Yearly Archives: 2017

Breast Lift vs. Breast Augmentation

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There are two primary reasons women seek to make cosmetic changes to their breasts: They want smaller breasts to be larger or they want sagging breasts to sit higher on the chest—or sometimes both. Each goal is accomplished by a different type of breast surgery. Toronto based cosmetic plastic surgeon Dr. Wayne Carman performs both augmentation and lifts, and seeks to guide his patients in determining which procedure or combination of surgeries is best suited to deliver the desired results.

Breast surgery to augment the breasts involves the insertion of an implant to add volume. Varying implant shapes and styles allow for customization that can determine the ultimate feel and fullness of the breast. The most important characteristic of an implant is the volume though using an appropriate shape and style can enhance the final result as well.

An increase in volume makes breasts appear larger, but drooping breasts with downward-pointing nipples will continue to sag. Implants can actually contribute to this look, as added weight can further pull down breasts, especially for women whose skin is particularly lax.

A breast lift or mastopexy removes excess skin and tissue to position the breasts higher on the chest with the intent of creating a perkier, more youthful silhouette. This procedure may also involve surgically repositioning the nipples so that they point upward and outward instead of down. Since tissue is being removed, a lift does not increase breast volume, and so will not cause them to appear larger.

For some women who desire an increase in volume, especially those with healthy skin and significant projection, augmentation surgery is enough to give them the look they want. Others are happy with a lift alone. Still others may consider combining the two in order to gain both volume and projection. This is not uncommon for women who have had one or more children who nursed, since childbearing and lactating can cause breasts to lose volume as well as sag over time.

In some cases, only one breast may require surgery in order for the patient to maintain a look of symmetry. Dr. Carman also performs breast reduction, which may be used to help with balancing asymmetries, reducing volume to combat the pull of gravity which may cause shoulder and neck pain or simply to help a woman who wants to change her proportions so that clothes fit better.

To schedule a consultation to determine an ideal breast surgery procedure—whether a lift, augmentation, or both—call the Cosmetic Surgery Institute in Toronto at (416) 322-7108 or 1-888-451-1140. You may also visit drcarmanplasticsurgery.com.

What to Know About Cosmetic Surgery Before-and-After Photos and Visual References

General, Plastic Surgery

When patients are considering cosmetic surgery, it is common for them to seek out before-and-after photos of people who chose the same procedure. While this is an ideal way to get a sense of possible cosmetic surgery results, Toronto based Dr. Wayne Carman cautions anyone looking at such images to remember that no two surgeries are alike. Surgical results cannot be precisely duplicated or replicated from one person to another.

A patient’s ultimate look depends upon a wide range of factors, including his or her unique anatomy, the procedure or procedures performed, the surgeon’s skill and preferred techniques, the healing process, and more. When considering breast augmentation, for example, the same size implants will look different on a short, thin woman than they will on a tall, heavier woman. This is why a surgeon cannot simply give you the exact look of a celebrity’s nose or a friend’s toned belly. What works aesthetically for other people does so because it complements their features as a whole.

In other words, while a long, thin nose may look elegant on your favorite movie star’s face, the same look might be completely incongruous on your own.

What before-and-after photos can do is give the viewer a good idea of the types of results available, both generally and from a specific surgeon. Women interested in breast augmentation, for example, may browse images to see how the various shapes and styles of implants change the breasts once inserted. Rather than a template to be “copied and pasted,” however, the photos reveal what is possible. Photos provided by a specific surgeon will also provide a library of that surgeon’s results, revealing how well scarring is camouflaged and other details.

Anyone seeking to browse before-and-after photos should try to find patients who resemble their own body as closely as possible in terms of height and build for body-focused procedures and facial structure for face-focused surgeries.

When it comes to expectations, Dr. Carman works with each patient as an individual, explaining what a particular procedure can and cannot do and making recommendations based upon that unique patient’s anatomy, goals, and other variables. Learn more by scheduling a consultation at the Cosmetic Surgery Institute in Toronto by calling (416) 322-7108 or 1-888-451-1140. You may also visit drcarmanplasticsurgery.com.

BOTOX®: Yesterday, Today, and Tomorrow

BOTOX

Though it’s now a globally popular household name, that has not always been the case for BOTOX® Cosmetic. Toronto area cosmetic plastic surgeon Dr. Wayne Carman has watched over the years as the injectable first arrived on the market, was treated by the media as a curiosity, then surged forward in popularity to become the most frequently administered cosmetic treatment each year around the world.

BOTOX® has roots that stretch back long before that. We have to look as far back as the late 19th century when a researcher first linked cases of food poisoning in Belgium to a specific bacterium: Clostridium botulinum. For six decades after this discovery, scientists studied the microorganism and its ability to paralyze muscles in the human body—a dangerous condition when it develops unintentionally, but a potentially beneficial one if applied with precision in a medical setting.

In 1981—just shy of 100 years after the initial Clostridium botulinum discovery— the U.S. Food and Drug Administration-approved trials culminated in an announcement from an ophthalmologist who had determined that injections of the bacterium could safely and effectively treat strabismus, which is a muscle imbalance causing crossed eyes and squints. An FDA approval for that treatment followed, as did another for injections to calm uncontrolled blinking.

Clostridium botulinum quickly became a go-to answer for conditions marked by involuntary muscle movement. Trials and FDA approvals continued. By 2016, the injectable now known as BOTOX® was regularly used to treat neck spasms and upper and lower limb spasticity. In addition, it was also found to positively impact excessive underarm sweating by preventing sweat glands from producing moisture. It has also found a place in the treatment of bladder overactivity and chronic migraine headaches. In that time, it also landed approvals for two cosmetic uses: smoothing forehead frown lines and crow’s feet caused by repetitive muscle movement.

Research into new applications continues to this day, with reports in 2017 of scientists exploring the possibilities of using BOTOX® to treat mood. Early research seems to indicate a link between injections and a reduction in symptoms of depression.

Learn more about what BOTOX® can do and how it works. Schedule a consultation at the Cosmetic Surgery Institute in Toronto by calling Cosmetic Surgeon Dr. Wayne Carman at (416) 322-7108 or 1-888-451-1140. You may also visit his practice’s website at drcarmanplasticsurgery.com.

Upper Vs. Lower Eyelid Surgery

Blepharoplasty, ,

Dr. Wayne Carman has discussed blepharoplasty in general before on this blog, but there are a few finer points to consider when it comes to upper versus lower eyelid surgery. Toronto women and men who choose a blepharoplasty procedure may be seeking to address sagging on the top, puffiness on the bottom, or both for an overall look of rejuvenation.

Upper eyelid surgery focuses upon problems with skin that has lost its elasticity. Laxity can cause a perennial look of tiredness or convey negative expressions such as anger or sadness. If severe enough, it can even impinge upon a person’s field of vision.

The point of upper lid blepharoplasty is to tighten this area, restoring a more naturally alert look. To do this, Dr. Carman hides the incisions in the folds of the upper eyelids, using this approach to access the internal structures and remove tissue as well as reposition muscle as necessary.

Lower eyelid surgery addresses a similar problem, but with different consequences. As lower lid tissue grows lax, it also sags—but whereas upper lids hang down to increasingly obscure the eyes, lower lids pull away to expose the underside of the eye. Also, fat pouches beneath the eye can become pronounced, creating puffy bags that contribute to a tired, aging appearance.

A lower lid blepharoplasty also involves removing tissue—including excess skin and fat—and tightening the area to give it a firmer, more contoured look. The incision for this procedure is typically made on the inside of the lid or just under the lash line to avoid leaving any visible scars.

Patients seeking improvement may choose to deal with the upper lids, the lower lids, or both at the same time.

Learn more about eyelid surgery in Toronto by calling Plastic Surgeon Dr. Wayne Carman at (416) 322-7108 or 1-888-451-1140, or visit www.drcarmanplasticsurgery.com.

Implant Size is Not Cup Size

Breast Augmentation,

There are a lot of numbers that women need to know in relation to their breasts, with one of the most important being bra size. Determining the right size is key to getting proper support and a comfortable fit that looks and feels good. Some women who choose to get breast augmentation believe they can choose a larger bra size and use that number to determine the size of their breast implants. Toronto plastic surgeon Dr. Wayne Carman explains that the two numbers are not the same—and the best way to determine ideal implant size is to work with a plastic surgeon who is experienced in breast augmentation surgery and who has a history of satisfied patients enjoying natural results.

Bra size is actually determined by a formula that involves a woman’s bust size (the measurement taken around the entire body, including the fullest part of the breasts, but not the arms) minus her band size (the measurement taken around the body and across the ribcage, just under the bust). The resulting number can be used to reference a chart of bra sizes, which start with AA at the smaller end and work their way up through the alphabet.

The problem is that just about every manufacturer sizes its bras a little differently, leading to differences across the board. A woman may find that one size fits her well in one brand, but is too tight or loose in another brand.

Breast implants, however, are sized by volume, measured in cubic centimeters. Implant volume is a far more important number for accurate implant sizing, as it only indirectly relates to cup or bra size. Breast implants are also sized by diameter, which should be roughly the same size as or slightly smaller than the width of the breast.

This may sound like a lot of math and figures to understand, but this is what a consultation and pre-operative meetings are for. Dr. Carman works closely with all of his patients to help them understand exactly how implants are sized and to work with him in determining the ideal implant for each unique situation.

Learn more about planning breast implant surgery in Toronto by calling Plastic Surgeon Dr. Wayne Carman at (416) 322-7108 or 1-888-451-1140, or visit www.drcarmanplasticsurgery.com.

How Do Fat Injections Compare to Fillers?

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Volume loss is a frequent contributor to visible signs of aging. Round, youthful contours can gradually give way to harsher, more angular planes as collagen and hyaluronic acid diminish in the skin and facial fat decreases and shifts. On the face, this loss can manifest as hollowness of the cheeks and thinning around the mouth and the lips. The contour changes can even lead to sagging that causes jowls to form. For patients in the Toronto area, plastic surgery is one solution.

Injectable dermal fillers have grown in popularity in recent years, with formulas based upon elements that occur naturally in the body. While the volume and other benefits they provide offer a temporary solution, Dr. Wayne Carman has found that better results come from injections of a patient’s own fat.

Fat injections involve a plastic surgeon removing fat from a donor area—typically a place where excess fat is available in some abundance, such as the hips or belly. If carefully extracted and processed, this fat is what Dr. Carman considers to be the ideal material for adding volume.

Once separated from other liquids and concentrated, the fat can be used for everything from restoring full cheeks to subtly giving lips a boost to modestly augmenting breasts.

After the injection process, the relocated fat needs a couple of months to settle into its new home in the body. Once it does, it can be expected to remain permanently —far longer than the months offered by many dermal fillers.

Dr. Carman prefers fat transfer to fillers at his Toronto plastic surgery practice because of the versatility and natural looking results of this technique. When fat is taken from a patient’s own body, it means there are no foreign materials, allergy concerns, or similar risks.

Learn more about fat transfer in Toronto by calling Plastic Surgeon Dr. Wayne Carman at (416) 322-7108 or 1-888-451-1140, or visit www.drcarmanplasticsurgery.com.

Enhance a Facelift with BOTOX® in Toronto

Face Lift, ,

Cosmetic surgical procedures and nonsurgical treatments may seem like opposites, but in fact are quite complementary. While some patients choose injectables because they are not ready for a more involved surgery, others want the long-lasting improvements that surgery offers. The truth is that each tactic offers unique benefits when properly planned.

Take, for instance, a facelift and BOTOX® Cosmetic. Toronto plastic surgeon Dr. Wayne Carman makes both available at his practice, so he understands what they can do alone or together as part of a treatment plan.

The two cosmetic options are different. A facelift focuses upon the lower portion of the face – cheek, jawline and neck. It often involves fat removal, eliminating excess skin, and tightening deeper tissues to create a tighter, more defined jawline and neck.

BOTOX®, meanwhile, more often focuses upon the upper portion of the face, relaxing muscles in the forehead and to the side of either eye to prevent the contractions that cause pronounced crow’s feet and frown lines to appear.

The effects of a surgical facelift are immediate, and the improvements are permanent. BOTOX® injections offer skin-smoothing results that develop over days and last for months as facial muscles are kept in a relaxed state. The effect gradually wears off after which motion returns to the muscles and dynamic wrinkles begin to re-appear.

Though BOTOX® is administered by injections in a matter of minutes and a facelift is an extensive surgical procedure, the two can be used in tandem to give an overall rejuvenated look. The wrinkle-smoothing effects of injectable BOTOX® can help to smooth the upper face while a facelift has its main effect on the lower half.

Plastic Surgeon Dr. Wayne Carman can explain more about how BOTOX® can enhance a facelift at his Toronto practice. Call (416) 322-7108 or 1-888-451-1140, or visit www.drcarmanplasticsurgery.com.

Dr. Carman Explains Forehead Lift vs. Eyelid Surgery in Toronto

Plastic Surgery, ,

An alert, attentive expression is a positive thing—especially when compared to the alternative of a tired-looking face that conveys disinterest and exhaustion. The eyes are a particularly important feature in this, which is why sagging of the upper half of the face can be a problem. A forehead lift can address a drooping brow, while lax upper and lower eyelids can be corrected with eyelid (blepharoplasty) surgery. Toronto plastic surgeon Dr. Wayne Carman performs both procedures, emphasizing their different, but complementary benefits to patients who want to know more about each.

Identifying the cause of unwanted drooping is key to correcting the problem, since cosmetic issues that originate in the brow will not be altered by eyelid surgery, and vice-versa.

Aging causes the forehead to develop wrinkles and furrows, and eyebrows can appear heavier over time. Through small, judiciously placed incisions behind the hairline, Dr. Carman uses endoscopy techniques to work beneath the forehead skin to lift and re-contour the brow area for a smoother elevated look.

As time passes, gravity and skin laxity also takes its toll on the eyelids, causing the upper lids to sag and crinkle and lower lids to pull away from the bottom of the eye. Fat beneath the skin can also form pouches beneath the eye, creating a puffy, tired look.

Eyelid surgery, more properly known as blepharoplasty, can be performed on the upper lids, lower lids, or both. Upper eyelid surgery involves removing and tightening tissues to create a smoother contour. This procedure may even help to improve vision, if the sagging skin was sufficient to cause a physical obstruction to sight.

Lower eyelid surgery also involves tightening tissues, and is done in a way to preserve the natural protective coverage of the eye itself. Fatty pouches are often repositioned or removed as necessary.

Blepharoplasty and a forehead lift procedures can be performed individually, or they may be combined for ideal facial rejuvenation. Some patients may also choose to address the dynamic wrinkles on the sides of the eyes and on the forehead with BOTOX® injections, further improving their youthful, rejuvenated look.

Learn more about the options for rejuvenating the upper face—including a forehead lift and eyelid surgery—in Toronto by calling Plastic Surgeon Dr. Wayne Carman at (416) 322-7108 or 1-888-451-1140, or visit www.drcarmanplasticsurgery.com.