Davis

Liposuction was the second-most popular cosmetic surgery procedure performed in America in 2018, behind only breast augmentation. And it appears to be gaining in popularity. Five percent more Americans had liposuction last year than in 2017.

But this isn’t the liposuction that you grew up hearing about. The more interest there is in a procedure, the more incentive there is to perfect it. That’s become the case with almost every kind of cosmetic surgery. As the stigma surrounding plastic surgery has fallen away, the new interest has given rise to widespread innovation.

Rapid evolution

In the case of liposuction, it’s felt most acutely because it’s a procedure that, for decades, didn’t really change much. We removed fat by sticking in a cannula and sucking—which made tunnels that could result in strange contours.

But there’s been so much evolution recently in the ways we remove fat that a technology that’s just a few years old can quickly begin to feel outdated. The cannulas got smaller and better. And in some forms of liposuction, instead of sucking out solid blocks of fat, surgeons are now melting it, which enables them to remove it more evenly.

The melting usually involves radio frequency or thermal energy emitted from a cannula. A new technique called BodyTite uses radio frequency in conjunction with liposuction to tighten skin. Before its arrival, surgeons could remove fat with liposuction, but if a patient had poor skin elasticity—which was just about everyone—they’d need a lift to remove the excess skin, which was a separate procedure.

BodyTite firms skin from 10% to 40%, which is enough to help skin bounce back if you’ve had 10 to 20 pounds removed with liposuction.

Rather than melting the fat, SafeLipo uses rapidly vibrating cannulas to emulsify it to the consistency of a smoothie, which allows it to be removed evenly and gently, without bleeding. Some of the remaining fat is then used as fat grafts, allowing the skin to be re-draped smoothly.

Smart surgery

Aside from better results, these new procedures are also enabling a much greater degree of precision. If, for example, your eyes go straight to a bulge of fat just outside your bra near your armpit every time you get dressed, a ping pong ball-size amount of tissue can be removed from that area under local anesthesia. Removing just that little bit can make a big difference.

The recovery is also garnering lots of new attention, driven largely by a concerted effort to discover and implement nonnarcotic (read: non-addictive) medications. One new slow-release pain medicine called liposomal bupivacaine can be injected during surgery and provide 48 to 72 of relief afterward.

So, think of liposuction as an umbrella term rather than a single surgery. And somewhere under that umbrella is a procedure that can help you achieve your unique goals.

The famous procedure of rhinoplasty sure hasn’t shown any signs of losing popularity. In fact, plastic surgery options for nose modifications have continued to be one of the most talked-about treatments in our Cherry Hill, New Jersey office.

Today on The Plastic Surgery Revolution, board-certified plastic surgeon Dr. Steven Davis explores the history of rhinoplasty. Dr. D also covers the evolution of this procedure, and the most common places patients tend to be treated.

We are proud to offer rhinoplasty as a specialty of ours here at Davis Cosmetic Plastic surgery. Would you like to see before and after photos from our patients? Take a look and see if this is the right procedure for you!

If you are interested in scheduling an appointment with Dr. Steven Davis, please feel free to give us a call or contact us here.

We look forward to speaking with you soon!

Thank you for tuning in to The Plastic Surgery Revolution on the evolution of rhinoplasty. If you would like more content, please check out our Youtube channel.

More Podcasts From Dr. Davis

[display-posts category_id=”10″ posts_per_page=”5″]

A breast lift always goes hand-in-hand with breast implants, right? Not anymore.

There are legions of women out there whose breasts sag, or maybe one breast droops a little more than the other, and they have zero interest in larger breasts. They just want them restored to what they used to be.

Until recently, their options would have been limited to a traditional breast lift, which helps, but only for a relatively short period. Now, plastic surgeons are turning to bioresorbable mesh scaffolds instead. It’s an absorbable mesh shaped like a demi cup that gives internal support to make breast lifts last longer. In clinical trials, patients are maintaining their results after almost six years. (For all the recent advances, none is capable of outlasting nature—not yet, at least.)

Internal support leads to longer-lasting results

Breast sagging is caused by a number of factors, including pregnancy and breastfeeding, changes in weight, high-impact exercise, aging, menopause, and genetics. In other words, life. These same factors can also cause the surrounding skin to weaken along with the breast tissue.

A traditional breast lift entails removing excess skin to tighten the surrounding tissue, which raises and firms the breast. The procedure’s popularity has risen an incredible 99% since 2000. But the result can be a bit disappointing, ultimately. Some of it is lost to gravity within weeks of the procedure. And after a year or two, even if the nipple stays high, the bottom part of the breast will begin to fall.

The idea of adding some internal support to help the traditional lifts last longer is not new. But earlier versions were prone to complications. The latest generation, however, of which there are several brands, is made of a polymer that breaks down naturally, a lot like absorbable stitches, but at a slower rate.

While the mesh dissolves over 12 to 18 months, collagen and elastin enter the scaffold and create a support system that’s three to four times stronger than the existing tissue. The procedure doesn’t change cup size, but it does result in higher, fuller breasts. Even more, unlike earlier versions, it’s completely undetectable to the touch.

Shape and proportion, now just size, matter now

A unique phenomenon has been unfolding over the last few years. As we’ve become more conscious of our appearance (thank you, social media), the stigma of plastic surgery has decreased sharply, all while the procedures themselves have gotten better. The breast lift is one instance. Breast augmentation, which is still commonly paired with the breast lift, is another.

Now, shape and proportion, not size alone, are what matter, which represents a significant paradigm shift in the way we’re approaching breast augmentation.

Today’s more anatomical implants are slightly fuller at the bottom than at the top. The most popular sizes are still relatively large, but they look more like real breasts. Beyond these new teardrop shapes, implants now also come in more sizes and widths, which allows the plastic surgeon to choose ones that uniquely fit each body.

While there’s a certain amount of artistry in every cosmetic procedure, it’s especially prominent in the breast lift and breast augmentation. The latest advances grant the plastic surgeon more freedom in that regard. And patient reaps the benefits, with results that are more in line with a subtle enhancement of their natural features.

The term laser has become a catchall for a very deep (and deepening) pool of plug-in dermatologic devices. But the truth is, they can function very differently. Many of these machines rely on different kinds of energy, such as ultrasound or radiofrequency, to achieve distinct effects.

A true laser—which stands for light amplification by stimulated emission of radiation—is characterized by a few key features, including its wavelength, which is absorbed by select targets in the skin, and its pulse width, or the rate at which that beam of light is delivered. Generally, the longer a wavelength, the deeper it penetrates (up to a point). And the faster a pulse width, the better it is for small targets.

Resurfacing lasers target water molecules within the collagen layer of the dermis. Heating the water creates a grid of what’s referred to as microthermal zones, which basically trick the skin into healing itself, triggering extensive repair and collagen production.

Lasers are being used to do pretty much everything these days, from erasing sun damage and wrinkles to rejuvenating tired-looking skin, and often with little to no downtime. Here’s a closer look at two of the most popular kinds.

Nonablative resurfacing lasers

Nonablative resurfacing lasers are the go-to treatment for moderate sun damage, melasma, and small scars.

The term encompasses fractional lasers and picosecond lasers outfitted with a special lens that essentially breaks up the beam. Rather than targeting lone spots, they cover widespread areas. Their main function is to refresh and rejuvenate by building new collagen, helping to smooth the skin, and getting rid of some of the pigmentation that comes with sun damage.

Nonablative resurfacing is appropriate for most skin types. As to which laser is right for you, it depends on what’s being treated. A mild fractional laser, like the Fraxel Clear + Brilliant, will provide a dramatic radiance boost, but only subtle textural improvements. On the stronger end of the spectrum, there’s the Fraxel Dual, whose wavelengths can correct significant, but not deep, UV damage on the face, neck, chest, arms, and hands.

The Dual’s 1927 wavelength is great for pigment, pores, fine lines, and even precancerous lesions, while its 1550 wavelength effectively treats deep wrinkles and scars.

With a mild resurfacer, the treated skin may be flush for an hour or so and a little dry for a day. With the stronger kinds, it’ll look red right after, then a little dirty for up to a week as the damaged cells are shed.

Ablative lasers

Ablative resurfacing lasers treat deep wrinkles, severe sun aging, and prominent scars.

These lasers act on water, too, but their higher energies, and the way in which they’re absorbed, generate greater heat, which creates a more purposeful wound on the skin’s surface than nonablative resurfacing, when the topmost layer remains intact. Ultimately, ablative resurfacing leads to even more collagen renewal.

It is a more intense process than nonablative resurfacing—in turn, it’s not recommended for dark complexions—but the latest generation of fractional ablative lasers are safer and more predictable than the old non-fractionated ablative lasers, with which depigmentation and scarring was a real risk.

That said, the downtime is still more significant than it is after a nonablative procedure. Plan on laying low for at least a week. There will likely be some significant swelling and scabbing, but the recovery