Adam Augenstein, MD, Plastic Surgeon in Charlotte, NC, Discusses Popular Male-Focused Procedures

The latest statistics for the past year from the American Society of Plastic Surgeons (ASPS) show that more and more men in the country are dipping their toes into cosmetic procedures, increasing by nearly 30 percent since 2000. Adam C. Augenstein, MD, dual board-certified plastic surgeon in Charlotte, NC, and founder of Aesthetic Surgery of Charlotte, explains how awareness is spreading among men about the benefits of both surgical and minimally invasive aesthetic procedures.

The latest techniques practised by plastic surgeons today tend to be quick and require little to no downtime. This has also led to plastic surgery becoming much more accessible and offering benefits to men from a variety of backgrounds. Men are also taking more interest in their physical appearance, as exhibited by the metrosexual and hipster grooming habits of today.

The competitive job market often propels men to opt for facial rejuvenation procedures such as BOTOX® Cosmetic (often dubbed “brotox”), dermal fillers, or facelift surgery, due to a fear of encountering ageism in the workplace and wanting to appear more fresh-faced and energetic. Additionally, cosmetic procedures can provide men with a shot of confidence as they increasingly become single later in life and re-enter the dating pool.

Non-surgical methods, such as Kybella® (to reduce chin fat) and the above-mentioned facial rejuvenation injectables, are very convenient options with minimal treatment and recovery time, and provide subtle but effective improvements without the average person being able to tell they had a procedure performed.

Surgical procedures tend to be performed quite differently for male and female patients. Popular cosmetic surgeries for men include:

  • Liposuction: The most often-treated areas in men include love handles and the “beer belly”. Liposuction for the neck and chin area is also becoming popular as a way to achieve a more chiseled jawline.
  • Chin augmentation: Along with reducing chin fat, an augmentation can strengthen the look of the jawline. In 2016, 55 percent of surgical chin augmentations were performed on men.
  • Rhinoplasty: In men, the overlying skin on the nose is typically thicker, which will affect the extent of change surgery can produce. Men’s noses also tend to have a higher bridge and greater width. Men often prefer a more prominent, angular nose with a less delicate tip. Many are also looking to correct injured noses or a deviated septum to improve both form and function.
  • Gynecomastia (enlarged male breast) reduction and pectoral implants: A sculpted and toned chest is the ideal for most men.
  • Eyelid surgery: Skin, muscle, and fat can be tightened, or skin and fat may be removed from the eyelids if they are in excess and cause drooping (which can also cause obstructions to a clear field of vision). Eyelid contours may also be improved. The result is a more wide-awake, youthful appearance.
  • Facelift: As the gold standard in facial rejuvenation, this procedure can tighten facial tissues, remove excess, sagging skin and fat, and boost volume in deflated areas. Brow lifts and eyelid surgeries are often performed in conjunction with a facelift.

Both surgical and non-surgical cosmetic procedures can carry an element of risk, which is why it is important to conduct your own research on both the procedures you may be interested in, as well as potential doctors you plan to visit (ensure they are board-certified in plastic surgery and experienced in the procedures of your interest).

The consultation is the first step to determining what treatment plan would be most beneficial for you. Be prepared with information about your personal and family medical history, which areas of the face or body you would like to improve, and any questions you may have for the surgeon.

Adam C. Augenstein is one of the few plastic surgeons in the Charlotte, NC, area to be certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology – Head & Neck Surgery. He would be happy to advise anyone looking to learn more about cosmetic and reconstructive surgery or non-surgical cosmetic procedures. To request a consultation with him, contact Aesthetic Surgery of Charlotte online or by phone at (704) 837-1150.


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.

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.

Liposuction in Los Angeles: Is it Worth it?

Liposuction, a Los Angeles cosmetic staple, is here to stay. According to a study conducted by The American Society of Plastic Surgeons [ASPS], liposuction procedures in the United States increased by five percent in 2014, making it one the fastest growing cosmetic surgical procedures in the country. While liposuction grows in insatiable popularity, it continues to garner scrutiny in the lay and medical communities. It’s dangerous, some warn. The effects don’t last, others say. Recent research, however, counters the naysayers in a myriad ways.

First, liposuction is safer today than it was even a year ago. “The demand for plastic surgery continues to grow as medical advancements are made and technology improves resulting in a wider array of options for patients,” said ASPS President Scot Glasberg, MD. As more and more patients opt for liposuction and other cosmetic procedures, medical practitioners learn more about, gain skills in, and streamline their surgeries, making them safer.

Liposuction has been accessible to the public for more than three decades, according to the American Academy of Cosmetic Surgery, during which time the community of cosmetic surgeons has established several layers of certifications and trainings a doctor must undergo in order to perform liposuction procedures. Surgeons certified through the American Society of Plastic Surgeons take special classes, tests, and recertification in order to keep liposuction as safe as possible.

During the last 30 years, surgeons and researchers in the medical field have been able to find what factors and circumstances make liposuction safe and viable for some patients, and dangerous for others. Some laypeople see liposuction as a means to lose weight and reduce the health risks associated with obesity, when it should be viewed as a way to spot control and contour the body. The more tissue a patient wants removed, the more risky liposuction is. According to a study conducted by the ASPS, major complications occur in fewer than 1 in 1,000 patients during or after liposuction, and the complications usually occur when a patient has fat removed beyond their BMI threshold. This means that when a patient with a lower BMI (Body Mass Index) has too much fat removed at once (between 3 to 5 liters), they are at more risk to develop seromas, or fluid build-ups under the skin. Bigger patients undergoing large-volume liposuction are at a lower risk for developing seromas. Still, 5 liters of fat weighs roughly 20 pounds; an obese person would most likely have to couple liposuction surgery with other lifestyle changes to achieve a desired weight.

Liposuction is safest for patients wanting to address their “trouble spots,” or areas on their body that retain fat regardless of how much they diet and exercise. These areas typically include the inner and outer upper thigh, hips, lower back, and abdomen. These stubborn, fat-storing areas are determined by where on the body patients are genetically disposed to carry more fat cells. Ideal liposuction recipients are in relatively good shape, and have supple and firm skin. Not only do these ideal patients face less risk, they typically also enjoy better results, as their skin tends to shape up nicely after their procedure. The American Board of Cosmetic Surgery corroborates by stating, “Liposuction can improve your shape, which can help you look thinner and more fit, but it’s not a weight loss method. While some overweight patients can benefit from the reshaping effects, the most satisfied patients tend to be happy with their weight prior to surgery.”

Potential liposuction patients in Los Angeles worry that the dreamy results of their surgery will be fleeting, and that the fat will return soon after. Recent research, however, suggests that once the fat cells are removed from an area, they are gone for good. The American Academy of Cosmetic Surgery claims that gaining the same fat back after liposuction is a myth. “At birth, the body stops producing fat cells, but they do get bigger or smaller depending on your weight. Liposuction reduces the amount of fat cells in targeted areas.” According to Cori Agarwal, M.D, a surgeon at University of Utah Health Care, “The interesting thing about liposuction is that once you’ve sucked out those fat cells, they’re gone for good, unless you were to gain a lot of extra weight,” Agarwal said. “If you’re at your baseline weight, you’re not going to gain fat in those areas.” Nevertheless, medical professionals offer the caveat that falling into unhealthy habits after your surgery may result in accumulating fat in other areas of your body.

Most, if not all, cosmetic surgeons agree that prospective patients should discuss liposuction with their doctor before making any final decisions. Surgeons like Dr. Mark Youssef of Younique Cosmetic Surgery in Los Angeles are more than happy to discuss the risks and rewards associated with, as well as candidacy for liposuction. For those who safely qualify for liposuction, the rewards supremely outweigh the risks.

A new study reveals that older patients don’t face greater risks when it comes to cosmetic procedures, including liposuction

Liposuction is among the most popular cosmetic procedures for patients of all ages and across all locations, including Dr. Brad Bengtson and Dr. Ryan Mitchell’s Grand Rapids facility. But despite the fact that one of the primary goals for many cosmetic surgical procedures is to directly combat the effects of aging, many older patients who might most benefit could be put off by fears that surgical procedures will carry greater health risks to them than to the rest of the population.

Anyone considering cosmetic surgery should consult with a board certified plastic surgeon like Dr. Bengtson of Grand Rapids, who will thoroughly review a patient’s medical history and take all appropriate measures to minimize and educate clients about possible risks. Certain procedures, like Dr. Brad Bengtson and Dr. Ryan Mitchell’s Laser Liposuction SlimLipo™, which varies from traditional liposuction techniques by minimizing bleeding and pain and therefore reducing the healing time from a standard liposuction procedure, are so minimally invasive that patients of any age can return to their typical routine as early as the following day.

But according to a recent study performed by a team of plastic surgeons at Vanderbilt University Medical Center, there is no significant difference in the percentage of complications that occur for patients over the age of 65. In a press release announcing the results of the study, the project’s author and a plastic surgery resident at the university noted that the numbers of elderly patients electing to undergo cosmetic surgery is increasing every year.

Vanderbilt University partnered with CosmetAssure, an insurance company endorsed by the American Society of Plastic Surgeons that specifically insures elective cosmetic surgical procedures including liposuction, abdominoplasty, and male breast surgery, all of which Dr. Bengtson and Dr. Mitchell perform at an accredited outpatient surgery center in Grand Rapids.

CosmetAssure’s database of patients included more than 6,700 elderly patients with an average age of 69, as compared to an average of 39 for the rest of the patients involved in the study. Despite the fact that the older patients had higher overall rates of diabetes, a higher average body mass index, and other factors that could increase the odds of complications, the rate of postoperative complications was only 1.94 percent among the elderly as compared to 1.84 percent among other patients. Doctors specifically looked at results for patients over the age of 80 and discovered that the differential in complication rates was merely .3 percent.

According to an article about the study posted on ScienceDaily, the study incorporated data from more than 129,000 patients over a five-year period.

The author of the study released the findings in Chicago last October at the American Society of Plastic Surgeons’ annual meeting. Among the interesting and unexpected findings was the fact that males accounted for a higher percentage of older patients, at a rate of 11.3 percent compared to 6.2 percent of younger plastic surgery patients.

While the study also found that older patients traditionally favor facial procedures, a number of Dr. Brad Bengtson’s patients complain about the effects of age on other parts of their body—specifically excess fat that no longer responds to dieting and exercise as effectively as it once did. Laser Liposuction SlimLipo™ in the Grand Rapids area can bring a firmer, tighter appearance to patients’ problem areas, including the chin, neck, arms, thighs, abdomen, and love handles. The procedure is popular among both men and women, with limited downtime owing to the fact that the laser is applied through a few small incisions and the procedure itself can take as little as an hour.

Dr. Brad Bengtson and Dr. Ryan Mitchell both pride themselves on offering their patients natural results that won’t draw attention to the fact that they’ve had something done. Dr. Bengtson is a member of 11 professional organizations, including the American Society for Aesthetic Plastic Surgery, the American Society of Plastic Surgeons, and the American Medical Association. He has been voted one of the Best Doctors in America in Plastic Surgery for 19 consecutive years. Dr. Ryan Mitchell recently finished a world-renowned fellowship in body contouring at the Pittsburgh Medical Center. To schedule a consultation or to learn more about their many procedures available, including liposuction, in the West Michigan area, visit, call 616-588-8880, or email