If you’re considering breast augmentation, it is important to be an active participant in the process. The ASPS has developed the following list of questions to ask during your consultation:

  • Are you certified by the American Board of Plastic Surgery?
  • Were you trained specifically in the field of plastic surgery?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure?
  • Is the office-based surgical facility accredited by a nationally-or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for breast enhancement or breast enlargement?
  • What will be expected of me to get the best results?
  • Where and how will you perform my breast augmentation surgery?
  • What shape, size, surface texturing, incision site and placement site are recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How many additional implant-related operations can I expect over my lifetime?
  • How will my ability to breastfeed be affected?
  • How can I expect my implanted breasts to look over time?
  • What are my options if I am dissatisfied with the cosmetic outcome of my implanted breasts?
  • How will my breasts look if I choose to have the implants removed in the future without replacement?
  • Do you have breast augmentation before-and-after photos I can look at for this procedure and what results are reasonable for me?
  • If so, at which hospitals?
  • How are complications handled?
  • After pregnancy? After breastfeeding?
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For Optimal Facial Rejuvenation, Plastic Surgeons Should Consider What’s Going on Under the Skin

What makes us look older? Wrinkles and sagging result not just from changes in the skin, but also from age-related changes in the underlying facial bones, according to a report in the January issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The researchers, led by Robert Shaw, Jr., MD, at the University of Rochester Medical Center, analyzed computed tomography scans of the facial bones in young (age 20 to 40), middle-aged (41 to 64), and older (65 and up) age groups. All scans were performed for medical reasons-not for planning plastic surgery.

Aging Linked to Changes in Eye Sockets, Jaw Bones, and More

Detailed measurements in three-dimensional reconstructions of the CT scans showed some important differences in the facial bone structure (or facial skeleton) between age groups. “The facial skeleton experiences morphologic change and an overall decrease in volume with increasing age,” Dr. Shaw and colleagues write.

One prominent change was an increase in the area of the “orbital aperture” – that is, the eye sockets. In both men and women, the eye sockets became wider and longer with age. Aging also affected the bones of the middle part of the face, including reductions in the glabellar (brow), pyriform (nose), and maxillary (upper jaw) angles.

The length and height of the mandible (lower jaw) decreased with age as well. Although these changes occurred in both sexes, many occurred earlier in women – between young and middle age. In men, most of the changes occurred between middle age and old age.

Plastic surgeons are experts at dealing with changes in the skin and underlying soft tissues that contribute to an aged appearance of the face. However, as the new study demonstrates, they must also understand the contribution of changes in the underlying facial bones.

“The bony components of the face are important for overall facial three-dimensional contour as they provide the framework on which the soft-tissue envelope drapes,” Dr. Shaw and coauthors write. For example, the enlarging eye socket and decreasing brow angle could contribute to frown lines on the forehead, “crow’s feet” at the corners of the eyes, and drooping of the lower eyelid.

By using materials and techniques for skeletal augmentation, plastic surgeons can improve the outcomes of facial rejuvenation, Dr. Shaw and colleagues believe. They discuss the “aesthetic implications” of changes in the facial bone structure, and outline some strategies plastic surgeons can follow to optimize the final results for patients who desire a more youthful appearance.

Posted in Facial Surgeon | Comments Off

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