Brow lift Vs. Blepharoplasty: What’s the Difference?

Posted on August 9, 2011 by

As plastic surgeons in Louisiana, we’ve encountered a lot of patients who feel like their “eyes” look mad, sad, or tired, but they feel just the opposite.  They know that most of these unwanted facial expressions around the eyes are caused by aging, but they’re unsure if they need a brow lift or a blepharoplasty procedure, or even if they can get away without surgery altogether.

First, it is important to clarify exactly what is bothering each individual patient and where they “see” the aging.  Then, the discussion centers around which intervention will work the best for each person’s condition and desires.  Many times, we can utilize Botox and wrinkle fillers with beautiful results, alleviating most or all of the signs of aging without needing to perform surgery.  Other times, when facial aging is more advanced, we consider different surgeries for around the frame of the eyes, which usually consist of some form of a brow shaping or lifting procedure, and blepharoplasty, which is upper and/or eyelid surgery.

Which one does what?

A brow lift is exactly what it sounds like, with the added benefit of brow shaping, utilizing more recent and advanced techniques, either endoscopic (utilizing tiny access sites) or open (usually with incisions shorter than 2 inches on each side).  Blepharoplasty is essentially an eyelid procedure where excess folds of upper eyelid skin are removed from the upper lids, many times with contouring of the entire length of the upper lid.  Lower lid blepharoplasty can include skin tightening, but mainly streamlines and minimizes hollows and bulges from the lower lids and orbital rim.  This is accomplished through hidden incisions, by tightening and repositioning the eyelid muscle and providing a smoother platform beneath the eyelid skin.

If the part of the brow closest to the temple region is drooping, with persistent wrinkles and hooding by the outside of the eyes, a patient usually is a candidate for a brow lift.  Older methods of brow lifts could effectively lift the entire brow, but usually required longer incisions and inexact brow shaping.  In our practice, we have found a temporal brow lift is very effective in repositioning the outside of the brow and skin beneath it, and has the added benefit of shorter incisions and exact brow shaping.  Brows that have a sagging of the outside part of the brow tend to make a person look sad or mad; therefore, lifting the portion of the brow to its appropriate height can immediately improve appearance and dramatically improve the sad or tired appearance.  Another advantage of temporal brow lifts is the ability to shape the brow and not cause over-elevation of the inner part of the brow, which can result in a “surprised” look.

If a patient merely has excess skin on the upper lids, then we would more than likely suggest a blepharoplasty. You don’t have to live with a tired, sagging eyelid appearance. Through a relatively straight-forward, tried and true plastic surgery procedure, our surgeons can tighten and revitalize both upper and lower lids. With the excess skin removed and the fatty deposits that cause puffiness smoothed and contoured, a patient’s eyes will appear greatly rejuvenated.

A blepharoplasty can also go hand in hand with a brow lift; however, it doesn’t have to. Whichever a patient chooses, The Wall Center is happy to give them the results they are seeking.

Have you ever had one of these procedures? If you haven’t, which one would you most likely opt for?

To your health and beauty,

The Doctors Wall

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Say No To IV Skin Whitening

Posted on August 3, 2011 by

While most of our culture is obsessed with being tan, and even risk skin cancer to get their nice bronze skin, there are also those that wish to lighten their skin. Perhaps you suffer from uneven skin tone or areas of skin discoloration and wish to know your options.  In Louisiana, The Wall Center does not perform any type of generalized skin whitening procedure, though our latest Fraxel skin resurfacing laser as well as IPL photofacials can dramatically improve skin discoloration and even completely remove spots (dyschromias). However, there is still a need to warn you that there is an unapproved skin whitening procedure making its rounds in the Phillippines.

The Phillippines FDA has issued an advisory that warns of the potentially serious risks of using the popular intravenous skin whitener glutathione. Glutathione is a liver-generated compound that plays a role in antioxidant defense, metabolism and regulation. When injected into a vein, glutathione inactivates the enzyme tyrosinase, which helps melanin production. With the melanin production stunted, the pigment lightens to pheomelanin.

It has been found that in very high doses, glutathione is unsafe and may cause serious health risks of the users. A patient receiving twice-weekly glutathione injections may see:

  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis
  • Thyroid function derangement
  • Possible kidney dysfunction, potentially resulting in kidney failure
  • Severe abdominal pain
  • Possible overload of renal circulation

If you feel the need to lighten your skin, there are other ways to do so. Many treatments use a combination of topical lotions or gels containing melanin-inhibiting ingredients along with a sunscreen, and a prescription retinoid or RetinA derivative. These are your safer options!

To your health and beauty,

The Doctors Wall

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Labiaplasty: What is it Good For?

Posted on July 4, 2011 by

Have you heard of labiaplasty? Not everybody has. The labia are the external folds of skin that surround the vulva, the skin that covers the clitoris and vaginal opening. Labiaplasty is a cosmetic surgical procedure to make the labia—either the labia majora or labia minora (or both)—smaller, although sometimes it’s done to create labia where there were none, ie, to correct a birth defect.

Why is a Labiaplasty performed?

The most common reason a labiaplasty is performed is to reduce the length of the labia minora – the smaller skin fold surrounding the vagina.  When standing, the labia minora is typically the same length or smaller than the larger labia majora.  This is typically due to good old genetics, but childbirth can damage the labium (plural of labia), which explains why, here at our Shreveport, LA, plastic surgery office, a Mommy Makeover procedure sometimes includes a labiaplasty.

Aging and weight gain/loss cycles can also make the labium lack an attractive fullness, resulting in sagging. However, most labiaplasty procedures are performed for women who have overly long labium, labium that are misshapen, or labia that are mismatched, i.e., one is longer than the other. Things that you and I take for granted, such as wearing tight jeans or stretchy workout clothing, riding a bike, horseback riding and similar activities are embarrassing and/or painful for women with very long labium. These women are often self-conscious during intimate relationships and find it difficult to enjoy sex because they think they look abnormal and because intercourse can be painful for them. Naturally, their discomfort makes it more difficult for their partner to enjoy the experience, as well.

How is a Labiaplasty performed?

Labiaplasty is an outpatient procedure. It can be performed under local anesthesia, IV sedation or general anesthesia. When it’s done along with other cosmetic procedures, it’s performed under general anesthesia. The decision about anesthesia is discussed during a woman’s private consultation in our plastic surgery office in Shreveport. Some women are comfortable with local anesthesia while others wouldn’t consider anything less than general anesthesia. My goal is to make the procedure as comfortable as possible for each particular woman.

What’s the Recovery Time from a Labiaplasty?

Most of my labiaplasty patients feel comfortable going back to work or school in three days. The area will look immediately better, but swelling may take a full 6 weeks to go away.  You cannot have intercourse, exercise, or swim for 6 weeks as this tissue is very fragile.

I’ve Heard that Labiaplasty can be performed with Lasers. Do you use a laser?

Laser vaginal rejuvenation is an entirely different procedure and is banned in many countries.  Using a laser on fragile vaginal tissue in the hopes of making the vagina tighter, causes a burn, and can cause serious injury and pain with intercourse. Laser vaginal rejuvenation is not condoned by the ACOG (the American College of Obstetricians and Gynecologists).

If you have concerns about the “look” of your labium, are having discomfort wearing slacks or participating in certain activities, schedule an appointment with me for a private consultation. It may be quite easy to take care of, but without an exam, you won’t know.

To your health & wellness,

Dr. Holly Casey Wall

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Are Teen Plastic Surgeries on the Upswing?

Posted on May 30, 2011 by

Here in Shreveport, we perform plastic surgery on teens, although the procedures focus on procedures to adjust physical features that are appropriate for a teenager, such as a rhinoplasty to reduce and remodel a large nose; otoplasty (ear) surgery for teens with ears that are protuberant (although otoplasties are performed on children as young as 4 years old); breast reductions for girls with overly large breasts that cause discomfort and/or embarrassment; and male breast reduction for boys whose breast tissue is larger than appropriate (gynecomastia). We rarely see teenaged girls who want a breast augmentation, for example, unless the breasts are obviously unequal in size (asymmetric), to the point that wearing a swimsuit is embarrassing.

However, the media seems bent on telling us that cosmetic surgery is on the upswing for teens. This isn’t proven, at least according to a study done by the American Society for Aesthetic Plastic Surgery, of which all three board certified plastic surgeons at The Wall Center are members.

According to the 2010 statistics on cosmetic surgery, teens primarily undergo the following procedures (which includes both surgical and non-surgical):

  • Laser hair removal (51,000 procedures last year)
  • Skin treatments (including 16,200 chemical peels and 10,400 microdermabrasion treatments)
  • Ear surgery (10,700 procedures)
  • Nose jobs (9,100 procedures)

In fact, the ASAPS reports that the number of cosmetic procedures for patients age 18 and under, which were numbered at 300,000 a decade ago, tallied only 125,000 last year. How much of that is due to the economic downturn in 2010 versus another reason is anyone’s guess. That research hasn’t been done.

What do you think about teens having cosmetic surgery? Does anything go or should parents put a restriction on what should be done before their child reaches the age of 20? We’re interested in hearing what you have to say!

To your health & beauty,

The Doctors Wall

 

 

 

 

 

 

 

 

 

 

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The Answer to Flat Cheeks

Posted on March 11, 2011 by

If your cheeks are flat and lack definition, due to aging, weight loss or simple genetics, they can cause you to look older, deflated, and even a bit more masculine. There are various methods to contour the cheeks to add volume, giving the face natural-looking symmetry, youthful balance, and a more feminine appearance. Some methods are permanent, others are long lasting and some are temporary.  Additionally, some options will work better than others, depending on your unique facial structure and your specific needs.

FOR PERMANENT RESULTS
Silicone cheek implants are ideal for many patients who desire more volume as opposed to a slight increase in the cheek area.  Implants will permanently add fullness and create a lifting effect. Keep in mind that silicone facial implants are tried-and-true devices with an excellent safety record, and have been FDA approved for years, as opposed to liquid silicone injections, which are not FDA-approved.  Another method of facial rejuvenation that enhances the cheek area is a volume-enhancing mid-face lift, which is extremely popular among our Louisiana plastic surgery patients. Using a small incision at the lower eyelid, a mid-face lift repositions the lower cheek fat and tissues back into a higher position on the cheekbone and face.  A mid-face lift does require a bit more downtime than cheek implants, but some patients may need the added lifting effect of the mid-face lift that cheek implants can’t give by themselves.  Many times, these procedures can actually be combined to provide a maximum effect of lifting and filling.

FOR LONG-LASTING RESULTS
By injecting fat from another part of your body, like the hips or buttock region, we can give you fuller, plumper cheeks. Fat transfer is currently a popular option for long-term fullness, but using this method requires an additional lipo-like procedure to be performed. The added bonus? Removing fat from an area where you have too much!

FOR FAST, BUT MORE TEMPORARY, RESULTS
Fillers are a good way of test-driving what your cheeks could look like with fat injections, a mid-face lift or cheek implants. Placing Sculptra Aesthetic or Radiesse in the upper area of the cheek adds fullness and can also lift the area below the cheek. Perlane, Juvederm and Artefill can also be used to achieve similar results, with each having its own characteristics and duration.  Some fillers work better in certain conditions and places on the face than others, and this is another reason it is very important to seek out a board-certified plastic surgeon specializing in cosmetic surgery—experience with using these products and performing these surgeries cannot be overstated!

By lifting your cheeks with one of these methods, your other facial features are subtly lifted, too—like the corners of your mouth and your jawline—which gives a nice contour.

To your health & beauty,

The Doctors Wall

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Do you know your Breast Implant Warranties?

Posted on February 8, 2011 by

Here’s good news for those of you with breast implants.

Unlike those who receive hip or knee implants, patients who have breast implants receive warranties that can be put into play if they need replaced. Although the implant companies, Allergan and Mentor Corp., which combined sell about 99% of the breast implants in the US, don’t cover every part of the replacement expense, their warranties are quite extensive. This proves the trust they have in their products.

Just in case you aren’t aware, these are the generous warranties currently offered by both companies:

  • Up to $3500 in financial assistance if surgery was performed after May 1, 2009
  • Silicone filled and saline filled breast implants are both covered
  • Lifetime product replacement—is there any other product in your life with this?
  • Automatic enrollment at the time of your original surgery

Our Louisiana plastic surgery practice is one of the biggest breast augmentation practices in the country, performing over 700 breast augmentation procedures annually. In fact, we’re the largest Mentor account in the states of Louisiana, Arkansas and Mississippi. All 3 of us are part of Mentor’s LEAD program, which is a highly select group of breast augmentation surgeons from around the country, advising Mentor in breast aesthetics. This is an honor for us, and we take our responsibility seriously.

To your health & beauty,

The Doctors Wall: Simeon Sr., Holly and Simeon, Jr.

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Considering laser liposuction? SAFELipo a better alternative

Posted on January 31, 2011 by

We have seen a dramatic and, unfortunate, increase over the past few years in patients who come to us from all over the US after having been disfigured by laser liposuction procedures. In many instances, unqualified physicians performed these procedures. While liposuction has gained acceptance and popularity, not all treatments and providers are able to deliver the results patients seek.

Due to the current state of medicine in this country, many doctors are expanding into services they were never trained to perform, including plastic surgery. After seeing disappointing results, many patients are surprised to learn that their “plastic surgeon” was actually trained as a family doctor or general surgeon, and simply took a one-day or weekend course to learn how to use a surgical laser to perform liposuction.

Laser liposuction is aggressively advertised under brand names such as Smartlipo™, SlimLipo™, and CoolLipo™.  These devices use a low-energy laser to melt targeted fat cells. Marketing claims include skin tightening, reduced bruising, and quicker recovery over conventional liposuction methods, but the reality is that the plastic surgeons at The Wall Center are seeing a very high number of unsatisfied and unhappy laser liposuction patients, many with uncorrectable deformities.

While using lasers to perform liposuction may sound like a sophisticated, space-age way to simply melt away unwanted fat, The Wall Center surgeons want you to realize the potential hazards of devices “designed to destroy fat cells and coagulate tissue,” as one device manufacturer states in its marketing materials.

Destroying fat cells and burning up tissues inside the body does not really make sense to us as plastic surgeons. We have seen and treated a number of patients with deformities from laser liposuction. It’s important to note that the extreme heat produced from these laser devices can drastically increase the risk of a bad result. In some cases, even the tried-and-true techniques we’ve used for years to fix contour deformities are insufficient to correct the damage these laser devices can produce inside the body. From what I’ve seen, much more research needs to be done with these devices, and potential patients need to be educated about laser liposuction and its risks – and about the importance of having a board-certified plastic surgeon perform their liposuction, regardless of the technique used.

The number of people we see with poor laser liposuction results from other practices continues to rise. A recent example is one of our patients, C.P., a 28-year-old former swimsuit model. She saw an ad in her local newspaper for in-office Smartlipo laser liposuction that promised to remove unsightly bulges of unwanted fat with no downtime and a low price tag. While she had hoped for an improvement in her tummy and flanks, she was left with an uneven, wavy appearance, and worst of all, an unsightly crease across the skin of her abdomen. Despite allowing the same doctor, who was not a plastic surgeon, two more attempts at fixing her problems with additional laser liposuction, C.P.’s previously attractive midriff was now ruined. C.P. sought my help, because I specialize in liposuction in Louisiana, and because of my experience treating post-liposuction contour deformities using my SAFELipo™.

Unlike laser liposuction and other heat-producing technologies like ultrasound and radiofrequency, SAFELipo does not generate any heat, eliminating the possibility of burning and destroying tissues inside the body.  SAFELipo gently separates unwanted fat from its attachments so it can be removed easily, minimizing any damage to blood vessels, nerves, and the remaining fat layer.  Waviness and lumpiness are almost unheard of utilizing SAFELipo’s unique fat equalization process.  All three of us here at the Wall Center for Plastic Surgery (Simeon Sr, Holly, and Simeon Jr) agree that our results with SAFELipo are far and away superior to anything we’ve ever done using any other technique or technology.

Dr. Simeon Wall Sr is a pioneer in liposuction surgery, and has witnessed a steady evolution of the procedure and the technology since its introduction to the United States in the early 1980s. In the hands of a trained, experienced, board-certified plastic surgeon that specializes in cosmetic surgery, advanced liposuction techniques like SAFELipo can produce beautiful results. But these improvements are directly tied to the surgeon’s ability more than to the technology or techniques. Above all, it’s important to choose your surgeon carefully. Look for a surgeon who is certified by the American Board of Plastic Surgery and a member of American Society for Aesthetic Plastic Surgery. Don’t be swayed by special offers and discounts – you simply can’t put a price on your health and wellbeing.

To your health & beauty,

The Doctors Wall: Holly, Simeon Sr. and Simeon Jr.

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