9 Questions to Ask When Considering a Facelift

From time to time, the American Society for Aesthetic Plastic Surgery (ASAPS) sends out informative articles about cosmetic surgery. Here's an abstract of one I recently received as a board certified plastic surgeon member

What to think about when you want a facelift

Despite the growing use of Botox and injectable fillers, the facelift, continues to be a popular choice for longer-lasting results. The ASAPS reports in 2012, 119,006 facelifts were performed, a 2.5 percent increase vs 116,066 facelifts in 2011

Here are 9 things to think about when considering facial rejuvenation:

1. Am I a good candidate for a facelift? Ask your plastic surgeon. He or she will advise you, considering your age, skin type and goals.

2. What kind of facelift should I get? Finding the right surgeon is more important than deciding on the right surgical technique. Look at the surgeon's facelift results. If you like them, trust the surgeon's advice to get the results you want.

3. How long does the surgery take, and what is the recovery time? A mini-facelift takes less than two hours. A standard facelift usually takes three to four hours and may take up to six when combined with other things like eyelid or brow surgery. Recovery times differ but, generally, noticeable swelling goes down in 10 to 14 days.

4. How will I look different? A good facelift should make you look younger, more rested and relaxed.

5. What should I look for in a plastic surgeon? Carefully inspect the before-and-after photos on the surgeon's website. You may also ask to see additional photos during your initial consultation. Make sure your surgeon is certified by the American Board of Plastic Surgery (ABPS).

6. What are the risks? As with any surgery, a facelift procedure carries risks. Infection is rare, but possible. Bleeding after a procedure may result in hematomas. Healing is usually uneventful (unless you are a smoker) and nerve damage is usually temporary. The risks are closely related to your surgeon's skills, but there are risks even in the best surgeon's operating room.

7. Should I wait to lose weight before having a  facelift? If it is just a few pounds it won't make much of a difference. If it is more, hold off until you feel comfortable with your weight.

8. How long will the effects of a facelift last compared with fillers? Unlike the temporary results from fillers, which may require follow up treatments in a few months, results of a facelift will last for years. How long, of course, depends on skin quality, significant weight changes and environmental factors such as excessive sun exposure.

9. Should I undergo other procedures together with my facelift? A procedure commonly done in conjunction with facelifts is a blepharoplasty or eyelid lift. These procedures are frequently performed together, as indicated by need.

If you choose me as your surgeon, these questions and any others you may have will be discussed to your satisfaction during your consultation with me, for which I charge nothing.

Do you have "moobs"? Don't use marijuana.

Moobs?

Moobs is a shortened name for “man boobs”, which is a slang term for male breast tissue, also known in medical terminology as gynecomastia.  Gynecomastia is far more common than people think.  It affects anywhere from 33-41% of men between the ages of 25 and 45.  And it affects 55-60% of men over the age of 50.  

It also is a matter of considerable distress for men who suffer with it, not withstanding Seinfeld's use of it as a comedic theme in an episode a few years ago. It can be the subject of frequent and humiliating teasing.

Gynecomastia is caused by a hormone imbalance between the male hormone, testosterone, and it’s female counterpart, estrogen.  When estrogen dominates, men are prone to develop “moobs”. 

Now, we are finding in animal studies, that the active ingredient in marijuana may contribute to the imbalance of estrogen over testosterone. Can this cause “moobs” in pot smokers? Are we going find an increase in the occurrence of gynecomastia? I know as a Fort Myers plastic surgeon, I have seen a great increase in the number of men with gynecomastia.  Nationally, the number of men who had surgery for gynecomastia rose 30% from 2011 to 2012.  

So you may want to reconsider the “joint” if you have “moobs”.

It helps to be nuts to live longer.

CALL ME "NUTS"

What's a plastic surgeon doing talking about nuts? As a medical doctor, I am interested in anything that contributes to better and longer life.   

A new study shows that eating a handful of nuts may lead to a longer and healthier life.  So, when someone says "nuts to you", they may be wishing you good health.

A study of over 119,000 men and women found that those who at 1.5 oz. of nuts every day were 20% less likely to die over the next 30 years!  

There was a 29% reduction in death from heart disease and 11% decrease in cancer deaths!  

But, let's remember that generally people who eat nuts are less likely to be smokers, more likely to eat fruits/vegetables and be leaner!  Interesting!  

Maybe next time you are on the treadmill – pop a few nuts!

A Different Kind of Cosmetic Surgery Testimonial

I frequently get thank you notes from patients, which I post to the “testimonials” page of my website. I am very happy to receive them. In many ways, they are more valuable than the fee I receive for my surgical procedures. It is extremely rewarding to learn from patients of their happiness, satisfaction or how something I have done has changed their lives.

A recent one has a little different character because it refers to the work by another doctor that left the patient unhappy. I am very reluctant to criticise another doctor. I know we all study hard and work hard to serve our patients. Nevertheless, as with any field of endeavor, some people are better at some aspects than others; they have more experience, have more specific training, or are more sensitive to a patient's needs. So there are bound to be differences in performance.

With that as background, here's what JT wrote to me about the results of her cosmetic surgery:

“I had an opthalmologist perform a blepharoplasty of both eyelids – complications followed, and then he did a brow lift on one eye causing a major disfigurement of my facial appearance. 

It was time to see a plastic surgeon and I chose Dr. Robert Brueck. His friendly smile, caring personality and reassurances of “I can help you” were comforting and confidence earning. Dr. Brueck did a corneal browlift, repeat blepharoplasty of both eyes and a fat graft injection into a scar. 

Dr. Brueck called me the evening after the surgery to see how I was!! One week after surgery, the results are dramatic. I am pleased with the entire office staff and I would highly recommend Dr. Brueck.”

The point I guess is to be certain that your surgeon is trained at the highest level to do what you want done. Be sure he or she understands you, what you want and your expectations. (This one of the major benefits of consultation and why I do them without charge.) 

I'll leave it at that except to say in good humor, “Please don't ask me to do your cataract surgery”.

To Tummy Tuck or Not?

American Society for Aesthetic Plastic Surgery (ASAPS) has recorded a video interview with a patient who decided to have a "tummy tuck." Her explanation should be encouraging for anyone, perhaps you, who also is considering a tummy tuck. 

At the least , you will find it genuine and interesting, I'm sure.

 

If you would like to know more about tummy tucks, please visit my web page on the subject, and sign up to receive notices about new body sculpting techniques when they occur. 

Sign for Dr Robert J Brueck updates about cosmetic surgery procedures 

Is testosterone a new health risk?

Many new ads pepper our media marketing testosterone products to men to increase vigor, lean muscle mass, strengthen libido and, well, you name it.  Many of these products require a prescription.  

A recent study now reveals that older men receiving testosterone supplements may be at an increased risk for heart attack and stroke.  The study involved 8700 men.  Of this group 1 in 7 received testosterone.  After 3 years of follow up, the men who took testosterone had a 26% risk of stroke, heart attack or death versus 20% of those who took no testosterone.  These men were in their early 60’s in average.

As a plastic surgeon in Fort Myers, which has a large senior population, I encourage all my patients not to rush into any "magic cures". Ask questions of your doctor. Be cautious. And proceed only after you are sure of no bad consequences.

Do birth control pills contribute to glaucoma?

It always fascinates me, even as a medical doctor and board certified plastic surgeon, how various supplements, nutrients, medicines - basically anything we ingest - can be linked to a disease state.  

Now we come to learn that women who took birth control pills (BCP) for more than 3 years had TWICE the risk of glaucoma, a leading cause of blindness.  This may be due to decreased levels of estrogen which  has a protective effect on the eye.  So you just may need to be checked or screened by an opthalmologist for glaucoma.

Incidentally, if you have elevated pressure within your eyeballs, that can lead to glaucoma, your eye doctor can prescribe eye drops to reduce that pressure.

Dr. Brueck asks: "Are you washing your face the wrong way?"

Is there a right way to wash your face?

Hey, You’re washing your face wrong


As a board certfied plastic surgeon and member of the American Society for Aesthetic Plastic Surgery, I recieve information about beauty from the association's Smart Beauty Guide. This message is based on an original article by C.A. Shenigo

Slapping on and rinsing off your face cleanser is NOT the correct way to wash your face. A lot of women are washing your faces wrong. According to a recent article in Allure Magazine, 70% of women still use soap and water. SOAP and WATER?! 

“How and what you wash your skin with sets the tone for the rest of your skin care.” Allure quotes one dermatologist as saying. “Many patients are either using the wrong cleanser or over washing, which leaves skin dried out, or under washing and going to bed with the day’s pollution on their skin.”

It’s safe to say that rule # 1 is wash twice a day — morning and afternoon. Since the skin’s repair process is heightened overnight, washing your face in the morning helps to eliminate the waste products that surface while you sleep. And washing your face prior to bedtime helps to eliminate the free radicals, pollution, and environmental aggressors that your skin has been collecting all day. Imagine all of those disgusting things marinating on your face all night long.

Can we agree that not all skin is created equal. Some faces are oily. Some are on the dry side. Some are prone to acne, some to rosacea, and some are so sensitive that one wrong move could result in stinging redness and itchiness. It all adds up to how and what you wash your face with is as big a deal as the rest of your skincare.

Dry skin requires moisture. The last thing you need is a cleansing product with harsh ingredients that can suck the oils out of your skin. Using a creamy or milky cleanser with ingredients like nicotinic acid and niacinamide, no more than twice a day, can help rebuild the lipid barrier that keeps the moisture in your skin.

Oily skin, on the other hand, warrants foamy face washes that produce large amounts of lather that allows the cleanser to reach maximum surface area. But don't overdo it with harsh formulas or lathering more than three times a day. You want to remove enough oil, without over drying — which will just produce more oil.

Skin that’s both very oily and dry requires a cleanser with a gentle foaming agent and glycerin to both cleanse the oily parts and the dry ones in a one-two punch. 

With acne prone skin, you can wash your face up to three times a day, which is nice in the warm summer season— but you can’t do it with foamy cleansers. Dermatologists recommend using cleansing formulas with salicylic acid, benzoyl peroxide, or glycolic acid — mild exfoliators that remove the day's buildup of oil and dead skin cells, and clean clogged pores. If you’re really brave, you can even use a trendy oil cleanser, which clings to the oil blocking your pores, so you can rinse both down the drain.

Sensitive skin or skin prone to rosacea are different situation, with the water temperature nearly as important as the cleanserss you use. The serious flushing of rosacea and burning redness of sensitive skin requires a gentle touch that can not be achieved with water that is too warm. Use a cleanser that has been tested on a small area for three days. Use it morning and night, with cool to lukewarm water This will help deter your skin’s vasodilation process, which just makes skin redder. Do not use products that include fragrance if your skin is really sensitive.

Positive reviews are major motivators for plastic surgeons. So I am happy to post these.


A recent review from a patient via RealSelf.com - 

"From the first visit Dr. Brueck’s staff was outstanding! The consultation was free too! I never felt uncomfortable at any of my appointments. The doctor answered every question I had and he was very kind, puts you at ease. I had been to other plastic surgeons in the past, but I will continue to see Dr. Brueck because he is the best! In fact I just scheduled another surgery which I will have soon and I can’t wait for it." - 12/8/2013, (2 months post operative). 


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'I am so pleased with the outcome of my tummy tuck and with my breasts. I feel like a new person. Dr. Brueck did an outstanding job. He answered all my questions prior to surgery and followed up afterwards by calling himself at home. Never hass an M. D. done that (for me). His staffwere so friendly and helpful too.” DH 12/9/2013
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“Dr. Brueck was awesome-staff was great-Shy is wonderful. Results far exceeded my expectations and it's only been 3 1/2 weeks! Lipo on stomach, inner/outer thighs, back and buttocks. Compression garment was way too big so just bought one online. Very happy from start to finish.” - MD 12-4-13

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“Great. Dr. and staff are outstanding. Love my new face!! - LO 12-2-2013

There may be more than herbs in herbal supplements

As a board certified plastic surgeon, I see ads for herbal supplements everywhere.  

They have been touted to cure a multitude of diseases and provide a “new lease” on life.  

Now buyers of herbal supplements need to be aware that many supplements contain unlisted additives.  These dilute the “herbs” and can cause problems for people suffering from allergies.  

The bottom line is that quality control is non-existent.  

How big is this business?  It is a $5 billion dollar business.  The FDA requires companies to test their products for safety but there is an “honor” code that the supplements do contain what is printed on the label.  

Again, buyer beware.

Should children have plastic surgery?

I recently read that a New York plastic surgeon would ask his younger patients (children & teens) to draw a picture of how they see themselves.  

This self portrait may be revealing to a child’s self-image – a view into his or her world.  

Many times young children will be brought into my Fort Myers plastic surgery practice for ear surgery, ie. their ears protrude too much.  In these cases I will ask the parents to leave the room and ask the child how they feel about their ears.  

In other words, am I doing the surgery for the child and their self esteem – their image or their parents?  It is important to make this distinction.  Many times a physical deformity can be damaging to a child’s self esteem.  

I remember when I was in high school and had to wear glasses.  Wow!  What a shock – what an eye opener – no pun intended.  I was now 4 eyes.  Pretty devastating to one’s ego and self esteem.  

A child becomes the brunt of jokes, ridicule or as we like to now call it now, a victim of bullying.  In many cases surgery can go a long way to helping correct not only the physical problem but, more important, the child’s psyche or self esteem.