.
Terry L. Hand, M.D.
Member, American Society Of Plastic Surgeons
Member, American Society For Aesthetic Plastic Surgery
Certified by The American Board of Plastic and Reconstructive Surgery |
| Join Our List |
|
|
THE NATRELLE PRECONSULTATION KIT
The Allergan company has created this kit to designed to educate you about the breast augmentation. You can try on breast implants in your own home with 4 different sized "faux" implants and a special bra. A book and an educational DVD are also provided as well as $170 in rebates for Natrelle implants, Botox, Juvaderm and Latisse.
This kit may be ordered directly from Allergan from the attached link for $39.95. Please go to the link below for instructions and further information.
|
|
ASK THE DOCTOR
I have bags and loose skin under my eyes, can I use a skin filler to correct the problem until I can afford to have my eyes done?
This is a question that I often deal with. The answer is most often no. Most individuals that need eyelid correction have issues that are uniquely addressed by a blepharoplasty and only a blepharoplasty. Under each of the 4 eyelids , there are 3 compartments of fat that surround the eyeball. As you age, they begin to herniate out through the muscle and create puffiness and shadowing. At the same time, the fat at the top of your cheekbone begins to migrate downward. The solution is to take out the right amount of fat to alleviate puffiness but not to create hollows. The muscle and skin also need to be tightened and trimmed. At the same time that the lower eyelids are corrected, the fat above the cheekbone is repositioned upward to redefine the mid-face to it's more youthful look.
Injecting cosmetic fillers to the lower eyelid area may temporarily look OK but ultimately can look lumpy and/or just puffy and odd. None of the needed corrections that involve excess skin, muscle and/or fat are accomplished.
That being said, I do believe that a small amount Botox assists dynamic wrinkles caused by repetetive motion. I would suggest to most of my patients that have been counseled that blepharoplasty is the choice that would be most appropriate, to wait until the timing is correct. Opt for the most beneficial procedure rather than a quick fix that may exacerbate the problem. |
|
|
Latisse Timeline and Photos
Just because it's interesting, I thought I would include the general timing as to when most patients see results. So far most are seeing an increase in length and thickness now that it has been has been exactly 16 weeks since my first group of patients started treatment.
Lisa says her eyelashes are still growing and she wants to give them every opportunity to continue! Cheri has gone to a maintainance regime of applying every other day. Many patients are using one drop for both lids now on a daily basis. Everyone seems to be right on schedule for the expected results addressed by the timeline. Those with medium to dark lashes seem to get darker, light lashes may be slightly darker but still require mascara.
The below photos are of Cheri on the day she began Latisse and at the 12 week point, without makeup.
Cheri Pre- Latisse 
Cheri 12 weeks after starting Latisse
Coming next month: Comments from patients on their 16 week results!
|
 |
|
|
| 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? Our office always accepts check, Visa and Mastercard. Some patients have found the ability to use a line of credit established solely for cosmetic surgery procedures to be cost effective and convenient. We now have a secure application that links directly to CareCredit from our financing page of our website by clicking on the blinking information box at the top of the page. Within minutes of applying, a line of credit is established to use whenever you are ready to pursue your procedure.
CareCredit is a financing agency that can establishes a line of credit accepted by most plastic surgeons, dentists and veternarians. Different offices participate with various plans offered by this lender. Because of our relationship with Allergan, any procedure or combination of procedures that includes breast implants is eligible for 6 month interest free financing. As always, 3 months, same as cash financing is always offered. Credit lines from $300 to $25,000 are available with instant qualification and credit availability. View the CareCredit payment calculator
|
|
Obagi Promotion
|
 |
|
10% Off
All Obagi Products!
Expires June 30, 2009
|
|
|
|
Thankfully, our wonderful Marin summer has begun! The summer also brings our very comfortable, temperate days full of opportunities for sun exposure. This month I am featuring an article with tips about the best choices of sunscreens and rules to follow to take care of your skin. My top reccommendation is to just do it, wear it every day. Sun damage is cummulative and no one is immune to aging changes, no matter how resilient your skin is in your youth. The greatest gift to give your children is to sunscreen them daily and to establish a habit of protecting their skin for the rest of their lives. Sun exposure catches up with everyone, some sooner than later. The risk for melanoma doubles after five blistering sunburns. In my practice,excessive sun exposure is the single greatest factor in premature aging.
New on the horizon and soon to be available this later month is Dysport, the alternative the Botox. The costs and exact details of the product are still forthcoming to our practice. More information should be available by the end of the month. I am open to new alternatives but honestly have to say that Botox is an incredible product that my office has used very effectively for multiple issues. Most recently, the treatment of neck banding by relaxing the hyperactive muscles has been very popular with some of my patients.
This month a synopsis of a presentation from the last meeting of the American Society of Plastic Surgeons, validates the high degree of patient satifaction after most breast enhancement, reduction, and lift procedures. I have decided to make breast lift (mastopexy) our featured procedure. I find this procedure is well tolerated by patients, resulting in greatly improved body image and choices in clothing options. Although I usually include a before and after photo on this page, I have decided to post only a link to my breast lift gallery page, in order to respect those patients that do not wish to view nudity.
This month's interactive tool is actually a patient educator box of goodies from the manufacturer of Naturelle breast impants. The decision to undergo breast augmentation is often made over years. Understandably, the ability to "try on" different sizes of implants in one's own home can be very appealing. Although there is a cost for this box of sizers, a sports bra and DVD's with information, there are also a bunch of coupons for rebates for the implants, Botox, Juvaderm and Latisse. The other alternative is to schedule a consultation where I can go over all of your choices, let you feel the difference in silicone or saline implants and try on choices.
Latisse is ever expanding in popularity. Most patients that are currently using it say they will give up food before Latisse! This month I am including a photo of Cheri's eyelashes before starting Latisse and after 12 weeks, both without makeup. Lisa has incredible results too but won't even go to the gym without mascara. Good luck getting a photo of her without makeup! However, she will bat her lashes at anyone that will look. Her newest Latisse tip: take the brush and cut off 1/2 of the bristles so that the brush is 1/2 as thick, drop 1 drop at a time into the nipple of the bottle and apply to the lashline. If the lashline is wet, 1 drop may be all you need instead of 2!
All the best,
Terry Hand, M.D.
|
Featured Procedure: Breast Lift (Mastopexy)
|
 Mastopexy, commonly referred to as a breast lift, is a plastic surgery procedure designed to lift and reshape sagging breasts. A woman's breasts will naturally become less firm and sag slightly with aging and gravity. The addition of pregnancy, breast feeding or changes in body weight further undermines the skin's elasticity and will contribute to drooping of the breasts and stretching of the size of the areola. Breast lift is designed to restore breasts to their natural, youthful state while maintaining their current size. The breasts will be lifted higher on the chest wall and the nipple will be restored to its correct position. The addition of breast augmentation may accompany mastopexy for the woman that would like increased breast volume. During consultation, Dr. Hand will clearly describe the anticipated size and shape of the breast that should result from the breast lift. The addition of breast implants needs to be carefully planned to include the patient's wish for increased size. She should also understand that the base diameter of the implant needs to be appropriate for the size of the chest wall in order to create the most natural appearance.
Procedure Description
Dr. Hand performs the breast lift procedure in our accredited Marin County outpatient surgical faculty. The mastopexy procedure is always performed utilizing general anesthesia.
Mastopexy is performed with several variations on technique depending on the amount of sag and stretching of the areola. The most common procedure addresses the entire breast and involves an incision that runs completely around the nipple and as an inverted T, with an incision from the nipple to the crease of the breast and underneath the breast. This approach is always used on the woman that has a nipple pointed significantly downward with a loose skin capsule. The reason for this approach is that Dr. Hand can restore the areola to a youthful, pre-pregnancy size and extra skin volume can be resected horizontally and vertically creating an optimal contour. The result will be firmer, more youthful breasts.
Another procedure for the patient that has less breast sag is the "lollipop" or "vertical" pattern. This procedure that does not involve the incision under the breast is best for breasts with only a small amount of sag.
Recuperation and Healing
Immediately after the surgery, Dr. Hand will wrap the breasts in a compressive dressing that is to remain undisturbed until the 1st post-operative appointment the following day. The breasts will be rewrapped for another 2 to 5 days for compression. The patient should wear a non-underwire supportive bra for another 4 to 6 weeks most of the day and at night to lend further support to the breasts. The breasts will appear bruised and swollen for the 1st week following surgery. They will continue to "round out" over the next several weeks. Postoperative pain is easily controlled with oral pain medications. The incision sites should gradually fade over 3-12 months.
|
| "Fantastic Four" of Breast Procedures Leave Women Extremely Satisfied |
99% Would Have Breast Plastic Surgery Again, Says Study Presented at ASPS Annual Meeting
CHICAGO - Breast augmentation, breast lift (mastopexy), combination breast lift/augmentation and breast reduction achieve high satisfaction rates; enhance self-esteem and quality of life; and 99 percent of women would have their surgery again, according to a first-of-its-kind study presented at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2008 conference. The study found breast lift and lift/augmentation to have a high level of patient satisfaction that rivals breast augmentation and reduction.
"Many studies have shown breast augmentation and reduction are highly gratifying procedures for women, but until now we've had limited information on patient satisfaction for breast lift or combination lift/ augmentation. This data fills in the gap," said Eric Swanson, MD, ASPS Member Surgeon and study author. "When the vertical technique is used in the augmentation/lift procedure, patient satisfaction is high."
In this prospective study, 325 patients were interviewed about their breast plastic surgery over a five year period, with a response rate of 81 percent. Almost all patients, 99 percent, would have their procedure again and 91 percent of patients reported improved self-esteem. Overall, patient satisfaction was 96 percent. The average result rating was 9.2 out of 10. According to Dr. Swanson, the high patient satisfaction rates for breast lifts and reductions in the study applied only to the vertical technique which was used on all patients.
The study also evaluated preferred breast shape, discomfort level, and recovery. Most women preferred a convex breast shape, i.e., fuller contour at the top of the breast. "Naturally, breasts are fuller towards the bottom, but our study found patients want more fullness on top, which is hardly surprising in view of the purpose of bras," said Dr. Swanson.
Patients reported using prescription analgesics an average of 5.4 days, resumed driving in 5.8 days, returned to work in 7.5 days, and felt "back to normal" in 27.8 days. Pain rating was moderate overall, 5.4 out of 10, higher for breast augmentation (5.9) and lower for breast reduction (3.3). "Prior to breast surgery, women often ask about discomfort level, recovery time, and when they'll be able to return to normal activities," said Dr. Swanson. "With this study, we now have the answers, provided by patients themselves."
Nearly 348,000 women had breast augmentations in 2007, making it the number one cosmetic plastic surgery procedure performed last year, according to ASPS statistics. In addition, more than 106,000 women had breast reductions and 104,000 women had breast lifts last year.
|
| Sunscreen, Never Leave Home Without It! |
|
 1. Who needs to use sunscreen?
In a word: everyone! More than 1 million new cases of skin cancer will be diagnosed in the United States this year.1 Many studies have found an association between sunburns and enhanced risk for melanoma, the deadliest form of skin cancer.2 The Food and Drug Administration (FDA) and the American Academy of Dermatology recognize six skin categories:
I Always burns easily, never tans, extremely sun-sensitive skin
II Usually burns easily, tans minimally, very sun-sensitive skin
III Sometimes burns, tans gradually to light brown, sun-sensitive skin
IV Burns minimally, always tans to moderate brown, minimally sun-sensitive
V Rarely burns, tans well, sun-insensitive skin
VI Never burns, deeply pigmented, sun-insensitive skin
The American Academy of Dermatology recommends that, regardless of skin type, a broad-spectrum (protects against UVA and UVB rays) sunscreen with a Sun Protection Factor (SPF) of at least 15 should be used year-round.
2. What are UVA and UVB rays?
Sunlight consists of two types of harmful rays - ultraviolet A (UVA) rays and ultraviolet B (UVB) rays. UVA rays (which pass through window glass) penetrate deeper into the dermis, the thickest layer of the skin. UVA rays can cause suppression of the immune system, which interferes with the immune system's ability to protect you against the development and spread of skin cancer. UVA exposure also is known to lead to signs of premature aging of the skin such as wrinkling and age spots. The UVB rays are the sun's burning rays (which are blocked by window glass) and are the primary cause of sunburn. A good way to remember it is that UVA rays are the aging rays and UVB rays are the burning rays. Excessive exposure to both forms of UV rays can lead to the development of skin cancer. The United States Department of Health & Human Services has declared ultraviolet (UV) radiation from the sun and artificial sources, such as tanning beds and sun lamps, as a known carcinogen (cancer-causing substance).
3. When should sunscreen be used?
Sunscreen should be applied every day to exposed skin, not just if you are going to be in the sun. While UVB rays cannot penetrate glass windows, UVA rays can, leaving you prone to these damaging effects if unprotected. For days when you are going to be indoors, apply sunscreen on the areas not covered by clothing, such as the face and hands. Sunscreens can be applied under makeup, or alternatively, there are many cosmetic products available that contain sunscreens for daily use because sun protection is the principal means of preventing premature aging and skin cancer. It's never too late to protect yourself from the sun and minimize your future risk of skin cancer. Don't reserve the use of sunscreen only for sunny days. Even on a cloudy day, up to 80 percent of the sun's ultraviolet rays can pass through the clouds. In addition, sand reflects 25 percent of the sun's rays and snow reflects 80 percent of the sun's rays.
4. How much sunscreen should be used, and how often should it be applied?
Sunscreens should be applied to dry skin 15-30 minutes BEFORE going outdoors. When using sunscreen, be sure to apply it to all exposed areas and pay particular attention to the face, ears, hands and arms. Coat the skin liberally and rub it in thoroughly - most people apply only 25-50 percent of the recommended amount of sunscreen.7 One ounce, enough to fill a shot glass, is considered the amount needed to cover the exposed areas of the body properly. Don't forget that lips get sunburned too, so apply a lip balm that contains sunscreen with an SPF of 15 or higher.
Sunscreens should be re-applied at least every two hours or after swimming or perspiring heavily. Even so-called "water-resistant" sunscreens may lose their effectiveness after 40 minutes in the water. Sunscreens rub off as well as wash off, so if you've towel-dried, reapply sunscreen for continued protection. Also, while there are a number of combination cosmetic products, such as moisturizers that contain sunscreen, it is important to remember that these products also need to be reapplied to achieve continued UV protection.
Read The Entire Article | |
|
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. |
|
|
