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Top 5 Plastic Surgery Myths- by Dr. Mark Bishara, MD

Many myths surround the seemingly glamorous world of plastic surgery. But in fact, plastic surgery is a lot like every other medical specialty with highly-trained physicians providing many different services. Here are the Top 5 Plastic Surgery Myths.
#5 Plastic Surgery is All About Beauty and Vanity
Although breast augmentations, Botox and facelifts get all the press, plastic surgery encompasses everything from correcting birth defects such as cleft palates to post-cancer breast reconstruction and work-related hand injuries.
Plastic surgeons care about the functional and overall results after surgery, not just the aesthetics (although we are specifically trained to optimize those, as well). When a patient does choose to have surgery for cosmetic reasons, it is often to correct areas which are not amenable to diet, weight loss or nonsurgical procedures.
#4 Plastic Surgery Patients are the Rich and Famous
If plastic surgeons only operated on the 1%, we wouldn’t have a thriving plastic surgery industry.
Most aesthetic patients are not the rich and famous, but are average people who simply wish to restore confidence, enhance their overall appearance and improve their lives.
#3 Only Women Get Plastic Surgery
Although women have been the traditional customers of plastic surgery, men are turning to plastic surgery in increasing numbers.
Less invasive procedures such as Botox, laser treatments and dermal fillers can give men a rejuvenated and naturally youthful appearance without any downtime and at relatively low costs. These, along with liposuction, are the most popular cosmetic surgery treatments for men, with many men reporting a need for a competitive edge in the workforce as the reason they have pursued cosmetic treatments.
#2 Plastic Surgery Leaves No Scars and Lasts Forever
Plastic surgeons are great at making scars look better, more refined and smaller, but all types of plastic surgery will generally cause some type of scar formation. We can often recommend the best way to minimize scarring, and give advice and treatments on how to make your scar look as great as possible after surgery.
And while many plastic surgery procedures are long lasting and can give you years, if not decades of personal satisfaction, many factors determine how long the results will last. Plastic surgery can turn back the hands of time – but the clock keeps on ticking. Great skin care, less-invasive office procedures, surgical touch-ups, and your overall health are all important to maintain your natural good looks.
#1 Plastic Surgery is the Same as Cosmetic Surgery
All plastic surgeons do not have the same training. Many doctors trained in, and board certified in, other specialties such as gynecology or family medicine have ventured into plastic surgery, causing what is known as “white coat confusion“. Yes, they are board certified – but not in plastic surgery.
Being board certified in plastic surgery means that a physician has undergone years of specific training related to all the nuances of cosmetic and plastic surgery. Patients choosing a surgeon for their cosmetic and plastic surgery procedures should always inquire about a doctor’s specific board certifications.

This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa with offices in Mansfield and Southlake, TX



 

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My Face Looks 50, My Hands Look 65

Like the rest of our bodies, our hands show signs of aging that may include brown spots, thinning skin, wrinkles, and large veins. I recently had a very happy facelift patient who looked 15 years younger, but suddenly the skin on her hands didn’t match her rejuvenated face. There a few simple procedures that can make your hands match your new youthful appearance. Plastic surgery on the hands can be rather complicated. However, a few minor non-invasive procedures can be done successfully with impressive results.
Brown spots on the hands can be treated topically with a daily application of hydroquinone cream. In addition, fine wrinkles and pigmentation may benefit from a chemical peel. Light TCA-peels are most effective for eliminating uneven pigmentation in the long term and smoothing the skin. Daily use of a good hand cream containing glycolic acid, Vitamin C, Vitamin E and Beta-carotene is recommended. One of the most effective and convenient procedures is the use of Intense Pulse Light (IPL). This form of photo-rejuvenation will smooth color irregularities and evens skin tone.
With age and sun damage, the skin of the hands may also begin to atrophy, leaving hands with a bony appearance. A procedure known as structural fat grafting can soften wrinkles, cover prominent veins and tendons, and disguise enlarged joints on the hands. It restores the soft tissue that is lost with age or disease, and helps fill out grooves between the bones of the hand, as well as help improve the color and texture of the skin.
Structural fat grafting involves removing fat cells from other areas of the body such as the abdomen, back, buttocks, or flanks, purifying them and then transplanting them into the back of the hand through a series of strategically placed injections. When grafted successfully, these fat cells will continue to live there permanently with lasting results.
Dermal fillers are an alternative to fat grafts for adding volume to the back of the hand. These products are commonly used in other parts of the body, especially the face, and can be employed with minimal discomfort and virtually no down time.
To help minimize swelling, the hands are elevated and cold compresses are applied for 48 hours. Under normal conditions, regular activity can be resumed almost immediately thereafter.
During your consultation, ask specific, detailed questions, view several before/after photos of the surgeon’s work, and obtain several referrals from past patients to inquire about their experiences. Good doctors will be happy to provide you with this information.

This information is brought to you courstesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

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The Three P's of Plastic Surgery

It used to be that one would go to a salon simply to get one’s hair and nails done, but these days salons offer all kinds of beauty treatments including cosmetic injectables and even more invasive procedures. The prices can be very cheap, but the results can be catastrophic.
Why is it crucial for consumers to take a second look and ask more questions? Notably, there were dramatic cases out of Miami last year when reports surfaced about illegal cosmetic injections being performed on several women. “Doctors” were accused of injecting these women with substances like mineral oil, super glue, concrete, and Fix-a-Flat. The women reportedly were getting buttock injections in hopes of attaining a healthy “backside”, but they could have lifetime disfigurement as a result.
Earlier this year, in Tyler, Texas, a salon owner was arrested for injecting clients in the breast and buttocks with an unknown substance (likely automotive grade silicone) and closing it with a superglue-type sealant. Why would someone get this done to their body? Perhaps it is the very low cost and the lack of information about what these victims are being injected with.
Please be educated on the three P’s of getting a cosmetic procedure done as safely as possible: Product, Practitioner, and Place.
1. Product – Make sure the product you are getting injected with is an FDA approved product for the particular area you are wanting injected. The FDA has approved certain products for injection into different regions of the face for cosmetic purposes, like Botox, Juvederm, Restylane, Radiesse, and Sculptra. There is no synthetic material that has been approved by the FDA for injection in the breast so that is a red flag itself. Ask what neurotoxin or filler is being used, and even research the product labeling online. If a provider refuses or is unable to tell you what material you are being injected with, do not let that person treat you.
2. Practitioner – Know what type of practitioner to go to like a physician trained to do cosmetic procedures or his/her designee has cosmetic injection training.
3. Place – Don’t get injected in a place that you feel uncomfortable undergoing a procedure in such as a salon, mall, or private home. These are medical procedures and they should be performed in a medical office or medical facility due to its sanitary environment with resources at hand. Often the price may seem too good to pass up, but if you hear of a Groupon ad that’s too good to be true or a salon owner that is offering rock bottom prices on something that is going to be injected in your face or body, let the buyer beware as it be dangerous or even fatal. Even at a Botox “party” or event, a physician must be supervising anyone who is doing these procedures and they must the appropriate credentials.
In other words, do your research, ask questions, and become informed!

This information is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

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Is Plastic Surgery the Ultimate Gift

Cameras, jewelry, iPods. These are things we expect to see on the wish lists of our friends and family. But, a face lift? Yep, it seems that cosmetic procedures have found their way into Santa’s sack.
With this trend, though, comes a warning. While giving someone a pricey surgery can be considered kind and loving, it can also come with problematic implications. Because the choice is such a personal one, gifting a plastic surgery procedure can be interpreted as meddling and insulting. If you’re thinking of bestowing a loved one with the gift of physical improvement this year, make sure it will be well-received.
Gift-Giver Beware
It wasn’t so long ago that plastic surgery was a hush-hush topic; something that people did but didn’t discuss. But with its rapid rise in popularity and the openness with which many celebrities discuss the work they’ve had, the stigma has been lifted. And with that lift, we’ve seen the fairly recent phenomenon of giving surgeries as gifts.
Presenting significant others and family members with cosmetic procedures has become increasingly common. And it’s not unusual for people to use the holiday season as an excuse to pay for a loved one’s surgery. This practice, however, can rub some people the wrong way.
Surprise Surgery
When it comes to buying someone else a surgery, the worst mistake is making it a surprise. For example, giving your girlfriend a gift certificate for a breast augmentation can cause offense if she didn’t ask for it. It would be like giving someone a membership for a weight loss program; it sends an obvious message that you’re unhappy with their appearance. What was meant to be a present is actually an insult.
There’s really no right way to offer someone a surgery unexpectedly. If you give a certificate for a specific procedure, it’s very clear that you’re critical of that particular part of their body. And if you give an open-ended certificate to a plastic surgeon’s office, it comes across as a general affront to their entire appearance. You might as well say, “I’d love you more if your body were different.”
The Right Way
Giving the gift of surgery is less problematic when it’s on the patient’s wish list. If someone expressly asks for a surgery, then the gift can be considered extremely generous and thoughtful. If the asker isn’t able to afford the procedure on their own, receiving it as a present can be a dream come true.
Before making a purchase, remember that the choice to have a plastic surgery is a very personal one that should be made without the influence of others’ desires for your appearance.
The best possible scenario goes as follows: You are absolutely certain that someone wants a specific procedure as a gift- and you give them a gift card. In a consultation, the surgeon will be able to fully inform the prospective patient about their options, the risks involved and the expected outcomes, as well as an accurate cost. Only after these preliminary steps, should the gift be considered.
There are certainly more conventional and less awkward gifts than that of a plastic surgery procedure. A present should never result in hurt feelings or compromise of one’s own desires. But, if you’re still thinking about wrapping up a surgery gift certificate, make sure it’s for the right reasons.

This note is brought to you courtesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

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Minimally Invasive Facial Rejuvenation- by Dr. Mark Bishara, MD

Aside from being the largest organ of the human body, skin is also the only organ continually exposed to the surrounding world, interacting with the environment and reflecting the general health condition and age changes.
How Skin Ages
Understanding the mechanisms by which the skin ages has been increasing significantly, along with considerable progress on the way to prevent and reverse the visible signs of aging. However, there are still several mysterious factors concerning aging process and why we all appear to age differently. Aging of the skin is likely caused by both intrinsic (biologic) ‘intrinsic aging’, and extrinsic aging (environmental) factors ‘extrinsic or photoaging‘; these factors are interconnected and may share a final common pathway. The quality of skin features is greatly affected by aging, as skin ages, it tends to become roughened, lax and wrinkled with some pigmentary changes.
The main feature of photodamaged skin is solar elastosis; with accumulation of elastotic material in the dermis. Meanwhile, photoaged skin shows gradual decrease in collagen content. Additionally, collagen becomes disordered with decreased synthesis and enhanced breakdown. These changes contribute to the skin laxity and wrinkling formation.
Skin Rejuvenation
Besides being an art, facial rejuvenation is a developing science. Patients now routinely present to their physician requesting information on improving the signs of facial aging; it is the physician’s responsibility to select the most appropriate intervention(s) based on the patient’s age, physical needs and concerns, extent and location of volume loss and cosmetic goals. Different therapeutic approaches were used throughout the years to give the face a youthful appearance. However, because each person is unique, there is no one modality that is best for everyone. Therefore, to choose the most appropriate therapy, distinctions must be done between rhytides caused by loss of collagen within the dermis, wrinkles due to volumetric loss of fat, redundant folds created by gravitational pull and those caused by hyperfunctional facial muscles.
For ease of patient education, the treatment options for addressing these changes may be simplified into five categories, often referred to as the ‘5 Rs (Redraping, Resurfacing, Retaining, Relaxing and Refilling) of skin rejuvenation: surgically Redraping and lifting redundant tissue; Resurfacing photoaged skin with ablative or non-ablative technologies whether physical, chemical or mechanical; Retaining with skin care; Relaxing dynamic rhytides that are due to hyperfunctional muscles with neurotoxins and Refilling of diminished subcutaneous tissue by restoring 3D volume.
Ablative and Non-Ablative Procedures
Although ablative modalities remain the gold principle for photodamaged skin rejuvenation, its use is associated with risk of side effects as well as a prolonged and an unpleasant post-treatment ‘downtime’ and recovery period. Thus, interest in ablative treatment has waned considerably while non-ablative modalities as well as fractional skin rejuvenation have become appealing alternative treatments.
New perspectives in non-ablative skin rejuvenation treatments have been established with the development of new technologies and techniques, which are used to rejuvenate skin with minimal downtime and complications. Many different terms have been used to describe these procedures including: subsurface resurfacing, laser toning and minimally invasive skin rejuvenation. These modalities are designed to produce many cosmetic benefits, including improvement of wrinkles, skin laxity and texture.
Beside lasers and various in-office procedures, many topical skin care agents were used for prophylaxis as sun screens and for rejuvenation such as retinoic acid and different anti-oxidants including vitamins C and E, co-enzyme Q10 and green tea.
Choosing the appropriate treatment modality which will be the key to success in skin rejuvenation depends on careful evaluation and determining the patient’s needs, skin type and condition, to frame a treatment plan. Good candidates for minimally invasivetechniques tend to have minimal facial sagging. Patients should understand that skin texture will improve and fine lines will be softened but not eradicated. Cumulative aesthetic benefits will occur gradually and will be less dramatic than those seen with ablative resurfacing. Patients with Fitzpatrick skin type III or less are generally best candidates for different procedures with minimal risk of complications.
Goals of Minimally Invasive Treatments
The goal of most minimally invasive treatments is to induce selective dermal injury which results in wound repair response; while keeping the overlying epidermis intact. In response to the induced dermal injury, the healing process begins to stimulate the fibroblast with deposition and reorientation of collagen bundles. Such modalities for skin rejuvenation could be classified into two types, the first relates to treatment of ectatic vessels, pigmentation and pilosebaceous changes, while the second refers to dermal remodeling with wrinkle reduction and/or skin tightening.
Dr. Mark Bishara, whith office in Mansfield and Southlake, TX- provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. All of our procedures are performed using the most advanced, state-of-the-art equipment.
At our office we offer many treatments that are ablative as well as non-ablative.  Our Pragon Med Spa offers many laser services- skin tightening, skin resurfacing, as well as peels and microdermarbrasion.  Our office also offers Botox, Juvederm and Radiesse.  The new Juvederm Voluma XC will be coming soon.  Please call our office for more information at (817) 473-2120.
 

 

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