TOP TEN THINGS YOU WILL NEED FOR COSMETIC SURGERY

1. Prescriptions: The most important you will need when recovering from surgery are the prescriptions that are given to you at your pre-operative appointment. It is a good idea to get these filled prior to your surgery so that you will not have to worry about running to the pharmacy on your way home from the hospital. These prescriptions usually include a pain medication and possibly an antibiotic.

2. Ice Packs: Icing is an important part of your recovery for the firs 24-48 hours. In this period of time icing will help to decrease the amount of swelling you will experience. After this time icing can also be used for comfort. For example, icing after liposuction helps greatly to decrease the amount of pain experienced. Making your own ice packs is quite easy. Take a heavy duty freezer ball and fill with 3 parts water and 1 part rubbing alcohol. This mixture will get really cold, but will not harden!

3. Ointment: Most cosmetic surgeries (but not all) will require you to use ointment of some kind on your incisions. It is a good idea to have both an antibiotic ointment such as Neosporin as well as a non-antibiotic ointment such as Aquaphor or Vaseline. We will instruct you on where and when you should use these ointments for your specific surgery.

4. Liquids: Hydrate hydrate hydrate!! This is very important for both before and after surgery. We recommend that the day prior to your surgery you up your fluid intake. You must not have ANYTHING to eat or drink after midnight the night before your surgery, but up until that point we ask you to push those fluids. After surgery, you will be able to eat and drink anything you can tolerate, however, some patients are not able to tolerate solid foods right away so having a lot of different liquids to choose from is a good idea as it is so important to keep hydrated.

5. Proper Undergarments: Depending on what type of surgery you are having you may need to purchase new undergarments to aid in your recovery process. If you are having breast or abdomen surgery you will be given a compression garment at the time of your surgery to wear for at least the beginning of your recovery process. You most likely will need to purchase something else to get into for the end of your recovery process. For example after breast reduction surgery you will wear the breast binder provided for the first one to two weeks, but following this most patients will wear a sports bra, cotton bra without under wire or a tight tank top with a shelf bra in it until you are 6 weeks out from surgery. Some patients also find the abdominal binder we provide them with to be bulky under clothing. It is usually necessary to wear this for the first 4 weeks to ensure you are getting enough compression, but after this time when patients are going back to work they usually are able to get into some kind of shape wear that is more sleek under their clothes. Make sure to ALWAYS ask us if what you want to wear is okay. It is a good idea to bring the garments you have bought (with the tags on, so you can return is necessary) to one of your appointments for us to approve.

6. Comfy Clothes: Being comfortable after surgery is key! Make sure you have plenty of comfortable sweatpants, fuzzy socks and slippers and big sweatshirts for after surgery. If you are having breast surgery it is easier in the initial recovery period if you have shirts that either button or zip up the front.

7. Gauze and Hypoallergenic Skin Tape: You may not end up needing gauze depending on the surgery you have, however, it is a great idea to have it in case you do. We recommend using tape as sparingly as possible to avoid extra irritation to your skin. Typically placing gauze over your incisions and then applying your breast or abdominal binder over it will keep the gauze in place. Having some tape at home in case you need it is a great idea too though.

8. Gloves: Make sure you have gloves in a size that will fit whoever is taking care of you after surgery. If you have drains that need to be emptied or need help with dressings it is a good idea for whoever if helping to wear gloves while they are helping you. Make sure that they wash their hands before after they help you even if they do wear gloves!

9. Antibacterial Soap /Hand Sanitizer: We will ask you to use antibacterial soap in the shower starting a few days before the surgery. After surgery hand sanitizer will come in handy for your caretaker as they will be doing a lot of hand washing!

10. Pillows: Make sure you have plenty of extra pillows for use after your surgery. It sometimes difficult to find a position that is comfortable after surgery, but pillows can help to fix this dilemma. We recommend that after surgery you sleep with your head elevated. This can be achieved by sleeping in a recliner for the beginning of your recovery period, however, not everyone has a recliner! So, you can fake it by propping yourself up with pillows. You may also want to put some pillows on your sides so you don't roll over while sleeping and under your knees.

The last thing that did not make the official list but is also important to have on hand is our phone number! (413) 565-4400. If you have questions or concerns after surgery we are always available to help! Our trained receptionists are able to answer many questions and of course Dr. Brooks, Leah and Julia are also available if they cannot answer your question! We are here to make your recovery process as comfortable as possible!

INTRODUCING, JUVEDERM VOLUMA

The newest filler, Juvederm Voluma, recently received it's FDA approval for injection to the midface. This new filler is the third in the line of Juvederm products. It joins Juvederm Ultra and Juvederm Ultra Plus. All three of these fillers are Hyaluronic Acid (HA) based fillers. Hyaluronic acid is a naturally occurring sugar molecule in your skin that helps with hydration.

Voluma is formulated to help add volume to the cheek area. Voluma has a greater lift capacity than the other Juvederm products and therefore helps to lift and add volume to the midface/cheek area in order to restore contour to the face creating a more youthful appearance!

 If you are interested in learning more about Voluma or other fillers and to see if you are a good candidate, call our office for a consultation with Leah Kenney, PA-C or Julia Boucher, PA-C at 413-565-4400.

Save on Botox & Juvederm by doing your Holiday Shopping!

Most of our Botox and Juvederm patients have already heard of Brilliant Distinctions, a reward program through Allergan (the manufacturer of Botox and Juvederm) where the patient is able to rack up points for future treatments, which can be used to create coupons. Up until very recently the only way to accrue points was to get treatments of Botox or Juvederm. Each syringe of Juvederm or unit of Botox is equal to a certain amount of points. Each time a patient came to our office to have a treatment our receptionists would bank the appropriate points into the patient's account and then, before their next treatment, they could log on to their account to see if the points they had were high enough to create a coupon. This point system still exists, however, Brilliant Distinctions now offers a brand new way to get points!!

Introducing....the Brilliant Distinctions MALL!!

Now, when patients log on to their BD account they have the options of earning points by shopping at the Brilliant Distinctions Mall. Before you read further if you have not yet signed up for Brilliant Distinctions, go to Brilliant Distinctions and SIGN UP NOW! 

So, how does this Mall really work? Once you click on the Shop at the Brilliant Distinctions Mall Link on your BD home page you will be taken to a page that looks like this:

 

This page not only gives you access to TONS of stores that offer BD points, but it also informs you about any specials deals that are being offered! How convenient is that??? 

 You can search for your favorite store either by category or through the search bar at the top of the site. If you aren't sure what you are looking for simply browse through the deals or popular retailers!

Once you find a store that you would like to shop at, you can click on the icon of the store and it will take you to a page showing you how many BD points you will earn per dollar and showing any deals that are being offered. Here are some examples:

 

Now, you are ready to SHOP!

Click the SHOP NOW purple button and it will bring you right to the store's website where you can shop your heart out! 

It's a simple as that! Do your Holiday Shopping through Brilliant Distinctions from the comfort of your home and earn points for your next Botox or Juvederm treatment! 

Now, go SHOP!

Mommy Makeover 101

After giving birth many women experience a significant change in their body. Both the abdomen and breasts can change dramatically, leaving women feeling as though they no longer recognize their body.

During pregnancy the rectus abdominis muscles in the abdomen spread to allow room for the growing uterus. In some women these muscles don't come back together the way that they were prior to pregnancy. This, along with loss of tone of these muscles leads to a bulging rounded appearance to the abdomen. Many women complain of still looking pregnant even after spending countless hours in the gym. Unfortunately there is no amount of diet and exercise that will completely fix this issue. Other complaints in the abdomen from postpartum women include sagging stretched excess skin and stretch marks. While this is partly related to the amount of weight gain or multiple pregnancies, genetics also does play a part in the degree of severity. Unfortunately it's not just the abdomen that is affected following pregnancy, the breasts also can change. Most women complain of droopy, deflated breasts following pregnancy and breast feeding.

While these changes are well worth it in exchange for creating a human life, it doesn't mean women are condemned to live with them forever. So, what can be done to give these women back their pre-baby bod? This is where the "Mommy Makeover" comes into play. This is a term coined to refer to the different surgeries that can done to correct the changes occurring following pregnancy.

Most classically a Mommy Makeover involves an Abdominoplasty or "Tummy Tuck". This can be either a Mini Tummy Tuck or a Full Tummy Tuck. The Mini Tummy Tuck involves correction of the diastasis recti along with a small excision of skin. Women who have a small amount of excess skin below the umbilicus (belly button) only and a diastasis recti qualify for this procedure. Most women require a Full Tummy Tuck which corrects excess skin above the umbilicus, hooding of the umbilicus, excess skin below the umbilicus and diastasis recti. Liposuction of the flanks or "love handles" is usually performed at the same time as a Tummy Tuck if there is excess fat. Usually liposuction alone is not an option, but if there is truly only excess fat in the abdomen and no excess skin or separation of the muscles, this could be an option.

 Breast surgery as part of a Mommy Makeover typically includes a Breast Augmentation, Breast Lift or combination of the two. Many women coming into the office believe they need a Breast Lift as they complain of sagging droppy breasts. This may be true, but many women do not actually have true ptosis (drooping) of the breast, but have lost the volume in the breast and have that deflated balloon look. A silicone or saline implant is used to best correct this by filling up the breast to what it was prior to pregnancy or larger if the woman so desires. True ptosis involves the position of the nipple as depicted in the picture below. A Breast Lift will correct the position of the nipples bringing it back up where they should be pointing forward instead of towards the floor. This will also remove any excess skin. Sometimes the issue is both the position of the nipple and a loss of volume. For this an Augmentation and Lift could be performed together.

 
These procedures are typically performed in the hospital as day stay procedures under general anesthesia. If both an abdomen and breast surgery is desired, these can usually be performed at the same time. Recovery from procedures such as these is typically between 4-6 weeks. Just like any surgery, these procedures do have risks associated with them which can be discussed in detail at a consultation visit.

To learn more about the Mommy Makeover or to find out which specific surgeries would be right for you call the office to set up a consultation with Dr. Brooks. 413-565-4400

INTRODUCING COOLSCULPTING

We are so happy to announce that we will now be offering Coolsculpting at The Office of Dr. Glen Brooks! 

Coolsculpting is a non-surgical method of fat reduction that uses cryolipolysis to permanently kill fat cells. Cryolipolysis is the use of controlled cooling to injure and kill subcutaneous fat cells while keeping the overlying skin unharmed. This method of fat reduction requires NO surgery and NO downtime! You can have the procedure performed on your lunch break and you can work out the same day! There are very minimal side effects with the most common being redness, bruising, swelling, tenderness to the touch, cramping, itching, tingling and numbness. Coolsculpting permanently kills 20-25% of the fat cells in the treated area.This is great for that stubborn pocket of fat that just doesn't go away even with diet and exercise! If 20-25% of the fat in an area isn't enough, the area can actually be treated again for further fat reduction and an additional 20-25% reduction can be expected.

So, what does this procedure actually entail? Well, I was lucky enough to be able to try it firsthand before we decided to offer it at our office. The most popular places to have this procedure performed are all of those areas in the mid-section with cute little names such as love handles, belly pouch and muffin top.The bra strap roll is another area that gets great results from this procedure. The mid-section is not the only area that can see great results though, the upper arms can be treated as well as the inner thighs. I decided to stick with one of the typical areas and had my love handles treated. Just like any procedure we do at our office the first step is to have pictures taken. After that the area to be treated is marked using a plastic applicator and a washable marker. Next a cold wet gel pad is applied over the area to be treated. This isn't the most appealing thing, but it is necessary since it helps to protect the skin. The applicator cup with suction is then placed over the area marked to be treated. The skin and fat is sucked up into the cup. Now, I'm not going to lie, this is initially a little uncomfortable, but it is very bearable. I mean, if you take your skin and pull it up, well, it hurts! In the beginning is also feels REALLY cold, but your body gets used to it shortly and for the remainder of the treatment there is only mild discomfort if any! For most areas the applicator is put on with the patient standing up and then the patient is positioned on a bed with lots of blankets and pillows to ensure complete comfort!

Below is a picture of the applicator with the suction on. You can see my skin and fat sucked all the way up into it!

I was able to check my email, spend some time on facebook and pinterest and watch a TV show on my ipad all while getting rid of my fat! One important thing to note is that while yes you can do lots of things to keep yourself occupied during the treatment, you can't get up or really move around at all for danger of the applicator popping off. If the applicator comes off in the first ten minutes, it can be put right back on without an issue, but if it's after that it's considered another treatment and has to be payed for. So, being relatively still is a must. Also, remember to go to the bathroom before you start your hour long treatment so you don't end up having to pee half way through! 

Below is a picture of me all set up watching a show on my ipad during my treatment!

 

Now, obviously with an area like the love handles, the treatment takes 2 hours since each area needs to be treated for 1 hour. A little before the end of the 1 hour you will feel a slight difference as the machine goes into massage mode. The medical professional adminstering the treatment will be notified by the machine 2 minutes before it ends and will come up to take it off as soon as the treatment ends. There is no pain as the machine comes off. The treated area looks red immediately after the machine is removed and the area that was sucked farthest into the cup is raised and looks like a big red stick of butter. Don't worry, this goes right down after it is massaged. In my opinion the massage was the worst part of the whole procedure, but others who have been treated say it didn't bother then at all. It is not that the massage actually hurts, but more that it feels like pins and needles or like running your hands under warm water after being outside in the snow with no gloves. The massage is done by the medical profressional adminstering the treatment and only lasts about 2 minutes.
 

Below is a picture of what the treated area looks like immediately after the applicator is removed. (Unfortunately I was not able to get a picture of myself, this is of another patient who had the treatment performed to the lower and upper abdomen)

After this, the treatment is DONE and you are free to go about your life with no restrictions whatsoever. I was able to go backpacking the next day and hike 6 miles with no discomfort! Some people who have been treated did report some discomfort after and and some reported it was enough to keep them from being able to work out. This discomfort can be diminished or potentially prevented by wearing compression in the treated areas. The one side effect that I did note was numbness. I had numbness in the treated area for about 3 weeks following the procedure. 

So, what about results? Just like most procedures, it takes a little while to see the results. Coolsculpting results usually take between 2-3 months to see, however earlier results have been reported. I personally started to notice a difference in how my pants fit around my sides about a month after the procedure. I continued to see a difference during the 1-2 month period after my treamtent and by probably 9 weeks I saw the final result. One of the best things about Coolsculpting is that it really does work and works on every single patient! No matter what, 20-25% of the fat in the treated area will be destroyed permanently!

-Julia Boucher, PA-C

To learn more about Coolsculpting and determine if it is the right treatment for you
 call the office to make an appointment for a consultation with
 Dr. Brooks, Leah Kenney PA-C or Julia Boucher PA-C
413-565-4400
www.drglenbrooks.com

Check out some before and after pictures below to see the results for yourself!
Before on the left, after on the right.

 

Typically, there is minimal to no downtime after the treatment though patients may experience temporary pain or discomfort. Side effects can include redness, bruising, swelling, tenderness to the touch, cramping, itching, tingling, and numbness. Numbness can persist up to several weeks after a procedure. - See more at: http://www.coolsculpting.com/how-it-works/patient-faqs#sthash.GEeiGnqW.dpuf

Typically, there is minimal to no downtime after the treatment though patients may experience temporary pain or discomfort. Side effects can include redness, bruising, swelling, tenderness to the touch, cramping, itching, tingling, and numbness. Numbness can persist up to several weeks after a procedure. - See more at: http://www.coolsculpting.com/how-it-works/patient-faqs#sthash.GEeiGnqW.dpuf

WHAT IS IMPLANT BASED BREAST RECONSTRUCTION?

As most people have heard by now, actress, Angelina Jolie reveled recently that she has made the difficult decision to undergo a bilateral nipple sparing mastectomy after finding out that she was positive for the BRCA1 (breast cancer) gene. Angelina disclosed her decision along with a brief account of what the road to reconstruction consisted of for her through an op-ed in the New York Times. Her decision to not only go through these procedures, but to share her experience with the world is courageous and  inspiring to women around the world.

Breast Reconstruction Awareness is on the rise with help from the Plastic Surgery community and ASPS naming a national BRA (Breast Reconstruction Awareness) Day in October, as well as actresses or other people in the spotlight coming out about their experience with either breast cancer or as in Angelina's case, a genetic susceptibility towards breast cancer. With these stories being out there for every day women to read, it opens up the opportunity for them to seek further information. Women who have a family history of breast or ovarian cancer may be more likely to ask their Doctor about BRCA testing and women who are deciding whether or not to undergo prophylactic mastectomy with breast reconstruction may feel empowered and inspired to make that decision after hearing another woman's story.

Angelina opted for an implant based approach to reconstruction which is becoming more and more popular and is quite appealing to most women as it usually means less time in the hospital after surgery and an easier road to recovery. The process of this reconstruction starts at the day of the mastectomy. Most mastectomy's these days are skin sparing, meaning the breast surgeon takes all of the breast tissue along with the nipple areolar complex, but leaves the skin envelope. Angelina Jolie actually had a nipple sparing mastectomy, meaning all of the breast tissue was removed, but the skin and nipple areolar complex was left intact. This may be an option for some women depending what type of breast cancer they have or if they are having prophylactic mastectomies. This is something that should be decided with the breast surgeon. As the skin envelope is left with either type of mastectomy it is easy to fill this up with either a tissue expander or implant immediately after the breast surgeon has finished their part of the surgery. Most commonly tissue expanders as used so that the skin and muscle can be gradually expanded. Tissue expanders are implants that have a metal port so that they can be gradually filled with saline, both in the operating room and in the office after everything has healed. These are placed under the pectoralis muscle as illustrated in the picture below.

Once the tissue expanders are filled to the appropriate size they can then be exchanged for an implant of the same size. This usually happens approximately 3 months after the initial surgery. With the availability of devices such as shaped silicone implants as shown in the picture below, plastic surgeons are able to create a very natural and real looking reconstructed breast.

Dr. Brooks was asked recently to talk about what a Double Mastectomy with reconstruction is, check out this video of his appearance on Mass Appeal regarding this subject!

What is a double mastectomy?

WHAT'S THE RIGHT AGE TO START ANTI-AGING?

Anti-aging treatments start a lot younger than we think! Good parents start their children on an "anti-aging" regime the very first year of their life by making sure their kids are always smothered in sunscreen! People who then avoid the sun or wear sunscreen religiously and avoid things like smoking and a poor diet end up with much smoother, tighter, younger looking skin when they reach their 40s than those on the other end of things. So, anti-aging isn't just about treatments it's about PREVENTION! If you never form those wrinkles than you won't have to do those things to get rid of them! Or more realistically (since we will all form wrinkles eventually) you will be able to get rid of them much easier! 

Patients are frequently coming to the office for a facial rejuvenation consult for either fillers or neuromodulators (botox, dysport, xeomin) and asking us, am I too young to be starting this? How old are most of your patients? Patients are frequently worried that if they start something like Botox or Juvederm early on it will somehow make things worse going forward. This could not be FURTHER from the truth! Botox and other neuromodulators can actually be a form of wrinkle prevention! Yes, they work great as a treatment for wrinkles that are already exist, but they work even better for preventing those wrinkles from ever forming. Neuromodulators work by preventing the muscles from moving, so therefore, if those muscles don't move and then the skin doesn't crunch, well, you never get those wrinkles! So, NO, starting in your 20s or 30s is not too young! 

As far as when to start an anti-aging skin care routine at home, there is no right answer. As mentioned earlier, starting with sunscreen and healthy behaviors should be a life long thing! But when to start things like retinoids and glycolic acid treatments depends a lot on each individual's skin. If you notice fine lines and wrinkles, it may be the time for you to start. Certainly if you are getting fillers or botox you should defnitely be adding in an at home anti-aging regime! If anti-aging is something that crosses your mind when examining your skin in the morning, then you are probably ready! 

For more information on what you should be doing for you skin come to the Spa on the Green for a skin-care consultation with either Jen or Heather (our lovely aestheticians). Call 413-565-2405 to make your consultation today!