Botox it seems is everywhere. Plastic surgeons and dermatologists have been very good at developing treatments and medication applications which have pushed Botox and now others like it, such as Dysport, into the top spot for most requested nonsurgical cosmetic procedures. With the success of botulinum toxin for dynamic wrinkles, there has been a trickle of treatments leaving the hands of plastic surgeons and dermatologists to ‘Botox parties’ and now a flood of treatments marketed in hair and nail salons and day spas all across the country. And not to be outdone by the hair salon next door, it is likely that your dental hygienist will offer Botox after your next cleaning.
If you somehow just can’t find Botox at a corner near you, try to Google ‘Botox Specials’ and work your way through the 10,000 plus listings for an offer near you. We dare you to give your e-mail, as the Botox specials and coupons will begin to arrive like owl letters for Harry Potter. Groupon? There is deal every day. Who will ‘do’ your Botox? It can be hard to say, though the weekend courses to teach ‘injectionists’ abound, some of which are sponsored by the manufacturers themselves. Some individuals we see race from special to special trying to get the best deal and lowest cost for the product without the concern for what the treatment will actually be. More time (and loyalty) might be spent selecting a hair colorist, because Botox is just Botox, right?
The word on the street is that not all Botox is equal. The medication is dose dependent, and the effectiveness depends on proper storage, and proper dilution. As the number of specials increase and the prices fall, corners can be cut just with dilution alone like a bartender watering a drink. Botox storage is also critical, as once mixed the medication will lose its effectiveness in a short period of time. When it comes to Botox, freshness is everything. Use it or lose it, and a salon just might not be willing to let it go.
So who will ‘do’ your Botox? We hope it will be us, your trusted plastic surgeon. Remember, the specialized service, knowledge of anatomy, facial aesthetics, proper application, and development of treatment plans has made Botox what it is today. Maintaining a record of where, how much, how often, will keep you looking consistently great time after time. The next deal of the day might not provide that. You probably spend a fortune at your special hair colorist, and give a nice tip to boot because they got you in. Why should you rush off with a coupon for your Botox application and see what you get. Otherwise Botox is just Botox, and it’s no bargain.
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Center for Aesthetic Surgery Dr. Peter E. Johnson | 847-296-5470 8901 W. Golf Rd, Ste 204 Des Plaines, IL 60016 | View Map |
Dr. Peter E. Johnson Plastic Surgeon
Wednesday, October 3, 2012
Friday, September 28, 2012
Considering Large Breast Implants? When can “Big” be “Too Big”?
The stock market has often been compared to hemlines. When skirt hemlines are rising so is the market, and as hem lines fall goes the Dow Jones market index. With the recovery and rise of the stock market since 2008, we have seen hemlines in skirts and shorts as high as they can go. Confidence is on the rise, but not just in hemlines. It seems that the size of breast implants might also be tied to our emergence from the Great Recession.
If we look at our trendsetting West Coast, the high profile breast implant has taken center stage, with common implant volumes of 500cc and more. Mentor has even released a new breast implant, the Ultra High Profile which can put the most volume on the smallest of chests. In the late 90’s, it seemed that a 270cc to 360cc, round, smooth, lower to moderate profile implant, would give wonderful results for almost anyone. With the prosperity of that time came implant inflation with Bay Watch and Pamela Anderson. The following decade resulted in the implant decline of 2000’s with the silicone gel implant moratorium. As the size of implants and interest in them fell back, by 2008 the market came to rest at a new low as well. Now with an increasing interest in higher profile breast implants, we are again at an implant ‘high’ and the worry is that implants and indeed the current markets have gotten a bit ahead of themselves.
High profile breast implants do have an important role in breast augmentation, though there are arguments against them. There are thoughts that they may have a higher risk of complications such as bottoming out, thinning and stretching of the breast, and showing through the breast tissue. Difficulty arises too when considering breast shape and symmetry. In our suburban Chicago practice, we focus on a ‘natural look’, though in some areas this goal may refer to an implant look, or a very full look, a ’higher’ breast look, or even a fake look. There is nothing wrong with a high profile implant if the choice is carefully made, but be careful what you ask for if you are only following the trend. When markets are high, hems are very short, and implants are large, euphoria can be replaced with regret. Caution is key.
Remember that as you consider breast size, think of your investment in good looks over years. Be as big as you want to be, but only as big as you are meant to be. The fit and proportion should last a lifetime. Stay true to yourself, and remember that other peoples choices are just that and trends don’t need to be followed. Implant sizes and dimensions require skill and judgment that we feel only a surgeon should make. What implant you will need for breast augmentation is determined by a careful assessment of your particular breast and chest size, shape, and breast tissue. Even the breast skin envelope and position of the nipple and breast fold will influence your augmentation. Photos of what you like and what you wish for are an excellent tool to help us get your augmentation just right. A picture is worth a thousand words, and far better ones than “natural”.
The stock market is now at a four year high, and implants are bigger than ever. Many large breast implants came out with the last big market correction, and we just might be headed for another fiscal cliff. This is a great time for those considering breast augmentation to choose a safe “buy and hold” approach. Find a look you can enjoy for a lifetime, ups and downs and you will have made a very good investment in yourself, even when the next bubble bursts.
If we look at our trendsetting West Coast, the high profile breast implant has taken center stage, with common implant volumes of 500cc and more. Mentor has even released a new breast implant, the Ultra High Profile which can put the most volume on the smallest of chests. In the late 90’s, it seemed that a 270cc to 360cc, round, smooth, lower to moderate profile implant, would give wonderful results for almost anyone. With the prosperity of that time came implant inflation with Bay Watch and Pamela Anderson. The following decade resulted in the implant decline of 2000’s with the silicone gel implant moratorium. As the size of implants and interest in them fell back, by 2008 the market came to rest at a new low as well. Now with an increasing interest in higher profile breast implants, we are again at an implant ‘high’ and the worry is that implants and indeed the current markets have gotten a bit ahead of themselves.
High profile breast implants do have an important role in breast augmentation, though there are arguments against them. There are thoughts that they may have a higher risk of complications such as bottoming out, thinning and stretching of the breast, and showing through the breast tissue. Difficulty arises too when considering breast shape and symmetry. In our suburban Chicago practice, we focus on a ‘natural look’, though in some areas this goal may refer to an implant look, or a very full look, a ’higher’ breast look, or even a fake look. There is nothing wrong with a high profile implant if the choice is carefully made, but be careful what you ask for if you are only following the trend. When markets are high, hems are very short, and implants are large, euphoria can be replaced with regret. Caution is key.
Remember that as you consider breast size, think of your investment in good looks over years. Be as big as you want to be, but only as big as you are meant to be. The fit and proportion should last a lifetime. Stay true to yourself, and remember that other peoples choices are just that and trends don’t need to be followed. Implant sizes and dimensions require skill and judgment that we feel only a surgeon should make. What implant you will need for breast augmentation is determined by a careful assessment of your particular breast and chest size, shape, and breast tissue. Even the breast skin envelope and position of the nipple and breast fold will influence your augmentation. Photos of what you like and what you wish for are an excellent tool to help us get your augmentation just right. A picture is worth a thousand words, and far better ones than “natural”.
The stock market is now at a four year high, and implants are bigger than ever. Many large breast implants came out with the last big market correction, and we just might be headed for another fiscal cliff. This is a great time for those considering breast augmentation to choose a safe “buy and hold” approach. Find a look you can enjoy for a lifetime, ups and downs and you will have made a very good investment in yourself, even when the next bubble bursts.
Saturday, September 22, 2012
Breast Augmentation: The Shape of Things to Come
Though it seemed that the evolution of the silicone gel breast implant stopped with the silicone implant moratorium in 1992, our office among others, continued clinical trials of implants we hoped will improve the outcome of breast reconstruction. Implants at the time of the moratorium came in a limited variety, round low to moderate profile implants, which do extremely well for augmentation of the breast. Augmentation is in essence enhancement of the natural breast size. Reconstruction of the breast where the breast shape and characteristics have been lost is a different matter. Our work has evolved in studies with the Allergan 153 implant, the Mentor Lumera, and now the Allergan 410, all of which are shaped implants which better mirror the natural breast shape and form. The shaped implants, also called teardrop have a tapered upper edge which can prevent a rounded look and mimic the natural breast profile. Instead of working with the implant diameter and projection alone, the shaped implants allow us to vary the height, width, and the projection independently.
As the new shaped form stable implants from Sientra have reached the market, and both Mentor and Allergan are in the process of FDA approval for their versions, we are likely to hear much more about them and how they will benefit breast augmentation. In our practice, we prefer an implant that is soft and fits and flows within the breast, moving and shifting in shape as the breast naturally moves. The best implant is one that does its job enhancing the breast in a way that cannot be seen or felt, out of mind. Smooth, round, moderate profile implants, either saline or gel will provide the need for most, and it is unlikely that stiffer shaped implants will have a broad appeal. Just our guess, however shaped implants will give us better control when we need it most. The very tight AA breast just might take on a better silhouette when compared to a round implant, and with breast asymmetry we might be able to keep the projection and dimension where we need it. Thin breast tissue and ripples? Again, the shaped implant may be a solution as it will show through less and ripple less than either saline or gel.
Though shaped breast implants will not take the place of current implants in breast augmentation, for those with special challenges, shaped implants will indeed be the shape of things to come.
As the new shaped form stable implants from Sientra have reached the market, and both Mentor and Allergan are in the process of FDA approval for their versions, we are likely to hear much more about them and how they will benefit breast augmentation. In our practice, we prefer an implant that is soft and fits and flows within the breast, moving and shifting in shape as the breast naturally moves. The best implant is one that does its job enhancing the breast in a way that cannot be seen or felt, out of mind. Smooth, round, moderate profile implants, either saline or gel will provide the need for most, and it is unlikely that stiffer shaped implants will have a broad appeal. Just our guess, however shaped implants will give us better control when we need it most. The very tight AA breast just might take on a better silhouette when compared to a round implant, and with breast asymmetry we might be able to keep the projection and dimension where we need it. Thin breast tissue and ripples? Again, the shaped implant may be a solution as it will show through less and ripple less than either saline or gel.
Though shaped breast implants will not take the place of current implants in breast augmentation, for those with special challenges, shaped implants will indeed be the shape of things to come.
Friday, September 21, 2012
The Ultimate in Breast Lift
Breast lift is an increasingly attractive option for rejuvenating and restoring a youthful and perky shape lost over pregnancy, or perhaps weight gain and loss. Traditionally, breast lift has been about firming the breast tissue, and lifting the nipple up and onto the front of the breast. At best, a great lift is a ‘no bra needed’ look. The trending or the “ultimate” in breast lift is a combination of lift, and augmentation for the upper fill and roundness we just cannot seem to get through a lift alone.
With volume loss in the breast, and relative skin excess, the nipple can appear low, or for that matter the whole breast can appear to sag lower on the chest. With good support and an upper push, things are not so bad. But sooner or later you must get out of the bra and into a bathing suit. Then again there is the dreaded pencil test. Not the one about cleavage, but the one about the breast that hangs over when you place the pencil in the breast fold underneath. Only a nipple that sits an inch above the fold gets a passing grade.
A good breast lift will move the nipple up to where it belongs, with or without a bra, through an around the nipple approach, or a vertical lift, if the upward move must be greater. Still, the breast may show an upper scoop or a lack of projection above the nipple and the ultimate in breast lift can be had by the addition of an implant, even a small one to fill out the remainder of the breast and firm and round out the breast shape. The majority of those we see who ask about breast lift, favor the look of the lift and implant combined. Even a little fill will do if a fuller cup size isn’t the goal, and the ultimate in breast lift is worth looking into.
With volume loss in the breast, and relative skin excess, the nipple can appear low, or for that matter the whole breast can appear to sag lower on the chest. With good support and an upper push, things are not so bad. But sooner or later you must get out of the bra and into a bathing suit. Then again there is the dreaded pencil test. Not the one about cleavage, but the one about the breast that hangs over when you place the pencil in the breast fold underneath. Only a nipple that sits an inch above the fold gets a passing grade.
A good breast lift will move the nipple up to where it belongs, with or without a bra, through an around the nipple approach, or a vertical lift, if the upward move must be greater. Still, the breast may show an upper scoop or a lack of projection above the nipple and the ultimate in breast lift can be had by the addition of an implant, even a small one to fill out the remainder of the breast and firm and round out the breast shape. The majority of those we see who ask about breast lift, favor the look of the lift and implant combined. Even a little fill will do if a fuller cup size isn’t the goal, and the ultimate in breast lift is worth looking into.
Wednesday, September 19, 2012
Proud member of the ‘Sun Scare’ Industry
While catching up on the pulse of the nation, I just happened to notice that we have been rebranded as part of the ‘Sun Scare’ Industry. Yes, we have been guilty of giving out “misinformation” about the harms and risks of ultraviolet radiation and been active participants in recommending sun blocks and sunscreens to hapless millions at a cost (and our personal benefit?) of billions of dollars. I have also sadly come to learn too that plastic surgeons and other well meaning physicians within this industry are vastly outnumbered, as there are more sun tanning salons in the U.S. than McDonald’s. The tanning industry is no lightweight, and polls have indicated that 90% of those who work within its ranks believe that sunbed exposure causes no health risk! This is something you have to see for yourself, and we suggest www.SunlightScam.com so you too can appreciate where the argument is going.
The tanning industry has rounded up notable endorsements, even from a few physicians who feel that the skin cancer link to sun exposure is a weak one, but they don’t stop there. The key to their defense of the sun is vitamin D. Vitamin D, of course, is an essential vitamin and the lack of it even has its own disease, rickets. Proper bone formation and bone strength relies on vitamin D, even for adults. Our skin becomes a vitamin D factory when exposed to sunlight. And, for all of you lactose intolerant out there, other than your skin, dairy products are the only place you can get it: not meat, vegetables, fruit, or breads. The salon staffs are no longer the agent of photo aging, wrinkles, and skin cancer, but Vitamin D Angels, spreading a warm happy glow and good health. Could it be as well that tanning beds and the vitamin D produced also prevents cancer? You got this right. Some have proposed that vitamin D also prevents cancer of the colon and breast, and the tanning salon is really about cancer prevention. I have to admit I really did not see this one coming.
Unfortunately, the link to cancer prevention and vitamin D is a very weak one. However, the link of sun and ultraviolet exposure is a very strong one. Skin cancer rates are up by 50% according to the National Cancer Institute, especially in young women -- perhaps many of those young women, 28 million visits to tanning salons each year and growing, are in that number. It is a fact that skin cancer kills young women, something the Australian’s have come to know all too well. They believe strongly as a nation the link and risk of sun exposure and ultraviolet exposure. Did you happen to notice the beach volley ball in the recent Olympics? The American team was wearing, well, not too much and was great for ratings; however the Australian team had ‘full cover’ of arms and legs. I may be proud to be American, though I am also proud to be a member of the Sun Scare Industry. Go Australia, you are right on this one.
The tanning industry has rounded up notable endorsements, even from a few physicians who feel that the skin cancer link to sun exposure is a weak one, but they don’t stop there. The key to their defense of the sun is vitamin D. Vitamin D, of course, is an essential vitamin and the lack of it even has its own disease, rickets. Proper bone formation and bone strength relies on vitamin D, even for adults. Our skin becomes a vitamin D factory when exposed to sunlight. And, for all of you lactose intolerant out there, other than your skin, dairy products are the only place you can get it: not meat, vegetables, fruit, or breads. The salon staffs are no longer the agent of photo aging, wrinkles, and skin cancer, but Vitamin D Angels, spreading a warm happy glow and good health. Could it be as well that tanning beds and the vitamin D produced also prevents cancer? You got this right. Some have proposed that vitamin D also prevents cancer of the colon and breast, and the tanning salon is really about cancer prevention. I have to admit I really did not see this one coming.
Unfortunately, the link to cancer prevention and vitamin D is a very weak one. However, the link of sun and ultraviolet exposure is a very strong one. Skin cancer rates are up by 50% according to the National Cancer Institute, especially in young women -- perhaps many of those young women, 28 million visits to tanning salons each year and growing, are in that number. It is a fact that skin cancer kills young women, something the Australian’s have come to know all too well. They believe strongly as a nation the link and risk of sun exposure and ultraviolet exposure. Did you happen to notice the beach volley ball in the recent Olympics? The American team was wearing, well, not too much and was great for ratings; however the Australian team had ‘full cover’ of arms and legs. I may be proud to be American, though I am also proud to be a member of the Sun Scare Industry. Go Australia, you are right on this one.
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