Wednesday, December 30, 2009

Ask Dr. Man- Rhinoplasty

Dear Dr. Man, My daughter is graduating high school this year and is very self-conscious about her nose. She hates the bump on her nose. I don’t think it’s that bad, but it really bothers her. She’s going off to college next year and wants to get this fixed before she goes away. Is she too young? What exactly does this procedure entail?

Surgery to reshape the nose (otherwise known as rhinoplasty) is one of the most common of all plastic surgery procedures. It is common among men and women of all ages, young and old. Rhinoplasty can be used to reshape the nose in many ways, depending on the patient’s needs and desires. Some of these ways include reducing or increasing the size of the nose, changing the shape of the tip or the bridge, narrowing the span of the nostrils, or even changing the angle between your nose and your upper lip. Rhinoplasty can also be used to correct injuries or birth defects, or to help relieve breathing problems.

The best candidates for rhinoplasty are people who are looking to improve their appearance, are physically healthy, psychologically stable and realistic in their expectations.

Rhinoplasty can be performed under local with IV sedation or general anesthesia, depending on the extent of the procedure and on what you and your surgeon prefer. Rhinoplasty usually takes an hour or two; however, complicated procedures may take longer. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. You can reduce these risks by carefully following your surgeon's instructions. In the days following surgery, your face will be bruised and swollen, but this passes. Each day, your nose will begin to look better. Healing is a gradual process; and some subtle swelling may be present for months after surgery.

Rhinoplasty can do wonders to enhance appearance and boost self-confidence. When meeting with your plastic surgeon, you and your daughter should discuss expectations and realistic options for her.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Tuesday, December 29, 2009

Ask Dr. Man- HBOT Treatments

Dear Dr. Man, My sister recently had some plastic surgery done and, shortly after her surgery, the doctor had her get HBOT treatments. He said that it would help her body heal more quickly. Can you tell me more about these treatments and how they work?

HBOT is an acronym for Hyperbaric Oxygen Therapy, which is a specialized therapy that uses an increase in atmospheric pressure in order to allow the body to incorporate more oxygen into blood cells, blood plasma, cerebral-spinal fluid and other body fluids.

The body’s healing process occurs when a severely compromised tissue in the body begins to receive oxygen, and blood circulation to the tissue resumes. The damaged tissue may not have been receiving enough blood for it to heal, due to a lack of blood circulation caused by the initial trauma or surgery

So how does hyperbaric oxygen therapy work? Patients are placed inside a pressurized chamber. Once in the chamber, the surgery site can now begin to receive a healing dose of oxygen through the surrounding body fluids and plasma—even if the blood supply to the tissues is compromised. To boost the oxygen concentration in oxygen chambers, supplemental oxygen may be added into the chamber during treatment.

When in the hyperbaric oxygen tank, red blood cells instantly fill with oxygen and the extra oxygen dissolves directly into the blood fluid. In just a few minutes, this extra oxygen builds up tissue oxygen levels far above normal. In fact, patients can inhale 2.4 pounds of oxygen in just one hour (the normal is 6 pounds per day).

How long treatments last depends on the doctor or therapist’s particular protocol for that individual. Every person and every condition is unique; and the hyperbaric treatment may require a one hour or two hour session. A program should be set out for each individual, which may require three treatments a week for several weeks or more.

There is much more information and research available on this remarkable subject. The New England Journal of Medicine has much documentation on the use of HBOT for the treatment of such indications as multiple sclerosis, acute carbon monoxide poisoning, gas gangrene, air embolism, diabetic foot wounds, infections, burns, ulcers and edema. This is but scratching the surface of the many uses of hyperbaric technology.

Email Questions and Comments

Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Monday, December 28, 2009

Ask Dr. Man- Tattoo Removal

Dear Dr. Man, I got a tattoo of my fiance’s name on my ankle and now we’re no longer together. Needless to say, this is embarrassing and I want it off of my skin. What’s involved in removing tattoos? Do I have to have surgery? Signed, Bad Move in Boca

Due to advancements in technology and a de-stigmatization of the practice, tattooing has undergone a tremendous surge in popularity over the years. In fact, according to U.S. News & World Report, tattooing has been the fastest growing sector of retail business in the last ten years. However, many people who get tattoos in their youth, or those who get tattoos that remind them of an ex-partner, can wind up regretting this permanent marking. Yours is a problem we see quite often.

Until the 1990s, scraping the skin or slicing it off was the only way to remove unwanted tattoos. Scars were inevitable after these tattoo removal techniques, not to mention a great deal of pain and recovery time. Fortunately, with advancements in laser technology, lasers can now penetrate the skin to target specific pigments, breaking up the tattoo dye into tiny units that the body can absorb. There is a technology called the Vaculight Laser system, which uses a YAG laser. It is an excellent treatment to remove tattoos from the body. The laser is color sensitive and targets the pigments most often used in tattoos, without affecting surrounding tissues. The effect of the laser on your tattoo varies depending on your levels of water, melanin (pigment) and hemoglobin content.

Treatments last from 15 minutes to an hour, depending on the area of the body and how big the tattoo is. Laser tattoo removal with the YAG laser can remove tattoos of all colors, shapes and sizes. Also, an infrared tattoo removal machine is very effective and may have fewer side effects. It can treat any color tattoo. Six to eight treatments are usually necessary; and laser treatments are scheduled at four-week intervals. The laser tattoo removal has always worked well with blue and black tattoos. Now, with the med-lite laser, even yellow and green color tattoos can be effectively treated. There is minimal discomfort during the procedure, though redness may appear and last for several days.

Potential problems include scar formation and the fact that the tattoo removal procedure may never replace your original beautiful skin.

If you are interested in laser tattoo removal, I advise you to speak with an experienced and qualified plastic surgeon to do the procedure.



Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Sunday, December 27, 2009

Ask Dr. Man- Finding a Doctor

Dear Dr. Man, I live in Vermont and am visiting South Florida. I saw your column and thought it would be a good idea to write to you. I’d like to get some work done on my body- specifically, my face and my tummy. As I said, I live in Vermont and I don’t even know where to start when finding a doctor up there. Is there a website or phone number I can call to find reputable doctors? Signed, Emily

Dear Emily, When you decide to have cosmetic surgery, the first and most important step you can take is to find a doctor that is right for you, one that can help you reach your goals. There are many ways to go about finding a good doctor. In my opinion, the phone book and advertisements are not the best resources for information. Instead, I recommend asking friends, family members, and colleagues you respect. Another good source is your family doctor or other medical professionals. Exercise caution if you choose to use the Internet, and make sure any information you get is from a credible source. Be wary of web sites that provide referral services, which are often paid for by the doctor. Better Internet sources are those of professional organizations, such as the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery.

Once you have a list of doctors to choose from, I suggest calling a few offices and getting answers to the following important questions before deciding on a surgeon.

· Is the surgeon board-certified in plastic surgery? Board certified plastic surgeons are full-time plastic surgeons who are certified by the American Board of Plastic Surgery (ABPS), and who have the surgical skills and judgment to perform a wide range of aesthetic and reconstructive procedures on the total body.

· Is the surgeon a member in good standing of the American Society of Plastic Surgeons, Inc. and the American Society for Aesthetic Plastic Surgery (ASAPS)? These organizations represent board-certified plastic surgeons in the U.S. They can provide a list of board-certified plastic surgeons in your area. For more information about the American Society of Plastic Surgeons, call 888-4-plastic or visit www.plasticsurgery.org; and the American Society for Aesthetic Plastic Surgery, call 215-587-9322 or visit www.surgery.org).

· Is the surgical facility fully equipped and accredited to perform outpatient surgery? Does the surgeon have privileges to perform these same procedures in the hospital? Accrediting organizations that can provide you with more information are: the American Association for Accreditation of Ambulatory Surgery Facilities (888-545-5222 or www.aaasf.org); the Joint Commission on Accreditation of Healthcare Organizations (630-792-5800 or www. jaaacaho.org); and the Accreditation Association for Ambulatory Health Care (847-853-6060 or www.aaahc.org).

Once you find this out, set up a consultation with the doctor and make sure you feel totally comfortable with him or her. Best of luck to you!



Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Saturday, December 26, 2009

Ask Dr. Man- Implant Questions

Dear Dr. Man, I’m strongly considering getting breast implants, but I’m concerned about breastfeeding the future. Granted, I don’t anticipate having a baby anytime soon; however, when the time comes, I want to be able to breastfeed. Is this possible? I recall hearing something about silicone not being safe when breastfeeding. Is this true? Signed, Future Mom

This is a question I get asked very often. Women who plan to have breast surgery are often concerned whether they will be able to nurse their babies in the future. The simple answer is “yes, most likely,” although women must understand that there is always some risk of complications. The ability to breastfeed after surgery depends upon various factors, which we will discuss in today’s column.

There was a concern in the early 1990’s with the reports of a “silicone illness.” Some people feared that silicone from the breast implants could leak into a mother’s milk and thus affect a baby’s health. However, later studies have shown that there was no base to this since the silicone molecule was too small to get into the milk ducts.

There is also the option of using saline implants in breast augmentation surgery. Saline implants are also extremely safe. There is no evidence that saline solution could pass into the milk ducts; this solution is harmless anyway and should not harm the mother’s or baby’s health.

Breastfeeding after having surgery could depend upon the type of the surgery and the incision site. Peri-aeroral, made around aerola, incisions are believed to be the most risky of all. Nerves and vessels could be damaged during the surgery; thus affecting nursing and lactation. Therefore, most surgeons choose to insert an implant through the incisions made under the fold of the breast, through the armpits or trans-umbilically (through the belly button) in order to avoid possible troubles in baby nursing.

The efficiency of breast feeding depends very much upon the implant placement. Most breast implants are placed under the muscle so that the milk ducts are not harmed during the surgery. However, with any breast surgery, there is always a risk of affecting the function of milk ducts.

Breastfeeding problems as a result of getting breast implants are most likely minor; however, you should be informed and aware of them so that you can evaluate the ratio of risk and success of the particular procedure. Be sure to discuss your future breastfeeding plans with a board-certified plastic surgeon.




Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Wednesday, December 23, 2009

Ask Dr. Man- Non Surgical Wrinkle Treatments

Dear Dr. Man, I’m only 42 years old but I have such bad wrinkles. They’ve only gotten worse since I moved to Florida. I must admit that I spend a lot of time in the sun because I am an avid golfer. I’m most interested in getting rid of the wrinkles on my face, but I’d rather not have surgery. Are there lasers treatments or other non-surgical methods of removing facial wrinkles?



The year-round sunshine in Florida exposes us to more sun than most people in the rest of the country are exposed to. This added exposure to the sun can ultimately lead to premature aging of the skin, as you seem to have noticed. Sun damage causes the skin to lose its elasticity, and lines and wrinkles begin to appear. After a while, the skin’s texture can begin to appear rough, with brown spots or red irregular pigmentations. There are many non-surgical treatments available- both old and new ones, which can help reduce wrinkles and sun damage on the face.



Peels can be an excellent choice to help reduce wrinkles and sun damage. Peels are minimally invasive, cost-effective and involve minimal downtime. Peels also offer flexible treatment options, ranging from light to medium to very deep. Lighter peels include alpha hydroxy acids, beta hydroxy acids, and combination peels. Superficial lines can be treated using these lighter peels. Glycolic acids can help improve skin clarity and increase the thickness of the skin, making it appear more youthful. A series of treatments are required to achieve optimal results; the additional treatments also make excellent “refreshers” for the skin. Beta hydroxy acids, including salicylic acid, are very good and very effective at reducing pigmentations. They are an excellent choice for people with darker skin, acne and oily skin. Combination peels, which entail applying salicylic acid and a special formula known as Jessner, can also be beneficial.



Another procedure that is used to treat lines, wrinkles, hyperpigmentation and acne is TCA, otherwise known as “the designer peel” or “the work horse of the peels.” TCA allows us to do many more things to treat the skin, even more than some expensive lasers. TCA can be used either superficially or deep; lighter skin types allow for deeper penetration. Depending on the depth required, several applications are applied in various concentrations.



Phenol is excellent for treating deep lines and sun damage. Used since 1903 as a skin rejuvenator, it uses a chemical known as phenol, combined with buffers, to remove wrinkles, lines and sun damage. It is considered the “gold standard” by plastic surgeons and dermatologists.



Technology is in the forefront today with new advances in procedures such as intense pulse light (IPL), Erbium, Thermage, Fraxel and Portrait, just to name a few.



The method you choose will depend upon your desires as a patient, as well as the depth of wrinkles and sun damage. I recommend you meet with a board certified plastic surgeon to discuss which treatment option is right for you.



Email Questions and Comments


Dr. Man

Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Tuesday, December 22, 2009

Ask Dr. Man- Plastic Surgery Consultation

Dear Dr. Man, I’ve been thinking about having plastic surgery for over 2 years now and I finally decided to go for it. I have an appointment with a plastic surgeon in 2 weeks. I’m going to talk to him about having several procedures done. I remember you saying in a previous column that people should come prepared with questions at their consultation. So, what kinds of questions should I ask during my consultation?

Once you find a board-certified plastic surgeon with whom you feel comfortable, it is important to know the right questions to ask during your consultation. The following are a list of some of the questions you might consider asking a surgeon during your consultation. You can use these questions as a guide when composing your own list of questions. Be sure to be specific, and make sure the doctor knows about your goals for the surgery so that he or she can advise you properly.



· Ask about the surgery itself. Where will it be performed and who will perform it? Will it be done in a hospital, outpatient center, or doctor’s facility? If the doctor has operating facilities, you will want to make sure the facility is currently licensed and accredited. Ask how long the procedure will take, what type of anesthesia will be used, and who will administer the anesthesia.

· Ask what your options are with regards to the procedures you are considering. What you may think is the best procedure may not be what the doctor recommends; or, there may be medical reasons that preclude you from having certain types of procedures. Therefore, ask the surgeon what he or she thinks is the best option for you, based on the results you want to achieve.

· Ask the surgeon if you can speak to patients who have had the procedure that has been recommended to you. This is an excellent means of learning more about the procedure and finding out if patients were happy with their experience and if their expectations were met.

· Ask what results you can realistically expect and how long these results will last. Will there be any scarring; and, if so, where will the scars be located and how can they be concealed?

· Ask about the risks. Are there any possible complications? Ask if there will be any pain or discomfort. Inquire about drainage tubes, dressings, bruising, and swelling. How long will the recovery time be?

· Ask when you will be able to go back to work and resume your normal activities. Will there be any physical limitations? When can you resume exercise? When can you wear makeup again?

· Ask about costs associate with the surgery, such as: fees for the surgeon, the anesthesiologist, the recovery room nurses, the operating room and follow-up visits. Many doctors today offer financing options. While most cosmetic surgery today is not covered by insurance, you still may want to ask.

After your consultation, you may discover that you really didn’t connect with the doctor, or that he or she isn’t answering all of your questions to your satisfaction. Whatever the reason, you need to be sure; therefore, if you don’t feel 100% comfortable with the doctor, then consider consulting with another doctor until you feel totally comfortable with your choice.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Monday, December 21, 2009

Ask Dr. Man- Underarm Sweating

Dear Dr. Man, I’m a 28 year old male- I consider myself a handsome guy. However, I have an embarrassing problem. I sweat terribly no matter what I do. I’ve tried deodorants, antiperspirants, powders and creams and NOTHING has worked. I’m very self-conscious when I go out on dates or even when I’m working. I saw on TV something about Botox injections for this problem. Does this work? Can you tell me more about it? It would be a dream come true if it works for me.

First and foremost, don’t be embarrassed. Several people suffer from excessive uncontrollable perspiration, called “hyperhydrosis.” The sweating can occur in the hands, face, underarms, and forehead. It sounds like you have what is called axillary hyperhydrosis, which is excessive sweating in the underarm area.

The nervous system of people with any type of hyperhydrosis is typically overactive. This over-activity produces an excessive sweating response. Excessive sweating can be detrimental in many ways, but typically causes mostly social and work related problems, as you have described.

Recent studies have shown that people suffering from excessive underarm sweating can benefit tremendously from Botox injections under the arm. The FDA has approved Botox in treating this type of severe underarm sweating when it cannot be treated with topical or other medications. The Botox injections reduce over-activity of the nervous system in the underarm area. The treatment usually results in a drastic reduction in sweat production.

Botox treatments in the underarm area have been shown to produce low instances of side effects and reduce sweating for 6 months to 2 years. Botox treatments for hyperhydrosis consist of about 15-20 injections into the underarm. Repeated treatments are required, and their frequency depends on how the patient’s sweating reacts to the Botox. Typical injections occur every 6 to 8 months.

Patients should be examined for the cause of their excessive sweating, which may be the result of a more serious ailment.

Botox injections to treat excessive underarm sweating has shown to increase the quality of life for many people afflicted with this ailment. Be sure to visit a board-certified plastic surgeon to see if this treatment option is right for you.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Sunday, December 20, 2009

Ask Dr. Man- Breast Implants Silicone and Saline

Dear Dr. Man, I’m 34 years old and have always had small breasts- size 32A. I’m a small lady, but I’ve always felt self-conscious and wanted larger breasts. I’m seriously considering getting implants but don’t know where to start. How do I know what size implant is right for me? What’s the difference between silicone and saline implants? Signed, Mary in Boca

Dear Mary, There are many factors to consider when getting breast implants. When you meet with a board-certified plastic surgeon for a consultation, he or she will be able to talk to you about your various options. In the meantime, I will provide you with some basic information to help you understand the process and considerations when choosing to get breast implants.

There are two main factors to consider when it comes to the size of your implants, namely: the size of the breast in proportion to the size of your body and the characteristics of your breast tissue. Every individual differs in these areas. The ideal breast size should balance with your height and weight measurements. The size also largely depends upon how much natural breast tissue you have. For example, a woman with more breast tissue will need her implants filled with fewer cc’s (volume) in order to get the size she desires.



Many women believe that an augmented breast will not sag, which is not true. The tendency of the breast to sag is related to the loss of skin elasticity and how thin the tissue is surrounding the breast. If you choose an implant that is too large, it can actually cause the tissue to stretch and, thus, cause more sagging to occur.

With regards to silicone versus saline, there are benefits and tradeoffs for both. Studies have shown both saline and silicone implants to be safe and effective. Before the FDA banned the use of silicone implants in the U.S. about 13 years ago, over 90% of surgeons preferred silicone over saline. The reason is because silicone implants feel and look more natural, can be more predictable and are considered safe. In 2006, the FDA lifted the ban on silicone breast implants.

Silicone implants have been reported by patients to feel softer and more natural than saline. They also have the ability to naturally adjust as you move. This does not mean, however, that they are the right choice for every woman. Saline implants can feel more firm than natural breast tissue. They have been known to ripple, and this can be felt if the breast tissue covering the implant is insufficient. However, adjustable saline implants can be useful in some women, whose breasts are very asymmetrical, or in women who have had massive weight loss and whose skin has stretched a great deal. Adjustable saline implants also allow the surgeon to fill the implant after surgery, in attempt to achieve the desirable size and fullness the patient is looking for. .

The type and size of the implants that are best for you depends upon what you want and what your breast tissue will allow you to have. I encourage you to discuss all of your options with a board-certified plastic surgeon during your pre-operative consultation. Best of luck to you!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Saturday, December 19, 2009

Ask Dr. Man- Botox

Dear Dr. Man, I’m 69 years young and I feel great, but I have wrinkles and frown lines that make me look old. My 42 year old daughter just got Botox injections and she looks phenomenal. Can you tell me more about what Botox actually is and what I can expect from the injections? Are they painful? Also, my husband wants to get Botox injections- can men get them too? Signed, Delray Grandma

Dear Delray Grandma, Botox Cosmetic has become an extremely popular means of reducing certain facial wrinkles, especially frown lines of the forehead and crows feet around the eyes. Frown lines are the vertical lines caused by contraction of the muscles of the eyebrows. Injecting Botox next to the muscles of the eyebrows and forehead causes the muscles to relax, smoothing out the vertical lines. Botox has become very popular with both men and women, in order to regain a more youthful appearance.

Botox, a therapeutic muscle relaxer, is a by-product of botulinum toxin A (it is not a toxin itself). It acts directly on the nerves of the muscles, preventing the muscles and nerves from receiving electrical impulses. Botox is applied via injections, using a very fine needle. The procedure is relatively painless and takes only several minutes.

Botox has been used safely for over 20 years and was approved by the U.S. Food and Drug Administration for cosmetic use in April 2002. There are minimal side effects, although some complications, such as allergic reactions or swelling, may occur. Patients who are on antibiotics or other drugs should advise their doctor in advance, as these drugs may act to increase or reduce the potency of the injections. The results of Botox last about four to six months, depending on the patient, and should be repeated as necessary.

Botox is also used to treat some other medical conditions. It is used to help decrease hyperhydrosis (excess sweating). Botox can also be effective for severe migraine or cluster headaches that don’t respond to other methods of treatment. Talk to your doctor if you have any of these problems, to see if Botox injections are the right course of treatment for you.

Botox Cosmetic has become so popular that some people are even hosting Botox parties, in which several men and women gather together for cocktails and wrinkle-reducing injections. Be advised that the FDA has issued statements warning of the possible hazards of "Botox parties." A Botox injection is a medical procedure that should be performed in a controlled medical environment. According to the FDA, administering this treatment during a cocktail party greatly diminishes the gravity of this medical procedure. There is always a risk of adverse reactions or side effects after a Botox injection; so patients need to be in a medical setting that is equipped to handle an emergency situation. In addition, the ingestion of alcohol at or around the time of injection could worsen any bruising at the injection site.

Also, beware of places that offer “bargain Botox injections,” as they may dilute the concentration of Botox in each injection, which can make the results of the treatment less effective. Talk to a board-certified plastic surgeon or dermatologist to see if Botox is right for you.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Friday, December 18, 2009

Ask Dr. Man- Male Surgeries

Dear Dr. Man, I’m a 48 year old successful real estate agent. I must admit that I take pride in my appearance. I feel like I’m fighting my age lately. Is it still taboo for men to get plastic surgery? I considered it a few years ago and people laughed at me. But I think I’m hearing more about men getting plastic surgery lately. If so, what types of procedures are available to men to fight the signs of aging? I’m interested in cutting-edge surgeries too.

Just like women, many men want to fight the signs of aging. Plastic surgery is not just for women. Many men are getting plastic surgery to reduce their wrinkles and trim their waists. Many men also desire more hair. Men are rejuvenating their faces with face, neck and eye lifts, forehead and brow lifts; having lasers and peels to remove the wrinkles and make their skin look younger; resculpting their noses, and undergoing liposuction and tummy tucks.

There are many new and improved plastic surgery options, depending on what you are looking to correct. The advent of non-ablative lasers and tissue tightening devices such as Thermage offer mini-lifts without surgery. New fillers such as Restylane and Perlane give men more choices to remove lines and wrinkles and fill in deep creases and folds. The Vaser, a new liposuction procedure, removes double chins, “spare tires” and “love handles” around the waist, large protruding abdomens and more. These procedures allow the plastic surgeon to be a true sculptor of the human body.

Many men, and even women, work out and take care of their health; however, they find they still have extra fat around the middle, tummy or back. Because liposuction removes localized fat that doesn’t respond to diet and exercise, it is one of the best procedures to help men attain their desired body shape. Male breasts are another area where liposuction, and sometimes surgical correction, can help to improve the appearance of the chest area and restore self-confidence.

Men are also having pectoral implants to increase the size of their chests, and calf implants to give the legs a more pleasing shape. Another popular procedure includes body contouring to lift the buttocks, thighs, arms and abdomen; it also helps to reshape the body and remove excess, hanging skin. This procedure is especially useful after weight loss of 50 to 100 pounds or more, and is becoming more common.

If you’re considering plastic surgery, visit a board-certified plastic surgeon for a consultation to help you decide which procedure is right for you.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Thursday, December 17, 2009

Ask Dr. Man- Juvederm

Dear Dr. Man, I’ve been seeing commercials on television for Juvederm, which is supposed to help wrinkles. They mention eliminating lines (parentheses) around the mouth, which is exactly what I have and want to get rid of. Can you tell me more about Juvederm? Is this injected into the face? Signed, Parentheses in Boca

Dear Parentheses, When wrinkles, creases and sunken areas of the face begin to appear with aging, the use of facial fillers is usually a good treatment option for most people. Some common fillers are hyaluronic acids, fat, and collagen, just to name a few. Like other hyaluronic acid injectable fillers (e.g. Restylane, Perlane, etc.), Juvederm™ is injected directly into the face for immediate, natural looking results. Juvederm is the most recently approved dermal (skin) filler on the market today. It is designed to smooth out facial folds and wrinkles to produce a smoother, more youthful looking appearance for up to six months.

In 2006, the U.S. Food and Drug Administration approved Allergan’s Juvederm as the “next generation of hyaluronic acid dermal fillers.” Juvederm is said to provide longer-lasting, smoother results than its competitors. Hyaluronic acid is a naturally occurring complex sugar found in living organisms that creates structure and elasticity in the skin. With age, the body’s production of hyaluronic acid decreases, and injectable fillers help restore facial volume. Juvederm, however, is unlike other hyaluronic acid fillers in that it consists of a smooth gel containing higher levels of non-animal and cross-linked acid, leading to longer lasting results.

The ideal candidates for Juvederm treatments include individuals with moderate to severe folds and wrinkles around the nose and mouth area. Some of the benefits of Juvederm include:

* Minimized appearance of wrinkles and folds
* Immediate improvement in facial volume and structure
* Minimally invasive treatment with no downtime
* Longer-lasting results

Some patients experience mild, temporary side effects including swelling, bruising, redness, and tenderness; however, most patients tolerate Juvederm very well.

Talk with a board-certified plastic surgeon to see if Juvederm is the correct procedure for you. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Wednesday, December 16, 2009

Ask Dr. Man- Male Breasts

Dear Dr. Man, I’m a 52 year old man- in relatively good shape. As I get older, I’m finding that I my chest is starting to look more like that of a woman’s. My wife says it doesn’t look that bad, but it really bothers me. I’ve gotten to the point where I’m embarrassed to take my shirt off in public at the pool. I’ve been told there is surgery available to correct this. Can you tell me more about it? Signed, David in Boca Raton

Dear David, It sounds like you have a common condition called gynecomastia. Gynecomastia is a medical term that comes from the Greek words for "women-like breasts." This condition can become more prevalent as men age. Gynecomastia affects an estimated 40 to 60 percent of men. In fact, we’ve seen an increase over the years in men coming into our office for this problem.

Though certain drugs and medical problems have been linked with male breast overdevelopment, there is no known cause in the vast majority of cases. For men like you who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and/or glandular tissue from the breasts and, in extreme cases, removes excess skin, resulting in a chest that is flatter, firmer, and better contoured.

The best candidates for this surgery have firm, elastic skin that will reshape to the body's new contours. Surgery may be discouraged for obese men, or for overweight men who have not first attempted to correct the problem with exercise or weight loss. In some cases, breast reduction may be performed through less invasive procedures, such as the newer suction lipectomy technique, which we will discuss in next week’s column.

When you meet with your board certified plastic surgeon for the first time, he or she will need a complete medical history and physical exam. First, your surgeon will examine your breasts and check for causes of the gynecomastia. If a medical problem is the suspected cause, you'll be referred to an appropriate specialist. In extreme cases, your plastic surgeon may also recommend a mammogram, or breast x-ray. This will not only rule out the very small possibility of breast cancer, but will reveal the breast's composition. Once your surgeon knows how much fat and glandular tissue is contained within the breasts, he or she can choose a surgical approach to best suit your needs.

Surgery for gynecomastia is most often performed as an outpatient procedure; however, in some cases, or those where other medical conditions present cause for concern, an overnight hospital stay may be recommended. The surgery itself usually takes about an hour and a half to complete, while other procedures may take longer.

Gynecomastia surgery can enhance your appearance and self-confidence. The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you'll be very satisfied with your new look. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Tuesday, December 15, 2009

Ask Dr. Man- Nipple Inversion

Dear Dr. Man, I like the look of my breasts, but I hate the way my nipples don’t stick out at all. My doctor told me I have something called inverted nipples. Can you tell me more about this and whether or not there is surgery available to correct this condition?

An inverted nipple can look flat or have a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples. Inverted nipples can cause functional problems for women, as well as emotional concerns. Another reason some women undergo nipple inversion repair is to improve the efficiency of breastfeeding.

Inverted nipples can be repaired with a minor surgical procedure that improves nipple projection and nipple appearance. The objective is to reshape the nipple and areola so that the nipple projects out from the breast, enhancing the appearance of the breast while preserving sensitivity of the nipple. The technique that leaves the milk ducts intact can also help preserve a woman's ability to breastfeed.

The doctor makes a small incision in the nipple area and then corrects the inversion using stitching or local rearrangement of your tissue. Once the inverted nipple has been corrected, the incision is stitched closed and gauze dressings are placed over your breast. When correction of nipple inversion surgery is performed by a qualified, board-certified plastic surgeon, complications are infrequent and usually minor.

Some patients request other enhancements to their breasts at the same time of their nipple inversion surgery. Depending on the size and condition of your breasts, a breast augmentation, breast lift or breast reduction can be performed to enhance the size and shape of your breasts. Your surgeon can discuss these options with you.

A special surgical bra is placed over your breasts after the surgery to ensure that your breasts are held in the best position for healing. You should sleep on your back for the first week after surgery to help with the healing process. You should wear the special surgical bra placed over your breasts after surgery at all times for the first few days. A softer sports bra should be worn at all times for the first two weeks after surgery. The bra should be worn even while sleeping to help hold your breasts in the correct position. You may take the bra off to shower or bathe, but must put it back on immediately after drying off.

Most patients return to work or school, as well as driving, within a couple of days after surgery. Most patients can resume heavier exercise about three to four weeks after surgery. Scars on your breasts should be protected from the sun for at least a year after surgery.

If you are in general good health and have a clear understanding of the limitations and potential results of your nipple inversion repair, you should be a good candidate for the procedure. Talk to a board certified plastic surgeon to see if this surgery is right for you.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Monday, December 14, 2009

Ask Dr. Man- Arm Brachioplasty

Dear Dr. Man, Over the past year, I lost 52 pounds and I feel great. I eat right and exercise daily, but I can’t get rid of the flabby skin under my arms no matter how much exercising I do. I’m seriously considering surgery. Can you tell me more about what kind of surgery I might need? Signed, C.J.

Dear C.J., Congratulations on your weight loss- that is quite an accomplishment. As you have observed first-hand, it is very common to have excess skin in the upper arm area following a dramatic weight loss. Also, as we get older, our upper arm skin can become loose and flabby. Loose upper arm skin is most often related to weight loss. When people are overweight, they tend to develop heavy upper arms. To accommodate the increased volume of the upper arms, the skin stretches. After weight loss, skin often fails to tighten; and therefore, it sags. The way to improve this problem is through an arm lift, also called brachioplasty. An arm lift is a surgical procedure to remove loose skin and excess fat deposits in the upper arm. An arm lift can help tighten this skin, which can do wonders for self-esteem.

Prior to surgery, the plastic surgeon marks the areas of excess skin to be removed. Once the skin is removed, the wound is stitched together and occasionally a drain is used. The operation is most commonly done as an outpatient, which means you can be home within a few hours. After surgery, bandages are applied. This can be anything from an extensive absorbent bandage with elastic support to a simple dressing with paper tapes (steri-strips). Patients are usually back to work within a week. Exercise can usually be resumed within about 2 weeks.

One of the drawbacks of this surgery is the scarring. Scars will extend from the armpit to the elbow, along the inside of the arm. In general, those with very loose saggy skin are happy to exchange the loose skin for the scars; however, those with a small amount of looseness will probably not want the scars. Those people with a small amount of loose skin can benefit from skin tightening effects delivered by radio waves, in treatments such as Thermage or Titan. These methods can be effective by themselves or combined with minimal suction.

In some cases, your plastic surgeon may suggest that liposuction be used in conjunction with the arm lift to remove excess fat in the upper arms. Your plastic surgeon can help evaluate your needs and discuss treatment options.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Sunday, December 13, 2009

Ask Dr. Man- Twilight Sedation

Dear Dr. Man, I’m getting some plastic surgery done in two weeks and my surgeon told me they would be using twilight anesthesia. Can you tell me what this is please? How does it differ from general anesthesia?

Many cosmetic procedures are performed under twilight sedation. Twilight anesthesia is local anesthesia with the addition of a sedative, such as Valium, given intravenously to relax you. This type of anesthesia is generally chosen for procedures lasting greater than an hour or for a few minor procedures that are being done at the same time in different body areas. It is also used when areas being treated cannot be well anesthetized using local anesthesia. Intravenous sedatives are generally a good addition to the local anesthesia injections given by the plastic surgeon. The combination helps make patients feel comfortable during the procedure.

With twilight sedation, you will be sedated to the point of being asleep, but you will not be unconscious or intubated. Twilight sedation does not provide pain relief to the area being operated on; so local or regional anesthetics may be used as well. Twilight sedation generally involves a shorter recovery and causes less, if any, nausea or vomiting.

In some cases, if the doctor finds that twilight anesthesia does not allow the surgical procedure to be carried out safely and comfortably, the doctor may switch to a general anesthetic.



A general anesthetic provides complete loss of pain sensation and loss of consciousness. It is often used for longer surgical procedures where a substantial amount of tissue manipulation is required. It is also used if multiple smaller procedures are being performed in different areas of the body.


General anesthesia is administered by injection, gas or a combination of both. This causes you to fall into a deep sleep. Your doctor may also use other medications for pain relief and muscle relaxation. Advances in anesthesia have made general anesthesia safer than ever.



No matter which type of anesthesia your doctor uses, be sure to have someone available to pick you up following your surgery, as you should not operate a vehicle. You’ll want to rest after the surgery to let the anesthesia to wear off and to let your body heal from the surgery.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Saturday, December 12, 2009

Ask Dr. Man- Eyelid Surgery

Dear Dr. Man, I’ve always had dark puffy bags under my eyes- my mom and grandmother have it as well. My eyelids also have a lot of excess skin and it makes it difficult to apply eye makeup. As I age (I’m 39 now), I find that the problem is getting worse. I’ve tried every cream and potion you can imagine but nothing has worked. I’m ready to have surgery, but I’d like to know why this happens and what treatments are available. Signed, Puffy in Boca Raton

Dear Puffy, Many people consider the eyes the focal point of the face. Your eyes give clues about your age, your mood and whether you are tired or rested. When it comes to facial rejuvenation, eyelid surgery is a good starting point because the eyelids are often the first part of your face to show the signs of aging, sun exposure, gravity and smoking.

Fatty tissue that protrudes from the eye sockets causing bulging above or below the eye can also be a genetic trait that shows up early in life; however, it can also be a result of gravity and aging. This can happen in both men and women, old and young. Sun exposure over the years can have a direct effect on the weakening of the elastic fibers that keep the eyelid skin taut.

We tend to especially notice sagging and bags under our eyes when we are tired. However, as we get older, they can become more noticeable. Bulging fat pockets result when fat pads that cushion the eyes begin to fall forward, pull away from the bone of the lower eyelids, and sag. The skin and muscle of the eyelid tend to thin and stretch over time.

Another effect of aging is when the upper eyelids become heavier and fuller and may even form a ‘hood’ over the eyelashes. As you have experienced, many women find that they have trouble applying eye shadow, or that mascara winds up getting on the upper eyelids. The hooding may also result in decreased peripheral vision, for example, when driving or playing a sport. You may also feel an added heaviness to the upper eyelids as a result of the bulging fat pockets and excess skin.

An eyelid lift, otherwise known as blepharoplasty, can help get rid of hooded or droopy eyelids. It can also help eliminate protruding fat bags above and below the eyes. The goal of eyelid rejuvenation is to remove excess skin, reduce fat deposits, tighten loose eyelid muscles, and re-establish a natural crease in the upper eyelids. Eyelid surgery does not directly correct dark circles under the eyes, but it can help eliminate the shadowing effect caused by bulging fat pockets and loose skin.

During surgery, excess fat and skin (and muscle if necessary) are removed from the upper and/or lower eyelids (depending on the specific type of eyelid surgery you get). The effects of cosmetic eyelid surgery generally lasts many years; and surgery often does not need to be repeated.

Since the eyes are such an important part of the face, rejuvenating them is a key step in maintaining a youthful appearance.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Friday, December 11, 2009

Ask Dr. Man- Thigh Lift

Dear Dr. Man, I’m 41 years old and in pretty decent shape; but my inner thighs are flabby and it makes me very self-conscious. Is liposuction the way to go? Is there any other surgery to correct this problem? Signed, Pam

Dear Pam, The skin along the inner thighs generally has less tone and elasticity than the skin along the flanks or the outer thighs. As a result of aging, weight loss and excessive exposure to the sun, the skin of the inner thighs can become thin, loose or hanging.

Even for people with a thick layer of fat along the inner thigh, liposuction alone will not make the skin tighter. What can be done is a procedure known as a thigh lift, which is usually done in combination with some liposuction. The surgeon generally performs liposuction of the inner thigh area first, in order to loosen the overlying skin. Then, an incision is made along the groin crease where the front of the thigh meets the lower abdomen. The incision continues around the upper inner thigh and ends in the crease below the buttock. The skin and tissue underneath are then pulled upward until the skin is taut, and the excess tissue is then trimmed off. A deep layer of stitches is placed in the strong connective tissue of the thigh. Dissolving stitches are then used to close the skin.

After surgery, you can expect to wear a lower body compression garment around the clock for about two weeks, except when showering. You may feel some generalized discomfort along the thigh area, along with a burning sensation along the stitch line in your groin crease at the top of the thigh. You may find it difficult to bend forward or sit in a chair, as this puts the most tension on the stitches. Standing or reclining flat tends to be the most comfortable position for patients the first few days after surgery. You should avoid strenuous activity for three to four weeks following surgery.

The down sides to an inner thigh lift are prolonged recovery and possible visible scars. I would recommend possibly first attempting liposuction alone with some of the newer methods of fat removal.

Visit a board-certified plastic surgeon to see if this or another type of surgery is right for you.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Thursday, December 10, 2009

Ask Dr. Man- Endoscopic Browlift

Dear Dr. Man, I went for a consultation with my plastic surgeon and after speaking with him and evaluating my needs, we decided on an endoscopic browlift. The doctor gave me a little background about the procedure and what it will achieve, but can you give me some more details about what to expect, particularly with regards to recovery? Signed, Maya

Dear Maya, As we age, it’s very common to develop droopy eyebrows, hooding over eyes, forehead creases and frown lines. A browlift (a.k.a. “forehead lift") is a procedure that restores a more youthful, refreshed look to the area above the eyes. It can help to reduce deep creases, horizontal lines, and furrows in the forehead, while lifting heavy, droopy eyebrows that can create a hooding effect over the eyes and make a person appear angry, sad or tired. A browlift is a minimally invasive procedure often performed in conjunction with a facelift or eyelid surgery; however, it can be done as a standalone procedure.

The brow lift your surgeon recommended is one of the more commonly used techniques. Instead of one long incision from ear to ear (which the traditional browlift uses), this technique requires approximately three to five one-inch incisions. An endoscope (wand with a small camera on the end) is inserted into one of the incisions in order to see the underlying muscles and tissues. Next, the eyebrows are released and secured in a higher position underneath the skin. The frown lines are also decreased by weakening the muscles that cause them.

Many surgeons prefer the endoscopic technique for a brow lift because the scalp incisions are minimized, there is a lower chance of permanent scalp numbness, and the recovery is generally shorter. This technique is also recommended for people with thinner hair.

To reduce swelling after a browlift, you should keep your head elevated. Bandages are removed in a short time, and stitches are removed within a week. You should be able to shower and shampoo your hair within a few days.

Some numbness and tightness of the forehead are common after surgery. Your cheeks and eyes may also bruise and swell, but that should not last too long. Most people are up and about within a few days; however, you should rest for at least the first week after surgery. Avoid rigorous physical activity for a couple of weeks after surgery. Most of the visible signs of surgery should fade within the first few weeks.

The position of your brow can have a major impact on facial expression. An elevated and smooth brow can do wonders for restoring a youthful look and a positive facial expression. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Wednesday, December 9, 2009

Ask Dr. Man- Areola nipple reduction

Dear Dr. Man, I have an embarrassing problem. Ever since I had my baby and breastfed her, my areolas are extremely large. My nipples are also pretty large and they look like they’re sagging. I feel very self-conscious. I was a 36D chest before I had the baby and I am now a 36DD. I don’t mind the larger breast size, but I really am uncomfortable with the size of my areolas and nipples. Is there surgery to correct this? If so, can you tell me more about it?

Usually when people think of enhancing the breasts, they think about breast lifts, breast reductions and breast enlargements. However, for some people, concerns are much more localized; specifically, they are unhappy with their areolas and/or nipples. The nipple is the projected part and the areola is the dark pigmented skin that surrounds the nipple. Luckily, there is surgery available to correct these concerns.

First and foremost, do not feel embarrassed. It is actually quite common to develop enlarged areolas after breastfeeding, especially in large breasted women. Some large breasted women even develop large areolas without breastfeeding. If the size of the areola is disproportionately large for the breast, it can give the breast an older, aging appearance, making surgery desirable.

Some men who develop enlarged breast tissue (also known as gynecomastia) can also have large areolas. Often men who have large areolas seek surgery to reduce the size of their areolas, since larger areolas are considered a feminine feature.

Areola reduction is standard during breast reduction and breast lift surgery to reduce the size of the areolas to make them match the size of the new breasts and to give the breasts a more youthful appearance. Areola reduction can also be performed as a standalone procedure.

There is another procedure called nipple reduction that can either be performed as a separate procedure or in combination with other breast surgery. Many women develop large, projecting nipples that, in some cases, can droop, especially after breastfeeding. During surgery, the nipple is telescoped back into the breast, providing a more youthful and balanced appearance.

Nipple and areola surgery can do wonders for self-esteem and body image. Surgery usually takes 1-2 hours and the patient can return to normal activities within a day or two. Sensitivity is usually maintained and all steps are taken to maintain the patient's ability to breastfeed.

I recommend visiting a board-certified plastic surgeon to see if these surgeries are right for you. Good luck.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Tuesday, December 8, 2009

Ask Dr. Man- Smart Lipo

Dear Dr. Man, I saw a commercial for Smartlipo on TV last night. It made it sound like I can get it done and be at work the next day. This would be great because I lead a busy lifestyle. How does it differ from traditional liposuction? Signed, Bella in Boca Raton

Dear Bella, The first thing to remember is that television shows and commercials have a tendency to glamorize plastic surgery and promise unrealistic results. You should always speak to a board-certified plastic surgeon so you have realistic expectations for whatever procedure you choose to have done.

That being said, Smartlipo is the first and only laser lipolysis system to offer a revolutionary, minimally-invasive procedure for the removal of fat. Using a high-powered laser, Smartlipo is a new laser body sculpting procedure that requires less downtime and fewer side effects than traditional liposuction.

Smartlipo can be a great supplement to traditional liposuction procedures, although it does not replace conventional liposuction. Smartlipo is ideal for treating small areas of the face, neck, arms, breasts, and areas of loose and flabby skin. For most patients, usually only one treatment is required.

If you have areas of fat that do not respond well to diet and exercise, then you may be a candidate for Smartlipo. Ideal candidates are generally in good health, of normal body weight and have realistic expectations for the results.

A very small cannula (tube) containing a laser fiber is inserted into the skin. The cannula is moved back and forth, delivering the laser’s energy directly to the fat cells, causing them to rupture and easily drain away. Because the cannula is smaller than the traditional cannula used for liposuction, Smartlipo is a minimally invasive procedure and can be performed under local anesthesia. The laser causes small blood vessels to coagulate immediately on contact, resulting in less bleeding, swelling and bruising, as well as a quicker recovery time than conventional liposuction. Because general anesthesia is unnecessary, the procedure is very safe.

The session may last from 45 minutes to one hour for each area treated. After the treatment, patients wear a compression garment for several days to several weeks, depending on the body area being treated.

Everyone heals differently, but there is usually minimal downtime. Activity may be resumed gradually, but patients should avoid strenuous exercise for about 2 weeks.

Results can be seen in as soon as a week, with continued improvement over several months. The really good news is that Smartlipo provides lasting results. Adults do not create new fat cells; when a person gains weight, existing fat cells expand. The Smartlipo procedure permanently removes fat cells; so, if you do gain weight, most of the fat will be deposited in areas where the procedure was not performed. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Monday, December 7, 2009

Ask Dr. Man- Lip Augmentation

Dear Dr. Man, I’m 61 years young and I like my appearance overall, but I can’t stand the way my lips look. As I age, I find that my lips look thinner. What treatments are available? I want it to look natural. Signed, Tristan in Boca Raton

Dear Tristan, Full lips have always been sought after, regardless of age. A plump pout is considered to be a sign of youth and an icon of sensuality. However, as we age, the lips can lose their plumpness and fullness. The upper lip, in particular, can appear thin; and the distance from the tip of the nose to the upper lip lengthens as the lips drop "down,” which can cause a frown-like appearance around the mouth.

Lip augmentation is a very popular form of cosmetic surgery. Thousands of people every year go to a plastic surgeon to either receive injections, implants or surgery to enhance the look of their lips and feel more secure in their appearance. A lip lift or lip augmentation can increase the volume and fullness of the lips and give a more attractive contour and natural pout. Lip augmentation can also be useful for people who have small, deflated lips, asymmetry, reconstructive needs, dropping or sagging upper lip, lack of color, wrinkling from smoking or aging and other complaints.

Lip augmentation uses synthetic or biological products or surgical restructuring to enhance the lips using several different treatment options. These fillers require local anesthesia. A common procedure is the use of your own fat or filler materials to give the soft lip tissue more fullness and support. These materials can be injected or implanted into the skin and can include collagen or fat, or new fillers, such as Restylane, Juvederm and Cosmoplast. Some people even go a step further and have a surgical lip lift, which shortens the area between the nose and upper lift, in order to reduce a frown-like appearance.

Lip lifts are usually performed in the doctor's office under local or I.V. sedation. After treatment, people usually experience some swelling and bruising. In the case of incisions, sutures are removed after several days. As with all surgery, there are some risks, which you should discuss with your surgeon.

Talk to your plastic surgeon to decide which treatment is right for you. Understand that no one can perform miracles; however, a highly skilled surgeon can transform what you do have into a more balanced look altogether. Lip augmentation can enhance your natural look and; in turn, do wonders for improving self-confidence. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Sunday, December 6, 2009

Ask Dr. Man- Rhinoplasty

Dear Dr. Man, I’m a 52 year old man who recently got divorced and am looking to start dating again. However, I’m self-conscious because of my nose, which is quite big and slightly curved. I’m seriously considering plastic surgery to correct it. Can you tell me more about what this procedure entails? Do only young people and women have this surgery? Signed, Bruce in Boca Raton

Dear Bruce, Surgery to reshape the nose (otherwise known as rhinoplasty) is one of the most common of all plastic surgery procedures. It is common among people of all ages, both men and women. Rhinoplasty can be used to reshape the nose in many ways, depending on the patient’s needs and desires. Some of these ways include reducing or increasing the size of the nose, changing the shape of the tip or the bridge, narrowing the span of the nostrils, or even changing the angle between your nose and your upper lip. Rhinoplasty can also be used to correct injuries or birth defects, or to help relieve breathing problems.

The best candidates for rhinoplasty are people who are looking to improve their appearance, are physically healthy, psychologically stable, and realistic in their expectations.

Rhinoplasty can be performed under local with IV sedation or general anesthesia, depending on the extent of the procedure and on what you and your surgeon prefer. Rhinoplasty usually takes an hour or two; however, complicated procedures may take longer. When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.

When rhinoplasty is performed by a qualified plastic surgeon, complications are infrequent and usually minor. You can reduce these risks by carefully following your surgeon's instructions. In the days following surgery, your face will be bruised and swollen, but this passes. Each day, your nose will begin to look better. Healing is a gradual process; and some subtle swelling may be present for months after surgery.

Rhinoplasty can do wonders to enhance your appearance and boost your self-confidence. When meeting with your plastic surgeon, discuss your expectations and realistic options for you. Best of luck to you!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Saturday, December 5, 2009

Ask Dr. Man- Breast lift

Dear Dr. Man, I’m a 29 year old mother of 3 year old twins. I’m in great shape and exercise daily, but after my kids were born and I breastfed, my breasts sag very badly. Can you tell me more about a breast lift? Also, can I get implants at the same time I get a breast lift? Signed, Sagging in Boca Raton

Dear Sagging, Over the years, factors such as pregnancy, nursing, and the force of gravity can take their toll on a woman's breasts. The skin loses its elasticity, the breasts lose their shape and they begin to sag. A breast lift, or mastopexy, is a surgical procedure to raise and reshape sagging breasts. A breast lift repositions the breasts into a more pleasing position and gives a more pleasing contour and shape. A breast lift can also reduce the size of the areola, the darker skin surrounding the nipple.

If your breasts are small or have lost volume--for example, after pregnancy--breast implants can be inserted in conjunction with mastopexy to increase both their firmness and their size. Breasts of any size can be lifted and enhanced, but the results may not last as long in heavy breasts.

Many women seek mastopexy because pregnancy and nursing have left them with stretched skin and less volume in their breasts. However, you should be aware that if you're planning to have more children, it may be a good idea to postpone your breast lift. While there are no special risks that affect future pregnancies (for example, mastopexy usually doesn't interfere with breast feeding), pregnancy is likely to stretch your breasts again and offset the results of the procedure.

During the procedure, the surgeon will mark the areas of skin that will be removed above and below the areola. The nipple will then be moved to a new, higher position while the excess skin above and below the nipple is removed and the breast reshaped. The procedure takes approximately two to four hours and can be performed in an outpatient surgery facility. Patients may experience temporary swelling, numbness and bruising. Most patients return back to work in 1-2 weeks and can resume full activities in about 3-4 weeks. Best of luck to you!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Friday, December 4, 2009

Ask Dr. Man- Protruding Ears

Dear Dr. Man, I’m 21 years old and graduating from college. I’ve always been very self-conscious about my ears because they stick out. I never wear my hair up because I don’t want anyone to see my ears. Now that I’m going to be entering the working world, I’d really like to get this fixed. I heard there is a procedure that can correct this. Can you tell me more about it? Signed, College Grad in Boca Raton

Dear College Grad, Congratulations on your upcoming graduation. Ear surgery, otherwise known as otoplasty, is usually done to set prominent ears back closer to the head or to reduce the size of large ears. For many people, especially school age children, large, protruding ears can be an embarrassment and the source of teasing and ridicule from classmates. Luckily, there are procedures available to help.

Many children over the age of 4 have this surgery; but it is certainly not uncommon for adults to have this surgery as well. Because of the emotional aspect of having large, protruding ears, it is usually better to have the surgery earlier than later. However, there are generally no additional risks associated with ear surgery on older patients.

Otoplasty is usually performed with IV sedation. The procedure, which takes about 2-3 hours, requires the surgeon to remove skin and cartilage from the back of the ear. Sutures are placed behind the ear and over the repaired cartilage. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.

Immediately after surgery, the patient's head will be wrapped in a bulky bandage to promote the best molding and healing. Within a few days, the bulky bandages will be replaced by a lighter head dressing similar to a headband. Stitches are either removed or will dissolve in about a week. Scars are well hidden. Patients are usually back to school or work in a week.

In the initial meeting, your plastic surgeon will evaluate your condition and recommend the most effective technique. He or she will also give you specific instructions on how to prepare for surgery. Most patients, young and old alike, are very pleased with the results of ear surgery. If you've discussed the procedure and your expectations with your surgeon before the operation, chances are you will be quite pleased with the results. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Thursday, December 3, 2009

Ask Dr. Man- Chin Implant

Dear Dr. Man, I’ve been embarrassed by the appearance of my chin since I was a little girl. I saw an episode of Extreme Makeover and the woman got a chin implant and looked great. I’d like to get this done,, but I’m nervous because I don’t know what to expect. Can you tell me what chin implant surgery entails? Signed, Sarah in Boca Raton

Dear Sarah, Chin implant surgery is a common procedure used to bring balance to the facial structure by correcting a weak chin. The chin defines our profile; therefore, chin implant surgery helps to improve the shape, contour, and balance of the face using special implants designed just for the chin. A weak chin can make a normal nose appear larger and an already prominent nose seem even larger; a weak chin may also give the appearance of a fleshy neck. Therefore, chin implants are often done in combination with nose surgery or a facelift.

Your surgeon will select the proper size and shape implant to enhance your appearance. During the surgery, the implant is inserted through a small incision underneath the chin or through the mouth. Several stitches are used to close the suture site. Usually the chin is taped after surgery to minimize swelling and discomfort. Sutures in the skin will be removed in a few days. If an intra-oral incision (in the mouth) is used, the sutures will dissolve.

After surgery, patients may feel temporary discomfort, with some swelling, bruising, stiffness, or numbness in the affected area. It is normal to experience some temporary difficulty with smiling and talking. Black and blue marks may be visible around the chin and neck. Your plastic surgeon will instruct you about dental hygiene, eating and any restrictions to your activities after surgery.

Just a warning: The results you see on television, especially shows that involve extreme plastic surgery with multiple procedures, may often be more dramatic than what you see in real life. Remember, doctors are not miracle workers; however, a highly skilled surgeon can transform what you do have into a more balanced look altogether. Chin implant surgery can do wonders to improve the facial structure; and many patients love their new look after surgery.

I recommend that you consult with your plastic surgeon to see if getting a chin implant is the correct decision for you. Good luck!

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Wednesday, December 2, 2009

Ask Dr. Man- Portrait

Dear Dr. Man, I’m 42 years old and I have a twin sister. She recently had a procedure done called Portrait and she looks phenomenal. Now I look like her mother when I stand next to her because of all of my wrinkles. Can you please tell me more about Portrait? Signed, The Older Twin ,

Dear Older Twin, The first thing I want to remind you is that two people, even twins, can have the same procedure done and yield different results. So, please keep that in mind and have reasonable expectations no matter what procedure you decide to have.

That being said, I’ll be happy to tell you more about Portrait. This newer technology is proven to deliver true skin regeneration. Officially known as Portrait® Plasma Skin Regeneration System (from Rhytec), Portrait reduces and softens the deep lines in the face. Results are immediate and long-lasting, with clinical studies showing improvements for as long as a year after treatment. Portrait is FDA-cleared, and is an effective treatment for wrinkles (deep and fine), brown spots, and pigmentations. It also helps improve skin tone and elasticity, in addition to tightening lax and sagging skin. It is approved to treat the face, neck, décolleté, arms and hands.

When most people think of “plasma,” they think of televisions; however, this treatment is very different. Portrait is the first system to employ a highly energized gaseous state known as “plasma” to produce unique controlled thermal energy at and below the skin’s surface. While some treatments lead to improved skin only at the surface, Portrait alters structures below the surface, creating unique conditions for continuing regeneration and improvements in wrinkles, tone, texture and discoloration. It creates a natural response to new skin cell regeneration and collagen growth, similar to a newborn baby’s skin.

Your physician will tailor your treatment depending on your needs and lifestyle. Treatments can vary from one treatment at a higher setting to three treatments at lower settings. Patients are given topical anesthetic cream one hour prior to the treatment; and the treatment itself is usually completed within about 30 minutes. Patients can expect to feel a localized sensation of heat during the treatment.

Following treatment at lower settings, patients can expect to look and feel sunburned for 24 to 48 hours. Within 24 hours after the procedure, they can resume normal activity and wear mineral makeup. Some shedding can occur within the following 3 to 5 days. Following treatment at higher settings, patients can expect to feel a more intense sunburn sensation, with a browning/bronzing to the outer layer of skin. Patients can resume normal activity and wear mineral makeup within 48 to 72 hours. Shedding may occur within the week following treatment. Once shedding has occurred, the redness of the regenerated skin may last up to 2 weeks. This is a much shorter duration compared to CO2 or Erbium Laser treatment.

The benefits of using Portrait can be seen soon after treatment, and patients tend to see progressive improvements over time. Portrait is a safe, non-surgical way to rejuvenate the skin. Combined with Botox and Dermal Fillers, it can provide patients with synergistic benefits that can do wonders for the skin. I believe that Portrait uniquely addresses the growing demand for cosmetic improvement with minimal downtime, and little or no risk of side effects or complications associated with other more aggressive anti-aging treatments.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.

Tuesday, December 1, 2009

Ask Dr. Man- Face Fillers

Dear Dr. Man, I am a 55 year old active woman who exercises and eats right. I also use excellent skincare products and try to take really good care of myself. However, in the past year or so, I have noticed changes to my face that I’m very unhappy with. It seems like my face is caving in and my lips are so thin. I prefer not to get surgery, but I’d really like to improve the look of my face. Any ideas? Signed, “Faced with an issue”

Dear Faced, Because of age, gravity, and natural daily expressions, the fullness and roundness of the face can weaken and droop downward, making the rounded contours of younger years a faint memory. Also, as we age, the fat and collagen in the face begin to dissipate, which can make the face look tired and drawn. The good news is that there are many treatments available to you.

Non-invasive use of synthetic filler materials are extremely popular, safe and very effective. These materials are injected into various parts of the face, and even into the lips for a fuller appearance. A local anesthetic is given, and the injections usually take 30 minutes or less to do. Some of the more popular synthetic fillers used today are Restylane, Cosmoplast, Hylaform Plus and Sculptra.

Restylane, which is hyaluronic acid-based, offers improvement to the sunken area under the eye. It can also help diminish the appearance of dark circles by reshaping the deep contours that can create shadows in that area.

Cosmoplast can be injected into the lips to help thinning, and can also be placed above the lip to help get rid of the vertical lines caused from smoking or pursing of the lips.

The FDA has recently approved the use of Hylaform Plus, which is also a hyaluronic acid-based dermal filler, for the correction of moderate to severe facial wrinkles and folds in the face.

Another newer filler is Sculptra. It is FDA-approved to treat facial fat loss in HIV patients, but is also used these days off-label for cosmetic improvement, in order to treat deeper facial creases and to create volume in the mid-face, which can be lost with age. Sculptra takes up to three sessions, usually a month apart, to achieve the best results.

Finally, I must tell you about the use of your own body fat as a filler to enhance the face. In fact, this is often considered the golden standard of fillers, since it uses your body’s own materials. This procedure, which can sometimes be done with a local anesthetic, involves taking fat from another area of the body (usually from the belly), and injecting it into the face. The excess fat can even be harvested for future injections.

Discuss your options with a board certified plastic surgeon in order to help decide which treatment is the best choice for your individual needs.

Email Questions and Comments


Dr. Man


Dr. Daniel Man is a board-certified plastic surgeon who has dedicated his life’s work to helping people look younger and improve their appearance through cosmetic surgery. He is a noted author, artist, inventor and educator. Dr. Man has been featured on major television networks, as well as national and local magazines and newspapers for his work as both a plastic surgeon and an artist. He has a successful private practice in Boca Raton, FL. For more information about Dr. Man, visit www.drman.com.