The device, which is manufactured by Cynosure, uses a laser to treat the physiological structure of cellulite. During treatment, a series of tiny incisions are made. Next, the Cellulaze device is inserted through the incisions so the proprietary SideLight 3D side-firing technology reaches the actual causes of cellulite, which lie beneath the skin. The laser targets:

• Herniated pockets of fat
• Stiffened septae
• Thin skin

The treatment works by heating the skin to stimulate collagen production, melting underlying fat, and loosening the fibrous bands that produce skin irregularities.

Since the incisions that are created during the procedure are so small that they do not require stitches, the Cellulaze procedure is considered minimally invasive and results in virtually no scarring. The Cellulaze laser fiber itself is no wider than one millimeter.

Over the next six to eight weeks, cellulite begins to disappear as the skin tightens. During the next year, patients continue to notice an improvement in skin tone.

Cellulaze has been clinically proven to reduce the appearance of cellulite in just one treatment session. Compare this to cellulite creams, skin tightening, and other cellulite-busting procedures that have to be performed multiple times to obtain visible results.

Although there are hundreds of other cellulite treatments on the market, Cellulaze is the only one that has been shown to increase skin thickness by 25 percent and skin elasticity by 29 percent one year after treatment, according to clinical data that was submitted to the FDA.

“Based on the scientific data and the patient results we have observed over the past several years of evaluating the device, Cellulaze represents a new and highly effective standard of treatment for cellulite,” said Dr. Barry E. DiBernardo, a board certified plastic surgeon and Clinical Associate Professor who was one of five clinical investigators involved in the Cellulaze study.

Cellulaze is currently being marketed in several countries, including the European Union, Australia, Canada, and South Korea.

Western Europeans’ concerns over the safety of silicone breast implants made by French company Poly Implant Prothese (PIP) continue to grow as more women are made aware of the potential health risks associated with the devices.

PIP began manufacturing breast implants in 1991; they shut operations down in 2010 when European regulators pulled their silicone breast implants off the market because they contained non-medical-grade silicone filler. During that time, an estimated 300,000 PIP silicone implants were sold, mostly in Western Europe and Latin America.

The implants have since been found to have high rupture rates. However, French and British authorities do not think they pose an increased risk of cancer.

Still, the French government recommends that the 30,000 French women that have the silicone implants undergo surgery to have them removed. The French government will cover the cost of surgery.

The British government has taken the position that the 40,000 British women that have the silicone implants do not need to have them removed at this time. The government is continuing to review the potential risks associated with PIP implants.

It was revealed that the U.S. Food and Drug Administration notified PIP’s manufacturers of 11 breaches from standard ‘good manufacturing practices’ at PIP’s plant in southern France in 2000 when the company submitted an application for approval of its saline implant products (at the time silicone implants were not approved for use in the United States). According to a warning letter from the FDA, PIP did not have a quality assurance process that would ensure the manufactured products matched design specifications, did not investigate deflation problems with the product, and failed to report 120 complaints in France and other countries. The FDA ended up rejecting PIP’s application for saline breast implant approval in the United States.

Disclosure of the FDA’s complaints raises questions about the safety of PIP’s saline implants, in addition to their silicone implants.

BELOTERO Balance®, a hyaluronic acid-based dermal filler that is manufactured by Merz Aesthetics, was approved by the FDA earlier this month for the treatment of moderate and severe facial wrinkles.

BELOTERO® is produced with Cohesive Polydensified Matrix (CPM) technology, which gives the hyaluronic acid increased elasticity and viscosity. The injectable is designed to soften facial lines and folding for several months.

BELOTERO Balance® is currently approved for use in Austria, Germany, Italy, Russia, Switzerland, and the United Kingdom.

Merz obtained approval from the FDA based on the results of a study that included 118 patients. Each patient was treated with the BELOTERO Balance® dermal filler on one side of the face. The other side of the face was treated with an FDA-approved bovine collagen.

Next, patients were evaluated according to the five-point Wrinkle Severity Scale (WSRS). The wrinkles treated with BELOTERO Balance® exhibited a greater reduction in wrinkles, for a longer period of time when compared to the wrinkles treated with collagen.

The patients involved in the study did not experience serious side effects or complications from the BELOTERO Balance® injections. Mild to moderate swelling, bruising, and injection site nodules were reported.

According to Rhoda S. Narins, MD, the lead investigator of the study and a dermatology professor at New York University Medical School, “BELOTERO Balance® is a soft dermal filler that is designed to achieve meaningful results by integrating into facial skin tissue. Patients are able to see a visible softening in their lines for a natural look that lasts.”

Merz Aesthetics is a medical cosmetic company that manufactures a several facial injectable products. RADIESSE® is a hyaluronic acid-based filler that offers results that last for about two years. Earlier this year, Merz received FDA approval on another wrinkle-reducing injectable, Xeomin®. Xeomin® is a botulinum toxin-based injectable that is comparable to BOTOX Cosmetic® and Dysport®.

The results of a recent study shows that patients that underwent breast reconstruction surgery using tissue from their own abdomen experienced an improvement in their self confidence and overall quality of life in as little as three weeks after surgery.

The study included 51 women, ranging in age from 28 to 77, who had the MS-TRAM or DIEP flap breast reconstruction procedure done at the University of Toronto sometime between June 2009 and November 2010. The researchers had the participants complete questionnaires at three key points during the surgical process: before surgery, three weeks after surgery, and three months after surgery.

The questionnaires were design to evaluate patient satisfaction and quality of life after breast reconstruction surgery. Questions touched on the following topics:

• Anxiety
• Depression
• Thoughts about cancer
• Psychosocial, sexual, and physical well-being

The researchers of the study found that the women experienced significant improvements in their sexual, social, and mental health after surgery. They also found that the patients experienced increased stomach problems, including pain, bloating, bulging, and muscle weakness.

Patients that are thinking about undergoing breast reconstruction surgery after mastectomy will benefit from learning about the results of the study.

“In the current health care environment where patients and providers increasingly seek evidence-based data to guide clinical decisions, discussing satisfaction outcomes with patients will help them make educated decisions about breast reconstruction,” Dr. Toni Zhong, one of the researchers of the study, said in a news release. “Our study can serve as an important source of evidence to guide the decision-making process for both surgeons and patients.”

Dr. Zhong, of the University Health Network Breast Restoration Program at the University of Toronto, Andrea Pusic, MD, a plastic and reconstruction surgeon at Memorial Sloan-Kettering Cancer Center in New York, and their colleagues authored the study. It is published in the journal Cancer.

In this blog post, we review some common questions about the tummy tuck recovery process.

How Much Weight Will I Lose after Tummy Tuck Surgery?

Patients should not expect to lose a large amount of weight from the tummy tuck procedure. The excess skin that is removed will result in some weight loss, but it is typically no more than five pounds. Tummy tuck is a body shaping procedure rather than a weight loss method. Patients will have a noticeable flatter tummy, and folds of excess skin will be permanently removed.

How Long Does Numbness Last After Tummy Tuck?

Numbness is a common side effect of tummy tuck surgery. Many patients find that the lower abdomen is numb for as long as a year and a half after surgery. Sensation will begin to return on the sides of the lower stomach first, and then gradually return to the center of the stomach. However, if nerves were severed during surgery, patients will experience permanent numbness just above the incisional, or scar, line.

How Long Should I Wear a Binder or Compression Garment after Surgery?

Compression garments offer a number of benefits to tummy tuck and liposuction patients. They minimize swelling and pain, improve blood circulation, and help maintain the new body shape. Compression garments and binders should be worn anywhere from two weeks to six weeks after surgery, depending on the individual patient’s case.

How Long Should I Wait to Have Intercourse after Surgery?

Tummy tuck surgery is a serious operation, and patients need to allow some time to heal before engaging in sexual intercourse. In general, patients should wait at least four weeks before having sex after tummy tuck surgery.

Should I Undergo Tummy Tuck Surgery Right After a C-section?

No. It is important that you take time to heal after having a child and allow time for your skin to shrink as much as possible. This takes a minimum of six months. Once you have lost your baby weight and your skin has contracted, you may consider surgery.

Can I Have a Baby After a Tummy Tuck?

Although there are no health reasons that will prevent you from getting pregnant again, it is recommended that you wait to have a tummy tuck until you are finished having children. Getting pregnant will stretch out the abdominal skin again and may result in the need for re-treatment. If you do decide to get pregnant after tummy tuck surgery, you should wait at least six months before trying.

If you are thinking about undergoing breast augmentation, check out our recovery timeline for information about the side effects that occur after surgery.

Swelling/Tightness: The size and shape of the breasts changes significantly during the first few months after breast augmentation surgery as swelling subsides and the implants settle into place. The worst of the swelling occurs three to five days after surgery. In patients that underwent subglandular (over the muscle) implant placement, the swelling goes down quite a bit by week two; in patients that underwent subpectoral (under the muscle) implant placement, most of the swelling is gone by week four. Patients should have a pretty clear idea of the final size of their breasts by six weeks after surgery, but it can take up to three months for all swelling to go away.

Bruising: Patients experience little bruising after breast augmentation surgery. If any bruising occurs, it fades within a week or two.

Pain: The amount of pain that you experience is related to your surgical treatment plan; generally patients that have under the muscle breast augmentation and those that have larger implants placed will experience more pain. Pain is typically at its worst two to three days after surgery, and all discomfort should subside by two weeks after surgery.

Nipple Sensitivity: Nipple sensitivity is caused when the nerves are stretched out during and after surgery. In a few weeks to three months, the nerves should return to normal.

Nipple Numbness: Nipple numbness is a less complication of breast augmentation. It is caused when a nerve is injured during the incision or dissection steps of surgery, or when too much pressure is placed on the nerves after the implant is inserted. Nipple numbness is more likely to occur in small-framed patients that have large-width breast implants placed. While patients may experience temporary nipple numbness, sensation should return within six to 12 months.

Muscle Spasms: During the subpectoral breast augmentation procedure, the pectoral muscle may be stretched out, resulting in temporary muscle spasms after surgery. The risk of this occurring increases in patients that have large implants placed. Generally, muscle spasms stop within three to four weeks of surgery.

Settling of the Breasts: Immediately after breast augmentation surgery, the breasts will seem a little high. The breasts will gradually settle into the pocket, resulting in a more natural looking appearance. Patients should expect it to take anywhere from three to six months for the breasts to settle completely.

Breast Massage: Massaging the breasts after surgery can maintain the softness of the implants, keep it mobile, and prolong great results. Patients should start massaging their breasts a few days to a week after surgery.

Scar Treatment: Scar treatments such as the use of silicone healing sheets can be used once the breast augmentation incisions have begun to heal. They should not be used on open wounds. Typically, patients can start to use silicone sheets three weeks after surgery; they should continue use for about three months.

Medicis, the makers of Restylane, announced last week that the FDA approved its premarket approval application supplement to expand the approved use of the popular dermal filler to include lip enhancement.

Restylane is an injectable gel that contains hyaluronic acid and adds volume to the skin. It is commonly used to fill in wrinkles and plump up the lips.

The FDA originally approved Restylane for use in the cosmetic treatment of the nasolabial folds, the vertical, curved creases that develop on either side of the mouth.

However, plastic surgeons and dermatologist have been using the product off the label for years. When injected into the lips, physicians found that the product safely and effectively added fullness to the upper and lower lips. Most surgeons find that Restylane lip injections look more natural than lip implants and offer more predictable results than fat transfer injections.

With the FDA approval, physicians and patients can feel more comfortable using Restylane injections to add volume to the lips; the FDA recommends that the product be used on patients that are 21 years of age or older.

“We are pleased with the FDA’s decision to expand the RESTYLANE label to include lip augmentation,” Medicis Chairman and CEO Jonah Shacknai said. “This marks another significant milestone for RESTYLANE, now the first and only hyaluronic acid dermal filler approved in the United States for lip augmentation. We were very encouraged by the compelling data from the robust pivotal clinical study, showing effectiveness for up to six months, with a clear majority of eligible subjects opting for retreatment at six months.”

Prior to receiving the FDA approval, Medicis conducted a study of 180 patients. According to the conclusion of the study, Restylane injections were well tolerated by patients, and lip-enhancing results lasted for up to six months. After the six months were up, 80 percent of the patients included in the study elected to undergo Restylane lip injections again. Associated side effects were reported as mild, and included pain, swelling, bruising, and erythema.

Oncoplastic surgery is a fancy name for a procedure that makes it easier for women with breast cancer to avoid a mastectomy by having a lumpectomy and a breast lift/reduction at the same time.

Normally, a  breast cancer can be treated by a lumpectomy only if the tumor is in a good location and is small compared to the size of the breast.  If a lumpectomy and radiation is done under non-ideal circumstances, as with a relatively large tumor, the woman’s breast can be permanently deformed. Oncoplastic techniques allow a larger lumpectomy to be performed by the breast surgeon and then the plastic surgeon will sculpt the remaining breast tissue into a normal appearing breast.  This is done by  performing a breast reduction or lift on the remaining tissue and on the opposite breast to create symmetry.

A breast reduction involves the classic “anchor” incisions: around the areola, down the front of the breast and in the fold beneath the breast. In most cases, sensation to the nipple is preserved.  Occasionally, due to a lack of blood supply, the nipple may need to be removed and replaced as a free graft.  In these cases, there is a permanent loss of sensation to the nipple.

There are several advantages to Oncoplastic Surgery:

1.  A breast cancer patient who might otherwise be a bad candidate for keeping her breast can now do so;

2. The post-operative radiation is better tolerated in a smaller breast;

3. Pre-operative symptoms of breast enlargement  are usually relieved;

4. It is much safer than trying to “fix” a breast that is distorted following radiation therapy.

This type of procedure is applicable to patients who have extra skin and breast tissue at the time of their cancer diagnosis.  Smaller-breasted  patients can still have a standard lumpectomy.  Women who are interested in avoiding mastectomies should discuss this procedure with their surgeons.

2.  Desire to Change Size Some younger patients may have had implants that were just too small and want to move to a larger implant.  Conversely,  middle-aged patients may find that their native breast tissue is increasing as they gain weight later in life.  This makes their overall breast size too large and they are frequently interested in downsizing their implants.

3.  Better Quality Implant Over the years, the rippling that accompanies saline implants can get worse, and motivate patients to move to silicone to diminish this problem. This is especially true in patients who have textured saline implants, which are particularly prone to rippling.

4. Malposition The most common, long-term problem with saline implants is that they stretch out the patient’s breast tissue and the implant ends up too low and too far out to the side.  This is most bothersome to patients whose original motivation for the procedure was to restore fullness in the upper part of their breasts.  With stretching of the lower part of the breast, patients  lose their upper breast volume and end up having the same, “droopy” shape they started with, only now they are bigger.

With stretching of the side of the breast, patients notice migration of their implants to the side (or even off their chests) when they lie down.  Problems related to stretching of the breast from saline implants can usually be treated with revisional surgery and conversion to a silicone implant.  Because silicone is “thicker” or more viscous than saline, there is considerably less tendancy for the implant to stretch the patient’s breast. As a result, the implant position is much more stable over time.

No matter what the motivation,  very few patients who  change to silicone regret their choice. If you are dissatisfied with the results of your saline augmentation, consider changing them to silicone.

Earlier this month, the U.S. FDA approved marketing for Medicis Pharmaceuticals Corp’s new non-invasive fat removal device, the LipoSonix system, which uses ultrasound technology to destroy fat cells.

Days after the FDA cleared marketing of the device, Medicis agreed to sell it to Solta Medical Inc. for $35 million. This business decision allows Medicis to maintain focus on its facial aesthetics and dermatology products.

The Liposonix system is already in use in Europe, Japan, and Canada.

Liposonix Candidates

Patients that are interested in undergoing a liposuction alternative and have at least one inch of excess fat on their stomachs, waistlines, or flanks may be good candidates for Liposonix treatment. In addition, patients should be at least 18 years of age, in good health, and near their ideal body weight (Body mass index should be at 30 or lower).

The Liposonix Procedure

The Liposonix procedure takes about one hour to perform. During the first step of treatment, the physician will use a surgical pen to make markings on the stomach. Next, the Liposonix device is directed at the treatment area, focusing high-intensity ultrasound waves to areas affected by excess fat. Over the next eight to 12 weeks, your body will naturally expel the fat cells from your body, resulting in a slimmer appearance. According to the manufacturers of the device, patients typically drop one dress size after undergoing Liposonix treatment.

Liposonix Side Effects

The Liposonix procedure does not require the use of anesthesia or incisions, making it much less invasive than surgical procedures. However, patients do report some discomfort when undergoing treatment. The most common side effects of treatment include pain, swelling, redness, and bruising.

Although Dr. Pin does not employ use of the Liposonix system at our practice, we do offer liposuction surgery. Liposuction is still considered to be the most effective fat removal treatment on the market. If you are interested in undergoing liposuction with Dr. Pin, contact our practice today.