What is NeoGraft®? San Francisco Area Hair Restoration Specialists Drs. David Lieberman & Sachin Parikh Break It Down

Hair transplant surgery has come a long way from “hair plugging” and follicular unit transplants (FUT). Follicular unit extraction (FUE) is the gold standard in today’s hair restoration procedures, and the biggest advancement in this respect has been NeoGraft®. San Francisco area hair restoration specialists Drs. David Lieberman and Sachin Parikh explain how this sophisticated technology has made FUE hair transplanting much more precise, rapid, and natural-looking.

NeoGraft®, which is the first FDA-approved automated and minimally invasive device for hair restoration in the United States, minimizes the likelihood of scarring, as it eliminates the need for any large incisions, staples, sutures, or “plugs”, and allows patients to freely be able to wear their hair long or short in the future.

FUE entails collecting and transplanting thousands of individual “follicular units”, taken from healthy donor sites on the scalp. While the process of follicular unit extraction may be done by hand, the NeoGraft® device offers a much more efficient solution.

This technology improves on the manual collection technique, as it works based on a system of negative pressure (using a small rotatory punch) to rapidly, yet precisely, extract each hair follicle (including the attached shafts and roots) from the donor site. Patients under local anesthesia experience little to no discomfort as the NeoGraft® device works its magic.

During the actual harvest procedure, a magnifier is typically used to closely observe the scalp, while the NeoGraft® device’s micromotor that creates a tiny hole as it extracts each follicular unit. The area is left with a very small, round mark, which will heal over time and ultimately shrink to a tiny dot. And as the hair grows back in the donor area, these already small dots will be obscured from view.

By using NeoGraft®, a doctor is able to control:

  • The speed and diameter of the micropunch
  • The depth and orientation of each hair follicle
  • The distance between each extracted hair follicle

NeoGraft® balances being precise and meticulous with being extremely efficient – as each follicular unit extracted can hold between one to four hairs, the process as a whole can involve the extraction of thousands of hairs in total (typically between 2,500 to 3,000 grafts).

The hair follicles that are removed are completely intact, and the NeoGraft® results in little to no trauma to the surrounding areas of the scalp.

The donor area is typically at the back of the head, as this hair is more resilient to the effects of testosterone fluctuations. Each graft extracted by NeoGraft® has the same consistency in length and diameter, so the results of transplantation is more even and uniform-looking.

While FUE – generally via NeoGraft® – has become the norm in most cases of hair restoration, it may be more appropriate to utilize the strip-harvesting method or try non-surgical methods of for some patients. This can depend on a number of factors, and the most suitable form of harvesting will be best determined in a consultation with an experienced, board-certified physician.

In a few cases, NeoGraft® can even facilitate a type of scar revision without the actual hair transplant. If a white scar, for example, shows through dark hair, NeoGraft® can be used to make tiny holes in the scar, which will revascularize during the healing process and make the scar flesh-colored instead, thus making it much less stark or noticeable.

Drs. Lieberman and Parikh, who are both board-certified head and neck surgeons themselves, would be happy to consult anyone who is looking to learn more about their options for hair restoration and/or determine whether NeoGraft® is right for them. To request an appointment with them, contact the Lieberman & Parikh Center for Hair Restoration online or by phone at (650) 327-3232.

Statistics on Facial Plastic Surgery: The Bay Area’s Dr. Stanley Jacobs Notes Increases

The face has been an object of attention for as long as humanity has been around: It graces ancient pottery, fills museums of antiquities, and now is presented virtually on countless smartphones and social media platforms each day. In addition to driving technology’s ability to capture and preserve someone’s looks for posterity, the world’s collective fascination with the face has also given rise to a growing desire to adjust individual features, an endeavor possible now like never before via facial plastic surgery. Bay Area facial cosmetic surgeon Dr. Stanley Jacobs has studied the long and fascinating history of facial aesthetics, which is why he noted with interest the recently released statistics from the American Society of Plastic Surgeons.

According to the published numbers, plastic surgeons in the United States performed about 17.1 million total cosmetic procedures in the United States in 2016, an increase of three percent over the year before.

While the most commonly performed surgery was breast augmentation, three other surgeries in the top five—rhinoplasty, blepharoplasty, and facelift—are focused solely on the face, and the other—liposuction—is frequently used to shape specific regions of the face. Given that the numbers for each procedure were higher in 2016 than 2015, it’s safe to say that facial plastic surgery is on the rise.

Liposuction—a surgical fat-removal technique that can be used on the neck, cheeks, and elsewhere—is in the second slot, with 235,237 procedures reported. That’s an increase of six percent in one year.

The next three most commonly performed procedures ranked as:

  • Nose reshaping, up two percent to 223,018
  • Eyelid surgery, up two percent to 209,020
  • Facelift surgery, up four percent to 131,106

Breast augmentation was the most commonly chosen cosmetic surgery procedure among women. Not surprisingly, this didn’t register at all on the list of male-chosen surgeries. For men, facial plastic surgery ruled the year, with nose reshaping and eyelid surgery taking the top two spots. Liposuction and facelift were at places four and five, respectively, with male breast reduction sitting at No. 3.

As facial plastic surgery is proving increasingly popular, so, too, are minimally invasive procedures that focus on temporarily rejuvenating and refreshing the skin. The uncontested top procedure overall—dominating over all other options, nonsurgical and surgical alike—is an injectable form of botulinum toxin type A. The 7,056,255 injection sessions in 2016 are up four percent from 2015’s 6,757,198.

There are several brand names available in this category (Dysport® and Xeomin® among them), but the most prominent is BOTOX®. Injections reduce muscle contractions. If properly applied with precision by a trained and experienced injector, BOTOX® can slow activity in the specific muscles that cause noticeable frown lines on the forehead, as well as crinkly crow’s feet.

Second to botulinum toxins, but still far surpassing surgical choices are soft-tissue fillers, tallying 2.6 million applications in 2016. This is followed by chemical peels with 1.3 million

Often, patients can combine the effects of facial plastic surgery and nonsurgical options to get a benefit unattainable from a single procedure or treatment. Dr. Jacobs, for instance, combines a surgical facelift with a the carefully controlled application of chemical peels to address both the skin and its underlying architecture in what he’s called a SynergyLift™.

The American Society of Plastic Surgeons compiles its statistics annually by sending out a survey to member surgeons, combing a dedicated database, and extrapolating the resulting aggregated information. The results are considered by many to be the most comprehensive statistics exploring cosmetic and reconstructive plastic surgery in the United States each year.

Dr. Stanley Jacobs is a triple board certified doctor specializing in facial plastic surgery. Bay Area residents may recognize him from his segments on KRON4, as well as his frequent appearances at events in the greater community. For more information, call his office in Healdsburg at (707) 473-0220 or in San Francisco at (415) 433-0303. He also has an online contact form.

Fat Grafting: St. Louis Doctors Explain an Advanced Cosmetic Surgery Technique

In St. Louis, the cosmetic surgery specialists at West County Plastic Surgeons of Washington University see a variety of patients with a variety of needs. In this Missouri city, women and men seeking a new look are the same as those throughout the country: They want that area to be smaller, while this area could use some more volume. An increasingly popular solution to both problems is fat grafting.

While dermal fillers and even implants have taken an ever-larger share of the spotlight—and certainly have their own benefits—fat grafting is a cosmetic surgery procedure with multiple established uses, as well as a body of researchers continuing to explore new and innovative applications.

But first: What is fat grafting? The procedure is used to take fat from a donor area somewhere it’s plentiful on a patient’s body, after which it is processed and injected elsewhere into the same patient.

The process is, of course, more involved than that. Specifically, the procedure starts with a consultation with a professional cosmetic surgery specialist to determine whether fat grafting is the best options for delivering a patient’s desired results. With fat grafting is identified as the right course, the patient can expect a procedure in two parts: removing the fat and re-introducing the fat.

For removal, the doctor will administer a solution into the donor area to make the tissue firmer (known as “tumescent”), a technique that reduces both pain and blood loss, leading to less bruising and faster recovery. Using a cannula, the doctor will then loosen and suction out the necessary fat cells, collecting them in a special container.

Note that though fat cells are being removed, liposuction is not intended as a strategy for weight loss.

The harvested fat cells will be spun in a centrifuge to separate them from other materials removed along with them during the liposuction procedure. Once isolated, the cells intended for fat grafting are moved into small syringes, ready for injection where desired.

Because these cells are a patient’s own fat, the body is more receptive to them than other foreign substances. The “familiarity” lowers risks of rejection and related complications and extends the life of aesthetic results, often by years.

Patients should know that the volume of fat to be injected at this point is significant, but not large. As a cosmetic surgery procedure, fat transferddd is best used for contouring and detail work. West County Plastic Surgeons of Washington University uses the technique to correct post-mastectomy contour deformities in breast cancer patients, other contour problems around the body due to trauma or surgery, and hollow or sunken areas on the face due to volume loss and shifting fat.

For instance, fat grafting can be used to fill in a divot left behind after the removal of a benign leg tumor. It can also restore a youthful roundness to the apple of the cheeks, which also tends to pull up the sagging tissue that causes jowls.

Fat grafting can also be used in augmentation for patients who want to change the size and contours of their buttocks.

Because the nature of a treatment depends on its scope, the amount of time a fat grafting cosmetic surgery procedure may take typically ranges anywhere from one to five hours. Similarly, recovery may be expected to take anywhere from two days to two weeks.

As for future applications, the West County Plastic Surgeons of Washington University team is working with the American Society of Plastic Surgeons to study and evaluate other cosmetic surgery-related uses for fat grafting, including breast augmentation, the reconstruction of an entire breast, and healing aids enriched by stem cells.

Note that liposuction can be performed as a standalone procedure, without the doctor harvesting the fat for later use. Any patient considering combining fat removal with fat grafting should be sure to discuss the idea during the consultation.

Contact the West County Plastic Surgeons of Washington University team to learn more about fat grafting and related cosmetic surgery options, including facelift. Call (314) 996-8800 or reach out online.

Considering a Tummy Tuck? Harrisburg, PA, Surgeon Dr. John Stratis Outlines Your Options

Whether you have recently experienced weight changes, given birth, or simply developed a beer belly or “spare tire” over time, the contour of the abdominal area can be corrected with a tummy tuck. Harrisburg, PA, body and breast focused plastic surgeon Dr. John P. Stratis – one of the cofounders of the comprehensive cosmetic surgical practice at Stratis Gayner Plastic Surgery – explains how a tummy tuck or abdominoplasty is performed and the procedural options that are available to you.

A tummy tuck is a surgical procedure in which excess fat and skin are removed and the underlying muscles tightened to improve the look of the abdomen. While the operation can achieve dramatic results, it requires skilled and experienced hands to be safe and effective.

According to the latest statistics collected by the American Society of Plastic Surgeons (ASPS), the number of tummy tuck operations performed by member surgeons each year in the United States has increased by 104 percent since 2000. Individuals of all genders can receive tummy tucks. New mothers often have the procedure performed as part of a mommy makeover, while men often develop noticeable bellies as they age due to weakening and permanently stretched out muscles and skin tissue.

There are several types of tummy tuck surgery available to patients. Your surgeon will help you decide which procedure is most appropriate for you depending on your unique abdominal profile and the type and extent of results you are looking to achieve.

A traditional or standard tummy tuck is performed under general anesthesia and is performed on an outpatient basis. One or two incisions are made during surgery. One is made in the lower abdomen below the line of most kinds of underwear and swimsuits just above the pubic bone. A second may be made around the navel or belly button to allow the surgeon address the upper abdomen. Excess skin and fat will be removed, and the lower and upper abdominal muscles will be tightened. A new hole will be made in the repositioned tissue to allow the belly button to show through.

For some patients who have experienced extensive weight loss—whether with the assistance of bariatric surgery or otherwise—a fleur-de-lis tummy tuck may be ideal. In order to be effective long-term the patient must be committed to the healthy eating and exercise habits that enabled the weight loss.

A fleur-de-lis tummy tuck involves two incisions. While the first is made in the lower abdomen, the second is created vertically down the midsection to more comprehensively address the lax abdominal tissue. The length of this second incision depends on the amount of abdominal correction required, but it typically will not extend above the breastbone. The belly button may also be positioned at a level that looks more proportionate and aesthetically pleasing. Once the tummy tuck is complete, the surgeon will close the incisions with dissolvable sutures to heal properly. The procedure is performed under general anesthesia on an outpatient basis.

Your surgeon may recommend a mini tummy tuck if the cosmetic correction desired is minor. While a mini tummy tuck is less extensive than a traditional one, many patients find that the procedure gives them the results they were looking for with less recovery time required. A mini tummy tuck addresses only the lower abdomen, removing excess skin below the navel and repairing the muscles there. Some surgeons also perform liposuction along with the mini tummy tuck to better contour the remaining tissue

After any sort of tummy tuck is performed patients usually notice an immediate difference. Bruising and swelling in the operated areas are common and resolve in the weeks after. A special garment may be worn after surgery to keep these side effects to a minimum and allow the incisions the freedom to heal. A drain may also be used to reduce any buildup of blood and other fluid.

Some surgeons employ a long-acting local anesthetic, Exparel, during the procedure for sustained post-operative pain relief. They may also prescribe patients pain relief medications for their comfort during the recovery period and allow patients to do whatever they feel comfortable doing after the procedure. This “self-limiting” leads to a faster recovery. It typically takes about six weeks after a tummy tuck for patients to be able to safely and comfortably return to all their normal activity, but most patients can drive and return to work after a week.

Dr. Stratis is board-certified by the American Board of Plastic Surgery and specializes in performing tummy tuck procedures. To learn more about the surgery and which method may be most suitable for you, request a consultation with him online or call the practice at (717) 728-1700.

Four Ways to Rejuvenate an Aging Neck, from Surgery to Kybella®

While a wrinkled and sagging face bears most of the blame for giving away a person’s age—or even making someone look older than their years—the reality is that the neck also significantly contributes to the problem. Considering the 2015 introduction of Kybella®, Boston-area board-certified plastic surgeon Christopher Davidson, MD, has appreciated the increasing availability and popularity of neck-focused procedures and treatments. Here are four to consider:

• Kybella®

A primary aesthetic complaint from both men and women is a double chin, caused by a pocket of fat that can stubbornly refuse to change no matter how consistently someone diets or exercises. This fat is a problem for anyone who wants facial definition, as it softens what would otherwise be angular lines and creates the impression of multiple chins—especially when looking down. Since fat-reducing lifestyle alterations are not always successful, the most effective treatment often involves the physical destruction of the unwanted fat cells. Kybella® accomplishes this by rupturing them with deoxycholic acid, a chemical the body uses to break down fat during digestion. The form used in Kybella® destroys fat cells it encounters in the submental area, and these cells are then eliminated from the body.

Kybella® is an injectable, and a single treatment session can involve up to 40 or 50 injections, all carefully placed in the targeted area. The FDA has cleared Kybella® for use in reducing double chins, and since its powerful active ingredient can damage any cells it encounters, application is limited to specially trained medical professionals who can minimize risk and maximize results, which appear over the course of weeks and months as fat is gradually removed.

• Liposuction

Another option for eliminating unwanted neck fat is liposuction, which involves removing fat cells by suctioning out the unwanted material with a thin tube known as a cannula. This takes the fat cells in question out of the equation and can give the chin-to-neck transition area more definition. With the fat gone, results are immediately noticeable—and will become increasingly apparent as post-procedure swelling subsides. Patients who choose this method are often those searching for a double chin treatment with fast-acting results.

• Neck lift/facelift

Not all aesthetic neck issues are due to excess fat. In fact, the loss of fat can, in some cases, leave loose skin behind. Young, healthy skin readily conforms to body contours, but after years of being stretched out by underlying fat, some skin—especially skin that has lost collagen, hyaluronic acid, and elastin due to aging and environmental factors—simply won’t shrink back down.

Sagging skin on the neck creates a turkey wattle effect, and drooping skin on the face, due to volume loss higher on the cheeks, can form jowls that appear at the jawline. A facelift is a surgical procedure that lifts away those jowls, while a neck lift focuses on tightening the skin below the chin. Together, these two options can significantly revitalize a patient’s profile, so they are frequently performed in combination.

These procedures may also involve some amount of fat removal via liposuction.

• Juvéderm Voluma®

As noted above, volume loss in the cheeks leads to problems farther down, as the natural structures holding tissues in a firm, youthful position give way to laxity. By reintroducing volume with the hyaluronic-acid-based injectable Juvéderm Voluma®, support can be temporarily rebuilt, rounding out what is known as the “apple” of the cheek and effectively pulling up the sagging tissue that forms jowls.

Any of these options can be performed as a standalone procedure, but they may also be combined to produce a desired youthful effect over time.

Learn more about any of the neck treatments and procedures mentioned here, including Kybella®, from Boston-area plastic surgeon Christopher Davidson, MD, who has more than a decade of experience in the field. Call his office at (781) 237-7700 or visit his contact page.

What You Should Know About Safe Liposuction in Los Angeles

Many patients who are thinking about undergoing liposuction in Los Angeles find themselves wondering, “How much fat can I remove safely?”

First, it should be noted that liposuction remains one of the safest plastic surgeries to help patients remove stubborn fat that won’t respond to diet or exercise. The most common side effects from liposuction are generally temporary swelling, bruising, and soreness; irritation or minor scarring around the incision; and loose skin that often tightens after a few months. Less common side effects of liposuction might include color changes to the skin or some uneven surfaces in the treated area.

Of course, one of the most significant differentiators between a safe, successful liposuction and a procedure that comes with more serious complications or side effects is the skill of the physician. In a recent study by Northwestern University’s Feinberg School of Medicine, the University of Illinois’ Division of Plastic Surgery, and the Lehigh Valley (Pa.) Health Network, the researchers found that only about 1.5 percent of patients experienced a post-operative complication following liposuction. What’s more, they found that the most significant contributing factor to a safe surgery was not the procedure itself, but the skill of the doctor administering the liposuction.

Interestingly, they also found that patients with a higher Body Mass Index (BMI), were able to safely tolerate having larger volumes of fat removed through liposuction.

“BMI plays a role in outcomes of liposuction volumes, and higher-BMI patients may be able to tolerate more liposuction than lower-BMI patients,” one of the researchers said.

In other words, they discovered that patients with a high BMI were able to safely tolerate higher volumes of removed fat, whereas patients with a lower BMI needed to have less fat removed to stay within safe limits. It should be noted that the cases surveyed for the study did not result in any serious complications.

Another study came to similar conclusions when examining complications in cases of high-volume liposuction. In the study compiled by authors from the Loma Linda University School of Medicine and California Medical Association, they determined that liposuction at the hands of trained physicians is significantly safer: “Experience has shown that when properly trained surgeons perform large volume liposuction under ideal conditions, it is a safe and effective procedure for removing excess fat with low complication and morbidity rates.”

That study concluded with five pillars of safety when it comes to liposuction:

  1. The surgeon must be properly trained and educated in liposuction
  2. The anesthesiologist must be well trained and have a complete understanding of the physiology associated with infusion and removal of large volumes of fluids.
  3. The facility should be certified and accredited and must be completely equipped to deal with any problem or complication that may occur during or after the procedure.
  4. The support staff should be thoroughly trained and familiar with the procedure.
  5. The patient must be a strong candidate for the procedure.

Liposuction was the second most popular cosmetic procedure in America in 2015, according to the American Society of Plastic Surgeons. There were 5 percent more liposuction procedures last year as compared to the year before, making for a total of 225,000 Americans who chose to take hold of their appearance and remove stubborn fat. And yet, even with so many people opting to have a liposuction procedure, it still remains a safe option when patients make sure to pick the right surgeon who will help them get to the look they want.

If you have more questions when it comes to liposuction, Los Angeles is fortunately an excellent area to find a trained, accredited, and experienced physician to handle your procedure. Dr. Steve Svehlak and Dr. Dan Yamini have been safely performing liposuction and other cosmetic procedures for patients in the area and are happy to answer your questions and help you determine the best way to achieve the look you want. You might also consider liposculpture, in which a surgeon with an artistic eye can help sculpt contours to the patient’s desires. Dr. Svehlak and Dr. Yamini have many years of experience in this technique, as well as with laser technologies like “SMART Liposuction” and ultrasound “Vaser Liposuction” to further ad to the refinements of the procedure. To schedule a consultation, contact Sunset Cosmetic Surgery online or call them directly at 310-858-9100.

Breast Augmentation for Breast Asymmetry

Breast asymmetry, or the unevenness in the size, shape, and/or position of a person’s breasts, is not an uncommon or unhealthy condition. David Kaufman, MD of St. Joseph’s Hospital of Long Island, states that many women experience some degree of breast asymmetry. This can range from a barely perceptible variance in appearance to breasts being different cup sizes. While breast asymmetry is normal and healthy, it can be a difficult for women with significantly uneven breasts to find bras, clothes, and bathing suits that fit well. Not only is significant breast asymmetry physically uncomfortable, it can affect the self-confidence of females affected by it. Plasticsurgery.com states women looking to make their breasts more even should consider undergoing breast augmentation.

How can breast augmentation in Santa Monica serve patients with breast asymmetry? According to Finesse Plastic Surgery, there are several options available including utilizing breast augmentation surgery to insert a saline, silicone or Gummy Bear Breast Implants into one or both breasts; or using a fat graft to correct unevenness in a patient’s breasts.

The most popular asymmetry corrective option in Beverly Hills is breast augmentation surgery. Patients may opt to have the small breast filled with a saline or Gummy Bear Breast implant to make it larger or shapelier, matching the general form of its counterpart. As it tends to look more natural, a Gummy Bear Implant is a favored option for a single breast implant. Adversely, Patients may decide, instead of just the one, to have both breasts augmented to equalize and enhance their appearance. This procedure is a superb two for one deal: not only will patients correct their asymmetry; they will get the size and shape breasts they want.

Whether patients choose a single or double breast augmentation, there are several options available for both procedures. Mark Youssef, MD of YOUnique Cosmetic Surgery in Santa Monica, CA, offers a handful of surgery options for breast augmentation, giving patients the ability to choose what best meets their needs. Dr. Youssef can insert saline, silicone, or Gummy Bear implants through a peri-areolar, inframammary fold, or transaxillary incision. A peri-areolar incision is made along the bottom curve of the areola, and allows the surgeon to be incredibly precise. An inframammary fold incision is made under the breasts’ crease, and work well with larger implants. A transaxillary incision keeps scarring at a minimal, as the surgeon cuts along the fold of the armpit and forms a path for the implant to be inserted in the breast. For patients interested in saline implants, Dr. Youssef can utilize a TUBA incision, in which a cut is made along the upper curve of the navel and a channel is created to insert implants in one or more breasts. These four options work wonderfully for single or double breast implants as they offer natural results and leave minimal scarring.

The most natural type of breast augmentation may be a fat transfer, which is a non-surgical procedure. As states on the American Society of Plastic Surgeons’ website, surgeon removes fat from an unwanted area of the patient’s body and injects it into their breasts, or in some cases, breast. This procedure is best for women who want to subtly change the appearance of their breasts, and works well to correct slight breast asymmetry. Surgeons can use fat transfers to add volume to specific areas of the breast, which can correct both size and shape asymmetry.

While completely normal and healthy, breast asymmetry can be unsightly, uncomfortable, and in some cases, painful. Women looking to bring symmetry to their breasts can utilize breast augmentation, both surgical and non-surgical, to achieve their perfect look. If you are interested in a breast augmentation procedure to correct asymmetry, finding a cosmetic surgeon experienced in breast augmentation surgery is incredibly important. An experienced surgeon will help you find the best procedure to meet your unique body goals.