Put your best face forward onlin

Nothing brings attention to self-image like social media in today’s age of high definition and instant recall. Pictures on Facebook, Instagram and Pinterest can go from several hundred to multiple thousands. Even your professional LinkedIn profile asks for a headshot. This awareness has caused some to run to their board certified plastic surgeon’s office for a ‘facebook facelift.’  What is this you ask?  Social media and online dating sites have changed the way people get to know you, stay in touch with you or are introduced to you for the first time.  How you look online is suddenly just as important as a first impression in person, so some people turn to cosmetic surgery to put their best face forward. Depending on your age, genetics and lifestyle, the recommended treatment will vary.  Young men and women in their 20s often choose procedures that will help them gain aesthetic symmetry or proportion. Perhaps their nose shape or size overwhelms the face. Others could have thin lips or a weak chin. These problems can be addressed by surgical procedures that can help improve facial balance or by using fillers that can increase volume in deficient areas.  In your 30s, when the first signs of facial aging appear. You will have to work hard to stick to a proper skincare routine that exfoliates, hydrates and adds nutrients to your skin. The first signs of wrinkles and the loss of volume can be treated with injections of Botox and fillers. If you see yourself with bags under the eyes, the beginnings of creases when you smile and patches of brown spots from sun damage, you may want to talk to a board certified plastic surgeon about nonsurgical treatments and an anti-aging strategy.  If you are a "mature" internet-user keeping in touch with family and friends can also benefit from Botox, fillers and skin rejuvenation techniques; however, a face lift might be worth consideration.  Men and women are having face lifts earlier to get in front of the aging curve - some from their late 40s to early 50s. The skin and body is healthier, so surgery could be easier and keep you looking younger for longer.  Lastly, keeping the skin clear and bright is key to looking good at any age. A tan might have an immediate good effect. But years of harsh UV rays without sun protection can cause premature wrinkling. With laser skin resurfacing, microdermabrasion and chemical peels, along with staying out of the sun, you can improve skin while preventing further aging.  Even if just sharing with close friends, many are choosing to improve how their faces look in photographs. From nonsurgical procedures that can refresh your look, to a more in-depth procedure that can turn the clock back, talk with a board certified cosmetic surgeon about ways to put your best look on display.

Why do you take herbal and/or dietary supplements.?

You must feel they make a difference in your physical condition. Yet, when filling out the medical information form before your medical or surgical appointment, do you include all of them in the list of "medicines" you take?

Many people don't feel they are important enough to include with their prescription drugs when informing the physician about their medicinal intake.

Dr. Foad Nahal MD, editor in chief of Aesthetic Surgery Journal points out, "Many patients don't disclose their intake of herbs or supplements, and they are often not aware of the risk of complications, which can seriously compromise surgical outcomes and patient safety," 

As a plastic surgeon in Florida, were many older people regularly take herbal and dietary supplements, I am always concerned that these items appear in the surgical patient's medical record. "Natural" products can have dangerous bleeding effects. Dr. Subhas Gupta of Loma Linda University affirms that herbal foods, supplements, teas and other homeopathic remedies can compromise patient safety if their effects are not considered prior to surgery.

The most popular herbs and supplements with potentially dangerous bleeding effects include Chinese peony, garlic, ginger, ginko, ginseng, oil of wintergreen (methyl salicylate) and Saw palmetto (Serenoa repens, Salbalserrulata). I recommend to patients that they stop ingesting these items two to three weeks before surgery is scheduled, just to be on the safe side.  I also advise them not to resume taking them until my approval after the surgery.                   
Of course, every patient is different and therefore this can only be considered general information, not medical advice. Only your doctor should give you that. 

Incidentally, some doctors even recommend against using aspirin or ibuprofen several weeks before Botox-type injections. These pain relievers can thin the blood and cause bleeding, which can increase bruising at the injection site.

Does exercise make you look older?

From time to time, as a plastic surgeon in Fort Myers and Cape Coral, Florida, I get articles from the American Society for Aesthetic Plastic Surgery that I think might interest you too. For example, think of all the things that can add to making you look like you are older than you are: frowning, smoking, gravity and the passage of time.

Now add one more possibility. Is your workout regimen also making you look older than you are? According to Shape, there may be some exercises that contribute to less-than-appealing changes in the body.

Do you run Beware of "runner's face" Some folks think that jogging has an impact on the elasticity of the skin. It is not the pavement pounding that leads to sagging skin,however.It is the free-radical damage from increased oxygen intake that contributes to wrinkling, according to the source of this information. At the same time, studies show that it takes very strenuous exercise to increase cell damage, so running a few times a week isn't going to change the skin tautness much  .


Bouncing workouts and your breasts
"High-impact exercise, like running and jumping rope, can contribute to premature sagging by stretching out the ligaments in your breasts," according Sabrena Merrill, a personal trainer quoted by the information source. Fortunately, sports bras can help reduce the impact of such activities on one's breasts. Some women may choose to have a breast lift, which, according to the American Society for Aesthetic Plastic Surgery (ASAPS), can result in a "more youthful breast contour."

Do you love working out outdoors? 
You may put yourself at the risk of serious sun damage. That can cause many skin problems, including premature wrinkling. It's important always to wear sunscreen, even if you're out for a winter jog. If the sun is out, it can negatively affect your skin, so make sure to put lotion with an SPF of 30 or higher when heading out for fresh air.

Is it too late for your appearance if you have not been as diligent as you could have been in your younger years?

Forrtunately, Botox injections and chemical peels, performed by a Board Certified Cosmetic Surgeon can help treat these premature signs of aging, and help you look as youthful as you feel.

So, don't stop with the workouts. As with anything, awareness and moderation are the keys to succes..

A heads up about Soccer

Soccer has really enjoyed a resurgence in America.  

American teams are becoming more and more competitive on the world scene.

It is a very highly skilled game where hands, except for the goalie, are forbidden.  Using your head to deflect or direct the ball is very common in soccer.  

A new study done by scientists at Imperial College in London, which has come to my attention as a Board Certified plastic surgeon in Fort Myers, FL,  examined the force of a soccer ball striking a players head.  This is a very rare study.  

The results?  Quite surprising.  

The forces generated were equal to the forces generated by amateur boxers and head gear offered little protection.  

Also a larger ball generated more force.  Do NOT over inflate because higher ball pressure means more force.  

With all the talk about head injuries in football and concussions, more studies and caution may be needed in soccer.

Responding to comments

We receive many comments concerning Dr. Brueck's blog We'd like to respond. But, when a comment comes as "anonymous" there is no way answer that comment directly. If you want a direct response, you must sign your comment.

A recent comment asked what publisher we use. The answer is Dr. Breuck's blog is published on blogspot.com. Google offers it as a free platform.

Hope this helps

Are your eyes the windows to your soul?

They definitely are the windows to your future.

If your upper lids get fleshy and hooded, you look tired, old and unenergetic. That can influence how people see you and what they expect from you.

Looking for a job? The younger-looking person has an advantage. Working for a promotion? What if all your boss sees when she looks in your eyes is an aging face.

So, eyelid surgery is growing in popularity. And the demand is being energized by real problems with patient vision. An ophthalmologist, who tests you for peripheral vision, may tell you that your ability to see and read will be affected by eyelids that obstruct vision and reduce the amount of light entering the lens of eye when you read.

When that happens, the doctor may prescribe eyelid surgery. And it may be covered largely by insurance (at least for now). The doctor may even have a surgeon in his office that can perform the surgery, and probably do a good job. Board certified plastic cosmetic surgeons, however, have very specific and stringent standards for surgical procedures.

Many people, who would not go to a cosmetic surgeon for an eye test seem to be unconcerned about having the eye doctor do eyelid surgery, also known as blepharoplasty. If the surgery is medically indicated, insurance also covers work by a cosmetic surgeon. If it is simply a cosmetic eyelift, insurance probably won't cover it. It may well be worth it, however, as a career investment.

This was all triggered by "thank you note" forwarded to me the other day:

"Though my ophthalmologist suggested that I have upper eyelid surgery, the decision to have the surgery was more difficult than the choice of surgeons. In choosing Dr. Brueck, I assumed I would experience excellent medical care delivered in a professional manner; my expectations were more than met.

The skills of the surgeon were never in doubt. but the courtesy and efficiency of the staff were a pleasant surprise. The pre-op and post-op instructions were communicated in a clear and understandable manner. The reminder calls regarding appointments were appreciated. The caring attention of Dr. Brueck's nurse was certainly notable.

I would recommend Dr. Brueck without any reservation to my family and friends. He will make a surgical experience as pleasant as possible."

Thank you for your attention

Just in time for Valentine's Day. A new heartburn.

Heartburn is a condition few people live their lives without not experiencing.  The dreaded acid reflux can keep us up all night unless we take the magic purple pill (nexium) or another acid reducer.  You'd think years of medical school to become a plastic surgeon would exempt me. Nope.

Now there is a new heartburn that puzzles GI specialists because it is NOT related to acid reflux. 

Almost half of patients with GERD (Gastroesophogeal Reflux Disease) have no signs of acid erosion on their esophagus and DO NOT respond to acid reducing medicines.  

This new heartburn on the block is aptly called, "NERD", yes "NERD", and it stands for Non-erosive Reflux Disease.  Now why couldn’t I have thought of that?  

GI experts now think that 50-70% of GERD patients are really NERDS!  (Somehow that comes out wrong, doesn't it?  Usually they are female, younger, and thinner.  Certain things may help such as don’t lie down within 3 hours of eating, take antacids, quit smoking, avoid tight clothes, sleep well and lose weight.

 Everyone has skin problems. As a board certified cosmetic surgeon, I am concerned with skin condition, skin being the envelope in which all cosmetic surgery takes place. Whether you never seem to break out or have any red areas, scars or freckles, collagen depletes and skin gets looser, wrinklier and dryer. Add acne or rosacea and things get more complicated. 

Color 

If rosacea, hyperpigmentation or melasma is the problem, there’s a solution to dramatically improve your condition. Depending on your skin type, this might indicate an approach combining the use of lasers, chemical peels and prescription medication.

Rosacea might require oral medication in connection with topical creams.

Hyperpigmentation, melasma and uneven skin tone might call for the use of hydroquinone

Deep chemical peels can be used to lighten hyper-pigmentation, scars and spots

Pulsed light or a pulse dye laser can be used to treat blood vessels and thickening skin caused by rosacea and redness.

Skin texture and wrinkles 

Who doesn't want smooth, flawless skin?  When you age, however, wrinkles show up and the elements affect your overall skin health. Dead skin cells can make your skin look tired and drab. It can even block absorption of skincare products meant to help.

CO2 laser resurfacing can treat moderate to deep wrinkles, fine lines and tighten loose skin.

Regular, light peels or micro-dermabrasion can keep skin looking healthy and vibrant.

Deep chemical peels can remove sun damage, medium wrinkles and help smooth skin texture

Acne 

What works for one person, may not work for another. It is best to get your skin looked at and follow a  treatment blended specifically for your skin. 

Active acne outbreaks can be treated with medication, topical treatments and regular skin maintenance that might include light chemical peels, micro-dermabrasion and facials

Isolaz and photodynamic therapy can also keep breakouts under control by using light therapy in combination with technology that reduces bacteria 

Acne scars can be treated with resurfacing lasers, light treatments and chemical peels, depending on the type and degree

Deep pitted acne scars might require surgical excision and at times, dermal fillers to fix depressions

The quickest and easiest solution for one giant zit often is a cortisone shot. This will sting a little and set you back about $150. Your zit will be swollen for a few hours, but will be gone by the time you get to the airport.

Gives new meaning to the expression, "Comfortable in your own skin."