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Ask The Experts: John M. Taylor
09/19/2007
John M. Taylor, MD, FACS
Allure Plastic Surgery Center
Long Branch, NJ
732-483-1800
John M. Taylor, MD, FACS is owner and director of Allure Plastic Surgery Center, where he offers the latest trends in plastic surgery, among a wide range of cosmetic and reconstructive procedures. He is considered by many in the area to be one of the most truthful and compassionate surgeons in Monmouth County, and he has graciously agreed to present us with his insight, and answer many of the common questions people have but haven’t had the opportunity to ask.
Is it true that silicone gel breast implants are back on the market?
Yes. Score one for the FDA! After almost 15 years of studies, the FDA concluded that silicone gel implants are safe for both cosmetic and reconstructive breast surgery. As of now, for cosmetic patients, they are indicated for women 22 years of age and older or any woman undergoing post-mastectomy reconstruction. The newer ones have a more durable outer shell, which is less prone to rupture, and a “cohesive” gel fill that doesn’t migrate if the implant does rupture. Although saline-filled implants are still an excellent option (and widely used), gel implants have a softer, more natural feel.
What options are available to women looking for breast reconstruction following mastectomy?
They generally fall into two categories: implants used for reconstruction, and the use of a woman’s own tissue, or “autologous” reconstruction. Implant reconstruction is usually done in stages, first by placing a temporary implant, known as a tissue expander, under the skin and muscle at the time of mastectomy. It is used to gently and gradually stretch the tissues [over several weeks] back to a desired breast size, and is replaced with the permanent breast implant during a second surgery. Alternatively, skin and muscle from the back (the latissimus dorsi flap) can be used to replace the missing tissue, along with an implant in a single- stage procedure; however, my personal preference is to use this as a “fallback” procedure in reconstructed breasts damaged by radiation therapy. For women desiring autologous reconstruction, the TRAM flap is still the mainstay. This uses tissue from the abdomen that would normally be discarded with a “tummy tuck” and uses it to shape a new breast. In our practice, we now also perform a cuttingedge version of the TRAM flap known as the DIEP, or Perforator Flap – a microsurgical technique that spares the rectus abdominus muscle, thereby lessening the risk of hernia or abdominal bulge, and making it a desirable alternative for active women. All techniques can be followed by nippleareola reconstruction to complete the new breast.
What are some non-surgical alternatives available today for facial rejuvenation, to avoid invasive facial cosmetic surgery?
Currently we see so many men and women because there are so many options to rejuvenate the face without all of the downtime, risk, and expense of major surgery. Some involve good skincare plus, perhaps, chemical peels, microdermabrasion, or photo-facials to tighten the skin. Soft tissue fillers are used to fill in lines and wrinkles or to augment the lips, while Botox Cosmetic® is used to weaken muscles that cause the “dynamic” wrinkles of the face. I even have patients in their twenties who are coming in for Botox Cosmetic® now to help prevent the wrinkles from forming! One particular filler has been so effective in subtly restoring youthful volume to the face that some are calling it the “liquid facelift.” One last word – sometimes surgery is necessary to achieve the desired results. An advantage to seeing a plastic surgeon, even for non-surgical rejuvenation, is that you’re apt to get an honest opinion from someone who has “all of the tools in his toolbox.”
I’ve lost a lot of weight and I feel great, but what can I do now about all of this loose skin?
“Post-bariatric body contouring” is one of the fastest-growing areas of plastic surgery. Although tightening and lifting procedures are available from almost head to toe, television has unfortunately glorified the “extreme makeover.” My sincerest advice to anyone embarking on a new “svelte” life is doing the surgery in multiple stages to make it as safe as possible so you and your loved one can enjoy your new body!
All of the skincare products sold at the doctor’s office…aren’t they just fancy versions of what I can get at the department store?
Products you see in a physician’s office may contain prescription drugs and cannot be sold in a retail store. The store products are often just expensive moisturizers. At Allure Plastic Surgery we offer the Obagi® line of skincare products, which, in my opinion, do an amazing job of correcting damage and restoring health to the skin.
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