Category: Plastic Surgery Tips & Guides

Capsular contracture is the term used to describe scar tissue that can form around breast implants which may cause the breasts to harden, look or feel different, and may cause some discomfort from the tightening of the capsule. Capsular contracture is the most common yet unpredictable complication following breast augmentation.  Although we do not know what causes a capsular contracture to form in one woman and not in another, or why one breast may harden while the other remains completely soft and natural, there are some techniques that have reduced the risk in our patients.

(Before and After)

Capsular Contracture can be associated with the following:

• Infection
• Hematoma
• Saline Implants
• Sub glandular placement of Implants
• Radiation
• Nicotine
• Diabetes
• Collagen Vascular Disease
• Rheumatoid Arthritis
• Lupus
• Sjogren’s Disease

*Although there are no scientific studies linking nicotine and capsular contracture however there are multiple studies that show harmful effects of smoking and nicotine itself on wound healing after surgery.

No one can predict the outcome or prevent capsular contracture however there are some things to consider that are low risk- a healthy patient, sub-muscular placement of implants, using textured and form stable implants.

 

How is Capsular Contracture Diagnosed?

A capsular contracture is usually diagnosed on physical examination by a plastic surgeon. You may notice that one or both of your breasts are not as soft as they once were or may actually begin to harden, your breasts may begin to look or feel different, or you may experience some discomfort from the tightening of the capsule.

Dr. Robbins will examine you to determine if indeed you have a capsular contracture. The examination of each breast is classified on a Baker scale of I to IV:

Grade I: The breast is soft and normal

Grade II: The breast is less soft than normal, and the implant can be palpated

Grade III: The breast is firm, the implant can be palpated easily, and an asymmetrical distortion of shape can be appreciated

Grade IV: The breast is hard, tender, painful, and the shape distortion is pronounced or severe

 

Treatment for Capsular Contracture

Capsulectomy (complete removal of the scar capsule).

For those patients without significant softening, the only other effective treatment is to completely remove the scar tissue surrounding the implant. Although this does not eliminate the possibility of future scar tissue forming around the implant, it does reduce the risk of subsequent capsular contracture.

If you think you may have capsular contracture or would like more information, please visit us at www.robbinsplasticsurgery.com or call 615-237-5552 to schedule your appointment with Dr. Robbins.

 

Our options for restoring facial volume have expanded over the years with muscle relaxation via neurotoxins such as Botox, and the evolution of how fat atrophy in the face leads to stereotypical architectural changes with aging. Plastic surgeons can now add volume to refresh the face. In order to achieve a youthful but natural appearance for my patients, I use a combination of muscle balancing, skin resurfacing and tightening, as well as volume restoration. Ultimately, we will all face the battle of gravity and may require surgery to remove excess skin.

Ways to Achieve Volume

One way to restore facial volume is by using hyaluronic acids as a direct filler. Another option is a lactic acid (Sculptra), which acts as an inflammatory material inducing collagen synthesis to create a guided tissue volume additive over time. Both are easily administered in the office without any donor site pain or bruising. While these procedures are easy and safe, it takes experienced hands, eyes and judgment to achieve the best outcomes. Results can be expected to last up to two years.

Fat grafting is another source of filler material to restore volume to the face. Fat is easily harvested from the abdomen or the thighs to use in the face. The technique is a gentle form of liposuctioning, which then requires a minimal amount of processing followed by reinjection into the desired locations. In the office setting under local anesthesia, patients may not enjoy some of the pressure sensations required to obtain the fat.  The advantage of fat is that it is cheaper to obtain than manufactured materials. In most cases, there is a relatively unlimited supply. Furthermore, peripheral stem cells may direct cellular differentiation leading to improved tissue quality.

Fat vs. Fillers

Fat is certainly more technically demanding and unforgiving. For injections around the eyes to smooth the eyelid cheek junction, I prefer hyaluronic acid. When injected smoothly with appropriate application, no lumps or bumps should occur. In the lips, when I am working to recreate vertical ridges of the phyltral columns of the upper lip and “Cupid’s bow” points, as well as a nice rolled margin of the lip, I prefer hyaluronic acid because it is the consistency of caulking material and can provide shape. Fat is soft, and does not exert force on the skin in the same way as fillers. However, recent research from the University of Texas Southwestern Medical Center demonstrates excellent results of restoring large volume loss of the upper lip beyond the vermillion by placing fat cells in a broad area, making the loose skin less apparent.

With regard to the common area of deflation of the sub-malar fat pad in a non-surgical case, I prefer the highly crosslinked stiff material of Voluma, which does an excellent job of re-supporting the facial structures to a more youthful position. If I am already performing a surgical case of a face or neck lift, I often  add volume to the face prior to elevating the tissue; this is when I choose fat, because of the ease of harvest and injection under anesthesia. Some thin women may show very demarcated loss of volume in the temple area giving the face a skeletonized appearance around the eyes and making the brows seem to sag. This is an excellent indication for Sculptra.

Fat grafting is an evolving technique in plastic surgery. Every industry conference has a significant discussion about the techniques and the science behind the results, with just about every region of the body applicable to its uses, including face, breast, hand, buttock and other contour deformities. For the early stages of facial rejuvenation, which can occur in the third decade of life and beyond, much of the volume restoration is performed with off-the-shelf filler agents in an office setting due to ease and convenience.

For more information on Fat Grafting or Fillers, please call our office (615) 237-5552 to schedule a consultation to see if you are a good candidate for fat grafting.  www.robbinsplasticsurgery.com

Breast augmentation surgery has become one of the most popular, simple, yet precise procedures.  With over 300,000 breast augmentations performed in U.S. last year, many doctors prefer silicone over saline.

When considering breast augmentation, Dr. Robbins encourages his patients to do their homework. Information is power!

The success of breast augmentation often rests with the provider. A patient must truly have a comfort level and confidence with the surgeon they choose.  Dr. Robbins is a highly trained, caring and compassionate surgeon and was voted Best of Nashville in October 2015.

There are many myths and concerns and breast implants. Let’s take a look at some of them.

• Breast implants can be dangerous. Of course, this is a concern. Again, this goes back to the quality of the provider/ doctor. Robbins encourages all prospective patients to schedule a consultation with him to discuss all your questions and concerns.

• There is a myth that silicone implants aren’t safe. Women who are considering breast augmentation need to understand that the latest generations of silicone gel implants have a solid track record of safety.  Silicone implants have been back on the market since 2006.  The implant companies, Allergan and Mentor, revised the implants with a thicker outer shell and they are filled with a cohesive silicone gel.  The gel feels a bit more natural breast tissue.

• How will the implants look after surgery? Appearance is primary to those seeking the procedure. Dr. Robbins focuses on proportion to the rest of one’s s physicality. He wants any breast augmentation to be the perfect fit for your body size (hips, shoulders and chest). Today’s studies have shown that natural is the new look.  Robbins seeks continual patient feedback on how they would see themselves in their new look.

In the initial consultation Dr. Robbins and his staff will provide pre and post surgery information and are committed to making sure all your questions are answered.

Dr. Robbins uses the latest in technology to take the guesswork out of sizing.  Crisalix 3D imaging, gives the patient lifelike computer renderings and a representation of the new “woman.”  This new 3D imaging allows you to see your post surgery results before surgery!

Many women wonder how fast they can return to work, exercise and other physical activities. Although this may vary with the individual, Dr. Robbins and his staff will be a key part of your recovery process.

Dr. Robbins believes that the key is confidence.  Breast augmentation surgery can make a women feel attractive to others, especially to herself and giving her the confidence she needs to feel beautiful.

For more information, please call (615) 237-5552 for your consultation today or visit our website at www.robbinsplasticsurgery.com

Cosmetic Procedures for Men are on The Rise!

 

Our society places a high value on looking young and fit.  Today, men of all ages are having plastic surgery. The most common procedures in which men are requesting include a more balanced nose, a trimmer waistline, no more man-boobs and eyelid surgery.

On the contrary to what society may believe some men can be very self-conscious about their bodies.  Men want to feel confident and look their best as many of us do.

 

Though women are generally relatively open about their cosmetic procedures, “men are incredibly secretive,” said Dr. Robbins.  As a result, men opt for cosmetic surgery procedures that are less obvious and for which healing can be carefully scheduled.

Some men start with non-invasive procedures such as Botox to help erase crow’s feet and brow lines.  Botox offers a relatively low-cost, low-commitment options that appeal to some men.

Rhinoplasty (nose surgery), liposuction and gynecomastia (male breast reduction) are popular surgery’s however male blepharoplasty (eyelid surgery) is growing in popularity every year.

 

Men know that eyes are often one of the first features to show signs of aging.  Droopy eyelids and wrinkles can cause you to look tired and older than you are.  With eyelid surgery, you can reduce signs of aging in the eyes by removing excess skin and fatty tissue.

If you would like to discuss your cosmetic concerns, please call our office 615-237-5552 or visit www.RobbinsPlasticSurgery.com to schedule your consultation!

Spring time is the ideal time to sculpt your body with plastic surgery!

Dr. Chad Robbins from Nashville, TN says “spring is a very busy time of the year for those who are thinking about their summer bodies.”

He suggests that those who want to slim and tone their bodies “should consider a healthy diet plan, liposuction and or a tummy tuck”.

Many of those who are eating right and (sticking to their new year’s resolutions) are exercising regularly, may be bothered by some minor imperfections.  Addressing these concerns now with cosmetic surgery allows adequate recovery time so that you can have your body in shape for summer.

“Although many people who have plastic surgery may return to their normal routine in 7-10 days but it can take up to 2 months for swelling and bruising to subside,” Dr. Robbins says.  “So for those who want to look great in their swimsuit by summer, spring is the ideal time for surgery.”

Body contouring procedures are intended to help refine specific areas of the body that do not respond to diet and exercises.  Dr. Robbins says, “plastic surgery is not a ‘quick-fix’ weight loss tool” and should be thoroughly discussed at your consultation visit.

Some of the most popular plastic surgery procedures for spring include liposuction, tummy tuck and breast augmentation.  For people who have lost a substantial amount of weight, Dr. Robbins suggests considering procedures such as arm lift and a thigh lift.

When people start thinking about warmer weather and wearing their bathing suits, they want to feel confident in the way they look.  For many, plastic surgery is the perfect way to improve their body and self-image.

To learn more about plastic surgery and the surgeries you may be considering, please call 615-237-5552 for your consultation appointment.

Botox is one of the most popular treatments for a variety of reasons, but there are still a few misconceptions about what it does and doesn’t do, and who the best candidates for use are.  Here are five of them:

Myth #1 -The procedure is very painful.

The truth is that most people compare the sensation of the injections to a mosquito bite. A very fine needle is used with a slight pinching feeling but it only lasts for a few seconds. No anesthetic is used or necessary during the procedure.

 

Myth #2 -Getting Botox injections will cause you to lose the ability to have facial expressions.

The truth of the matter is that these procedures will simply enhance expressions rather than erase them completely. Those who have had the treatments performed by a trained and skilled injector are still able to display the entire range of facial expressions including frowning, smiling and appearing surprised. The treatment simply relaxes the muscle at the injection point.

 

Myth #3 –Cosmetic Botox consists of botulism or food poisoning.

Botox is made from a purified protein that is derived from the toxin. Many medications are derived from toxins and are completely safe. There has been extensive research and testing on Botox to ensure it is both safe and effective for users.

 

Myth #4 – If you stop getting Botox, it will make your wrinkles worse

Botox will prevent your wrinkles from worsening while you keep up with your treatments. If you decide to stop having Botox treatments, you will slowly lose the relaxing effect of Botox and will resume the normal development of wrinkles with movement.  Botox results are not permanent and typically last three to four months.

 

Myth #5 – Botox is just for wrinkles

Botox is NOT just for wrinkles!  It has been used to treat migraines by reducing muscle tension and creating less strain on the nervous system. Botox can also be used to temporarily block sweat glands to stop excessive sweating, and even might help patients who suffer from depression.

 

Click HERE to learn more about Botox!

New Year’s Eve is often thought of as a time of rebirth or rejuvenation, the chance to start anew. We all come up with the typical resolutions for the upcoming year (losing weight, exercise more, make a budget), but often our ideas fizzle out by March. Maybe it’s time to make some life changes that might be more adaptable and have you feeling like a new person!

Sleep, wake up, work. And repeat. That’s a daily grind that will have you burning out the next time your alarm goes off. There’s more to life than work! Here are some helpful ways to make your New Year’s Resolution turn you in to a new YOU!

1. Wake up slowly.

Starting the day off with your cell phone or lap top reading emails often sets a negative tone for the day and truthfully most issues can wait. Take 30 to 45 minutes to wake up slowly and shower before checking email.

2. Start your day off with meditation.

Start every morning with a short 5–10-minute meditation. The meditations can help visualize the things you are most grateful for and allows you to minimize negativity and distractions. Early morning meditation increases self-awareness and helps put into perspective what really matters.

3. Exercise-try yoga.

Aside from obvious health benefits, working out clears the mind. Try to develop an exercise routine and remember 2 days is better than none. If you’ve never tried yoga you are missing out! It’s the only place your phone is completely off and your mind is focused on you only—no clients, employees or projects. It’s the easiest way to reset your mind and body in 60 minutes.

4. Set specific time slots when you don’t work.

Focusing on work is a great excuse for not taking care of you. Set specific time slots for no-work and instead spend time on family and you. These slots can be first thing in the morning (before 8 a.m.) and dinnertime (5 to 8 p.m.). Other family members will benefit from your no-work schedule too.

5. Keep a journal.

Life is very busy and journaling is a way to help you remember. Make it simple, bullet point things you did, people you met, how you felt, etc. It’s a great outlet to help you be present, remember the little moments and sort out challenges in both your personal and professional life.

6. Talk to friends and family.

Your friends and family are your biggest supporters. Even if you are having a very stressful and busy day, pick up the phone for a few minutes just to say hi to Mom or your best friend, and talk about the good things that are happening in their lives. It will keep you grounded.

7. Make time for play.

Everyone needs some play time! Doing something that brings laughter and joy is the best way to nurture you.

8. Unplug from Social Media

Today’s world is attached to their smart phones; laptops etc…but with that attachment come stress! Give yourself a break from social media and work on your relationships and communication skills. Make time each day to unplug.

9. Read something fictional.

Refresh your mind by taking an afternoon break from your workflow and escaping to another world. Reading fictional stories stimulates the right side of your brain, sparking creative thought. That stimulation can make your day go a little smoother by thinking differently and most importantly rejuvenating your soul.

       10. Get enough ZZZs.

The scientific benefits of sleep are innumerable. More sleep equates to more happiness, better health and improved decision-making. Not to mention that it detoxes the brain.

 

The holidays are here and most Americans pack on a few extra pounds over the next month or so!  One thing to keep in mind is don’t try to diet during the holidays just try to maintain your weight.  Here are some helpful tips to for you to “Beat the Holiday Bulge”.

Tip #1. Do not skip breakfast!  Breakfast is the most important meal of the day because it provides energy for your body.  If you don’t already eat breakfast, then start!

Tip #2.  No skipping meals. Always eat normally on the day of a party. People who skip meals to save up calories tend to overeat everything in sight once they get there.  Eating sensibly, starting with a nourishing breakfast, have a light lunch, then a small snack or salad shortly before the event.

Tip #3.  Be a food snob. If you don’t love it, don’t eat it!  Remember, it’s not your responsibility to sample everything on the table.  Scan the table of foods you truly treasure and skip the everyday dishes that are available all year long.  Go ahead and indulge in your personal holiday favorites, then find a seat and, slowly and mindfully, savor every mouthful.  Don’t be afraid to hide the leftover food or foods you don’t love under the napkin and throw away.

Tip #4.  Chew gum. When you don’t want to eat, pop a piece of sugarless gum into your mouth.

Tip #5.  Drink Lots of Water. You’ve probably heard it before, but this is one diet-friendly adage that’s tried and true, so start hydrating. Drinking two cups of water before eating a meal can help you lose weight. The water helps you feel full sooner, so you eat less!

Robbins Plastic Surgery has released their “Favorite Things,” annual list of all of the products they believe will make great holiday gifts.

The list includes everything from small stocking stuffers to feel good services and more!

Facial Dermaplaning

Dermaplaning is an effective way of exfoliation. Using a blade we shave, or remove, the dead skin cells from the epidermis. Along with exfoliating, dermaplaning also helps remove the unwanted velus hairs from the face. Usually, you can see a difference after the first treatment allowing your skincare products to absorb directly into your skin.

Cost -$65

Botox/Dysport

Neurotoxins are used to relax the facial muscles, resulting in smoother skin and fewer wrinkles. It’s used in areas such as the forehead, where horizontal wrinkles tend to form and also wonderful to use as a preventer from forming deeper facial creases.

Cost -$5-$13 per unit

VI Peel

VI Peel™ is a skin treatment used to improve the appearance of the skin on your face, chest, hands, or other areas.  As a medical-grade chemical peel, the VI Peel™ is an effective treatment to improve several skin issues including acne, uneven skin texture, uneven tone, fine lines, wrinkles, acne scarring, sagging skin, hyperpigmentation, enlarged pores, and age and sun spots.  The VI Peel™ also provides a more youthful look by brightening the overall appearance of your skin and improving collagen production.

Cost -$225

Latisse 

Great eyelashes don’t just happen overnight.  That’s why it’s important to note that Latisse works gradually and remarkably, with full results between 12-16 weeks.  As the treatment progresses, you’ll first begin to see changes in length.  Then, gradually, you’ll notice more thickness and darkness in your lashes.

Cost – $120-$160

Intellishade

Revision Skincare Intellishade SPF 45 is a 4-in-1 product for all skin types. Along with broad spectrum protection against UV rays, this item also works as your moisturizer, anti-aging product and foundation makeup.  This light tinted moisturizer hides the appearance of discoloration, redness and dark spots for a more even tone.

Cost – $52

ZO Skin Health Foamacleanse

ZO Medical Foamacleanse is a foaming cleanser designed to remove impurities, clean pores, and leave skin feeling refreshed and hydrated. Formulated for all skin types, Foamacleanse™ contains a potent blend of antioxidants to help protect skin from the harmful effects of daily exposure to the elements.

Cost – $49

ZO Skin Health Exfoliating Polish

Round magnesium crystals exfoliate dead skin cells, increase epidermal turnover and create a clearer, smoother, more even-toned complexion. But the benefits go deeper than that. Vitamins A, C, C-Esters and E provide powerful anti-oxidant protection. Then active ingredients can penetrate your skin and work much more effectively.

Cost – $67

 

We all want to look better and most people will go to any extreme to achieve beautiful skin.  Chemical peel treatments remove the outer dead layers of your skin allowing your epidermis to become more permeable to nutrients.   Robbins Plastic Surgery now offers the VI Peel™.  It is a popular option because it does more than just remove your visibly damaged skin.  It also treats your skin on a cellular level, working with acids and vitamins to help build collagen without sacrificing comfort for beauty.  VI Peel™ is a skin treatment used to improve the appearance of the skin on your face, chest, hands, or other areas.  As a medical-grade chemical peel, the VI Peel™ is an effective treatment to improve several skin issues including acne, uneven skin texture, uneven tone, fine lines, wrinkles, acne scarring, sagging skin, hyperpigmentation, enlarged pores, and age and sun spots.  The VI Peel™ also provides a more youthful look by brightening the overall appearance of your skin and improving collagen production.

If you are looking for a great way to reduce the signs of aging, Robbins Plastic Surgery is proud to offer the VI Peel™ as a part of their skin care treatment program.  The VI Peel™ is the first peel to combine the strongest and most effective acids, yet it is virtually painless.   A single VI Peel™ will achieve significant repair and add a healthy glow to your skin.

VI Peel Ingredients and Facts  

A VI Peel™ uses a unique blend of active cosmoceutical ingredients such as Trichloroacetic Acid (TCA) 7%, Salicylic Acid 2%, Retinoid Acid 8%, Phenol, Glycolic Acid, and Vitamin C.  Retin-A is a proven wrinkle fighter while TCA relieves fine wrinkles and surface blemishes.  Salicylic acid is an exfoliant and an anti-inflammatory agent and Vitamin C stimulates collagen while battling wrinkles and hyperpigmentation.  Phenol provides long lasting solutions to major issues such as deep-set wrinkles and more.

What to Expect

For the first 24-48 hours after your peel is applied, the chemicals begin to sink deep into your skin and there will be no obvious change to your skin’s surface. By the 72-hour mark, your skin will begin to peel and will continue to do so for the next few days because of the VI Peel’s™ deep exfoliation.  By day six, the peeling will subside and it will be almost undetectable with the use of the VI Derm™ daily moisturizer.  You may wear make-up prior to and after the peeling process but not while your skin is peeling.  After the peeling cycle is finished, results will include a more youthful glow and improved tone and texture.  Patients can receive VI Peels™ repeatedly every two weeks until they receive their desired results; however, most patients are pleased after just one treatment.

Wear Your Sunscreen

It is important to take care of your new skin.  You should avoid sun exposure by wearing a sunscreen at all times and cut back on exfoliating as your skin has just experienced major exfoliation with your VI Peel™.  Excessive sun/UV exposure and/or exfoliation will put your skin at risk for redness and irritation.