Medical Mondays: News Notes
Monday, April 2, 2012
TOPIC: Mommy Makeover
Mary Gingrass, MD: plastic surgeon
Melinda Haws, MD: plastic surgeon
News notes via www.webmd.com
The Most Common Cosmetic Surgery in 2011 Was…
Cosmetic Surgery Sees Increase in 2011, While Botox and Other Minimally Invasive Procedures Fall
WebMD Health News
March 20, 2012 -- Almost 9.2 million cosmetic procedures were performed in the United States in 2011, and Americans spent nearly $10 billion on cosmetic procedures last year.
These are some of the key findings in the new statistics from the American Society for Aesthetic Plastic Surgery (ASAPS).
Cosmetic surgical procedures increased almost 1% since 2010, while minimally invasive procedures decreased almost 2% in the same time period.
This is the 15th year the ASAPS has tracked plastic surgery. Since 1997, cosmetic procedures have increased 197% for men and women combined -- and there have been some changes over the years.
"Surgery seems to be slowly coming back," says ASAPS President Jeffrey M. Kenkel, MD. He is a professor and vice chairman of the department of plastic surgery at the University of Texas Southwestern Medical Center in Dallas.
Noninvasive procedures such as injectables do have a role, but individuals are looking for more durable results, says Kenkel.
One of the reasons that the numbers are creeping up is that people need to stay in the work force longer, which means that they must compete with their younger counterparts for the same jobs, he says.
Liposuction topped the list of most popular plastic surgeries in 2011, and injections of botulinum toxin type A (including Botox and Dysport) ranked as the top nonsurgical procedures, the new statistics show.
Top Surgical Procedures
According to the new statistics, the top five surgical procedures in 2011 were:
Fully two-thirds of women opting for breast augmentation with implants chose silicone-filled breast implants in 2011. Kenkel says this shows that women and plastic surgeons are becoming more comfortable with the safety of these implants.
Due to safety concerns, there was a 14-year ban on the use of silicone breast implants. This ban was lifted in 2006. In a further nod confirming the safety of these implants, the FDA recently approved a new silicone-gel breast implant from Sientra, making it the third company to market these implants in the U.S.
Top Nonsurgical Procedures
In 2011, the top five minimally invasive procedures were:
Women had almost 8.4 million cosmetic procedures in 2011, and men had almost 800,000. The number of cosmetic procedures for men increased over 121% from 1997, which was the year that ASAPS first started tracking these statistics.
The new statistics were based on questionnaires sent to dermatologists, otolaryngologists, and plastic surgeons. More than 1,100 doctors returned the questionnaires. The final sample included responses from 420 plastic surgeons, 384 dermatologists, and 211 otolaryngologists.
Plastic Surgery After Weight Loss
Many people who have lost 100 pounds or more are overjoyed at their success -- but may be dismayed that their body does not have better shape and tone.
With plastic surgery after weight loss, you can remove loose, heavy folds of skin -- and improve the shape and tone of tissue in the arms, thighs, breasts, buttocks, face, and abdomen.
For years, prescription retinoids (face medications like Retin-A, Renova, and Tazorac that contain the vitamin A derivative) have been assumed to be the best antiaging products. Indeed, decades of clinical research show that they speed cell turnover to smooth wrinkles, fade sunspots, and build collagen. But now there are claims that they can also thin the skin and cause chronic inflammation (peeling, lobster-red faces), actually leading to premature aging. The issue is dividing...A variety of cosmetic surgeries can help you gain a trimmer, firmer shape: Body contouring (body lift surgery), tummy tuck (abdominoplasty), buttock augmentation, breast lifts, and arm lifts.
Body Contouring (Body Lift)
Body lift surgery is one of the most common procedures to improve the body's appearance after weight loss surgery. It's also long-lasting, if you keep your weight stable.
Here's what happens: With one incision along the abdomen, the surgeon can remove excess, sagging skin -- lifting and tightening the buttocks, abdomen, waist, hips, thighs, and arms in one procedure. Liposuction is often used to remove fat and improve the body contour. Buttock augmentation may be done --because buttocks often flatten with extreme weight loss.
Body lift surgery can dramatically change your appearance, and the results are permanent, except for a little natural firmness that's lost with age.
But body lifts are not without some risk. For example, there will be some scarring. Some people continue to have problems with loose skin. Some people need a follow-up cosmetic procedure.
The higher your BMI [body mass index], the more likely there will be complications. Possible complications of body lifts include bleeding, infection, tissue death, abnormal scars, and formation of a seroma -- a mass or lump that results from fluid buildup in an organ or tissue.
Your surgeon can talk to you about the potential problems. But for most people, the result is a smoother, more normal body shape.
Tummy Tuck (Abdominoplasty)
A "tummy tuck" is often performed as part of body lift surgery -- to remove fat and skin, and in some cases help tighten your abdominal muscles, creating a smoother, firmer abdomen. A tummy tuck can help flatten your stomach when diet, exercise, and weight loss have not done enough. Don't confuse a tummy tuck with liposuction -- although you may need liposuction as part of your tummy tuck.
A full tummy tuck involves a large incision from hipbone to hipbone, around the naval. Your surgeon can then manipulate the skin, tissues, and muscle --and repair weakened abdominal muscles. Your belly button will be lifted to a more pleasing spot. In some cases, a second incision is necessary to remove excess skin in the upper abdomen. While there will be scars, they will fade somewhat.
The result is a firmer, flatter abdomen that better matches your trimmer figure.
Breast Lift (Mastopexy)
If your breasts are sagging, a breast lift can help lift, firm, and reshape them. In a breast lift, excess skin and tissue are removed, and the nipple is repositioned higher on the chest. Some people also need a breast implant to improve the breast's shape.
At times there is need for a touch-up procedure. If there are slight differences between the breasts after breast lift surgery, the surgeon may need to reposition the nipple.
Should You Have Plastic Surgery After Weight Loss?
You are likely a good candidate for plastic surgery after weight loss if:
If you're a woman planning a family, it's best to wait until after you've had your babies before having plastic surgery after weight loss.
Cosmetic Procedures and Liposuction
"The battle of the bulge." That tiny, five-word phrase has been shoved in our faces for years, thanks to television, newspapers, and magazines. But sometimes, no matter how hard you fight, the bulge has a tougher army. The fact is that certain people have fat cells that will not shrink, despite diet and exercise. You can thank heredity for that in some cases.
Liposuction is an option to remove small bulges that won't budge and to improve your body's shape. The areas most commonly treated include the hips, abdomen, thighs and buttocks, and face. Liposuction does not remove cellulite, only fat.
A good candidate for liposuction should have realistic expectations about the results of the procedure as well as these basic qualities:
Patients with poor skin quality (cellulite) are not good candidates for liposuction because they may develop skin irregularities due to under- or over-correction of localized fat deposits. Age is generally not a major consideration when discussing liposuction; however, older patients often have less elasticity in their skin and thus may not achieve the same benefits of liposuction that a younger patient with tighter skin might achieve.
What Do I Need To Know Before Undergoing Liposuction?
The first step before undergoing liposuction will be to arrange a consultation with your surgeon. During the consultation, your surgeon will discuss which options are best for you, your skin type, the effectiveness and safety of the procedure, the potential financial cost, and what your expectations should be. Do not hesitate to ask the surgeon any questions you may have. Now is not the time to be shy.
Once you have decided to undergo liposuction, your surgeon will give you any instructions you will need to prepare for the surgery. This may include dietary guidelines or alcohol restrictions or the taking or avoiding of certain vitamins. Be sure to tell your surgeon of any allergies you have as well as any and all medications you are taking. This includes over-the-counter and prescription medications as well as herbal supplements.
How Is Liposuction Done?
Depending on the type of liposuction you are undergoing, the procedure may be performed as an outpatient procedure at the doctor's office or surgery center, or if large amounts of fat are being removed, the procedure will be done in a hospital and may require an overnight stay.
Before the procedure begins you will be given an anesthetic. Again, depending on the degree of fat being removed and the type of liposuction being performed, anesthesia varies. It may only be locally applied or you may require a general application in which case the surgery will be done while you are sleeping.
Once the anesthesia has taken effect, the liposuction procedure is performed using a suction device attached to a small, stainless steel instrument called a cannula. Through small incisions, the cannula is inserted into fatty areas between skin and muscle where it removes excess fat either using a suction pump or a large syringe. This results in a smoother, improved body contour. The length of the procedure will vary with the amount of fat needing removal.
Types of Liposuction
Though the basics of liposuction described above remain the same, there are a couple of different techniques that can be used during liposuction. These include:
How Long Does Recovery After Liposuction Last?
Under most circumstances, when liposuction is an outpatient procedure, recovery is usually quick. Most people can return to work within a few days and to normal activities within about two weeks. You should expect bruising, swelling, and soreness for a least a few weeks. However, every person's outcome will vary based on factors such as volume of fat cells removed and area of removal. Your doctor will discuss what results you can expect to achieve and how to best maintain your new body shape.
Are the Results of Liposuction Permanent?
The fat cells are removed permanently during liposuction, so if you gain weight after the procedure, it usually will not concentrate in the area that was treated. However, it is important to note that liposuction will not prevent you from regaining weight. To keep your new shape and new weight after liposuction, you must follow a proper diet and exercise plan.
What Are the Risks of Liposuction?
All surgical procedures involve some risk. However, liposuction has a good safety record and the risks associated with the procedure are minimized when performed by a specially trained, board-certified plastic surgeon.
Although rare, risks include infection and skin discoloration. As with all surgery, common sense is important. The risk of medical problems can be minimized by avoiding extremely long procedures or excessive removal of fat.
Is Liposuction Covered By Health Insurance?
Because it is a cosmetic procedure, liposuction is not covered by most health insurance plans. Ask to talk with a representative at your insurance company who can explain the costs of the procedure and payment options.