BREAST AUGMENTATION

Our office encourages all of our patients to return every year for a "checkup" of the breasts as needed after the first 3 months of followup care.  Although I  have many patients with implants that have remained intact for 15 to 20 years, chances are that at some time after implantation, a silicone or saline implant will eventually need to be replaced.  A saline implant will simply deflate and the saline is reabsorbed into the body.  In the unlikely event a silicone implant ruptures, it is a little trickier to diagnose. The current FDA recommendation is for a MRI examination at 3 years after implantation and every two years afterward.  My general recommendation is that unless there are lumps or palpable issues that I can feel within the breast, I recommend doing nothing.  I do however always encourage my breast implant patients to remember to take antibiotics immediately prior to dental procedures and afterward. My office is happy to call in a prophylactic prescription for that purpose. 

LIPOSUCTION
 
The main aftercare instruction for liposuction that is very important to follow is to wear the postoperative garment for 3 weeks following the procedure.  The garment greatly assists skin retraction and minimallizes bruising and edema.  Maintaining a consistent body weight also increases the likelihood of long-term satisfaction.  Regular exercise and a healthy diet will further assist physical well being.
 
INJECTABLES/BOTOX/FILLERS  

These products are wonderful and not so wonderful for the same reason:  they are not permanent.  In my years of practice, I have seen several trends that affect the usage of fillers.  For awhile, both lips injected to produce a dramatic pout was in vogue.  Over the last few years, I am seeing many more patients to outline the upper lip only and to minimally inflate the lower lip so that it is marginally larger.  I am seeing an increase in fillers for correcting the nasolabial lines and small, fine wrinkles elsewhere on the face.  Now there are fillers that can be tailored for  thinner skin and thicker skin types.  The depth and location of the wrinkle may affect the type used as well.  I rarely make a decision as to which one to use until I visually see what I am correcting.
 
Botox is a product that many of my patients consider as the "wonder drug".  Over the years, it's usages have skyrocketed.  Initially I used it only between the eyebrows  and in the crow's feet beside the eyes.  Now we use it in other locations that can really make a difference, such as: across the forehead, in the neck bands, at the ball of the chin to relieve puckering, at the top of the nose for "snarl"  lines, in the corners of the mouth for downturns and in the upper lip for "bleed lines".  Botox will simply go away when treatment is discontinued and muscle activity will resume, usually within 3 to 4 months.  When Botox treatments are done regularly,  the deeply pleated muscles will begin the relax and the lines diminish.  I have not seen "resistance" to repeated injections with long term usage.  Most of my patients consider it a "quarterly maintenance" procedure.

FACIAL COSMETIC SURGERY:  Facelift and Eyelids
 
The facial skin will continue to age because we are human. There are several habits to lose or gain that will make a significant difference though.  I always encourage daily usage of sunscreen  because sun damage is cummulative and associated with skin cancers and accelerated aging.  Discontinueing smoking is important in skin oxygenation and adequate protein ingestion is paramount in maintaining skin health and thickness.

After a few years, aging will start to reoccur after a facelift. Usually the muscles of the face remain in fairly good shape but the lower face may begin to see a small amount of laxity.  A mini-lift will often readdress the minor changes with very little down time. For minor crinkling of the eyelid skin in the years after a blepharoplasty, I often advise a periocular peel to further tighten the eyelid.
 
Skin care is important as well.  Our office RN Lisa offers monthly treatments of dermaplaning combined with glycolic peels, for a basic maintanence procedure.   Skin care products  ranging from glycolic acid creams and basic moisturizers to the Obagi regime can be recommended and tailored to your specific needs.

Rhinoplasty is a plastic surgery procedure designed to refine and alter the contour of the nose. By improving the facial symmetry of the nose, the facial balance is redefined and other facial features are complemented. The nose may be reshaped in a variety of ways by reducing the overall size, removing an unwanted hump, changing the shape of the tip or the bridge, narrowing the width of the nostrils or changing the angle between the nose and upper lip. In addition to cosmetic improvement, breathing problems associated with a deviated septal cartilage causing inhibited airflow may be improved. The decision to have a rhinoplasty procedure performed is appropriate for a variety of surgical candidates. A patient may have had a traumatic injury that distorted or impeded airflow in the nose. Another patient may simply be dissatisfied with the nose the individual was born with. Some patients will notice that aging changes have redefined the anatomy. All of the above are reasonable candidates for surgical correction of the nose with the clear understanding that the nose should be reshaped to fit the structural anatomy of the face so that facial harmony can be achieved. The overall desired outcome is that of a natural appearing nose that fits the face.

Recuperation and Healing 

After rhinoplasty, the nose will most likely have an external splint and packing that has been applied during the surgical procedure. The packing will be removed in 1-2 days, the splint after 7 days. The patient will be instructed to breathe only through the mouth, returning home for a night of bed rest with head elevation.
Initial discomfort is easily controlled with oral medications. The majority of swelling and bruising subsides progressively over 2-4 weeks. A realistic approximation of the final result is evident in 3 months. The final result may continue to evolve and refine for 12 to 14 months. Light exercise may be permitted at 7-10 days. Heavy contact sports should be avoided for 4-6 weeks.