Core Plastic Surgery News

Birmingham, Alabama

Fillers/Injectables

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. If you would like to know more about these products and techniques you can visit our blog at www.coreandassociates.com/blog/ or call Regina Windham at 205-397-2100 for a private consultation with Dr. Core.

New Cutting Edge Procedure

Lower Eyelid Muscle Lift
Dr. Core developed a technique that he calls lower eyelid muscle lift, which is applicable to patients who have skin re-laxation without significant amount of excess fat of the lower eyelid. This procedure lifts and tightens the lower eyelid. It also lifts and tightens the cheek area just underneath the lid which helps shorten the distance between the edge of the eyelid and the beginning of the cheek, which is a characteristic of a beautiful face. The procedure is lower risk than a stan-dard lower lid blepharoplasty and virtually eliminates the risk of ectropion (pulling down of the lower lid). The procedure can be done under local anesthesia but is most commonly com-bined with other facial rejuvenation procedures under general aesthesia.

New Products

Dysport is a simple, effective, non-surgical treatment that works by relaxing facial muscles on the forehead, thereby reducing and smoothing away frown-lines and wrinkles.Therefore, it has the same mechanism of action as Botox. Cost at this time is yet to be determined but initial esti-mates are that it will be less expensive than Botox.

Saline Vs Silicone

Saline implants: this has been the primary implant that we have used in our augmentation practice over the last 12 years. As long as patients have adequate tissue coverage over this implant, it has been a highly reliable and successful procedure which has enhanced the lives of hundreds of women that have come to our practice for endoscopic breast augmentation. The disadvantages of saline implants occur when one starts to have large implants and a small amount of tissue coverage. In these cases we have been successful converting these patients to smooth silicone gel implants which have alleviated most of these problems. Leakage from a saline implant has been estimated to be approximately one per one-hundred implants per calendar year. This estimate is actually likely somewhat high since we have over 1,000 patients with saline implants throughout the southeast and we only replace an average of 1.5 implants per year. In addition when a saline implant leaks, it is of no medical risk to the patient. The material that leaks out of the implant is sterile saline, which is the same material that is included in an IV that a patient receives during surgery, so there is absolutely no risk of any health problems when the implant leaks.

Silicone implants: most people feel that the advantage of silicone implants is that they are somewhat more attractive, especially in patients with little tissue coverage over the implant. They have more of a natural feel, are not quite as firm as the saline implants, seem to have less rippling and are slightly lighter per unit volume than a saline implant. For the most part, the medical issues from the past have been resolved to the extent that the FDA now feels that placement of silicone gel implants is safe and that there is an extremely low risk of developing other medical problems such as autoimmune disease. However, silicone gel implants do still have a slightly higher rate of capsular contracture where the natural scar (capsule) that forms around the breast implant after surgery can start to squeeze down (contracts) on the implant and make the implant appear firm. The capsular contracture rate for silicone implant however is much lower than it used to be. Back in the 1980’ and 90’s the contracture rate for silicone implants was quite high, some people stated as high as 30 to 50 percent. However, due to the use of cohesive gel as opposed to liquid silicone gel in these implants, the capsule rate has dropped to somewhere in the range to 3 to 5 percent, almost even with the saline rate of capsular contracture. An advantage of silicone implants is that they can be placed in front of the chest muscle more easily than the saline implant. This is due to the fact that silicone implants require less tissue coverage than do saline implants. For this reason, this implant may be more appropriate in cases of droopy breasts (ptosis) or in patients who do not want any deformity when they flex their muscles, such as women who are into fitness and/or body building.