Disclosures. About Me. Plastic Surgery: The Science of Aging, The Art of Restoration. William A. Wallace, MD FACS. Fleming Island Plastic Surgery
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1 Plastic Surgery: The Science of Aging, The Art of Restoration William A. Wallace, MD FACS Fleming Island Plastic Surgery Disclosures Lattice Biologics, Scottsdale AZ Scientific Advisory Board Member About Me (William A. Wallace, MD FACS Plastic Surgeon)
2 Key Points Plastic Surgeon misconceptions Plastic Surgery Scope of Practice Common patient complaints warranting a Plastic Surgery evaluation Emerging procedures in Plastic Surgery
3 Plastic Surgeons What s in a name? πλαστικός Plastikos: Greek - To shape or mold Misconceptions A Cosmetic Surgeon is a Plastic Surgeon Facial Plastic Surgeon, Occuloplastic Surgeon, Potatoe/Potato Board Certifications/Memberships are all the same
4 Misperceptions PLASTIC SURGEON What my friends think I do What my patients think I do What my mom thinks I do What I think I do What society thinks I do What I really do
5 Plastic Surgery Trends (2015) Top 5 Surgical Procedures in 2015 Liposuction (396,048 procedures) Breast Augmentation (305,856 procedures) Tummy Tuck (180,717 procedures) Eyelid Surgery (169,708 procedures) Breast Lift (148,967 procedures) Top 5 NON-Surgical Procedures in 2015 Botulinum Toxin (4,267,038 procedures) Hyaluronic Acid (2,148,326 procedures) Hair Removal (1,136,834 procedures) Chemical Peel (603,305 procedures) Microdermabrasion (557,690 procedures)
6 Most significant increases between 2014 & 2015 SURGICAL Buttock Lifts (up 32%) Male Breast Reduction, for the treatment of Gynecomastia (up 26%) Buttock Augmentation (fat transfer/implants) (up 21%) Neck Lift (up 17%) Labiaplasty (up 16%) Most significant increases between 2014 & 2015 NON-SURGICAL Non-Surgical Skin Tightening (up 58%) Tattoo Removal (up 39%) Hair Removal (up 37%) Microdermabrasion (up 33%) Photo Rejuvenation (IPL) (up 30%) Wound Healing St. Vincent s Clay Wound Center
7 Hyperbaric Oxygen Therapy Adjunct to traditional wound healing 100% oxygen at 3 ATM of pressure Equivalent po2 2280mmHg Daily treatments depending on condition 2-3 hours/treatment treatments Hyperbaric Oxygen Indications Carbon Monoxide Poisoning Cyanide Poisoning Osteoradionecrosis Decompression Sickness Compromised Grafts/Flaps Arterial Gas Embolism Necrotizing Fasciitis Compromised Amputations Acute Traumatic Ischemic Injury Chronic Refractory Osteomyelitis DFU Soft Tissue Radionecrosis Acute Peripheral Arterial Insufficiency Crush Injuries
8 Pressure Ulcer Aging Non Surgical Options Facial Aging
9 Botox You already know about Botox Skin Aging Obagi System Retinoic Acid Hydroquinone Facial Resurfacing Laser Chemical Peel Dermabrasion (not MICRO!) Midface Aging - Volume Loss Skeletal not soft tissue deficit Voluma Radiesse Fat
10 Voluma Microneedling Skinpen Microinjury to skin layers Scar formation (i.e., collagen) in dermis No scarring of epidermis 3-6 treatments for maximum results Acne, fine lines, sun damage
11 Skinpen Neck Aging Non Surgical Options Kybella Deoxycholic Acid Dissolves Lipids Injected into preplatysmal fat
12 Hand Aging Non Surgical Options Hand Aging Radiesse NonSurgical Fat Removal
13 Coolsculpting Cryolypolysis minutes/area Results in 8-16 weeks Coolsculpting Complication Paradoxical Adipose Hyperplasia (PAH) Originally reported incidence: 1/20,000 (0.0051%) Recent studies suggest 2/422 (0.47%) 1 1 Singh, S. M., Geddes, E. R.C., Boutrous, S. G., Galiano, R. D. and Friedman, P. M. (2015), Paradoxical adipose hyperplasia secondary to cryolipolysis: An underreported entity?. Lasers Surg. Med., 47: doi: /lsm SculpSure Laser Lipolysis (1060nm) 25 minute/treatment Results in 6-12 weeks Zero incidence of PAH Can actually use to treat PAH
14 Hair Removal Alexandrite Laser Eliminates actively growing follicles Requires 4-6 treatments Tattoo Removal Q Switched YAG laser Green and White Inks difficult Typically requires 4-6 treatments
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