Wrinkles and sagging that appear on our face as we age aren’t just due to changes in our skin, according to a new study in Plastic and Reconstructive Surgery journal. These changes are also a result of age-related changes in our facial bones, the study found.

Researchers, led by Dr. Robert Shaw, Jr. of the University of Rochester Medical Center, analyzed computed tomographic scans that were performed for medical reasons of the facial bones for three age groups: young (age 20 to 40), middle-aged (41 to 64) and older (65 and up). For each age group, the scans of 20 women and 20 men were reviewed.

The measurements revealed differences in the facial bone structure between age groups. “The facial skeleton experiences morphologic change and an overall decrease in volume with increasing age,” the researchers wrote.

The study showed that the eye socket area became wider and longer in both men and women as they aged. Aging also caused reductions in bones in several areas of the face, including the:

• Brow
• Nose
• Upper jaw
• Lower jaw

While researchers observed the changes in both sexes, many of the changes happened earlier in women — between the young and middle age groups. On the other hand, in men most of the changes occurred between middle age and old age.

The researchers believe that by using techniques and materials for skeletal augmentation, plastic and cosmetic surgeons can have improved outcomes for facial rejuvenation. “Skeletal augmentation offers long-lasting rejuvenation of the facial skeleton and may be performed in conjunction with soft-tissue redraping,” they wrote.

Dr. Haiavy offers several facial rejuvenation procedures, including face lift, brow lift, cheek augmentation and eyelid surgery.

There are a wide variety of cosmetic procedures to keep your face looking young — from face lifts to Botox — but what about for the neck? A recent article in the New York Times says there are more options these days to improve the appearance of the neck area.

Botox injections in the neck muscle can make neck “bands” less conspicuous in a patient with great skin tone, said Dr. Rod Rohrich, chairman of the plastic surgery department at the University of Texas Southwestern Medical Center in Dallas. However, just like for the face, Botox requires upkeep, as results last about three to four months.

If the neck has too much fat, liposuction may be an option, especially if the person has elastic skin that can bounce back afterward.

A neck lift remains the best choice for a lasting fix, and it may involve one or both of the following procedures:

• Cervicoplasty to remove excess skin
• Platysmaplasty to remove or alter neck muscles

Surgeons say that men seem to get more isolated neck lifts than women, according to the article. “Usually with women, they are getting a face- and neck lift,” said Dr. Felmont Eaves, the president of the American Society for Aesthetic Plastic Surgery. “In men, we don’t have exact statistics, but it’s pretty common to see them come in just for the neck.”

“There’s no way a man’s neck, with all that tissue hanging down, can be graceful,” said Dr. Phil Haeck, the president of the American Society of Plastic Surgeons. He said he has done two neck-only lifts for every three facelifts in his practice this year.

Learn more about neck lift surgery.

Looking ahead to the New Year, the American Society for Aesthetic Plastic Surgery (ASAPS) spoke with cosmetic plastic surgeons from around the country to come up with a list of 2011 cosmetic surgery predictions.

Face Lifts & Facial Rejuvenation

One area where surgeons believe there will be growth is in face lift surgery. As they economy improves, the demand for face lifts will increase, as those who have been waiting to get surgery may be ready in 2011.

Body Contouring

As more people realize the health dangers of obesity, more will turn to bariatric surgery for weight loss. As a result, the number of patients seeking cosmetic surgery procedures for body contouring after weight loss will also increase. These procedures include tummy tuck, breast lift and body lift.

Injectables

Already the most popular non-surgical procedure according to ASAPS’s 2009 statistics, injectables will continue to grow in popularity as they evolve and new options become available. Wrinkle fillers such as Botox, Dysport, and Juvederm are just a few of the options available for today’s consumer.

Buttock Lifts

According to the Society, celebrities like Kim Kardashian and Beyonce have made a shapely rear a “must-have accessory.” It predicts that in coming years patients will be seeking more “posterior body lifts, buttock lifts, and surgical and nonsurgical buttock augmentations to shape and augment their buttocks.”

Fat Reduction

While liposuction will remain the gold standard in surgical fat reduction, ASAPS is predicting change in this area of cosmetic surgery. New non-surgical techniques will continue to be developed, including freezing, zapping and lasering fat, as possible alternatives to surgery.

Avoid Cosmetic Surgery “Bargains”

Unfortunately, the Society also predicts consumers will look for bargains on cosmetic procedures. Procedures, such as “discount injectables” bought overseas and cosmetic procedures performed by untrained practitioners will lead to an increase in negative cosmetic surgery experiences, which can be avoided by researching your cosmetic surgeon.

What is the LAP-BAND®?

The LAP-BAND® is a small, adjustable, flexible stomach band that limits the amount of food intake and therefore leads to significant weight loss over time.  The advantage of the band is that it is usually performed laparoscopically (with the help of small cameras and minimal incisions), does not involve any stomach or intestinal stapling or re-routing and it is reversible.

Who is a candidate?

FDA just recently voted in favor of expanding the use of the LAP-BAND®.  The proposal would lower the LAP-BAND® requirement to a BMI of 35 or higher, or as low as 30 with one related health problem.

Here is a picture of one of our acutal patients who has lost 118 lbs so far.

Click on the picture to read Kym’s story

How does the process work?

At Surgical Arts of the Inland Empire, we work closely with a bariatric surgeon, nutritionist and other health care professionals to help our patients through the whole process.  The patient is evaluated by our bariatric surgeon who educates them about their options.  Most PPO insurances may cover the procedure.  The surgery takes about an hour and performed on an outpatient basis.

The success of the procedure is dependent on appropriate adjustment of the band as well as lifestyle modifications.  Usually on average, patients lose about a pound per week.

What’s Next?

I see many patients that have lost significant amount of weight either by diet and exercise, the LAP-BAND® or bypass procedure on a weekly basis.  They have transformed their lives and are healthier but still feel trapped in the old body because of the excess loose skin left in the tummy, arms, breast or thighs.

We address their concerns by tailoring a treatment plan specific to the problem areas.  The most common procedures for post-massive weight loss patients are: Tummy Tucks, Body Lifts, Arm Lifts, Breast Lifts and Thigh Lifts.

Learn more about post eeight loss body contouring.

You can call us at 909-579-3111 for more information or to see if your insurance may cover any of these procedures.  Surgical Arts of the Inland Empire is our fully accredited surgical center located at 8680 Monroe Court, Suite 100, Rancho Cucamonga.

An interesting study was recently published in the Canadian Journal of Plastic Surgery that compared physical characteristics and implant details of women who underwent breast augmentation in three different geographical locations: Kelowna, British Columbia, Canada; Loma Linda, California; and Temple, Texas.

Because of the increase in breast augmentation surgeries — according to statistics from the American Society of Plastic Surgeons, there has been a 45% increase in women seeking breast augmentation since 2000 — the researchers wanted to look at the demographics of these patients, as that’s often been lacking from other studies.

A hundred consecutive breast augmentation cases were retrospectively reviewed at practices in each of the three cities. The authors gathered data on height, weight, body mass index (BMI), age, the number of children the patient had and implant volume.

For weight, BMI and implant volume, the three group medians were significantly different. BMI was lowest in the Canadian city and highest in Temple, Tex. Temple patients had the smallest average implant size, significantly lower than the other two cities.

In addition to comparing geographies, the study also reveals data for all 300 patients combined. On average, the breast augmentation patients studied were:

• 34 years old
• 5’ 4” tall
• 128 pounds

The study also found there was a statistically significant positive correlation of BMI and implant volume in the U.S. cities — the higher the patient’s BMI, the larger the implant volume used. The researchers wrote, “Implications from this correlation found in our study include possibly improving implant volume predictions preoperatively, leading to improved efficiency, outcomes and reduced reoperation rates.”

They also say that the patients’ BMI could potentially provide an additional data point on which to make operative planning decisions.

Dr. Haiavy performs breast augmentation surgery and is one of the few surgeons in Southern California to perform the transumbilical (belly-button) breast augmentation.

An FDA Advisory Committee has recommended with an 8-2 vote that the FDA extend the currently approved use of Allergan‘s Lad Band® System, used for weight loss surgery, to patients that have a body mass index of 35 and above.

The Lap Band, an inflatable silicone tube that is placed on the upper portion of the stomach and effectively limits food intake and suppresses hunger, is currently indicated for patients with:

• BMI of 40 or higher
• BMI of 35 or higher combined with a health problem such as diabetes or high blood pressure

The change would make the Lap Band available to patients who have a BMI of 35 or higher and patients with a BMI of 30 or higher and at least one weight-related health problem.

The FDA committee’s decision came after a five-year study of 149 obese patients treated with the Lap Band that found over 80 percent lost at least 30 percent of their weight after a year.

According to an msnbc article, the FDA will make a final decision on the wider use, but the agency typically follows the advice of its advisory panels.

If granted wider usage, millions more people could be eligible for the Lap Band weight loss surgery. About 15 million Americans are candidates under the current guidelines and about 27 million more fit under the broader group, Allergan said.

To learn more about the Lap Band surgery or to discuss whether you might be a good candidate, contact Inland Cosmetic Surgery to schedule a consultation.

A recent article in the New York Times documents the expanding work schedules of dermatologists, cosmetic surgeons and other professionals who offer aesthetic treatments. Their columnist writes, “In most major cities, if you want pad Thai or a sweater dry-cleaned when most people are sleeping, there’s someone who will take care of it (for a price). These days, the same is true of beauty treatments.”

When it comes to simple beauty treatments, it’s not necessary to be open and available to patients at all times, but your doctor or aesthetician may be more flexible than you think.

Dr. Neil Sadick, an dermatologist in NYC, says his busy patients have been asking for early morning and late evening appointments; “Patients used to be able to get out of work when they wanted to, but things have changed,” so he has also changed, adjusting his office hours to be more convenient. Dr. Sadick mentions another reason to stay open longer: intense competition among doctors in the area. In New York, being available will set a doctor apart from the regular 9-5 crowd.

Extended hours may be expected in the city that never sleeps, but is it true here in Rancho Cucamonga? In many ways it is, according to Dr. Haiavy.

The doctor says: “We always strive to accommodate our patients. Knowing that some are busy with their work and careers, we do offer late hours on Wednesday and on request.  We also have a group of patients that need to be seen early in the morning.  I have seen patients and done Botox as early as 6 a.m. For patients traveling to the Inland Empire from out of town, we do offer services on the weekend.”

“Our Aesthetician Marlene comes in to do permanent makeup and skin care on some Saturdays.  We also have events outside the office at local salons that have extended hours for patient convenience. My patients always come first and they can reach me on my cell or pager anytime of the day or night. That has been my philosophy and attitude from the start.”

Read the article “Beauty House Calls in the Wee Hours“

Hyaluronic acid fillers, such as Restylane and Juvederm, are effective at correcting smile lines, and a new study shows they also favorably affect the first impression you make on others.

The Chicago Center for Facial Plastic Surgery conducted the study with 22 participants who received injections of hyaluronic acid fillers into their nasolabial folds. Photos were taken of the patients’ faces in a relaxed pose at baseline, optimal correction visit and four weeks after optimal correction.

Then 304 evaluators completed a survey rating first impressions in several categories for each photo. Over 5,700 first impressions were recorded.

The findings indicated a significant improvement in mean first impression in several categories at the optimal correction visit. The categories included dating success; attractiveness; financial success; relationship success; athletic success; and overall first impression.

The authors wrote in their conclusion, “Full correction of the nasolabial folds with hyaluronic acid filler significantly and positively influences the first impression an individual projects.”

Commenting on the study, dermatologist Dr. Kenneth Beer wrote, “When used correctly, they [hyaluronic acids] help restore more youthful proportions. For women, this includes higher cheekbones, fuller temporal areas, and more sculpted facial features. Hyaluronic acids may also be used to camouflage the bone loss associated with menopause and its loss of reproductive capacity. Transforming a postmenopausal face into one that has the features of a premenopausal face will have a profound effect on first impressions.”

The study appears in the November issue of the Dermatologic Surgery journal, and the abstract is available for free online.

There were an estimated 200,000 bariatric surgeries performed in 2009, according to the Endocrine Society. As the number of patients undergoing weight loss surgeries continues to grow, the society saw the need for standards of care following these procedures, so they created a task force that has published guidelines for post-op bariatric surgery follow-up and monitoring.

The seventeen recommendations were published online in the Journal of Clinical Endocrinology and Metabolism by the task force that was headed by David Heber, MD, PhD, of the University of California Los Angeles.

The task force recommends that clinicians should:

• Monitor bone density and serum nutrient levels after bariatric procedures that can reduce nutrient absorption.
• Consider vitamin and mineral supplements for all patients who’ve had weight-loss surgery.

The guidelines also recommend that patients’ postoperative diets should that include 60 to 120 grams of protein per day immediately after surgery and for long-term nutritional management.

The task force wrote:

“To guide patients through the transition to life after bariatric surgery, a multidisciplinary team that includes an experienced primary care physician, endocrinologist, or gastroenterologist should provide care, and patients should consider enrolling postoperatively in a comprehensive program for nutrition and lifestyle management.

“Such support can ease the transition to life after bariatric surgery and may help prevent weight regain.”

The task force also recommended that patients be monitored clinically for nutrient deficiencies; the guidelines included a symptom list for deficiencies in six major vitamins and minerals.

They also called for a more rigorous study of diabetes and other metabolic disorders in bariatric surgery patients in order to obtain better data on long-term outcomes and possible complications.

The abstract is available online at the journal’s website. Inland Cosmetic Surgery offers lap band surgery and post bariatric body contouring procedures.

New research found that bariatric surgery patients had a significant improvement in memory function three months after surgery. The study was conducted by Gladys Strain, PhD, director of research for laparoscopic and bariatric surgery at Weill Cornell Medical College, who says that bariatric surgery’s effects on cognition have not been well studied before this.

Strain’s study compared 120 bariatric surgery patients (most with gastric bypass and some with lap band) and 60 obese patients who did not undergo surgery. Patients were tested for attention, executive function, memory and language skills before and after surgery, within a 12-week period.

There were no changes for attention, executive function and language skills during the three-month period. However, there was improvement in memory among the bariatric surgery patients, which was not found in the comparison group.

While it’s not clear why the patients’ memories improved, Strain speculates it could be because of a decrease in depression after weight loss surgery. “Bariatric patients have an increased incidence of depressive disorders and anxiety and sedentary lifestyles,” Strain explains. As they lose weight, that depression may lift, perhaps explaining the improvement in cognitive skills, she says.

Read more about this study on WebMD.