The overall number of cosmetic procedures in the U.S. decreased by 2 percent in 2009, according to statistics just released by the American Society for Aesthetic Plastic Surgery.

According to the society, surgical procedures like breast augmentation, liposuction and abdominoplasty decreased by 17 percent, while non-surgical enhancements such as Botox and Juvederm increased by 0.6 percent.  “Plastic surgery is feeling the effects of the recession, just like many other sectors of the marketplace,” said ASAPS President Renato Saltz.

The ASAPS survey tabulated responses from 928 board certified physicians to compile the procedure data, which is useful for understanding trends.

Breast Augmentation the Top Cosmetic Surgery in the U.S. for 2009

For the second year in a row, Breast augmentation was the most frequently performed plastic surgery with 311,957 procedures performed. Surgeons have suggested several reasons for the procedure’s continuing success.

In the Wall Street Journal, Dr. Renato Saltz suggests that there may still be some excitement about the reintroduction of silicone gel breast implants.

Dr. Bruce Genter, a Philadelphia plastic surgeon, agrees and says it could also be the relatively quick recovery time of breast augmentation and the “immediate gratification” that patients experience. Also, “there is an overall upbeat aura about breast augmentation that is not pervasive in other cosmetic surgical procedures,” says Genter.

Statistics show another possible reason: the favorability of breast augmentation among younger women.  For patients 19-34 years old, breast augmentation was the top surgery, while patients age 35-50 chose liposuction more frequently.

More 2009 data will be publicized in the coming weeks from other surgery societies, so it will be interesting to compare their findings and discuss the cosmetic trends that emerged during the recession.

A plastic surgeon on the west coast has been talking publicly about his patient’s harrowing story of workplace violence, hoping that breast implant manufacturers will contribute supplies for the reconstructive surgery she needs.

Lydia Carranza’s breast implant deflated when she was shot in the chest last summer – an incident that claimed the life of her co-worker and left her with disfiguring scars.  When a man opened fire in the dental office where she worked, Lydia was shot twice: “The bullet fragments were millimeters from her heart and her vital organs,” said Dr. Ashkan Ghavami to the Los Angeles Times.

According to a firearms expert interviewed for the story, the deciding factor between life and death for Lydia may have been the presence of her saline breast implant.  Of course he goes on to tell readers they should not get “breast enhancements as a means to deflect a possible incoming bullet.”

Read the entire story on LATimes.com

An NPR broadcast this morning discussed the importance of exercise for aging people. As people get older they lose muscle mass, meaning your body weight can stay the same but your percentage of body muscle decreases.  Muscle repair also becomes much slower during your “golden years.”

Carrying muscle means burning calories,  affecting your weight, health and body shape. Cheryl Phillips, president of the American Geriatrics Society Cheryl Phillips says “aging muscles actually contribute to the increase in the amount of fat we store in our bodies.”

What should you do about it?  Before you get out of your chair and start doing yoga, listen to the program online to learn more details about “why we gain weight as we age.”

• Link: National Public Radio

Although the tummy tuck is a common “post-bariatric body contouring” procedure, the discussion of it typically revolves around female patients. Men can actually undergo a tummy tuck as well to finalize their weight loss results and remove excess abdominal skin.

Male patients are less likely to be aware of this cosmetic procedure and may even feel embarrassed to inquire about it; such was the case with one man who documented his tummy tuck on a blog. He says he perceived a “stigma or shame associated with male tummy tucks,” that made him hesitate when inquiring about the operation.

Plastic surgeons can offer gender-specific advice about procedures like this.
On realself.com, a male member asks about skin laxity on his abdomen due to weight loss:

I’m dealing with loose skin after a 50 lbs weight loss in my teens. I’ve totally transformed and I’m very athletic with well-defined abs, but have laxity mostly below the navel and around the lower back. The problem areas are very localized and I hide it under the belt line with no one suspecting I was obese. But I feel “unfinished.” The front skin is very thin and hangs, the back is mostly smooth. Is there a tummy tuck technique that would excise the abdominal skin and provide modest tightening in the lower back?

Christopher Hess MD, a plastic surgeon in northern Virginia responds: “Even though we tend to have better skin tone than women, we can still end up with excess skin due to skin memory. It sounds like you could undergo a mild excision of the excess tissue– less than a mini tummy tuck.”

When a man has achieved a greater weight reduction, the full tummy tuck may be recommended. “Do not hesitate to use a full abdominoplasty for a male patient with extreme skin laxity. Men tend to heal better than women after abdominoplasty,” advises Tulsa cosmetic surgeon Angelo Cuzalina.

Others agree: a comprehensive approach may be necessary for some male patients. Dr. Alan Matarasso, scientific editor of Aesthetic Surgery Journal, commenting in the publication Cosmetic Surgery Times says “you really need to treat [men] circumferentially, all the way around, because if you ask most men what bothers them, it’s the ‘love handles,’ and that goes all the way around to the back.”

For men, tummy tuck surgery might be discussed less frequently, but it is clearly performed on a regular basis. If you think you are a good candidate, ignore any perceived “stigma” and ask for the information you need.

Dr. Samaha is the first plastic surgeon on the South Shore to offer the Axis Three 3D portrait system, the imaging system that helps you visualize the results of your procedure.

Now, instead of comparing before and after photos of people who vaguely resemble your body type, you can visualize the results on your own body.

This is a really useful tool for the consultation process. Most plastic surgeons with the device are using it as a visual aid for educating patients about breast augmentation, but the technology is also developed for many facial plastic surgery procedures.

• Read more about Axis Three 3D portrait with Dr. Samaha

Abdominoplasty, known more commonly as a “tummy tuck,” is one of the top five most requested cosmetic surgery procedures in the U.S. It removes excess skin and fat from the middle and lower abdomen, tightening the muscles of the abdominal wall, and repositioning the navel to recreate a taut, youthful looking abdomen. For individuals who have a sagging, protuding abdomen, the results are often very satisfying.

Q: What’s the difference between a mini tummy tuck and the traditional tummy tuck?

With a full abdominoplasty, stretch marks from pregnancy can usually be eliminated, as well. If a significant amount of fatty tissue is involved, liposuction is often combined with abdominoplasty, in order to further sculpt the abdominal area and attain an optimal result.

The mini abdominoplasty is sometimes called the “scarless tummy tuck.” It’s also referred to as a partial abdominoplasty or a “mini tummy tuck,” This procedure is a simpler variation of abdominoplasty surgery, and is an excellent option for those who have only a small amount of excess fat and minor skin sagging below the navel area.

During a mini abdominoplasty procedure, excess fat and loose skin are removed and the skin is drawn downward and sculpted into place near the edge of the pubic hairline. As with a full abdominoplasty, the mini tummy tuck is sometimes combined with liposuction to achieve an optimal result, and the mini abdominoplasty requires less surgery time and a smaller incision.

Q: Where is the incision placed with a mini abdominoplasty?

A: A mini tummy tuck incision is typically placed along the edge of the pubic hairline. You should be able to wear a two piece swimsuit and clothing that reveals your mid-section with no problem.

• Read more about tummy tuck surgery in Boston

Saturday’s broadcast of Sirius Doctor Radio featured a program called “The Dean’s List: A Decade in Medicine,” outlining the major medical breakthroughs that occurred during the past decade.  Host Dr. Andrew Brotman of NYU and other physicians discussed these breakthroughs in depth, some of them directly related to plastic surgery.

Along with the procedure, drug, and medical discovery of the decade, The Surgery of the Decade was “Minimally Invasive,” including advanced techniques that utilize “smaller incisions, laparoscopes, robotics and computer-aided surgery.”

Cosmetic procedures like TUBA breast augmentation, the endoscopic brow lift and others would fall into this category.

• Read the full story here.

Winter in Massachusetts can be harsh and this year is definitely no exception.  These conditions – low temps, dry air, and sun exposure – can be hazardous for your skin health.

Modify your skin care routine and you can maintain that healthy complexion through the winter.

Skincare products

Use an antioxidant moisturizer with these water-binding, anti-inflammatory ingredients:

• amino acids
• fatty acids
• ceramides
• sodium PCA
• glycerin

Keep those lips from cracking!  Use high quality lip balm with hemp oil, shea butter, vitamin e, beeswax and SPF 15 to keep your lips smooth and soft.

Winter Skin Care Tips

1. Stay hydrated
2. Remember your sun protection, even in the winter.
3. When your skin is tight, reapply moisturizer.
4. To allow better penetration of moisturizer, exfoliate problem areas with glycolic or salicylic acid.
5. Get a humidifier in your house or apartment.
6. Visit our skin & wellness center for professional advice and treatment.

Q: What is the best type of liposuction?

A: While the operator is always the most important factor, several new liposuction platforms have been introduced in recent years. There is no best method because each platform has particular benefits. For example, water assisted liposuction is great for removing a large volume of fat, while VASER ultrasonic liposuction is great for precise body contouring.

Q: Why do I keep hearing about new liposuction methods?

A: Plastic and cosmetic surgeons are trying to set themselves apart with more effective liposuction methods. You might hear about “reduced downtime” or “reduced trauma to surrounding tissues” in the marketing for these procedures; just know that any proven liposuction technique will utilize the same basic tools as the standard tumescent liposuction technique.

Q: Can I get liposuction anywhere on my body? What is the most common area to treat?

A: Many people aren’t aware that liposuction can be done on so many areas of the body. While the abdomen and thighs are probably most common, you can also get liposuction below your chin or even on the ankles.

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Before the New Year begins, we propose making a few promises to benefit your skin.

Without procrastination and without excuses, let’s resolve to take the following steps:

1: Gift yourself with a series of microdermabrasion treatments to soften fine lines and acne scars, minimize or eliminate sunspots, stimulate collagen production and give your face a youthful glow. Go every 2 weeks or so for a quick microdermabrasion session and reap the full benefits of more even, younger-looking skin.

2. Safeguard your investment in microdermabrasion treatments by scheduling touch-up sessions 2 or 3 months. A session only takes an hour, it’s relaxing and pleasant, and our skin will look younger and more radiant all year long.

3. Get serious about using sun block to protect your investment. Obagi makes a great one that won’t block pores, make the skin feel greasy or cause unwanted breakouts. Use it regularly according the directions; because you don’t want premature wrinkles, blotchy skin or an increased risk of skin cancer.

4. Let a professional aesthetician teach you how to use the right skin care products in the right order at the right times to keep your skin looking its best through the holiday season and beyond. Don’t cherry pick in the drug store; buying every trendy new product that comes along just because you like the packaging. Instead, pare down, simplify and do the right thing.

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