Five Things to Look for in a Plastic Surgeon: Philadelphia’s Dr. Timothy Greco Offers Advice

Plastic surgeons are entrusted not just with patients’ health, but also with their long-term appearance. The work they do has lasting impact. Because of this, it is imperative that men and women who want an aesthetic change ensure that they make the right choice in a plastic surgeon. Philadelphia-area double board certified facial cosmetic plastic surgeon Dr. Timothy M. Greco has five suggestions for anyone considering a procedure—and the person who will perform it.

1) Education Matters

Every plastic surgeon should have a curriculum vitae (a CV, for short), which lists their relevant accomplishments, available for review. Many display it prominently on their website, giving patients easy access to the most vital and relevant biographical elements. Dr. Greco particularly recommends noting where they obtained their medical degree, followed by where they performed their internships, residencies, and fellowships. Look for education relevant to their plastic surgery specialty—as well as more focused training, if applicable. As a facial cosmetic plastic surgeon who performed a head and neck surgery residency, Dr. Greco emphasizes the importance of choosing someone who focused their training on what they now offer. Put simply, anyone seeking a rhinoplasty would be well served by selecting a surgeon who made the nose, face, and head an integral part of their education.

2) Experience Matters, Too

Beyond a quality education, a healthy CV should list significant experience in work at hospitals and universities. Typically, more detailed bios are also available, and these can feature more in-depth information about a plastic surgeon’s experience in the field, citing anything from pioneered techniques to practices opened to areas of particular focus. Look for an established history in the field, as well as evidence of years spent actually working directly with patients. Also important is a commitment to continuing to gain experience, as well as share the benefits of that experience with others.

3) What Do Others Think?

There are two groups of people whose opinions anyone considering a plastic surgeon should seek out: fellow professionals and past patients. First, doctors singled out for recognition by their peers are those who have gained respect and acclaim in the field, which does not typically happen unless they have built a solid reputation on a foundation of quality work. Of course, the proof is in the results. Testimonials reveal what satisfied patients think of their surgeries and the surgeon who handled them. These are generally curated by the practice, so they are uniformly positive. Still, they are genuine expressions, so take note if they are scarce. Some plastic surgeons will connect interested patients with past patients if asked, for a more personal glimpse into the practice details.

4) See For Yourself

In addition to hearing from past patients, anyone considering a plastic surgery should be able to see examples of their surgeon of choice’s previous work. Many practices make before-and-after galleries available on their websites, offer to show prospective patients case photos during or after a consultation, or both. This is one of the best ways to get a sense of a plastic surgeon’s capabilities. No one will be able to exactly replicate the results seen in any of the photos, but the images will show everything from how the doctor keeps features in proportion to whether scars are visible or not. A patient can get a good sense of what sorts of results to expect if choosing this surgeon.

5) Do You Click?

Finally, the right plastic surgeon for someone will “click.” That means patients should feel that the person they are choosing to guide their transformative journey listens, understands them, and has made sure they feel informed, safe, and confident in their decision. Surgery is an intimate process, so the partnership between patient and surgeon should be solid and natural.

To find out more about Dr. Timothy Greco as a plastic surgeon, contact his plastic surgery practice in Philadelphia by calling (610) 664-8830 or visit http://www.drgrecoface.com.

A Los Angeles Dermatologist Explains BOTOX® and Its History

For men and women alike in Los Angeles, BOTOX® is an everyday reality. While the injectable made headlines a decade or so ago as a novelty, its widespread acceptance in the United States and the world (it remains the most commonly performed cosmetic treatment on the planet, according to a variety of surveys) has since transformed it into a household name. Celebrities, office workers, and anyone looking to relax some wrinkle-forming facial muscles chooses it for its quick application, safety, and proven results.

How did BOTOX® achieve its chart-topping status? The injectable traces its roots all the way back to the 1890s, where a Belgian food poisoning incident first led to the discovery of the Clostridium botulinum bacteria. Researchers quickly learned of its paralyzing effects, but it wasn’t until about 60 years later when scientists began finding that they could develop helpful applications based on the bacteria. In the United States, the Food and Drug Administration saw sufficient promise in the research and gave doctors authorization to run trials involving humans.

The first official reports on what the formula later to be known as BOTOX® could do came in 1981, when an ophthalmologist announced that patients suffering from involuntary crossed eyes or walleyes—a condition known as strabismus—found temporary relief from the vision-disrupting symptoms when injections were made into the muscles that pulled the eyes in one direction or another. More eye-related research followed, leading to a pair of FDA approvals in 1989.

From that point on, BOTOX® could be officially marketed and used to stop the involuntary muscle action behind strabismus, as well as a similar culprit causing involuntary blinking known as blepharospasms.

Since BOTOX® demonstrably prevented signals from triggering muscle contractions—and did so safely—research continued in this vein. The next FDA approval was also for involuntary muscle action, centralized just a bit farther down from the eyes: in the neck. Cervical dystonia can be an uncomfortable-to-painful problem, causing the neck to twist and turn, then stay frozen that way so that patients have to carry their head at an odd angle. This FDA approval came in 2000.

An FDA approval given in the year 2002 stood out as the act that launched BOTOX® into international popularity, and newspapers ran with the headlines for years after, along with photos of needles sticking out of patients’ foreheads. The injectable had branched out from medical to cosmetic applications, cementing its position in the spotlight as it allowed anyone willing to try it to enjoy a relaxed, more youthful appearance.

Just two years later, the FDA gave its nod for the first non-muscle-related use of BOTOX®: treating excessive underarm sweating, known as hyperhidrosis. Six years after that, in 2010, it voiced approval for the treatment of chronic migraines, bringing a chance of some relief to people who spend at least 60 hours a month reeling from the pain in their head. Involuntary muscle action took another blow that same year, when the FDA also provided approval for using BOTOX® to treat upper limb spasticity.

2013 was another two-for-one year, with BOTOX® gaining approval to smooth out crow’s feet on the cosmetic side and help curb an overactive bladder on the medical side. Dr. Derek Jones served as an investigator for the crow’s feet study.

Most recently, in 2016, treatments for the lower half of the body were welcomed into the official FDA-approved fold when the agency announced its green light for doctors using BOTOX® to treat lower limb spasticity.

While board-certified dermatologist Dr. Derek Jones and the other physicians on his team use BOTOX® only for cosmetic applications, they do so knowing that the injectable is backed by decades of careful research, rigorous testing, and FDA-led scrutiny designed to ensure that the product is both safe and effective. Learn more about BOTOX® in Los Angeles from the team at Skin Care & Laser Physicians of Beverly Hills by visiting skincareandlaser.com or calling 310-246-0495.

What is PRP? Forth Worth’s Dr. Peter Damico Explains

The human body is quite good at healing itself when it receives wounds, primarily thanks to platelets in the blood, which rush into action to stop blood loss and begin the process of building new tissue. In recent years, medical innovators have translated this natural ability into a healing treatment based on the creation of “platelet-rich plasma,” or PRP. Fort Worth’s Dr. Peter Damico uses PRP at his skin care practice in Texas, applying injections of platelet-rich plasma to stimulate skin rejuvenation.

The PRP procedure is simple: A small amount of a patient’s blood is extracted. Not much blood is needed, because there are roughly 150,000 to 450,000 platelets in each microliter of healthy blood. In just 30 milliliters of blood, there can be up to 13.5 billion platelets. Too few platelets can cause unrestricted bleeding from both external cuts and internal damage. Too many platelets can cause the formation of clots within the bloodstream.

Each platelet, also known as a thrombocyte, is born in the blood marrow and lives for a little more than a week while circulating throughout the bloodstream. Platelets are very small, but they can be harvested in large numbers.

To create PRP, a small amount of a patient’s collected blood is then spun in a centrifuge to separate the valuable platelets from the red blood cells and other components. Though there are a great many platelets in the final sample, the number is incredibly small when compared to the total number of platelets in the body. In a healthy person, the platelets removed for PRP do not impact the body’s numbers in any significant way. The blood withdrawn is far less than given during a blood donation session, which typically is about 1 liter. Plus, with PRP, the removed platelets are returned to the body.

After removal, the platelets are treated, and then injected into the targeted area, entering at a much higher concentration than found in untreated blood.

PRP has been researched and used for decades to help with sports injuries, with the idea that it promotes more rapid healing. Since platelets are especially suited for soft-tissue repair, the medical community has made an effort to explore other uses for the injections, including into skin that bears the telltale marks of age and damage.

The introduction of concentrated platelets via PRP can be beneficial on its own, but it works particularly well when paired with a treatment that makes miniature wounds in the skin, such as microneedling.

Microneedling uses a collection of small needles to create a series of microchannels into the skin, each of which triggers natural healing processes. The punctures are too small to be considered actual damage, but they are significant enough to prompt fresh collagen production. The rejuvenating effects can be further boosted with corresponding PRP injections.

In the case of a large wound, stimulated collagen and clotting platelets work together to close the opening in the skin. When they receive the signal to move, platelets swarm to the affected area and change their exterior to make themselves stickier. They begin to pile together, sending out chemical messages that attract even more platelets to the wound. This is known as “aggregation.”

In the absence of any wound that needs closure with microneedling and PRP, the increased collagen and platelets instead improve the skin that’s already there, giving it a healthy glow and reducing the appearance of imperfections caused by ultraviolet radiation from exposure to sunlight, the natural gradual loss of beneficial components in the skin, and other factors. PRP, especially when combined with other treatments, can increase skin moisture and elasticity to reduce fine lines and wrinkles, lighten dark spots where hyperpigmentation has occurred, and revive cells that have taken on a dull, lifeless look.

In addition to PRP, Dr. Peter Damico offers a variety of other injectables for skin health and beauty, including BOTOX® and Juvéderm®, in Fort Worth. Learn more or schedule a consultation by calling (817) 738-9268 or visiting the Skin Care Fort Worth contact page.

The Secrets of Skin, Collagen, and ThermiSmooth® in Grand Rapids

Skin has a lot going on beneath the surface. While it may seem like a simple, thin layer of tissue that covers the body from head to toe, it’s actually made up of several layers, each composed of and containing a variety of proteins, carbohydrates, and other essentials. So a phrase like, “ThermiSmooth® at Grand Rapids’ Bengtson Center tightens loose skin to clear away wrinkles” is true, but there is far more to the picture.

As the body’s largest organ, skin can be divided into three parts: the outermost epidermis, the farther down dermis, and the deep subcutis.

The epidermis itself is made up of several layers that are constantly cycling, with special cells called keratinocytes repeatedly creating a new layer that gradually works its way upward over the course of about five weeks. By the time it reaches the surface, this layer is made up of dead cells that provide protection to the layers beneath, but also show the signs of damage skin has endured.

The dermis is responsible for giving skin its flexible structure and support. This layer is full of the proteins collagen and elastin, which work together to create a framework that holds everything in place, but still allows for a range of motion and movement. While these proteins are regularly damaged and destroyed, the skin creates new ones throughout a person’s youth, keeping the skin healthy and pliant. Over time, however, less and less collagen is replaced, which leads to a gradual loss of support in the skin. This reveals itself in small ways, such as wrinkles that appear as skin loses its ability to retain moisture, and in larger ways, as formerly stable facial structures begin to droop and sag.

ThermiSmooth® acts on the second layer, the dermis, by stimulating new collagen growth with ultrasound energy. This energy, when precisely controlled and delivered, generates heat, which triggers something known as neocollagenesis. ThermiSmooth® basically convinces the body to repair a wound.

In the skin, cells called fibroblasts start the collagen-building process when there is an injury in order to repair damage and close any breaches in the surface. Exposed to ultrasound-generated heat, as with ThermiSmooth®, these cells kick into gear. New collagen restores diminished flexibility and provides a framework that, among other benefits, supports hyaluronic acid, a component of healthy skin that holds moisture. Combined, these elements can revitalize an area by increasing the skin’s volume and thickness in a positive way. Wrinkles smooth out, and sagging tissue lifts back into place as it regains the support it needs. Because of this, ThermiSmooth® can be used to address laxity in a variety of areas, including the face. Dr. Brad Bengtson at the Bengtson Center for Aesthetics & Plastic Surgery in Grand Rapids is developing techniques for ideal application of ThermiSmooth® around the mouth and eyes, and on the forehead and neck. He is also evaluating ThermiSmooth® technology for use at his practice in treating wrinkles and other laxity problems in the skin on the arms and legs, chest and back, abdomen, flanks, thighs, and hips.

The radiofrequency energy delivered by ThermiSmooth® is designed to act on collagen production, leaving other elements in the dermis, including glands and hair follicles, to continue their normal functions. Another device in the Thermi® line is specifically tailored to destroy unwanted sweat glands.

Below the dermis is the cushioning subcutis layer, which holds fat for insulation and use in case the body needs energy from the stores there.

All three layers work in harmony to make the skin that keeps bacteria and debris away from our internal organs, acts as a barrier against the elements, and helps people navigate the world around them by relaying information from nerves found throughout the dermis.

Patients can find more information on skin, collagen, and ThermiSmooth® from Dr. Brad Bengtson’s Bengtson Center for Aesthetics & Plastic Surgery in Grand Rapids. To request a consultation, call (616) 588-8880 or visit http://www.bengtsoncenter.com and click on “Contact Us.”

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.

How to Address Hyperhidrosis Using miraDry® in South Jersey

We all sweat. In fact, sweat is a normal part of a healthy lifestyle. But what about those of us who sweat too much? For millions of people around the world who suffer from excessive sweating, a treatment known as miraDry® can effectively stop the problem—which, for many people, is a source of great discomfort and embarrassment—and will undoubtedly come as a great relief.

Excessive sweating, also referred to as hyperhidrosis, affects approximately 3 percent of people worldwide. Sweat is, of course, a natural response the body uses to cool itself when temperatures are high or we are engaging in strenuous activity like sports or exercise. What differentiates a case of hyperhidrosis from ordinary sweating is that people affected by the condition will find that they sweat excessively even when their bodies do not need to be cooled down, which is why a treatment like miraDry® is often recommended.

Patients with hyperhidrosis, before it has been treated with miraDry®, may find themselves sweating from one part of the body—such as the palms, feet, underarms, or head—while other parts of the body stay cool. As a hyperhidrosis treatment, miraDry® focuses solely on excessive underarm sweating.

According to the American Academy of Dermatology, “This excessive sweating can interfere with everyday activities. Hands can be so sweaty that it becomes difficult to turn a doorknob or use a computer. Sweat from the underarms often soaks through clothes, causing obvious sweat marks. Because the skin is often wet, skin infections can develop.”

As a treatment, miraDry® is used to significantly reduce sweat glands under the arm. First, it’s important to understand that there are two types of sweat glands: eccrine and apocrine. There are approximately 4 million sweat glands in the body, and miraDry® destroys only about 2 percent of those—but removing that 2 percent can contribute to vast improvements in a patient’s lifestyle by reducing unwanted sweat.

The treatment works on both types of sweat glands found there: apocrine and eccrine glands. Eccrine glands open directly onto the skin’s surface across most of the body. These glands secrete fluid onto the skin’s surface, which then cools the body as it evaporates. Apocrine glands develop specifically in areas where there is an abundance of hair follicles, such as the underarm. They empty into the hair follicle beneath the skin’s surface and secrete a milky fluid that can develop an odor once it mixes with the natural bacteria on your skin. Eccrine glands secrete when we are engaged in exercise, whereas apocrine glands come into play when we’re nervous or stressed.

miraDry® uses targeted energy to destroy sweat glands in the underarm. However, by targeting those glands, miraDry® does not adversely affect the body’s overall ability to cool itself.

During a miraDry® treatment, your doctor will first numb the area in the underarms. Next, a miraDry® handpiece is placed on the treatment area. Patients will feel a slight suction as the handpiece draws the tissue closer to the surface. It then uses energy to destroy the unwanted glands while delivering a cooling sensation to make for a comfortable patient experience.

Indeed, miraDry® is the only non-invasive technology the U.S. Food and Drug Administration has cleared for reducing sweat in patients. After miraDry®, patients might experience some swelling or bruising, with minimal to zero downtime afterward. The results will take effect almost immediately, and clinical trials have shown that sweat glands do not grow back, making the results of a miraDry® session essentially permanent in many cases.

If you are one of the millions of people who is suffering from hyperhidrosis and looking for help, there is a great resource for miraDry® in South Jersey. Dr. Robin Levin has been practicing since 2000. She is a board-certified dermatologist at the South Jersey Skin Care & Laser Center and ready to answer your questions about hyperhidrosis and help you find relief from excessive sweatiness. If you would like to learn more and schedule an appointment, contact the center online or call them directly at (856) 810-9888.

Three Advantages of Using a Physician-Only Clinic When Looking for a Dermatologist in Los Angeles

It can often be daunting when trying to find a doctor, particularly when you’re not always sure that you’re getting a trained, fully educated physician. With the increasing popularity of cosmetic procedures, it can be particularly tricky to locate a dermatologist in Los Angeles. After all, are you getting the doctor or a physician’s assistant? Is your preferred specialist really the type of specialist that you need?

 

Most of us already know that it is preferable to find a dermatologist who has met only the most stringent of medical standards—education, post-graduate training, and career certifications—but sometimes actually finding that dermatologist is a challenge in and of itself. Of course, one way to be sure that your dermatologist meets the rigorous qualifying standards you would expect from any physician is to seek out a physician-only clinic. A physician-only clinic ensures that whoever treats you, it will be a licensed dermatologist who can help you achieve the results you want.

 

With that in mind, here are a few reasons why you should consider a physician-only clinic when seeking out your dermatologist.

 

  1. Board Certification

In order to even become a board-certified dermatologist, the medical professionals at a physician-only clinic must undergo training and education requirements that reach well outside the scope of non-physician staff, such as nurses and physician assistants. Your dermatologist requires first a bachelor’s and medical degree, followed by a one-year internship and a three-year dermatology residency. Only then can they begin the process of obtaining board certification. Next, the dermatologist must verify his or her medical degree, then demonstrate the proper experience and skills to the American Board of Dermatology, the American Osteopathic Association, or the Royal College of Physicians and Surgeons of Canada. Your dermatologist, unlike other non-physician staff, must continue to renew board certification every 10 years.

 

 

  1. Avoidance of Costly, Unnecessary Procedures

There are some things that only a trained and certified dermatologist knows. Other medical professionals—nurses, physician assistants, and even physicians without a background in dermatology—can make decisions that will end up costing you more money or undergoing unnecessary procedures, and these are the types of decisions that a dermatologist knows to avoid.

 

In the paper “Should Non-Dermatologists Practice Dermatology?” it was reported that a physician who is not a dermatologist is more likely to order a procedure that is unnecessary and costly: “Plastic surgeons were much more likely to perform excisional biopsies of these lesions than dermatologists (50.5 % vs. 1.4%, respectively). Surgical excisions of these extremely common lesions not only increases the overall medical care cost, but also may put patients under completely unnecessary risks, such as longer anesthesia and higher chance of cutaneous infection.”

 

  1. Confidence

After achieving board certification and the necessary experience that comes with it, what really separates a dermatologist from a physician assistant or nurse is the confidence and expertise to make informed decisions that have the best possible outcome for patients. Consider a study, “Nurse-Led care in Dermatology: A Review of the Literature,” published in the British Journal of Dermatology, which found that there is little comparison when it comes to the expertise and confidence that a dermatologist brings to the table. This study notes: “The evidence emerging from the literature indicates that nurses are treating a number of dermatological conditions, primarily using treatment protocols, across a broad range of clinical settings.” It goes on to report findings that primary care nurses, and especially practice nurses, were not confident of their treatments, particularly related to specific conditions related to psoriasis and eczema. At least part of the problem, it seems, falls on unmet educational needs.

 

Find Your Preferred Dermatologist

If you’re ready to explore your options in at a physician-only clinic and meet with a dermatologist in Los Angeles, call the doctors at Skin Care and Laser Physicians of Beverly Hills to arrange a consultation, 310-246-0495. You can also visit them online to complete the contact form and schedule your appointment today.