According to the statistics made public by the American Society of Plastic Surgeons (ASPS), the plastic surgery procedure which increased the most in popularity by percentage from 2010 to 2011 was chin augmentation. There was a 71% increase in the number of chin enlargements performed as compared to a 4% increase in breast augmentations, 5% increase in facelifts, 1% increase in liposuction and a 3% decrease in rhinoplasties (cosmetic nasal surgery).

Though this percentage increase is quite substantial, it is a result of the fact that chin augmentations are not performed in large numbers as compared to many other plastic surgery procedures. To put this is into proper perspective, breast augmentations are greater than 20 times more commonly done than chin augmentations … and that it the way it should be! After all, what adds more obvious beauty, confidence and happiness to the world as experienced by women and men – larger, firm, voluptuous and attractive breasts or a normal appearing, nondescript chin?

Duh!

What do the “experts” think is the impetus for this sudden and substantial increase in the number of chin implant procedures being performed?

The sentiment is that this is the direct result of the greater usage of video chats with people seeing their aging facial images or weak chins on their computers along with intense competition for limited jobs and an aging baby boomer population in general. A chin implant can help provide for a stronger more balanced face which does convey to others a sense of strength, authority and confidence which is particularly important in the business world. It can also help to rejuvenate an aging face both by reversing some of the natural atrophy of the chin that occurs over time as well as effacing some early jowling.

Whether this will become a trend or not, time will obviously tell. However, this is a relatively simple and “minor” procedure that can have an outsized impact.

For more information on chin enlargement or for any other plastic surgery procedure or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

If you are a woman, the odds are that there have always been a few issues regarding your appearance that have bothered you. Maybe it was the size, shape and/or asymmetry of your breasts that made you feel very self-conscious and not very sexy. It could have been that pooch in the middle of your abdomen that seemed grotesquely large. Or possibly it was that mini-muffin top or broad hips just didn’t make the grade for you. Whatever you thought was horrible back then you long for now.

Why is that?

Because you have had one or more children – and they have DESTROYED your body!

Yup! Ironically, in the scheme of things, those were your golden years of beauty. Now you are older, more tired and believe that negative adjectives like flabby, droopy, deflated, broad and fat well describe your appearance. You feel frustrated and even more self-conscious and less attractive now. It may seem almost hopeless but…

You do have options to help correct the devastation that pregnancies have wreaked on your body. In fact, you may even end up looking better in many ways than you did prior to becoming pregnant – and feeling better about yourself as well.

How is that possible?

A mommy makeover.

As explained in the Mommy Makeover section, the most common procedures performed to deal with the physical changes following pregnancy include cosmetic breast surgery such as a breast augmentation with or without a breast lift or even a breast reduction – combined with an abdominal procedure such as a full tummy tuck (abdominoplasty) or mini tummy tuck. Liposuction and other procedures can also be performed concurrently.

The results from mommy makeovers can be overwhelmingly positive and immensely rewarding. They can help a woman regain confidence, self-esteem, and feel happier as well as attractive and sexy again. A patient of mine who underwent a mommy makeover, shares her positive sentiments in the following video:

For more information on a mommy makeover or any other plastic surgery procedure that I perform or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Though cosmetic surgery procedures have been considered mainstream for years and have achieved a high level of popularity in this country, some are still of the opinion that in many ways, these procedures are somewhat frivolous or superficial in nature. A study just published in the April 2012 edition of Plastic and Reconstructive Surgery provides new insight of the effects of two common cosmetic procedures, liposuction and tummy tucks, on the psyche of patients and the effects on the quality of life. It seems that beauty is more than skin deep.

This clinical study assessed the quality of life and other consequences in a total of 360 patients, 85% of which were women, who underwent liposuction and/or an abdominoplasty. Of these, 60 percent had liposuction alone, 35 percent a combination of liposuction and abdominoplasty and the remainder, a tummy tuck solely. Thirty percent of these patients also had other procedures performed concurrently such as breast augmentation and eyelid surgery.

The findings of this research revealed a remarkably high level of satisfaction with these procedures and their positive impact on self-esteem and quality of life. Of those who underwent liposuction alone, 93.5% of patients would do it all over again if faced with the same decision; 97.3% would recommend liposuction to others. For those patients who underwent an abdominoplasty alone or with liposuction (lipoabdominoplasty), these numbers were even higher – at 97.1% and 99.3%, respectively.

In the patients who just had liposuction, 82.6% stated that they had an increase of self-esteem. For those individuals who had a tummy tuck as well as liposuction, this number was an astounding 91.4%, with 76.4% noting an increase in the quality of their life. Furthermore, 91% stated that they were now motivated to stay in good shape with almost 62% actually reporting weight loss after their surgery.

There are a lot of numbers here but they clearly reveal the overwhelmingly positive impact that liposuction and tummy tucks have on not only physical beauty but also on mental well-being and quality of life. Taking this one step further, the study further undermines the misguided notion that cosmetic surgery is a frivolous endeavor or desire of superficial people.

For more information on tummy tucks, liposuction or for any other plastic surgery procedure that I perform, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Botox® Cosmetic, the rejuvenating and anti-wrinkle wonder, is celebrating its 10th year anniversary this month. Back in April of 2002, it was approved by the FDA (Federal Drug Administration) for the cosmetic treatment of frown lines between the brows. Its clinical usage, however, dates back to the 1980s when it was employed for the treatment of opthalmological (eye) problems. Over the ensuing years, Botox® has been found to be effective in the treatment of a multitude of medical issues such as chronic migraine headaches, excessive sweating (hyperhidrosis), and muscle spasm disorders such as of the neck, bladder, vocal cords, anus and even vagina.

There now may be yet another therapeutic benefit of Botox®: the treatment of depression. The potential beneficial relationship between the usage of Botox® and the improvement of clinical depression has been noted for years including by several small studies and anecdotal reports. A scientifically sound pilot study recently performed at the Hannover Medical School in Hannover, Germany with the results recently presented at the 20th European Congress of Psychiatry, provides far more substantive evidence to support this relationship. Importantly, it was not supported by any of the manufacturers of the botulinum toxin.

This study was conducted as a randomized, double-blind, placebo-controlled trial (jargon for the study being conducted using scientific principles that would minimize bias in the results) using injections of either onabotulinumtoxinA (Botox®) or placebo into the appropriate muscles between the brows that are associated with the frown lines (the procerus and corrugator muscles in the glabellar region of the forehead) in 30 female and male patients with chronic major depression. These individuals were already being treated with antidepressant medication. Assessment was quantified using a standardized depression rating scale.

What were the findings?

The study investigators discovered that just one Botox session resulted in not only the diminishing of the frown lines (as expected) but also in a strong and persisting improvement in the depression of these patients who had not responded adequately to previous treatments. At 6 weeks, the Botox® treated group experienced a 50% improvement in their scores compared to only 9% in the placebo group. Under the category of a full response, 60% of the Botox® patients experienced this versus only 13% in the placebo group. Even more amazing, 33% of the Botox® treated patients experienced complete remission.

A few theories have been advanced to explain this phenomenon including positive feedback from friends, family and others who might have told patients that they didn’t look so angry anymore (due to diminished or suppressed frowning and wrinkling). The person can also note this when he or she looks in the mirror and doesn’t always appear to be so angry or even old anymore.

There study provides additional evidence in support of the old adage that “if you look better, you will feel better”!

If you would like more information on Botox® or other anti-aging treatments such as Juvederm®, Restylane® or Radiesse® or to schedule a complimentary consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

I have been using the Ultrapulsed CO2 laser since it was first introduced around 20 years ago and have been firmly impressed with the results that I can provide my patients in addressing qualitative issues of their skin associated with aging and sun damage. Given the right person and set of circumstances, the CO2 laser for facial skin rejuvenation can provide spectacular and predictable results that virtually always exceed those that can be obtained using any other alternative approach. That includes any of a myriad of chemical peels, micro-dermabrasion, standard dermabrasion, photofacials with intense pulsed light (IPL), and other lasers including Erbium.

The following patient of mine, a 52 year old woman, is a typical example of what can be obtained using the Ultrapulsed CO2 laser for full face skin rejuvenation. No other procedures were performed on her.

Before CO2 laser skin resurfacing

Two months after CO2 laser

Before CO2 laser

Two months after CO2 laser

Before CO2 laser

Two months after CO2 laser

“Full” healing of the skin occurred in less than one week with some pink coloration present at one month. The postoperative photos were taken at less than two months after the procedure and without any cover-up makeup on.

This dramatic outcome is essentially impossible to equal with any other approach available today. Of course, it is not just the CO2 laser itself but also the extensive experience of the plastic surgeon that plays a crucial role in being able to obtain such a significant yet natural appearing result without complications.

If you would like more information on CO2 laser facial skin rejuvenation or for any other plastic surgery procedure that I perform or to schedule a free consultation, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Here at the Arizona Center for Aesthetic Plastic Surgery, I see a tremendous number of patients who are seeking improvements in the appearance of their face though the usage of dermal fillers such as Juvederm® and Restylane® rather than with surgery such as facelifts or even fat injections (lipofilling). Notable, there has been a quite significant increase in demand for these products over the last several years which can be, in large part, attributed to the recession and overall poor economy. Though these may not be the ideal or even first line solutions for signs of facial aging, they are at least far more affordable and do provide for facial rejuvenation. They are often combined with the usage of Botox®.

Who are these people seeking improvements though dermal fillers?

They are largely women and range in age from the twenties up to the seventies. Their frequent concerns include addressing wrinkles, creases, folds, lines, scars, areas of deficient volume and volume asymmetries. Most of these are expected consequences of the aging process. Of course, a very popular reason for their usage is to augment lips that are either congenitally small or smaller than desired or have atrophied over time age.

Dermal fillers can be injected to soften, make less conspicuous or even ablate creases, folds and lines essentially anywhere on the face. The most common areas that they are used for are around the mouth (nasolabial folds and marionette lines), the jowls and contour depressions below the eyelids. They can also serve to add volume to areas that are deficient in volume for a multitude of reasons. Common locations include the cheeks, cheek bone area and chin but can also include the brows and even jaw line and nose.

I do offer my patients several dermal filler options for the treatment of these issues. They include Juvederm® Ultra XC and Juvederm® Ultra Plus XC, Restylane®, Perlane® and Radiesse®. Which one or ones are recommended for a particular patient would depend on a variety of factors and would be discussed at the time of consultation (as would risks, expectations, etc.). For lip enlargement, the choices are either Juvederm® (Ultra or Ultra Plus XC) or Restylane®.

Though dermal fillers like Juvederm® and Restylane® are not intended as replacements for plastic surgery procedures of the face (though they can be used as adjuncts to these procedures), they offer cost effective solutions for facial rejuvenation and do so without the discomfort of surgery and with minimal if any down time. So now you can afford to look even better!

If you would like more information on the dermal fillers Juvederm®, Restylane® or Radiesse® or for any plastic surgery procedure that I perform, please call my office at 480-451-3000. You can also schedule your complimentary consultation with me at that time as well.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

There are some people still feel that plastic surgery is largely frivolous and is geared to the self–obsessed who have too much time and money on their hands. Fortunately this attitude is rare nowadays in America. Plastic surgery has become main stream – it’s not just a Scottsdale “thing”. Besides, plastic surgery is more than just cosmetic enhancements like breast augmentation, facelifts and nasal surgery. There is also reconstructive plastic surgery which encompasses myriads of issues such as breast reconstruction after breast cancer, treatment of skin cancers, burn scars and deformities, hand surgery, gender reassignment, replantation (reattachment) of amputated body parts, closure of large body defects from trauma or cancer, congenital deformities like cleft lip and palate, and so forth.

As a plastic surgeon, I often take for granted the amazing things that can be accomplished since I have done most all of it over the years. Patients are so appreciative and not infrequently astonished at the results that can and are obtained. Of course, there are a few who insist that a plastic surgeon should be able to perform cosmetic surgery without leaving a scar whatsoever.

I guess that I must have slept through the “Being a Magician” lectures.

Unfortunately, outcomes are not just dependent on the expertise and skills of the plastic surgeon. The patient, with all their unique combinations of variables and factors, significantly impact the results. A plastic surgeon can perform the most technically and artistically amazing procedure but if the patient has very poor skin tone, smokes, is obese, very old or is not very compliant with instructions, the results will be less than ideal. Let me give you two examples.

Take a plain and ordinary person who literally blends in with the background – you won’t really notice them in a crowd. Give them various supplements. Perform incredibly intricate plastic surgery procedures with painstaking meticulousness and a divinely gifted aesthetic eye and the results can be, well heavenly! See below.

An absolutely stunning outcome!

I’m sure that there are countless women who would give almost anything to look like her. And men – well, they won’t be able to stop themselves from staring and hoping… She is strikingly beautiful with long graceful legs, great curves and ideal proportions and natural appearing breasts that do not scream breast augmentation.

But wait! There is more to the story.

This alluring, voluptuous beauty was born … a male!

Which makes the outcome light years more amazing than it already is!

Conversely, even when the most creative and advanced techniques are used by eminently talented plastic surgeons, inherent and significant negative issues associated with particular patients can severely impact and “limit” the outcome.

Transformation: Chastity to Chaz

The most well known example: Chaz Bono.

But then again, if the final result makes that person happy, so be it!

For more information on breast augmentation or any other plastic surgery procedure or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Though it may seem like a somewhat recent fad, earlobe stretching and gauged earlobes can be traced to back to ancient times – thousands of years ago. It was a custom practiced for a variety of reasons, such as religious ones, by countless diverse cultures throughout the world – including tribes in Africa, Asia and America.

We know that back in 1320 B.C., for example, the Egyptian pharaoh King Tutankhamen (also a teenager!) had stretched earlobes.

King Tutankhamen and stretched earlobes

So did Ötzi the Iceman, Europe’s oldest natural mummy, and a man who lived about 5,300 years ago. Even Buddha from around the 6th century B.C. sported stretched earlobes.

Buddha and stretched earlobes

Back then, there weren’t prohibitions against gauged earlobes as a condition of employment by local merchants, farmers or the armies. Then again, maybe that is why Buddha roamed the countryside for many years – not necessarily to impart his wisdom but instead to find gainful employment with someone who would overlook his stretched earlobes.

In our American culture, unless you work in a Starbucks, second hand clothing store, marijuana dispensary, are a paid OWS (Occupy Wall Street) “volunteer” or the like, it may be quite difficult to obtain a respectable and well paying job if you have gauged earlobes or the consequences of their past existence. That may or may not change in the future, but at present, that is the reality. If you are seeking to enlist in the military and have this deformity, you must either seek surgical treatment to close the defects and reconstruct the earlobes – or don’t bother applying.

I see a tremendous number of people with gauged earlobes in my practice who are seeking to reverse their previous “statements of individuality”. Many are pursuing surgical correction because they are seeking better employment opportunities, want to enlist in the military, or would like to apply to decent colleges and universities. Others have finally grown up or have children and want to be seen as more respectable role models.

To meet this relatively recent and burgeoning need, I have developed a variety of precise reconstructive plastic surgery techniques that allow me to recreate attractive and relatively normal appearing earlobes. This can all be accomplished in my office using local anesthesia with essentially no down time. Discomfort afterwards for most of my patients is minimal to mild. Sutures are typically removed at around one week.

If you would like to obtain more information on the treatment of gauged and stretched earlobes or on any other plastic surgery procedure that I perform or to schedule a complimentary consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Plastic surgery to correct enlarged labia minor, known as a labiaplasty or labioplasty, has been rapidly increasing in popularity over the last several years. In Labiaplasty (Labia Minora Reduction): Why? , I noted that women seek this procedure for not just aesthetic reasons but also functional ones. In fact, contrary to popular public opinion and perception, it appears that functional reasons are the predominant motivation for women to pursue this procedure which is also supported by two large studies on the subject revealing the percentages to be 85% and 63%, respectively.

What are the most common reasons that women seek labiaplasty?

It is clear that the aesthetic issue involves the dissatisfaction with the appearance of enlarged labia minora that protrude noticeably beyond the borders of the labia majora. Many women regard this as a significant deformity which can substantially and adversely affect their self-esteem and lead to diminished sexual desire or even avoidance of sexual intercourse.

The functional problems include pain, irritation, chafing, stretching, compression and dermatitis that can be related to or exacerbated by a wide array of physical activities such as running, jogging, bicycling, horseback riding, and dancing. Many women also have significant pain while having sex and can experience irritation of their labia minora for days afterward. Tight fitting clothes are not only associated with many of these issues but also can embarrassingly reveal the underlying anatomic labia minora enlargement.

Is a labiaplasty an effective procedure and are women satisfied with the results?

Assessment of the results from a variety of medical studies on labiaplasty revealed an extraordinarily high satisfaction rate in women who have had this surgery. In fact, in excess of 95% of women were quite satisfied with the outcome of their labiaplasty procedure. This rate was also independent of the particular surgical technique employed as well as whether the primary motivating factor for those seeking the procedure was aesthetic or functional. Given the choice, most women would do it again if given the option.

Clearly, this is quite an effective procedure!

For more information regarding the labiaplasty (labioplasty) procedure or for any other plastic surgery procedure that I perform, or to schedule a complimentary consultation with me, you can call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Though it may seem like it has been around forever given its widespread popularity and publicity including media exposure, BOTOX® Cosmetic (produced by Allergan, Inc.) is celebrating its 10th year anniversary of FDA approval for the treatment moderate to severe frown lines between the brows. In 2002, it was the first product to receive such an approval and it remains the standard by which all other competing products are measured. (The medical usage of BOTOX® goes all the way back to 1989 when it received FDA approval for its usage in the treatment of blepharospasm, an abnormal condition involving the eyelid.)

Ten years later, it remains the overwhelming market leader as well as the therapeutic standard for the treatment of facial wrinkles. I surely can strongly attest to this through my brief but disappointing experiences evaluating the competing wrinkle treatment alternatives, Dysport™  and Xeomin®.

As a celebration marking this 10 year milestone anniversary, the company producing BOTOX® Cosmetic has made available a limited time rebate on it which I can offer you and which can add up to a total of $200 in savings (if you undergo 3 treatments). In order to be eligible for this rebate, you must have your first treatment with Botox®Cosmetic before April 30, 2012. There is additional information on the limitations and restrictions to this offer at the product website.

For more information on Botox® Cosmetic treatments or on any other plastic surgery procedure that I perform or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

As I noted in a previous blog (Surgery For Gynecomastia (Enlarged Male Breasts) Has Become Very Popular and Satisfying), surgery for gynecomastia (enlarged male breasts) continues to increase in popularity. This is a consequence of several factors: a greater awareness of the issue, the desire to have more sculpted, masculine breasts; feelings of insecurity, inferiority and self-consciousness of having feminine appearing breasts; and the knowledge that there are very effective and safe treatments for this condition. Men from all over the Valley – Scottsdale, Phoenix, Glendale, Mesa, Tempe, Chandler, and Gilbert as well as elsewhere – are seeking surgical treatment for their enlarged male breasts.

Treatment of gynecomastia usually consists of ultrasonic assisted liposuction (UAL) with or without direct excision of breast tissue. In rare cases of focal gynecomastia, commonly found in body builders who are using or have used anabolic steroids in the past, only direct excision of breast tissue is needed in order to obtain the desired result. The following patient of mine illustrates a typical case of enlarged male breasts.

This is a 22 year old male with gynecomastia that has persisted since puberty (photos A, C and E). He is so self-conscious about this that he will not even remove his shirt in public. There is no history of steroid, marijuana or any signficant alcohol use.

A) Enlarged male breasts before surgery - frontal

B) After treatment with liposuction

C) Enlarged male breasts before surgery - side

D) After treatment with liposuction

E) Enlarged male breasts before surgery - oblique

F) After treatment with liposuction

Treatment consisted of ultrasonic assisted liposuction (UAL) without any need for direct removal of breast tissue. A total of 325cc of fat was liposuctioned from both breasts using small incisions placed along the lateral aspect of the lower breast fold (photos B, D and F). The ultimate outcome was exactly what the patient had desired.

For more information on male breast reduction surgery for the treatment of gynecomastia or for any other plastic surgery procedure that I perform or to schedule a complimentary consultation with me, please contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

In November, I presented a report on Xeomin®, a newly available wrinkle treating neuromodulator that had been recently approved by the FDA. Available in various countries worldwide since 2005, it was touted as an alternative (cheaper?) to BOTOX® and a competitor of Dysport®. All three products are based on the same botulinum toxin A molecule but their formulations are different. They act by temporarily paralyzing the underlying muscles in order to treat wrinkles.

In November 2011, I was selected as one of only a limited number of physicians in the Scottsdale and Phoenix metropolitan area to able to offer Xeomin® for the treatment of wrinkles before its more widespread introduction planned some time later this year. The information provided and data available indicated that its effects and duration were similar to those of Botox®.

What were my findings in the 3 months that I have been offering Xeomin® as another option in the treatment of wrinkles?

Initially, my patients were very ecstatic. The onset of effect and its ability to treat wrinkles compared quite favorably to that of BOTOX®. Many of them had previously been treated with BOTOX® and stated that they noted little or no difference except in the much more appealing price. Then…

Suddenly and unexpectedly at six to seven weeks, they noted a fairly rapid return of their muscle function and with it – wrinkling again. This was a uniform finding in all the patients that I had contacted.

Not good at all – even at a significantly lower cost!

In comparison, my experience and the general consensus for the duration of effect for BOTOX® is around three to four months. Therefore, I can’t justify continuing to offer Xeomin® even at a significantly lower price knowing that it lasts around only half as long as the iconic and efficacious BOTOX®. (Note: I don’t offer Dysport® any longer either as I found it to be very unpredictable in effect as well as duration.)

So, if you are interested in treating those undesirable frown lines, Crow’s feet or other hated dynamic facial lines and creases, you still have the choice of BOTOX®, BOTOX® or BOTOX®!

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Wouldn’t it be nice if you finally had the tummy tuck that you have always been dreaming about – the surgical dressing comes off and … BAM!

There it is: a flat and drum tight tummy that you have waited so long to have. Minimal swelling. Awesome looking belly button. Ready to prance around in a bikini.

Wow!

Guess what?

You’re probably still hallucinating from the Percocet!

What then should you truly expect with regard to the swelling of you abdomen following a tummy tuck and how soon it will resolve?

Usually there will be diffuse swelling for a few weeks following surgery which can fluctuate with activities and then it will gradually subside. While this will occur for the majority of the abdomen, many patients will actually notice the appearance of a firm convex band of swelling encompassing the incision which may become evident around 4 – 8 weeks postoperatively. This can surely be disconcerting. As long as there is no abnormal collection of fluid beneath the skin (seroma) or a hematoma that could somewhat mimic this protrusion, there is nothing to worry about.

By around 4 – 6 months, most of the swelling of your abdomen will have resolved. However, it can take up to a year for it to maximally disappear, at which point you can appreciate the more long term result. Of course, you will want to be active, exercising and eating appropriately in order to maintain your weight (or lose some if you need to).

If you would like more information on a tummy tuck or to schedule a complimentary consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

A good plastic surgeon must be precise, discerning, have a great sense of aesthetics, balance and harmony. In a recent post (Breast Augmentation Fail or When Not to Disclose One’s Assets), I discussed the case of actress AnnaLynne McCord and her less than ideal results from a breast augmentation. Despite the significant asymmetries of projection and shape between the left and right side, she seemed quite determined to flaunt her flawed assets. Because she is beautiful, does great charitable work, and stays out of trouble and the headlines, she gets a pass.

AnnaLynne McCord flaunts her flawed results

Now let’s look at the case of Adriana Lima, the Brazilian born model. She is most well known as a Victoria Secret Angel and as a spokesmodel for Maybelline cosmetics but she also is a supermodel, actress and has graced the covers of countless magazines for more than ten years. Since 2005, she has been ranked in the top five of Forbes’ lists of the 20 highest-earning models in the world.

Looking for some good and interesting material to write about, I came across a recent photo shoot of her in a bikini that was posted online which caught my eye (actually both of them). I thought to myself: “Aha. She’s the one that I’ve been looking for!” Who knew that she was so famous?

Now about breast implants and a more tasteful breast augmentation. Below is a photo of her “aug” natural. Before plastic surgery.

Adriana Lima au natural - before breast implants

Pretty. Has potential. Not much money or fame – yet.

Now, after a very nice breast augmentation.

Adriana Lima, supermodel, after breast augmentation

Her breasts are relatively “natural” in appearance rather than being disproportionately or grotesquely large. In clothes (this is a bit of a stretch!), she has good symmetry, cleavage, projection and her breast implants are situated at the same height on her chest.

Worthy of fame and fortune.

My only gripe has nothing to do with her breast enlargement. It has to do with her emaciated, pseudo-anorexic appearance. Look at those ribs and her extremely skinny body!

If you would like to schedule a complimentary consultation with me or obtain additional information on breast augmentation surgery or on any other plastic surgery procedure that I perform, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Arizona Plastic Surgeon on Boosting Confidence in the New Year

According to the American Society of Plastic Surgeons (ASPS), cosmetic procedures have been on the rise since 2009, with over 13.1 million total procedures performed in the past year. Going into the new year, Dr. Steven Turkeltaub, a board-certified plastic surgeon in Arizona, says if there is some improvement in the economy there will be an increase in aesthetic procedures being performed as more patients will be in a better financial state. Additionally, Dr. Turkeltaub discusses some cosmetic treatments to help patients feel and look younger, despite the economy, during the transition into a new year.

At his Arizona plastic surgery practice, Dr. Steven Turkeltaub says he has seen an increase in cosmetic enhancements during this current holiday season. He notes the holidays have traditionally been a particularly popular time of year for people to undergo aesthetic procedures, and adds that the extended holiday vacations offer an opportune time for many patients to seek both surgical and minimally or non-invasive procedures such as BOTOX® Cosmetic injections that can improve appearance as well as boost self-confidence. “The increase in surgical procedures around the holidays is likely related to people being off from work or having a much lighter schedule at this time of year. They may also have more help at home.”

For patients looking for affordable yet noticeable enhancements, Dr. Turkeltaub says that non-surgical injections and dermal fillers like Juvederm®, Restylane® and Radiesse® and BOTOX in Phoenix provide low-cost alternatives to surgical procedures and can provide immediate and effective results with little to no downtime for recovery. He notes that patients often look for simple procedures during the holidays that will improve their self-confidence during the stressful and often physically-taxing holiday season. “Non-surgical procedures such as BOTOX® injections and facial dermal fillers can affect enough changes for many people to produce noticeable improvements such as looking more youthful and relaxed, less angry and less tired.”

Although minimally invasive procedures can produce effective improvements in a patient’s appearance, Dr. Turkeltaub says they cannot truly substitute for the results and dramatic transformations of surgical enhancements like a facelift or breast augmentation in Phoenix. “Non-surgical procedures can provide improvements, but they are not a true replacement for surgery when it is indicated. Undergoing single and straightforward surgical procedures such as a breast augmentation rather than the performance of multiple ones together at far greater costs can improve one’s appearance without breaking the bank.”

Dr. Turkeltaub states that regardless of whether patients choose a surgical or non-invasive path to attain an improved, rejuvenated appearance and increased confidence, he recommends consulting with an experienced board-certified plastic surgeon before considering any treatment. He adds that through the honed skills of a board-certified surgeon, along with a dedicated staff, patients can experience the benefits of a fresh start to the new year with higher quality cosmetic results.

About Steven H. Turkeltaub, MD, PC

Dr. Steven Turkeltaub completed both his undergraduate degree and his medical degree in the Six-Year Medical Program at Boston University, graduating summa cum laude, where he was also a member of the Phi Beta Kappa scholastic honor society and the Alpha Omega Alpha medical honor society. He trained during a general surgery residency at the University of Miami/Jackson Memorial Hospital in Miami and Northwestern Medical Center in Chicago, in addition to a plastic surgery residency at the University of Massachusetts Medical Center. Dr. Turkeltaub is a member of the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, the Arizona Medical Association, and several other professional societies. His past appointments include two terms as President of the Maricopa County Plastic Surgeons Society and one as Secretary/Treasurer, as well as Clinical Instructor and Attending Physician in Plastic and Reconstructive Surgery at the University of Massachusetts Medical Center. Dedicated to continued education in plastic surgery, Dr. Turkeltaub has been published in several journals and books and attends many national symposiums each year to keep up with the most effective techniques. He is board-certified by the American Board of Plastic Surgery.

Dr. Turkeltaub’s practice, the Arizona Center for Aesthetic Plastic Surgery, has two locations at 10290 N. 92nd St., Suite 207 in Scottsdale, AZ and 18275 N. 59th Ave., Bldg. E Suite 126 in Glendale, AZ, both reachable at (480) 451-3000. The practice can also be contacted online via the website www.turkeltaub.com, www.arizonabreast.com, or facebook.com/drturkeltaub.

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When it comes to breast reduction surgery, I find that women contemplating this procedure don’t usually place the appearance of the final scar at the top of their list of concerns. This is quite the opposite for those considering a mastopexy (breast lift) where this is a major area of concern.

Why is this the case despite the fact that the incisions, usually anchor shaped, are often identical?

The reason is that women who are seeking breast reduction surgery are doing so because of the annoying and even debilitating effects that their massively enlarged breasts are having on them and their quality of life.  Women seeking a mastopexy are doing so largely for aesthetic reasons.

Does this mean that the appearance of the scars is relatively unimportant?

Of course not!

I am just as diligent and meticulous in the repair of breast reduction incisions as I am with the mastopexy ones (as well as for all incisions for all procedures). These are closed using long acting deep sutures in a multilayered repair that avoids the unnecessary and displeasing rail-road track suture marks in the skin. Skin tapes are applied for additional wound support and security and may be used for a total of two to three weeks. At that point in time, my patients will usually begin applying a topical silicone gel to help the scars heal as ideally and inconspicuously as possible. This is usually continued for several months. For patients at higher risk for developing hypertrophic scars or keloids or showing early evidence of their manifestation, silicone gel sheets are used to aggressively deal with these issues.

Most breast reduction scars heal very well, usually as fine lines, and are quite acceptable. It is rare in my experience to see keloids develop in darker complected women.

Before breast reduction

After breast reduction

Before breast reduction

After breast reduction

If you would like more information on a breast reduction surgery or on any other plastic surgery procedure that I perform or to schedule a consultation with me, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Too often, liposuction is driven by technology and associated marketing rather than by the training and skill of the medical practitioner. You have seen or heard the frequently slick ads touting the amazing outcomes that can be yours when you have your liposuction using “their” miracle machine. Such may or may not include the following:

SmartLipo™
Slimlipo™
LipoLite™
Etc.™

The most important factor is not the machine. It is the doctor performing the liposuction. No machine can correct for poor technique, lack of experience, improper training and a lack of appreciation and understanding of aesthetics.

Unfortunately, many of those physicians (or clinics) that advertise and use these liposuction machines, can be characterized by one or more of these deficiencies. They may market themselves as cosmetic surgeons (possibly because they took courses, etc.) but, in fact, their primary medical training was in family care, internal medicine, emergency medicine, cardiology and so forth.

You don’t see the word “surgery” attached to any of these. That should also serve as a warning.

There are general surgeons who do use these liposuction machines. However, their training is in areas completely unrelated to liposuction and the aesthetic realm. Another hint: most plastic surgeons first train in general surgery and THEN undergo at minimum of an additional two to three years of specialized training in plastic surgery before opening their practices. It must just be that the additional training and experience is important.

So – who do you want to have performing liposuction on your body?

Thought so!

Make sure that your doctor a plastic surgeon who is board certified by the American Board of Plastic Surgery. I am and have been practicing in the Scottsdale and Phoenix area going on 25 years.

Now, for a little levity, check out this video touting an amazing suction machine.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Drains, which are flexible silicone tubes that are connected to a reservoir known as a bulb, allow for the egress of fluid which could accumulate between the skin-fat layer and the underlying muscle. They have been used in abdominoplasties (tummy tucks) for decades for the purpose of minimizing the incidence of fluid accumulation, known as seromas. Most commonly, two drains are placed for a full tummy tuck whereas only one is used for a mini tummy tuck.

There are some plastic surgeons who don’t use any drains – touting a suturing technique that they feel makes their usage unnecessary. This approach hasn’t convinced most plastic surgeons yet and so it is presently employed by a minority.

The drains are typically placed either in the vicinity of or within the abdominal incision itself and remain in place until 24 hour drainage totals decrease below a particular numeric level. The amount used as the metric does vary among physicians. Many use a number of 20cc or less over a 24 hour period for 1 – 2 days; others consider up to 30cc or even more within a 24 hour time frame. There are even some plastic surgeons who largely ignore the drainage quantity and, instead, use the element of time – removing them after a fixed period such as a few days or at one week.

How long can you expect that the drains will be left in for?

Unfortunately, the duration of time that the drains will remain in place after a tummy tuck is extremely variable among individuals and can’t necessarily be predicted prior to surgery unless, of course, a fixed period of time is used. I use relatively strict criteria before the drain tubes are sequentially removed in my patients and this clearly seems to minimize the risk for the development of a seroma. Most of my patients will have both of their drainage tubes removed by two to three weeks; many in less than a week and a half. It is the very rare patient whose drains remain in place for more than four weeks.

The down side for either taking out the drains too soon or failure of the approach that doesn’t use drains is the undesirable accumulation of fluid deep to the skin (seroma). This problem needs to be treated either by repeated (that is, on multiple occasions) aspirations of the fluid which entails the sticking of a needle into the tissues in order to remove the fluid or even the re-insertion of another drain. On rare occasions, surgery may be required to address what can become a fixed and deforming accumulation of fluid.

For more information on a tummy tuck or on any other plastic surgery procedure that I perform or to schedule a complimentary consultation with me, you can call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Breast ptosis, the medical term for drooping of the breasts, occurs to some degree in a vast majority of women who have at least some breast volume present. This is the inevitable result of a combination of loss of elasticity of the skin of the breast and the stretching of underlying tissue support “fighting” against the unrelenting forces of gravity. The picture is not a very pretty one for the many women who want to regain or obtain that more youthful, firm, voluptuous, alluring shape. Furthermore, there is a negative impact on their self-confidence, sexuality and allure.

What can be done to either recoup or obtain that youthful, perky and sexually attractive shape?

Clearly, a breast lift (mastopexy) with or without implants (breast augmentation) will provide the rejuvenation of the breasts with lifting, recontouring, tightening and even adding volume. This can be facilitated employing incisions that range either from one just around the areola to an anchor shape one that also involves a vertical and horizontal component. Unfortunately, many women are very apprehensive about these incisions which ultimate become “scars” and want to avoid them at all costs.

A question that I am frequently asked and which many women have as also evidenced by myriad postings online is: “Can I just get much bigger implants to avoid having to do a breast lift?”

Often, women either know other women who have pursued this approach or they were told this in consultation with other physicians, many who either didn’t have the experience, sensibility or training regarding this issue or lowered their standards in order to “close the deal” and perform the surgery. It is unfortunate that these physicians, quite often not plastic surgeons, wouldn’t do what was in the best interest of their patients just to make a buck (or lots of bucks).

Personally, I will either do what is right for my patients or won’t perform the surgery. It’s all about principles. Period!

Now, why is placing too large an implant in the breast in order to avoid having to do a breast lift a very bad idea?

Let me explain this briefly. The skin is already thin (or thinner) with decreased elasticity (stretchiness) with breast ptosis. Placing an even larger implant than is ideal will stretch out and thin the skin even more. Added to this, many of these physicians recommend that the best way to counter the drooping breast skin is to directly stretch it out by placing the implants above the muscle. What eventuates is that the breasts descend at a more accelerated pace lower on the chest and abdominal wall. The granny breast caricature (no offense to grandmothers)!

Not a pretty picture!

Ultimately, the only treatment of this would be a complex reconstruction that would require an anchor shaped scar (which may or may not have been originally recommended) and possibly one or two procedures. The skin will be much thinner and less elastic than it would have been had the appropriate procedure been performed initially. The final outcome, after spending at least double or more the amount of money than it would have originally cost, will always be significantly inferior to what it could and should have been. Add to this the extra down time, discomfort, inconvenience, etc. and you should easily conclude that not pursuing the correct procedure was a very poor choice.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

XEOMIN Now Available at Arizona Plastic Surgery Practice

At his center for plastic surgery in Phoenix, Dr. Steven Turkeltaub is now providing a recently released alternative to BOTOX® Cosmetic called XEOMIN® for wrinkle reduction. He states that this new product offers an effective alternative to BOTOX® Cosmetic in helping patients reduce fine lines and enhance the vibrancy and youth of their skin and does so at a more affordable price.

Dr. Steven Turkeltaub, a board-certified plastic surgeon in Phoenix, AZ, has announced that he will be offering XEOMIN® as an option to BOTOX® Cosmetic for the treatment of certain facial wrinkles. Though it has been used in many other countries worldwide since 2005, it was in July of this year that the U.S. Food and Drug Administration approved the usage of XEOMIN® in the United States as a treatment for the reduction of glabellar (frown) lines. Dr. Turkeltaub says that he is excited about the new product, which can serve as an effective and more affordable alternative for BOTOX in Phoenix. He also states that treatment with this product can offer patients a noticeable reduction of facial lines and creases translating into a softer, more rejuvenated and youthful appearance.

Dr. Turkeltaub says the benefits available to patients seeking wrinkle reduction from XEOMIN in Arizona are very similar to those associated with BOTOX® Cosmetic, but with a more affordable price tag. XEOMIN® also requires no freezing or refrigeration until opened which reduces costs as well as the risks for unintended or unidentified impairment of viability.

Dr. Turkeltaub is one of a very limited number of physicians in the Phoenix metropolitan area selected by Merz, the manufacturer of Xeomin®, to offer this product at present. XEOMIN® will officially be available nationwide to physicians in the spring of 2012.

Providing the latest advancements in plastic surgery in Arizona, Dr. Turkeltaub says he hopes that XEOMIN® is just one of numerous additional innovations in cosmetic enhancements and facial rejuvenation that will ultimately become effective realities. As with any medical procedure, Dr. Turkeltaub also says he recommends consulting with an experienced and qualified board certified plastic surgeon before undergoing any treatment.

About Steven H. Turkeltaub, MD, PC

Dr. Steven Turkeltaub graduated from the honors Six-Year Medical Program at Boston University and Boston University School of Medicine, receiving both his Bachelor of Arts and Medical Doctor degrees in six years. He was a member of both Phi Beta Kappa and Alpha Omega Alpha, graduating summa cum laude. Dr. Turkeltaub completed his general surgery residency at the University of Miami/Jackson Memorial Hospital and the Northwestern Medical Center in Chicago. He also trained extensively in plastic surgery at the University of Massachusetts Medical Center. Dr. Turkeltaub subsequently served during an academic appointment as Clinical Instructor and Attending Physician in Plastic and Reconstructive Surgery. He is a member of the American Society of Plastic Surgeons, the Arizona Society of Plastic and Reconstructive Surgeons, the Arizona Medical Association, and several other professional organizations. Dr. Turkeltaub is board certified by the American Board of Plastic Surgery and has been rated and awarded as a Patients’ Choice Physician.

Dr. Turkeltaub’s practice, the Arizona Center for Aesthetic Plastic Surgery, has two locations at 10290 N. 92nd St., Suite 207 in Scottsdale, AZ, and 18275 N. 59th Ave. Bldg. E Suite 126 in Glendale, AZ. Both locations are reachable at (480) 451-3000 or online via turkeltaub.com, arizonabreast.com, or facebook.com/drturkeltaub.

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