There are still a few things in life that we need to plan ahead of time.  Prepping for a surgery, for example, can take months including the recovery time.  So what about this coming Valentine’s Day? Do you still have time for a quick treatment or two?  It is probably too late to schedule surgery now and be recovered in time for the romantic holiday, but facial injections or laser treatments are still a great idea. Here are your options:

Botox/Dysport: Relax the wrinkles between your eyebrows, on your forehead and around those pesky crow’s feet. On average your results will take 4-5 days to appear and will last 3-4 months. But don’t wait until the last minute, come see us by February 7^th.

Juvederm, Restylane: Erase those smile lines and give a sexy plump to your lips at least 2 weeks before the big day. Your final result will be evident within 5-7 days of treatment and will last 6-9 months. We can stretch this one to February 2^nd.

Skin Rejuvenation: Even out skin tone; erase light acne scars and brown spots; improve your skin’s texture and reduce the appearance of fine lines with a laser treatment. Our laser treatments (in order to get great results) do require a bit of downtime (3-4 days), but if you’re willing to commit you’re going to be very happy with your results. See us by February 2^nd to be ready for your valentine.

Dr. Franckle sees patients on Tuesday afternoons and all day Thursdays.

Only a couple days left before Valentine’s Day – be ready with an appointment!

Most women undergoing a mastectomy are given the option of breast reconstruction to rebuild the size and shape of the removed breast(s).  Many women (like Giuliana) chose to reconstruct the breast immediately following the mastectomy (during the same surgery).  There is also an option to hold off on reconstruction and perform it at a later time.

Whether the procedure is performed immediately or down the road, there are two basic options for breast reconstruction:  the use of implants or your own body’s tissues:

Breast Reconstruction with Implants

After a mastectomy, the breast skin is not thick or strong enough to hold a reconstructive implant.  The plastic surgeon therefore inserts a special temporary implant called a tissue expander behind the major muscle on the chest wall. This expander is needed to stretch the chest wall muscle to make a pocket for the breast implant.

Over a period of several months, saline is injected into the expander, slowly expanding the chest wall pocket. When the pocket is fully expanded, the device is removed and a breast implant is placed in the new pocket.  Other secondary operations may be performed at the same time or later, such as nipple reconstruction.

Immediate Reconstruction with Your Own Body’s Tissue

The body’s own tissues can also be used to reconstruct the breast.  Your surgeon will remove tissue from certain areas of the body and use those to reconstruct the breast.  Tissues (skin, fat, and muscles) can be taken from the abdomen (DIEP Flap/Free Flap); the back (Latissimus Flap) or buttock (Gluteal Flap).  In some cases there isn’t quite enough tissue and a small implant is added to give enough volume.

As Giuliana Rancic stressed during several interviews, her decision to have a double mastectomy and breast reconstruction was all hers. Patients referred to plastic surgeon Dr. Franckle learn all of their options at the time of consultation.  Every effort is made to give you a choice between simple and more complex procedure, depending on medical needs and your wishes for the final result.

Plastic surgeons are jumping on the bandwagon of “Daily Deal” websites like Groupon and Living Social, offering deep discounts on lasers, Botox and filler treatments. Doctors want to get new patients in the door and consumers are getting a great deal on a treatment. Sounds like a win-win, right?

Daily Deal websites are a great promotion tool for many products and services, but for plastic surgery they are just too risky.

The number one concern with these websites is the lack of proper screening for the patient.  You have limited time to purchase these deals and that leaves little time to research and no time to visit the doctor to see if you are a candidate.  With any plastic surgery treatment screening the patient is an extremely important part of the job. A doctor needs to see you face to face, discuss what are looking to treat and if your expectations are realistic. Everyday patients can be turned away from our office simply because they are not candidates for the treatment they are seeking. Or even more commonly patients come into our office thinking they need a Botox treatment and it turns out they really need a series of laser treatments. You never really know until you see the doctor.

Secondly, when a patient purchases a deal they may feel pressured to undergo the treatment no matter what because they already paid for it. (And returning the “deal” is not a quick or easy process). At the same time, one worries that a doctor may feel obliged to perform the treatment (whether or not the patient is a candidate) because they already purchased the services.

We get it – you want to save some money. Understandable. Here is a better way to save money. Become a fan on Facebook, follow us on Twitter, subscribe to our newsletter – we’ll keep you informed of the new developments in plastic surgery. You will also see promotions on non-surgical treatments offered from time to time as a special thanks to you, our patient. The essential difference is – you will not be required to pre-purchase a treatment for which you may not be a candidate for or not even need.  This way, you can rely on us to keep your best interests as our only consideration.

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We would venture to bet that anyone who suffers from migraines is willing to explore just about any treatment to obtain relief from the pain.  The symptoms of migraine (pain, photosensitivity, and nausea) are keeping 30 million Americans miserable for up to a day or even more.  Medication is still considered the only effective solution to conquer these debilitating symptoms, but a plastic surgery procedure has recently been publicized as a revolutionary way to treat migraines.  How?   Supporters are claiming that the glabellar muscles (muscles between the eyebrows) and related nerves which are surgically removed during a browlift are removing a trigger point which can cause migraines.

It has followed that the non-surgical procedures using the botulinum toxins such as Botox Cosmetic, Dysport, and Xeomin, have also made similar claims in being effective in the treatment of migraines.  These popular treatments work to block those same nerves resulting in paralysis of the glabellar muscles.  It was only a matter of time before some doctors starting connecting the two.

All of these claims came about by circumstance; patients receiving a browlift or botulinum toxin treatment that had previously suffered from migraines were claiming that their migraines were cured.  These patients turned to their doctors for answers as to why this happened.  Thus, the connection was made. So far, however, these claims have not stood the test of extensive medical analysis.

So where is allthis buzz coming from? NewBeauty.com performed their own study with 49 migraine sufferers.  The patients underwent a Botox Cosmetic treatment followed by a brow lift procedure and found that 57% had their headache symptoms completely eliminated.

That study may have encouraging numbers but this is not in-depth research!  It would be wonderful if botulinum toxin treatment is eventually proven to be an effective treatment for migraine sufferers.   It is a simple, safe, non-surgical treatment and would likely be well-tolerated by migraine patients.  Until then, it is considered experimental and will not likely be covered by insurance.   My opinion is to watch and wait.  This is currently under investigation by many reputable scientific groups.  Until then, we may just have to call the patients in NewBeauty’s study lucky.

NewBeauty.com Article: http://www.newbeauty.com/dailybeauty/entry.aspx?id=2468

Another feature is low-cost, high volume cosmetic surgery centers; following Elsie Soto (among others) through her unhappy experience with this type of center. These medi-spas contain countless doctors, large medical staffs and are lacking in the doctor-patient relationship. The articles are not meant to frighten patients or discourage them from plastic surgery, but instead to remind them that faster and cheaper may not mean better.

“…making cosmetic surgery affordable for the masses.”

Soto visited several plastic surgeons before choosing Strax Rejuvenation and Aesthetics Institution. She chose Strax because the cost they quoted her was less than 50% of what other doctors had told her.  At these large clinics, to keep prices down, doctors are overfilling their schedules instead of giving themselves adequate time with each patient to be sure the procedure is down correctly.

Soto felt she was “just another patient … in what seemed like an assembly line of patients.”

Large cosmetic surgery centers are juggling high volumes of patients every day.  In many cases, the doctor you meet with for a consultation isn’t the doctor who performs your surgery.  Soto compared these large practices to a Denny’s restaurant, with patients funneling in and out all day.

“…claims about the low risk, dramatic results and short recuperations time are misstated.”

A highly publicized quick-fix procedure, The Lifestyle Lift, is under investigation by the Florida attorney general for this very reason.  There is no such thing as a “quick fix surgery.”  These procedures have risks, demand recovery time. They can have dramatic results, but that won’t happen overnight.

“Doing procedures in office surgery centers saves money, something that many consumers…found attractive…”

Don’t be fooled by “in office” procedures. Surgeons certified by the American Board of Plastic Surgery must perform in accredited ambulatory surgery centers to maintain certification. Many in-office operating rooms are not accredited and do not have to abide by any regulations or meet certain standards to keep patients safe.

These high volume centers are frequently where you can find untrained physicians. They are using a loop-hole in state laws to get around basic training requirements for their doctors.  Since the procedures are performed under local anesthesia, they do not raise a red flag in the regulatory system which prevents untrained doctors from performing medical procedures outside of their scope of training.  Comparing the training of residency in plastic surgery (80 hour work weeks for a minimum of 6 straight years following medical school) to a weekend “course” taught by another untrained doctor is no comparison at all. Be smart when choosing your plastic surgeon and don’t be afraid to ask questions.

Placement Matters…

Breast implants can be placed under or over the chest muscle.  If you are looking for the most natural-looking breasts you may want a “subpectoral implant,” placing the implant under the muscle. This tends to look more natural because there is a layer of skin and muscle over the implant, in comparison to an implant placed over the chest muscle where just a layer of skin covers it.

They don’t last forever…

Patients often ask if they should expect to have their implants replaced after ten years.  The FDA labeling states that the implants are expected to last ten years, but that is because all medical devices need indication from the manufacturer as to how long they should last.  In reality,
breast implants can last many years longer than ten.  It is not unusual for a patient to come for a check-up with 15-20 year old implants that are functioning just fine.  Remember there is no guarantee regarding how long your breast augmentation will look the way you want or if they will last a specific amount of time.  Until the implant wears out or you decide for a change there is nothing for you to do.

You will have a scar…

We are making an incision in your skin which always leaves a scar. The good news is the scar is usually well hidden by the natural skin folds of the body.  The underarm area, around the areola (nipple), or in the crease just below your breast are good places to hide the scar. There are pros and cons for each depending on individual circumstances.

Pregnancy will not hurt your implants…

As you know, pregnancy affects many parts of a woman’s body, including the breasts. When a woman begins lactating, the breast tissue enlarges and that can stretch the skin around the breast. What will not be affected are the implants themselves. The implants will remain the same, it is the tissue around the implants that may be affected. This could result in the need for a lift after you are finished breast feeding.  During your pregnancy concentrate on that – your implants will be fine.  You may need a touch-up, but we can discuss that after you are finished having children.

Who remembers the compare and contrast exercises from grade school?  You know – Venn Diagrams, Graphic Organizers, Comparison Trees, weighing the pros and cons. You may have dreaded them back then, but they can be an excellent method in weighing your options and determining what is best for you.  Here we are putting those tactics to use when comparing two injectable fillers offered at our practice.

Juvederm Ultra has been a favorite among our patients for years now while Sculptra Aesthetic is a new addition. Sculptra is an innovative product and very different from other injectables on the market.  Because of that we thought the best way to explain it is to compare with something many patients already know – Juvederm Ultra.

What is it?
Sculptra: Poly-L-lactic acid; A synthetic material naturally absorbed into the body that works to replace lost collagen
Juvederm Ultra: Hyaluronic acid; a naturally occurring, hydrating substance in your skin to correct lost structure and volume.

How quickly does it work?
Sculptra: Results emerge gradually over several months
Juvederm Ultra: Results will be noticeable immediately

How long will it last?
Sculptra: Results typically last up to 2 years
Juvederm Ultra: Results lasting 6-9 months

Where would you use it?
Sculptra is a great option to use in the cheeks were volume has decreased with age
Juvederm can be used to fill in creases around the mouth and to plump lips.

Is more than one treatment necessary?
Sculptra: On average, patients will need three injection sessions over the course of a few months for a full treatment.
Juvederm Ultra: Patients will only need one injection session at a time

What is the cost per treatment?
Sculptra is sold in vials, each vial is priced at $750. Some patients may require more than one vial per session.
Juvederm is sold in syringes with each costing $750. Again more than one syringe may be necessary based on the patient.

Each injectable has its pros and cons.  Sculptra will require more time and money up front, but it lasts for 2 years. Juvederm is less of a commitment at first but you will need to revisit the office in 6-9 months.

Both products are priced equally but …. to welcome Sculptra to the office we are having a special event in which we are offering 20% OFF your total treatment and up to a $150 rebate for our first 10 patients to book an appointment ($50 rebate per vial, up to 3 vials  rebates per patient).

You’ve seen the news stories lately; “Grandma Getting a Boob Job,” or “A Facelift to Keep Grandpa Looking Young.” Plastic surgery for patients 65 and older has recently gained popularity in the media, but this has been a trend for several years now.  According to the American Society of Aesthetic Plastic Surgery, 8% of all plastic surgeries performed in 2010 were performed on those over the age of 65. That is 84,685 surgeries.  That number leaves many asking “why?” Why risk an elective surgery at an older age?  Well, you’ll be surprised to find that the
“grandmas” and “grandpas” of the world have the same reasons you do…

The most common motives women in their 40’s and 50’s give: re-entering the job market after taking time off to raise children; getting back into the dating market after being divorced or widowed;  and finally moving forward with that surgery they’ve wanted for years.

The reasons older generations list as to why they wanted plastic surgery: the job market, dating again and finally committing to that procedure they’ve been dreaming about. And you thought you didn’t have anything in common with your older relatives…

In an article from the New York Post, several recent divorcees discuss how plastic surgery restored their confidence.  Diana Solomon, a former model, found herself heartbroken after her 25 year marriage ended, “I was crying every day, and I couldn’t get out of bed.” A breast augmentation, Botox and laser treatments completely changed her outlook, “At 51, I not only feel better, but I look better than I ever have…”

Marie Kolstad, still working as a property manager at age 83, with 13 grandchildren, 12 great-grandchildren and a very active lifestyle underwent a breast lift and implant procedure last month.  In her interview with ABC News, Marie explained why a woman in her 80’s would consider plastic surgery; “…your breasts go in one direction and your brain goes in another…It was more about looking in the mirror and liking who I am.”

No matter what age, men and women are treating themselves to the procedure or treatment they’ve been wanting.  If you’re in good health, plastic surgery may not be able to turn back the hands of time, but it can certainly refresh your looks to match the energy you feel inside.

Source: NYC’s divorcees get Plastic Surgery http://www.nypost.com/p/entertainment/had_revenge_surgery_P34ICFDzy19ZMgnunHq0pO/

Source: 83-Year-Old Gets Breast Implants to Keep Up With Kids  http://abcnews.go.com/Health/breast-implants-83-senior-citizens-elect-plastic-surgery/story?id=14266043

With advanced technologies at our figure tips, surgery is not always the best option for a patient. Laser treatments can accomplish much of what you are looking for with less downtime, no surgery and no needles.

What are you looking to treat?

Freckles/Skin Texture: Microdermabrasion and chemical peels are popular treatments because they can improve the look of your skin without a prolonged healing process.  What if we told you that a laser treatment could accomplish everything microdermabrasion can with additional benefits? Fine lines, mild acne scars, freckles, skin tone and texture can all be improved with a series of MicroLaserPeels.  With each treatment the laser will partially ablate the skin’s surface, stimulating new skin cells to grow.

The average patient will need 2-3 treatments, 2-3 weeks apart and healing time is generally 2-3 days. (Just remember 2-3!) As your skin heals it will look and feel like you have a sunburn, with some redness and flaking of dead skin cells.

Wrinkles: The number one treatment for wrinkles these days is an injectable; either Botox or a dermal filler. But some of us don’t feel comfortable with the idea of needles around our face, so what other options do we have?  The Profile Contour Laser uses a focused laser light to remove thin layers of the skin’s surface, heating up the underneath layers and stimulating new skin cell growth.  Dead cells are replaced with new, healthy cells reducing the appearance of wrinkles. Again there is some healing time associated with the treatment, especially when deeper wrinkles are being addressed. 5-7 days of redness and sloughing can occur.

Rosacea/Broken Capillaries: Rosacea is a chronic condition that requires several different approaches for optimal control.  Lasers are one effective treatment in removing the redness due to overgrowth of small surface capillaries.  During the treatment you will feel a hot sensation as the laser pulses are absorbed into the unwanted vessels, heating them and destroying them.  Lasers have been a great supplement to the traditional treatments used, although additional treatments may be necessary.  That will be determined by Dr. Franckle during your consultation. The good news is this treatment has virtually no downtime.

A term that has been appearing frequently in news stories, articles, blogs and even on reality television is gynecomastia, enlarged male breasts.  All men, like women, have breast tissue but with this condition the breast tissue is distended.  Gynecomastia can induce pain in some men, but the most common complaint is embarrassment.

Before discussing treatment, it is good to know what is actually happening in your body to cause this:

Definition: “gyne” – meaning female; and “mastia” meaning breast; a term used for abnormal enlargement of breast tissue in men, usually
due to hormone imbalance.

What Does Gynecomastia Look Like? The most common form is described as “puffy nipples.” The enlarged breast tissue forms a hard circular mass concentrated around the areola (nipple) causing that area to appear “puffy” or “dome shaped.”

Why does this happen? The male breast tissues become enlarged due an imbalance in sex hormone levels.  The levels of estrogen, the female hormone, are increased relative to levels of androgens, the male hormones, causing growth in the tissues. There are different forms of gynecomastia, based on how the hormone imbalance developed:

• Pure Glandular Gynecomastia: Commonly found among bodybuilders; the use of steroids for an extended period of time results in excess testosterone levels, which is converted into estrogen, causing a hormone imbalance.
• Hereditary Gynecomastia: Hormone imbalance can be a hereditary trait and if so is typically apparent before or during puberty.  Studies show that as much as sixty percent of young boys can inherit hormone imbalance causing gynecomastia.

Are there other causes of Gynecomastia? There are a number of other medical conditions and/or medications that list gynecomastia as a side effect.  Disorders, trauma or infection involving the male testes (testicular cancer) can lead to hormone imbalance and in turn gynecomastia.   Medications treating hyper tension, certain antibiotics, anti-ulcer drugs and highly active anti-retroviral therapy (HAART) for HIV disease have also been linked to gynecomastia cases.  Excessive drug abuse; including alcohol, marijuana and heroin can also have an effect on male hormone levels.

Now that you’re an expert on the how and why of gynecomastia, click here to learn how Dr. Franckle can correct this issue: http://premierplasticsurgeryarts.com/breast-reduction-for-men-new-jersey/