We are all excited about our new QuickLift television ad that is now airing. This procedure, often done under local anesthesia, has made it possible to achieve an amazing natural younger look with minimal down time. Our satisfied patients have referred others to make this one of the most popular procedures we perform.
Franklin Richards, MD, FACS
Gynecomastia, breast enlargement in men, affects an estimated 20-40% of men at some point in their lives. In a small number of men it is related to a genetic condition. It may also be caused by the use of marijuana as well as the prescription drugs Aldactone, Furosemide and Digoxin. Anabolic steroids and medications that contain or promote the effects of estrogen have also been implicated. In the vast majority of cases the cause is unknown.
Gynecomastia typically develops in adolescence and and may involve one or both sides. The degree of development may be from a small amount of swelling beneath the nipples to changes that resemble a woman’s breast. Men affected are typically apprehensive about their appearance and do not like to be seen with their shirts off. It decreases their self esteem.
Treatment involves removing the excess which consists of both glandular tissue and fat. If the tissue is mainly fat, liposuction alone will suffice. For most men, the use of ultrasonic liposuction followed by removal of the small amount of remaining breast tissue using a grasping instrument through the same, small incision in the armpit works best. This technique avoids scars on the breast or nipple. If it is small and primarily breast tissue, as is often seen in very fit individuals, excision through a small opening in the nipple is the best choice. In a few men excess skin must also be removed and is typically done by a donut shaped incision around the nipple leaving only a circular scar around the dark skin of the nipple.
The procedure takes about 1 1/2 hours and is usually described as minimally painful. Typically, three to seven days are taken off from work. A compression garment is worn for one to two weeks and small drainage tubes are removed in 4-7 days. A small amount of swelling is typically seen for a few months before final results are achieved. Before and after photos can be viewed here.
Scarring in the arm pit or around the nipple is usually minor. Temporary numbness may be present. Infrequent complications include infection, fluid accumulation and firmness in the area that may require injections to decrease.
Frank Richards, MD
Dean Jabs, MD
The traditional notion of a “facelift” is far different today than it was even a decade ago. The thought of lifting the “entire” face with long incisions and wide undermining of the skin is archaic. This type of procedure will lift the face, but it lifts all of the face. If areas of the face do not need lifting and they are lifted those areas then look overdone and unnatural. Today we have smaller procedures that are directed to specific areas of the face. This allows for much faster healing and a markedly more natural look. Most patients return to work in one to two weeks. For instance, the most common concern we see today from someone desiring a facelift is laxity of the lower cheek and neck. These areas can nicely be corrected with a S-lift procedure using small incisions and minimal skin elevation. It can even be done under local anesthesia. It takes about 2 ½ hours to perform. It should be looked at as a mini-face or mini-neck lift. However, don’t misled let the word “mini”. The results (please see our photo section) are remarkable. There is a very natural look and it is long lasting (about 10 -12 years). If the concern is the middle of the face over the cheekbones or in the forehead (with wrinkles and droopy eyebrows) there are procedures specifically directed for theses areas as well. Bigger is not always better, especially when it comes to facial rejuvenation.
Franklin Richards, MD
Did you know that for any given breast implant size you have about sixteen different implant styles- all from the same implant manufacturer? Say you want a 350cc implant. Do you want it to be silicon gel or saline? What outside texture would be best for you – smooth or textured? Most breast implants come in different profiles – high, moderate and moderate plus. Which breast implant profile would look most natural for your breast? What about the implant shape – round or tapered? If you are considering breast augmentation, as you can see, you have several options. Breast augmentation surgery is NOT a “cookie cutter” operation where one single way to do it is appropriate for all patients. To achieve a natural look it is extremely important to choose an implant that is appropriate in size, shape, profile, texture and material for you existing anatomy. Only after a detailed examination should you choose your breast implant once you know all of the options with the pros and cons of each possible choice. You want it to be perfect, make your decisions about breast augmentation only after being fully informed.
Cosmetic surgery procedures in this area and across the country have dramatically increased over the last decade. There are many reasons for this.
1. Procedures are becoming less invasive and yet more effective.
2. Faster recoveries using smaller incisions and often, local anesthesia.
3. Techniques that dramatically reduce post-op pain.
4. Procedures that give natural looking results eliminating the signs of surgery.
5. Procedure prices have not increased or are lower, especially when you consider inflation. Most cosmetic surgical procedures are performed on those with middle incomes.
6. The ageing of America, causing a demand to look younger, more rested or better able to compete in the work place.
7. Cosmetic surgery is accepted in society.
Not all breast implants are the same. Obviously, there are many different sizes, but there are also different shapes, profiles, textures and fill materials. Breast implants can be grouped in two major categories: saline (or salt water) and silicon (or gel, sometimes called gummy). However, within these groups there are several different choices which are important to make to get a good result with breast augmentation. Breast implants have different profiles. A moderate profile implant is used most often. This is a flatter implant that gives a very natural looking result. However, sometimes a high profile implant may be required. This implant is narrower and has more projection. It will prevent the the implant from extending beyond the sides of the chest in an thin individual who wants to go to a larger size. There is also a moderate profile plus implant which has a profile between that of the regular moderate profile implant and the high profile implant.
All implants are either textured or smooth. The texture looks similar to Velcro placed on the outer surface of the implant. It was developed to help reduce breast firmness after surgery. However, if the implant is placed behind the muscle it does not prevent firmness any better than a smooth implant. The textured implant will also not move on the chest. When you lie down, instead of the implant flattening and going to the side of the chest like a smooth implant, the textured implant tends to stick straight up.
There is also a tapered or tear drop implant (sometimes called a anatomical implant). This implant is thinner at the top and fuller at the bottom. This implant is sometimes used to give a natural flow to the breast to prevent a “balloon ” look. However, if you go behind the muscle you will get a natural look with a round implant because the top of the muscle compresses the top of a round implant giving the tapered look. Also, the tapered implants are all coated with the texture mentioned above and they will not move on the chest.
In summary, whenever possible, we try to use the flattest implant that will fit the chest with a smooth surface to give the most natural look and feel to breast augmentation.
Franklin Richards, MD, FACS
The American Society for Aesthetic Plastic Surgery (ASPRS)
American Society of Plastic Surgeons
Just want to let you know that we are now carrying GloTherapeutics 7.5% Vitamin C Eye Gel and Vital Eye Cream (2 products, used together) in both our Bethesda and McLean offices. This dynamic duo packs a powerful punch, improving the fine lines and darkening around the eye area as well as delivering deep hydration, leaving this area smoother and revitalized. They both absorb effortlessly into the skin and can even be used under makeup! With the holiday season upon us, we know you want to look your absolute best, so call us or stop by today to pick up these two superstars while supplies last. Hint: they would make great stocking stuffers as well!!
Practice Manager
We mentioned already that our office is launching a promotion on Latisse. You can obtain this fabulous product for the fantastic price of (a $130.00 value). But wait, we are making this deal even better. For limited time only, we are adding another excellent product…Vivite Vibrance Therapy to help brighten, hydrate and protect your skin all this for FREE!!!. Buy one Latisse box and get one free Vivite Vibrance Therapy. For more information on this product visit www.viviteskincare.com.
CSA Staff
What a deal!! Our office is offering a special on LATISSE. You can now purchase a box of LATISSE for just $95.00. The original cost is $130.00. Purchase now while supplies last.
Please call our office if you have any questions.
For more information on this product, please visit the website at http://www.latisse.com
CSA Staff
The number of Botox injections in our area and across the country has continued to increase since Botox was first FDA approved several years ago. It is now the most frequently performed ‘procedure’ in plastic surgery offices. This ten minute office injection has been shown to be very safe and extremely effective in removing facial wrinkles. It is most often done to treat the area between the eyebrows, the forehead and the crow’s feet wrinkles around the eyelids. You should know that it temporary. The first injection usually lasts about three months. Subsequent injections tend to last longer and longer as you continue to use Botox. An exceptionally high patient satisfaction rate with Botox will continue to make these treatments popular for years.