Posted: December 24, 2013
Happy Holidays and Happy New Year to all my colleagues, staff, family and friends. And of course, to the wonderful patients I have had the opportunity to meet, get to know well, enjoy, and laugh with, while helping them look and feel the best they can be. It is so rewarding to change people’s lives, see their self-esteem grow, overcome difficult situations, while enhancing their personal and professional life. It’s been a busy year.
We have had a very successful year. My vision of success is not about money, and never has been. It is about being happy, enjoying each and every day, bonding with my staff and patients, and laughing at all the little anecdotes that we experience on a regular basis in our office. I take pride in my work and do my very best to deliver the best results possible, and seeing those results come to be true is rewarding and fulfilling. That is the magic. Success means that my work is as good as it can be, both the patient and I are optimally satisfied, and positive and rewarding life-changes result. Honesty, openness, being genuine, and enjoying the unique differences among people are qualities that all of us at Desert Hills Plastic Surgery embrace.
I have admired the strength and optimism of our patients this year. Many have undergone major face and body transformations, and have gone through surgery with a great mental attitude and stoicism despite sometimes dealing with difficult personal challenges. In these cases, plastic surgery has helped them to feel good about themselves, putting them in a position to overcome adversity, and ultimately be successful or in a better position in life.
Our most popular procedures this year have been “Mommy Makeovers”, basically a laymen’s term for breast and abdominoplasty surgery in one surgical setting in women after childbearing. This combination of breast and body surgery is also very common in patients who have had major weight loss. Breast implants remain very common in our community with ongoing trends utilizing high-strength cohesive silicone gel implants. Breast lifts and breast reductions are also very popular in our practice and I feel that our results speak for themselves.
Liposuction techniques have also improved and evolved for me over this year. Newer cannulas, and slight changes in my technique have allowed me to obtain more dramatic changes in contour than ever before. It is important to be aggressive in the lower back and waistline, “scooping-out” the lower back to make the buttocks look rounder and more projecting. A curvy silhouette is popular, maintaining female curves, and buttock enhancement with fat grafting continues to be a sought-after procedure. Fat grafting to the breast and buttocks has continued to evolve and works well. In the breast, fat grafting works best to fill contour defects from previous surgery or complications associated with breast implants. It can add subtle upper pole fullness in women after mastopexy. For generalized breast augmentation, we are not quite there yet. Several sessions of fat grafting are typically required for a natural looking augmentation of at best ½ bra cup size, which is quite subtle. Results are not at all like results obtained with breast implants. Fat grafts do take well in the buttocks, but patients underestimate the invasive nature of the procedure and the labor-intensive proper method of reinjecting the fat so that it revascularizes and survives. In the case of Brazilian Butt lift and Buttock Augmentation in general, media hype has popularized the procedure without providing true insight on the nature of the intervention when done properly by Board Certified Plastic Surgeons, and the inherent risks, expense, and recovery process.
As I enter my 15th year of practice, I have maintained the majority of the same patients since I started my cosmetic plastic surgery practice in Henderson and Las Vegas, Nevada. Now I get to see their sons and daughters, in addition to meeting new patients every week. Everyone comes back for more. Breast implant patients return for implant maintenance, and patients continue to age, weight fluctuate, experience gravity, and have babies, with ongoing desires for procedures to make them look and feel their best. We also continue to have many patients who fly in from all over the world to have plastic surgery here. Las Vegas is a destination for plastic surgery, and I love meeting and interacting with all different ethnicities.
As me and my patients have continued to age, facial rejuvenation procedures have become much more common in my practice. In the midst of middle age myself, I have become passionate about mastering the “natural looking” facelift with without stigmata of surgery. I like to wear my hair back in a ponytail and relate to women who are not ok with visible scarring or unnatural results. The best plastic surgery in these cases looks like no plastic surgery was done–you look like yourself, only younger, more attractive, and less tired-looking. Minimally invasive procedures are ideal, and it is best to start earlier rather than later. Around age 50 is a good time to think about facial rejuvenation surgery. Botox and fillers ideally should be started in your 30’s; medical grade skin care products and sunscreen in your 20’s. Studies have shown that the younger you are when you undergo surgery, the more natural the results (as there is less dramatic of a change needed), the results last longer (because you have better skin tone), and with more mild skin excess, you qualify for less invasive procedures. Endoscopic brow lift with mini-facelift has become my workhorse for natural facial rejuvenation surgery. Blepharoplasty (eyelid surgery) may also be indicated, and just about everyone needs volume in the form of fillers. In order to look youthful and natural, you need to understand the aging process. It is not just about sagging skin, wrinkles, jowls and extra neck skin. Facial fat loss and descent, along with underlying skeletal remodeling contribute to loss of the youthful Ogee Curve of the cheek:
Fillers have continued to improve, providing natural results with ideal longevity. Our injection techniques have also improved, focusing on three-dimensional restoration of youthful anatomic structure versus “wrinkle-filling”. Hyaluronic acid fillers such as Belotero, Juvederm, Restylane, and the new Juvederm Voluma dominate the market. Sculptra and Radiesse are stimulatory, stimulating collagen synthesis, and work great in certain areas. Fat transfer and fat grafting to the face remain popular, but in my opinion, the media hype with stem cells have blown the benefits of fat grafting to the face out of proportion to the actual results and risks. Although it sounds appealing to use your own tissue for facial volume loss, the procedure is very technique dependent, unstandardized, and unpredictable. Most of the fat reabsorbs during the first year and patients become disappointed as their face deflates after an initially good facelift result. Risks of lumpiness, overcorrection or weight gain changing the result is nearly impossible to correct. I prefer the hyaluronic acid fillers, their naturalness, smoothness, ease of injection, and long-term predictability. They are also easily reversible in any case of overcorrection or complication using the enzyme hyaluronidase (Wydase), so I feel the safety is better. Beware of products that are “permanent”. Every year you age, with weight changes, stress, or even illness, your face can look different. A “permanent” unchanging product in the face can become perceptible, lumpy, and impossible to correct. It is ideal to be able to touch up your face with yearly visits to your plastic surgeon to maintain an ideal result with fillers and to account for your year of facial changes.
The unnaturally full lip trend has passed; yet natural and beautifully shaped lips that are well proportioned with the chin, a well-defined jawline, and a heart-shaped face look youthful and attractive. Hollow lower eyelids, cheeks, and temples should be filled as a unit, so the bony structure looks natural. Just because you have hair hiding the sides of the face doesn’t mean you neglect hollowness (skeletonization) affecting the lateral contours of your face. A simian look, with chipmunk cheeks is not attractive or natural. Botox remains highly addictive for smoothing the upper third of the face, however I have been disappointed with the longevity of Botox, and also the alternatives including Dysport and Xeomin. I am waiting for a longer lasting alternative, and hopefully that is around the corner
I have been very fortunate to have a loyal and stable staff like family, and a great husband that is also our Board Certified Anesthesiologist with 25 years of experience. We all make a great team!
I also appreciate my plastic surgery colleagues in this community that continue to provide friendship and support.
I also love being a mom, and have a nice balance between my full-time work and full-time job as a mother of 4. My kids are becoming teenagers now (ages 15,13, 10 and 3), and that is interesting, while my 3 year old is a challenge but cute and quite entertaining.
More than ever this year I have been spending a considerable amount of time writing about plastic surgery, which I enjoy. It is rewarding to learn and share my knowledge, while reporting on interesting experiences in the office, operating room, and at conferences and seminars. I love to keep up with the new advances in the field of plastic surgery, the latest trends, and be able to offer the latest technologies and treatments in plastic surgery. Sharing that information with others, while informing and educating the consumer about what works and what doesn’t, is important to me and keeps me up to date on the latest advancements in the field of plastic surgery. It is also important for me to help our patients distinguish media hype and advertisements from truths, and make them aware of treatments that really do work and have benefit.
So from me, Dr. Hayley Brown, and my husband, Dr. Steve Brown, as well as our incredible staff at Desert Hills Plastic Surgery Center, Michelle, Nicole, and Alethea, warmest wishes for a joyful holiday season and happy new year and we look forward to seeing you all in 2014!