I wrote some blogs on breast surgery a few weeks ago and then took a break to focus on summer sun precautions.   Now I want to finish the breast series with this blog on scarring and incisions.  Scarring is always a concern when choosing a cosmetic surgery. We want to be able to focus on the beautiful results of the surgery, not the incision scars it may leave behind. Fortunately, with a Breast Lift, there are a variety of incisions, some more inconspicuous than others. However, different techniques may be required based on how much sagging you want corrected. The incision I recommend will be based on your personal goals, existing breast tissue, and the amount of excess skin to be removed. Here is an explanation of each of the possibilities.

Minimal Sagging: Crescent Incision
This incision is very small and traces around the upper half edge of the areola. While this is minimal scarring sounds ideal, it can take away only a minimum amount of skin. This makes it only an option for patients who have very little sagging to correct. For this reason, it is the least frequent incision technique and is usually only done in combination with a breast augmentation.
Mild Sagging: Peri Areolar or “Donut” Incision
The Peri Areolar incision is a circular incision tracing around the outer edge of the areola. This technique can also be used to reduce the size of the areola if that is desired. Like the Crescent incision, this “Donut” incision is commonly performed along with a Breast Augmentation and can address mild sagging.

Moderate Sagging: Vertical or “Lollipop” Incision
Two incisions are required for this technique, as it can accomplish more extensive reshaping of sagging breasts. They form the pattern of a lollipop, hence the nickname. The first incision is around the outer edge of the areola and the second runs down vertically from the bottom center of the areola to the underlying crease where the breast meets the torso, called the inframammary fold. This is a very common incision technique since it allows for the removal of a moderate amount of excess skin and reshaping of the entire breast. Fortunately, these scars are easily hidden in bras and bikini tops.

Extensive Sagging: Inverted T or “Anchor” Incision
Dramatic results for reshaping the breasts are available with the Inverted T incision. Getting its nickname as the “Anchor” lift because of the incision pattern, this technique involves 3 scars. One is around the outer edge of the areola, then another is down vertically from the bottom outer edge of the areola to the breast crease, and the last one is hidden in the horizontal crease of the inframammary fold. This technique allows for the removal of a significant amount of excess skin and sagging tissue. It is also used when the Breast Lift is combined with a Breast Reduction. This gives beautiful correction for reshaping pendulous breasts, which is when the nipple is below the edge of the crease of the inframammary fold and it is pointing downward.

In my expert hands, these incisions will be as minimal as possible, and over time, with your proper care these scars will fade. Regardless of which incision technique is required, your scars will be concealed and far from your mind when you see how lovely your lifted breasts look in your clothes and bathing suit. Contact me for a consultation at www.davinciplastic.com.

Steven Davison M.D.
Board Certified Plastic/Reconstructive Surgeon

Mother’s Day is Sunday May 14. Most moms sacrifice their bodies, sleep, possibly a lucrative career, and much physical, mental and emotional energy for their children. While it’s all worth it, most moms want to restore some of the youthfulness and refreshed appearance that has been given up to time and family sacrifice. This is why more and more moms want cosmetic procedures as their Mother’s Day gift. Giving the gift of youthfulness as a gift certificate or as a specific procedure, such as a Mini Facelift, is growing in popularity and can make for a very happy mommy.

Putting your best face forward
A Facelift is the gold standard of facial rejuvenation. It’s one of the most common surgical procedures I perform. There’s definitely an art to realigning the facial tissue so that the skin doesn’t look stretched or “wind blown” and lays in a naturally firmer, more rested and youthful position. Each surgery is unique due to individual facial structures and skin condition. For those dealing with the early signs of loose sagging skin who want a faster recovery time, a Mini Facelift could be an option.

What is a Mini Facelift?
A Mini Facelift is a shorter surgery with a hidden incision that is smaller than a full Facelift. It is best for those who have minimal aging of the forehead and neck and relatively good skin elasticity. You can simulate the effects of a Mini Facelift by placing a finger on either side of the jaw and pulling skin back toward the earlobe by about a centimeter on each side. It can also be a great refresher for people who’ve already had a Facelift.
What aging issues does a Mini Facelift address?
A Mini Facelift mostly addresses loose skin in the mid face that has dropped. It helps with refining the skin in the lower face for a smoother, tighter jawline. Marionette lines, which are the folds around the corners of the mouth, can also be slightly reduced with this procedure, although the nasolabial folds will not.
How is a Mini Facelift different from a full Facelift?
…..During the Mini Facelift, the sagging skin and tissue is repositioned and attached in a very slightly higher. These factors make the Mini Facelift very comforting to anyone weary of any complications or recovery from surgery:

…..During the Mini Facelift, the sagging skin and tissue is repositioned and attached in a very slightly higher. These factors make the Mini Facelift very comforting to anyone weary of any complications or recovery from surgery:

…..While there is some variance in what this procedure involves, the Mini Facelift primarily takes place above the parotid salivary gland, which reduces the risk of nerve damage.
…..The surgery has minimal downtime with swelling and discomfort resolving over just a few days to a week. It’s sometimes referred to as the “weekend lift” because the recovery is so fast.
…..Mini Facelifts are also performed using local anesthesia.

When  a Mini Facelift is not enough?
The success of a Mini Facelift requires firmness of the tissues otherwise results can be disappointing or short lived. A full Facelift will be the right choice in the case where there is substantial skin laxity and droopiness This procedure would require a longer recovery time and a larger incision, but the full Facelift would provide the desired results of a long lasting youthful appearance when there is more loose skin.

To see if a Mini Facelift is a good fit for you personally or to give as a Mother’s Day gift, schedule a consultation at our newly updated website www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

MINI TREATMENTS ARE IN HIGH DEMAND, are more REFINED and are HERE TO STAY.  I’ve blogged about:  Mini FaceLift to “refresh the face”, Mini NeckLift to take years of aging off the lower 1/3rd of the face and Mini EyeLid Lifts (Blepharoplasty) to rejuvenate the eyes.  There are other “mini” procedures. I offer brief overviews of these 3:

MINI CHEEK LIFT is usually performed in combination with the Mini FaceLift to achieve the maximum desired results and improvement in the midface area.  Mini CheekLifts can be performed through the same incision that is used for the Mini FaceLift to minimize incisions and scarring.  Incisions are hidden inconspicuously in skin folds and creases where they fade away.  Mini CheekLift surgery removes excess skin and tightens muscle to accentuate and define the cheekbones.

MINI LIPO PROCEDURE is treatment of choice when neither diet nor rigorous exercise succeed in sculpting certain areas of the body.  That’s no excuse to abandon healthy nutritious food and exercise.  The body needs a balance in those areas everyday.  But, as we age, the body often resists things that used to work thus “liposuction” for removal of excess fat deposits and to sculpt those resistant areas to a more desirable shape.  Mini incisions, small canulas and years of expertise allow me to sculpt the neck, breast, arms, flanks, hips, knees, abs and other areas of concern. Discomfort is usually minimal and many patients resume normal activities following treatments.

MINI TUMMY TUCK (Abdominoplasty) can deal with an adverse scar from a C Section, a lower tummy pouch formed from fat and excess skin located below the belly button and can be safely performed in office with local anesthesia.  Mini Tummy Tuck involves removing excess skin and tightening lower abdominal muscle (below the belly button).  I work through a small incision and often include liposuction to further sculpt the treatment area.

MINI PROCEDURES ARE IN HIGH DEMAND and ARE HERE TO STAY! They entail shorter incisions, briefer downtime and are Popular among those in their 40’s, 50’s and others who are starting to see age related changes but who don’t yet require a more traditional procedure or full blown surgery.  STARTING EARLY, like Celebrities, before aging becomes too visible; before lines, wrinkles and grooves too deeply etched, and before skin and muscles lose elasticity and tone...starting early allows you to have “mini” procedures and blocks the visible signs of aging so you can look years younger always!

MORE MEN ARE HAVING MINI PROCEDURES  (e.g. body contouring) according to recent survey/report results from the AMERICAN SOCIETY of PLASTIC SURGEONS and THE AESTHETIC JOURNAL.  Treatments men are requesting include:  removal of excess body fat, Gynecomastia (reduction of overly large male breasts) facial injectables, laser treatments, hair removal, skin resurfacing and, of course, Botox referred to as “BROTOX.”  Surgeons across America are seeing more men.  Men choosing cosmetic surgical and non surgical treatments increased by 42% since 2010.  And, they become regular clients because they believe cosmetic/aesthetic procedures are an important part of their regular healthcare routine and that younger, fitter looking men get career advancements.

See my website for complete info on all procedures offered at DAVinci: HTTP://www.davinciplastic.com.

Before we know it, Fall will be upon us with all it’s glorious colors and lots of social events. Are you ready to put your “best self” forward?  Let’s talk.

Best to you and yours.

Steven Davison M.D.

“DAVinci…where we combine the supreme elements of art and surgical science.”

The Mini treatments idea was born about 20 years ago based upon the needs of younger patients (40ish) who wanted the benefits of cosmetic procedures, who didn’t need full blown treatments such as facelifts, and whose schedule demanded less downtime etc. These are younger Boomers, Generation X and now also includes the Millennials. What we learned back then was:  1) that aging occurs in stages,   2) that younger people usually need less invasive treatments, and that  3) “mini” options could work very well as long as they started early enough (at the first signs of aging) and maintained the results.  Http://www.davinciplastic.com.

Modified versions of traditional procedures being done today are much more refined, than those offered 20 years ago, by virtue of more advanced precision instruments that enable us in achieving totally natural looking results with increased longevitiy.  Yes, smaller surgeries are right for many people, usually those in their 40’s and early 50’s who are seeing visible age related changes.

Here’s the Bottom Line for today’s Mini Treatments chosen by our patients: 1)  look younger faster,  2) less downtime/ shorter recovery,  3) quicker results, 4) smaller incisions, 5) permanent results when possible.

There are many, many people who qualify for and benefit from these  mini procedures.  What surgeons expect from their patients is this:  realistic expectations.

For the next few blogs I want to cover “mini” procedures:  who they’re for and the many benefits.  This will include the Face, nose, eyes, and neck procedures.  So, look for these blogs.  I also want to do a “primer” on injectables to get you up to speed on what’s really involved there today.

MINI PROCEDURES ARE MAINSTREAM TODAY and are as much in demand as Botox, Dysport, Juvederm and our other great fillers.  Let’s start with the face:

Mini Facelifts “refresh” the face by addressing the most common signs of aging like sagging skin in the lower 1/3rd of the face and possibly the upper neck during one procedure. The Benefits include shorter recovery time, shorter incisions/nearly invisible scars and permanent yet subtle improvement.  Limitations include:  inability to effectively correct excessively slack skin and large areas of wrinkles. Longer incisions are required to deal with excessive skin laxity.  True Mini Facelifts correct the underlying structure and loose skin.  Beware of “fake” mini lifts that are superficial only; that claim to be done in under an hour and without anesthesia.  This is not a true facelift and will not achieve desirable results especially in older patients who may need more work than the mini can offer.

BOTTOM LINE:  the Mini Facelift is terrific for many people who opt for it soon enough and who choose a board certified plastic surgeon who is fully trained and experienced in performing facial surgeries.

MINI FACELIFT OVERVIEW:   1) WHO IT’S FOR…those in late 30’s, 40’s or early 50’s with fairly good skin laxity and the first signs of aging in the mid and lower face.  Younger patients have fewer signs.    2) ANESTHESIA:  Local or sedation   3)  LENGTH OF SURGERY:  2-4 hours,   4)  RECOVERY:  some swelling, bruising and general discomfort for a few days.  Resolves on it’s own with rest and oral pain medication.  5) RESULTS: usually last for 5 to 10 years with maintenance.

Hope your summer is going well.  Let’s talk about your concerns and help you get your best face forward!

Best to you and yours,

Steven Davison M.D.

“DAVinci…where I combine the supreme elements of art and surgical science.”

Since I’m specially trained and very experienced in reconstructive and revision surgeries I do a lot of “Nose Jobs.”  Patients of all ages, stages in life and from all cultures come to me because they are unhappy with a previous nose (rhino) surgery.

Rhinoplasty surgery is done to change the size, shape  and form of the nose and/or to correct functional problems such as difficult breathing caused by a broken nose (deviated septum), fracture or disease.  So, when the outcome from a nose surgery is not desirable, often I am asked to fix it.  Following are some very important points you need to know and understand about revision nose jobs.

Revision Rhinoplasty is always more challenging than the original (primary) rhinoplasty surgery.  Several reasons for this are as follows:

1. The geography of the nose was altered during the first surgery.  This involved removal of cartilage which provides form and structure for the nose
2. The cartilage needed for the revision surgery must then be borrowed from someplace else
3. An extra incision is required to allow for borrowing the needed cartilage
4. The nasal lining has typically turned to scar tissue in the operated nose
5. Risk of little spider veins increases with a second surgery (telangectasias)
6. Revision Rhinoplasty is very complex and detailed since nasal form has to be restored and function (breathing mechanisms) have to be repaired
7. These challenges increase the time involved in the surgery
8. Very Few surgeons are qualified to perform these highly specialized revisional surgeries

Even though Revision Rhinoplasty has its own set of unique considerations, it is among the most rewarding of all surgeries.  The nose is the most prominent feature on the face so getting it right is most rewarding to people having this surgery.

HOW I PERFORM REVISION RHINOPLASTY:  There are 2 methods used for nose surgeries:  Open Technique and Closed Technique. Open involves incisions made inside the nose and 1 under the nose between the nostrils.  Closed means incisions are inside the nose only.

Revision Rhinoplasty surgery is frequently performed using the open approach which allows for more “complex” nose jobs to be corrected with natural looking, desirable outcomes.  Borrowed cartilage is taken from behind the ear, when needed,to restore nasal form and function.  This incision is well hidden.  The under the nose incision is barely visible and fades to a very faint thin line over time.

Here are 3 frequent questions I’m asked:

1. About anesthesia…I use local with sedation or general.  We determine that during your consultation to choose what’s best for you.

2.  Who can have Revision Rhinoplasty?  Men and women of all ages (must be in good health) and teen boys and girls who are fully grown.

3.  How long does the surgery take?  This depends upon the complexity involved.  It could be from 45 minutes to 3 or 4 hours.  The important thing here is to achieve a pleasing outcome with restored function.

These are the top three questions.  The rest are on my website: https://www.davinciplastic.com.

If you have nose problems from a previous surgery and have been afraid to approach it again…let’s talk.  I am specially trained in these surgeries and have been performing them for years. I still perform them on a regular basis using today’s most refined instruments and techniques…those that are proven safe and reliable. My patients get the results they desire and deserve.

HAVE FUN in the SUN.  BUT REMEMBER THE HATS, GLASSES, SUN SCREEN, WATER, UMBRELLAS ETC.

Steven Davison M.D.

“DAVinci…where I combine the supreme elements of art and surgical science.”