Indiana Plastic Surgery Blog

It’s common knowledge among surgeons that healthy patients – with a stable weight, who don’t smoke – see more successful results. That’s why they often decline to operate on a patient who is in a poor state of health as a result of risky habits. Such patients face a greater chance of complications such as delayed healing.

Those interested in cosmetic and facial plastic surgery should first go through a sort of ‘lifestyle makeover,’ modifying their habits until they have reached a goal of satisfactory health. At Indiana Plastic Surgery, we want our patients to have the best surgical experience possible, so we ask them to first focus on being healthy. The ideal patient refrains from smoking or using illegal drugs, has a stable weight, and realistic expectations about cosmetic surgery.

Contact us for a consultation and we can provide more specific information on health and surgery outcomes.

I love summer in Indiana!  It’s when we hit the beach, take the kids to the pool, barbeque with our friends, and enjoy the warm weather. Meanwhile, protecting your skin from the sun and choosing the right treatments can prevent premature aging to keep you healthy and looking your best. If you’re heading out for some fun in the sun, here are some skin management tips and rejuvenation methods that can keep you looking hot while you’re out in the hot sun.  

If your skin is in need of rejuvenation, a few microdermabrasion treatments each year can make a big difference.  Microdermabrasion removes the top layer of skin to reveal a fresh, healthy layer underneath. It also stimulates collagen production, which improves skin elasticity.  It’s an easy procedure that can reduce the appearance of fine lines, wrinkles and even some forms of skin damage.  If you use skin care products (we carry NIA24, Prevage, and PCA), it can increase penetration to make your regimen more effective.  For many patients, this combination of at-home skin care and microdermabrasion is all it takes to achieve smoother, more silky looking skin. 

If you exhibit age spots, zap them away with a laser or Chemical Peel. Rejuvenate your skin while reducing or removing age spots

Sunscreen is important any time of year, but especially during these hot summer months. Choosing the right sunscreen for your face – one that addresses your skin type and skin conditions – is not always easy.  Use a sunscreen every day. For days spent mostly indoors, use a foundation with an SPF15 or higher. For outdoors you want at least an SPF45 that is waterproof or water-resistant. The right sunscreen can prevent sun damage, skin problems, and even skin cancer.  Harmful UV rays can damage skin cells deep within the skin’s surface, making your cells vulnerable to toxins (free-radicals) in the environment.

Let us help you maintain the health of your skin. Come visit us at Indiana Plastic Surgery to find out which treatment will work best for your skin type; then look forward to looking hot all summer long!

In the recent past, we’ve seen many drugs make their way to the market inadvertently, becoming hugely popular for uses that were never intended; such is the case with Latisse, Allergan’s new eyelash enhancement drug.

Latisse was born out of a group of popular medications called topical prostaglandins, drugs frequently used to decrease intra-ocular pressure in glaucoma patients.  What optometrists labeled a ‘complication’ or side effect of using prostaglandins was “hypertrichosis,” a condition characterized by darkening, thickening, and lengthening of the eyelashes.

Allergan offered the topical prostaglandin Lumigan in 2001, a drug that contained the active ingredient bimatoprost. Two important precursors to Latisse occurred after the FDA gave clearance for Lumigan.

Jan Marini Skin Research Inc had over $2 million worth of product seized by the Food and Drug Administration.  The product, Age Intervention Eyelash, evidently contained bimatoprost, which was unapproved for cosmetic use at the time. Allergan later filed a patent infringement suit against Jan Marini and several other companies that had tried to market bimatoprost in their eyelash enhancing drugs.

Some doctors started prescribing Lumigan off-label to enhance eyelashes.  Knowing the desirable side effects it could produce. But Lumigan wasn’t formulated for cosmetic use and many believed more research was needed to confirm the safety of topical prostaglandins for cosmetic use.

Clinical trials and further research is exactly what Allergan Inc did.  In one early study, 278 healthy adults with minimal to moderate eyelash prominence applied bimatoprost or a placebo to their lash line.  The results were favorable; researchers observed that the average patient’s eyelashes were 25 percent longer, 106 percent fuller, and 18 percent darker, while only 3.6 percent experienced itchy eyes and redness, and only 2.9 percent experienced skin hyperpigmentation.

Latisse received FDA approval late last year for the treatment of ‘inadequate’ eyelashes.  Allergan now owns the patent on use of bimatoprost for eyelash enhancement.

For more information on Latisse in Indiana, contact us.

In order to increase her agility and hopefully improve her game, tennis player Simona Halep says she plans to undergo breast reduction surgery next fall.  

According to news sources in the UK, Ms. Halep complained that her large (34 DD) breasts have slowed her reaction time on the court and caused discomfort. “It’s the weight that troubles me – my ability to react quickly”, she told The Sun.

In 2008, Halep won the junior French Open.  She is now ranked 317^th in the world.  

Women pursue breast reduction surgery for a several reasons, increased mobility being just one of them.  One breast reduction patient stated, “Before I didn’t want to run anywhere, [not] even across the street. If something happened, I would not run.  It was painful and embarrassing” (Klassen 2009).  

Beside issues with physical activity, many women hope to alleviate irritation around their bra strap and underneath the breast, pain in the back and neck, and discomfort during sleeping.

The procedure is a sort of ‘normalizing’ experience for women.  After surgery, patients often say they are less self-conscious, they fit into more regular sized clothes, and that they typify what is perceived as the ‘normal’ female body.

For more information on breast reduction in Indiana, see this part of our homepage or contact us.

By now, doctors have established that Botox can help smooth out facial wrinkles and folds, but is that all?  Experts once believed that off-label use of the drug – one originally developed for treating muscles spasms – would be fairly limited. If you do a little research at the present time however, you’ll hear of physicians using Botox many interesting purposes.

Doctors use Botox to treat headaches, and their basic procedures are very similar to wrinkle treatment. It hasn’t been explained just how the Botulinum toxin provides relief; it may work to inhibit certain pain-transmitting nerves. Nonetheless, many people suffer from fewer headaches after being treated with Botox.

Last March, the New York Times published a story on the off-label use of Botox to help those who have suffered a stroke and have trouble relaxing certain muscles. According to the experts, “only about 5 percent of the stroke patients who could benefit from its use ever get it.”

As reported in the Journal of the American Academy of Dermatology, researchers from Allergan Inc. conducted surveys about sweating, revealing that almost 3 percent of the U.S. population (7.8 million people) believe their sweating to be excessive. At the time of the survey (in 2004), less than half of the respondents had sought medical help for the problem. Botox blocks the localized release of a specific chemical that stimulates sweating, and so the FDA approved it for this use years ago.

Aside from these therapies, surgeons and dermatologists are finding even more cosmetic uses for Botox. Dr. Lawrence Reed recently told an ABC news affiliate that “we’re at the tip of the iceberg where Botox is going to be used.” Reed has apparently been pioneering some interesting new cosmetic applications.

For acne, Dr. Reed injects Botox just below the skin: “It decreases the muscle pump and blocks the production of oils, so we use it for acne,” he claims. Other patients of Dr. Reed found success using Botox to relax certain muscles and actually make their eyes appear larger, and to supplement laser skin resurfacing.

Just a few words of caution: If you’re considering Botox for any off-label use, make sure you choose a qualified physician. Despite the optimism surrounding Botox as a ‘wonder drug’, there have been complications and side effects associated with off-label use and inexperienced providers.

A survey conducted by researchers from the American Society for Aesthetic Plastic Surgery (ASAPS) has given us some insight about patients who choose wrinkle treatments. Researchers sent questionnaires last March to 687 patients who had received Botox and/or dermal filler treatment. 

The following statistics illustrate the opinions of the ‘typical’ patient. Who is the ‘typical’ patient?  According to surveyors, she’s “a married, working mother between 41-55 years of age with a household income of under $100,000.”

70 percent of the respondents claimed that Botox and dermal fillers play an important role in their cosmetic routine and about the same number of patients said they had combined the two.

When asked what their motivation was for pursuing Botox treatment, 34 percent said their appearance looked “stressed” or “angry”. Others said that a friend, family member, or their physician had recommended it, or they were preparing for a social event. 66 percent said they received Botox treatment 2-3 times per year. 72 percent of the respondents chose Botox to treat glabellar lines – the vertical lines that appear between your eyebrows.  

When asked about their motivation to use hyaluronic acid fillers, the majority (63 percent) of patients reported a desire to remove facial wrinkles and folds – mostly the nasolabial folds that travel from the nose to each side of the mouth.

A full summary of the results is available (in MS Word) here.

Archives of Facial Plastic Surgery recently published a study featuring a medical performance and safety evaluation of Dysport, the new wrinkle-reducing, Botox alternative, marketed by Medicis Pharmaceutical.  The study focuses on use of Dysport for treatment of moderate to severe glabeller lines (forehead wrinkles), and the results appear mostly optimistic.

The FDA has given clearance for the drug, and it should become available very soon.  Dysport is being introduced by Medicis with the hope that it will be a direct competitor to Botox – a product that allowed Allergan Inc. to net $1.3 billion in revenue last year.

A dermatologist out of California who participated in the study commented to Bloomberg news, saying “the side effects are the same as Botox” and “many of our patients liked it even better.”

The active ingredients in Botox and Dysport are very similar; they each contain a particular ‘botulinum toxin’ that has been proven to relax the muscles that cause wrinkles in the face.

Few people may realize that Dysport has been sold overseas for years.  Nonetheless, Botox has claimed over 80 percent of the worldwide market.  One market analyst speculates that “[Dysport] may be priced 15 percent lower than Botox” which could allow it to take a significant share of that market.

There are 3 main concerns women express about their skin:

 - Wrinkles

 - Age Spots

 - Sagging Skin

All of these conditions indicate premature aging due to sun damage. If you don’t address sun-damaged skin quickly it may lead to undesirable skin conditions later in life – conditions like uneven skin tone, sun spots and severe wrinkles.

Fortunately, we now have decades of research available on cell rejuvenation, skin health, and the roles certain ingredients can play in  this process. It is a proven fact that products containing the three key antioxidant vitamins – A (Retin, Retinyl, Retinoic Acid or Retinol); C (Ascorbic Acid); and E (Tocopherol), as well as the nutrient Niacin, accelerate cell turnover.

Vitamin A is beneficial in multiple ways; the most important benefit is probably the stimulation of collagen growth.  Vitamin C and E are super-charged rejuvenators, and the nutrient Niacin acts as a sort of damage control.  Together these components naturally rejuvenate by ‘turning on’ the cells that make collagen and elastin. When combined in a product, they can effectively treat signs of premature aging.

The TODAY SHOW recently featured the NIA24™ product line, which contains several of these potent ingredients. 

 One of the most important factors in skin health is retaining moisture and replenishing the water in our skin. NIA24™ deeply hydrates skin while also protecting against the environment.  It also reverses pre-existing skin damage by aiding body’s natural repair mechanisms.  The ‘power ingredient’ in NIA24™ is NIACIN.

Niacin prevents melanin production from reaching the skin to reduce unwanted pigmentation.  Once you start using NIA24™ new sun spots will stop appearing and exfoliation – the next important step in the process – will begin.  You will shed brown spots and sun spots, revealing the healthy, clear skin underneath. 

For more information on NIA 24 and other skin care products at Indiana Plastic Surgery, see our homepage here.

The New York Times reports that medical practices in Prague are offering free surgical enhancements to nurses as an employment incentive.  One nurse  interviewed had opted for breast augmentation and liposuction, free of charge.  

The piece raises some interesting ethical questions: While the procedures could certainly be beneficial to individual nurses in the short term, would such a practice harm the nursing profession as a whole?  

According to reporter Dan Bilefsky, nurses in the region “insist they are under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”  Critics argue that the incentives could promote an idealized body image for nurses, in a profession already suffering from misconceptions about technical competence.  A spokeswoman from the Czech nurses association suggests that nurses are still perceived as “low level workers” with little to offer besides manual labor.  Nurses after all, aren’t intended to be models, but caregivers that provide an enormous benefit to the medical profession and the public they serve.  A misplaced emphasis on their physical appearance could undermine public perceptions of their competence and value.

Still, others argue that there isn’t any problem with offering incentives through procedures like breast augmentation or rhinoplasty, claiming they’re analogous to employee discounts at a retailer, vacation packages, or other career perks.  

Perhaps the ethical problems brought by these incentive programs aren’t a product of the programs alone, but rather a product of the sexism and discrimination that underlie them.

Statistics from the American Society for Aesthetic Plastic Surgery reveal that for the first time, breast implants have surpassed liposuction in popularity.

The figures indicate that 355,671 breast augmentation surgeries were performed last year, compared to 341,144 liposuction procedures.

In a press release, ASPS President Alan Gold, MD comments that “for the first time in the twelve years these statistics have been collected, liposuction is a runner up in popularity to breast augmentation.”

Dr. Gold theorizes that “changes in fashion, i.e. décolletage baring styles, might be a factor behind this change.”

Of the 10.2 million cosmetic procedures undergone in America in 2008, 92 percent were had by women.

Last year’s top 5 surgical procedures are as follows:

1. Breast Augmentation
2. Liposuction
3. Eyelid Surgery
4. Rhinoplasty
5. Abdominoplasty

Last year’s top five non-surgical procedures include:

1. Botox
2. Laser Hair Removal
3. Hyaluronic acid wrinkle fillers (Juvederm, Restylane)
4. Chemical Peel
5. Laser Skin Resurfacing