Dr. Levens' Parkland Life Magazine Articles

The Questions You’re Asking...about Cosmetic Surgery
By David J. Levens, MD, PA, FACS

Rather than focusing on a specific procedure or treatment, this month’s column will answer some of today’s most frequently asked questions about cosmetic surgery. 
           
Q.  How young is too young for breast implants or nose reshaping? 
A.  For implants, preferably 19 or 20 so the patient is mature enough both physically and emotionally to make such a major decision.  When reshaping the nose, the goal is to bring the nose into balance with other facial features, so those features really should be fully mature before surgery.  At 15 or 16, they usually are.
           
Q.  Is there any way to get rid of those awful “hanging wings” on my upper arms without being left with long, ugly scars?
A.  If the amount of skin to be removed is very minimal, the incision can be hidden in the armpit.  If there is considerable excess skin (usually the case if the hanging skin has been caused by massive weight loss or aging), long incisions on the upper arms can’t be avoided. Although the scars can be quite long, they can be made less conspicuous with careful attention to the location and repair of the incision.   There are also highly effective scar reduction treatments on the market.
           
Q.  Where are incisions made for a thigh lift? Can the patient walk afterwards?  Are both legs done at one time?
A.  Often, the only incision is made in the crease between the upper thigh and groin and the scar can be concealed under a bathing suit.  In a patient following massive weight loss, it may also be necessary to place incisions along the inside of the thigh which has the potential for more significant scarring. Both legs are done at one time.  Patients are encouraged to get up and walk right away but complete recovery can be lengthy, especially before any vigorous activities are permitted.
           
Q.  I know a facelift often has to be repeated after 12 or 15 years, but is the same true for a tummy tuck? 
A.   No.  A tummy tuck is generally considered to be a permanent procedure, unless the patient has a very major weight fluctuation after the surgery, either from pregnancy or simple weight gain.  In such cases, the skin and/or muscles may become stretched again and revision surgery would be needed to restore the flat abdomen achieved during the initial surgery.  Patients should postpone a tummy tuck if they are considering another pregnancy and ideally be at their ideal, sustainable weight.
           
Q.  How do I know if I need a liposuction on my stomach or a tummy tuck?  
A.  Generally, if you have a belly bulge, but good abdominal muscle tone and no excess, hanging skin, liposuction alone might do the job. It can reduce fat in the area, prevent fat from accumulating in the same place in the future and is much less invasive than tummy tuck.  But if you have weak muscle tone and hanging skin, which is usually the case after pregnancy or major weight loss, you’ll need a tummy tuck.  During the surgery, the abdominal muscles are tightened and excess skin is removed.  Sometimes, liposuction is performed at the same time to remove excess fat and sculpt the entire area.
           
Q.  If I have liposuction on my hips, can the fat taken from there be used to fill wrinkles on my face?
A. Definitely.  A patient’s own fat is a very good soft tissue filler. Like Restylane, fat injection is not permanent and may need to be repeated for optimal wrinkle reduction. 
           
Q. With all the new wrinkle fillers and facial treatments on the market, are facelifts becoming passé?
A.  Facelift surgery is still the only long-term way to remove hanging, excess skin. However, new products and treatments are helping people postpone surgery or achieve acceptable improvement without it.  Fillers like Restylane and Radiesse not only fill wrinkles but restore volume which can sometimes create a “lifted” look.  Treatments such as microdermabrasion, intense light treatments, peels and others can dramatically improve skin quality and restore it to a more youthful look.  However, all such treatments must be repeated on a regular basis to achieve and maintain results. Over time, non-surgical treatments can become comparable in cost to a facelift which typically lasts 7-10 years.
           
Q.  Can eyelift and browlift be done at the same time and how long before I could return to work? 
A.  Both out-patient procedures are often done at the same time and recovery schedules are similar.  For 7-10 days after a browlift, there is forehead tightness and possibly mild headache.  Both resolve as swelling decreases. Numbness of the scalp can persist in small areas but will gradually improve.  After eyelid surgery, there is very minimal discomfort and some swelling for the first 5-7 days.  For either procedure, patients return to work and social activity in 7-14 days. Aerobic activity should be avoided for 2-3 weeks.  Patients generally do not drive for one week after eyelid surgery or until all swelling is gone and vision has returned to normal.  It is also imperative to avoid sun exposure.

Interested in seeing past articles? See our archived Parkland Life Articles page.

David Levens, MD, PA, FACS has been practicing cosmetic surgery in Coral Springs since 1989.  In addition to his private practice at 1725 University Drive, Dr. Levens has served as Vice Chief of Staff and Chief of Surgery at the Coral Springs Medical Center. He is Certified by the American Board of Plastic Surgery and is a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons.  Dr. Levens has been cited repeatedly in Miami Metro Magazine’s annual lists of “Best Doctors in South Florida”.  He earned his medical degree at Columbia University, New York, and served residencies in general surgery and plastic surgery at Montefiore Hospital & Medical Center, New York.  He lives in Coral Springs with his wife, Linda, and their two children, Danielle and Ben. He can be reached at 954-752-1020 or www.DrLevens.com