Denver Cosmetic Surgery Blog.com

How long does a facelift last?

Dr. Steven Vath — Fri, 09 Mar 2012 21:30:48 +0000

When people are considering a facelift, they ask, “how long does it last?” This question baffles me. Not because it doesn’t make sense to me that people want to know an answer. And not because I am unaware of the evolution that occurs for my patients after facelift surgery. The question baffles me because I don’t know what they mean by ”last”. Everyone readily accepts the basic premise that lifting surgery is not permanent. No one contests the idea that the benefits of a facelift are slowly lost over time. Yet, people ask about the duration of the results and I don’t understand what measurement they would use to determine “last” versus “not last”. Sometimes, I start the answer by asking if they mean that “lasting” is the time period until they are back to where they were before surgery. Often, people will respond, “OK, sure- until then”. So I’ll oblige and reply that it generally takes 10 or more years to be back a pre-surgery state. I then quickly add that, within one month after surgery, no one cares what they looked like prior to the procedure. I say that it would be disengenuious of me, knowing how people react after a facelift, to pretend that this 10+ year answer means anything to patients after the procedure is over. People don’t remember what they looked like before surgery, nor do they care. So again, I ask what does “last” mean? The plastic surgery studies evaluate the gradual return of jowling, nasolabial folds, marrionette lines, and lax neck skin, in an attempt to rate the duration of facelift improvement. But this doesn’t help me answer the patients’ question because I still don’t know what they mean by “last”.

I believe what people are asking is, “when will I be dissatisfied with my appearance again?” And if I’m correct, their is no way for me to know when this will be, even if I’ve done the best face lift possible. The most honest answer is that a facelift lasts until a person doesn’t like the way he or she looks any more and there’s no way to predict which endpoints would create this personal conclusion. Therefore, we can’t know when the parameters will be reached for each person to deem the results, “no longer lasting.” If I do the exact same facelift on identical twins and they get the same results, they may have completely different perspectives on the duration of the improvement depending upon their individual mindsets. Even when I know precisely how my patients would look each year after a facelift, I simply can’t predict when they will no longer enjoy their results.

So how do I answer this puzzling question without getting overly-philisophical about the human condition? Just as I have done above. The benefits of a facelift are lost with time at a variable rate depending upon each person’s skin elasticity, etc. But the duration of happiness someone enjoys from their results is dependant upon a mindset that is only truly understood by each person, and me, after surgery. All I can do is turn the clock back in the most natural and safest way and hope that my patients find the experience rewarding for many, many years.

Dr. Steven Vath

Capsular Contraction: New solution

Dr. Steven Vath — Tue, 31 Jan 2012 23:53:55 +0000

Today, I saw a woman who has had multiple capsular contractions. This is a tough problem that only happens to a few percent of people that undergo breast augmentation. But when it does, it’s very frustrating for both the patient and for me. I genuinely want every patient with whom I interact to be happy and have no problems. But this just isn’t reality. Although I feel that I can keep complications to a minimum, capsular contraction is one that I just can not completely control. No plastic surgeon can. That’s why capsular contraction is one of the most prevalent topics discussed at national and international Plastic Surgery conferences.

After breast implant placement, the body forms a capsule (scar tissue) around the implant. It’s normally very soft and pliable, but in some people it hardens, thickens, and contracts. This is called capsular contraction. The prevailing theory behind this is based upon bacteria that incite the thickening; however, antibiotics provide no reduction in it’s incidence. The standard treatment is to surgically remove the capsule. There is no “scraping” involved. The scar tissue is meticulously dissected away from the surrounding breast tissue and removed. Then, the implant is replaced and generally, the contraction doesn’t redevelop. But in some people, it does. When someone gets recurrent capsular contraction, the management options are limited. In the past, completely removing the implants was the only definitive solution.

But now, there is another option. Strattice (TM) is a matrix of acellular, cadaveric, porcine, dermal graft. Basically, it’s re-engineered pig skin that can safely be used to drape around the implant and prevent capsular contraction. By placing it next to the lower portion of the implant, it does not allow the body to form the linear capsular scar that can tighten, lift the implant, and distort the breast. This is an exciting development. Although recurrent capsular contraction is the worst case scenario associated with breast augmentation surgery, it is no longer untreatable and the hope of implant preservation exists.

Dr. Steven D. Vath

3-D breast imaging is here

Dr. Steven Vath — Wed, 18 Jan 2012 00:31:37 +0000

The Center for Cosmetic Surgery recently purchased the Vectra 3-D imaging system. Our new web page all about it will be live soon. We’ve been using this new technology in consultations for several weeks now and it has made a remarkable difference in the educational process. This system captures multiple pictures of a person’s body and reconstructs a three dimensional image which can be rotated on the computer screen. Then, a virtual augmented preview of the breasts can be displayed, using any size implants. Primarily, it serves as a tool to enhance the discussion, gather valuable feedback from patients, and provide a better idea of the expectations from surgery. Mostly, people find it comforting to preview their after-surgery result from breast augmentation before the surgery even happens.

The world of plastic surgery is not as technologically driven as many may think. But this is one advancement that I am embracing. It fills a void in the consultative process around breast augmentation: it answers the frequently asked question, “What will I look like after breast augmentation surgery?”Although there was no way to answer this before, now there is. And patients are loving it.

Dr. Steven Vath

Black Diamond

Dr. Steven Vath — Sat, 14 Jan 2012 00:09:19 +0000

It’s not necessarily true that a surgeon who does a high volume of a certain procedure is very good at it. But it is true that a surgeon can’t be very good at a procedure unless he or she does a high volume. In line with this but at the risk of sounding as if I’m bragging about Dr. Wolfe and myself, I think it’s important that people searching for breast augmentation surgeons know that we are a Black Diamond account with the major and dominant breast implant manufacturer in America, Allergan. This means that we have been recognized for the large number of implants that we purchase from the company. And, I should add that we are their #1 account in their Northwest region, meaning we order more breast implants than any practice, center, or hospital in this large geographic area.

So, while this does not prove that you’ll receive the best care and the finest breast augmentation surgery at the Center for Cosmetic Surgery, our Black Diamond status with Allergan is one important factor that allows for us to be the best and may also be a result of the same.

Humbly,

Dr. Steven Vath

Buttock fat injections

Dr. Steven Vath — Tue, 10 Jan 2012 23:13:19 +0000

My practice manager and I were noticing that inquiries coming into the Center for Cosmetic Surgery regarding fat injections to the buttocks seem to be increasing. I’ll admit, fat injection sounds really cool: the ability to take your own natural fat and move it to another area of the body seems enticing. Furthermore, the plastic surgery studies largely support this treatment method to enhance the butt…. but, I’m not a supporter. The technique to properly inject fat into a body area is not rocket science. In fact, I did this procedure in the past with relative frequency and it’s easy to perform, but the results just weren’t good. So I stopped. I believe that the fat either gets absorbed by the body so that the benefits are temporary, or it leaves an unattractive lumpy contour. So, on issues like this, where I find myself disagreeing with some of the plastic surgery community, I go back to my common recommendation to prospective patients; search for pictures on the web. If something works well and doesn’t just produce the occasionial good outcome, plastic surgeons will post before and after pictures of the results all over the web in an effort to educate, and yes, sell what they do. And certainly for a procedure that has such huge and growing demand, if it’s successful, there should be ample proof. But I can’t find a wealth of impressive pictures. Case closed. Despite positive claims from many surgeons, and sporadic support in the plastic surgery literature, I do not believe that fat injection to the buttocks is a reliably good operation and do not recommend it to patients.

If anyone out there has had great results from this procedure, please share your experience with me. I’d love to hear from you. But for now, I still have to accept that plastic surgery does not have solution to every concern, no matter how enticing it sounds.

Dr. Steven Vath