A published online study describes how the bioengineered ears were developed. Basically, the injectable molds and 3-D printing that comes from living cells are used to make ears that are indistinguishable from the human ear. Over three months, these ears developed cartilage that replaced the collagen used to make them. The consistency of the mold is similar to Jell-O.
Scientists began constructing the ears with a digitized 3-D image of the patient’s ear. Next, the image was converted into a solid ear by using a 3-D printer to construct the mold.
This advancement is promising for reconstructive surgeons who have been at a loss to help children born with microtia. In addition, patients who have lost a partial or entire external ear from cancer or an accident may benefit from a bioengineered ear.
Before this breakthrough, some surgeons would replace ears with Styrofoam-like materials. Others would reconstruct ears from a rib harvested from the patient. For children, harvesting a rib is a painful challenge and the results were far from natural looking.
Another key benefit of this bioengineered ear is that the process is much faster than previous methods. It only takes several days for all stages from designing the mold to nourishing the cell culture for implant.
Generally, implanting a bioengineered ear on a child should not occur before he or she is at least five years old. Generally, ears have developed to 80 percent of their expected adult size. As more tests of the bioengineered ear prove safe and effective, Cornell researchers hope to complete the first human ear implant within the next three years.
This is an amazing article of the technology that is available today to recreate natural looking human parts. I can see this same technology being used to reconstruct someone’s nose that may have either traumatically been injured or required significant resection due to cancer. It is truly amazing that we can take patient’s cells and then cause them to grow appropriately over a scaffold or mold into the shape that we desire, but this is where we are in the year 2013 and it is quite an exciting time. Regarding the ears, the surgery still needs to be performed for placement of this cartilaginous framework and more than likely it is still a staged procedure due to the fact that they would then need to go back and release the ear from the head and create a postauricular sulcus.]]>
Sixty patients who underwent a secondary facelift procedure were part of a research study at the University of Southwestern Medical Center in Dallas, Texas. Plastic surgeons performed a secondary rhytidectomy on 57 women and three men who were 60 years old at the time. Patients received repeat facelift procedures when signs of aging returned. On average, their first facelift procedure lasted nine years. Additionally, during the course of this 20 year study, 10 of the patients underwent a third facelift.
As a result of focusing on unique surgical principles, the second facelift proved to be safe and effective in giving patients a youthful appearance. Only a small percentage – five percent – experienced complications after the second procedure.
While most individual cases may produce different results, surgeons will follow techniques that extend the effects of the procedure. Even with the good results shown in this study, having a secondary rhytidectomy procedure may require the use of unique surgical techniques. Generally, plastic surgeons should follow the five R’s of a secondary facelift. These include resect the skin, release, refill, reshape and redrape.
Some cases presented unique challenges. Nevertheless, the overall conclusion of the study was that most patients can expect to achieve a youthful and natural appearance after a second rhytidectomy.
This is a nice review on revision facelifts. I was interested to read the five R’s of the secondary facelift since this was information I had not come across before. They include resect the skin, release, refill, reshape, and redrape. I find it interesting since they put resect the skin first in the list. I would consider that by far the least important aspect of a second facelift and, in fact, in many instances revision facelifts have very little excess skin especially when it is a relatively acute revision facelift from a poor outcome in the recent past. I certainly highly agree with release and refill as well as reshape and redrape. Releasing can mean different things to different surgeons but about 95% of facelift surgeons do not release the way that I personally do during an extended SMAS deep plane facelift. Release of the zygomatic retaining ligament is very important for an additional lift and improvement in the mentolabial fold and this is especially true for revision facelift patients since the far majority of them have really had no midface improvement from their prior facelift. I, therefore, feel that the extended SMAS deep plane facelift with very sophisticated subplatysmal and platysmal work through a separate incision under the chin creates extraordinarily natural and rejuvenated faces without the look of prior surgery. The refill part of the five R’s in my hands would be fat grafting and occasionally facial implants although fat grafting seems to have a much quicker recovery than combining facial implants with facelifts. With that said, chin augmentations are not uncommon with facelifts, but this is really in a different area of the face than I was discussing previously. Essentially the midface and cheek areas need additional volume due to the aging process and a chin augmentation would not typically be something that someone needs due to the aging process but rather something that they most likely needed most of their lives and ultimately due to the fact that they were going to get a facelift, they went ahead and decided to get the chin implant at the same time. Redraping is also a very important part of the revision facelift, but it is really redraping in the correct direction to allow for the safe and tension-free resection of the excess skin that is created. Ultimately, I feel that revision facelifts are quite an art but when performed correctly can provide amazingly natural rejuvenation that will last a very long time.]]>
The greatest growth is in minimally invasive procedures. These tend to be cheaper, with shorter healing times. The ASPS indicates that they serve as an introduction as well. Invasive surgical procedures have not grown the way minimally invasive procedures have, but that growth will come.
The more minimally invasive the procedure, the more it has increased in the past year. Botox procedures and microdermabrasion are both up eight percent, while dermal fillers are up five. Laser hair removal saw a four percent increase, and chemical peels grew by two percent.
Conversely, some surgical procedures decreased in the past year. Breast augmentation, in particular, saw a decrease of seven percent. Liposuction fell one percent as well. Some other surgical procedures increased as well, such as facelifts, which grew six percent.
What does it all mean? Plastic surgery is on the rise, but some procedures are more popular than others are. Facial rejuvenation is still one of the most popular, and saw the most growth in the past year. Female breast augmentation dropped, but male breast reduction rose significantly.
Reconstructive plastic surgery, those procedures designed to restore looks or function to parts of the body, grew one percent in the past year as well. Scar revision was down by two percent, but tumor removal — the most popular procedure by a wide margin — was up one percent.
Overall, it is satisfying to see an increase in important medical procedures as well as cosmetic appearance-enhancing treatments. Insurance coverage is historically an obstacle for some procedures, including female breast reduction. That these procedures are seeing an increase is a good sign for women and for plastic surgeons.
This article is a review of the ASPS statistics over the past several years. This seems relatively typical since overall noninvasive treatments have been steadily outgrowing the surgical cases and historically due to the significant recession we have had over the past several years surgical cases have dropped significantly compared to the years prior to 2008; nonetheless, just like the economy these surgical cases seem to be coming back but at a much slower rate than the nonsurgical modalities, such as Botox and fillers, so overall this article essentially mimics what my own personal office experience has been and I look forward to many more years of growth in the future.]]>
Surgery, even minor plastic surgery, is still effectively an open wound in the body. This means that makeup acts as a contaminant, and the act of applying it is putting unnecessary stress on the wounded area. Makeup can, in some cases, lead to longer healing times or even infection.
Thankfully, most cosmetic surgery procedures heal quickly, so with a little caution you can go back to using makeup frequently if you desire. Each procedure is different, however, so you should ask beforehand how long you would have to wait. For example, a facelift affects much of the face, and takes ten or so days to heal enough for safe makeup application. A nose job or brow work only affects small areas of the face, so the rest of the face is fair game. Rhinoplasty procedures should be left alone for three or four weeks, while eye work takes around two weeks to heal.
Some caution is especially required for chemical peels and laser skin resurfacing. These procedures remove the outer protective layers of skin, and so makeup can cause irritations if applied before that protection returns. In most cases, this will take under a week.
Every patient is different, and each of these healing estimates is just that — an estimate. Your skin may take longer to heal, especially if you’re older, or it may not take as long. In either case, your surgeon will be able to tell you when it’s safe to use makeup again. You can always wait an extra few days or weeks for total healing, but the choice is yours. After all, the point of the surgery is to make you look better without the need for makeup, so why not let yourself heal and see how you look before covering it up again?
This article gives a relatively brief review of makeup in relation to cosmetic surgical procedures and overall the information in the article is relatively accurate although I feel like the timing is fairly off. In a nutshell, surgical procedures that require sutures can only be contaminated in the area where the incision was made and, therefore, the rest of the skin is, otherwise, unaffected; therefore, I allow all my patients to apply cover makeup to anything that is not a suture from day one of the procedure. This includes facelifts, browlifts, rhinoplasties, and blepharoplasties. For patients that undergo laser resurfacing, they do have to avoid makeup until the skin has fully re-epithelized, which in some instances may take up to seven days. At that point those patients really need to be careful with their makeup and I highly recommend a powder-based formulation that will not cause excessive irritation of the skin; otherwise, in a nutshell I essentially expect all my patients to look quite good by seven days out from whatever procedure they decide to have done.]]>
The most obvious problem with some procedures is scarring. Most incidents of bad scarring are not caused by the doctor, but by the patient’s genetic profile. People with higher skin pigmentation or darker skin are at a higher risk for massive scarring. To be on the safe side, patients should always check out their doctors credentials. Although any doctor or dentist can legally perform a plastic surgery, patients will want a physician who specializes in the field.
Another misconception involves liposuction. People believe that if they get liposuction, the fat will move to another part of the body. In reality, this is not what happens. The human body has a set number of fat cells. If these fat cells are removed with surgery, that area of the body will not gain weight proportionately. When the patient starts to gain weight, the added pounds will be distributed primarily among areas with more fat cells.
Women should also be wary about the shape of their breastbone. If the sternum is too depressed or wide, it will make the breasts develop a large gap if the woman gets breast enhancements. They should also notify their doctor about any supplements they are on or about their smoking habit. Supplements can interact with anesthesia and cause life-threatening complications. Although nicotine habits do not cause as many complications during surgery, they can stop the wound from healing and cause the skin to turn black.
This article in a way states the obvious that anytime we do something to someone there is a risk involved with any sort of a technique or procedure whether that is fillers, breast augmentation, liposuction, or a facelift and as a double board-certified facial plastic surgeon a very significant part of my job is to educate my client as to the expected outcome as well as the risks of these procedures so that they can make an informed consent regarding the procedure. Firstly this means that they need to be able to choose wisely their surgeon and understand that they are much more likely to end up with an excellent outcome from a surgeon who has been well trained and has extensive experience in the procedure that they desire. Secondly they need to be well educated on the risks of the procedure so that they can decide whether they feel that the risks are low enough that they want to have the procedure done and thirdly they need to be educated on the expected outcome including the early postoperative period so that they understand what to expect during those first few days after surgery. I have found that this greatly reduces the patient’s anxiety levels since they already know what to expect and when they are recovering they are much more at ease due to the fact that what they experienced is what they expected.]]>
A face lift will normal be done in a hospital or in the surgeon’s office. They will give the patients a sedative and local anesthesia so they do not feel anything. Afterward, the doctor will make an incision at the hairline. This cut will curl around the temple and earlobes. If the neck needs to be tightened, they may also make a cut along the chin.
The plastic surgeon will then carefully separate fat and muscle tissue from the skin. If there is extra fat, he will use liposuction to trim it away. The underlying SMAS layer of the skin will then be folded and put in place to lift the cheeks. This method will also firm the neck area and make the jawline look more defined.
The last step is to remove any excess skin. To do this, the doctor will pull the skin back and cut away unneeded skin with a laser or knife. Once this is complete, the skin will be sewn together again. To prevent scarring, the stitches will normally be placed along the hairline. Any scars that appear will be unnoticeable.
Overall, the surgery should take less than four hours. Costs for face lifts range from $6,000 to $12,000. The surgeon’s fee alone normally totals $5,000. Since this is a cosmetic procedure, most insurance companies will not cover the cost of a face lift. When it comes to cosmetic procedures, patients get what they pay for. Lower-priced procedures are often of worse quality. Before a patient gets a face lift, they should always check the doctor’s credentials or talk to former patients.
To see facelift before and after photos of Dr. Campbell’s patients please visit our photo gallery.
Overall this is a very brief and somewhat generalized article on facelift surgery and since I personally performed extended SMAS deep plane facelifts in the operating room this is a technique that they really do not mention in this article but is worth noting due to the fact that I am able to release some ligaments in the face that allow me to lift in a more aesthetic direction as well as more significantly and yet retain an extraordinarily natural result. They also do not go into the details of what happens when we work on the muscles underneath the chin since frequently I will be working on the fat deep to the muscle and contouring this even deeper layer before I end up contouring the muscle layer, which then allows the redraping of the skin to create a very elegant and youthful neckline. I certainly would not be performing these highly technical procedures if it did not allow me to create better results than the simpler, more general techniques. So in essence facelifts do have some similarities but in highly experienced hands one can reach a higher level of improvement and rejuvenation using these highly sophisticated techniques.]]>
A recent study shows that more than 25 percent of eyelid lift patients report symptoms of dry eye following the procedure. The reported dry eye symptoms were excessive irritation and watering. Studies show that although these symptoms are easily managed, patients rarely bring up the issue. This is typically an issue that patients talk about when they’re asked. Although it is uncommon, some patients can experience dry eye symptoms for years. This easily managed issue can be taken care of when it is addressed with a physician.
Unfortunately, dry eye is something that goes underreported. Some researchers and doctors believe there should be more dialogue with patients before and after eyelid lifts. Giving patients more information about the symptoms of dry eye may increase reporting. A study of 892 people who underwent an eyelid lift showed that almost 27 percent had symptoms of dry eye following the procedure. It was also noted that 26 percent had chemosis, or swelling of the eye. The side effects are noted to be more common with people who underwent more aggressive surgical techniques, or had both upper and lower eyelid lifts done.
The eyelid lift surgery is one of the most common types of cosmetic surgeries. Many physicians agree that dry eye is fairly easy to manage. There are some cases where dry eye will be a difficult long-term condition. A proposed solution is to conduct a pre-surgical tear analysis. This could help identify people who would most likely have trouble with long-term dry eye symptoms following a procedure. Researchers are calling on surgeons to keep an open dialogue with patients about potential symptoms of dry eye. If one in four of every patient experiences symptoms related to dry eye, it is an important issue to talk about.
Dry eye is certainly common after eyelid lifts but at least in my own personal experience the dry eye symptoms typically are short-lived and long-term patients feel that their eyes are quite normal again. I do discuss dry eye with my patients prior to them undergoing a blepharoplasty since it is extremely common to have the sensation of dry eyes in the immediate postoperative period. Again, fortunately the far majority of these cases will resolve and in the interim we use some lubricating eye drops and occasionally even prescribe some steroid eye drops if the swelling in the eye, which is called chemosis, does not resolve quickly.]]>
A recent survey conducted on behalf of Reuters News shows that cosmetic surgery is a popular choice for people who are interested in medical tourism. The poll was conducted by Ipsos, an independent market research company. The poll reveals an interesting opinion across the globe. Almost a third of people worldwide said they would be open to traveling abroad for surgical procedures at reduced costs.
The Organization for Economic Co-operation and Development (OECD) noted that cosmetic surgery is one of the most common reasons for medical tourism. They hypothesize that the reduced costs for procedures and cheaper airline tickets are contributing factors to the rise in medical tourism.
The poll also reflected some interesting American opinions. Of Americans polled, 38 percent stated that they would consider medical tourism. Canadians ranked higher at 48 percent. A staggering 66 percent of Italians said they would be open to medical tourism.
The poll also reflects the age groups for opinions. It was reported that adults under the age of 49 were more likely to be interested in medical tourism than their older counterparts. Of people between the ages of 50 and 64 that were polled, only 15 percent were open to medical tourism. The numbers reflect only a slight difference between men and women. Men were reported to have been more open to medical tourism than women.
The survey reflects very interesting trends in worldwide medical opinion. With more research options for patients, many are open to participating in medical tourism. The lower prices for procedures in developing countries combined with cheap airfare make this an option many people are open to. The trends are not limited to North America. Some of the countries that were included in the poll were Argentina, China, France, Germany, Italy, Mexico, Russia, Spain and Turkey.
Medical tourism has been going on for quite a while now and I have certainly personally seen several patients over the years who unfortunately had complications due to surgery that was performed overseas and then they end up back in the United States with these complications and ultimately many of these patients end up needing further surgery to correct the difficulties. Realize that the FDA is a very strict governmental organization that has guidelines and policies geared toward the safety of our citizens in the United States and the FDA has no authority overseas and many other countries have very little in the way of licensing organizations or other entities looking out for the safety of surgical patients. I, therefore, do not see medical tourism as a good option for most Americans simply because you are going to end up with a higher level of patient care and safety in the United States than you will in most other areas of the world. Unfortunately, the lower cost in other areas of the world is what draws patients to consider this dangerous option and in many circumstances these cost savings are far outweighed by the potential complications that can occur in these circumstances.]]>
If you want smoother, tighter facial skin, but feel squeamish about going under the knife, ask your doctor about a non-invasive procedure called Ulthera. Ulthera is a revolutionary new way to treat weak, sagging facial skin through ultrasound technology. Without making a single cut, the doctor uses Ulthera to penetrate the outer layers of your skin, deep down to the bed of muscle that directly affects your skin’s appearance. Heat energy is then applied to stimulate your body’s production of collagen, replacing weak dermal structures with stronger, more supple skin.
In addition to being a non-invasive, results-oriented therapy for aging skin, Ulthera offers one other huge benefit: unlike other cosmetic ultrasound technologies, Ulthera allows your doctor to actually see inside your skin, to the deepest layers where the damage lies. This revolutionary technology, called “DeepSEE,” enables your doctor to apply Ulthera’s healing heat therapy directly to the areas where your face needs it the most. DeepSEE takes the guesswork out of ultrasound therapy. Instead of blindly applying heat energy to the entire face, your doctor can pinpoint your neediest areas and treat them specifically. Because your doctor is able to target your weak spots with his own eyes, you get the best, most thorough treatment possible.
In addition to the delicate eye and brow area, some doctors have used Ulthera to treat flawed skin around the mouth, jowl, and other parts of the lower face. At this time, Ulthera has been FDA-approved for brow lifts only, but anecdotal evidence suggests that it is effective for other facial areas as well. Clinical trials continue.
Ultherapy is really a revolution in facial rejuvenation in that it finally is able to provide the holy grail of energy deposition into the tissue in that it can completely and utterly harmlessly bypass the overlying skin while at the same time providing a significant amount of energy deep into the tissue to create a breakdown of collagen and new collagen deposition, which in turn then tightens and lifts. It is the only device ever to be given an FDA indication for facial lifting and has absolutely no downtime. At the Quintessa Aesthetic Center, we have some of the most experience in the country using Ultherapy and though this technology will never replace a true facelift, it is fantastic for those that do not desire any sort of surgical intervention or for those with very early signs of facial aging. It will be very interesting to see what lies in the future for Ultherapy as many centers are starting to do studies on off-face treatments such as the decollete area, arms, belly, and legs.]]>
Whether you want clearer skin, fewer wrinkles, or a better-defined physique, cosmetic surgery has a solution for you. In fact, cosmetic surgery has so many different solutions for you, you may feel overwhelmed by the seemingly endless buffet of surgical and non-surgical options available. Thankfully, your doctor can help you select the procedure, or procedures, that best fit your needs. Often, patients discover they benefit from an individually tailored combination of both surgical and non-surgical therapies.
Surgical and non-surgical cosmetic therapies can be successfully combined to create the vibrant, youthful appearance you desire. A mini tummy tuck, for example, may be combined with laser therapy for a C-section scar, improving the look of a pregnancy-ravaged abdomen. A chin implant, when combined with a facial rejuvenation procedure, can yield a stronger jaw line and more confident appearance. When you treat your cosmetic concerns from a number of different angles, you are more likely to be satisfied with the results. And, the results you get are more likely to last.
Patients often find that one type of therapy does not resolve all of their cosmetic issues. Your doctor can cultivate a personalized regimen of treatments that will help you look your very best. During your initial consultation, share with your doctor all of your ideas and concerns. Your doctor will make recommendations based upon your desires, your general health, and his professional assessment of your needs.
At Campbell Facial Plastic Surgery and Quintessa Medical Spa, we have always provided our clients with customized treatment programs so that we can maximize their results while at the same time trying to minimize cost and downtime. By combining a variety of different options all together, we can typically drastically increase their overall rejuvenation as if these treatments multiply upon each other as opposed to add to each other. I discuss this in all my consultations regarding combination treatments and for most patients looking at significant amounts of facial rejuvenation I will classically recommend a fully comprehensive approach that includes surgical intervention to virtually all areas of their aging face that require intervention. I also typically would then recommend customized areas of structural fat grafting and in most circumstances some sort of laser resurfacing or ProFractional Laser to rejuvenate their skin. By treating all areas of the aging face, we get an astonishing amount of rejuvenation that is extremely natural appearing and extraordinarily long lasting. Overall, the value from combination treatments is much greater due to this significant boost in the overall rejuvenation which, of course, then allows for a longer lasting result.]]>