Tuesday, September 9, 2008

Slim Evidence for Effectiveness of Cellulite Treatments

smooth shapesPlenty of people would be glad to take your money and give you cellulite treatments. But there’s not much high-quality evidence that the effects of any treatment will last more than a few hours or days, the WSJ reports.

Most treatments use some kind of massager that makes the tissue swell. The temporary swelling eliminates the dimples that characterize cellulite. But when the swelling goes down, the dimples come back.

FDA approval for the devices used in the treatments is based only on fleeting results; the agency doesn’t evaluate how long the change lasts.

New treatments add a laser or some other energy source that’s supposed to have an effect on the fat cells under the skin, but there’s no proof that this improves long-term outcomes.

“There’s nothing that has been shown in any objective way to create improvement for cellulite,” Robert A. Weiss, president-elect of the American Society for Dermatologic Surgery, told the WSJ.

Wednesday, September 3, 2008

Breast Enhancement

While my wife was reading her 800 page Vogue, I happened to glance over and see an ad for the BRAVA breast enhancement system. For years the back pages of women’s magazines have had these types of ads and uniformly breast enhancement pills, creams, and other products do not work. What makes this interesting is that the BRAVA system does work. It has legitimately been studied and published in academic plastic surgery journals. It is a vacuum/suction device placed on the breasts and it does stimulate the breast tissue to grow. However, it requires months of use and will only increase the breast size a small amount. It might work well if you have a party coming up, but for long term, bigger, better results breast implants are still the best option

The PULL procedure

One of the most difficult and highly visible areas of the body to loose fat and excess skin in is the pubic area. In some cases, people are genetically predisposed to a sagging “pouch” in the pelvic. In other cases, due to pregnancy or extreme weight loss, the abdomen fails to return to its original shape. In an attempt to “fix” this area of the body, some people are hitting the gym, while others are turning to plastic surgery to achieve their desired look. While body contouring works well to eliminate many of the unsightly sags in the abdominal area, some patients have skin sagging in the pubic area as well. The excess skin—or pannus—that hangs down from the abdomen isn’t effectively treated with liposuction or a tummy tuck.

I have created my own technique for targeting sagging skin in the pubic area. I call this procedure PULL (Pubic Undermining Lift and Liposuction). It is a combination of skin and fat excision in the upper pubic area combined with liposuction of the lower pubic and surrounding areas. Two small incisions are made in the pubic area (near the bikini line). First, liposuction is done to remove excess fat in the area. Then the incision is enlarged and the skin is lifted and pulled to create a smooth appearance. The excess skin is cut away and the skin lines are closed.

The PULL procedure can be performed alone or in combination with a standard tummy tuck or a body lift. The procedure takes 1-2 hours and is done either in a hospital or “surgicenter,” and patients are generally sent home that same day. There is very little bruising afterwards and most patients recover within a few days with almost no down time. The scar is easily hidden in the same crease as a standard tummy tuck. The scar itself extends only over the pubic area.

The PULL procedure isn't just for weight loss patients. Many people are becoming self-conscious about sagging skin in the pubic area. But most significantly, the PULL technique is a safe and effective way to rejuvenate this area without resorting to genital surgery. With the emphasis on low-cut fashion, the PULL procedure may benefit these patients, as well.

Welcome to Beauty lies....

I thought the best way to start is to post some of the articles that I've written for some of the beauty magazines in the past. Many of you have requested reprints so in this age of modern media it is easier to just post a blog. As many of you know, there is too much disinformation out there in too many beauty publications driven by way too many publicists. It has been my goal to provide my patients and audience with an honest and thoughtful opinion about plastic surgery. At the same time I hope to entertain my audience and provide a laugh and a glimpse into the life of a plastic surgeon. Thanks