“The bigger the better…” is out in breast augmentation

Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

“The bigger the better…” is out in breast augmentation

Mariah Carey’s new album cover, “The Art of Letting Go,” reveals a curvy 43-year-old singer. One thing that does stand out—when you look at this photo compared to photos taken much earlier in Carey’s career–is her breast size.

Pop stars often start fashion, hairdo and makeup trends. Even the shapes of their bodies make statements. In this case, though, Carey’s larger breasts are not what’s trending. In fact, I’ve noticed in my practice that women are opting for a more natural, proportional look after breast augmentation.

No implants needed

Breast augmentation by fat transfer–a procedure that uses one’s own fat to plump the breasts one cup size–is all the rage. Sometimes, we can go a cup and a half larger.

The concept is simple, we remove fat from places a woman doesn’t want it and use that fat (rather than implants) to rebuild, rebalance and re-volumize breasts that might have lost some of their size and perk over time. The result is a natural looking larger (but not too large) breast. You can see and example here: Before and After Breast Augmentation.

Other benefits of breast augmentation by fat transfer include:

  • Only local anesthesia is generally needed for the procedure.
  • Results last for the long-term– several years in many cases.
  • We don’t use a scalpel, so there are no visible scars.
  • There is no capsular contracture, which is hardening of the breasts, because we use fat, which is soft.

Good candidates need to have enough unwanted fat to do the procedure and only want up to be up to a cup and a half larger.

What’s new in breast augmentation with breast implants?

For those who want to go up in breast size by two cups or more, we’ve come a long way in refining breast augmentation with implants. Today’s patients have more options. For example, newer implants include the Allergan Natrelle 410 and Mentor MemoryShape implants (FDA approved in June 2013). These are cohesive get breast implants. Cohesive gel is firmer and retains a fixed shape. But, in my opinion, while they are newer options, they are not as popular as the softer, more pliable silicone and saline implants.

Learn more about breast augmentation by fat transfer and breast augmentation, in general, go to: http://www.milfordmd.com/pages/fat-transfer-breast.html


Can we maintain near flawless beauty into our 70s?

November 18, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

Can we maintain near flawless beauty into our 70s? Just take a look at Raquel Welch!

Women are looking better and better as they age. I think three things help determine how a woman will look in her 60s, 70s and 80s: lifestyle (including sun exposure and smoking), genetics and whether or not a woman has cosmetic facial rejuvenation surgery, as well as how skilled and experienced her surgeon is.

I know the last two might be controversial. After all, many women maintain beauty into their later years with only a healthy lifestyle and good genetics. But to achieve a look relatively free of wrinkles, lines and furrows that come with a lifetime of expressions and movements; to keep eyebrows elevated, cheekbones crisp and the neckline defined, one needs a little help.

The caveat to that is that help has to be by a skilled cosmetic surgeon.

Case in point, look at Raquel Welch. The actress emerged November 16 at the 2013 Governors Awards looking spectacular.

But if you look at befores and afters of Ms. Welch since the days of her famous bikini pinup poster in 1966, you’ll see a graceful (albeit artful) transformation. Yes, I think Ms Welch probably eats right, exercises and seems to have great genetics. But I also believe (and many colleagues agree) that Ms. Welch had a little help with facial cosmetic surgery.

Specifically, I think she might have had:

• a facelift, which has given her a jowl-less neckline and a more sculpted lower face;
• eyelid surgery, which has helped her to maintain the open, almond shape of her eyes;
• Botox, to address forehead and other lines and lift her eyebrows; and
• fillers, to re-volumize her face and lips.

Whether Ms. Welch has maintained her looks so beautifully with the help of cosmetic surgery has not been confirmed. But if it is the case, her looks at age 73 are iconic for today’s older woman. I’ve seen many women in their 70s and, even, 80s who look spectacular with the help of artful, skillful and mindful facial cosmetic surgery.

For more about what we do to rejuvenate the face, see procedure descriptions and before and after photos at http://www.milfordmd.com/.

A cosmetic surgeon’s secret for avoiding overdone lips

October 28, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

A cosmetic surgeon’s secret for avoiding overdone lips

We’ve all seen results from cosmetic surgery gone awry. One of the biggest offenders, in my mind, is the very avoidable problem of overdone lips. Lip augmentation should look natural, not like it’s part of a bad Halloween costume!

The secret for naturally enhanced lips is this: The goal isn’t to simply make lips larger. Even if you have small, almost nonexistent lips, the goal is to sculpt, rather than to inflate.

If a patient has nice lips that have deflated over time, we focus on replacing volume along the areas where volume has been lost, including the cupid’s bow, philtral columns (the two columns of skin above the cupid’s bow), oral commissures (where the upper and lower lips meet) and, of course, the vermillion red border of the lips.

For most people, the perfect lip is one where the ratio of the top lip to the bottom is 1:1.6. The top lip has a more central pouty fullness that tapers. The bottom lip is robust, mostly in the middle half. Some people, for example the actress Audrey Tautou, have entirely different ratios that are also beautiful.

When augmenting lips, I create symmetry, correct irregularities (from nature or trauma) and restore the lips’ more youthful fullness.

My top filler picks for the lips include hyaluronic acid fillers Juvéderm Ultra Plus or Perlane. Sometimes, I’ll use a little Restylane, depending on the patient’s needs. For fine, superficial vertical whistle or smoker’s lip lines, I prefer Belotero Balance or Prevelle Silk. Creating beautiful lips is art work and not simply squirting something in the lips.

For examples of our lip augmentation befores and afters (real patients), visit http://www.milfordmd.com/pages/before-after-fillers.html.

Lack of “gravity” has nothing to do with Sandra Bullock’s youthful look

October 22, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

Sandra Bullock looks stunning in photos since the release of her new movie Gravity. Ironically, some would say gravity has yet to take its toll on the 46-year-old Bullock.
But that’s not the case.
Gravity isn’t what pulls down our faces as we age. We don’t look older and saggier as a result of gravity. Rather, volume loss and changes related to aging are to blame. And we can reverse these changes with tried and true cosmetic surgery techniques.

What really happens is this: Facial skin sinks due to changes and loss of the underlying bone, muscle and fat. The skin sags from loss of elasticity. Loose skin is more likely than snappy, tight skin to sag.

The results? Our eyes look more sunken in, our cheekbones have less softness and prominence and our lips look smaller.

In-office cosmetic surgery fixes include laser resurfacing and other cosmetic surgery procedures, which can help to revive skin elasticity. We also use fillers from fat to Juvederm to address facial volume loss and relaxers such as Botox to calm overactive muscles.

These are lunchtime procedures that can naturally rejuvenate the face and lips to more youthful shapes, without looking “done.”

See this example of a before and after using our liquid facelift, which uses the nonsurgical cosmetic surgery techniques I described to help turn back the real hands of time: http://www.milfordmd.com/pages/before-after_facelift.html

Avoiding bad cosmetic surgery is a concern not only for women, but also for men

October 14, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA
News of Bruce and Kris Jenner’s recent split became an opportunity for jabs at the former Olympic star’s looks. No doubt, Bruce Jenner has experienced bad results from cosmetic surgery. What happened to Bruce Jenner, however, should be avoidable.
Jenner’s cosmetic surgery problems are so noticeable that comedians have a field day at his expense. “Weekend Update” co-anchors Seth Meyers and Cecily Strong commented on Saturday Night Live that the Jenners “have decided to start looking like other people,” and that Bruce is excited to start his new life as a “single, middle-aged woman.”

We’ve all seen cosmetic surgery gone wrong. There can be many reasons for the less-than-ideal and bad results, but some of the most common are highly avoidable.

One way to avoid bad cosmetic surgery results is to go to an experienced cosmetic surgeon, who has a portfolio of good patient results in the specific procedure you want. So, if you want a facelift, meet with a potential cosmetic surgeon and ask to see his or her facelift before and after photos. Make sure what you see are the surgeon’s results and not ‘sample’ before and after photos.

Ask to speak to actual patients. It’s always great to get a referral from someone you know has had good results.

And beware of any surgeon who touts ‘dramatic’ results. You don’t want your skin pulled so tight that your eyes are at a different angle and your skin drapes like curtains. Instead, you want a cosmetic surgeon who aims to rejuvenate your face, so that you look like the same person—just refreshed, rejuvenated.

Another problem has to do with patients’ desires to have more and more done. People panic about aging. And some surgeons are happy to oblige with repeated procedures and extreme surgeries. Don’t have cosmetic surgery to please others. Do it for yourself. Don’t strive for perfection. There is none. Finally, realize that having too much done to your skin and features will distort even the most beautiful and handsome (take Bruce Jenner as an example) men.

So, to avoid bad cosmetic surgery results, go to a cosmetic surgeon who is highly experienced and regarded by patients as achieving natural looking results—not dramatic results. Second, take a realistic approach to aging. Let the experienced cosmetic surgeon guide you so that you avoid becoming overdone.

For examples of our befores and afters (real patients), visit http://www.milfordmd.com/pages/before-after.html.

Keeping Scarlett Johansson’s youthful face shape in one’s 40s and 50s might require fillers, fat

October 10, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA
There’s no doubt, Esquire magazine’s new Sexiest Woman Alive, Scarlett Johansson, has the facial features society considers beautiful and youthful. But naturally maintaining those features as the face ages and loses volume is rare—maybe nonexistent.

Why? Because as we age, we lose the volume that gives us those cheekbones, plump lips and vibrant eyes.

The good news is we can three-dimensionally re-volumize the face nonsurgically, using natural living fat cells taken from elsewhere on the body, as well as popular hyaluronic fillers. You read that right: fillers do more than smooth lines and plump lips. When used artfully, they can re-volumize the face.

Caution: this rebuilding or re-volumizing of the face requires skill and artistic ability, as well as a thorough understanding of the underlying bone, muscle, fat and skin structures. Doctors and others who inject the fillers and fat without paying enough attention to these details can create misshapen, swollen, unnatural faces.

After all, the goal is to look natural; not ‘done.’

Read more about filler options at http://www.milfordmd.com/pages/fillers.html.
On Twitter: https://twitter.com/RBmilfordMD/

Miley Cyrus’s twerking spotlights the butt at a time when illegal buttock injections are common

There are two trending items that I think are ironically related. One is the emphasis on Miley Cyrus’s buttock (or lack of it). One can’t help but notice how her butt isn’t protruding in some of those twerking pictures that went viral. At the same time, illegal buttock injections continue to kill people. Yes, people (predominately women) are dying from a procedure that should be relatively safe, if performed by a credible and experienced physician.

Sun Sentinel reporter Adam Sacasa reported earlier this month (on September 5, 2013) about a recent tragic turn of events having to do with bad butt procedures by a sham provider.

A man named Calvin Edward Butler, dubbed the ‘motel surgeon’ was sentenced to eight years in prison and accused of illegal injections of silicone into people’s butts.

According to the article, “Investigators learned of the Krazy Glue-sealed injections in January after a man and woman came to them telling stories of how Butler … injected their buttocks with silicone from a plastic cup.”

This guy did the injections in a motel room and charge people $200 each for the procedure. One of the poor people who fell for this fake medicine suffered an infection and had to have another surgery.

At least this person lived to tell about it. Some aren’t so lucky.

Done right, the Brazilian butt lift or Dominican Derriere, also called butt augmentation, is a great procedure for creating a more rounded, perky buttock. It’s a minimally invasive procedure performed in our office while the patient is comfortable and awake.

And, it’s safe. We don’t use implants; rather, we use a patient’s own fat and transfer it to the buttocks. In my experience, using fat results in more natural look than butt implants.

For more about the “real” butt lift, go to http://www.milfordmd.com/pages/brazilian_butt_lift.html.

Key words: Miley Cyrus, twerking, butt, illegal buttock injections, buttock, Brazilian butt lift, butt augmentation

Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

Breast enlargement, or augmentation, is today’s most in-demand cosmetic surgery among women. Even so, many women avoid having the surgery because of their concerns about breast implants. The big news in cosmetic surgery is breast implants are no longer the only way to achieve enlargement. We can transfer one’s own fat from one place on the body, where it isn’t wanted, to the breasts where it augments naturally. The result? Natural looking, natural feeling, larger breasts!

I’ve been doing fat transfers to enlarge or reconstruct breasts for some time now and can say–with confidence–that patients love the results.

Autologous (meaning one’s own) fat transfer has a great track record in facial rejuvenation. I love using fat to rebuild body structures that have either deflated over time or would simply benefit from augmentation. Just recently, I rebuilt a 68-year-old women’s face. She looks years’ younger now and, in a few weeks, should be a hit at her class reunion and upcoming holiday events.

For the breasts, fat taken from areas such as the patient’s arms, hips, thighs or abdomen, does much the same as it does in the face, or even the hands. It gives the breasts a natural plumpness. We can increase the breasts one cup size with each autologous fat transfer procedure. We don’t try to enlarge or rebuild the breasts more than one cup size at a time because the fat is more likely to take if we use the step-wise approach.

The entire natural augmentation procedure is completed with the patient is awake and comfortable in our office procedure suite. We use thin blunt instruments, called cannulas, to deliver the fat into the breasts. (That’s after having liposuctioned it from another part of the body.) So, there are no incisions, which can result in scarring. Patients emerge with slimmer legs, thighs or tummy from liposuction and larger, implant-free, incision-free breasts!

I’m not the only physician who believes autologous fat transfer for breast enlargement is a mainstream option for women. The American Society for Aesthetic Plastic Surgery announced September 23, 2013 that it is the “cosmetic treatment many women have dreamed of – taking the fat from their hips and thighs and redistributing it to their breasts.”

The press announcement notes that while fat injections have been safely used for many decades, the safety and long-term benefits of autologous fat transfer to the breasts is ongoing. Among the potential concerns related to fat grafting to the breast is that it might produce changes in the breast that might appear suspicious on mammogram, prompting further testing. Still, natural fat breast augmentation represents an important advance in cosmetic surgery for women who want breast enlargement or reconstruction without implants.

See befores and afters of women who have had this procedure in my practice and learn more about natural breast augmentation with autologous fat transfer at this link: http://www.milfordmd.com/pages/fat-transfer-breast.html. For more information ask for Laure at MilfordMD Cosmetic Dermatology by calling 570-206-4000.

Cosmetic surgeon Richard Buckley, MD, who practices in Milford, Penn., comments on the growing trend of using one’s fat, rather than synthetic breast implants, to enlarge or reconstruct breasts.

“Many women who want larger breasts are concerned with the use of breast implants. What many don’t know is there is another option that doesn’t involve the use of saline-filled or silicone implants. Today, we use a woman’s own fat to enlarge her breasts,” says cosmetic surgeon Richard Buckley, MD. “When done correctly, the result is a natural-looking cup-size enlargement, without the potential unnatural feel of implants or scars from incisions to place those implants. A physician’s experience in fat transfer is very important because the success of this procedure is highly technique-dependent.

Miss America 2014 Nina Davuluri’s Darker Skin an Emerging Research Focus in Cosmetic Dermatology

September 16, 2013
Cosmetic Surgery for Real, by Richard Buckley, MD, Milford, PA

Miss America 2014 Nina Davuluri’s Darker Skin an Emerging Research Focus in Cosmetic Dermatology

Custom-designing facial rejuvenation treatments for people with skin of color is an emerging trend in cosmetic dermatology.

The newly crowned Miss America Nina Davuluri, who is an American of Indian descent, is the perfect example of a darker skin type that can present challenges in cosmetic dermatology. The issue is this: Dermatologists often have to approach darker-skinned patients differently than they do lighter-skinned patients. Why? Skin types, which range from very light to very dark, respond differently to lasers, chemical peels, topical agents and other treatments we use to rejuvenate the face.

It’s also important to keep in mind that people with various skin types age and heal differently. And the aging-related skin concerns of a person of African American descent might be very different than those of a light-skinned Caucasian.

To make matters more complicated, there is variation of skin color within ethnic and racial groups.

Here are a few skin rejuvenating tips:

If you want to address a cosmetic concern and are a person with darker skin (which could include being of South Asian, Hispanic or African American decent), seek out a cosmetic dermatologist, cosmetic surgeon or plastic surgeon who has experience treating a similar skin type to yours. If you don’t, you risk not only a bad result but also scarring and other unwanted side effects.

We’re finding combination therapies can be extremely effective in people with darker skin types who want to address skin pigmentation issues. One of the most important products we add to the treatment mix is sunscreen. That’s a great tip, right there: No matter how dark your skin, sunscreen should be among your go-to beauty agents. It can help prevent troublesome skin pigmentation issues from occurring or getting worse.
For more about how we address common skin aging concerns, including pigmentation, wrinkles, skin texture see our webg site at http://www.milfordmd.com/pages/skin-of-color.html and call our office at 570-296-4000.

Key words: skin of color, Miss America, Indian descent, chemical peels, lasers, topical agents, sunscreen, cosmetic dermatology, darker skin, African American, South Asian, Caucasian, Hispanic

Dr. Marina Buckley and Dr. Richard Buckley