Aesthetic Medicine

Patient Education Seminar

Innisbrook Resort and Golf Club, Palm Harbor, Florida

April 14, 2010

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The medical press has stated that the BMI (body mass index), which is used to calculate risk of heart disease, diabetes, stroke, death rate and a myriad of other medical problems may not be the most accurate predictor.

A more accurate predictor may be the waist and hip circumference. In both women and men, a waist greater than 35 inches for women and 40 inches for men, may be associated with a 3 times increase of heart disease. Having a big waist may raise the death rate even in men and women that are not overweight. In fact, having large hips and a small waist reduces the risk of heart disease.

The problem appears to be visceral fat. This type of fat surrounds our organs such as intestines or liver. The menopause, hormones, pregnancy and overeating may stimulate the subcutaneous fat. A good diet will greatly reduce visceral fat and subcutaneous fat and therefore reduce chronic diseases and premature death. Genetics alone determines who has more fat cells in the hips or in the waist. Hundreds of abdominal crunches daily will not give anyone a flat tummy. Read the rest of this entry »

As if it didn’t seem challenging enough already to keep your skin looking young, here comes bad news from a Dutch team of plastic surgeons: women are more prone to wrinkling around the mouth than men. And it’s not just that women develop more lines and crevices, the team reported in the November/December 2009 issue of the Aesthetic Surgery Journal, the wrinkles women get tend to be deeper than those on male faces.

To test the perception that women have more and deeper wrinkles than men, the plastic surgeons examined both surface skin and full-thickness sections from the upper lip area of male and female cadavers. Physiological differences they discovered that may contribute to more profound wrinkling in women include:

- Women have fewer sweat glands and sebaceous (oil secreting) glands around the mouth than men do. This could mean the skin is less well supported from under the surface and therefore more prone to sinking into fissures. Read the rest of this entry »

Here are my 2010 top 10 predictions in the world of Aesthetic Medicine

1. Dysport will become a strong competitor to Botox. Dysport, a new entry into the world of botulinum toxin, was launched in the spring of 2009 and has begun to see increased demand as market awareness grows.

2. Non-invasive body contouring and laser assisted rejuvenation will continue to grow in popularity.

3. Face lifts will continue to drop in demand while liquid face-lifts will grow in popularity, especially with the younger market (40 -54 year olds).

4. Fat transfer, specifically for natural breast enhancement, will become sought after by women who were previously uncomfortable with implants.

5. Laser Lipolysis will continue to be one of the most in-demand medical aesthetic procedures due to its minimal downtime and great results. Read the rest of this entry »

The eye area is one of the first to show signs of aging with fine lines, skin laxity, and under eye bags starting as early as the late 20s and early 30s. Non-surgical or minimally invasive rejuvenation options have become especially popular among both men and women who are either nervous about undergoing surgery, want to avoid scars and prolonged downtime, or who have such early changes that more invasive procedures would be inappropriate.

Tiny lines around the eye area are typically due to chronic movement such as squinting and loss of collagen and elasticity from excess sun exposure. The best treatment for dynamic (movement related) wrinkles is injections which relax the orbicularis muscle around the eye.

Botox and Dysport are both great options which last approximately 4 months. Treatments can prevent the development of future wrinkles over time by decreasing overall movement. Patients can have the procedure done over their lunch hour and return to work immediately. Read the rest of this entry »

Fat can be a fountain of youth. We have looked with disgust at the fat that is removed when we do liposuction but it is this fat that can remove our wrinkles and improve the way we look. Science now tells us that the fat we throw away is really is the key to reverse aging. As we age, wrinkles appear on our face. The wrinkles can be identified as frown lines, crow’s feet, sagging jowls and crepetations on the skin. Wrinkles appear when we lose fat under the skin which is exactly what happens as we age.

Artificial fillers are not the only products available to remove wrinkles and frown lines because now we have our own fat that we can be shifted to any location we want. Fat is naturally rich in stem cells that make it the ideal filler. This “liquid gold” can be used to make us look younger without artificial fillers. We can harvest as much fat as we need to fight the effects of aging.

The fat cells are easily harvested with a small liposuction canula under local anesthesia. In order to give the fat a greater survival, more stem cell are obtained from a patients own blood and mixed with the fat. The fat cells are now ready to be reinjected directly under then skin to add volume to the face, restore the oval look, reduce jowling, and iron out the wrinkles to off set the signs of aging.

Fat is already being used to permanently augment the breast or the buttock. I even use the fat to rejuvenate the hands. Transferred fat is also used to increase breast cleavage, rejuvenate and plump the vulva, mons and increase the volume of the vagina for greater sensitivity. The fat is even used to increase the length and girth if the penis.

Read the rest of this entry »

Liposuction gained popularity when my mentor and teacher, Dr Jeffrey Kline, introduced the formula for what can rightly be called the Kline solution. Dr Kline demystified the use of tumescent anesthesia and allowed the cosmetic surgeon to perform liposuction safely, effectively, with minimal risk, blood loss, while allowing for a quick recovery. The technique called for small cannulas and excellent results were routinely obtained for almost all parts of the body.

Since that time, many new instruments came on the scene to try and improve the liposuction procedure. In the case of vaser liposuction, tumescent fluid is injected into the body area being treated and instead of using a cannula to disrupt the fat, vaser liposuction uses ultrasound high frequency vibration to break fat cells apart. Laser assisted liposuction (LAL) simply uses laser energy to liquefy the fat which then has to be removed with a cannula. Smart Lipo made by Cynosure, offers all the benefits of a high quality laser lipolysis system and the benefit of experience in the market. CoolLipo, like other laser lipo systems, uses laser wavelengths to dissolve fat and firm up the skin. CoolLipo is best for small areas and can also be used to tighten the shin. Read the rest of this entry »

A more youthful version of yourself can easily be accomplished without major surgery! We can restore a more youthful face depending on what we wish to change or restore. The facial rejuvenation is more easily accomplished if we divide the face in three parts: the upper, mid face and lower face.

The upper face can be improved by focusing on the eye brows, upper and lower eye lids and crows feet. The lateral eye brows can be elevated with a simple temporal stitch to give gentle lift and open up the eyes. The upper eye lids can be tightened using an ablative laser or a simple blepharoplasty. The puffy lower eye lids (festoons) can be easily eliminated with a percutaneous laser in 15 minutes without any incisions. The fat under the lower eyelids is addressed with a few bursts of the LipoTherme laser beam. The crow’s feet are greatly reduced or eliminated with the skin tightening LipoTherme laser or the Erbium ablative laser or both.

The middle face is not always treated with a full face lift. I use the laser to tighten the facial tissue from the inside followed by a laser to rejuvenate the skin from the outside. The laser can also remove wrinkles and uneven skin pigmentation. Here we can also use the patients own fat to fill in the larger wrinkles resistant to the laser. The mokers lines are also treated by placing the laser beam directly below the skin of the upper lip. Lip augmentation can also be performed with fat transfer or a lip implant. Silhouette sutures, used in Europe to restore the mid face, are placed in less than an hour with minimal down time. The silhouette sutures can be used in combination with the laser that tightens the skin from the inside and a very small and barely visible mini face lift incision.

The lower face can be rejuvenated with liposuction of the neck, chin jowls with the lipolaser not only to melt away the fat but also to tighten the skin. If wrinkles are very pronounced, a small and barely visible incision is made behind the ear to give a beautiful neck lift.

Some people do require a full face lift, which involves gentle restoration of the upper, mid and lower face. These procedures are performed in our surgery center under local anesthesia and, if needed, under conscious sedation. The patient has minimal down time and a quick recovery. All procedures are tailored to the individual needs of the patient.

With the economic crunch causing people across the country to tighten up their belts, it’s not surprising that at-home treatments are growing in popularity as people try to avoid the additional cost of visiting a physician. While people may accomplish a lower price point, they also run a significant risk of harm to themselves.

Injectables such as Botox, Dysport, and Juvederm, as well as dermatological treatments such as chemical peels require special training for proper use, as several women have found out. More and more horror stories are popping up in the media and through my colleagues.

I hear about paramedics, who think that they can handle giving themselves dermal injections since they use needles daily. They use products that claim to be a facial filler to plump up wrinkles. They inject these products under the eyes and near the mouth. They feel fine at first, but the next morning they wake up with huge bags under the eyes and a large pustule on the cheeks.

This DIY practice is extremely dangerous: a few millimeters off, you can puncture your eyeball or hit a blood vessel, possibly causing blindness.

I hear about people buying dermal filler products from some websites that may look legitimate, but are not authorized to dispense prescription drugs. These websites state that the products they sell are similar to Dysport, Botox and other injectables. Customers are instructed to watch a video and start injecting themselves away.

FYI, both Dysport and Botox carry a black-box label, meaning they have a risk of serious side effects. While the risk is low, there is concern that the toxin can spread and cause severe and even deadly respiratory problems. Both products belong only in the hands of trained professionals. Generic products are not approved by FDA, and may contain harmful substances. Beware of  the illegal sale of prescription drugs online, and please do not inject yourself.

Schedule a free consultation to discuss your needs and the options we can offer. Our charges are very competitive and you will have a peace of mind that the procedure is done correctly and by a physician.

We are happy to announce that we have completed the launch of a new web resource for women – DesigningVagina.com. This new web site is dedicated to the rapidly growing field of vaginal cosmetic surgery and genital enhancement. Given the importance of these issues for the well being and sexual life of our patients we thought that this part of the practice deserves special attention.

Our perceptions regarding cosmetic surgery are changing. Breast augmentation, liposuction, facelift and Botox are household words for many Americans. Vaginal cosmetic corrections and enhancements of the appearance may still be new terms but the role these procedures may play in women’s life cannot be underestimated.

There is nothing to be embarrassed or shy about!

Schedule your free consultation to discuss your options.

Dr. Cappiello specializes in the following procedures, which will improve appearance, self esteem, and enhance your sex life:

• Vaginoplasty (vaginal rejuvenation)
• Labiaplasty Minora (labial reduction)
• Labiaplasty Majora
• Clitoral Hood Reduction
• Hymenoplasty (repair of the hymen or revirginization)
• G-spot Enhancement