Quick Fixes
Medical advances have offered many new solutions to skin woes. Wrinkles, dark spots, and sagging can be a thing of the past, and fast. Simple procedures can quickly turn back the clock and give a fresh, younger look.
If you are looking to abolish wrinkles, consider Botox injections, offers Dr. Melissa Morgan, a board-certified dermatologist.
“Botox relaxes lines in the forehead, around the eyes and lips,” explains Morgan.
If sunspots are what ails, laser treatments are a fast option, offers Morgan with caution.
“Anyone wanting laser treatments should be carefully evaluated, especially those with darker complexions,” explains Morgan.
Turn sagging skin around with dermal fillers. “Dermal fillers improve volume loss in the lips and around the nose and mouth,” says Morgan.
These procedures do come with some risks. As with any medical procedure, educate yourself about any cosmetic treatment being considered.
“(You) should be fully aware of the risks, benefits and post treatment care,” says Morgan.
These treatments are generally safe and effective for anyone over 25 years old. But, to best ensure you have good results, find a qualified person to perform your cosmetic treatment.
“Be confident that the person performing your treatment is a uniquely qualified professional and is practicing within the scope of their training,” advises Morgan.
Men can enjoy the youthful results, as well.
“Women make up the majority of those seek cosmetic treatments; however, more men are becoming interested,” adds Morgan.
Winning Skin
Our battle with skincare often begins during tender teen years when it seems blemishes pop up at the worst times. Then, as we age, our concerns shift to wrinkles and age spots. Dr. Melissa Morgan, board certified dermatologist, lays out the best plan of attack to discover perfect skin.
The sheer number of options available makes finding the right product for your individual needs overwhelming. Drugstore shelves are lined with the latest and greatest skincare lotions and potions. However, Morgan advises a gentle formula is best.
“Cetaphil, CeraVe, Aveeno and Neutragena cleanser, lotions and sunscreens are excellent over-the-counter skin care products,” shares Morgan.
Armed with the right tools, Morgan says perfection is found in simplicity. Start with a gentle cleansing. Aggressive products and scrubbing can damage your skin.
“Physical exfoliants, like net sponges, loofa sponges or any type of exfoliating scrub or brush, can damage the top layer of skin which compromises the barrier function of the skin,” explains Morgan.
Follow the gentle cleanse with moisturizer from head to toe, and, most importantly, protect skin from sun exposure.
“Eighty percent of how our skin ages is due to sun exposure,” cautions Morgan. “Damage from ultraviolet light accumulates over time and leads to pre-mature aging and increase risk of skin cancer.
“Sun damage is much easier to prevent than it is to repair,” adds Morgan.
If you have a persistent skin issue, it might be best to see a dermatologist, says Morgan.
Nose Solutions
Rhinoplasty, or the “nose job,” is one of the most commonly known forms of cosmetic surgery available today, but is it right for you?
Well, that depends on what you want. But it comes down to this: If you’re tired of looking in the mirror and seeing a schnoz you just don’t like, odds are there’s a way to fix the problem, no matter what the reason is.
“The most common reason why somebody would like to have a rhinoplasty is because their nose is bigger than they would like to have,” says Dr. Tim Love, an experienced cosmetic surgeon in Oklahoma City.
According to Love, rhinoplasty can be adapted to fix a whole wide range of problems, from a bridge that feels too wide, a tip that seems too long or nostrils that seem too big — but it all comes down to what you want. Though the costs for the procedure run into the regions of the upper four-digits, in the hands of a capable, board-certified surgeon, the results can be incredibly satisfying.
The best advice Love has for anyone seeking cosmetic surgery of any kind is finding a qualified, board-certified surgeon to take on the task. “Prices may vary based on the quality of what you’re getting,” he says. “The internet’s a great tool – do your homework.”
You, Only Better
Building A Better You
Cosmetic surgery can help make a better you, physically and emotionally.
Whenever plastic or cosmetic surgery is mentioned, some instantly conjure a host of horrifying mental pictures, from fictionalized surgical addictions on television or the big screen, to some frighteningly real celebrity disasters. Rarely do we glimpse the everyday people who comprise the majority of cosmetic surgery patients. From recovering from a personal loss to gaining the confidence to face the world as others do, patients who seek cosmetic surgery come from all walks of life.
“I think the public sometimes views patients that have cosmetic surgery as vain and insecure about themselves,” says Dr. James Koehler of Tulsa Surgical Arts. “Most patients are not like this, and are really just seeking to improve an area of their appearance that bothers them, that they cannot change. I think there is sometimes the idea that patients get ‘addicted’ to having things done. I have seen patients that try to use cosmetic surgery to solve their personal problems, but that is a rare situation. “
Much more common are stories like those of the following patients, all of whom elected to have cosmetic surgery, and shared their thoughts on the process.
Susie
Susie Monroe was, quite simply, tired of looking tired.
“My husband had died recently. I felt that I wanted to do something for myself,” the 67-year-old office manager says. Upon the decision to have a total facelift, Monroe sought out the skills of Dr. Joey Manduano, a Tulsa-area cosmetic and reconstructive surgeon.
“Susie wanted to look less tired and more youthful,” Manduano says. “She wanted to look how she felt. This desire matched her inner being.” According to the surgeon, it’s not unusual for his patients to have recently lost a loved one. However, he says, the motivations to have cosmetic surgery run the gamut, and procedures are sought for both emotional and medical reasons.
“Some patients are going through divorce or the loss of a loved one and are starting to date again or go out socially,” Manduano says. “Some are having vision difficulties because their eyelids are hanging down, or they want to remove extra skin after natural weight loss or gastric bypass … There are lots of different paths to the office. Sometimes, people say they have lost their jobs; they are older while everyone else is younger, and they need to get back into the job market. That reason has not been infrequent during the past few years’ economy.”
The most important thing before deciding to move forward with surgery, Manduano says, is establishing a definitive grasp on the patient’s expectations. “You have to get that out of the way right up front,” he says. “You must honestly assess what their expectations are, and whether these can be accomplished realistically and safely.”
After her procedure, Monroe says that despite her positive feelings about the surgery and her faith in Manduano, she experienced some post-operative anxiety – again, not infrequent, according to her surgeon. However, Monroe says that while she had bruising, there was no pain. “I must say I was a little scared when I first looked at myself right after surgery,” Monroe says. “I am not sure I realized what I would look like then. But boy, look at me now. I feel so much better about myself, and I feel so much younger. I now look like I feel.”
Manduano says patients often have post-operative anxieties and questions about pain, healing, and how long it will take before they can resume daily activities. “Luckily,” he says, “across the board, complications are less than one percent. Danger of anesthetic issues or surgical misadventures is about the same as getting in a car wreck. That doesn’t keep you from driving.”
Monroe describes Manduano and his staff as extremely supportive, and her experience went much like that of any other surgery, from pre-surgery consultation with an anesthesiologist to follow-up office appointments to assure that everything was healing as planned. Manduano says that post-operative support is especially important in the doctor-patient relationship.
Jessica
Born with Poland Syndrome, a birth defect that causes an underdeveloped or absent pectoral muscle on one side of the body, Jessica Rafala had no right chest muscle, several underdeveloped ribs and no right breast. At 17, her insurance provider covered the cost of an implant. Unfortunately, that turned out to be a temporary solution. Twelve years and two children later, her implant collapsed, leaving her disfigured once more. This time, she was in for a nasty shock when her insurance provider declined to cover her procedure.
“I remember I sat at my kitchen table and just cried my eyes out,” the 29 year-old stay-at-home mom says. “I knew there was no way I could afford this reconstructive surgery on my own, and I was totally shocked that my insurance could deny me. I thought it was no fault of my own that I was born with this deformity, and now I was just supposed to live like this.”
After contacting as many surgeons around the country as she could locate – all of whom either said, “Good luck, but no” or worse, failed to reply at all – Rafala was put in contact with Dr. Angelo Cuzalina of Tulsa Surgical Arts. Cuzalina, director and past president of the American Academy of Cosmetic Surgery and an adjunct faculty member at Oklahoma State University, offered to perform Rafala’s surgery completely free of charge.
“Jessica’s case was special in that she had a congenital deformity with lack of development of one side of her chest, and problems after some attempted corrective surgery performed years ago elsewhere,” Cuzalina says. “Because it was a case that fell in a crack between cosmetic and reconstructive, insurance was of no help, and she could not afford the procedures required on her own. It was really just by chance that I came across her plea for help, and I found her story sincere and sad. I just felt the need to help if she could make it to Oklahoma.
“Most doctors do want to help whenever we can for people in need,” he adds. “We are just limited by time and resources, but it sure feels good when a situation works out that can really help someone who needs it.”
Rafala elected to have a breast lift on her left side with a silicone implant placed under the muscle, as well as to remove her collapsed implant and have a new one placed on her right side, where she had never developed a breast. On the day of her surgery, her doctor outlined the surgery areas with a marker and briefed her one last time on the procedure. After receiving a numbing agent and being hooked to an IV, she consulted with the anesthesiologist, whom she describes as “a really knowledgeable and warm person.”
“It really meant a lot to me, how concerned they were with making sure I was comfortable,” she says.
While many patients are nervous before undergoing surgery, Rafala says that excitement and gratitude overshadowed any apprehensions she might have felt heading in for such a procedure. “Once I met Dr. Cuzalina, I felt completely at ease. He made me feel so relaxed and treated me like a friend. He has such a kind heart and genuinely cares, and I felt that immediately when I met him. He took his time with me to answer all the questions, and I walked out of the office with nothing but positive feelings. After my surgery, my feelings were even more positive. The surgery and my results were even better than I could have ever imagined.
“This procedure and Dr. Cuzalina’s generosity totally changed my life,” she adds. “He gave me a gift better than anything I could open up, and it was my self-confidence. I finally feel ‘normal’ and I can look in the mirror and smile. That is something I could never repay him for. Nobody should have to live with a deformity, and I feel really blessed that Dr. Cuzalina was brought into my life.”
Thomas
A 38-year-old entrepreneur from central Oklahoma, Thomas had always lived a very fit and healthy lifestyle. But as he aged, he began to notice that no matter how hard he worked out or how well he ate, some areas of his body simply refused to cooperate.
“The neck area, for example, would not slim down even if I reached my ideal weight,” he says. “Also, the dreaded love handle area seemed to only go away if I got my body fat to about eight percent, which is close to impossible to maintain with such a busy lifestyle the average person has with career and family.”
Thomas elected to have Vaser hi-definition liposuction performed on his abdomen, waist and neck with Dr. James Koehler. Koehler describes Thomas as both representative of many of his patients, and also as a good candidate for surgery. “He was in good shape and of stable weight. He was not using liposuction as a weight-loss procedure, and he works out regularly. He wanted to do this for himself and wasn’t doing it to please anyone else,” Koehler says.
According to the surgeon, that kind of motivation is important. He emphasizes that “a properly motivated patient does not rush into surgery, but has spent quite a bit of time thinking about the procedure and understands the risks of surgery.
“Cosmetic surgery can be very gratifying and life-changing in some situations for patients that are doing it for the right reasons.,” says Koehler. “Also, the goal of the surgery is to have an ‘improved you,’ not a ‘completely different you.’ Patients that have a poor body image that think that surgery is going to fix their life problems are not good candidates.”
Thomas admits that he had some negative preconceptions before having the liposuction procedure. “Prior to the procedure, my negative feelings of the cosmetic surgery I would receive were that you were getting results without working hard, and in return, that would make it hard to maintain a healthy lifestyle and workout habits,” he says. “My positive feelings were the quick and dramatic results that could be achieved. After the procedure, my positive perceptions were confirmed, while my negative perceptions turned out to be unrealistic. I have actually been so happy with the results that I increased my work-out schedule and started a healthier diet to make sure I maintain the look.”
Thomas experienced no complications from his surgery, he says. According to Koehler, “The most common complications are minor ones, which may include prolonged bruising, swelling, minor localized infection and minor wound separation. Each procedure has specific potential complications, which the surgeon will go over prior to surgery. Major complications are infrequent but are a risk with any surgical procedure.”
His patient adds, “In my 17 years working in the health care field, I have never experienced a physician and staff as dedicated to patient results and satisfaction as Dr. Koehler and his office.”
Surgeons’ Suggestions
While every patient had a different surgeon, procedure and motivation for having plastic or cosmetic surgery, all agreed emphatically on one issue: Do your homework. Not only should you make educated decisions about potential procedures, you should always do some research about your surgeon. Manduano says this is particularly important, as some doctors who were medically trained in other areas have started performing cosmetic surgery on the side.
Manduano says that the most important question potential patients can ask is if their surgeon has hospital privileges. “A lot of people are doing these procedures in offices, where there’s no assurance of quality of care,” he says. “If you’re contemplating a physician, ask if they have privileges. You can’t get enough referral information. Don’t be swayed by the ads. One would have to ask, ‘Why aren’t referrals enough? Why are they advertising?’”
“Make sure you find the right doctor and somebody with the experience in the type of surgery you need,” Rafala cautions.
Thomas says, “There are several cosmetic surgeons that can perform the same procedures. However, the outcome and experience you receive will be dependent on the doctor you choose.”
– Tara Malone
More Cosmetic Surgery Topics
Top of the Heap: Most popular cosmetic procedures show little change.
Winning Skin: Skin perfecting procedures.
Perfect Pearly Whites: Cosmetic dentists work to craft the perfect smile.
Sculpting Netherland: Women and men are seeking improvements in places not obvious to the naked eye.
Quick Fixes: Refresh your look with little downtime.
No Hair? No Problem! For men facing baldness, cosmetic surgery can be the answer.
Nose Solutions: One easy procedure can provide the nose you’ve always wanted.
No Hair? No Problem!
While the notion of plastic surgery tends to conjure up overblown images of reality shows and Beverly Hills, the truth is that cosmetic procedures are part of a wildly popular practice no matter where you are, even in Oklahoma – for women and men both, with procedures for men being more common than you might think.
“(For men), hair replacement is high on the list of cosmetic procedures, and also liposuction,” says Dr. Tim Love of Oklahoma City, a surgeon with 30 years of experience in the cosmetic surgery field.
Why someone would want a cosmetic procedure entirely depends on his or her own goals and desires, and a good plastic surgeon will work closely with patients to craft an ideal treatment plan that results in exactly what they want. They look at a variety of factors, for instance, “When it comes to hair transplants,” says Love, “(what we do) depends on the age, the gender, the motivation and the individual circumstance.”
Over his 30 years, Love has seen rolling advances in the technology behind hair transplant surgery, as well as a steady stream of customers ready to take on his services. The procedure is very adaptable to anyone’s individual needs, from a mild, receding hairline to cases of full-on baldness, and the prices scale to reflect the degree of work needed. Love’s practice, notably, falls on the very affordable end of the spectrum. At a low price of $3 per individual graft, finding a total cost for your transplant is just a matter of simple math, where a typical procedure involving 1,500 grafts (resulting in up to 4,000 new hairs) comes out to a $4,500 procedure. And while it may seem like a heavy sum up-front, it’s easy to see that a hair transplant is more affordable and satisfying for a patient in the long-term as a high-quality, permanent solution to hair loss.
Top of the Heap
The numbers from 2011, the most recent available, have been collected and analyzed, and according to the American Society of Plastic Surgeons (ASPS), there have been only slight changes in the list of the most popular cosmetic surgical procedures and minimally invasive procedures.
The five most common surgical procedures in the South Central division, which encompasses Oklahoma and seven other states, are breast augmentation (approx. 51,000 procedures in region), nose reshaping/rhinoplasty (approx. 42,600), liposuction (approx. 31,000), eyelid surgery (approx. 24,000) and tummy tucks (approx. 19,000).
The region’s most common minimally invasive procedures include Botox/Dysport, with approximately 800,000 procedures conducted in 2011, followed by soft tissue fillers (approx. 198,000), laser hair removal (approx. 164,000), Sclerotherapy, a treatment commonly used to reduce the appearance of varicose veins, (approx. 130,000) and microdermabrasion (approx. 103,000).
Although, nationally, facelifts supplanted tummy tucks in rising into the top five of procedures for the first time since 2004, those numbers were not reflected in the statistics for the South Central division, where the tummy tuck remains on the list. Cosmetic surgical procedures not in the top five, but which showed great increase in popularity nationally, include chin augmentation (up 71 percent), lip augmentation (up 49 percent), buttock implant (up 43 percent) and buttock lifts (up 38 percent).
Soft tissue fillers were among the fastest growing cosmetic minimally invasive procedures in 2011 nationally, while minimally invasive procedures rising in popularity but not making the top five yet include cellulite treatment (up 21 percent), laser skin resurfacing (up nine percent) and laser treatment of leg veins (also up nine percent).
In 2011, some $10.9 billion was spent on cosmetic procedures in the U.S., up 2.95 percent from the 2010 statistics. The Mountain/Pacific region remains the most enamored of cosmetic procedures, with 3.9 million procedures conducted overall.
Perfect Pearly Whites
The smile is one of the first things many people notice. For many, a face’s most obvious expression of joy is also a subject of worry. Luckily, cosmetic dentists around the area give you the best options to get your teeth looking perfect.
Cosmetic dentistry has become a sort of catch-all term for dentistry that deals with “smile design,” as Tulsa area dentist Dr. Andrew Carletti says. To put it simply, cosmetic dentists are general dentists that have learned cosmetic techniques to offer patients.
“You can’t specialize in cosmetic dentistry,” says Carletti. “It’s not a recognized area of dentistry.”
But that does not mean if your general dentist calls himself a “cosmetic dentist” that he or she is not an experienced professional. It’s just a good idea to make sure you are comfortable with your dentist and see before-and-after photos from previous patients.
“It’s like an analogy to a car repair place,” says Carletti. “Everyone can do a transmission, but sometimes you have to go somewhere that can specialize in transmissions.”
There are a variety of procedures under the umbrella of cosmetic dentistry. The two most common are veneers and whitening procedures.
Veneers are either porcelain or composite (a synthetic substance used for fillings) coverings that are placed directly over the existing teeth. These can be used to lengthen teeth appearance, give the appearance of bigger teeth and improve smile alignment.
Whitening is probably the most common way to affect a smile, be it through over-the-counter remedies or at a dentist’s office.
“The over-the-counter remedies are great for freshening up a smile,” says Dr. Chris Ward, a dentist with a practice in Owasso. “But they have a limited amount of the whitening solution in them.”
Whitening solutions used in most dentist’s offices are around 25 percent more concentrated than whitening strips bought at the drug store and therefore offer more immediate and lasting effects.
Many dentists offer tray bleaching, where the dentist will create custom trays for teeth with whitening solution to use at home. There are also more intensive methods that take place in a dentist’s office that will have a more immediate affect on teeth’s whiteness.
However, when it comes to teeth whitening, be careful of some homemade recipes and stick to only what a dentist recommends.
“Often, I hear about brushing with baking soda, and I’m very against that,” says Ward. “Just straight baking soda is very abrasive, and it’s a question of you removing tooth structure to get there.”
There are also some more creative ways to go about getting the perfect smile.
“One patient came in with a People magazine that had a picture of Jessica Alba on the cover,” says Carletti. “She said ‘I want my the teeth to look like that.’”
Using Photoshop, Carletti was able to help design the right smile for his patient using the magazine as base.
With new and classic technologies at their disposal, cosmetic dentists have made it even easier to ensure a patient’s smile will meet anyone’s standards for perfection.
