Have you been browsing physicians’ websites looking for a plastic surgeon? You may have noticed that some medical doctors have a string of letters after their name beyond the basic MD. FACS is the designation for Fellow American College of Surgeons. The ACS was founded in 1913. It is an organization that is committed to maintaining high standards for surgical care and ethics among its members. You can see the extensive application process for accreditation here. Education and advocacy for both surgeons and patients are primary goals of this professional society.

Fellows Believe in Volunteering

The ACS also promotes and facilitates volunteerism through Operation Giving Back. This humanitarian program matches doctors with medical facilities and patients to whom they can offer such services as reconstructive surgery. San Diego is home to the Fresh Start Clinic where surgeons can volunteer their expertise in such specialties as ophthalmology, otolaryngology, and general plastic surgery. Children and young adults from the U.S. and locations all over the world are frequently recipients of these donated services.

On the show Good Morning San Diego, plastic surgery news is delivered by Dr. Robert Singer that dispels one of the common misunderstandings about procedures done on teens. According to Dr. Singer, even though there has been an increase in cosmetic treatments performed on minors over the past few years, most of these are not surgical in nature. Statistics can be misleading because less risky procedures such as laser hair removal and microdermabrasion for acne are lumped in with other, more invasive operations.

Corrective procedures such as rhinoplasty, breast reduction (on both teen girls and boys), and otoplasty (ear pinning) are still some of the most common surgical procedures performed on patients under the age of 18. Breast augmentations and liposuction for body sculpting are rarely undertaken unless there is a medically indicated reason to do so. It appears that trained, board certified San Diego cosmetic surgeons are not getting carried away with their scalpels when it comes to treating teen patients – that’s just another urban legend that has caught the imagination of the public.

It’s important to remember that plastic surgery before and after photos only show you one aspect of the results of a procedure. This is true even if they are taken with an eye toward the highest level of clinical accuracy. That’s because a picture usually only shows you a static view of the outcome of plastic surgery. Botox is a perfect example of why this can be problematic.

One of the top complaints some patients have about these injections is not about how their face looks at rest. The ability of Botox to relax lines in the face and restore a younger appearance is very satisfactory. It’s facial movements that can sometimes look unnatural. That’s not something you generally see in a testimonial photo since the focus is on the reduction of the wrinkles in the forehead. However, the “frozen face” look is an effect that is pointed out in lots of tabloid photos claiming that this or that actor/actress has had the treatment.

Alternatives to Just Looking at Pictures

That’s why it can be helpful to actually talk to someone who has had a recent Botox injection. Then, you can see for yourself whether they retain the ability to express a range of emotions with their facial muscles. Also, take a look at videos posted of patients before/after the procedure to see the types of changes you might expect to experience yourself.

Often, the extent to which side effects occur has to do with the quantity of product used and where it is injected. This is something to discuss with your specialist prior to having this type of plastic surgery. Botox does wear off over time, so at least you don’t have to worry about permanent effects. However, if you are cautious about whom you trust with your face (by choosing a board certified plastic surgeon), you are more likely to get good results on your first visit.

With arm lift surgery, there is no avoiding some scarring. The procedure involves removal of excess skin, so there will be a line where the two edges of the incision are drawn together. It typically runs from the elbow to the armpit. This line isn’t always straight – it may be jagged depending on where the surgeon needed to cut to most effectively excise sagging skin and fat. The degree of scarring doesn’t just depend on the skill of the brachioplasty surgeon. San Diego patients who have this procedure done after massive weight loss, those who smoke, and those who don’t follow proper after care procedures are at increased risk of unsightly scars.

On the bright side, this scar line is not necessarily visible when the arm is at rest. It can also be covered by wearing a blouse that has an elbow length sleeve. With a knit shirt that has 3/4 length sleeves, it is possible to show off the new contour of the arm without being self conscious. For most patients, the scars will fade some over time and become less noticeable. However, scar revision is sometimes recommended if they remain unsightly.

A Fraxel laser is a fractional laser that is used to slightly damage specifically targeted areas of facial skin. The goal of the treatment is to trigger the body’s normal healing process so that the freshly restored skin will give a youthful appearance to the face. It is often used to treat scarring, discoloration, and fine lines. Laser treatments may also be used in conjunction other rejuvenating cosmetic products such as Retin-A or Juvederm. San Diego plastic surgeons who are experienced in skin restoration know when and how to combine these various treatments for the greatest overall improvement in a patient’s appearance.

There are several different Fraxel models available from the manufacturer. Two are non-ablative lasers (meaning they leave the outer layer of skin intact) and one is an ablative device that breaks down all the skin cells it strikes. The ablation treatment is the most aggressive choice and is frequently used for resurfacing facial skin that is significantly acne scarred. The other non-ablative treatments are intended to address skin tone, discoloration, fine lines, and overall texture.

What Do Patients Think of the Fraxel Laser?

Patient reviews regarding satisfaction with this treatment tend to be mixed. Some patients are dissatisfied with what they feel to be minimal results and distressed by the discomfort of the procedure. Others are worried about changes in their skin that occur several months after a skin rejuvenation session and may or may not be directly related to the Fraxel treatment. Many patients are delighted with the results and enjoy having a smoother skin tone.

There are a number of side effects experienced by patients who are treated with a Fraxel laser.  Swelling and redness are the most common. However, some people also experience acne breakouts, infection, and other issues. Many of these side effects are treatable and generally resolve over time. Using sunscreen faithfully and avoiding too much UV exposure is one tip doctors recommend for all patients who have undergone facial laser treatments. Failure to follow this advice may lead to ongoing problems with uneven pigmentation.

For many cosmetic surgery candidates, scar removal is a top priority – especially if the scarring is located on their face. Acne scars are some of the most common imperfections that people want corrected. Patients also seek treatment for scars that resulted from accidents (or prior plastic surgeries). The type of procedure required to minimize or remove the affected tissue depends on the type of scarring present. Scars may appear raised or recessed and are often pigmented differently than the surrounding skin.

For facial scarring caused by acne, many plastic surgeons and dermatologists recommend a chemical peel, laser resurfacing or dermabrasion treatment. San Diego patients may also be advised about the use of steroid injections for raised (keloid) scars. Revision cosmetic surgery is sometimes required to correct scars that occurred as the result of poor healing or hyperactive scar formation after an operation. However, people who are prone to scarring may experience a recurrence even with the best of care.

Having a gastric bypass operation is a life changing experience – in more ways than one. This surgery radically alters the way a patient’s body processes food. It doesn’t just restrict the amount a person can eat (like banding does). The Roux-en-Y procedure causes food to bypass a significant portion of the small intestine. Sometimes, this operation results in complications such as:

• Gallstones and/or kidney stones
• Difficulty staying adequately hydrated
• Vitamin/mineral deficiencies
• Low blood sugar
• Inability to tolerate certain foods

Even with a successful surgery, the first 6 months after the procedure may be marked by:

• Vomiting or pain if too much food is eaten at one sitting or if it is eaten too quickly
• Changes in mood
• Dry skin and loss of hair
• Flu-like symptoms including aches and pains

Of course, the most well known effect of gastric bypass is that it causes patients to lose a great deal of weight – often very quickly. Many patients require plastic surgery after weight loss. San Diego bariatric patients should be aware that this part of their recovery is not generally covered by insurance. They will have to pay out of pocket for corrective procedures to remove excess skin and reshape their body so it looks normal again.

Smart Lipo (SmartLipo™) is the brand name of a trademarked line of laser-based liposuction machines manufactured by a medical device company called Cynosure. The name SmartLipo also refers to the technique that is followed when using the equipment. This type of liposculpture is performed as an outpatient procedure under local anesthesia. This approach combines the tumescent liposuction method – which is preferred by most plastic surgeons – with the use of a patented Cynosure laser.

Product/Technique Features

This procedure is somewhat similar to ultra-sound assisted lipo; but it uses a burst of energy from a laser instead of vibrations from a UAL device to rupture fat cell membranes. The fat may then be suctioned out using a cannula. In cases where only a small quantity of fatty tissue is destroyed, it may simply be absorbed into the patient’s system and not require suctioning.

In addition to affecting fat cells, the laser is also designed to target the small blood vessels in the treatment area. This causes fast coagulation. Along with the epinephrine in the tumescing solution, the laser is thought to help minimize bleeding during and after the procedure. A shorter than average down time is one of the benefits claimed by proponents of the SmartLipo system.

Depending on the wavelength selected, the Smart Lipo equipment may be used for removing large quantities of fat, providing minor skin tightening, or both. Since this is a highly targeted device (much like UAL), it is often advertised as useful for lipo procedures on small, delicate areas of the body. This may include the face and the neck area underneath the chin.

Additional Considerations

Of course, the skill and experience of the cosmetic surgeon plays a major role in both recovery time and aesthetic results. The Smart Lipo website points out that patients may need to wait 3 months to a year to see the final outcome of this procedure depending on the extent of the surgery. So, evaluating the results should be done after the patient fully recovers to judge whether a follow up session is required to make any corrections. Bear this in mind when you are reading liposuction testimonials. Those from patients who have waited to see the long-term effects of the procedure are likely to be the most accurate.

Whether your natural skin color is light or dark, having an even skin tone is an indication of health, youth, and beauty. When uneven pigmentation occurs (especially on your face), this detracts from your overall appearance. Understanding some common causes of blotchy skin can help you determine whether or not to get a chemical peel treatment. San Diego dermatologists and cosmetic surgeons who specialize in procedures to improve the tone of your skin can assist you in identifying which of the following conditions you might have.

Sun Damage

This is one of the most common causes of uneven skin pigmentation. If you don’t wear sunscreen regularly when you spend time outside, this can cause cumulative damage to your skin that may show up as age spots. Chemical peels are often prescribed for patients with UV damaged skin.

Hormones

Pregnancy and some medications that affect hormone levels may cause dark blotches on your skin (this is called melasma). These may fade after childbirth or when you stop taking the medication that is causing the hormone fluctuations. Hyper-pigmentation of this type may or may not be improved by a chemical peel depending on how deep the melanin is in the skin.

Allergies

Allergic reactions and auto-immune conditions can cause your skin tone to be very uneven. In these cases, treating the underlying problem is important. Some patients with skin allergies don’t respond well to a chemical peel and may wish to ask about alternative solutions.

No discussion of plastic surgery would be complete without an acknowledgment that sometimes, things can go terribly wrong. The following cosmetic surgeon horror stories demonstrate that taking risks can end in tragedy:

Surgery Abroad

If you live in San Diego, you may have read the news about the horrific experience of Lourdes Trinidad – a California resident who took a quick trip across the border to have liposuction. She ended up paying with her life for this plastic surgery vacation. The surgeon allegedly disappeared after the procedure instead of providing proper aftercare.

Botched surgeries and complications are a very common experience for patients who have procedures performed outside their home country. Remember that plastic surgery testimonials are only part of the picture and fully vetting a surgeon’s experience and credentials is critical. This is easiest if you are investigating a plastic surgeon in your own country.

Bargain Basement Prices

Author Grace Gold, writing for “Style List”, has collected a gruesome array of stories about cheap surgeries gone wrong. Generally, there is a reason that a physician chooses to steeply undercut the competition. Usually, this is because his or her lack of credentials and training makes it impossible to compete for patients who want high quality work and are willing/able to pay for it.

Gold also points out that qualified plastic surgeons may sometimes offer deeply discounted prices by taking on an unreasonable workload. This isn’t good for patients since surgeon fatigue can increase the risk of mistakes.

So, play it safe and stay away from “slashed” prices – whether at home or abroad.