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How Do I Choose a Plastic Surgeon?

Choosing the right plastic surgeon is the most crucial step in getting the results you want. Do you know who’s trained to do your surgery?You may be surprised to learn that any doctor with a medical license can legally perform cosmetic (aesthetic) surgery. They aren’t legally required to have any specialized training in that area. So, if you’re considering cosmetic surgery, you need to do your homework to find the plastic surgeon who’s best qualified to perform your procedure. It only makes sense to choose someone who’s highly trained and experienced. But how can you know who’s the best doctor for the job?

Who’s Trained in Cosmetic Surgery?

The specialists listed below are trained in cosmetic surgery. It’s a good idea to get familiar with what specific procedures each specialist is trained to perform.

Medical specialists who receive cosmetic surgery training include:

  • Dermatologic surgeons – trained for surgery of the skin
  • Ophthalmologists/oculoplastic surgeons – trained for surgery around the eyes
  • Otolaryngologists/facial plastic surgeons – trained for surgery on the face and neck
  • Plastic surgeons – trained for surgery in all areas of the face and body

What Type of Certification Should I Look for in a Plastic Surgeon?

Surgeons trained in the United States receive certification from the American Board of Medical Specialties (ABMS). Look for a surgeon who is certified by the American Board of Plastic Surgery, the American Board of Cosmetic Surgery or other reputable professional board.

ABMS board certification means the surgeon has:

  • Met training standards in a valid training program
  • Passed a rigorous written examination
  • Passed oral examinations, including presentation of actual cases they’ve performed

What If They’re Not American Board Certified?

While looking for a board-certified plastic surgeon is a great place to start, there are a couple of special circumstances to consider.

New surgeons. It takes time to go through the board certification process. Newly practicing surgeons may be “board eligible,” meaning they’ve completed the appropriate training. If their training program focused on the procedure you’re interested in, they may be a good fit for you.

Internationally-trained surgeons. Surgeons trained internationally may be excellently trained and experienced, but they’re not eligible for certification by an ABMS board. This doesn’t mean that you shouldn’t choose them. In fact, internationally trained surgeons are often recruited by medical schools because of their special skills and expertise.

What Else Should I Consider When Choosing a Plastic Surgeon?

When interviewing plastic surgeons, make sure you check the status of their medical license, verify their board certification and ensure they operate in a certified facility

You should meet with each possible candidate and make sure you feel comfortable with the surgeon, his or her team and their facilities.

Be sure to ask:

  • What specialties are you trained in?
  • Where did you receive your training?
  • What experience do you have performing the procedure(s) I’m considering?

Are You Looking for a Qualified Plastic Surgeon?

Emory Aesthetic Center has a skilled team of board-certified cosmetic surgeons  who offer extensive experience in a variety of procedures.

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Or call us at 404-778-6880 to schedule your personal consultation

About Dr. Eaves

eaves-iii-felmontDr. Eaves recently returned to Atlanta, Georgia, to head the Emory Aesthetic Center as Medical Director, having previously completed his plastic surgery residency as well as a fellowship in endoscopic and minimally invasive plastic surgery at Emory University, The Emory Clinic, and associated hospitals. Before joining the Emory Aesthetic Center, Dr. Eaves was a partner in Charlotte Plastic Surgery for more than fifteen years and served as group president from 2010-2012.

His professional and institutional committee memberships and offices include an impressive list of national, international and local plastic surgery organizations, societies, boards, task forces, advisory councils, coalitions and foundations, including having served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) from 2010-2011 and Trustee (2011-Present).

Dr. Eaves’ primary areas of academic inquiry have been in minimally-invasive and endoscopic aesthetic surgery, patient safety, system and process improvement in plastic surgery, evidence-based medicine applied to plastic surgery and recontouring surgery after massive weight loss. He has received several patents for new medical devices he developed, and has made major clinical service contributions to his field. Dr. Eaves has published more than 100 articles, book chapters and book reviews on plastic surgery in peer reviewed publications, as well as manuals, videos, computer programs and other teaching aids and has coauthored the first textbook on the topic of endoscopic plastic surgery.

What to Think About When Considering a Facelift

lovely250x250Despite the popularity of noninvasive treatments such as Botox and dermal fillers, facelifts still make up a sizeable portion of a cosmetic practice. The longer lasting results and improvement in neck tightening are only some of the reasons a facelift is still a more highly satisfactory procedure. If you are considering a facelift, or in the beginning stages of researching it, there are many questions that you may have. Below are answers to some of the more common questions to help you as you begin your decision making process.

How long is the procedure and what is recovery like?

Facelifts come in many iterations. A “mini-lift” may only take 1.5 – 2 hours to perform, yet a standard lower face and neck lift may take up to 3 hours or more. Additional time may be necessary if other procedures are added, such as blepharoplasty (eyelid lift) or forehead lift. Recovery usually takes about 10-14 days, although after that time you may still experience swelling in the facial and neck tissues and some redness around the incisions. I caution patients to avoid scheduling important family or business events within the first 6 weeks, especially if photographs are to be taken.

How do I know if I’m a good candidate for a facelift?

Many patients have the misconception that you are a candidate for a facelift based on age alone. This is far from the only criteria that may steer your cosmetic surgeon towards a recommendation for a facelift. If you have looseness in the jawline and neck areas, a favorable anatomy that would allow a significant improvement with tightening, and have no contraindications to a procedure under general anesthesia, your surgeon may recommend a facelift. There are other issues to take into account as well, such as skin texture and a history of poor scarring. A consultation with a board certified cosmetic surgeon is important so that you can discuss all the factors involved in candidacy.

Can’t I just have a mini-facelift?

Please see one of our earlier blogs What is a Mini-Facelift? for a more in depth discussion, but mini-facelifts are appropriate for a small subset of facelift patients: mainly those who have little to no excess skin in the neck and only very early signs of looseness around the jawline. Because the surgery and recovery are not significantly different between a facelift and mini-facelift, the most important factor to consider is really what your anatomy dictates will give you the best result, not the length of the incision itself.

What if I want to lose weight-should I do it before or after?

If you are planning on losing 10 or more pounds, it would be best to undergo your surgery after your weight loss. This is because looseness in the tissues can develop again after surgery if there is significant loss of weight. This can be disappointing to both patient and surgeon. You also do not want to gain significant weight after a facelift, so I advise patients to be at a stable weight regardless, prior to undergoing surgery.

What are the risks of a facelift?

Common expected side effects include bruising, swelling and stiffness in the neck and shoulders for a few days and up to a week. True risks include infection, bleeding under the skin of the cheek or neck, nerve damage (temporary or permanent), and poor scarring. These risks are rare, in most cases less than 2%, but they can occur. The best way to manage this is to feel comfortable with your surgeon prior to any procedure so you know they will stand by you in case there is a problem.

Will a facelift take the place of fillers?

The short answer is no. Dermal fillers are helpful for volume loss and deeper folds or lines in many cases. A facelift is helpful to reposition loose tissues in the neck and lower face. The two can be quite complementary. Just as fillers cannot take the place of facelifts, facelifts are not mutually exclusive of fillers. The combination can improve the contours of the face quite well using each technique’s individual areas of strength.

Ultimately, the decision to undergo any type of cosmetic elective facial surgery is a big one that requires homework and possibly multiple visits to multiple surgeons to find one that suits you best. A consultation that addresses your concerns, rather than your surgeons concerns, will likely leave you with the most information to make an educated decision.

If you are considering facelift surgery to rejuvenate and improve your appearance, come see one of the board-certified physicians of the Emory Aesthetic Center for a complimentary consultation. We can discuss your goals and determine what treatment is right for you.

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or call us at 404-778-6880 to schedule a consultation

About Dr. Sethna

anita-sethna-avatarDr. Sethna understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients.

A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

Takeaways from Dr. Nahai’s “Facial Rejuvenation” Live Chat

facial rejuvenationThank you to everyone who joined us for the Facial Rejuvenation live chat hosted by Emory Aesthetic Center surgeon, Dr. Foad Nahai. Dr. Nahai discussed both surgical and nonsurgical solutions to help rejuvenate the face, including dermal fillers, Botox®, eyelid lifts and face lifts.

We were thrilled with the number of people who registered and were able to participate in the chat. The response was so great that we had a few questions we were not able to answer so we will answer them below for your reference. You can also check out the chat transcript for a full list of questions and answers:

Is their a technique such as skin tightening that can decrease hollowness around the eyes and decrease the appearance of dark circles?

Foad Nahai, MDDr. Nahai: Sometimes, shadows resulting from contour irregularities, or hollowness, around the eyes can accentuate the dark circles. Fillers may be a solution in these situations. Also, skin care including retinols, skin bleaches, as well as surgical intervention, such as an eyelid lift, may help to improve this.

Is there a difference in the outcome or a reason to use microdermabrasion versus use of a laser on the face?

Foad Nahai, MDDr. Nahai: There is a very significant difference between the two. Microdermabrasion is a lighter therapy and is used for more superficial purposes. Laser resurfacing, however, can range from light and superficial, to heavy and deep. Both are effective for minor skin changes but only lasers can be used for more significant or deeper problems.

How can I get rid of under the eye wrinkles and is there something that can be done to whiten eye sclera?

Foad Nahai, MDDr. Nahai: There are several options for improving eye wrinkles that include creams, facial peels and surgical skin removal or lifting. After examining your skin, a specialist will be able to recommend the best treatment for you. There are eye drops available which can help to improve “blood shot” eyes, but there is not a procedure to whiten the sclera.

I fell a couple years ago, and my forehead hit a curb right above my eye. Of course I had a huge black eye as a result. It has been 2 years and I still have darkness around that eye – a shadow in the same shape as the black eye. Can anything be done to lighten this?

Foad Nahai, MDDr. Nahai: Dark circles under the eyes represent one of the most challenging areas for improvement. The eyelid skin is extremely thin, with minimal if any fat between the skin and muscle. However, there are non- surgical options, such as retinols and skin bleaches, and surgical options that can help provide some improvement.

Question: Is there anything you recommend for the treatment of rosacea?

Foad Nahai, MDDr. Nahai: A variety of topical agents are available to treat rosacea. After an evaluation of your condition by a dermatologist, he/she should be able to advise you on the best treatment options for you.

 

If you missed this informative chat with Dr. Nahai, be sure to check out the full list of questions and answers on the chat transcript. Be sure to visit the Emory Aesthetic Center website for more information on therapies and solutions to keep you looking your best.

The Skinny on Fuller Lips: Lip Lift

Lip AugmentationAlthough lip augmentation or filling is quite common these days, and can lend very beautiful results, there are times when a surgical procedure such as a lip lift can be more ideal.

As we age, the upper lip can lengthen quite significantly. This can be caused from collagen loss in the skin as well as loss of bony volume that provides support for the soft tissue. Lip lengthening over time can lead to a disharmonious relationship between the upper and lower lips. In many cases, because it is an often overlooked issue, inexperienced injectors can misdiagnose the problem as loss of volume in the lip and treat with fillers alone. Although this may help with the overall look of the lower third of the face, it is unlikely to really re-establish a more balanced look.

While a surgical option may sound drastic, a well performed lip lift is quite easy to recover from and can make a significant improvement. The procedure can be done under local anesthetic alone, or with sedation to make it more comfortable, and is generally complete within an hour. A small, curved incision is made just under the nose and a portion of skin removed – the incision does not extend into the mouth, so eating and drinking after surgery is not a problem. Absorbable sutures are placed to bring the tissues together and a few sutures on or just under the skin to obtain as thin a scar as possible. After a week or so, the majority of swelling and bruising resolves and the lip takes up a more balanced portion of the lower third of the face.

The biggest downside to this procedure is the fact that a scar must be made since skin is being removed. In most cases, however, the scar heals exceptionally well and is hidden nicely in the curves and shadows under the nose. If the scar is persistently red or raised, minor procedures can be done to minimize the scar even further to obtain the best possible result.

Although lip lifting is not as popular or easy as fillers, in some cases the patient’s anatomy calls for this to be done to help achieve a more youthful proportion between the upper and lower lips. If the area between the bottom of your nose and the top of your lip appears to be increasing with time, this may be an option for you. As always, make sure you are consulting with a surgeon well-versed in all your available options to allow you to make as educated a decision as possible. Our physicians at the Emory Aesthetic Center can help guide your lip augmentation decision process to achieve the best result for you.

About Dr. Sethna

Anita Sethna, MDAnita Sethna, MD, understands that facial plastic and reconstructive surgery demand a marriage of science and artistry, and she enjoys using precision, skill, and vision to make her patients’ dreams reality. Dr. Sethna’s meticulous attention to detail and her passion for maintaining a natural look ensure optimum results for her patients. A dedicated teacher, Dr. Sethna is devoted to assisting residents in facial trauma or reconstructive cases at Grady Hospital. She relishes the opportunity to educate residents and medical students in all aspects of patient care. Dr. Sethna has a strong interest in several areas of facial plastic surgery research and has presented at national meetings on the importance of resident and fellow education in rhinoplasty techniques and adjunctive measures to decrease discomfort during cosmetic procedures.

Chemical Peels – What Are They and How do They Work?

Chemical PeelThere are three components related to the aging of the face – loss of volume, descent of the tissues and changes in the skin. As we age the skin loses elasticity resulting in the loss of fullness and that youthful glow. In addition, over time the activities of facial muscles such as smiling, frowning, and puckering of the lips lead to those lines we refer to as smile/frown lines and crow’s feet. Eventually these lines become deeper and are etched in the skin. The process is only accelerated by sun exposure and smoking.

However, there are nonsurgical options to help slow down and reverse the aging process. Retinols, such as Retin A and Renova (derivatives of vitamin A) have a proven role in slowing the process, but there are also skin resurfacing treatments available, such as chemical peels and lasers that are also effective in reversing sun damage and, to a certain extent, the changes associated with aging skin.

Lasers and peels basically function in similar fashion. Both remove the top layer of skin and stimulate collagen deposition or tightening in the deeper layers. The laser relies on heat energy, while chemical peels rely on acid to achieve similar effects. The skin which regenerates appears more youthful with diminished lines and a glow. With lasers the amount of heat can be regulated, while with chemical peels, the concentration of the topical agent is adjusted to regulate the depth of penetration and effectiveness.

There are currently three categories of chemical peels – glycolic acids (fruit acid peels), trichloracetic acid (TCA) and croton oil peels. The glycolic acids are the mildest and the croton oil is the strongest. The concentrations of all are adjusted to suit the individual patient’s skin condition. The milder glycolic acid and more dilute TCA peels are often referred to as “lunch time “peels. There is little down time and the redness resulting from the peel is short lived. These lighter peels are best for individuals with slight skin changes, require no anesthesia and are commonly performed in our Emory Aesthetic Center Spa. These lighter peels may be applied to all skin types and colors.

For stronger peels, the concentration of the TCA and croton oil are adjusted according to the changes in the skin and the location. Higher concentrations are applied to areas with deeper lines and lower concentrations for the thinner skin around the eyes. These deeper peels require anesthesia as there is discomfort associated with them. Typically sedation and local or topical anesthesia is required. Peels may be performed as an isolated procedure or in combination with surgical procedures such as facelifts and eyelid lifts.

For best results we advise that our patients prepare their skin by applying retinoids and “skin bleach” creams to the face for up to three weeks before the peel. The deeper peels which can take up to an hour are usually performed as outpatient in a procedure room or, in some cases, the operating room. There is immediate swelling and some red coloration of the peel areas. Recovery varies based on the type of peel used, the concentration applied and skin type. It may take as little as five days to two weeks or more.

Peels are not a substitute for surgical procedures but are often applied in conjunction with surgery to enhance the result and improve skin texture. The Emory Aesthetic Center, and our cosmetic surgeons, have extensive experience with peels and can customize a plan that best fits your individual need.

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