Innovations Facial Plastic Surgery

Heidi Montag, Guiness, and cosmetic surgery

2011-05-17T08:35:00.000-07:00

What do Heidi Montag, the Guiness Book of World Records, and cosmetic surgery all have in common? They can be done to excess. Recent press has been given to Heidi Montag, the woman known for her many cosmetic surgical procedures in one day, saying that she regrets her many surgeries. On the opposite end of the spectrum is a recent report that the Guiness Book has certified Cindy Jackson, a 55 year old who has had 52 cosmetic surgeries, as the person having had the most cosmetic surgeries. Both cases bring to light a problem - anything, including cosmetic surgery, can be done to excess.
As a physician, I am becoming more concerned with the commercializiation of cosmetic surgery. More and more people who are not trained in cosmetic and plastic surgery are getting in on the lucrative nature of the business. Sometimes, the physician has to be the one to say no to a patient and identify that there may be a psychological problem needing treatment instead of a wrinkle needing nipping.
The question comes down to when is it too much? In reality, there is no number. For some patients, repeat fillers and botulinum toxin products can produce very nice results helping to maintain a youthful look. Unfortunately, repeat surgeries can lead to regret or even worse, a reconstructive problem as happened with Michael Jackson's nose. At the end of the day, patients need to remember that these are elective medical procedures, regardless of where they are performed, and in some cases, they are not needed.

The Plastic Surgery Myth

2010-12-10T12:34:00.000-08:00

One of the biggest myths in plastic surgery is that after surgery everyone should know that you had something done. In fact, if the procedures are done well, no one should know you have had surgery. First, people are not that observant. While they may notice that something is different, they won't see exactly what was done. If plastic surgery results are less than optimal, then it is obvious that something is done. Second, if someone sees you on a daily basis then the new look will become the baseline. Similarly, without seeing before and after photos you may not really notice a change.

Eyelash Treatments including Transplants and Latisse

2010-11-12T14:17:00.000-08:00

So you want to have more prominent eyelashes? There are several options to treat eyelash loss. The options range from medical treatment such as the prescription product Latisse to surgical eyelash transplants. In most cases people are either born with non-prominent eyelashes or may experience eyelash loss after plucking.

Latisse is a prescription medication which has been shown to increase the fullness and number of eyelashes. It works by increasing the amount of time eyelashes spanned in the growth part of the hair cycle causing less to fall out and more to grow. The exact mechanism it is unknown.

The generic name of the medication is bimatoprost. The medication was originally approved to treat glaucoma. As a side effect, increased eyelash growth was noted. The maker of Latisse, Allergan Corporation, did independent studies and obtained US FDA approval to market the drug for eyelash growth of the upper eyelids only. While safe, there are side effects to the medication including darkening of the skin along the eyelid and a risk of discoloration of the colored part of the eye itself. The company points out that although discoloration has occurred with the glaucoma application, it has not occurred in the clinical trials or use of Latisse. This is likely because with glaucoma the medication is directly dropped into the eye while with Latisse it is applied with special applicators to the eyelashes only.

The effect of Latisse can be seen in approximately 4-6 weeks and wants discontinued the eyelashes will return to their original condition. Applying more of the medication at each application is not useful. The medication is available by prescription only and costs between the $100-$150.

For people who were looking for a more permanent solution, eyelash transplants are an option. Using hair from the scalp, individual hairs are cut and placed into the upper or lower eyelid. While a permanent solution, there are several drawbacks to this procedure. The survival rate of the transplanted hair is approximately 60%. This is much less then with hair transplant procedures to the scalp. There is also a risk of eyelashes which grow inward and cause irritation of the eye and cornea. If this happens the eyelash would have to be removed. The transplanted eyelashes maintain the characteristics of scalp hair, which while natural means that the hair will grow to the same length as on the scalp and therefore the eyelashes need to be trimmed regularly.

Winterize Your Skin

2010-11-12T14:14:00.000-08:00

Over the Counter and Alternative Allergy Treatments on CBS 11

2010-10-13T06:23:00.000-07:00

Mercury in Skin Lightening Creams

2010-08-24T14:05:00.000-07:00

Buyer be ware is the word from the Chicago Tribune earlier this year. Mercury has been outlawed as an additive in cosmetic and skin care products except for eye area cosmetics since 1990. Several states, including Michigan have gone further and outlawed mercury in all cosmetics. Unfortunately, just because it is law, does not mean it is so.

Skin lightening agents in certain African and Meditteranean countries have used mercury as an active ingredient as it is a very effective product. The problem is that long term exposure, which includes exposure through skin absorption, can lead to tremors; emotional changes (e.g., mood swings, irritability, nervousness, excessive shyness); insomnia; neuromuscular changes (such as weakness, muscle atrophy, twitching); headaches; neuropathy and disturbances in sensations; memory problems. Studies have shown that as many as 50% of African skin lightening creams contain mercury. Unfortunately, this has come to the US.

The Chicago Tribune went to local retailers and bought 50 skin lightening creams over the counter and had them tested by an independent laboratory. Six of the fifty came back with illegal amounts of mercury, up to 30,000 ppm. The six creams that tested high originated in China, India, Lebanon, Pakistan, and Taiwan. When asked about regulations, the FDA admitted that they did not have enough regulators to control the amount of materials coming from foreign sources.

So how can you be careful of the products you are buying:

Have the product tested. While this sounds quite wild, there are several independent labs which will test chemicals for $100 or less. Considering that some of these products can cost $100 or more, this is a small investment.
Check out your product at http://www.cosmeticsdatabase.com/. The database contains independent testing of many available over the counter products.
Buy from your plastic surgeon or dermatologist. While not a guarantee of being mercury free, products licensed to physicians are often closely monitored by the FDA. In addition, more information is often provided on the ingredients of the products to the physicians for their evaluation than is available for over the counter products.
If you are looking for lightening creams, consider prescription hydroquinone. While it may limit the number of products available, if a product is prescription only, there is much tighter FDA regulation including regulation and oversight of the production facility. This is not necessarily true for over the counter products.

Michael Douglas' Voice

2010-08-20T06:22:00.001-07:00

As a head and neck surgeon, I also perform reconstruction after head and neck cancer surgery. There are a lot of stories about Michael Douglas in the media and some misinformation. Unfortunately, all that we know is that Mr. Douglas suffers from 'throat' cancer and is set to undergo chemotherapy plus radiation therapy. There are many anatomic parts of the throat including the tonsils, voice box, tongue, and base of tongue which could be affected. There is also no mention if the tumor has spread to the lymph nodes of the neck. All of this information is important to determine what the chances of voice damage will be after treatment. Unfortunately most head and neck chemo/radiation results in dry mouth, changes in voice, some difficulty swallowing, alteration or loss of taste, and may still require surgery. There are a lot of unkowns but it appears that he is receiving very aggressive treatment and will hopefully fully recover.

What Happened to Angelina Jolie?

2010-02-18T11:14:00.001-08:00

http://www.usmagazine.com/healthylifestyle/news/doctors-explain-whats-wrong-with-angelina-jolies-face-2010182

A recent online post from US magazine shows that Angelina Jolie had something done to her face, possibly plastic surgery. The ridges along the jaw on the side of her right face are not natural. There are no normal anatomic structures (muscle, nerves, or blood vessels) that run that direction in that location. It is possible that this could be makeup. Alternatively, it could indicate some type of suspension suture or device that was used to create the results of a facelift in a minimal surgery technique. Unfortunately, this is not a technique which is commonly used in the United States.

Plastic Surgery is Surgery

2010-01-13T07:01:00.000-08:00

http://www.cnn.com/2009/HEALTH/12/10/plastic.surgery.problems/index.html

Recent publicity of plastic surgery deaths has once again brought to light the fact that plastic surgery is surgery. Unfortunately, because of the cash nature of the business, less than qualified physicians are performing procedures, some with very serious consequences. For more information about choosing a plastic surgeon or help with wading through the advertising, visit my website or take a look at my book on Cosmetic Surgery.

Women Want Hair Restoration More Than Botox

2010-01-05T08:40:00.000-08:00

An interesting survey performed by Harris Interactive shows that women would prefer more hair to Botox(r). Unfortunately, women are not always good candidates for hair transplant surgery.

Top Ten Plastic Surgery Advances of the 21st Century

2010-01-04T10:47:00.000-08:00

With the first ten years of the twenty first century coming to a close, a recent survey of plastic surgeons helps shed light on some of the biggest innovations during this time. Medicine is a constantly evolving field and plastic surgery is no different. Plastic surgeons though are unique in that they deal with both reconstructive medically necessary procedures as well as cosmetic improvement techniques. The top ten advances in cosmetic and reconstructive plastic surgery over the last ten years, in order of priority, include:

Face transplant surgeries

“There is nothing new about the surgical techniques used for this procedure. The new and exciting part is that we are using our technology to help redefine the faces of those who have literally lost their identity due to trauma. That is exciting,” says facial plastic surgeon Dr. D.J. Verret.

Return of silicone breast implants for cosmetic surgery

While silicone breast implants for reconstructive purposes never took a hiatus, after strenuous scientific review and new treatment guidelines, silicone implants for cosmetic surgery have returned. According to plastic surgeon Dr. Evan Sorokin, “After 15 years of intense scrutiny silicone implants were determined to be safe and effective and were welcomed back to the market with surgeon's open arms.”

Fractional laser resurfacing

The introduction of fractional laser resurfacing at the turn of the century meant that the prolonged skin healing, prolonged skin redness, and risks of classic laser resurfacing have been minimized without minimizing results. The technology started with lasers designed to treat age spots and has spread to lasers which also treat wrinkles. Unlike older laser technologies, fractional treatments can be completed with topical anesthesia alone. “There has been a long search for a technology which produces the same results for wrinkle improvement as the carbon dioxide laser without the complications or long recovery. The fractional technology applied to carbon dioxide lasers is the answer to that search,” according to facial plastic surgeon Dr. Matthew Kienstra.

Combination liposuction technologies

The combination of laser and ultrasound technology with old liposuction techniques provides some new possibilities for decreased recovery and improved liposuction results. Though the scientific evidence is still mixed, continued development means this is a very promising innovation. “There is a lot of art involved with the application of the technology and it appears to be the first technology which will allow true sculpting of the body,” says Dr. Ed Khoury.

Pain pumps for cosmetic surgery

Patient controlled analgesia has been used for years in surgery to allow patients to give medications through the vein to control pain. Recently, devices have been introduced which allow patients to provide pain relief at their own discretion right to the site of pain. Dr Sorokin comments, “Pain pumps have greatly decreased hospital stays and decreased recovery times for both our cosmetic and reconstructive surgery patients.”

Increasing number of organic make ups

“About 20-30% of what we put on our skin is absorbed through the skin,” according to naturopathic doctor Dr. Kimberly Wilson. “The use of organic make up products helps to decrease the amount of toxins we expose our skin to and thus helps women to live healthier. Over the last ten years there has been a significant growth in organic skin products which definitely means healthier skin.”

Laser vein therapy

For many patients, the days of pain and days of recovery to get rid of pesky leg veins are long gone. The advances in laser technology have allowed many patients to undergo very successful leg vein removal with local anesthesia and limited time off their feet.

Increasing variety of dermal fillers

For people who do not like the lines on their face, there are options for treatment including skin, or dermal, fillers. Dermal fillers have been around since the 1980s but unfortunately early fillers didn’t last that long. Recent introductions into the market have seen an increase in longevity of the results (sometimes several years), an increase in use, and an increasing number of areas in which they are used. Plastic surgeon Dr. Ronald Friedman notes, “Dermal fillers and botulinum toxin products enable patients to undergo chemical browlifts and liquid facelifts, frequently delaying or obviating the need for surgery.” According to the American Society for Aesthetic Plastic Surgery survey, there were over 1.5 million dermal fillers injections in 2008, up from just half a million in 2000.

Hair cloning research

Though hair cloning is not a commercially available procedure, the technology has come a long way in the last ten years with several companies currently performing clinical trials. “Once the technology becomes commercially available, surgeons will no longer be limited by a finite donor site. The dream of a full head of hair will become a reality,” says Dr. Verret.

Stem cell harvesting from fat acquired during liposuction

While there is a considerable controversy about embryonic stem cells, recent technology has allowed extraction of stem cells from the fat removed during liposuction procedures. These cells hold promise for future scientific research and as yet unthinkable medical discoveries.

About the Survey – Survey results are based on a poll of plastic surgeons in December 2009 asked “What is the biggest innovation in plastic surgery from the last 10 years?” Results were tallied and the top ten vote getting responses were reported. All quotes are used with permission.

About Dr. Verret - Dr. D.J. Verret is a facial plastic surgeon in Plano, Texas. He is certified by both the American Board of Facial Plastic & Reconstructive Surgery and the American Board of Otolaryngology Head & Neck Surgery. He has authored numerous peer reviewed journal articles, several medical book chapters, two books on patient education topics, is an assistant clinical professor at UT Southwestern Medical School, presenter at multiple national and international facial plastic surgery meetings, and a clinical instructor in the facial plastic surgery fellowship program.

Is a pain free and scarless hair transplant possible?

2009-12-03T11:31:00.000-08:00

The easy answer - No. Though hair transplant surgery patients have minimal discomfort, a pain free procedure is just not possible. Some physicians will use intravenous sedation, similar to that used during a colonoscopy, to sedate a patient during the injection of the numbing medication. For most patients though, a light sedation with valium is usually all that is necessary for the couple of minutes that the injections are placed. Once everything is numb, the procedure does not hurt. After the procedure is finished, there is some discomfort, most often felt at the donor site as people sleep. This discomfort is also fairly minimal.
As for a scar free procedure, this too is not possible. Anytime the skin is cut there will be a scar. What is most often referred to as a scar free procedure is when follicular unit extraction techniques are used for removal of the hair. Though this does prevent the straight line scar associated with strip harvesting, if the hair is cut short or shaved, the scars will often be visible.

Get Your Cosmetic Surgery Before January 1, 2010 And Maybe Save 5%!

2009-11-24T07:08:00.000-08:00

Section 9017 of page 2045 of the Senate healthcare bill currently under consideration contains a 5% tax on all elective cosmetic medical procedures. This includes dermal fillers such as Juvederm and Restylane, neuromodulators such as Dysport and Botox, laser treatments, and more conventional surgical procedures such as facelifts and nose jobs. Should the tax pass the Senate and be approved by the House, it would take effect January 1, 2010. For patients who are considering any type of cosmetic surgery, it would be a good idea to consider having the surgery before the end of the year in order to save the 5% tax should it pass.

Be Careful of Medical Services At MedSpas

2009-11-23T08:52:00.000-08:00

A recent article in the New York Times highlights some of the lax regulations when it comes to cosmetic surgery. Unfortunately, this laxity in regulation can have deadly consequences.

http://www.nytimes.com/2009/11/05/fashion/05skin.html

Regulations on medical practice vary by state. In the state of Texas, there is no requirement for training for performing cosmetic procedures. Any physician can legally perform any medical procedure. It is more important than ever for patients to be wary of procedures performed by physicians or other health care providers that are not qualified to perform those procedures. Remember that these are medical procedures with serious side effects and consquences. While price is important to most patients, don't let it be a deciding factor in your health.

Is a chemical peel safe at home?

2009-11-12T11:00:00.000-08:00

The answer lies in the type of chemical peel which is to be performed. Superficial chemical peels such as alpha-hydroxy acid (AHA) peels are safe and often available over the counter for use. Deeper chemical peels, such as TCA peel or phenol peels should only be performed by a trained and experienced physician. While the results of a medium to deep depth chemical peel can be quite dramatic, the complications associated with them can also produce some rather dramatic scarring and unpleasant results. Be careful too of brand name peels. Be sure to know what is the underlying chemical or chemicals in the peel. Unfortunately the chemicals used for chemical peels are often not FDA regulated as they have industrial uses. As such, anyone can purchase them and use the products. This can lead to unfortunate and devastating results.

10 Ways To Improve Job Interviews

2009-11-01T18:18:00.000-08:00

As a facial plastic surgeon I have gone through many job interviews during training, had the opportunity to hire office staff, and worked with people on improving their image for job interviews. In short, I have seen all sides. From my experience, I have compiled a short list of things that hopefully will help people improve their job interview skills, especially for those suffering recent unemployment. These are in no particular order.

Don't Be On Time - Be Early!

The absolute last thing that a prospective employer wants is an employee who is late. From the employer's perspective, if you can't be on time for the interview, how will you be on time on a daily basis. Be sure that are at least 10 minutes early for an interview. If you are unfamiliar with an area, make a dry run before your interview. If the interview is in a large office building, go so far as to going into the building and finding the office where the interview is to be conducted. If you have to travel a long distance to the interview, consider getting a hotel room near the interview location the night before. If you are paying for your travel and the interview is out of town, arrive a day early to ensure that you are not the victim of airline or mass transit delays.

As part of the be early philosophy - Only reschedule an interview if ABSOLUTELY necessary. If you reschedule for a later point in time, this only allows others to make that first impression first - and take your job. Rescheduling also sends the signal that this job is not your priority. No prospective employer wants someone that does not give their position importance.

Dress For Success

There is no such thing as being overdressed for an interview. While I don't suggest wearing a tuxedo for an interview, I would suggest wearing your best coat and tie. Be sure to shine your shoes and press your shirt, too. Let's say that you are interviewing for a job where the usual dress is blue jeans and polo shirts - still wear a coat and tie. A prospective employer will not think anything if you overdress. If you underdress, they will immediately be turned off.

Remember - Moderation

Whether it is jewelry, makeup, or perfume, moderation is critical - (I would argue that you should not wear perfume or cologne at all). This applies to men as well. Excess of any of these can be distracting. The last thing that a potential employer wants is distraction.

Control Your Hair

Hair is often overlooked but is a very important part of a first impression. Hair should be well groomed. Consider visiting your stylist or barber shortly before the interview - but not too close just in case the stylist gives a less than stellar performance and time is needed for the hair to grow back

Study Up On Your Employer And Interviewer

One of the most irritating things as an employer is having someone come into my office who does not know my background or what is offered in my office. Do your homework before any interview. This is important for two reasons. First, you want to know if the business is a good fit for you. Second, you want to know as much about the person and place where you are interviewing as they know about you. The internet is a great source of information. Visit the company's web site. If you know the name of the person who is interviewing you, search for them. Determine if they have written any books, articles, or book chapters which can give an insight into their interests. Everyone likes to talk about themselves. If you can get lucky and get an insight into the personal life of your interviewer, talking about their interests can be a great way to leave a positive impression. At a minimum, at least know the basics about the company you are asking for a job from.

For Women - Consider a Makeup Makeover

I know I suggested moderation of makeup earlier. By the same token, appropriately applied makeup can take years off of a person's face and in some people, create results similar to surgical procedures. But it has to be done right. Find a makeup artist. This may end up costing money, but think of it as an investment, not an expense. Properly done makeup should blend nicely and not be noticeable.

Consider A New Look

Whether it is a surgical change such as a facelift or eyelid surgery, noninvasive procedure such as botulinum toxin or dermal fillers, or improved skin care regimen, consider cosmetic surgery. With a large number of older perspective employees searching for sales and marketing jobs having to compete with younger people, looking young is an unfortunate requirement. While there is no fountain of youth, consultation with a facial plastic surgeon about your options can be a wise investment. Remember, a first impression is made in less than a second and the eyes are the first thing that a person sees. Simple procedures such as botulinum toxin injections for wrinkles can help to remove some signs of aging around the eyes and decrease a mad look and most importantly improve a first impression.

Don't Pad Your Resume

If a prospective employer finds that you have padded your resume with experience or training which you do not have, that will lead to an immediate filing in the big round filing cabinet.

Be Sure That Your References Are Positive

When asking someone to be a reference, ensure that they will be positive and supportive of you and your abilities. Make sure that they provide you with the best contact information and will be available to provide a timely response for your prospective employer. Just because someone will say something nice, if they can't be reached to say it in a timely manner, it won't help. There is also a difference between a reference and a good reference. Just because someone said they will act as a reference, doesn't mean that they will talk you up and make sure you have the best chance possible at a job.

Send A Thank You Note

Always send a personalized thank you note after an interview. Be sure to insert information from the interview into the note to show that it is not a form letter. Also reemphasize why you want the position and what would make you the best candidate. Don't include your entire resume, they already have that, simply include a brief sentence or two. By sending a thank you note, you not only show appreciation for the time of the interviewer as well as your attention to detail but your name and credentials get back in front of them for a second time. As an interviewer I can tell you - not many people send thank you notes.

Revision Facelift & Revision Plastic Surgery

2009-10-28T11:59:00.001-07:00

Recent media has focussed on revision facelift and redo cosmetic surgery.

http://www.nytimes.com/2009/10/29/fashion/29Skin.html
http://www.sunderlandecho.com/news/Rise-in-ops-to-fix.5765818.jp

While there is always the possibility for redo surgery, the articles bring to light several considerations. First, unlike medically necessary procedures, there is much choice for patients in cosmetic surgery. Unfortunately this can create a niche for minimally invasive procedures which produce minimal results. This can create the need for revision facelift procedures in a rather short period of time after the initial surgery.
Second, with rhinoplasty procedures, it is imperative to choose a surgeon who can ensure the ability to breathe out of the nose regardless of the aesthetic look. Unfortunately many rhinoplasty revision surgeries are necessary to correct breathing problems after aesthetic rhinoplasty surgery.

Faclift Talk with Dr. LaFerriere

2009-10-22T10:56:00.000-07:00

Listen to the latest edition of Innovations Radio. Dr. Verret talks with Dr. Keith LaFerriere about facelift surgery. Learn the facts and separate the myths about plastic surgery. http://radio.innovationsfps.com

Concerns about cosmetic surgery

2009-10-20T11:04:00.000-07:00

When people are considering face lift surgery, there are many concerns. Some of the most common concerns which can be dispelled are outlined below:

A face lift is a very painful procedure.

False - There are many different anesthetic methods used for face lift procedures. The type of anesthesia used for the procedure will determine the comfort of the patient. After the surgery, pain is generally not a concern. While everyone has a different perception of pain, it is very unusual for patients to require narcotic pain medication for more than one day after any type of face lift procedure. Some patients never use narcotic pain medication. For more patients, the biggest challenge after face lift surgery is to remember to take it easy since they tend to feel rather well.

I will looked pulled and unnatural after surgery.

False. A properly performed facelift procedure will look completely natural. Attention to detail and concentration on placing deeper structures in their more youthful position rather than just focusing on skin manipulation provides the most natural results. While everyone sees poorly performed facelifts, most people will never know if they see a well performed facelift.

General anesthesia scares me!

General anesthesia should not be scary. But should you not want general anesthesia, there are other options for most facelift procedures. Be aware though that longer and more complicated procedures may have to be split into multiple sessions for safety and patient comfort.

Innovations Radio

2009-10-08T10:33:00.000-07:00

Listen to the inaugural broadcast of Innovations Radio - the internet radio broadcast dedicated to helping you look and feel your best. http://radio.innovationsfps.com.

Blepharoplasty improves quality of life

2009-10-06T18:33:00.000-07:00

http://www.news-medical.net/news/20091004/Blepharoplasty-increases-patients-quality-of-life.aspx provides an article outlining the findings of a study on quality of life after eyelid surgery. Though a small study, results presents at the national ENT meeting showed improvement in several measures of quality of life after eyelid surgery. For more information about blepharoplasty surgery, consider a consultation with Dr. Verret.

Is Hair Loss Normal?

2009-09-29T09:46:00.000-07:00

Absolutely. Hair naturally goes through a growth cycle. The cycle is made of three phases - growth (anagen), transition (catagen), and resting (telogen). Hair on different parts of the body spends different time in each part of the cycle. It is natural to lose about 100 hairs per day. This may be seen on your pillow, on your comb, or in your sink. For patients suffering from hair loss, about 50% of the scalp hair can be lost before it is noticeable.

Permanent Lip Augmentation

2009-09-28T10:47:00.000-07:00

A common concern as people age is a change in the lips. As people age, the lips appear to evaporate. Technically, there is a loss of definition of certain portions of the lip, a slight deterioration of the muscle of the lip, and some loss of facial fat. To correct these issues and produce a fuller, more youthful lip, there are several options.

Facial fillers are often used for lip augmentation. Unfortunately, if not done properly, injections into the lip can result in a "duck bill" look. The biggest problem with facial fillers is that they are temporary. Though some are reported to last up to a year in other areas of the face, facial fillers used for lip augmentation will likely last only a short period of time.

As a permanent alternative to facial fillers, there are several lip augmentation surgery procedures which can be performed. These include lip implants, facial fat graftings, and subnasal lip lifts. The procedures are aimed at recreating the cupid's bow area of the upper lip, filling the red portion of the upper and lower lip, and redefining the natural slope of the lip. Lip augmentation surgery can often be undertaken with local anesthesia. Care must always be taken to ensure that natural resutls are obtained. Well performed lip augmentation is not detectable and patients most certainly are not confused for water foul.

Hair Loss Treatment

2009-09-26T08:03:00.001-07:00

Want to learn more about genetic testing for hair loss and read tips on choosing a hair transplant surgeon? Read this month's BaldManMag at http://baldmanmag.com.

Do I Have To Shave My Eyebrows After An Eyebrow Transplant?

2009-09-22T09:46:00.000-07:00

The question of the day is 'Do I have to shave my eyebrows after an eyebrow transplant?'

The answer is yes. Hair on all parts of the body goes through a hair growth cycle. The length of a strand of hair is dependent on the amount of time it spends in the growing stage of the hair cycle - or the anagen phase. Hair on the scalp can remain the anagen phase of the growth cycle for 2-6 years. Hair on the eyebrows only remains in the growth cycle for 30-45 days. When a hair is transplanted, it maintains the growth cycle as if it had never been transplanted. This means that if left unattended, transplanted hair from the scalp to the eyebrows would grow as long as the hair on the back of the head. Regular eyebrow maintenance is therefore required after an eyebrow transplant.

Question of the day - Insurance Reimbursement for Hair Transplants

2009-09-16T07:57:00.001-07:00

A common question from hair transplant patients is, "Will insurance reimburse the cost of hair transplants?" The answer is maybe. As with anything in the insurance realm, there are many policies out there and the only way to determine if a certain policy will reimburse for any procedure - ask the insurance company. In general, hair transplants are considered cosmetic procedures. There are certain exceptions namely hair transplant surgery which is performed to correct balding after trauma, burns, and some cancer reconstructions.

Summer Is the Time For Plastic Surgery

2009-09-15T11:00:00.000-07:00

In an interesting story out of Great Britain, there has been an increase in teachers undergoing cosmetic surgery. The article, available at http://www.prweb.com/releases/2009/09/prweb2845814.htm, indicates that teachers are using their summer vacations to undergo cosmetic surgery. The most common plastic surgery procedure - cosmetic eyelid surgery. If you are a teacher and considering surgery, Dr. Verret does participate in several teacher reward programs, offering discounts to teachers in various DFW school districts,so inquire today-972-608-0100!

Non surgical facelift?

2009-09-14T13:05:00.000-07:00

Most people want to feel younger but not many have the time necessary to recover for a facelift surgery. For some of those patients, the non surgical facelift may be the answer. Using dermal fillers or sometimes a patient's own fat in certain areas of the face can provide rejuvenation without the need for long recovery or any down time. If you are considering a non surgical facelift, consider talking with facial plastic surgeon Dr. D.J. Verret today by calling 972.608.0100 and scheduling an appointment!

What is the cost of a mini facelift?

2009-09-10T09:48:00.000-07:00

The question of the day today is one that I receive quite often by prospective patients - what is the cost of a proedure? While we have set pricing for procedures that we perform, by just calling and asking the price of a procedure over the phone does not give the whole picture. The most common call we get about cost is 'What is the cost of a mini facelift?" While the cost is easy to quote, what you can not tell over the phone is if a person is a candidate for the procedure they are asking about, does the person need other procedures to reach their goals, and does other medical conditions necessitate performing the procedure in a particular setting. For these reasons, my office generally does not provide quotes over the phone except for straight forward procedures such as Botox, Dysport, and facial fillers (Evolence and Juvederm).

Laser Resurfacing | Cosmetic Eyelid Surgery | Hair Transplant Donor

2009-09-09T09:25:00.001-07:00

The latest in the innovations in facial plastic surgery series is now available.

Laser Resurfacing | Differences between CO2 and Erbium lasers
Cosmetic Eyelid Surgery | Options for periorbital rejuvenation
Follicular Unit Extraction | FUE vs. donor strip for hair transplant harvesting.

September Innovations Newsletter Released

2009-09-09T06:51:00.000-07:00

Visit http://innovationsfps.com today to read the latest innovations newsletter. Highlighted this month includes an article on forehead lift urgery for migraine headaches as well as a discussion of Dysport and Botox.

Why Do We Have Earlobes?

2009-09-08T15:42:00.000-07:00

Plano facial plastic surgeon Dr. Verret is quoted in newsweek.com for an article about the meaning of certain apparently useless organs. If you should tear your earlobe, consider Dr. Verret for earlobe repair.

http://blog.newsweek.com/blogs/thehumancondition/archive/2009/09/01/the-appendix-fights-illnesses-seven-misunderstood-body-parts-explained.aspx

Are Chemical Peels Good for Hyperpigmentation

2009-09-08T15:16:00.001-07:00

Medium depth chemical peels are a good choice for persons with hyperpigmentation. A 35% TCA peel will work well to even out pigment accumulated over time. As always, there are risks and use in dark skin people should be avoided. There are other options including lightening creams containing hydroquinone, intense pulsed light treatments, and even facial resurfacing. A consultation with a qualifieid dermatologist, facial plastic surgeon, or plastic surgeon is always a good starting point. For more information, visit http://innovationsfps.com.

LLLT for Hair Loss

2009-09-01T16:43:00.001-07:00

A recent study in the Journal of Cosmetic Laser Therapy (http://www.ncbi.nlm.nih.gov/pubmed/19466643?ordinalpos=19&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum) demonstrates mixed results for low level laser light therapy (LLLT). While the study was very small (7 patients) and did not have a control arm, the authors showed an increase in terminal hairs for patients who underwent treatment. Unfortunately, this did not translate into a noticeable change in hair loss. The authors acknowledges that LLLT is a promising therapy but point out that their study contributes to the need for further testing to determine who is an effective candidate for the treatment.

Free Plastic Surgery Isn't Always Free

2009-08-31T20:27:00.000-07:00

This is a terrible story out of Las Vegas with two valuable lessons.

http://www.ktnv.com/Global/story.asp?S=10829826

The brief story is that a patient 'won' a free plastic surgery procedure of her choice. A family practice physician who advertised himself as a board certified cosmetic surgeon performed a breast augmentation with local anesthesia. Complications occurred and the physician performed a second 10 hour procedure using local anesthesia. The patient eventually required hospitalization and is undergoing reconstructive surgery.

Two important take home points -
1) Don't search out the cheapest plastic surgery.
2) Board certified doesn't necessarily mean competent.

Every cosmetic surgery procedure has complications, even botulinum toxin injections. While many procedures have become commercialized, simply searching for the cheapest procedure is not necessarily the best idea. This can result in the procedure being performed by someone who is not trained or competent in performing the procedure.

While there is great press indicating that patients ensure that their physician is board certified - not all board certifications are the same. If you have a question, ask the physician who is the certifying board. Reputable boards maintain web sites with a listing of the criteria for physicians to be certified. Reputable boards will ensure that physicians have appropriate residency and fellowship training to prepare them to perform the procedures that are being certified. The board will also require written and oral examinations as well as sometimes providing logs of cases to prove competency. Unfortunately, some boards will only require the physician to pay a yearly fee and will welcome physicians of all training, even if they are not really qualified to perform the procedures they are advertising.

In the end, patient be ware.

Hair Loss Survey

2009-08-24T13:20:00.001-07:00

Log in to http://surveys.drverret.com/index.php?sid=55556 today to take Dr. Verret's survey on hair loss. The survey is trying to determine public perceptions of people with hair loss and gauge the psychological ramifications for people with hair loss. Take the survey and stay tuned for the results...

Cosmetic Eyelid Surgery | Blepharoplasty Dallas

2009-08-19T11:41:00.001-07:00

Do you look tired even though you are well rested? The problem may not be with your sleep patterns but rather with the way that your eyes look. Excess upper eyelid skin and excess fat in the lower eyelids can produce a tired look. For some patients, natural aging that causes descent of the brows can also produce smaller eyes which give the appearance of being tired. Cosmetic eyelid surgery, or blepharoplasty, can help to relieve the tired look. For some patients, this can be done with local anesthesia in the office while others may require intravenous sedation. In either case, complete general anesthesia with endotracheal intubation (a breathing tube) is rarely indicated. For more information about blepharoplasty Dallas or cosmetic eyelid surgery, visit Dr. Verret's website at http://www.innovationsfps.com.

Snoring

2009-08-18T06:43:00.000-07:00

Snoring can not only be an annoyance but can also indicate a much more serious condition called obstructive sleep apnea. Basically snoring is caused by the vibration of tissue in the respiratory tract. While a basic definition is simple, determining the exact cause of a person's snoring can be quite a bit more difficult. Any location in the respiratory tract can be the culprit: the nose, the back of the throat, the base of the tongue, the soft palate, the tonsils, even the voice box.

While medications and certain conditions such as obesity can predispose to snoring, what can be done to help people who snore. There are a couple of options. For patients who suffer from anatomic abnormalities of the nose, a septoplasty or rhinoplasty (nose job) may be necessary to correct the problem. For some patients, surgery to reduce the size of the base of tongue can be helpful. In others, procedures which permanently make the soft palate harder can be useful.

Simple things like not drinking alcohol late at night, nasal strips which widen the nose, and sometimes sleeping slightly inclined can help with snoring. As always, it is important to visit with a physician who is experienced in sleep medicine to ensure that the snoring is not an indication of the more serious problem of obstructive sleep apnea.

Hair Transplant Myths

2009-08-11T19:37:00.001-07:00

A hair transplant is not permanent!
True and False – The hairs which are transplanted during a hair transplant procedure will not fall out due to the factors which cause male or female pattern baldness. The hair can fall out though for other factors which cause hair loss such as trauma, certain medical conditions, and certain medications. In general though, these are extreme circumstances. For all practical purposes, transplanted hair is permanent. Now here's why the statement is partially true. While transplanted hairs are practically permanent, the native hair can continue to fall out. This is why patients (except those considered a Norwood class VI) are encouraged to undertake additional therapy to try to preserve what they have remaining.
Hair transplants are expensive.
True and False – While the dollar amount cost of a hair transplant can get quite hefty, especially for patients with significant hair loss, when the costs are broken down or compared with the lifetime cost of other treatments, it is not that significant. For patients who choose a hair replacement system over hair transplantation, consider that these systems require regular maintenance as well as replacement. When these costs are added over a patient's lifetime, they can easily surpass the cost of a hair restoration session – which does not require lifetime maintenance. The other fact of hair transplantation is that it is a VERY labor intensive procedure. For patients with significant hair loss, it is not uncommon to spend 40-80 man hours on a SINGLE hair transplant. Considering that this includes time of a highly skilled and educated surgeon as well as specialty trained hair technicians, the overall cost of the transplant is quite reasonable. This figure does not include equipment costs, costs to maintain a medical facility, or other operating expenses.
Hair transplants do not look natural.
False - Well performed hair transplants look completely natural. The key is finding a physician who specializes in the procedure and has the knowledge to create a natural appearing hairline.
Hair transplants are painful.
False – The discomfort associated with hair transplants is usually minimal and limited to the initial injection of anesthesia and some donor site discomfort for a couple of days after the procedure. The discomfort of the initial injection can be easily combated with light sedation, such as valium, the use of ice and distracters such as a small hand held vibrator, or for patients who are particularly troubled, through the use of intravenous sedation for the initial part of the procedure. The discomfort after the procedure is usually limited to the donor area since this is taken from the back of the scalp and patients have to sleep on the area. This is usually for only a couple of days and can be treated with pain medication taken just before bed time. The caveat is always that the perception of pain varies between individuals. While this represents the experience I've seen with my patients, everyone is different and everyone heals in a different way.

Neuromodulators – Botox® and Dysport™

2009-08-11T19:32:00.001-07:00

Neuromodulators are a class of medications which change the way that messaging is conducted between nerves and muscles. The most common medication in this class is botulinum toxin. Botulinum toxin is a purified protein derived from the bacterium clostridium botulinum. The medication has been in use for over 20 years initially under the trade name of Botox® and now as well under the trade name Dysport™. The medication blocks the release of the chemical acetylcholine. Acetylcholine is the chemical which allows nerves to communicate with muscles and make them contract. When the chemical is blocked, the muscles are paralyzed.

The medications are temporary and last only a couple of months. While whole body muscle paralysis can be fatal, locally paralyzing select muscles can help with certain medical conditions and aesthetically decrease wrinkles on the face.

There are currently two medications approved for use in the United States by the US FDA: botulinum toxin type A (Botox®) and abobutulinumtoxinA (Dysport™). The indications for the medications are different but the results are generally the same. By injecting the medication into an area around a muscle that you wish to paralyze, temporary paralysis and improvement of a certain medical condition can be achieved. The results though are temporary and may require repeat injections every 2-3 months.

Care must be taken with the medication in those who are pregnant or thinking of becoming pregnant as birth defects have been reported in the babies of pregnant women who used the product. Care must also be taken in patients who have an allergy to milk or milk products when using Dysport™.

Type of Hair Restoration

2009-08-11T19:22:00.001-07:00

For patients with male or female pattern baldness and select other medical conditions, there are options for hair restoration. As with any other medical condition, patients with hair loss must have an evaluation by a trained physician to ensure that an underlying medical condition is not the cause of their problem. Once it is determined that treatment is merely cosmetic, there are several options which can be examined:

Hair replacement systems
Often referred to as wigs or toupees, hair replacement system are artificial replacements for lost hair. There are many types of systems with widely varying quality. All will require some form of maintenance, will need replacement at some point, and have limitations. For patients with temporary hair loss due to medical treatment such as chemotherapy or patients who want a quick result, these are good options. Costs vary depending on the quality of the system but can easily rival or exceed surgical hair restoration over the long term.
Scalp Reduction Surgery
While not considered state of the art, scalp reduction surgery is aimed at reducing the amount of bald scalp. There are limitations but for patients with small areas of baldness due to alopecia areata or scarring, this can be a good option. It is also a viable option when used in combination with other hair replacement techniques.
Hair plug surgery
An older technology which has generally fallen out of favor, hair plugs tend to produce an unnatural hairline which is easily discernible as being operated.
Follicular unit grafting

Considered the current gold standard of hair restoration surgery, follicular unit grafting relies on placing individual hair follicles, the part which grows the hair shaft that everyone sees, in a natural appearing fashion. The results are generally quite good and produce hairlines which are so natural that a barber will often not know that anything was done.
Follicular unit extraction
A subset of follicular unit grafting techniques, follicular unit extraction or FUE, relies on taking out follicular units from the donor area using individual punches instead of a continuous strip. Though there are advantages in some patients, the technique significantly increases the time or procedure, cost, and can thin the donor site.
Medical treatment
There are three medications approved to treat hair loss in the United States by the FDA. These include finasteride, minoxidil, and brimtamoprost. Finasteride and minoxidil are the only ones approved for scalp hair. Though a complete discussion of the medications is beyond this article, consider that these medications are aimed at preserving what a patient has left and not necessarily increasing hair density or causing hair growth, though this may be an added bonus.
Low level laser therapy
Though good quality medical studies have not been performed, anecdotal evidence and limited patient studies suggest that LLLT can increase hair growth.
Alternative therapies

Many herbal, dietary, and alternative medicine treatments have been suggested for hair loss. Some have reasonable scientific evidence to suggest that they are beneficial. Before considering any of these treatments, be sure to discuss it with your doctor. Some of the treatments can negatively interact with other medications, and some pose risks for patients with certain medical conditions.

Eyebrow Transplants

2009-08-11T19:16:00.001-07:00

Eyebrow plucking is a common practice for many women as a means of attaining facial symmetry and aesthetics. Unfortunately, the eyebrows are a very sensitive structure which are prone to scarring very easily. If the follicle of the eyebrow hair develops scarring, the follicle may stop growing hair resulting in a bald spot where the eyebrows should be. This can result in using temporary makeup, eyeliners, or permanent tattoos to recreate the natural eyebrows. Unfortunately, these solutions often do not produce a natural appearing result.

An option for people who are troubled by the lack of eyebrows due to chronic plucking or other causes is eyebrow transplants. By taking hair from the scalp, natural appearing eyebrows can be easily created. The hair, once transplanted, will begin to grow without a problem.

Eyebrow transplants are fairly straight forward procedures. A strip of hair is harvested from the back of the hair leaving a small scar which is easily covered by the natural hair. The hair is then divided under a microscope into individual hairs. Small incisions are made where the natural eyebrows should be. The dissected hairs are then inserted into these small incisions. Though the hairs may initially fall out, they will start to grow within 3-6 months and continue to grow as if the hair was on the back of the head.

The one drawback to eyebrow transplants is that the transplanted hair will continue to grow as if it were on the back of the head. This means that regular clipping of the eyebrows will be necessary to maintain a natural and short eyebrow hair appearance. In theory, the hair could grow as long as a pony tail.

The risks of eyebrow transplants are minimal but present. Consultation with an experienced eyebrow transplant surgeon will ensure that you have a full disclosure of the procedure before anything is planned.

Common Causes of Hair Loss

2009-08-11T19:05:00.001-07:00

There are many causes of hair loss. Some are benign and come with heredity and age while others can signal underlying medical problems. Anyone with unexpected or irregular hair loss should consult with a physician for evaluation.

Androgenic Alopecia

Commonly termed male pattern baldness is a condition which can also affect females though with a different result. Hair loss is due to the effect of androgens, actually break down products of testosterone, on certain hair follicles. In men, this type of hair loss only takes place on the top of the head and the crown of the head. Certain areas of the scalp will not be effected nor will the rest of the body. The cause is multifactorial. Genetically, the hair loss can come from your mother's side of the family or your father's side. It may skip generations and the degree of hair loss may vary between effected individuals in the same family. This type of hair loss is particularly suited to being treated with hair transplants.

Telogen Effluvium

Significant trauma or illness can cause telogen effluvium. Basically hair falls out and is pushed into the resting part of the hair cycle. Usually within about 6 months of the trauma, the hair will start to grow again.

Chronic medical diseases

Chronic conditions such as diabetes and low thyroid hormone levels can cause hair loss. Usually once the underlying medical condition is controlled, the hair will regrow.

Traction alopecia

Wearing hair in a tight braid can cause scarring of the hair follicles and cause hair loss over time. If scarring has occurred, this can be permanent.

Psychological problems

Certain psychological conditions cause patients to irrationally pull out their hair. Unfortunately the hair loss can be permanent when scarring occurs in the areas which are pulled out. Patients require counseling and sometimes medications to treat this troublesome problem.

Medications

Many different types of medications can cause hair loss. Unfortunately some vitamins which are taken to grow hair can cause loss when the vitamins are taken in large doses. In most cases, when the offending medication is discontinued, the hair will regrow.

Alopecia areata

A localized form of hair loss which can progress to a whole body hair loss, alopecia areata is thought to be an autoimmune disorder. In this condition, it is thought that the body somehow determines the hair follicle is a foreign object and fights it off, killing the follicle. Though treatments in some instances can cause hair regrowth, there is no universally accepted treatment algorithm and hair transplant surgery may be necessary.

CNN Story followup

2009-08-11T12:48:00.000-07:00

I was reading a story on CNN.com about skin cancer and thought I might add my two cents. The story is http://www.cnn.com/2009/HEALTH/05/04/hm.skin.cancer/index.html. It is very good but I'm sure because of space fails to mention a few interesting facts.
1) Basal cell skin cancers, the most common type of skin cancer, is most common on the head and neck and more common on the left than the right side of the body. Though no one knows exactly why, this may be due to sun exposure while driving.
2) Glass does not protect against the whole spectrum of ultraviolet light. This goes for glass in your car and your home/office. For complete protection, you will need special coating on the glass or some type of coverage like a shirt or sunscreen.
3) If you've had one type of skin cancer, you are at increased risk of other types.
4) The best sunscreen bases are zinc, titanium, and avobenzene. These will provide protection against both UVA and UVB rays.
5) See you doctor regularly if you have a history of skin cancer, family hisotry of melanoma, signficant sun or UV exposure, or have any growth on your skin which is troubling. Early detection is the key to minimal surgery and complete cure for any type of skin cancer.

Botox(r) vs. Dysport(tm)

2009-07-24T10:28:00.000-07:00

In this installment of the Innovations in facial plastic surgery update, Dr. D.J. Verret discusses similarities and differences between Botox(r) and Dysport(tm), the newest neuromodulator approved for cosmetic use in the United States. For use in glabellar furrows, Dysport can help to smooth facial wrinkles. For more information, visit Dr. Verret on the web at http://www.innovationsfps.com or call for a consultation at 972.608.0100.

Maintenance after Plano Hair Transplants

2009-07-24T10:27:00.000-07:00

In this installment of the innovations in facial plastic surgery update, Dr. Verret talks about appropriate maintenance therapy after hair restoration transplant surgery. Specifically, Dr. Verret discusses the two medications currently approved for hair loss in the United States, minoxidil and finasteride. For more information about hair loss, hair transplants, and hair restoration, visit Dr. Verret on the web at http://drverret.com

Mohs Micrographic Surgery for Skin Cancer Removal

2009-07-24T10:24:00.001-07:00

In this installment of the innovations in facial plastic surgery update, facial plastic surgeon Dr. D.J. Verret talks about Mohs micrographic surgery. A special type of procedure for skin cancer removal, Mohs surgery helps to preserve as much normal tissue as possible when removing a skin cancer. For more information about Mohs, visit Dr. Verret on the web at http://innovationsfps.com or call for a consultation for repair after Mohs surgery 972-608-0100.

Protecting Skin from Sun Exposure and Ultraviolet (UV) radiation

2009-06-16T11:03:00.001-07:00

While exposure to the sun is necessary to ensure adequate Vitamin D production, too much of the sun is not a good thing. It is important, especially during the summer to protect your skin from the sun’s ultraviolet radiation. The sun emits energy both that we can see and that we cannot see. Part of the energy we cannot see is termed ultraviolet light (UV light). UV light is arbitrarily divided into UV-A and UV-B.

Protection from sunlight is important for many reasons. UV exposure, both from sun and tanning beds, is the most common and avoidable risk factor for skin cancers including basal cell skin cancer, squamous cell skin cancer, and melanoma. In addition to skin cancer risk, sun exposure can cause in increase in the aging process. Long term exposure to sun can cause age spots, some of which can progress to skin cancer. UV exposure also decreases the amount of collagen in the skin and increases the amount of elastin. Collagen and elastin are opposing components in the skin which contribute to skin tightness. Collagen is good and helps to keep skin tight, while elastin is a major component in loose, baggy skin and wrinkles.

Sun exposure in the northern hemisphere is greatest during the summer months, particularly between 10am and 4pm. Just because you are inside does not mean that you are protected. Most glass windows only protect against a part of the ultraviolet spectrum. Interestingly, basal cell skin cancers are more common on the left side of the body and this is thought to be due to sun exposure while driving a car.
There are simple steps which can be done to decrease your sun exposure and protect your skin, the largest organ of the body.

• Wear sunscreen
• Wear long sleeve shirts, even in the summer
• Wear jeans and not shorts
• Wear a cap or large bandana to protect from sun exposure
• Sit in the shade, not out in the middle of the sun
• Beware of reflected sun exposure from concrete and other reflective surfaces
• Limit your outdoor activities between 10am and 4pm during the summer
• Avoid ultraviolet tanning beds and booths – these are as harmful as sun exposure

When choosing sunscreen, it is important to wear a sunscreen with at least SPF 30 and an additional UV-A protection. The sun protection factor (SPF) is only a measure of protection against UV-B radiation, not UV-A radiation. It is also important to reapply every 90-120 minutes, sooner if there is excess sweating or swimming which can remove the protection.

As always, if you have significant sun exposure or notice a spot on the skin which is concerning, consultation with a physician, possibly a dermatologist, is always warranted. For patients with extreme sun exposure, yearly consultation with a dermatologist is a good idea to ensure that there are no concerning moles.

Facial Aging Explored by DFW Facial Plastic Surgeon

2009-06-16T10:07:00.000-07:00

In this installment of the innovations in facial plastic surgery update, Plano facial plastic surgeon Dr. D.J. Verret discusses some of the latest principles in understanding facial aging. Included in the discussion are skin changes with sun exposure, facial fat loss, and age spots. For more information, visit his web site at http://InnovationsFPS.com or call for a consultation 972.608.0100.

keywords: plastic surgery, cosmetic surgery, facial aging, sun spots, wrinkles.

Spider Vein and telangiectasia primer

2009-06-12T12:05:00.000-07:00

Small blood vessels, sometimes called spider veins or more appropriately telangiectasias, can be an unsightly problem. They can also represent a more serious underlying disease. This primer is aimed at helping patients to understand the causes of spider veins and some of the treatment options.

What are spider veins?

Spider veins also referred to as vascular spider, arterial spider, spider nevus, or spider telangiectasia are small visible blood vessels. They may represent either small arteries or veins.

What causes telangiectasias?

Telangiectasias can occur naturally in otherwise healthy patients. They may also represent a more serious medical condition. Those illnesses associated with telangiectasias include:
• Ataxia - telangiectasia
• Bloom syndrome
• Cutis marmorata telangiectatica congenita
• Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
• Klippel-Trenaunay-Weber syndrome
• Nevus flammeus such as port-wine stain
• Rosacea
• Spider angioma
• Sturge-Weber disease
• Xeroderma pigmentosa
• Liver disease
Spider veins or dilated veins in the legs can also represent a more serious blockage of other vessels in the legs. For patients with minimal telangiectasias that present a cosmetic concern, additional workup is not often undertaken. Evaluation by a trained physician before any treatment is undertaken is necessary to ensure that the spider veins do not represent a more serious medical condition.

What are my treatment options?

If the spider veins are caused by a medical condition, the key to treatment is treatment of the underlying medical condition. If the concern is only cosmetics, there are several options depending on the size and location of the vessel. For small vessels on the face, intense pulsed light system or green light lasers such as KTP can be used to treat the lesions. For larger vessels, electrocautery, ligation, endovascular clotting techniques, or sclerotherapy can be used to shut off the blood flow to the vessel and make it disappear.

What is the first step in treatment?

The first step in treatment is consultation with a physician who specializes in treating vascular lesions. A good starting point for lower extremity lesions is a vascular surgeon, preferably one who is versed in treating not only the medical causes of the problem but also versed in the use of lasers and other techniques to address the aesthetic problems associated with them. For facial lesions, a facial plastic surgeon or general plastic surgeon can certainly both diagnose and treat small vascular abnormalities such as telangiectasias.

Rhinoplasty Primer Part 1

2009-06-04T12:17:00.000-07:00

What is a rhinoplasty?
Rhinoplasty refers to any procedure which forms the nose. This can be a procedure aimed at changing the function of the nose (improving breathing) or changing the appearance (cosmetic rhinoplasty). In either case, the underlying structure and ability to breathe must be preserved. There is no point in creating a nose which looks perfect but does not allow air to flow.

I want to change the shape of my nose but I don’t want surgery, what are my options?
There are some options for rhinoplasty which do not involve surgery. These non-surgical alternatives are particularly suited for people with humps that desire the hump to be camouflaged. The technique involves placing temporary fillers, such as hyaluronic acid, into the nasal dorsum to camouflage the imperfection.

Can a rhinoplasty surgery address both problems with nasal breathing and the look of the nose?
Combined procedures are often undertaken to address both concerns. In either procedure, it is imperative that functional considerations be maintained. In some cases, the desires of the patient cannot be achieved because it would create the inability to breath out of the nose.

What type of anesthesia is needed for nasal surgery?
The nose is a very sensitive structure with many different nerves providing innervations. Because of this, a deep intravenous sedation or general anesthesia is needed to undergo any type of rhinoplasty procedure. In some cases, cartilage must be taken from the rib to recreate lost structure. In these cases, an overnight stay in the hospital may be necessary.

What are some risks of rhinoplasty surgery?
There are risks associated with any procedure. The exact risks are dependent on a patient’s medical condition, type of anesthesia, and exact procedure performed. Consultation with a qualified surgeon is necessary to understand the risks and benefits of any surgery. General risks include but are not limited to difficulty breathing through the nose after surgery, developing a hole in the middle part of the inside of the nose (septal perforation), worsening the cosmetic look, bleeding, bruising (including getting bruises around the eyes), infection, and scarring.

What is the recovery time after surgery?
Recovery will again depend on the exact procedure performed. Generally within a week most normal activities can be resumed. For some patients, a longer period is necessary before more strenuous activities can be resumed. As always, consultation with a qualified physician is necessary to determine the expected recovery from a specific surgery.

What is the first step?
The first step for anyone considering a rhinoplasty procedure is consultation with a specialist surgeon. Facial plastic surgeons, plastic surgeons who specialize in rhinoplasty, or otolaryngologists (ENT doctors) are a good starting point for consultation.

Hair Loss Treatment Options

2009-06-01T11:50:00.000-07:00

What are my options for hair loss?
There are many options for treating hair loss. For some cases, there is an underlying medical cause which, once the medical disease is treated, the hair will grow back. For other patients, especially those with male and female pattern baldness, surgical and non-surgical methods exist which are aimed at recreating a natural appearing hairline.
What are the non-surgical options for hair restoration?
Non surgical options include diet modifications and herbal and dietary supplements. Currently there are three medications which can be used for hair loss. Minoxidil and finasteride have specific indications for hair loss. Bimatoprost ophthalmic solution was recently approved for eyelash growth. For some people suffering from hair loss, hair systems may be a good option. Toupee’s or wigs have come a long way. Costs, methods of application, need for replacement and upkeep, and look all play into the decision to purchase a hair replacement system.
What are the surgical options for treating hair loss?
Hair transplants, scalp reductions, scar revisions, and local flaps are all options for treating hair loss. The exact surgical methods and options which may be best for each individual patient are beyond the scope of this article. Determining the best option for an individual patient relies on consultation with an experienced hair restoration surgeon. A patient’s cause for hair loss, desires for hair restoration, and other medical conditions will all play into what procedure may be appropriate or best for an individual.
What is the first step in the evaluation of hair loss?
The first step is always consulting with a trained and knowledgeable physician. If the loss is due to a medical condition, fairly to properly treat the disease can result in additional irreplaceable loss. For some patients, the diagnosis is straight forward. For some, it may require additional testing.
What doctors are qualified to treat hair loss?
Many doctors are qualified to diagnose the cause for hair loss. In some cases, a primary care physician can easily diagnose the cause. In some more advanced cases, referral to a dermatologist may be necessary to get an answer. When it comes to surgical correction of hair loss, there are no set guidelines for whom to consult. A good starting point is a dermatology, plastic surgeon, or facial plastic surgeon who specializes in hair transplant surgery.

Lip Augmentation | Lip Rejuvenation | Lip Implant | Lip Filler

2009-05-11T06:12:00.000-07:00

Rejuvenation of the upper lip can be a challenge. Recent publicity has focused on both facial fillers and implants for lip rejuvenation. Unfortunately, simply placing fillers into the lips can actually worsen a person's area of concern rather than create the desired improvement. Evaluation of the lip relies upon evaluation of the entire perioral area as well as the bony structure of the midface and the texture of the skin. True lip rejuvenation usually relies upon a graded approach after complete midfacial and perioral evaluation.

Evaluation of the patient desiring lip augmentation first relies upon looking at the midface. Determining if a patient has a properly placed upper jaw in all dimensions is essential to determine if there is an adequate base for building on the soft tissue. Once the proper midface assessment is made, the association of the upper lip to the lower lip can be examined. The upper lower lip should have slightly more show than the lower lip with a 1:1.6 ratio. Evaluation of the upper lip relies upon evaluating both the skin and placement of the lip. The length of the upper lip is dependent on the height of the person, but usually lip length is between 19-21mm. The placement of the upper lip should also allow show of the upper teeth, between 1-3mm at repose. The skin of the upper lip is examined for both rhytids (wrinkles) and natural landmarks. A youthful lip has a nice round appearance with a gentle upslope from the nose to the edge of the lip. The middle of the upper lip also has two columns termed philtral columns which are well defined in the youthful face. The edges of the lip should be evaluated. In some patients aging has created overhang in the corners of the lips and a down turn appearance of the lips.

Complete and adequate perioral rejuvenation relies upon addressing all of these areas. Addressing these areas may require several different procedures. In some situations, such as a long upper lip with little red show, addition of facial fillers along the red/white border can produce a fullness to the lip and also elongation and aging of the face.

To address skin wrinkles and discoloration, chemical peels and facial laser resurfacing can be undertaken. Temporary fillers such as hyaluronic acid and collagen can be used to improve wrinkles and help to recreate natural landmarks of the lip. Permanent alternatives such as fat augmentation serve as a good alternative in patients who are happy with temporary filler results and wish long term results for lip augmentation. In either case, simply instilling the filler along the red/white border of the lip will usually not address all of the signs of aging.

Permanent implants serve a useful purpose but care must be taken as there are downfalls to using either. For patients with short upper lips, a subnasal lip lift can be undertaken where a small incision is made under the nose and a small strip of skin is removed to allow greater show of the upper lip. The scar is very well hidden and this can help to reverse signs of aging such as elongation of the upper lip and decrease in red show. Frowning at the corner of the mouth can be corrected by removing a small triangle of skin at the corners of the mouth.

Low Level Laser Therapy to treat Hair Loss

2009-03-19T10:02:00.000-07:00

An interesting technology has recently emerged as a non-surgical alternative to treat hair loss – low level laser therapy (LLLT). The technology has been around for almost 50 years and has been proven to be helpful in treating chronic pain, decreasing inflammation, and helping with wound healing. Interestingly, some of the initial experiments with LLLT in the 1960’s suggested it can lead to increase hair growth. A Hungarian researcher, Andre Mester was investigating if LLLT caused cancer in mice when he noticed that the treated spots actually showed increased hair growth. This observation was mostly lost until the last few years.

There is no clear explanation for how LLLT may increase hair growth. One theory is that LLLT somehow increases blood flow to the treated area. Another suggests that LLLT transfers light energy directly to the hair cells and causes increase growth activity through this increase in energy. It does not appear to work at all on areas which are completely bald and is a treatment that requires constant maintenance to maintain effect.

LLLT devices designed to treat hair loss come in two varieties: those used at home and those designed for use in a physician’s office. The home devices allow a person to perform treatment in their own home but generally do not provide the intensity or the even coverage of the office based systems. Though the office devices provide greater energy and even coverage, it does require repeated trips to the physician’s office for the treatment. No studies have been performed to indicate if one is better than another though.

There are several home based systems which are marketed but only one has received clearance from the US FDA to indicate that it is effective at treating hair loss, the Hairmax Lasercomb®. According to their web site, “The HairMax LaserComb® is cleared by the FDA for The Promotion of Hair Growth in males with Androgenetic Alopecia who have Norwood Hamilton Classifications of IIa-V and Fitzpatrick Skin Types I to IV.” Unfortunately, there are no published placebo controlled double blind studies to indicate the effectiveness of LLLT at treating hair loss.

LLLT appears to be useful for patients both male and female suffering from androgenic alopecia. It does not appear to be effective in treating areas which are already bald and is more effective at treating areas which are thinning. Treatment protocols used in physician offices generally involve treatments 2-3 times per week for 6 weeks then once a week for the next 3-4 months. If positive results are seen, additional touch up procedures are undertaken on a regular basis. Each session takes approximately 20 minutes. Home treatment systems have similar protocols. Though touch up procedures are generally felt to be necessary if positive results are seen, no study has looked at results more than 6 months after treatment.

Eyebrow transplants, eyelash transplant, beard transplants, and chest hair transplants

2009-03-18T11:49:00.000-07:00

I know hair can be transplanted to the scalp, but where else can hair be transplanted?

Hair transplants can be used to replace eyebrows lost to trauma or years of plucking, eyelashes, the beard area, and chest hair. It is important to note that transplanted hair will continue to grow as if it were in its native location. This is important because the growth cycle of hair is different depending on its location. Scalp hair has a longer growth cycle than hair on the arms or legs. Transplanted hair may need to be trimmed more than would be expected for native hair.

What are some donor sites for hair transplant surgery?

For patients undergoing hair restoration for androgenic alopecia, typical male pattern baldness, the hair must come from an area which does not have receptors for dihydrotestosterone. Typically the donor site is the side of the scalp or back of the scalp. This provides the best match for color, texture, and growth. This is also the area used most often for transplant to other areas of the body. Should there not be enough hair on the scalp or the patient desires another donor site, hair may be taken from any other part of the body. The problem with donor sites other than the scalp, especially for a scalp recipient site is the difference in hair cycle. Hair on parts of the body other than the scalp generally have a shorter growth cycle than hair on the scalp and spend more time in the resting phase of the hair cycle. This leads to hair which is not as long as scalp hair and can produce an unnatural appearance after grafting.

How are eyebrow transplants different from scalp hair restoration?

Though the majority operation is the same for either scalp restoration or eyebrow restoration, several important differences must be noted. First, the distribution of the eyebrow hair is very random and does not follow as orderly of a pattern as scalp hair. Great care must be taken to ensure that the random nature of native eyebrow hair is maintained if any transplant is undertaken. Second, most surgeons will only use single or double follicular unit grafts when recreating eyebrows as this produces the most natural eyebrow recreation.

What is follicular unit extraction?

In an effort to provide differentiation, some surgeons have begun harvesting the donor sites through a process termed follicular unit extraction. In a manner similar to previous hair plug removal, very small punches are used to remove single or double follicular unit grafts. The grafts are then transplanted similar to a traditional donor strip follicular unit grafting procedure.

The biggest advantage to this procedure is the lack of a linear scar compared to strip harvesting techniques. For patients who may one day decide to shave their heads, this can be advantageous. Because individual hairs are harvested by one person, operating times for this method are longer than strip harvesting and often more costly. Studies have shown a slightly higher follicular transection rate than with traditional strip donor site harvesting. Unfortunately no clinical studies have been done to compare the results of FUE to traditional donor site harvesting methods. Overall, a clear advantage of FUE to donor strip harvesting has not been shown to make it the preferred method for harvesting donor hair during follicular unit grafting procedures.

2009-03-18T08:48:00.000-07:00

It can be difficult for patients looking for information to find professional advice without having to wade through pages of medical jargon or shameless propaganda. The "Patient Guide" series from W.J. Sonnier Publishing is taking the gibberish out of medicine and offering straightforward, professional information in terms patients can understand.

Dr. D.J. Vetter is the author of the first two books in the "Patient Guide" collection, "The Patient Guide to Cosmetic Facial Procedures" and "The Patient Guide to Hair Loss and Hair Restoration." Dr. Vetter is a specialist working exclusively in the field of facial surgery following extensive training in both facial plastic surgery and otolaryngology. During his post residency fellowship at the University of Missouri – Columbia, Dr. Verret was involved in over 400 facial plastic surgery procedures, and he has helped thousands of patients since opening his own practice.

His experience led to the launch of "The Patient Guide to Cosmetic Facial Procedures," which offers patients a medical professional's view on the numerous surgical and non-surgical procedures currently available for facial rejuvenation. Dr. Verret explains, in depth, the benefits and risks associated with today's most common procedures, including face and neck lifts, cheek and chin augmentation, chemical peels, facial resurfacing, ear pinning and rhinoplasty (the traditional nose job).

"The Patient Guide to Hair Loss & Hair Restoration," Dr. Verret's second book in the series, provides patients with details about the causes of hair loss, how to prevent hair loss and what to do after balding has begun. The book provides extensive information on hair restoration surgery, herbal supplementation, diet modification, low level laser light therapy and hair replacement systems, including wigs and toupees.

W.J. Sonnier is offering discounts on all "Patient Guide" books to medical professionals interested in using them for patient education purposes.
Dr. Verret's professional career extends far beyond his practice and the "Patient Guide" books. He is a regular speaker at the University of Texas Southwestern Medical School Otolaryngology Grand Rounds conference and acts as a clinical assistant professor at the university itself. He also sits on the board of directors for the Texas Cosmetic Surgery Society and has been invited to be a member of the faculty for the latest American Academy of Facial Plastic and Reconstructive Surgery Fellowships.

"I'm proud…to teach the next generation of surgeons the craft I love," states Dr. Verret.

For more information, visit www.wjsonnier.com.

Comparing Costs in Dallas hair loss treatment | Hair Transplant | Hair Restoration Surgery

2009-03-17T11:36:00.000-07:00

It is wise for cosmetic surgery patients to obtain a second opinion before undergoing any procedure. With all other things being equal, price can play a significant factor in patient choices for surgery. When comparing prices for hair loss treatment, it is imperative to ensure that a patient is comparing apples to apples.

There are many pricing structures used for hair restoration surgery and understanding them can make comparing procedure prices much easier. The current state of the art in hair restoration surgery is termed follicular unit grafting. Though there are different methods for harvesting the donor hair, the procedure basically comes down to harvesting hair from the side and back of the head, dividing the donor hair into individual grafts, and placing these grafts in the recipient area.

Two terms must be understood to compare pricing structures: grafts and follicles. The follicle refers to the individual hair and associated structures. This corresponds to one hair. Graft is the unit which is placed in the recipient site. This can consist of one or more follicles. Most surgeons will use individual follicle grafts along the edge of the hairline and multi-follicle grafts in other areas. Some surgeons though will use single follicle grafts through the entire transplanted area. Even though two surgeons report that they will use the same number of grafts, because of differing follicles in each graft, the total number of hairs transplanted may be vastly different. When getting an estimate of cost and size of the transplant, it is important to get not only number of grafts but also number of hairs which will be transplanted. Surgeon A may transplant 1,000 single follicle grafts for $2000 whereas surgeon B may transplant 1,000 multi unit grafts for $3000. Surgeon A will transplant less total hair and possibly for a higher per hair cost than surgeon B. In this case, comparing surgeon A to surgeon B based solely on number of grafts would be misleading.

Some patients with significant hair loss may require multiple transplant sessions to obtain their desired results. Studies have shown that the longer the time out of the body, the less the survival rate of the transplanted hairs. Multiple shorter sessions may be more beneficial than a single prolonged session not only for graft survival but for patient comfort. Some physicians will charge by the session while others will charge for the number of grafts obtained while others may charge a combination of the two. When determining cost for multiple sessions, it is important to obtain the total cost for all sessions. If surgeon A charges $5000 per session and thinks it will take two sessions while surgeon B charges $3 per graft regardless of the number of sessions, surgeon B will need to place over 3,000 grafts in 2 sessions to meet surgeon A’s prices. Patients are urged to obtain an estimate of the total cost based on a per hair, not per graft, basis to allow for comparison.

In order to compare one surgeon to another when considering hair transplant surgery, obtain a cost estimate based on a total number of hairs transplanted. Though exact numbers of transplants will depend on the number of hairs obtained from the donor area, most hair restoration surgeons can estimate the number of hairs needed for a transplant and the approximate cost involved. The best comparison is made with a price per hair estimate. To determine the price per hair, simply divide the estimate for the total cost by the total number of hairs to be transplanted. If the estimate is given as a price per graft, be sure to ask how many hairs are transplanted per graft.

Septoplasty Surgery | Dallas rhinoplasty | Nasal

2009-03-10T12:31:00.000-07:00

In this edition of the Innovations in Facial Plastic Surgery Update, Plano facial plastic surgeon Dr. D.J. Verret explains septoplasty surgery which can be used to treat snoring, difficulty breathing through the nose, and other problems. Septoplasty surgery is an outpatient procedure which can be reimbursed by insurance. For more information about septoplasty and nasal surgery, visit Dr. Verret on the web at http://www.InnovationsFPS.com
septoplasty surgery snoring nasal airway obstruction breathing difficulty

Snoring | Septoplasty | Septoplasty Surgery

2009-03-10T11:39:00.000-07:00

What causes snoring?

Snoring is caused by abnormal air passage through the aerodigestive tract combined with vibration of the soft tissues of the head and neck. The exact cause of snoring can be difficult to determine as there are several culprits assuming no significant pathologic process such as a cancer: deviation of the nasal septum, collapse of the nose when breathing in, enlarged adenoid tissue, collapse of the tongue to the back of the throat, obstruction of the airway from enlarged tonsils, collapse of the top of roof of the mouth, vibration of the uvula, collapse of the walls of the back of the throat, and floppy epiglottis (top of the voice box). Sometimes more than one area is the cause of the problem.

Is snoring bad?

Besides creating a poor bed fellow, snoring can be the sign of a more significant problem, called obstructive sleep apnea (OSA). People with OSA actually stop breathing for extended periods during the night. Long term, OSA can lead to significant health problems such as high blood pressure, enlarged heart, and in extreme cases, death.

What treatment is available for snoring?

The first step in treatment for straight forward snoring is determining what area is causing the problem. At times, a step wise approach with multiple treatments is necessary to completely fix the problem. Options for non-surgical repair include special mouth appliances to keep the tongue in position and the palate firm, tape over the nose to keep the nose wide, and CPAP machines which blow pressurized air into the nose to ensure that patients continue to breathe all night long. Surgical options for repair include nasal reshaping surgery, septoplasty, tonsillectomy, adenoidectomy, uvulopalatopharyngoplasty, laser assisted uvuloplasty, genioglossal advancement, tongue base reduction, and other surgeries aimed at addressing the cause of the snoring.

Where should I start if I want to treat snoring?

The first stop would be to visit an ears, nose, and throat physician for a complete head and neck exam. This will often include passing a small fiberoptic scope through the nose to look at the back of the throat. Additional testing may be necessary to determine if a patient suffers from OSA. Imaging, such as X-rays, CT scans, or MRI scans, is used if an abnormal anatomic abnormality is seen.

Will insurance reimburse for these procedures?

Depending on the cause of your snoring and the severity of the problem, insurance may reimburse your cost. As always, only your insurance company can determine if the costs are reimbursable and you should check with them before undergoing any procedure if this is a concern.

For more information about snoring, septoplasty, septoplasty surgery, deviated septum surgery, nasal reshaping, or rhinoplasty in Dallas, visit Dr. Verret on the web at http://innovationsfps.com.

Patient Guide Series

2009-03-09T13:30:00.000-07:00

Dr. Verret is pleased to announce the publication of the Patient Guide Series. The first two books in the series, the Patient Guide to Cosmetic Facial Procedures and the Patient Guide to Hair Loss & Hair Restoration, are objective evaluations of the current technology in each field. For more information or to purchase the electronic or paperback copies of the book, please see http://www.wjsonnier.com

Latisse Plano | Plano Eyelash Growth

2009-03-09T13:29:00.000-07:00

In this edition of the innovations in facial plastic surgery update, Plano facial plastic surgeon Dr. D.J. Verret discusses the latest medication approved by the US FDA for hair growth - Latisse(tm). Marketed specifically for eyelash growth, Latisse(tm) was approved in January 2009 and is available by prescription only. To learn more about hair loss and hair restoration options, visit Dr. Verret on the web at http://DrVerret.com.

Bell’s Palsy Primer | Idiopathic Facial Paralysis

2009-01-27T06:42:00.000-08:00

What is Bell's palsy?

Bell's palsy is a form of facial paralysis with no known cause. It is generally considered a diagnosis of exclusion and is made when all other causes of facial paralysis have been ruled out. To be considered Bell's palsy, a facial paralysis should involve all the muscle groups on one side of the face, be sudden in onset, have the absence of signs of central nervous system disease, and have an absence of signs of ear or cerebellopontine angle disease. Care must be taken in the initial workup of Bell's palsy to ensure that the facial paralysis is not caused by tumor, autoimmune disease, or other causes.

What causes Bell's palsy?

The exact cause of Bell's palsy is unknown. There are several proposed causes but none have been definitely proven.

How do you treat Bell's palsy?

There is no consensus on the treatment of Bell's palsy. Most physicians will consider a mixture of steroid treatment, antiviral treatment, and in the most severe cases surgery.

Patients who suffer from Bell's palsy or any type of facial paralysis have several obstacles to overcome. The first is drooling which can occur because of lack of motor control of the lips. The second and more important is ensuring that the eyes remain moist and do not dry out. With facial paralysis, the normal tearing mechanism does not function properly and patients can suffer from dry eyes which can lead to corneal abrasions and problems with vision. To counter this, patients must regularly use eyedrops and sometimes undergo procedures to close the eyelids until function has returned.

What is the prognosis with Bell's palsy?

Fortunately, complete recovery is the rule after an episode of Bell's palsy. Approximately 80-90% of patients will recover completely. Of the remaining patient's most will recover some if not most of their facial nerve function without a significant complication.

What if I don't have return of function?

Though rare, persistent facial paralysis after Bell's palsy can be a debilitating problem। For patients with facial paralysis of any cause, not just Bell's palsy, there are several options for rehabilitation।

When paralyzed, the brow can droop causing difficulty seeing। In order to counter this droop, a surgery can be performed which raises the brow and sets it in a new position। The procedure is similar to forehead lifts performed for cosmetic reasons.
Closing the eye completely can be a problem in patients with facial paralysis because of inability to control the orbicularis oculi muscle। By implanting a gold weight into the upper eyelid, the eyelid can be helped to close and thereby keep the eye from drying out.
Patients who have facial paralysis can have pull down of the lower eyelid and difficulty keeping the eye moist। In order to combat this problem, several procedures can be undertaken. First, if the lower eyelid is lax, a lower eyelid tightening procedure called a canthoplasty or canthopexy can be performed. Second, in order to take the weight off of the lower eyelid causing the pulldown, a midface lift can be performed to pull the cheek back into its normal position.

For patients who suffer from drooling because of difficulty moving their mouth and difficulty breathing through their nose because of collapse of their nose several procedures are available which can help. By taking tissue from the leg, using synthetic material, or using the masseter muscle, a connection can be made between the masseter or temporalis muscle which are not controlled by the facial nerve to the muscles surrounding the mouth and nose. In this way, by clenching the teeth, the muscle is pulled tight and the patient can appear to smile and close the mouth. Though this takes some training, it can be a useful adjunct to other procedures for facial rehabilitation.

While this is not a complete list of possibilities, evaluation of a patient with persistent facial paralysis should be undertaken by a neurologist or head and neck surgery specialist.

Dr. Verret is a facial plastic surgeon in the north Dallas suburb of Plano, TX. He is board certified in Otolaryngology Head & Neck Surgery and fellowship trained in facial plastic and reconstructive surgery. He specializes only in cosmetic and reconstructive surgery of the face and neck. His practice includes surgical and non-surgical techniques including Botox, Juvederm, facial fillers, acne scar revision, rhinoplasty (nasal reshaping), blepharoplasty, facelift, eyelift, brow lift, and hair restoration. If you suffer from Bell's palsy or need help in diagnosing of a facial paralysis, consider Dr. Verret. For more information be sure to visit him on the web or call for an appointment at 972.608.0100.

Fractional laser resurfacing Dallas | Cosmetic Surgery Plano | Plastic Surgery Texas

2009-01-27T06:34:00.000-08:00

What is fractional laser resurfacing?

Conventional laser resurfacing used an erbium or carbon dioxide laser to remove layers of skin. The laser contacted almost every part of the skin where it was aimed. In fractional laser resurfacing, the same lasers are used but the laser beams skips a space between firing so that there is a normal area of tissue between each treated area. This creates a checkerboard type pattern in the treated area.

What is the advantage of fractional laser resurfacing?

Because there are islands of normal tissue between the treated areas, patients treated with fractional laser resurfacing have a decreased amount of redness and a quicker recovery time compared to traditional facial resurfacing patients.

What can factional laser resurfacing treat?

Fractional laser resurfacing is an excellent option to treat fine to deep lines and wrinkles, age spots, as well as acne and traumatic scars.

What type of anesthesia is used?

Topical anesthesia is generally enough to perform fractional laser resurfacing.

What type of after care is needed?

After the procedure patients will experience sloughing of the outer layer of skin, similar to a sunburn. This is generally complete within a week. Care must be taken not to pick at the sloughing skin as this can create scarring. Once the skin has come off, the remaining skin will be red for a time period. Once the outer layer of skin has regrown, about 1-2 weeks after the procedure, make up can be reapplied and cover the redness. Until that time, bland moisturizer such as petroleum jelly must be applied to keep the area moist, prevent crusting, and avoid scarring.

How many treatments are needed?

Most facial rejuvenation patients require only one treatment to get the desired results. For patients with deeper lines and wrinkles 2-3 treatments may be necessary to get the desired results. These treatments are spaced out over 3-6 months to allow the skin to heal.

Dr. Verret is a facial plastic surgeon in the north Dallas suburb of Plano, TX. He is board certified in Otolaryngology Head & Neck Surgery and fellowship trained in facial plastic and reconstructive surgery. He specializes only in cosmetic and reconstructive surgery of the face and neck. For more information about laser resurfacing Dallas, skin, skin resurfacing, laser skin resurfacing Texas, skin resurfacing Texas, CO2 laser skin resurfacing, cosmetic laser resurfacing skin surgery, fractional skin resurfacing, and facial skin resurfacing call Dr. Verret 972.608.0100 or visit him on the web at http://innovationsfps.com

Dallas Plastic Surgery Anesthesia | Texas Cosmetic Surgery Anesthesia

2009-01-09T11:20:00.000-08:00

In this edition of the Innovations in facial plastic surgery update, north Dallas facial plastic surgeon Dr. D.J. Verret explains different types of anesthesia which are used in facial cosmetic and plastic surgery. For more information about the lastest facial plastic surgery procedures in Texas, visit Dr. Verret on the web at http://innovationsfps.com

Fractional Laser Resurfacing Dallas | Texas carbon dioxide laser

2009-01-09T11:07:00.000-08:00

In this edition of the Innovations in facial plastic surgery update, north Dallas facial plastic surgeon Dr. D.J. Verret explains the difference between conventional and fractional laser resurfacing. For more information about fractional laser resurfacing, carbon dioxide laser resurfacing, erbium laser resurfacing, wrinkle treatment, or rhytids, visit Dr. Verret on the web at http://innovationsfps.com

2008-11-04T18:35:00.000-08:00

In this edition of the innovations in facial plastic surgery update, Dr. Verret talks about treatment of keloids and the difference with hypertrophic scars. For more information about the difference between keloids and hypertrophic scars and their treatment, visit Dr. Verret on the web at http://innovationsfps.com or call for an appointment 972.608.0100

Hair Transplant | Hair Restoration | Hair Loss Dallas

2008-11-04T11:13:00.000-08:00

In this edition of the innovations in facial plastic surgery update, Dr. Verret talks about the latest technique in hair restoration using follicular unit grafting especially the differences between current techniques and older hair plug techniques. For more information about the difference between current hair transplant technology and older hair plug techniques, visit Dr. Verret on the web at http://drverret.com or call for an appointment 972.608.0100

Rhinoplasty | Nose Job | Dallas | Texas Revision Rhinoplasty

2008-11-04T11:12:00.002-08:00

This installment of Innovations Facial Plastic Surgery update covers rhioplasty, Texas rhinoplasty, Dallas Rhinoplasty, or nasal reshaping surgery. Dr. Verret is a facial plastic surgeon in Plano. His practice serves Dallas, Plano, Frisco, McKinney, Allen, Prosper, Denton, and all of North Texas. For more information, visit him on the web at http://www.innovationsfps.com or call for an appointment at 972.608.0100.

Blepharoplasty Dallas | Eyelid Surgery Plano | Texas Bleph

2008-11-04T11:12:00.001-08:00

This installment of the Innovations in Facial Plastic Surgery update covers eyelid surgery or blepharoplasty including cosmetic eyelid surgery and visual field eyelid surgery. The short video briefly describes what blepharoplasty is and provides reference for further information. For more information about blepharoplasty in Dallas or other cosmetic surgery procedures, visit Dr. Verret on the web at http://innovationsfps.com

Evolence | Collagen Filler | Dallas | Plano | Texas

2008-11-03T20:07:00.000-08:00

In this edition of the Innovations in Facial Plastic Surgery update, Dr. Verret discusses Evolence, the newest facial filler approved by the US FDA. For more information about Evolence, collagen, collagen in Dallas, facial fillers, Juvederm, or other facial plastic surgery, visit Dr. Verret on the web at innovationsfps.com

Brow Lift Dallas | Plano | Endoscopic Forehead Lift

2008-11-03T20:04:00.000-08:00

Hair Transplant | Dallas Hair Restoration | Plano Hair Loss

2008-10-22T10:17:00.001-07:00

In this edition of the innovations in facial plastic surgery update, Dr. Verret talks about the latest technique in hair restoration using follicular unit grafting. For more information about the difference between current hair transplant technology and older hair plug techniques, visit Dr. Verret on the web at http://drverret.com or call for an appointment 972.608.0100

Acne Scar Treatment in Dallas, Plano, Frisco, Texas

2008-10-22T10:15:00.000-07:00

In this installment of the Innovations in Facial Plastic Surgery update, Dr. D.J. Verret discusses some options for acne scar treatment, acne scar revision, and acne. These include facial resurfacing, subcision, and others. For more information abut this and other facial rejuvenation options in Dallas, Plano, Frisco, and all of Texas and farther, visit Dr. Verret on the web at www.innovationsfps.com or call for a consultation at 972.608.0100

keywords: acne scar treatment, facial filler, plano, dallas, frisco, mckinney, prosper, texas, facial rejuvenation, plastic surgery

2008-10-22T10:12:00.000-07:00

In this edition of the Innovations in Facial Plastic Surgery update, Dr. Verret discusses skin cancer including basal cell, squamous cell, and melanoma. For more information about skin cancer, Mohs surgery, sentinel lymph node biopsy, or facial reconstruction, visit Dr. Verret on the web at innovationsfps.com

First Impressions

2008-09-28T07:12:00.000-07:00

Whether you are on a date or interviewing for a job, first impressions are very important. Within only a few seconds decisions can be made which can effect the result of your interactions with a person – for better or worse. So what can be done to improve your first impressions?

Dress Appropriately

A neat and clean appearance up front says a lot about a person. Before leaving for the first impression, take a look in the mirror from head to toe and make sure that every hair is in place, the shoes are polished, jewelry is kept to a minimal and is not distracting, cloths are pressed, and clothes fit properly. You can even have a friend or relative take a look before you leave to ensure that everything is in place. And remember – what you wear to a club on Saturday night is not the same attire you should wear to an interview Monday morning.

Plan your encounter

Think about your encounter before you arrive. Try to anticipate some common questions that might be asked and rehearse your answers. While you don’t want to come off sounding like you are reading a script, you should have some well though and rehearsed answers to prevent from saying ‘um’ and ‘hum’ too many times.

Make small talk

People like to talk about themselves. In any encounter, make small talk. It will not only allow you to determine if you have something in common with the person you are talking to, but it will also allow them to talk about themselves. This will also put people at ease and make an already tense situation more relaxed.

Stay relaxed

When talking with someone new, pretend like you are talking to an old friend – without colloquialisms. Don’t cross your arms and try to keep good eye contact. But don’t get too relaxed. If you are standing, stand straight up and don’t lean on anything. If you are sitting, maintain good posture and don’t slouch. A more relaxed posture sends the message that you are not interested in what the other person has to say.

Be happy

Smile. Stay positive. Don’t be negative. People don’t like talking to those who are down. A positive attitude will go a long way to keeping you in the game.

Try a new look

In a recent study presented at the American Academy of Otolaryngology meeting in 2008, people who were treated with Botox cosmetic had “improved first impression scores for dating success, attractiveness, and athletic success.” There are an increasing number of older people still in the job market who undergo more complete face and body rejuvenation to stay competitive in the market. If you are a man going bald, consider a hair transplant. Unfortunately, looks do matter and with the wide range of options today for both surgical and non-surgical cosmetic rejuvenation, considering cosmetic surgery is not a far out option
Remember – first impressions are lasting, but take less than a minute to form. Doing what you can to improve your first impression can mean the difference in the job market and the dating world.

For more information about improving your first impression, visit facial plastic surgeon Dr. D.J. Verret on the web at http://innovationsfps.com.

Evolence

2008-09-12T15:08:00.000-07:00

Learn about the latest facial fillers - Evolence. Evolence is a cross linked collagen which does not require skin testing and can last on average from 6 months to a year. It is indicated for filling deep nasolabial folds (lines between the nose and mouht) as well as marionette lines.

Hair Restoration and Hair Loss Options

2008-09-09T13:48:00.000-07:00

What is the difference between a follicular unit and a graft?

A follicular unit would be what is commonly referred to as a hair. The follicular unit is made of the visible hair, t he follicle, and associated glands. When a transplant is performed, the hair may fall out because of ‘shock’ but the follicle stays behind. In about 4-6 months, the follicle will reenter the growth cycle and a new hair will grow. A graft may be made up of between 1 to 6 follicular units. When performing follicular unit grafting, individual follicles will often be transplanted along the edge of the hairline with 2-4 unit grafts used to create the density inside of the edge of the hairline. Be careful when comparing different physicians as some will charge by the follicle and some will charge by the graft. Physicians who charge by the graft will give you more transplant for the buck.

What is the down time after a hair transplant?

Down time is usually pretty minimal. Some physicians will allow patients to wear baseball caps immediately after the transplant when leaving the office. There will be some swelling and the transplanted area may be red for a time period. Small scabs do form but these generally dissolve or can be removed in one week. Depending on your occupation, you may be able to return to work in just 1-2 days.
Will my hair look like a doll’s head after a hair transplant?
Using the state of the art technology – follicular unit grafting, the days of the punched doll’s head look are gone. Current hair replacement surgery will produce a very natural appearing hairline that even your barber will be hard pressed to find.

Will you notice the donor area?

While there is the possibility of a widened scar at the donor area after the procedure, even a widened scar is usually not seen as the donor area is in the back of the scalp where hair naturally grows down over the incision. In most cases though, even looking for the scar is difficult to actually see it. In some cases, hair will even grow back through the incision line creating a perfectly camaflouged incision.

How long do the hairs last?

If the cause of your baldness is typical male pattern baldness or female pattern baldness, the transplanted hair will be permanent and will not fall out. In some other cases, transplanted hair may be susceptible to the original process which caused the hair loss. It is important to remember that you can still lose hair from the original area and it is important to take steps to try to preserve the hair you have and choose a physician who will create a hairline which takes into account the possibility of continued loss.

Dr. Verret is a facial plastic surgeon in the north Dallas suburb of Plano, TX. He is board certified in Otolaryngology Head & Neck Surgery and fellowship trained in facial plastic and reconstructive surgery. He specializes in the latest technology for hair loss treatment Dallas, hair restoration, hair transplant, and follicular unit transplants. For more information be sure to visit him on the web or call for an appointment at 972.608.0100.

Keloid and Hypertrophic Scars

2008-08-25T11:53:00.000-07:00

Abnormal scarring can be a very troublesome problem and can occur as a result of trauma, skin piercing, or surgery - basically anytime the skin is broken. Keloids or hypertrophic scars can occur in any skin types but are more common in African American and Hispanic skin types. A previous history of keloids speaks to an increased risk, but the risk is not one-hundred percent. For patients who experience these conditions, there are many possible treatments but none that have proven to be effective in all cases. Often several treatments must be combined to get optimal results.

While additional research must be done, it appears that keloids and hypertrophic scars are not separate entities but on a continuum with one another. Hypertrophic scars are raised scars which remain in the line of the scar. Keloids are also raised but extend outside of the discrete scar. In order to minimize the risk of either, great care must be used in wound closure to ensure that no tension exists on the wound.

If a person suffers from a keloid or hypertrophic scar, there are several options for repair. Direct excision is always an option though this solution alone will almost certainly result in a recurrence of the process. Topical or injection therapies offer good adjuncts to surgical excision to help prevent recurrence. Though no treatment has shown 100% efficacy at preventing recurrence, several are used with good results depending on physician preference. Intralesional steroid injections, often with kenalog, is a useful tool not only to help prevent recurrence but also to help decrease keloids that are present. Additional therapies with the chemotherapy drug 5-FU directly into the lesion and imiquimod applied to the top of the excised area can be helpful in decreasing recurrence rates. Several studies have been done with the application of silicone sheeting for several hours a day for several days to months after surgical excision of a keloid with very favorable results. The mechanism of action is not entirely known but thought to be related more to the moisturizing effect on the wound than the silicone itself.

For keloids which are particularly troublesome, large, or recurrent, a short course of radiation therapy after excision can be beneficial. Because of the potential side effects of radiation, this therapy is reserved for particularly troublesome cases but can be very useful in the right circumstances.

For more information about keloid, hypertrophic scars, keloids, keloid scars, cryotherapy for keloids, keloid treatment, keloid scar removal, keloid in piercing, keloid repair, or keloid removal visit Dr. Verret on the web at http://innovationsfps.com.

Permanent Alternatives to Botox and facial fillers

2008-08-11T08:35:00.000-07:00

In this installement of the innovations in facial plastic surgery update, Dr. Verret covers permanent options for temporary facial rejuvenation procedures such as Botox, Juvederm, Restylane, and other facial fillers. For more information about this and other innovations in facial plastic surgery, visit Dr. Verret on the web at http://www.innovationsfps.com. keywords: lip augmentation, fat transplant, Botox, Juvederm, hyaluronic acid, Restylane, Perlane, Radiesse, fat transfer, facial fat injection

Hair Restoration Options

2008-08-08T10:53:00.000-07:00

In this installation of the Innovations in facial plastic surgery update, facial plastic surgeon Dr. D.J. Verret talks about the options for hair restoration after hair loss. For more information about hair loss treatments, hair restoration, follicular unit grafting, or hair transplants, visit Dr. Verret on the web at http://drverret.com keywords: hair loss, hair restoration, eyebrow transplant, hair transplant, folliculat unit grafting, hair loss treatment

Facial Rejuvenation During Wedding Planning

2008-08-05T14:12:00.000-07:00

For people who are getting married or involved in the wedding planning process, looking your best for the special day is of the utmost importance. Unfortunately, the signs of aging can taint the photographs which provide a lifetime of memories of the event. To that end, some people consider cosmetic surgery before the wedding to help them look younger. Timing is critical in helping to determine what procedures can be performed and what results a person can expect from facial rejuvenation before a wedding.
If you have less than 2 weeks before a wedding, it is ill advised to undergo any kind of cosmetic surgery procedure, even Botox Cosmetic or facial fillers. At this point, consideration should be put into having a makeup makeover and skin care evaluation. This often provides excellent results and can be worth the time and investment to produce nice results without risks.
If you have 2-3 weeks before the big day, consider Botox Cosmetic or facial fillers such as Juvederm, Restylane, or Evolence among others. These can help to soften the lines and wrinkles of the face that speak to a person’s age. While the injections can be performed in the office, they can sometimes result in bruising or swelling of the face which may take a week to subside. It is therefore best to pursue these treatments at least 2 weeks in advance of the big day to ensure that everything is back to normal for photographs.
If you have 2-3 months before the ceremony, consider other procedures such as a facelift, nose job, or brow lift. Some laser treatments can safely be performed if you have 2-3 months to recover as well. All of these procedures require some down time and have risks of bruising and swelling. With lasers, the skin will take time to heal and for redness to subside. Generally 2-3 months is enough time to allow for resolution of facial redness to at least a degree that can be covered by makeup. In the unlikely event that a complication occurs, generally 2-3 months is enough time to resolve the complication.
If you have hair loss and wish to have a head of hair similar to what you had when you were younger and have 6 months before the wedding, consider undergoing a hair transplant. Though the procedure is an outpatient procedure performed using local anesthesia, it can take 6 months for the results to show and the hair to regrow. In addition, hair can be transplanted to the eyebrows to create natural, full eyebrows without the need for pencils or permanent makeup.
Memories from a wedding can last a lifetime. If you are getting married, are part of a wedding party, or are involved in wedding planning, planning ahead can allow for facial rejuvenation which can make those memories even more special.
For more information about facial rejuvenation when wedding planning, facelifts, hair transplant, eyebrow transplant, or Dallas rhinoplasty, visit Dr. Verret on the web at http://innovationsfps.com or call for a consultation at 972.608.0100.

Chin Surgery (Mentoplasty)

2008-07-29T15:42:00.000-07:00

What is a mentoplasty?

Mentoplasty is chin reshaping surgery, sometimes chin augmentation and sometimes chin reduction. It can take several forms from altering the bone of the chin to changing the soft tissues to placing implants to improve the chin’s contour. The type of surgery depends on the surgical goals.

What is a sliding genioplasty?

A sliding genioplasty is a surgery aimed at changing the projection of the chin. The projection of the chin is how much (or little) the chin extends from the face in the profile view. In some patients with extreme chin underprojection, surgery of the bone is necessary to produce the proper chin projection. In a genioplasty surgery the chin bone is cut and the bone is advanced. The bone is then help into place with either wires or metal plates until it is healed. With the bone in a new position, the soft tissue of the chin is projected further away from the lip.

What materials can be used as implants for a chin implants?

Implants for mentoplasty range from solid implants such as artificial bone and bone cements to hard silicone to other synthetic materials. Some materials allow for in growth of soft tissues while the body forms capsules around others. In either event, the best materials are those which feel natural, can be left in place with no long term effects, and produce the desired results.

What are the risks of mentoplasty?

Every surgical procedure has risks. In order to determine the exact risks associated with a mentoplasty, an experienced and trained physician must be consulted who can sit down and determine if the procedure is right for you and what risks you may run when undergoing the procedure. Most patients who undergo mentoplasty run the risk of numbness of the lower lip and lower cheek area, infection of the implanted material requiring removal, and possibly not getting the desired results.

What are the incisions for a mentoplasty?

Mentoplasty can be achieved either through an incision on the inside of the mouth or through an incision on the skin surface of the chin. Either way, the incisions when healed are not noticeable. Which incision is best depends on the type of mentoplasty performed.

Why should I get a mentoplasty?

If you have a cosmetic concern about your chin, a mentoplasty may be for you. In addition, in some patients with complaints that their nose is too big, a mentoplasty can actually make the nose appear smaller by changing the viewing lines of the face. Therefore, in some instances, a mentoplasty is combined with a rhinoplasty to obtain optimal results.

For more information about chin implant Dallas, chin implant Texas, chin implant, recessed chin, chin augmentation, or chin augmentation surgeons, visit Dr. Verret on the web or call for an appointment 972.608.0100.

Laser Skin Resurfacing

2008-07-28T18:39:00.000-07:00

Laser skin resurfacing produces excellent results in the right hands but can be horribly disfiguring in the wrong hands. Laser skin resurfacing can help to correct years of aging through reduction in age spots, wrinkle removal, and tightening of skin. Through skin tightening, laser skin resurfacing can be a good treatment for scars, particularly acne scars.

Is laser skin resurfacing safe?

Absolutely. Laser have been used for many years to improve the color and texture of skin. Today there are many options for lasers to perform skin resurfacing depending on the type of skin and the desired results. As with any medical procedure, there are risks and consultation with an experienced and trained physician is necessary to determine if you are a candidate for the procedure and to determine what exact risks you might face.

What is the down time with laser skin resurfacing?

With any type of laser which destroys the outer layer of skin, there will be a period of redness while the skin heals. Most skin resurfacing treatments require a period of skin care with moisturizers to prevent scarring and poor wound healing. Again, consultation with an experienced physician can ensure that you are informed before undertaking any cosmetic surgery procedure.

What does laser skin resurfacing treat?

Acne scars
Age spots
Scars after surgery
Scars from accidents
Wrinkles

What is the best laser for the procedure?

The best laser for the procedure depends on the type of skin the patient has and the desired result. For some people, an intense pulsed light machine may be best while for others carbon dioxide (CO2) lasers in combination with other skin rejuvenation procedures may be the best alternative.

Is everyone a candidate for the procedure?

Unfortunately, not everyone is a candidate. Some medical conditions preclude laser resurfacing treatments. Care must be taken with people who have dark skin as some laser treatments can create pigment irregularities. These pigment irregularities can be permanent and once produced can be very difficult if not impossible to correct.

Is the cost covered by insurance?

In most cases, skin rejuvenation procedures are not covered by insurance. In some instances, insurance may consider payment if the procedure is used to treat a previous accident or the results of a previously covered procedure. The only way to determine if a procedure is covered by insurance is to ask the insurance company.

For more information about Texas laser skin resurfacing, laser skin resurfacing, skin resurfacing, laser skin resurfacing Texas, skin resurfacing Texas, CO2 laser skin resurfacing, cosmetic laser resurfacing skin surgery, fractional skin resurfacing, and facial skin resurfacing call Dr. Verret 972.608.0100.

Meaning of moles on the face

2008-07-25T08:47:00.000-07:00

Colored spots on the face can be moles or may be something more sinister. Determining exactly what a spot is absolutely requires examination by a qualified physician and possibly even biopsy of the lesion. This article is meant to describe different lesions which can appear on the face, not to provide diagnosis of any lesion.

What is the meaning of moles on the face?

Some spots on the face have been present since birth and pose no threat. These spots are termed congenital nevi and have no potential to become cancerous. They may grow over the course of a lifetime but they are not deadly. Unfortunately, some spots on the face represent skin cancer, the most deadly of which is melanoma. To consider if a mole is worrisome for melanoma, some basic guidelines have been established to help determine if further diagnosis or treatment is necessary. These have obtained the pneumonic ABCDE.

Asymetry – moles which are not the same on both sides, in other words are not a mirror image of one side to the other, are worrisome.
Borders – if the mole has irregular borders, this can be a worrisome sign
Color – if the mole has many colors in it. A mole which is black is not necessarily bad. If the mole though has black, brown, white, and different shades of these colors in it, that can be worrisome.
Diameter – worrisome are moles which are greater than 6mm in diameter.
Elevation/Evolution – a mole which is growing in size or has different elevations above the level of the skin should be evaluated.

While these rules can be applied to melanoma, other types of skin cancers can often be seen as moles. The two most common types of skin cancer are basal cell cancer and squamous cell cancer. The biggest risk factor for any of these is ultraviolet radiation exposure – either from sun or tanning beds. There are many other risks factors which are beyond the scope of this article. I a mole is changing in size, color, or shape; an unusual growth appears on the skin; you notice a color change on your skin; or you have a sore which won’t heal, evaluation by a trained physician with possible biopsy is definitely warranted.

I want to know how to get rid of moles?

The removal of moles depends on exactly what they are. Fortunately, not all moles are cancerous. For moles which are not cancerous, conservative measures can be used to remove unsightly moles for cosmetic reasons. Shaving the skin, clipping the moles, freezing the moles, and some topical medications can be used to remove moles. If the diagnosis of a mole is in question, any biopsy should be sent for pathologic examination. For lesions which proved to be cancerous, more aggressive treatment is necessary. In some cases, radiation therapy and/or chemotherapy may be necessary in addition to surgery to provide the best chance of cure.

If you have a question about the meaning of moles on the face or anywhere on the body, you should consult an experienced physician. It may be necessary to visit a dermatology and even undergo a biopsy of the mole to determine exactly what it is. The key to survival is early diagnosis.

For more information about mole removal, the meaning of moles on the face, how to get rid of moles, cancerous moles, pictures of skin moles, changes in moles, or repair of facial defects, visit Dr. Verret on the web or call for an appointment 972.608.0100.

Acne Scar and Accidental trauma scar Treatment

2008-07-24T09:37:00.000-07:00

Facial scarring either from accidents or acne can not only be physical but also emotional. Removing or minimizing the scars can remove stigma and long held memories. Fortunately with today's technology there are many different options to help treat scarring.

Acne Scar Treatments

The first step in treating acne scars is to control the acne outbreaks. Without control of the outbreaks, scar revision would be pointless. Once the acne outbreaks are controlled, scar revision can be undertaken. Procedures such as subcision, facial fillers, dermabrasion, ablative laser treatments, dermaroller, and dermasanding can all be undertaken to help lessen the visible signs of acne. In some patients, multiple treatments must be combined to get the best results. For patients with deep 'ice-pick' scars, treatment is a multiple stage process that generally combines multiple treatment options for optimal results. The treatments may take several months to finish and results are sometimes slow in the making. Final results though are often quite remarkable.

Trauma scar revision

Anytime that the skin is broken, a scar will result. In plastic surgery, surgeons are taught to make skin incisions in areas that will hide the scar. Unfortunately when a break in the skin is due to an accidental trauma, skin incisions are not often made in areas which easily hide the scars. At times, additional procedures are necessary to produce optimal results. For some scars, revision surgery is necessary to make the scar irregular. The eye is drawn to straight scars in some areas and by making the scar irregular, the scar is less noticeable. In other cases, skin resurfacing is a good option to make the scar less perceptible. In cases where a keloid has formed, additional surgery and treatments may be necessary to ensure that the scar is as minimal as possible. Consulting with an experienced and trained physician is always necessary to obtain the optimal results. Physicians who deal with skin cancer reconstruction and trauma cases can be especially good at obtaining scar revision results which are as minimal as possible. While it is generally impossible to remove the scar completely, by utilizing a large armamentarium of techniques, a well trained surgeon can create scars which are difficult to notice.

For more information about acne scar removal, scar treatment, acne scar treatment, keloid scar, hypertrophic scar, thyroidectomy scar, or acne scar surgery, visit Dr. Verret on the web or call for a consultation at 972.608.0100.

Hair Loss Treatment Algorithm

2008-07-22T08:44:00.001-07:00

Hair loss, though not a fatal condition, can have devastating psychological consequences. Patients often look for options to correct hair loss and the ideal solution would be permanent, natural, and create a head of hair like the patient had in their early teen years. When thinking about hair loss treatment in Dallas, think about a plan for treatment.

Determine the cause

For some people, hair loss is a factor in growing old, such as those with male pattern baldness, or more medically speaking androgenic alopecia. For others, hair loss can be due to trauma or even some medical conditions. The first step in treating hair loss is to define the cause. If it is a medical condition causing the hair loss, treating the medical condition will often reverse the hair loss.

Determining your course of treatment

For patients with hair loss, there are many options for treatment. Of course, there is always the option of not doing anything. For patients who are not interested in surgery, but want a more youthful appearance, hair pieces are a good option. The downside is that a poorly designed hair piece can be easily identified. It will not grow and change color as normal hair and often must be attached daily. This can also be obvious should the attachment wear off.

Currently two medications are available to help prevent further hair loss and allow for some increase in hair density. Under the tradenames of Rogaine and Propecia, these two are the only drugs approved by the US Food and Drug Administration to treat hair loss. Other over the counter herbal remedies have been used to treat hair loss with mixed results.

For a more permanent solution, hair transplants and surgery are an option. Some surgeries aim to reduce the amount of bald area while others aim to replace lost hair. Unfortunately once a hair dies or is injured, it does not regenerate. Transplants can be done in which individual hairs are moved from one area of the head to another to produce a very natural appearing hair line.

Research and execute

Once you have determined that you are looking for a hair loss solution, do your research. Find a physician who can talk to you not just about one options, but about all options that are available. A knowledgeable hair loss physician can evaluate the patient and determine first if further medical testing is necessary. Then, they can outline all of the options for treatment that are available. A physician who understands the hair loss and aging process will be the one who can produce the best and most long lasting results.

For more information about hair loss and hair restoration, visit Dr. Verret on the web at http://drverret.com.

Reversing the Signs of Aging

2008-07-18T09:27:00.000-07:00

As people age, several things happen to the face which contribute to the stigmata of aging. Facial fat stores are decreased, the skin increases elastin and decreases collagen, and supporting structures of the face descend with gravity. This results in a hollow face with drooping skin and sagging jowls. Fortunately, there are procedures which can help to reverse the signs of aging. Depending on the amount of aging that a person has experienced, some of the procedures can be performed as 'minimally invasive procedures' requiring very little in the way of down time.

Temporary Fillers

There are many options for temporary fillers to fill in areas with fat loss. Hyaluronic acid (marketed under the trade names Perlane, Restylane, Juvederm, and others), collagen, hydroxyapetite microspheres (tradename Radiesse), poly-L-lactic acid (tradename Sculptra), and others are available to help fill in deep lines and wrinkles. Unfortunately all of these are temporary solutions. The good and the bad news is that if you like the results, they will go away in several months. If you don't like the results, they will go away in several months.

Facial Fat Augmentation

To correct volume loss due to fat loss in the face as a more permanent solution, fat can be obtained from the abdomen or thighs and transferred to the face. Fat that is transferred is permanent, though it may take 1-3 procedures to get the results that are desired. The reason for this is that the procedure will produce swelling which can interfere with the results that are seen. In addition, some of the fat which is transferred does not take and requires additional application to produce the desired results. As with any procedure, there are risks. These can be elucidated by visiting with a trained and experienced facial plastic surgeon or plastic surgeon who performs the procedure.

Facelift

In order to correct sagging skin or laxity, sometimes a lower facelift needs to be performed. There are many types of facelifts and not every facelift is made for every patient. Unfortunately, the amount of down time and operation is usually equated to the amount of aging that the patient has. If a patient has minimal signs of aging, a minimal facelift can be performed with excellent results. For patients with more severe aging, a more involved facelift needs to be performed to achieve the best results.

As always, facial rejuvenation should be tailored to the patient's individuals desires and physical examination. All procedures have risks and should be discussed with a physician before undergoing any procedure. Be sure to share with your doctor all of your medical history including any over the counter medications you are taking as these can effect your results and risks.

For more information about facial fillers, Dallas cosmetic surgery, facial plastic surgery, or facelifts in Dallas, visit Dr. Verret on the web or call for an appointment 972.608.0100.

Cosmetic & Functional Rhinoplasty

2008-07-15T15:48:00.000-07:00

Rhinoplasty
Rhinoplasty refers to any surgery which aims to reshape the nose either for cosmetic or functional reasons. Some people chose to have a rhinoplasty because they cannot breathe through the nose (functional rhinoplasty) or to improve the look of the nose (cosmetic rhinoplasty). In either case, the approaches to rhinoplasty are generally the same. Two approaches can be used – either an internal approach or an external approach. The difference is that the external approach leaves a small scar on the tip of the nose, usually imperceptible when healed. The external approach allows greater access to the structural support of the nose and allows for greater ability to define nasal features. Some techniques require the open approach to the nose while other can be accomplished through a closed approach.
When considering functional rhinoplasty, several areas of the nose should be addressed. The opening of the nose, called the external valve, the middle part of the inside of the nose, called the septum, the structures on the outside wall of the inside of the nose, called turbinates, and the internal nasal valve. Care should also be taken to evaluate the back of the nose and the adenoids as these can be enlarged and contributing to difficulty breathing through the nose. Failure to evaluate the adenoids, in certain circumstances, can mean missing more ominous medical problems such as cancer. Each one of these areas can contribute to difficulty breathing through the nose and may need to be addressed separately or together to get the best possible results.
When considering a cosmetic rhinoplasty, function must be maintained. It would be imprudent to get a cosmetically perfect nose if you can’t breathe through it. Cosmetic changes should bring aesthetic improvement to the nose without causing a functional problem.
When considering Dallas rhinoplasty surgery, at times the surgeon will need to obtain either bone or cartilage to alter the supporting structure of the nose. This bone or cartilage, often referred to as grafts, can be obtained from the skull, ear, ribs, or even the nose itself. While most surgeries can be planned knowing that additional structural material is needed, sometimes physicians must make decisions during the operation to obtain additional supporting material.
As always, it is imperative to visit with a trained and experienced rhinoplasty surgeon when considering rhinoplasty surgery. Risks of the procedure vary depending on the approach used, medical health of the patient, medications used by the patient, and additional graft material which must be used. As always, your surgeon should sit down and learn your expectations, convey their experience and expected results, and go over all risks and benefits to the procedure before undertaking surgery.
For more information about rhinoplasty, revision rhinoplasty, visit Dallas facial plastic surgeon Dr. D.J. Verret on the web or call for a consultation 972.608.0100.

Brow Lift/Forehead Lift Incisions

2008-07-14T11:19:00.000-07:00

Approaches to a brow lift
For people who think that their eyebrows are too low, have a heavy look to the eyelids, or want help with wrinkles on the forehead, a brow lift may be the answer. A brow lift has several approaches with the goal to elevate the eyebrows and the soft tissue between the brows and the eyelids. As an added bonus, some of the approaches serve to tighten the forehead skin and smooth out the upper eyebrow wrinkles.
Endoscopic Brow Lift
The endoscopic approach to the brow lift makes incisions just inside of the hairline. Through these incisions the tissues are elevated off of the underlying bone to the level of the bone around the eye socket. Once this is done, the tissues are pulled up and secured. There are variable ways to secure the tissue but most studies indicate that some type of securing is necessary for about a week for the tissues to reattach to the bone. The incisions are hidden in the hairline and as such are not noticeable. This type of approach is good in most patients but can be problematic in those who are bald or who have a high hairline.
Trichophytic brow lift
This is the more classic method for brow lifting. An incision is made along the entire hairline. Through this incision the tissues are again lifted off the bone. Excess skin is removed and the incision is closed. Once healed, the incision is very difficult to see.
Direct brow lift
A direct brow lift is done by excising skin just above the eyebrows to pull them up. This is good in older people who have severe laxity of the brows and who cannot tolerate another approach. There is a visible scar left just above the brow but often this will look like a wrinkle when healed.
Upper blepharoplasty brow lift
For those patients who simply want to put the brow in a new position and are not worried about forehead wrinkles, an upper blepharoplasty brow lift can be performed. Through the same incision that a blepharoplasty is performed, the skin and other tissues are elevated off the bone of the forehead. An absorbable device is then place to hold the brow up until the tissues have healed in the new position. Once healed, the scar is very difficult to see.
For more information about brow lifts, forehead lifts, or other cosmetic procedures, visit Dr. Verret on the web at http://innovationsfps.com or call for a consultation 972.608.0100.

Facial Rejuvenation Options

2008-07-06T15:16:00.003-07:00

Are you thinking about cosmetic surgery? Do you wish that you can look younger in just minutes? Unfortunately the fountain of youth is not available but there are surgical and nonsurgical options to help you look younger.
They shall rejuvenation relies on evaluating each part of the face and determining the best option for correction. Experienced and trained surgeons can effectively negotiate all of the available options and put together a personalized plan for each patient to achieve the best results possible. For example, if you have a tired look, this may be due to multiple conditions including a droopy brow, excess that around the eyelids, or excess fat around the jowl area. Each of these has certain procedures which can help. It is crucial to consult with who can identify the area of concern and who has a large arsenal of ways to correct me. There is not a single treatment which helps every single patient. Consulting with a person who is not well trained in cosmetic surgery can result in a single procedure being assigned to fix every problem.
When evaluating the face, it is often helpful to define the face in several different areas. The brow, area around the eyes, cheeks, area around the lips, and lower face along the edge of the bottom jaw bone are each separate areas which must be treated independently. The neck as well is a separate area and must be evaluated and treatment options identified separately from the face. The ideal treatment offers the best result personalized to each patient with the least amount of complications, risks, and downtime. Unfortunately, some treatments which offered the least down time also offer the least results. Patients should be wary of treatments which are offered to correct any degree of aging changes. While before and after photographs can be helpful, they can also be misleading. What one patient is able to achieve with a certain treatment is not a guarantee of what other patients can achieve with the same procedure.
For more information about cosmetic surgery in Texas, plastic surgery in Dallas, facial rejuvenation, visit expert facial plastic surgeon Dr. D.J. Verret.

Facial Rejuvenation Options

2008-07-06T15:16:00.001-07:00

Cosmetic Surgery Confidentiality

2008-07-06T11:14:00.001-07:00

Confidentiality during plastic surgery procedures is often a concern for patients. Fortunately, reputable cosmetic surgeons understand this concern and take steps to ensure that confidentiality is maintained. If you are looking for a cosmetic surgeon and are concerned about confidentiality consider a few points.

Look for a surgeon who abides by HIPAA regulations or has set standards of confidentiality.

The health insurance portability and accountability act of 1996 sets up standards for among other things, privacy and confidentiality of medical records. It also sets stiff penalties for those who break the law, often fines up to $10,000 per occurrence for breaking the laws. Unfortunately, not all physicians are covered by the HIPAA statutes, especially physicians who are not participating in insurance plans. A reputable plastic surgeon, even though not bound by HIPAA will have regulations in place in their office to ensure patient medical record confidentiality. Be sure to question your surgeon about their privacy practices.

Consider a vacation destination.

Consider having your surgery in a location which is within driving distance of your home, but far enough away that people will not know you. Recovery times vary, but you can consider a week or two 'vacation' to another city in which you have your procedure and recover before returning home. Some physicians will even offer travel discounts or special accommodations for traveling patients. You will want a physician who is close enough to your home that you could travel back to the office in case of a complication.

Determine what your physician's office flow is.

Most cosmetic surgeons will have some system for maintaining privacy of their postoperative patients. Patients coming in before surgery may have a common waiting room, but patients returning after procedures should have a separate waiting area or entrance to ensure that they can maintain privacy during their postoperative period. If there is not a completely separate area, the physician may arrange his/her schedule to ensure that postoperative patients are scheduled in such a way as to not be seen by other patients. Be sure to ask your surgeon what their accommodations are for maintaining privacy after surgery. Unfortunately, some offices do not maintain private areas and patients are required to mingle with other patients.

Ask about the use of photographs

Cosmetic surgeons will often maintain preoperative and postoperative photographs at least as part of the medical record. Patients often ask to see these photographs as evidence of the physician's skill. If you are considering facial procedures, be sure to ask your surgeon what their policy is on use of photographs. A reputable surgeon will only show photographs for which he has obtained explicit permission from the patient.

As always, finding a surgeon with experience and training is crucial. If you are considering plastic surgery in Lafayette, LA or elsewhere and are concerned about privacy, consider a trip to Dallas to visit expert facial plastic surgeon Dr. D.J. Verret. But his experience in the Dallas facelift to work for you. Call today for your consultation 972.608.0100 or visit him on the web.

Permanent Alternatives for Temporary Facial Fillers using facial fat injections

2008-07-03T11:28:00.000-07:00

Are you tired of having to get repeated filler injections to produce the youthful facial results that you desire? There are permanent alternatives to fillers such as Juvederm, Restylane, and Radiesse which may be an option for you to achieve a more youthful appearance permanently. In certain circumstances, your own fat can be taken from the abdomen or thighs and transferred to the face. As people age, several things happen, among them, atrophy of facial fat and descent of facial muscles.

Where can fat be transferred to?

Fat augmentation can be performed in the lips, to the cheeks, around the eyes, and in the jowl area.

How long does it last?

Fat is a permanent alternative to temporary fillers. While the fat itself is a permanent option, it may take 2 or 3 treatments to get the results that you desire. It is very important not to over transplant an area as removal is often quite difficult.

Can someone else donate fat?

Unfortunately not. The fat is taken from the person who is wishing for the transfer. Almost everyone has enough fat which can be harvested from either the abdomen or the thigh to augment the face.

What are the risks?

There are risks with any procedure. The most common risk is bruising and swelling. This may last for several weeks and is variable. As always, steps can be taken to minimize the risk but it is present. Additional risks are dependent on the location from which the fat is harvested, the location to which the fat is transferred, the medical condition of the patient, and medications (including over the counter dietary supplements) the patient is taking. Consultation with an experienced and trained facial plastic surgeon or plastic surgeon can ensure that you have a full understanding of the risks before undergoing any procedure.

Is the procedure covered by insurance?

Generally fat transfer is not covered by insurance. In certain circumstances if the fat loss is due to trauma or some medical conditions insurance may cover the cost. In these cases, it is best to call your insurance company and ask them in advance.

What type of anesthesia is necessary?

Fat transfer can be performed using only local anesthesia. For patient comfort, more sedating anesthesia can be used but is generally not necessary.

For more information about permanent alternatives to facial fillers, facial fat injections, permanent alternative to Juvederm in Dallas, cheek augmentation, fat transfer, fat augmentation, lipotransfer, permanent alternative to Restylane, or facial fillers, visit Dr. Verret on the web or call for a consultation 972.608.0100.

Cosmetic Surgery Risks

2008-07-01T08:28:00.000-07:00

Everyone considering cosmetic surgery should always be concerned about the risks of the procedure. Whether the procedure is Dallas Botox or Juvederm or a more invasive procedure such as a facelift, risks are inherent. Some risks span the gamut of procedures and others are specific to certain procedures. As always, you should speak with an experienced and trained surgeon before undertaking any plastic surgery procedure as risks are dependent on the individual, the procedure being performed, and the exact method for performing the procedure.

Bruising and swelling

Any procedure will result in a variable amount of bruising and swelling. While no person can estimate the amount of bruising and swelling, some things can be done to decrease the amount. Avoid medicines which prevent blood clotting such as Aspirin and Ibuprofen. If you are taking prescription strength aspirin or other prescription medications that prevent blood clotting, speak with your doctor about stopping those medications for a few days around the time of the procedure. Be careful of over the counter supplements and vitamins as some of these can also increase your risk of bruising.

Poor cosmetic result

Every cosmetic surgery procedure is done to try to improve the way something looks. Unfortunately, some procedures end up causing things to look worse or maybe not quite the way things were expected. Be sure to convey to your plastic surgeon anything that bothers you about your results. Often times, a simple revision procedure can be undertaken which corrects the problem.

Scarring

Anytime the skin is broken, a scar will result. A skilled cosmetic surgeon can hide these scars in areas where they will not be easily seen. Scars can take quite a while to fully heal. Be sure to abide by the surgeon’s recommendations for scar treatment. Be careful of sun exposure as this can lead to either light or dark scars.
While these risks are common to almost any cosmetic surgery procedure, be sure to sit down with a trained and experienced plastic surgeon before undertaking any procedure. Disclose to your surgeon all medications, including over the counter and herbal supplements you may be taking. Every procedure has its own risks and a skilled cosmetic surgeon can speak with you about them so that you can make an informed decision about any plastic surgery procedure.

For more information about cosmetic surgery, visit expert facial plastic surgeon Dr. D.J. Verret on the web or call for an appointment 972.608.0100.

Anesthesia Types Explained

2008-06-20T07:32:00.000-07:00

Anesthesia is defined by Stedman’s medical dictionary as “loss of sensation resulting from pharmacologic depression of nerve function or from neurological dysfunction.” What that means for the patient is comfort during procedures. When considering cosmetic surgery, there are several options for anesthesia depending on the type of procedure performed. Local anesthesia, regional nerve blocks, topical anesthesia, intravenous sedation, and general anesthesia are all options when considering surgery.

What is local anesthesia and how is it different from topical anesthesia?

Local anesthesia is the use of medications injected into the ‘local’ area, the area immediately around what is to be operated on, which results in numbing. The medications used may last anywhere from one hour to most of the day. Local anesthesia generally involves a shot but topical anesthesia can be used to minimize the pain. Topical anesthesia using the same compounds but instead of going below the skin, the anesthesia is applied to the skin’s surface. The problem with topical anesthesia is that it does not penetrate very far under the skin’s surface so for more invasive procedures, local anesthesia with shots is required.

What are regional nerve blocks?

In different parts of the body, there are well defined patterns of nerve innervations. For instance, the sensation for the middle part of the cheek is from a nerve which comes out of the face just below the eye socket. By numbing this nerve, the entire cheek, upper lip, and upper teeth can be numbed. A regional nerve block takes advantage of this anatomy and numbs an entire nerve. Unfortunately some areas of the body are innervated by multiple nerves and regional nerve blocks are not possible.

What is intravenous sedation?

Intravenous (IV) sedation involves administering medications which make a person sleepy. In true IV sedation, a breathing tube is not necessary as the person is able to breath on their own and protect their own airway. The medications used often have a short half life so that when the medication is stopped within a very short time it is out of the body and the person is wide awake. This type of anesthesia is most often used in colonoscopy procedures. The medications use cause a type of amnesia so the person will most likely not remember anything even though they were awake.

What is general anesthesia?

General anesthesia is the type of anesthesia that most people associate with surgery. Medications and or gas is used to make the person sleepy. A breathing tube of some type is used to protect the airway and help the person breath. The medications generally cause amnesia so that the person does not remember the event.

For more information about plastic surgery Dallas, cosmetic surgery Dallas, or Botox Dallas visit Dr. Verret on the web or call for an appointment 972.608.0100.

Want to get rid of the turkey waddle?

2008-06-19T07:29:00.000-07:00

Do you wish you could get rid of that turkey waddle on your neck? There are several options for helping to get rid of that waddle. Depending on your age, certain non-surgical options exist which can help. For older people who no longer have good skin elasticity, surgical intervention may be necessary. The good news is that most of the procedures can be performed using local anesthesia in an office setting?

What are my options for helping the neck?

While there are several non-surgical options for improving the neck, the most drastic improvement which will be necessary in older people and those with significant neck concern will be seen with surgery. The options are neck lift, liposuction, and lower facelift. A neck lift is a procedure which is aimed at improving neck contour alone. This usually will not correct the jowl area or cheeks. A platysmaplasty may be necessary to correct laxity of the neck muscle which can produce bands in the midline of the neck. Liposuction is a good option for excess fat under the neck. Unfortunately in individuals over 40 years of age, additional procedures are often necessary to correct skin laxity which occurs after the fat is removed.

What is the latest innovation in neck surgery?

The latest procedure to hit the market is the ribbon lift. A tunnel is made under the skin into the neck area. The incision is made just in front of or below the ear. An absorbable device is then placed to hold the muscle of the neck up and hold the skin in place. Excess skin can be trimmed and the incision closed. The device will be absorbed by the body in several months.

What is the down time?

Down time for the procedures depends on the actual procedure that is performed. More extensive procedures will have longer down time. As with everything, consultation with an experienced and trained facial plastic surgeon is necessary to determine if you are a candidate, which procedure is best, and what the risks are with the procedure. The surgeon can also talk with you about the expected recover.

What is the cost of the procedure?

Costs of the procedures vary. Most surgeons will offer some type of financing and these are cosmetic procedures and generally not covered by insurance.

For more information about neck lift or neck liposuction visit Dallas facial plastic surgeon Dr. Verret on the web or call for an appointment 972.608.0100.

Female Hair Loss Examined

2008-06-17T14:16:00.000-07:00

Hair loss in women can be troubling and often more difficult to deal with than in men. Male hair loss often is often well defined as male pattern baldness. Unfortunately, in females, hair loss is not only difficult to deal with but due to many different reasons. Female baldness, while at times a natural part of aging, is often due to medical conditions. It is important in female hair loss to determine if the cause is a medical condition as treating the problem can often improve the hair loss or at least prevent further loss.
If you are experiencing female hair loss, be sure to see a physician who is experienced in treating people with the condition. Often, a visit to a dermatologist is necessary to rule out medical conditions before simply performing a hair transplant.
In female hair loss, the pattern of alopecia is often difficult to determine so treating the loss is more difficult and must be handled by a surgeon with expertise in treating female baldness. Female pattern baldness as well as other causes can be treated with hair transplants. Using microfollicular grafting techniques, hair can be harvested from areas with full density and transferred to areas that have less than full density. Caution should be taken though as some causes of loss may continue to produce alopecia even after transplantation. Female pattern baldness, similar to male pattern baldness, can be treated in the exact same way with the same expected results.
For more information about hair loss treatment for female hair loss or plastic surgery Texas, visit Dr. Verret on the web at http://drverret.com.

Nose job without surgery

2008-06-17T07:41:00.000-07:00

Do you wish you could change the shape of your nose without surgery? Think that your nose is too big but don’t want the down time associated with surgery or a general anesthetic? Non-surgical alternatives do exist for people wishing to change the shape of the nose. Using temporary fillers such as hyaluronic acid (tradename Juvederm, Restylane, Perlane, and others), rhinoplasty surgeons can alter the shape of the nose without the need for surgery.

How long do I need to be off of work with a non-surgical nose job?

Non-surgical rhinoplasties can be performed in the office with very minimal down time. Though there may be bruising and swelling associated with the procedure, generally patients can return to work the same day and most any activity within 1-2 days.

What type of anesthesia is used?

The procedure utilizes facial fillers to change the contour of the nose. Local numbing medicine, similar to what is used at the dentist office, can be used with or without topical anesthesia. There is no need for general anesthesia or going completely to sleep.

Where is the procedure performed?
The procedure can easily be performed in the physician’s office. The procedure can be scheduled at the patient’s discretion and usually takes less than an hour to perform.

What are the risks?

While there are risks with any procedure, generally the biggest risks are mild redness at the injection site, bruising, and swelling. Should bruising and swelling occur, it is generally mild and resolves within several days. As always, it is vital to speak with an experienced physician before undergoing any procedure and to disclose your entire medical history to determine if there are certain risks particular to your medical history that you must know before undergoing the procedure.

For more information about the nose job without surgery, cosmetic surgery Texas, or rhinoplasty in Dallas, visit Dr. Verret on the web at http://innovationsfps.com or call for a consult at 972.608.0100.

Otoplasty - ear pinning surgery for dumbo ears

2008-06-16T19:57:00.000-07:00

Protruding ears can be a horrible problem. Children, long the victims of cruel nicknames like “Dumbo ears” or “Mickey Mouse,” are the most likely candidates for otoplasty, but this surgery can be performed at any age after the ears have reached full size, usually around five to six years of age. Even if the ears are only mildly distorted, the condition can lead to self-consciousness and poor adaptation to school. As soon as the ears reach their full size, otoplasty can be performed, and often the sooner the better.

But otoplasty is not just for children. Adults can benefit from otoplasty surgery. Ear pinning, or otoplasty, is a procedure which helps to make the ears more symmetric, reduce the size of the ears, and decrease the protrusion of the ears.

When considering otoplasty, parents must be confident that they have their child's best interests at heart. In pediatric surgery, a positive attitude toward the surgery is crucial. The patient is going to be naturally scared and reassurance from patients is crucial to allay any fears about the procedure.

Adult candidates for otoplasty should understand that the firmer cartilage of fully developed ears does not provide the same molding capacity as in children. Timing is always an important consideration. Having the procedure at a young age is highly desirable in two respects: the cartilage is extremely pliable, thereby permitting greater ease of shaping; and secondly, the child will experience psychological benefits from the cosmetic improvement.

In adults, otoplasty can be performed using local anesthesia in the office. In children, the procedure is generally done under general anesthesia as it can last for several hours and often patient compliance is an issue. Surgery begins with an incision just behind the ear, in the natural fold where the ear is joined to the head. Depending on the problem that is identified, cartilage and skin may be removed or the ear may be bent backward and sewn with permanent stitches under the skin to hold the new ear shape into the desired position. The incision is then closed and the incision is unable to be seen when healed.

The risks are minimal. There will be a thin white scar behind the ear after healing but because of the location, it will be difficult to see. There is a possibility of bleeding but generally a head wrap is worn as a compression dressing to prevent bleeding. Pain should be minimal and if excess pain is felt, the physician should be notified.

Insurance does not generally cover surgery that is purely for cosmetic reasons. Otoplasty is generally not covered by insurance. As always, it is imperative to speak with a qualified and experienced surgeon to determine the exact risks and procedure to be performed.

For more information about otoplasty, plastic surgery Texas, or cosmetic surgery Texas, visit Dr. Verret on the web at http://innovationsfps.com or call for a consult 972.608.0100.

Chin Implant Surgery

2008-06-16T10:07:00.000-07:00

Are you considering having a rhinoplasty in Dallas, nose job? Do you think your nose is too big? Your nose may not be too big, you chin may be too small. The facial aesthetics that most people take for granted are defined by the entire face and the proportions of different parts of the face. If you chin is too small, it may accentuate a nose and cause your nose to look too big.

What are my options for chin reshaping?

Chin reshaping or mentoplasty surgery involve either reshaping the bone of the chin or adding some type of implant to increase the projection of the chin. Reshaping the bone of the chin involves breaking the bone and moving it forward. Implants, including silicone, wire mesh, and other synthetic materials, can be implanted through a small incision either under the chin or inside of the lower lip to increase the projection of the chin. Additionally, fat may be added to the chin in select circumstances to increase the projection of the chin.

What is I already had a rhinoplasty?

Revision rhinoplasty surgery is always an option. If the chin is the only problem, chin surgery may be undertaken separately to correct the chin problems.

What type of anesthesia will I need?

Chin implant surgery can generally be performed with only local anesthesia, similar to what happens at the dentist’s office. If you desire, additional sedating medication can be used to help make things a bit more relaxing.

How long do the results last?

Regardless of the type of implant used or if bone is moved, chin surgery is generally permanent.

As always, consultation with a qualified surgeon is essential to determine if chin implant surgery is right for you. If you are considering plastic surgery revision surgery, consider Dr. Verret in the north Dallas suburb of Plano, TX. Visit him on the web at http://innovationsfps.com.