Dr. Richard Hainer

Labiaplasty

2008-11-14T05:58:00.000-08:00

Q: After the birth of my two children, my labia have remained enlarged creating discomfort and making it hard to wear certain clothing. Is there something that can be done?

A: Aesthetic surgery of the female genitalia is becoming more popular as social acceptance of these cosmetic and reconstructive procedures continues toward mainstream. The situation you describe is one of the most common complaints I hear. Usually secondary to childbirth, enlarged labia can also be genetic in origin. I actually see more younger women with this complaint than those post-childbirth. Reduction Labiaplasty is a procedure for women who have a problem with large labia minora or asymmetric labia. Labiaplasty permits the reduction of large labia to reduce their outward appearance and correct misshapenness or irregularities. In addition to the aesthetic outcome which by itself can greatly enhance self-esteem, better local hygiene, relief of chronic irritations and less interference with sexual intercourse have been seen as the main benefits. It is very common for many of my patients to say that they were unaware of this procedure, and had they known about it, they would have had it done years ago.
In general, the procedure involves the surgical removal of the excess, protuberant tissue while maintaining the natural contours of the labia without visible scarring. In some cases, the excess tissue extends above the clitoral hood which can also be reduced. The actual incision depends on the specific anatomy but uniformly heals well with no visible scars. The newest technique involves removal of an inferior wedge of tissue thereby preserving the natural edge of the labia. Other ancillary procedures can also involve contouring the labia majora or mons area, often using minimally invasive techniques such as ultrasonic liposuction. In most instances, reduction labiaplasty can be performed under local anesthesia in the office with minimal post-operative discomfort and quick return to work.
To learn more about female aesthetic genital surgery, please log onto my website at www.drhainer.com or come in for a complimentary consultation.

SmartLipo

2008-07-21T10:39:00.000-07:00

With so many different liposuction techniques now available it’s no wonder so many potential candidates are confused about which method to chose. First, it is important to start with the basic concepts of liposuction. Liposuction is a form of body contouring where fat is removed from various problem areas a patient may have via small, thin hollow “cannulas” that aspirate the fat from the body. The best candidate for liposuction contouring is near his/her ideal body weight and has good elastic skin quality such that when the fatty tissue is removed the skin can essentially shrink wrap and create a nice smooth contour. Liposuction is a contouring technique, not a weight loss method. Those patients who are significantly overweight, have large fluctuations in their weight, or who have poor skin quality are not candidates. Liposuction is not a remedy for cellulite, which by the way has no permanent remedy. And remember, despite tiny incisions, liposuction is real surgery, with real blood loss, with potentially serious, complications. So chose your surgeon carefully and insist they be board certified Plastic Surgeons.
As for the technique, every form of liposuction involves infiltration of a tumescent solution into the fatty tissues as the first step. This fluid often contains lidocaine for anesthesia and epinephrine to constrict the tiny blood vessels in the fatty tissue thereby minimizing blood loss and postoperative bruising. Once the fluid is infiltrated, small- caliber hollow cannulas ( 2mm-4mm in diameter) are used to suction out the fat. In traditional liposuction (SAL or suction-assisted lipectomy) the fat extraction is purely mechanical yielding a chunky, yellow fat slurry. It’s a time consuming procedure, physically demanding on the surgeon and is as much science as artistry. Now comes the confusion.
The next technique on the complexity ladder is PAL or power-assisted lipectomy. In this method, the cannula is now power assisted either with an electric or air driven motor. So instead of the surgeon doing all the mechanical work, the cannula vibrates back and forth (about 90 cycles/minute) making it easier on the surgeon. Kind of like an electric knife as compared to a traditional one.
UAL or ultrasonic-assisted lipectomy is the next method. With this technique, the cannula is now part of a more sophisticated device that generates ultrasonic vibrations at the tip of the cannula. This energy does two things, it essentially liquefies the fat but also creates heat. The tumescent fluid does help absorb the heat but care must be taken because burns can occur. In the early days of UAL,it was thought that the heat that is generated beneath the skin surface could help stimulate the skin to tighten or shrink wrap, but that is only the theory and in practice ,the skin tightening effects are unimpressive at best. Two UAL devices exist,the Lysonics device which I use can deliver both continuous or pulsed energy or the VASER device which is only pulsed. So when UAL is used, the mechanical effort is minimal, surgeon fatigue is minimal, because the fat is essentially being melted. These devices however, do not extract the fat out efficiently, so traditional cannulas still need to be used to remove the fat slurry,which is now frothy yellow like melted fat rather the the chunky fat with more traditional techniques.
So finally there is the newest technique, known as “SmartLipo”. This device uses a laser, specifically an Nd:Yag laser to melt the fat and also coagulate tiny blood vessels in the fat. The cannula is only 1mm so the access incisions are small. Heat is generated and the claim is that this device can also significantly tightened the skin .So well in fact is the skin tightening effect, that physicians who offer SmartLipo say patients with even very lose skin can achieve remarkable results. Well, the reality is that this device albeit using a smaller cannula than the other methods is no more efficient at fat extraction than UAL. The skin tightening is completely unproven and claims of skin tightening are not FDA approved and there is no clinical evidence of this effect. And lastly, the fat still needs to be extracted by traditional cannulas. So while the claims by Cynosure, the company who sells the SmartLipo device are lofty, there is little science to back up these claims. For my money, I’d rather have a Smart Surgeon and good old fashioned DumbLipo!

Eyelids

2008-02-22T11:07:00.000-08:00

Q: My coworkers keep telling me I look tired and when I look in the mirror my eyes look dark and puffy. Is there a solution?

A: Without question, your eyes are the focal point of your face. They truly are the windows to your soul. The more youthful the eyes, the younger you look. Unfortunately, aging, gravity, and even heredity can dramatically affect the appearance of your eyes.

Aging of the upper eyelids usually causes skin excess, puffiness, and heaviness. In some cases, the eyebrows and forehead may be contributing factors. A proper exam will assess these issues to determine if a browlift may help. In some patients, the upper eyelid heaviness is so extreme that the visual fields are compromised. In these instances insurance may actually cover the costs of correcting the upper eyelid problem.
The surgical procedure called a blepharoplasty is designed to remove the excess skin and fat of the upper eyelids and restore their youthful look.

The lower eyelids can also significantly contribute to the puffiness and dark circles. In some cases, excess skin is removed while in others the skin is tightened with laser or chemical peels. The excess fatty tissue can either be removed or repositioned to fill in the hollowing beneath the eyelids (the so-called tear trough deformity). In older patients, the eyelid itself needs to be tightened and repositioned to restore a more youthful contour and shape.

During your initial consultation, all of these factors will be addressed and considered. By doing so, an appropriate treatment plan will be outlined to restore the youthful appearance of your forehead, eyebrows and eyelids. Please feel free to call for a complimentary cosmetic consultation or log onto www.drhainer.com.

Breast Augmentation/Breast Lift

2008-01-04T10:28:00.000-08:00

Q: Since the birth of my second daughter, I’ve gone from a firm 36C to a saggy 34B. Will implants help?

A: Your dilemma is not an uncommon one. Pregnancy is only one cause for your problem. Some women never develop breasts while other women simply get smaller or atrophy with age. Whatever the cause, nonetheless, breast implants may be the solution to your problem, or at least part of the solution. Breast augmentation using implants will definitely restore lost fullness to your breasts and may even solve the shape issue. For women with small breasts implants are clearly the best solution. However, if your breasts have developed significant droop or ptosis, you may also need a breast lift or mastopexy.

In essence, breast augmentation is designed to enlarge the breast volume while providing a small amount of lift effect. A mastopexy is purely aimed at restoring the shape of your breasts without changing their size. So, if you are content with a B cup then a lift is all you need. If you also desire larger breasts then you may need both a lift and augmentation.

The degree of ptosis will determine what type of mastopexy is needed to achieve the desired result. The more ptotic the breasts, then the more extensive the lift. During the initial consultation, measurements will be taken to assess just what kind of mastopexy will work for you. For additional information on breast augmentation and breast lift surgery procedures, log onto www.drhainer.com or call my office for a complimentary consultation.

Body Contouring

2007-11-28T11:13:00.000-08:00

Q: I’m 5’4” tall and weigh 135lbs, exercise 3 times a week, and watch what I eat. Yet, I can’t seem to lose the bulges of my outer thighs, hips and stomach. Is there help for me?

A: I see many patients who share the same scenario. Despite exercise and diet, certain problem areas persist. These localized areas of adiposity or fatty deposits are in many cases genetic. Patients will often comment that others in the family share the same body structure. In some instances the problem areas develop after pregnancy or weight loss. No matter what the cause, the solution typically involves a so-called body contouring procedure. Body contouring can be classified into excisional and nonexcisional.

Nonexcisonal body contouring is simply another way to say liposuction (also known as suction-assisted lipectomy or SAL). Liposuction involves the removal of fat via small, access incisions through which thin metal rods or cannulas are inserted. These cannulas are attached to a specialized suction device so that as the fat is disrupted it is removed through the cannula. Liposuction also involves the injection of large amounts of fluid (tumescent fluid) just prior to the actual suctioning, which usually contains an anesthetic (lidocaine) as well as epinephrine, which constricts blood vessels and thereby minimizes bleeding and bruising. Most of this fluid is then removed with the fat. Traditional SAL is therefore a mechanical process of breaking up the fat and removing it with suction. Newer methods exist which also utilize ultrasonic energy to disrupt the fat (ultrasonic-assisted lipectomy or UAL) or vibration energy (power-assisted lipectomy or PAL). A well-trained, experienced, board certified plastic surgeon will use each as needed to obtain the optimal results.

The key for successful liposuction however is the skin. Once the fat is removed, the skin must shrink and reshape. Healthy, elastic skin will recoil. Older, sun damaged, stretch-marked skin will not. Which brings us to excisional body contouring. Excisional simply means “cutting away” the excess. Tummy tucks (abdominoplasty), arm lifts (brachioplasty), inner thigh lifts, and buttock lifts are all examples of excisional body contouring. The hallmark to all of these procedures is that not only must fat be removed, but excess skin must also be removed to obtain the desired result. In many cases, liposuction and excisional body contouring are combined. The main point to remember is that with significant skin excess or poor quality skin, liposucton alone will not solve the problem.

The final point to mention is that body contouring is designed to optimize shape. It is by no means a method of weight reduction. Patients must fall within 15-20% of their optimal weight before body contouring should be considered. If someone is more than 20% above their target weight then they should lose those extra pounds before proceeding with body contouring. Conversely, body contouring procedures also will not prevent future weight gain. So it is important to continue regimens that maintain your optimal weight.

During the initial consultation and examination, decisions will be made regarding the quality of skin and the quantity of fat excess so that the appropriate procedure will be selected to obtain the optimal results. For further information about body contouring procedures log onto http://www.drhainer.com/ or call me for a complimentary consultation.

Tummy Tuck

2007-10-22T07:56:00.000-07:00

Q: I have been considering a tummy tuck but am afraid of the pain with this procedure. Is there a less painful alternative?

A: An abdominoplasty or tummy tuck is undoubtedly one of the more extensive body contouring procedures. The procedure involves the surgical removal of excess skin and fatty tissue of the abdomen as well as tightening of the underlying abdominal muscles. It is a form of excisional body contouring whereby the extra tissues are surgically removed. For women who have had children, the underlying muscles have often separated and stretched causing a so-called diastasis recti. This diastasis or separation is sutured together creating a tight abdominal wall which acts much like a muscle corset. The tighter the corset, the better the overall shape and contour that can be obtained.

Unfortunately, surgical muscle tightening is ultimately what causes pain. Historically, abdominoplasty procedures have always been associated with a painful recovery. For the past 4 years, I have been using a sophisticated pain control mechanism called the Stryker Pain Pump. This device was first developed for orthopedic surgeons who use it after shoulder, knee or hip surgery. The pump is a completely automated device that delivers a long-acting anesthetic agent via thin catheters to the site of pain. For the orthopedic patient, this usually involves a joint. For tummy tuck patients, the catheters are positioned directly on top of the muscles that have been stitched together. The pump lasts 3-5 days and has dramatically reduced the pain associated with surgery, with some patients actually having no pain at all. For most, the need for additional pain medications is significantly decreased thereby reducing narcotic related complications and speeding the recovery process. For my practice this device has proven extremely effective and I use it for all of my tummy tuck patients. For more information log onto my website at www.drhainer.com or www.stryker.com/instruments/painmanagement.

Endotine Forehead Lift

2007-10-04T08:20:00.000-07:00

Q: What is an Endotine forehead lift?

A: A forehead lift or browlift is intended to reposition drooping eyebrows and soften creases of the forehead and between the eyebrows. The traditional “open” browlift involves a long ear-to-ear scalp incision (bicoronal) that is used to elevate the forehead and eyebrow tissues, remove excess skin and reposition the eyebrows. This long incision leaves an unsightly scar often with scalp numbness and a long recovery time. The “endoscopic” browlift uses small 1-inch incisions behind the hairline through which a small endoscope is inserted to detach the same tissues. The forehead and eyebrows are then repositioned and held in place by two small “endotine” devices. The endotine is a small triangular-shaped device that holds the tissues with small, sharp prongs. Once the tissues have healed, this device simply dissolves away. In essence, leaving no trace and no scars. For me this has revolutionized how I do browlifts. Recovery is fast, swelling is minimal and the results are dramatic.
Recently, this endotine device has been redesigned to be used as a method to lift the cheeks, also through inconspicuous incisions. This so-called endotine midface or malar lift is also changing the way I do cheek lifts. For more information about the endotine forehead lift or the midface lift, call for a complimentary consultation, log onto my website at http://www.drhainer.com/ or, log onto the official endotine website at http://www.coaptsystems.com/.

Gynecomastia

2007-08-21T05:47:00.000-07:00

Q: Is there a treatment for gynecomastia? I’ve had abnormally large breasts ever since high school despite exercise and weight loss?

A: Gynecomastia is abnormal persistence of breast tissue after puberty. It represents the most common breast abnormality in men. Most pubertal breast enlargement resolves on its own while most post-pubertal cases require intervention. Before surgery is considered, a thorough medical workup should be performed to exclude any pathological causes of the gynecomastia. In the vast majority of men, the workup is negative at which point direct treatment can be safely recommended.

Gynecomastia is staged according to its severity as well as the tissue composition. Breast enlargement can be composed of both breast tissue and fat. The amount of each will determine what type of treatment will work best for you. In over 85% of cases ultrasonic-assisted liposuction is all that is necessary to correct the problem. In some cases breast tissue must also be removed by direct surgical excision and in a small percentage of cases a true breast reduction must be performed. Based on a thorough examination and consultation, the appropriate procedure will be selected to correct the problem with the least amount of incisions and scarring. For a complimentary consultation call my office or log onto my website at www.drhainer.com.

Plastic Surgeon Versus Cosmetic Surgeon

2007-08-03T10:26:00.000-07:00

Q: I’m confused…what’s the difference between a cosmetic surgeon and a plastic surgeon?

A: Comparing a board-certified plastic surgeon to a cosmetic surgeon is like comparing a diamond to a cubic zirconium. From a distance, they may look the same, but when closely scrutinized, the diamond is rare and priceless while the zirconium is worth very little and fabricated. Board-certified plastic surgeons, roughly 6500 in this country, are certified by the American Board of Plastic Surgery (ABPS), one of only 16 specialty boards recognized by the American Board of Medical Specialties, a branch of the AMA. Once certified by the ABPS, a surgeon is eligible to become an active member of the American Society of Plastic Surgeons (ASPS), the world’s premiere plastic surgery society. Continued membership requires extensive Continued Medical Education (CME) as well as uncompromised ethical conduct.

A “cosmetic” surgeon is essentially a meaningless term. The American Board of Cosmetic Surgery is one of over a hundred “self-designated” boards in this country. It is not recognized by the AMA and is therefore a “meaningless” board. It simply validates those physicians trying to appear to be plastic surgeons but who really have no formal training in plastic surgery. Any physician can become a “cosmetic surgeon” without any true formal training. Do you really want an ENT or oral surgeon performing your tummy tuck or breast augmentation? Well, it’s happening more than you may think.

Be safe, be discriminating, do your homework and above all…be selective. Remember, you have only one face and one body. For more information, log onto my website at www.drhainer.com and read my section on “Choosing a Plastic Surgeon”” or log onto the official ASPS website at www.plasticsurgery.org to get a list of all board-certified plastic surgeons in your area.

Botox

2007-07-10T09:51:00.000-07:00

Q: I’ve heard so much talk about Botox but am still confused about it’s indications. Will botox treat all of my facial wrinkles?

A: Facial lines and wrinkles are classified as either dynamic or static. Dynamic or hyperkinetic wrinkles occur due to facial muscle activity. Static lines represent actual creases in the skin itself. Some dynamic creases, if left untreated, will eventually create static ones, while some static lines deepen further as the underlying muscles of the face are activated.
In general, static wrinkles are treated with fillers. These dermal fillers essentially occupy space and “fill in” the wrinkle. There are now a large variety of fillers to choose from depending on the issues at hand, with the list growing yearly.
Dynamic creases, those created by the underlying facial muscles, are best treated with botox. Botox is a neurotoxin that binds to muscle neuroreceptors and essentially selectively paralyzes that particular muscle. Initially used by neurologists and ophthalmologists for various muscle-related problems, botox is now used for cosmetic purposes to treat dynamic facial wrinkles. By weakening a particular facial muscle or group of muscles, these wrinkles will disappear. The duration of action of botox is 3-6 months with essentially no side-effects. The key to obtaining excellent results is the physician injecting the botox. They should have a complete understanding of the anatomy of the facial muscles in order to precisely treat the wrinkles. Most complications due to botox are not side-effects of the drug itself but simply that the injections were done incorrectly. Seek out a physician trained in plastic surgery, facial plastic surgery, or oculoplastic surgery who knows the anatomy. For more information log onto my website at http://www.drhainer.com/, onto the official botox website at http://www.botoxcosmetic.com/, or call for a complimentary consultation.

Lower Eyelids

2007-06-22T11:38:00.000-07:00

Q: Over the years I have developed dark circles and puffiness under my eyes. My family and co-workers have told me I look tired. Is there a solution?

A: Puffiness and dark discoloration of the lower eyelids are common complaints. As we age, the tissues of the lower eyelid become thinner and less elastic. This can also be a congenital issue not related to age at all. As a result, the three small fat pads of the lower lid bulge out creating puffiness and shadowing. Furthermore, the thinning of the eyelid skin allows the small blood vessels to be more visible creating the bluish discoloration. This darkening is not a pigment problem but a skin thinning problem so bleaching creams used to treat hyper pigmentation are not effective.
The treatment for these problems often involves surgically removing the extra fat of the lower eyelid. This can be done through a small incision inside the eyelid without any visible scars or sometimetimes through an incision just under the lash line if some extra skin also needs to be removed. Treating the discoloration can be done effectively with a mild chemical peel which improves the quality of the skin and thickens and smoothes the skin thereby not allowing the blood vessels to shine through. Teamine, a topical preparation, is also very effective at constricting these vessels and thereby lessening the discoloration without surgery.
For more information about eyelid surgery or any other cosmetic plastic surgery, log onto my website at www.drhainer.com or call my office for a complimentary consultation.

Combined Surgeries

2007-06-01T08:28:00.000-07:00

Q: I’m faced with the prospect of a hysterectomy and have been considering a tummy tuck.. Could these two procedures be done at the same time?

A: Combination procedures have become commonplace in plastic surgery. It is not uncommon to coordinate a cosmetic procedure with another procedure such as a urologic or gynecologic surgery. Several studies have demonstrated that the overall complication rates are no different whether combined or done separately. In many cases, it can consolidate two procedures into one and reduce expense and limit recovery time. Combining a tummy tuck with a hysterectomy is a logical combination ultimately making the gynecologic procedure less technically demanding, reducing operating time and ultimately providing an aesthetically pleasing end result. Many of my patients completely overlook the fact that they have had a hysterectomy because they are so excited about their tummy tucks. Breast augmentations, facelifts, eyelid surgery, breast reductions, and liposuction are but a few of the procedures that can be combined with other surgery. With increasing demands to limit downtime, combining cosmetic surgery with other planned procedures is a reasonable strategy but should be individualized to the patient and to the extent and type of surgery desired. As always, the goals are always to ensure patient safety while meeting their aesthetic expectations and desires. For more information, log onto my website at www.drhainer.com or call for a complimentary consultation.

Cellulite

2007-05-11T11:53:00.000-07:00

Q: Is there a permanent solution for cellulite?

A: Cellulite or gynoid lipodystrophy is a uniquely female problem. Nearly $3.5 billion are spent annually on magic potions and treatments. The problem stems from how women store body fat. Fat in women is stored in compartments separated by thin membranes. These membranes connect from the overlying skin to the underlying muscles creating the dreaded “cottage cheese” appearance.

Topical treatments include concoctions of herbs and other potions. Mechanical treatments involve ultrasound or some form of massage aimed at stretching these membranes and smoothing out the skin texture. Endermologie employs deep roller massage while Dermosonic uses vacuum massage combined with ultrasound. These massage treatments may temporarily improve the appearance of cellulite by creating swelling and fluid retention in the tissues. Unfortunately once the treatments are completed, the swelling resolves and the cellulite returns completely unchanged.

Unfortunately, the bad news is that there is currently no permanent solution to cellulite. Liposuction may help if there is fat excess but it is also not designed to target cellulite. As we learn more about fat and fat metabolism we may ultimately find a permanent solution. As for now, save your money and don’t be fooled by lofty promises and unrealistic claims. For more information, log onto my website at www.drhainer.com or call for a complimentary consultation.

Fat Grafting Breasts

2007-04-20T10:55:00.000-07:00

Q: I recently came across a website where breast augmentation was being done using fat injections rather than implants. Is this safe?

A: Structural fat grafting has become an extremely versatile technique used by many plastic surgeons. Popularized by Sydney Coleman MD, a New York plastic surgeon, this technique involves the harvesting of a patient’s own fat through gentle, traumatic aspiration methods. The fat is then centrifuged, purified and loaded into small syringes used for injection. The basic theory centers around the fact that fat is living tissue and if handled carefully and injected correctly, it will re-establish new blood supply and become a permanent filler. Some fat, however, may not survive the grafting procedure and can form micro-calcifications as it dies and is resorbed by the body. These micro-calcifications are the problem when dealing with the breasts. Clearly, fat grafting would work to enlarge a patient’s breasts. However, if micro-calcifications were to develop, it would make the detection of breast cancer impossible because one common mammographic finding in breast cancer are micro-calcifications. It is for this reason that fat grafting should never be performed for breast augmentation.
Otherwise, fat grafting has many uses as permanent filler. It can be used in the face, cheeks, and lips and for plumping-up deep folds. It is useful for acne scars and depressions. It can even be used to enlarge the buttocks. Despite its endless potential applications, fat grafting should never be used to augment the breasts because of its high risk in preventing the detection of breast cancer. For more information about structural fat grafting log onto my website at www.drhainer.com or schedule a complimentary consultation.

Liposuction

2007-03-02T08:49:00.000-08:00

Q: I’m 5’4” tall and weigh 135lbs, exercise 3 times a week, and watch what I eat. Yet, I can’t seem to lose the bulges of my outer thighs, hips and stomach. Is there help for me?

A: I see many patients who share the same scenario. Despite exercise and diet, certain problem areas persist. These localized areas of adiposity or fatty deposits are in many cases genetic. Patients will often comment that others in the family share the same body structure. In some instances the problem areas develop after pregnancy or weight loss. No matter what the cause, the solution typically involves a so-called body contouring procedure. Body contouring can be classified into excisional and nonexcisional.

Nonexcisonal body contouring is simply another way to say liposuction (also known as suction-assisted lipectomy or SAL). Liposuction involves the removal of fat via small, access incisions through which thin metal rods or cannulas are inserted. These cannulas are attached to a specialized suction device so that as the fat is disrupted it is removed through the cannula. Liposuction also involves the injection of large amounts of fluid (tumescent fluid) just prior to the actual suctioning, which usually contains an anesthetic (lidocaine) as well as epinephrine, which constricts blood vessels and thereby minimizes bleeding and bruising. Most of this fluid is then removed with the fat. Traditional SAL is therefore a mechanical process of breaking up the fat and removing it with suction. Newer methods exist which also utilize ultrasonic energy to disrupt the fat (ultrasonic-assisted lipectomy or UAL) or vibration energy (power-assisted lipectomy or PAL). A well-trained, experienced, board certified plastic surgeon will use each as needed to obtain the optimal results.

The key for successful liposuction however is the skin. Once the fat is removed, the skin must shrink and reshape. Healthy, elastic skin will recoil. Older, sun damaged, stretch-marked skin will not. Which brings us to excisional body contouring. Excisional simply means “cutting away” the excess. Tummy tucks (abdominoplasty), arm lifts (brachioplasty), inner thigh lifts, and buttock lifts are all examples of excisional body contouring. The hallmark to all of these procedures is that not only must fat be removed, but excess skin must also be removed to obtain the desired result. In many cases, liposuction and excisional body contouring are combined. The main point to remember is that with significant skin excess or poor quality skin, liposucton alone will not solve the problem.

The final point to mention is that body contouring is designed to optimize shape. It is by no means a method of weight reduction. Patients must fall within 15-20% of their optimal weight before body contouring should be considered. If someone is more than 20% above their target weight then they should lose those extra pounds before proceeding with body contouring. Conversely, body contouring procedures also will not prevent future weight gain. So it is important to continue regimens that maintain your optimal weight.

During the initial consultation and examination, decisions will be made regarding the quality of skin and the quantity of fat excess so that the appropriate procedure will be selected to obtain the optimal results. For further information about body contouring procedures log onto www.drhainer.com or call me for a complimentary consultation.

There Is No Substitute For A Good Facelift

2007-02-02T11:17:00.000-08:00

As the babyboomer population ages, the demand to stay looking young has evolved and flourished. As no surprise, the number of cosmetic surgical procedures is increasing every year by an exponential rate. These procedures span not only the entire gamut of invasive techniques, but also noninvasive ones. Products like Botox and Restylane have quickly become household words. Yet prospective patients need to be aware that not all new techniques and technologies are valid. As with any other consumer good, cosmetic plastic surgery has become a buyer beware market.

Facial rejuvenation procedures continue to be in the top five cosmetic procedures performed. These include not only facelifts, but also eyelid surgery, forehead lifts, nose reshaping, and even cheek and chin implants. The classic facelift (rhytidectomy) has always been considered a dramatic procedure. The goal of this procedure is to reposition facial structures affected over the years by aging tissues, sun exposure, and gravity. The classic facelift addresses not only the face but also the jawline and neckline and can provide 10-12 years of durability. The scars, when done properly, heal extremely well and become nearly imperceptible blending into the naturally occurring folds and the hairline. A well-executed facelift, performed by a properly trained, board-certified plastic surgeon can provide dramatic results and can truly turn back the hands of time.

Unfortunately, prospective patients, influenced by trends in minimally invasive surgery, and constrained by a fast-paced, instant-gratification lifestyle want a quick fix. They want the results offered by the facelift procedure, but want them with little downtime, via short incisions or even no incisions at all. Spawned by such demands, there has been an explosion in unproven techniques and technologies offering “One-Hour Facelifts” and “Non-surgical Facelifts”, usually by unqualified physicians wanting a piece of the cosmetic surgical pie.

The so-called “One-Hour Facelift” is supposed to offer dramatic effects via a small incision in front of the ear with essentially no downtime. The technique usually involves placing several pursestring –type sutures in the deeper layers of the face in an attempt to tighten the facial muscles. The reality is that the technique does not work, has no proven anatomical basis and lures patients by false claims. A one-hour facelift will essentially provide you with one hour of results.
As for the “Non-surgical Facelift”, the technology behind this claim is Thermage. Thermage utilizes the use of radiofrequency energy that claims to tighten facial skin by stimulating collagen production, thereby offering facelift results with no incisions at all. In reality, as our experience with Thermage broadens, a patient can expect at best 30% improvement in facial wrinkles and skin laxity with at most a 6 month duration of effects before having to be repeated. 30% improvement also means 70% no improvement. Hardly worth $2000-3000 every 6 months.

In conclusion, do your homework. Seek out a qualified, well-trained, board-certified plastic surgeon. And above all, don’t believe everything you read and hear. If it seems too good to be true, it usually is.

Importance Of Credentials

2006-10-25T10:19:00.000-07:00

First and foremost, welcome to my website. I hope you will find it informative and useful in your decision-making process regarding your potential plastic surgery. As an initial step, I encourage you to read the section entitled “CHOSING A PLASTIC SURGEON”. Being a board certified plastic surgeon, I stress to all of my patients during their initial consultation the importance of choosing a board certified plastic surgeon. You only have one body, so make sure you do your homework before going under the knife. Ensure that whomever you chose is board certified by the American Board of Plastic Surgery and is an active member of the American Society of Plastic Surgeons (ASPS). To chose otherwise may lead to disaster and potentially uncorrectable results. Don’t let flashy ads or rock-bottom prices sway your decision. As with anything in life, you get what you pay for, plastic surgery being no exception, particularly in this highly competitive world we live in today.

As for me, I received my undergraduate degree from the University of Michigan and continued there completing my medical education at the University of Michigan Medical School. I then completed a full 5 year residency in General Surgery at the University of Michigan and Henry Ford Hospital in Detroit. This then led me to Portland, Oregon where I completed a fellowship in Plastic Surgery at the Oregon Health Sciences University. As a final stop, I went on to do an additional year of fellowship training at the Cleveland Clinic in Hand Surgery. Currently, I am board certified in General Surgery, Plastic Surgery and Hand Surgery. It has been a long and grueling road amounting to 8 years of post-graduate school training so as you might expect I am proud of my educational background and am a strong advocate for patients to seek out appropriately trained surgeons.

Stay tuned for future Blogs where I will address not only pertinent questions about plastic surgery but also shed light on current hot topics. Feel free to email me questions you might have, and again thank you for visiting my website.