Dr. Core recently was the guest professor of the University of Toronto in Toronto, Canada where he was invited to give the University of Toronto lecture. The University of Toronto lecture is an annual distinguished lectureship given by a plastic surgeon who is widely recognized as a leader in the field of aesthetic surgery. Dr. Core’s lecture this year was entitled Endoscopic Plastic Surgery – Where are We Now and Where Can We Go. In addition to the University of Toronto lecture, Dr. Core gave several other lectures which were on mid-face rejuvenation, endoscopic breast augmentation, and abdominal wall reconstruction. Dr. Core is a recognized authority in each of these areas. Other guest lecturers at the yearly meeting were Dr. Renato Saltz, the President Elect of the American Society of Aesthetic Plastic Surgery who spoke on cosmetic medicine along with Dr. Mark Jewel the past president of the American Society of Aesthetic Plastic Surgery who spoke on cosmetic abdominoplasty techniques.
Dr. Core again was invited to be the instructor for the American Society for Aesthetic Plastic Surgery’s yearly teaching course on endoscopic facial plastic surgery. Dr. Core has taught this course for 12 consecutive years at ASAPS and currently along with Dr. Renato Saltz is the instructor of the longest running instructional course in the history of ASAPS meeting. Dr. Core has been requested to teach the course again next year and has literally taught endoscopic techniques of brow lifting to plastic surgeons all over the world for well over a decade. A course this year also included Dr. Core’s personal technique on lower eyelid and mid-face rejuvenation.
Liposuction first became a popular procedure back in the 1970s. Used appropriately,liposuction is for the removal of areas of fat that remain despite healthy diet and exercise habits. It is not for those who have trouble maintaining a healthy weight, and who are looking for an easy route to fat loss. In our practice, we perform two important and successful liposuction procedures. The Tumescent Procedure To perform the tumescent liposuction procedure, large amounts of salty solution are injected into the fatty area to be removed. Local anesthetic and adrenaline reduce postoperative pain and keep blood loss to a minimum. Filling the fatty tissue with fluid helps loosen it, so it can easily be removed with suction. Practitioners typically use this method for patients with firmer skin tone. The Ultrasonic Procedure High frequency sound waves turn fat to liquid in the ultrasonic liposuction procedure. If patients have looser skin, many practitioners elect to use this method. Many surgeons feel this technique is for patients who tend to have loose skin. This technique can also be used correctively for stubborn, uneven areas on which liposuction has previously been performed. It can be very helpful for removing areas of excessive breast tissue in men.
For questions please find us on the web at www.coreandassociates.com. If you or a loved one are in the Birmingham, Alabama area, and are considering liposuction, please contact us at the office of Dr. Grady Core at 205-282-4034 to schedule an appointment.
Well, nobody right? Is it just for the rich and self absorbed? Is it just an exercise in vanity? Well, before we write off all those who seek to change a part of themselves let’s look at a few interesting facts.
First of all, “What is the function of a face?” For all other types of “necessary” surgery we look at what the functional aspect is and consider the value of the surgery based on the functional issues. For example, if someone were to be born with feet that were malformed to the degree they didn’t function as well as they could or that they interfered with function with standing. It clearly is important to try to fix feet and make sure they are present and functioning properly. A foot is critical for everyday life. It gets you to work, it helps you stand in front of others, and it helps athletes to run, and so on. No one would question the value of fixing your foot. However, what does a face do? What is the difference between someone born with a great face and someone born with one not as great or even malformed? While most people don’t question surgery for those of use with congenital defects like craniofacial syndromes; on the other hand, if you have a huge hump nose, or ears that stick straight out, or eyes that droop on the side, or any other type of facial issue where the issue doesn’t cause major social stigma, there are many loud voices willing to be critical of you for seeking to change something that nature gave you calling it vain. Why do these people even care? It’s your nose or whatever. Anyway, they are out there, the critics of plastic surgery who find the occasional bad complication and use it as a soapbox to wail against any attempt to improve on something nature gave you that is less than what we would desire or is frankly malformed but within the range of acceptability for carrying on a normal life.
So, what is the function of a face? Well our face is what we meet the world with and physical attractiveness it is the number one source of how we are initially perceived by others. The research on the subject of how attractive children and adults are treated by others compared to those considered less attractive is enormous. While the critics of our profession may not like this it is basic human biology and there is nothing, and I mean nothing that will ever change it. No amount of politically correct intellectualizing. Parental self esteem training or psychological mantras will ever change the way basic human biology functions in regard to this issue. It is what it is and the fact is that more attractive people and younger looking people will always be perceived differently and treated better than others. Well you say so what. Look at Mick Jagger, he made it. What about others who have been known to be somewhat of an ugly duckling like Whoopee Goldberg, Albert Einstein, or Benjamen Franklin? Well these people all had something to help them overcome the issue with their appearance and not all of have an IQ of 150, a natural comedic talent, or superb interpersonal political skills. Even if we did there is still no question that physical attractiveness plays a role in how we meet the world and ultimately our confidence level. So, then if a face has a safely correctable issue then it is to our benefit in terms of how our face functions for us to have in modified into a more attractive or younger shape. Research has shown that after cosmetic surgery, self esteem rises dramatically and people have better success with interpersonal relationships as well as business relationships. Frequency of sexual relations goes up as does personal income. Not that this happens for everyone but it has been shown to be a distinct trend in patients undergoing cosmetic surgery. So, let’s not be so quick to criticize those that seek to change things which bother them because of nature not being as kind to them. The function of a face is definitely something to consider.
Injectable fillers for facial contours continue to be a rapidly expanding market in the aesthetic arena worldwide. This huge demand has created a large volume of new materials for injection. We have continued to see expansion of the HA based products such as Restylane and Juvederm. HA type fillers have been the mainstay of our innovative volumizing practice which has grown significantly. Volumizing is the practice of refilling the face which has lost volume with aging and reshaping the face in a more youthful look. Core Plastic Surgery was the first surgery practice in Alabama and one of the first in the United States to utilize facial volume enhancing techniques as early as the mid-1990s with a product called Cymetra which was a collagen based product. Since that time refinements in technology have allowed us to be much more specific and achieve much better results. We use HA fillers to put off the need for surgery in some patients and we also use it in our post-facelift patients as well to enhance their results with facial volume. The classic use for the products has also been for lip enhancement which Dr. Core does frequently. Evolence is a new product which is collagen based we have had good success with for the nasolabial folds and now we are using it throughout the face and even around the eyes to improve the deep creases which make you look tired. If you would like to know more about these products and techniques you can visit our blog at www.coreandassociates.com or call Regina Windham at 205-282-4034 for a private consultation with Dr. Core.
Silicone gel implants have continued to make increasing strides in capturing market share from saline implants especially in such places as southern California and in Florida. Data released by a mentor corporation over a year ago said that patient satisfaction of silicone gel implants was slightly higher than that with saline implants over time and the capsular contracture rate was only slightly worse than saline implants. For those patients who do not mind having an incision under their breasts, silicone gel implants seem to be an excellent product giving a highly aesthetic feel to the breasts with good shape and a low incidence of rippling and capsular contracture. On the other hand, patients who are interested in no scar on the breasts techniques such as through the umbilicus or through the axilla are still likely better off with saline implants as long as they have good tissue for coverage of the implant. While some centers such as Core Plastic Surgery are producing an early experience with silicone gel implants through the axilla, it is still a very early experience and too early to recommend this approach routinely. Mentor Corporation reports that in most practices across the country, silicone gel has reached at least 50 percent of the volume of new breast augmentations coming into the surgeons’ practices. In many practices, silicone has now passed saline as the dominant implant in terms of percentage of the practices’ new augmentation patients. However, in other practices such as Core Plastic Surgery, saline continues to be the leader by a wide margin due to requests for endoscopic techniques. For further information regarding silicone gel implants or saline implants, call Core Plastic Surgery, 205-282-4034.
While many non-surgeons jumped on the bandwagon with smart lipo when the marketing hype first hit, many more plastic surgeons were actually more conscious and would not bite on this initial effort. It now appears that the results from smart lipo are not stacking up to that hype. Due to this fact, the new marketing emphasis is now on “skin tightening”. While the jury is still out on the results in general as well as the skin-tightening claim, consumers should be wary of any new technology, which suddenly changes boats in the middle of the stream. In addition, I feel consumers should try to obtain their information directly from board certified plastic surgeons and not from manufacture’s web sites in general. While most manufacturers are very cognizant of patient safety and truly want to make their products helpful for patients, on the other hand, the consumer must remember there is always financial bias inherent in any information that comes from a manufacturer. There is still no substitute for choosing a qualified plastic surgeon and visiting them in person and hearing the scoop from them directly.
Facial implants help provide balance to your facial features and increase your self-esteem by changing the face you were born with to one you desire. There are various implants on the market today, crafted from a variety of materials. A facial plant can help reshape a chin, create the appearance of a chiseled jawbone, enhance cheekbones or fix a crooked nose. If you are considering a facial implant you should also think about the risks. These implants can shift out of place and require a second surgery to correct. An infection can also occur, that requires your surgeon to temporarily remove your implant in order to treat it. Be sure you fully understand your procedure and the risks associated with it, before you proceed. At Core & Associates in Birmingham, Alabama, you will receive the best possible care and attention. If you would like to schedule a private consultation, please send us an email or give us a call at (205) 282-4034.
One is for looks; one is to function. It’s the difference between cosmetic and reconstructive surgery.
Cosmetic surgery is elective and is performed on someone in order to enhance their appearance and elevate their self-esteem. This surgery is not typically covered by insurance companies.
Reconstructive surgery takes place in the aftermath of an accident or misfortune of some kind. It is performed to correct abnormalities caused by birth defects, disease, or trauma. Reconstructive is often covered by health insurance coverage, though the percentage of coverage varies from one company to the next.
At Core & Associates in Birmingham, Alabama, you will receive the best possible care and attention. If you would like to schedule a private consultation, please send us an email or give us a call at (205) 282-4034.
Dr. Core has recently begun use of the unique new injectable agent called Evolence. Evolence is a combination of a collagen based material which has been stabilized chemically to prevent rapid absorption by the body so it lasts much longer than prior collagen injectables. It is therefore a natural substance but has the advantage of longer durability. However, Dr. Core has found the most exciting aspect of Evolence is the immediate and dramatic results obtained in the nasolabial fold areas of patients who are good candidates. In addition, Evolence does not have a coagulant in the product so the risk of bruising and swelling go way down. Most patients can have the injection in the morning and go out to dinner that evening with no visible side effects. Evolence is now available at Core Plastic Surgery. The injection will be performed by Dr. Core himself and will be preceded by a consult to determine suitability.
“I have a number of friends who have had eyelid surgery that looks very unnatural. How has eyelid surgery changed over the years?”
There have been two major changes in eyelid surgery over the past 10-15 years. The first one is preservation of fat in both upper and lower eyelid region. Both techniques previously involved a removal of fat pads, both in the upper lids and lower lids which often left patients with a hollowed out and rather bizarre appearance. Some well-know celebrities went through this procedure and, in fact, when performed on younger patients, it actually makes them appear older. If one will simply look at the eyes of some of the young women in popular magazines such as Vogue or Glamour, and take a close look at the eyelid area, you will see that there is still fullness and fatty tissue in both the upper and lower lids, especially in the upper lids. The difference between this fat and the fat in the aging lid is that this fat has good support and structure and this brings us to the second change in eyelid surgery over the last 10-15 years and that is the concept of support. Previous eyelid techniques involved excision and removal of “excess skinâ€. In actuality while excess skin can be present in some patients, most of the time the skin is not excess, it is just relaxed and unsupported and in addition has photo aged in such that it has fine lines and wrinkles. The modern technique for making eyelids look more youthful is to provide more support, both for the underlying fatty tissue as well as the overlying skin. The main component that provides this support is fascia and muscle. Unfortunately, fascia in the eyelid areas also is attenuated that operations to try to support this layer has not been very successful. On the other hand, muscle support techniques have been successful and actually were reported as early as 1972 by Dr. Ulrich Hinderer. While other people have advocated various forms of muscle support over the years, they have never became very popular with plastic surgeons probably because they were poorly understood and the techniques for providing muscle support were not very sophisticated. Dr. Core has over the past ten years developed his own technique for muscle support, which can be varied depending on the needs of the patients and is applicable mostly in lower eyelid surgery. In upper lid surgery the more natural appearance comes from the formation of a proper crease in the upper lid with fat preservation. In the lower lid, the best results come from fat preservation, possible fat redistributation, as well as a support of the muscular sling over the lower eyelid. The overlying skin is then treated either with simple tightening (if true redundancy is present) or with resurfacing if the problem is fine lines and wrinkles. Second question is:
“I underwent a rhinoplasty several years ago and when I breathe the sides of my nose collapse making it difficult for me to breathe in forcibly. What can be done to correct this?”
This unfortunately is an all too common condition with older style rhinoplasties wherein the lower lateral cartilages were over resected. This was a very popular style rhinoplasty in the 60’s and 70’s and in some cases even into the 80’s, depending on the age and level of experience of the surgeon. Rhinoplasty styles have changed over the last ten years where more cartilage is preserved and left intact for structural support. However, in your case the lower lateral cartilages have been over resected and therefore can no longer support the airways especially during forceful inspiration. However, the good news is that this can be corrected without major surgery. In many cases a small portion of cartilage can be taken from the septum and used as an internal graft putting incisions inside the nose which helps support the lower outer sides of the nose. Recovery from this procedure is very rapid and there are no splints or packing necessary.
