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Cool Sculpting is great for contouring a focal spot or bulge.  It is not for weight loss.  The most common locations treated are the lower abdomen and flanks.  The procedure is noninvasive, takes about an hour and you can go back to work or even to the gym afterward.   An applicator draws tissue into a vacuum cup and freezes the fat cells.  Because fat freezes at a higher temperature than skin the fat cells die but the normal tissue is fine.  Your body’s lymphatic system then takes away the fat naturally.  You can expect a 20% reduction of fat in the area treated over the next 3 to 4 months.

Areas commonly treated are upper abdomen, lower abdomen and flanks.  During the month of May we offer a 50% discount on the second area.  For example, if you treat the flanks you can get the lower abdomen treatment at half price.

This is a common question.  The answer depends on what area of the face you would like to address.  Fillers vary in viscosity, their thickness or cohesiveness.   More viscous injectable fillers are generally placed deeper within the skin in areas of less movement and tend to last longer.  Less viscous fillers can be placed within the dermis to treat wrinkles and in the lips to define or enhance lips.

One of the ways a face ages is volume loss. Radiesse is a highly viscose filler which can be placed in the cheeks to replace volume and diminish nasolabial folds and prejowl depressions around the mouth. Radiesse (calcium hydroxyl apatite) is the most viscous filler available in the US.   Because it holds its shape better it can also be used to smooth the profile of the nose and increase the projection of the chin.

Lips, on the other hand, are soft, mobile and kissable. You want a soft, smooth less viscous product like Juvederm (hyaluronic acid) for lips. Wrinkles around the lips and mouth are also better suited to juvederm ultra.

As you can imagine more than one filler may be needed to best address overall facial aging.  Fortunately we at Weniger Plastic Surgery offer every safe effective option available to treat your individual needs.

Question: My husband always looks mad.  Do men get botox?

Answer: Real men get botox.  In the industry we affectionately call it Brotox.  You could consider a gentle hint by giving him a gift certificate for Father’s Day or Birthday for 25 units of botox.  The 11 lines between the eyes that make us appear angry and usually require around 25 to 30 units.

Question: Are body lifts just for people who have lost a lot of weight. I have not lost weight, but the skin on my thighs, abdomen, and buttocks tightening. I am 57 years old and from Hilton Head.

Answer: Your situation of laxity with just aging is very common especially in thinner people. I have to say that some of the best results I have ever had with body lifts are from healthy thin patients like yourself, and not with massive weight loss patients. That is because the skin is usually in better shape without the massive weight loss. So the answer to your question, I would give you an enthusiastic yes, because patients like you are often the very best patients to get excellent results after body lifts.

Question: What areas of the body respond best to liposuction?

Answer: The best areas for liposuction are areas where there are localized excesses of fat with underlying tight skin. Generally, some of the best areas are arms, thighs, and love handles. Liposuction of the tummy is quite popular, although if patients who have already had children and the skin is a bit loose, liposuction can make things look worse as far as contour irregularities and laxity of the skin are concerned. Also, in the saddlebag areas, if there is loose skin, liposuction can make things flatter, but actually the skin can be more irregular.

Question: What options are available for reconstruction after mastectomy?

Answer: Well, there are multiple volumes of books written on this subject. In general, reconstructions are either done with your own tissue, most commonly tissue from the tummy, or with implants. Sometimes, the implants require some soft tissue coverage also, such as with the muscle from the back. So in general, I see most reconstructions as either being tissue based or implant based. These days though, there is a third type of breast reconstruction which is done with fat grafting. Of course, this is a tissue based option also, but it is a much smaller operation, although it usually requires multiple operations, which can be done in an outpatient setting.

Question: I am interested in decreasing the size of my breasts. What sort of results could I expect if I opt for liposuction alone versus breast reduction surgery?

Answer: Liposuction of the breasts can be a reasonable option for very young patients. As patients get older, there are not just problems with size of the breast, but often times droopiness and loose skin. If this is the case, then if you are unhappy with your nipples being low, liposuction would certainly not help as it could make it worse. On the other hand, if you are very young and the breasts are large, but still very perky, liposuction can be an option, although of course this still deflates the breast.

Question: I suffer from rosacea and had severe scarring of acne. Will dermabrasion be a good solution?

Answer: One of the problems with rosacea is that in my experience it makes the skin more reactive and causes much more prolonged redness after any treatments on the skin. Nonetheless, dermabrasion could be used for acne scarring. I myself never used dermabrasion because in my mind, this has been replaced by fractional resurfacing for scarring, which is now really the standard of care.

Question: What sort of skin conditions are chemical peels used to treat?

Answer: Chemical peels are usually used to treat mild crepiness or mild wrinkles on the face. They are probably not the best treatment for deep wrinkles such as those around the lips, but are quite good at giving a fresher, more uniform, and smoother appearance to the face overall.

Question: I have scheduled my facelift and now have a very important special engagement that will take place three weeks afterwards. What will I look like by then? Will people be able to tell if I had surgery?

Answer: Usually, two to three weeks after surgery, bruising is gone, but there is still a little bit of swelling. It is the kind of thing that can be easily covered up with makeup in most cases. I think three weeks is reasonably safe time after surgery, but then again, it depends exactly what is being done in the surgery. Personally, I have noticed that with aggressive fat grafting around the eyes, and with cheek lifts, swelling persists longer than with other procedures.

Question: I have very nondescript cheekbones. Can cheek implants help?

Answer: Cheek implants definitely are great way to give better structure over the cheek area. This can be laid under the eyes, close to the eyelids, or farther out to the sides. There are many types of cheek implants with different effects, and these implants can help many cosmetic problems, and are relatively easy to put in place.

Question: I hate my breasts. My husband says that I am obsessed with breasts, but I am just obsessed with mine and I always compare mine to others. My breasts hang and they are quite terrible. I am interested in a breast lift. Can I get breast augmentation at the same time?

Answer: Yes, having breast implants and the breast lift at the same time is very common, and probably a third of the augments that we do involve lifts at the same time.

Question: Is it true that having breast implants can affect your insurance coverage, for instance with premium increases, denials with breast related problems, etc.?

Answer: Well, certainly I am not an insurance expert and definitely you would never work for an insurance company, but in my experience, the worst that I have seen is an exclusion for problems related to the cosmetic breast implants themselves and again, no health insurance covers complications of cosmetic surgery, so I would say that these exclusions are not really any different from what we would expect, and that health insurance does not pay for complications of cosmetic surgery.

Question: I had a mastectomy 14 years ago.  I did not opt for breast reconstruction at that time.  What would be involved if I want to choose breast reconstruction now?

Answer: You really just need to come into the office, so that we can understand what the defect looks like, and I need to know if radiation was performed.  We also need to know if the pectoralis major muscle is still intact, and make sure that the nerve supply is okay.  We also want to look at the scarring.

There are certainly some types of reconstructions that would be available, but whether your own tissue or an implant and tissue expander would be better, or even fat grafting would be better, I just cannot say for sure.  So, we would need to see you in consult.

Question: My breasts are about two cup sizes different.  Is it possible to get a breast reduction in just the larger breast?  Will health insurance cover this?

Answer: I really do not know if health insurance would cover it.  I would say that they probably would in a younger patient because they would consider it a deformity, but I have never run into this situation for only reducing one breast.  I certainly have done this in the case of breast cancer reconstructions doing a reduction of one side for symmetry and I would say most reductions or lifts take off a different amount on both sides, but I am afraid I just cannot answer your insurance question.  The best thing is to ask your insurance company.  It certainly is possible to do the surgery on one side technically, but the insurance question is really a question for the insurance company.  Sorry, I cannot be of more help on this one.

Question: I would like to have a breast lift with augmentation.  Do you put implants underneath the muscle?  How long does this procedure usually take?

Answer: It is 2013, so really all implants should be below the muscle now.  This has to do with visibility, palpability, rippling and capsular contracture rates.  An augment with a lift definitely takes longer than an augment, but it really depends, which type of lift.  Sometimes the scar is just around the areola, sometimes it is more of a lollipop type scar, and sometimes it is a horizontal incision along the inframammary fold.  Breast augmentations with lift usually takes somewhere from two to three hours where as a breast augment itself takes less than an hour.

Question: I am from Hilton Head and I have never been diagnosed with this, but I think I have tuberous breasts because mine developed into weird shape.  Can this be improved with implants?

Answer: I have never really seen a statistic for the prevalence of tuberous breasts, but I think it is incredibly common, and there are many girls walking around with tuberous breasts, i.e. constricted lower pole deformities than we think.  I have never really done the statistics, but I would bet that probably 10% of my patients have at least some mild form of tuberous breast deformity.  This certainly can be improved with implants, although it takes a particular type of muscle dissection to really improve it without a lift.  In the more severe cases, a lift with a scar around the areola is really required to give a good shape.

I am excited to tell you that this problem cannot only be improved with implants, but can be completely corrected into turning some very unusual breasts into really fantastic breasts, not just acceptable breasts.

Question: I heard that the body lift is really like a combination of procedures like the tummy tuck, liposuction and the thigh lift and that it can be performed all at once or in stages.  Will it be safer to perform it in stages?

Answer: There is an advantage to shorter surgeries, but if you consider that the more dangerous parts of anesthesia are going to sleep and waking up, then there is probably an advantage also to one larger surgery.  Of course, with a larger surgery, there is a larger recovery, and more risk related to the individual procedure.  I do think though that if someone who is going to have an around the world/circumferential abdominoplasty/lower body lift, that this is best performed in one stage and would be the preference.  I do think it is more recovery, more anesthetic time, probably more risk, although this has never been proven, and definitely more expense to do it in stages.

Question: What are the instances when you can have a short scar rather than one from hip bone to hip bone from abdominoplasty?

Answer: The patients who are good candidates for short scars, i.e. mini abdominoplasties are those without much loose skin.  These are patients who might have a belly button hernia fixed or muscles tightened and some liposuction, but really do not have any hanging skin.  If there is any excess of skin, the scar and the size of the surgery has to be big enough to get rid of the loose skin, or else it is not really worth having the procedure.

Question: Do chemical peels require anesthesia?

Answer: It really depends on the strength of the chemical peel.  For very strong peels like strong PCA peels or Phenol peels, anesthesia would be required.  I personally do not do these in my practice anymore.  All the chemical peels that we do are actually pretty light, because when it comes to aggressive skin resurfacing, I feel that the control over depth that I have with laser resurfacing is very important in regards to the safety of the procedure.

Question: Are injectable fillers effective in treating scars?

Answer: There are a few isolated circumstances in which I do like fillers, either fat or fillers off the shelf.  This is when the scar is atrophic, meaning that there is a depression to the scar.  This can sometimes make the scar more obvious because of shadows that are caused by the depression.  In this case, a filler just under the surface of the skin can be even more effective than surgery.

Question: Are there general things that Hispanic patients want changed about their nose with rhinoplasty?

Answer: I would not say that there is any general thing that Hispanic patients want, because I do think there are different noses from different Latin countries.  I have had patients with narrow tall noses who want dorsal humps taken down.  I would say more commonly as I have seen patients with very flat noses with wide alas that want their dorsum to be brought up and a more chiseled appearance.  I would say that a lot of patients have wider nostrils, but I really cannot say that there is any one ethnic nose that correlates to all Hispanic patients.

Question: What is the average age of your facelift patients?  Do you think 40 is on the young side to be considering a facelift?

Answer: The average age in my practice is probably a bit older than normal and is in the late 60s, probably right around 68 or 69.  We have done patients from the 30s all the way up to 82.  It is really patient’s health that is more important than their age.

I do not really think 40 is on the young side to be considering a facelift, but I do think the type of procedure might be very different from what is needed on an older person, and you certainly need to have your situation considered very specifically.  I also think that you might be a good candidate for a mini facelift without having seen you yet.

Brazilian butt lifts are one of the most rapidly growing operations in plastic surgery.  Over the last two or three years, our practice has seen a large increase in the interest in Brazilian butt lift.  This is due largely to media attention of the procedure, and also pop culture interest in some celebrities with more exaggerated body contours.

The Brazilian butt lift is simply a procedure of adding volume to the buttocks.  This is done by grafting fat from other areas of the body into the buttocks where the cells would live and contribute to the size and shape.  In this procedure, fat is harvested from another area of the body, which is most commonly the waist including love handles and abdomen.  If the love handles or back rolls or abdomen do not provide enough fat for the volume desired, we can also perform liposuction in other areas such as the inner thighs, which are also quite popular.  Technically, the fat could be removed from anywhere where the patient desires to have volume reduction.  Often times, the Brazilian butt lift is combined with the tummy tuck as well, to give the ultimate improvement in contour.

What is really desired by most patients is the smaller waist and a fuller higher more projected buttocks.  In this way, patients can have a narrower waist and wider hips.  Often times, patients do desire very exaggerated proportions, although this is often limited by the patient’s own skeletal structure, because the limiting bony foundations cannot be moved.

Brazilian butt lifts are done as an outpatient operation, and usually take only approximately 2.5 to 3 hours.  The recoveries are quite straightforward, in that the patient should avoid lying or siting on the buttocks for approximately a month.  This is achieved by sitting with pads under the thighs so the buttocks itself is not touching the chair.

The common range of fat grafting amounts are usually between about 500 mL to 600 mL per side up to about 1200 mL per side.  Generally, any more than that put in one side of the buttock will not fit well, and therefore the fat will probably not survive the transfer, so it is not probably not beneficial to use anymore of fat than that at one time, and it probably does increase the rate of possible complications.  Often times though, the amount of fat that is transferred is really limited by the amount of fat that the patient has in other areas available for transfer.

Overall, Brazilian butt lift patients are some of our happiest patients because the change in contour is so immediate and dramatic, and the patients usually have a good understanding of exactly what they are asking for and it is often easier to deliver the expected result with this operation than with other operations.  Especially combined with the tummy tuck, a Brazilian butt lift can really be a home run and can be incredibly satisfying for the patient.

Bikini season is just around the corner.  Are you ready?

Now is the time to treat ugly varicose veins and spider veins if you want to be ready for spring.  The length of time needed for complete resolution of the vein depends on the type of treatment.  Generally the bigger the vein the longer you will need.  The best treatment depends on the size of the vein.  At Weniger Plastic surgery offer all treatment modalities.  Laser or radio frequency for fine less than 1 millimeter veins, sclerotherapy for veins less than 3 mm, foam sclerotherapy for larger varicosities and VNUS closure for symptomatic greater and lesser saphenous systems.   Call today for a free consultation to see what treatment will work best for you!

My toe nails are deformed.  Is there anything I can do about it?  Nail polish just doesn’t cover it.

There are several different options for the treatment of Onychomycosis or nail fungus.  The appearance is thickened yellow nails most frequently affecting the big toe.  All treatments take some patience because the nail itself must regrow before it looks normal again.  The over the counter treatments usually do not work because it is hard to penetrate the nail and consistently use the product.  Oral prescriptions meds work better but require liver function testing and abstaining from alcohol for at least 12 weeks.  Even with strict compliance the efficacy is around 70%, meaning in3 out of 10 people it does not work.

Last year the FDA approved laser treatment for nail fungus.  It works by heating and thereby killing the fungus.  Usually one treatment is enough.  The nail is reevaluated after 3 months.  At that time, if the nail is growing out normal no further treatment is advised.  If not a 2^nd treatment can be done.   The cost for over the counter treatments are around 30 dollars Oral medications and labs around 1000 dollars cash.  This is sometimes covered by insurance.  The charge for laser is 500 dollars for the 1^st treatment and if further treatments are required the charge is 100 dollars.

The absolute best treatment for vertical lines around the mouth is by far laser resurfacing.  The trade off with fantastic results is down time.  To “erase” lip lines with laser requires for most people at least 10 days before you are ready out without needing to explain “what happened. “If you don’t have down time there are other good options.  Retin A applied nightly is the corner stone for all wrinkle care and prevention.  In addition tissue growth factors like TNS cerimide by Skin Medica smooth and feed your lips.  Lastly, perfect for Valentines are lip fillers in the hyaluronic acid family like Juvaderm  and Restylane .  Returning your lips to their natural volume plumps the lips as well as the lines.  This month at Weniger Plastic Surgery with any lip filler you may receive a free facial!

Is Your Botox Made In America?

Recently, the FDA has urged physicians across the U.S. to use Botox bought only in the U.S. In fact, hundreds of surgeons received letters from the FDA demanding that they cease use of all Botox and similar products obtained from foreign sources. This has become something of an epidemic in recent months and it’s important that patients be warned as well. Both physicians and patients alike are routinely bombarded with advertisements for discount deals on Botox and other injectables, many of which are from Canada, China and Mexico, and unheard of markdowns are being offered on sites like Groupon and Living Social.

Too Good To Be True?

As the old adage goes, “If it sounds too good to be true, it probably is.” These discount deals of unlicensed Botox and other injectables from foreign sources often equate to a compromised product that can compromise patient safety.  In some cases, products are being diluted which means that results will not be as optimal. Other times, the products may be ineffective or contaminated due to improper handling, shipment and storage.  And some products are even proving to be counterfeit.

Before allowing any syringe to be injected into your face, make sure that it is a safe, effective, full-strength product that has been properly manufactured, properly stored and remains uncontaminated. Ask your physician what it is, where it came from, and whether or not it’s FDA approved.  Licensed products should have appropriate safety labels that ensure both practitioner and patient are aware of the safe, appropriate use and handling of the product as well as the potential risks and side effects.

Pass Up the Botox Bargains

For those of you tempted by the Groupon deals, remember that when it comes to enhancing your face, whether it’s surgery or injecting substances beneath the skin, cheaper is not always better.  It’s far more important that you have an experienced and qualified plastic surgeon using FDA-approved, quality products in a safe manner. If that means spending a few extra bucks, it’s certainly worth it for your health and your beauty.

Dr. Frederick G. Weniger is an expert plastic surgeon located in Bluffton, South Carolina, near Hilton Head and Savannah, Georgia. At his private practice, Dr. Weniger performs a full array of surgical and non-surgical treatments for the face, breast and body, including brow lift, eyelid surgery, facelift, rhinoplasty, breast augmentation and breast lift, tummy tuck, liposuction, Botox, injectables, skin resurfacing and more.  To learn more about Botox or other treatments, contact Dr. Weniger at (843) 757-0123.

Question: What are some of the risks associated with getting either Botox or Dysport?

Answer: In the hands of a board certified plastic surgeon, I would say the risks are minimal and mostly that of bruising, undesirable cosmetic outcome, headache that can last a day or two.  In more sensitive areas of the face, improper injection can cause worse cosmetic or even functional problems- such as when injected around the eyes or the mouth.

Question: I’ve heard chemical peels can improve the appearance of scars. Are different peels used for different types of scars?

Answer: In my opinion, chemical peels have very little role for scars compared to laser modalities such as Broadband Light and fractional resurfacing.

Question: What age is too young to receive liposuction?

Answer: There is not really an age, but the patient should be done growing.  Also, we need to be sure that general weight-loss is not a better answer, that motivations are appropriate, that the patient is mature and realistic about the procedures as well. Also, younger patients require parental consent.

Question: Is it necessary for the body lift to be performed in a hospital?

Answer: Really any surgery planned over 6 hours should stay overnight, and that usually requires a hospital.  Almost always, body lifts meet that criteria, so I always do mine at the hospital – safety first!

Question: As a healthy 38-year-old man, what do I need to do to achieve the best outcome for my upcoming forehead lift?

Answer: The best 2 things are a stable weight and good medical skin care, including Retin-A or a synthetic retinoid.

Question: I am a 54 year old woman from Hilton Head.  My upper eyelids are droopy and I have deep wrinkles at the corners of my eyes.  Will an upper blepharoplasty help both of these conditions?

Answer: An upper blepharoplasty may help by itself, but you could be describing a problem at the outer edges that would require laser resurfacing or possibly, if there is hooding of skin in the crows’ feet area, then you might also need a browlift.

Question: I’m a week past my breast lift and my nipples look like pieces of pepperoni slices sewed on my breasts. When with they look normal again and like a natural part of my breasts?

Answer: Wow – I have never heard of them described like that – but you are right! That is exactly what it looks like at first! Don’t worry, though: they will become more subtle with time (months). This is normal after a breast lift surgery.

Question: Is tissue expansion always required for breast reconstruction? Are there any techniques in which it’s not needed?

Answer: No- it is not always required.  Usually when your own tissue is used for reconstruction, or if there is enough skin available for even a breast implant reconstruction, then tissue expansion is not needed.  It is certainly easier for the patient when expansion is not needed.

Question: I’m only 15, but my breasts are already huge. I’m tired of everyone staring at me, and it makes me very self-conscious. Is it a good idea for me to get breast reduction surgery?

Answer: Breast reduction can change peoples’ lives, and too-large breasts can really make teenagers suffer. For this reason, I think that breast reduction can be particularly helpful in teenagers.  In fact, one of my favorite surgeries ever was a breast reduction on a 15 year-old cheerleader, who had become unable to run or do a lot of the jumps with her sport. Her parents were so happy afterward that they both cried at her postop visit.

I would just mention that it is really best if the size has stopped changing before surgery, but we can discuss this in more detail at the consult.

What is new in weight loss? Green Coffee, Saffron extract Raspberry Ketones, Qsymia and Belviq.

The active ingredient in green coffee chlorogenic acid has been shown to inhibit glucose release, increase fat metabolism in the liver and decrease the absorption of fat in the gut. Saffron extract is thought to work by increasing serotonin thereby decreasing cravings. Raspberry Ketones increase the secretion of adiponectin resulting in fat loss. As herbal supplements they as not regulated by the FDA. Qsymia and Belviq are the two newest medications approved by the FDA for weight loss. Belviq is a selective serotonin agonist directed at the serotonin 2C receptor unlike its cousin fenfluramine which targeted the serotonin 2B receptors and is thought to be the cause of adverse cardiac effects. Qsymia is a combination pill utilizing two medications, phentermine with Topamax, both of which have been used for weight loss for some time. All medications have side effects and should be used for the shortest time necessary and are not appropriate for everyone. The good news is that people rarely need these newer medications to lose weight.

The belief that a medication will magically make you lose weight is a big mistake. You must change your eating habits. Medications are very helpful to reinforce changes until good habits come naturally. Having been in practice for 21 years I have seen many weight loss plans come and go. What sets us apart at Weniger Plastic Surgery is that we do not make our money off of medications, supplements, pills, injections or special foods. The cost of 650$ covers all of your appointments until you reach and maintain your weight loss goal. By paying up front we have your commitment to following through not only with the initial weight loss but long term maintenance. Money and seeing results are great motivators. Weekly follow up visits at no additional charge keeps you motivated, allows us to monitor your results and make necessary modifications to keep you on track. You have no excuse not to lose the weight.

I find most people do best starting off with the HCG diet. The diet is very simple and you get dramatic results. It is a great jump start to making lasting changes in food choices and amounts. The next phase strengthens those changes as you continue to lose weight at a more gradual pace. Some people need medications like phentermine to reinforce changes in habits. There is no additional cost if this becomes necessary. Lastly once your goal is met we see you back to assure long term maintenance. New year a great time to start a diet but ending the year at your goal is fabulous.

Did you know Weniger Plastic Surgery offers VNUS Closure sclerotherapy and LASER treatments for varicosities and spider veins?  The underlying cause of varicose veins and heavy, achy legs can be treated with the Closure procedure.  Learn more about laser vein removal here.

A New Year a New You! Don’t let another year go by saying I wish I had done . . . . . . The older you are the longer the list. A great start is sitting down and making the list. Next get the information you need to make it happen. If it involves looking and feeling better give us a call. The consult is free and you will leave knowing your options without any pressure. The only thing holding you back is you.

Introducing Pelleve!   Pelleve Is an FDA approved treatment which utilizes radio frequency technology to subtly rejuvenate the face with virtually no downtime or pain.  The radio frequency technology allows me to target energy at the layer where the skin and fat meet. The energy stimulates collagen fiber growth over the next 3 to 6 months which in turn plumps and tightens skin thereby reducing wrinkles.  Pelleve works great in conjunction with botox or dysport which target the muscle.  At this time we are offering a free Pelleve treatment around the eyes when you get botox or dysport.

At the Weniger Plastic Surgery Event last night Dr. Weniger said “if you are only going to do one thing for your face medical skin care is the best thing you can do for your skin.” But what is medical skin care? Medical skin care refers to products which require medical supervision to be safely and effectively used. After an analysis of your skin the most safe and effective products are prescribed for your specific needs. Because the products are stronger and specific to your needs they work better than nonprescription products you might buy in a drug store or at a cosmetics counter.

Frequently clients are resistant to trying medical skin care because of bad experiences with Retin A. Having an aesthetician work with you in choosing the appropriate strength and its proper introduction and use, allows the client to tolerate Retin A so that they may enjoy the great benefits Retin A offers. Retin A treats fine wrinkles and acne. Because it increases cell turn-over it allows your other products like hydroquinone to penetrate better and get to the cells that produce brown spots. Medical skin care systems like Obagi, Skin Medica , NeoCutis, ect. work synergistically to give the best results with the least side effects. Because they work together and are more concentrated less product is needed and in the end you get the best bang for your buck!

How can I get rid of these varicose veins before summer? The best treatment depends on the size of the offending vein and symptoms in the leg. If you experience pain, throbbing, burning, fatigue, cramps or restless legs, then there is a good likelihood you have venous insufficiency. To find out for sure an U/S is performed. The defective vein needs to be treated with a simple in office VNUS closure procedure which is usually covered by insurance. If on the other hand you are not symptomatic, it is simply a cosmetic problem, then injecting the fine purple to red veins with Sclerovein in the best solution. Cosmetic procedures are not covered by insurance and treatments start at 250 dollars. The remaining fine spider veins are best treated with a 1064 LASER. LASER treatments start at 200 dollars. Now is a great time to have treatments done before its time to get your shorts back out.

At our recent Weniger Plastic Surgery Event, so many 1^st time Botox patients were surprised at how painless Botox injections are.  There were also lots of questions about how Botox works and how much it cost.  Botox and Dysport work by inhibiting muscle contractions so the skin on top doesn’t move as much and then the wrinkles go away.  Brows can also be shaped by relaxing the muscles the “crow’s feet.”  This gives them a nice lateral lift.  The cost is determined by how many units are needed to relax an area.  For example the vertical “eleven” lines between the eyes usually require 20 to 25 units of Botox or 40 to 50 units of Dysport.  At Weniger Plastic Surgery we charge by the unit rather than the area.  Each person is unique so to achieve optimal results tailoring the number or units to that patient works the best.  I love to see patients back two weeks after a procedure to see the results and fine tune treatment units for the next time.  Happy Holidays from Susan and all the staff and Weniger Plastic Surgery!

The latest buzz in the world of fillers: The newest filler on the market is Belotero Balance recently released by Merz Aesthetics. Belotero like, Juvederm, Restylane and Perlane, is a Hyaluronic acid.

Hyaluronic acid is a viscous fluid found naturally between joints in our bodies. When injected into and under skin it adds volume to lips and cheeks and reduces wrinkles.

Belotero is less viscous or more liquid like than Juvederm so it is very nice for fine wrinkles and lips. On the other end of the spectrum is Perlane which is thicker, more viscous than Juvederm, Restylane or Belotero and is better placed deeper where you are looking for more volume, like cheeks.

At Weniger Plastic Surgery we carry all of the fillers approved by the FDA so we can tailor the best products to fit your specific needs.

Question:

When reconstructing a single breast, how close of a match will it get to the natural breast? Will they be approximately the same size?

Answer:

It really depends on the type of reconstruction that is done, the body type of the patient, and what the natural breasts looks like. It is usually not that hard to get the same size. It is getting the same shape that is the most difficult.  This is why the Federal Government guarantees that patients can get symmetry procedure for the opposite side in order to match the reconstructed breast. It is often easier to do the reconstructed breast. It is often easier to do the reconstruction on the cancer site and then try to da a lift or reduction or some other operations on the opposite breast to try to get the match just right.

Question:

My breasts have been incredibly sore since my breast reduction. When will this get better?

Answer:

It is really unusual to have soreness in the breasts after reduction. Usually, there is very little pain, and that is usually gone in a week or two. I would have to say that I have never heard of pain lasting more than a month in a breast reduction, which makes me wonder how long it has been for you. If there is a lot of bruising (again which is unusual), this could lead to more pain.

Question:

Does pelleve improve cellulite at all?

Answer:

I think that Pelleve probably does improve cellulite, but it is extremely hard to prove because cellulite is probably most improved by increasing the skin tension and elasticity.

Question:

I have sunken cheeks and would love to add more fullness to my face. Is there one type of filler that works best for this and provides long-lasting result?

Answer:

Yes-Your own fat. I love fat grafting to have fullness to the face because it is permanent. Though not all the fat survives, but what does survive is permanent. Unfortunately though, a lot of patients with sunken cheeks are quite thin and do not have enough fat to graft.  For these patients, I like Sculptra if I want to add volume to the entire face and I like Radiesse if I am only going in the cheeks themselves. Sculptra lasts two to three years, and Radiesse lasts a bit over a year.

Question:

I love the idea of a mini tummy tuck, but I don’t want to be disappointed by the results if I’m going to go to the trouble of having surgery. How do I know if this would be sufficient for me or if I need a full tummy tuck?

Answer:

A full tummy tuck is more about removing a lot of loose skin, whereas a mini tummy tuck is more about tightening the muscles, maybe doing a little bit of liposuction, and tightening the skin down below the belly button and the pubic area. If there is a secere loose skin problem, then a mini tummy tuck would be a waste of time.

In all honesty, you really need to see a plastic surgeon who has got a lot of experience with both of these, because this is really a clinical judgment area, and I think it is one of the trickier decisions in body contouring.