Cosmetic surgery study raises eyebrows

Some facial surgeries make you look younger and others make you look more attractive

October 17, 2013

Operations that change the size and shape of your nose, chin, cheeks and jawline can increase your attractiveness, according to Southwest Florida board certified cosmetic surgeon, Dr. Robert Brueck MD F.A.C.S.

A recent study of plastic surgery patients and their results raised a lot of eyebrows due to some unexpected results. Pre-op and post-op photos of patients (37 women and 12 men) who had facial rejuvenation surgeries such as facelifts, brow lifts and eyelid cosmetic surgery were evaluated by independent reviewers. The study found that plastic surgery made people look about three years younger but did not have a significant effect on how "attractive" they appeared to be.

Michael Yaremchuk, M.D., Chief of Craniofacial Surgery at Massachusetts General Hospital, discussed the study results with colleagues from the American Society for Plastic Surgery (ASAPS) and put the study in context to explain the results. They turn out to less surprising when the facts are considered:

• The study, published in JAMA Facial Plastic Surgery, included only one plastic surgeon's surgeries, which may not reflect plastic surgery results in general.
• It doesn't include any pictures of the surgical results.
• Most patients in the study had eyelid surgery (upper and lower lid blepharoplasty and browlifts), which can make eyes look round and hollow from the removal of too much fat and skin, which can appear to be be aging. In addition, young women actually have low brows, which may elevate with age. So it's no surprise that this surgery did not make people look younger.

Even more significant, according to the Yaremchuk, brow lifts, eye lifts and face lifts are designed to bring ones appearance to where it was years before. If ones face was considered attractive before the "lift," it will, at best, return the face to that appearance. If the face was considered unattractive before, it will return to a younger version of that "unattractive" face.

Attractiveness for a face is a result of the balance of facial features (nose, chin, cheeks and jawline). Cosmetic surgeries that change the size and shape of these features can make ones face more attractive. The primary determinant of facial appearance is the facial skeleton. Procedures with the most significant impact on facial appearance are those that manipulate the skeleton: rhinoplasty (alters the nasal bones) and cheek bone, chin and jaw implants.

So, it makes perfect sense that face lifts, brow lifts and eyelid surgeries can help you appear younger, but you should not expect them to change your level of attractiveness. If you're happy with your underlying facial structure and want to look younger, a face lift can achieve that goal. It's true, however, that "younger" is often perceived as more "attractive".

Plastic Surgery Stats from 2011

WHAT ARE WE DOING? WHERE HAVE WE BEEN?

The top 5 surgical procedures in 2011 were:

breast augmentation - 307,000 up 4%

nose reshaping 244,000 down 3%

liposuction 205,000 up 1%

eyelid surgery 196,000 down 6%

facelift 119,000 up 5%

With the rise in popularity of facelifts, tummy tucks fell from the top 5.

Botox/disport 5.7 million up 5%

tissue fillers 1.9 million up 7%

chemical peel 1.1 million down 3%

laser hair removal 1.1 million up 15%

micro dermabrasion 900,000 up 9%

With the recession, it is not surprising to see the growth of non-surgical

procedures.

Actually, without local statistics, but observing as a Fort Myers plastic surgeon, I think our profile is very similar.

ANTIBIOTICS AND BREAST AUGMENTATION

News from Dr. Robert J. Brueck MD , plastic surgeon in Fort Myers, FL

For years, we used to prescribe pre-operative antibiotics for breast augmentation patients. We would then continue the antibiotics for several days post-op. The question is, is it really necessary?

A recent study seemed to answer that question.

A study of 605 patients over 4 years revealed there was NO difference in over all complications, infection or capsular contraction in patients who received 3 days of postoperative antibiotics versus those who received none.

NEW CANCER DRUG FOR BASAL CELL CARCINOMA

This is another in Dr. Robert Brueck's blog posting as a Fort Myers plastic surgeon dealing with skin and cosmetic surgery issues.

The most frequent type of cancer in the common form of skin cancer is called basal cell carcinoma. This cancer is so common and it frequently increases with age.

It usually grows locally and is treated with surgery the majority of the time.

A new drug called Erivedge will be available to treat more advanced forms of basal cell in patients’ who are not candidates for surgery or radiation. It is also indicated in treating metastatic basal cell – that is a rare breed.

In 32 years I can recall maybe 1 or 2 cases. This is the first ever FDA drug approved for metastatic basal cell carcinoma.

Buyer Beware - A cautionary tale from Dr. Brueck

This is the blog of Dr. Robert J. Brueck, MD, Board Certified plastic surgeon. Dr. Brueck practices in his licensed plastic surgery center in Fort Myers Florida. Here he comments on the folly of seeking "cheap" surgery and going ahead with it despite having no knowledge of the surgeon, his training or his credentials. For a complete statement of Dr. Brueck's medical education and training, including his Board Certification, visit his website at Beauty-by-Brueck.com

There are many axioms in the English language. One that comes to mind is the proverbial, "if it’s too good to be true, it probably isn't true". As we ride through this terrible economy, another prudent saying is, “buyer beware.” This has been proven to never be now than ever.

People are always looking for “the deal.” But in your search for the perfect deal you may come up short or even dead.

In South Carolina, a boutique owner was arrested following the near death of one of her clients from a botched buttock lift/implant. The patient was a woman from New Jersey who sought out the procedure. Michelle Rosa apparently flies doctor’s in from outside the country to perform their procedures in her salon or boutique.

So the "he said, she said" continues and the finger pointing and blame continues on.

But a simple question – why would ANYONE (looking for a deal) have a major cosmetic procedure performed in a boutique by a doctor they don’t even know?

Yes, a boutique. Not a licensed surgery center. It is simply a recipe for disaster. Truly, buyer beware.

Not ANOTHER Tax? Aren't you taxed enough?

(Ed: Dr. Robert J. Brueck, MD FACS of Fort Myers and Cape Coral FL , feels compelled to speak his piece about the new proposed tax of 5% on cosmetic surgery. His comments follow.)

What a total sham and disgrace this whole concept and idea is.

If our legislators would spend as much time thinking about cost reduction and cutting expenses as they do on taxing us into the eternal abyss with new and creative taxes, we would be much better off. When and where will it finally end?

This administration has created a deficit in one year equal to the deficit in all of Bush’s last 4 years. The spending is totally outrageous and out of control and is creating an enormous Armageddon for America.

I read where the city government of Pittsburgh wants to TAX the tuition paid by all students at universities within the city limits of Pittsburgh. This would raise approximately 60 million dollars a year and go to reduce the pension costs and obligations of city employees!

Did they ever think for one second that these benefit packages and wage structures were out of line and unsustainable? Maybe they should cut benefits and salaries and not create new taxes.

They now want to tax the buying and selling of stocks, but ONLY 0.25% FOR NOW. It’s like a state income tax that the legislators sell to the citizens of a state, with the promise that it will never go above 1.5% and then 5 to 10 years later it’s up to 4, 5 or 6%.

The bottom line is that POLITICIANS cannot be trusted with our money. End of discussion.

In keeping with the tax on cosmetic surgery and the push for health care "reform", we are told that $500 million will come from cuts and cost savings in Medicare expenditures and this will help offset the increased cost of health care spending, so that it will be “budget neutral”.

These are the same people that said a trillion dollar stimulus, ie: pork barrel, bill will keep unemployment under 8% and create 3.5 million new jobs. The result a year later is that we’ve lost 3 million jobs on top of the 3.5 million we were promised which creates a deficit of 6.5 million jobs. Unemployment is at 10% and will probably go higher. In reality, it is much higher because so many people have just thrown their hands in the air and said, "enough is enough.”

The administration claims that there is this much waste in Medicare and my response is simply, "where the was the government 2, 5, or even 10 years ago that allowed hundreds of billions of dollars of waste to occur?" These are the same people who want to come now and control 17% of our gross national product. And of course their response is, if we have this red ink, these loses, this fraud, this embezzlement, all we have to do is tax the people just a little bit more.

The Botox cosmetic tax will be broad ranging, ie: ANY cosmetic procedure, Botox, fillers, dental caps, teeth whitening, braces, etc. the list is endless. This tax is also discriminatory because 90% of cosmetic procedures are performed on women.

These are not sin taxes like cigarettes, which place a tremendous burden on the health care system. This is clearly a tax on the middle class who earn $30 to $60 thousand a year. According to The American Society of Plastic Surgeons, 60% of all cosmetic procedures are from this income group.

I remember the President saying “NO NEW OR INCREASED TAXES ON THE MIDDLE CLASS” THEN WHAT IS THIS?

This increased cost may also cause some people to risk cosmetic procedures overseas such as Costa Rica and other areas of the Caribbean and around the world. I think most plastic surgeons have seen the results of these people who have gone offshore to “save money”. This will greatly increase their risks.

This tax will also create a new level of bureaucracy to enforce and collect this “new tax”. A while back New Jersey tried this approach and it was a nightmare and total failure. When ,oh when, will we ever, ever learn.

Each and every day my anger grows when I see our government slowly, in unrelenting fashion; erode our individual rights and freedoms.

IT IS TIME FOR ALL OF US TO WAKE UP AND BE HEARD!

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Dr. Brueck is a Board Certified plastic surgeon practicing in Fort Myers and Cape Coral, FL. For more information about his specialties, please visit his web site at Beauty-by-Brueck.com. To schedule a free consultation with Dr. Brueck, please call Judy at 239-939-5233

WRINKLE CREAMS - MIRACLE DEVICES? More hype than happening.

(Ed: As a Board Certified plastic surgeon, Dr. Robert J. Brueck, MD, FACS, is frequently asked by people he meets or has free consultations with if there is ANY substance to the claims advertisers make about "Miracle Wrinkle Creams and Devices." Here is Dr. Brueck's response, from a recent article he wrote:)

"I am so amazed how people are inundated with infomercials about beauty products that supposedly turn back the clock.

I remember recently seeing one that related to the 'neck/exerciser'.

I don’t know the exact name or title of this product, but you put this product on your chin and the other end goes up against your neck and you go up and down, up and down like you are bobbing for apples in a pool of water and after 10 to 15 years of doing this 3 or 4 times a day you have a beautiful more youthful neck line. And it’s only $29.95 plus shipping and handling and if you act now we will throw in at no extra charge our new miracle neck cream so you too can have a softer, more youthful neck. I think you get the gist of this.

Then I get an occasional patient who comes into the office to see me and asks me about this new miracle breast cream that is supposed to give you fuller, more youthful breasts. People buy them because they are cheap and people are desperate.

Sad but true, they don’t work.

Consumer reports in their 2009 addition recently reported on “winkle creams”. The sense of the article is simple, save your money.

The priciest cream tested was Perricone MD for $95. It was costlier than the over-the-counter drugstore brands. But notice, they put the MD in there... ah that must mean it works, it’s tested, it’s MD approved.

Sorry folks it doesn’t!

So the bottom line is save your money, go to Vegas, roll the dice, have some fun and, if you are lucky, you may come back a few dollars richer."

Dr. Brueck is Board Certified in Plastic Surgery and discusses the various procedures available at his Fort Myers - Cape Coral, FL in his web site at Beauty-by-Brueck.com.

You're invited to visit the web site or arrange for your own private, no charge consultation by calling 239-939-5233. If you would prefer to speak with a woman first, ask for Judy. Thank you.

Can you trust Plastic Surgery directories? Here's what Dr. Brueck thinks.

Thank you for visiting my blog. I try regularly to offer news and opinions about beauty and cosmetic surgery that I find interesting and helpful.

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This issue's subject is plastic surgery directories and thoughts on how they, and some probing questions, can help you find the right cosmetic surgeon for you.

Used to be there were two, maybe three directories in our lives. The White Pages, the Yellow Pages and, at one time, City Directories.

With the onslaught of the Internet and the Web, there are now more directories than weeds in an untended lawn. All manner of entrepreneurs have discovered they can create a directory and sell companies a place in it.

Some of these directories have no subject discipline. If you have a few bucks, you can have your web site listed in a directory. Others, have requirements that a company or individual be in a certain business.

Plastic surgery directories are like that. You must be a qualified plastic surgeon to be included in the directory. There are a few of them and they all require medical/surgical qualification at some level.

The general idea is that someone looking for a plastic surgeon will enter an appropriate search term, such as breast augmentation, in one of the Web Search Engines. Among the results they receive will be a few Directories of Plastic Surgeons.

The directory can be sorted by geographic location or other criteria. If you are looking for a plastic surgeon in "Anyplace Town", the directory will deliver a list of plastic surgeons in or around "Anyplace Town".

It will also include a profile of the doctor, an email address, a telephone number and, occasionally a web site address, for each doctor. There is nothing wrong with this. In fact, for someone seeking information and access to a local plastic surgeon, a directory can be very helpful, just as the Yellow Pages can be. (Of course, the internet is usually more responsive, more comprehensive and more current than a printed directory.)

The Yellow Pages can be an instructive analogy, though. Doctors run paid advertisements in the Yellow Pages. Similarly, doctors are required to pay to be included in online directories. This doesn’t make any doctor who pays to be included a bad doctor. He or she would not be listed without meeting what are quite demanding qualifications.

The problem is that an extremely well qualified plastic surgeon may not be willing to pay the directory publisher to be included. That doctor could be the finest surgeon in town, board certified in his or her practice, recognized by his or her peers as the best. If, however, he or she chose not to pay to be in the directory, you as a searcher wouldn’t know it, and you wouldn't learn about that doctor in this otherwise very helpful list. It’s not that you get false information. It’s just that you don’t get all the information.

What can you do about it? Use the directories, by all means. Look in more than one. A surgeon may have paid to be in one directory but not another. When you have zeroed in on the surgeon or surgeons that you want to advise you, go to the consultation with a list of questions.

1. Are you, doctor, board certified in the procedure I am interested in? May I see your certification?

2. How many other patients you performed this procedure for? Can you give me a short list that would be willing to comment on your work?

3. Can you show me before and after photographs of your work?

4. Am I a good candidate for this procedure? What are the chances of complications?

5. What can I expect after the procedure has been completed? What will recovery be like?

6. If you were unavailable to perform this surgery, who would you recommend in your place?

7. Can you give me the name of a patient who was not happy with your performance?

Question #7 is a real test. No surgeon is perfect. Each of them has had at least one patient that he or she did not completely satisfy. If the surgeon can’t answer that question, it should set off an alarm in your head.

Does it mean the surgeon thinks he or she is “perfect”?

Does it mean the surgeon has not paid enough attention to patients to know when one is not 100% satisfied?

Does it mean the surgeon has something to hide?

Incidentally, whether you contact the person the surgeon names or not is less important than asking the question and paying attention to he answer.

So, can you trust plastic surgery directories? More so than not.

In the words of a past President of the United States, however, “Trust but verify.”

Cosmetic Surgery - To Tell or Not to Tell

Frequently patients will ask me, “Dr. Brueck, when can I go out in public and be presentable?”

I guess only you can answer that.

It depends on whether you want anyone to know if your lack of apparent aging is due to the crafty art and skill of your plastic surgeon or the fact that you are blessed with “good genes.”

But when apparent lack of aging is due to non-surgical procedures most Americans are willing to offer a confession. A recent survey from the Aesthetic Surgery Education Research Foundation (ASERF) found that nearly 9 out of 10 or 87% of respondents openly discussed their use of Botox and dermal fillers. These non-surgical treatments are now mainstream.

Just who are these women who openly confess their use of Botox and fillers?

They usually are married, working mothers, age 41-55, with a household income under $100,000. These women are health conscious and philanthropic in their views and many volunteer for charitable organizations. The reason for doing this is “to look more relaxed, less stressed-out”.

So there you have it. A new interactive conversation, open, honest, and why not?

Plastic Surgery - Update on “RELOXIN”

Botox has enjoyed a “monopoly” ever since it came on the scene.

It’s long awaited rival Reloxin has been delayed by another government bureaucracy, the FDA.

It may not come out until late 2009, but when it does “WOW”. The competition will be great as it always is. Prices will likely come down.

The FDA’s reasons for the delay concern the company’s plan to handle potential risks.

Hold on to your hats; the roller coaster ride will soon begin.

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Interested in Botox as a filler? Check out Dr. Brueck's website for more information.

Plastic Surgery - Viagra for Cellulite? Hmmm

We all know about “Sildenafil”, better known as Viagra.

Now, Viagra MAY the answer to the nemesis of all cellulite.

Researchers in Zagreb, Croatia have found that Viagra, when combined with skin moisturizers, may have a beneficial effect on cellulite. Viagra has an enzyme that has broken down fat in test tubes. Viagra also has the ability to increase blood flow to the area.

So the “theory” is rub the Viagra on the cellulite → breakdown the fat cells → and with the new blood supply → whoosh the cellulite is gone.

It sounds great! It could really be some “pricey moisturizing cream”.

Stay tuned more to come.

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Want to know more about plastic surgery? Interested Fort Myers/Cape Coral resources? Take a look at Dr. Brueck's website. It's chock-a-block with helpful information.

Plastic Surgery - Do breast implants cause cancer?

Do breast implants cause cancer?

It's a question I have been asked over and over.

There is a new study published in the "National Journal of Cancer" that suggests women with breast implants have a lower risk for breast cancer. The analysis included 6,222 women in Sweden and Denmark, 80% of whom had silicone implants.

This study represents the longest follow-up to date of women with breast implants . 85% of the women were followed for over 10 years and 50% for more than 15 years.

Based on general population rates, researchers expected 115.62 women out of this study group to have breast cancer, but only 84 cases developed.

This is statistically significant and once again proves the safety and efficacy of breast implants.

For more information about implants for breast augmentation, please visit my Web site at Beauty-by-Brueck.com and click on the link to breast augmentation.

Short Arms – Long Legs - Who Cares?

We truly do live in an information age. Researchers are gathering thousands and thousands of pages of data on just about anything.

Now, this interesting study shows how limb length may be correlated with Alzheimer’s.

It has been believed that the portion of the brain most impacted by Alzheimer’s Disease (AD) develops simultaneously when the limbs are growing most rapidly.

This study, done at Tufts University, explored the relationship between the length of arms and legs with the risk of dementia.

The researchers studied 2798 men and women. Conclusion: the researchers found that the risk of AD and dementia decreased as knee height and arm span increased. This finding may show the importance of nutrition in early childhood to maximize limb length.

Get out the protein, Mom.

Is Vitamin D the new Wonder Drug? Dr. Brueck comments.

A recent study done by researchers in Germany studied the Vitamin D levels in 3200 men and women.

They found that those study participants who had high Vitamin D levels were less likely to die from cancer.

A number of studies by other researchers have shown that increased Vitamin D levels increases bone density and may modify, in a favorable way, cardiovascular risk factors.

Ah, my favorite bedtime snack – a couple of Vitamin D tablets.

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If you are going live longer because of Vitamin D, why not do it beautifully? Read Dr. Brueck’s website, Beauty-by Brueck.com , for ideas about cosmetic surgery procedures that can help you realize the most beautiful you possible.

Ask the Plastic Surgeon - How does Vitamin D Work?

There have been countless studies done about free radical production, which can damage cellular DNA, the body’s building block.

Chemicals, radiation and sunlight are just some of the many causative factors in producing free radicals in our bodies.

Researchers at the University of Rochester Medical Center found a key genetic mechanism as to how Vitamin D works.

Vitamin D induces a gene, G6PD, that increases the production of an enzyme, glucose-6-phosphate-dehydrogenose (now, that’s a mouthful). This enzyme protects the cells against damage by free radicals.

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Dr. Brueck's blog, Beauty-by-Brueck, offers countless observations about good health, especially as relates to plastic and cosmetic surgery.

Melanoma - The most dreaded skin cancer

Dr. Robert Brueck, Board Certified cosmetic surgeon in Fort Myers, Florida, reports on a new book about this dreaded form of skin cancer. Concerns about melanoma spring from its propensity to spread via the lymphatics as well as the blood stream.

The incidence of melanoma is rising by 4%-6% each year.

For years, we have been taught and have been telling our patients that sun exposure is a predisposing factor.

Now, along comes a book entitled "The Sun and the "Epidemic" of Melanoma: Myth on Myth!" The author is Dr. Bernard Ackerman, a world renowned expert on melanoma. His book attempts to dispel some myths about melanoma.

Dr. Ackerman believes genes are more important than sun exposure. He notes in his book that Asians and Africans only develop melanoma on their palms, soles, nails and mucous membranes (re: mouth-type).

I personally feel genes are very important, ie. we inherit skin type - freckles and such - from our parents. This can predispose us to melanoma.

I also feel that the sun can, in some cases, act as a catalyst to initiate the development of melanoma.

We are learning more every day. In the meantime, it's probably best to limit prolonged exposure to the sun and keep your skin covered whenever possible outside in the sun. I also recommend that you subscribe to a 'feed' of this blog to continue to receive updates about this subject and news from the world of cosmetic surgery.

As a Board Certified cosmetic surgeon practicing in sunny Fort Myers, Florida, I also cover a wide range of plastic surgery and cosmetic surgery subjects on my web site, http://www.Beauty-by-Brueck.com . You are invited to visit.