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Should I do Smartlipo or Traditional Liposuction?

Posted on November 6th, 2009 in Liposuction, Plastic Surgeon Articles & Interviews, Procedures & Breakthroughs by Makemeheal.com Staff

By, David Shafer, MD

Liposuction is a general term used to describe removal of fat using a suction machine. Tumescent liposuction is the most popular method. In this technique, tumescent solution is injected into the area of fat to be removed. The tumescent solution typically contains lidocaine (to reduce pain) and epinephrine (to minimize bruising). After the solution is injected, liposuction is performed using cannulas (long, thin tubes) to suck out the fat. Fat can be removed from almost anywhere on the body. The most popular areas are the abdomen, waist, back, bra rolls, thighs, buttocks, and chest. Liposuction is usually performed under anesthesia to help minimize any discomfort and to monitor your body during the procedure. Awake liposuction is also possible, but it takes a motivated patient and surgeon since the tumescent solutions must be injected very slowly and the suction performed very meticulously. The volume removed during awake liposuction is also much less than can be removed under general anesthesia in a hospital or surgical center. All types of liposuction are based on variants of the tumescent technique. Liposuction is only for healthy patients.

lipo, 3 months

Recently, laser liposuction (particularly Smartlipo) has received considerable attention and popularity. Smartlipo involves an extra step after the injection of tumescent fluid and before sucking out the fat. During the Smartlipo procedure, a small fiberoptic cable is inserted under the skin and uses a laser to destroy or melt the fat cells. The laser can be set to different modes with different wavelengths to focus more on destroying fat and/or heating up the skin. It is thought that heating the skin leads collagen production and a slight tightening of the skin. After the laser treatment with Smartlipo, the surgeon then performs traditional liposuction with smaller cannulas to remove the melted fat. In most cases, Smartlipo can be performed while you are awake. The advantages are potentially a quicker recovery, slightly smaller incisions, focused treatment and potential for slight skin tightening. Disadvantages, however, are less aggressive treatment since you are awake and can feel the movement of the cannula, smaller volumes of fat removed, inadequate skin tightening and potential for skin burns if you are being treated by an inexperienced surgeon. Also, you should keep in mind that the Smartlipo machine is also sold to doctors who are not plastic surgeons and they perform the procedure with little or no training in liposuction.

In my Manhattan plastic surgery practice, I use both Smartlipo MPX and Power-Assisted Liposuction. I use the Smartlipo MPX, a dual-wavelength laser lipolysis machine, for patients who have small or focused areas requiring liposuction such as love handles, abdomen, arms and neck. I perform these procedures in an accredited, office-based operating room while my patients are awake. In most cases, we perform the procedure on a Friday and patients are ready to go back to work on Monday. For patients requiring larger volume liposuction on multiple areas of their body, I perform Power-Assisted Liposuction in a hospital or surgical center while the patient is under general anesthesia. The Power-Assisted Liposuction (PAL) machine uses a vibrating cannula to quickly breakup the fat and easily such it out. This is a great device for larger volumes of fat to be removed. This can still be performed as an outpatient procedure. However, in the hospital setting, the patient has specialized monitoring. Our priority is patient safety and every precaution is taken to ensure that the procedure is safe and effective.

Whether Traditional or Smartlipo is best for you should be determined in consultation with your plastic surgeon. In either case, liposuction should not be viewed as a weight-loss procedure. Rather, it should be considered a body contouring procedure. Liposuction is not going to prevent you from gaining weight. It will, however, remove fat from specific areas and make drastic changes to your body shape. I like to tell patients that liposuction is a “second chance” to have a nice body. For one reason or another, you let your body get out of control and need fat removed. After liposuction, the patient needs to maintain a healthy lifestyle, eat a balanced diet, and exercise regularly to maintain the results.

Dr Shafer, plastic surgeryDr. David Shafer completed his plastic surgery residency at the world famous Mayo Clinic. He was then selected to continue his education at the prestigious Manhattan Eye, Ear & Throat Hospital. While most plastic surgeons go directly into practice after residency, Dr. Shafer had the honor to operate with many of the world’s most distinguished plastic surgeons. This unique experience allowed Dr. Shafer to advance his skills to a level that most surgeons take a lifetime to develop. Dr. Shafer continues to operate at MEETH and now teaches the next generation of plastic surgeons from NYU, Columbia and Cornell.

Ask Dr. David Shafer A Question on Makemeheal.com

Visit us at www.ShaferPlasticSurgery.com.

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More Plastic Surgery for Gwyneth Paltrow?

Posted on November 6th, 2009 in Celebrity Plastic Surgery by Ruby Marr

Gwyneth Paltrow has joined the ranks of actors who do more than just act; they also try to save the world in their own way. While Gwyneth has joined the Web community with her Goop website, has she also joined the plastic surgery community of Hollywood?

In the past, Gwyneth has likely had a nose job to help enhance her career and may have also undergone a breast augmentation to boost her appeal after having children. (See Make Me Heal’s story on Gwyneth Paltrow’s plastic surgery). Now 37, many suspect that Gwyneth has had rejuvenation procedures, like a facelift combined with injectables.

Gwyneth Paltrow, Plastic Surgery

Plastic surgeon Dr. Richard Ellenbogen says, “Gwyneth does look altered…she has a sort of ‘”too good to be true look for her age”…she is tight …tighter than before. She is smooth, which in my opinion indicate a facelift and injectables.”

On the other hand, Gwyneth is clearly blessed with great genes—just look at her mother, actress Blythe Danner—and may just use fillers combined with some careful Botox to stay looking good.

Manhattan plastic surgeon Dr Jennifer Walden says, “Gwyneth Paltrow is another timeless Hollywood beauty. She is blessed with beautiful parents and it shows. I do not think that she has had a face lift and eye lift, although she may have been injected with Botox on her forehead and crows feet area to make them appear smooth.”

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “Gwyneth Paltrow looks great, and that is not the result of a facelift. She may have had a few fillers around her face, but that is about it. She is a beautiful woman, and would not benefit from any major procedures at this time.”

Gwyneth is always up to something, on or offscreen, and fans of the leggy blonde can see her next move in Iron Man 2, due out next year.

Read the complete plastic surgery profile of Gwyneth Paltrow on Plasticopedia, the largest celebrity plastic encyclopedia.

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Reality Show Contestant Ruptures Breast Implants And How To Repair It

By John Di Saia, MD

When a reality show contestant ruptured her breast implants after jumping 20 feet off a rope swing, I felt compelled to address the concern that some breast augmentation patients have about this problem.

Bursting a breast implant is not usually so dramatic as what the reality show girl experienced.  Then again, it is uncommon for a patient to know when the break occurred. Breast implant rupture is usually a low key event. Maybe in this case the lady did do some soft tissue damage as well as the break seems to have occurred with a fall from some height. It is conceivable to cause a muscle tear although I have only seen small ones. Torn muscle can hurt.

Usually the implant ruptures quietly and slowly over a few days the breast gets smaller (with a saline implant). If the implant is a silicone gel type, the rupture may not be noticed for quite a while. This is one of the reasons the new FDA recommendations are for breast MRIs periodically after silicone gel breast implant surgery.

The “fix” involves removal of the broken implant and frequently the capsule of scar tissue around it. Silicone gel implants generally have a larger amount of this scar reaction and in removing this scar the healthy tissue available to cover the implants gets thinner. This can be a problem if done repeatedly or if the reaction is long standing or extensive as the breast can be left looking more foreign. The newer generation silicone gel implants will hopefully have less of this reaction than their predecessors, but the truth is we don’t have enough information yet to really say that. The answer to how surgeons minimize this potential problem is a matter of opinion.

John Di SaiaJohn Di Saia MD (www.ocbody.com) is a board certified Plastic and Reconstructive Surgeon. He has been board certified by both the American Board of Surgery and the American Board of Plastic Surgery. He reviews cases for the California Medical Board in their expert reviewer program and contributes to a number of medical journals and internet forums. His practice is founded on the concept of a Higher Level of Care.

Ask John Di Saia a question on Makemeheal.com

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Courtney Love Scared off of Plastic Surgery

Posted on November 5th, 2009 in Awful/Bad Plastic Surgery, Celebrity Plastic Surgery by Lisa Stanfield

Kurt Cobain’ widow Courtney Love has undergone her share of plastic surgery disasters since his death in 1994. But her days of going under the knife are over, thanks to a chance encounter with Jocelyn Wildenstein, aka Catwoman.

Courtney love, Plastic Surgery

At 45, Courtney has undergone two or three nose jobs, lip augmentations, breast implants and liposuction. But after seeing the horror that is socialite Jocelyn Wildenstein, Courtney has been said to swear off plastic surgery.

A popular British tabloid has quoted Courtney as saying, “I could do with another boob lift, but no way.

“I don’t want to end up looking like her. She looked freaky.”

To achiever her “freaky” appearance, Jocelyn is rumored to have spent in the neighborhood of $4 million on brow lift, blepharoplasty (eyelid surgery), fat grafting and/or cheek implants, a facelift, lip injections in the form of Collagen, and chin augmentation. Now, she is rumored to be undergoing reconstructive plastic surgery (See Make Me Heal’s story on Jocelyn Wildenstein’s plastic surgery).

Although she hasn’t reached Catwoman status yet, Courtney’s decision to cease having plastic surgery seems like a good idea, considering all the botched procedures she’s had in the past (See Make Me Heal’s story on Courtney Love’s plastic surgery).

Plastic surgeon Dr John Di Saia has another theory on Courtney’s intention to stay away from plastic surgery, saying, “She has had her share and I also hear she’s out of cash. Good for two reasons.”

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “Courtney Love has made a wise decision to avoid altering her appearance further. She had some work done in the past, and would not benefit from further procedures. Courtney appears satisfied, and as long as she is comfortable that is what matters.”

While Make Me Heal is glad that Courtney is done with the knife for now, it is likely that once Jocelyn’s image fades from her memory, her zeal for plastic surgery will return, as it has before.

Read the complete plastic surgery profile of Courtney Love on Plasticopedia, the largest online celebrity plastic surgery encyclopedia.

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Are Arnold Schwarzenegger and Maria Shriver Wedded to Plastic Surgery?

Posted on November 4th, 2009 in Celebrity Plastic Surgery, Male Plastic Surgery by Lisa Stern

At 62, Arnold Schwarzenegger has already lived several lifetimes, first as a bodybuilder, then as an action hero and now as a political giant. In each incarnation, his success has depended on his looks, so it’s no small wonder that he has always face rumors of plastic surgery, now more than ever.

Rumors of Arnold’s under the knife adventures include chin and cheek implants and more recently, a face and necklift as well as injectables like Botox.

Arnold Schwarzenegger, Plastic Surgery

Plastic surgeon Dr. Richard Ellenbogen says, “Arnold Schwarzenegger is a 62 year old man. Now, honestly do 62 year old men look as good as him? He’s juiced with steroids and has had two heart operations. We hate to out manly men like Arnold, but his face is tight,his skin is not wrinkled, his jawline is anything but saggy. Duh! If it quacks like a duck and walks like a duck, it is a facelift, chin adjustment, necklift and probably a laundry list of injectables and other procedures…he looks great. Congrats to his plastic surgeon.”

As full and healthy looking as Arnold is, his wife, 54-year old Maria Shriver, is anything but. Almost scarily too thin, Maria looks like she is in need of some fat grafting to her face, in addition to the Botox injections she likely uses to smooth out her forehead.

maria Shriver, Plastic Surgery

Dr Ellenbogen says, “Maria Shriver appears to have not had any major plastic surgery procedures. She may have had some injectables. Her face appears to have deflated from loss of fat. She would look great with facial fat grating, a simple procedure where her own fat is extracted from her waist and injected into her face. The down time is much less magnitude than a facelift. Fat grafting can be combined with a facelift for a very rejuvenated look when performed by an expert.”

On the other hand, both Arnold and Maria may be aging naturally and are just blessed with good bone structure. However, they may have occasional Botox injections to keep them looking good.

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “Arnold and Maria are aging nicely, and I do not see the possibility of any major work having been done. Maria may have had some Botox in her forehead, but overall her look is natural. She may benefit from fillers around her face to even out some of her natural lines. Arnold may have had a bit of Botox in the forehead as well, but that is about it. Speculations that he had the appearance of his chin altered through genioplasty are very unlikely. Arnold has a strong profile, and his genetics are responsible for his facial features looking strong at his age.”

Manhattan plastic surgeon Dr Jennifer Walden says, “Maria is blessed with great genes and beautiful bone structure. I feel she has always maintained a fairly natural, conservative look. It is possible Ms. Shriver has had injectibles to keep her face free of wrinkles. There have been many rumors that Arnold went under the knife for a chin implant and possible face lift, but it appears that as he let up on the weight training and body building most of his “bulk” in his neck and face dissipated. I think it is a combination of slimming down and aging that contributes to his face changing over the years. I wouldn’t be surprised however if he did use Botox as well as other injectables.”

Whether or not California’s first couple has been under the knife or not, Arnold won’t be reprising his role as “Governator” come the next election.

Read the complete plastic surgery profile of Arnold Schwarzenegger on Plasticopedia and Maria Shriver on Plasticopedia, the largest celebrity plastic surgery encyclopedia.

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More Plastic Surgery for the Girls of The Hills?

Posted on November 4th, 2009 in Celebrity Plastic Surgery by Jet H. Ross

The new season of The Hills may be missing Lauren Conrad, but it sure isn’t missing any drama, or rumors of plastic surgery.

Spencer Pratt, king of reality show controversy recently Twittered a hint that Whitney Port, who now has her own spinoff, The City, had a rhinoplasty before she became a reality show star.

While there seem to be no photos to prove Spencer’s nose job theory, it does seem likely given the narrow appearance of Whitney’s current nose.

Whitney Port, Plastic Surgery

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “It is possible that Whitney Port had some work done to her nose at some point in her life. It appears a little bit narrow, which is more evident down by her tip. She looks great regardless, and any surgery that may have been performed on her nose at the time was not overdone.”

Plastic surgeon Dr Sherrell J Aston says, “Comparison of much earlier photographs of Ms. Port reveal that she now has a nose that is thinner in the tip, narrow through the middle and shorter. These changes can only occur with a Rhinoplasty.”

Previous rumors of Whitney’s plastic surgery include rumor of a breast augmentation (See Make Me Heal’s story on Whitney Port’s breast augmentation).

The Hills’ brunette beauty, Audrina Partridge, has also been the subject of numerous plastic surgery rumors, all of which she has denied, except for an investment in breast implants. (See Make Me Heal’s story on Audrina Partridge’s plastic surgery).

Audrina, Plastic Surgery

While Audrina has attributed the changes in her appearance to losing her baby fat, her altered appearance may in fact be due to a nose job.

Manhattan plastic surgeon Dr David Shafer says, “Audrina’s nose does look a bit more refined in the latest photos, but it is hard to tell if she had surgery or not.”

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “In more recent pictures, Audrina Patridge’s nose looks like it is a nicer shape for her face. The tip appears a bit more filled out, and suits her profile better. It’s possible she had a little bit of work done. It was originally very narrow in the middle of the bridge, and some cartilage may have been used to widen it. I think the final result looks great, and her surgeon did an excellent job.”

Whether or not the girls have had nose jobs, they have certainly blossomed into beautiful young women and it is not Spencer Pratt’s place to share their plastic surgery secrets.

Read the complete plastic surgery profile of Audrina Partridge on Plasticopedia and Whitney Port on Plasticopedia, the largest online celebrity plastic surgery encyclopedia.

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Is Plastic Surgery Disaster Jocelyn Wildenstein Looking Less Feline?

Posted on November 3rd, 2009 in Awful/Bad Plastic Surgery, Celebrity Plastic Surgery by Erica Hurtz

Socialite Jocelyn Wildenstein is a cautionary tale of bad plastic surgery, using the knife to transform her appearance. But lately she has been looking slightly less bizarre, leading Make Me Heal to wonder if she has had some revision plastic surgery.

69-year old Jocelyn is rumored to have spent around $4million in an effort to make herself into a “Catwoman,” and thus more pleasing to her former husband, a big game cat lover. Her drastic cosmetic procedures have made her a tabloid favorite over the years, but recently many have begun to notice that Jocelyn’s appearance has tamed down some, which could be a result of a new round of cosmetic procedures designed to reverse the results of “Catwoman.”

Jocelyn Wildenstein, Plastic Surgery

Plastic surgeon Dr. Richard Ellenbogen says, “Whoever redid Ms. Wildenstein is a genius. I can’t think of a harder reconstruction. I’m sure the doctors who did the face transplants didn’t work as hard I have redone her face over and over in my mind over the years…good job colleague.”

To reverse Jocelyn’s drastic procedures, plastic surgeons would have to work very hard to lower Jocelyn’s preternaturally raised brows and very full face.

Manhattan plastic surgeon Dr David Shafer says, “Jocelyn Wildenstein’s brows are back in normal position, her cheeks are smaller in size and her lips are starting to look normal. Whatever she did works. She has a way to go, but she is headed in the right direction.”

Jocelyn’s previous plastic surgery procedures likely include brow lift, blepharoplasty (eyelid surgery), fat grafting and/or cheek implants, a facelift, lip injections in the form of Collagen, and chin augmentation.

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “Jocelyn Wildenstein appears to look a bit different from photos taken a year ago. Her facial features look a bit more natural than they once were. There is a possible reversal of a browlift to lower eyebrows and the corners of her eyes may have been dropped. Regarding her less full face, on a rare occasion, fat can be removed. And if it was injectable silicone, the silicone can be excised but this happens on very rare occasions as well.”

Whatever the reason for Jocelyn’s change of face, whether it’s years of tabloid ridicule, or her new man, Make Me Heal is glad the Jocelyn seems to be restoring herself to her former glory.

Read the complete plastic surgery profile of Jocelyn Wildenstein on Plasticopedia, the largest online celebrity plastic surgery encyclopedia.

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Did Gary Shandling Have some Funny Plastic Surgery?

Posted on November 3rd, 2009 in Celebrity Plastic Surgery, Male Plastic Surgery by Dana Jackson

Funny man Gary Shandling hasn’t been in the limelight lately, but Make Me Heal suspects he has been spending his time off from entertainment getting plastic surgery.

Turning 60 at the end of the month, Gary has begun to look his age and has likely turned to plastic surgery to keep him camera ready for his appearance in the Iron Man sequel, due out next year. Gary’s plastic surgery seems obvious to Make Me Heal, because his neck and face no longer match.

Garry Shandling, Plastic Surgery

Gary may have had cosmetic surgery on his neck, as either liposuction or a necklift.

Manhattan plastic surgeon Dr David Shafer says, “Obviously something is different with Gary Shandling’s neck from the before and after photos. Whether he had liposuction of the neck or a neck lift is unclear.”

The other reason his neck appears to be a different age from his face is that his face has gone through plastic surgery, but the doctor failed to make his neck match. As a result, his face appears smooth, while his neck remains wrinkled.

Plastic surgeon Dr. Richard Ellenbogen says, “Gary Shandling looks bloated. His neck is so fat, either his plastic surgeon didn’t know how to do necks, or he simply went to some injectables-crazy dermatologist who never looked below his jawline. Plastic surgery is a balance of all parts of the face. If they all fit, nobody knows. Gary Shandling doesn’t match.”

It seems likely that Gary has used injectables in his face, likely both Botox and fillers such as Juvederm or Restylane.

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “Gary Shandling may have had some Botox in his face and forehead, as lines that were once present are no longer there. Other than that, I do not believe he had anything else performed.”

Hopefully Gary’s sense of humor hasn’t changed along with his appearance and Make Me Heal looks forward to seeing what he does next.

Read the complete plastic surgery profile of Gary Shandling on Plasticopedia, the largest celebrity plastic surgery encyclopedia.

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Did Tyra Banks Have Weight Loss Surgery?

Posted on November 2nd, 2009 in Black Plastic Surgery, Celebrity Plastic Surgery, Ethnic Plastic Surgery by Carrie Zender

Supermodel Tyra Banks notoriously told tabloids to kiss her fat a** when less than flattering pictures of her in a bathing suit appeared. Now the talk show host has stopped embracing her big, beautiful body and lost enough weight to slim down, although not to her former runway weight. Given Tyra’s history with the knife, Make Me Heal can’t help but wonder if weight loss surgery has been involved in Tyra’s dramatic transformation.

Tyra Banks, Plastic Surgery

At age 35, Tyra recently dropped from an estimated size 14-16 to a slimmer size 8. While supermodels are notorious for regularly gaining and losing weight in the name of fashion, Tyra has declared herself retired from modeling, so she may not be as adept at weight loss as she once was.

Plastic surgeon Dr. Richard Ellenbogen says, “Tyra Banks is a lot thinner. I’ll give her the benefit of the doubt that she did it by diet. Could be either way though…lipo or diet. Models notoriously gain and lose weight concominant with their relationships and work schedules. They’re actually masters at it and above all, Tyra is a model.”

Although Tyra has refuted rumors of a breast augmentation once and for all, she has been the subject of other plastic surgery rumors, including a likely nose job early in her career (See Make Me Heal’s story on Tyra Banks’ plastic surgery).

However, given Tyra’s recent passion for honesty and encouraging women to live a healthy lifestyle, Tyra could have lost the weight on her own.

Plastic surgeon Dr Sherrell J Aston says, “It is entirely conceivable that Tyra lost weight without any surgical procedures. One can do this with proper diet and exercise. Tyra looks great.”

Manhattan plastic surgeon Dr David Shafer says, “Tyra looks great in her latest photo shoot. However, there is not much skin showing. Often with significant weight loss, the skin loses its elasticity and its youthful appearance. I suspect that is why she is covered so much in these photos.”

Tyra’s shenanigans are always in the news, stirring up controversy and Make Heal looks forward to her next crazy stunt.

Read the complete plastic surgery profile of Tyra Banks on Plasticopedia, the largest online celebrity plastic surgery encyclopedia.

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George Clooney Eyelid Plastic Surgery Rumors Return

Posted on October 30th, 2009 in Celebrity Plastic Surgery, Male Plastic Surgery by Jet H. Ross

George Clooney is well known prankster in Hollywood, and his latest jokes have gone public, with George playing around with whether or not he’s had plastic surgery. Make Me Heal thinks the latest rumors could be true, as the gray-haired fox himself didn’t start them.

George Clooney, Plastic Surgery

A few years ago, George scammed his fans when he told Julia Roberts he’d had his done (See Make Me Heal’ story on George Clooney’s eyelid surgery). Then the now 48-year stud took back his comments, saying that they were nothing but a joke (See Make Me Heal’s story on George Clooney’s plastic surgery).

However, it seems that the rumors of a blepharoplasty may have recently come true, as indicated by George’s rejuvenated-looking eyelids at a recent red carpet appearance.

Plastic surgeon Dr. Richard Ellenbogen says, “George Clooney appears in earlier pictures to have heavy upper eyelids and presently they appear deeper above. This doesn’t happen by chance, in my opinion. Things usually get worse, not better, as you get older. However, there may be some exceptions.”

For eyelid surgeries, scars are done on the inside of the lid, so there would be no obvious signs under the harsh lights of the photographers

Manhattan plastic surgeon Dr David Shafer says, “Looking at the before and after photos, there leaves little question that he had surgical intervention. Often eyelid surgery can be performed from inside the eyelid, so no scars are apparent. Now, just a little Botox Cosmetic and he will be all set.”

Dr. Paul S. Nassif, a facial plastic and reconstructive surgeon and a rhinoplasty specialist in Beverly Hills, California says, “It is possible that George Clooney had blepharoplasty. In older photos, you can see there is a bit of skin giving the eyes a slightly tired look. The skin is not as apparent in more recent photos. If he did have the surgery, his surgeon was conservative and did a really nice job in creating a subtle change.”

Whatever George has done, whether it is getting more sleep or getting a little plastic surgery, has left him looking like the Hollywood leading man he is.

Read the complete celebrity plastic surgery profile of George Clooney on Plasticopedia, the web’s largest celebrity plastic surgery encyclopedia.

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