Question:
I have a burn on my lower face on one side. It is over a year old now. What procedure do you think is best for reducing this scar, dermabrasion or the laser resurfacing? Will the pinkness of the scar go away after the procedure?

Answer:
Scar revision for skin burns can be very challenging.  Burns of the face are difficult to camouflage and revise for obvious reasons.  The most important thing is to let the scar mature which you have done.  The size of the scar, meaning the surface area and not just the length will also play a role in how the scar can be revised.  Dermabrasion or laser resurfacing may be used to decrease the appearance of the scar, but, I would have to see the scar to really know what we are dealing with.   The pinkness of the scar will fade over time, but, only to a certain degree.  I would be happy to see you in consultation so that I can more thoroughly evaluate your scar and decide the best course of action.

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Question:
I have seen some online pictures of results with SlimLipo and I am amazed. I have a double chin. Can this procedure be done on the face?  Can some of the fat be removed from my cheeks at the same time?

Answer:
SlimLipo can absolutely take care of your double chin.  The procedure can also be used to address some excess fat around your jowls if that is what you are referring to.  The great thing about SlimLipo is that it will not only remove fat, but, SlimLipo will also tighten the skin giving you a slight lift.  I am fairly conservative in my approach to fat removal of the face and really like the added benefit of the skin tightening that SlimLipo gives.

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Question:
I was planning to get a facelift this past year but now I lost my job. What types of non-surgical facelifts do you do? Is this a lower cost alternative to the facelift?

Answer:
I am truly sorry to hear about your job.  I have been doing lectures around the country and get to see the status of the economy in other regions and have spoken with my colleagues with regards to their own personal experiences.  In Washington, DC we are somewhat insulated because of the large proportion of government employees. The economic condition around the country is slowly starting to recover, but, nowhere near where the economy needs to be.  One of the biggest motivators for my patients seeking cosmetic surgery is so that they look better as they are re-entering the job market.  I have been performing a great deal of dermal fillers to the face that help to fill in the face if it appears deflated.  In the right candidate, these fillers give you a lifted appearance by filling out the face rather than tightening and removing skin.  There are alternatives to a full facelift if that is what you have been seeking, but, I am afraid that the non-surgical alternatives to a facelift for those individuals who will only benefit from a full facelift are disappointing and expensive.  I would be happy to see you in consultation to see if you are a candidate for a MACS lift, mini-facelift  and possibly combine dermal fillers with your treatment, and we can determine whether the results that you are seeking can be achieved without the cost of full surgical intervention.

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Question:
My mother wants a complete facelift.  I think she is too old for this operation. I worry that she won’t heal and I am also concerned that she will have a lot of pain. She is 77 years old. Can you tell me what she has in store for herself after the surgery in terms of the pain and being able to take care of herself?

Answer:
I have taken care of a number of patients well into their 70’s for full facelifts and other procedures.  You are smart for doing some of the research for her and especially focusing on the safety issues related to a facelift as well as the outcome.  Although your mother is 77 in chronological age, I am certain that she simply does not feel “77″ and when she looks at the person staring back at her in the mirror she is a little confused and perhaps a little depressed.  Simply, she has the desire to look as young as she feels.  Facelifts should be performed in such a way that when the healing has taken place, you should look refreshed, younger, but, not different.  Although a facelift requires a great deal of surgery, the recovery from the procedure is actually not as difficult as one would think.  Pain is generally not an issue.  Pain medications are given for discomfort, but, most patients do not experience significant pain.  I use a pressure dressing following surgery, and this can be uncomfortable but, not painful.  I change the original dressing to a smaller one on the first post operative day.  Your mother can expect bruising and swelling of the face and neck following the procedure but, this will subside over one or two weeks post operatively.  I would suggest staying with her for several days following surgery, but, I really like my patients to be up and ambulatory the first day following surgery.  She will likely be able to take care of herself after a few days, but, it is nice to have someone around until I see her the for her second postoperative visit.

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Question:
I have too much skin in my neck that seems to cover my chin. I would like a weekend neck lift but I would like to have it done under local anesthesia.  I hope this is possible. Do you actually cut off the extra skin? Where do you make the incision?

Answer:
Too much skin in the neck is a common problem we see as we begin to age.  A combination of things occur that lead to the appearance of excess skin in the neck and chin.  Skin ages and stretches as we get older.  A combination of sun exposure, genetics, and possibly smoking all contribute to this.  We also see a loss of volume in the neck and chin area.  We lose fat as we age and this fat is what keeps the skin for appearing loose and deflated.  A weekend neck lift may be a little bit misleading as the recovery period for an isolated neck lift is relatively quick, but, you will be required to wear a neck dressing for about a week following the procedure, but, will not be in significant discomfort.  To answer your question more specifically, depending upon the amount of excess skin you have in your neck and chin region, it is likely that the skin will be cut and removed.

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Question:
I have fat fairly evenly dispersed all over my body but it is really only the arms that I care about. I would like liposuction on my upper arms. I am 67 years old. Do you think that the skin will retract and tighten?

Answer:
The SlimLipo procedure is a wonderful procedure that exceeds the expectation of my patients.  I spend a great deal of time with my patients so that they understand not only what SlimLipo can do for them, but, in many cases, what SlimLipo or any other liposuction procedure cannot accomplish.  Although SlimLipo will definitely tighten the skin surrounding the area that fat was removed, there are definite limitations.  It is not a procedure that is a substitute for surgical excision of skin if you are really a candidate for the brachioplasty procedure.  SlimLipo will definitely help tighten the areas if loose skin is not the only issue and it is more of an issue of fat in your upper arms accompanied by some excess skin.

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Question:
I am pretty excited about SlimLipo. I have wanted liposuction for some time, but hated the thought of sagging skin afterwards.  I know SlimLipo tightens the skin and I am ready for the procedure. How many days should I take off work for recuperation? I am getting my arms and thighs done.

Answer:
I am happy that you are excited to have the SlimLipo procedure.  It is really a fantastic procedure.  It will not only remove the excess fat of your thighs and arms, but, it will also tighten the skin so that you do not have a great deal of redundant loose skin following the procedure.  One of the keys to our patients satisfaction with the procedure is that we establish realistic expectations with the procedure.  It is important to realize that SlimLipo or any liposuction technique is not a substitute for diet and exercise.  Nor is SlimLipo going to tighten your skin to the same extent as surgical excision of your skin if you are a better candidate for that.  If you understand these concepts, you will not be disappointed in your results.  The greatest advantage with the SlimLipo procedure is the relative ease of recovery you will have compared to traditional liposuction procedures.  Patients having their thighs done are generally up and around the day of surgery and can return to work in about 2 days with some discomfort.  Your arms, however, will take longer for you to heal.  The muscles are very sensitive and although you will feel comfortable following your procedure, you will have upper arm soreness for several days.  I would suggest avoiding driving for several days following the procedure until you are comfortable with mild strenuous activity using your arms.  Compression garments will be worn on your upper body, hips, and thighs for about a week or possibly two following your procedure.

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Question:
Botox worked wonders on a friend of mine. I know that he gets injections every few months. Does this treatment continue to work forever, or do the wrinkles reach a stage where surgery is recommended?

Answer:
Your question with regards to Botox is a good one but, not a simple answer.  In the doses that Botox is administered for cosmetic treatments, there have been no reports of muscle resistance over time to the Botox treatments if you have always responded well to Botox treatments.  Some of the areas such as a drooping brow, or sagging at the corners of the mouth, which are addressed very nicely with the use of Botox, will continue to droop as we get older and at some point the effects of Botox treatments to these and other areas will not really give you the result you were getting several years earlier.   It is not that the Botox has stopped working but, rather you are likely a candidate for surgical correction of these problems.

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