Well it's official, winter is here.  Although the cold, dismal weather never seems to last for long in Marin County, it is a great time for a tune-up (sorry, I couldn't resist).  Many procedures are well suited for  cold weather times because clothing tends to lend more coverage,  sunshine on newly refreshed skin should be limited and most importantly, our social agendas tend to be a little less demanding.  When the spring comes and our wonderful weather returns, it is always quite pleasant to feel refreshed and revitalized in appearance and spirit.  What are my top 4 suggestions for this time of year?
 
Out with the old skin and in with the new!  I am an absolute believer in the Obagi skin care system, having seen dramatic results for a wide variety of my patients.  I encourage most patients to start their skin care regime during these colder months in order to minimize sun exposure for the first 2 months.  Our office offers the entire Nu-Derm line as well as the Obagi Blue Peel.   The Nu-Derm line is a structured skin care system that renews the skin at a cellular level, decreases fine lines and dramatically evens out pigment changes.  The blue peel does the same with one rapid peel that should be followed with Obagi products to maintain the refreshed skin.
 
Lose an inch, gain a smile!  Liposuction is one of the most popular procedures in my practice for several reasons:  Most of us gain weight unevenly as we age.  Fat deposits stubbornly occur in places we never thought could happen to us. Using the Vasar liposelection technique, areas such as the bra line rolls and thickening waists, hips, thighs or knees can be retailored to achieve symmetry with the rest of the body.  A compressive garment does need to be worn for about 3 weeks following surgery, making this time of year a great time to wear loose fitting, casual clothing.
 
Less is more!  One of the pieces of advice that I give to all of my patients is to curtail most exercise and physically demanding activities for about 2 weeks after a surgical procedure. The reason for this is to avoid increasing your blood pressure and heart rate which often leads to more bruising and swelling.  I am always amazed at how quickly recuperation occurs for those that allow their bodies to rest and recharge as advised. This cool, wet weather offers a great opportunity to rest without the temptation of outdoor activities for a short time. 
 
Turtlenecks are your friend!  Facelift is another procedure that is often done this time of year.  Although bruising is often minimal, a small amount will occasionally be noticed on the neck. This occurs because during a facelift the neck is redefined and often corrrection of neck banding is done . For that reason, the camouflage clothing route (the turtleneck), is often welcomed by those looking to disguise any postoperative bruising in the first few weeks after a facelift.

Liposuction is a surgical procedure designed to sculpt and remove localized fat in areas that appear to be resistant to diet and exercise. Very often, because of the aging process, fat redistributes to locations that were previously never a problem. Liposuction targets these areas permanently. The possibility to gain weight still exists, so fat redistribution may occur with a large weight gain. Liposuction may be performed on the neck, the arms, abdomen, hips, back bulges, buttocks, thighs and knees. An appropriate candidate for liposuction is in good health and usually is of average weight with healthy, elastic skin. Some individuals have bulges in the neck or thighs that have been apparent since puberty, changing little with weight loss. Others, particularly when entering the 40's, will see increased abdominal fat and back fat that lingers. Often, genetically inherited fat accumulations can be altered positively. Small amounts of fat, removed from isolated areas, often create amazing results in the body's contour.

Dr. Hand utilizes Vaser liposelection, an internal ultrasonic instrument that is tissue-selective in that it targets unwanted fat while preserving other surrounding tissues. This technique also promotes smoother contours, decreased healing time and bruising. It is much more precise than older methods that used large cannulas and were not selective of the tissues that were disrupted. The ultrasonic waves produced by a special cannula tip, essentially rupture and emulsify the targeted fat cells, making them easier to aspirate with smaller cannulas.