These implants were placed in the sub-glandular condition, which has a higher incidence of capsular contracture. I performed a change of plane and placed him in a partial submuscular position and supported the lower pole with GalaFLEX scaffold (P4HB). View this post on Instagram
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Before:
– Saline implants, dual-plane
– Breast and nipple-areolar ptosis
After:
– Removal and replacement of saline implants for Sientra 385cc moderate profile hsc+
– GalaSHAPE 3D ace
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Bruxism is a condition in which you grind, gnash or clench your teeth. If you have bruxism, you may unconsciously clench your teeth when you’re awake (awake bruxism) or clench or grind them during sleep (sleep bruxism). Mild bruxism may not require treatment. However, in some people, bruxism can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems.View this post on Instagram
Sagging breasts can be disappointing and conspicuously small breasts can feel inadequate. Clothes that fit neatly at the shoulders and waist but appear too large at the bust line can be awkward. But you don’t have to be self-conscious when you wear swimsuits or form-fitting tops. You can achieve your desired breast size through the medical procedure known as breast augmentation
Read more about Breast Augmentation
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Another important technique to point out from the case that we’ve recently posted about(please see our grid @dreffiepolitis ), is the use of Galaflex Ravioli construct.
The GalaFLEX Scaffold (Galatea Surgical, Inc., Lexington, MA) for plastic and reconstructive surgery belongs to a new generation of products for soft tissue reinforcement made from poly-4-hydroxybutyrate (P4HB).
It is comprised of high-strength, resorbable P4HB monofilament fibers. It is a knitted macroporous scaffold intended to elevate, reinforce, and repair soft tissue. The scaffold acts as a lattice for new tissue growth, which is rapidly vascularized and becomes fully integrated with adjacent tissue as the fibers resorb.
The “ravioli” technique involves using 2 pieces of extra thick ADM to completely wrap the TE/implant. The 2 pieces of ADM are cut to the size of the TE/implant with 1 piece covering the anterior and the other covering the posterior surface of the TE/implant.
Acellular dermal matrix (ADM) is a soft connective tissue graft generated by a decellularization process that preserves the intact extracellular skin matrix. Upon implantation, this structure serves as a scaffold for donor-side cells to facilitate subsequent incorporation and revascularization. In breast reconstruction, ADM is used mainly for lower pole coverage and the shaping of a new breast. It helps control the positioning of the implant in the inframammary fold, and prevents the formation of contractile pseudocapsule around the breast implant.
The “ravioli” construct is something Dr. Stephen Sigalov came up with which involves performing a 360 degree wrap of the implant with Galaflex to stabilize the implant in the breast pocket given the normal landmarks are obliterated with the mastectomy. The Galaflex or P4HB totally resorbs (turns in CO2 and H20) in 18-24 months and is replaced by the patients own Type 1 collagen to provide long lasting implant support. Type 1 collagen is the strongest collagen in the body. This prevents issues such as stretch, bottoming out, malposition, implant flipping etc.
Bothered by creases between your eyes? Or by the “angry” look your face has turned into? You can smooth out the troublesome area between your eyes and eliminate wrinkles on your forehead and around your eyes through facial rejuvenation using the neurotoxin called Botox. The use of Botox has revolutionized facial rejuvenation as injections can be safely and rapidly delivered to wipe out wrinkles without surgery.
Botox is a special, non-harmful neurotoxin (neuro-modulator) used to temporarily paralyze the small facial muscles that contribute to wrinkle formation. The primary ingredient is the extract of botulinum protein derived from the bacterium, Clostridium botulinum.
Botox is just one of the brands of neurotoxins used in facial rejuvenation—the other brands approved by the FDA are Dysport and Xeomin. All the brands work in the same way by targeting specific muscles to make them more rejuvenated.
Interestingly, Botox can be used for both upper and lower face rejuvenation. For the upper face, Botox is approved for injection into the Glabella (frown) lines and the lateral orbital lines (Crow’s feet). The Glabella lines are found between the eyebrows, and tend to give a tired angry appearance. In the lower face, Botox helps address corners of the mouth and flattened upper lips.
Botox has been a success in another area as well: patients with gummy smile. The neurotoxin is injected deeper into the muscles under the nose, leading to relaxation of these muscles and elimination of the smile. While this treatment is a little more invasive, it offers good outcomes.
You may see a doctor for Botox injection when:
The ideal candidates for Botox are people of all ages, who are generally healthy, and very transparent with their providers to avoid any possible complications.
When talking to your plastic surgeon, be open and honest about:
What patients seem to like about Botox is that there is no downtime. It is done in the doctor’s office and takes 5-15 minutes. Using a micro-needle, a small amount of the neurotoxin is injected into the specific facial muscles responsible for the creation of facial lines and wrinkles. The pain associated with the injection is minimal and short-lasting.
The most commonly targeted areas are the forehead and outer eye area, with 1-3 injections delivered to every muscle. Once in the muscle, the neuro-modulator causes relaxation and allows the skin to remodel and the lines to fade over time. With proper injection of adequate quantities of the neurotoxin, anatomic structures such as eyebrows get delicately shaped to achieve improved appearance.
Although Botox is a minimally invasive procedure, it should still be done by a skilled, experienced board-certified surgeon such as Dr. Effie Politis. Working with a plastic surgeon who frequently administers neuro-modulators will help you achieve your treatment goals and expectations.
At Politis Plastic Surgery, each and every patient is treated by Dr, Politis because her knowledge of facial anatomy and broad experience give her the ability to customize treatment that suits the needs of a patient. Doing so also enables her to provide patients with the safety and precision necessary for remarkable results. Rest assured that Botox and the other neuro-modulators on the market are all FDA approved, safe and have been used for years for other medical conditions.
Following Botox injection, you will notice the fine lines and superficial wrinkles disappear or decrease altogether within a couple of days. Results are apparent in 1-2 weeks and last 3-4 months after a single treatment. The neurotoxin also reduces signs of aging and premature wrinkles.
When the effects start to wear off, you can return for a re-injection. You can have your re-injections done every 6 months, but 4 months is better.
In summary, for a successful Botox therapy:
If you have additional questions and concerns about Botox, schedule a consultation with Dr. Effie Politis at (813) 542-2587. For more information about facial rejuvenation procedures, visit the Politis Plastic Surgery website.
You need some sun exposure. We all do. When your skin is exposed to the sun, your body is able to make Vitamin D, which in turn helps with calcium absorption for stronger and healthier bones. But it only takes a short amount of time in the sun to make the Vitamin D you need, and too much exposure can be dangerous. In fact, excessive unprotected exposure to the sun’s ultraviolet (UV) rays can cause skin damage, immune system suppression, eye damage and skin cancer.
Skin cancer is the most common cancer in the United States. One in five Americans will develop skin cancer before reaching 70 years of age. According to the Skin Cancer Foundation, every year almost 7,000 people die of melanoma, the most severe form of skin cancer. Up to 90-percent of melanomas are related to UV exposure–specifically with severe sunburns–and are therefore highly preventable. Fortunately, daily sunscreen use is effective in preventing sunburns and skin cancer.
A lot of unprotected overexposure to the sun occurs during childhood and teenage years. Because skin cancer is associated with cumulative UV exposure and sunburns early in life, the lack of protective behavior among teens is a major contributing factor to the cancer. For many teens, skin tanning is perceived as attractive and future problems such as skin atrophy and melanoma are seen as quite far away, encouraging unhealthy sunbathing behavior. Tanning damages skin cells, speeds up visible signs of aging and may lead to skin cancer, even in people in their twenties.
Using a broad-spectrum sunscreen with an SPF of at least 30 can protect the skin against both UVA and UVB rays. Those who learn to apply generous amounts of sunscreen on their skin every day can prevent skin cancer. Sadly, only about 15% of teens apply sunscreen regularly, just roughly 26% perform skin self-exams, and more than 19% use artificial tanning products. Promoting sunscreen use among children and teens while discouraging risky behaviors is therefore an effective approach to preventing skin cancer.
Studies with adolescents and young adults indicate that appearance-based interventions are more effective than classic health education approaches in encouraging regular sunscreen use and healthy skin behaviors. Among teens, self-perceived attractiveness has a strong influence on self-esteem and is the primary motivation for tanning. This is why appearance-based interventions are ideal for promoting positive skin behaviors among the young. In fact, appearance-based face-aging interventions have already provided better outcomes for young people in other areas, such as tobacco use prevention.
One such appearance-based intervention is the face-aging app. With these apps, teens are able to witness ultraviolet (UV) radiation-induced facial aging firsthand. Face-aging apps show the effects of UV on the skin in general and on skin cancer development in particular, thus creating photo-aged selfies with sagging skin, spots, wrinkle formation, and malignant skin lesions.
The apps work by having the users take front-facing close-up pictures of their faces and then selecting skin tones from graded options. Users can then see simulated images of how they would look after being aged 5, 10, 15, 20 or 25 years into the future based on skin type. The users are also able to see how the images would differ if they used or did not use sun protection or underwent weekly tanning.
The simulated images give users varying degrees of wrinkles, spots, discoloration, loss of volume, age, as well as showing pre-cancerous and cancerous spots on the face. These face-aging apps include a feature that indicates how skin cancer risks increase with different skin practices and while providing useful information about sun protection.
Snapping selfies (self-taken photos) and using filters to modify them is a popular teen activity. App-based interventions engage teens with familiar technology and show them how their faces can age due to excessive exposure to ultraviolet light from the sun or from tanning beds.
And while UV photography can be effective in monitoring sun damage, it is very expensive. This makes a free mobile face-aging app—available in Google Play, Apple’s App Store or other platforms—a cost-effective alternative and a fun intervention for skin-protection strategies.
Face-aging apps have been proven effective in changing habits to reduce UV exposure in children and adolescents. According to a JAMA Dermatology study conducted by a multinational team of researchers to assess the potential benefits of apps as educational tools (among nearly 1,600 students in grades 9 through 12 in southeastern Brazil) the results were remarkable. For example, students shown how to use a freely available mobile face-aging app had a daily use of sunscreen increase from 15% to 23%.
The study also demonstrated that overall use of sunscreen increased by roughly 50% among teens who used the app. It helped to achieve almost double the percentage of teens who performed at least one skin self-exam, while also reducing youth engagement in other risky skin behaviors.
A plastic surgeon can help you and your loved ones improve your skin care routine and prevent skin problems. Plastic surgeons such as Dr. Effie Politis are increasingly integrating new technologies in their practice to boost positive outcomes. Tools such as face-aging apps are being embraced by physicians to educate patients about sun exposure, preventing skin problems and reducing the risk of skin cancer.
If you have questions about your skin, skin care and encouraging healthy skin behavior, speak with Dr. Effie Politis for expert guidance. For more information on plastic surgery and appearance enhancing services, visit the Politis Plastic Surgery website.
The eyes are the windows of the soul. But with age, eyelids stretch and the muscles supporting them weaken. In my practice, I often meet patients who come in for face rejuvenation that involves the eyes.
Drooping lids and bags under the eyes make the face appear tired, angry or sad. Apart from making you look older, sagging skin around your eyes can reduce your side vision (peripheral vision), particularly the upper and outer parts of your field of vision.
Blepharoplasty (eyelid surgery) is a popular procedure for both men and women. I mostly perform it on patients between the ages of 30 and 70 who have excess eyelid skin that causes a “tired” appearance. You are an ideal candidate for blepharoplasty if you are a healthy individual aged 30 years or older and have realistic expectations about eyelid surgery. Younger patients may undergo the procedure if they have a family history of baggy lower eyelids.
Before you can undergo blepharoplasty, you will need a consultation with a plastic surgeon. During the session, the surgeon will evaluate and discuss your expectations, goals and concerns. She will also take your medical history, examine your eyes and eyelids, and take you through the available surgical options, including their risks and complications.
Eyelid surgery is conducted on the upper or lower eyelids and involves an eyelid lift with selective fat removal. The surgery is performed under local or general anesthesia in an outpatient setting with no overnight hospital stay. The goal is to remove excess eyelid skin which can produce a “hooding” effect that may interfere with vision, address slight drooping of the eyelids, or treat bags and dark circles under the eyes.
With upper lid blepharoplasty, you can expect an incision just above your eyelashes, over the upper lid, and leaving a fold above the eye for an area to apply makeup. For the lower lids, the incision will be hidden underneath the eyelashes to provide a nice contour. The key to this surgery is being conservative and doing only what is necessary.
Although frequently done for aesthetic reasons, you can have the procedure for functional reasons. For instance, you might consider eyelid surgery if droopy eyelids are keeping your eyes from opening completely or pulling down your lower eyelids. Removing excess tissue in your upper eyelids can improve your vision and, at the same time, make your eyes look younger and more alert.
Blepharoplasty is for you if you have:
Eyelid surgery can performed at the same time as another procedure, such as face-lift, brow-lift or skin re-surfacing.
Blepharoplasty is generally well tolerated by patients. Successful operations done by an experienced plastic surgeon will enhance the appearance of the eye area, producing a more youthful and rested look. However, it is considered a major surgery, so you should think carefully about your specific expectations and goals.
Complications are rare, but after the operation you can expect some swelling and bruising that lasts about 2 to 6 weeks. An over-resection of the upper eyelid skin can result in dry eye symptoms if the eyes do not close correctly. In some cases, over-resection of the lower eyelid skin occurs, leading to ectropion, an inversion of the lower lid that causes irritation. Also, undergoing both upper and lower eyelid surgery can cause unwanted changes in the lateral corners of the eyes.
Blepharoplasty rejuvenates the upper and lower eyelids through the removal or repositioning of excess skin and fat. It gets rid of loose or sagging skin folds that create a heavy eyelid, eradicates excess fatty deposits, and eliminates the puffiness around the eyelids that create bags under the eyes. The final result is a more relaxed, refreshed and youthful appearance. When surgery is done for functional reasons, patients are usually able to see better when driving or reading at night.
You may schedule a consultation with me by calling (813) 542-2587. For more information on face rejuvenation, eyelid surgery and other plastic surgery procedures, visit the Politis Plastic Surgery website.
Do you find your breasts too small or have one that is smaller than the other? Would you like to reduce the size of your breasts after pregnancy? Do you want to correct uneven breasts after breast surgery for other conditions and to improve your self-confidence?
If so, then breast augmentation is a perfect procedure for you.
Also called augmentation mammoplasty, breast augmentation is a surgical procedure to increase the size, shape or fullness of the breasts. During the procedure, the surgeon makes an incision and places a silicone, saline or alternative composite breast implant under breast tissue or chest muscles. Fat from another part of the body may also be used—a procedure called fat transfer breast augmentation.
A breast implant is a medical prosthesis placed inside the breast to create, reconstruct or augment the physical form of the breast. There are three main types of breast implants used in breast augmentation.
1. Saline implants
These are implants filled with sterile saline solution. The salt solution is contained within an elastomer silicone shell. The amount of saline that your surgeon will allow in the elastomer depends on the goals of the surgery, including the firmness, shape or size to be achieved. If the saline implant leaks, the salt solution is absorbed and expelled naturally by your body.
2. Silicone gel-filled implants
These are implants made of a silicone outer shell and filled inside with a silicone gel. Again, the amount of silicone gel added into the silicone shell depends on the shape, size or firmness of breasts to be achieved. If a silicone-filled implant leaks, the gel either stays in the shell or escapes into the breast implant pocket. Since leaking silicone-filled implants may or may not collapse, you will need more regular checks with your doctor for this implant than if you choose saline-filled implants.
3. Alternative composite implants
Breast implants may also be filled with soy oil, polypropylene or other material. When choosing an alternative composite material, your plastic surgeon will consider whether you have adverse reactions or allergy to any of these materials. In the end, the material chosen should not cause problems if it leaks into your body.
When considering breast augmentation, you will first discuss your goals with your plastic surgeon. The goals should be realistic and informed by what the procedure can do. Your surgeon will also help you understand the possible risks, complications and follow-up care. A typical breast implant lasts 7-12 years on average.
Breast augmentation does not correct severely drooping breasts. Actually, drooping breasts require a different procedure called breast lifting. The breast lift can be performed along with breast augmentation to make your breasts both fuller and lifted, but it can also be a separate operation. Your plastic surgeon will guide you in making this decision.
You will start by choosing a surgeon to help you with the procedure. A skilled and experienced plastic surgeon such as Dr. Effie Politis will offer good advice and perform the procedure with a higher chance of success. So if you are considering the operation, speak with your plastic surgeon about it and be specific about your preferences for breast size, feel and appearance. Once you choose to have breast augmentation surgery, your plastic surgeon will help you choose the size and shape of implant you need by putting different sized implants into your bra to see how they fit and feel.
The surgeon will describe the specific types of implants that may be used—textured or smooth, round or shaped like a teardrop, saline or silicone—together with options for surgical techniques. It is your responsibility to review information provided to patients by the manufacturer of the implant. You will also need to keep copies of this information for your records.
Your plastic surgeon may recommend that you have a baseline mammogram before the surgery. If you are on certain medications, such as aspirin or other medications that increase bleeding, your doctor may adjust them. If you are a smoker, you will have to stop for a while before the procedure. Likewise, you should arrange for a friend or family member to drive you home after the surgery and even stay with you for a day.
This is a surgical procedure. A general anesthetic will be used so that you are asleep during the operation—though local anesthesia may also be used, which means you would be awake during the procedure.
The choice of incision depends on the type of implant, surgeon-patient preference, your anatomy, and how much enlargement is involved.
After making the incision, your plastic surgeon will insert the implant into a pocket.
To close the incisions, your plastic surgeon will apply layered sutures or stitches in your breast tissue. The stitches, surgical tape or skin adhesives will help to close the incisions and keep the skin closed. While the incision lines will be initially visible, they will fade in time. Swelling caused by the surgery will resolve within two weeks.
Soon after the surgery, the anesthetic will wear off and your surgeon will provide medicine to relieve the pain. The sutures are made of absorbable or dissolvable material and will disappear within 6 weeks. But if your sutures do not dissolve or if drainage tubes are placed near your breasts, you will need a follow-up appointment to remove them.
Your surgeon will also provide information on how to care for your breasts after the procedure, how to take prescribed medication, when to schedule a follow-up visit and when to call your doctor for help. You will be advised to seek immediate medical help should you experience any sign of infection, such as chest pains, shortness of breath, unusual heart beats, fever, warmth or redness in the breast area.
Your doctor will also advise you on what type of brea to wear and post-operative exercises, such as moving and flexing the arms to relieve discomfort and pain. You should not engage in strenuous physical activity for the first 6 weeks after the surgery.
Every surgical procedure has risks, including breast augmentation. Among patients who undergo breast reconstruction, 46% of those with silicone gel implants and 21% of those with saline implants typically require at least one additional surgery within 3 years. Likewise, 25% of women with silicone implants and 8% of those with saline implants change their mind and undergo surgery to remove the devices.
It is not uncommon for breast augmentation patients to have some kind of complication.
Breast augmentation is a great option for enhancing the size and shape of your breasts, improving your body image and boosting your self-confidence and self-esteem. At Politis Plastic Surgery, we offer the procedure to women who want to increase the fullness and projection of their breasts, enlarge small breasts, restore breast symmetry, reconstruct their breasts after mastectomy or injury, restore breast size and shape after breastfeeding, pregnancy or weight loss, and to boost their self-image and self-confidence.
If you are dissatisfied with the appearance of your breasts and considering breast augmentation, contact Dr. Effie Politis for a consultation. For more information on breast augmentation, visit the Politis Plastic Surgery website.
