The Eyes are an Important Part of Full Facial Rejuvenation

Upper and lower eyelid surgery are important and integral parts of full facial rejuvenation, in order to obtain the most natural effect.

Along with the front of the neck, the eyes are the first things you look at when you meet a person, and one of the first features that changes as they age.  Plastic surgery of the eyelids historically is challenging and has inspired a wide spectrum of surgical techniques.  Although upper and lower blepharoplasties are often performed along with a facelift,  some surgeons avoid eyelid rejuvenation because of the potential for long-lasting complications and an unnatural look if it is not done correctly.

Eyes look old when they begin to sag, bulge, wrinkle, and become hollow.  Older patients often complain of sagging skin and excess wrinkling, which also makes their eyes look tired.  Even younger patients who request plastic surgery of the eyes have noticed a change in the shape of the eye, including the beginnings of saggy upper eyelids, or bulging lower eyelid fat, which will give them a tired look.

One of the reasons eyes look old is that fat pockets in the face begin to increase, or deflate, and change shape, with separations forming between them.  This makes transition zones like the lower lid and cheek junction more obvious. This phenomenon is sometimes more marked in men than in women.   A blepharoplasty attempts to remove or shift the fat pockets and skin to restore the eye to its original shape, or as closely as possible.

Steps involved in achieving the most natural looking effect from eyelid surgery involve:

1.    Augmenting the supportive deep malar fat compartment in the cheek by soft tissue injection
2.    Preserving the lower lid muscle with minimal fat removal (if at all)
3.    Removing minimal skin

The goal of the eye rejuvenation is to minimize structural changes in the face and avoid the unnatural wind-swept look of old-style facelifts that can make the skin look shiny and features look strained.

Key elements of the eyelid rejuvenation process are restoring and preserving the natural shape and contour of the eye by preserving fat, preserving eyelid muscles at all costs to make it safe and keep the eye from becoming dry as we age, and restoring the deep malar fat compartment in order to blend the eyelid-cheek junction.

But before it is necessary to undergo a blepharoplasty or facial rejuvenation, we suggest avoidance of sun exposure, use of sunscreen which will go a long way in putting off premature aging of the face. Many people use botox and soft tissue fillers to the face which can help to prolong a youthful look.

What is the ASPS?

The American Society of Plastic Surgeons (ASPS) is the largest plastic surgery specialty organization in the world. Founded in 1931, the society is composed of board-certified plastic surgeons who perform cosmetic and reconstructive surgery.

Only members of the American Society of Plastic Surgeons may display the ASPS Member Surgeon logo. This symbol of excellence in plastic surgery is what to look for when deciding on a surgeon. It tells you that you are choosing a physician who is certified by the American Board of Plastic Surgery or by the Royal College of Physicians and Surgeons of Canada ­ important credentials.

Dr. James Tang has been a member of ASPS since 1983.

Men and Plastic Surgery

Cosmetic surgery for men has entered mainstream society, appealing to men from all walks of life. Cosmetic surgery for men is a growing trend, numbers continually rise yearly. While women still lead, affordable cosmetic surgery costs, along with the convenience of non-invasive and minimally invasive options available, have caused men to embrace the idea of cosmetic surgery.

Advancement and accessibility are not the only reasons men are choosing cosmetic surgery. Our society places emphasis on a man’s appearance in the workplace and in dating situations. An attractive more youthful appearance exudes confidence. Men today find the need to stay competitive in the workplace with a refreshed appearance. After divorce men find cosmetic surgery an ideal option for a confidence boost for returning to dating.
Men are requesting many of the same cosmetic procedures as women. The top most requested procedures for men are facelift, eyelid surgery, liposuction, rhinoplasty, and breast reduction, rhinoplasty.
Men and Facelift Surgery
Facelift in men, as in women, is to make the face look more youthful, by reducing sagginess and excess skin around the lower part of the face and neck. A facelift can make a man look five to ten years younger.
Men and Cosmetic Eyelid Surgery
Cosmetic eyelid surgery can be performed on the upper or lower eyelid. Upper eyelid surgery is performed on drooping eyelids. Lower eyelid surgery reduces puffiness.

Men and Liposuction
Liposuction is a body sculpting procedure. This is a great cosmetic procedure for removing fat from troublesome areas of the body. Men usually choose to have liposuction performed on the chin and the waistline.
Men and Rhinoplasty
Rhinoplasty is a cosmetic surgery procedure that reshapes the nose cartilage. This procedure refines the nose contours. Reshaping the nose can create significant improvements to one’s appearance by complementing other facial features.

Men and Breast Reduction Surgery
Breast reduction surgery is offered to men desiring a more masculine chest. Breast reduction involves a procedure to remove excess fat and tissue. The outcome is a more desirable male chest.

Men and Nonsurgical Cosmetic Procedures
Nonsurgical cosmetic procedures are also attractive to men. Non-surgical procedures cost less than more invasive cosmetic surgery. Topping of the list are Botox injections, as a temporary answer for more youthful appearance. In fact, many injectable fillers like Juvedern and Artefil can be applied to different areas of the face to restore a vibrant look. Among other popular non-invasive cosmetic procedures are laser skin resurfacing, laser hair removal, chemical peels and microdermabrasion.
Cosmetic surgery has become extremely safe and a common procedure over the years and the cost has decreased along with the risk.

FDA says silicone implants are safe to stay on market

FDA announced that silicone breast implants will be allowed to remain available to the public.

FDA releases updated safety data, allowing silicone breast implants to remain on the market.

NBC Nightly News (6/22, story 7, 1:25, Williams) reported, “Five years after they were allowed back on the market in this country, the FDA is saying they are confident [silicone breast implants] are indeed safe, although the risks are real.”

The Wall Street Journal (6/23, Dooren, Burton, Subscription Publication) reports that on Wednesday, the Food and Drug Administration announced that early findings from an analysis of safety issues and adverse events associated with silicone-gel breast implants revealed no new concerns. Therefore, the agency said it will allow the devices to remain on the market. The Journal quotes the FDA as saying in the announcement, “Despite frequent local complications and adverse outcomes, the benefits and risks of breast implants are sufficiently well understood for women to make well informed decisions about their use.”

The Los Angeles Times (6/23, Mai-duc) notes that the FDA was “criticized by consumer groups in 2006 for approving the implants after a 14-year hiatus because of widespread fear that they caused a range of illnesses.” But, the FDA said the analysis released Wednesday, “indicates that they have a ‘reasonable assurance of safety and effectiveness’ when used properly. … ‘What we can say is the current data doesn’t indicate that silicone gel-filled breast implants are linked to breast cancer, connective tissue disease or infertility,'” FDA’s Center for Devices and Radiological Health Director Dr. Jeffrey Shuren “said in an interview.” The Times points out that the analysis was conducted by implant manufacturers: “Santa Barbara-based Mentor Worldwide and Irvine-based Allergan Inc., which were required to conduct post-approval studies on more than 80,000 women over 10 years.”

The National Journal (6/23, Brownstein, Subscription Publication) reports that Wednesday’s analysis summarizes “four years of data after the 2006 approval of the implants, which had been scrutinized for evidence they could leak and cause cancer, fibromyalgia, rheumatoid arthritis, and a range of other ills.” The study is expected to continue until 2016.

The AP (6/23, Perrone, Neergaard) reports that the FDA also made several cautionary statements. For one, “don’t expect breast implants to last for life”: The agency warned Wednesday that about “20 percent to 40 percent of patients who have implants for cosmetic reasons will need another operation to modify or remove them within eight to 10 years.” For reconstruction patients, the “number is even higher at 40 to 70 percent.” The FDA also emphasized that women making decisions on the gel implants need to understand that they come with complications, including “painful scar tissue and ruptured implants.” Other problems include implant “wrinkling and a lopsided appearance.”

Additionally, Bloomberg News (6/23, Larkin) reports that the FDA on Wednesday “reiterated its warning from January that as many as 60 of the five million to 10 million with breast implants globally have developed a rare type of cancer called anaplastic large cell lymphoma. This risk is ‘profoundly small,'” Dr. Shuren stressed.

Mommy Makeover Tips

If you are considering a “mommy makeover”, Cy Fair Plastic Surgery has these tips:

  • Wait at least six months to one year after having your last child to undergo “mommy makeover” procedures
  • Be specific about your post-baby body goals so that your surgeon can recommend the most appropriate procedures
  • To optimize the final outcome, if you are trying to lose weight, do so before undergoing “mommy makeover” procedures
  • Go to a board certified plastic surgeon such as Dr. James Tang
  • Ask to see before and after photos of your plastic surgeon’s recent work

We are offering a limited time discount of $1000 off the mommy makeover combo of breast augmentation and tummy tuck.  Call us now for your free consultation at (281) 955-0115.

Facelift Study Finds Patients Look 12 Years Younger

For Most Patients, Facelift Improves Appearance and Quality of Life

Patients who have undergone a facelift rate themselves as looking an average of 12 years younger after surgery, according to a study in the February issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

In a detailed analysis of the outcomes in 122 patients, the patients were highly satisfied with their results. Ninety-seven percent of patients said the results met their expectations. Forty percent rated the results even better than expected. Nearly 90 percent of patients said they had received positive reactions from other people regarding their new appearance, while only seven percent reported negative reactions. More than 80 percent of patients reported improved self-esteem, and 70 percent reported improved quality of life. Just over one-third of patients reported some type of complication, although these were mainly temporary problems (for example, dry eyes). Just two percent were unhappy with their scars.

The Recovery Process

On a scale of 1 to 10, the average pain rating was 5. Pain lasted an average of ten days, with six days on prescription pain medications. Most patients felt that pain was about what they expected or less. Recovery was fairly prolonged, with an average of 24 days off work. Patients resumed driving after about two weeks and were able to sleep comfortably again after about two-and-a-half weeks. Patients said it took about one month before they looked “presentable” in public and two-and-a-half months before they were “back to normal.”

Study results help inform patients

The results will be useful in counseling patients on what to expect before facelift surgery. Well-informed patients are more likely to be satisfied.

Want to look 12 years younger? There’s no better time than now. Cy Fair Plastic Surgery is offering a special limited time $150 discount on any procedure over of $1000 or more. Call us at (281) 955-0115 to schedule a free consultation.

Botox Injections for Hypertrophic Masseter Muscles

by James Tang, MD

Now there is a treatment for people with wide, “chipmunk” appearing cheeks, due to hypertrophic masseter muscles.  These are the muscles along the sides of our cheeks that can give a very wide looking face if these muscles are over developed.  These muscles are used for chewing along with several other muscles and can now be treated with botox to give the face a slimmer appearance without affecting the function of chewing.  Treatment is with three to five injections to each side of the face directly into the masseter muscle with 2 units of botox per injection.  Botox is a neurotoxin in an injectable solution which inhibits nerve conduction to muscles.   Within a few days the effect will be quite noticeable and the effects last from six months to a year.  It is possible to repeat treatments every six months if needed.  The treatments are painless and there is no down time.  Cost is from $350 to $500 per treatment.  Call us at 281-955-0115 if you have any questions or wish to schedule an appointment.



New and Improved Buttock Implants

Posted by James Tang, MD

I have been doing buttock, or gluteal, augmentation for several years, and have tried a number of implants made by different manufacturers.  I have even tried injecting a patient’s own fat into her buttocks in a procedure called the “Brazilian Butt-lift”.  However, I have found that the fat tends to be resorbed by the patient’s own body and the effect of the fat injection will gradually fade and disappear over time.  Although buttock implants are permanent, up to now, I have not been completely satisfied with them for a number of reasons.  All the buttock implants are made of silicone, the same material that has been used successfully in breast implants for over forty years.  It is an inert substance, but up to now, most buttock implants made of silicone are too firm and do not feel natural.  Now a company called Implantech has made a new buttock implant that is far superior to others that are currently available.  It is much softer and more natural feeling.  It comes in three different sizes from 280 cc’s to 430 cc’s.  It comes in a teardrop shape with a smooth surface.  This procedure is done under general anesthesia and the recovery time is about one week.  Post operative pain is minimal.  The results are very natural and pleasing.  This will be of great benefit with women who feel that they do not have enough contour to their buttock areas.  Just call 281-955-0115 to set up a free initial consultation.

Choosing implant size

One of the best ways you can communicate to your plastic surgeon the size of implant you want is to show him pictures of women who have the size that visually you desire. If you have chosen a good plastic surgeon he should be well educated and experienced in assessing what size implant that would translate to for you. Bring in several pictures to your consultation to show him, including things you may want to avoid.

Your plastic surgeon may have you “try on” different implant sizes to see what feels right on you. A common mistake and something that is very important thing to keep in mind, is that it is best to avoid getting stuck on an idealized cup size. Try to stay open to what feels best for you. There are many contributing factors to creating an ideal cup size; things to take into account like ribcage size, chest shape and height, and these factors can make a certain cup size on one woman look like an entirely different size on another.

The key thing to remember is go into your consultation with some idea of what you want and an open mind. Do not get overly attached a cup size just because so and so has that cup size.  Take the time to find what flatters your body best. Above all, find a qualified, experienced plastic surgeon whom you trust to help steer you in the right direction.

Breast implant options: Low, Moderate, or High Profile Implants

Breast Implant Options: Low, Moderate, or High Profile Breast Implants

One of the less talked about breast implant options is the profile. There are three implant profile types: low, moderate and high. The profile of the implant you choose will impact the appearance of your implants. The profile is what determines how far the implant protrudes from your chest wall. Selecting a profile can be complicated as it not only based on your desired look but also the size of your current breasts and your overall body shape. Your board certified plastic surgeon will help you determine which profile is right for you.

Low Profile Implants: Low profile implants project the least amount. Low profile implants are generally considered best for women with wider frames.

Moderate Profile Implants: Moderate profile implants are the standard implant that projects a predetermined amount per measurement of base diameter.

High Profile Implants: High profile implants offer the most forward projection out of all of the profile types. High profile breast implants are typically recommended to women who have narrow chests. And additional benefit, high profile implants are less prone to visible rippling.

Advances in breast implant products allow plastic surgeons to choose the implant size and projection that will best suit the patient’s body type and provide the most natural looking result. If you are interested in breast augmentation, contact us. We will help you determine which profile is right for you as well as explain the other implant options available.