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!

A scar is nature’s thread, mending broken or cut skin with a waterproof closure. A skin cut initiates a complex inflammatory process designed to manufacture that thread. Like a skilled army, specialized cells lay down a clot to stop the bleeding, while wound-healing chemicals flow to the rescue. One of those chemicals is histamine.

Histamine stretches out a blood vessel like a stocking, opening up little holes to allow special healing cells to leak out. You might be familiar with a certain side effect: Histamine can make scars itch.

Collagen-producing cells go to work like a garment factory, knitting the wound closed. Just as the factory needs electricity to run, those cells need extra energy and oxygen.

In the lungs, red blood cells load up oxygen like cargo boats, and they float down the blood vessels, handing out oxygen where it’s needed. For a wound to heal, however, the limited network of blood vessels isn’t sufficient to supply enough oxygen.

What’s a body to do?

How about… grow more blood vessels? And that’s exactly what happens. The body creates more capillaries to bring more oxygen-rich blood. The red blood inside the capillaries flows just below the scar’s surface. The result is sort of like… a blush.

That’s why scars are pink.

In the final phase of scar-making, the disorganized, heaped-up, young collagen reorganizes into its flat, mature form. (It’s like seeing a teenager grow up.)

Once the job is done, the extra capillaries are no longer needed, so they disappear, slinking off without a trace.

That’s why scars fade.

The ideal scar is thin, flat, and asymptomatic, but that takes time, up two years. (Some scars take even longer to grow up, just like some humans.)
So how do you get a ‘star’ scar?

Plastic surgeons create scars every time they cut skin. Part of the art of plastic surgery consists of hiding incisions—in folds, within hair, and along contour changes. But those incisions leave scars. (Plastic surgeons aren’t magicians.)

It’s natural for patients to hope for a perfect scar: thin, flat, and white, but not everyone heals that way. Factors that affect scarring include:

1. Genetics: You inherit your scar-forming qualities from your parents.
2. Tension: An incision closed under tension is more likely to be thick, raised, and wide.
3. Location and type of skin: Eyelid scars are typically better than back or chest scars.
4. Age: Children are more likely to develop thick scars between the ages of 8 and 16, while older people with thin skin are more likely to form fine scars.
5. Wound condition: Shredded skin edges are more likely to cause thick scars than cleanly cut ones.
6. Proper closure: Surgical technique can impact the result, though the best technique won’t overcome other factors.
7. Blood supply: Factors such as smoking can result in death of skin, leading to delayed healing, a wider scar, and the need for surgery to close the wound.
8. Infection: A wound infection can disrupt the wound and lead to a wider scar.
9. Poor diet: Inadequate nutrition can delay healing and result in opening of the wound.
10. Health: Medications, medical conditions, and previous radiation can affect wound healing, so share your medical history with your doctor.

And that’s the story of scar formation.

It’s really sort of magical if you think about it!

Potential patients may be concerned about scars after plastic surgery. Though no one can predict how an individual will heal, one’s parents’ and siblings’ scars can give an idea of inherited scarring potential. Patients can improve their chances of good scars by being honest with their doctors about their medical histories and finding an ABPS board-certified plastic surgeon trained to minimize and/or hide scarring. The chances are they’ll be pleased with the results.

Written by Melissa Chapman

At 41 years-old, I have learned that beauty is truly skin deep, and yet just when I think I’ve finally allowed that statement to fully integrate into my overall consciousness, an off-hand comment hurled my way can revert me back to that 16 year-old insecure teen who desperately wanted a nose job.

To provide you with a bit of background, I come from an extended family of chronic rhinoplasty patients. Both the men and women in my family have gone under the knife to have their ‘ethnic’ looking noses transformed into the more coveted Roman, white Anglo Saxon Protestant ones. And really, what choice did I have to veer from our family tradition when the matriarch of my family, my grandmother, offered me, as she had my cousins, the money to pay for the procedure? In fact, I will NEVER forget sitting at my dining room table with her as she peered into my eyes and said in the sweetest voice, “Oh Melissa, you are so pretty… except for that nose.” Thanks grandma!

While it was intended to be a lovely gesture on her part, I declined the offer. Even at the tender age of 16, I felt that concealing my true ethnicity would almost be a betrayal to the men and women upon whose backs I stood – those who bore the torment of Anti-Semitism, those who were murdered for it and those who didn’t have the means or access to refine their facial features so they could pass as gentiles. So I’ve lived with my big ethnic nose for 41 years, and like it or not, one of my kids has inherited it as well. However, if one of my kids were bullied and made to feel less than because of their nose, would I consider allowing them to get nose surgery?

I chatted with ABPS board-certified plastic surgeon and Adjunct Associate Professor of Plastic Surgery at Columbia University, Arthur W. Perry, MD, FACS about the trend of teens under 18 undergoing plastic surgery to combat bullying and he had some very insightful opinions to share.

Melissa Chapman: Have you operated on teens who have felt insecure and were being bullied?

Dr. Perry: I have not operated on teens who openly admit to being bullied, but I frequently operate on teens who feel insecure about their appearance. This includes girls with large noses, small breasts, or protruding ears, and boys with large noses, female type breasts, and protruding ears.

MC: How young is too young to consider surgery to avoid bullying?

Dr. Perry: Different procedures can be performed at different ages. Protruding ears can be operated on in kids as young as six years. Rhinoplasty surgery can be performed on girls at age 14 and boys at age 16. The FDA requires girls to be 18 before they can have a breast augmentation, although this age is quite arbitrary and sometimes punitive. Boys with breast growth can be operated on as young as 16 years. These ages are for anatomical issues and bullying is much more complicated than that. Bullying is a psychosocial problem and I am not sure it can be solved by simply altering someone’s appearance. Kids can get picked on ruthlessly with even minor differences.

MC: Do you think the bully wins when a person resorts to surgery to change his or her looks because of bullying?
Dr. Perry: Maybe, but that doesn’t preclude surgery.

MC: When would you refer a child to counseling rather than plastic surgery?

Dr. Perry: If a child has a significant deformity, then surgery is reasonable. I have two hours of preoperative discussions with kids, adolescents and their parents and I need to feel comfortable that they understand the risks and benefits of the surgery and still want to move forward with the surgical procedure. If there is a question about the psychological status of a child, I will request clearance from a psychiatrist. Even if the child is cleared by a psychiatrist, I need to feel comfortable that he or she has a good grasp of the ramifications of the surgery and I will not operate if I can’t connect with the child.

MC: Would you perform cosmetic surgery on a teen who has no deformity but thinks they need to look better and wants cosmetic surgery? For example breast surgery, lip injections or liposuction?
Dr. Perry: To justify surgery on a teen especially an underage teen, there must be an anatomical abnormality that is correctable with surgery. Cosmetic surgery is designed to make abnormal appearances normal. I often refuse to operate on people who have unrealistic goals.

MC: There have been reports of young children having plastic surgery for protruding ears, large noses and weak chins to avoid bullying. What other surgeries have you done to avoid bullying? What are the most common surgeries- if any- performed on teens to combat bullying, etc.?
Dr. Perry: Male breast growth is a source of much unhappiness and ruthless bullying among teenage boys. Boys with large breasts do not take off their shirts at the beach and often opt out of gym class. Male breast growth is readily fixed with an outpatient procedure. It is probably the biggest source of embarrassment in boys, although most kids “outgrow” this condition and don’t require surgery.

MC: What changes, if any, do you need to make during surgery on a younger patient who is still growing?

Dr. Perry: As a rule, we don’t operate for cosmetic reasons until growth is largely complete. The ear is 90% of adult size by age six, and the nose is 95% of adult size by age 14 in girls and 16 in boys. Breast growth in girls is complete by age 18 in virtually everyone.

Ultimately I think this is a decision a parent, their child and their physician need to contemplate and agree on as a team. As for me and how I would deal with this, should my own daughter or son feel compelled to alter their nose or another facial feature? I believe it is not so black and white. While I hope my kids would be able to love their features for their rich genetic history and accept them as an intrinsic part of who they are, I also know that being bullied for the way they look and having to endure social pressures and taunts could have long-lasting impact on their self-esteem and the choices they make. Therefore undergoing surgery would need to be a decision we’d make in conjunction with the guidance of a therapist and a board-certified plastic surgeon like Dr. Arthur Perry who has an extensive understanding of the teen psyche. Bottom line- it would NOT be off the table.

Between the days spent at the beach and nights lounging on the patio, summer offers the perfect time to stay outdoors and bask in the beautiful weather. Since this season provides ample opportunity for showing off your favorite shorts and cocktail dresses, women generally spend a great deal of time shaving, hoping that their days will not be ruined by those small, prickly hairs that won’t seem to go away.

However, for women who are sick of shaving, waxing or using hair-removal cream, there is another option – laser hair removal, a nonsurgical procedure that may be able to greatly reduce the appearance of hair on the skin’s surface.

Understanding the procedure
This procedure deactivates hair follicles on the skin, preventing hair from coming back. A low-energy laser is guided over the area – whether the legs, armpits or face – ensuring all hair follicles have been properly treated. In 2013, more than 900,000 patients sought this procedure, according to the American Society for Aesthetic Plastic Surgery. Before selecting this operation, patients must attend a consultation with a board-certified surgeon, who will discuss the benefits, risks and factors that may affect the surgery.

As with most cosmetic procedures, however, this treatment has its pros and cons. There are a few misconceptions that surround laser hair removal surgery.

Breaking down the basics
Among some of the most popular topics patients frequently ask about include pain levels, time and effectiveness. Generally, people feel little pain when going under the laser. While some may experience​ discomfort, few report high pain levels. This does, however, depend upon a variety of factors, including lifestyle habits, age and genetics.

Another common concern among laser hair removal hopefuls is the time commitment. Depending on the area of your body you hope to target, as well as your skin’s pigment and hair color, you may require frequent treatments to get rid of all hair. According to Smart Beauty Guide, most patients see permanent results after about three to eight sessions.Reader’s Digest reported that this can be attributed to the fact that most hair follicles have to fully grow before they can be removed – meaning whatever patches are inactive during the first session may start growing after treatment.

Prior to selecting this procedure, patients should be sure to thoroughly discuss the risks and expectations with their surgeon. Speaking with a board-certified medical professional prior to inquiring about the operation ensures your personal interests, limitations and lifestyle factors have been properly accounted for. Additionally, these individuals can provide a more comprehensive overview of what you may be able to expect from the operation.

Call Oasis Medical Spa & Wellness at (309) 662-6772 to schedule a consultation with our nurse to see if you are a candidate for Laser Hair Removal today!