Surgery Lowdown | Cosmetic Surgery Advice

Eyelash Transplant: UK First

2009-08-11T10:29:00.000-07:00

Surgeons are claiming to have made medical history with a pioneering transplant – but it won't be saving any lives. Cosmetic surgeons have performed Britain's first successful eyelash transplant, in which hair from the back of the patient's head is grafted on to the eyelid to give long, thick lashes.

With luscious lashes up there with clear skin and white teeth as a must-have for many women, surgeons believe that the £3,500 operation will prove popular. The four-hour procedure, which is already widely performed in the US, was undertaken by the plastic surgery firm Transform.
But as well as offering an alternative to false eyelashes or lashings of mascara for women desperate to look doe-eyed, the procedure is recommended for trichotillomania, an impulsive condition which causes sufferers to pull out their own hair; alopecia suffers; and cancer patients who have suffered hair loss.

The first UK patient to undergo the surgery was 19-year-old Louise Thomas (not her real name), from Manchester, who suffers from trichotillomania.

"Having suffered from trichotillomania for 17 years, I learned to accept that I'd never have real lashes again. That's quite a hard issue for a young girl to come to terms with," Ms Thomas said. "The results are absolutely amazing! I feel so feminine again and simple things like being able to wear mascara have made such a difference to my confidence."

"There are some people who have lost eyelashes through burns or alopecia, whom a little refinement could help enormously," said David Gault, a consultant plastic surgeon and member of the British Association of Aesthetic Plastic Surgeons (Baaps).

"However, if you just want longer eyelashes, I would think about it. If the surgeon put an eyelash in at slightly the wrong angle then the patient would not get the results they want".
The procedure is billed as "pain free and minimally invasive", but because the transplant eyelashes do not fall out naturally like ordinary eyelashes, they need to be trimmed every six weeks.

The technique was pioneered in the US to help burns victims, but has grown in popularity. Recent research by the American Academy of Cosmetic Surgery revealed that "eyelash rejuvenation" topped the wish list of procedures. Another US eyelash enhancer tipped to hit UK shores is Latisse, an ointment that was originally a treatment for glaucoma but which causes eyelashes to grow longer and thicker.

Facelift eases migraine pain

2009-08-06T05:13:00.000-07:00

A simple operation that ends the misery of migraines while rejuvenating the face has been devised by surgeons. The one-hour procedure offers fresh hope to the millions whose lives are blighted by crippling headaches. In the UK, migraines affect one in eight men and women and lead to more sick days than any other illness - costing the economy billions a year. Current drugs have side-effects and do not work for everyone, but the operation, which is based on the forehead lifts carried out by cosmetic surgeons, is more than 90 percent effective at easing the pain.

And it has few side-effects, the official journal of the American Society of Plastic surgeons reports. Professor Bahman Guyuron, the leading plastic surgeon who made the discovery, said: "I have a huge number of patients who have not had any symptoms for over five years. "They tell me, one after the other, that their lives have changed."

Guyuron, a director of the American Board of Plastic Surgery who has published more than 150 articles in respected medical journals, stumbled on the idea while carrying out forehead lifts for cosmetic purposes. He realised that removal of the "frown muscle", or Corrugator supercilii, seemed to stem migraines. Guyuron believes many migraines are caused by nerves in face, neck or scalp being irritated by over-tight muscles and that removing or loosening these eases the pressure and therefore the pain. He has carried out numerous studies into the technique and regularly trains other surgeons.

The "frown muscle" is most commonly operated on, providing the added benefit of a smoother forehead. Other migraine hotspots include the temporalis muscle, which is found in the temples and plays an important role in chewing. Stopping it triggering migraines results in the eyebrows being shifted slightly to the side - and a more youthful look. In his latest study into the subject, Guyuron has compared the surgery with a dummy treatment in which patients were operated on but their muscles left intact.

Forty-nine men and women with severe migraines had the proper operation and 26 the other procedure. A year later, 57 percent of patients who had the full operation had been cured, compared with just 4 percent in the other group. In all, 83 percent of those who had muscle removed said their migraines were much less severe or had stopped. But when other studies involving more than 400 patients are taken into account, the success rate soars to above 90 percent.

Guyuron said: "Patients are back to work in a week or less and the benefits last for the rest of their lives. I would not call the surgery radical. If it was a 10-hour operation I would call it radical. "There was no cure for migraines until I discovered this op. Every patient had to take medication to reduce the potential of migraines or to take the symptoms away." Lee Tomkins, of British charity Migraine Action, welcomed the innovation but said: "Caution is needed until a scientific assessment of such an intervention is made. We would certainly encourage any future clinical trials."

John Cleese says Hair Transplants are No Laughing Matter

2008-11-14T08:12:00.000-08:00

Throughout his career, John Cleese has been ahead of the game - and yesterday, the star of Fawlty Towers gave hope to many follicularly-challenged males when he told Richard Madeley and Judy Finnegan that he'd not only had a hip transplant but a hair transplant.

The explanation he gave was typical Cleese: "Because I've got a very strange shaped skull, very pointy and I don't like wearing wigs."

Treatments for male pattern baldness have come a long way from Hippocrates' times - he applied a mixture of pigeon droppings, horse-radish, cumin and beetroot to his head. Cow saliva, bats milk, deer marrow, spiders' webs, horses teeth and coffee are other remedies that men throughout the ages have turned to in an increasingly desperate attempt to turn the tide of hairlessness (the term 'snake oil' originally comes from a tonic hawked in 19th century America as a baldness therapy).

However in the 21st century there have been steps forward for the man mourning his hair loss. There are medicines that have been proven in some cases to encourage new hair growth and stop the rate of hair loss (Minoxidil and Finesteride); and there are human trials currently taking place to see if hair follicle cells grown in the lab will grow in the head once replanted .

Most importantly, if you have a spare £5-8,000, hair transplantation has improved – and is continuing to improve - beyond the dreams of its early practitioners. Cleese lives in America now, but there are surgeons who are looking at this in the UK.

Greg Williams is the consultant in charge of the burns unit at London's Chelsea and Westminster hospital. He is one of a handful of surgeons in the UK who are pioneering new techniques for hair transplantation, and treats those who have lost hair, eyelashes and eyebrows due to burns, cancer treatment and male pattern baldness, though the latter is not available on the NHS.

Male pattern baldness (also known as genetic hair loss or alopecia androgenetica) is the most common form of hair loss in men. It usually develops gradually, typically involving the appearance of a bald spot on the crown of the scalp accompanied by thinning at the temples. The condition will affect half of all British men by the time they are 50 (almost a third are appreciably bald by the age of 30).

It occurs when hair follicles, the tiny sacs in the scalp from which hair grows, become sensitized to the hormone dihydrotestosterone, or DHT, which stimulates the growth of facial and body hair. The follicles shrink, so the hair becomes thinner and grows for less time than normal. The condition runs in the family, and the strongest influence is on the mother's side: if your maternal grandfather went bald, that's probably a better indicator than if your father's father lost his hair.

Put simply, hair transplantation works by taking hair from the areas that are not affected by hair loss and transplanting them to the areas that are. According to Mr Williams the results are "very good", though the take of grafts is less reliable in scar tissue than in healthy normal tissue (75–80 per cent for scar tissue compared to 95-98 per cent in normal tissue).

"Any man with male pattern baldness will have a horseshoe of hair remaining around the back and sides of his head," says Mr Williams, and it is from here that a strip of skin will be taken under local anaesthetic. The hairs from this section of skin will retain their own characteristics (ie they grow) rather than acquiring those of the place to which they are transferred (where hair does not grow). Dissecting the hairs from this strip of skin into their follicular units is painstaking work ("you have to have OCD to do this job", says Williams) and performed by a team of three or four technicians. Filling in a patient's temples alone, say, could require 500 hairs.

Old fashioned 'plugs' – the ones that gave hair transplants a bad name - would implant 12-15 hairs at one go. The modern ones use 1-3 hairs, inserted in incisions ranging from .75mm to 1.5 mm in diameter. "I normally aim to use single hair follicular units in the most important aesthetic areas, like eyebrows, eyelashes or the front hairline," says Mr Williams. "Further back I use larger groups of hairs." On average, the surgery takes around five to six hours.

It takes around 6-9 months to see the effect, but by then the hair should be growing as it did in its old home (patients who have had eyebrows or eyelashes done need to be aware of this, and the fact that they will now have to trim them every 5 -7 days). Although all patients are made aware that more work may be needed in the future , as male pattern baldness is progressive, the process can be life-changing.

"I had a patient who used to wear his hair over his eyes all the time because his eyebrow had been burnt off," says Williams. "Now he wears it off his face and that's made a big difference. There's another man who I'm about to operate on who can't go for job interviews because he feels he has to wear a hat all the time. It can be crippling."

Indeed. A recent survey of five European countries found that British men are unhappier about being bald than most of their European counterparts, but are too embarrassed to do anything about it. More than half said going bald made them feel old and less attractive.

Two years ago, LibDem MP Mark Oaten blamed his midlife crisis and ensuing sex scandal on losing his hair. It's unfortunate then that skilled hair transplantation is still so rare - the British Association of Hair Restoration Surgeons of which Williams is a member numbers only 11 members, and he is only one of two surgeons in the country who transplants eyelashes.

But he remains upbeat. "The reason it's not so popular in the UK is that the training is almost non-existent and people have memories of the bad transplants in the past," he says. "Cosmetic surgery in the UK lags behind America by about 10 years but as we are seeing more and more men having plastic surgery and botox I'm sure there are more who will be interested in hair transplantation."

And with Cleese speaking out with enthusiasm for such operations, Williams is likely to be right.

Julianne Moore Changes Mind About Cosmetic Surgery

2008-11-14T08:06:00.000-08:00

The star of new movie 'Blindness', 47-year old Julianne Moore, has always been outspoken about her negative feelings concerning cosmetic surgery. But recently, it seems the Oscar-nominated actress has had a change of heart.

The actress has been quoted as saying a few years ago, “I would never ever have plastic surgery. We’re all just going way too far. I know it’s a product of the whole celebrity industry, but it’s something I absolutely detest. I want my daughter to see what is real, not what is unachievable and fake.’ The 46 year old actress believes in aging gracefully and that the aging process is a “fact of life.” Moore adds, “I’m a 43-year-old woman, and 43-year-old women have lines. I think imperfections are important, just as mistakes are important. You only get to be good by making mistakes and you only get to be real by being imperfect.”

She also more recently spoke out against Botox, a dermal injectable used to combat wrinkles, saying, “”I don’t know why women do Botox. It doesn’t make them look younger, it just makes them look like they had work done. You are not going to look the same as you did at 25. What are you going to do about it?”

But now, the red-headed vixen is changing her tune in regards to going under the knife, reportedly saying, “I never say never.”

But the newfound open-mindedness came with a caveat, as she is quoted as saying, “The only thing that worries me, the analogy I use is ancient Chinese feet-binding.

At what point did they decide that small feet were more beautiful? People started making them smaller and smaller until they were stumps and not beautiful at all.

I feel we have decided that being expressionless and young looking is the most beautiful thing and, in pursuit of that, it becomes more and more exaggerated and totally obliterates what we look like.”

On his blog, Dr. Anthony Youn writes, “I think the Chinese foot binding analogy goes a bit far. Much of plastic surgery is meant to restore the body to a previous state or remove excess skin that can become both a cosmetic and functional problem, such as tummy tucks and thigh lifts. The aim of good plastic surgery is a natural rejuvenation, not abnormal deformation like in Chinese foot binding.”

Dark Side of Cosmetic Surgery Addiction

2008-11-14T08:00:00.000-08:00

The Telegraph reported recently on a Korean woman addicted to plastic surgery has been left unrecognisable after her obsession led her to inject cooking oil into her face.

Hang Mioku, now 48, had her first plastic surgery procedure when she was 28; hooked from the beginning she moved to Japan where she had further operations - mostly to her face.

Following operation after operation, her face was eventually left enlarged and disfigured, but she would still look at herself in the mirror and think she was beautiful.

Eventually the surgeons she visited refused to carry out any more work on her and one suggested that her obsession could be a sign of a psychological disorder.

When she returned home to Korea the surgery meant Hang's features had changed so much that her own parents didn't recognise her.

After realising that the girl with the grossly swollen face was indeed their daughter her horrified parents took her to a doctor. Once again the possibility that Hang had a mental disorder was raised and she started treatment.

However, this treatment was too expensive for her to keep up and she soon fell back into old ways.

Amazingly, she found a doctor who was willing to give her silicone injects and, what's more, he then gave her a syringe and silicone of her own so she could self-inject.

When her supply of silicone ran out Hang resorted to injecting cooking oil into her face.

Her face became so grotesquely large that she was called "standing fan" by children in her neighbourhood - due to her large face and small body.

As Hang's notoriety spread she was featured on Korean TV. Viewers seeing the report took mercy on her and sent in enough donations to enable her to have surgery to reduce the size of her face.

During the first procedure surgeons removed 60g of foreign substance from Hang's face and 200g from her neck.

After several other sessions her face was left greatly reduced but still scarred and disfigured.

And it would seem that even Hang can now see the damage she has done; she now says that she would simply like her original face back.

Vegas Doctor Refuses Surgery to Smokers

2008-11-14T07:54:00.000-08:00

A Summerlin-area surgeon is making sure his patients not only know, but see, the negative consequences of smoking on certain cosmetic procedures.

For a face lift, a tummy-tuck or a breast lift, Dr. Samir Pancholi, a board-certified cosmetic surgeon who practices at 8068 W. Sahara Ave., requires that his patients stop smoking four weeks before the procedure and refrain from smoking for four weeks after the surgery.

If they are having a hard time grasping the concept of the dangers of smoking, he shows them graphic pictures of people who falsely said they quit smoking prior to their surgeries.

Patients see dead, black skin and fat around the operated area. They see raised, red scars and deep bruising. They see skin tissue that needs to be removed, sometimes requiring a skin graph to repair. In some cases they see photos of patients who had to be hospitalized and receive antibiotics.

"People are shocked," Pancholi said. "I really do gauge how receptive people are to me showing them the pictures. I show them the pictures if I feel they're not really getting it, or if they feel I'm blowing smoke at them about the seriousness of the situation."

Some 12 million cosmetic surgery procedures were performed at a cost of $12 billion in 2007, with the number of procedures up 7 percent from 2006, the American Society of Plastic Surgeons reported. The number of procedures had doubled since 2000, the society said.

Because of the growing number of procedures, more studies are being done and more is coming to light about the effects smoking can have on certain cosmetic surgeries.

Nicotine from cigarettes restricts blood flow and oxygen to the healing skin, potentially causing the tissue operated on to die.

For procedures like Botox or breast augmentation, Pancholi recommends that patients quit smoking, but doesn't require it because survival of the tissue is not as dependent on blood supply. In procedures like a tummy tuck, where skin at the bottom of the stomach depends on blood flow supply from around the rib cage, the bloody supply is coming from a long distance, requiring no restriction to blood flow, Pancholi said.

Pancholi is not the only surgeon requiring patients to kick the habit. Dr. William Zamboni, professor of plastic surgery the University of Nevada School of Medicine and spokesman for the American Society of Plastic Surgeons, mandates that his patients completely abstain for three weeks before and three weeks after for a face lift, breast reduction or a tummy tuck.

"More than ever are plastic surgeons aware of the dangers of smoking on certain plastic surgeries," Zamboni said. "I don't know exactly the percentage of how many doctors require abstinence of smoking for a time, but I hope that 100 percent of board-certified plastic surgeons make it mandatory. If the patients having those procedures don't quit smoking before and after, they're just asking for trouble."

Even one cigarette puff or walk through a smoky casino could damage the tissue, Zamboni said.

"And if they have family members who smoke, they must go outside," he said.

To be sure his patients have quit, Pancholi requires that a week before the surgery, every patient take a urine test to check nicotine levels.

"You do see people who just can't quit," Pancholi said. "I don't feel comfortable doing the surgery. There are other alternatives that are less risky. They may not provide ideal results, but when it comes to health versus cosmetic, I choose health."

If patients are serious about quitting, but can't seem to do it, even with graphic pictures, Pancholi prescribes medicine like Chantix to help patients quit. Nicotine gum, however, cannot be used because it has nicotine.

The good news about requiring people quit for a period of time is that some who have been trying to quit for years find a motive to help them quit permanently.

"If they can quit smoking for six weeks, they're pretty well off to quit," Zamboni said.

About one in five of Zamboni's patients who are required to quit smoking will quit for good, he said.

"In life, they've never abstained for six weeks, so once they've done that, they realize they can quit," he said.

In general, Las Vegas is a very popular city for cosmetic surgery because of the entertainment industry. Both Zamboni and Pancholi said the most popular cosmetic surgery is breast augmentation.

Television shows focusing on cosmetic surgery and lower costs are a couple reasons cosmetic surgery is growing, but TV doesn't always depict the risks of the procedures, Pancholi said.

"The perils of cosmetic surgery are not presented on television," he said. "Hopefully I can reiterate some of the risks to patients in my office so they understand before surgery and after."

Big Brother Celebrity Sues Plastic Surgeon

2008-10-21T04:06:00.000-07:00

Ex-Celebrity Big Brother contestant Pete Burns will get compensation for botched lip injections which left him feeling 'repulsive' and 'suicidal'.

The 1980s pop star sued Harley Street surgeon Dr Maurizio Viel after suffering swelling and blisters caused by the treatment.

Last week the doctor's legal team admitted to the High Court that Pete was not properly warned of potential side-effects of the product called Outline Original.

Dr Viel also failed to observe guidelines about its use in conjunction with other products, and gave an excessive number of follow-up injections.

Pete claims he was forced to sell his musical back-catalogue because he was unable to work, and will also be suing Dr Viel for financial losses.

Auriana Griffiths, from firm Irwin Mitchell, said: "The barrister representing Dr Viel confirmed last week in court that the allegations of negligence set out in the original documents filed at court have been admitted.

"At this stage, the investigation into the value of the case is ongoing and no figure has been agreed."

Botox Jabs May Cause Long Term Damage

2008-10-21T04:00:00.000-07:00

The Telegraph has reported about the growing trend in applying botox injections to the bectoral region. The procedure, pioneered by American doctors, involves injecting the botulinum toxin into the pectoral muscles, causing the chest to rise up.

Trends in American cosmetic surgery tend to be transferred quickly to the UK, but British surgeons have expressed concern about the possibility of the "Botox boob job" being carried out by beauticians or nurses, due to less strict regulation than in the US on non-surgical treatments.

"These are the major muscles that you use to ski, turn over in bed, do everything. For me, the risks outweigh the benefits," Dr Nick Milojevic, a Botox specialist at the Harley Medical Group cosmetic surgeons, told the Independent. "You'd need a lot of Botox for this treatment to work, so it would cost around £1,000 per treatment, and it is something you'd need to repeat three times a year."

There are a range of similar treatments already available in the UK, the most popular being the "boob jab," in which a temporary filler is pumped into the breast. Milojevic described the most popular filler, Macrolane, as "one of the most exciting things to happen in aesthetic medicine in years."

Despite the high cost of Macrolane, at around £2,800 for the initial treatment and a £1,400 annual top-up, interest in the procedure has grown exponentially. Nationwide cosmetic surgery chain SurgiCare, which has recently introduced Macrolane, yesterday announced a 135% increase on last September in enquiries about breast augmentation.

However, Nigel Mercer, president of the British Association of Aesthetic Plastic Surgeons (Baaps), warned that: "If put in the wrong place, filler can leak out through the ducts in breasts. You can also get granular formation – lumps". He added: "The thought of a nurse performing this is alarming. The Government are shy of regulating this industry, although professionals and consumers are pushing for it."

Obesity is Cause of 31% Rise in Surgery

2008-10-17T04:35:00.000-07:00

Flabby skin caused by obesity or dramatic weight loss has led to the number of men having a £4,000 operation to reduce "moobs" – fat on their breasts – rise by a quarter in five years, while 18 per cent more women have undergone breast uplifts.

Since 2003, tummy tucks on both sexes have risen by almost one third, according to Harley Medical Group, Britain's biggest cosmetic surgery company.

It says the many of the procedures are for patients who have lost large amounts of weight from dieting and require post obesity surgery. The firm has carried out more than 10,000 such operations over the past five years.

Senior surgeon Waqar Malik said 21 per cent of men and 22 per cent of women in the UK are classed as clinically obese, a figure which is predicted to rise to a quarter of all adults in 2010, meaning that tummy tucks may overtake breast enlargement as the clinic's most popular treatment over the next 10 years.

Doctors say men are finding it more acceptable to pay to alter their appearance. Just a few years ago, most plastic surgeons would not have operated on men.

Last week The Daily Telegraph disclosed that three-quarters of Britons are too fat and that 10 per cent more adults are overweight or obese than previously believed, putting them at risk of suffering serious health problems such as Type 2 diabetes and heart disease.

John Wright, from Lincolnshire, who had a tummy tuck operation and male breast reduction, called gynaecomastia after he lost 22 stone, said: "After the immense effort and hard work of losing so much weight it was utterly soul destroying to see vast folds of skin hanging from my body.

"My local GP would not refer me to have cosmetic surgery on the NHS and so I was forced to go private. I used almost £10,000 of my savings, but I think it was worth every penny."

Lisa Littlehales, head nurse at The Harley Medical Group, said: "It is heartbreaking to see patients who have achieved so much to lose dramatic amounts of weight so embarrassed by their post weight loss bodies.

"Surgery is able to transform both their bodies which have been so vastly overstretched and in the process restore their confidence."

A male breast reduction operation costs £4,050. The surgeon makes an incision near the nipple and removes excess fat by liposuction. The operation takes 1 to 2 hours and patients can return to work in a few days.

For a £6,090 tummy tuck an incision is made below the belly button across the stomach from hip to hip. During the procedure abdominal muscles are tightened and excess skin is removed.

Figures from the British Association of Aesthetic Plastic Surgeons (BAAPS) show a 61 per cent increase in the number of men having surgery to flatten their stomachs last year. Liposuction is now the second most common operation performed on men after nose alterations.

Australian Surgeon Issues Warning

2008-10-17T04:34:00.000-07:00

BRISBANE: A leading local plastic surgeon is warning against the dangers of under-qualified doctors, claiming rogue operators are on the rise in the CBD.

Dr Andrew Broadhurst, 40, a fully accredited plastic surgeon with five years’ experience, runs Enhance Plastic Surgery in Fortitude Valley.

A member of the Australian Society of Plastic Surgeons (ASPS), Dr Broadhurst believes up to 50 per cent of practising doctors are under-qualified to be performing serious cosmetic or plastic surgery.

“Yes, there are a lot of rogue operators out there,” he said.

“It (dangerous surgery) happens all day, every day it happens everywhere.

“The results of defective, ill-informed or falsely advertised surgery can be devastating and many patients feel cheated by the system because an under-qualified doctor or glamorous advertisement coerced them.”

Dr Broadhurst said the lucrative nature of plastic surgery procedures, such as breast implants, saw many rogue operators rush to perform them.

“There is a vast difference between an actual plastic surgeon and what can be termed cosmetic doctors,” he said.

“A plastic surgeon has more extensive education and training.

“While unfortunately anyone with a medical degree can perform cosmetic surgery in Australia, it actually takes seven years of specialisation on top of your degree to qualify as a full plastic surgeon.”

He said his average client was aged 20-50, many of whom were ill-informed.

“It’s not your Ascot-Hamilton set it’s your average Joe Blow off the street getting all these procedures,” Dr Broadhurst said.

An ASPS spokeswoman echoed Dr Broadhurst’s concerns about under-qualified doctors, but said Queensland was the only state in Australia where to use the term “plastic surgeon” you had to be qualified as one.

Twiggy Gives Opinion on Cosmetic Surgery

2008-10-17T04:32:00.000-07:00

In an interview with the Daily Mail, supermodel Twiggy, nee Lesley Hornby, corrects past perceptions of her views on plastic surgery.

At almost 60 years of age, Twiggy still looks great. To date, Twiggy follows a sensible diet and exercise plan, one which does not involve plastic surgery, which she describes:

“I work hard, I try to eat healthily and I do plenty of exercise. I’m not fanatical, but I try to be sensible. I eat organic food, I avoid fried stuff and I don’t eat desserts that often.
God bless Jamie Oliver for getting everyone thinking and talking about healthy eating. I do Pilates and tap-dancing classes. The secret is to find a form of exercise that you enjoy.”

Although she is a fan of plastic surgery, she has not yet undergone any cosmetic surgery.

When posed the question, “You’ve said that you would never resort to plastic surgery. Do you think that the pressure to keep looking young for ever has become too great?” by the Daily Mail, the leggy blonde responded:

“Actually, what I said was that I haven’t had plastic surgery yet. I’m not totally against it. I’ve had friends who have had little things done and they look sensational. I think that if you’re going to have it done, research it properly and go to the best surgeon. I have, however, said that I’ll never have Botox.”

If Twiggy’s exhaustive career as a supermodel, Broadway star, actress, author, TV presenter and producer, and fashion designer continues, plastic surgery can’t be far off as stress takes a toll on the appearance.

So far, Twiggy’s anti-aging efforts have proven to be more than successful and it’s nice to know that she’s realistic in her views of plastic surgery and sees that it may become necessary in her future.

Twiggy OK with Cosmetic Surgery

2008-10-17T04:31:00.000-07:00

“I work hard, I try to eat healthily and I do plenty of exercise. I’m not fanatical, but I try to be sensible. I eat organic food, I avoid fried stuff and I don’t eat desserts that often.
God bless Jamie Oliver for getting everyone thinking and talking about healthy eating. I do Pilates and tap-dancing classes. The secret is to find a form of exercise that you enjoy.”

Although she is a fan of plastic surgery, she has not yet undergone any cosmetic surgery.

When posed the question, “You’ve said that you would never resort to plastic surgery. Do you think that the pressure to keep looking young for ever has become too great?” by the Daily Mail, the leggy blonde responded:

“Actually, what I said was that I haven’t had plastic surgery yet. I’m not totally against it. I’ve had friends who have had little things done and they look sensational. I think that if you’re going to have it done, research it properly and go to the best surgeon. I have, however, said that I’ll never have Botox.”

If Twiggy’s exhaustive career as a supermodel, Broadway star, actress, author, TV presenter and producer, and fashion designer continues, plastic surgery can’t be far off as stress takes a toll on the appearance.

So far, Twiggy’s anti-aging efforts have proven to be more than successful and it’s nice to know that she’s realistic in her views of plastic surgery and sees that it may become necessary in her future.

Dr Mandell-Brown is top Rhinoplasty Surgeon

2007-09-13T08:33:00.000-07:00

Cincinnati, Ohio (PRWEB) September 13, 2007 -- Dr. Mark Mandell-Brown was voted the "Top Doc in Rhinoplasty Surgery," according to a poll of 1,500 physicians held by Cincinnati Magazine. Due to his ability to sculpt a "Natural Look,"™ Dr. Mandell-Brown is the number one choice among both physicians and patients in the tri-state area.
Dr. Mandell-Brown in Cincinnati, Ohio has performed thousands of rhinoplasty procedures and has provided patients with exceptional results. Although rhinoplasty surgery is very common now, it does require the skills of an experienced artistic sculptor to create positive results. There are risks involved with Rhinoplasty, and there are methods to avoid these risks and complications.

Estimates indicate that more than one-quarter million people have Rhinoplasty surgery performed each year in the United States. Rhinoplasty remains the most common cosmetic surgery option among men and women alike. With at least 20% of the population admitting that they are uncomfortable with their noses, it is easy to see why rhinoplasty has become such a popular cosmetic surgery option.

Statistics indicate that the most common complication arising from rhinoplasty procedures stems from cosmetic issues.

Prior to having your rhinoplasty surgery, request to see before and after photos from the physician of the same type of surgery you desire. It is also important to ask questions regarding the number of successful procedures performed and how the surgeon will deal with complications, in the event they arise.

The best way to avoid potential problems is to ensure you have an open dialogue with your physician regarding the desired results. Working with a skilled physician experienced in the delicate art of rhinoplasty is a positive step toward ensuring beautiful results.
Dr. Mandell-Brown utilizes computer imagining during consultations in order to demonstrate the potential goals of rhinoplasty surgery. While it should be understood that computer imaging does not guarantee a specific result, it does work to enhance communication between the physician and the patient.

About Dr. Mandell-Brown - Mark Mandell-Brown, MD, is a double-board certified facial plastic surgeon and body cosmetic surgeon with more than 20 years of experience as a cosmetic surgeon in the Dayton - Cincinnati - Ohio area. He specializes in "Natural Look"™ cosmetic surgery for the face and body and utilizes a "minimal incision" approach for the face and body.

Facelifts - Before and After

2007-08-11T07:21:00.000-07:00

Here are our before and after pictures of facelift surgery. We will be continuing our before and after series with other cosmetic surgery procedures...

As you can see, the facelift surgery brings back a more youthful appearance in each of the more successful cases above.

Breast Implants - Before and After

2007-08-01T11:14:00.001-07:00

Here are our before and after pictures of breast implant surgery. We will be continuing our before and after series with other cosmetic surgery procedures...

All the results in the above photos were the results of procedures undertaken in the United States. As you can see though, cosmetic surgery can be a great enhancement.

Basic Tummy Tuck Information

2007-07-30T05:51:00.000-07:00

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on tummy tucks...

Abdominoplasty

The decision to have this procedure should only be made after an examination in consultation with your surgeon. If you have loose muscle and excess skin in both the upper and lower abdominal areas with only modest fat deposits you will most likely require a full Abdominoplasty/Tummy tuck. If however you have loose skin confined mainly to the lower abdominal area but have retained good skin and muscle tone above the umbilicus with little or no excess fat, then a "mini tuck" may suffice. Alternatively if this is accompanied by modest excess fat in the upper abdomen then liposuction may be used in conjunction with the "mini tuck" to improve the result. It would be fair to say that the term "mini tuck" is actually a misnomer as the scar is about 10 inches long and cannot be deemed very "mini" therefore most surgeons find that the most pleasing results can really only be achieved by performing a full Abdominoplasty/Tummy tuck.

Following surgery, be prepared for considerable swelling and bruising of the abdomen. This will be even more noticeable if the Abdominoplasty/Tummy tuck was accompanied by Liposuction. The bruising usually lasts app 3/4 weeks. While most of the swelling will have dissipated by this time, some subtle swelling will still be present for up to 3 months.

In addition you will notice that the abdomen will feel firm to touch, particularly along the edges of the incision site. This will be as a result of the normal healing process laying down elements of scar tissue to facilitate healing. When this occurs, massage as instructed by your surgeon will speed up the recovery. It gradually resolves in time but may take a few months to complete. You should expect the sensation to the skin over the lower abdomen to be reduced after surgery. This is as a result of surgical trauma to the nerves in the region. Although this usually recovers in a few months, permanent numbness in the region can ensue. Abdominoplasty/Tummy tuck is usually performed under general anaesthesia (completely asleep). You will require a minimum of one overnight stay at the hospital.

When an Abdominoplasty/Tummy tuck is performed by a qualified plastic surgeon the risks are small, nonetheless, specific complications with this procedure can and do occur. Providing one accepts you must not expect to see results immediately and be aware of the recovery period, the results are pleasing. The procedure will give confidence to the individual and allow you to wear clothes that you found were previously unsuitable. The effects are generally long lasting provided you follow a balanced diet and exercise regularly.

Basic Liposuction Information

2007-07-30T05:48:00.000-07:00

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on liposuction...

Liposuction is the removal of localised unwanted lumps and bulges of fat by the use of fine straw like metal tubes, called cannulaes. In women and men, these localised fat deposits may be formed virtually anywhere on the body but are more commonly deposited on the abdomen, hips, flanks, inner and outer thighs, knees and chin. In men a condition called gynaecomastia (fatty breast enlargement) is very common.

The cannulaes are inserted into the body fat through tiny incisions. A vacuum is subsequently applied through a hose attached to the cannula and the fat is drawn out of the body. Liposuction is not an alternative to weight loss and exercise, but rather a means of resculpting the body into a slimmer profile by removing the fat that does not respond despite strenuous diet and exercise efforts.

In the some cases however, patients may have decreased skin elasticity as witnessed by loose, hanging, or crepey skin in the affected area. In these cases liposuction alone will not produce the desired result and you may therefore require some form of skin removal/reduction instead (i.e. tummy tuck) or perhaps in combination with liposuction.

Liposuction is the probably the most popular cosmetic surgery procedure in the UK. It is an effective technique for giving you a new body contour with minimal scarring. In most instances it will improve your body image by making you feel better and more comfortable about your body.

The results can be permanent, providing you eat sensibly, exercise regularly, and maintain your weight. As long as your expectations are realistic and understand that the final results may take from a few weeks to a few months before becoming apparent, you should be happy with your new shape.

Liposuction will not remove the orange peel skin condition known as cellulite.

Basic Eyelift Information

2007-07-27T08:26:00.000-07:00

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on eyelifts...

Blepharoplasty (Eyebag / Eyelift Surgery)

The normal ageing process involves the stretching of the eyelid skin resulting in excess folds and wrinkles, sagging of the fat around the eye itself and appears as bulges in the upper and lower lids. Heredity is often an important factor when young or middle-aged patients exhibit changes that are usually associated with older age. These patients are used to comments from their friends that they constantly look tired, despite having had a good night's rest.

Although Eyelift/Eyebag removal surgery can correct drooping upper lids and puffy bags below your eyes, it cannot remove crow's feet lines, or eradicate all eyelid creases. Any attempt to do so would invariably require excessive tensioning of the skin, which would result in a downward pulled or staring appearance of the eyelid. Nor does it improve or lift sagging eyebrows. Procedures such as laser skin resurfacing (for lines and wrinkles) and the Brow lift (for sagging eyebrows) are designed for these purposes.

A properly performed Blepharoplasty procedure will brighten the face and restore a more youthful appearance. And while it is true that it can add an upper eyelid crease to Asian eyes, it will not erase evidence of your ethnic or racial heritage.

On the upper eyelids the incision is carried out in the natural crease line that occurs approximately 1 cm above the eyelashes. The incisions may extend into the crow's feet or laughter lines at the outer corners of your eyes. Surgery here is designed to correct both the excess skin and the excess fat. After making the incisions, the excess skin and muscle is trimmed from the upper eyelids together with any fat, which is usually present on the area adjacent to the sides of the nose. The incisions are then closed with very fine sutures.

On the lower eyelids, the technique very much depends on the patient's individual circumstance and requirements. Therefore if the problem is mainly prominent lower bags without excessively loose skin, you may have what is termed as a Transconjuctival Blepharoplasty. In this procedure the incision is made inside your lower eyelid, leaving no visible scar. Alternatively, when loose skin needs to be trimmed, the incision starts underneath the eyelashes and extends 1 cm or so outwards into the crow's feet area. The skin is then lifted upwards and outwards, gently tensioning the area and overlapping skin removed.

Eyelid surgery is performed using either local or general anaesthesia depending on the extent of surgery. In the former, the skin around your eyes will be numbed using an injection. This is usually accompanied by some intravenous sedation to make you feel relaxed and insensitive to pain. In the case of a general anaesthetic you will be completely asleep. The type of anaesthetic suitable for you will be discussed at the time of the consultation.

The Eyelift/Eyebag surgery together is normally carried out under a general anaesthetic, but in most single procedures (uppers or lowers) are commonly performed as a sedation day case procedure.

Basic Nosejob Information

2007-07-27T08:18:00.000-07:00

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - this one's on nosejobs...

Rhinoplasty

Rhinoplasty is carried out under general anaesthesia and in some cases through incisions inside the nostrils, In the majority of cases there are no external scars, unless you decide to have the size of the nostrils reduced (alar base reduction). In this case small scars around the sides of the nostrils are necessary which are placed in the natural crease lines between the nose and cheek.

In Rhinoplasty, firstly the hump is removed with a delicate chisel cut to give the new profile. If nothing else were to be done the bridge line would be too wide and so it is usually necessary to fracture the nasal bones in a carefully controlled way, to allow them to meet in the midline and narrow the bridge line again. A plaster cast is applied for app seven days to support and protect the bones while they set into their new position. The tip of the nose is shaped by cartilage underneath the skin. These are adjusted in size and shape to refine the nose so that it matches the new profile. When surgery is complete, small dissolvable stitches are used inside the nostrils and the plaster cast and nasal packs are applied.

Nasal packs may be necessary to prevent bleeding and ensure that the lining of the nose adheres correctly. If breathing passages have been operated upon, it may take longer for the nose to clear. This procedure can be done either as a day case or overnight stay in hospital.

It is essential that you understand you must be patient. The nose takes between 6/9 months for the final shape to be fully achieved.

Basic Facelift Information

2007-07-27T07:59:00.000-07:00

We've created basic descriptions and explanations of the most popular procedures for you to help you figure it all out - the first is on facelifts...

Facelift (Rhytidoplasty)

The best candidate for a facelift is a man or woman whose face and neck have begun to sag, but whose skin still has some elasticity. There is no need to wait until hanging folds or almost irreversible changes have taken place. While the facelift procedure is probably the most sought after within the over 40's group, increasingly these are being carried out on younger patients. In fact these days, many patients prefer earlier corrections to maintain youthful appearances, and therefore avoid living through a period of looking "old and tired".

The incisions used for both men and women are the same, although there is a slight difference, as result of the hair bearing nature of the male facial skin. Generally speaking the incision starts high in the temple area (hidden by the hair at this point) then courses down in front of the ear round the earlobe and up behind the ear before curving gently back into the hairline of the neck. It may on occasion, be necessary to add an incision in under the chin. A facelift can be performed either with local anaesthesia or a full general anaesthetic. This may also depend on whether you will be having extra work done to the eyes or brow area. Surgery for a facelift can take between 2-3 hours, although this takes longer when combined with additional surgery i.e. eyelid surgery.

Facial Fillers

Restylane and Outline effectively improve the most common initial signs of ageing, between the eyes (Glabbelar) nose to mouth depressions lines (Naso labial) and fine line around the lips. These products do not need allergy tests and the results can be seen immediately. Fillers involves injecting a substance into the skin to correct wrinkle, depressions, and scarring. When injected beneath the skin, fillers plump up the line depressions and fill out sunken areas of the face. They can also add fullness to the lips and cheeks.

Laser Skin Resurfacing

Lasers in medicine have been around for a number of years and have always been synonymous with "state of the art". Through constant development and research, laser technology eventually linked with computer technology, and the skin- resurfacing laser was created. Although many lasers now exist for different purposes, the carbon dioxide laser has emerged as the mainstay of treatment of wrinkles and scarring. It is thus very effective in rejuvenating ageing skin particularly around the mouth and eyes. Often the procedure is done in conjunction with another cosmetic operation such as a facelift or eyelid surgery. Certain skin blemishes, moles and warts can also be addressed with the carbon dioxide laser, It should be noted however that laser resurfacing is basically confined to treatment of the face and its suitability for treatment of the neck, hands and other areas has not been fully established.

It is important to understand that only finer lines can be completely eradicated with this procedure. Deeper wrinkles or smile lines etc. can only be reduced in depth and not removed altogether. In these cases, the improvements are in the order of about 50%. Additionally laser skin resurfacing will not remove dynamic lines where the skin is attached to the muscle, such as the nasolabial (nose to mouth) lines.

Laser resurfacing is a clinically induced burn; the software within the machine allows the surgeon to regulate the depth of penetration to safe levels, in order to allow even delicate areas of the face to be treated. The technique works by passing a beam of laser light of high power but very short duration (seven millionths of a second) onto the skin surface. It is in fact this phenomenal speed, which limits the spread of the generated beat to deeper tissues, thereby limiting any risk of scarring. Patients with darker skin such as those of Asian or Mediterranean background are at a higher risk of colour changes developing after the treatment and therefore will be advised accordingly.

Our Mission

2007-07-26T04:59:00.000-07:00

Surgery Lowdown is here to offer practical and safe advice on all questions and concerns related to cosmetic surgery. Any statistics, medical findings and industry recommendations we hear about will be listed here.

With so many practices offering a number of different cosmetic surgery procedures it's important that you're armed with the right information. As doctors and surgeons ourselves, we know that getting good advice can often be difficult and sometimes costly just for a consultation.

So whether you're considering rhinoplasty, liposuction or laser eye surgery we'll provide regular industry updates recommending the safest procedures and warning about those that are dangerous or risky. Thanks for reading,

Justin Stanton MD MMed(Plast) FRCS(Plast)