The Fraxel laser is a relatively new machine that is utilized to improve upon almost all of the skin surface issues. When we talk about the surface of the skin particularly of the face we are talking about acne scars, we are talking about wrinkles or rhytides, we are talking about brown spots, various pigmentary changes, spider veins, rosacea, and things like that. Now the Fraxel is relatively revolutionary in that it can improve upon all of those issues of the face with minimal to no downtime never creating any raw surface. Some of the older treatments like the older CO2 laser resurfacing or the deeper chemical peels were relatively difficult to deal with as a patient because they create a raw surface and a lot of downtime. What is unique about the Fraxel is that it does not have the downtime or the intimidating recovery that some of the older procedures had. At the same time, it really corrects all of the surface problems of the skin. The other thing that is unique about it is that we are able to treat areas off the face such as the neck, the chest, the hands, and the forearms with a Fraxel laser and we could not treat those areas with older techniques that were creating a raw surface and healing issues, so the Fraxel laser is really a revolutionary new treatment to the skin on all parts of the body.
There are a number of other different surgical procedures that can be done on the face besides facelift. Very commonly the other procedures are done in conjunction with facelift or on the other hand done individually or if the facelift itself is not needed. Those basically run the gamut of blepharoplasty either upper lid blepharoplasty or lower lid blepharoplasty. If an individual has droopiness or descent of their forehead and brow tissue, we can do a brow lift. There are number of different types of brow lifts with minimal incisions. A rhinoplasty or nasal surgery is very commonly done if people have fullness to the dorsum or dorsal hump area, if they have problems with the tip being not well refined. Other procedures are facial implants, primarily cheek implants or chin implants. Sometimes liposuction to the face and/or the neck is done in combination with facelift procedure.
A very common concern of a lot of patients prior to a facelift procedure is that they will end up looking like they are walking around in a wind tunnel or have this unnatural plastic overtight appearance to their face. That really is not a phenomenon that people have to worry about. I think we have all seen individuals that walk around and look like that, but with a well done facelift and elevation of the underlying soft tissue countering what gravity has done over the years that really should not be a concern of anyone.
There are different degrees of face lifting procedures. Obviously that would depend on how advanced the aging process is. The earlier type procedures that we are doing on patients are short incision or mini facelift procedure. That is typically when incision is located either to just the temple area or the area in front of the ear where we are not having to carry the incisions back behind the ear. As the aging process continues and more laxity begins to occur across the jaw line and the neck then we often are talking about a more full facelift procedure which entails incisions both in front of the ear as well as behind. All those incisions are well hidden and minimally visible.
The term facelift is rather broadly encompassing. With the aging process of the face there is various degrees. The aging process really starts in the 30s and continues progressively from there. Some of the early phenomenon that we see are things such as droopy skin of the upper eyelids, some puffy bags or fat pockets of the lower lid, those would be some of the earlier changes. As time progresses, what we will typically see is some hollowing out or descent of some of the soft tissue of the central cheek kind of reducing the appearance of the high firm cheekbone. Again as the aging process continues beyond that, some things that we see are early gelling or laxity along the jaw line, deepening of the nasolabial folds, and some laxity of the skin of the neck.
The results of liposuction are amongst the most rewarding. In liposuction we are typically treating focal areas of fat pockets that are either there genetically or persistently there after diet and exercise. These areas become somewhat of a frustration to people that have done their homework and been on a good exercise and dietary regimen. It is not uncommon after liposuction for a woman to go down two sizes in her clothes. That would be particularly in a case where there are certain limiters such as the hips or the lateral thighs. As I tell all my patients after liposuctions one of several things will happen, either the existing clothes fit much better or the individual can go down one to two sizes. It just depends on where they are starting from and where they end.
The recovery from liposuction is relatively easy. Of all the surgical procedures that we as plastic surgeons perform, it is probably the least uncomfortable. It is important to wear compression garments to enhance skin contraction and to reduce the length of swelling. I pretty much do not restrict activity after liposuction. Certainly, the first 24 hours one would want to take it easy and drink plenty of fluids. Beyond that, if it is not uncomfortable basically you can do it. If you are doing smaller areas and utilizing a SmartLipo recovery is even reduced further with minimal bruising, minimal swelling, and minimal pain. That is one of the unique features of SmartLiposuction.
Hi, my name is Dr. John Robert Leikensohn and I going to spend a little time talking about liposuction. This is an area that I feel very qualified to speak about.
I have been doing liposuction since 1982. I was certainly one of the first groups of doctors to be doing liposuctions. Most liposuction techniques are done using tumescent technique. This is where in fluid is infused. It is a mixture of a numbing agent and something to stop bleeding. During the year since liposuction has been started there has been a myriad of different types of liposuctions and what we use now is mainly fine small cannula liposuction either done manually or with what we call a power assisted liposuction. Ultrasonic liposuction is also available for specific indications.
The newest and most exciting technique in liposuction is what is called SmartLipo. I am happy to say I have the fourth SmartLipo machine in the United States and probably the first in Florida. We also serve as a training center for other doctors who would like to learn how to use SmartLipo. SmartLipo is a laser assisted lipolysis where through a 1 mm incision which is very tiny, a laser guided cannula is inserted and the fat cells are literally blown up. Following this, we usually remove any particulate matter with just a regular fine liposuction cannula. The advantage to this is in selected cases you can also get a certain degree of skin tightening from this, so I feel at the Plastic Surgery Center this is one procedure that both Dr. Scott and I offer the most modern up-to-date methods available.
Amongst the plastic surgical procedures that I perform, liposuction is one of the most rewarding from my standpoint and from the patient’s standpoint. Typically the individual is getting liposuction as certain areas that are rather frustrating they are relatively refractory to diet and exercise and liposuction is the final procedure that can bring those areas down proportionate to the rest of the body.
Tummy tuck procedure is a procedure that we would not want to minimize as far as the recovery goes. When we are tightening the abdominal wall to improve upon the poochiness of a tummy, one has a moderate amount of discomfort. Today, we use a pain pump system which are basically small little catheters placed in the operating room on top of the tightened muscular connective tissue layer and through those little catheters we infuse local anesthetic or numbing medicine which really has revolutionized the recovery of a tummy tuck today. I would go out on a limb and say that the pain pump system that we use today is the best thing since life spread when it comes to tummy tuck. It has reduced the recovery time, improved the activity after the tummy tuck, and has really been revolutionary.
