Topics in Plastic Surgery: Cosmetic & Reconstructive Surgery

The weekend Facelift in NC

dave@lookingyourbest.com (Dave Stringham) — Wed, 26 May 2010 15:38:00 +0000

I think that "weekend facelift" is a misleading term, as it suggests dramatic surgical improvements are possible with minimal surgery. As with most things which sound too good to be true, so it is with the "weekend facelift". As you might expect, the degree of improvement one obtains from surgery is, in general, directly proportional to the surgeon's effort. An hour of surgery through a shorter incision can not be expected to produce a result approaching that of a conventional facelift. A better term, however, might be "Mini-facelift", as no surgeon can guarantee a two-day recovery, and patients' expectations may be inappropriately heightened by the promise of a big improvement by a minimal surgery.

The Cheek lift or Midface lift in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Wed, 26 May 2010 15:32:00 +0000

The primary aging change in the cheek area consists of a combination of deflation and descent of the cheek fat pads, creating a hollowed appearance below the lower lids and deepened nasolabial folds (oblique lines which extend from each side of the nose to the area beside the corners of the mouth). Descent of the midface/cheek fat pad can also contribute to the exaggeration of marionette lines and downturning of the corner of the mouth.

Cheek area rejuvenation by mean of a mid face lift can be performed as part of a facelift procedure, but is also sometimes performed alone to specifically address deflation and descent of the cheek fat pad. The procedure is performed through two hidden incisions. One is made inside the mouth, at the apex of the space between the gums and the lower cheek. The second incision is hidden behind the hairline of the temple area. Through the intra-oral incision, the cheek fat pad is freed from the cheekbone. A suspension suture is used to grasp the cheek fat pad, and the suture is then passed below the skin to the temple-area incision. Upward traction on the suture elevates the cheek fat pad, and with it the corner of the mouth is elevated slightly. The nasolabial folds soften and in some cases can be almost completely eliminated. The suspension suture is then anchored to the deep soft tissues below the scalp, producing a permanent elevation of the midface.

Less Recovery Time with Vaser Liposuction

dave@lookingyourbest.com (Dave Stringham) — Wed, 26 May 2010 15:19:00 +0000

A specialized form of liposuction, vaser liposuction removes targeted areas of fat that fail to respond to healthy weight loss methods. Using his surgical skills and gentle touch, Dr. Law gently reshapes the body to achieve slimmer, natural-looking contours that achieve dramatic improvements. The process of performing Vaser liposuction is similar to traditional liposuction, except after applying the wetting solution, Dr. Law administers sophisticated ultrasound technology to break apart fatty deposits. Then, the fat is removed with the cannula.
Using state-of-the-art ultrasound technology in Vaser liposuction allows several advantages, including higher levels of precision, faster recovery periods, and minimal pain and bruising. Unlike traditional liposuction, Vaser liposuction targets fat tissue, while not damaging other important tissues, like nerves, blood vessels and connective tissues.
Vaser liposuction is not fit for everyone, which is why Dr. Law thoroughly evaluates patients to determine if they are good candidates for the procedure.

Male Breast reduction in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 18:31:00 +0000

Enlargement of the male breast is referred to as gynecomastia, which may occur in response to certain medications or hormonal conditions but most often has no clearly identifiable cause. Gynecomastia may develop at any age, and may occur on one or both sides. In most patients it can be corrected with liposuction or with a combination of liposuction and direct excision (removal) of breast tissue and/or skin. Surgical correction of gynecomastia produces a dramatic, positive change for patients with this troublesome problem, as it is usually a source of significant self-consciousness and embarrassment. For most patients the results are quite liberating, especially in terms of participating in athletic endeavors and relaxing at the beach or pool.

Tummy Tuck for Men

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 16:17:00 +0000

Men are also candidates for tummy tucks, especially those who have experienced significant weight loss, and as a result have excess abdominal skin and laxity of the abdominal wall which generally cannot be corrected with exercise alone. In male abdominoplasty, it is sometimes possible to achieve the desired post-operative appearance by means of fairly aggressive liposuction of the anterior abdomen and circumferential trunk, combined with removal of redundant lower abdominal skin via a suprapubic incision. In many cases, this does not require enough skin excision to warrant the creation of a new belly button, and thus surgical scars are avoided in that area. Other male patients with significant anterior abdominal skin excess will require significant skin excision and the requisite umbilicoplasty. Midline tightening of the rectus muscles is performed to flatten the abdominal profile

Upper Arm Lift in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 16:07:00 +0000

Brachioplasty is designed to remove excess upper arm skin (and some cases, fat as well) and requires an incision that runs from the underarm area to the elbow. The scar is placed in the inner aspect of the upper arm, facing the side of the chest, to help conceal its presence. This is a great operation for fair-skinned patients who are generally in their fifties or older, as the skin is often fairly thin, and results in a scar which is faint and minimally visible. In younger patients, this fairly long scar tends to widen, become pigmented, and even thicken - which means that younger patients must seriously consider if the scar is an acceptable trade-off for the improvement in upper arm contour.

In some cases, when the skin excess exists primarily in the upper half of the upper arm, the skin excision can be performed in the underarm area only, avoiding the scar along the inner aspect of the upper arm. Underarm incision brachioplasty can often be combined with liposuction to produce a very favorable upper arm contour. This can be a good option for some younger patients and for those with more deeply pigmented skin. In some patients with an 'in between' amount of skin laxity, the underarm incision may be combined with an incision that extends only halfway down the arm, thereby avoiding the 'armpit to elbow' scar.

For more information about arm lift or liposuction or if you would like to schedule a complimentary liposuction consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today

The Breast Lift in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 15:53:00 +0000

Having a breast lift operation involves making a decision to trade an improved breast shape and contour for some (well-placed and concealed) surgical scars on the breast. For the Raleigh breast lift patient who is displeased that her nipples are downpointing, it may be a relatively easy decision. The surgical incisions are strategically placed to be as minimally noticeable as is possible. One component is around the areola, which is usually well concealed by the color difference between breast skin and areolar skin. The second component extends vertically from the '6 o'clock' position of the areola to the fold below the breast, and as the majority of this scar faces downward, it is usually quite acceptable.

Breast lift surgery works well for patients with enough existing breast tissue to build a projecting 'breast mound'. However, in most breast lift Raleigh / Durham patients it is difficult to create sustainable fullness in the upper poles of the breasts by means of a mastopexy alone. This is particularly true in patients who have experienced significant deflation following pregnancy and lactation. For patients who indicate that they wish to achieve a fair amount of fullness in the cleavage area as a result of their breast lift surgery, I recommend that they undergo augmentation mastopexy. This surgery combines a breast lift with the placement of a breast implant usually of modest size, which produces the most youthful breast profile possible.

Using Fat Grafting to restore youthful appearance

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 15:38:00 +0000

Fat grafting has been performed by plastic surgeons for decades. There is no question that fat is the ideal material for soft tissue augmentation, and that the results obtained with fat grafting are the most natural-appearing. However, one problem with this procedure in years past has been resorption (breakdown) of the grafted fat, so that the resulting improvement is not permanent. The grafted fat must gain its own blood supply in its new location in order to persist long-term, and this generally is not possible when large amounts are injected at once and when specialized instrumentation and techniques are not employed.

Structural fat grafting can be performed on eyelid hollows, to fill sunken cheeks, for filling sunken hollows under eyes eyes and is often used for blepharoplasty correction when too much skin and or fat has been removed in an eyelid surgical procedure. Some people who have experienced fat loss as a result of procedures such as IPL or Thermage can also benefit greatly from permanent fat injections.

Browlift for the men in NC

dave@lookingyourbest.com (Dave Stringham) — Fri, 21 May 2010 15:10:00 +0000

As opposed to the female brow, a man's brow is aesthetically acceptable at, or even slightly below, the orbital rim. The male brow may or may not be arched laterally, and most commonly it is relatively horizontal in orientation. In cases where the male brow has descended well below the orbital rim, and the upper lid tissues appear heavy and redundant, a browlift can be an effective means of rejuvenating the upper third of the face. A great deal of care must be exercised, however, to avoid overdoing and thereby feminizing a male brow. Although men are much less often good candidates for browlifts than women, endoscopic or trans-blepharoplasty removal of the corrugator (or vertical frown line) muscles is as applicable to males as it is to females, to permanently soften or completely eliminate vertical frown lines between the eyebrows.

If you would like to schedule a complimentary browlift consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today!

Facial enhancement via implants

dave@lookingyourbest.com (Dave Stringham) — Wed, 19 May 2010 16:24:00 +0000

For enhancement of the cheek bone area, I rely exclusively on structural fat grafting. Careful and meticulous fat grafting not only avoids some of the potential complications of solid cheek implants, but it also allows more precise 'customization' of the aesthetic improvement that can be obtained for each individual patient. It is also my opinion that structural fat grafting produces a more natural-appearing facial enhancement of the cheek area than what is generally achieved through the placement of solid implants over the cheekbone.

Moderate enhancement of chin projection in appropriate patients can dramatically enhance the profile, in a manner that is completely natural-appearing. It is remarkable how increasing chin prominence in some patients will reduce the apparent prominence of the nose, and restore an overall sense of harmony and balance to facial features.

For more information about chin implants or if you would like to schedule a complimentary chin implant consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today!

Needing an upper eyelid surgery in North Carolina

dave@lookingyourbest.com (Dave Stringham) — Wed, 19 May 2010 16:13:00 +0000

The next time you flip through Vogue or Allure (guys, just grab one at the checkout stand) take a close look at the eyes of the models. In most of them, women in their teens and twenties, you will see only a sliver of the upper eyelid, if it is visible at all. In many, the upper lid is completely obscured by soft tissue fullness between the brow and eyelashes, which I sometimes refer to as the 'brow roll'. Perusing the fashion magazines provides quick confirmation that the youthful upper lid is not a skeletonized upper lid.

The eyes are the primary facial feature that communicates tiredness or exhaustion (and, likewise, energy and vitality). Your cheeks and your neck don't really reflect whether or not you've had a good night's rest. But miss a night of sleep and your eyes will make it obvious to everyone. Aesthetic plastic surgery of the eyelids can produce a dramatic rejuvenating effect, literally taking years off of a person's appearance. Interestingly, many patients find that following eyelid surgery friends will say 'You look great!', but they usually cannot pinpoint exactly why.

For more information about eyelid surgery or if you would like to schedule a complimentary eyelid surgery consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today!

Needing an upper eyelid surgery in North Carolina

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 20:38:00 +0000

Nose surgery in Raleigh, NC

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 20:23:00 +0000

Quite obviously, noses come in an endless variety of shapes and sizes, as do patients' expectations for nasal refinements. These factors make rhinoplasty an extremely challenging, and extremely rewarding, surgical endeavor. Prior to performing rhinoplasty surgery I carefully evaluate preoperative pictures with every patient, on at least two occasions. We determine together the postoperative goals, with a realistic appraisal of the improvements which are possible. It is absolutely essential to ensure that the proposed changes will ultimately 'fit the face'.

Rhinoplasty may be performed alone, or in concert with other facial rejuvenation procedures. One important consideration in assessing the appearance of the nose in profile is whether or not the anterior projection of the chin is in harmony with the anterior projection of the nose. An inadequately projecting or 'weak' chin may contribute to the appearance of an overly large nose. In some patients undergoing rhinoplasty, I also perform chin enhancement using a soft, anatomic implant placed over the most anterior aspect of the mandible through an incision below the chin. On occasion I perform a chin implant alone (instead of rhinoplasty), as in some patients the enhancement of the anterior chin projection in profile may be adequate to 'reduce' the apparent nasal projection.

Nose surgery in Raleigh, NC

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 17:45:00 +0000

Botox to treat Hyperhidrosis in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 17:36:00 +0000

The social embarrassment associated with excessive sweating can be profound. Whether the problem is primarily underarm sweating or palmar sweating, or both, the impact on normal social interaction can be significant. Some individuals with excessive underarm sweat production wear special pads and garments to try to 'stem the tide'. Many with excessive palmar sweating avoid shaking hands at all costs.

The chemical that is released by nerve endings to stimulate muscle contraction, acetylcholine, is the same chemical that causes sweat glands to produce sweat. BOTOX ® works, in both cases, by preventing the release of this chemical from nerve endings, thereby blocking muscle contraction (when injected in the area of facial muscles) and blocking excessive sweat production (when injected into the skin of the underarms or palms).

For more information about Botox or if you would like to schedule a complimentary Botox consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today!

Skin Tightening with lasers in Raleigh, NC

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 17:13:00 +0000

This has traditionally been accomplished with laser peels (carbon dioxide, erbium) or deep chemical peels (phenol, high-concentration TCA), which resurface the skin by creating a second-degree burn. The epidermis is essentially burned through and the dermis is injured, stimulating new collagen production.

The ideal method for improvement of facial wrinkles and lines, therefore, should stimulate new collagen production in the dermis without injuring the epidermis (which results in long downtimes and the possibility of pigmentation changes and scarring). Our goal is to improve the quality and tone of facial skin without (or with as little as possible) downtime. The skin care treatment of every client is individualized, as the needs of no two faces are exactly alike. Our highly-trained team of aesthetic professionals can determine which services are right for you.

For more information about skin care or if you would like to schedule a complimentary skin care consultation, please contact the Raleigh, North Carolina office of Dr. Michael Law Today!

Laser Hair Removal in North Carolina

dave@lookingyourbest.com (Dave Stringham) — Tue, 18 May 2010 16:52:00 +0000

For many women and men, unwanted hair is a nuisance....or even a source of embarrassment. Until recently, laser hair removal has been uncomfortable, time-consuming, expensive and provided results that were inconsistent at best.
Advances in laser technology have resulted in far better results, and treatments that are safer, faster and more comfortable than ever before. Laser hair removal works on just about any area of the body where smooth skin is desired... underarms, face, neck, back, legs, shoulders, bikini line, you name it.

We use a patented cooling device for that means a more comfortable treatment and eliminates the need for topical anesthetic. The DCD, dynamic cooling device is the ONLY cooling device that provides consistent cooling from the first pulse to the last. No cooling system is safer or provides a more comfortable treatment. There is no one laser ideal for all skin types. Therefore, we have 2 different lasers for hair removal. Dark or tanned skin requires a laser with a long pulse. A longer pulse means that more of the laser energy is delivered to the root of the hair rather than to the surface of the skin where pigmentation problems might occur with lasers designed to treat light skin.

For more information about laser hair removal or if you would like to schedule a complimentary laser hair removal consultation, please contact North Carolina Cosmetic Surgeon Dr. Michael Law today!

Having your Plastic Surgery done by Celebrity Doctors…

dave@lookingyourbest.com (Dave Stringham) — Fri, 14 May 2010 16:52:00 +0000

Do you want plastic surgery from the same doctors who are featured on celebrity television programs like Entertainment Tonight, Extra, and Dr. 90210??? Highly trained plastic surgeons who are trained to sculpt and enhance your natural beauty? Surgeons who provide unsurpassed medical expertise and commitment to patient education and care, and plastic and cosmetic surgeons who will assist you in achieving the figure of your desires?

One of the most important things to remember when working with a plastic surgeon is to set realistic goals. If you work with the wrong plastic surgeon, he may promise you beauty results that simply aren't possible. When you work with the professionals at Beverly Hills Physicians, you never have to worry about false promises.

Have you had your surgery done by a doctor because he worked on a movie star you like??? Tell me about how you found this doctor, and your experience with him/her...Other information about cosmetic surgery and cosmetic surgeons.
Beverly Hills plastic surgeon
plastic surgeon

Tummy tuck, is it right for you...

dave@lookingyourbest.com (Dave Stringham) — Thu, 13 May 2010 20:05:00 +0000

The best candidates for tummy tucks are women or men in relatively good shape who have large fat deposits or loose abdominal skin that did not respond to diet , exercise or both. Women who have had multiple pregnancies and stretched their abdominal muscles and skin will specially benefit from such a procedure. Older patients who are obese and have lost the elasticity of their skin can also benefit from this procedure. Tummy tucks can be used alone or in combination with liposuction to achieve the results you seek. Ask your surgeon what he recommends for you.
Partial and complete abdominoplasties are performed on an outpatient basis and can be done under general anaesthesia. Complete abdominoplasty usually takes two to five hours while partial abdominoplasty may take an hour or two.

Have you had this surgery done??? How were your results???

Ankle injury can be serious...

dave@lookingyourbest.com (Dave Stringham) — Thu, 13 May 2010 17:20:00 +0000

When an ankle is injured from twisting in towards the other foot, called an inversion injury, most commonly the anterior talofibular ligament is stretched or torn. If the two other primary ligaments on the outside of the ankle (the posterior talofibular ligament and the calcaneofibular ligament) are also injured the primary bone of the ankle, the talus, can be displaced from beneath the tibia, and the ankle "shucks" out of joint. A physician or trainer examining the ankle soon after injury can compare the amount of "shuck" to the opposite ankle and develop a grade for the amount of injury suffered. Usually, if the injury is limited to one ligament, the instability is less. If all three are involved , the ankle is more unstable. The nerve supply to injured ligaments can also be injured. The nerves provide "proprioception" or position sense, in effect telling the brain where the foot is in space. In the healing process, it is critical to re-train the healing ligaments to regain the neural connections required for a stable ankle. Specific exercises can effectively do this.

Have you had a simple injury go bad??? Tell me about it...

Achilles Tendon pain is common...

dave@lookingyourbest.com (Dave Stringham) — Thu, 13 May 2010 17:12:00 +0000

Rupture, or tearing, of the Achilles tendon is a common condition. This typically occurs in the unconditioned individual who sustains the rupture while playing sports, or perhaps, from tripping. There is a vigorous contraction of the muscle and the tendon tears. The patient will often describe the sensation that someone or something has hit the back of the calf muscle. Pain is suddenly present, and although it is possible to walk, it is usually painful. More importantly however, the leg is weak. This is particularly noticeable when trying to push off while walking, and there is not sufficient strength to do so.

Has your surgery gone well??? Tell me about your experience...

Ankle injury can be serious...

dave@lookingyourbest.com (Dave Stringham) — Thu, 13 May 2010 16:59:00 +0000

What the heck is a bone spur???

dave@lookingyourbest.com (Dave Stringham) — Thu, 13 May 2010 16:40:00 +0000

A bone spur is a prominence of the bone that can often cause irritation to the overlying skin. This "spur" can be an irregularity of the shape of the bone or can be a small outgrowth of bone or cartilage. If this prominence or "spur" is in an area that is prone to pressure from shoes or from the ground during walking, it can become symptomatic and begin to cause discomfort.

Ok, this really hurts... How did you fix yours???

Otoplasty in North Carolina

dave@lookingyourbest.com (Dave Stringham) — Wed, 12 May 2010 16:52:00 +0000

Otoplasty is performed through an incision which is hidden on the posterior surface of the ear, and involves placing permanent sutures in the cartilage to produce a natural-appearing fold. The ear cartilage may also be anchored closer to the head with permanent sutures, and in a few patients some cartilage may be removed. Patients wear a protective head dressing for one week postoperatively, and they must not participate in sports or Physical Education activities for eight weeks following otoplasty surgery.

Otoplasty is very effective in restoring the normal proportions of the ears and in restoring a sense of balance to the head and face in general. Many young female patients I have treated relate that they enjoy wearing their hair up for the first time following an otoplasty.

Face and Neck Lift in Raleigh

dave@lookingyourbest.com (Dave Stringham) — Wed, 12 May 2010 16:26:00 +0000

Loss of skin elasticity with age (and sun exposure) allows the lateral and lower cheeks, which aren't tightly attached to facial bones, to 'sag'. On either side of the chin are ligaments which hold the skin more tightly against the jawbone (mandible). This is where, and why, 'jowls' develop. I have also observed that many people develop both atrophy of soft tissues and slight recession of the mandible between the chin and the jowl area, which serves to exaggerate the appearance of jowls.

The majority of patients having a facelift surgery also have aging changes in the neck, which can be corrected and improved through a variety of surgical procedures. To improve the neck contours, the facelift can be extended over the jawline and onto the anterior and lateral aspect of the neck. In other patients without major aging changes at or above the jawline, neck rejuvenation alone may be performed. The procedures that I employ to rejuvenate the neck are described in detail under the heading Neck Lift in the Facial Rejuvenation menu.