.
Terry L. Hand, M.D.
|
| Join Our List |
|
|
Breast Augmentation, Real People, Real Surgery: Episodes 1-3
This months interactive tool is a group of 3 videos made by the American Society For Aesthetic Plastic Surgery describing the experience of an actual breast augmentation patient. This is a video link, so please note that sound is involved. Click on the link below to view her experience and results after breast augmentation.
| |
|
Ask The Doctor
Lately I have seen many infomercials and print advertisements for low cost, 1 to 2 hour facelifts. Can you comment? A.H.
I am frequently asked this question and my first response is "buyer beware". I divide facelifts into 2 major catagories, mini-lift and regular facelift. A mini-lift is geared for a younger patient that requires no neck correction or the patient that has had a facelift in years past and may just need a touchup. A facelift takes 3 to 4 hours to perform and will address sagging muscle, facial skin and neck issues such as banding and submuscular fat.
Any doctor that promises local anesthesia and a swift procedure with little downtime, is being untruthful when a regular facelift is the appropriate corrective procedure. I understand that some patients for whatever reason will not want a regular facelift. My issue with the infomercials that I have seen is that it appears that a regular facelift was performed when actually the clinics perform a mini-lift that will not deliver the results advertised.
A regular facelift that addresses multiple aging changes, requires about 2 weeks of social downtime. A mini-lift usually causes less bruising and swelling intially but still requires a long weekend of recovery, with the expectation that some bruising and swelling will occur. The appropriate procedure must be presented after a careful evaluation. The surgeon should strive to provide information on the procedure that will address the aging changes the patient wishes to correct, while making an anesthesia choice that does not compromise patient safety.
The most important thought to communicate is that a facelift is a complex procedure, requiring an artistic expertise that comes from doing multiple procedures. Components that seem simple such as incision placement and closure, the set of the earlobes and the vector of pull to the facial skin separate a good facelift from a quick procedure by an inexperienced physician. My best advise is to see actual photos of patients that have had the procedure performed by the plastic surgeon, mandate board certification by the American Board of Plastic Surgery (insuring adequate training) and insure that the doctor has hospital privileges to perform the same procedure (many do not, hense the necessity to operate only in an office suite with local anesthesia). Prospective facelift patients should have a clear understanding of the planned procedure and the recovery time. Careful evaluation of all of the above issues should factor in to choosing a surgeon to perform your cosmetic surgery. |
| Latisse Timeline
The beginning of next month will mark the 16 week point of optimal results for Lisa and Cheri. At that time, they will need to use Latisse 1 to 2 times per week to maintain their lashes. Drop by to see their results or for a quick, no-cost appointment to check out Latisse.
 |
 |
|
|
| Patient Financing Plans |
 |
|
Recently our practice has had inquiries about what financing plans are available, at what rates and what is it going to cost per month?
Care credit is a well established financing agency establishes a line of credit that is accepted by most plastic surgeons, dentists and veternarians. Different offices participate with various plans offered by this lender. Our office offers 3 month, same as cash financing for all procedures over $300.00. There are also a variety of plans from 24 to 48 months that offer an extended payment program at 13.9% interest.
Because of our relationship with Allergan, the manufacturer of Naturelle implants, a 6 month interest free plan is offered for any patient undergoing breast augmentation alone or in combination with other procedures. Credit lines from $300 to $25,000 are available with instant qualification and credit availability.
|
|
|
|
|
Thank you for taking your valuable time to once again read our newsletter. As always, our office would like to extend the offer of a no cost consultation for our loyal clients that subscribe to this newsletter. Please do not hesitate to let Cheri or Lisa know if you have further questions about any of our procedures or financing.
Sincerely,
Terry L. Hand, M.D.
|
| Our Favorite Products!
Our 2 favorite product lines are Obagi and Glycolix products, always available for purchase.
Glycolix 10%, 15% and 20% Cream
UltraLite & Fortified Glycolix Facial Cream |
a |
|
Entire Obagi Nuderm Skincare Line | |
|
|
The big news in the plastic surgery world this week is the FDA approval of Dysport, a similiar botulinium toxin to Botox. The hylauronic acid filler market has developed products such as Elevess, Restylane, Perlane and Juvaderm which are different versions of the same product with individual benefits. Competition amongst the manufacturers has created pricing advantages for the consumer. I expect Dysport will probably become a major competitor of Botox. Dysport was originally slated to be called Reloxin and has been used in Europe since 1991. Although I have been very pleased with the quality control and reliability of Botox, I will thoroughly investigate this new product and it's efficacy for my patients.
This month's interactive tool is a video sponsored by the American Society For Aesthetic Plastic Surgery that profiles a real breast augmentation patient and her experience with the procedure. I find that for most patients, the ability to hear from another person that has undergone the procedure is very helpful in the decision making process.
Latisse continues to be the "fun" product of my practice. I never thought that when checking in with patients, I would be privy to discussions regarding the best eyeliner brush and who knew that plum mascara enhances green eyes. It is a wonderful adjunct for those patients that have undergone eyelid rejuvination as well. All of my patients are loving the effects of Latisse and reporting longer, fuller lashes. Lisa and Cheri have now been using Latisse for 12 weeks. Both ladies have experienced a dramatic increase in length and thickness. Lisa (the mascara ringleader) has decided that Latisse combined with Lancome Definicils mascara is perfection!
In this edition of our newsletter, I have provided a case study of one of my patients that has graciously allowed me to discuss her timeline for surgical and nonsurgical procedures. This study shows that occasional procedures, selectively done when the time is right, can help an individual maintain a rested, attractive appearance.
Our featured article relates to an issue I have dealt with often in my practice, the effects of herbal medications on cosmetic surgery procedures. Although drug interactions may be caused by supplements that are thought to be harmless, I am also vigilent in informing patients about the possibility of anti-inflammatory usage that may promote bleeding, swelling and bruising if used within 10 days to 2 weeks of a procedure. I advise all of my patients to tell any physician, that is doing any type of surgery, all medications or supplements being utilized prior to a procedure to avoid drug interactions.
All the best,
Terry Hand, M.D.
|
| A Little Now, A Little Later: A Study Of Small Procedures Over 7 Years |
|
One of the great advantages of a long term cosmetic surgery practice is the relationships that are formed between myself, my staff and my patients. I see many of my patients at sometime during the year for a minor procedure such as Botox and/or filler or perhaps a surgery. Sometimes we meet for a chat to discuss what is new, what is real or hype or a chance to make a plan for future appropriate options. I would like to share a review of one of my patients who was recently delighted when we reviewed her patient file photo history together. The photos below represent my patient 7 years ago and 1 week ago. As you can see, she looks more refreshed in 2009 (age 52) than she did in 2002 (age 45). She has graciously consented to allow a chronological review of her surgical and non-surgical choices and the timeframe she she has used in choosing cosmetic improvement.
2002 2009
2002 2009
2002: Quadrilateral blepharoplasty: The skin, fat and muscle of all four eyelids was surgically corrected. During this procedure, I also performed a mid-face lift to reposition the fat above the cheekbone and to lift the midface and soften the nasolabial folds (the folds between the nose and corner of the mouth). She also began to use Botox in her furrow lines between her eyebrows approximately every 4 months. Notice the improvement of the laso-labial folds with the midfacelift.
2006: Extended mini-facelift: At this point, our patient was starting to lose definition in her jowl area and had the beginnings of loss of neck definition. By extending the mini-facelift scar slightly and minimally tightening her cheek muscles, I was able to bring her face back to a natural, refreshed look. She also began to get dark skin tags on the side of her neck that responded well to the diolite laser. Later that year, she had 1 cc of Restylane in her nasolabial creases (nose to mouth).
2007: Obagi Skin Regime: This year was the year to refine her skin texture and color. She is an avid outdoor athlete that managed to carefully follow the protocol while making sure she was sunscreened during her athletic pursuits. After 6 months, her face was very homogenous in color and her skin had a very healthy glow. She has continued on a maintanence program and receives compliments on her beautiful skin often. About 12 months after her previous Restylane injection, she repeated her Restylane injection to her nasolabial lines.
2009: Latisse: Although this patient had nice eyelashes to start with, she has spectacular eyelashes now. She began using Latisse in early February and is delighted with the increase in length, fullness and "fringiness". She is planning an appointment for some filler to her upper nasolabial creases and has continued with her Botox regime. |
|
Featured Procedure: Facelift
 |
|
Rhytidectomy, commonly referred to as a facelift, is a plastic surgery procedure designed to tighten loose skin on the lower third of the face, the neck and the jaw line. The facelift procedure refreshes the natural facial symmetry unique to each individual while removing major folds and wrinkles on the face and neck that naturally occur with aging. The neck and jaw line regain a more youthful definition. The best results are seen in candidates with reasonable surgical expectations of looking rested, refined and naturally vibrant. Healthy men and women with sagging or laxity in the neck and jowl generally see great improvement.
Dr. Hand performs the facelift procedure in our accredited Marin County outpatient surgical facility. Depending on the extent of the procedure, the procedure may be performed under local anesthesia with sedation or general anesthesia. Several variations of facelift are available dependent on the amount of correction needed. Most procedures are completed in two to four hours. The procedure that best addresses the anatomical issues and patient's concerns will be decided at the consultation.
Mini-lift: This procedure is designed for the younger person that observes a general loosening of his or her face but has no major folds or wrinkles. The incision begins hidden in the hair above the ear and continues in the natural curve in front of the ear, finishing at the base of the ear or slightly behind it. Minimal swelling can be expected since no muscle correction is done. The scars fade quickly and will be difficult to visualize.
Facelift: This procedure is designed for the more mature face that not only has laxity of the skin but also muscle in the lower face that has relaxed. This patient may have "neck bands" and/or facial fat that has collected under the chin. Most often the neckline has lost its definition and youthful angles. The incisions begin much as in the minilift but extends behind the ear and up into the hairline. This facelift addresses all areas of the lower face and neck by tightening the underlying muscle, followed by trimming and redraping the facial skin. Frequently, another incision is made under the chin that allows Dr. Hand to tighten the muscles in the neck that have separated and usually cause banding and to remove fat deposits. A neck suspension is commonly done to improve neck definition.
Mid-facelift: This procedure is always performed by Dr. Hand on the patient that chooses lower lid blepharoplasty as a facial rejuvenation choice. Through the lower lid blepharoplasty incision, the malar fat pads are repositioned and the mid-face is lifted vertically to assist in softening the nasolabial lines (the lines between the nose and the lip).
Recuperation and Healing
A compressive dressing will be wrapped around the head immediately after surgery and will be changed the next day by Dr. Hand. On the third postoperative day, the dressing may be removed and the patient should shower and gently wash the hair. Most patients will see swelling and bruising subside within 1 to 3 weeks depending on the amount of muscle correction. Generally, the more extensive the procedure, the longer swelling continues. Sutures in front of the ear are removed at 4 days after facelift. The sutures behind the ear will be removed at 10 days to 2 weeks after the procedure. Most patients can begin light exercise after 10 days and regular exercise at 2 weeks after surgery. Depending on the amount of swelling and bruising, most patients can return to work in 1 to 2 weeks. Postoperative discomfort is easily controlled by oral medications.
Dr. Hand will carefully evaluate all aspects of the face during consultation. He will present recommendations based on attaining the most aesthetically pleasing outcome. Often, the midface and eyes need to be addressed with surgical correction (blepharoplasty) and sometimes the eyebrow position needs to be elevated (forehead lift) to achieve the best result.
|
| Are Herbal Supplements Putting Aesthetic Surgery Patients at Risk? |
New York, NY (April 14, 2009) - For many people, the words "natural" or "herbal" are virtually synonymous with safety and purity. Products available over-the-counter without a doctor's prescription are often mistakenly believed to be free of significant risks. A report in the March/April issue of Aesthetic Surgery Journal warns that more than 40% of plastic surgery patients use herbal supplements in the two weeks prior to undergoing surgery. And, while some herbal supplements may provide benefits during recovery, commonly used herbal medications such as ginkgo biloba, ginseng, garlic, echinacea, valerian root and others can have deleterious effects when combined with surgery. When undergoing plastic surgery, the most significant and potentially dangerous effects of alternative medicines occur during the operative and immediate postoperative periods. "In considering the dizzying array of supplements available, the main concerns of the plastic surgeon are interaction with other medications, cardiovascular effects, alteration of coagulation [bleeding] and sedative effects," says David J. Rowe, MD, lead author and Assistant Professor of Plastic Surgery at University Hospitals Case Medical Center, Lyndhurst, OH.
Unfortunately, as many as 70% of patients may not disclose the use of alternative medications to their surgeon or conventional health care provider, sometimes because they feel these physicians have little knowledge or interest in naturopathic medicine, or they feel physicians may disapprove of such treatments. Some patients simply fail to recognize the relevance of supplement usage to their current medical or surgical care. Patients need to be aware that full disclosure of all medications - both those that are prescribed and those that are obtained over-the-counter - is extremely important to their health and safety. They should also understand that inconsistent and unregulated manufacturing standards and lack of regulation for many herbal supplements mean that quality and dosage may vary considerably among products.
Click To Read Entire Article | |
|
This month our office is offering a single and a multiple syringe promotion!
Single Syringe Promotion: $100 off of 1 syringe of Elevess, the only dermal filler with lidocaine local anesthesia in the product!
Net cost to the patient: $475.00 per syringe
Multiple Syringe Promotion: A manufacturer rebate of $100 off of 2 syringes of Restylane.
Another $100 off of 2 syringes of Restylane from our office.
Net cost to the patient: $475.00 per syringe
| |
|
