Monthly Archives: February 2019

Surgical vs. Non-Surgical or Liquid Rhinoplasty

Surgical Rhinoplasty

Traditional rhinoplasty is a surgical procedure performed when fairly large changes to the nose are needed or desired. Surgical rhinoplasty is often performed through an “open approach” where a small incision is made at the base of the nose, but can also be performed through a “closed approach.” Whether open or closed, the nasal bones, cartilage, and musculature can then be changed to produce a more aesthetic result. Surgical rhinoplasty is often performed to refine or reduce the overall size of the nose and, in those cases, involves reductive techniques such as reducing a bump on the bridge of the nose, refining the nasal tip, or making the width of the nose smaller. Although results may take longer to appear, surgical rhinoplasty is the only procedure capable of significantly altering the shape and size of the nose permanently. It is also used to correct internal and functional issues such as breathing impairments. Rhinoplasty surgery is usually performed under general anesthesia and the length of time varies based on the level of complexity and the patient’s desires. Due to the surgical techniques utilized and resulting changes from the procedure, recovery involves more bruising and swelling as compared to nonsurgical rhinoplasty. There is not a predetermined age requirement for a surgical rhinoplasty although it is recommended that a patient reach facial skeletal maturity before considering surgery. This typically occurs around 14 years of age at the earliest for girls and later for boys. The cost of traditional or surgical rhinoplasty varies by region of the country but usually starts around $5,900 to $6,900. A traditional rhinoplasty is the ideal procedure for patients interested in permanently refining the shape and size of the nose in a significant way.

Nonsurgical Rhinoplasty aka Liquid Rhinoplasty

Nonsurgical rhinoplasty, also known as liquid rhinoplasty, is the term given to the alteration of the appearance of the nose using dermal fillers and/or a person’s own fat. In general, liquid rhinoplasty is used to cover or camouflage areas of the nose and is thus used for augmentation or enhancement of certain features. Liquid rhinoplasty can be used to cover bumps, define the tip of the nose, help correct asymmetries, and/or add overall volume. Due to injections occurring within the skin, surgeons are able to contour the nose in a detailed and precise manner. Nonsurgical rhinoplasty does not correct functional issues as the filler or fat is injected only in the superficial layers of the nose and does not impact the nasal passages or airways. General anesthesia is not required for this procedure which allows patients to monitor progress and give personal feedback throughout in order to achieve optimal results. Because the procedure does not involve surgery, results can be seen immediately with practically no down time. Although results are immediate, the enhancements from dermal fillers fade over time and results typically only last for up to two years. While appealing in many ways, nonsurgical rhinoplasty is limited in scope and duration of results. Patients interested in temporarily camouflaging certain aspects or making subtle refinements in the shape of the nose may be a good candidate for liquid rhinoplasty. The cost of a nonsurgical rhinoplasty varies, but averages around $500-$700 per syringe of dermal filler used. The price of a liquid rhinoplasty using liposuction and fat transfer varies significantly depending on if the procedure is performed under local or general anesthesia, the amount of liposuction performed, and other associated procedures.

If you would like more information on either surgical or nonsurgical rhinoplasty, call today to schedule a consultation with Dr. Traci Temmen in Tampa, Florida. During the consultation you will have a chance to discuss your areas of concern and decide which treatment option is best for you!

What is a Board Certified Plastic Surgeon

As a patient deciding to have plastic surgery for the first time, it can be overwhelming and confusing when trying to find the right surgeon. A variety of factors contribute to a patient’s decision on who to trust to perform their surgery. Although surgical experience, personality, training, and reliable references are all important factors to consider, board certification by the American Board of Plastic Surgery may be the most important of all. This is often times where patients are misled as there is a significant difference in the meaning of a physician who is “board certified” versus one who is board certified by the American Board of Plastic Surgery.

Plastic surgery is focused on achieving a more desirable appearance and therefore procedures can create a life-long impact. In order to make an informed decision regarding the right plastic surgeon based on your needs and desires, it is important to understand what it truly means to be a board-certified plastic surgeon. The United States has very few legal limitations regarding the types of procedures a physician can perform as well as how these procedures can be advertised. This legal loop hole allows for any kind of doctor to perform plastic surgery procedures without any formal training! Furthermore, if a doctor is certified in their respective field (i.e. Ob-Gyn, Emergency Medicine, Internal Medicine, etc…), that doctor can “truthfully” say that they are “board-certified.” Granted, that doctor is not board certified in Plastic Surgery, but they conveniently leave that part out! Finally, there are many “made-up,” legitimate-sounding boards that allow any practitioner to be a member for a fee (of course) and intentionally mislead patients into thinking they are being treated by a board-certified plastic surgeon. California has recently taken legal action against one of these “made up” boards and their false advertising:

Wednesday, December 19, 2018- Taken from the American Society of Plastic Surgeons Website

Today, the Medical Board of California (MBC) took a major step to protect patients in the state when it unanimously voted against allowing members of the American Board of Cosmetic Surgery (ABCS) to advertise as “board certified” cosmetic surgeons. ASPS is proud to have worked in advance of this vote to educate the MBC and show that ABCS certifications are not backed by a level of training that puts them on par with American Board of Medical Specialties (ABMS) member boards.

“This is, frankly, a tremendous relief. California has a large number of cosmetic surgery patients and the most ABCS members of any state, which means it holds the greatest potential for those patients to be misled by advertisements that a doctor is a ‘board certified cosmetic surgeon’,” says ASPS President Alan Matarasso, MD, FACS. “Today’s ruling means those patients are less likely to choose a particular provider because they were exposed to a confusing ad. That’s going to make patients safer. Our specialty owes a huge debt of gratitude to all the plastic surgeons who invested their time and talents to help protect our patients.”

Today’s ruling closes the book on a two-decades-long story. In 1996, California law was changed so that the state’s physicians could only advertise ABMS certifications, unless a non-ABMS board was specifically reviewed and deemed equivalent to an ABMS member board by the MBC. ABCS has applied for equivalency under this process multiple times, and the MBC has repeatedly found that ABCS falls short of the state’s standard that requires their training programs to be equivalent in scope, content, and duration to training accredited by the Accreditation Council for Graduate Medical Education (ACGME).

While ABCS has previously had the option to re-apply, that is no longer the case. In 2018, California changed its board certification law and eliminated the MBC’s equivalency review process as of Jan. 1, 2019. As a result, ABCS cannot apply again and force the MBC to reconsider today’s decision.

The American Board of Medical Specialties (ABMS) is the national agency that regulates sub-specialty boards. Only those that have completed a residency in plastic surgery, underwent at least five to six years of rigorous training, and have taken a written and oral plastic surgery board examination are qualified to obtain plastic surgery board certification. The American Board of Plastic Surgery is the only plastic surgery board recognized by the ABMS that has the ability to evaluate the level of skill and training of plastic surgeons. Every surgeon that completes a plastic surgery residency and becomes board certified is trained to perform a full range of reconstructive and aesthetic procedures. Due to the high level of education and extensive training required to achieve board certification in a sub-specialty, board certified plastic surgeons are more qualified and more likely to provide you with optimal results.

Dr. Traci Temmen in Tampa, Florida went to medical school for four years at the University of Pennsylvania School of Medicine. Following graduation, she moved to Tampa, Florida to continue her training in an integrated plastic surgery residency for six years. She has been in private practice since 2011 and is a proud member of the American Board of Plastic Surgery.

Brazilian Butt Lift Safety

If you follow many plastic surgeons on social media or listen to the news, you will have heard recent safety concerns about the Brazilian butt lift surgery, also known as the BBL. A Brazilian butt lift generally refers to liposuction of the trunk with transfer of the harvested fat to the buttocks and hips to create a curvier, more voluminous buttocks. Unfortunately, if not performed correctly by an experienced, board certified plastic surgeon, the fat transfer portion of the Brazilian butt lift can be deadly. Fat injected deep into the gluteal muscle can inadvertently enter the deep veins of the pelvis. Once in this large vasculature system, fat globules can cause fat emboli in the lungs and even death.

Many surgeons and patients are now asking then, “Is the BBL safe?” The answer is yes. the Brazilian butt lift is a safe surgery if performed by a safe plastic surgeon. So, what do plastic surgeons do to make the BBL a safe surgery and take the best care of their patients? Most importantly, fat should not be injected deep into the buttocks and is only transferred into the subcutaneous layer above the gluteus muscles. Additionally, the fat should be injected with blunt cannulas with constant attention paid to exactly where the injecting instrument is located. Finally, proper patient positioning, tactile control of the instruments, and transferring the fat under low pressure all ensure optimal patient safety.

Because of this concern over the safety of the Brazilian butt lift surgery (and the fact that the BBL neither originated in Brazil nor actually “lifts” the buttocks), some plastic surgeons have started to refer to this procedure as Safe Subcutaneous Buttock Augmentation, or SSBA. This name highlights the fact that when performed correctly, with fat transferred only in the subcutaneous layer, this surgery can safely and efficiently augment the buttocks and hips.

Dr. Traci Temmen in Tampa, Florida is just as concerned about her patients’ safety as they are. She performs each Brazilian butt lift with meticulous attention to detail, safety, and aesthetics. She monitors everything in the operating room, right down to the thermostat setting, to guarantee her patients the safest, most beautiful result possible. Dr. Temmen routinely attends plastic surgery conferences where BBL safety is a core topic and stays up to date on the most recent BBL literature to ensure she is at the forefront of this evolving surgery. If you are interested in a safe Brazilian butt lift, call Dr. Traci Temmen today at 813-771-6393.

Labiaplasty vs. Vaginal Rejuvenation

While labiaplasty and vaginal rejuvenation are both surgical procedures of the female genitalia, they differ in several ways. Labiaplasty surgery is designed to reduce the size of the labia minora in order to decrease discomfort and improve cosmesis. Vaginal rejuvenation surgery is a reconstructive procedure that tightens the vaginal opening and vaginal canal.

Labiaplasty

The labia minora are located inside the labia majora and consists of two folds of tissue surrounding the opening of the vagina. Just like breast size or height, the labia minora can be enlarged or asymmetric from birth or may develop these changes gradually over time. Regardless of the reason, an enlarged or asymmetric labia minora can result in painful intercourse, difficulty finding comfortable exercise clothing, irritation of the groin area, and dissatisfaction with the overall external appearance. Labiaplasty is the surgical reduction in size or adjustment of appearance of the labia minora. It is used to improve external appearance, correct asymmetries, and/or address discomfort experienced during exercise, sex, walking, sitting, and other activities of daily living.

Dr. Traci Temmen usually performs labiaplasty surgery under local anesthesia as in in-office procedure. Patients can drive themselves to the office, drive home, and the surgery itself takes about 30-45 minutes. Clitoral hood reduction, double fold excisions, perineoplasty, labia majora reduction, and fat transfer to the labia majora can often be done at the same time. The recovery time for labiaplasty is relatively quick; patients can resume normal activities and return to school or work after approximately 2-3 days and sexual activity after 6 weeks.

Vaginal Rejuvenation – Vaginoplasty – Vaginal Tightening

Vaginal rejuvenation, also known as vaginal tightening or vaginoplasty, is a surgical procedure that tightens the muscles of the vaginal wall and decreases the size of the vaginal opening. Many women seek this procedure after vaginal deliveries or the natural effects of aging on the pelvic floor. These patients often complain of a lack of friction during sex, tampons “falling out,” and a sensation of vaginal gaping or widening. After undergoing vaginal tightening patients note increased sensation and friction during sex as well as a feeling of greater core tone.

Dr. Traci Temmen performs vaginal rejuvenation under general anesthesia in the operating room and takes about one to one and a half hours to perform. Patients go home the same day, may return to work within two to three days, and can resume exercise and sexual activity after six weeks.

The cost of labiaplasty procedures typically start at $3,900 while vaginal tightening starts at $6,900; these prices may vary depending on the level of difficulty, any associated procedures, and anticipated time in the operating room. Most health insurance plans do not cover either procedure but Dr. Temmen has a variety of payment options to accommodate your financial needs. Regardless of your areas of concern or discomfort, Dr. Traci Temmen will strive to achieve the results you desire, both functionally and aesthetically.