Q. What does an upper arm lift involve and how long is the typical recovery time?
A. Patients who have lost a significant amount of body weight often present with excess skin involving the arms. This is especially true after bariatric (weight loss) surgery where patients typically lose greater than 100 pounds.
Excess skin is removed from the arms and the final scars are placed in the inner aspect of the
upper arm. Depending on the degree of skin excess, the scar sometimes extends down to the
elbow. Most patients are very pleased with the contour improvement after this surgery and
consider the potentially permanent and visible nature of the scars to be a welcome tradeoff.
Finally, scars fade considerably in 6-12 months in most cases.
Q.What treatments are available for Varicose veins/spider veins? How long is the recovery period? Who is a good candidate?
A. Spider veins are a common complaint in patients who typically stand on their feet all day. Over a number of years, these spider veins become more prominent and this prompts patients to seek treatment. Treatment options include selerotherapy (saline injections) or laser treatments (our preferred method). Laser therapy is very effective and requires little to no down time. Multiple treatments, depending on the number of veins, present are required. The most typical treatment locations include the legs and face and the treatments must be done on un-tanned skin. Overall, the best candidates for laser treatment have a fair skin type. In contrast, Varicose veins are large, typically painful, dilated veins that require a vascular surgeon to treat.
Q.I had a lip lift 2 years ago. My scars on my lips feel very hard, tight & firm and I also have nerve (painful) sensation. The scars remain irritated – is there anything I can do to get rid of the sensitivity?
A.Generally speaking, scars on the body are fully mature and maximally healed at one year. If it has been two years and the scars are still bothering you, then an evaluation by a plastic surgeon is indicated. Occasionally, surgical scar revision or steroid injections may be indicated to improve the appearance of the scar and to decrease the firm feel. As far as the painful sensitivity is concerned, this may be a permanent problem. However, a consultation with a neurologist may be appropriate as medications, such as Lyrica, have been known to decrease paraesthesias (painful nerve sensations).
Q.I have deep vertical lines on my upper lip. What can be done for this?
A.Signs of perioral aging such as vertical lines of the upper lip can be treated in a number of ways. Lines in the upper lip can be caused by the action of the underlying muscle. These dynamic wrinkles can be improved with Botox injections to decrease muscular activity. Static wrinkles that are present when the lip is at rest can be treated with CO2 laser resurfacing and/or soft tissue fillers. Example of soft tissue fillers include one’s own fat, collagen and hyaluronic acids. The amount of correction that can be achieved and how long it will last will depend on the patient’s condition at presentation and the techniques used. Restylane, Juvederm, and Radiesse are examples of fillers that are popular currently. They are injected into the skin to fill out wrinkles. The results can last from six months to twelve months. These treatments have minimal down time.
Q.What is the best treatment for someone who has scars resulting from acne?
A.Facial scars that result from acne damage can often be a very distressing problem for patients. Generally speaking, therapy with resurfacing technology (i.e. lasers and/or dermabrasion) in combination with dermal fillers (hyaluronic acid, calcium hydroxylapatite, collagen, etc.) can be very helpful.
Resurfacing with lasers, for example, can help smooth the edges of the scar, reducing their depth and ultimately making them less noticeable. Because acne scarring also leads to volume loss in the skin (typically pitting of the skin is seen) adding a bulking agent can greatly enhance the result of the laser resurfacing.
Q.What are fillers? What does Radiesse do to make you look younger?
A.Dermal fillers have become increasingly popular among patients because they are minimally invasive, require little down time and are highly effective at mitigating the signs of facial aging.
One such filler is Radiesse which received FDA approval for cosmetic applications in 2006, namely treatment of the nasalabial folds. It is a good volumizing agent and also works well in augmenting the cheeks and smoothing the jawline. Radiesse is thought to maintain a good correction for one year or more and some studies also indicate that the product stimulates collagen production by the body. Therefore, the effects of the treatment may have some permanency.
Q.My daughter has a small lump, not really visible, just under her eyebrow on the outer corner. I think it is a dermoid cyst, we’re not sure if it is growing, if so slowly. The doctor said not to worry and to have it removed when she gets a bit older. It worries me, I don’t want it to affect her eye in a negative way. I’ve read online that they are quite common, even often occurring in that very location.
A.Dermoid cysts are benign growths that are commonly seen involving the lateral 1/3 of the brow, the nose and the scalp. In general, they are considered to be rare with an estimated incidence of .002 to .005 % of births. The cysts that involve the corner of the eyebrow generally are confined to the soft tissue of that region and do not extend more deeply to involve bone or intracranial structures.
Dermoid cysts do tend to enlarge over time and can get infected, so surgical removal is generally recommended while the growth is small.
Q.What is the longest lasting correction for frown lines that extend from the corner of the mouth down the chin?
A.To correct contour deficiencies of the face, a variety of injectible soft tissue augmentation agents have emerged. Restylane, Radiesse, and fat are some of the most popular fillers. Restylane lasts 6-12 months and Radiesse 1-2 years. Fat can be permanent, but 50% of it goes away after the initial treatment. Soft tissue fillers also serve as an excellent adjunct to more definitive and long lasting techniques such as a face and neck lift.
Q.What is involved when someone undergoes a neck lift procedure?
A.What type of neck lift surgery you undergo depends on what concerns you have about the appearance of your neck and a careful examination of your anatomy. Loose skin, loose or redundant musculature and excess fat are the common stigmata of an aging neck. Which type of neck lift surgery you undergo will depend on which of these you present with. Patients with good skin quality and only excess fat can undergo liposuction alone. Those with redundant muscle must have surgery to transect or re-sect the muscle. Finally, those with excess skin require an incision along the posterior ear and hairline to remove the excess skin. More times than not, patients present with a combination of problems involving skin, muscle and fat. These patients require a combination of the above techniques to achieve an ideal neck. Often neck lift surgery is combined with other surgeries such as face lifts.
This general Information is not intended to provide individual advice. Please make an appointment with a physician to discuss you particular situation and needs.
