What's New in Facelifts?
A facelift is still the procedure that is considered to provide the fullest rejuvenation to the face and neck. Facelifting has been around for decades during which time many changes and refinements have taken place. Such changes have involved incisions (placement, length), level at which the lifting is done (just skin, skin and deeper layers), types of sutures used (thread lifts), etc. This huge amount of information is often confusing and it is difficult to understand the differences from sources other than a plastic surgeon.
Let's start with the basics of what a facelift is. The conventional facelift procedure provides "lifting" of the neck and cheek tissues. This improves the jowls, looseness in the neck, and wrinkles caused by loose skin. The old-fashioned procedure was simply a skin pulling procedure. Most plastic surgeons no longer do a "just-skin" lift and now do procedures in which the deeper tissues of the face are also lifted. This provides more improvement in jowls and neck, but also tends to be longer lasting. Terms that are often used when referring to these techniques are: subperiosteal, deep-plane and SMAS lift.
As plastic surgery has evolved, a greater emphasis for minimally invasive procedures occurred. In facelifting, such changes have brought the development of procedures with smaller incisions, less surgery and quicker recovery. Two such procedures that have been heavily marketed and many people know about are the Thread Lift and the Lifestyle Lift. The Thread Lift is based on the use of special barbed sutures that are fed into the face through small incisions in the hairline. The skin is then pushed up and kept in place by the barbs. The skin initially bunches up and then supposedly smoothes over. Dr. Mast does not do this procedure after fully analyzing the technique and the results, including the absence of any significant research studies. It is our feeling that the results were very short-lived and many problems could occur with the sutures and the skin not completely smoothing out. This turned out to be true. The company that made the sutures has gone out of business due to these problems as well as the sutures breaking and inability to remove the sutures.
The Lifestyle lift is a bit of a mystery. This technique is a proprietary technique and only surgeons who pay the company that "owns" the technique can market it and use it. Almost no information regarding the technique can be obtained through standard medical literature. As best as we can tell, the technique is a skin only facelift with an incision confined to in front of the ear. The before and after photos seen on the various websites are not consistent with our experience on what is medically or surgically possible. Similar to the Thread Lift, there are no reputable studies in the medical literature.
The procedure that Dr. Mast uses for minimally invasive facelift is called the MACS Facelift. MACS stands for Minimal Access Cranial Suspension. This technique uses an incision which is about one half the length of a conventional facelift and is dependent on suspension sutures to pull up the deeper tissues and the overlying skin. This technique has been subjected to excellent research studies and has been published in the top Plastic Surgery journal. The procedure provides the same or nearly the same results as the conventional facelift in properly selected patients, while allowing quicker recovery with less risk for complications.
At Accent, safety is our number one priority. Using the MACS Facelift adheres to this ideal: it is a procedure that has been documented as an effective and safe technique, the results are long lasting and the use of the technique is not dependent on purchasing the rights or information to use it.
What's New with Breast Implants?
General Information
Breast implants are used for breast enlargement and also for breast reconstruction. About 15 years ago, implants filled with silicone gel were removed from general use in cosmetic breast enlargement due to concerns with their safety. They remained available for use in breast reconstruction during this time. The silicone gel-filled implants were still used in Europe and elsewhere in the world for cosmetic enhancement as well as reconstruction. While they were being used, information about the safety of the implants was collected and analyzed showing that the implants were very safe and did not cause any illnesses in women who had them. It also showed that if the implants leaked, the silicone gel did not get into the body and spread to glands and organs. Because of this very strong safety information, the United States FDA allowed silicone gel implants to be used in breast enlargement done cosmetically. This approval occurred in November 2006.
What's so good about silicone implants?
Implants are filled with saline solution (same fluid as an IV) or silicone gel. The silicone implants are softer and more natural feeling. This is most noticeable in woman with very small breasts, women with very thin skin, and women with very little breast tissue. A more natural look is also possible in these women since the silicone implants tend to have less waves or ripples. For women with denser breast tissue and thicker skin the differences may not be as big between saline filled and silicone-gel filled implants.
Are there any down-side aspects to silicone gel filled implants?
Two disadvantages about silicone gel implants are related to cost and leaking or rupture. The silicone implants cost more than saline implants so the overall costs for surgery with these implants are more than with saline implants. Saline and silicone gel implants leak or rupture at about the same rate, which is very small. If a saline implant leaks, the breast gets smaller, there is no pain and the body absorbs the saline fluid. Surgery is straight-forward to remove the implant and replace it with a new implant. If a silicone gel implant leaks, the gel is usually trapped by the thin scar capsule that is present around all implants. Over time, the capsule will usually get thicker and could lead to hardening of the breast, changes in the way the breast looks or to pain in the breast. The surgery to remove and replace the implant is a little more involved than with saline implants. However, even if the implant leaks, no overall health issues or illnesses will occur.
What's the bottom line?
Women now have the choice between using silicone gel implants and saline implants. With your plastic surgeon, each woman can now decide which implant type is best for her.
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Contact: (352) 271-5367 • 4340 Newberry Road, Suite 203, Gainesville, FL 32607 • questions@accentmd.com
