Category Archives: Skin


Permalink to Free Facelift Preview

Free Facelift Preview

Considering a Facelift? Here at Advanced Concepts in Plastic Surgery, we like to give things away free if at all possible.  Since we almost never get that chance, after all, body sculpting tends to have many fixed costs associated with it, I thought I’d let everyone in on a little secret.

Everyone considering facelift surgery wants to know what he or she will look like after the facelift surgery is performed.  It is only human nature that if we are going to pay for something, we want some idea what we will be getting!

Of course as a plastic surgeon in Sacramento, I’ve performed thousands of face-lifts over the last 25 years but as hard as I may try to describe what I will be doing, words can only go so far.  You will look more rested, this or that will be lifted, skin will be smoother and more relaxed. The mental picture a patient will get will likely be somewhat accurate but they may still have a hard time picturing.

Over the years a lot of software has been developed to duplicate what the result of facelift surgery will be.  However the facelift preview software still relies on the surgeon’s ability to manipulate the software and may exaggerate or understate what the final result may be. It also only shows a two-dimensional image.

What if there was a way to preview the result of a facelift in a simple, cost-efficient way?  In fact, what if it were free and you didn’t even have to visit a plastic surgeon for a consultation? Well there is.  In plastic surgery, this method has been known for years.  In fact, I learned about it in my residency years ago.  Another plastic surgeon recently published and article about it although the idea has been around for decades.

And the fancy, high tech method to previewing what your facelift surgery will end up looking like? –Lie down.  That’s it.  Lie down on your back with a mirror and look at your face.   Most of the sagging effects are due to gravity and lying down takes some of that out of play.  Pictures taken of this position nicely preview a future facelift.    Now if you’re a real stickler for accuracy you could say lying down only accounts for some of the effects of gravity and ideally you would actually do well to stand on your head.  This is true and some doctors have actually written about this as well.  Dr. PatrickTonnard, when talking about the MACS facelift, one of the best facelift innovations of the last 10 years, has a picture showing this in his book.  However, from a practical standpoint not many people can stand on their heads for very long, or want to.


Permalink to Thermage Is Non-Invasive Skin Tightening

Thermage Is Non-Invasive Skin Tightening

What is Thermage skin tightening and is Thermage right for you? Lately, perhaps in response to the current economic conditions, or perhaps just because people are coming to understand that in the area of cosmetic surgery we have much more to offer than just surgery, I am asked about non-invasive solutions. One particular area of concern is the problem of loose skin which is a result of aging and/or child rearing.  One of the very successful non-surgical, non-invasive procedures we offer here in Sacramento is called Thermage.

Thermage is a noninvasive radiofrequency (using radio waves) technology to tighten the skin in the face and body.  It has been cleared by the FDA since 2002 and has been used in 80 countries by more than 2500 physicians in over 500,000 procedures.  When facial aging occurs, skin sags.  One of the reasons this happens is because the skin is attached by fibrous bands to the muscle underneath. When these bands are stretched out, the skin starts to hang. Thermage delivers radiofrequency energy through the skin heating these bands. The heating causes the collagen to shrink as it heals and it and goes back to its original and normal length over several months. The final result is smoother skin with less sagging.   Thermage can be used in many areas of the body including the face, neck, arms, abdomen, hips, and thighs.  With some patients, it can also be used for cellulite control. When used in the body, with a special new larger tip, it can actually cause a reduction of several inches in diameter of the waist or legs.  It is not the same as abdominoplasty or tummy tuck, but for those who are not a candidate for abdominoplasty but have some problems with loose skin in the tummy area, it Thermage may reduce the problem significantly.

The current version of Thermage is the third and best generation of radiofrequency technology.  Previous generations delivered large burst of energy and had a reputation for being uncomfortable. The new generation has solved the discomfort problem by decreasing the energy pulse and combining it with a vibration tip and cooling, which distracts nerve fibers, preventing them from feeling discomfort.  The patient feels a warm feeling at the touch of the machine but not discomfort.

Thermage is an excellent tool and can be used for facial tightening in younger women who do not yet need a surgical procedure such a a full or mini face life, or women who have had a facelift that has begun to loosen over time but are not yet candidates for another procedure.  It is the only solution in women with moderately loose skin in the arms legs and abdomen. In the past, these patients were not candidates for either liposuction or skin removal procedures but now they can be treated with Thermage.  It also works very well for women who have a slight excess in skin and fat but do not want liposuction.

Call our office to learn more about how Thermage skin tightening may be the non-surgical, non-invasive solution for your needs.


Permalink to Baby It’s Cold Outside!

Baby It’s Cold Outside!

winterAs winter approaches just days away, it is time to bundle up, put a fire in the fireplace, turn on some classic old movies and have your significant other serve you some warm soup and hot apple cider.  And all the while you can know that when spring arrives, your new bod will be healed up beautifully and warm weather clothes will be next on the list!

Yes, winter is the best time for plastic surgery because bundling up is comfy, covering up is warm and watching TV for a few days while it rains outside means you are missing nothing while letting your new breasts, abs, tummy, or all of the above heal up and achieve their ideal form in time for the spring unveiling!  And by summer, every bathing suit on the rack will be calling out your name!

This is your chance to schedule an appointment that will make next spring and summer two seasons to remember!  We have limited openings that we can still schedule during the winter surgery season and if you call today.

The timing could not be better for a tummy tuck, breast augmentation, breast lift, mommy makeover, or a newly sculpted 6-pack abs created by Vaser Hi Def liposuction!

Call Teresa at 916-925-5522 to schedule an appointment to discuss just how good you will be looking by next spring!

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Permalink to Plastic Surgery- The Edge You Need?

Plastic Surgery- The Edge You Need?

I got the job??

I got the job??

Plastic surgery, can it help you keep your job?

Plastic surgery is often thought of as being a luxury provided to the wealthy.  In fact, the vast majority of people seeking out plastic surgery are middle-class.

The current recession has resulted in massive job loss that has affected individuals across the economic spectrum from entry-level to highly paid managers and executives.  Many of these people are particularly vulnerable because they are…..older.  Not senile, not old enough to retire by any means,but old enough where potential employers are wondering whether they still have their youthful energy and enthusiasm; whether they are current and on top of what’s going on in their fields.

Unfortunately, one of the main ways that people make these kinds of decisions about energy, knowledge and ability is through appearances.  In American culture, youth is king.  Look at the most sought after demographic for television.  18 to 34 is the age group most valued because they are seen as the movers and shakers.  Once people are in their forties they are considered to be starting over the hill.  Especially in today’s technocentric economy, being older equates to being less computer literate, a lack of drive and creativity.  In comparison, youth is associated with drive, new ideas, creativity and endless energy.  This creates a significant problem for the aging worker in our society.  Despite his or her appearance, creativity and savvy, an aging employee is likely judged simply by appearance and possibly thought to be out of touch.  This is when a few minor adjustments may be in order.  This is where plastic surgery may be the edge you need! Maybe a little eye lift to make you look less tired, a face lift that takes 10 to 15 years off your appearance, or a combination of procedures such as a tummy tuck, liposuction and breast lift (also known as a “mommy makeover“) that makes you appear more fit and youthful!

These little nip/tuck procedures are not only for women!  Men may find that a little face rejuvenation, or even a Vaser Hi Def liposculpture of the abs to create a “6-pack” may make you appear more dynamic and aggressive at work!

This reminds me of one of my recent patients who was a successful executive in a large corporation and was downsized.  The reason he came in was his friends and family asked him repeatedly if he was tired.  This was because he had skin hanging over his upper lids and bags under his lower lids.  The eyelid surgery took 10 years off in one morning.  After his surgery he was more confident and looked a lot younger.  This gave him a competitive advantage over other jobseekers his age and set him on a level playing field with younger applicants.

Any way you look at it, appearing younger, looking sharper, less tired  and frankly, younger, gives a worker a better shot at keeping a job or getting one.  This may not be fair but it is a reality in a society where all things being equal the taller, less heavy, better-looking person gets the job.  This is why more and more people are seeking plastic surgery, not for purposes of vanity or simply maintaining their looks but in today’s economic reality, it’s because they’re interested in keeping their job or getting one.


Permalink to Facelift or Fillers?

Facelift or Fillers?

“Facelift or filler, What do you think Dr. K?”face lift questions

Facelift or filler, seems like an easy question. For the moment we will not address brow lifts and eyelid lifts. But the process to get the answer is fairly complicated.  As always it goes back to your anatomy.  If you look at your face there are many ways to diagram it or separate the parts.  One way is by skin adherence and mobility.  Around the mouth skin is adherent to the muscle, there isn’t much fat and there’s a lot of emotion in this area.  The rest of the face, cheek, jowels, and neck have a layer of fat between the skin and muscle and less adherence with less motion when we eat, talk or laugh.  But it does have more of a tendency to sag as we get older.  In addition one of the unfortunate aspects of aging for many people is a loss of facial fat.  No one really knows why it goes away.  It just does.  It seems to be related to declining hormone levels but all that still needs to be worked out.  Look at the photos of people in college, in mid life, and then when their old.  The loss of fat, the gaunt look is quite striking.  As an easy visual, think of Al Pacino in the Godfather and then again in his latest movie.

So we have two areas of the face by these criteria.  The central area just above and below the lips creates wrinkles from use and the lips themselves shrink.  Does lifting and pulling help any of this?  No.  What’s worse an ill-advised attempt at improving the lips by pulling (face lift) gives the widened stretched lizard lips sometimes seen in aging movie stars on late-night talk shows.  Lipstick lines, nasolabial folds, and the lips themselves are perfect for fillers which plump up and spackled these lines.  One exception to this rule is the tear trough area just under the eyes which can present as a darker circle but not a bank or a bulge but a hollow.  This area also responds very well to fillers.

On the other hand if there are jowls, multiple cheek wrinkles, and heavy nasolabial folds and neck issues, fat, hanging skin, muscle bands, then a facelift is the only way to go.  Fillers may help slightly with the nasolabial folds but by themselves cannot lift the jowls and neck.

Now that we know what a filler does, what is it?  There are many different kinds ranging from collagen to silicon to fat.  The most commonly used ones now are hyaluronic acid such as Juvederm and Restylane.  This is a natural component of our skin and was formerly obtained from rooster combs but is now available by being made by bacteria.  This substance which looks like a clear jelly is injected through a small syringe with a very small needle.  Depending upon the area, this can be done with no anesthesia, topical anesthesia or nerve blocks like a dentist.

Facelift or filler?  Look at the mirror what do you see?  Then see if your doctor agrees.


Permalink to Inner Thigh Lift

Inner Thigh Lift

 

Thighs

Thighs

A frequent problem area for many women is the inner thigh.  This is because the inner thigh area is a common place for fat accumulation or a tendency for excessive loose skin, especially for women who naturally carry more weight in the hips, buttocks and thigh areas. In addition, the inner thigh area has thinner skin than most areas of the body and is less elastic.  This can lead to sagging skin, especially after weight loss.  The problem of sagging skin in the inner thigh area can also occasionally occur after liposuction procedures.  In most areas of the body, the skin naturally shrinks very well with liposuction but sometimes in the inner thigh, it does not and this is solved with an inner thigh lift.  The inner thigh lift addresses the problem of sagging skin in this area by combining the advanced technology of Vaser® liposuction with surgical removal and tightening of excess skin.

With the inner thigh lift, liposuction is performed with the Vaser® for maximum fat removal.  The extra skin is marked, measured and removed in a half moon pattern.  A final scar lies carefully hidden in the groin crease.  In a more severe case such as substantial weight loss there is a vertical component almost to the knee to take up all of the loose skin.

The procedure is performed as outpatient surgery and takes three to five hours under full sedation.  After the patient goes home, downtime is approximately one week before going back to work.  Light exercise can begin at two weeks with a return to full exercise at one month.

Advanced Concepts in Plastic Surgery was one of the first cosmetic surgery clinics in the Greater Sacramento area to offer inner thigh lifts.   Dr. Andrew Kaczynski has been performing successful inner thigh lifts for over 15 years.


Permalink to Breast Augmentation Incisions

Breast Augmentation Incisions

breast augmentation incisions

breast augmentation incisions

There are basically four incisions for breast augmentation: armpit, nipple, breast fold, and belly button. Each has advantages and disadvantages.Some are better for certain types of implants. Some are better for certain body types. There are no wrong incisions. Just different and better choices.

The breast fold incision was the first incision to be performed. It is generally the simplest and can be made as long as necessary for large implants.  Problems include bad scars which can’t be reversed, visible scars when a small bikini rides up and even a loss of the implant by working its way through the incision due to gravity and healing problems.

The below the nipple incision is another option. The scars are hidden in the border of the dark skin and light skin. This allows excellent exposure to the entire breast especially for adjusting asymmetry and revisions. This skin really scars well. Even large implants can be placed when the incision is extended and can be closed with a crescent closure.

The armpit is also an excellent method and I have performed hundreds. It works very well for saline and for smaller implants. But it is a long way to the chest muscle because of the release of the muscle can be difficult to get the implants to drop enough. The biggest issue with this incision is a possibility of the implants riding up and inability to put in large implants.

The umbilical is the newest incision and only a few surgeons use it. Its use is limited to saline implants and can cause asymmetries due to the distance from the incision. In experienced hands you can get good results. Silicone implants can not be placed through the long tunnel from the belly button to the breast. It therefore has limited uses in modern-day breast implant surgery.

Which incision do I favor? My most frequent choice is the under the nipple incision. This gives excellent exposure, good visualization of the muscle for release, works great for secondary procedures, and gives excellent scars. I have put in up to 700 CC silicone implants with this incision. It’s a workhorse in my practice. In selected patients I will do an axillary or inframammary incision. The umbilical incision is a long run for a short slide and I do so few saline implants these days that this is not an incision that I use.

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Location Info

  • Andrew Kaczynski, MD

  • Advanced Concepts in Plastic Surgery
  • 77 Cadillac Drive
  • Sacramento, CA, 95825
  • or

  • 9719 Village Center Drive, Suite 110
  • Granite Bay, CA 95746
  • (916) 925-5522