XEOMIN: A BOTOX alternative

What is XEOMIN?

Approved by the FDA in July 2011 for treatment of moderate to severe glabellar lines (frown lines between the eyebrows), XEOMIN is a BOTOX alternative comprised of the same active ingredient, botulinum toxin type A, as found in BOTOX.

How does XEOMIN reduce the appearance of wrinkles and lines?

Like BOTOX, XEOMIN solution is injected into the muscle at the site of the trouble area. The medication blocks signals from the nerves, resulting in the weakness of the target muscle thus forcing the muscle to become smooth and unable to fully contract.

According to the manufacturer of XEOMIN, also the maker of the popular filler Radiesse, results can be noted within a week from injection and last anywhere from three to six months.

The injection should be performed in a an office setting and typically takes less than an hour to complete. After the procedure, patients may experience mild bleeding, bruising or swelling at the injection site.

XEOMIN vs. BOTOX and Dysport

XEOMIN is distinct from other injectables of its class in that it is void of the additives and proteins found in BOTOX and Dysport. This may allow those who are allergic to BOTOX and Dysport the opportunity to treat their fine lines and wrinkles with pure botulinum toxin type A. Even better, XEOMIN is currently offered at a lower cost than other botulinum injectables.

Possible Risks

As with other botulinum injectables, XEOMIN poses the risk of spreading beyond the site of injection and causing paralysis to other muscles. In rare cases this can cause drooping eyelids, difficulty swallowing or breathing. This is why you should consider injections by an experienced provider in an appropriate physician’s office.

Am I a candidate?

If you are looking for a non-surgical means to reduce wrinkles and fine lines of the face and are between 18 to 65 years old, you may be a candidate for XEOMIN. For more information, call our office at 423-648-4011. Advanced Surgical Concepts is one of the select few cosmetic surgery practices in Chattanooga, Tennessee to offer XEOMIN.

Hair Transplant FAQ

If hair transplants are so natural looking now, why doesn’t everyone losing hair get a transplant?

There are many reasons people experiencing hair loss do not undergo hair transplant surgery. For one, the general population is largely unaware of the advancements in the field of hair restoration and do not realize the coverage and natural appearance possible.

Another reason is that many people are not great candidates for the procedure. This may be due to several factors including extensive loss, not enough loss, and even unrealistic expectations

Which hair restoration technique is best?

Today’s technique is much different from transplant procedures of the past.Most physicians now employ a technique where a strip of tissue is removed, cut into follicular unit grafts or 1-4 hair grafts cut to size and transplanted into the area of loss.

What is Follicular Unit Extraction (FUE)?

Follicular Unit Extraction is a technique in which hair follicles are extracted from the donor area using a surgical instrument such as a biopsy “punch”. These punches come in a range of sizes. The skin along with the hair follicle is removed with no staples or stitches closing the wound. It is a very tedious procedure.

Where Does the Hair Used in a Hair Transplant Come From?

The hair that is used in most types of hair transplant procedures typically comes from either the sides of the head or the base of the scalp. The “ring of hair” that most men have during the final stages of hair loss is typically where much of the donor hair comes from. A patient should expect to have his head looked at during a consultation in order to determine the density of the hair in the donor area and whether or not he would be an ideal candidate for a hair transplant procedure.

How long does a hair transplant procedure take?

Approximately 4-6 hours.

Am I awake during the procedure?

Yes. A local anesthetic is used to numb the scalp. This way, you can read, listen to music, watch television or sleep.

Is a hair transplant painful?

There is minimal discomfort during the initial numbing.

What do I look like after the surgery? Can I go to work the next day?

After surgery, we bandage the scalp with gauze wrap and compression bandage for the first 24 hours. After the bandage is removed, the scalp will have some redness and scabbing on the areas where the grafts were transplanted. These should heal within 4-5 days. Most patients who have a procedure on Thursday or Friday, return to work by Tuesday the following week.

Is there an immediate result from the transplant?

No. It takes about 6-12 weeks for the new hair to begin to grow and 9-12 months for the final result.

What do the new hairs look like?

They will look like your normal hair as they grow in beginning fine and reaching its full thickness between 9-12 months.

I was told the newly transplanted hairs would fall out. Is this true?

Yes. Within 10 days to 2 weeks following the procedure, the newly transplanted hairs fall out. However, the tissue with the growth information remains and resurfaces the scalp in about 4-5 months.

What are the most common complications from a hair transplant?

The side effect we see most, although not often, is folliculitis (pimples). This occurs after a hair transplant begins to grow and presents itself as ingrown hairs. It is accompanied by redness and bumps that resemble pimples. Occasionally we also get reports of nausea from pain medication and swelling around the forehead region.

Varicose vein therapy..more than cosmetic

Varicose veins, those unsightly bulging, rope-like cords on the legs affect an estimated 40 percent of women and 25 percent of men of all ages. Problem veins generally appear from age 20 forward.

Veins return blood back to the heart to be recirculated. To return this blood to the heart, the leg veins must work against gravity to lift the blood back to the heart. This gravity effect is multiplied when standing. Small, one-way valves open to allow blood flow upward, towards the heart, and then close to prevent it from flowing backwards. Muscle pumps in the lower limbs push the blood upward with each muscle contraction.

Obstacles in the way of blood return to the heart (such as pregnancy or obesity) also decrease the vein’s ability to return blood back to the heart efficiently. In addition to the visual appearance, many patients may experience pain (an aching or cramping feeling), heaviness/tiredness, burning or tingling sensations, leg swelling/throbbing as well as tender areas around the veins themselves.

Varicose Vein Formation

Varicose veins occur when the valves in superficial leg veins malfunction or cannot work efficiently. When this occurs, the valve may be unable to close, allowing the blood that should be moving towards the heart to flow backward (called venous reflux). The vein blood becomes stagnate, backs up and pressure builds. Blood then collects in the lower veins causing them to enlarge and become varicose.

These veins are very thin walled and cannot tolerate the increased pressure; they enlarge in relationship to the added stress. The pressure may be so great that fluid can leak from the faulty veins causing leg swelling leading to dermatitis and skin ulcerations. As a matter of fact, varicose veins have been shown to be the number one cause for restless leg syndrome.

Factors leading to Varicose Veins

Factors leading to varicose veins include heredity, gender, pregnancy and age. Some factors may speed up the development of this disease and make the veins worse. The major factors include pregnancy, prolonged standing in one place, obesity, hormone levels and physical trauma from previous episodes of deep vein thrombosis (blood clots).

Varicose veins of the rectum are called hemorrhoids and varicose veins of the esophagus are called esophageal varicose veins. While many people have heard of varicose veins of the legs, very few truly understand their underlying cause and the potential they have for developing into serious medical issues.

Varicose Vein Treatment

Conservative measures (like compression hose) are helpful but do not treat the underlying cause of the disease process. Compression therapy helps adjust the superficial vein pressure to cause the vein blood flow to take other veins deeper in the limb. Without correction of the mechanical problem, varicose veins will usually enlarge and worsen over time. Legs and feet may begin to swell and sensations of pain, heaviness, burning or tenderness may occur.

Twisted, ropey veins are related to mechanical problems and the usual answer for mechanical problems is mechanical therapy. Premiere vein centers use endovenous laser or radiofrequency techniques to permanently seal faulty varicose veins with conservative, non-surgical methods. Advanced varicose veins may lead to vein inflammation (phlebitis), deep vein thrombosis (blood clots) and non-healing ulcers and sores of the lower extremities.

Most vein therapy is covered by insurance and Medicare if medical symptoms can be directly related to the visible veins. High resolution ultrasound evaluation is mandatory in the work up of venous disease.

Saline or Silicone?

Before undergoing breast augmentation surgery, it is important to choose the consistency of your breast implants wisely. All implants are not created equally and thus serve different aesthetic purposes. For optimal results, patients should weigh the pros and cons of saline and silicone breast implants.

Saline Breast Implants

Saline, a silicone based shell with a saltwater solution filling, is the most common implant used for breast augmentation. Their firmness is often criticized as being too indiscreet, but some women choose them for that very reason.

Saline implants are particularly ideal for women that possess a significant amount of excess breast tissue. Because the implants are filled during the procedure, the volume can be adjusted so that the excess skin smoothly covers the implant, allowing for optimal fullness and shape. This also allows the surgeon to make a smaller incision, resulting in a smaller scar.

Although saline implants are more affordable than silicone implants, saline implants have a few disadvantages such as a less natural or harder feel and increased potential for rippling. The appearance of rippling is most common in women who lack the tissue needed to support the implant.

Silicone Breast Implants

Silicone implants, a shell of flexible silicone filled with a firm gel, mimic the tissue of a real breast. They are ideal for thin or small breasted women with thin, chest skin. Once deemed as unsafe, silicone gel implants were reintroduced to the market with the approval of the FDA in November of 2006. Since then, silicone implants have grown in popularity and remain supported by the FDA as a safe and effective device when used as intended.

Silicone implants provide a more natural look and feel than saline implants. Although silicone implants are more natural looking than saline and less likely to ripple, they still present some disadvantages like the need for a larger incision and a higher cost than saline. Silicone implant leaks are also harder to detect than saline implants, but are highly rare if used as intended.

For patient safety, it is important to understand that breast implants, whether saline or silicone , are not lifetime devices and must be replaced according to manufacturer ‘s guidelines (typically every ten years). Both saline and silicone implants come in a variety of shapes and sizes which you can view and feel during your consultation with your cosmetic or plastic surgeon.

Whether you choose saline implants or silicone implants, it is important to review the advantages and disadvantages of both devices with your Board Certified Cosmetic Surgeon.

Liquid Facelift: Turn back the hands of time

Although the skin appears tighter after facelifts, balance and youthfulness can be lacking due to volume loss. The goal of volume replacement is to help patients look more like they did 10-15 years ago, not to make them look like someone else. The term “liquid facelift” refers to treatments that can be performed using injectable therapies that require little or no downtime.

Neuromodulators work on the underlying muscles by relaxing them [Botox, Dysport, Xeomin], softening wrinkles [facial fillers] or appearing to lift a certain area of the face. Other therapies add volume [facial fillers, fat transfer].

As the face ages, it loses volume. This causes shifts in the youthful contours and prominent landmarks of the face. Loss of facial fat, muscle, bone and reduced skin elascity leads to folds, lines, jowls and wrinkles – the dreaded signs of age. Facelifts work to return facial structures to the original positions by shifting muscular structures, removing excess skin and re-drape of the skin to carry a more youthful contoured position. However, facelifts carry increased cost, downtime and surgical interventions. Many 40-50 year olds are looking for facial rejuvenation to tide them over until their facial aging mandates a formal surgical procedure.

Tissue Filler Injectables

Tissue fillers are another group of injectables used for liquid facelifts. The most commonly used are Restylane, Perlane, Juvederm and Radiesse. Not all products can be used just anywhere on the face. Depending on the patient’s appearance and the treatment location, one or a combination of these products can be used to reduce the appearance of wrinkles and provide plumping of various facial structures. Hollowing under the eyes, mid face droop, hollow temples and chin sag can dramatically improve with volume. Cheeks can be enhanced to return that heart-shaped, youthful face and to lift the nasolabial folds. Nasolabial folds and marionette lines can be treated with tissue fillers as an adjunct to mid face surgical lift procedures.

Sculptra and Selphyl exist in a category called collagen stimulators. They can be used to add volume to most areas of the face. Each work by stimulating the body’s natural collagen, which helps smooth out the lines and wrinkles. Selphyl uses platelet-rich plasma to trick the body to generate more collagen.

Neuromodulators:Botox

Neuromodulators relax dynamic muscles that create wrinkles as they contract. Areas that can be treated with Botox include crow’s feet. frown lines, forehead lines, neck lines and chin dimpling. Botox can elongate the appearance of the chin and elevate the corners of the lips, enhancing the patient’s smile. A small amount injected in the lip border reduces the appearance of lip lines and can help the lips appear more plump.

Botox injection is the most popular nonsurgical cosmetic procedure today. Improvement of the wrinkles may last up to four to six months. Until recently, Botox was the only botulinum toxin A preparation with a cosmetic indication. Dysport, the first competitor with similar indications was approved in April 2009. Xeomin has now entered the market with lower unit price than that of Botox and Dysport.

Facial balance can be returned using a combination of the products discussed- with little downtime and without major, invasive surgery. Facial injection is an art form and you must choose your artist well. Review before and after photographs and make sure you have appropriate expectations for non-surgical facial enhancement before you present for facial review. Make sure that your aesthetic ideal matches that of your cosmetic surgeon injection artist.

Melasma: The mask of pregnancy

Melasma is an acquired hyperpigmentation of sunexposed skin areas, or in plain English, “dull brown spots.” It presents as symmetric hyperpigmented spots which can be separated or bunched together along the cheeks, nose, the upper lip, the chin and the forehead, and can occasionally occur in other sun-exposed locations. Melasma spots are dark, irregular brown-toblack patches that gradually, over time, may develop into mask-like patterns.

What Causes Melasma?

The exact cause of melasma is uncertain. In many cases, there is a direct relationship with female hormonal activity because melasma occurs with pregnancy and with the use of oral birth control pills. Other factors related to melasma include “sun” sensitizing medications, mild ovarian or thyroid dysfunction, and certain cosmetics.

Yet the most important factor in the development of melasma is exposure to sunlight. Without the strict avoidance of sunlight, potentially successful treatments of melasma are doomed to fail. Tanning bed exposure has increased the incidence of melasma in the United States. Melasma, though distressing, is a benign process.

Melasma is rare before puberty and most commonly occurs in women during their reproductive years. Although it can affect anyone, melasma is particularly common in women, especially pregnant women and those who are taking oral contraceptives or hormone replacement therapy (HRT) medications. It is much more common in women than in men; in fact, women are affected in 90 percent of cases. When men are affected, the clinical presentation is identical. Melasma does not cause any other symptoms beyond the cosmetic discoloration. However, the facial discoloration can be devastating.

Persons of any race can be affected by melasma, however, it is much more common in people of darker skin types than in lighter skin types, and it may be more common in light brown skin types from areas of the world with intense sun exposure. Melasma is also prevalent in men and women of Native American descent (on the forearms) and in men and women of German/Russian Jewish descent (on the face).

Melasma is usually diagnosed by a physician visually or with assistance of a Wood’s lamp (black lamp). Under the Wood’s lamp, excess melanin pigments in the epidermis can be identified. Some melanin deposits are superficial in the skin while others may be deep in the dermis. The deeper the pigment deposits, the more difficult it is to treat. The discoloration of melasma usually disappears spontaneously over a period of several months after giving birth or stopping the oral contraceptives or hormone replacement therapy.

Melasma Treatment

Treatments to hasten the fading of the discolored patches include; topical depigmentation creams, acid peels, and laser skin resurfacing. Depigmentation creams such as hyproquinone (HQ) can be used directly on the dark spots. HQ is a chemical that inhibits a specific enzyme involved in the production of melanin pigments. Acids ointments are used to increase skin cell turn-over, pushing the brown discolorations to the surface so rapidly that it results in pigment fading. Other acid treatments are thought to decrease the activity of melanocytes or pigment cells.

When topical treat-ments fail, most patients proceed with facial peels using alpha hydroxy acids or chemical peels with glycolic acid. Yet, some of the most dramatic changes in melasma spots have been attained with laser skin resurfacing treatments. In all of these treatments, the effects are gradual and a strict avoidance of sunlight is required before, during and after completion of therapy. The use of broad-spectrum sunscreens with physical blockers such as titanium dioxide and zinc dioxide is preferred over that with other chemical blockers. This is because UV-A, UV-B and visible lights are all capable of stimulating pigment production. Say goodbye to the tan beds! Last, but not least, cosmetic makeup can be used to reduce the appearance of melasma. Melasma, though annoying, has no known relationship to skin malignancy.

Mini Facelift

This patient is shown before and after having a Mini facelift in conjunction with a blepharoplasty (eyelid lift) performed by Dr. White.

Degradation of skin elasticity, deflation of facial volume and descent or falling of facial structures are an unfortunate effect of aging. The traditional facelift addresses each of these issues, but with a price: down time and expense. Many men and women 40 to 65+ who don’t wish to look their true calendar age consider facelift procedures to erase sagging jowl s and that loose, draping, wrinkled skin under the chin.

The office-based mini facelift is a mid-range mini surgical facelift to address the mid to lower face. The post operative effect provides a more natural appearance with limited down time when compared to other formal facelift procedures. Most “traditional” facelifts are performed with general anesthesia and involve multiple weeks of downtime and a long incision beginning at the upper temple and extending behind the hairline on either side of the face to the nape. The minimal incision mini facelift, which has been performed since the late 1990s, is the basis for the officebased mini facelift. The mini facelift proves an overall lift to the lower region of the face and upper neck, offering significant age diminishing effects with minimal downtime and lasting results.

Mini Facelift: The Solution for Saggy Jowls and Neck

The mini facelift is designed for men and women who want to stay ahead of the “Ds” of the aging process: Degradation, Deflation, Descent. As we age, most individuals lose elasticity in their skin and develop varying degrees of descent along the jaw line and beneath the chin. The mini facelift not only tightens skin, it is designed to suspend the underlying structures of the lower face and upper neck. This suspension of the lower face offers the benefit of a more youthful appearance without the wind blown look of a formal facelift. This “turn back of time” from the mini facelift will last until the normal aging process resumes for the individual. Lifestyle choices, heredity, bone structure, skin type and sun exposure all play a part in determining how long the mini facelift surgical results will last for each individual.

Mini Facelift: The Procedure

The mini facelift is an outpatient procedure that usually takes one to two hours to perform, depending on age of the patient and the degree of facial correction desired. Oral pre medications are given to help relax the patient, local block is used for the skin. A small, relaxed S-shaped incision is made beginning along the sideburn, extending along the front of the ear, around the earlobe and up to the hair line back from the ear toward the nape of the neck. Great attention is given to the placement of the incision line to provide an inconspicuous scar after healing. Short skin flaps are created with meticulous care. The underlying connective tissues and facial musculatures are gently lifted and tightened using a simple suture technique. The sutures are anchored to dense tissue around the facial bones to suspend the sagging facial tissues. This suspension enhances the appearance of the jaw line andupper neck. The leftover redundant skin is then tailored to match. The incision is carefully closed using plastic surgery techniques designed to reduce tension and minimize any visible scarring.

In some cases, a small incision will also be made under the chin to remove excess tissues; this tuck with liposuction of the neck and jowl area may be performed in conjunction with the mini facelift for optional aesthetic results in the neck region.

Unlike the conventional facelift that may result in a “pulled back” appearance, the mini facelift offers very natural-looking results. Patients enjoy an overall firming of the lower facial area, noticeable jaw line definition and a more elegant neckline. Generally, the results obtained with the mini facelift are predictable and quite dramatic, sometimes erasing five, ten, even fifteen years from one’s appearance.

Board Certified Cosmetic Surgeon Dr. White is considered an expert at the mini facelift. Call 423-648-4011 to schedule your mini facelift consultation.

Treatment of Wrinkles and Scars

Laser resurfacing uses heat induced by laser light to destroy and remove (vaporize) the upper layers of the skin. This causes new skin to grow. It is typically used to remove or improve the appearance of wrinkles shallow scars (from acne, surgery or trauma) and other skin defects. The laser sends out brief pulses of high-energy light that are absorbed by water and certain substances in the skin called chromophores. The light is changed into heat energy, and the heat then vaporizes thin sections of skin, layer by layer. As the wounded area heals, new skin grows to replace the damaged skin that was removed during the laser treatment.

Fractionated CO2 Laser

The CO2 (carbon dioxide) laser is the most common type of laser used for resurfacing. Fractionated lasers are also used frequently and are growing in popularity because they do a similar job, but penetrate less deeply and therefore heal more quickly with little or no down time. Laser resurfacing is usually very precise and causes little damage to the surrounding skin and tissue. It is done most often on the face, but it may be done on skin in other areas of the body like the chest, back and hands.

The areas to be treated by laser resurfacing are cleaned and marked with a pen. A nerve block with a local anesthetic is usually used to numb the area before treatment. You may also be given a sedative or anti-anxiety medication. If your entire face is going to be treated, you may need stronger anesthesia (in some cases, general anesthesia), pain relievers or sedation.

Laser Resurfacing: The Procedure

You may be given goggles to wear to prevent eye damage by the laser. The laser is passed over the skin, sending out pulses. Each pulse lasts less than a millisecond. Between passes with the laser, the skin may be cooled. The number of passes required depends on how large the area is and what type of skin is being treated as well as the type laser used for the treatment. Thin skin around the eyes, for instance, requires very few passes with the laser. Thicker skin or skin with more severe lesions requires a greater number of passes. The pulses from the laser may sting or burn slightly, or you may feel a snapping sensation against your skin. Laser resurfacing is usually done in a doctor’s office or out-patient surgery center.

Conditions Improved by Laser Resurfacing

Laser resurfacing may be used to remove or improve the appearance of:

• Wrinkles

• Superficial scars caused by acne, surgery or trauma that are not growing or getting thicker

• Color (pigment) changes or defects in the skin, such as liver spots (lentigines), port-wine stains or coffee spots. (Any growth that could be malignant should be evaluatedusing a biopsy before laser resurfacing is done.)

In general, laser resurfacing tends to have good results with fairly low risks. Wrinkles caused by aging and long-term sun exposure, such as those around the eyes and mouth, respond well to laser resurfacing. The long-term results for these types of wrinkles are unknown, and you should keep in mind that new wrinkles will probably appear as your skin continues to age. Wrinkles caused by repeated movement and muscle use (such as those on the forehead or along the sides of the nose) may be improved but not eliminated. They often come back months or years after treatment because the muscles continue to perform the activities that caused the wrinkles before treatment.

Endovenous laser therapy for varicose veins

Up to 40 percent of women and 18 percent of men have problems with severe varicose veins. Slow stagnate venous blood return to the heart often causes leg aches, burning pain, stinging pain and, with time may lead to nonhealing skin ulcerations of the distal limbs. The bulging blue and sprawling ropy varicose veins that prompted your “no shorts” rule can now be effectively resolved without fear of surgery, pain or long recovery periods, thanks to endovenous laser treatment (EVLT). Before EVLT, vein stripping surgery was the mainstay of vein therapy, along with compression stockings. In place of the “stripping” surgical procedures that required the leg to be cut open and faulty veins to be cut out, the new EVLT laser procedure is minimally invasive and neither is necessary.

Evaluation of symptomatic varicose veins starts with a detailed history and physical examination. A detailed ultrasound review of the lower extremities is completed to map out the limb veins to determine the site of the faulty valves and their relationship to the varicose veins. The veins are not constant like arteries; each person has unique vein patterns and unique varicose vein problems. A personalized attack plan is necessary with ultrasound mapping to plan efficient eradication of the problem varicose veins.

EVLT: What to Expect

The endovenous laser treatment costs less than traditional stripping surgery for varicose veins and usually takes less than two hours to complete. EVLT can be administered in an outpatient setting without general anesthesia and minimal scarring. Ultrasound is used to map out the main veins at the time of EVLT. After a local anesthetic is applied, a thin laser fiber passes through a needle injected into the leg (usually near the knee). The faulty vein or veins are then sealed using high energy laser techniques. The limbs are then wrapped for a short period of time with compression wraps. Sometimes, EVLT is used in conjunction with sclerotherapy where a sclerosing solution is injected into small spider veins. This causes the small veins to seal, allowing for a better cosmetic final result.

But, before you stop shopping for shorts again, your condition first needs to be properly evaluated to ensure that you are a candidate for EVLT laser therapy. This procedure is not for spider veins or for cosmetic reasons. The patients who are best candidates for EVLT laser therapy have significant ropy varicose veins which cause the symptoms of burning, stinging, heavy leg sensations along with leg swelling, and who have failed more conservative treatment options.

EVLT:Ideal Candidates

Not every patient is a good candidate for EVLT, but it does work well for most. Traditional surgery still has its advantages for some (more severe) cases. Based on physical exam and a detailed ultrasound, your physician should be able to find out if the EVLT procedure would be the right course of action for you. Most insurance carriers and Medicare cover payment for varicose vein therapies as long as it is medically necessary and not just for cosmetic reasons.

Why is Cosmetic Surgery Board Certification important?

Cosmetic surgeons combine knowledge, surgical skill, technical expertise and ethics to achieve their goal of providing aesthetic enhancement for their patients. When choosing a cosmetic surgeon it is important to select a cosmetic surgeon who is board certified. In most states it is legal for any physician who holds a valid medical license, with or without surgical training, to practice cosmetic surgery. Board certification is important because it makes certain that your cosmetic surgeon has the training, qualifications and experience needed to perform your cosmetic surgical procedure safely and skillfully. A board certified cosmetic surgeon has greater insight into your needs, has knowledge of state-of-the-art techniques and the surgical skill and judgment to recommend and perform the cosmetic surgical procedure that will enhance your appearance effectively and safely.

Having said that, board certification does not equal quality care or quality outcomes. Having a Tennessee driver’s license does not make one a good driver—it only verifies that they have successfully completed the examination and have been issued a license to drive.

Becoming Board Certified in Cosmetic Surgery

In order for a surgeon to become board certified in any medical specialty, they must go through a long demanding process that takes years to complete. The American Board of Cosmetic Surgery [ABCS] is the only certifying board that exclusively tests a surgeon’s knowledge and experience in cosmetic surgery. Surgeons develop their cosmetic surgical skills through post residency training and experience. The point is that a cosmetic surgeon’s skill and ability will depend on the surgeon’s cosmetic surgery training and experience, not on core board-certification.

The number of people seeking cosmetic surgery has grown rapidly over the past several years. As part of a greater focus on appearance, people are turning to cosmetic surgery as one means of enhancing their appearance. At the same time, more and more doctors are practicing cosmetic surgery.

Given the growing number of cosmetic surgery patients and the highly competitive pool of doctors performing cosmetic surgery, it is vital that you obtain accurate information regarding cosmetic surgery and the doctors who perform it. Before you undergo cosmetic surgery, it is important you become informed about the doctor’s education, training, experience and proven competence with respect to the specific procedure you seek.

Cosmetic surgery may be performed in various facilities such as hospitals, surgical centers and office settings. An accredited surgical facility must meet certain minimum standards to obtain and maintain its accreditation.

Research Before Undergoing Cosmetic Surgery

Before the surgery, your doctor should explain to you the risks and possible complications, and potential side effects, including the pros and cons of the procedure. In addition, ask about the surgeon’s privileges in an accredited surgery center or a hospital to perform cosmetic surgery.

As for how you should choose a cosmetic surgeon or cosmetic surgical center— You should do the research locally and online. You can perform a standard internet search with the name of the doctor or the procedure about which you would like to receive more information. What do you see online? Negative or positive feedback or reviews.

Make sure that your surgeon has a good reputation, a strong background in the surgical field, and above ALL … that he or she produces good results. Training is important; board certification is important; but skill, judgment and artistic detail are evidenced by experience and outcomes — not board examinations.