Today I had a patient come in for liposuction, but like most Santa Barbara residents, she has a very active lifestyle. Â We talked about the fact that liposuction results in nearly complete fat evacuation, but requires somewhat intense postoperative care, with a compression garment and a lack of excessive physical activity for a few weeks.
CoolSculpting, on the other hand, reduces the fat in the area treated by about 20% per treatment- a noticeable and significant improvement. Â Areas treated with CoolSculpting can be treated a second time if necessary, effectively removing nearly 50% of the fat in the area treated after both treatments. Â The big advantage here is the recovery, which is minimal. Â Since patients can return to vigorous workouts and physical activity the day after the procedure, CoolSculpting is very popular here in Santa Barbara. Â Additionally, since there is not a requirement for compression dressings afterward, that aspect of recovery is also more pleasant.
It is important to keep in mind that CoolSculpting, while an excellent way to reduce pockets of fat, is not necessarily a substitution for liposuction. Â Patients with generalized fat that does not collect in discrete regions will benefit more from definitive liposuction than CoolSculpting. Â Certain areas, such as the buttocks and lateral thighs, are much better treated with liposuction and we see excellent results in such patients.
Please feel free to call the office at 805-969-9004 to make an appointment to discuss which is right for you- CoolSculping or Liposuciton in Santa Barbara.
The nasolabial folds, sometimes called the nasolabial crease, is a highly misunderstood region of the face that gets a lot of attention in facial cosmetic surgery. Since the increased popularity of soft tissue fillers exploded with the aesthetic enhancement of the lips, many practitioners have taken to injecting the areas of the nasolabial folds in an attempt to make them disappear.
While injection of soft tissue filler into the nasolabial folds can helps soften their depth, it demonstrates a misunderstanding of how the fold develops and what its causes are. When we “fill” an area with an injectable such as Juviderm or Restylane, we usually do so in an attempt to add volume to an area that is deficient or has shrunk. In the nasolabial area, however, there is never a loss of volume causing the crease. In fact, you can see that even babies and children have nasolabial folds…
The nasolabial crease itself is not a sign of aging. For the same reason, a puffed out, over-filled nasolabial fold that has been treated with excessive injectable does not produce a youthful, or even natural appearance.  Why is this?
In fact, the nasolabial folds appear worse as we age because the cheek above and lateral to the fold falls downward as we get older. Like the skin and tissue in the area of the jowl and neck sags progressively over time, the cheek tissue falls over the nasolabial region, causing a worsening shadow in the crease. The fix for this problem is not to fill the area below the fallen tissue, but instead to lift the cheek back to its youthful position. Just as a Santa Barbara face lift repositions the facial tissue to eliminate excess in the jowl and neck, the cheek lift recreates the natural youthful appearance by returning the cheek tissue to its rightful place. The cheek lift enhances the soft tissue over the cheek bone, where this tissue was found in youth, and removes the fullness from the lower cheek. The result is a youthful appearing mid-face with less wrinkling and less shadows in the upper and lower cheek region. This is why this procedure is often referred to as a mid-face lift.  I will be very pleased to discuss the Santa Barbara cheek lift with any prospective patient- the minimal incisions that are required and the excellent results that are seen make this operation one of my most popular enhancements in facial plastic surgery.
Congress is currently debating a 5% federal taxation of users of cosmetic medical treatments like you. As a plastic surgeon, I urge you to oppose this tax for several reasons outlined here.Please get involved!
The tax is punitive and places an additional burden on the middle class – According to the American Society of Plastic Surgeons (ASPS), sixty percent of patients considering a cosmetic medical procedure are squarely in the middle class, earning between $30,000 and $90,000 per year. This tax would come on top of increased payroll and income taxes sure to result from health reform’s $849 billion cost, and would penalize those who have made a well-educated and informed decision in consultation with a specialized physician to opt for cosmetic medical treatments.
The tax discriminates predominantly against women – Data from the ASPS shows that 91 percent of patients seeking cosmetic medical procedures are women.[1] And many of these women are seeking treatment to improve their appearance to enhance their self-image and self-confidence which helps them succeed at work and in other areas of their lives.
The tax does not serve the goals of health reform – President Obama has stated that the goal of health reform is “to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country.” Since these procedures are generally not covered by insurance, the proposed tax will not reduce the cost of health care nor will it reduce insurance premiums. Further, it will increase administrative costs for physician offices.
The tax puts cosmetic procedures in the same category as cigarettes and alcohol – So called “sin taxes” on cigarettes and alcohol were imposed to try to change unhealthy behavior and cover the significant costs that these products placed on the health care system. This is logical. But a tax on cosmetic medical procedures is illogical because they are healthy and merely a responsible form of self-improvement. Furthermore, these procedures do not impact the heath care system since patients pay for these procedures themselves and they are not covered by insurance. People should have the freedom to decide what is best for their personal health care, including their own aesthetic appearance and therefore be free to correct, alter or enhance their appearance responsibly, in consultation with a physician, without being forced to pay an extra tax.
The tax will be impossible to effectively and equitably administer – It is not clear which procedures will be subject to the tax and which will not.   The line between “cosmetic” and “reconstructive” surgery is not always clear and leaves the decision of medical necessity up to tax auditors- a completely inappropriate proposition.  Further, the same procedure performed on two different patients could lead to different conclusions concerning application of the tax.
The tax discourages innovation and promotes dangerous and unregulated alternatives – Because only drugs and procedures regulated and approved by the Food and Drug Administration (FDA) will be subject to the tax, manufacturers may choose to circumvent FDA regulation to avoid the tax. Further, patients may seek untested and potentially dangerous treatments from unlicensed practitioners to avoid the tax, including seeking treatment across our borders and overseas.
For all these compelling reasons, IÂ urge you to help stop the cosmetic tax.
You can express your opposition to this tax proposal by reaching out to your local Senator by calling 1-877-221-8207 or visiting the American Society of Plastic Surgeons website at www.plasticsurgery.org. The time to act is now– the Senate is currently debating the bill, so please voice your concerns today.
“Tanning beds have been ranked alongside cigarettes, arsenic and asbestos as posing the greatest threat of cancer to humans by an international cancer research group.”- from a Reuter’s news article last week.
Skin cancer is finally being recognized as the significant cancer that has significant morbidity and even mortality. Â The chief culprit to cause this problem is radiation from the sun, but for those that just can’t get enough sun in the outdoors, the tanning booth has been the go-to option. Â Finally reports are surfacing that have tagged the dangers of this increased radiation exposure.
Many plastic surgery patients, particularly here in California, and PARTICULARLY here in Santa Barbara, are sun worshippers. No doubt that the sun in moderation is a good thing- even psychiatrists have reported that the sun is the general basis for light therapy and is good for both the mood, as well as converting precursors to Vitamin D which helps your bones with calcium. Â BUT, too much of a good thing is a bad thing, and excessive exposure to the radiation of the sun, which is really what a tanning bed emulates, provides a high risk for skin cancer.
Such radiation can be a causal factor in basal cell cancer, as well as squamous cell cancer, and additionally the more deadly melanoma. Â But for those more aesthetically inclined, I remind them that even the conditions that are pre-cancerous, such as actinic keratosis, are sun related, and these spots need to be treated too. Â The treatment for the minor cancers, as well as many of the pre-cancers, may be invasive enough to cause permanent scarring, and nobody wants extra scars on their face. Â Since the face is one of the most exposed areas on the body- this is often where the lesions manifest themselves.
The take home message- we are gifted in Santa Barbara and most of the rest of California to see the sun in the sky so much of the year, but SUN SCREEN IS A MUST!!!! and….. TANNING BOOTHS ARE A MUST NOT!!!!!
I’ve finally been persuaded to put up a Facebook page for our office, which you can find HERE. I’m seeing more and more questionable information out there, and so I think that the tools of social networking may be an excellent way for patients to have access to us, and additionally allow patients to be made aware of things going on in the world of plastic surgery in Santa Barbara and Montecito. Through Facebook, I’m hoping to be able to make people aware of things going on at the office, and special situations such as our “Fillers for Firefighters” event which you can read about below. So visit our Facebook page, become a fan, and keep up to date!!!!
