May 16th, 2012
It appears that when silicone breast implants were approved by the FDA in 2006, the great saline versus silicone battle began. You have the choice between the two as a breast augmentation patient, so it is important you know the similarities and differences of both products. Knowledge is power. As a breast augmentation specialist, I want to help you make the best decision for your individual needs and desires.
One question I am often asked is which weighs more, saline or silicone. I understand this question to be important to you, because when you think of weight, you think of heavy, and when you think of heavy, you think of discomfort. However, when it comes to saline and silicone implants, you may be happy to know that there is only a minor difference in weight. At the same time, that weight difference does not play a significant role in the comfort of your breast.
Just by holding a saline breast implant in one hand and a silicone breast implant in the other, you may get the impression that silicone breast implant is heavier. However, the opposite appears to be true. This is based on the specific gravity of saline breast implant versus silicone breast implant. The specific gravity of saline is 1.0; that of silicone 0.97. Therefore, 100 milliliters (cc’s) of saline weighs 100 grams and 100 milliliters (cc’s) of silicone weighs 97 grams. Also, the silicone bag that holds in the saline has its own minor weight. An example is as follows. A 400cc saline implant weighs a total of 425 grams. A similar volume 400cc silicone implant weighs 400 grams. As you can see, the difference is not significant (25 grams is about 1/20 of a pound).
Putting the weight factor aside, there are several noteworthy similarities and differences between the two implants that may help you make your decision on which one to receive. Many patients ask me which implant is “better.” I would say neither one nor the other is necessarily better as they both are FDA-approved products with great qualities. The following information on saline and silicone implants should help you understand these similarities and differences.
Saline breast implants are adjustable in regards to volume although there are many silicone breast implant sizes. It may be a bit easier to adjust breast size with saline implants in women who do have unequal breast sizes. The incision used to place a saline implant is slightly shorter than for silicone because they can be placed in the pocket before they are inflated. Silicone implants are more similar to the feel of natural breast tissue than saline implants. This allows the breast to feel more natural especially in women with small breasts. They both provide the same appearance to the breast in that they are round in shape.
In the early 1990s at the request of the FDA, silicone implants were voluntarily removed from the market by the implant manufacturing companies in order to study their safety. There were concerns about a link between silicone implants and autoimmune disease. After many years of study, no link between silicone and any disease process could be identified. Silicone implants were approved by the FDA in November 2006 and made available to the general public for cosmetic breast augmentation.
Both types of breast implants are not meant to be lifetime devices and may eventually rupture. It is known that saline implants do have a higher risk of implant rupture than silicone. However, if a saline breast implant does rupture, the saline solution will naturally and safely absorb in the body. The breast will lose its volume making rupture easily detectable. A ruptured silicone implant is more difficult to detect, as the breast will maintain its shape and size. However, detection can be attained with an imaging study such as an MRI.
As with any surgical procedure, it is important to consult with your doctor. I find it essential that you ask as many questions as possible, and I am more than happy to answer them to not only educate you, but give you piece of mind. Please set up a breast augmentation consultation with me at my Scottsdale plastic surgery office today. You can can call the Scottsdale office at 480.890.0600 or send us a email by filling out the contact form on our website.
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May 14th, 2012
Millions of men and women of all ages and ethnicities are affected by unsightly stretch marks. There are numerous factors that cause these unattractive skin markings, including puberty, hormonal changes, pregnancy, and weight gain. Whatever may be the case, I am thrilled to say I can help you improve and lessen the appearance of these marks with the advanced Palomar Laser Icon, available at my Plastic Surgery office in Scottsdale Arizona.
For years, there were very few options when it came to stretch mark treatments. Since the FDA-approved Palomar’s fractional laser treatment, this procedure has been an excellent option for those searching for an effective way to lessen the appearance of their stretch marks.
The non-invasive laser treatment does not require anesthesia, but for those who are especially sensitive, a topical anesthetic can be applied to the area prior to the procedure. The Palomar Laser Icon handpiece delivers an array of high-precision microbeams to the skin with its 1540 Fractional Laser. The ultraviolet laser light disrupts the molecular bonds in the skin, which causes the tissue to split up in a process known as ablation. The Smooth Pulse delivery of the laser system controls the heat, which reduces any pain. Most patients experience little to no discomfort. In basic terms, the laser stimulates the production of collagen and elastin in the deeper layers of the skin, where the stretch marks are formed, and renews the skin. This will bring a significant improvement in the skin over a series of repeated treatments.
Stretch mark laser treatment requires little to no downtime. As with any medical procedure, there are potential side effects. Though it is rare, some patients experience redness and swelling in the treated areas. Most patients resume normal activities immediately after the procedure. Everyone is different and depending on the severity of your stretch marks, I would recommend at least four treatments in three-week cycles for optimal results.
It is important that you have realistic expectations before and after your stretch mark laser treatment. While it is known that there is no cure for stretch marks, I am committed to helping you reduce the appearance of them and give you a boost of confidence. Please call my office today for a consultation at 480.890.0600, we are conveniently located in Scottsdale Arizona off of North Scottsdale Road and Jackrabbit.
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April 6th, 2012
With recent advancements in facelift techniques, now has never been a better time to schedule a consultation with our Scottsdale Plastic Surgery office. As a cosmetic surgeon, I understand that facial aging involves not only skin laxity and sagging, but deflation and loss of fat in the face. New breakthroughs and technology such as facelifts with fat transfer has led to a more natural and beautiful outcome.
There are many facial procedures that involve fat transfer to adjust proportions of the face. I will go over a few of the more common facelift procedures.
Lip Augmentation
As we age, the fullness in our lips decreases. Through fat transfer, I am able to increase the surface area of the lip. This procedure restores fullness and returns the lips to a more youthful appearance. I use the fat transfer technique to achieve the correct shape and volume. I understand the contours of the lip and enhance it to produce an aesthetically appealing improvement.
Eye Region
Many patients want a healthy and sensual appearance to their eye region, which I deliver by adding fullness to the brow, upper eyelid, and the temple. As we grow older, the fullness of the eye area dissipates and the structure of our skull slowly emerges. Blood vessels are no longer hidden and the muscles become more visible. With my fat transfer technique, I can restore the brow, upper eyelids, and temples to more youthful and healthy proportions.
Chin
Unfortunately, the loss of the fullness in the jawline and chin marks the first signs of aging. The face deflates as the underlying fullness is reduced over time. A chin and jawline lift through fat transfer can substantially reverse the aging process. I can restructure the jaw line and chin, as well as strengthen its appearance. The fat transfer procedure can restore fullness between the chin and the fat of the jowl, and thus alter facial proportion. The end result is a more cleanly sculpted facial profile.
Lower Eyelid & Cheek
Fat transfer can restore fullness to the lower eyelids and cheek, soften wrinkles and crow’s feet, decrease pore size, and lighten lower eyelid darkness. This technique can also be useful for masking noticeable silicone cheek implants, diminishing the appearance of bulging eyes, and improvement of facial deformities.
If you’re like most people who have one or all of these procedures, you’ll be very pleased with your new refreshed, alert appearance. Patients often tell me that they never realized how much their sagging chin or eyes contributed to the signs of aging, until they see how much younger and more rested they appear after the surgery and healing. Please call us today at (480) 890-0600 to schedule a consultation. We are conveniently located in Paradise Valley off of Scottsdale Rd and Jackrabbit Rd.
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April 4th, 2012
Individuals looking to achieve a slender and more striking midsection may be perfect candidates for tummy tuck surgery (“abdominoplasty”). I can help patients achieve a dramatic enhancement to their self-image through this procedure.
The surgery involves the removal of excess skin and fat from the middle and lower abdomen and tightens the muscles and fascia of the abdominal wall. This type of surgery is usually sought by patients with sagging skin and lax muscles after pregnancy or major weight loss.
There are two options that I offer for a tummy tuck. During a complete abdominoplasty, an incision will be made on the abdomen from hipbone to hipbone. This is the option for those patients who require the most improvement. The cut will be made low, at about the same level as the pubic hair.
I then manipulate and shape the skin, tissue, and muscle as needed. This procedure produces a new opening for the belly button because it’s necessary to free the navel from surrounding tissue. Drainage tubes may be placed under the skin and these will be removed in a few days.
A mini-abdominoplasty is often done on my patients whose fat deposits are located below the navel and entail shorter incisions. During this procedure, the patient’s belly button most likely will not be moved. The skin will be detached between the line of incision and the belly button. Depending on the patient’s own personal condition and the difficulty of what they need, the technique may only take up to two hours.
During recovery, there will be some pain and swelling in the days following the procedure. I usually prescribe a pain medication and muscle relaxer if needed and instruct patients on how to best live with the short-term pain. Tenderness may last for several weeks or months. Some people experience temporary numbness, bruising, and overall fatigue.
As with any surgery, there are risks involved. Complications are extremely rare, but can include infection and bleeding.
Based on your anatomy and individual goals, I can recommend a full tummy tuck or partial one. Before doing so, it is important that you carefully research this cosmetic procedure and sit down with me for a consultation. I will answer all of your questions and discuss several aspects involving the procedure. For additional information or to schedule a consultation, please contact our Scottsdale Plastic Surgery office at 480.890.0600
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April 2nd, 2012
Breast Revision Surgery with Scottsdale Plastic Surgeon Dr. Robert Spies
Breast revision surgery is an operation performed after a woman’s first breast augmentation. There are many reasons why a woman would request a second surgery and many times it’s because of personal preference and not something such as breast implant deflation or rupture. It is important to note that breast implants are not lifetime devices and may need to be replaced eventually.
Some women opt for breast revision surgery just to change their breast size, wishing they had “gone bigger.” According to the FDA, approximately 37 percent of all breast revision surgeries in the U.S. are due to patients wanting a larger size implant. During a breast augmentation consultation, many women are concerned about having breasts that are too large. Unfortunately, once they get used to their new breasts and the swelling subsides, sometimes they change their mind and opt for a fuller size.
There are other reasons patients request a secondary cosmetic breast procedure. A small percentage develops capsular contracture. Some patients want to switch from saline to silicone implants because they desire a softer and more natural feel or because of rippling problems. Post- pregnancy breast changes is another reason to request a breast revision procedure. And lastly, some women are unhappy with the placement of their breast implant or other issues such as double-bubble, symmastia, or bottoming out.
Breast revision surgery can be more difficult than the initial breast augmentation for many reasons. Scar tissue is a major factor that makes it more difficult to predict a good result. Also, I am confronted with the stretching of tissues or anatomical changes caused by previous implants.
I believe that breast revision can oftentimes be more successful when the implant is placed in a different area from the first surgery. For instance, placing the implant under the muscle instead of over it and vice versa. There is less scar tissue and less tissue deformity from the first surgery when operating on a different area. But the best course of action is always determined on an individual basis.
No matter what the patient’s reason is for breast revision surgery, I am here to ensure that she is completely happy the second time around. Please call our Scottsdale Plastic Surgery office today to schedule a consultation. It is my goal to improve your self-image and I want to ensure that you have the breasts you’ve always dreamed of. I will help you understand more about the procedure and the recovery period associated with it.
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March 30th, 2012
Countless patients come to me who are tired of removing hair through waxing, threading, shaving, or using questionable chemical applications. Luckily, there’s a new, safe alternative with laser hair removal.
Laser hair removal uses a combination of energy and heat to abolish follicles without damaging the skin around them. After a series of sessions, my patients experience permanent hair reduction. Razor burns, skin irritation, and ingrown hairs will become a thing of the past. After a laser hair removal treatment, you’ll have the confidence to put on that new summer swimsuit and show off your smooth and soft skin.
It’s no surprise that the demand for intense pulsed light (IPL) hair removal and laser hair removal treatments are at an all-time high. Old-fashioned hair removal techniques can be painful and expensive. Light-based hair removal permanently reduces undesirable facial and body hair, in fewer treatments and with more comfort than is possible with traditional procedures.
For over a decade, FDA-approved Palomar lasers have been the industry standard. Lasers, although clinically effective, have limitations regarding skin color, hair color, and hair thickness. Because of this, Palomar developed a new pulsed light technology that improved clinical outcomes for more skin types and colors.
Although laser hair removal successfully slows hair growth, it doesn’t guarantee everlasting hair removal. It typically takes several laser hair removal treatments to provide an extended hair-free period. Periodic maintenance treatments may be needed as well.
One thing to understand is that you have millions of hair follicles on your body, all of which cycle through diverse phases. The limitation of laser hair removal is that it can only treat a certain percentage of those follicles at any given time, so it must be done at different stages. Because no two bodies are the same, your treatment plan will be personalized for your particular needs. I typically recommend that my patients receive a minimum of six laser hair removal sessions that take place four to 10 weeks apart.
The lasers generate rapid pulses that feel and are tolerated differently for each patient. Luckily, each session only takes a few minutes. Most clients describe the sensation as a mild “hot pinch,” similar to the feeling of being snapped with a rubber band. In most cases, the sensation goes away almost immediately. For those with a low threshold for pain, I usually recommend taking Tylenol a few hours before the procedure, but under no circumstances should anyone take pain medications that might thin the blood.
For more information on laser hair removal or to schedule a consultation please contact our Scottsdale Plastic Surgery office at (480) 890-0600.
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November 19th, 2010
I recently read an article about Betty White, where she discussed her Hollywood friends who have had plastic surgery. She said she found many are now unrecognizable to her, due to having too many cosmetic procedures. She then stated that she is glad she has never ‘gone under the knife’.
I would like to comment on this by stating most people who choose plastic surgery do obtain natural results. This is the most important goal that I achieve when I perform cosmetic as well as reconstructive surgery. Most people I see to discuss plastic surgery are referred by former patients pleased with their outcomes. When asked about their results, they all say they look natural.
We have all seen people who look like they have had too much done, especially to their face. Skin looks thin and excessively pulled, noses are pinched and turned up and normal facial expressions are nearly absent. I do occasionally see these people in Scottsdale and Paradise Valley, Arizona who come to my surgical center for help to repair previous work done elsewhere. However, it seems to be more prevalent in Hollywood, partially due to the extensive public exposure famous people receive. I also believe that celebrities want to look different than non-celebrities and ask their surgeons for this result. The key to obtaining natural and pleasing results when considering plastic surgery is making the right choices.
The first and most important step is choosing a plastic surgeon you can trust. One of the best ways to reach this step is finding a doctor certified by the American Board of Plastic Surgery. This is the only board certification approved by the American Board of Medical Specialties and assures a person that the physician is certified to perform plastic surgery of the face and all areas of the body. I tell every new prospective patient that I am board certified as well as a member of both the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS). Both societies promote high standards in regards to training, ethics and physician practice.
Another important step is to thoroughly discuss with your surgeon your expectations and desired outcome. Ask to see before and after pictures of patients who have had the same procedure you are considering. Also ask if you could speak with some of these patients as well. I always provide upon request a list of several patients who are always happy to speak with prospective new patients. When discussing expectations, one should always ask about the doctor’s experience performing that specific procedure as well as his or hers outcomes and potential risks and complications. An honest, reputable doctor will always discuss these topics without hesitation. Lastly, always inquire about options available if you are not satisfied with the outcome.
Using this guideline will lead you to a successful outcome including natural results that will be appreciated by you and others.
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November 19th, 2010
I read in the newspaper yesterday about Michael Douglas discovering he has throat cancer. I remember the same story several years ago about Eddie Van Halen. Both have a history of smoking cigarettes. Michael Douglas has chosen chemotherapy and radiation therapy for treatment of this disease.
It immediately brings forth the dangers of cigarette smoking or use of nicotine in any form. Smoking is a strong risk cancer for throat cancer (voice box and vocal cords) and other cancers inside the mouth and throat such as tongue and tonsils. I perform reconstructive microsurgery to rebuild areas of the mouth and throat that are removed during cancer surgery. Most of these patients have a history of smoking. Some also have a history of excessive alcohol use as well.
Treatment for this type of cancer includes either chemotherapy and radiation therapy which both Michael Douglas and Eddie Van Halen chose or surgical excision and repair.
Most people think of plastic surgeons as cosmetic surgeons performing tummy tucks, facelifts and cosmetic breast surgery. However, there are some who perform cosmetic and reconstructive surgery as well. I am one who does both. The reconstructive operations include rebuilding a woman’s breast after breast removal for cancer treatment as well as head and neck reconstruction after removal of throat or mouth cancers.
The other discussion in regards to cigarette smoking is its destructive nature to skin and your body’s blood supply. Nicotine lowers the blood supply to different parts of your body by causing disease in your arteries. This is quite evident on facial skin. You are much more prone to looking older than you are due to early development of skin wrinkles, damaged skin with a course texture and deep lip lines. These problems are much more difficult for a plastic surgeon to treat with continued smoking. At the same time, performing surgery on a smoker is much more dangerous with higher complication rates. Problem that could occur include skin loss or gangrene, excessive bleeding, higher infection rate and wound healing problems including breakdown.
Hopefully, discussions like this will help some people stop smoking. As a plastic surgeon, I do want my patients to look better and feel better about themselves, but also to lead a more healthy lifestyle. Cessation of smoking is the first step.
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