Rowe Plastic Surgery Blog

Plastic Surgery and the Recession

April 5th, 2011

http://money.cnn.com/2011/04/04/pf/plastic_surgery_economy/?section=money_latest

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More Cosmetic Q&A

January 4th, 2011

We had the opportunity to catch up with Dr. Norman Rowe (http://www.normanrowemd.com/), top NY plastic surgeon to answer our reader’s questions about how to fix their problem areas. No consultation fee required.

Q.) I have fluctuated in weight over the past ten years and my breasts are less than perky. What can I do to lift them naturally without surgery? Sarah, 25, New York, NY

A.) Dear Sarah, breast droop occurs when the elastic tissue is diminished in the breast itself and also in the skin of the breast. This happens with age, breast feeding and also fluctuations in weight, just to name a few. Perhaps the easiest non-surgical lift can be afforded with a push-up bra. While there are claims that creams, massage treatment and other non-invasive methods with treat this condition, I feel they offer limited success at best. Two years ago there was a buzz regarding the use of Botoxä for the treatment of breast drop. This involved injecting into the chest muscles in an attempt to get women to stand-up straighter. Needless to say, this was more hype than science and is not generally used today. The only tried and true treatment involves surgery, which can be performed on an outpatient basis with little downtime.

Q.) I have cellulite on my butt and thighs and I’ve tried dozens of creams, I just can’t seem to get rid of it. Help please! Mary Beth, 37, Palm Springs, CA

A.) Dear Mary Beth, the treatment of cellulite is very difficult and usually does not respond to creams as it is a function of the connective tissue deep below the skin surface. Certain exercises that improve circulation and lymphatic drainage in the area help as well as a good diet. I have had success in the treatment of cellulite with carbon dioxide gas injection. This is done in an attempt to improve circulation to the area in question.

Q.) I recently gave birth and my stomach is covered in stretch marks, I’ve tried lotions and nothing works. I want to wear a bikini again. What treatment do you recommend?  Sue, 29, Tampa, FL

A.) Dear Sue, congratulations on the new addition (baby not the stretch marks). Stretch marks are actually scars below the surface of the skin and therefore difficult to treat. I offer my patients with stretch marks laser therapy as this is the best treatment for surface scars and deep scars (stretch marks). It usually require 2-3 sessions and generally quite successful.

Q.) I recently lost 75lbs on the F-Factor Diet and feel amazing. I want to show off my new figure but I have hanging skin under my arms and around my tummy. Is there a surgery or treatment I should be looking into? Jasmine, 56, San Antonio, TX

A.) Dear Jasmine great job on the F-Factor Diet. After people have had success on the F-factor diet, they sometimes may want or need to finish the process with a visit to a plastic surgeon. Weight loss, especially large amounts, sometimes may leave the person with hanging skin, around the belly, thighs, breast and face. A solution for this common problem rests in how aggressive the person desires to be and how severely the skin hangs. The hanging skin is just that, skin and does not respond to working out or lifting weights. Now don’t get me wrong, working out is great for you, but its not going to do much for the extra skin around your belly or those hanging breasts.

The excess skin is generally dealt with in one of two ways. First involves deep laser resurfacing treatments that remove the top layer of skin and new skin grows in with more collagen and therefore, tighter. This method usually works for people with minimal amounts of excess skin or those who do not desire more aggressive alternatives. The down time is about a week.

The second general method involves surgical excision of the extra skin. These treatments are called facelift, breast lifts, tummy tucks, thigh lifts, etc. They are very successful but do involve a certain amount of down time and of course a scar.

People always ask about liposuction in order to improve the hanging skin. This in general does not work as it only removes fat and does not address the skin excess. While there are some liposuction manufactures that claim their products can tighten skin, usually there is far too much skin excess than can be addressed with these machines.

Dear Readers, these were all great questions to everyday problems encountered in the attempt to feel our best. Keep up the good work and keep reading “Skinny in the City”, and keep those questions coming.

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Don’t Wait Any Longer

January 4th, 2011

I think that the trend in the entertainment industry, to use a cliché, can be paraphrased as an ounce of prevention is worth a pound of cure. Most A-listers are starting to do little “tune-ups” beginning at an earlier age (mid-20’s) so they don’t need a major overhaul when they are in their 40’s or 50’s. Most of these early aging prevention maneuvers do not require surgery and can be useful to fend off wrinkles for everyone, no matter where on the list they are.

A simple and easy way to freshen up before a big event is with the use of Botox™, Dysport™ or Myobloc™. All of these reduce wrinkles of the forehead crows feet and bands of the neck. Botox™ and Dysport™ take between 3-5 days to begin to work whereas Myobloc™ works almost immediately. This is the wrinkle fixer of choice for the tired looking A-lister who gets a last minute invitation to the red carpet. The use is any of these agents is quite quick and easy and relatively inexpensive. I addition to the wrinkle “relaxers” there are the injectable agents that are used to fill in deeper wrinkles of any hollow in the face. I use these agents alone or in addition to Botox™ to maximize the results. These last anywhere from 6 months to 4 years depending on the filler used. Again these are relatively quick and easy to use, inexpensive and give instant results.

Laser and chemical skin rejuvenation are other very popular techniques more recently. The reasoning for this is that the lasers and chemicals have become “gentler and kinder” than in the past. Therefore, you are not left lobster red for a month after a procedure. These are quick and easy and yield their result sin a few days to weeks.

For the person who requires a bit more results than the above techniques can offer but is not ready for the knife, thread lifts are an option. This involves using special suture (thread) that is treaded from ear to chin via a small needle stick to lift the jowls, neck, and cheek. It can be used in the forehead for a browlift and even the breast for a breast lift. The results may not last as long as tradition surgery but, there is much less scarring.

As I stated above, I see cosmetic surgery patients demanding more results with less scarring and down time. I also see younger patients coming into my office to get preventative treatment in order to help avoid the 40 something make-over.

This is the best advice I can give anyone reading, the best way to treat a wrinkle is to not let it get started in the first place.

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Men and Plastic Surgery

January 4th, 2011

Men are quickly taking an ever-increasing portion of the cosmetic procedure pie, representing nearly 10% of cosmetic patients. In my practice, males account for 20% of my patients. I find that the main difference between men and women is that men are usually playing “catch-up” to women. Meaning they usually start the process later in life than women. Therefore, they require more aggressive treatment. There are some nuances with regards to the care of men versus women, such as with facelifts and chest surgery for enlarged breast. Some of my male patients say that they have hesitation about having procedures, namely surgical procedures. I feel this is due to cultural and societies taboos. Within the past 5 years I have witnessed an increase in men getting botox and other fillers. Some of the more common surgical procedures I perform on men include liposuction, rhinoplasties (nosejob) and blepharoplasties (eyelid surgery).

I tell all my patients, men and women, the best way to treat a wrinkle, skin aging, etc., is prevention, so guys get over your hesitations and take care of yourself.

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Never Be Seen Without Botox

April 4th, 2010

This award season, the red carpet was inundated with frozen faces. Women looking younger than ever (Demi Moore, anyone)? But it’s not a face lift that gives these celebrities their wrinkle-free expression, it’s botox. 85% of procedures done by plastic surgeons last year were non surgical, says ASAPS. What does this mean? Well, you should never be seen without botox, that’s for certain.

I had the privilege of speaking with Dr. Norman Rowe, board certified plastic surgeon who has spent the last 10 years mastering the art of botox. And yes, botox is an art.

History of Botox: Botox has been on the market since the 1980’s, used for people with strabismus (lazy eye). Then people started to inject it into the muscles of the forehead. In 2006 it became approved cosmetic use. Botox lasts around 5 months, men being shorter, women being longer. “Botox has 2 main effects. 1 it has a prophylactic effect – prevents wrinkles from getting worse. Therapeutic meaning it reverses some wrinkles which you may already have.
You’re never too young to start botox – 30 percent of my patients are in their 20’s.

Uses for Botox: “Commonly used in the area between the eyes glabella (vertical lines), forehead and a little less effectively used for crows feet.” Also, you can use botox in the neck to take away vertical neck bands and reestablish a feminine jaw line, like a face lift. Use under the armpits for girls to stop sweating. Eyelid itself to enhance and open up the eye. Scalp in order to get a lift in patients who could get an eyelid droop. Gives the appearance of a larger forehead for someone who has a short forehead. Also inject in soles of feet for sweating. Pain, tmj and headaches. Lastly, facelift patients for scars to minimize scaring.”

“Interestingly, there is an increase in men getting botox because there’s no down time. It’s the perfect alternative to facelift surgery,” explains Dr. Rowe.

What to expect: Given enough botox and fillers you can delay the need for a surgical intervention and that is the future of plastic surgery. Botox cream, being tested in europe.

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Plastic Surgery Question And Answers

January 18th, 2010

Cosmetic surgery, like any surgery, is not a proposal to be entered into lightly. You, the patient needs to do you homework in as much as the doctor needs to do his/hers. Many times when we go to a doctor we do not or forget to ask questions that are not only important to us ask but necessary to help ensure a good outcome. Over the years in my practice I have heard just about every conceivable question come out of a patients mouth. All are very important, especially for the patient asking the question.  I have listed a few of the most frequently asked questions as well as my responses for a variety of different cosmetic procedures. Remember, these are generalities, nothing is written in stone and these are my responses, others may vary.

General Questions

Am I a good candidate for the procedure?

• · This takes into issue your medical status, factors that can affect your outcome and a reasonable result you can expect. The best plastic surgery candidate is someone with realistic expectations and an understanding of the limitations set by medicine, technology, and each patient’s own body. Good candidates have a strong self-image, and well-developed reason for pursuing a plastic surgery procedure. They are looking for improvement of a physical trait, knowing that while this positive change may enhance their self-image, it will not change people’s perception of them. Dangerous motivations for plastic surgery would be purely doing it to gain popularity, or attempting to reverse recent life crises.

Are you board certified and if so in what specialty?

• Many physicians and non-physicians are performing cosmetic procedures. Some are not qualified to do so. Ask your doctor what specialty he/she received his/her primary training in.

Where is the surgery performed?

• · That can depend on the surgeon. Most plastic surgeons are affiliated with local hospitals and can arrange operating room times as needed. Many carry out a similar procedure at surgical centers, while other surgeons have private surgery suites in their own office space. You’ll find that many plastic surgeons fit into all or most of these categories, and offer options to each patient. They would then help you choose your surgery location based on comfort, safety, scheduling issues, and sometimes geography issues (which surgery location is closest to home, etc.).

Can the procedure be performed under “twilight” anesthesia or does it require general anesthesia?

• · This depends on the procedure and the comfort level of the anesthesiologist and surgeon. In general, the more involved the procedure, the more likely the need for general anesthesia.

Do you routinely perform the procedure I want?

What are the risks and complications?

How long will the effects of the procedure last?

At which hospital(s) do you have privileges to perform the procedure I’m considering?

Facelifts

How long will I be bruised?

• · While every patient is unique and there are a variety of factors affecting bruising, I generally explain to patients to expect bruising to last approximately one week.

When can I get back to my normal routine and work?

• · Again this depends on the patient and what you consider “normal”.  Again, I generally explain to patients 10 days before that can expect to feel like themselves again.

Liposuction

How much weight am I going to lose with liposuction?

• · Liposuction is not a weight loss procedure. It is best used to “sculpt” a patient who has a relatively good shape but requires a bit of help in those areas that they just cannot work off in the gym.

Breast Augmentation

What is the difference between saline and silicone?

• · These are the types of liquid that fills the implant. Both implants types use a silicone shell.

Is silicone safe?

• · Simple answer, yes.

Will I be able to breast feed after implant surgery?

• · If you were able to breast-feed before surgery, you should be able to breast feed after surgery.

These are just a sampling of the questions that you may want to ask, to familiarize yourself with your procedure and surgeon. Please study your procedure, surgeon and options carefully. If you do, all involved will be much more comfortable with the results.

Dr. Norman Rowe uses the latest techniques and ideas in attempt improve patient’s looks. After having completed his plastic surgical training at the prestigious New York University Medical Center and world renowned Manhattan Eye Ear and Throat Hospital, Dr. Rowe went on to develop and improve in the area of minimally invasive and short-scar surgery. This allows him to offer his patients facial and body rejuvenation with nearly invisible incisions. In addition, he uses the latest non-surgical treatments in anti-aging in order give each patient a more youthful appearance with no scars.

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New Cosmetic Surgery Procedures To Help You Look Younger

January 18th, 2010

Advances in medicine are taking place on an almost daily basis. Cosmetic surgery is not exempt from these improvements. Cosmetic surgery is doing more with less. That means less of an inconvenience, less down time, less swelling and less bruising. This not only serves your desires for a less time consuming method of facial rejuvenation, but also usually being less costly.

Realistically, what can be done? One of the easiest and most popular methods of getting that fresh, just back from vacation look is with the use of Botox® Cosmetic. This drug has been FDA approved for cosmetic uses for 2 years. When properly administered Botox may not only smooth out wrinkles, but also can prevent them from getting worse. It does this by weakening wrinkle-forming muscles of the face. It is used primarily for wrinkles between and around the eyes, the forehead and for improvement in the appearance of the neck. It can also be used to treat excessive sweating and migraine headaches. The effect of the botox takes a few days to begin and in general lasts a few months or longer depending on each patient. Another common method of rolling back the years is to elevate wrinkles with a skin filler. The filler is injected in the skin below a wrinkle to fill out the crease in the skin. They give the area a fuller, more youthful appearance. There are a variety of fillers that differ in the time that they last. This can be as short as 3 months to a period of years. These fillers are commonly used in the nasolabial lines (wrinkles next to the nose), forehead creases, acne scars, and wrinkles at the corners of the mouth. The more commonly used fillers are Restylane®, Juvaderm®, collagen and even your own fat (removed from another part of your body!).

Skin resurfacing is another option to treat fine lines of the face, mouth and eye. The more commonly used methods utilize either a laser, chemical peel or dermabrasion. All produce redness for varying time after the procedure depending on the depth of the wrinkles (the deeper they are, the longer you will have redness) and the techniques use. However, after a few days, “cover-up” can be used to disguise any discoloration.

A new method for removing deeper wrinkles and sagging skin without major surgery involves the use of special threads. This recent advancement uses threads (similar to the threads used in an operating room to sew up a wound) to elevate skin and sagging fat. It can be used to elevate the cheeks, neck and forehead areas. This can usually be done without making an incision or scar. This dramatically shortens the recovery period.

All of these procedures can usually be done in a doctor’s office and do not require an operating room. The important point you need to remember is to find a well-qualified plastic surgeon that is well trained in all of these techniques and one that you are comfortable with. Don’t be embarrassed to ask the doctor what his/her credentials are, how many of the procedures he/she has done and is he board certified. Board certification means he/she is credentialed by a governing body in plastic surgery. Any physician may legally perform these procedures; therefore make sure the physician you use is qualified to perform the procedure. After all, it’s your face.

So if you want to make some desired changes to your face and want to do it quickly and for less money, new cosmetic plastic surgery procedures may be the answer you’re looking for.

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Cosmetic Surgery And The New You

January 18th, 2010

Cosmetic surgery is no longer the “hush-hush”, back room specialty that it once was. Today, cosmetic surgery is everywhere, from billboards to television. Having cosmetic surgery is as commonplace as going to the dentist. In 2006, The American Society for Aesthetic Plastic Surgery reports over 11.5 million procedures were performed. That is an increase of 446 percent since 1996. Numbers of procedures are only expected to increase. The American Academy of Cosmetic Surgery reports that 1 of every 5 adults anticipates having plastic surgery done at some time.

Cosmetic surgery can be done to treat wrinkles and lift the face, eyelids, forehead, neck and breasts. The legs, and arms can be lifted. A more youthful appearance can be given to ANY part or area of the body. If a lift is not for you and all you want is to get rid of that stubborn fat that you just can’t seem to get rid of, then liposuction may be the answer. This involves minimal downtime and almost immediate results.

If you don’t need or want surgery for that youthful look, then there are other methods of facial and body rejuvenation. One of the most popular is the use of botox to not only smooth out wrinkles, but also to prevent them from getting worse.

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Cosmetic Surgery: Reconstructive Surgery for the Soul

January 18th, 2010

Over the years I had many patients whose families questioned their reasoning for have plastic surgery. I have even had patients question their own reasoning for wanting to improve some part of their body. I want to take a moment to talk about this.

Plastic surgery’s roots are in the origin of its name, plastikos, the Greek word meaning “relating to molding or shaping”. This includes the creation of replacement body parts and correction of deficiencies for those patients who are victims of trauma, malignancies and congenital differences, all in the hopes of helping those who are befallen with these maladies.

During the more recent history of plastic surgery, a natural extension of this mission has been in the area of aesthetic surgery. This can only be viewed as an expected addition to plastic surgery in that plastic surgeons are in a unique position to appreciate form and the molding of tissues to that shape which not only is functional, but also cosmetically pleasing.

As surgeons, we strive to make patients whole again, whether that is correcting a cleft lip, making a patient a new breast or salvaging a mangled extremity. Is this no different from making the cosmetic patient whole again? While some may perceive cosmetic surgery as seemingly superficial, if performed on the properly selected patient and for the right reasons, are we not making them whole again? Are we not correcting a real or perceived deficiency? Are we not performing reconstructive surgery on the soul? The true problem lies in the definition of a perceived difference. While everyone’s perception is unique, as a plastic surgeon my work is to determine if the patient has a true problem or not.

That being said, cosmetic surgery has evolved over the decades and is changing ever faster more recently. In the not to distant past, aesthetic surgery was something talked about in a muffled voice and rarely did even a person tell their closest friend they were contemplating have a cosmetic procedure. It was reserved for the elite. This attitude has obviously changed, for the better I might add. Is there anything wrong with a person who takes an opportunity to improve themselves when they have the chance? No. When I have a toothache, I go to a dentist. If I want to improve the way I feel about myself, I go to a plastic surgeon.

The definition of plastic surgery is in some regards dependent on the surgeon. My definition may be different from yours, but ultimately the definition is wholly dependent on the patient to determine. So cosmetic surgeons must be must look at as reconstructive surgeons who work on different areas of the patients body, including those areas that we may not be able to feel or see but deeply affects the patient nonetheless. If the surgery makes the patient feel good, then it’s a success.

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