Return from American Brazilian Meeting

I am just now catching my breath after a very busy American Brazilian Meeting, in Park City, Utah. The meeting was truly international, with members of 14 countries present.  A broad variety of cosmetic topics were covered and I came home more energized than ever to practice the art of Plastic Surgery.  My presentations went very well and I was struck by something as I was presenting my work.  There really are three categories the Plastic Surgeon can work in; 1. The early or youthful patient wanting to age in a balanced way, hoping to avoid major intervention in the future, treated non surgically, with filler and Botox/Dysport 2. The patient who really is a surgical candidate but does not want to have surgery and is willing to accept limitations of current non surgical technology 3. The surgical patient who, for a variety of reasons, may have fallen short of the desired outcome and does not want more surgery, the so called surgical buffer/salvage.  On a daily basis, I work on all three categories and patients are getting more dramatic improvement than I ever could have imagined.  While patient expectations continue to climb, fortunately, technology is out pacing their expectations. Several plastic surgeons came up to me after my presentation and said they never thought of cosmetic enhancement in the way I presented, the so called "Aesthetic Enhancement-Lite".  I am excited for the future and feel we are seeing a powerful wave and I am proud to be riding it!

Traditional Tummy Tuck is not always the answer!!

When I was in training more than 10 years ago, we really only had one option for the woman (or man!) who had extra skin and fat on the tummy.  While traditional tummy tuck is the gold standard and a good option for many, there are many cases where you can get a wonderful/even better overall result with the mini tummy tuck and/or laser assisted liposuction.  How is this possible and why is this such a different way to look at cosmetic surgery.  The reality is less cutting and fewer points for scaring is better for many patients.  In particular, the mini tummy allows for tightening of the stomach without a scar around the belly button and the scar above the pubic area is quite short and easy to hide.  The reason a mini tummy tuck can work now when it was not as good an option more than 10 years ago is the availability of laser and ultrasound assisted liposuction.  These technologies allow for impressive fat reduction, especially in the upper belly, while also allowing for skin rejuvenation to the upper abdomen (belly).  The mini also allows the surgeon to tighten the six pack muscles (the rectus muscles) and/or repairing a belly button (umbilical) hernia.  The recovery is usually easier, with many patients back to work within a week.  Did I mention the surgery is less expensive as well.  There may even be patients who are really candidates for traditional tummy tuck (abdominoplasty) but they are concerned about the extent of surgery, cost, and/or are willing to compromise on the extent of the surgical result.  They may choose laser liposuction, ultrasonic liposuction, or mini tummy tuck even though the traditional tummy tuck would give the best "cosmetic correction".  Obviously, if someone has lost a lot of weight or has a significant amount of loose skin after pregnancy, then the traditional tummy tuck is the way to go and worth the extra work and potential recovery.  Bottom line, pick what is most important to you and make sure your surgeon is aware of your priorities and desires!

Fat injection can be enhanced with sculptra

I have encountered a finding that I am very excited about, sculptra injection to further enhance a previous facial fat injection patient. Here is the deal, an attractive women I treated with facelifting and fat injection a couple of years ago. She wanted further enhancement and needed it in the cheeks and had limited reserves for further grafting. We decided to do sculptra and 2 treatments later she looks amazing with no down time. I have noticed a response, even after the first injection, that is better than previous patients treated with sculptra alone. I am excited to perform this combination in future patients, as this approach has not been described.