Ask Dr. Man- Forehead Lift

Dear Dr. Man, I’m fifty-two years old and I’m very unhappy with the way the top of my face looks. My eyebrows are droopy and saggy, and I have lines and creases in my forehead. I want to have plastic surgery to fix it, but I’m not sure what needs to be done. Any advice you can give me is greatly appreciated. Signed, S. in Boca Raton

Dear S., As we age, it’s very common to develop droopy eyebrows, hooding over eyes, forehead creases and frown lines. A forehead lift (a.k.a. "brow lift") 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. A forehead lift or "browlift" is a procedure that restores a more youthful, refreshed look to the area above the eyes. The procedure corrects drooping brows and improves the horizontal lines and furrows that can make a person appear angry, sad or tired.

In a forehead lift, the muscles and tissues that cause the furrowing or drooping are removed or altered to smooth the forehead, raise the eyebrows and minimize frown lines. Your surgeon may use the conventional surgical method, in which the incision is hidden just behind the hairline; or it may be performed with the use of an endoscope, a viewing instrument that allows the procedure to be performed with minimal incisions. Both techniques yield similar results -- smoother forehead skin and a more animated appearance

The forehead muscles run vertically down the forehead and attach to the eyebrows and eye sockets. In a forehead lift, the muscles and tissues that cause the furrowing or drooping are repositioned to smooth the forehead, raise the eyebrows and minimize frown lines. Frown lines between the eyes can also be reduced with the use of Botox injections. The results give the face a more alert, rested and youthful appearance.

A forehead lift is generally performed right in the plastic surgeon’s office under general or I.V. sedation, through an endoscope using small incisions. This procedure lasts approximately one to two hours. During recovery, patients may experience temporary swelling, bruising, or numbness. Patients are usually back to work in several days.

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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.

Ask Dr. Man- Rhinoplasty

Dear Dr. Man, I’m 28 years old and have disliked the appearance of my nose for as long as I can remember. I’m seriously considering getting a nose job. Can you tell me a little about nose jobs and what to expect? Thanks, Sarah in Boca Raton

Dear Sarah, Did you know that surgery to reshape the nose (also known as rhinoplasty) is one of the most common of all plastic surgery procedures? 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 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 and better. Remember, healing is a gradual process; and some subtle swelling may be present for months after surgery.

While rhinoplasty can do wonders to enhance your appearance and boost your self-confidence, you must think carefully about what your expectations are. For example, the “perfect nose” on your favorite celebrity may not necessarily be right for you. When meeting with your plastic surgeon, discuss your expectations and realistic options for you. Good luck!

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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.

Ask Dr. Man- Portrait® Plasma Skin Regeneration System

Dear Readers, Today, I’d like to discuss a new technology proven to deliver true skin regeneration. This technology is 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 regime 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.

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Next topic: Rhinoplasty

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.

Ask Dr. Man- Getting Rid of Wrinkles

Dear Dr. Man, I just turned 50, but since I’m out in the sun playing tennis almost everyday, I look more like I’m 60. I would love to get rid of the wrinkles and sun damage on my face, without having surgery. I read about new lasers and other non-surgical ways to remove wrinkles. Can you tell me about some of these treatments? How do I know which treatment is right for me?

Florida’s year round sunshine beckons us outdoors; however, too much fun in the sun can prematurely age the skin. Sun damage causes the skin to lose its elasticity, and lines and wrinkles appear. After a while, the skin’s texture begins to appear rough, with brown spots and red irregular pigmentations. There are many non-surgical treatments available- both old and new- that 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, are also 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 takes the spotlight today with new advances, with procedures such as intense pulse light (IPL), Erbium, Thermage, Fraxel, and Portrait, just to name a few. We will discuss these new types of lasers and technological advances in more detail in next week’s column.

The method used should depend upon the patient’s desires, as well as the depth of wrinkles and sun damage. Sit down with your doctor and discuss all of your options, in order to decide which treatment is right for you. Good luck!

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.

Ask Dr. Man - Liposuction

Dear Dr. Man, I eat healthy and work out five days a week, but still have a stomach pouch. Can you give me more information about liposuction? Also, how do I know if I should get liposuction, or whether I need a tummy tuck?

Did you know that liposuction is the number one procedure of choice to remove belly fat? Liposuction is safe, requires little downtime, and can be performed on just about any area of the body. It is most commonly used to remove excess fat from the stomach, abdomen, inner and outer thighs, buttocks, back, neck, arms, and knees. Scars are minimal; and risks may include swelling, infection and “dimpling” of the skin.

Liposuction is often performed under local anesthesia. Fat is removed by inserting a hollow tube, known as a cannula, through tiny ¼ inch incisions under the skin. The cannula is connected to a suction device that vacuums out the unwanted fat. After liposuction, patients wear a surgical garment for several days to weeks.

Men most often request liposuction in order to remove bulging around the waist and calves (a.k.a. spare tires), and to reduce the appearance of enlarged male breasts, a condition known as gynecomastia. Since “six pack abs” have become quite popular among men, we are seeing a procedure known as “ab etching” increase in popularity as well. This procedure removes fat between the muscles and ribs, so that the ab muscles appear more prominently. This gives the patient a much more defined, muscle-toned appearance.

Women most often request liposuction to remove excess fatty deposits developed during pregnancy. Tummy pouches, loose belly skin, “love handles” around the waist, flabby arms, and bulges on the back and buttocks are also among the most common complaints. Ultrasound-assisted liposuction is very effective for these areas of “high” density fatty tissue.

Whether you require an abdominoplasty (tummy tuck) or liposuction depends on the amount of fat you need removed. Larger volumes of excess fat may require a surgical tummy tuck, or a combination of both liposuction and tummy tuck. If you and your surgeon find that you have too much loose skin, liposuction may not be enough, and you may need a tummy tuck. Good luck to you!

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Next topic: Getting rid of cellulite.

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.

Ask Dr. Man- Face Fillers

Dear Dr. Man, I am a 48 yr old mother of three. In the last few years, I have noticed in changes to my face that I would like to improve. My face seems to be sinking, and it seems like my lips are thinning. I don’t want surgery, but would like some improvements to my face. I’ve thought of consulting a plastic surgeon, but am unsure of what to ask for. Please help!!

First and foremost, I want to assure you that you are not alone and that there are many options available to you. 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 more tired and drawn.

Luckily, there are treatments that can help. 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, 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 newest filler on the block 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 these options with your doctor in order to help decide which treatment is the best choice for your individual needs.

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Next topic: Liposuction.

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.

Ask Dr. Man - Proceedures for Men

Dear Dr. Man, I am a 58 year old man who works as a high-profile account executive. Lately, I have been feeling as though the aging process has taken its toll on my appearance. With all of the younger men moving up the corporate ladder in my company, I want to stay as young as possible. I keep my body healthy by eating right and running, but my face is really starting to show signs of aging. Do you think it is appropriate for men to have plastic surgery on their face in order to look younger?

Before I answer your question, first let me tell you that you are not alone. I see many male patients who express a need to look younger due to the competitive nature of their profession. Some people have the misconception that an older male may be less efficient than a younger one, which has resulted in more males seeking cosmetic intervention. Some men seek plastic surgery in order to simply look and feel better about themselves. Whatever the situation, there are many procedures available that are increasing in popularity among men. In fact, did you know that male plastic surgery comprises 15% of all plastic surgery cases in the United States?

The procedures used on men are similar to those used on women; however, there are many differences in the structure of a man’s body. For example, men’s skin tends to be thicker, and the facial area has more hair, which results in a greater blood supply. Therefore, there may be differences in the techniques used when treating men and women.

Some of the most commonly performed surgical procedures on men are nose re-shaping, eyelid surgery, liposuction, and hair transplant, just to name a few. To further enhance their appearance and confidence, men are seeking facelifts as well. The great thing about today’s surgical procedures is that current methods for plastic surgery now have a quicker recovery time, which means less down-time from work.

Non-surgical procedures are also quite common among males. Botox™ injections, skin rejuvenation, and general enhancement to the face with filler materials are just a few of the treatments that are popular among men today.

Speak to your medical doctor for a referral to a plastic surgeon. During your consultation, ask questions and make sure you feel comfortable with the surgeon. Your surgeon can educate you on available treatments, both surgical and non-surgical. You can then make an educated decision regarding your individual needs. Good luck!

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Next topic: Facial rejuvenation with fillers.

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.

Ask Dr. Man - Skin Rejuvenation

Dear Dr. Man, I am a 62 years old woman and my skin is really starting to show signs of aging. I’ve tried cosmetics and over-the-counter treatments, but nothing seems to help. Some of my girlfriends have had different plastic surgeries, and they look fantastic. I’m ready to go in that direction, but I just don’t know which treatment to have. What are my options? Signed, Anonymous in Delray Beach

Dear Anonymous, The aging process of the skin varies among individuals. Inevitably, with age, our faces begin to lose the natural collagen and elasticity we are born with. Hormonal changes can also cause loss of moisture and thinning of the skin.

The best care you can give your skin is to protect it from the sun and use proper skin care, preferably a regimen recommended by your doctor. Taking care of your skin is the foundation for preventing the signs of aging, but it is only the beginning. As we age, our skin goes through changes; and even people who follow the strictest skin care regimen eventually show some signs of aging.

Fortunately, there are many treatments and procedures available on the market today. You didn’t mention specifically what signs of aging you have, so let’s talk today about some of the various treatments available to fight the aging process.

The earliest signs of aging generally occur around the eyes and forehead area. Specifically, crow’s feet, frown lines and thinner skin around the eyes are some of the first signs. Non-invasive treatment for these may include Botox™ and/or other filler materials to the affected areas. There are noninvasive resurfacing tools that are now available as well, such as Fraxel Laser, Erbium laser, Portrait Resurfacing, and Medium Peel.

There are also surgical corrections for these conditions, such as the use of suspension lifts to improve contour of portions of the face and neck. These procedures go by many names, such as thread lift, feather lift, barbed suture lift, etc. To help the sagging skin around the eyes, there is a commonly performed procedure known as blepharoplasty, which is used to give the eyes a fresher, less tired look. This usually requires some anesthesia. Check with your surgeon to see if you are a candidate for any of these procedures.

Deeper chemical peels, lasers, and dermabrasion are sometimes recommended for deeper lines and wrinkles. These procedures will most likely call for the use of anesthesia in the form of IV sedation.

New technology is becoming more common and being used more frequently when it comes to skin rejuvenation. Be sure to speak to your plastic surgeon to determine which procedure is best for you.

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Next topic: Procedures for men.

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.

Ask Dr, Man - Top Qestions to Ask at a Consultation

Last time we discussed how to find a doctor that is right for you. The next step, once you find a doctor with whom you feel comfortable, is 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 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 procedure 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 can you 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 may still 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 comfortable with your choice.

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Next topic: Skin rejuvenation

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.

Ask Dr Man – Finding a Plastic Surgeon

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. Television shows like Extreme Makeover, Nip & Tuck, and Dr. 90210 feature the latest trends in plastic surgery; however, you must remember that these are entertainment programs that often present extreme cases that may not reflect your interests.

So, that being said, where should you begin? 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).

Next topic: Preparing for your consultation: Top questions to ask.

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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.

Ask Dr. Man – Saline vs. Silicone

Dear Dr. Man, What's the different between silicone and saline implants? Do plastic surgeons even use silicone anymore? I'm considering getting implants and I'm not sure how to choose. Signed, "Thinking about implants" in Boca Raton

Dear "Thinking," Before the FDA banned the use of silicone implants in the United States 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. However, after cases of some silicone implants rupturing, the FDA put a ban on use of silicone implants. Even today, surgeons are limited to using silicone implants on secondary breast procedures only. It is my belief, however, that at some point in the near future, patients will have a choice of silicone or saline.

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.

If you are a woman looking to switch your implants from saline to silicone, I suggest discussing it in length with your surgeon. Some surgeons may recommend that you keep your saline implants if you are happy with their appearance and they have presented no complications.

The type of implant that is best for you depends upon what you want and what your breast tissue will allow you to have. You and your surgeon should weigh the benefits and tradeoffs of both saline and silicone. If you are thinking about breast implants, I encourage you to discuss all of your options with your surgeon during your pre-operative consultation.

Studies have shown both saline and silicone implants to be safe and effective. An experienced surgeon will help you choose what is best for you. Next week, we'll review some guidelines that can help you choose a plastic surgeon.

Next topic: How to find a good plastic surgeon.

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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.

Ask Dr. Man - Breast Implants FAQ

Dear Readers,

Some of the questions I get asked most frequently by patients are related to breast implant size. Today, I’d like to address a few of the more popular questions.

How do I know which implant size is right for me?
The answer to this question depends on two factors:
- The size of the breast in proportion to the size of your body
- The characteristics of your breast tissue.

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. A woman with more breast tissue will need her implants filled with fewer cc’s in order to get the size she desires.

Many women believe that an augmented breast will not sag, which is just 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 cause the tissue to stretch and, thus, cause more sagging to occur.

What if my surgeon and I do not agree on the size of the implant?
If you are asking for an implant size that your surgeon feels may be too large for you and, thus, create an undesirable surgical result, I recommend that you go back to the drawing board. There is a delicate balance between what you want and what you finally end up with. If you want a very large implant, you must realize that, over time, your skin may not be able to support such a size. The weight of the implant can stretch and thin the skin, which can lead to visible ripples around the edges of the breast, a larger sagging breast, and possibly the need for additional surgery. I often ask my patients, “Do you really want to take that chance?”

My friend’s implants look perfect. Can I have the same size as her?
First and foremost, as I tell all of my patients, no implant will produce the same result in two different women. Just because your friend has implants filled with 300cc’s, this does not mean it will produce the same results for you. Skin characteristics and quality are different in each person.

Be sure to choose a surgeon who spends time with you and discusses the characteristics of your breast tissue and options that are realistic for you.

Next topic: Breast implants: the silicone versus saline debate.

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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.

Ask Dr. Man - Introduction

Dear Readers,

Allow me to introduce myself. My name is Dr. Daniel Man. I am a board-certified plastic surgeon with a successful private practice in Boca Raton, and over 25 years of experience. For years, it has been my mission to help people improve their appearance and feel better about themselves.

My goal is to educate people on the latest trends in plastic surgery. Are you curious about a new procedure you heard about? Not sure what to expect from your first consultation with a plastic surgeon? Trying to decide what procedure is right for you? I’m here to answer all of your questions and more. I will address a range of different topics related to plastic surgery, such as:

• How young is too young for plastic surgery?
• How do I decide what size breast implants to get?
• How do I get rid of the tummy from when I was pregnant?
• Do I really need a facelift, or are there other ways to delay the aging process?
• Is plastic surgery getting a bad rap?
• Should men get facelifts?
• Do breast implants cause any known diseases?
• Can I get a neck lift without a face lift?
• Are “extreme makeovers” true, as portrayed on television?

I encourage you to email me with any questions you may have. I look forward to hearing from you.

Next topic: What size breast implants should I get?

Email your questions or comments to:

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.

Attorney General Eric Holder Honors Dr. Daniel Man

A pioneer in more natural face, neck and forehead lifts, skin rejuvenation peels and laser surgery, Dr. Daniel Man is the originator of The Vertical Bed, which he combines with Smart Lipo and other advanced liposuction techniques. He was selected as the first plastic surgeon in South Florida to use the device and his facility named a Smart Lipo Teaching Center of Excellence. Take a virtual tour of our state of the art, plastic surgery center. He is an active member of the American Society of Plastic Surgeons and the Palm Beach County Society of Plastic Surgery. Named “Physician Hero” finalist by Palm Beach County Medial Society, he has been recognized not only for his achievements in his chosen field of plastic surgery, but also for his charity and humanitarian contributions by such notables as Florida Governor Jeb Bush, Senator Bob Graham and the City of Boca Raton. He is the recipient of the NCVRW Service Award for 2009 from Attorney General Eric Holder for his pro bono service to victims of domestic abuse.