Viewpoints: Controversies in Plastic Surgery
SMAS vs. Deep Plane Facelift: Which is Best?
What is the SMAS? The earliest facelifts were single layer procedures that only tightened the skin. Good results were possible but longevity and scar quality were limited by high wound healing tension on the skin. In the 1970’s surgical anatomists described the Superficial MusculoAponeurotic System, or SMAS. This is a dense connective tissue layer in... read more
Are Breast Implants Associated with Cancer?
First, some background. Breast implants are available in both round and tear drop shapes and each type can have either a smooth or rough (textured) outer surface (Figure 1). The material inside the implant, either saline water or silicone gel, have both been proven safe after decades of investigation and are not in question. However,... read more
Multiple Procedures: How Much Is Safe To Do At Once?
Why consider combining procedures? There are scenarios that naturally favor this approach. For example, facial aging typically affects both the eyes and face by a certain age. Treating just one area may produce a disharmonious appearance. Therefore blepharoplasty (eyelid surgery) and facelifts are commonly done at the same time. Similarly, changes in both the breasts... read more
When to Leave Your Breast Implants Alone
The vast majority of women have successful breast augmentation surgery and are pleased with their results for decades. However some women are tempted to have a second procedure to make a good result even better. In other instances a problem may exist or develops over time that warrants additional surgery. An important goal is to... read more
Sagging Upper Eyelids: Do I Need a Browlift Too?
Most individuals are best served by eyelid surgery (blepharoplasty) alone to restore a youthful appearance to the upper eyelids. Browlifts add a layer of complexity to the process, as well as increased operating time and cost. However, browlifts significantly improve results when used in the right situations. Also, the recovery time is about the same... read more
Abdominoplasty Methods: How Much is Enough?
A complete abdominoplasty, or “tummy tuck”, is a major surgical procedure that removes stretched skin and excess fat, flattens the abdomen by tightening underlying muscles, and improves the overall contour of the waist. It has the toughest recovery of all plastic surgery procedures associated with it and leaves the biggest scars. However, in the right... read more
Shaped vs. Round Breast Implants
What are shaped breast implants? Shaped breast implants, also known as anatomic or tear-drop implants, have an asymmetric shape with a round base that tapers to a thin top (Figure 1). They are designed to mimic the natural downward slope of the upper breast while providing sufficient volume in their lower portion to enlarge it.... read more
Fillers vs. Facelifts: Where Are the Boundaries?
Injectables are becoming more and more popular for facial rejuvenation, but there is a limit to what these agents can accomplish. Depending on the patient’s age and the type and severity of their wrinkles and folds, a facelift may be a better alternative. What types of injectables are used for facial rejuvenation? There are two... read more
