Park Meadows Cosmetic Surgery Blog

Results Revealed in ASPS Procedural Statistics Report
For Immediate Release: March 22, 2007

ARLINGTON HEIGHTS, Ill. – Males had more than a million cosmetic plastic surgery procedures in 2006 according to statistics released today by the American Society of Plastic Surgeons (ASPS). Surprisingly, the overall number of male cosmetic plastic surgery procedures declined by 7 percent; however, there was growth in minimally invasive procedures that provide volume in the face and in surgical procedures for a more toned body.

“Although we’ve seen a slight dip in some of the traditional male plastic surgery procedures, the numbers reveal men are focused on adding volume to their face and reducing volume in the body,” said ASPS President Roxanne Guy, MD. “These are healthy men who want to look as good as they feel.”

Men looking to revitalize their aging face preferred procedures that were less invasive, less expensive and required less healing time. Soft tissue fillers experienced the largest growth between 2005 and 2006 with hyaluronic acid (Restylane®, Hylaform®) and polylactic acid fillers (Sculptra®) leading the charge, growing by 85 percent and 66 percent respectively. Botox® injections, microdermabrasion, and laser skin resurfacing increased by 202 percent, 112 percent and 49 percent since 2000.

In contrast to facial procedures, men increasingly turned to surgery to achieve a more toned body. Since 2005, thigh lifts increased by 39 percent, male breast reductions by 22 percent, and tummy tucks by 4 percent. Thigh lifts grew by 180 percent and tummy tucks by 165 percent since 2000. Although total procedures for pectoral implants and calf augmentations are relatively low, they climbed 99 percent and 49 percent respectively since 2005.

The ASPS website has statistics from the 2006 National Clearinghouse of Plastic Surgery Report, information on procedures and referrals to ASPS Member Surgeons.

ASPS procedural statistics are collected through the first online national database for plastic surgery procedures, Tracking Operations and Outcomes for Plastic Surgeons (TOPS). This data, combined with the annual survey sent to American Board of Medical Specialties certified physicians most likely to perform plastic surgery, results in the most comprehensive census on plastic surgery procedures.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Park Meadows Cosmetic Surgery offers you two of today’s top doctors in the field of plastic surgery. Dr Randolph C Robinson is double board-certified by the American Board of Oral & Maxillofacial Surgery and the American Board of Cosmetic Surgery. Dr Jeremy Z Williams completed extensive training in plastic surgery at The Johns Hopkins Hospital in Baltimore, MD before returning to his native home, Colorado. Both are committed to providing you with top quality care, from your initial consultation to your full post-operative recovery. Please contact their Denver, Colorado office at 303-706-1100 to learn which type of breast plastic surgery is right for you.

ASPS Reports Significant Increases in Skin Removal and Lift Procedures
For Immediate Release: March 22, 2007

ARLINGTON HEIGHTS, Ill. - While cosmetic minimally-invasive procedures continue to see an increase among all age groups, baby boomers are adding skin and body lift procedures in increasing numbers, according to statistics released today by the American Society of Plastic Surgeons (ASPS).

Since 2005 for people ages 40 to 54, thigh lifts increased 27 percent, lower body lifts increased 24 percent, upper arm lifts increased 23 percent, thread (face) lifts increased 22 percent, breast lifts increased 11 percent, and tummy tucks increased 7 percent. Similar increases in the same procedures since the previous year were also reported for the age group 55 and older. In fact, the combined age groups experienced a 12 percent increase in these cosmetic procedures from 2005 to 2006.

“Baby boomers are experiencing the unavoidable—loss of skin elasticity with age,” said Roxanne Guy, MD, ASPS president. “In thirty year-olds, the need for more invasive procedures can be delayed by using injectable fillers and lasers. Not so for treating the loose skin boomers are experiencing.”

A recent AC Neilsen survey found that baby boomers not only want to look younger, but also feel younger. The study showed the boomers perception reflects a new middle age in their sixties resulting from their forties being considered the new thirties. The desire to match their perception of age with how they look is important to baby boomers.

A Harris Interactive consumer survey conducted for ASPS in 2006 found similar results. For instance, the ASPS survey of 800 women ages 35 to 69 found that the majority would prefer their face to look 13 years younger. The survey also found women were most likely to be extremely or very concerned about wrinkles and sagging skin. The majority (81 percent) of respondents were 40 to 64 years old.

Close to 5 million total cosmetic procedures were performed on women and men ages 40 to 54 in 2006, who made up 45 percent of total patients. Patients ages 55 and older in 2006 made up 26 percent of total patients with 2.8 million total cosmetic procedures.

The ASPS website has statistics from the 2006 National Clearinghouse of Plastic Surgery Report, information on procedures and referrals to ASPS Member Surgeons.

ASPS procedural statistics are collected through the first online national database for plastic surgery procedures, Tracking Operations and Outcomes for Plastic Surgeons (TOPS). This data, combined with an annual survey sent to American Board of Medical Specialties certified physicians most likely to perform plastic surgery, results in the most comprehensive census on plastic surgery procedures.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Park Meadows Cosmetic Surgery offers you two of today’s top doctors in the field of plastic surgery. Dr Randolph C Robinson is double board-certified by the American Board of Oral & Maxillofacial Surgery and the American Board of Cosmetic Surgery. Dr Jeremy Z Williams completed extensive training in plastic surgery at The Johns Hopkins Hospital in Baltimore, MD before returning to his native home, Colorado. Both are committed to providing you with top quality care, from your initial consultation to your full post-operative recovery. Please contact their Denver, Colorado office at 303-706-1100 to learn which type of breast plastic surgery is right for you.

ASPS Reports 53 Percent More Minimally-Invasive Procedures Since 2000
For Immediate Release: March 16, 2006

ARLINGTON HEIGHTS, Ill. – Rest and relaxation seem like impossible feats to most Americans trying to balance the demands of family and career. This balancing act could account for the continued growth in minimally-invasive cosmetic plastic surgery procedures with 8.4 million performed in 2005. According to the statistics released today by the American Society of Plastic Surgeons (ASPS), minimally-invasive procedures increased 13 percent from the previous year and 53 percent since 2000.
Minimally-invasive cosmetic procedures are mostly performed in an outpatient setting, do not call for general anesthesia, require little to no downtime and usually cost less than the more invasive cosmetic surgeries. The top five minimally-invasive procedures this year and since 2000 are Botox® (3.8 million), chemical peel (1 million), microdermabrasion (840,000), laser hair removal (780,000), and sclerotherapy – elimination of spider veins (590,000).

“For facial rejuvenation especially, we have seen a shift from surgical treatments to a more subtle approach,” said ASPS President Bruce Cunningham, MD. “As patients choose to address signs of aging with less invasive procedures, plastic surgeons also have more tools at their disposal to care for these patients. For instance, plastic surgeons may use more than one type of product or procedure to treat different areas of a patient’s face.”

Since 2000, total surgical cosmetic procedures have decreased by five percent. In the same time period, facelifts decreased 19 percent and forehead lifts 54 percent; however, Botox® injections increased 388 percent and laser skin resurfacing 59 percent. Another notable trend - collagen and fat injections have decreased 58 and 13 percent respectively since 2004, but on the rise are hyaluronic acid (Restylane®, Hylaform®), polylactic acid (SculptraTM), and calcium hydroxylapatite (RadiesseTM) fillers. This can be attributed to the fact that collagen and fat injections can be time consuming with allergy tests and harvesting procedures, and the newer fillers can achieve similar, if not better, results.

To obtain a full report of the 2005 National Clearinghouse of Plastic Surgery Statistics, which includes trending data on gender, age, geography, surgeons fees, ethnicity and more, contact ASPS Public Relations.

Since 2003, statistics have been collected through the first online national database for plastic surgery procedures, Tracking Operations and Outcomes for Plastic Surgeons (TOPS). This data, combined with the annual survey sent to more than 17,000 board-certified physicians in specialties most likely to perform plastic surgery, results in the most comprehensive census on plastic surgery procedures.

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

Park Meadows Cosmetic Surgery offers you two of today’s top doctors in the field of plastic surgery. Dr Randolph C Robinson is double board-certified by the American Board of Oral & Maxillofacial Surgery and the American Board of Cosmetic Surgery. Dr Jeremy Z Williams completed extensive training in plastic surgery at The Johns Hopkins Hospital in Baltimore, MD before returning to his native home, Colorado. Both are committed to providing you with top quality care, from your initial consultation to your full post-operative recovery. Please contact their Denver, Colorado office at 303-706-1100 to learn which type of breast plastic surgery is right for you.

I gave several lectures this month on distraction osteogenesis or bone lengthening. The procedure was developed by Gavriel Ilizarov, a Soviet orthopedic surgeon from Siberia to lengthen legs and arms. About 15 years ago, when I returned from my craniofacial and plastic surgery fellowship in France with Dr. Paul Tessier, I researched and invented several devices for internal distraction osteogenesis. The devices are now used to lengthen the bones of the face, arms, and legs. The internal position of the device decreases the amount of pain and makes the recovery easier.

The lectures were given at the Denver Review Course for Oral and Maxillofacial Surgery, the Colorado Academy of Osseointegration, and the Orthopedic Department at Walter Reed Army Medical Center. I enjoy the teaching side of things, especially the young doctors who are eager to learn. Walter Reed Army Medical Center outside Washington, D.C. is an amazing place. The surgeons and facility are first class and it made me so very proud of our soldiers and their sacrifices on our account. I hope that my devices can be used to ease their pain and restore their injuries.

In a few days, I leave for Vietnam again to help train doctors there in reconstructive surgery. Our group, Face the Challenge is a Christian medical relief organization, and has been incorporated as a 501(c)(3) since 1993. I will give a report on the trip next month.

Breast cancer cases are on the rise and have been increasing over the last 10 years. At the same time the number of deaths from breast cancer is declining. The rising incidence is largely due to an aging population and better detection with mammograms. Because more cases are being detected early many cancers are treated and “cured” effectively. In addition, new drugs have become available that specifically treat certain types of breast cancer.

Unfortunately, some forms of breast cancer are difficult to detect and often go undiagnosed. One such type of breast cancer is inflammatory breast cancer. Inflammatory breast cancer (IBC) is an advanced and accelerated form of breast cancer that usually does not show up on routine screening exams such as mammograms or ultrasounds. Inflammatory breast cancer requires immediate aggressive treatment with chemotherapy prior to surgery and is treated differently than more common types of breast cancer. Inflammatory breast cancer also is more common in certain ethnic populations such as African Americans. Important symptoms of inflammatory breast cancer include: swelling, itching, pink or dark colored area with an unusual texture (much like the skin of an orange - hence it is described as peau d’orange), ridges and thickened areas of the breast skin, a bruise that doesn’t go away, nipple retraction, nipple discharge, breast is warm to touch, and breast pain. Any of these symptoms should be checked out by a doctor. It is important to remember that “you do not need to have a lump to have breast cancer.”

Botox produces paralysis limited to specific facial muscles that are injected. The paralysis of specific muscles, in turn, eliminates or lessens the wrinkles that arise over top of the muscle. Botox works by blocking the nerve signal that stimulates muscle movement. This block usually takes full effect by approximately 36 hours after injection. Because the junction between nerves and muscles (neruomuscular junctions) are constantly turned over, muscular function gradually returns after approximately 3 months. These new neruomuscluar junctions prevent permanent paralysis of the treated muscle and necessitate re treatment every 3 months.

An abdominoplasty or tummy tuck is usually not covered by insurance as medically necessary. Many women after pregnancy, who have excessive skin and fat in the lower tummy, also have spreading of the muscles. In the tummy tuck operation, the skin and fat are removed and the muscles are tightened to give a flatter abdomen. When the muscles are spread apart so that there is a hernia (bulging of fat or intestine through the abdominal wall) then insurance may cover the repair which could include a tummy tuck at the same time. If there is an indication for a hysterectomy or other abdominal surgery, a tummy tuck could be coordinated at the same time but it may or may not be covered. Bariatric surgery or surgery to treat obesity will sometimes cause extra hanging skin after the patient has significant weight loss. Insurance may cover the weight reduction surgery but usually does not cover the contouring surgery to remove the skin, which in most cases requires an abdominoplasty. The best solution to the question is to have a consultation and have the surgeon’s office perform a predetermination to see if it is covered under the patient’s policy.

Randolph C. Robinson, M.D., D.D.S., F.A.A.C.S.

Utilization of pain–pump in breast augmentation procedures

Breast augmentation procedures have continued to rise over the last decade.
Since 1992 the number of breast augmentations has increased over 450%, the largest increase in plastic surgical procedures. The growing demand for breast augmentation procedures is always an on going effort to obtain better results with less recovery and using newer and more innovative techniques. Where as the desire for the particular size or shape of the breast is an intimately personal decision, all patients share in a common the initial post operative discomfort associated with these procedures.

Breast augmentation unlike many other plastic surgical procedures has relatively short down time associated with it. However, the first 3-4 days post augmentation can be difficult with regard to pain control. Classically, pain control has been managed for centuries with utilization of narcotics analgesia. In recent years Various other surgical disciplines have began using implantable pain devices to Deliver numbing pain medications directly to the surgical site.

Non-narcotic pain pumps have been used for sometime in abdominoplasty, “tummy tuck” procedures as well as other cosmetic procedures. Recently, these pumps have been approved for use in breast augmentation and breast reconstruction procedures.

There are a variety of catheters available on the market one of which is
The “ON-Q Pain Buster.” ON-Q PainBuster is a high-tech balloon-type pump that is filled with a non-narcotic numbing medication (local anesthetic) that continuously infuses a small amount of medication into your area of discomfort for the critical days following surgery. The ON-Q pain pump and catheter system utilizes a patented technology to administer a controlled amount of pain solution directly into the region the augmentation has been performed. implanted for 3 days after which they can be easily removed by the patient or the physician with little or no discomfort. You may wear the pain pump externally in a fanny pack or clipped to your clothing during your recovery.

During surgery, the surgeon implants a tiny catheter around the surgical area. The catheter remains implanted for 3 days after which they can easily be removed by the patient or the physician with little or no discomfort. You may wear the pain pump externally in a fanny pack or clipped to your clothing during your recovery.

During your recovery when the catheters are in place the utilization of pain medications, such as narcotics, is significantly decreased. Typically without a pain pump, patients will take 1-2 narcotic tablets every 3-4 hours for the first 3-5 days after surgery. It is not uncommon from an anecdotal stand point to see patients who only take 3-4 pills over a 4 day period while the catheter is in place. This decrease in use of narcotics to manage pain allows patients to lead a more active lifestyle, in the initial post operative recovery, still remaining well within the safe limitations of activity

Studies have clearly demonstrated that utilization of pain pumps and catheters in breast augmentation can:

• Decrease pain
• Increase patient satisfaction
• Significantly decrease use of narcotics
• Reduce narcotic side-effects which may include nausea, vomiting and constipation
• Help you get back to your normal activities faster

I believe utilization of the catheters is a dramatic advantage in the armamentarium of the surgeons seeking to provide optimum results and outcomes for patients desiring augmentation.

-Jeremy Z. Williams, M.D.

Dr. Williams has recently been named an Assistant Clinical Professor in the Department of Surgery, Division of Plastic and Reconstruction Surgery at the University of Colorado at Denver Health Science Center and School of Medicine. Dr. Williams has had a lifelong interest in academic plastic surgery. Most recently, Dr. Williams has spent approximately seven years at the Johns Hopkins Hospital in Baltimore, Maryland (ranked by U.S. News & World Report as America’s #1 hospital for the last 15 years). Dr. Williams hopes to continue and maintain his pursuits both in academic and teaching capacities through his affiliation with the University of Colorado. In addition, he maintains an active interest in the pursuit of new innovations through research in the field of plastic and reconstructive surgery.

This month, Dr. Randolph C. Robinson at Park Meadows Cosmetic Surgery in Lone Tree, Colorado reported performing one of the first ultrasonic assisted abdominoplasties in Denver. The technique using high frequency vibration energy to cut through the tissue is thought to cause less tissue damage compared to other conventional methods such as electrocautery. The instrument that was used is made by Ethicon Surgical, a subsidiary of Johnson & Johnson based out of Cincinnati, Ohio.

Dr. Robinson said that the surgery took a little bit longer to perform than conventional methods, but the opportunity to cause less tissue damage during the procedure and thus speed the recovery will be of benefit. The Harmonic scalpel which was used during the procedure has been used in urologic surgery, thyroid surgery, and neurosurgery over the years, but is new in the cosmetic arena. The process is still under development, but it is hoped that the reduction in tissue injury during surgery will reduce complications and improve the healing process.

For more information please contact Tammy L. Garcia of Park Meadows Cosmetic Surgery at 303-706-1100