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Question of the Week: Multiple Procedures, 1 Price?

Atlantic Coast Aesthetics Question of the Week, which comes from our Facebook audience. The patient asks, “I’ve been looking into having my neck lifted & maybe the lower face. I’ve been reading about different doctors’ takes on it. Some say the lower face lift & neck lift are the same with 1 price, some say they are 2 different surgeries at 2 different costs. Many say there’s the neck lift, lower face, middle face, upper face, 3 procedures, 3 different costs? Does that mean I should go with the doctor that offers the face & neck lift as 1 procedure at 1 price? ” 

Here what Dr. Pane has to say

Dr. Pane says that some surgeons who will do the face and neck lift at the same time, but it’s important for patients to watch where they’re going for the consultation. Most surgeons don’t offer breakdowns of different parts of the face such as upper, lower and neck. Typically, the surgeon will assess the patient’s problem areas and get a sense of what needs to be done. After the assessment, the surgeon then provides a package pricing that is going to encompass all the procedures the patient may benefit from. The available packages and options will vary depending on whether the provider is a plastic surgeon that does the full range of facial procedures or one that may only do a part of the work that is possibly needed for face and neck field. Dr. Pane stresses that it’s important to keep that distinction in mind.

Dr. Pane notes that just because a given surgeon declines to do a certain procedure doesn’t make the provider a bad or incompetent doctor. Most providers who decline to perform certain services do so because of a lack of experience and abundance of concern for the patient’s well-being. While this is laudable in itself, it becomes a problem when the doctor tries to convince the patient into a position that doesn’t properly address the problems the patient faces. When this occurs, the patient should always trust their own instincts and eyes first and foremost, because the patient is the one who has to live with the results or lack of same.

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Liposuction Procedure By ACA. #QotW

This week’s ACA Question of the Week comes from one of our viewers who asks, “Would I be a good candidate for Liposuction and what areas would I get?” Dr. Pane noted that the patient in question sent in photos, which is always helpful but a distant second best to a live, in-person consultation where the problem areas can be evaluated in various postures and attitudes, such as sitting, standing and lying prone.

One concern many patients have concerns the inevitable scar from a tummy tuck. Many patients prefer to avoid this option because of uncertainty about where the scar will end up and how visible it will be. While for a tummy tuck the scar is normally concealed beneath the waistline of one’s underwear, liposuction does leave less scarring and therefore they opt for a full session of liposuction. Dr. Pane points out that this may be desirable for thinning out subcutaneous fat deposits around the back and sides. In Florida, where the laws governing cosmetic procedures in general and liposuction in particular are fairly stringent, doing the liposuction first often turns out to be a safer procedure.

The primary criteria to consider here are what the patient expects the ultimate outcome to be and the overall condition of the skin in the affected areas. If the skin is relatively firm and otherwise in good condition, liposuction may be the preferred option, leaving the possibility of having a tummy tuck on the table for later. However, some patients prefer to do this the other way around, having the tummy tuck and then returning later if necessary to have lipo done to help sculpt the problem areas. Patients who may find this to be more desirable are generally those who have a good deal of “pinchable” fat beneath the skin coupled with moderate to severe laxity in the areas of the fat deposits.

Normally, Dr. Pane says the ideal option would be to perform both procedures at the same time. This has the advantage of limiting the healing time to one set of invasive procedures and greatly reduces the possibility of the need for a second. However, depending upon the patient’s individual anatomy and preferences, the prospect of a second procedure either as a standalone or because revision has shown itself to be necessary should be discussed with the provider during the initial consultation to avoid unpleasant surprises later.

It is important to keep in mind that every person has a unique anatomy and reasons for how and why their body is the way it is. Because of this, there is no “one size fits all” option that works for every patient’s needs. Also, diligently adhering to the recommendations given by the surgeon and staff before, during and after the procedure greatly increase the chances of a satisfactory outcome and a swifter, easier recovery with less chance of postoperative complications. While there is no way to absolutely guarantee that these cannot occur, proper presurgical and postoperative aftercare can make a large difference in the final results the patient can expect.

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Vaginal Reconstruction Procedure in #QOTW!

Sometimes at Atlantic Coast Aesthetics, we receive a question that has even our highly trained staff raising their eyebrows and shrugging their shoulders. One example of this is our ACA Question of the Week, which came in from West Palm Beach. The patient asks, “Do I see a gynaecologist, a plastic surgeon or a urogynaecologist? Willing to travel overseas if need be.” Dr. Thomas A. Pane, our Chief Medical Officer and founder, chose to take on this question as a way to showcase the limitations of even good photographs in explaining what the problem is or what can be done to address it.

Three Problems that arise:

The patient did not say what the procedure was that led to the situation, but did mention that the patient has never given vaginal childbirth. This brings up the first obstacle, Dr. Pane says. 

The second problem is that while the patient sent good-quality photographs of the vaginal area, a picture is highly limited in demonstrating “feeling” without a clearly apparent blockage, scarring or deformity in the genital area. 

Another issue is that while this may well be a problem which is correctable through cosmetic surgery, the bladder and bowel problems the patient reports seem to indicate that more drastic surgical intervention may be needed. 

For more information visit the blog post, click: Female Genitalia Procedure 

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Breast Implants In Question of the Week!

“Hello I’m 27 years old. I think gravity and excess of exercise killed my boobs, so I want to make them look pretty again. I wanted to transfer some fat but they tell me it can cause future problems so they recommend me an implant. I wanted something very natural so I wanted anatomic because I believe it will look so fake with round, but a surgeon recommended me round implants with high projection (200cc or 250cc). I’m so scared of looking like 2 coconuts. What do you recommend for me?”

Dr. Pane says that for all practical purposes, most patients are likely to do better with round implants. Round implants will always present more or less the same profile, even if the implant somehow turns inside the body. Furthermore, round implants will usually be broader and flatter at the bottom, which simulates the appearance of a “typical” breast profile. There is no evidence that anatomical implants are particularly superior to round ones, and the likelihood of possible aesthetic problems should the anatomical implant.

Potential problems which is really a topic into itself is the question of fat transfer as the basis for an implant. There are a number of limiting factors that will determine whether or not a patient is a good candidate. The first question is whether the patient has sufficient subcutaneous fat deposits to transfer, for example patients who exercise regularly and have a low body fat percentage are less likely to have enough fat to transfer.

Second possible issue with fat transfer is the thickness and elasticity of the breast skin. If the skin is too thin, too loose or too tight, fat transfer may not be a viable option. With most cosmetic surgery procedures varies by patient and can really only be determined properly with an in-person clinical consultation and evaluation of the current breast profile.

The last issue is that of saline versus silicone, which again is an entire topic all its own. Each has...to read the complete blog post click: http://acplasticsurg.com/breast-implants-question-from-boca-raton-fl/

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QOTW: Breast Implant Removal Surgery By Dr. Pane

Not every cosmetic procedure is a success, especially when years go by and the body changes. There are a number of reasons why people might want to revise or even reverse earlier surgeries, including poor initial results, body changes that work against the original surgery’s intended purpose or just a change in point of view about one’s body. Our Atlantic Coast Aesthetics Question of the Week is concerned with exactly this problem. The patient from North Palm Beach tweeted, “What can I expect from breast implant removal surgery?” Dr. Pane wanted to address this question because people are often surprised at just how easy this type of surgery can be, as well as make the point that no cosmetic surgery results can be expected to last forever.

First, Dr. Pane stressed that breast implants are not a lifetime surgery.

Implants can be expected to last between 5-10 years before they need to be replaced 

Problems that develop with breast implants are associated with changes in the body. For example, pregnancy, weight gain and loss and other changes can affect how the implant functions over time.

Second thing to keep in mind is that breast implants

May perform better or not so well over time depending upon their composition, for instance, fat-transfer breast augmentation is one method that can help prevent this. 

Saline and to a lesser extent silicone can deflate and leak over time this becomes most noticeable when the patient attempts to compress the breast/s and they flatten instead of resuming their normal shape and contour.

Third, Dr. Pane observes that breast implants can

From a medical and mammary function standpoint, thinning of the surrounding breast tissue this is not a big deal. 

From an aesthetic point of view, however it may necessitate doing a breast lift at the same time as the implant removal procedure to help minimize sagging and other possible problems.

In the case of the patient, a breast lift is usually best done simultaneously with the implant removal. The main reason for this is simple because the surgeon is already inside the breast. Its far easier to do both procedures at one time and have one healing and recovery period than to remove the implants, allow time for that to heal and then make new incisions which start the healing clock all over again.

Experiencing far less discomfort after surgery than they expected many patients react well to the implant removal procedures. Removing the implants under the pectoral musculature that causes the pain is, far less painful than having them put in.

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Tummy Tuck Concerns Answered By Dr. Pane! #QotW

This week’s Atlantic Coast Aesthetics Question of the Week comes from Miami, Florida and is concerned with tummy tucks. The viewer asks, “Tummy tuck-is it safe? What are the risks and side effects?” Because tummy tuck procedures are one of the most commonly performed procedures at ACA, our founder and Chief Medical Officer, Dr. Thomas Pane, wanted to take on this question to explain not only how they work and what they do but why tummy tucks, or abdominoplasty procedures, are one of the safest forms of cosmetic surgery available today.

Abdominoplasty, commonly known as a tummy tuck, is usually done in situations where patients have experienced some laxity in the skin of the abdomen. There are a number of reasons why abdominoplasty may be performed, including:

For women who have given birth, ideally those who are done with childbearing

Patients who have lost a great deal of weight due to illness or bariatric surgery

Patients with other conditions that cause sagging, slackness or laxity of the abdominal skin

A tummy tuck begins by making an incision along the lower surface of the sagging area and trimming away the excess skin. The skin that remains is then anchored and attached at the lower incision site. This has the effect of tightening and giving the skin a more toned appearance and can also help alleviate, but not fully remove, the appearance of stretch marks.

Dr. Thomas Pane explains that he does these procedures as a same-day surgery, meaning that the patient is usually sent home the day of surgery. Side effects tend to be mild to moderate and include tenderness, soreness, redness and drainage along...to read the complete blog post: http://acplasticsurg.com/tummy-tuck-safe-risks-side-effects/

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QotW: Facelift Procedure For A Thin & Saggy Skin.

Facelifts are still the go-to procedure people think of when they hear the words “cosmetic surgery,” and at Atlantic Coast Aesthetics, we field a lot of questions about this common procedure. One example is our Question of the Week, which came in from our Facebook audience. The patient asks, “I am 65, slim, with a long face. It has been suggested to me that fat grafts would not be very successful in my case as I do not have (quality or quantity) of good fat supplies. I have been contemplating a facelift for many years and fat grafting to deep folds and lack of volume has been suggested but this comment about the success of this procedure is confusing.

Dr. Pane started by observing that based on the description of the face, non-operative or less invasive procedures such as Botox are unlikely to achieve the results the patient wants. What is more likely is that a facelift will be required to help tighten the skin of the face and help restore a more youthful and firm profile to the facial area. This may or may not be accompanied by a necklift, depending on the condition of the skin in that area and whether it is far gone enough to warrant the additional surgical intervention. An in-person clinical evaluation of the area would help point the surgeon in the right direction concerning this.

Regarding the fat transfer, Dr. Pane said he found the comment about the patient lacking adequate adipose tissue to achieve the transfer made no sense. The reason for this is because a fat graft to the face to help fill out the area beneath the skin does not require nearly as much fat as a Brazilian buttlift or fat-transfer-aided breast augmentation. Generally, everyone has sufficient fat somewhere on their body to help fill out the face. Where the fat comes from, be it the breasts, buttocks, abdomen or thighs is another matter, but one way or the other, the typical human being normally has plenty of fat for this application.

To read the complete article click: Facelift Procedure

Watch Dr. Pane Explain Procedure Below! 

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Flat Stomach & Enhanced Waistline Procedure Answered in Question of the Week!

At Atlantic Coast Aesthetics, we get a lot of questions from patients who are looking to correct poor results obtained elsewhere. This is the case with the patient asking our ACA Question of the Week. She says, “I am 52 years old. 2 C-sections 1992, 1996. I had a liposuction done in June 2015 (stomach, flanks, waist and pubic areas) and I am not happy with the results. I ended up with an uneven stomach and a lump in my stomach on the left side. My stomach and love handles are worse than before the liposuction. Thanks in advance for your opinions.”

Dr. Pane observed that since this patient sent in pictures of the problem areas, it is easier to properly evaluate what is going on. After age 35-40, the skin begins to lose a lot of its elasticity and firmness. This makes it more prone to sagging, wrinkling and stretching, especially in women who have had at least one pregnancy. Where pregnancy has occurred, especially where a C-section has been performed, it becomes more likely that there will be sagging skin on the lower abdomen as the woman grows older.

In addition, if the initial liposuction was improperly performed, there may have been areas of adipose tissue that weren’t contoured properly, resulting in an apparent lump from the outside. A clinical evaluation and examination in person would really be needed to determine this for sure, but these are some possibilities that exist. In this case the patient was given to expect that the liposuction would contour the sagging skin and help flatten the abdominal area, which is true, but only to a point. If the skin was younger and more elastic, the liposuction would probably have had a more dramatic effect, but for this patient it may not have been the best choice.

If the issue was an improperly performed liposuction, additional lipo may help to smooth out the rough spots and present a more uniform, smoothly contoured abdominal profile. However, Dr. Pane says his first instinct would be to perform a complete abdominoplasty, or tummy tuck,” which would allow for the removal of the excess skin and tightening of the muscles of the abdominal wall to help sculpt and shape the area better. While this procedure would leave a scar, in situations where C-section has been performed a scar already exists, so this will not pose an insurmountable problem.

As with any other surgical procedure, the risk of postoperative complications does increase if the procedure has to be redone or corrected. These risks can be greatly reduced by having a skilled, experienced surgeon perform the necessary revisions. It is also important to know and understand all the potential benefits, drawbacks and limitations of the available options. In this case, the scar from the abdominoplasty will add a small amount of length to the existing scar, but the results in terms of the contouring that can be expected are likely to be much more satisfactory.

When a procedure is being redone or revised, aftercare becomes even more critical than usual because of the elevated risk of additional complications. This includes following all postoperative directions and being alert for any signs of problems, such as unusual bruising, tenderness, swelling or incision drainage. The patient should also avoid activities or environmental factors that may inhibit or interfere with healing, such as direct sunlight, drinking alcohol, smoking and exposure to salt water. If a problem develops, the patient should always check in immediately. It’s better to have a “false alarm” than ignore a problem until it becomes potentially life-threatening. 

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#PressRelease: Live Video For 67 Weeks Straight!

Dr. Thomas Pane, founder of Atlantic Coast Aesthetics in Florida, is pleased to announce that he has just completed his 67th weekly live answer video.

To ask Dr. Pane a question about cosmetic surgery, please visit the clinic's website or their Facebook page at https://www.facebook.com/acplasticsurg/

As a cosmetic surgeon, Dr. Pane is committed to making sure he answers all of his patients' questions as thoroughly as possible. The Palm Beach cosmetic surgeon also knows that many people are curious about various procedures.

This inspired Dr. Pane to launch the weekly question and answer segment. People are encouraged to participate by visiting Atlantic Coast Aesthetics' Facebook page or website and submitting a question. Every week, Dr. Pane selects one of the questions and discusses it and the answer in a video.

To watch one of the recent videos, please check out https://www.youtube.com/watch?v=p-GwPZymxTA.

To read the complete press release click the link: http://www.prnewswire.com/news-releases/dr-thomas-pane-from-atlantic-coast-aesthetics-completes-67th-weekly-live-answer-video-300316907.html

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Men and Tummy Tuck Procedure. #QotW

An ongoing misconception we at Atlantic Coast Aesthetics encounter a lot is the notion that cosmetic surgery is only for women, despite the fact that a number of plastic surgery procedures are utilized by men and women alike. One example of this is tummy tucks, the topic of this week’s Atlantic Coast Aesthetics Question of the Week. The patient asks, “I had gastric sleeve surgery 5 months ago [and] I lost 75lbs. I’m considering a male tummy tuck with [a] six pack. How does the process work?”

In men, tummy tuck surgery is almost exclusively done when someone has lost a lot of weight. This could be through the traditional standby of diet and exercise or the more radical measure of bariatric surgery. From a purely anatomical and physiological standpoint, the basic procedure is no different for a male than a female, because the priority here is to tighten and adjust the loose skin left from the rapid weight loss so it shows a flat, even profile over the abdomen. This means that the excess skin is removed and the remainder attached together over the abdominal wall just below the underwear line, to minimize the telltale scarring of this type of procedure.

The primary concern with a tummy tuck is that the patient has reached a plateau in weight that can be expected to remain reasonably stable for an extended period of time. This is because if the patient begins to gain weight again or starts losing a lot of weight very quickly, the procedure may have to be revised or completely redone. In the case of weight gain, this can also lead to stretch marks and in some situations there may be a risk of rupturing the connected skin at the attachment site. For this reason, achieving a relatively stable weight without substantial loss or gain is an important benchmark in determining whether a tummy tuck is appropriate for a given patient at a certain time.

In this particular case, it’s possible to perform the procedure at five months post-op from the original bariatric surgery, but Dr. Pane says it’s better to wait a little bit longer and ensure the weight loss has plateaued properly. This will help avoid the necessity for revision or further intervention later and ensure the patient gets the best possible results from the procedure, because revision always has a higher risk of potential problems than the original procedure. Therefore, if at all possible, taking the extra time may be worthwhile now to prevent complications further down the road.

Another point of concern is the six-pack profile the patient desires. If the skin of the anterior abdominal wall, or front of the body in laymen’s terms, is relatively thin, the muscle definition beneath will show through fairly clearly. If it is not or greater definition is desired, it is possible to use liposuction in a procedure called abdominal etching to delineate the musculature and add definition. Dr. Pane says the problem with this procedure is that it is almost always a poor idea to combine abdominoplasty and abdominal etching into a single surgery because the patient is just asking for problems with the healing process.

Generally speaking, Dr. Pane says that keeping abdominal etching and other muscle-defining procedures as options can be done, but normally a single procedure should do the job. As long as the weight remains stable and the patient remains on the diet and exercise plan worked out with the surgeon who did the bariatric surgery, the muscles should show ample definition without further intervention being necessary or desirable. However, as with any other kind of surgical procedure, taking the time to ensure the best possible results and following aftercare recommendations is the single biggest determinant of success or failure.

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Risk Factors In Laser Treatment Is Answered By Dr. Pane

Dr. Pane notes that it’s important to set a clear definition for what is being discussed. Naevii, or moles, are raised areas with heavy pigment on the skin. Moles are generally not responsive to laser therapies. However, if the problem is age spots or a pigment condition like melasma, also known as chloasma, laser therapy can be very effective for these kinds of problems. Because laser treatments are not appropriate for moles, Dr. Pane feels one of these is the more likely problem and the rest of his observations stem from this point.

With regards to the actual treatment, a carbon dioxide laser uses highly focused light energy to remove the top layer of skin down to the dermis in a very precise and predictable way. Fractional laser treatments are almost never done individually. Instead, they are done over a series of treatments about a month apart. The purpose of fractional laser treatment is to reduce the amount of energy being poured into the patient’s skin, downtime and potential side effects of the treatments by breaking up the face into individual treatments unit over time.

As with any other procedure, fractional CO2 laser treatment has its pros and cons. One of the pros of fractional laser treatments is that generally the peeling and scaling of the skin associated with a full laser treatment doesn’t occur because of the reduced laser energy and limited area in which the laser is being used. Another benefit is that fractional laser treatments take less downtime for each treatment. However, this can also be one of the biggest drawbacks because over time, fractional CO2 treatments...to read the full blog post follow: http://acplasticsurg.com/risks-factors-involved-laser-treatments/

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Breast Implant Revision #QotW

Unfortunately, sometimes plastic surgery procedures go awry and don’t deliver the results the patient expected. Our Atlantic Coast Aesthetics Question of the Week comes in from a Facebook viewer who ran into this problem. She asks, “I have 375cc Mentor implants, high profile and under the muscle. They have progressively got[ten] worse aesthetically. I had them done in December 2014. I was a tuberous A cup. Their shape, size, and the asymmetry is really disappointing. How do you think they could overall be improved? I am seeing a consultant from Spire Hospital tomorrow. I originally went with MYA. This photo was taken during slight muscle contraction to emphasize the “flat” surface in my right [breast]. I appreciate your words.” Our founder and Chief Medical Officer, Dr. Thomas Pane, selected this question because this is a situation that, while not common, can and does happen, and it’s important to understand that it can be corrected.

Dr. Pane explains that a tuberous breast profile differs from the traditional breast aesthetic because instead of a smooth curve down to the aureole and nipple area, there is the curve from the shoulder and upper chest and then a swelling at the aureole. While this doesn’t mean there’s anything wrong with the breast per se, some people consider it unsightly. Breasts come in a range of shapes, sizes and profiles, ranging from very mild to quite pronounced, even when a breast profile is described as “tuberous.”

In this case, Dr. Pane says that after reviewing the pictures the patient provided, what most likely happened was that the patient’s breasts were mildly tuberous to begin with, but the implant used for the patient was larger than the breast itself. The result was that the breast’s natural shape ended up “stacking” on top of the implant’s sha...to read the complete blog post click ( Breast Implant Revision )

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Men Asking About Popular Procedures! #QotW

Atlantic Coast Aesthetics is proud to be one of the top providers in the country for cosmetic surgery. We believe that one reason for this is the fact we value patient questions like this one, from Ft. Pierce, FL. The patient asks, “What is [the] best option in my case: tummy tuck or liposuction or both? I lost 50 kg [and] now I am 116 kg [with a] height of 183 cm. My age [is] 32, man!” Dr. Thomas A. Pane, our Chief Medical Officer and founder, wanted to address this question because it also addresses a common misconception about the abilities and limitations of both of these kinds of procedures and their intended purposes.

Dr. Pane noted that liposuction and tummy tuck procedures are two wildly different things. Liposuction is intended to remove and contour fat deposits beneath the skin to create a more aesthetically pleasing shape to the area under consideration. A tummy tuck is used to eliminate excess skin in the abdominal area left over from rapid, drastic weight loss. While the two can and frequently are done in tandem, such as during a Mommy Makeover, the two procedures are not the same, although they are often conflated by laypeople.

Liposuction is not normally done in situations where the patient has already lost a significant amount of weight, as the fat deposits would already be reduced in size enough to make this unnecessary. Because people do not shed fat in a uniform, predictable, even way every time, liposuction may be appropriate in situations where the adipose deposits have left large lumps and pockets beneath the skin, interfering with a smooth skin contour. However, this can only be properly evaluated during an in-person clinical evaluation, because this type of evaluation relies heavily on not only visual but manual inspection of the area under consideration.

A tummy tuck, where excess skin is trimmed away to present a smooth, tight surface, is commonly done for people who have lost a great deal of weight quickly, such as women who have given birth and people who have undergone various forms of bariatric surgery, as well as by losing weight the old-fashioned way or through some forms of illness. Liposuction may be appropriate in some cases to aid with the proper contouring of the overlying skin, but generally in these cases a tummy tuck is the standard corrective procedure. This is because when people lose weight that they have been carrying for an extended period of time very quickly, the skin over the areas of highest loss often stays stretched out, resulting in sagging and pouching. By trimming away this loose skin, the remaining skin can be tightened to make the area look more uniform and visually appealing.

As with any other kind of surgical procedure, tummy tucks have benefits and risks that vary from patient to patient. Engaging the services of a skilled, experienced cosmetic surgeon can help to minimize risk while maximizing the overall benefits of the procedure. In some cases, a tummy tuck may not be necessary and a less invasive procedure might be a better option. To determine this, the surgeon will evaluate the patient’s current condition, desired outcome and medical history. This helps determine which procedure or complex of procedures would best suit the patient’s needs with the lowest risk of complications.

Following instructions before, during and after the procedure and awareness of warning signs and things that don’t feel quite right is also a critical component of success with cosmetic surgical procedures. Signs of a possible problem may include unusually heavy drainage, redness, discomfort, swelling or discharge from the incision area. These signs vary among patients and procedures, but rigorous monitoring and checking in when something doesn’t look or feel right can help prevent these problems from developing or getting worse.

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#QOTW Co2 Laser Resurfacing By Atlantic Coast Aesthetics!

ACA Question of the Week this week. This question comes in from a Twitter follower in Pompano Beach and asks, “Planning on spending August escaping the heat. Sun exposure is hard to escape. I am a daily sunscreen user. Pros and Cons welcomed. Thank you.”

To read the complete blog click: Co2 Laser Resurfacing

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Restylane Injections By Atlantic Coast Aesthetics #QOTW

Sometimes the results of cosmetic procedures aren’t everything the patient hopes for. In these situations, other options may need to be explored. This may be the case with our Atlantic Coast Aesthetics Question of the Week, which comes to us from North Palm Beach. The patient asks, “I had Restylane injected on my tear trough on May 4, 2016. I was told it would last for 9 months. But contrary to what I was told, it only lasted for a week. I work out every day (Zumba) for an hour. Does my workout have anything to do with my filler’s disappearance?”

Dr. Pane observes that injections into the tear trough and certain other areas are very tricky to do correctly. This is in part because of the small area and level of precision required to accurately target the injection. While they are far from impossible to perform, a high degree of caution is necessary to ensure the injection performs as intended. An injection that is improperly placed or performed could create a number of problems for the patient, one of the less serious of which is the possibility that the injection may not deliver the anticipated results.

When one surgeon examines another’s work after the fact, there is often no way to say with any certainty what exactly went wrong. Dr. Pane notes that the patient’s exercise regimen is unlikely to be the cause of the problem in this situation. It is more likely that the initial swelling from the Restylane injection was taken as the final effect, or that the injection was performed improperly, missing the tear trough and injecting the filler nearby instead of in the target area. In either event, the Restylane is unlikely to have stopped working so soon after the initial injection.

In this situation, Dr. Thomas Pane suggests an in-person evaluation and comparison of before and after photographs to get a sense of what the initial problem and expected results were. Some patients do not respond to Restylane or other fillers in the expected way, while others may find that some fillers are better than others for achieving the desired effect. Restylane is generally well-tolerated, but every patient is different and a treatment that delivers great results for one person may offer minimal or no results for another. For this reason, only a clinical evaluation can accurately determine what the problem is and suggest the proper corrective action.

Filler injection procedures depend greatly upon the skill and capability of the surgeon delivering them as well as the patient’s tolerance for the filler. However, the patient’s expectations concerning the filler and....to read the complete blog post, click ( Restylane Injections Procedures )

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QOTW: Platelet-Rich Plasma

A PRP, or Platelet-Rich Plasma, facelift is a relatively new twist on more traditional facelift methodology. Because of this, we at Atlantic Coast Aesthetics field a lot of questions about the procedure, like this one from our Facebook audience. The patient asks, “What is the best care for face after PRP? I am 66 and just trying to see what different doctors say?” Dr. Thomas A. Pane, our founder and Chief Medical Officer, saw this question as a good opportunity to discuss not only aftercare, but how the procedure works and the limitations patients can expect from PRP facelift procedures.

The first consideration is the patient’s age, Dr. Pane says. At 66, there is inevitably some loss of skin elasticity. While a younger patient may be able to receive good results from only having the PRP procedure, in which platelet-rich plasma is isolated from the patient’s own blood and then reinjected into the face, with little or no augmenting surgery, a patient of this age should not expect the same results from PRP alone. This is largely due to the skin and musculature becoming slack and losing elasticity over time, pointing up one of the more significant limitations of the procedure.

Second, the degree of surgical intervention required to tighten the skin of the face and the musculature beneath varies significantly from person to person. This is a point where age does not matter quite as much, because the primary criterion here is the suppleness of the skin and the firmness of the facial muscles. Assuming a good skin care regimen has been followed, the need for surgery in addition to the PRP procedure may be limited. To properly determine this would require an in-person consultation and evaluation of the patient’s skin, muscles and desired results to establish what the parameters for the patient would be.

There is no universally agreed upon aftercare regimen for patients who have undergone PRP, and every surgeon has a slightly different preference with regards to what should and should not be done. Dr. Pane advocates for avoiding direct sunlight and environmental factors that may irritate the face...to read the complete blog post click ( Platelet-Rich Plasma Facelift ) 

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#QuestionoftheWeek Dr. Pane explains

Atlantic Coast Aesthetics, we get a lot of questions about facelifts, like our ACA Question of the Week. This question came in from our Twitter followers and asks, “Facelift or mini-lift: which one is better?” Dr. Pane took on this question because it offered an opportunity to dispel one commonly-held myth about facelifts and give patients a better understanding of how facelifts work, what they are intended to treat and which version may be best for a given patient.

On a purely procedural level, Dr. Pane says there really isn’t a great deal of difference between a “full” and a “mini” facelift. The incisions required are made in the same places and positioned for maximum concealment in both cases. Both can be done under local or general anesthesia. The recovery rate and time to full recovery are basically the same for both versions and with proper technique and aftercare, the incidence of postoperative complications is essentially identical.

The practical difference lies mainly in the length of the incisions and what the procedure is intended to correct. Jowling, wattling or loose skin around the neck area is generally not correctable with a mini-facelift because of the smaller incisions, which means that the area affected by the mini-facelift is smaller as well. Mini-facelifts are generally performed under local anesthesia, although this is not a “hard and fast” rule, while standard facelifts are typically performed under general anesthesia.

To learn more, click ( Facelift Difference )