Cosmetic Surgery Center, Dallas | Dr. Rai

The American Society for Aesthetic Plastic Surgery has issued its forecast for 2009. They based it on many interviews with cosmetic surgeons around the country.

Overall they expect to see the same diversification of cosmetic surgery patients as happened during 2008. Surgeons have been tailoring procedures for more and more individual situations and this in itself invites more individuals to come for a customized procedure. More men have been coming for rejuvenating work and that trend is expected to continue.

• Dermal fillers will continue to be popular and new products will evolve
• There will be increasing demand for body contouring surgeries as more people realize the dangers of obesity and become serious about weight loss. After the weight has entered a person’s "normal" range, procedures such as tummy tucks and liposuction will be needed to deal with sagging muscles and loose skin.
• Because BOTOX has been such a success, another similar product called Reloxin will gain FDA approval. It is currently in testing. Other competing products will probably enter the testing phases.
• There will be more testing of new ways to remove fat. They will be either alternatives to liposuction or adjunct procedures for it.
• More men will seek cosmetic surgery procedures.
• There will be more non-invasive or minimally-invasive procedures. Manufacturers and surgeons will come up with new techniques and devices to give you better results and shorter recovery times.
• Cosmetic tourism will decline as more people realize the importance of follow-up care.
  

On the warning side, there is a less exciting prediction:

• People looking for bargain rates will cause an increase in media horror stories. Products obtained from foreign sources at discount rates and procedures done by inadequately trained personnel will provide good fuel for those in the mass media seeking to frighten the population.
• As a result of these publicized incidents, more people will start to check the qualifications of cosmetic surgeons and the public in general will become more sophisticated about healthcare choices.

At our Cosmetic Surgical Center, we meet all standards for safety and appropriate training. Dr. Rai is board-certified for plastic surgery and serves as the Chief of Plastic Surgery at Medical City Dallas Hospital. He is also on the staff of three other hospitals. For more information, please see Meet Dr. Rai.

If you would like to participate in the growing benefits and popularity of rejuvenating the face and body, please contact cosmetic surgeon Dr. Rai today for a personal consultation.

While it seems that the entire female population is going after breast enlargement, there are some who would like to have smaller breasts. Breast reduction is one of the few cosmetic surgeries that are done for health reasons as well as beauty reasons. Another such procedure is often rhinoplasty, as reshaping the nose can improve breathing and in some cases that is the goal of the procedure.

When the breasts are very large and heavy, a woman usually suffers from backaches and pain in the neck and shoulders. Bra straps bite into the shoulder skin. Agility and speed of movement are reduced so that a woman may not be able to participate in sports. The breasts may hang low and develop skin irritation in the breast crease.

A breast reduction will remove unwanted fatty tissue, glandular tissue and skin. Dr. Rai will discuss the procedure with you beforehand and learn what size you would like your breasts to be. You can also discuss anesthesia with him, as the procedure may be done with general anesthesia or with local anesthetic and an IV sedative.

Often the nipples will be raised and reattached higher to create a more perky look. In combination with the removal of excess bulk, this gives the effect of a breast lift. When the incisions are closed, stitches are placed deep in the tissue as well as on the surface, to give added support to the new shape.

Your results will be long-lasting. You will now have better body proportions and can enjoy the pleasure of buying a whole new wardrobe.

To learn more about breast reduction and whether you might be a good candidate for it, please call or email our cosmetic surgery office to schedule a free consultation.

Botox injections are the top non-surgical cosmetic procedure according to the American Society of Plastic Surgeons. In 2007, 4,625,192 Botox injections were given, up from 4,090,517 in 2006. The next in popularity is injections of dermal fillers, at only 1,050,722 procedures in 2007.

How Does Botox Work?

Unlike dermal fillers, which inject some type of substance beneath the skin surface to plump it up or support it, Botox works by paralyzing muscles. The tiny dose is injected into a specific muscle and for a few months prevents that muscle from contracting. It does that by blocking a chemical called acetylcholine which motor nerve endings would normally release into the muscle. In other words, it blocks the brain's message telling the muscle to contract.

Botox is most often used for frown lines, where it is injected into the small muscle which draws the eyebrows together and downwards (called the corrugator supercilii). By blocking any use of this particular muscle, Botox prevents you from frowning and forming those wrinkles. It is also used to treat horizontal forehead lines and some other face and neck areas.

Non-Cosmetic Uses for Botox

A substance which relaxes muscles and stops them from contracting could potentially have other uses than cosmetic, and in fact Botox is used in ways that don't receive the publicity of its cosmetic use.

• Some doctors are using Botox to treat migraine headaches by preventing muscle contractions which create tension. Injections are made into muscles of the eyes, forehead, side of the head and back of the head.
• Others have successfully used it to reduce excessive sweating in the underarms or palms. By blocking the acetylcholine from being released from nerve endings to the sweat glands, it blocks the message telling the glands to secrete sweat. This use for Botox has FDA approval.
• Botox has a good track record in reducing the painful muscle spasms of cerebral palsy. It reduces drooling and helps a patient walk by relaxing the calf muscles so that the feet can be placed flat on the floor. Chronic muscle contraction causes the secondary problem of permanent muscle shortening, and Botox can prevent that by keeping the muscles relaxed.
• Botox is being used for stroke, brain injury and spinal cord injury patients, to relax the chronic stiffness and immobility of affected muscles. This is more effective on smaller muscles like those of the hands than it is on larger leg muscles.

Many of these uses of Botox are off-label, meaning that they are legal but not FDA-approved. A physician can make a professional judgment in individual cases which may not have been specifically tested in the FDA testing phases.

Our use of Botox is cosmetic and if you would like to know more about how it might help you, please contact our cosmetic surgery office today for a personal consultation.

The abdomen is the entire area between the ribs and the pubic bone. It contains a cavity which holds the digestive system and other organs such as the liver and spleen. The cavity is enclosed in front by the abdominal wall, composed of muscle, fat and membranes.

The abdominal wall has five muscles and their fibers run diagonally, horizontally, and vertically. They are in layers with various membranes in between known as fascia. Directly beneath the abdominal skin is a fascial layer with fat. When we gain weight, this layer expands as the fat cells store more fat.

Less Muscle Support

The muscles in the lower abdominal wall have less support than most other muscles in the body. They have fascia on their front side but not on their back side (the internal side bordering on the abdominal cavity). This means that they more easily become lax and are harder to keep well-toned.

During pregnancy or massive weight gain, the abdominal muscles are stretched. They sag and provide less containment for the abdominal contents. The skin stretches over them and the body now has a bulging look which makes many people feel uncomfortably "middle-aged". Extra fat accumulates inside the abdominal wall and cavity. Diet and exercise can tone and reduce most other body areas, but the abdomen may remain pouchy.

Tummy Tucks

An abdominoplasty (tummy tuck) tightens the abdominal fascia and one of the abdominal muscles called the rectus abdominis. It is a long, flat muscle which runs vertically for the full length of the abdominal wall. It is divided vertically in its center by a long fibrous band called the linea alba. The fibers on each side of this band can be stitched towards this center line to provide a stronger outside wall for the abdomen.

Excess skin is removed and both excision and liposuction remove unwanted fatty tissue. The navel is repositioned higher on the abdomen, now that sagging is removed.

If you have faithfully followed an exercise regimen and a nutritious diet but still have a protruding abdomen, please do not feel that you have failed. The natural lack of fascial support for abdominal muscles makes it virtually impossible to flatten the abdomen with diet and exercise once it has been expanded.

Please contact our cosmetic surgery office if you would like to know more about tummy tucks. We will schedule a personal consultation for you with one of our cosmetic surgeons.

According to Fox News recently, cosmetic surgery patients are loudly asking for famous facial features. Fox News interviewed plastic surgeons in several states and learned that media coverage is the guiding light for what new patients think they want to look like. Mere beauty is not enough, and negative fame is not inspiring these patients; their Pied Piper is favorable publicity.

So there are few requests to look like Paris Hilton or Britney Spears. And as media fame waxes and wanes, requests change accordingly. Many patients previously asked for Sharon Stone's nose but now ask for one like Jessica Alba's. Where Heather Locklear's cheeks were previously popular, now people want cheeks like Carrie Underwood's.

Men are not exempt from this trend. Full pouts are in fashion for both sexes and male patients have been asking for lips like Mario Lopez. A good jawline is always a popular masculine feature and men are asking to look like Daniel Craig or Hugh Jackman.

The most popular look of all is apparently that of Scarlett Johansson, thought to have the perfect combination of lips, cheeks and breasts. Her face is considered to be the ideal "apple" shape with cheeks tapering down nicely to the jaw. Women used to ask more for Pamela Anderson's breasts but now are favoring a smaller size and asking for breasts like Scarlett's of a size C.

One has to wonder how many cosmetic surgery patients are asking to look more like themselves.

If you would like to schedule a personal consultation with Dr. Rai, please call or email our cosmetic surgery office today.

Hairs are made of dead cells -- if they were live, it would hurt to cut them. Each hair is from 0.02 to 0.04 millimeters wide and an average head has somewhere between 100,000 and 150,000 hairs. Blond heads tend to have more than red or dark heads. Men have around 30,000 hairs in a mustache or beard.

A Three-Phase Cycle

1. Anagen -- the Growth Phase

Each hair grows from a root inside a follicle in the skin's middle layer, the dermis. The follicle is a tiny bulb-shaped structure with an oil gland next to it to lubricate the hair. The base of the follicle is known as the dermal papilla and it is nourished by a tiny artery, with a companion vein to remove waste products. Proteins and keratin are made continuously in the growth phase, giving the hair its necessary ingredients.

At the rate of about one half-inch to one inch per month, a hair will continue growing anywhere from two to six years. In that time it can grow as long as about three feet, although usually it grows no longer than about waist-length. At any one time, about 85 percent of all your hairs are in this growth phase.

2. Catagen -- the Transitional Phase

At the end of the growth phase, the follicle shrinks down to about one sixth of its normal length. The hair stops growing. The dermal papilla subsides and rests in the fatty tissue of the skin's subcutaneous layer. The transitional phase lasts between one and two weeks. Only about one percent of hair is in this stage at any given time.

3. Telogen -- the Resting Phase

For a month or a little more, the follicle rests. The old hair may still be there, or may have fallen out. If it is there, it does not grow. At the end of this time, the follicle expands again and enters a new growth phase. A new hair forms inside it and pushes any lingering old hair out as it grows. On average, we lose about 100 hairs per day. About 14 percent of hairs are in the resting phase at any one time.

As we age, individual hairs grow thinner. The dermal papilla is sensitive to certain hormones which regulate hair growth and trigger each phase of the cycle. In people with a genetic tendency towards hair loss, hormones known as androgens will close down the follicle so that it produces no more hairs.

However, other things also influence hair growth such as quality of nutrition, vitamin supplements and emotional states. Scientists do not have a full understanding of hair growth, such as what triggers it to begin in a fetus, what keeps it going, and why it grows more in some body areas than others.

Please contact our cosmetic surgery office if you would like to schedule a personal consultation and learn more about the rejuvenating procedures we offer.

We hear a lot about collagen being an ingredient in some dermal fillers such as Cosmoderm and Zyderm. It is also an ingredient in some skin lotions and creams. In past years it was used alone as an injection for treating wrinkles, but is not popular now, since other fillers such as Restylane give longer-lasting results.

Everyone has a great deal of collagen in the body, as it is the principal protein in connective tissue like tendons and supportive membranes around body organs. It is found in bones, teeth, muscles, cartilage and blood vessels, and is often used in skin and bone reconstruction after a severe burn injury and in other orthopedic and surgical procedures. It has tensile strength.

Medical collagen comes from young cattle or pigs which have been bred for the purpose and certified to be free of a condition called Bovine Spongiform Encephalopathy (BSE; also called Mad Cow Disease). These cattle are kept separate in "closed herds". Some countries such as Australia have never had any incidence of this disease and breed animals safely for collagen production.

Collagen in the Skin

Collagen makes up about 80 percent of the skin. In the skin's middle layer, the dermis, collagen works with elastin, another fibrous protein which has elasticity, to support the skin with an interwoven matrix of fibers. Collagen also works with keratin, which is another strong protein found in hair, nails and teeth -- also in animal hooves and horns.

Our skin's outer layer, the epidermis, contains dead keratin, in the cells which will be discarded. They give the skin a toughness on the surface and some insulation, and protect the newer, living cells beneath. By moisturizing the skin surface you can prevent the keratin from splitting and cracking.

As we age, the body produces less collagen. This creates weakness and gaps in the skin's supportive matrix, which is a contributing cause to wrinkles. Use of a lotion containing collagen will not help, as the lotion cannot penetrate to the deeper level where it is needed in the dermis. This is why it must be injected.

To learn more about the best ways of rejuvenating your skin, please contact our office for a personal consultation.