What Is Coolsculpting?

Coolsculpting represents a significant advance in the treatment of problem fat collections. The technique has been clinically proven and has FDA approval.

The procedure involves placing an applicator over the involved area. Suction is then applied, which draws the soft tissue into the device where it’s held in place. The skin and fat are then cooled in a controlled manner. Upon completion of treatment, the involved area is gently massaged to smooth contour irregularities that have been created by the device.

When single anatomic areas are treated, the procedure typically lasts about an hour. Depending on the magnitude of the problem, multiple treatments may be necessary.

Commonly treated areas include the abdomen, flanks, hips, bra strap area, inner thighs, outer thighs, saddle bags and banana rolls.

In the vast majority of patients who undergo coolsculpting the results are excellent. The procedure is very safe and there appears to be no long term problems associated with the procedure.

Unfortunately, the procedure isn't for everyone. Patients with large amounts of fat or loose skin may need more aggressive procedures. In this group, liposuction or skin resections may be more appropriate. It is important to remember that the best results occur when there’s appropriate patient selection and expectations are realistic.

Coolsculpting Complications

Coolsculpting has been available in the United States for several years and in Europe for a much longer period of time. Over 50,000 patients have undergone Coolsculpting safely with minimal complications.

The procedure involves placing an applicator head over the involved area. Suction is then applied, which draws the soft tissue into the device where it’s held in place. The skin and fat are then cooled in a controlled manner. Upon completion of treatment, the involved area is gently massaged to smooth contour irregularities that have been created by the device.

Patients typically describe an uncomfortable feeling as if a block of ice was being held against the area. Within ten minutes, the area becomes numb and patients become more comfortable. At this point they are able to read a book, watch a DVD, listen to music or sleep.

                
A small number of patients experience bruising and swelling which spontaneously resolves in 2-3 days. Occasionally, patients experience pain which is often described as dull and achy. This also resolves quickly.

                
Rarely, nausea can occur when abdominal Coolsculpting is performed and is probably secondary to traction on the abdominal contents. This is fortunately uncommon and quickly resolves on its own.

These problems occur sporadically and don’t appear to be modulated by mechanical factors such as applicator size. At this time, no long term complications have been identified with this procedure. The procedure is associated with high satisfaction rates and is an excellent option for treating localized adiposity. 

Facelift Surgery for Rejuvenation of the Neck

It’s not unusual to see women who have significant changes in their neck area as a result of facial aging. In many cases, this may be the primary manifestation of aging, with the face itself being relatively unaffected. These changes may include loss of definition of the jaw line, loss of the sharp angle between the neck and jaw, laxity of the underlying neck muscles with the formation of bands called turkey gobblers, fat accumulation, and of course excess skin. To obtain an excellent result, all of these issues need to be addressed. With this in mind it’s important to remember that all patients have unique facial anatomy and specific aesthetic goals. Therefore, treatment plans may vary from patient to patient depending upon their underlying anatomic deformity.

The procedure that is most likely to accomplish these goals is a facelift. This procedure corrects the abnormalities of the underlying muscles which ultimately defines the jaw line, removes the neck bands, and improves the angle between the jaw and neck. It also addresses fat accumulation and excess skin to further accentuate these improvements.

Teen Breast Reduction

When younger patients have significant breast enlargement with associated symptoms, we don’t feel that they should be denied the benefits of this procedure because of an arbitrary age cutoff. Before proceeding, there are several unique considerations in this group that must be considered.

One of these is the issue of breast growth. We would prefer stabilization of breast growth for at least six months prior to proceeding with surgery. Another issue is the age of consent. Because of this, parents should be involved in every step of the decision- making process.

Breast Augmentation Options

Several questions need to be answered before proceeding with breast augmentation surgery.  These pertain to the following issues: 1) Implant size, 2) Implant type, 3) Incision location, 4) Under or the over muscle, and 5) With or without a breast lift.

Depending upon the answers to these questions, a large variety of treatment options potentially exist. Each patient should be considered individually since no two patients are the same. Patients may have unique anatomic findings and specific aesthetic goals that impact their treatment plan.

In general terms, data shows that the majority of implants are placed under the muscle through an inframammary approach.  There is a greater tendency to use silicone gel implants than saline implants, but saline implants are still frequently used.

Will Pregnancy Ruin My Breast Implants?

Breast implants are not impacted by pregnancy and breast-feeding, but the surrounding breast tissue can be significantly impacted. These changes vary from patient to patient following breast augmentation and pregnancy. Some patients are minimally impacted, while others note sag of their native breast tissue, loss of breast volume, and stretch marks. These changes are probably not related to breast implants, but are instead related to the natural biologic tendencies of the breast tissue. In other words, loss of breast volume, sag, and stretch marks would occur even if breast implants weren't present.

Exercise Following Breast Augmentation

Recovery times following breast augmentation surgery vary from patient to patient. These times are significantly impacted by the nature of the procedure, the patient’s employment, and the patient’s social situation. It’s important to realize that even though breast augmentation is a cosmetic procedure, it’s still a significant operation with associated risk. For this reason, premature return to normal activity can result in an increased incidence of complications.
  
We generally recommend light activity for the first week following the procedure. After one week, patients are allowed to gradually resume normal non- strenuous activities. Strenuous activities and heavy lifting are not allowed for at least six weeks in most cases. At six weeks, most patients are able to resume all of their normal activities.

Insurance Coverage for Blepharoplasty?

When redundant upper eyelid skin results in obstruction of vision, it’s more than a cosmetic issue.  Patients often have excess skin, which obstructs vision superiorly and laterally.  Under these circumstances, excess upper eyelid skin can actually cause significant functional problems.  For instance, this can create problems when driving a motor vehicle and this can be potentially dangerous.  When this happens insurance carriers will occasionally view upper lid blepharoplasty as
medically necessary and cover its expense.

Before insurance carriers cover the expense of blepharoplasty they require that certain criteria be met.  These include documentation of symptoms and physical findings associated with visual field obstruction.  In addition, visual field studies that demonstrate visual field obstruction are critical to insurance approval.

Visual field studies are typically performed by an ophthalmologist or optometrist. The study is performed by measuring the patient’s response to a series of flashing lights. The patient’s responses are recorded and a computer- generated report is made. This report will demonstrate any visual field defects that the patient may have. The initial study is followed by a secondary study in which the upper eyelids are taped in an upward direction.  Improvements in the results of visual field studies with the upper lids taped as opposed to untaped would indicate that blepharoplasty would benefit the patient.

Should I Get Breast Implants If I Plan On Getting Pregnant Later?

The results of breast augmentation surgery are never permanent. Changes in weight, normal aging, pregnancy, and breast-feeding can all be expected to change the breasts. Each patient who is considering breast augmentation and possibly pregnancy should be considered individually based on their personal situation. As a rule, if a patient is planning pregnancy within a year of surgery, we generally recommend postponing surgery until after the pregnancy. Most patients who present for breast augmentation don't have plans for pregnancy in the short term, but realize that it's probably in their future. It's important for this group of patients to realize that pregnancy may impact their final result.

The impact of pregnancy on breast augmentation varies from patient to patient. Some patients are minimally impacted, while others note sag of their native breast tissue, volume loss, and stretch marks. This often results in the need for secondary procedures, such as implant exchange and breast lift.

Abdominoplasty, Mini Abdominoplasty, Liposuction, or Coolsculpting: How Do I Choose?

At Surgical Images, we see many patients who have concerns about the appearance of their abdomen. Many of these patients present because of the effects of pregnancy, massive weight loss, over eating, or lack of exercise. Most of them have tried diet and exercise and despite this, have been unable to solve their problem. These patients have difficulty finding clothes that fit properly and feel that people stare at them. This often results in lowered self-esteem, self-confidence, and self-image. For those reasons, they seek plastic surgery consultations.

There are multiple options available for treating abnormalities of the abdominal wall. These include: coolsculpting, abdominoplasty, mini abdominoplasty, and liposuction of the abdomen. Often, patients aren’t certain about which procedure is most likely to accomplish their aesthetic goals. This is important because these procedures have different levels of complexity, pain, recovery, and cost. It’s not unusual for patients to express an interest in a specific procedure and then during the consultation find out that it will not accomplish their goals. For these reasons, a comprehensive evaluation is essential to obtain an optimal result.

You’re Invited to a ‘Cool Night Out’ at Surgical Images!

The Physicians of Aesthetic Surgical Images extend an invitation to you to join us for the first ‘Cool Night Out’ event. At this event, you can learn about the CoolSculpting treatment, view a live demonstration and enter to win a CoolSculpting treatment!*

Presented by: The Physicians of Aesthetic Surgical Images
Thursday, February 23, 2012
5 p.m. – 7 p.m.
Hosted at Aesthetic Surgical Images
8900 W. Dodge Road
Omaha, NE 68114

CoolSculpting® in Omaha

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Patients often inquire about non-invasive procedures for small, stubborn pockets of fat, as an alternative to liposuction in Omaha. The physicians of Aesthetic Surgical Images are excited to offer the new technology of Coolsculpting® by ZELTIQ as an option for men and women looking to safely eliminate fat cells without surgery. CoolSculpting® uses a cooling process which freezes fat cells, and the body removes them naturally.