The goal of almost any elective plastic surgery procedure is to achieve a more youthful look. But just how many years can you actually drop? Nine. That’s according to a recent study in the Archives of Plastic Surgery. Of course it depends on which surgery you have done and how many treatments you choose to do too.
At the University of Toronto, 40 volunteer medical students studied the photographs of 60 plastic surgery patients aged 45 to 72. In their “before” photos, the volunteers guessed near the correct age, assuming the patients were about 1.7 years younger than their actually age. Then the volunteers studied photos of the patients after they received either facelifts and necklifts; facelifts, necklifts and eyelid surgery; or eyelid surgery plus lifts to the face, neck and forehead.
The first group (facelifts and necklifts) were guessed to be 5.7 years younger. The second group (facelifts, neck lifts, and eyelids) were perceived to be 7.5 years younger. And the last group that had the most surgeries (facelifts, necklifts, forehead lifts and eyelid surgery) were guessed to be 8.5 years younger than their true age.
Some people may not want to undergo a full facelift and if so, there are alternatives:


For people with less facial aging, a neck liftforehead lift, mid-face lift, eyelid surgery, or chin surgery can minimize the effects of aging and offer a fresher, more youthful look.


There are a number of surgical and non-surgical options that can improve one’s cosmetic appearance: fillerslaser skin-tightening procedureslasersfat contouringIPL Fotofacial and Botox. Each has benefits and drawbacks. Mini procedures do not produce the long lasting maximum improvement that is achieved with a natural appearing artistically performed lift performed by an expert experienced plastic surgeon. The best result is achieved by a combination of elevating the sagging tissues, removing the excess skin, contouring the fat, and adding micro-fat grafts or fillers where there is a deficiency.
Besides a facelift, Juvederm Voluma also helps volume loss in cheeks.  JuvedermTM VolumaTM is the latest of the Juvederm range of hyaluronic acid fillers specifically designed to restore volume in areas of volume loss. Common areas include the cheeks, cheekbones, and chin. Additionally, due to its versatility it is also suitable for adding definition to the jaw line.

Please contact the office of Dr. Mark Bishara to find out what we can do to help you reduce or eliminate the signs of aging.  You can call our office at (817) 473-2120 or visit our website for more information at

There are seasons for everything, but one thing you wouldn’t expect to be seasonal is cosmetic surgery. Any plastic surgeon, however, will tell you that the spring is the season for breast augmentations and liposuction, and the season for facelifts is right after Christmas. And many other procedures are more common during certain times of the year.

The reasons for this seasonality become obvious when you consider each procedure. During the spring, women start thinking about that dreaded bathing suit. They try them on and might notice a little fat that wasn’t there last year, or they might wish they filled it out better in certain areas. Since it takes a month or so to look reasonable in a bathing suit after cosmetic surgery, by July 4, if the surgery hasn’t been performed yet, many women wait until after the summer. 
When it comes to facial surgery, like face or eyelid lifts, fall or winter surgery is most common. While you should be able to face the public two weeks after a facelift, you might not really want to. You’ll have residual swelling and even a little bruising up to a month after the lift, and there’s always a chance of some odd lumps and bumps. It’s a lot easier to wear scarves or heavier makeup when it’s cold outside. When planning for cosmetic surgery, you might be pleasantly surprised at how fast you recover, but 5-10% of people have one thing or another that slows down their recovery. When planning out your schedule, you really have to plan for the worst-case scenario.
Recovery from larger procedures takes longer than recovery from smaller procedures. And older women take longer to bounce back than younger ones. And, of course, if you have significant medical problems, you have a much higher chance of a complication after surgery; you and your surgeon may decide to forgo surgery and improve your appearance with less invasive procedures that are less demanding on your body.
While some office procedures like Botox, Xeomin and Fillers, are easier to do and really don’t have seasonality, not all types of procedures are suited for the summer. Chemical peels and some laser treatments require strict avoidance of sun, so unless you live in a cave or are a vampire, you might consider having these treatments during the fall-winter months.

This Information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa in Mansfield and Southlake, TX
Please visit us on our Facebook page at The Paragon Plastic Surgery and Medspa


Fillers, Fat or Surgery: Which One should you choose?

Each option has its place when correcting the eyes.  Base your decision on what bothers you, your budget and the result you are looking to achieve.
Choose Fillers: to fix hollowing in the tear troughs if there is no loose skin.  Ideal patients are those who have a depression like a tear through in their lower lids, had too much fat removed during surgery, or are hollow under the eyes.  Fillers are reversible and no overcorrection is required.
Choose Fat: for longer lasting results.  Your plastic surgeon will remove fat from elsewhere on your body, clean it and then inject it under the eyes for volumizing effect.  Fat also blends the area between the lower lid and the cheeks.
Choose Surgery (Blepharoplasty): to correct loose skin or excessive muscle and/or fat in the lids.  Removing some of this volume and distributing the contours equally restores the look of the eyes.
En Espanol
Rellenos, grasa o cirugía: ¿cuál debería elegir?
Cada opción tiene su lugar cuando la corrección de los ojos. Base su decisión en lo que te molesta, su presupuesto y el resultado que se busca alcanzar.
Elija Rellenos: fijar vaciamiento en los valles de lágrimas si no hay piel suelta. Pacientes ideales son aquellos que tienen una depresión como una lágrima a través de sus párpados inferiores, había eliminado el exceso de grasa durante la cirugía, o son huecos debajo de los ojos. Los rellenos son reversibles y no se requiere corrección excesiva.
Elija grasa: para obtener resultados más duraderos. Su cirujano plástico eliminar la grasa de otras partes de su cuerpo, limpiarlo y luego inyectarlo bajo los ojos por efecto de volumen. La grasa también combina el área entre el párpado inferior y las mejillas.
Elija Cirugía (Blefaroplastia): para corregir la piel floja o muscular excesivo y / o grasa en los párpados. Extracción de algunos de este volumen y la distribución de los contornos igualmente restaura el aspecto de los ojos.

Top 10 countries for cosmetic surgery revealed as figures show rising demand for penis enlargements and other procedures

Cosmetic surgery is booming worldwide as people flock to have millions of operations including breast augmentation, liposuction and Botox.
More than 23 million cosmetic and non-surgical procedures were performed in 2013, according to the International Society of Aesthetic Plastic Surgery (ISAPS).
The United States topped the international chart, with almost 4 million people going under the knife or needle, followed by Brazil with more than 2 million procedures.
Britain did not feature in the top 10 but was ranked 14 in the world by the number of plastic surgeons, with an estimated 865 in business.
Figures released by the British Association of Aesthetic Plastic Surgeons (BAAPS) earlier this year showed 17 per cent more operations were performed in the UK in 2013 but the count of 50,122 did not include non-surgical procedures reflected in the ISAPS figures.
A spokesman for BAAPS said little information on the treatments can be collected in Britain because dermal fillers and laser treatments are unregulated.
Botox is the most popular cosmetic procedure in the world. The toxin is injected to paralyse facial muscles to slow down the ageing process.
Other popular non-surgical treatments included fillers, laser hair removal and chemical peels.
More than 1.7 million breast operations were performed last year, making it the most popular cosmetic surgery worldwide, followed by liposuction, eyelid surgery, and rhinoplasty.
Women were by far the biggest consumers in the cosmetic surgery market, making up almost 90 per cent of all procedures in the world – more than 20 million.
Men underwent more than 3 million procedures, mostly rhinoplasty, breast reduction and eyelid surgery.
Penis enlargements were most popular in Germany, where almost 3,000 men had the operation, followed be Venezuela, Spain and Mexico.
According to BAAPS, “boob jobs”, eyelid surgery and facelifts are most popular among women in the UK, while men prefer nose and eyelid surgery, as well as breast reductions.
The number of procedures has rocketed as the economy recovers.

LOS 10 PAÍSES PARA CIRUGÍA ESTÉTICA revela como cifras muestran la creciente demanda de las ampliaciones del pene y otros procedimientos
La cirugía estética está en auge en todo el mundo como la gente en masa a tener millones de operaciones, incluyendo aumento de senos, liposucción y Botox.
Más de 23 millones de procedimientos cosméticos y no quirúrgicos se realizaron en 2013, según la Sociedad Internacional de Cirugía Plástica Estética (ISAPS).
Los Estados Unidos encabezó la lista internacional, con casi 4 millones de personas pasar por el quirófano o aguja, seguido de Brasil con más de 2 millones de procedimientos.
Gran Bretaña no figuró en el top 10, pero fue puesto 14 en el mundo por el número de cirujanos plásticos, con un estimado de 865 en los negocios.
Las cifras publicadas por la Asociación Británica de Cirujanos Plásticos Estéticos (BAAPS) a principios de este año mostraron 17 por ciento más de las operaciones se llevaron a cabo en el Reino Unido en 2013, pero el recuento de 50.122 no incluyeron procedimientos no quirúrgicos reflejan en las cifras ISAPS.
Un portavoz de BAAPS dijo poca información sobre los tratamientos se pueden recoger en Gran Bretaña porque los rellenos dérmicos y los tratamientos con láser no están regulados.
Botox es el procedimiento cosmético más popular en el mundo. La toxina se inyecta para paralizar los músculos faciales para ralentizar el proceso de envejecimiento.
Otros tratamientos no quirúrgicos más populares incluyen materiales de carga, la depilación láser y peelings químicos.
Más de 1,7 millones de operaciones de mama se realizaron el año pasado, por lo que es la cirugía estética más popular en todo el mundo, seguido por la liposucción, cirugía de párpados, y la rinoplastia.
Las mujeres eran con mucho los mayores consumidores en el mercado de la cirugía estética, lo que representa casi el 90 por ciento de todos los procedimientos en el mundo – más de 20 millones.
Los hombres se sometieron a más de 3 millones de procedimientos, en su mayoría de la rinoplastia, reducción de senos y cirugía de párpados.
Las ampliaciones del pene fueron más popular en Alemania, donde casi 3.000 hombres tenían la operación, seguidos ser Venezuela, España y México.
Según BAAPS, “trabajos del boob”, la cirugía de párpados y estiramientos faciales son más populares entre las mujeres en el Reino Unido, mientras que los hombres prefieren la nariz y la cirugía de párpados, así como reducciones de mama.
El número de procedimientos se ha disparado ya que la economía se recupere.

The BotTom line when it comes to an insurer’s decision to pay for plastic surgery is typically whether a procedure is considered medical necessary.

Americans love to look good, but insurers are often reluctant to pay the bills to help us look better.
Last year we spent nearly $11 billion on cosmetic procedures, according to the American Society for Aesthetic Plastic Surgery. Of the more than 10 million procedures performed, the most requested was breast augmentation.
But Cameo Wichinsky, a 42-year-old investment fund manager living in Santa Monica, wants to take her figure in the opposite direction.
Having long lived with the discomfort of breasts large enough to cause shoulder and neck pain and to limit her level of physical activity, she’s ready to go under the knife to reduce her breast size and, she hopes, improve her quality of life.

“I’m at the stage of my life when I’m ready to be active and be at my highest level. These things get in the way,” Wichinsky said.
Despite the fact that she has health insurance, she says she’ll have to shell out the nearly $9,000 for breast reduction surgery, which she has scheduled for November. Her insurer won’t cover the procedure.
“Insurance is a huge hassle,” Wichinsky said.
There was a time when health insurers more readily paid for breast reductions. We tend to think of breast reduction as reconstructive surgery and not cosmetic, even though it has that cosmetic aspect to it.
Plastic surgery is expensive. It’s important to know ahead of time what insurers will pay for.
The line between the desire for improved physical appearance and medical need can be fuzzy in the world of health insurance. Although few people expect to have their health plan pay for their tummy tucks or face lifts, there are procedures that legitimately warrant coverage.
The bottom line when it comes to an insurer’s decision to pay for a procedure is typically whether it’s considered medically necessary, experts say.
“Generally, if a procedure is necessary to repair or preserve the healthy functioning of the body, it’s likely to be medically necessary,” said Carrie McLean, senior manager of customer care with online insurance broker
“If the procedure is typically considered standard practice for any given diagnosis, that may also meet the criterion for medically necessary,” she said.
Exactly where that line is drawn depends on the individual and his or her circumstances, not the procedure itself, said Patrick Johnston, president of the California Assn. of Health Plans, which represents 40 health plans insuring more than 21 million Californians.
For example, a middle-aged man interested in a tummy tuck to restore the six-pack of his youth isn’t likely to get much sympathy from his insurer, he said, but it’s a different story for someone who lost 150 pounds after bariatric surgery and is left with excess skin.

“This is a recognized standard of treatment for morbidly obese individuals,” Johnston said.
In the same way, he said, a nose job to correct a deviated septum or surgery to lift drooping eyelids that impair vision are other common surgeries likely to be covered by a health plan.
Consumers have a variety of legal protections that guarantee access to certain cosmetic procedures.
Women who have undergone a mastectomy after a diagnosis of cancer, for example, are guaranteed coverage for reconstructive surgery.
“Both federal and state laws guarantee a woman who has had a mastectomy as a result of breast cancer coverage for breast reconstruction,” Johnston said.
California law also requires insurers to cover the repair of a child’s cleft palate, which includes any medically necessary dental or orthodontic services that are an integral part of reconstructive surgery.
If you’re in the market for a cosmetic procedure, here are some important reminders.
• Check with your insurer in advance. In most cases you’re likely to need your insurer’s pre-authorization to obtain coverage.
It’s a good idea to work with your doctor. Submitting medical records, letters from specialists who have treated you for long-term symptoms and in some cases photos can all lend support for the medical necessity of the procedure and increase your chances of gaining approval.
• Pre-approval may not be enough. Breast reduction surgery such as what Wichinsky plans is a good example of the devil being in the details.
Most insurers dictate how many grams of tissue must be removed from each breast for the procedure to be covered. Asking in advance what those requirements are can help avoid surprise bills.
• You can appeal insurer decisions. Don’t be deterred if your insurer initially denies coverage. You frequently have to appeal the claim … to obtain insurance coverage.
This Information is brought to you courtesy of Dr. Bishara and The Paragon Plastic Surgery & Med Spa