truly rejuvenate the breast.” 46 THEPLASTICSURGERYCHANNEL.COM

An Interview with Richard J. Zienowicz, MD by THE PSC

THERMIVA A VERY PRIVATE MAKEOVER

An Interview with Camille Cash, MD by THE PSC frequency generator, made by Thermi Aesthetics powers an “S” shaped hand piece with a tip that is able to control the level of heat delivered.” The pilot study underway in Laguna Beach, California is led by gynecologist, Dr. Red Alinsod. He serves as the chairman of ThermiAesthetics Women’s Health Advisory Clinical Board and he developed ThermiVa.

“Rejuventate very private and

personal areas with zero discomfort and zero downtime.”

rinary incontinence is no laughing matter, yet laughter, sneezing, jump rope or just picking up the kids can trigger it. Combine that with aging, and it can be a real problem. In the hands of plastic surgeon Dr. Camille Cash, one or two treatments with ThermiVa® can make life a whole lot more comfortable for women struggling with urinary incontinence. “The treatment works by strengthening the pelvic wall.”

WHO BENEFITS FROM THERMIVA? “Women in their 30’s, 40’s, 50’s and 60’s are all viable candidates, particularly if they are experiencing or nearing menopause and noticing a drop in estrogen can benefit from the effects of ThermiVa treatments,” says Dr. Cash. “Hormonal fluctuations can cause dryness and urinary tract infections. The radio frequency device in some ways turns back the clock by stimulating collagen.”

“At first, ThermiVa was perceived as only a way to tighten up ‘lady parts’. Now, it’s dual purpose can truly change the way you feel about things in both your love life and daily activities,” says Dr. Cash.

Dr. Cash is thrilled with the results as patients come in and tell her how it enables them to do ‘jumping jacks’ with confidence at the gym and regain their love lives at home. “It can be life changing and is performed in the comfort and privacy of the office. This is an easy way to enhance people’s lives.”

HOW THERMIVA WORKS “A non-surgical radiofrequency energy transfers heat directly to the vaginal region, allowing external and internal looseness to be treated with a tightening method. The radio

You can feel noticeable improvement following one treatment, but a series of three treatments is recommended. 47

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Making Wrinkles Magically Disappear Interview with Bradley Calobrace, MD

Facelift vs. Fillers Interview with Lee Thornton, MD

A Younger Looking Neck Interview with Bradley Calobrace, MD

The Halo™ Glow Interview with Ashley Gordon, MD

Perfecting The Nose Interview with Dustin Reid, MD

The Art of Rhinoplasty Interview with Stephan J. Finical, MD

It’s All in the Eyes Interview with James D. Namnoum, MD

When is it Time for a Facelift? Interview with Clifford P. Clark III, MD

Plump Up the Volume Interview with Mark S. Elliott, MD

Tech Neck: The New Turkey Neck Interview with Paul A. Watterson, MD

49 THEPLASTICSURGERYCHANNEL.COM

FACE

FACELIFT, FILLERS, EYES, NOSE

FACE

“It’s like magic, erasing forehead lines and wrinkles with no visible incisions.”

azing into the mirror and realizing your face is full of lines is disheartening. Considering a surgical procedure on your face can be even more frightening. Where will the incisions be? How bad is the scarring? Enter the endoscopic brow lift, a surgical procedure aimed at raising the forehead through small incisions that are hidden in the hairline. Dr. Brad Calobrace, a board certified plastic surgeon in Louisville, Kentucky, strongly believes in the procedure. “When patients want something more permanent, surgery may be a better option. It’s like magic, erasing forehead lines and wrinkles with no visible incisions.”

ELEVATING THE BROWS In all facets of plastic surgery, patients are extremely concerned with scarring. Patients want to restore youthfulness to their face, but at what cost? “An endoscopic brow lift is a procedure to elevate the brow and make the aesthetics of the forehead and brow look better,” says Dr. Calobrace.

MAKING

WRINKLES MAGICALLY DISAPPEAR An Interview with Bradley Calobrace, MD by THE PSC

A traditional brow lift involves a much larger incision across the scalp, a trade off that scares a lot of patients. “We didn’t like performing a brow lift so much because it usually involved an incision across the entire scalp,” says Dr. Calobrace. “It looked sort of Frankensteinish. An endoscopic brow lift allows us to use small incisions hidden in the hair-bearing region of the scalp.”

WHEN DOES A PATIENT NEED TO CONSIDER A BROW LIFT? “One of the heralding signs is somebody that has a lot of wrinkles in their forehead,” says Dr. Calobrace. “That means they’re lifting their eyebrows a lot, and for a good reason: their brows are low. You don’t want to take eyelid skin out if it looks like they have too much; it may be because the brows are too low. The first thing we want to look at is, are the brows in an appropriate position? If they aren’t, then we need to elevate them.” While the procedure is called an endoscopic brow lift, more than just the brows improve. “It improves the 11’s between the eyebrows and it softens the lines across the forehead. It also cleans up the upper eyelid. Finally, it can even improve crow’s feet. What I like about it is patients see a dramatic aesthetic change,” says Dr. Calobrace. 50

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“There comes a time when fillers are no longer valid.”

FACELIFT VS. FILLERS

An Interview with Lee Thornton, MD by THE PSC

WHAT CAN BOTOX® DO? Botox is a prescription medicine that is injected into the facial muscles, where it temporarily improves the look of crow’s feet lines and frown lines by weakening the muscles that form the lines. Most people choose to have the injections repeated about every four months, when its effects wear off. Botox doesn’t begin working immediately upon injection, rather it takes effect over the three to five days following injection.

t’s a difficult decision. Should you take the step of having a surgical facelift or could fillers provide you with enough volume to appear refreshed? It’s a question best answered by a board certified plastic surgeon like Dr. Lee Thornton with Meridian Plastic Surgery in Meridian, Mississippi. “There’s a tipping point, when it comes to these decisions. When facial fillers are not doing the job and the patient isn’t getting the results they want, it may then be time for a facelift.” Modern facelift procedures are taking the fear out of surgery with better-placed incision sites and quicker healing times.

FACELIFT TO FRESHEN YOUR FACE In the 1950’s, 60’s and 70’s traditional facelift techniques were used which pulled the face laterally. Since the mid 1990’s, many surgeons have instead adopted the vertical facelift, which is designed to defy gravity. A facelift directed in a vertical fashion, provides a more natural appearance; improving the neck, face and eyes in a balanced way.

Many things are taken into consideration when deciding the best approach to address aging in the face, including skin laxity and facial volume. In some cases, temporary fillers composed of hyaluronic acid (such as Juvederm®) are used to add volume. In other cases, harvested fat may be used to fill out features.

FILLERS FOR VOLUME

“When you look at surgery, it’s more about dealing with gravity and the more extreme effects of wrinkling or dropping of the face; it works by shifting the structure of the face,” says Dr. Thornton. “There comes a time when fillers are no longer valid, and if you want to get to the result the patient is looking for, you’ve got to abandon the fillers and go to a facelift or other surgical procedures for the face.”

Juvederm XC and Restalyne® are both hyaluronic acid based fillers, commonly used to provide volume in places where it has been lost due to aging, such as the lips or the lines from the nose to the corners of the mouth (called the nasolabial folds). They last on average between six months to a year. Juvederm Voluma® XC is the first and only FDA-approved injectable gel that is used to add volume to the cheek area, providing a subtle lift to the lower face.

The bottom line is that we all want a natural result. “When I have a good candidate, I tell my patients, without any qualms, that when you’re healed from this facelift, you should be able to sit next to someone at a dinner table and they will have no idea you have had a facelift.” Advances in science and technique allow patients to have the confidence that in the right hands they can achieve the natural, youthful results they desire. 51

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FACE

YOUNGER LOOKING NECK E

veryone has heard about facelifts, breast lifts and boob jobs, but what about procedures for the neck? A variety of problems can be associated with the neck: loose skin, extra fat and lack of definition. By utilizing modern technologies and decades of experience, Dr. Brad Calobrace of Louisville, Kentucky takes time to assess his patients who come in looking to rejuvenate the neck area. Some may only need a little liposuction under the chin, while others might require surgery to achieve their goals.

SINGLING OUT THE NECK FROM THE FACE “Women always come in asking for a facelift and I ask them, ‘What bothers you the most? Neck, jowls?’ and it’s always the neck. When a patient is bothered by the neck and jowl, you don’t always need to treat it with a facelift, unless there’s advanced aging,” says Dr. Calobrace.

NECK REJUVENATION TECHNIQUES Dr. Calobrace carefully examines his patients to determine the appropriate options. This allows him to identify the proper procedure with the patient. “There are so many options to be explored with a wide array of modern tools and techniques available to treat all levels of aging. When you’re bothered by the neck or jowl, don’t just think facelift,” says Dr. Calobrace. TruSculpt , which uses radio frequency to melt the fat and tighten the skin in the neck, is a non-invasive, nonsurgical process. If the patient has very early signs of neck aging, he may suggest a non-invasive option. Surgical options may also be considered. Liposuction alone may be recommended, or if a person seeks neck definition, they may be a candidate for a chin implant. Another surgical option is an anterior neck lift, which involves making a small incision under the chin to tighten the muscle from the front of the neck. If the neck aging is advanced and the skin is too loose, it may be that a traditional facelift is the best solution. ™

“You don’t always need to treat it with a facelift.” An Interview with Bradley Calobrace, MD by THE PSC

AN EXPERIENCED SURGEON IS KEY Choosing the right surgeon is key. A board certified plastic surgeon will have all of the modern tools available to treat a variety of neck issues, but that’s not all they offer. An experienced surgeon will accurately assess your individual issues in order to create a personalized treatment plan. “You need to go to a surgeon who has all the options available,” says Calobrace. “A face is very personal, and the more experience the surgeon has, the more artistic they become. You can see it in your patient’s face; they will appear rested and the results will be much better than they ever expected.”

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THE

HALO

™

An Interview with Ashley Gordon, MD by THE PSC

alo™ by Sciton is an ultra modern device that brings to “light” a complete skin rejuvenation. The treatment improves your skin’s overall tone and texture, significantly removing discoloration, and reducing pore size all to increase your skin’s luminous glow. Halo is the world’s first and only “hybrid” fractional laser that can simultaneously deliver non-ablative and ablative wavelengths in a single pass over the skin. This allows for deep dermal rejuvenation with epidermal renewal for a combined synergistic effect that you cannot get with any other treatment. The treatment is completely customized, so the options are limitless based on your particular skin concerns.

environmental pollutants, aging, stress and even allergies. When our skin cells don’t turnover as rapidly as they did when we were children, dead skin cells cling to our skin’s surface longer, leading to dull skin. Dull skin doesn’t reflect light and, in severe cases, can appear sallow. “A Halo treatment will remove all of the dull debris from the top layers of your skin to reveal your inner glow. Your skin will reflect more light because it’s healthier.”

“In the past, in order for patients to have a ‘wow’ type of result, they had to commit to an ablative procedure and a lengthy recovery. If they couldn’t, they were offered non-ablative treatments and often had to settle for marginal results. Halo truly offers the best of both worlds; the results of an ablative laser treatment with the minimal downtime of a non-ablative treatment,” says Dr. Ashley Gordon of Restora Austin.

EASE OF TREATMENT AND RECOVERY During your treatment, the laser is gently passed over the surface of the skin emitting quick pulses of laser energy. To avoid any discomfort, a topical anesthetic is applied and the laser has an integrated cooling tip, which keeps the skin comfortable both during and after treatment. In a day or two, you can apply makeup. “There is no real downtime and patients resume their normal activities within a few hours,” says Gordon.

WHAT TYPES OF SKIN DAMAGE DOES HALO TREAT? “One of the surprising things discovered during the Halo clinical trials was pore improvement,” says Gordon. “While nothing can completely get rid of pores, Halo is the only treatment that can significantly minimize the size and appearance of pores.” It also treats discoloration, sun damage, uneven skin tone, fine lines and dullness.

WHEN WILL I SEE RESULTS?

THE “GLOW” FROM A HALO TREATMENT

Always innovators in the field of aesthetic medicine, Restora Austin is proud to be one of the first practices in Texas, specifically the third, and one of the first in the country to acquire this cutting-edge technology.

You will see initial results between two and five days after your treatment, but your skin will continue to improve over time. Most patients see the greatest pigment improvement in the first two to three weeks. This is followed by a dermal regeneration phase that continues to improve for months.

For a variety of reasons, our skin can become dull and uneven. This happens because our natural skin cell turnover process slows down. This is often related to sun damage, 53

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FACE

PERFECTING

THE NOSE

An Interview with Dustin Reid, MD by THE PSC

our nose performs a balancing act right down the middle of your face and is always exposed. If your nose is out of balance or has an abnormality, you can’t easily hide it with makeup, and it can detract from your other features, calling too much attention to itself. On the other hand, when your nose is in harmony with the rest of your face, the symmetry actually enhances your overall look.

“The goal of rhinoplasty surgery is to harmonize your nose with the rest of your facial features.”

Dr. Reid’s rhinoplasty practice focuses on the nose’s relationship to the face. During a consultation he studies his patient’s faces to discover which features are out of proportion.

NOSES ARE COMPLEX Dealing with the nose is a delicate practice. If you are considering rhinoplasty, it is important to find a surgeon who is skilled and experienced with this particular surgery, such as Dr. Dustin Reid of Austin, Texas. “Over the course of the last few years it’s become something that I’ve been really interested in. The surgery itself is very technical and precise, and appeals to my nature.”

Dr. Reid and his partner Dr. Gordon stress the fact that a patient must focus on their own specific features and concerns. It is not a process of picking a nose out of a magazine that looks great on an actress or model. Your face is unique and the goal of rhinoplasty surgery is to harmonize your nose with the rest of your facial features.

Dr. Reid has been studying the complex architecture of the nose long enough to know that rhinoplasty is a subtle art involving many factors. “The nose by itself is not necessarily the issue. Balance is the goal,” he says. “Within the architecture of the nose there are many opportunities for subtle changes. Older techniques were destructive and manipulative. Surgeons might have had one nose that they gave to everyone, but every patient is different.” Dr. Reid takes care to evaluate the characteristics of your nose that are uniquely yours.

FORM AND FUNCTION For skilled surgeons like Dr. Reid, it’s easy to maintain the character of a patient’s nose while removing its hubris. Not only does your nose rest in the middle of your face, it allows you to breathe as well. While the changes made for aesthetic reasons may be minor, each small change carries a repercussion felt in the function of the nose. “My goal is that after surgery the patient is going to be able to breathe better than they could before. I want to be able to open the airways.” 54

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THE ART OF RHINOPLASTY S

urgical procedures performed on the nose can have dramatic effects on a patient’s appearance and inner confidence. “There are several things that typically bring a patient in to inquire about rhinoplasty,” says Dr. Stephan J. Finical who has a thriving practice in Charlotte, North Carolina. “ A hump on the bridge of their nose, also referred to as a dorsal hump; a bulbous tip, a big full tip to the nose; or the nose is out of proportion to the size of their face.”

A FRESH START “When I operate on people, they’re typically at a transition in life,” says Dr. Finical. While older people tend to have grown into their noses, young people can tolerate a change and are wondering what can be done to perfect the appearance of their nose. Dr. Finical recognizes the importance of waiting for surgery until major growth has stopped. “Rhinoplasty candidates are often people between two stages of life - high school graduates, college graduates or young professionals changing jobs or locations. There is also an influx of interest during the summer months, as people prepare to open a new chapter.”

“An adjustment of just a few degrees can give a person a new confidence.”

MASCULINE-FEMININE Men’s faces will often continue growing until they are twenty-one or twenty-two. With women, Dr. Finical asks how long it has been since a change in shoe size. If women have not changed their shoe size in several years they are probably done growing, then it’s safe to say they’re ready to talk options. A feminine nose, according to Dr. Finical, “Should have a bridge that projects less than the tip of the nose.” A woman’s nose should turn up ever so slightly to maintain a smooth set of curves from lip to brow that softens the features. In contrast, a masculine nose should run flat from bridge to tip. A man typically has a very straight nose that would protrude perpendicularly from the upper lip to achieve strong angles and straight lines from lip to brow.

A FEW DEGREES Recovery can range from a couple weeks to a month, depending on the severity of change. After the first week, stints and stitches are removed. The second week usually sees the swelling and bruising fade. Soreness may last another couple of weeks.

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FACE

“Most people begin to show aging around their eyes around the age of forty.”

IT’S

ALL IN THE T

An Interview with James D. Namnoun, MD by THE PSC According to Namnoum, the surgeon’s operation must address the lengthening of the skin line between the lash and the tear trough as well as the bulging of the fatty tissue around the eyeball.

o give an impression of youthful vibrance in the face, there’s nowhere more important than the eyes. As with any facial procedure, plastic surgeons strive for results that appear “natural” and “healthy,” words Dr. James Namnoum of Atlanta says are not mutually exclusive.

“What we’re doing in eyelid surgery is re-draping the skin, contouring the fat, and often tightening the corner of the eye in a way that makes the eye look beautiful and natural, giving the patient a very rested look.” Even fat-grafting can be employed between the lower lid and upper cheek to restore a healthy, smooth fullness that can make patients look much younger. The most important aspect of all surgeries, especially around the eye, is safety. Patients must demand a precision of expertise and execution from their selected surgeons.

THE AGE OF THE EYES According to Dr. Namnoun, “Most people begin to show aging around their eyes by the age of forty. People begin to look tired, with dark circles that won’t seem to go away.” The first thing people use to combat the appearance of aging is cosmetics. After a while, however, that just isn’t enough. Then begins the contemplation of a surgical response to aging. It is the patient’s hope that this response doesn’t actually appear surgical at all.

THE CHOICE Research is a patient’s most valuable asset when it comes to achieving a desirable result. They need to carefully select their surgeon. A consultation will give a patient an opportunity to discover if a chosen surgeon has the same goals as they do. Namnoum reiterates, “Communication is the essence of this. Understanding what’s being asked and what can be delivered is the essential part of making a successful encounter.”

THE SURGERY The smallest bones in the body are those around the eye. It should then be no surprise that surgeries around the eye are some of the most complicated. Namnoum explains, “The structure of the eyelid is very complex, which is why it takes a really sophisticated understanding on the part of the surgeon.”

56 THEPLASTICSURGERYCHANNEL.COM

“A skilled surgeon has the ability to bring to the table a lot of different operations.”

WHEN IS IT TIME FOR A FACELIFT?

An Interview with Clifford P. Clark III, MD by THE PSC

hough a facelift may be your first thought to make those lines disappear and make you look younger, it’s not always the best solution. Dr. Clifford Clark, a plastic surgeon in Orlando, Florida, talks about when it’s the right time to get a facelift.

EITHER SIDE OF THE SPECTRUM People fall on both sides of the spectrum. “There are patients that come in at an incredibly young age and say, ‘do I need a facelift?,’ and you almost want to laugh,” says Clark. “On the other end, you see a patient who has been pushing the envelope with fillers or doing every kind of non-invasive laser based treatment, and really what they needed to do was a facelift a long time ago. The most interesting patients are the ones on either side of the spectrum. Where the last thing in the world they need is a facelift, or the last thing in world they need are more fillers, Botox and laser treatments.”

START WITH A CONSULTATION If you’ve been looking in the mirror and you think it’s time for a facelift, you should start by having a consultation. “Choose someone you trust,” says Clark. “Choose somebody whose artistic abilities and sensitivities are aligned with what you’re looking for. In the end, you might find out there may be better options for your scenario than a facelift.”

TIME FOR A FACELIFT “If you’re not getting the result that you desire and the non-invasive techniques or the fillers or the Botox are not taking you where you want, that’s a very sure signal that it’s time for a facelift,” says Clark. “Most importantly, you know when it’s time. A doctor’s job is to guide you where you want to go.”

A FACELIFT IS NOT THE ONLY OPTION Clark notes, “A skilled plastic surgeon has the ability to bring to the table a lot of different operations.” Aging around the eyes, such as bags in the lower lids and heaviness in the upper lids, can be managed surgically. Botox® can be used to treat muscle spasms and to remove wrinkles. To enhance face volume, a fat transfer procedure can be done, where tiny incisions are used to collect your own fat and re-inject it into areas in the face that have lost volume over time. 57

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FACE

PLUMP

UP THE VOLUME

“Some of the earliest signs of aging are a loss of facial fullness.”

WITH FABULOUS

FILLERS An Interview with Mark S. Elliott, MD by THE PSC

Transferring fat is another option to plump up lips that is growing in popularity. Fat from an area on the body that has had liposuction can be processed and injected or grafted to almost any area. However, the body will reabsorb some percentage of the fat that is transferred. This means it may take more than one fat transfer procedure for the ideal results.

here’s no such thing as a “fat face,” those chubby cheeks are a sign of youth. Some of the earliest signs of aging are a loss of facial fullness and the presence of wrinkles. Softening those facial lines and restoring volume and fullness in the face often can be achieved non-surgically with injectable fillers. Fillers are often used to plump thin lips, enhance shallow contours, soften facial creases and improve the appearance of recessed scars.

WHAT IS JUVEDERM VOLUMA®? Juvederm Voluma® XC is the first and only FDA-approved injectable gel that is used to instantly add volume to the cheek area. Placed deeper in the cheek than fillers used in other areas of the face, such as the lips, Juvederm Voluma® provides contour and a subtle lift that can last up to two years.

WHO ARE THE BEST CANDIDATES? “If someone comes in with lots of skin laxity, adding volume won’t get them where they want to go,” says Mark Elliott, MD. “However, if it’s just a little jowling and some folds in the face, those patients are perfect for fillers and this may stave off surgery for a long time.” Dr. Mark Elliott is a board certified plastic surgeon who practices at Meridian Plastic Surgery in Meridian, Mississippi. He specializes in plastic and reconstructive surgery, and is well known for breast surgery.

WHERE SHOULD I GO FOR INJECTIONS? Carefully selecting an experienced plastic surgeon ensures that you are being treated by someone who has completed at least five years of surgical training with a minimum of two years in plastic surgery. Board certified plastic surgeons adhere to a strict code of ethics and operate only in accredited medical facilities. “Unfortunately, you have people injecting a variety of fillers with NO experience,” says Mark Elliott, MD. He offers words of caution, “There’s a technique to injecting, you need to go the correct depth and be cautious of how hard you are pressing; that alone can go a long way toward avoiding complications.”

HOW TO GET LOVELY LIPS A full, well-defined lip is a sign of youth. A thinning upper lip can give an appearance of anger or old age. If your lips are thinning, you may be a candidate for lip augmentation. There are many different ways to augment a lip, one of which is Juvederm® XC, a filler which can last up to a year. 58

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ext messaging, laptop use and aging all have a profound effect on our neck. Constantly bending down to use your smartphone or computer emphasizes the already ageold sagging skin problem. That sagging neck skin is one of the first tell-tale signs of aging. First, you notice the horizontal bands are becoming more pronounced, next thing you know the skin is saggy, and before long, that dreaded turkey neck appearance is prevalent. When gravity takes over it can be unforgiving in the neck area. The drooping neck skin can make you look older than your age. When the platysmal bands—the muscles that run under the neck like a hammock, begin to relax and aren’t tight like they are in youth, a skilled surgeon such as Dr. Paul Watterson can make a huge difference in a person’s appearance.

WHAT IS A NECK LIFT? A neck lift, also known as a rhytidectomy, is a surgical procedure that improves visible signs of aging in the jawline and neck. The neck lift ultimately removes excess fat and tightens the skin in the lower face that creates jowls. Beginning around mid-life, surgical skin tightening may be necessary. When the skin is tightened, small incisions are made behind each ear, and one under the chin. “When it comes to rejuvenating the neck, I view it as one of the most powerful parts of an overall facelift,” says Dr. Watterson. “A neck lift can mean all things beautiful in my opinion.”

LIPOSUCTION OF THE NECK Sometimes, liposuction of the neck alone can restore the look you desire. But, if you happen to have excess or sagging skin under your chin, a neck lift may be required. Skin elasticity, the amount of aging present, and the patient’s goals all determine what type of procedure is appropriate in the neck. Since everyone is different, it’s best to seek the advice of an experienced plastic surgeon to determine the best surgical plan for your goals.

RECOVERY Depending upon which procedure or combination of procedures a patient requires, the surgery itself may take up to three hours to perform. Following surgery, it is not uncommon to experience a burning sensation or numbness, which subsides fairly quickly. Recovery time varies, but you can usually expect to be able to return to work in a week or two. “The face is well vascularized, so it heals quickly and the incisions really aren’t painful,” says Watterson. “It’s more of a social downtime if you want to hide the fact that you had surgery.”

An Interview with Paul A. Watterson, MD by THE PSC

“Bending down to use your smartphone or computer emphasizes the already age-old sagging skin problem.”

TECH NECK:

THE NEW TURKEY NECK

59 THEPLASTICSURGERYCHANNEL.COM

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Not for pediatric use.

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New Alternatives to Botox速 Interview with Jason N. Pozner, MD

Chill Out, FAT Interview with Grant Stevens, MD

Placing Wrinkles on Pause Interview with Brian Brzowski, MD

Get the Look You Want Without Surgery Interview with Michael R. Schwartz, MD

Goodbye Deodorant Interview with Bruce W. Van Natta, MD

Zapping Fat with Vanquish速 Interview with Clifford P. Clark III, MD

A Non-Surgical Facelift Interview with Christine Hamori, MD

Big Results, Little Downtime Interview with Jason N. Pozner, MD

NON SURGICAL

IMPROVING APPEARANCE WITHOUT SURGERY

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NON SURGICAL

NEW

ALTERNATIVES TO BOTOX “One drawback to Botox injections is how long they last.”

An Interview with Jason N. Pozner, MD by THE PSC

The energy delivery methods of stunning nerves fall into two categories: radio frequency and cold therapy.

otox®, Xeomin® and Dysport® lead the pack when it comes to non-invasive cosmetic procedures to smooth wrinkles and lines on the face. A new group of minimally invasive technologies has arrived to produce the same results and keep those results for far longer than injectables. Dr. Jason Pozner of Boca Raton discusses three devices he thinks are great alternatives for patients who are weary of receiving injectables multiple times each year.

RADIO FREQUENCY DEVICES THERMiRF™ and NeuBELLE™ both use a radio frequency probe and are done under local anesthesia. “You insert a fine little needle into the area above the eyebrow,” says Dr. Pozner. “Basically, it stuns the nerve that controls frowning or raising your brow. The results smooth out your wrinkles and can last upwards of two years.”

BOTOX, BOTOX, BOTOX Injectable wrinkle-reducers and line-erasers are all the rage in cosmetic surgery, and for good reason. Their ability to erase signs of aging with a few simple injections has led many patients that may not be interested in a facelift procedure into plastic surgeon’s offices. Botox works by blocking the signals sent from the nerves to the muscles, preventing the muscles from contracting and forming wrinkles. Injectable toxins like Botox are known as neuromodulators. One drawback to Botox injections is how long they last.

COLD THERAPY A third device utilizes a different form of energy, called cold therapy, to achieve a similar result. This is called cryoneuromodulation. Myoscience’s iovera°® technology uses a device to freeze the nerves associated with frowning, instead of stunning them. “The downside to iovera is that the results may not last as long as the radio frequency devices, but it is still very promising,” says Dr. Pozner.

New advancements in cosmetic surgery technology have developed to address the drawbacks of toxin injectables. “There are a couple of devices coming that are toxin alternatives,” says Dr. Pozner. “There are some people who don’t want to get Botox every few months, and some who don’t get the results they used to get. With these new devices, results can last as long as two years.”

ARE THESE DEVICES RIGHT FOR ME? Many patients see the signs of aging every time they look in the mirror and wonder, “What can I do about it?” Botox is popular and well known as a treatment. Many patients go to the nearest office that offers it, hoping to get great results. The best way to ensure great results, whether it is from Botox or these new device alternatives, is to spend the extra time to seek out a board certified plastic surgeon to consult with. During the consult, board certified plastic surgeons, such as Dr. Pozner, are skilled at determining the right course of action and safely providing the greatest result for your unique concerns.

NEW TREATMENTS The alternative devices to Botox utilize different methods of energy to eliminate wrinkles, or, technically, to stun the nerves that cause wrinkles to be so noticeable. 62

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CHILL OUT, “The device freezes fat cells, a portion of which then die and are absorbed naturally by the body.”

An Interview with Grant Stevens, MD by THE PSC

hen it comes to “putting fat on ice” – look to Dr. Grant Stevens, a board certified plastic surgeon in Los Angeles. An industry leader in CoolSculpting® technology, his practice uses seventeen CoolSculpting machines. Why so many? The answer is simple, “We get results with our machines,” says Dr. Stevens. “It’s well worth the investment to have this technology because the demand is here to stay and our patients love the outcome.”

It can take six to twelve weeks to see the final results from one treatment. Each area can be treated multiple times; dramatic results can often be obtained with multiple treatments. Nearly two million CoolSculpting treatments have been performed worldwide to date.

SKIN TIGHTENING CoolSculpting may also thicken the skin, making it appear tighter. Cryodermadstringo is the scientific term for skin tightening following Coolsculpting treatments. It is currently being studied to determine exactly how much firmness a patient can expect. “In one female patient, the large fat volume loss did not result in skin laxity. Instead, four months after treatment, the tightened skin adhered well to her new body contours. Pronounced skin folds, evident in pretreatment photos, were no longer visible post-treatment,” says Dr. Stevens. “At this point, it’s unknown how predictable the skin-tightening results are and how other factors, such as patient age, skin condition, number of cryolipolysis cycles, and duration after treatment, may affect the resultant skin tightening.”

CANDIDATES So you’ve been working out, dieting and leading a healthy lifestyle, but those stubborn pockets of fat just won’t go away. Dr. Stevens would like to introduce you to CoolSculpting by Zeltiq. This technique doesn’t require surgery and can be performed during your lunch break.

FREEZING FAT Coolsculpting is a patented method also known as Cryolipolysis® which uses carefully controlled cooling to eliminate fat cells. No knife or needle is used. It is currently approved to treat fat in the tummy, thighs and love handles. Patients feel a vacuuming as the fat is suctioned into the device and then a cooling sensation. The device freezes fat cells, a portion of which then die and are absorbed naturally by the body. This reduces the thickness of the fat layer in the treated areas.

The best way to find out if you are a good candidate for a CoolSculpting procedure is to seek the advice of a board certified plastic surgeon. 63

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NON SURGICAL

edical advances with dermal fillers are ‘buying time’ for patients, and in some cases restoring volume and filling out hollow areas of the face for up to two years. That in turn can help you ‘put off’ a facelift. Experienced injector and plastic surgeon in Salt Lake City, Dr. Brian Brzowski says, “We are talking about low risk, minimal recovery and, in some instances, years’ worth of improvement.” One of the early signs of aging is volume loss in the cheeks. It’s caused by a combination of gravity pulling tissues in the face down and fat loss in the cheeks, which result in sagging skin and hollowing that slowly increases over time. Juvéderm® Voluma XC, Voluma for short, is the first injectable filler approved by the FDA to “temporarily correct age-related volume loss in the cheek area of adults.”

EXPERIENCED INJECTORS

“Skilled plastic surgeons know which types of filler to use in different areas of the face.”

Dr. Brian Brzowski advises seeking the advice of a board certified plastic surgeon prior to selecting which filler is right for you and your face. In the hands of a plastic surgeon, a patient can rest assured they are seeking treatment from someone who is an expert in facial anatomy.

VOLUME LOSS IS THE FIRST SIGN OF AGING “We know there is surgery that can tighten the skin through facelifts,” says Dr. Brzowski. “Restoring volume is now becoming more understood as part of the solution. When we use Voluma® on our patients, we see improvement that is profound in the mid face and jawline.”

PLACING WRINKLES ON

BOTOX AND JUVEDERM XC

PAUSE An Interview with Brian Brzowski, MD by THE PSC

Both Botox and Juvederm are non-surgical ways to treat facial aging, but they work very differently. Botox is used to target underlying muscle activity. When the muscles are active – frowning, squinting, etc., they cause wrinkles like frown lines and crow’s feet. Botox temporarily, for about three months at a time, reduces the activity of those muscles, relaxing them, and decreasing the wrinkles. Juvederm is a filler that is injected into areas where volume has been lost, “plumping out” areas such as the lips and the folds between the nose and the mouth. There are many types of fillers, and they vary based on how firm or soft they are. Skilled plastic surgeons know which types of filler to use in different areas of the face for the most natural and long lasting results.

64 THEPLASTICSURGERYCHANNEL.COM

r. Michael R. Schwartz has geared up his plastic surgery practice in Los Angeles with new technology to offer his patients all the latest options to fit their needs. He emphasizes to his patients that if they forgo surgery, it does not mean they can’t have great results.

NON-INVASIVE AND NO DOWNTIME Today’s non-invasive options offer you the ability to better your body without requiring the downtime associated with surgery. Patients are able to maintain their day-to-day lifestyle while addressing their appearance in ways that weren’t available just a few short years ago. Not everyone can take the time to have surgery that involves advance planning and weeks of downtime. You may be interested in surgery, but it may turn out that you are not a good candidate for surgery. “Patients come to you because you’re a surgeon and have expertise on how to keep people looking young and natural,” says Dr. Schwartz. “A lot of people come in and they’re not ready for surgery. Emotionally they’re not ready, and maybe they’re technically not ready for surgery; it’s not time.” Non-invasive technologies offer a great opportunity to fix minor issues in a short amount of time.

ULTHERAPY®

GET THE

LOOK

“Ultherapy is ultrasound skin tightening, and it works just like ultrasound works when you’re pregnant and looking at the picture of your baby,” says Schwartz. “The difference is Ultherapy’s sound waves go into the skin and meet under the surface, causing heat to tighten the collagen of the skin.”

VANQUISH®

YOU WANT WITHOUT SURGERY

“Vanquish is a radio frequency skin tightening device that is designed for the trunk, abdomen, the flanks, and, coming soon, the thighs. It doesn’t touch the patient at all; it creates heat by radio frequency that breaks down fat cells in the treated areas. The fat is released and washed out through the body,” says Dr. Schwartz. “You get a reduction in size and it takes about four to six treatments to see results. Patients can come in, have the procedure done in 40-45 minutes and head back to work without downtime.”

EXILIS®

“Exilis is also a radiofrequency technology. This device is a contact technology - meaning it touches the skin. It’s designed for the head and neck, although it can be used all over the body. It has two components: one part does fat reduction and the other part focuses on skin tightening,” explains Dr. Schwartz. “Used correctly, you can get skin tightening and a reduction in wrinkles.”

IMPORTANCE OF THE CONSULTATION With so many different choices, choosing what’s best for you has actually become more difficult. The Internet is a fantastic tool for finding information, but it can leave you overwhelmed. A board certified plastic surgeon, who has experience with all of these technologies, can assess your unique situation.

“A lot of times people end up in my office and they think they need surgery, but they don’t.”

“A lot of times people end up in my office and they think they need surgery, but they don’t,” says Schwartz. “I’m not always going to tell you that you need surgery. It’s important to come into the consult with an open An Interview with mind; perhaps you aren’t ready for surgery, and we can achieve Michael R. Schwartz, MD by THE PSC your goals with non-invasive devices.” 65 THEPLASTICSURGERYCHANNEL.COM

NON SURGICAL

GOOD BYE DEODORANT

An Interview with Bruce W. Van Natta, MD by THE PSC

hink about it: no more worrying about embarrassing sweat, ruining your silk blouse or those awful white marks on your clothes. A new, non-surgical treatment offers a permanent solution to sweaty underarms. Dr. Bruce Van Natta, a plastic surgeon in Indianapolis, Indiana says miraDry®, an energy-based tool, can zap away odor and sweat glands in the armpits.

body’s ability to regulate its core temperature. “The reality is, you only sweat about 2% of your body’s sweat through your armpits.”

EXCESSIVE SWEATING UNDER CONTROL Most people sweat when temperatures rise or during exercise, but there is a group of people that sweats more than the average person, due to a condition called hyperhidrosis. Millions of Americans suffer from excessive underarm sweat and feel the condition prevents them from doing some of the things they love to do and is a constant source of embarrassment. For these people, miraDry can safely, and non-invasively, provide long-term relief from the condition.

NEWLY APPROVED TREATMENT TO STOP UNDERARM SWEAT In a clinical study, patients experienced an average of 82% reduction in underarm sweat. “miraDry is an FDA approved electromagnetic energy that heats the sweat glands in the armpit,” explains Dr. Van Natta. “The treatment is performed in the office and is immediately effective.” The underarm area is numbed and the treatment takes just over an hour to complete. “One of the added benefits of the procedure is that it knocks out about 90% of the hair follicles,” states Dr. Van Natta.

RECOVERY The technology sounds almost too good to be true: no surgery, no downtime, won’t affect your body’s ability to regulate temperature, eliminates odor glands and 90% of underarm hair follicles, and no more deodorant. After treatment you may feel a little sore, but the recovery doesn’t entail anything that would prevent you from getting on with your daily activities.

Dr. Van Natta explains that while sweat glands are important, there is no need to worry. While the procedure stifles the ability to sweat under the arms, it doesn’t interfere with our 66

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An Interview with Clifford P. Clark III, MD by THE PSC

ZAPPING

FAT WITH

“It’s really quite pleasant, which is unique for non-invasive fat removal.”

on-invasive procedures in cosmetic surgery continue to be extremely popular, and the devices that remove fat without surgery are at the top of the list. BTL Aesthetics’ Vanquish ® is one such technology gaining momentum, finding its way recently onto national television shows. Dr. Cliff Clark, a plastic surgeon in Orlando, believes Vanquish stands alone as the only pain-free, non-invasive technology that produces real results for patients looking for non-invasive fat removal.

treatment! It’s really quite pleasant, which is unique for non-invasive fat removal devices.”

DOES IT REALLY WORK? “We take a balanced approach to these things. It’s not liposuction, that’s the first message,” says Clark. “The people, in our experience, that did not get a result are people without fat. You would think a thin patient would be the ideal candidate, but the device really needs some fat in order for the radio waves to tune into. Some of the patients who seem like they have too much fat for a good result actually have experienced fat loss with Vanquish. It might not be as visually stunning, but fat loss does occur.”

“VANQUISHING” FAT The device, often compared to Zeltiq’s non-invasive technology Coolsculpting®, removes fat by utilizing energy in the form of radio frequency. “Vanquish® is a means of non-invasively removing fat,” says Clark. “It’s come to the forefront recently using radio frequency. AM radio waves are literally “tuned” into the fat. Fat has a certain resistance, and the radio waves heat the fat up, causing fat loss.”

Dr. Clark’s use of Vanquish has helped him identify the kind of patient who will see the best results. As mentioned, very thin patients had very little results, while those with a moderate amount of fat had great results. Even in patients who have a lot of fat, a few Vanquish sessions crafted a noticeable reduction in fat.

“The unique thing about Vanquish is its use of radio waves without touching the skin,” says Clark. “There are panels that hover over the area being treated. Without the device contacting the skin, and using remote radio waves, the device heats the fat in a gentle fashion so it’s really not painful.”

While Clark shares the opinion that these non-invasive fat removal devices will not replace the more dramatic changes seen with liposuction, there is a definite place in cosmetic surgery for them. “When you see something like this on TV, it’s always a bit over-hyped. That being said, it really is a beautiful alternative to liposuction for a select group of people.”

“I’ve had the treatment several times so that I can describe it to my patients and stand behind it. I fell asleep during each 67

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NON SURGICAL

NON-SURGICAL

uvederm’s Voluma ® XC is the first filler approved by the FDA to temporarily correct age-related volume loss in the cheeks. Voluma has proven to be very popular with patients, not only for its results, but for how long those results can last – up to two years. Dr. Christine Hamori of Boston uses Voluma as a modern tool, lifting the patient’s cheek area back to where it was before aging caused volume loss. Voluma makes the case that non-surgical facial rejuvenation can be both effective and non-invasive.

FACELIFT

WHAT’S DIFFERENT ABOUT VOLUMA? Many fillers used in the face are made up of hyaluronic acid. Voluma differs from the other hyaluronic acid fillers currently on the market because the molecules of the hyaluronic acid are bound more tightly together. This gives the filler a stronger form, which produces a firmer filler. Instead of injecting close to the surface like many other softer fillers, it is injected onto the cheek base and it lifts the rest of the tissue. “If you pull the cheek back and inject, Voluma lifts the cheek, and it stays. It’s pretty amazing,” says Dr. Hamori. While two years is an incredible amount of time compared to other fillers that may only last six months, patients want to know the answer to the real question: How are the results? MAINTAIN A NATURAL LOOK WITH VOLUMA Dr. Hamori’s experience with Voluma shows the effectiveness of a stiffer filler to be remarkable. “It gives a more natural look,” says Hamori. “We’re finally realizing that just filling in lines and the nasolabial folds doesn’t make people look natural or any younger. I tell my patients that you don’t want to inject directly to the lines, you want to inject where you would put your fingers when giving yourself a little face lift in the mirror”. Physicians continually study the results of injectables to determine who the best candidate for their use is. When it comes to Voluma, Dr. Hamori finds younger patients can maintain facial volume very well just with a touch of Voluma. “It’s great for young people - maybe in their 30’s and 40’s who are just starting to have volume loss in their face,” says Hamori. “Just a tiny amount can make a huge difference for those patients. For older patients, a larger amount of the product can give a lift that lasts.”

An Interview with Christine Hamori, MD by THE PSC 68 THEPLASTICSURGERYCHANNEL.COM

veryone wants to look a little more refreshed, but with busy schedules there is little or no time for “downtime.” There are exciting new treatments available that can reduce fine lines and wrinkles, address pigmentation problems and pore size with little or no downtime required. One great option is Halo™ by Sciton. Dr. Jason Pozner with Sanctuary Medical in Boca Raton is one of the first in the nation to use Halo and his patients are enjoying a new youthful glow. Halo is a quick, easy treatment that provides results within weeks of treatment.

“This is the first time I’ve ever seen anything with such a huge impact on pores.”

WHAT DOES HALO TREAT? One of the most noticeable changes seen is with the patient’s pigment. It can also smooth out fine lines and wrinkles. Dr. Pozner has found that one Halo treatment, lasting fifteen to thirty minutes, vastly reduces sun damage and can produce a 30-60% reduction in pore size. “This is the first time I’ve ever seen anything with such a huge impact on pores,” says Dr. Pozner. “Previously, it would take me six months to impact the skin, however, with Halo we are able to reverse damage in the course of a weekend and vastly improve the appearance of a patient’s skin.”

WHAT IS HALO? Halo is the world’s first and only “hybrid” fractional laser. This means all the treatments can be customized. The procedure combines deep dermal rejuvenation with epidermal renewal for a combined effect that can’t be achieved with any other single treatment.

TREATMENT & RECOVERY Patients receive a topical anesthetic treatment before the procedure begins to reduce sensation. The laser also has an integrated cooling tip, which keeps the skin comfortable during and after treatment. Most patients say they feel only a little heat, and occasionally a prickling sensation. After twenty-four hours the skin will begin to peel. Makeup can be applied after a day or two, depending on how many passes of the laser have been done. After two to three days the patients develop a light bronzing appearance. By day three or four the skin will peel, revealing new skin beneath.

NOTICEABLE RESULTS Pigment improvement can be seen within the first several weeks. A dermal regeneration phase follows the treatment, which continues to improve the texture of the skin for months. Each additional Halo treatment will improve the results. It is very important to keep skin protected by using UV sunscreen for optimal results.

An Interview with Jason N. Pozner, MD by THE PSC

BIG RESULTS,

LITTLE DOWN TIME 69

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The science of heat. The beauty of control.

Temperature Controlled Radiofrequency

70 THEPLASTICSURGERYCHANNEL.COM

THERMI.com

Manly Surgical Solutions Interview with Louis P. Bucky, MD

Solutions for the Muffin Top Man Interview with Jarrod R. Daniel, MD

Have we Discovered the Cellulite Solution? Interview with Michael Lee, MD

The No Pain, No Drain Tummy Tuck Interview with Michael R. Schwartz, MD

Building Confidence with Labiaplasty Interview with Laurie A. Casas, MD

Labiaplasty and Beyond Interview with Christine Hamori, MD

Transgender Surgery Interview with Patricia McGuire, MD

Medical Spas Made Just for Men Interview with Grant Stevens, MD

No More Man Boobs Interview with Mary Gingrass, MD & Melinda Haws MD

Restoring Confidence in Men with Gynecomastia Interview with Shaun Parson, MD

FAST-TRAK Recovery Interview with William P. Adams Jr., MD

Stem Cell Research: Is the Verdict Still Out? Interview with Robert T. Grant, MD

71 THEPLASTICSURGERYCHANNEL.COM

TRENDING

ADVANCES IN PLASTIC SURGERY

TRENDING

MANLY SURGICAL

ove handles, facial lines and man-boobs; they are all real concerns for today’s man. The pressure to look fresh, youthful and happy is just as real among men as it is among women.

SOLUTIONS

MEN ARE GOOD CANDIDATES FOR INJECTABLES AND SKINCARE “Men are extremely good filler patients,” says Philadelphia plastic surgeon, Dr. Louis P. Bucky. In addition to fillers, cosmetic surgery and other treatments, Dr. Bucky is bringing skincare to his male patient’s attention. “Men are notorious for playing sports and working outside without wearing sunscreen. We feel now is the time for us to educate men on the importance of sunblock and skin moisturizing.” Dr. Bucky’s practice offers a full line of cosmetic skin care products that complement in-office treatments. Antioxidants, emollients, and sunscreens actively work to prevent future damage while retinols stimulate cell turnover and slow the signs of aging. Dr. Bucky carries his own line of skincare products alongside many professional lines.

FACELIFTS FOR MEN Facelift goals differ between men and women. Dr. Bucky explains, “It’s easy for a man to appear ‘overdone,’ as their tolerance, skin texture and muscle fibers make the surgery more unpredictable. Generally, men have stronger features, bigger faces, heavier necks, and more vascular skin, which in the hands of an inexperienced plastic surgeon can lead to poor outcomes.”

THE DREADED LOVE HANDLES As we age, the mid-section seems to take the biggest hit. Men frequently complain about “love handles,” the extra fat that tends to accumulate around the waistline. One of the most popular non-invasive fat removing procedures at Dr. Bucky’s office is called CoolSculpting®, an FDA approved device that freezes an area of fat in a simple one-hour procedure. CoolSculpting employs precisely controlled cooling to remove fat. It targets only fat cells, leaving skin and other surrounding tissue unharmed. Following the procedure, the body will gradually eliminate fat cells in the targeted area over an approximately three-month period.

An Interview with Louis P. Bucky, MD by THE PSC MALE MENOPAUSE AND MAN BOOBS It’s a hot topic and a lot of research is still ongoing. We know that in midlife, hormonal changes take place for everyone. “Aging men can be very sensitive to man boobs or what is medically termed gynecomastia. They want to look good in tight fitting trendy clothes, and they also want to feel confident without a shirt on,” says Dr. Bucky. It’s important that every patient seek the advice of a board certified plastic surgeon before deciding on any surgical procedure, whether it is for a facelift, fat removal or gynecomastia.

“Men can also be good candidates for Sculpt360®,” says Dr. Bucky. “Sculpt360 is a proprietary technique our office uses to enhance CoolSculpting results. One treatment can often reduce at least 20% of fatty tissue located in targeted treatment areas with little to no downtime.” 72

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An Interview with Jarrod R. Daniel, MD by THE PSC

SOLUTIONS FOR THE

MUFFIN TOP MAN T

BODY CONTOURING “The biggest problem area for men is typically the abdomen, that stubborn muffin top; that’s the bulk of it,” explains Daniel. Now, body contouring can be done with surgical or non-surgical modalities. Liposuction is surgery and involves more downtime, while CoolSculpting® allows people to have a treatment done over their lunch hour. With CoolSculpting a device is clamped on a target fat area. In about one to three months, fat reduction is seen in the area that was treated.

oday’s society places a high value on looking young and fit. Men of all ages and all walks of life are requesting plastic surgery for cosmetic reasons. Some are looking for a balanced nose, an eyelid lift or the removal of a muffin top. “Men get surgery as a tool to help them succeed, in a marketplace where looking fit, younger and more masculine is imperative. The better you look, the better your chances of ascending the corporate ladder,” says Charlotte, North Carolina plastic surgeon Dr. Jarrod Daniel. The American Society for Aesthetic Plastic Surgery (ASAPS) reveals that Americans spent over $12 billion on cosmetic procedures in 2014. One sector that’s seeing a big increase is men. According to ASAPS, more men are turning to aesthetic cosmetic procedures, with a dramatic 43% overall increase in procedures, including both surgical and non-surgical options.

EYELID SURGERY “With men, we see a lot of patients who may need eyelid surgery. It can be performed with a local anesthetic in office. The goal is to create a nice balance between the upper and lower lids,” says Daniel.

For most men, it can be as simple as reducing an angry or tired look with Botox® or neck contouring to tighten a loose neck or jaw line. In his experience, Dr. Daniel says, “Men want faster recovery times with a rapid return to work. We don’t like to wear make-up or talk about plastic surgery.”

END GOAL For all of us, a well-rested appearance is truly the end goal. “We want people to say, ‘Wow, you finally got some sleep,’ not ‘Who’s your surgeon?’ We take a natural approach and make sure our patients don‘t look overdone,” concludes Daniel.

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TRENDING

HAVE WE DISCOVERED THE

CELLULITE SOLUTION? An Interview with Michael Lee, MD by THE PSC

“A new device may be the answer we’ve all been waiting for.”

hen it comes to the body, there may be nothing more annoying than cellulite. Slim, toned, muscular, tall, short... cellulite doesn’t discriminate. The dimpled, orange peel texture typically strikes women, staining even the fittest of bodies.

WHAT IS CELLULITE? Cellulite is caused by fibrous tissue that pins down the skin in some parts, allowing other tissue to come up between those restrictive bands, displaying as dimpling. Cellfina reduces cellulite by slicing the small bands underneath the skin, allowing the tissues to relax and the layer to smooth out.

Dr. Michael Lee, a plastic surgeon in Shreveport, Louisiana believes a new device may be the answer we’ve all been waiting for. It’s called Cellfina®, and the Wall Center is one of the first plastic surgery offices in the nation to work with the recently FDA approved device.

RECOVERY AND RESULTS “The procedure itself usually takes about an hour or so depending on how many areas are being treated. Downtime is minimal and patients are able to go right back to work. Patient satisfaction has been extremely high and it’s a great option for many people,” states Dr. Lee. Another benefit of Cellfina is that a percentage of the final results are instant. There is some bruising, which typically only lasts a couple of weeks.

“Until now we’ve just not had a great solution for cellulite,” says Dr. Lee. Consumers have spent billions of dollars on lotions and potions and things that don’t work. While most treatment options offer very little in terms of results, Cellfina has shown proven results. “Cellfina is ideal because it’s performed under local anesthesia in a clinical setting. The device is placed over the dimpled area and the bands responsible for cellulite are released while leaving everything else alone,” explains Lee. 74

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ou’ve had your kids or lost weight and now you’re trying to get back in shape. Some things, namely your mid-section, are not getting a whole lot better. This is when many women look into a tummy tuck, also known as an abdominoplasty, to get rid of the stretch marks, loose skin and loose abdominal muscles. You may feel hesitant about the procedure knowing the recovery can be one of the more intense or painful procedures in plastic surgery. The discomfort combined with a limited ability to move around normally and those dreaded drains are a few reasons for your anxiety. But now, everything surrounding the typical tummy tuck is changing. Dr. Michael R. Schwartz, a board certified plastic surgeon in Los Angeles, tells us the no pain, no drain tummy tuck is here.

PAI N

Dr. Schwartz says there are two main components during surgery that help patients heal faster and with less pain. One is a surgical technique and the other is a non-narcotic drug administered into the wound site while the patient is still asleep.

PAIN REDUCTION Those first three days after an abdominoplasty can be critical and are often the hardest part of recovery. That’s why controlling the pain with the non-narcotic drug Exparel® is proving to be so effective. The breakthrough drug allows patients to be up and about sooner, without suffering the side effects that often accompany narcotics. Once Exparel has worn off, patients do well with simply using over-the-counter pain medicine to ease their discomfort.

THE

NO PAIN,

THE NO DRAIN TECHNIQUE The surgical technique Dr. Schwartz performs minimizes post-operative care and eliminates drains. This new technique is called the progression tension suture technique. Instead of laying the skin back on top of the muscles and having a drain provide pressure to heal the area, surgeons progressively stitch the abdominal skin down to the muscles as they go, eliminating the need for a drain. “This all revolves around using a different technique, it doesn’t change the result,” says Dr. Schwartz. “Our patients can move around freely and even be back to work and life much sooner. My patients tell me it’s much better than they expected. It’s an exciting time in plastic surgery when we can perform a life-altering procedure, changing body contours, that is virtually painless, as well as being less cumbersome to the patient and family members.”

NO DRAIN

TUMMY

TUCK

An Interview with Michael R. Schwartz, MD by THE PSC

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BUILDING CONFIDENCE

WITH LABIAPLASTY An Interview with Laurie A. Casas, MD by THE PSC

he labiaplasty procedure widens eyes to the unfamiliar, and somewhat taboo, world of genitalia correction. Shocking or not, the procedure offers something extraordinary to those suffering from issues with their own genitalia: hope. For women currently struggling in daily life to overcome the difficulties of abnormally large labia minora, the labiaplasty procedure provides an incredible success rate when performed in the right hands. Chicago plastic surgeon Dr. Laurie Casas helps guide women and teenage girls through the procedure, focusing on helping those who are struggling with a functional problem. Outsiders who wonder why women want to “look prettier down there,” are missing the bigger picture - these women are suffering physically and emotionally due to the size of their labia minora. Labiaplasty can mean an end to suffering, with little to no complications and a quick recovery.

WHO IS A CANDIDATE FOR LABIAPLASTY? “There’s two types of patients,” says Dr. Casas. “Pre-pregnancy, 17, 18, 19 year old girls, who come in with their mom; and post-pregnancy women.” The younger patients never had a chance at life with a normal labia; puberty and genetics combined to create an abnormally sized labia minora. Taking care of it early on will help ease discomfort and give these young women a boost of self-confidence. The older, post-pregnancy patients experienced a physical change over the course of a pregnancy and they want to return to their pre-pregnancy body. “100% of my patients have a functional problem,” says Casas. “There’s irritation, pain, discomfort and inability to wear normal clothes because there’s a bulge. Otherwise, I don’t feel like they’re a good candidate.”

AN EASY, IN-OFFICE PROCEDURE “I do the procedure in my office under local anesthesia,” says Casas. “Music therapy is key, in a warm, comfortable environment with my female staff. The patient comes in and is sedated while listening to music. The procedure takes about an hour to an hour and a half.” In addition to a relaxed, low-key experience, the recovery can be easy and worry-free. “The key for the patient is that they’re on board with the post-operative phase,” says Casas. “In my practice, it involves three days of icing the area around the clock and then eleven days of not performing any vigorous activity. Beyond that, it’s six weeks of not riding a horse, a bike, or engaging in sexual intercourse. If patients do all these things, it’s basically a 0% complication rate for my patients.”

THE BEST TIME IS NOW One of the hardest things for the younger patients is finding the answers to their personal questions. Why does my vagina look like this? Is this supposed to be so uncomfortable all the time? Questions like these can be hard to ask your mother, and even your doctor. The Internet provides teenage girls a chance to ask tough questions anonymously. “The web and the ability to educate yourself on good sites has changed this kind of procedure drastically,” says Casas. “It’s a little uncomfortable and embarrassing to talk to your parents about it, so it’s great to be able to research it on the web, understand the procedure, the risks and the complications.” With the help of good information and an experienced plastic surgeon, improving someone’s life - not just someone’s look – through labiaplasty is possible. 76

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LABIAPLASTY AND

BEYOND An Interview with Christine Hamori, MD by THE PSC

ore and more women are feeling the pressure to look and feel good both in clothing and behind closed doors. Labiaplasty is a one to two hour surgical procedure that reshapes the external vaginal structures including long or uneven labia. Some consider this procedure a game-changer because of the way it rebuilds a woman’s self-esteem.

undergarments,” says Dr. Hamori. “The age range of those requesting these procedures is quite broad; teens present with congenital asymmetry where older patients, who have had children, present with bilateral enlargement of the inner and outer labia.”

IS LABIAPLASTY BECOMING MORE POPULAR?

Boston plastic surgeon Dr. Christine Hamori is noticing a trend where women are not only bothered by the discomfort of large labia, but also by the appearance. Some of her patients ask for a consultation after they’ve been bullied or have heard derogatory comments such as ‘meat curtains’ or ‘elephant ears.’ Other patients feel uncomfortable and self-conscious around their partners. Dr. Hamori says, “Women tell me it’s so upsetting that it can affect their confidence and they want to have it fixed.”

Labiaplasty has shown a marked increase in popularity according to the American Society for Aesthetic Plastic Surgery. Labiaplasty procedures increased by 44% over the course of 2014. “The reality is that women have been grooming themselves differently for the past ten years, with many eliminating pubic hair altogether. Many of my patients want a clean, smooth look,” explains Hamori. The number of surgeons who are performing labiaplasties has also increased, from 21% to 29% in the past year alone.

WHO IS A GOOD CANDIDATE? Patients who seek labiaplasty don’t want the labia minora (inner lips) hanging beyond the labia majora (outer lips). Others feel bulky in pants or a bathing suit and are guarded when it comes to wearing revealing clothing. The final group of patients seeking the surgery are active athletes or triathletes who complain of ‘rubbing’ when biking or running. “Patients seeking labiaplasty frequently complain of bulkiness in their

HOW LONG IS THE RECOVERY? The recovery is about 4-5 days of bed rest followed by 2-3 weeks off from the gym. “I have a very high patient satisfaction rate with this surgery,” says Hamori. “They want to look pretty for themselves, to feel better in clothes, and more confident in the bedroom.”

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TRENDING

An Interview with Patricia A. McGuire, MD by THE PSC

TRANSGENDER SURGERY McGuire. Deciding on the type of implant is one of the most important considerations for someone contemplating transgender breast augmentation. Another factor to be considered is the shape of the implant. Typically, the implant will either be round or teardrop-shaped, with the round shape being the more popular of the two. Round implants are preferred because they give a round, proportioned appearance to the breasts.

he transgender topic is nothing new, but Olympian Caitlyn Jenner, formerly known as Bruce Jenner, is thrusting the subject back into the spotlight. St. Louis plastic surgeon Dr. Pat McGuire is a leader in the field of transgender surgery. Dr. McGuire performs surgery on those who have chosen to change their gender from male to female and from female to male. “When the Bruce Jenner issue came to surface, it brought light to a very misunderstood form of gender identity,” says Dr. McGuire.

BEST CANDIDATES Gaining approval for chest reconstruction or breast augmentation is not as straightforward for transgender individuals. Because both of these procedures are permanent, a reputable plastic surgeon such as Dr. McGuire, who is board certified with the American Society of Aesthetic Plastic Surgeons, will determine a candidate’s eligibility during the consultation based on a variety of factors. She always asks the following questions: Are they physically and psychologically healthy? Do they have a letter of recommendation from a mental health professional? Do they possess realistic goals and expectations?

PREPARING FOR GENDER CHANGE A lot of planning goes into a surgical gender change. Much of the preparation, including hormone treatments, are done at least a year before the individual looks to a plastic surgeon for help. The regimen typically takes about a year, and McGuire says most people are well informed, have done their research and are then ready for surgery. “Many know at a young age that they want to consider changing their gender,” says McGuire. “Others are often accompanied by a family member who knew before the individual did. I’m really impressed with the support system I’m seeing from friends and family prior to the patients’ surgery.”

PATIENT SATISFACTION “Really the most grateful patients I’ve treated are transgender patients; they are so excited someone is listening to their needs and wants to understand them. They really appreciate someone taking time with them. I recently received an email from a patient who said it’s so liberating not having to bind his chest. He’s now wearing clothes and living the life he wants to live, and that’s gratifying,” says McGuire.

LARGER, ROUNDER BREASTS During the consultation, many times the man who wants to make the switch to a woman has grand ideas about the chest. “A lot of transsexuals say they want a large, round breast, so I often use a high profile silicone gel implant,” says 78

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“W

here a Man can Feel Good about Looking Great™” is a slogan that’s been trademarked at a spa in Marina del Rey, California. ManLand is an environment where men can have surgical and non-surgical procedures in a place designed especially for them.

THE WAVE OF THE FUTURE? “Men have a renewed interest in looking great and staying young,” says Dr. Grant Stevens, a board certified Plastic Surgeon and the marketing master behind the new concept. Male plastic surgery is a booming market that shows men do care about how they look, not just in the aesthetic sense but in order to compete in the job market as well. The idea of only women undergoing plastic surgery is no longer the norm. Recent statistics from the American Society of Aesthetic Plastic Surgery show male plastic surgery rates are up 43% over a five-year period.

MEDICAL SPAS MADE JUST FOR

Seeing the growing trend, Dr. Stevens set out to design the perfect atmosphere just for men. He began by interviewing hundreds of men in his busy plastic surgery office and discovered exactly what they like and what they don’t like. “It’s like a cigar lounge meets a sports bar,” says Stevens. Even the restrooms are specially designed for men, complete with TV monitors showcasing Sports Illustrated® swimsuit models and urinals in the bathrooms. “Now what kind of man wouldn’t like that!” laughs Stevens. Stevens has torn down the walls of what was once a female dominated arena of beauty and aesthetics, and turned it into a space comfortable for men. When you walk in you’ll find leather chairs (no couches, men hate couches), fake buffalo heads, flat screen TV’s playing ESPN®, even a special manly scent that’s piped in through the air ducts. Everything needed to make what many refer to as a perfect man cave. “There’s not a drop of estrogen in here. It’s not intended to be girl-unfriendly, it’s just intended to be male-friendly,” says Stevens. When guys first come to the office, they may be a little self-conscious at first. But, Stevens says once they’re in the waiting room and see three or four other guys sitting around, they loosen up and pretty soon they are talking and joking around. It’s a place where men can kick back and not be concerned about who might see or judge them. “This is why they keep coming back,” says Stevens, “they’re comfortable.”

MEN “Where a Man can Feel Good about Looking Great™”

WHERE A MAN CAN LOOK LIKE A MAN

An Interview with Grant Stevens, MD by THE PSC

Stevens says men want to look natural, not overdone. “They want to look like a man!” Marina ManLand offers many procedures that appeal to men. Some of the most popular treatments are CoolSculpting® to freeze away fat, miraDry® to get rid of smelly armpits, NeoGraft® to restore hair loss, and of course “Bro-tox” (Botox®) to remove manly wrinkles. Men leave ManLand feeling comfortable and confident that they are looking their best. 79 THEPLASTICSURGERYCHANNEL.COM

TRENDING An Interview with Mary Gingrass, MD and Melinda Haws, MD by THE PSC

NO MORE MAN BOOBS

tatistics show that between 30-60% of men will develop some form of enlarged breasts in their lifetime. In adolescence, gynecomastia can lead to low-self-esteem issues and embarrassment. It can also occur in older men when they experience a decrease in their levels of testosterone and skin elasticity. At The Plastic Surgery Center of Nashville, Dr. Mary Gingrass and Dr. Melinda Haws routinely treat men both young and old with gynecomastia.

WHAT IS GYNECOMASTIA? “Gynecomastia is triggered by a decrease in the amount of the hormone testosterone compared with the amount of estrogen. The hormone imbalance can occur naturally in adolescence or it be caused by a variety of medications, steroids or supplements,” explains Dr. Gingrass. In most cases, the swollen breast tissue will go away without treatment within six months to two years. However, surgery may still be necessary to achieve desired results.

PUFFY NIPPLES Even with minimal breast tissue enlargement, an enlarged areolar diameter tends to produce a feminized chest appearance. For patients with this condition, an areolar reduction can be performed in addition to direct excision of breast tissue and liposuction. The trade-off for reducing the areola is that the patient must be willing to accept a scar. “The surgical procedure can often be done under a local anesthetic and it’s a super easy fix,” says Dr. Gingrass of the nipple reduction procedure.

TREATMENT FOR GYNECOMASTIA For most men with gynecomastia, liposuction is the best treatment. Both fat and breast tissue can be removed with ultrasonic liposuction. The gynecomastia surgery takes about one hour to perform and includes two small incisions. It can be done as an outpatient procedure and there is minimal discomfort involved. “Men come to us explaining how they’ve been ‘dressing around’ the enlarged breast tissue their whole life,” says Dr. Haws. “They tell us how happy they are that something can be done about it!” 80

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“Some males have struggled with their chest’s appearance for most of their adult lives.”

RESTORING CONFIDENCE IN MEN

WITH GYNECOMASTIA An Interview with Shaun Parson, MD by THE PSC

SOLVING THE PROBLEM

o matter your sex, everyone wants to look great. Slim midsections, toned arms, and a nice overall physique. As children grow and mature, they look to establish themselves. If they find themselves lacking in their physical appearance, it can directly affect their self-confidence and self-esteem.

Concern for gynecomastia may start in a pediatrician’s office, but a successful treatment might only be found in the office of an experienced plastic surgeon. “As a physician, you really want to focus on a few things,” says Parson. “You want to excise, or remove, the tissue, as well as use liposuction to smooth the area. There’s always a component of fatty tissue that’s in the chest, and that’s why a plastic surgeon is better at dealing with this. A general surgeon is typically going to excise the area, where a plastic surgeon is going to have more expertise and finesse at smoothing the area with liposuction.”

At the same time teenage girls are wondering when their breasts are going to grow, some teenage boys are wondering when their breasts are going to go away. The condition is called gynecomastia, and the impact on male self-esteem can be severely detrimental. “Gynecomastia affects half of all adolescent boys as they’re growing up,” says Dr. Shaun Parson, a surgeon in Scottsdale who routinely sees patients suffering from gynecomastia. “For the majority of that half, it ends up just going away. In the remaining group of kids where it doesn’t go away, a lot of the times those kids end up needing treatment, or would benefit from treatment.” Around 12% of adult males are afflicted by an overgrowth of breast tissue that effectively gives them breasts.

RESTORING LOST SELF-CONFIDENCE A male affected by gynecomastia and treated as a young adult could have the self-esteem issue solved before it gets out of hand. For some males who have struggled with their chest’s appearance for most of their adult lives, the psychological wounds are slower to heal following treatment, but can and have been healed in the hands of a plastic surgeon.

“The definition of gynecomastia is normal breast tissue, that we all have, that is overdeveloped,” explains Dr. Parson. “For young boys, it can bring up all sorts of negative connotations. One of the social derivatives is a “moob” or a “man boob,” and there are other, less acceptable descriptions. These boys don’t feel right. They don’t feel masculine.” While the most commonly discussed gynecomastia cases revolve around young males, the condition, if unaddressed, can persist far into adulthood.

“It’s one of those things where patients say, ‘Why didn’t I do this sooner?’ ” says Dr. Parson. “They’re back in normal exercise patterns within three to six weeks, depending on the degree of gynecomastia. For the smaller cases, it’s quick, they’re back, and they’re doing things they never thought they could do.”

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TRENDING

FAST-TRAK RECOVERY Bounce back fast after Breast Augmentation

An Interview with William P. Adams Jr., MD by THE PSC

s 24-hour breast augmentation a reality? It almost sounds too good to be true, but for moms like Alicia Flores, it is a reality. She was back in full swing just days after breast surgery, going back to work and taking care of her family.

my colleagues while performing the surgical procedure helps clearly illustrate new techniques and procedures.”

Alicia’s desire for breast augmentation came after having children and breastfeeding. She also had a pre-existing condition called a constricted breast, where the distance between the nipple and fold is very short, not allowing for a full rounded appearance in the lower part of the breast. After years of not being able to find a bra that fit and tired of feeling down about her post pregnancy body, she decided it was time for a professional consultation with a doctor who specializes in breast augmentation surgery. We caught up with Dr. William P. Adams, Jr., a board certified plastic surgeon in Dallas, Texas who performed her surgery.

The t 24 Hour Recovery isn’t just about bouncing back quickly after surgery, it’s about better outcomes for the patient. Part of Dr. Adams’ technique is taking a lot of measurements before surgery and knowing exactly which breast implant will best “fit” the patient. Precise measurements before and a gentle technique during surgery means less trauma to the patient’s breast tissue.

QUICKER RECOVERY - HAPPIER PATIENTS

Adams also uses state-of-the-art technology called Vectra® 3D imaging. With Vectra, patients can see with a 98 percent accuracy, what they will look like after surgery. This gives patients and surgeons the ability to communicate effectively about breast size; the number one question in all breast augmentation procedures.

LIVE BREAST AUGMENTATION SURGERY As it turns out, Alicia was the perfect candidate for an upcoming procedure Dr. Adams was scheduled to perform in Miami, Florida before a live audience.

“I’m so happy with my results, it’s exactly what I wanted,” said Alicia, as she dressed to go out for dinner with friends, just four hours after surgery. She spent the weekend shopping in Miami before taking a flight back to Dallas, and was back to work on Monday. As a hairdresser, Alicia said she had no trouble raising her arms and going about her day. “I was shocked, I didn’t have to take pain killers and I was able to pick up my daughter right away!”

Yes, doctors perform live surgery as a teaching tool for their peers. The event is called the Baker Gordon Symposium, where surgeons from all over the world come together to learn the newest techniques from their colleagues. In 2015, Dr. Adams was invited to demonstrate how to use the newer shaped silicone breast implants, which are perfect for constricted breasts, and to demonstrate his Fast-Trak 24 Hour Recovery breast augmentation procedure.

“At first,” explains Adams, “many surgeons and patients don’t always believe this type of recovery is possible for a breast augmentation procedure. But when they see it, in a live surgery setting, that’s when they have the epiphany that this is not only possible, but a powerful tool to enhance patient outcomes.”

“The Baker Gordon Symposium is a unique way for surgeons to communicate with each other on real life clinical plastic surgery,” says Adams. “Being able to answer questions from 82

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STEM CELL RESEARCH:

IS THE VERDICT STILL OUT?

here are very few buzzwords bigger than stem cells in the world of western medicine. Do they work or don’t they? What exactly do they do, anyway? Some research is in, but overall, the jury’s still out. As Dr. Robert Grant explains it, the stem cell marketing campaigns might not be so interested in waiting for the scientific jury before they officially extol their products’ powers.

cells are exactly the cause of what is being reported by some of these authors.” For now, claims about the effectiveness of stem cells remains largely a marketing ploy. “Unfortunately, stem cells - for all of the pizazz associated with the term - aren’t yet ready for prime time,” says Dr. Grant.

WHAT ARE WE REALLY DEALING WITH?

Stem cells in fat are still a mystery. Surgeons know they’re in there, and also that they seem to provide some benefit to the area where the fat is added. ‘Seem to’ and ‘might’ are not science, however, so before physicians can market stem cells as part of a facelift or any medical procedure, research must be able to provide proof to back up the claims.

Dr. Grant is quick to point out that much of the positive research promoting stem cell effectiveness is coming from procedures involving fat grafting. “The addition of volume, with fat grafting, has been one of the great advances,” says Dr. Grant. “And yes, there are stem cells that are in fat when it’s transplanted.” The primary purpose of fat grafting is to use a patient’s own fat cells from an area where they don’t need the fat, to provide volume where they do need it. Inside these transplanted fat cells exist stem cells. How many stem cells there are and what precisely they do is still being researched.

THE STUDIES The scientific community cannot claim with any certainty that stem cells affect the quality of a result. Dr. Grant explains, “We can’t say with any scientific certainty that those stem

THE VERDICT

Any current claim that stem cells are actively providing benefit is simply a marketing claim and not a scientific claim. “Lots of science and research is going into their use and ways that we can manipulate them,” says Grant. “But, unfortunately, if a surgeon or a doctor says to you that my technique uses stem cells and therefore I can get a better, long-term result, they’re really talking to you about their marketing and not their true outcomes.”

An Interview with Robert T. Grant, MD by THE PSC

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Real Plastic Surgeons - Real Answers 84 THEPLASTICSURGERYCHANNEL.COM

Safety First When it Comes to Surgery Interview with Geoffrey R. Keyes, MD

Before You Have Plastic Surgery Interview with Lee Thornton, MD

Turning OFF Nausea Interview with Richard A. Baxter, MD

Revision Surgery: What You Need to Know Interview with Richard A. Baxter, MD

Three Keys to Finding a Great Plastic Surgeon Interview with Geoffrey R. Keyes, MD

SURGEONS & SURGERY

ADVICE FOR PATIENTS FROM TOP SURGEONS

Leaders Share Their Knowledge Through Live Surgery The Plastic Surgery Channel

High Standards Equals Safety Interview with Tiffany McCormack, MD

Improving the Lives of Burned Children Interview with Stafford R. Broumand, MD

Whoâ&#x20AC;&#x2122;s Right for the Job? Interview with William P. Adams Jr., MD

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SURGEONS & SURGERY

SAFETY FIRST WHEN IT COMES TO

SURGERY

An Interview with Geoffrey R. Keyes, MD by THE PSC

Choosing a legitimate, expert surgeon that is board certified is a challenge on its own, but it is only the first step, and will require a consultation. If the surgeon has their own facility in which they operate, you now have something else to discover: has the facility been deemed safe? “You would never want to have your surgery in a facility that is not accredited or licensed,” explains Dr. Keyes. “How do you know it’s a safe place? If they’re credentialed and accredited by an outpatient accrediting association or licensed by the state, that means they’ve adhered to standards for patient safety that they can document.”

s much as we all want great, fast results from cosmetic surgery, it is extremely important to take the time to make sure we choose a surgeon who performs surgery in a safe facility. Dr. Geoffrey Keyes of Los Angeles knows exactly how important safety is and explains the importance of facility accreditation.

DEFINING SAFETY “Surgery is serious business,” says Dr. Keyes. “People think because they’re having cosmetic surgery that it isn’t as serious, but it is. Patients really need to know what to look for when evaluating a safe facility.” Fortunately for patients, various associations exist that give accreditation to doctor-owned/managed hospitals. One such association is the American Association for Accreditation of Ambulatory Surgery Facilities, or AAAASF for short. AAAASF has been inspecting and accrediting facilities for over 30 years.

Dr. Keyes notes that asking the right questions is very easy, and the consequences if you don’t ask could be severe. “It’s very simple. Just because a doctor is board certified doesn’t make them a good surgeon. And just because a doctor has his own small hospital, doesn’t mean he knows how to manage it. If you don’t research the background of the surgeon and the location where you’re having surgery, you could be asking for a potential lifetime of misery.”

HOW DO YOU KNOW IF YOUR SURGEON’S FACILITY IS SAFE? “When you call the doctor, you can ask where they operate, if it is accredited and which association is providing the accreditation,” says Keyes. 86

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BEFORE YOU HAVE PLASTIC SURGERY,

READ THIS

An Interview with Lee Thornton, MD by THE PSC

ou’ve made the big decision to have plastic surgery. It’s something you’ve been considering for a long time and you’re excited to follow through with your plan. But have you really done your homework to find the right plastic surgeon? Dr. Lee Thornton, a plastic surgeon in Meridian, Mississippi says, “The consumer needs to educate themselves and research the surgeon and the facility before making a final decision. The key is to know BEFORE you go.”

WHO CAN PERFORM PLASTIC SURGERY? Today more than ever, all types of physicians, from emergency room doctors, to OB-GYN’s, are getting into the field of plastic surgery. “We see more and more non-core specialists getting into this field. Many of these doctors doing plastic surgery are not board certified in plastic surgery. They often will go to a short training course and learn about Botox®, fillers, or even more advanced procedures like breast augmentation or liposuction. Then, they come back and implement these procedures into their practice without having enough training,” says Thornton. While an emergency room doctor performing plastic surgery or a dentist injecting Botox may not be against the law, it can be a red flag. “Once you’ve been through medical school and you’ve obtained any type of medical license, you are really free to do whatever you want to do medically, unless an institution puts restraints on you,” explains Thornton. “The local hospital might put restraints on you, but if you have a private clinic in town and you want to provide a service, you can hang a shingle and you can do pretty much anything that you want. There are no laws against that.” Current laws in many states permit any licensed physician to call themselves “plastic” or “cosmetic” surgeons, even if they have not been trained as a plastic surgeon.

DON’T STOP WITH THE SURGEON, CHECK OUT THE FACILITY Another important question for the patient to ask is if the facility they will perform the procedure in is accredited. “The facility is a reflection of the people who work there and the quality of work they are doing,” says Thornton. “If you find yourself in an unaccredited facility, you really need to ask questions as to why it’s not accredited and of course look further into the training and accreditation of the physician and staff.”

TOP 5 QUESTIONS TO ASK BEFORE PLASTIC SURGERY Before you have plastic surgery be sure to ask if your surgeon is certified by the American Board of Plastic Surgery, and if he or she is trained specifically in the field of plastic surgery. Also, be sure to ask if the surgical facility is accredited. Always be sure to find out how many procedures of this type the surgeon has performed and what the risks and complications are. 87 THEPLASTICSURGERYCHANNEL.COM

SURGEONS & SURGERY

TURNING OFF NAUSEA F

An Interview with Richard A. Baxter, MD by THE PSC AMENDING ANESTHESIA WITH EMEND®

or some patients, nausea from anesthesia can be a big downside to elective cosmetic surgery. Dr. Richard Baxter, a board certified plastic surgeon in Seattle, knows full well that nausea can plague some surgical candidates and has found a medication, that when taken before anesthesia, solves the problem.

The pre-anesthesia medication used by Dr. Baxter is called Emend®. Used to fight back nausea in cancer patients undergoing chemotherapy, the medication is also useful for nausea caused by anesthesia. “It works differently and prevents nausea,” says Baxter. “It’s not a rescue medication, it prevents symptoms from happening.”

NAUSEA FOR SOME Many people undergo surgery that requires anesthesia, and not all of them experience nausea. For those that do, the toll it takes during recovery might cause them to rethink if they really want to opt in to an elective surgical procedure. “You get this whole cocktail of drugs that are required to render you unconscious and not sense the pain, even if it’s just an IV,” says Dr. Baxter. “The body doesn’t necessarily like all of those things circulating through and people react differently.”

PATIENTS SUSCEPTIBLE TO NAUSEA CAN RELAX Dr. Baxter has found that offering Emend to worried patients has almost entirely solved the issue, “We’ve essentially had 100% success with it.” If you’re worried about feeling nauseous and reacting negatively to anesthesia, air those concerns with your board certified surgeon. Help with this issue has been found; all patients need to do is ask. “If we know patients are prone to nausea and they’re concerned, then we can offer this to them and they can take it before surgery,” says Baxter. “They’ll have a much smoother experience coming out of it. They’ll have the reassurance that it’s going to be a different experience.”

While not often thought about, the science behind anesthesia has come a long way, much like every other medical specialty. Even with advancements, some people still have difficulty coming off of anesthesia medications, resulting in post-surgery nausea. “There are a lot of good options that are out there that the anesthesiologist can do, but there is also a medication that we’ve found that’s very effective if given before anesthesia,” says Baxter. 88

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REVISION SURGERY: WHAT YOU NEED TO KNOW

An Interview with Richard A. Baxter, MD by THE PSC has a knowledge of the patient’s history and the strategy and execution of the original procedure, which is helpful when determining a path forward. “However, when you think it’s time to find a new surgeon for a revision, here’s one thing to consider: not every plastic surgeon has the temperament for taking on revision cases. These cases are challenging, expectations are high, and patients are often upset at having to undergo more surgery and expense. For someone who gets his fix by creative problem-solving like I do, it can be quite rewarding,” says Baxter.

hings don’t always go as planned. Sometimes it’s a matter of unintended consequences; sometimes expectations are not met. While it is important to properly and accurately identify the issue, it is perhaps even more important to trust that the surgeon of your choice is competent in both their abilities and communications.

WHAT HAPPENED? Dr. Richard Baxter is a nationally recognized expert in revision breast surgery. An increasing percentage of his practice is patients who are seeking corrective surgery for a procedure performed elsewhere. “When a patient has had a procedure they perceive has been botched, they are upset and they want to know what happened. They want to know, ‘What did that surgeon do wrong?’” says Dr. Baxter. “Sometimes, everything was done well, but the body’s healing process takes over. That’s a variable that we have little control over. In other cases, the patient’s expectations may have been exaggerated.”

It’s important to ask your plastic surgeon if revision surgery is a focus of his or her practice. A good surgeon to handle revision must instill confidence and comfort in the patient.

THE NEXT STEP “You don’t want Plan B to be the same as Plan A, just hoping for a different result,” says Baxter. “Revision surgery is not a time to ‘try, try again’ when the first surgery did not work.” When revision surgery is required, the patient is faced with new circumstances altogether. A board certified plastic surgeon, like Dr. Baxter, is well positioned to tackle the circumstances the second time around.

WHO TO TRUST Dr. Baxter says, “The original surgeon is in the best position to help correct any complications that may have occurred.” The surgeon who performed the initial procedure 89

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SURGEONS & SURGERY

An Interview with Geoffrey R. Keyes, MD by THE PSC

hoosing a surgeon can be a difficult task. You would think that the Internet would make this process easier, but instead it can become overwhelming. Patients need to know what information to look for in order to select a qualified surgeon. Dr. Geoffrey Keyes, a board certified plastic surgeon in Los Angeles, provides some rules to help you sort out the important information and move forward with the right plastic surgeon.

RULE #1: VERIFYING BOARD CERTIFICATION All surgeons go to medical school and train in surgery afterward, but not all surgeons go on to attain recognition by their peers in the form of board certification. There are many types of surgical specialties, so identifying a surgeon is certified by the appropriate board can be difficult. “Really, you have to start with understanding credentials,” says Dr. Keyes. “The only two specialties that train doctors to do rhinoplasty, for example, are otolaryngology/facial plastic surgery or general plastic surgery. Both require doctors to go through a rigorous training program, examination and eventually demonstrate their skills so that they’re able to perform these types of procedures.”

RULE #2: THE CONSULTATION Establishing the significant credentials of a surgeon is a process you can do from home, but determining if that surgeon will be compatible with you and your goals can only be achieved with a face-to-face consultation. “Even though you’ve researched on the web, the most important aspect is the consultation,” says Keyes. “How do you feel with the doctor? Do you sense a level of integrity? Did they show you pre and post-operative pictures from multiple views so you truly know the outcome?”

RULE #3: CONNECTING WITH YOUR SURGEON You’ve seen before and after photos and they look great! But how are you connecting with the surgeon? Do you feel comfortable in the setting, with both the surgeon and his staff? How do their facilities look and are they accredited? These are the final questions patients should ask themselves before deciding on a surgeon. “An understanding of how you feel they connect with you character-wise is the ultimate step,” says Keyes. “When you’ve put those three things together so that you’re comfortable with all of them, then you’ve found your surgeon.”

THREE KEYS TO FINDING A GREAT PLASTIC SURGEON

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LEADERS SHARE KNOWLEDGE THROUGH LIVE SURGERY “The growth as a specialty is really based on education and doing better procedures.” ~ James Stuzin, MD

eaders in the field of plastic surgery come together each year in Miami, Florida to teach other surgeons new techniques. But this isn’t your typical meeting; invited faculty surgeons perform live surgery while their peers watch and ask questions.

THE INTERCHANGE OF IDEAS Dr Stuzin says one of the reasons Dr. Baker originally founded this meeting was because surgery was often very proprietary back in the 1960’s. He remembers the early days when leaders in plastic surgery would let you visit them in the operating room, but would make you stand on the other side of the room, so you really didn’t know what they were doing. But now, that’s all changed. “It’s the sharing of knowledge that makes this meeting successful,” says Stuzin.

It’s called the Baker Gordon Symposium and it was the first live surgery meeting of its kind when it was introduced by Dr. Thomas Baker in 1968. It is now also the largest. “I’ve asked some of the world’s best surgeons to come and not only demonstrate their procedures, but to look at the subtleties that make good results, great results,” says Dr. James Stuzin, program director and chairman of the event. Dr. Stuzin, who is a plastic surgeon himself, says to perform live surgery at Baker-Gordon, you not only have to be a good surgeon, but a good teacher.

The sharing of techniques and nuance is part of the reason the field is growing so rapidly. “Physicians today grow up sharing knowledge, it’s in our culture, it’s in our DNA; being proprietary is counter-culture,” says Dr. Bucky. He explains, “So while you may feel like you’ve worked hard to gain this secret sauce, on the other hand, when you share knowledge it makes everything better for everyone else.”

A BETTER WAY TO EDUCATE “You have to be three times more prepared than you normally are for your own operating room,” says Dr. Lou Bucky. Dr. Bucky recently performed facelift surgery and said performing surgery live, made him a better surgeon. “I had to think through every step of the process so I could explain it to my colleagues while still getting the best result for my patient.”

The exchange of ideas is what makes the Baker Gordon Symposium so unique. “I think that’s what made this meeting not only successful but it continues to put it in the forefront of aesthetic surgery,” says Dr. Stuzin.

“Live surgery is a very different way to educate,” says Dr. William P. Adams, Jr. “While you can learn a lot from lectures and videos, there’s no way to duplicate actually being there.” Dr. Adams was also a former invited faculty surgeon and performed a difficult breast case while hundreds of surgeons looked on via satellite.

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SURGEONS & SURGERY

HIGH STANDARDS EQUALS SAFETY An Interview with Tiffany McCormack, MD by THE PSC

he coveted “Quad-A” rating at Dr. Tiffany McCormack’s Tiffany McCormack’s plastic surgery practice in Reno, Nevada, is raising the bar in the plastic surgery industry. When you are considering plastic surgery, you should choose your surgeon and the facility carefully to ensure your safety. “In addition to seeking out a board certified surgeon, choosing a surgical facility with AAAASF is very important. It must meet strict guidelines, above and beyond the average surgical center,” explains Dr. McCormack.

PRIVACY + SAFETY The American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF) ensures each facility, as well as its surgeons, meets strict requirements and maintains rigorous standards of patient safety and care. “Housing an AAAASF-accredited on-site outpatient facility at McCormack Plastic Surgery is somewhat of a unique luxury as it enables our patients to receive the same safety and quality of surgical care they would in a hospital setting, all in the comfort and privacy of our own office,” says Dr. McCormack. In addition to a private, certified surgery center, the office contains state-ofthe-art equipment for facial rejuvenation and body contouring procedures. Patients enjoy a discreet and private entrance for the utmost confidentiality. After all, who needs to know?

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IMPR♥VING THE LIVES

OF BURNED CHILDREN An Interview with Stafford R. Broumand, MD by THE PSC

mission and a way for Dr. Broumand to give back. He is on his third trip to APROQUEN to perform plastic surgery on children like Yudeisy. As Dr. Broumand walks to the porch to meet the family for the first time, he sees the extent of the child’s burns on her head, torso and legs. Without this surgery, the likelihood of Yudeisy being able to walk is non-existent. The scarring from the burns is so bad, it has encapsulated her entire left foot and ankle making it impossible to stand up or use the foot.“Basically this surgery is to make her function better and to give her whatever hope we can as far as appearance. It’s not just the surgeries that I do; that’s just the band-aid. APROQUEN has put together a team of professionals that will help with the compression garments, the physical therapy, the continued treatment and occupational therapy. The team will be working with her to make her life as good as it can be conStafford R. Broumand, MD and 14 month old Yudeisy; Managua, Nicaragua sidering this devastating accident.”

“W

A TEAM OF SPECIALISTS

e are going to be operating on this little girl. She is 14 months old. When she was 9 months old she was wrapped in a blanket on a hammock while her mother was working around the house. Flames from the burning embers, which were placed around to keep the mosquitoes away, caught the blanket on fire and burned this child.” Dr. Stafford Broumand, a busy New York City plastic surgeon, describes the tragic story of his upcoming surgery. He’s in a poor, remote area of Managua, Nicaragua and he has just arrived at the family home of his young patient, Yudeisy, to evaluate her condition. “Many of these families live in shacks or shanty-type villages where they often burn their trash on the open ground without barriers or any kind of protection from smoldering embers or sparks. This is a common occurrence and how children in Central America get burned every day.”

The next day, the surgery goes well and you can see the relief on the mother’s face as she kisses her daughter in the recovery room. Unfortunately, as Yudeisy continues to grow she will need additional surgeries and extensive physical therapy. The professional team and doctors at APROQUEN will be there each step of the way, offering a variety of free services including dental and cleft palate repairs, counseling and even a place for the patient’s family to stay while the child goes through surgery and rehabilitation. “When you give back to these kids and help with an institution that is devoted to improving kid’s lives—personally, it’s invaluable. What I’ve found is when you deal with kids who have been burned, they don’t know they’ve been burned. They have no idea there’s anything different than any other child. They just want to play and be like other children. We’re trying to give back some positive benefits to these kids so they can live a better life.”

STATE-OF-THE-ART BURN HOSPITAL OFFERS FREE CARE Dr. Broumand will perform multiple surgeries during his visit to a non-profit organization called APROQUEN. The hospital, located in Managua, Nicaragua employs a fully trained dedicated staff, welcoming children up to the age of 15, for treatment free of charge.

AN EVERYDAY OCCURRENCE IN MANY LOW-INCOME COUNTRIES Burns account for a significant portion of pediatric morbidity and mortality rates worldwide, especially in low-income countries such as Central America. Statistics tell us the majority of burns are due to fire or scalding, often related to cooking or open fire pits. APROQUEN knows the key to decreasing the burn numbers in their communities is through education and outreach.

APROQUEN was founded in 1991 by Vivian Pellas, a resident of Nicaragua who, along with her husband, suffered burns and broken bones in a 1989 plane crash, the worst plane crash Central America has ever seen. Pellas has since made APROQUEN her life’s mission. It has also become a 93

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SURGEONS & SURGERY

WHO’S

RIGHT FOR THE JOB? An Interview with William P. Adams Jr., MD by THE PSC

he news is overrun with stories of dentists offering Botox®, unlicensed practitioners injecting syringes full of fillers and family physicians consulting patients on liposuction. These stories are confusing to patients, leaving them to wonder, “Are cosmetic procedures really that serious? If my family dentist offers Botox, surely it must not be that big of a deal?” Dr. Bill Adams Jr., a board plastic surgeon in Dallas, believes patients deserve to know the truth. To be a board certified plastic surgeon, years and years of training and fellowships have to be completed. A physician offering cosmetic services should always meet these qualifications.

from years of experience; experience that only comes with specialized training over many years. “Who do you want injecting your Botox, someone who knows facial anatomy extremely well after performing countless facelifts and facial reconstructions? Or a dentist who knows a whole lot about teeth?” says Dr. Adams.

CONSIDERING SAFETY Results are one concern, but safety is the main concern. Does your practitioner offering injections know what to do if a rare complication arises? Too often patients have complications in rare scenarios because their physician didn’t know how to handle the situation. Yes, you will pay more at a plastic surgeon’s office, but you’re paying for safety as well as results.

THE MEDIA ASKS THE HARD QUESTIONS “The Today Show recently had a discussion on cosmetic procedures, highlighting physicians who perform cosmetic procedures but have no formal training. They highlighted the additional complications that can occur,” explains Dr. Adams. “By completing a plastic surgery residency, surgeons dedicate six to eight years learning how to perform these procedures. A one weekend course isn’t enough.”

THERE’S ALWAYS RISK

Patients may realize that they shouldn’t get Botox from their dentist, but may think that if it is just an injection their family doctor who went to medical school, might still be qualified.

“Patients looking for any procedure, even if they think it’s just a little skin procedure, need to remember that it is still a procedure there are always risks associated and bad complications can happen,” says Adams. “These are big problems that can affect your life forever. Physician experience, accreditation and expertise cannot be overstated when it comes to the importance of finding the right physician.”

Even if it appears to be “just an injection,” there are many other concerns behind cosmetic injections, such as where to place it and how much to inject. “What if Botox is simply not the product that you need?” asks Dr. Adams. Does your injector know all the available options? Have they been trained in them all? Answers to all of these questions come

When it comes to choosing a physician for cosmetic procedures, Dr. Adams says, “Aesthetic medicine shouldn’t be everybody’s domain. I like to drive cars, but that doesn’t mean I should go drive in the Indy 500. If you are not properly trained to perform these procedures, then you shouldn’t be doing them.” 94

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WEST WEST

THE BEAUTY ISSUE

LIFESTYLES/DOCTORS Arizona 98 Shaun Parson, MD............................................................................Scottsdale, Arizona California 100 Peter B. Fodor, MD*.........................Los Angeles, California & Aspen, Colorado 102 Geoffrey R. Keyes, MD*.........................................................Los Angeles, California 104 Michael R. Schwartz, MD..............................................Westlake Village, California 106 Grant Stevens, MD.............................................................Marina Del Rey, California Nevada 108 Tiffany McCormack, MD..........................................................................Reno, Nevada Utah 110 Brian Brzowski, MD.........................................................................South Ogden, Utah Washington 112 Richard A. Baxter, MD............................................Mountlake Terrace, Washington Illinois 114 Laurie A. Casas, MD..............................................................................Glenview, Illinois Indiana 116 Bruce W. Van Natta, MD*............................................................Indianapolis, Indiana Michigan 118 Brad Bengtson, MD.................................................................Grand Rapids, Michigan 119 Ryan T. Mitchell, MD................................................................Grand Rapids, Michigan Missouri 120 Patricia A. McGuire, MD...................................................................St. Louis, Missouri

SOUTH

MID

Georgia 122 James D. Namnoum, MD....................................................................Atlanta, Georgia Kentucky 124 Bradley Calobrace, MD................................................................Louisville, Kentucky Louisiana 126 Simeon Wall Jr., MD..................................................................Shreveport, Louisiana 126 Michael Lee, MD..........................................................................Shreveport, Louisiana Mississippi 128 Mark S. Elliott, MD*......................................................................Meridian, Mississippi 130 Lee Thornton, MD*.......................................................................Meridian, Mississippi North Carolina Charlotte Plastic Surgery.........................................................Charlotte, North Carolina 134 Kevin L. Smith, MD. 135 Stephan J. Finical, MD 136 Michael E. Beasley, MD 137 Paul A. Watterson, MD 138 Jarrod R. Daniel, MD * Advisory Board Member of THE PSC 96 THEPLASTICSURGERYCHANNEL.COM

SOUTH

THE BEAUTY ISSUE

NORTH

EAST

Tennessee 140 Mary Gingrass, MD........................................................................Nashville, Tennessee 140 Melinda Haws, MD.........................................................................Nashville, Tennessee Texas 142 William P. Adams Jr., MD*........................................................................... Dallas, Texas 144 Camille Cash, MD...................................................................................... Houston, Texas 146 Ashley Gordon, MD...................................................................................... Austin, Texas 146 Dustin Reid, MD............................................................................................. Austin, Texas 148 Ned Snyder IV, MD........................................................................................Austin, Texas 148 Robert Whitfield, MD..................................................................................Austin, Texas Florida 150 Mark A. Pinsky, MD.......................................................Palm Beach Gardens, Florida 152 David A. Lickstein, MD................................................Palm Beach Gardens, Florida 154 Jason N. Pozner, MD......................................................................Boca Raton, Florida 156 Clifford P. Clark III, MD..................................................................Winter Park, Florida

Massachusetts 158 Christine Hamori, MD*..........................................................Duxbury, Massachusetts New Jersey 160 Caroline Glicksman, MD*............................................................Sea Girt, New Jersey New York 162 Stafford R. Broumand, MD.........................................................New York, New York 164 Daniel Y. Maman, MD....................................................................New York, New York 166 Mark D. Epstein, MD................................................................Stony Brook, New York 168 Robert T. Grant, MD......................................................................New York, New York Pennsylvania 170 Louis P. Bucky, MD*...........................................................Philadelphia, Pennsylvania 172 J. Peter Rubin, MD*...............................................................Pittsburgh, Pennsylvania Rhode Island 174 Richard J. Zienowicz, MD..................................................Providence, Rhode Island

* Advisory Board Member of THE PSC 97 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Parson is a member of the Phoenix Thunderbirds, the hosts of the Phoenix Open and largest charitable organization in the state of Arizona. He is a devoted father of three who is actively involved in all sports and school activities. He enjoys gardening and is an outdoor BBQ/cooking enthusiast.

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SHAUN PARSON, MD Dr. Shaun Parson is a board certified plastic and reconstructive surgeon in Scottsdale, Arizona. He trained in plastic and reconstructive surgery at the Mayo Clinic in Rochester, Minnesota. Dr. Parson is double board certified as a diplomate in the American Board of Plastic Surgery and the American Board of Surgery. He is a Fellow of the American College of Surgeons. He currently serves on the board of the Arizona Society of Plastic Surgeons and has held the position of Chairman of Plastic Surgery and Chief of Surgery at Scottsdale Healthcare Shea Hospital. He is also a member of both the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. Dr. Parson has a special interest in cosmetic and breast surgery, and has been honored multiple times as one of Phoenix Magazine’s “Top Docs.”

Shaun Parson, MD 8901 East Mountain View Road, Suite 118 Scottsdale, Arizona 85258 (480) 282-8386 www.drparson.com 99 THEPLASTICSURGERYCHANNEL.COM

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PETER B. FODOR, MD BEHIND THE SCENES Dr. Fodor believes in minimally invasive surgery without compromising the aesthetic quality of the result. He specializes in revision surgery; many of his patients come from unsatisfactory procedures performed elsewhere. Patient safety is his first priority.

California Office 2080 Century Park East, Suite 710 Los Angeles, California 90067 (310) 203-9818 www.peterfodormd.com Colorado Office 420 West Main Street Aspen, Colorado 81611 (970) 925-4900 www.peterfodormdaspen.com

s the past president of the American Society for Aesthetic Plastic Surgery and a long-time member of the American Society of Plastic Surgeons, Peter B. Fodor, MD, FACS has expertise in a variety of cosmetic and reconstructive plastic surgery procedures. Born a Hungarian national in Romania, he escaped the brutal communist regime and immigrated to the United States, learned English as an adult and graduated first in his class from the University of Wisconsin Medical School just three years after his arrival to the U.S. He interned at Parkland Memorial Hospital in Dallas, Texas, followed by general surgery and plastic surgery residencies at the Columbia/New York Presbyterian Hospital system, including plastic surgery residency at St. Luke’s-Roosevelt Hospital. Dr. Fodor is an international leader in the field of aesthetic plastic surgery. He is highly respected as a teacher, surgeon and author. His Los Angeles plastic surgery practice, Century Aesthetics®, serves patients from throughout the United States and around the world. He also practices part time in Aspen, Colorado. Dr. Fodor is well known for his innovations in plastic surgery, particularly in the areas of minimally invasive facial rejuvenation and body contouring surgery. Skilled in a wide range of procedures including facelifts (traditional and endoscopic), rhinoplasty, liposuction, abdominoplasty and breast aesthetic surgery, Dr. Fodor is nationally and internationally recognized for his surgical expertise and outstanding results. He is a firm believer that the initial consultation and subsequent preoperative visits are of great importance to a successful experience with cosmetic surgery. Dr. Fodor and his staff conduct a thorough preoperative evaluation for each patient and address the patient’s aesthetic goals in detail before selecting the best surgical plan and techniques. In this way he provides a custom-tailored approach that best fits each patient’s individual needs. 101 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Keyes has been practicing medicine for over thirty years. As a leading rhinoplasty surgeon in Los Angeles, he has published and lectured internationally on plastic surgery techniques. Dr. Keyes has been featured on Dateline, Good Morning America, 20/20, Fox News, UPN LA, CNN and Montel Williams discussing cosmetic surgery. He has been quoted in Time Magazine, the Wall Street Journal, Outpatient Surgery, New Beauty Magazine and countless other national publications.

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GEOFFREY R. KEYES, MD D

r. Geoffrey R. Keyes is certified by the American Board of Plastic Surgery and the American Board of Otolaryngology â&#x20AC;&#x201C; Head and Neck Surgery. He has lectured and published internationally on topics ranging from rhinoplasty to patient safety during surgery. Dr. Keyes graduated from the Loyola University, Stritch School of Medicine and interned at Barnes Hospital-Washington University in St. Louis, Missouri. He served in two residency training programs at the University of Illinois Medical Center in Chicago before going into private practice. Today, Dr. Keyes maintains his surgical practice alongside a strong team of board certified anesthesiologists and registered nurses, providing the highest level of care to his cosmetic and reconstructive surgery patients both in and around the Los Angeles, California area and nationwide. Dr. Keyes is currently serving as president-elect of the Rhinoplasty Society and has held many other such positions including serving as past president of the California Society of Plastic Surgeons, past president of the Los Angeles Society of Plastic Surgeons, past president of the Aesthetic Society Education and Research Foundation and past president of American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF). He currently holds memberships with the American Society for Aesthetic Plastic Surgery, the American Society of Plastic Surgeons, the California Medical Association and the California Society of Facial Plastic Surgeons. Alongside his prominent surgical career, Dr. Keyes is the president and CEO of SurgiMetrix, which was founded in 1999 as the first Internet based compliance management system designed to track and monitor the delivery of safe surgical care through data entry. SurgiMetrix collects data for the AAAASF and is growing to serve other specialty boards, societies and associations. Today, with over 20,000 surgeons having input data over sixteen years, the AAAASF database is providing important information about surgical outcomes and enhancing data collection. Geoffrey R. Keyes, MD 9201 Sunset Boulevard Suite 611, Los Angeles, California 90069 (310) 859-9388 www.keycare.com 103 THEPLASTICSURGERYCHANNEL.COM

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MICHAEL R. SCHWARTZ, MD D

r. Schwartz completed his plastic surgery training at The University of Texas Southwestern in Dallas, one of the premier residency programs in the country. His training in plastic and reconstructive surgery included extensive training in all areas of cosmetic surgery. He has authored and presented numerous papers and is a regularly invited speaker at national plastic surgery meetings.

BEHIND THE SCENES Dr. Schwartz’s time away from work is always spent with his family and friends. When he’s not centered on family, he’s centering clay on his potter’s wheel. If he wasn’t a surgeon or an artist, he would have been a professional golfer.

In his practice in Westlake Village, California, Dr. Schwartz has developed a national reputation in breast, body and facial surgery. As an industry educator he teaches other plastic surgeons about new anatomic shaped breast implants. Dr. Schwartz is sought out by patients from around the world for his expertise in these areas. He is known for his caring, individual approach, artistry and his natural results. In his office, Dr. Schwartz and his staff strive to bring his patients the most personal, private, educational consultation and surgery experience. His surgery center has state of the art equipment and uses only board certified anesthesiologists. Dr. Schwartz is double board certified in plastic surgery and general surgery. He is an active member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. He is also a Fellow of the American College of Surgeons.

Michael R. Schwartz, MD 696 Hampshire Road, Suite 210 Westlake Village, California 91361 (805) 435 - 8256 www.drschwartz.com 105 THEPLASTICSURGERYCHANNEL.COM

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GRANT STEVENS, MD D BEHIND THE SCENES In the past 29 Years, Dr. Stevens has treated patients from all 50 states. Dr. Stevens has performed surgery all over the United States and in 63 foreign countries. His practice uses 17 CoolSculpting® machines to freeze the fat!

r. Grant Stevens is a board certified Los Angeles plastic surgeon and the medical director of Marina Plastic Surgery, serving the needs of Long Beach, Pasadena, and Beverly Hills plastic surgery patients. He specializes in cosmetic plastic surgery and has been named one of America’s best physicians in the “Guide to Top Doctors.” Dr. Stevens was also nominated by his colleagues as one of the best plastic surgeons in America, appearing in Castle Connolly’s “Top Doctor Guide.” He remains an active member at Marina Del Rey Hospital where he is past chairman of the Department of Surgery, past chairman of the Liposuction Committee and past co-director of the Breast Center. He is also on staff at St. John’s Medical Center and the Marina Outpatient Surgery Center. Dr. Stevens is a clinical professor of surgery at the University of Southern California Division of Plastic & Reconstructive Surgery. He is also the director of the USC – Marina Del Rey Aesthetic Surgery Fellowship and the co-director of the USC Aesthetic Surgery Division. Dr. Stevens graduated with honors from Washington University Medical School in St. Louis where he was awarded the Senior Prize in Surgery. He completed his general surgery training at Harbor UCLA Medical Center, then returned to Washington University-Barnes Hospital where he completed a Fellowship in Plastic and Reconstructive Surgery. He is a board certified diplomate of The American Board of Plastic Surgery and a Fellow of The American College of Surgeons and The International College of Surgeons. He was appointed by the governor to The Medical Board of California Medical Quality Review Board, and is on the Plastic Surgery Faculty at UCLA as well as USC. Dr. Stevens has been an invited Visiting Professor at Loma Linda University, The University of Switzerland, The University of Southern California, Tulane University, Louisiana State University, and The University of Texas Medical Branch at Galveston. Grant Stevens, MD 4644 Lincoln Blvd Suite 552 Marina Del Rey, California 90292 (310) 827-2653 www.marinaplasticsurgery.com 107 THEPLASTICSURGERYCHANNEL.COM

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TIFFANY MCCORMACK, MD C

ertified by the American Board of Plastic Surgery, Dr. Tiffany McCormack is a highly credentialed and experienced plastic surgeon whose philosophy is centered on strong doctor-patient communication and safety. Renowned for her ability to achieve an aesthetic balance that complements her patientsâ&#x20AC;&#x2122; natural beauty, she is distinctly proficient in cosmetic surgery of the breasts, body and face, as well as rejuvenation of the skin through various non-surgical and minimally invasive skin care treatments. Her expertise also includes a variety of breast reconstruction techniques for women who have undergone mastectomy following breast cancer.

BEHIND THE SCENES Dr. McCormack believes in natural results and providing a thoughtful, safe and caring patient experience. Her favorite sport as a spectator is little league, cheering on her two sons. Her passion outside of her medical practice is riding and showing horses.

Dr. McCormack obtained her undergraduate degree from Arizona State University prior to earning her medical degree from the University of Arizona, College of Medicine. She then went on to complete her plastic surgery training at Stanford University Medical Center, during which time she traveled abroad to assist in the repair of craniofacial abnormalities for impoverished patients. As a proponent of continuing education, Dr. McCormack remains actively involved in a number of prestigious medical organizations, including both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. She is also a Fellow of the American College of Surgeons. Throughout every stage of the plastic surgery process, Dr. McCormack remains intimately involved to ensure each individual receives an unprecedented level of personalized care and attention before, during, and after their procedure. Dr. McCormack tailors her approach to meet the unique needs of the patient, ultimately helping them achieve an optimal outcome with natural-looking results. Tiffany McCormack, MD 10791 Double R Boulevard, Reno, Nevada 89521 (775) 284-2020 www.plasticsurgeryrenotahoe.com 109 THEPLASTICSURGERYCHANNEL.COM

BRIAN BRZOWSKI, MD D

r. Brian Brzowski is a cosmetic plastic surgeon with a special interest in breast augmentation and the aesthetic problems resulting from pregnancy and weight loss. He is board certified by the American Board of Plastic Surgery and practiced general surgery for four years before receiving specialty training in plastic and reconstructive surgery. He is a member of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, an honor extended only to plastic surgeons that have attained the highest level of achievement in cosmetic surgical training, continuing education and clinical experience. A leading consumer group has named him a “Top Plastic Surgeon” for several years running. Dr. Brzowski is a Fellow in the American College of Surgeons. Dr. Brzowski received a Bachelor of Science in Biochemistry from the University of Georgia and a Doctor of Medicine from the Medical College of Georgia. He completed a five-year general surgery residency at Wilford Hall USAF Medical Center in San Antonio, Texas and trained in plastic and reconstructive surgery at the prestigious and internationally renowned Mayo Clinic in Rochester, Minnesota. Dr. Brzowski proudly served in the United States Military for thirteen years, finishing his service as Chief of the Department of Surgery/Flight Commander for Edwards Hospital at Edwards Air Force Base in California. He is a sought-after lecturer and speaks to physician and patient groups both locally and nationally. Dr. Brzowski has provided care for celebrities, royalty and foreign dignitaries. His greatest joy in medicine is the relationships that he builds with patients, their families and his fellow medical colleagues. He has also provided charitable care in Honduras and El Salvador with the Lion’s Club International Medical Mission. Brian Brzowski, MD 1525 E 6000 S. Suite C South Ogden, Utah 84405 www.brzowski.com 110 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES When he’s not making molehills into mountains, or mountains into molehills, Dr. Brian Brzowski can be found riding the mountains of the Wasatch Range on his adventure motorcycle. He gets the same thrill and adrenaline rush from this two-wheeled form of entertainment that he gets from his surgical cases. Dr. Brzowski has found balance and harmony, blending his passion for surgery with his need for raw excitement on the byways and roadways of the Mountain West.

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RICHARD A. BAXTER, MD A

formally trained artist and Board Certified Plastic Surgeon, Dr. Richard Baxter is known for utilizing state of the art techniques and technologies to create natural looking results. He has been voted “Western Washington’s Favorite Plastic Surgeon,” and was elected by his peers to be listed in the “Guide to America’s Top Physicians.” He works with an experienced and caring staff in an accredited, private surgical facility in the Seattle area. Dr. Baxter is a nationally recognized expert in revision breast surgery, anti-aging and nonsurgical options. His original research on subjects such as the internal bra has been cited hundreds of times. Patients come from across the country for his unique expertise.

BEHIND THE SCENES Dr. Baxter specializes in revision breast implant surgery. He authored a book on the anti-aging effects of wine. When he is not in the operating room he is dancing Argentine tango.

Dr. Baxter is a former clinical faculty member of the University of Washington School of Medicine, past president of both the Washington Society of Plastic Surgeons and the Northwest Society of Plastic Surgeons and founding medical director of Calidora Skin Clinics, now part of Skin Spirit – the nation’s #1 provider of Botox. Dr. Baxter’s “firsts” include: world’s first live plastic surgery webcast (1998); first proof-ofconcept article on the use of an acellular dermal matrix internal bra; first publication on the split muscle technique; first article in North America on the subfascial technique for breast augmentation; and first peer-reviewed publication on the use of high-profile breast implants. He continues to be involved in clinical research along with his busy practice, always seeking better solutions and improved patient experiences. When he is not in the operating room or teaching at a medical conference, Dr. Baxter can be found either working on his Argentine tango or in the art studio drawing from the live model. His drawings appear in the background throughout his website. Richard A. Baxter, MD 6100 219th St. SW, Suite 290, Mountlake Terrace, Washington 98034 (425) 776-0880 www.drbaxter.com 113 THEPLASTICSURGERYCHANNEL.COM

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LAURIE A. CASAS, MD D

BEHIND THE SCENES Dr. Laurie Casas is committed to excellence in aesthetic plastic surgery. She believes you can be elegant at any age. She is committed to patient safety, satisfaction and success.

r. Casas is a board certified plastic surgeon and senior clinician educator at the University of Chicago Pritzer School of Medicine, section of plastic surgery. She is committed to excellence in cosmetic medicine and cosmetic surgery. Named one of the top plastic surgeons in Chicago since 1992, she has a multispecialty cosmetic surgical and non-surgical practice. Her advanced training in cosmetic surgery of the face, breast and body and her commitment to achieving the most beautiful results possible for her patients has earned her a reputation as a perfectionist. As an academic cosmetic surgeon, Dr. Casas has treated patients from all over the world, each with individual desires and needs. As a national spokesperson on aesthetic plastic surgery, Dr. Casas is frequently quoted by a wide array of publications, including the New York Times, the LA Times, the Wall Street Journal, the Washington Post, U.S. News and World Report, Allure, Marie Claire, Vogue, Cosmopolitan, Self, Seventeen and the Chicago Tribune. She has appeared on national as well as local news programs, including CNN, CNBC, Fox News New York, Fox News Chicago and NBC News Chicago to name a few. The New York Times (October 2005) named Dr. Casas one of four top plastic surgeons in the country for breast implants. Laurie A. Casas, MD 2050 Pfingsten Road, Suite 270 Glenview, Illinois 60026 (847) 657-6884 www.casas.md 115 THEPLASTICSURGERYCHANNEL.COM

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BRUCE W. VAN NATTA, MD D BEHIND THE SCENES Dr. Van Natta manages his twenty-nine acre blackberry farm when heâ&#x20AC;&#x2122;s not working. He enjoys hunting, fishing and good bourbon. If he wasnâ&#x20AC;&#x2122;t a plastic surgeon he would like to have been a veterinarian - less hassle from the FDA.

r. Bruce Van Natta attended DePauw University in Greencastle, Indiana where he received his Bachelor of Arts degree in 1977. He received his Doctor of Medicine degree from Indiana University School of Medicine in 1981. From 1981 to 1982, Dr. Van Natta completed his post-graduate internship and surgery training at Indiana University Hospitals of Indianapolis. He completed his general surgery residency training also at Indiana University Hospitals from 1982 to 1986. Dr. Van Natta then completed a three-month fellowship specializing in hand surgery at the University of Louisville Hospitals in Louisville, Kentucky. From 1986 to 1988, he completed his residency training in plastic surgery at Indiana University Hospital in Indianapolis. In 1991, Dr. Van Natta received his board certification from the American Board of Plastic Surgery. He is a Fellow of the American College of Surgeons and holds the appointment of Clinical Assistant Professor in Plastic Surgery at Indiana University Medical Center in Indianapolis. He is actively involved in teaching presentations at a national level as an active member of the American Society of Plastic Surgeons and is also a member of the American Society of Aesthetic Plastic Surgery. In 2002, Dr. Van Natta merged his practice in partnership with Dr. Stephen W. Perkins. In 2007 they were joined by Dr. A. Michael Sadove and together formed Meridian Plastic Surgeons. This practice enables patients to have a full range of facial, body and aesthetic services performed at one location.

Bruce W. Van Natta, MD 170 West 106th Street Indianapolis, Indiana 46290 (317) 575-0330 www.indyplastic.com 117 THEPLASTICSURGERYCHANNEL.COM

BRAD BENGTSON, MD T

ransformation occurs both inside and out. Dr. Bengtson is dedicated to helping patients achieve natural and proportional results that are restored, refined, and renewed. The Bengtson Center for Aesthetics and Plastic Surgery in Michigan was founded to provide exceptional care, excellent safe outcomes and the highest level of personal service for patients, their families, friends and our community. Dr. Brad Bengtson offers patients in Michigan natural results that do not appear operated or “overdone.” Fine detail and excellence are central not only to the surgical procedure or treatment, but also to the entire experience.

BEHIND THE SCENES

In addition to plastic surgery, Dr. Bengtson also has a passion for all types of photography, including underwater. He is dedicated to helping patients achieve natural, balanced, proportional results. He believes the best plastic surgery is when you can’t tell a patient has had it done.

An innovator in the science of aesthetic surgery, Dr. Bengtson has authored landmark textbooks, book chapters and peer-reviewed journal articles. He lectures nationally and internationally and was a lead investigator for the recently approved Natrelle® Style 410 Highly Cohesive Gel implant in the United States. He was a founding member of Allergan’s Executive Council. He is a patent holder of eight medical devices, and an international educator and leader in breast aesthetic research. Brad Bengtson, MD 555 Mid Town Street #110 Grand Rapids, Michigan 49503 (616) 588-8880 www.bengtsoncenter.com

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RYAN T. MITCHELL, MD D

r. Mitchell is a native of Canada, with dual citizenship, having received his post-graduate medical degree in plastic surgery from the University of Manitoba, as well as his medical undergraduate and bachelorâ&#x20AC;&#x2122;s degree in biology from the University of Calgary. He chose to specialize in body contouring because he is passionate about helping people who have undergone a dramatic, life-changing experience, and wanted to be an integral part in helping these patients return to physical health and an active lifestyle. Dr. Mitchell is a Canadian board-certified plastic surgeon serving Michigan and the Midwest. He joins the Bengtson Center after completing a prestigious world-renowned fellowship in body contouring at the Pittsburgh Medical Center. At the Bengtson Center for Aesthetics and Plastic Surgery in Michigan, Dr. Mitchell is known for his dedication to excellence in patient care, surgical skills and passion for plastic surgery. He will listen carefully to your personal goals, explain your options, and above all, strive to provide safe results that exceed your expectations-every time. Ryan T. Mitchell, MD 555 Mid Town Street #110 Grand Rapids, Michigan 49503 (616) 588-8880 www.bengtsoncenter.com

BEHIND THE SCENES

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Dr. Mitchell loves animals. His favorite season is winter, which is not surprising considering where he is from. His favorite food, movie or no, is movie theater popcorn.

Pat McGuire, MD - Darwin Island, Galapagos

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PATRICIA A. MCGUIRE, MD D

BEHIND THE SCENES Dr. Pat McGuire is an identical twin. Her sister is also a physician, specializing in bone and mineral health and is a dean at Washington University School of Medicine. Her surgical philosophy is to make you look your best in the safest possible manner. She was a zookeeper at the St. Louis Zoo for her summer jobs in both high school and college.

r. Pat McGuire is a board certified plastic surgeon and clinical instructor of surgery at Washington University School of Medicine in St. Louis, Missouri. A St. Louis native, she attended Busch School, a magnet school in the St. Louis City Public Schools district through 8th grade and graduated from Ursuline Academy in Kirkwood in 1979. She graduated from the University of Missouri - Kansas City, School of Medicine in 1985, performed her residency in general surgery at Jewish Hospital, Washington University School of Medicine (1985-1989), followed by a residency in plastic and reconstructive surgery at St. Louis University (1989-1991). She is married to Robert Sciortino, MD, and has two daughters and three dogs. She has been in private practice with Parkcrest Plastic Surgery since 1991. Dr. McGuire is a member of the Alpha Omega Alpha medical honor society and was awarded the American Medical Women’s Association Award for Academic Achievement in 1985. She was president of the St. Louis Area Society for Plastic Surgeons from 2004-2007. Dr. McGuire is a member of the American Society of Plastic Surgeons, American Medical Women’s Association, American Society for Aesthetic Plastic Surgery, Association of Women Surgeons, St. Louis Metropolitan Medical Society, and St. Louis Area Society of Plastic Surgeons. She has been named as one of the “Best Doctors” by St. Louis Magazine (2005-2013). She was one of the first plastic surgeons in the area to be invited to participate in Allergan’s Style 410 cohesive silicone gel implant study as a clinical investigator in 2001. Dr. McGuire specializes in cosmetic and reconstructive surgery of the breast including augmentation, reduction, lifts and cancer reconstruction. She performs body contouring including ultrasonic assisted liposuction, power assisted liposuction and abdominoplasty. She also performs facial cosmetic procedures and hand surgery. Patricia A. McGuire, MD 845 N. New Ballas Court, Suite 300, St. Louis, Missouri 63141 (314) 485-4965 www.parkcrestplasticsurgery.com 121 THEPLASTICSURGERYCHANNEL.COM

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JAMES D. NAMNOUM, MD A BEHIND THE SCENES Dr. Namnoum loves to cook. He’s a master chef with a penchant for Italian food. He’s an exercise fanatic who enjoys running, golfing and weightlifting. When he’s not in surgery, Dr. Namnoum enjoys reading about history and politics.

graduate of the Johns Hopkins School of Medicine where he trained in general and plastic surgery, Dr. James Namnoum is a well-known expert in cosmetic and reconstructive breast surgery as well as aesthetic body contouring and facial cosmetic surgery. He is a popular and regularly invited lecturer in national plastic surgery symposia and has lectured on a variety of cosmetic and reconstructive topics across the globe. As a leader in the field, Dr. Namnoum’s reputation and commitment to advancements in plastic and reconstructive surgery have allowed him the opportunity to trial many of the industry’s newest technologies. A widely recognized innovator, he has made numerous contributions to the advancement of plastic surgery of the breast and body utilizing highly cohesive anatomical breast implants, autologous fat transfer and dermal matrices. Because Dr. Namnoum is among the first in the nation to have access to these innovative products, his patients are also among the first with access to cutting edge technology designed to enhance overall patient experience such as 3D computer result imaging and patient consultation software at his practice. In addition to breast procedures like breast augmentation and breast lift, Dr. Namnoum also has wide experience in body contouring, including abdominoplasty, belt lipectomy, and buttock enhancement with fat transfer, buttock lift and liposuction. He has treated many patients following massive weight loss designing aesthetic solutions to correct skin and fatty excess over the entire body and breasts. In keeping with his interest and commitment to women with breast cancer, Dr. Namnoum helped found the 501(C)(3) non-profit, Pink Ribbon Story Foundation (PRSF), in which he serves as chairman of the board of directors. PRSF honors and shares stories of breast cancer survivors to help other breast cancer patients and their families cope with the process and complete their recovery. James D. Namnoum, MD 975 Johnson Ferry Road, Suite 100, Atlanta, Georgia 30342 (404) 256-1311 www.atlplastic.com/namnoum 123 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Calobrace’s life-guiding motto is, “From those to whom much is given, much is expected.” He performs over one thousand cosmetic surgical procedures each year. He is an internationally sought consultant and educator on the subjects of advanced cosmetic and breast surgery.

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BRADLEY CALOBRACE, MD Dr.

Brad Calobrace is a board certified, Los Angeles-trained plastic surgeon who has been in private practice since 1997. Dr. Calobrace established Calobrace & Mizuguchi Plastic Surgery Center in Louisville, Kentucky in an effort to bring the latest technology and techniques in plastic surgery to the Louisville and Lexington areas. He is highly regarded throughout the country by both patients and other plastic surgeons as an authority in cosmetic surgery and non-surgical procedures. Dr. Calobrace excelled at academics from a young age, graduating valedictorian of his high school in Indiana. He is a graduate of Indiana University School of Medicine and he completed residencies in both general surgery and plastic surgery at the University of Southern California in Los Angeles. Subsequently, he completed a cosmetic and breast surgery fellowship at the Institute of Aesthetic and Reconstructive Surgery with Dr. G. Patrick Maxwell. Dr. Calobrace is a Fellow with the American College of Surgeons and his professional memberships include the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. Bradley Calobrace, MD 2341 Lime Kiln Lane, Louisville, Kentucky 40222 (502) 899 â&#x20AC;&#x201C; 9979 www.calobrace.com 125 THEPLASTICSURGERYCHANNEL.COM

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THE WALL CENTER BEHIND THE SCENES Holly and Simeon Wall spend their free time volunteering in the community and spending time with their two young boys.

The Walls are involved in organizations such as ReSurge, where they travel to China, Brazil, Haiti, Mexico and Peru. They perform cleft lip and palate surgery and burn surgery on those without access to plastic surgery.

Dr. Simeon Wall Jr. and his wife Dr. Holly Wall, practice

together at The Wall Center for Plastic Surgery, a fixture in Shreveport, Louisiana for over forty years. Holly and Simeon met on their first day of Internship, completing their combined general Surgery and Plastic Surgery residencies at Stanford University Medical Center, widely regarded as one of the top plastic surgery training programs the world. Dr. Holly Wall focuses her practice exclusively on aesthetic breast and body contouring for women. She is one of the busiest female breast and body surgeons in the country, as well as being a full-time mom. Holly currently serves as the Vice-President of the Louisiana Society of Plastic Surgeons. Dr. Simeon Wall Jr., is focused on primary and revisionary breast enhancement and body contouring with an interest in facial rejuvenation and rhinoplasty. Dr. Wall Jr. is credited with the development and refinement of SAFELipo®, which is a comprehensive body contouring process that’s been adopted by plastic surgeons across the country. Following the couples training at Stanford, they joined Dr. Simeon Wall Sr., finalizing Simeon Wall Jr.’s lifelong desire to practice with his father. The Wall Center is a triple certified Ambulatory Surgery Center, that covers 17,000 square feet and features a comprehensive laser center, medispa, extended stay guest suites, and a private fitness center. The Wall Center 8600 Fern Avenue, Shreveport, Louisiana 71105 (318) 562-1433 www.wallcenter.com 127 THEPLASTICSURGERYCHANNEL.COM

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MARK S. ELLIOTT, MD D BEHIND THE SCENES Dr. Elliott is passionate about physical fitness and loves to run marathons. He is known for his directness and honesty with both colleagues and patients. Dr. Elliott loves spending time with his family.

r. Mark Elliott was born in Jackson, Mississippi while both of his parents were in training at University Medical Center; his father in general surgery residency, and his mother in medical school. During his childhood, Dr. Elliott received several honors in both sports and academics. Dr. Elliott was All State in basketball and has since been selected to his high schoolâ&#x20AC;&#x2122;s Athletic Hall of Fame. He graduated LSU Magna Cum Laude. A career in medicine was chosen and he was accepted to Tulane Medical School with an honors scholarship. While at Tulane, Dr. Elliott was selected president of the Medical Honor Society, was valedictorian of his medical school class, and was selected as the top student in surgery. Dr. Elliott chose to pursue a career in surgery and chose Parkland Hospital as the place to get his training. After five years of successful residency, Dr. Elliott scored in the top 1% of applicants on his surgery board certification exam. Dr. Elliott was ready to pursue his career calling, plastic surgery. He chose the most renowned plastic surgery training program in American, Emory University in Atlanta. There he continued his outstanding record and left with the honor of being named chief resident for his final year of training. Dr. Elliott has continued his interest in sports and has run eleven marathons including two New York and three Boston marathons with a best time of 2.52. The dedication and tenacity he has demonstrated on the athletic field have transferred directly to his professional life. His practice is plastic and reconstructive surgery, vein surgery and wound care. Dr. Elliott was selected as one of the Top 10 Plastic Surgeons in Mississippi and is well known for aesthetic and breast surgery. Dr. Elliott prides himself on treating patients as he would his own family. Of all his accomplishments, his most precious is his family, wife Brooke, and children, Parker, Ally and Salone.

Mark S. Elliott, MD 5002 Highway 39 N., Building C Meridian, Mississippi 39301 (601) 693-7742 www.meridianplasticsurgery.com 129 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Lee Thornton fiercely strives for natural results. “Unless you see before and after photos, you should never be able to tell a patient has had a surgical procedure.” He emphasizes the importance of patient education in matching the right procedure out of many options to the right patient, “It is critical to a good outcome and a satisfied patient.” When not working, he likes to get away with his wife, Michelle, and their kids: playing golf, playing guitar, but, he says, “Never sitting idle, it kills me.” 130 THEPLASTICSURGERYCHANNEL.COM

LEE THORNTON, MD D

r. Thornton is a native Mississippian born into a medical family with a long history of impeccable surgical care in the region. From the time he was a child he was always extremely busy, with passion and intensity towards anything he pursued. In high school he competed on a national level in golf, played quarterback for his nationally ranked football team, raced motorcycles and played guitar in a rock band while graduating with honors. He attended college on an academic scholarship, played A1 position on the golf team and graduated with honors from Millsaps College. Chasing his ultimate goal of a career in medicine, he left for New Orleans to attend Tulane Medical School. In only four years at Tulane he completed his M.D. degree as well as Master’s Degrees in Public Health and Tropical Medicine, and graduated at the top of his medical school class. While at Tulane, he took full advantage of what New Orleans had to offer, playing guitar at local clubs and hustling pool in his spare time. Dr Thornton began his surgical training at University of Texas Southwestern Medical Center (Parkland) and became Board Certified in General Surgery. He was then selected to continue his fellowship in Plastic Surgery at the prestigious Emory University program. Not content with stopping his training at the traditional point, he went on to complete an additional fellowship in Cosmetic and Oculoplastic Surgery at Paces Plastic Surgery Clinic. He is Board Certified in Plastic Surgery and was selected as one of the Top 10 Plastic Surgeons in Mississippi. After finishing his formal training he founded Meridian Plastic Surgery in his hometown where he still thrives on staying busy in his personal and professional life. “I still play golf and guitar, ride enduro and trials motorcycles but nothing ever put me in ‘the zone’ as much as performing plastic surgery… It totally fulfills me, never gets old and is truly a great responsibility and honor.” Meticulous surgical technique and natural results are his obsessions in the operating room and despite practicing in a small southern town patients often travel great distances to see him. He has been married to his wife Michelle for twenty years and they have three daughters, Kinsey, and identical twins Hannah and Madi. They also have a son, Lachlan, ten years old, who is really good at golf, rides motorcycles and is currently learning his first guitar solo, Comfortably Numb, by Pink Floyd.

Lee Thornton, MD 5002 Highway 39 N., Building C Meridian, Mississippi 39301 (601) 693-7742 www.meridianplasticsurgery.com 131 THEPLASTICSURGERYCHANNEL.COM

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CHARLOTTE PLASTIC SURGERY Founded in 1951, Charlotte Plastic Surgery has grown

to include several surgeons, skin health specialists and nurse injectors. When Business NC honored the 15 best plastic surgeons in North Carolina in 2010, five of them were part of the Charlotte Plastic Surgery team. Charlotte Plastic Surgery serves the Charlotte region with two locations. A wide variety of services includes breast augmentations, tummy tucks, liposuction, facelifts, breast reductions, eyelid lifts, brow lifts, neck lifts, rhinoplasty and other procedures for women and men. Among top medical accreditations, Charlotte Plastic Surgery is certified by the American Association for Accreditation ofAmbulatory Surgical Facilities (AAAASF). Patients are encouraged to research qualifications and utilize complimentary consultations.

Left to Right: Paul A. Watterson, MD, Jarrod R. Daniel, MD, Michael E. Beasley, MD, Stephan J. Finical, MD, and Dr. Kevin L. Smith, MD Charlotte Plastic Surgery 2215 Randolph Road Charlotte, North Carolina 28207 (704) 237-0036 www.charlotteplasticsurgery.com 133 THEPLASTICSURGERYCHANNEL.COM

KEVIN L. SMITH, MD Charlotte Plastic Surgery

“The secret to plastic surgery is simple; good

plastic surgery isn’t seen,” says Dr. Kevin Smith. “I find the biggest joy in helping people improve their physical and mental well-being.” Dr. Smith offers multiple consultations so that patients don’t feel rushed or forced into any procedure. This has earned the trust of his patient over the years. He continues to learn new innovations and explore new techniques, always ensuring that any procedure offered is tested, effective and safe. Dr. Smith is board certified by the American Board of Plastic Surgery and is a Fellow of the American College of Surgeons. He is a member of the American Society of Plastic Surgeons, the American Society of Aesthetic Plastic Surgery and the Southeastern Society of Plastic and Reconstructive Surgeons.

BEHIND THE SCENES

In addition to writing a book and co-authoring multiple academic papers, Dr. Smith has been recognized locally and nationally as a “Top Doctor.” Some of his proudest accomplishments are his patients and their newfound empowerment.

In addition to plastic surgery, when he’s not working, he enjoys restoring classic cars.

Dr. Smith and his wife Deb are very involved in international medical missions and have served overseas. He has traveled the world teaching about reconstructive surgery.

He wants his patients to look better, not different. He feels that good plastic surgery is not seen - it is elegant and subtle, not obvious.

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STEPHAN J. FINICAL, MD Charlotte Plastic Surgery

Dr. Stephan Finical is a preeminent plastic

surgeon with Charlotte Plastic Surgery, one of the most respected groups in the country. His main focus is on aesthetic facial surgery, cosmetic breast surgery and body contouring. Most recently, Dr. Finical has been a pioneer in the use of the injectable pain medication known as Exparel®. He was one of the first to recognize and utilize this new drug in surgeries to help patients recover more quickly while reducing unwanted side effects that can occur with other pain medications. A magna cum laude graduate of Ohio Wesleyan University, Dr. Finical completed his medical studies and general surgical residency at Georgetown University, during which time he was named to Alpha Omega Alpha Honor Medical Society. Dr. Finical’s plastic surgery residency was carried out at the Mayo Clinic in Minnesota where he gained invaluable experience in the Division of Plastic Surgery. Then he completed his fellowship at the Oregon Health Science University. Dr. Finical is certified by the American Board of Plastic Surgery, the American College of Surgeons, the American Medical Association, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, among many others. In addition to his long list of surgical qualifications, he’s also published numerous peer-reviewed articles and has been recognized as teacher of the year. Educating his patients and working together with them as a team are his top priorities as a surgeon.

BEHIND THE SCENES

Dr. Finical comes from a family of athletes. His favorite job before medical school was working in a men’s clothing store. He’s on the board of The John Crosland School, a school for children with learning disabilities.

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MICHAEL E. BEASLEY, MD Charlotte Plastic Surgery

hen it came to his career path, Dr. Beasley always had a natural direction. His first mentors were his father and his grandfather. As physicians, they instilled in him the importance of the profession and inspired him to help improve the lives of others. A native North Carolinian, Dr. Beasley takes a great deal of Tarheel pride in graduating from the University of North Carolina at Chapel Hill, completing his medical studies there, and spending his general surgery residency at North Carolina Memorial Hospital in Chapel Hill. He next pursued his plastic surgery training at Emory University and completed his postgraduate fellowship in Atlanta with renowned surgeon Dr. Carl Hartrampf, Jr.

BEHIND THE SCENES

Dr. Beasley enjoys his profession because he takes a personal interest in the success of each patient. “One of the most important things I do is listen and advise,” he explains. “Listening is the best way to determine how to best serve every individual. I then do my best to provide quality, compassionate care utilizing a well-designed, proven, personalized surgical approach. For me, one of the most rewarding aspects of plastic surgery is when I get to share in the joy of a positive experience with each patient. Few things in life match that feeling.”

Dr. Beasley is recognized annually as one of “America’s Top Doctors” by Castle Connolly.

Away from the office, Dr. Beasley is an avid golfer and fly fisherman. He and his wife Denise have two children and participate in many Charlotte community organizations. Dr. Beasley is certified by the American Board of Plastic Surgery.

He is clinical investigator in numerous FDA trials for breast implants. He enjoys playing golf and fly-fishing when time allows.

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PAUL A. WATTERSON, MD

Charlotte Plastic Surgery

ind and gifted physician: there are no better words to define Dr. Paul Watterson. Patients feel an immediate ease and rapport with Dr. Watterson, who has been acknowledged throughout his schooling and medical career as both a master technician and a passionate surgeon whose gentle smile and calm nature establish trust and confidence. Dr. Watterson graduated from Utah State University, where he was voted student body president in 1977 and later appointed to serve on Utah’s Board of Regents. Following his freshman year, he devoted two years to missionary service in South Africa. Dr. Watterson finished his general surgery training at the University of North Carolina at Chapel Hill in 1987 and was subsequently awarded a coveted anatomic research fellowship at the Royal Melbourne Hospital in Melbourne, Australia. Upon completion of his plastic surgery residency at Emory University, Atlanta, Georgia in 1990, he received the Glancy Outstanding Resident Award by the Southeastern Society of Plastic and Reconstructive Surgeons. This same pattern of excellence has continued throughout his career. For the past twelve consecutive years, Charlotte physicians have voted Dr. Watterson “Top Doc” as published in Charlotte Magazine. “I have a love for my work and the absolutely positive impact it can have in a person’s life,” says Dr. Watterson. His patients understand that his top surgical priority is their safety and to honor their God-given beauty, “To me, natural is confident and beautiful.”

BEHIND THE SCENES

Dr. Watterson’s wife, Cydne, has a master’s degree in exercise physiology from the University of North Carolina. They have three sons – Neal, Nathan and Michael. His outside interests include sports of all kinds, camping, oil painting, fishing and volunteer work with the Boy Scouts of America.

Dr. Watterson loves to scuba dive. He’s not just an artist in surgery, he’s learning how to oil paint. He spent two years beginning at age 19 as a missionary in South Africa and Zimbabwe.

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JARROD R. DANIEL, MD Charlotte Plastic Surgery

eamwork has always been a vital part of Dr. Daniel’s life and career. It was important as a professional hockey player in his native Alberta, Canada. When he moved into medicine, he was part of an elite team of surgeons working alongside some of the world’s finest at the Mayo Clinic in Rochester, Minnesota. Now at Charlotte Plastic Surgery, he finds the camaraderie and collaboration among his fellow surgeons to be a key factor in providing the best possible care for all clients. “Creating connections with the patients and reaching goals together is what drew me to this field,” explains Dr. Daniel. “The pursuit of perfection constantly drives me to do better for my patients. And this practice puts them first.” Dr. Daniel encourages all those considering plastic surgery to research the surgeon’s qualifications, and to ask the tough questions to arrive at a shared vision. He understands the trust involved when patients put their expectations and lives in his hands, so he’s there for his patients from the first consultation through the surgery and post-op follow-ups.

BEHIND THE SCENES

Dr. Jarrod Daniel treats every single patient as if they were family. When he’s not at work he enjoys various activities with his wife, four young children and two dogs. Dr. Daniel played professional ice hockey and still has all his teeth.

He has showcased his talents by performing live surgeries at international conferences. In addition to delivering lectures on a multitude of topics, he has contributed chapters to several books in the field of plastic surgery. Away from the office, Dr. Daniel is a runner, a golfer and a fly fisherman. He enjoys spending time with his wife Frederique and sharing his lifelong love of hockey with their four children. Charlotte Plastic Surgery 2215 Randolph Road Charlotte, North Carolina 28207 (704) 237-0036 www.charlotteplasticsurgery.com

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BEHIND THE SCENES Dr. Haws has a dream to one day combine her love of travel with the practice of plastic surgery. She would love to circle the globe with her office staff, making the world a happier and more beautiful place. Dr. Gingrass is a third generation plastic surgeon! In her free time she enjoys getting her hands dirty in her garden. When not in the office, you will find Dr. Gingrass and Dr. Haws hitting the slopes together with their families.

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MARY GINGRASS,MD MELINDA HAWS, MD D

rs. Mary Gingrass and Melinda Haws met in 1989 in Springfield, IL at Southern Illinois University School of Medicine. Dr. Gingrass was a first year general surgery resident and Dr. Haws was a third year medical student. Both women had a strong interest in plastic and reconstructive surgery early in their training and quickly became friends. They frequently talked of practicing together at some point in the future.

Dr Gingrass and Dr Haws continued to gain notoriety as remarkably gifted, board certified plastic surgeons and their practice grew quickly. Both surgeons have been active members and contributors to the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons. They have both played significant roles in clinical studies within the aesthetic surgery industry, including numerous saline and silicone breast implant studies. Dr. Gingrass served as a Principle Investigator in the Allergan 410 shaped silicone implant study and Dr. Haws was a Clinical Investigator in the Sientra shaped silicone implant study.

Following residency both surgeons did the same fellowship in Aesthetic and Reconstructive Breast Surgery in Nashville, TN. After that they each pursued independent paths as plastic surgeons. In 1995 Dr. Gingrass joined a prestigious plastic surgery practice in Nashville and became a pioneer and international speaker on the (then) new technique of Ultrasound Assisted Lipoplasty. Dr. Haws pursued an academic career as an Assistant Professor at the University of Nevada School of Medicine specializing in microsurgery and breast surgery. In 2002 the stars began to align for this dynamic duo! Dr. Gingrass reached out to then best friend and colleague Dr. Haws and proposed they join forces, leading to the formation of The Plastic Surgery Center of Nashville.

Both surgeons enjoy an exceptionally busy breast and body contouring practice in the rapidly growing Nashville market. In recent years they have fostered an increased interest in labiaplasty procedures for women and Gynecomastia procedures for men. After many years in private practice together they attribute their success and continued growth to a mutual respect for each other and their commitment to an exceptional patient experience. From the initial consultation through the surgical recovery period, they are uniquely focused on each patient and their individual needs. Dr. Gingrass and Dr. Haws are both certified by the American Board of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. Dr. Haws currently serves as a Member-at-Large on the Board at the American Society of Aesthetic Plastic Surgery. Both doctors have been recognized as Top Docs by RealSelf and have received the prestigious RealSelf 100 Award.

The Plastic Surgery Center of Nashville 1915 State Street, Nashville, Tennessee 37203 (615) 467-6777 www.theplasticsurgerycenterofnashville.com 141

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WILLIAM P. ADAMS JR., MD W

illiam P. Adams Jr., MD is a board certified plastic surgeon in Dallas, Texas. He is an Associate Clinical Professor of Plastic Surgery at UT Southwestern Medical Center. Dr. Adams is an international authority on body contouring procedures, breast augmentation and implants - including traditional silicone and cohesive gel implants. He has developed new techniques for use in clinical breast implant surgeries that have increased safety for breast augmentation and breast reconstruction patients. He is active in educating plastic surgeons from around the globe on advances in augmentation procedures, including a redefined patient experience and a 24-Hour Fast-Trak recovery. He received his undergraduate degree with honors from Princeton University. He attended Vanderbilt University Medical School where he graduated in the top 10% of his class and received a prestigious award as the best graduating clinician. He completed both his general surgery and his plastic surgery residency training in the nationally renowned resident training program at the University of Texas Southwestern Medical Center, Dallas, Texas. He also completed an additional year of fellowship in plastic surgery at UT Southwestern. Dr. Adams is an international authority on breast implant surgery and related procedures. He has developed a new irrigant for use in clinical breast implant surgery that may increase safety for breast enlargement and breast reconstruction procedures. He is invited around the world to speak to surgeons, industry leaders and patients about breast surgery. Dr. Adams is currently conducting research on capsular contracture, cohesive gel implants and advanced breast surgical techniques. He recently published a Breast Augmentation textbook that has been so popular it is now planned for a second edition release. He is the lead investigator for a new surgical mesh that he is conducting studies for breast lift and other breast implant revision surgery. Dr. Adams is board certified by the American Board of Plastic Surgery. He is a member of the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS). He is member and past president of the Aesthetic Society Education and Research Foundation (ASERF), member of the Texas Society of Plastic Surgery, past president of the Dallas Society of Plastic Surgeons and a member of the Breast Implant Task Force (BITF). He is the program chair and board member of the American Society of Aesthetic Plastic Surgery. In 2010 Dr. Adams founded and currently serves as the Chief Medical Officer for The Plastic Surgery Channel, a multimedia news channel for plastic surgery. William P. Adams Jr., MD 6901 Snider Plaza, Suite 120, University Park, Texas 75205 (214) 965-9885 www.dr-adams.com 142 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Adams is a worldrenowned surgeon, educator, innovator and researcher of breast and body contouring. He is the founder of The Plastic Surgery Channel and Lifestyle Healthcare Channel. He enjoys spending time with his two children, who are almost teenagers.

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BEHIND THE SCENES Dr. Cash believes that plastic surgery should restore beauty not distort it, so that the end result is you, only better. She routinely receives thank you notes from patientsâ&#x20AC;&#x2122; significant others. A competitive swimmer since the age of 8, Dr. Cash is also an avid runner and a Pilates enthusiast.

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CAMILLE CASH, MD D

r. Camille Cash comes from a family of doctors dating back to 1915 that instilled in her the values espoused in the Hippocratic Oath. A top plastic surgeon in Houston, Dr. Cash describes work as “double satisfaction” when she sees her patients both looking better and feeling better about themselves. “Whether I’m performing a facelift or breast reconstruction, my goal is to restore both function and form, and then to witness my patients’ spirits take flight. It’s a challenge and a privilege for me.” Born in Baltimore, Dr. Cash spent most of her childhood moving back and forth between Texas and the Baltimore/Washington, D.C. area. Dr. Cash graduated magna cum laude from Howard University in Washington, D.C. She then returned to Houston, where her family lived, and earned her M.D. from Baylor College of Medicine. Deciding to become a surgeon, she entered a 5-year general surgery residency through St. Joseph Hospital. She was selected by her peers as “Resident of the Year” in 1998. As a chief resident in plastic surgery, she traveled to Lima, Peru with Operation San Jose on a medical mission to treat patients born with cleft lips and palates. She holds board certifications with the American Board of Surgery and American Board of Plastic Surgery. The majority of patients who visit Dr. Cash at her cosmetic surgery practice are women interested in procedures to enhance the breasts and contour the body as well as reconstructive surgery. She looks forward to expanding her practice to include more male patients, as she understands more and more men realize they can benefit from plastic surgery just as women do.

Camille Cash, MD 2150 Richmond Ave #103, Houston, Texas 77098 (713) 571-0600 www.camillecashmd.com

Even with a thriving private practice and an active family life, Dr. Cash finds time to devote to causes that are important to her. She is on the board of directors of the Sisters Network, Inc., a group that seeks to make reconstructive surgery more readily available to the underserved minority community. Dr. Cash met her husband, Chris Lowe, while attending Baylor. The couple and their three children live in Houston. 145

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BEHIND THE SCENES U.S. News, World Report and Castle Connolly have recognized the dynamic duo annually, Dr. Ashley Gordon and Dr. Dustin Reid, as two of “America’s Top Doctors.” Perpetual innovators, they developed the Tummy Tuck 360™ procedure revolutionizing traditional “mommy makeover” results. They are sought after consultants for laser and device companies, breast implant manufacturers, and other companies working toward the advancement of aesthetic medicine.

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DUSTIN REID, MD ASHLEY GORDON, MD D

r. Dustin Reid and Dr. Ashley Gordon, board-certified plastic surgeons, studied under leaders past and present in the field of plastic surgery at Emory University in Atlanta. Emory is widely regarded as one of the top plastic surgery training programs in the world. Working as a team during their first month at Emory, their creative spirits merged and their working relationship evolved into a friendship. Within a short period of time, their shared passion for plastic surgery, similar treatment styles, and a mutual respect for each other led to the planning of their future practice together, Restora Austin Plastic Surgery Centre in Austin, Texas. Restora Austin thrives by word-of-mouth referrals, and in 2014, they opened phase two of their master plan, INSPIRE Surgery Centre, a state-of-the-art facility, with a mindset for innovation and a reputation for excellence. Drs. Reid and Gordon are often referred to as the dynamic duo; their personalities and energies feed off of and compliment one another. While their relationship is like that of a brother and sister, with a constant banter between them, their mutual respect allows them to challenge and push each another in non-threatening ways. Their unique collaboration fosters innovation, like their Tummy Tuck 360™ procedure, and it is the reason they are recognized for being leaders in the field of breast enhancement, body contouring and facial aesthetic surgery, as well as non-surgical treatments. They are the only surgeons in Austin to offer SAFELipo® body contouring. Restora Austin was the third practice in Texas to acquire the Halo™ by Sciton laser. Their passion for their patients and aesthetic surgery is infectious, and it’s palpable when you visit Restora Austin and INSPIRE. They’ve created an atmosphere and cultivated a team of people who love what they do and are ready to deliver an exceptional patient experience. Although they both enjoy all aspects of cosmetic surgery, Dr. Gordon has a love for revisionary breast surgery and Dr. Reid for rhinoplasty. The challenge of these types of cases and the impact they have on their patients is very rewarding. Both surgeons are never satisfied with the status quo. They are always seeking ways to optimize their surgical outcomes, from less downtime, discomfort or scarring to extending the life of the result. For example, they were early adopters of Strattice® and Seri® in breast surgery. They creatively use these tissue matrices in many breast enhancement procedures. In primary cases, Seri® can be used to support the soft tissue and maintain the result, and Strattice®can be used in secondary or tertiary cases to break the “cycle of revision.” Drs. Reid and Gordon are Fellows of the American College of Surgeons, the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. They are recognized year after year by Castle Connolly, US News & World Report as two of the “Top Plastic Surgeons in Austin, Texas.” Dr. Gordon was named a Texas Rising Star in 2012 and 2013, and Drs. Reid and Gordon were both named Texas Super Doctors in 2014 and 2015. Restora Austin Plastic Surgery 901 W. 38th Street, Suite 401 Austin, Texas 78705 (512) 371-8817 www.restoraaustin.com 147 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Snyder’s Cinco de Mayo party starts on the eighth of March. He once won the World Series of Poker using UNO® cards. Dr. Whitfield: If he was not a surgeon he would want to own a Professional fútbol team. “In my spare time I am essentially an Uber™ service for my kids,” he says, but he loves the challenge of traveling five miles within an hour in Austin traffic. They take care of patients with the passion and enthusiasm that they would want for their own families.

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NED SNYDER IV, MD ROBERT WHITFIELD, MD D

r. Ned Snyder IV is a native of Waco, Texas, where he graduated salutatorian from Waco High School. He went on to graduate from the Plan II Honors program at the University of Texas at Austin. He received his medical degree from the University of Texas Medical Branch (UTMB) where he was a member of the Alpha Omega Alpha Honor Society. He remained in Galveston where he received his plastic surgery training at the recognized UTMB Department of Surgery. After completing his residency in plastic surgery, Dr. Snyder traveled to Ghent, Belgium. He completed a prestigious fellowship in perforator flaps and Deep Inferior Epigastric Perforator (DIEP) flaps for breast reconstruction under world-renowned micro-surgeon, Professor Philip Blondeel at the Universiteit Gent. Dr. Snyderâ&#x20AC;&#x2122;s passion is for autologous breast reconstruction, he is the original DIEP surgeon in the Austin area. He specializes in DIEP flaps and microsurgical breast reconstruction. Dr. Snyder is board certified by the American Board of Plastic Surgery and is an active member of the American Society of Plastic Surgeons and the American Society of Reconstructive Microsurgeons. Dr. Ned Snyder is married to Dr. Renee Snyder, a dermatologist, and they have three children together. Breast and Body Center of Austin 1510 W. 34th Street, Suite 100 Austin, Texas 78703 (512) 533 â&#x20AC;&#x201C; 9900 www.breastandbodycenterofaustin.com 149 THEPLASTICSURGERYCHANNEL.COM

r. Robert Whitfield is an experienced board certified plastic surgeon. He completed six years of surgical training at Indiana University Medical Center. He remained at the Indiana University Medical Center to complete his plastic surgery residency. At the completion of his plastic surgery residency he chose to gain additional training in microsurgery by completing a one year microsurgery fellowship in Las Vegas, Nevada. He is an active member of the American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, American Society for Aesthetic Plastic Surgery, the American Medical Association and he is a Fellow of the American College of Surgeons. Dr. Whitfield focuses on providing cutting edge techniques in breast reconstruction including fat grafting with and without BRAVA, single stage silicone breast implant reconstruction, twostage breast reconstruction and microsurgical breast reconstruction using the DIEP flap. Dr. Whitfield believes choosing to have surgery is a major life decision. He has personally been involved in helping make decisions about surgery since 1996. For each and every patient his desire is to help them understand any procedure they may have as well as let them know if they are a good candidate for that procedure. Patient safety is incredibly important and at the forefront of each surgical decision. After spending so many years training and practicing he only aims to provide the safest and most appropriate surgical care.

MARK A. PINSKY, MD S

ophistcated patients recognize that while cosmetic procedures may have the same name, the quality and results can vary dramatically. Dr. Mark Pinsky has been recognized as one of Castle Connolly’s “Top Doctors” and voted “Best Plastic Surgeon in Palm Beach County.” He has also been recognized with the Compassionate Doctor award. His medical school honors, board certifications and renowned technical expertise attest to his knowledge and skill. His aesthetic sense and dedication to patient satisfaction have built one of the most successful practices in the country. Dr. Pinsky’s philosophy and approach balances each patient’s desires with the transformation he knows can be achieved, for beautiful, proportionate results–often better than the patient thought possible. Skilled and experienced in a wide range of surgical and non-surgical procedures for the face, breasts and body, Dr. Pinsky offers women and men treatment options that achieve beautiful, natural-looking results. He believes an attentive, compassionate approach in combination with advanced technology, impeccable skills and an artistic eye allow him to provide patients with the best possible outcomes. Dr. Pinsky’s commitment to excellence is evident in his professional involvement and industry leadership. He is one of only ten surgeons nationwide selected for Allergan’s Breast Aesthetic Executive Council. He has been invited to speak at plastic surgery conferences all over the world, sharing expertise on the latest techniques with other surgeons. He has been published in International Aesthetic Plastic Surgery and Aesthetic Surgery and featured as an expert in an array of television news programs and national magazines. He has served as a spokesperson and FDA Clinical Investigator for Mentor®, Allergan Natrelle® 410, and Juvederm®. Dr. Pinsky’s devotion to delivering on each patient’s dream is evident in his involvement in research, industry executive leadership and most importantly, in the happiness of each patient in his care. Mark A. Pinsky, MD 11020 RCA Center Drive, Suite 2010 Palm Beach Gardens, Florida 33410 (561) 881-8800 www.pinskylickstein.com 150 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Pinsky enjoys adventures with his nine year old son, including snow skiing, jet-skiing and walking Coco, their chocolate Labradoodle. He loves having dinner out with close friends. Dr. Pinsky spends as much time as he can outdoors soaking up the beautiful Florida sunshine.

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BEHIND THE SCENES When he is not working, Dr. Lickstein loves spending time with wife and three daughters. President of the Meyer Academy in Palm Beach Gardens, Florida. He is the “The Godfather” of Palm Beach Burger Doctors, a group of sixteen doctors in Palm Beach that are in search of the perfect burger.

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DAVID A. LICKSTEIN, MD A

fter completion of world-renowned medical training at Northwestern University, Albany Medical College and Massachusetts General Hospital, Dr. Lickstein was delighted to return home to South Florida. Here, his surgical expertise and deep commitment to community involvement have helped him develop one of Palm Beach County’s premier full range aesthetic and reconstructive practices. Dr. Lickstein is best known for creating natural results in facial rejuvenation and for his approach to “Mommy Make-Over” surgery, a customized combination of breast enhancement and tummy tuck that emphasizes both proportion and form. Patients trust him to skillfully restore them to their more youthful selves. When it comes to reconstruction, he is one of the few surgeons in Florida with extensive experience with state-of-the-art single stage implant reconstruction after mastectomy, having performed the procedure since 2007. He is highly sought-after for his skill in skin cancer reconstruction and was recently named director of the Cutaneous Oncology/Skin Cancer Program at Jupiter Medical Center. In recognition of his skill and commitment he has been named “Best in Palm Beach Gardens” for the past eight years, a “Best Doctors in America” and a Castle Connolly regional “Top Doctor” by his peers. Most recently the Palm Beach County Medical Society honored him as one of a select group of physicians to whom members would refer their families. Nationally, his work has been featured on YAHOO, FOX, WebMD, and CBS. David A. Lickstein, MD 11020 RCA Center Drive, Suite 2010 Palm Beach Gardens, Florida 33410 (561) 962 – 1950 www.pinskylickstein.com

As a Board Certified Plastic Surgeon, Dr. Lickstein is active in both ASPS and ASAPS and works locally in hospital-based research studies. As a husband and a father of three girls, he generously supports local initiatives and charities with his time and his resources. 153 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Pozner lives by the philosophy, “I wouldn’t do anything on a patient that I wouldn’t do on a family member.” When he’s not at work he enjoys the gym, reading thrillers and playing with his seven parrots. If he did not become a plastic surgeon, he would have been a racecar driver.

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JASON N. POZNER, MD D

r. Jason Pozner is certified by the American Board of Plastic Surgery. He is a member of the American Society of Plastic Surgeons, the American Society of Aesthetic Plastic Surgery and the American Society for Lasers in Medicine and Surgery. He is the son of a successful health spa and diet center physician in New Jersey and he has made aesthetic surgery and skincare his life’s work. Dr. Pozner graduated from the Mount Sinai School of Medicine in New York with a distinction in research. He trained for five years in an intensive general surgery residency at the Mount Sinai Medical Center in New York. He completed a microsurgery fellowship at Montefiore Medical Center in New York and his plastic surgery residency at New York’s Downstate Medical Center. He completed an additional fellowship in aesthetic and endoscopic plastic surgery in Maryland where he was an assistant professor of plastic surgery at the esteemed Johns Hopkins Medical Center. He is currently adjunct clinical faculty at Cleveland Clinic Florida Department of Plastic Surgery. As the founder of Sanctuary Plastic Surgery and co-owner of Sanctuary Medical Aesthetic Center in Boca Raton, Florida, Dr. Pozner is a highly respected authority on both surgical and non-invasive plastic surgery techniques. Through these two facilities, Dr. Pozner and his medical partners offer a full range of cosmetic surgery procedures, laser treatments, varicose vein therapies, weight loss assistance and clinical age management. The nearly 20,000 square foot facility serves an international clientele that appreciates being treated like family. Dr. Pozner is widely experienced in the latest and most effective cosmetic procedures and is credited for inventing the fast-healing Arctic Peel laser procedure. Jason N. Pozner, MD 4800 N. Federal Highway, Suite C101  Boca Raton, Florida 33431 (561) 767-9161 www.sanctuarymedical.com 155 THEPLASTICSURGERYCHANNEL.COM

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CLIFFORD P. CLARK III, MD BEHIND THE SCENES Dr. Clark has been an investigator in FDA

Dr. Clifford Clark is a board certified plastic surgeon, the

medical director of Orlando Aesthetic Institute – a stateof-the-art surgery center located in College Park – and an assistant clinical professor at the University of South Florida. He specializes in cosmetic surgery and has been consistently recognized by patients, peers and readers of Orlando Magazine as a “Top Doctor” in Central Florida. He has also been featured on the elite list of “Best Doctors” by the U.S. News & World Report.

trials and has published articles and book chapters on facial rejuvenation. He is an assistant professor of plastic surgery at University of South Florida, where he enjoys participating in the training of the next generation of plastic surgeons. He, his wife and their three children love sailing on Biscayne Bay or exploring the Bahamas together.

Dr. Clark’s practice offers a full range of cosmetic plastic surgery for the face, body and breast, as well as the latest in non-surgical treatments including Botox®, Dysport®, facial fillers, lasers and skin care. Throughout his twenty years of clinical experience, Dr. Clark has set the bar for surgical excellence in Central Florida and helped advance the specialty through leading clinical research, training the next generation of aesthetic surgeons and continually refining surgical and non-surgical techniques. As medical director of Orlando Aesthetic Institute, Dr. Clark has created a facility that delivers optimal safety, privacy and patient care. His passion for plastic surgery translates directly into the consistently high level of care delivered to each patient.

Clifford P. Clark III, MD 701 West Morse Boulevard Winter Park, Florida 32789 (407) 629-5555 www.dr-clark.com 157 THEPLASTICSURGERYCHANNEL.COM

CHRISTINE A. HAMORI, MD Dr. Hamori, an ivy-league trained and board certified plastic surgeon, specializes in facial and body contouring surgery. Experienced in the art and science of body enhancement, Dr. Hamoriâ&#x20AC;&#x2122;s practice is devoted to helping both women and men achieve a positive body image and maintain a youthful appearance at any age. A graduate of Tulane University School of Medicine, Dr. Hamori completed her surgical residency at Boston University where she was chosen to be chief resident during her fifth year. She then completed a plastic surgery residency at University of Pennsylvania. Dr. Hamori has published and presented in numerous peer review journals and conferences on breast and nipple surgery and labiaplasty. She has appeared in and been interviewed by many media including Allure magazine, New Beauty magazine, Bostonâ&#x20AC;&#x2122;s WCVB TV, Channel 5 news, The Montel Williams Show and The Doctors. She is a medical advisory board member to The Plastic Surgery Channel and provides information and expertise related to cosmetic GYN surgical topics.

Christine A. Hamori, MD 95 Tremont Street, Suite 28 Duxbury, Massachusetts 02332 (781) 934-2200 www.christinehamori.com 158 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Hamori enjoys traveling and kite surfing whenever she has the opportunity. Her favorite dog breed is the Coonhound, and she has one named Homer. She is an avid triathlete, runner and former All-American fencer.

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CAROLINE GLICKSMAN, MD D BEHIND THE SCENES As a 2015 ASERF research grant recipient, she is currently studying the efficacy of her patented “Breast Implant Teaching Model” which is designed to improve pre-operative patient education and the education of plastic surgery residents. In practice since 1992, Dr. Glicksman strives to empower her patients to make smarter, safer, longer lasting choices when undergoing breast augmentation. She has realized that she will probably never be an “empty nester” as at least one of her four kids is always home.

Caroline Glicksman, MD 2164 Highway 35, Building A Sea Girt, New Jersey 08750 (732) 974-2424 www.drglicksman.com

r. Caroline Glicksman is a board certified plastic surgeon with a private practice in Sea Girt, New Jersey. She is also Associate Clinical Professor of Plastic Surgery at Jersey Shore University Medical Center. After completing her general surgery training at Mount Sinai Hospital in New York City, she completed her plastic surgery residency at New York Hospital-Cornell Medical Center and Memorial Sloan-Kettering Hospital. She went on to complete an additional fellowship in cosmetic surgery at the prestigious Massachusetts General Hospital in Boston. Patient education is on the top of Dr. Glicksman’s priority list. “I would never recommend a procedure or product that is not in the best interest of my patient, and I would rather my patients leave well educated, without an operation, than ever undergo an unnecessary procedure.” After starting her private practice in 1992 she became active in both the fight to mandate insurance coverage for breast reconstruction and the growing silicone breast implant controversy. Dr. Glicksman is committed to the long-term follow-up of every one of her patients. In 2005, she was one of a handful of surgeons sent to Sweden for extensive training in the use of form stable, highly cohesive gel breast implants, the newest generation of silicone gel devices. Dr. Glicksman is a frequently invited guest speaker at national and international plastic surgery meetings, lecturing on improving outcomes in breast augmentation while lowering revision rates. Dr. Glicksman has been credited for many years as being a “Top Doc in NJ” and the “NY Metro Area,” as well as one of the “Top Surgeons for Women.” She is regularly featured by both regional and national press. Married to an orthopaedic surgeon, Dr. Glicksman has four children. 161 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Broumand guides his patients through their plastic surgery and noninvasive procedures, always keeping them safe and natural looking. In his free time, he likes to look at contemporary art in New York City and around the world. A highlight for him is playing golf with his son.

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STAFFORD R. BROUMAND, MD D

r. Stafford Broumand has some of the most impressive credentials of any plastic surgeon within New York City. Dr. Broumand attended medical school at Yale University and completed general surgery at Mount Sinai Hospital. He trained in plastic surgery at the Massachusetts General Hospital/Harvard Medical School. Dr. Broumand continued on staff at Harvard Medical School and completed a fellowship in burn reconstruction at Massachusetts General Hospital/Shriners Burns Institute. He then continued his training and completed another fellowship in cosmetic and craniofacial surgery in France at the College des Medicines de Paris, France – Hospital Necker. He currently holds a faculty position as associate clinical professor of plastic surgery at Mount Sinai Hospital, as well as directing a busy plastic surgery practice in New York. Dr. Broumand is a plastic surgeon certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons. Dr. Broumand is a “New York Metro Area Top Cosmetic Doctor” and has been for ten years, as selected by Castle Connolly Medical Ltd. He was recognized as a “Top Doctor” in The New York Times Magazine, an honor voted on by his peers. In 2013, he was named President of the New York State Society of Plastic Surgeons. Additionally, Dr. Broumand has been named to the Super Doctors list – a prestigious, peer-nominated directory recognizing outstanding physicians from over forty different medical specialties. Dr. Broumand runs his plastic surgery practice with a personalized approach that ensures all his patients receive individual attention and care. Patients who select the practice of Stafford R. Broumand, MD, will always meet directly with the surgeon in all consultations and postprocedure follow-up appointments. Stafford R. Broumand, MD & Daniel Y. Maman, MD 740 Park Plastic Surgery 740 Park Avenue New York, New York 10021 P. 212 .879.7900 | www.740parkmd.com 163 THEPLASTICSURGERYCHANNEL.COM

DANIEL Y. MAMAN, MD H

arvard fellowship-trained and certified by the American Board of Plastic Surgery, Dr. Daniel Maman is renowned throughout New York City for his impressive credentials and extensive surgical expertise. In 2015 the New York Times named him a “Rising Star in Plastic Surgery” and he is a regularly featured surgeon on The Plastic Surgery Channel. Prior to medical school, Dr. Maman earned his Ivy-league undergraduate degree from the University of Pennsylvania and his Master’s degree from Oxford University in England. He then went on to obtain his medical degree from the Mount Sinai School of Medicine, after which he completed a six-year plastic surgery residency at Manhattan’s Mount Sinai Hospital, serving as chief resident. Subsequently, he underwent additional fellowship training at the acclaimed Massachusetts General Hospital / Harvard Medical School, concentrating on state-of-the-art implant and microsurgery flap methods for cosmetic and reconstructive breast surgery. During this time he also held an academic teaching position at Harvard Medical School, as well as a staff surgeon appointment at the Massachusetts General Hospital. At 740 Park Plastic Surgery, Dr. Maman performs an inclusive array of aesthetic treatments and procedures for the face, body, breasts and skin. He is highly proficient in breast reconstruction following breast cancer. Outside of his office, Dr. Maman serves on the surgical staffs at Englewood Hospital, the New York Eye & Ear Infirmary and Mount Sinai Hospital, and he holds a faculty position as an Assistant Clinical Professor of Plastic Surgery at the Mount Sinai School of Medicine. He remains involved in the instruction of the Aesthetic Surgery Fellowship Program at the New York Eye & Ear Infirmary, and he takes part in annual charity breast cancer clinics and surgical mission trips to help underserved patients. No matter the treatment or procedure, Dr. Maman strives to help each and every patient achieve beautiful, natural-looking outcomes through the most effective, least invasive means possible. From consultation through recovery and beyond, he is devoted to providing an unprecedented level of patient care. Daniel Y. Maman, MD & Stafford R. Broumand, MD 740 Park Plastic Surgery 740 Park Avenue New York, New York 10021 P. 212 .879.7900 | www.740parkmd.com 164 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Maman practices the most modern, cutting-edge techniques. He believes natural-looking results are the key to great plastic surgery. He treats his patients as he would his own family members.

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MARK D. EPSTEIN, MD D

r. Mark Epstein is a dual board certified plastic surgeon with additional qualifications and expertise in hand surgery. Dr. Epstein also serves as Chief of Plastic Surgery at North Shore Surgi-Center and is a clinical assistant professor of surgery at State University of New York Health Sciences Center at Stony Brook.

BEHIND THE SCENES Dr. Epstein’s favorite vacation destination is anywhere in Italy. Dr. Epstein is a college dropout, ask him about it, it’s a great story. He loves going to Van Halen concerts, “I have a guitar given to me and personally autographed by my good friend Ed Van Halen.”

His surgical training began at State University of New York Health Sciences Center and continued at the University of Cincinnati, Milton S. Hershey Medical Center, Raymond Curtis Hand Center in Baltimore, Women/Children’s Hospital at Harvard in Boston and has even taken him to Chang Gung Memorial Hospital in Taiwan. He is a Fellow of the American College of Surgeons and a member of the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgery. Always an innovator, Dr. Epstein is motivated to push the envelope of surgical technology and surgical advancements. He has refined recovery techniques that allow breast augmentation patients to return to full normal activity in the first 24 hours following surgery. One Day Recovery Breast Augmentation represents an entirely new approach to patient care and outcomes. He also enjoys taking body contouring to a new level by marrying the art and science of Vaser® 4D liposuction, abdominal surgery along with nutrition, diet, exercise and massage; he looks at the torso in its entirety, thus blending and sculpting and in the process, yielding amazing new bodies for his patients. With advanced surgical procedures comes the need for better instruments. Dr. Epstein has designed special surgical instruments to facilitate these new techniques. Dr. Epstein practices in the heart of Long Island in Stony Brook, New York. Together, with his amazing staff of nurses and aestheticians, they cater to each patient’s total needs, from skin care to surgery. They truly take care of their patients from head to toe.

Mark D. Epstein, MD 2500 Route 347, Building 22A Stony Brook, New York 11790 (631) 689-1100 www.epsteinplasticsurgery.com 167 THEPLASTICSURGERYCHANNEL.COM

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ROBERT T. GRANT, MD BEHIND THE SCENES Dr. Grant has completed twenty-five marathons on four different continents. He has been a visiting professor on every continent but Antarctica (and he’s happy he won’t be making that trip). He met Nelson Mandela and President George H. W. Bush in South Africa on the same day in 2003 at The President’s Cup golf tournament.

Robert T. Grant, MD 50 East 69th Street New York City, New York 10065 (212) 305-3103 www.weillcornell.org/rtgrant

Dr. Robert T. Grant is Plastic Surgeon-in-Chief for the combined

Divisions of Plastic Surgery at New York-Presbyterian Hospital/ Columbia University Medical Center and New York-Presbyterian Hospital/Weill Cornell Medical Center, the University Hospitals of Columbia and Cornell, a position he has held since April of 2006. Board certified in general surgery and plastic surgery, Dr. Grant is a member of the American Association of Plastic Surgeons, the American Society of Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. After receiving his MD degree from Albany Medical College, Dr. Grant chose to specialize in plastic surgery and completed his general surgery and plastic surgery residencies at New YorkPresbyterian Hospital/Weill Cornell Medical Center. Dr. Grant’s outstanding work and commitment to plastic and reconstructive surgery has resulted in leadership positions at North Shore University Hospital, NYU School of Medicine and New YorkPresbyterian Hospital/Columbia University Medical Center and Weill Cornell Medical Center. He is also associate clinical professor of surgery at Columbia University, College of Physicians and Surgeons and an adjunct associate professor of surgery (plastic surgery) at Weill Medical College of Cornell University. Dr. Grant’s expertise has made him a sought-after expert, not only for local and national radio and television appearances but also for magazine and newspaper articles and interviews. He is included in the annual Castle Connolly Guide of America’s Cosmetic Surgeons and has been named to New York Magazine’s list of “Best Doctors in New York.” “Plastic surgery is about quality of life,” says Dr. Grant, “and about a woman’s overall health and well-being. I partner with each and every one of my patients to identify and reach that balance of inner and outer beauty that is theirs and theirs alone, and to maintain that balance through every life stage.” 169 THEPLASTICSURGERYCHANNEL.COM

LOUIS P. BUCKY, MD D

r. Louis P. Bucky earned his medical degree from Harvard Medical School, followed by general and plastic surgery residencies at Massachusetts General Hospital in Boston, Massachusetts. His education and training built a strong foundation for one of the country’s premier aesthetic practices. Dr. Bucky is a clinical professor of surgery in the Division of Plastic Surgery at the University of Pennsylvania School of Medicine and is Chief of Plastic Surgery at Pennsylvania Hospital. Dr. Bucky is board certified by the American Board of Plastic Surgery. He is a Fellow of the American College of Surgeons. Dr. Bucky is a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the Northeastern Society of Plastic Surgeons —of which he is also past president—and the American Association of Plastic Surgeons. Additionally, Dr. Bucky is chairman of the Allergan Breast Aesthetics Executive Council, which is an advisory board comprised of ten elite and nationally recognized leaders in cosmetic and reconstructive breast surgery. Dr. Bucky performs over one thousand cosmetic facial, breast and body enhancement procedures each year. He remains dedicated to helping patients achieve their goals while maintaining his reputation built on outstanding patient care and exceptional surgical skills. Dr. Bucky has been named Plastic Surgery’s “Top Doc” in Philadelphia Magazine consecutively each year since 2001. Dr. Bucky has also been recognized by Castle Connolly, which publishes a resource for “America’s Top Doctors” in cosmetic and reconstructive plastic surgery. In response to his in-depth research concerning facial aging, Dr. Bucky has developed techniques to enhance a patient’s natural aesthetic following a cosmetic procedure. He was recently filmed performing a live surgical procedure by the National Cosmetic Network to help educate fellow surgeons on these techniques. In addition to his role as educator, Dr. Bucky has co-authored over one hundred publications in prestigious industry journals and received a number of honors for his research in melanoma, breast reconstruction and fat transplantation. His research has been featured on various platforms, including Good Morning America, CNN, Fox News, CBS News, MAMM Magazine and many more. Louis P. Bucky, MD 230 West Washington Square, Suite 101, Philadelphia, Pennsylvania 19106 (610) 257 – 7037 www.drbucky.com 170 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES Dr. Bucky performs more than one thousand face, breast and body procedures each year. His publications have been featured on nationally televised programming including CNN and Fox News. Recognized annually as one of Castle Connolly’s “America’s Top Doctors.”

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J. PETER RUBIN, MD D

r. Peter Rubin is Chair of the Department of Plastic Surgery, UPMC Endowed Professor

of Plastic Surgery, and professor of Bioengineering at the University of Pittsburgh. He is an internationally recognized expert in the science of adipose stem cells and fat grafting. He serves as co-director of the Adipose Stem Cell Center and is founder and director of the Center for Innovation in Restorative Medicine in the Department of Surgery at the University of Pittsburgh. Dr. Rubin is principal investigator in an NIH-funded line of research aimed at developing cell based methods for clinical soft tissue reconstruction after cancer therapy and directs a related line of research aimed at soft tissue reconstruction for injured soldiers as an investigator for the Department of Defense Armed Forces Institute for Regenerative Medicine. Dr. Rubin is the recipient of a Presidential Early Career Award for Scientists and Engineers (PECASE). The Presidential Award is the highest honor bestowed by the United States government on outstanding scientists and engineers early in their research careers. Dr. Rubin earned his undergraduate degree in biology from Grinnell College and his MD degree from Tufts University School of Medicine. He completed a categorical residency training program in general surgery at Boston University/Boston City Hospital. He took time away from the clinic to pursue a two-year fellowship in surgical basic science at Massachusetts General Hospital/Harvard Medical School. After graduating from general surgery residency, he completed a three-year residency in plastic surgery at Harvard Medical School. He is well known for his innovative techniques in breast and body contouring surgery and frequently lectures at institutions across the country and internationally. He has published a textbook on plastic surgery after weight loss, and currently is lead editor of a multi-author textbook project on body contouring surgery that is expected to be the standard reference.

J. Peter Rubin, MD 3380 Boulevard of the Allies, Suite 108 Pittsburgh, Pennsylvania 15213 (412) 383 - 8080 www.plasticsurgery.pitt.edu/person/j-peter-rubin 172 THEPLASTICSURGERYCHANNEL.COM

BEHIND THE SCENES As an internationally recognized expert in body contouring surgery, Dr. Rubin has been lead editor for two textbooks on body contouring, and has lectured around the globe. He’s an expert on the science of adipose stem cells and fat grafting. He helps our wounded military personnel recover from their injuries with innovative surgical procedures and cutting edge research. When he’s not at work, you might find Dr. Rubin at an art museum, on a bike trail or on the ice rink coaching his kids’ youth hockey team.

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BEHIND THE SCENES Dr. Zienowicz attended college on a full basketball scholarship. He has performed reconstructive surgery on an elephant on behalf of the Roger Williams Zoo. Dr. Zienowicz supports the children’s hospital in Costa Rica, Hospital Nacional De Niños, with burn surgery training and has been on more than a dozen surgical missions in Central and South America.

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RICHARD J. ZIENOWICZ, MD D

r. Richard Zienowicz trained at some of the finest medical institutions in the world, including the Cleveland Clinic, Harvard University/Massachusetts General Hospital and his alma mater, Brown. He is an active educator of young plastic surgeons as associate professor of plastic surgery at Brown University’s Medical School. Dr. Zienowicz is board certified in three specialties and serves as an oral board examiner for the American Board of Plastic Surgery. Just last year he did live surgery for an audience of over four hundred of the finest aesthetic surgeons from more than twenty countries at the world’s most prestigious breast meeting held yearly in Atlanta. He has been featured in the Rhode Island Monthly’s “RI’s Top Doctors” five times. Dr. Zienowicz often performs pro bono surgery for children. Most recently, he volunteered his time and surgical skills to repair cleft lip and cleft palates for children in Guatemala. He has also done burn reconstruction of the face, hands and breasts at the National Children’s Hospital in San Jose, Costa Rica. In the past several years he has been invited to teach all over the world as an expert in breast and body contouring surgery in countries ranging from Brazil to Japan. One of his greatest joys in life is restoring his patient’s self-image. He and his team strive to make every patient feel as if they are being taken care of as family.

Richard J. Zienowicz, MD 10 Bridge St. Providence, Rhode Island 02903 (401) 453-0120 www.bodybyz.com 175 THEPLASTICSURGERYCHANNEL.COM

LIFT YOUR BREASTS AND

KEEP THEM LIFTED Perky, uplifted breasts are a common wish for many women.  We all know the effects breast feeding, weight fluctuations and even gravity can have on our breasts, leaving them saggy and shapeless. This is one of the reasons breast augmentation surgery remains the most sought after procedure in plastic surgery, according to the American Society of Aesthetic Plastic Surgery (ASAPS). “It’s a good time for breast augmentation,” says Dr. Bruce Van Natta, a board certified plastic surgeon in Indianapolis. Breast surgery is evolving more than ever before and new materials are being developed that can help keep your breasts lifted and supported for many years. Dr. Van Natta routinely uses a natural material called GalaFLEX® by Galatea Surgical to give his augmentation and mastopexy (breast lift) patients an added boost. While a mastopexy procedure can correct drooping and re-shape the breast, a new internal soft tissue material can be used to help support a woman’s breasts and potentially prevent further droopiness.  A helpful way to think of this material is an “internal bra” that supports your breasts and becomes part of your own breast tissue over time. WHAT IS GALAFLEX AND HOW DOES IT WORK? “GalaFLEX is unique as it is a monofilament natural scaffold that is stronger, more biocompatible and more predictable than any other comparable product,” states Dr. William. P Adams Jr., a board certified plastic surgeon and lead investigator in the clinical trials. Dr. Adams says GalaFLEX provides a strong and flexible scaffold which encourages the growth of a patient’s own natural tissue by providing a platform for new collagen and elastin. The scaffolding mesh is made of an absorbable and naturally derived material called P4HB (prolyl 4-hydroxylase, beta polypeptide), a component of human connective tissue. Over time, new tissue is formed and developed around the scaffold. The scaffold is slowly absorbed leaving behind a matrix that is 4-5 times stronger than your natural breast tissue. This process takes place over a period of 12-18 months. P4HB products have been around a long time and are routinely used in hernia repairs and a variety of other plastic surgery procedures. An investigator in GalaFLEX’s post-approval studies, Dr. Glicksman, a board certified plastic surgeon in Sea Girt, New Jersey says women can’t feel or see the implanted material. “Most importantly, our clinical studies reveal that the material doesn’t interfere with future mammography or ultrasounds, a concern for many health conscious women.” For the past three years Dr. Adams has been using GalaFLEX in many of his breast lift patients and says the results have been very impressive. “In the controlled study, the results show women with the GalaFLEX mesh mesh have had 5 times less sagging compared to women without the mesh support.” BIG IMPLANTS = DROOPY BREASTS The added weight of an implant that is too heavy for a woman’s breast tissue can also contribute to stretching of the breast over time. “When a breast can’t hold up the weight of an implant, GalaFLEX can be put to good use. We treat a lot of patients with this support system for primary and revision surgery,” says Van Natta. GalaFLEX has also been proven useful in small busted women who would like a little bigger implant than their tissue would normally be able to support. Dr. Van Natta says, “I think it’s going to be a game-changer in breast surgery across the board.” 176 THEPLASTICSURGERYCHANNEL.COM

What Goes Up Doesn’t Have to Come Down Elevate your results... with

GalaFLEX TRANSITORY SCAFFOLD

MONOFILAMENT RESORBABLE SUPERIOR STRENGTH For more information, please visit our new website at www.galateasurgical.com

Galatea Surgical, Inc. A wholly owned subsidiary of Tepha, Inc. 99 Hayden Avenue, Lexington, MA 02421 T: 781.357.1750 • F: 781.357.1701 www.galateasurgical.com

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Relax. You’re Covered with Sientra.

The Industry’s First Capsular Contracture Care Program

Sientra Smooth and TRUE Texture Breast Implants TM

You want more than beauty. You want a youthful feel and peace of mind. Ask your Board-Certified Plastic Surgeon about Sientra’s Silicone Gel Breast Implants are indicated for breast augmentation in women at least 22 years old and for breast reconstruction. Breast augmentation includes primary breast augmentation to increase the breast size, as well as revision surgery to correct or improve the result of primary breast augmentation surgery. Breast reconstruction includes primary reconstruction to replace breast tissue that has been removed due to cancer or trauma or that has failed to develop properly due to a severe breast abnormality. Breast reconstruction also includes revision surgery to correct or improve the results of a primary breast reconstruction surgery. Breast implant surgery is contraindicated in women with active infection anywhere in their bodies, with existing cancer or pre-cancer of their breast who have not received adequate treatment for those conditions and, who are pregnant or nursing. Key complications include capsular contracture, implant removal, rupture and reoperation. For more detailed information about the risks and benefits of Sientra breast implants, please visit www.sientra.com/resources or call Sientra at (888) 708-0808. Sientra breast implants with High-Strength silicone gel are only available through board-certified or board-eligible plastic surgeons.

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