Tuesday, May 25, 2010

Ask Dr. Man - Thermage

Dear Dr. Man, I’m 55 years old and I live in Boca Raton. I want younger-looking skin and have thought about getting a facelift, but I haven’t decided yet. One of my friends at the tennis club said she got a treatment called Thermage and that it produced the same results as a facelift. Is this possible? Please tell me more about Thermage and what I can expect, results-wise.

Thermage is a technologically advanced approach to treating aging skin. It is currently used for treating loosening of the skin around the eyes, forehead, mouth and other areas of the body.

Thermage works by heating the underlying layers of the skin (dermis) with a unique delivery of radio frequency energy, while protecting the skin's top layer (epidermis) with a cooling spray. This is accomplished with advanced safety features that monitor skin temperature and regulate treatments. Thermage causes immediate collagen contraction, followed by new collagen production over a period of time, resulting in a more youthful appearance.

Each time energy is delivered, there is an immediate cool sensation, followed by a brief hot sensation, and again by a cool sensation. Depending on the size of the area treated, the procedure itself may take anywhere from 30 minutes to 2 hours.

One of the major benefits of the procedure is that it does not require any downtime, so you can resume normal activities immediately. Minimal redness is seen in some patients, but it usually disappears shortly after treatment. There is no special care needed after treatment. As a part of good skin care, sunscreen is recommended.

Some patients see results soon after treatment; although in most patients, results appear gradually over 2 to 6 months. Recently completed studies demonstrated continued improvements for at least 6 months after a single treatment session. Thermage is very safe. Although this is a relatively newer technology, the number of adverse effects has been small.

While Thermage is an excellent treatment option for many people, it is not a replacement for a facelift or blepharoplasty (eyelid lift). It is important to have realistic expectations when undergoing any treatment. If you’re considering Thermage or any other procedure, visit a board-certified plastic surgeon or dermatologist to see what is right for you.

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. Dr. Man has a private practice in Boca Raton, FL. www.drman.com

Monday, May 24, 2010

Ask Dr. Man - Areola Reduction

Dear Dr. Man, I’m 33 years old and live in Delray Beach, Florida. I’m the proud mom of 2 children. Ever since I had my babies and breastfed them, my areolas are huge. My nipples are also pretty big and they look like they’re sagging. I’m very self-conscious and not happy with the way my breasts look. I’ve heard of a breast reduction, but I actually don’t mind the actual size of my breasts. I really just want to get my nipples and areolas fixed. Is this possible? What can be done?

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.

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 2-3 hours and the patient can return to limited 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.

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. Dr. Man has a private practice in Boca Raton, FL. www.drman.com

Sunday, May 23, 2010

Ask Dr. Man - Lapex Laser

Dear Dr. Man, I live in West Palm Beach, but my friend who lives in Boca Raton mentioned that she got non-surgical liposuction. I’m totally interested and didn’t know this existed! I believe she mentioned something about lasers. Please tell me more! What can I expect?

Your friend was most likely referring to laser lipoplasty, or non-surgical liposuction. In our office, we use the latest technology called LAPEX 2000 LipoLaser. The new science of laser lipoplasty (non- surgical liposuction) is used by plastic surgeons to offer patients an effective, alternative treatment to surgical liposuction. The Lapex 2000 offers a safe and effective spot fat reduction solution that can be applied to multiple problem areas, including: abdomen and waistline, buttocks, inner and outer thighs, neck, arms, underarms, and upper, mid and lower back. Laser lipoplasty represents a pioneering and revolutionary new field of non-invasive liposuction and aesthetic treatment for fat and cellulite reduction.

During a treatment session, patients relax in a comfortable position while a trained technician applies the low level laser pads directly to the skin to the targeted treatment area for roughly 10 minute intervals. Then the pads or paddles are moved to the next area. Throughout the treatment, patients sit back, relax and enjoy the comforting massage-like experience by reading, listening to music, or watching television. After treatment, patients undergo 10 minutes of cardio exercise, typically by standing on a special vibration device that helps the body burn the fat that is released. Drinking plenty of fluids is encouraged, as well as additional cardiovascular exercise.

The procedure is safe and painless. Treatments are non-invasive and have no downtime. Most patients report a sensation of relaxation. The low-level laser technology has been studied and used extensively for over 30 years for other biomedical purposes, including stimulation of wound healing, pain relief, facilitation of liposuction with pre-surgery and post-surgery treatments - all with no known significant adverse reactions. Clients can resume their normal activities immediately after treatment with no bruising or swelling.

Many patients notice results after the first one or two treatments; however, a standard treatment protocol consists of two 40 minute treatment sessions every week for four to eight weeks. Maintenance treatments can be performed at less frequent intervals once desired results are achieved.

This treatment has been shown to be effective for people over the age of 18, and all body and skin types. It is ideal for patients who desire spot reductions for areas that do not respond to diet or exercise. The best results will be seen by men and women who want to get rid of stubborn areas of body fat despite exercising regularly and maintaining a healthy lifestyle. As with any fat reduction or body contouring procedure, results are drastically improved if the treatment is done in conjunction with an overall diet and exercise program. It is strongly recommended that each patient is evaluated based on body type and lifestyle so that reasonable expectations may be set.

Daniel Man, M.D., is a board-certified plastic surgeon that has dedicated his life’s work to helping people look younger and feel better about their appearance. He is a noted author, artist and inventor. 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. Dr. Man has a private practice in Boca Raton, FL.

Saturday, May 22, 2010

Ask Dr. Man - Surgery Abroad

Dear Dr. Man, My friend and I live in Boca Raton. We were talking the other day about getting some plastic surgery work done. My friend, however, is mentioning getting her work done in South America. I was shocked to hear this. I’m trying to convince her to stay here and get it done. What do you think?

I’ve heard of many women deciding to go abroad to have their plastic surgery performed in other countries. I’ve also heard many disaster stories of surgeries gone wrong as a result. While there are some very reputable surgeons in other countries, there are also surgeons and facilities that are not as reputable or safe. By staying in the United States, there are standards and board-certifications that can ensure a patient that they are going to a doctor who is certified and safe. Aside from the surgeon itself, it is essential that pre and post-operation facilities are sterile and clean; if they are not, it can cause infection. Infection can lead to serious illness or even death. Board-certified U.S. surgeons are also affiliated with accredited medical facilities that are equipped to handle any potential complications during surgery; whereas some foreign hospitals may not be equipped for such emergencies.

Some people decide to go abroad to have surgery because of cost. However, plastic surgery abroad can cost patients much more- both in health and money- than they expect. It is far more costly to have a surgery gone wrong than to get it done right in the first place. Revision surgery for botched cases can end up costing far more than the original procedure. Furthermore, for legal reasons, some U.S. surgeons may be reluctant to correct complications from procedures performed abroad. Also, U.S. malpractice laws do not apply abroad. If money is the issue, than I encourage patients to explore financing options through their U.S. plastic surgeon.

I recommend getting surgery in the U.S.; however, if your friend does decide to go abroad for her surgery, be sure that she researches the surgeon thoroughly. Also, research the facilities as well. Be sure they have sufficient facilities nearby that are equipped to manage any unexpected medical complications.

Daniel Man, M.D., is a board-certified plastic surgeon that has dedicated his life’s work to helping people look younger and feel better about their appearance. He is a noted author, artist and inventor. 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. Dr. Man has a private practice in Boca Raton, FL.

Friday, May 21, 2010

Ask Dr. Man - Nipple inversion and Breast feeding

Dear Dr. Man, I’m 24 years old and newly married, living in Boca Raton. We are planning to start a family within the next year or so and I want to breastfeed when I have a baby. Problem is that I have had flat nipples my whole life. I believe the doctor called my condition inverted nipples. Is there something I can do to correct this? I’ve always been rather self-conscious, but now I want to breastfeed so it is even more important to fix this. Is this a major surgery? Please tell me more.

Your condition is not uncommon. 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. Many women undergo nipple inversion repair 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.

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.

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. Dr. Man has a private practice in Boca Raton, FL.

Thursday, May 20, 2010

Ask Dr. Man - Biodesign Facial Filler

Dear Dr. Man, I live in Miami and I read your column every week. I want to have my face worked on. I have deep frown lines and sunken eyes. I’ve tried several facial fillers over the years, but now my plastic surgeon is recommending Biodesign, telling me it works better than most other facial fillers. Can you tell me more about it? How is it different from other facial fillers?

Thanks for being a loyal reader. Biodesign (tm) is a soft tissue facial implant material that restores volume and fills deep lines including: smile and frown lines, lip lines around the mouth, and deep depressions or sunken areas of the face. It is made from a natural protein material that contains growth factors and is bio identical to your own body’s tissue. It offers a permanent solution for patients who want an alternative to repetitive, costly, and sometimes painful filler injections.

Biodesign is ideal for filling in and creating volume to:
-Nasolabial folds: the “smile lines” extending from the outside edge of the nostril to the corner of the mouth.
- Glabellar lines: the frown lines between the eyebrows.
- Marionette lines: the “sad lines” extending downward from the outside of the corner of the lower lip.
- Depressions: the sunken in areas of the face and cheeks
- Eye areas: the under eye areas that are sunken in, have loose skin or wrinkles.

Biodesign is an advanced tissue repair technology that uses a naturally derived biologic material containing growth factors. It signals the body’s own tissues to grow and produce new cells, thereby incorporating the new tissue implant into surrounding tissues. Because the implant remodels host tissue instead of being absorbed in order to fill in and create volume, it provides a long-lasting result that is not a synthetic or foreign material. The implant does not wear off like temporary fillers that are associated with repeat treatments every few months as the body breaks down the filler. With Biodesign, repetitive and costly injections are not required indefinitely to be maintained.

Biodesign is bio identical to human tissue and is ideally suited for facial rejuvenation. Because it is a tissue builder or regenerator, it has the unique ability to be absorbed and incorporated into your body’s own tissue, which makes it resistant to infection, rejection or erosion. Once inserted, Biodesign signals the body to produce collagen and signals cells to grow into the tissue implant, which is bio-integrated over time. Studies have shown the tissue implant able to bio-integrate with the body’s own tissue, making it four times stronger. The implant has been used in millions of surgical procedures, including abdominoplasty, abdominal repair, pelvic repair and heart valves.

The 15-minute procedure is performed under local anesthetic in the patient examination room. Once the patient is anesthetized, a small opening is made into the skin and the implant material is inserted into the soft tissue and threaded underneath the skin.

Because the procedure is done under local anesthetic, there is no pain involved. While there may be some discomfort, patients are comfortable throughout the procedure. Patients may experience minor pressure as the implant is inserted into the soft tissue. Most discomfort, if present, usually resolves after several days. There is not very much bruising with typical cases, although this may vary from person to person. Some patients are more prone to bruising than others.

The results of Biodesign are long-lasting and permanent, as the implant is integrated into the soft tissue and stays there. Results can be seen immediately as the implant fills in the space. Initially, the implant may feel hard or irregular, but this gets better and softer over time as the implant integrates with the body’s own tissue.


Daniel Man, M.D., is a board-certified plastic surgeon that has dedicated his life’s work to helping people look younger and feel better about their appearance. He is a noted author, artist and inventor. 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. Dr. Man has a private practice in Boca Raton, FL.

Sunday, May 2, 2010

Ask Dr. Man - Facelift

Dear Dr. Man, I live in Miami, Florida and I’m 55 years old. I consider myself in shape, but my face is showing some signs of aging. My eyebrows are droopy and saggy, and I have lines and creases in my forehead. What kind of surgery would help?

As we age, it is 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. Visit a board-certified plastic surgeon to find out exactly what treatment would be best for you.

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. Dr. Man has a private practice in Boca Raton, FL.