The other day I was riding my bike through the beautiful Carpentaria country side, and met a fellow rider with whom I began to chat. We discussed bikes (of course), and my upcoming wedding plans, and then ventured into a discussion of plastic surgery in Santa
Barbara. She asked some excellent questions about facial anatomy and the changes that come along with the aging process. She also had questions about specific areas, and in particular the vertical lines on the forehead which we call “glabellar frown lines”. I explained that the quick and easy way to treat these were with Botox and this was done very commonly. I was interested to hear her response, however, which was concern about Botox as a “poison” that would make you sick.
It is not infrequently that I have this type of conversation in both the professional plastic surgery as well as the casual setting, as classic teaching is that botulism toxin, which Botox is made from, is poisonous when ingested in large doses (as from bad food). This substance is poisonous because it paralyses many muscles in your body when ingested in large quantities. When refined and used in miniscule amounts with specific placement, as we do with injections of Botox in my plastic surgery office, this toxin does not affect the entire body- only the individual muscle that it is applied to. By paralyzing the very small muscle that contracts just under the skin, the Botox injection prevents the contraction of that muscle and therefore prevents the wrinkle in the skin overlying that muscle from appearing. In this application, Botox is therapeutic, and not poisonous at all.
Lots of research has gone into development and purification and safety of Botox. I would not use it on my patients if I had reservations about it, and it ranks highly as one of the most satisfying patient therapies short of surgery. We must remember that like so many of the medications and even vitamins that we take, the proper dosing of the therapy is key. Too much vitamin A can kill someone if taken in overdose amounts. Similarly with Botox, the right dose, indication, and application by a certified professional are key to a safe, youthful appearance.
We have an exciting new announcement! Dr. Lowenstein and Dr. Sheffield have partnered with The Santa Barbara Institute of Aesthetics- S’Bia Medical Spa. S’Bia is the premier medical spa in the central coast, with fantastic services to augment your plastic surgery experience at the Montecito Center for Aesthetic Plastic Surgery. Patients of Dr. Sheffield and Dr. Lowenstein will now benefit from special referrals on a great variety of Spa Services including:
New patients of Dr. Lowenstien and Dr. Sheffield will enjoy a free one our consultation with Laurie Grizzard for an evaluation of skin care needs and establishment of a therapeutic regimen of anti-aging care, in addition to one free treatment. Evaluations may include recommendations of dietary changes and supplements, medical grade skin care with Obagi or other medical grade products, and preparatory recommendations to optimize your aesthetic surgical experience. Following surgery, ongoing evaluation and recommendations will provide a maintenance plan to help sustain and enhance a youthful appearance and healthy lifestyle. We are extremely pleased to offer these services to our plastic surgery patients, and anticipate a fantastic experience for you. This multi-dimensional approach to beauty and health will provide the most complete, comprehensive program of anti-aging in the California Central Coast.
It seems that more and more and more surgeons are performing breast augmentation in the same techniques that Dr. Sheffield and I have been proponents of for quite some time. The dual plane breast augmentation seems to be gaining favor by many plastic surgeons around the country. On of the most respected breast surgeons in the world, Dr. Dennis Hammond, is a friend who has been kind enough to participate on my panel at the ASPS meeting for two years running. He and I additionally share responsibility for much of the educational program at the ASPS meeting pertaining to surgery of the breast, and I have the highest opinion of Dennis as a great, thoughtful surgeon and educator. He is also a proponent of the dual plane approach for many patients, and like me, believes in an individualistic approach to breast augmentation and breast lifts. Breast implants should be chosen on the basis of individual patient anatomy, including length and width of the chest wall and torso, as well as specific patient expectations. (more…)
I’ve just returned from the 2008 meeting of the ASPS- thousands of plastic surgeons converged in Chicago last weekend to discuss the latest trends in plastic surgery, as well as issues of patient safety and improving plastic surgery outcomes for patients around the country and the world. I had the pleasure of being involved with two of the most popular programs, one of which I’ve been asked to put together now for I think the 6th year running. We discussed issues ranging from wound care to breast augmentation, breast lifts, breast implants, body contouring, facelifts, and eyelid surgery. I had the opportunity to teach by sharing my thoughts, while hearing from some of the world’s experts about their recommendations and experiences. Having previously served on the Board of Directors of the American Society of Plastic Surgeons, I also had the great opportunity to see many of my friends from around the country, and help mentor some of the younger, up and coming plastic surgeons. On top of that, I got to do some shopping on Michigan Avenue, and have some fantastic Italian food. And then there was that amazing Chicago style hot dog at O’Hare airport….. ☺ I’ll try to include some of my thoughts about some of our discussions over the next few blog entries, and I’ll limit my thoughts to plastic surgery instead of pasta and hot dogs.
Next week is the national meeting of the American Society of Plastic Surgeons which is in Chicago this year. This is the largest national forum for plastic surgery, and a great educational opportunity for everyone who comes. I haven’t missed one of these meetings in nearly 10 years, and every time I learn something new. As I’ve matured in my practice, I’ve had the opportunity to go from student to teacher in various forums, and I’m very much looking forward to this year’s programs. I’ve been asked to once again present a panel that I’ve been doing now for 6 years, called “Fresh Faces, Real Cases”- this is one of the most popular events of the meeting, and as director and moderator for this panel, I’ve put together a great program that should produce some very good discussion on breast augmentation, breast lift, body contouring, lower extremity reconstruction, breast reconstruction, and neck lifting. The breadth of the subject matter makes this one of the most enjoyable parts of the week for me, and the opportunity to interact with hundreds of plastic sugeons at one setting is a real highlight. Additionally I will be involved with another aesthetic panel, as well as several of the events involving the YPS (Young Plastic Surgeons) Forum- a subdivision of the ASPS which I used to head up when I was younger…. oh well. As the grey creeps into my head of hair, I’m less eligible to be seen as one of the young crowd.
Beauty for Life is a fantastic source of plastic surgery information, developed by the ASPS/ASAPS joint Cosmetic Medicine Task Force. This program has been designed to help you learn about procedures that can help you meet your personal beauty needs, at any age. By clicking on the link above, you can download the information to review on your computer, and feel free to discuss your thoughts with me during your appointment in Santa Barbara.
Last Friday I got to attend a course on the new soft tissue filler- Evolence. This is a Johnson and Johnson product that consists of cross linked collagen, which is a natural protein that makes up much of the connective tissue of the body. The advantages of this product seem to be many, but the primary thing that strikes me is that Evolence seems to last at least 6 months as opposed to the hyaluronic acid products like Restylane and Juviderm. (more…)
In about 2 weeks I’m going to attend a course which will allow me to use a new soft tissue filler made by Johnson and Johnson- it is a cross-linked collagen product for moderate to deep wrinkles and folds and is supposed to last AT LEAST 6 months. Only a plastic surgeon who has attended this seminar will be able to get and inject the Evolence product, so it is not something that will be easy to find in the run of the mill medical spa. I don’t anticipate that this will replace the other plastic surgery injectables that I use such as Radiesse and Juviderm and Resylane, but I do think for certain situations, this new product should be pretty fantastic. Give us a call or send us an email to schedule an appointment if you think this type of plastic surgery injectable soft tissue filler is something you might like to have.
I was looking through a newspaper this week and came across an ad for a “cosmetic surgeon” and his face lift using a laser, with before and after photos. The photos were interesting- a rather dramatic result was shown, with the caption “before face lift” and “after face lift”. Examining the photos a bit more carefully, I noticed a couple of classic tricks that advertisers can use… Firstly, in the “after” photos, the woman was wearing a significant amount of makeup- she was “dolled up” as my grandmother used to say. (more…)
