Written By: Jenny Isenman

As an aging woman, there are a handful of things I hold grudges against: gravity, collagen and adorable teenagers with their perky boobs and years of dewiness left in their skin. That said, I try to arm myself with the right weapons to fight the first two and I avoid high schools.

The pull of gravity and the “now you see me, now you don’t” attitude of collagen have led me to look for the right fillers to lift and plump those areas of my face that have dropped and deflated. Yep, imagine your face as a balloon. Over time the air dissipates no matter how tightly that thing was knotted. You can pull the balloon taught with the amount of air it has left (e.g. Botox, lifts, lasers etc.) which will look better… or, you can fill the balloon with more air (fillers). Both are better than looking like a wrinkled deflated balloon, but if I’m a balloon, I want to be refilled rather than taped with band-aids.

Enter my debate: Which air is better for your balloon? Most people choose the traditional fillers (e.g. Radiesse, Voluma, Scuptra, Restylane). I’ve written about these tools in the arsenal before, but new ways to harvest fat and graft it are making fat transfer an even more attractive alternative in certain cases (and giving it more uses). Last year, 48,059 fat transfers to the face were performed.

What’s New in Fat Transfer?

Fat grafting has been performed for over a century, yet in the past few decades it has hit a stride and continues to evolve and improve. New techniques in fat grafting including a gentle hand-harvesting method of microfat grafting, a streamlined purification process and a precise micro droplet injection process, are making the transfers more seamless and durable than they were in the past. The small size and higher blood supply attained by using these techniques has improved survival and longevity of the cells and provides a smoother result. The highly purified cells include a small amount of high density stem cells. These regenerative type cells not only fill but enhance circulation in the tissues.

How is Fat Transfer Used on the Face?

Fat grafting can be used anywhere on the face to help contour. It can restore volume to the under eye bags, hollowed out cheeks, deep furrows in brow, acne scars and areas around the temples, chin and mouth.

It is now being used to restore symmetry to people with a variety of facial malformations.
A recent study published in the Aesthetic Surgery Journal looked at using microfat grafting to correct disproportion in the mid- to lower-third of the face. The study found fat contouring to have great results and low morbidity. This means fat grafts could replace more invasive chin implants, oral surgeries and osteotomies.

How is it Fat Transfer Done?

When used for facial contouring, the amount of fat that needs to be harvested is minimal. Under local anesthesia, a small cannula is inserted into an area where you have excess fat and the tissue is extracted. The fat then goes through a purification process and is injected into the desired areas. Often more fat will be injected than is necessary because a small percentage does not survive, so a touchup 6 months later may be necessary.

You can go back to your daily life after the procedure. Bruising, swelling or redness in both the harvested and injection sites should be expected.

How Does Fat Compare to Traditional Fillers?

It’s natural. It looks natural, feels natural and comes from your own body (it doesn’t get more natural than that).

Due to the fact that it’s your fat, you don’t have to worry about allergic reaction or rejection

After the procedure you may also see improved color and skin tone. This may be due to the fact that you are adding living stem cells to that area.

Your face will continue to age and lose volume as it normally would, but the procedure is basically permanent.

Fat transfer is more costly than traditional fillers. However, if you do the math, you may find that fat is more cost effective than dermal fillers in the long run.

Fat grafting is a more time consuming process and should probably not be considered until after using traditional fillers and wanting a more permanent result.

Most importantly, remember you are dealing with something permanent. The results depend on the surgeon’s skills — his/her ability to harvest, purify and inject the cells. Make sure you seek out a board-certified plastic surgeon with highly developed skills and significant experience with fat transfer.

By Mary Cunningham

When Lilly Pulitzer debuted her capsule collection for Target this spring, the allure of bold, bright bikinis, sun hats and beach cover-ups in the iconic designer’s coveted prints offered at unheard of affordable pricing was so compelling that the collection sold out in mere hours! I was left without day-glow preppy beachwear. Tragic, except for the fact that I already have too many beach accessories and bikinis and besides, why cover up?

Easier said than done, right? Most of us, (men and women alike) are at least somewhat insecure about baring it all at the beach or pool. So, what to do if the Lilly Pulitzer solution isn’t available? Perhaps a more long-term investment might be worth looking into.

Whatever you seek to cover, consider a more long-term fix instead of a fashionable but temporary beach cover-up.

Here are some suggestions for dealing with many common problem areas that might be holding you back from strutting your stuff confidently and soaking up the sun.

Gynecomastia: This is a medical condition that laypeople often refer to, (however cruelly) as “man-boobs” or “moobs” as it is characterized by overly large breasts. Men with gynecomastia are hesitant to take off their shirts in public. If diet and exercise haven’t solved the problem, then male breast reduction surgery may be the answer, as it can restore the chest to a normal male contour, addressing any abnormalities in the male breast, nipple or areola.

Belly fat: Liposuction is best used for removing unwanted pockets of fat. If your belly fat is localized and pronounced in one area disproportionate to the fat distribution in the rest of your body, lipo could remove the stubborn fat that has been resistant to diet and exercise. Liposuction is not a means of weight loss, it works best when the individual is close to ideal body weight.

Hairy legs: Dark hair on pale skin in particular might compel someone to seek a semi- permanent solution to eliminate it. To banish it from legs or anywhere else, laser hair removal is a long-term alternative to the repetitious upkeep of waxing or shaving. Lasers provide options for removing various types of hair textures on diverse skin pigments – the procedure isn’t just reserved for the pale and raven-haired, but it will not work on dark skin and on white or gray hair.

Spider veins: These are dilated blood vessels with a branching pattern commonly found on the thigh. Note – they are not the same as varicose veins. Laser vein treatments can erase spider veins from the skin by directing a focused beam of light onto the spider vein, coagulating the blood inside the vessel and thus erasing it. This is ideal for small spider veins.

Stretch marks: These are narrow streaks or lines on the surface of the skin caused by anything from pregnancy to aging and weight gain/loss over time. Intense pulsed light (IPL) technology /photorejuvenation can alleviate many skin woes, including stretch marks. The heat from the light heats up collagen beneath the skin which heals the shallow scaring of stretch marks.

While any of the “problem areas” above can create some anxiety during beach season, each has a relatively simple treatment option that is worth looking into so the only reason you’ll need a beach cover-up will be to show off your fashion sense, not to hide what you’ve got going on underneath.

Written by: Mary Cunningham

Attention fellas: Plastic surgery isn’t just for the ladies anymore. In fact, it hasn’t been for a while but male-centric options are just now beginning to go mainstream. While male-focused procedures may not make the headlines as frequently, they are certainly available if you feel like it’s time for some sprucing up. There is a suite of procedures that can stand alone or be paired together for a dynamic transformation, which are as follows.

Chemical peel
Skin on your face, neck and hands create a first impression. While men can hide behind a 5 o’clock shadow, that doesn’t mean that the quality of your skin should be neglected. Dead skin builds up, creating a dull, rough surface and needs to be removed. Chemical peels are offered in a variety of strengths and formulas catered to your face’s needs at the time. It reverses sun damage, balances uneven skin tones, and reduces wrinkles. The variation of the chemical peel can be increased with each session.

Liposuction
When diet and exercise leave resistant pockets of fat, liposuction can surgically remove them from areas such as the buttocks, hips, love handles, saddlebags, thighs, calves, ankles, pecs, back, arms and neck. The unwanted fat can be injected into other areas the body, such as the pectoral muscles, sculpting your overall shape. Say hello to a six-pack!

Breast Reduction To Treat Gynecomastia
Gynecomastia is the swelling of breast tissue in men, usually caused by unbalanced hormones. Multiple reduction methods such as liposuction or cutting out excess glandular tissue or a combination of both liposuction and excision can be used to treat gynecomastia.

From outpatient facial treatments to surgical transformations, there are safe and effective options for men who are ready for a change. Remember to consult with a board-certified plastic surgeon to determine the procedure that is best for you.

Written by: Mary Cunningham

NBC’s story about the major consequences of seemingly minor facial treatments calls our attention to a scary but true scenario- doctors you trust for significant care in certain areas of your life –from dentistry to internal medicine–are not likely the best option to administer facial fillers or Botox. But until you know what qualifications to look for, you may be swayed to get an enhancement at the hands of a Botox novice.

To gain some perspective on what we should look for when considering Botox and other facial fillers, Michael C. Edwards, MD, FACS, the president of the American Society for Aesthetic Plastic Surgery gives us the basics on why credentials matter, even for routine aesthetic enhancements.

Mary Joan Cunningham: What have you seen as the most common negative results when someone receives Botox from an unqualified medical professional?

Dr. Edwards: The goal of Botox treatment is to relax the specific facial muscles in a manner to soften lines from muscle action and even lift the eyebrows a bit with proper placement. Treatment by an unqualified injector can lead to dropping the eyebrows, one or both sides, making some patients feel they look worse than they did before. Also, treating too close to the mid eyebrow can lead to a sagging or lazy eyelid called ptosis. These things can happen in the hands of a qualified injector, but I think you can feel confident the incidence will be rare.

Mary Joan Cunningham: Dr. Edwards, in your post about the difference between cosmetic and plastic surgeons, you explained that plastic surgeons receive far more training and have a deep knowledge of their specialization. While we understand why that is important when undergoing major surgery, does that carry a benefit for those only seeking Botox or fillers?

Dr. Edwards: Botox treatment should not be equated with surgery and although the laws differ state to state, there are differing levels of injectors (nurses to physicians of different specialties). If a doctor goes to a weekend course to bring this into their practice as a financial supplement, they should have a solid knowledge of the anatomy and action of the treatment administered. They should also have an understanding of potential risks and possible complications so they can recognize and treat these if they were to occur.

Mary Joan Cunningham: With that in mind, should patients seek out a member of ASAPS when choosing who to administer Botox injections?

Dr. Edwards: They can be rest assured that members of ASAPS have a detailed and comprehensive training about facial anatomy. Patients should feel confident seeking care from a board-certified plastic surgeon, facial plastic surgeon, occuloplastic surgeon and dermatologist.

Mary Joan Cunningham: What do you hope that those curious about Botox will take away from this interview?

Dr. Edwards: That they will realize Botox is a medication with intended positive effects. There are virtually millions of very happy and satisfied patients who undergo treatment every 3-6 months. Everyone should do their homework and seek out care from a properly trained and credentialed board-certified plastic surgeon, facial plastic surgeon, occuloplastic surgeon or dermatologist.

Not all health care professionals administering Botox have the same credentials and experience with facial muscles. Remember, this is the only face you have. Choose wisely.

Written By Mary Cunningham

One of the advantages of aesthetic plastic surgery is that it is an elective procedure. Unlike surgical emergencies of the ER, you have time to prepare.

If you’ve been considering a procedure, here are a few ways to get started:

1. Research board-certified surgeons.
Ok! You’ve decided you want to do… something. Most of us have an idea about the new look we are seeking which resembles the reflection in the mirror when we pull the neck and jowls up and back…or is that just me? But actually, we have no clue how to get there. Even if you’ve spent hours researching buzz-worthy procedures and reviewed hundreds of before-and-after slideshows on the internet, the fastest and best way to figure out how to get where we want to be is to consult with a board-certified aesthetic plastic surgeon. These are experts of the human body who will evaluate your body, your personal musculature and skin quality and recommend a treatment plan that is 100% personalized for you.

Start your search by finding local board-certified plastic surgeons on Smart Beauty GuideThese doctors are all members of the elite American Society for Aesthetic Plastic Surgery and meet a rigorous set of requirements to gain membership status. Set up an initial consultation with at least a few to discuss your desired results. As you listen to their recommendations, also take note of how you feel. You will be putting your trust in this expert for months to come as you prepare for and recover from your procedure. You want someone with whom you can communicate easily, who acknowledges your concerns, and who paints a clear picture of your preparation, healing protocol and realistic expectations for the results. Screen as many doctors as needed until you feel comfortable.

2. Research the procedure, recovery times and possible complications.
Now that you’ve decided on the course of action with your plastic surgeon, educate yourself on the procedure, the recovery times, and possible complications. Knowledge is power. Go into your surgery knowing what the entire process will entail, and ask your doctor any additional questions that come up. They have answers and believe me, they’re used to being interrogated. We are all nervous when trying something new – and surgery is a commitment. Know what you’re getting into beforehand.

3. Adopt healthy habits. No time to start like the present!
We know what we “should” be doing on a regular basis – eating more vegetables, exercising, drinking tons of water. But sometimes our daily grind distracts us from self-care. Yet to be an ideal candidate for surgery, it’s time to make health the top priority. Some doctors will advise losing a certain number of pounds, even if you’re going in for a weight reduction procedure. This is because “healthy patients recover better,” shared Las Vegas’ board-certified plastic surgeon Dr. Jeffery Roth.

Knowing what your plastic surgeon recommends will provide you with a health goal and a timeline to work toward in anticipation of your upcoming procedure.

4. Stop smoking.
Smoking impairs healing and recovery, which could mean scarring. After investing time and money on a surgery – that’s the last outcome we want! Your doctor, your plastic surgeon and the surgeon general will all advise kicking the habit for good. But if you’re not sure that’s an attainable goal, start by planning to quit smoking for four weeks before your procedure and not to resume until four weeks after and who knows? Maybe the temporary stop becomes a long term or permanent quit!

Like any other surgery, this will be a major life moment. Aesthetic plastic surgery is a major life decision, one that can—thankfully—be planned for. Check out the preparation toolkit page and let’s get planning!