Many of the women that I see who are seeking breast augmentation are very well informed about the many different sizes and styles available in breast implants, whether they are simple saline, silicone, or the new form-stable gummy bear implants.  Far fewer, however, are aware of the impact that the specific surgical approach, including implant placement and incision choice, can have on the final breast augmentation results.

One important early decision that needs to be made involves where the implant will be placed, specifically whether it will be underneath or over the chest muscles.  Placing the implants above the muscle, just under the skin and glandular tissue, is a less invasive procedure, involving less post-operative discomfort and downtime.  It also typically creates a fuller appearance and more pronounced cleavage.  However over-the-muscle implants may have a less natural look, particularly in women who started with only minimal breast tissue.  Additionally, any rippling caused by imperfections in the implant itself will be more readily apparent when the implant is covered only by a thin layer of skin.  While placing the implants beneath the muscle requires more invasive surgery, the result is usually a more subtle, natural looking slope in the upper breast.  Implants placed under the muscle also have a reduced risk of capsular contracture and are less likely to interfere with the results of a mammogram.

Incision placement can also affect the final appearance of the augmented breast.  An effort is always made to make incisions as small as possible (usually between 2cm and 6cm) and to make them in inconspicuous areas in order to minimize visible scarring.  However, the specific location of the incision depends largely on the type of implant used as well as the individual patient’s needs.  Most commonly, inframammary incisions are made underneath the breast, in the crease where the breast meets the torso.  These incisions allow for the most direct access to the breast tissue and chest muscle.  Since saline implants are placed into the body before they are filled, they can frequently be introduced through transaxillary incisions underneath the armpit.  Finally, periareolar incisions around the nipple can be used if the appearance of scars is a major concern.  However, I generally do not recommend this approach as it is associated with a higher likelihood of breast feeding difficulties and the loss of nipple sensation.  I have found that the use of the Keller Funnel™, a device that directly transfers the implant from the packaging to the breast cavity, allows me to safely place silicone and highly cohesive gummy bear implants using smaller incisions and with a reduced risk of the bacterial contamination that can cause infection or capsular contraction.

During our initial consultations I will carefully go over all of the options available and make recommendations based on your specific anatomy and aesthetic goals.  Only then will we be able to choose the particular approach that will lead to the best possible breast augmentation results.

If you have any questions about any of the treatments that I offer, please contact me today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit^SM, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

Body modification with tattoos and body piercings has become an increasingly accepted and popular mode of self-expression.  However, as younger people transition into more professional environments, they often find that these affectations have become a hindrance.  Fortunately, cosmetic plastic surgery techniques can often minimize or even eliminate these once-permanent alterations.

Like any other injury to the skin, piercings can lead to scarring.  Nose piercings, in particular, can often leave behind a small dimple on the skin or even a raised scar after they have been removed.  Dimples, or indentations in the skin, can usually be treated with soft tissue fillers like Juvéderm®.  These injections of hyaluronic acid, a substance that is produced naturally in young and healthy skin, can give the area more volume, smoothing out the skin surface and restoring a more even appearance.  Raised scar tissue, on the other hand, is best treated with chemical peels or laser skin resurfacing, which remove the surface layer of dead and damaged skin cells and allow new, refreshed skin to take its place.  However, in some cases, the scar may need to be cut out so that the nose may heal more completely.

Ear piercing has long been an almost universally accepted form of body art, but earlobe stretching, or “gauging”, which involves gradually enlarging the hole to accommodate progressively larger jewelry, has been met with more resistance.  Employers and professional associations often look negatively on stretched ears, and even the United States Army has a prohibition against enlarging the holes in the ear lobes greater than 1.6 mm.  Repairing these large holes and distorted tissue requires the use of scar revision techniques.  The scar tissue often needs to be completely removed from around the hole, and then the area must be sutured or fitted with a skin graft, depending on the size of the surgical wound.  Compression bandages, silicone-based creams or corticosteroids are often used after the procedure to minimize the formation of new scar tissue.

A similar form of reconstructive otoplasty, or ear surgery, is used to correct damage caused by trauma, as in cases of cauliflower ear.  Relatively common among boxers, wrestlers, and martial artists, cauliflower ear results when repeated trauma to the ear has caused blood clots to interrupt the usual blood supply to the cartilage.  Ultimately, this interruption causes the cartilage to die and contract in on itself, forming a shriveled up outer ear.  During reconstructive otoplasty, cartilage can be folded or trimmed to reshape the ear and create a more balanced, aesthetically pleasing appearance.

If you have any questions about any of the treatments that I offer, please contact me today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit^SM, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

Most people would like to look and feel younger, but are unsure exactly where to begin.  While the majority of people understand that maintaining a healthy lifestyle complete with balanced nutrition and regular exercise can help maintain your physical vitality, many often ignore the vital role of sleep in revitalizing the body.  The most recent scientific research suggests that adequate, healthy sleep can not only reduce the effect of general aging on the body, but can also improve the results of cosmetic plastic surgery procedures by strengthening the body’s natural recuperative processes.

Although it may seem as though sleep is a time when the mind and body are shut down, this is not the case.  Sleep is actually an extremely important part of the body’s natural cycle, during which a great deal of restoration and strengthening occurs.  The deepest stage of sleep is the only time that the body releases the growth hormones essential for cell repair and regeneration.  This is one of the reasons growing children require more sleep than adults.  However, if a given period of sleep is too short, or if the sleep cycle is frequently interrupted, the body has less time to repair and replenish itself.  Specifically, collagen and elastin, two protein fibers that give the skin its elasticity and help keep it hydrated, are replaced at a slower rate as the skin ages.  Without these regenerative proteins, the skin’s texture, thickness, and elasticity diminish.  While it is impossible to completely stop the aging process, adequate sleep gives the body more time to replenish these growth factors, and plays an important role in preventing premature skin aging.

Because sleep plays such an essential role in the body’s major restorative functions, like muscle growth, tissue repair, and protein synthesis, getting enough rest is vital to recovering from plastic surgery procedures.  Prolonged lack of sleep can disrupt your immune system, leaving you more prone to infection.  Long-standing sleep deprivation has been associated with increased heart rate, an increase in blood pressure and, higher levels of certain chemicals linked with inflammation, all of which can contribute to an increase in swelling and may put an unhealthy amount of strain on the heart.  Lastly, many plastic surgery procedures, like tummy tuck or liposuction, are significantly less effective on patients who are overweight or obese.  However, studies conducted at the Howard Hughes Medical Institute of Stanford University have shown that sleep-deprived people have reduced levels of leptin, the chemical that makes you feel full and increased levels of ghrelin, the hunger-stimulating hormone, in their bodies.  This is believed to be just one of the factors that accounts for the results of the Nurses’ Health Study, the largest and longest study to date on adult sleep habits, which found that women who slept five hours or less were 15 percent more likely to become obese when compared to women who slept seven hours a night.

If you have any questions about any of the cosmetic plastic surgery treatments that I offer, please contact us today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit^SM, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

The holiday season is rapidly approaching.  It’s a time of year filled with parties and social engagements, when we can get together with friends and family that we may not have seen in years.  However, those years do not always treat our faces kindly.  Botox® Cosmetic relaxes wrinkle-causing facial muscles between and around the eyes and along the forehead, reducing the appearance of crow’s feet, frown lines, and wrinkles for up to four months and giving you just the boost you need to step into the holiday season looking your best.

Join us on Tuesday, November 11^th, 2014, for Evening Aesthetics, a Botox® event hosted by Dr. Hunter Moyer and Atlanta Plastic Surgery, P.C.  Enjoy drinks and hors d’oeuvres while you chat with board-certified plastic surgeon Dr. Moyer about the latest news in plastic surgery techniques and technology.  Most importantly, take advantage of our exclusive Botox® offer.  This evening, Dr. Moyer will be personally administering Botox® Cosmetic injections for the low promotional price of only $10 per unit.  So bring a friend and enjoy an evening of beauty with Dr. Hunter Moyer!

Evening Aesthetics will be held in our spacious and beautifully appointed Cumming office, located at 1400 Northside Forsyth Drive, Suite 390, from 7:00 PM to 10:00 PM.  Although the event is free and the invitation is open to all, space will be limited, so be sure to RSVP by November 6^th, 2014 to Rebecca Brock at (404) 256-1311 or RBrock@atlplastic.com.  If there is insufficient time to complete everyone’s injections, those in attendance will be extended the promotional price on their next visit.

We look forward to seeing you at the event!  If you have any questions about any of the treatments that I offer, please contact me, Dr. Hunter Moyer, today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including CareCredit®, to assist you.  Don’t forget to connect with us on Facebook, Twitter, and Google+ for the latest plastic surgery news.

There are many changes that occur in the face as time and gravity begin to take a toll.  However, there is also a wide array of facial rejuvenation techniques that are designed to treat these signs of facial aging and keep you looking younger, longer.

If you have questions about any of the treatments that I offer, please contact us today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit^SM, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

One of the most exciting recent developments in plastic surgery has been the degree to which men have begun to embrace the possibilities of cosmetic plastic surgery procedures.  Since 2000, the number of plastic surgery procedures performed on men in the United States has increased by over 20%, according to the American Society of Plastic Surgeons (ASPS).  As the social stigma attached to male plastic surgery diminishes, men are coming to more readily opt to take advantage of what these procedures have to offer.

The majority of this increase in popularity is due to the increased use of non-invasive facial rejuvenation procedures.  Botox® Cosmetic injectable treatments, for example, can help alleviate many of the signs of facial aging, particularly the lines that develop between and above the brows and the crow’s feet that can accumulate at the edges of the eyes, by relaxing the facial muscles that cause wrinkling in the first place.  On the other hand, facial fillers like Juvéderm® and Restylane®, help restore the volume and youthful “plumpness” that gradually diminishes in the tissues of the face over the years.  Together, these quick and easy maintenance procedures can effectively counteract the damage caused by time and environmental factors, keeping your skin and face looking younger, longer.

However, the fascination with maintenance procedures doesn’t end with the non-invasive.  Over the past several years, men have been increasingly drawn to a number of surgical procedures designed to relieve tiny pockets of excess fat and tissue in areas that are either genetic or notoriously difficult to exercise.  Specifically, blepharoplasty (eyelid surgery) and liposuction remain two of the top five most popular cosmetic procedures among men, and both are excellent ways to make those minor, subtle changes that can make a significant difference in the overall appearance.

If you have any questions about any of the treatments that I offer, please contact us today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

No one can argue that the use of Botox® cosmetic to help alleviate the signs of facial aging has become incredibly popular.  In 2013 alone, over 6.3 million treatments were preformed in the United States with Botulinum Toxin Type A, the active ingredient in cosmetic injectables like Botox® and Dysport®, and that number continues to rise every year.  However, despite its incredible popularity, many don’t know the fascinating history behind the development of this extremely versatile facial rejuvenation procedure.

1820’s – Dr. Justinus Kerner studies a batch of improperly prepared blood sausages responsible for the death of several dozen Germans.  His experiments lead to a better understanding of the neurological symptoms of food-borne botulism (drooping eyelids, difficulty swallowing, muscle weakness, and if left untreated, paralysis and respiratory failure).

1890’s – While investigating an outbreak of botulism, Dr. Emile Pierre van Ermengem of Belgium is able to make a connection between botulism and a spore-forming bacterium he named Bacillus botulinus (later renamed Clostridium botulinum).

1953 – Physiologist Dr. Vernon Brooks discovers that injecting small amounts of botulinum toxin into a hyperactive muscle blocks the release of acetylcholine from motor nerve endings, causing temporary “relaxation” and reducing involuntary muscle spasms.

1978 – After several years of injecting botulinum toxin type A into monkeys in an attempt to discover if its muscle relaxing effects might help in the treatment of strabismus, or crossed eyes, Dr. Alan B. Scott receives FDA approval to inject tiny amounts of botulinum toxin into human volunteers.

1988 – The pharmaceutical company Allergan Inc. acquires the rights to distribute Scott’s batch of botulinum toxin type A, and begins conducting additional research.  Eventually, it is discovered that the drug can also provide patients with temporary relief from facial spasms, neck and shoulder spasms, and even vocal cord spasms.

1989 – The FDA approves botulinum toxin type A for the treatment of both strabismus (crossed eyes) and blepharospasm (spasms of the eyelid muscle).  Allergan introduces it to the market under the brand name Botox® Cosmetic.

1992 – After noticing that her blepharospasm patients were starting to lose their frown lines, Canadian ophthalmologist Dr. Jean Carruthers, and her dermatologist husband, publishes a study in the Journal of Dermatologic Surgery and Oncology stating that though temporary, “treatment with C. botulinum-A exotoxin is a simple, safe procedure” for the treatment of brow wrinkles.

1997 – Botox® use increases so rapidly that the country’s supply is temporary exhausted until a new batch receives FDA approval.

2002 – FDA approves Botox® Cosmetic (onabotulinumtoxinA), the same formulation as Botox®, for use in alleviating moderate to severe frown lines between the eye brows.

2004 – FDA approves Botox® for the treatment of severe underarm sweating that does not respond well to topical medicines.

2006 – Botox® sales soar past the $1 billion mark, with cosmetic uses accounting for about half of sales.

2010 – FDA approves Botox® therapy for increased muscle stiffness in elbow, wrist, and finger muscles with upper limb spasticity.   Later that year, Botox® becomes the first medicine to be approved by the FDA specifically for the prevention of headaches in adults who suffer from chronic migraines.

2014 – Botox® Cosmetic receives FDA approval for the temporary treatment of moderate to severe crow’s feet, also known as lateral canthal lines.

If you have any questions about Botox® cosmetic or are interested in any of the treatments that I offer, please contact us today to schedule a consultation.  Additionally, Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

In the past year, according to the American Society of Plastic Surgeons, over 1.6 million cosmetic plastic surgery procedures were performed in the United States.  Nearly a third of those procedures were either breast augmentations or liposuction treatments.  However, despite their incredible popularity, many are still unclear as to what, exactly, these two procedures entail.  Specifically, many come into my office wondering if they are a good candidate or what they can expect during downtime.

Breast Augmentation
Breast augmentation surgery involves using breast implants or fat to increase the size of the breasts or restore breast volume that has been lost after weight gain and loss, or pregnancy.  Breast augmentation is designed to increase fullness and projection of your breasts and can also improve the balance of the figure.

Am I a good candidate?  Breast augmentation is a very personal procedure and you should do it for yourself, not to please someone else.  Optimal candidates for breast augmentation surgery are physically healthy, have realistic expectations and breasts that are fully developed, and are dissatisfied with the size, shape, volume or symmetry of their breasts.

What can I expect from the recovery period?  After breast augmentation, the breasts will be wrapped in an elastic bandage or support bra to minimize swelling and support the breasts as they heal.  Once you are evaluated and cleared to leave the hospital, you will be given specific instructions that include how to care for your breasts following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, and when to follow-up with me.  You may be instructed to wear a support bra around the clock for the first week or two, and given other important post-operative care instructions.  Be sure to follow all instructions carefully in order to achieve the best possible breast augmentation results.  After a post-surgical recovery period of 24 to 48 hours, you will likely experience soreness and swelling for a few weeks and should reduce your level of activity accordingly.

Liposuction
Liposuction slims and reshapes specific areas of the body, such as the thighs, hips and buttocks, abdomen, waist, and back, by removing excess fat deposits that have proven resistant to diet and exercise and improving your body contours and proportion.  Liposuction can also be performed on small, precise areas like the upper arms, inner knee, calves and ankles, or even the cheeks, chin, and neck.

Am I a good candidate?  Ideal liposuction candidates are healthy adults within 30% of their ideal weight who have firm, elastic skin, good muscle tone, and no life-threatening medical conditions that can impair healing.  Because cigarette smoking can cause problems with blood flow and healing, non-smokers generally enjoy better results and a decreased risk of complications.

What can I expect from the recovery period?  Once your liposuction procedure has been completed, a compression garment may be used to cover the areas that have been treated.  These help to control swelling and compress the skin to your new body contours.  You will be given specific instructions on how to care for the surgical site, what medications you may need to apply or take orally to aid healing and reduce the potential for infection, any specific concerns to look for at the surgical site, and when to follow up with me.  Your final liposuction results may not be evident until the swelling has fully dissipated, a process that may take several weeks.

If you’re interested in any of the cosmetic procedures that I perform in Atlanta and Alpharetta, please contact us today to schedule a consultation.  I also provide a variety of options for financing, including Care Credit®, in order to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

Many people would like to look slimmer or more toned, and even if you exercise regularly and maintain a healthy diet you may find yourself troubled by localized fat deposits that seem to cling to specific areas no matter what you do.  Often these areas of concern can be addressed with liposuction, a body contouring procedure that suctions out stubborn fat deposits and provides a more slender and shapely physique.

It is important to note that liposuction is not an effective treatment for obesity, nor is it a substitute for proper diet and exercise.  Liposuction does not have the ability to tighten skin that has been stretched by fat deposits or to remove cellulite, the dimpled skin that typically appears on the thighs, hips and buttocks.  In fact, the removal of fat deposits with liposuction can, in some cases, leave sagging skin behind, particularly in more mature patients whose skin has lost some of the elasticity of youth.

The abdomen is an area commonly treated with liposuction in both men and women, as it can stubbornly hold on to fat deposits and is notoriously difficult to exercise effectively.  When the body first begins to store fat, it does so in areas where it can do the most good, protecting and serving the nutritional needs of the vital organs in the abdomen.  Only then does it go on to store fat in the less vital areas, like the arms and legs.  However, when losing weight, the body more readily gives up fat cells in the less vital areas first and stubbornly holds on to fat in the vital core.  That’s why it can be so difficult to lose weight in the abdomen and hip areas.  Only once fat has been nearly eliminated from everywhere else in the body will the fat in the abdomen even begin to be released.

Liposuction can provide benefits to the extremities, such as the upper arms and thighs, as well.  Such procedures may sometimes require more than one treatment to achieve the desired results.  However, they are less invasive than procedures like arm and thigh lifts, and so produce less scarring and require less down time.  In some cases, fat can be removed, via fat transfer techniques, from the hips, flanks, or thighs, and then re-injected into areas that may require augmentation or greater definition, such as the buttocks or even areas of the face.

If you’re interested in liposuction or any of the other cosmetic or reconstructive procedures that I perform, please contact us today to schedule a consultation.  Atlanta Plastic Surgery, P.C. provides a variety of options for financing, including Care Credit®, in order to assist you.  Don’t forget to connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.

When any foreign object is introduced into the body, it is the body’s natural reaction to form a kind of coating, or “capsule,” of scar tissue around it.  In the case of breast implants used during either breast augmentation or breast reconstruction, this natural immune response can be helpful.  As long as the capsule remains soft, it helps to keep the implant stable and in the correct place.  Some implants are even equipped with a textured surface in order to facilitate this process.  At times, however, these capsules can become thick and hard, a phenomenon called capsular contracture.  When this occurs, the breast grows increasingly firm and rigid, eventually shrinking or taking on an abnormal shape and becoming extremely painful to the touch.  The most accurate estimates suggest that the condition occurs in somewhere between 9 percent and 15 percent of breast implant recipients, making it one of the most frequently occurring breast augmentation complications.

Once capsular contracture occurs, breast revision surgery is often performed to alleviate the symptoms.  During this procedure the breast implant is usually removed, along with the enclosing capsule or tissue, and replaced with a new implant in a slightly different location (below the muscle if the previous implant was above the muscle, for example).  While this does alleviate the problem in the short term, it does not guarantee that the capsular contracture will not recur, and so a great deal of research is being devoted to determining ways that capsular contracture can be prevented.

Recently, a growing number of studies have suggested that the rate of capsular contracture can be significantly reduced by placing an acellular dermal matrix (or ADM) between the implant and the natural breast tissue.  I have performed extensive research on this subject and effectively utilized this material in many breast enhancement procedures.  Originally developed as an alternative to skin grafting in burn patients, an acellular dermal matrix is composed of skin from which the cells have been removed, leaving behind a sterile framework or “lattice” of tissue that the patient’s own cells can grow into and eventually replace.  Ideally, this material allows the body to integrate itself into the surface of the implant as it heals, to create a natural and pliable connection rather than a thick capsule of scar tissue.

If you have any questions or are interested in a breast procedure that I offer, please contact us today to schedule a consultation. Connect with me, Dr. Hunter Moyer, on Facebook, Twitter, and Google+ for the latest plastic surgery news.