Dr. Peña Plastic Surgery Blog

Naples, Fort Myers, Bonita Springs, & Estero, Florida

Thursday, February 25, 2010

Infection/ Reaction to Hydrelle

I tried Hydrelle in my cheeks when it first came out with excellent results. I repeated this injection about 7 weeks ago. About 12 days ago started having swelling and redness in one cheek then the other. Despite aggressive oral antibiotics , injections of Hyalouronidase, and intermittent oral and IM corticosteroids I have quite a reaction that is only now starting to turn around. I now find many similar stories o the net from several plastic surgeons around the country. With so many serious reactions to Hydrelle in such a limited time, I think this product should not/ will not last long on the market!
I am glad this happened to me rather than one of my patients that would be freaking out and rightly so. I have used Juvederm for 2 years and over 400 patients (including my own cheeks) and I have never seen anything like this.

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posted by Manuel M. Pena, M.D. at 7:46 AM

Monday, February 15, 2010

Get the Fat OUT!

Just got back from a major cosmetic surgery meeting last nite. How many ways will someone come up to 'get the fat out'. There is traditional Liposuction (hohumm), tumescent liposuction, Vaser Assisted (the ultrasound I use), six different 'Laser Assisted' liposuction devices, a water pick device (Water Jet)liposucttion. They all claim to be gentler and perhaps be better. The laser devices claim they can shrink the skin thus perhaps avoiding excisional surgery in borderline patients. These are the same claims made by the ultrasound assisted proponents originally.

Then there are the non invasive devices. Zerona a low energy laser that when applied to the body from a few inches away will cause a signal to your fat cells to open their walls and let their fat leak out. The lymphatic then gets rid of it. (but how long before they start filling up again). Not approved for 'slimming' yet.I have been following the Ultrashape.. an external ultrasound device that ruptures fat cells by concentrating external ultrasound energy beams from different directions in one area and blasting fat cells. (no FDA approval yet).Another device actually claims to freeze your fat from application OUTSIDE the body thus injuring the fat cells so that they die and are eliminated. The usual Radio frequency devices are still trying to find a home somewhere as they now claim they can 'zap' fat away.

All sounds too good to be true. Let's see which ones are around in two years.

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posted by Manuel M. Pena, M.D. at 4:19 PM

Botox/ Dysport study 3 month results

I examined and interviewed all four patients that I enrolled in my study three months ago. I also found out which side was Dysport and which side was Botox. The results were exactly the same for both the patoent and me, the examiner. So folks... stay tune to see if on lasts longer than the other.

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posted by Manuel M. Pena, M.D. at 4:13 PM

Tuesday, February 2, 2010

What is the Best Age for Breast Augmentation?

The actual best age for breast augmentation is, at best, unique to each person. At our Fort Myers breast augmentation clinic, I perform a thorough medical examination and review of your medical history. Many factors determine the best age for this procedure, that the standard FDA approved age minimum of 18 years, and statistically best age of less than 50 years are not universally engraved in stone.

Personal information includes having complete breast development. Results can change if breast augmentation is done when breasts are still developing. For this reason the American Society of Plastic Surgeons (ASPS) recommends 21 years as a minimum age for breast augmentation surgery. Exceptions to the age recommendations are made if there are severe breast asymmetries which can be severely crippling to young women.

Emotional maturity is another important factor that suggests waiting until you are in your mid-20s before having this surgery. What appeals to you at a young age may not seem important later. Other factors, like anticipated pregnancies, breast feeding and lifestyle need to be considered.

Women approaching age 50 need to have realistic expectations. Age-related changes affect the quality of their skin and body structure. If they have not taken excellent care of their bodies throughout life, plastic surgery will not be a miracle cure. Older bodies do not heal as well as younger ones. Age-related diseases can remain hidden yet still have a negative effect.

Please contact Fort Myers breast augmentation surgeon, Manuel Peña, M.D. for a personalized consultation about your goals for fuller or perkier breasts.

posted by Tiffany at 2:44 PM

Saturday, January 30, 2010

Trans Umbilical Breast Augmentation

Recently, I was out with some friends and our usual waitress told us she would not be there the next couple of weeks because she was having breast surgery. When my friends volunteered that I was a plastic surgeon and had over 2000 happy breast augmentation patients in Naples, she quickly explained that she was going to a surgeon in the East coast of Florida who performed the surgery through the belly button also nown as the TUBA.

Unfortunately I have more experience fixing the results of these than I care to have. There was a surgeon here who specialized in TUBAs. He is no longer practicing and I have seen the usual lists of complications associated with this procedure. The main problem with it is the lack of precise control. Kind of like painting a corner of a room with a pole and a brush while standing outside the room! The other problem is that the natural position that the implant goes is the
subglandular (above the muscle) position. That is a whole other story. Even when the surgeons claim that they are getting it behind the muscle I have found one behind and one in front on the same patient. the third problem is the need to use saline implants even on thin patients with thin breast tissue. These cases would be better served by silicone gel implants.

The most common problem I see is that the implants drop like bombs in 2-3 years and then often require a lift!. The excuses used by TUBA advocates is that you don't have a scar in the breast and you don't alter nipple sensation. If I had bad scars from the periareolar (around the nipple) scar.. I would not have done 2000+ breast augmentations. The same goes for losing sensation of the nipple....Bull#%&@!

Let's face it, it's a gimmick.. and not a good one. In defense of the surgeon.. the young lady said he had recommended Silicone gel through a periareolar approach. He had the right idea, but he did not emphasize the importance of the right approach and implant because he did not want to lose a patient.

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posted by Manuel M. Pena, M.D. at 3:28 PM

Friday, January 8, 2010

Questions to Ask Your Cosmetic Surgeon

When you are ready to ask the critical questions about cosmetic surgery, I, Fort Myers cosmetic surgeon, Dr. Manuel Peña am prepared to answer any that you have, and many that you might not think of.

Expectations

A well-informed, well-prepared patient has realistic expectations of what results are possible for them. My growing list of satisfied patients is founded on making sure each one knows what is possible, what is not possible and what risks are involved for them, personally.

More Questions

To get that kind of information I recommend asking at least 18 specific questions of any cosmetic surgeon before you choose one to do your surgery. In the course of your conversation, you will think of more questions. Answers to your questions should tell you about that surgeon’s qualifications and not just generalized statistics. Comparing the two is helpful, but if you do not know how his outcomes line up, you really do not know anything helpful to making this all-important decision.

It is important to ask to see before and after photos of treatments done by the cosmetic surgeon you might choose. Look for the artistic details as well as you consider your impression of what you see. You will want to see photos of all types of his work along with a large number of photos of procedures you are considering. One day you may return for another type of treatment. What you want to know is that his talent is consistent in all areas of his work.

If I can answer any questions you have for a Fort Myers cosmetic surgeon, please contact Florida cosmetic surgeon, Manuel Peña, M.D., and we will schedule a personalized consultation for you.

posted by Tiffany at 7:31 AM

Sunday, January 3, 2010

Advances in Bariatric Surgery

Bariatric or weight loss surgery is becoming a more mainstream answer to long term weight loss. As procedures become less and less invasive the use of surgery as earlier option will become a reality. Less morbidity, less recovery, and less cost is bringing a new development in the field of Weight Loss Surgery into the lime light. The so called TOGA (trans oral gastroplasty) literally sews or staples the stomach from the inside thus restricting the size and giving a person a feeling of being full quickly.

Average weight loss of 25 lbs over 3 months have been achieved. Will the stomach 'stretch out'? So far only the Gastric Bypass has withstood the test of time.

For now I will recommend old fashion behavior modification within a physician supervised program for my patients requiring significant weight loss.

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posted by Manuel M. Pena, M.D. at 5:37 PM

Disclaimer: Naples dentist Dr. Manuel Peña website provides information on cosmetic surgery in the Naples, Fort Myers, Bonita Springs, & Estero, areas in Florida. This information is not to be taken as medical advice.
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