Is a brow lift what you're looking for?

A brow lift and an eyelid surgery are two different procedures, and they produce different results—but I encounter many patients who don’t know exactly how to distinguish between them. It’s understandable that that’s the case: after all, as we age we undergo a variety of changes to our facial features, and it’s not always easy to tell exactly which one we’re noticing when we’re looking in the mirror (since mostly we’re just noticing that we look older!).

To help you figure out what’s what when it comes to brow lifts vs. blepharoplasty, here’s a quick rundown:

Upper-eyelid blepharoplasty requires making an incision (usually in the natural crease of the eye’s inner corner) and removing fatty tissue and excess skin from the eyelid itself. A brow lift, meanwhile, involves the altering and removal of the muscles and tissues in your forehead to smooth out lines and eliminate the sagging effect they can cause. A good litmus test for determining whether you need a brow lift or if an upper-lid surgery is enough on its own is this: Looking in the mirror, pull your brow/forehead up with your fingers and note the difference. Next, try simply lifting up the extra skin on your eyelids, and see what kind of difference that makes.

If getting rid of that excess baggage on your lids seems like it will do enough to rejuvenate your looks, then a blepharoplasty is what you’re looking for. If your real problem is that the muscles in your brow are dragging down your skin—giving you a furrowed, tired look—then a brow lift is probably in order.

Keep in mind that there are other options besides blepharoplasty and brow lifts as well, such as Botox or Dysport injections; sometimes they can give you just enough of a lift on their own so that surgery isn’t necessary! Determining which procedures are actually needed is something that is difficult to do on your own, however, so I would suggest scheduling a consultation with a board-certified plastic surgeon if you’re serious about pursuing any kind of upper-face rejuvenation, whether it’s surgical or not: a consultation is free, it doesn’t take long, and—best of all—it will ensure that you achieve the best long-term results possible!

For crepe-paper skin, ablative lasers are more effective.

For some, the most telltale (and unsettling) sign of aging is the crepe-paper quality that their skin begins to develop in later years. Over the years, I’ve had many patients ask me whether Fraxel restore—a non-ablative laser treatment—would be effective in tightening the skin and eliminating the creping (especially on the face).

While Fraxel lasers can have some positive effect upon skin creping, the improvements are only mild to moderate. To truly see results from laser treatments, you would need to undergo treatment by an ablative laser, such as the CO2 laser.

The basic difference between ablative (CO2 laser) and non-ablative (Fraxel laser) treatments is that ablative lasers remove the top layer of skin, while non-ablative lasers work by heating up your skin tissue so your body can lay down collagen. With Fraxel lasers, you have to undergo multiple treatments, spaced 2 to 3 weeks apart—and since it’s a milder, slower process, you won’t see results for several months.

Ablative laser treatments are certainly more invasive; they create a raw surface that takes time to heal, and the downtime is 3 to 4 weeks. However, there’s a reason that ablative CO2 laser resurfacing is considered the gold standard laser treatment: only one treatment is necessary (vs. the multiple treatments non-ablative lasers require), and it will be much more effective in eliminating the creping that’s bothering you. Another plus on the side of ablative lasers is cost—since you only have to do it once, an ablative treatment will generally be less expensive than non-ablative treatments.

Both ablative and non-ablative laser treatments have their advantages—and ultimately, it’s something that you should discuss with your plastic surgeon and then make your own decision about. If you want to truly get rid of that crepe-paper skin, though, ablative lasers are probably what you’re looking for!

If you're not sure how to talk about plastic surgery, here are some tips.

I came across an article at Times Live the other day addressing the issue of plastic surgery-related etiquette, and I found myself agreeing with much of what the author, Mary M. Mitchell, had to say. I thought I would share it here with you.

If you’re reading this post, it’s probably because you’ve had plastic surgery, are planning to, or are at least open to the idea—which means the lessons Ms. Mitchell had to impart aren’t necessarily meant for you. And yes, cosmetic procedures are far less stigmatized today than they were in past decades. However, I think most veterans of plastic surgery have had experiences with people who, upon discovering that they’ve had work done, have been less than kind (or polite, or sensitive) about it.

With that fact in mind, I thought it would do all some good to be reminded about some basic rules of etiquette. For those who haven’t had any work done, these are rules to live by when you’re speaking to someone who has; and for those who have undergone plastic surgery, this is a good reminder that doing so doesn’t mean that you’re inviting judgment or giving up your right to privacy—and that people should respect that.

The rules:

• Don’t blurt out a comment if you think someone has had something done.
• Don’t ask—if they want to tell you, they will.
• Don’t criticize. It’s their choice.
• Don’t offer judgment on the procedure’s success. If they tell you about their treatment, ask how they feel about the results.
• Don’t gossip. Plastic surgery is a personal decision, as is sharing the news.
• Be solicitous. If someone tells you they recently had work done, ask how they’re feeling.

If you’re interested in reading the full article that inspired this post, you can find it here.

ACCME has just recognized the ASPS for excellence in its field

For a long time, I’ve been a member of the American Society of Plastic Surgeons (ASPS)—an established organization within the plastic surgery community that is dedicated to advancing quality patient care by encouraging high standards of training, ethics, physician practice and research in plastic surgery.

I’ve always been proud to be affiliated with the ASPS, and this week, I was given yet another reason to feel that way: they have just been awarded with the Accreditation Council for Continuing Medical Education (ACCME)’s “Accreditation with Commendation” distinction.

The “Accreditation with Commendation” designation is ACCME’s highest level of accreditation status, and according to ASPS President Malcolm Z. Roth, MD, “fewer than 29 percent of the 690 ACCME-accredited CME providers have received this designation.”

What matters more to me here, however, is not the recognition itself, but what the ASPS has done to earn it. ACCME only awards “Accreditation with Commendation” to organizations that deserve it; their vetting process can take more than one year to complete. In order to earn this distinction, then, the ASPS had to thoroughly demonstrate that they are constantly working to improve their members’ professional practices, both through educational offerings and collaborative efforts.

As a plastic surgeon whose number one priority is to provide my patients with the highest-quality care possible, I’m happy to be able to say that I belong to an organization that is a leading provider of continuing medical education within the plastic surgery community. Congratulations on your new accreditation status, ASPS!

Artefill isn't like the other fillers.

You’re familiar with Juvéderm. You’ve probably heard of Radiesse and Restylane, too. But do you know what Artefill is—or what makes it different from these other injectable fillers?

First, the specifics: Artefill is the first and only nonresorbable filler to be approved by the FDA for use in correcting smile lines. It’s composed of 20% PMMA microspheres (tiny synthetic particles), 80% purified bovine collagen gel, plus a tiny bit of lidocaine (a local anesthetic), which helps to minimize discomfort for patients during injection.

What does this all mean? Basically, this: Artefill—unlike other fillers in its category, which are temporary—is designed in a way that prevents the body from absorbing it over time. So, while Artefill’s visible effects are virtually identical to those of Radiesse, Restylane, or Juvéderm, its life span is far longer. The bovine collagen within Artefill does eventually absorb into the body over time, but its microspheres don’t—they remain where they were injected, and help your skin produce more of its own collagen to replace the bovine collagen as it breaks down. This cycle of collagen replenishment makes it possible for Artefill to last as much as five times longer than the other fillers in its class, and to get the results you desire in just one or two treatments (depending on the depth of the wrinkles you wish to treat).

You’ll notice when you start comparing the various injectable fillers available that Artefill does carry a higher price tag than its competitors. Ultimately, though, since fewer injections are necessary with Artefill, most people find it to be a cost-effective choice—more up-front investment, but longer-lasting results.

If you’re interested in learning more about Artefill, give the San Francisco Plastic Surgery & Laser Center a call and set up a free consultation. We’ll be happy to help you figure out if this is the filler for you, or if one of the other fillers we offer here are better suited to what you’re looking for.

Our state-of-the-art lasers can remove even large, prominent tattoos.

One in five Americans has a tattoo—yet among those who don’t have one, 54 percent say they tend to think of people with tattoos as being “more rebellious,” according to a recent Harris poll.

That sentiment may have a lot to do with why removing tattoos is fast becoming as common as getting them is.

There is another factor in the increasing popularity of laser tattoo removal: a greater number of people are getting inked these days. Only 14 percent of Americans had tattoos in 2008, whereas 21 percent have them now. It’s a double-edged sword: on one hand, the more people who get tattoos, the more socially acceptable they’re becoming; on the other hand, the more people who are flocking to tattoo parlors now, the more people there are out there who are getting tattoos that they will regret later.

For most, the biggest tattoo-related concerns they have are also job-related. Given that more than half of people out there without tattoos associate inking with a “bad boy” (or “bad girl”) image, what does that mean for you if you’re job-hunting and have a tattoo in a prominent place? Will it affect your chances of getting hired?

The answers to those questions vary, of course: they can depend on what kind of place you’re seeking to work in, who’s conducting your interview, and more. For many, though—especially considering the current work climate, in which jobs are few and far between—risking losing a career opportunity over having a tattoo on their forearm, neck, or other visible area is simply not worth it.

Luckily, due to the technological advancements we’ve made in laser tattoo removal over the past few years, tattoos are no longer the permanent time-stamps they once were. If you have a tattoo that you’d like to get rid of, contact us here at the San Francisco Plastic Surgery & Laser Center. With our cutting-edge lasers, we can remove even multiple-color tattoos gently and efficiently, so you can stop trying to hide your ink with long sleeves and high collars—and get on with your life.

Doctors and patients will now have a third choice when it comes to silicone-gel implants

For a long time, Allergan and Johnson & Johnson have been the only two companies allowed to distribute silicone gel-filled breast implants in the U.S.—but all that changed two weeks ago, when the FDA approved a third company, Sientra, for that same privilege.

The decision to green-light Sientra’s implants came after three years of gathering data from 1,788 participants. The FDA says that Sientra’s studies yielded the same results as typical breast implant studies; risks can in some cases involve capsular contraction, asymmetry, and infection, according to the clinical data, but no more so than the other implants on the market.

In a statement after the FDA’s decision was made public, Sientra CEO Hani Zeini said that with this approval, his company has “successfully broken the existing duopoly in the U.S. by offering surgeons and patients a new choice.”

I’m not sure that Sientra’s intentions are as altruistic as that statement seems to try to make them sound; when it comes down to it, they’re a company selling a new product. However, there is a kernel of truth in what Zeini said—namely, that having another silicone-gel choice out there to choose from is a good thing from a doctor’s and from a patient’s perspective.

This is especially true because Sientra has said that it will be creating implants in multiple shapes and sizes; since I select the implants I use in breast augmentation based on each patient’s breast and body shape, having a greater variety to choose from will be extremely helpful. And, of course, increased competition is often followed by decreased costs—something to look out for in the future!

Real Housewives star Brandi Glanville talks about the cosmetic procedures she's undergone

Real Housewives of Beverly Hills cast member Brandi Glanville has had her share of plastic surgery done—and she’s not afraid to talk about it.

In a recent interview with Shape magazine, Glanville openly discussed the fact that she’s undergone some cosmetic work to maintain her looks: “I’ll cop to a few plastic surgery procedures like Botox and fillers,” she admitted. She has also acknowledged in the past that she’s had breast augmentation surgery.

When it comes to her skin, Glanville said, she’s tried various cosmetic procedures to keep it looking healthy, such as laser treatments and photo facials. She also protects her skin by staying out of the sun, using sunless tanning options like spray tans rather then heading to the beach or a tanning bed.

All in all, the Real Housewives star seems to have a pretty healthy attitude about plastic surgery; she’s an advocate for it—in moderation—and she lets criticism about her choices roll off her back: “I think everyone should do what makes them feel good,” she told Shape. We think so too.

Egyptian MP Anwar al-Balkimy risked everything for his rhinoplasty

Who knew you could lose your job because of a little plastic surgery?

A member of Egypt’s parliament learned that lesson the hard way this week when he was forced to resign his position after getting a nose job—and lying about it.

According to the Egyptian media, lawmaker Anwar al-Balkimy checked himself into a hospital on February 28^th of this year for a rhinoplasty. The problem: he’s part of an Islamist political party, Al-Nour, whose members follow a strict interpretation of Islam that specifically prohibits cosmetic surgery (they see it as interfering with God’s work). Knowing that his party wouldn’t approve of the surgery, al-Balkimy proceeded to check into a second hospital on the day following his surgery, claiming that he had been beaten and mugged.

Unfortunately for him, al-Balkimy was found out; now, not only is he losing his position in parliament and his party, but he’s also facing potential jail time over the false police report he filed about the mugging.

It’s hard to imagine all this happening here in the U.S., of course, but let’s face it—as much as public opinion has changed over the years about plastic surgery, and even though the stakes aren’t nearly as high for most, many people still don’t like to admit it when they’ve had work done. Every individual has the right to decide for themselves how much they want to share about the procedures they undergo, though, and I think that most people understand if someone chooses to fib a little to protect their privacy.

Luckily for those people who do keep their plastic surgery under wraps, as long as they don’t lie to the police about it, seems pretty unlikely that they’ll get in trouble—or fired—for it!

Do you hate how your neck looks when you're video chatting on your phone?

Would you get a facelift just to look better when you’re video chatting with your friends on your iPhone?

Well, apparently some people in Virginia will—a plastic surgeon there, Dr. Robert Sigal, recently started offering a new procedure specifically aimed at keeping your neck from looking flabby on video. He’s dubbed it the “FaceTime Facelift,” and he says there’s a real demand for it.

In a normal facelift, if the neck needs work, a plastic surgeon will usually make a small incision under the chin. Dr. Sigal says that this poses a problem for phone video-chatters, since they’re generally pointing the camera up at themselves from a low angle; it makes the scar too visible. His solution: move the incision location to a spot under the ear, where your FaceTime buddies will be blissfully unable to spot the telltale signs of your procedure.

While the name for this new procedure is admittedly very catchy, it seems more gimmick than anything else. If you find your neck flab unsightly, there are probably other times besides than when you’re video chatting that it bothers you. Plus, let’s be honest—there are already a number of types of facelifts that have been developed to address various patient concerns (the short scar facelift, mini facelift, non-surgical facelift, etc.) that will get the job done just as well. Then again, you could always just hold your phone up a little bit higher and angle your chin a little lower so people can’t see your neck!

If you’re intrigued by the “FaceTime Facelift,” you may have to fly all the way to Virginia to witness it firsthand—like most plastic surgery clinics, we don’t offer it here at the San Francisco Plastic Surgery & Laser Center. If you’re interested in reducing the effects of aging on your face and neck, however, we do offer a number of proven, effective facelift options here that we think will make you just as happy!