Dr. Peña Plastic Surgery Blog

Butt Lift

2012-01-30T14:46:00.000-08:00

Age, genetics, pregnancy, weight fluctuations, and lifestyle can all combine to make your backside flabby, saggy, and unappealing. Not only can this have a tremendous impact on your self-esteem, it can reduce your clothing options and leave you feeling less secure in your own body. Exercise and diet may be effective at targeting every other area of your body, but your bottom is often unaffected by these methods. In these cases, a butt lift from board-certified Naples plastic surgeon Dr. Manuel Peña may be just what you have been looking for.

The Brazilian Butt Lift

Dr. Peña offers the Brazilian Butt Lift technique to his patients. With this option, liposuction is used to remove excess fat from your waist and hips. This serves the dual purpose of shrinking those areas and providing the substance to be injected into your bottom. After your fat has been concentrated, it is re-injected into the upper portion of your buttocks to provide a rounder, firmer, more sensual appearance. Combining your butt lift with liposuction allows for your contours to become more defined, enhancing the appearance of your entire body in the process of giving you the butt of your dreams.

If you live in the areas of Naples, Fort Myers, Bonita Springs, or Estero, Florida and are unhappy with the appearance of your backside, please contact experienced plastic surgeon Manuel Peña, MD to schedule a butt lift consultation today.

Body Lift After Weight Loss Surgery

2012-01-28T14:44:00.000-08:00

Weight loss surgery is often the last step for people who are significantly over weight. The many surgical procedures that can result in weight loss have proven very effective at eliminating fat very quickly. Due to the rate of fat loss, patients of weight loss surgery find themselves with excess, sagging skin that detracts from their newly slimmed body.

The most ideal time to consider a body lift is following significant weight loss. A body lift not only firms and tightens excess skin to expose your slimmer frame, it can be combined with liposuction to remove those last few stubborn pounds. Consideration of a Body Lift should only be made after a satble weight is achieved for at least three months

Benefits of a Body Lift

The primary benefit of a body lift is its ability to restore a toned shape to your frame. This, in turn, can improve your overall health by encouraging a healthier lifestyle and improving your physical abilities.

Experienced Naples plastic surgeon Dr. Manual Peña has the ability to assess your frame following weight loss surgery and to customize a body lift procedure that meets your unique requirements.

If you live in or around Naples, Fort Myers, Bonita Springs, or Estero, Florida and substantial weight loss has left you with excessive amount of saggy skin, please contact board-certified plastic surgeon Manuel Peña, MD to schedule a body lift consultation today.

Am I a Candidate for a Neck Lift?

2012-01-26T14:38:00.000-08:00

A neck lift is one of the types of facelifts offered by board-certified Naples plastic surgeon Dr. Manuel Peña. However, whereas a full facelift involves your entire face, a neck lift is a less invasive procedure that only involves your neck and jawline. Dr. Peña can perform a neck lift alone or in conjunction with other facial rejuvenation procedures to help you achieve a younger, firmer, more attractive appearance.

The “Suture Necklift”, a more limited procedure which is performed thru tiny incisions in the chin and behind the ears can be appropriate for younger patients that have always had a poorly defined Jawline.

Neck Lift Candidates

Good candidates for neck lift surgery should:
• Be in generally good health
• Have excess, sagging skin around the neck and bottom portion of the jaw
• Have good skin elasticity
• Have realistic expectations

If you are unhappy with the appearance of your neck, Dr. Peña can assess its appearance and the quality of your skin and help you determine if this procedure is ideal for meeting your needs.

If you have several areas of concern throughout your face, Dr. Peña may recommend a full facelift or a neck lift combined with nonsurgical options such as BOTOX® Cosmetic to help you achieve the look of your dreams.

If you live in or around Naples, Fort Myers, Bonita Springs, or Estero, Florida and would like to know if you are a good candidate for a neck lift, please contact experienced plastic surgeon Manuel Peña, MD to schedule an initial consultation today.

What is Mastopexy?

2012-01-24T14:35:00.000-08:00

Mastopexy is the medical name for a breast lift. A breast lift is a procedure in which excess skin is removed from your breasts and they are lifted into a firmer, more youthful position. Due to pregnancy and breast feeding, as well as age and the inevitable effects of gravity, your breasts may begin to sag over time. When you begin to feel uncomfortable with the appearance of your breasts or find your clothing options limited, Naples plastic surgeon Dr. Manuel Peña can customize a breast lift procedure that will bring your upper body back into perfect symmetry with the rest of your frame.

Mastopexy with Augmentation

Many of the factors that can cause your breasts to sag can also cause them to lose volume. During your initial consultation, Dr. Peña will carefully assess your desires, as well as your entire frame and may suggest combining a breast lift with breast augmentation. When these procedures are combined, you can enjoy a much more defined and younger-looking profile. There is a procedure where the “Fallen” breast tissue below can be “brought up” and “tucked” under the upper breast tissue and acts as your own implant.
Both the breast lift and breast augmentation are popular choices for a mommy makeover, a procedure used to restore your body to its pre-pregnancy beauty. Dr. Peña will work with you closely to help you determine the procedure or combination of procedures that will best help you achieve your desired look.
If you live in the areas of Naples, Fort Myers, Bonita Springs, or Estero, Florida and are unhappy with the appearance of your breasts, please contact board-certified plastic surgeon Manuel Peña, MD to schedule an initial mastopexy consultation today.

Botox and it's actions in the Forehead

2012-01-03T11:25:00.000-08:00

For the last twenty years I have been injecting Botox into the forehead and for those twenty years I have painstakingly explained to my patients that BOTOX WEAKENS OR PARALYSES.... muscles. That is how it works! IT IS NOT MAGIC OR A FILLER! if you could have the will power not to elevate the brows for a 2 week period, you could achieve the same effect. The problem is that the more you are used to elevating the brows the more lines your forehead will have. After Botox those muscles that you were using for raising the brows will be weak and the resting position of your brows MAY BE LOWER.

For the last 10 years I have been going through an exercise with my patients wanting to have their forehead lines treated. Here t is: I ask them to close their eyes and imagine the best vacation they ever had. Immediately they have a far away look and their forehead relaxes and their brow position goes to resting. Usually Hawaii and "the beach" are mentioned as I ask them to open their eyes. Often they immediately "jack their" their brows back up, and I must go through the exercise again until they see their true brow resting position.
I then tell them that is how low their brows can go. It also can give the appearance of the eyelids hooding. This however is not the eyelid PTOSIS associated to Botox spread from the glabellar or frown line injections. The later is usually a 'trickling' down of a minuscule amount of Botox to affect an already weakened 'eyelid opening muscle' or Levator. This should resolve in 2-3 weeks and temporary improvement can be had with eye drops called Napthcon-A.

Back to the forehead. For a 'chemical brow lift' you weaken the muscles that bring the brow down with Botox. This is the transverse lined at the root of the nose and the upper portion of the 'crows feet' muscles. Sometimes the effect is so powerful that I have to place a tiny amount of Botox to the later brow where a devilish peak has developed. Careful.. cause too much here and you have undone the Brow lift.

Anyway, patients don't always listen to you as this being a possible side effect of Botox to the forehead and are amazed and angry when it does happen! Listen to your doctor... it could happen to you. BOTOX IS NOT A MAGIC ERASER!

The Benefits of Liposuction

2011-12-29T10:04:00.000-08:00

Liposuction is one of the most popular forms of cosmetic surgery performed in the United States. Used both alone and in conjunction with several other procedures, liposuction removes unwanted fat and cellulite from targeted areas of your body. Using advanced liposuction techniques such as VASER Lipo®, Naples plastic surgeon Dr. Manuel Peña can help you shed stubborn fat and restore an attractively firm appearance to your body.

Liposuction Benefits

The most obvious benefit of liposuction is its ability to remove deposits of fat that do not respond to diet and exercise. The removal of this fat has several benefits including:

• Enhanced appearance
• Improved health
• Restored feelings of self-confidence and appeal

As an additional benefit, once fat is removed, it will not return in that location. This makes the results of your liposuction permanent. Of course, you will need to adopt a healthy lifestyle complete with exercise and a well-balanced diet, but small lifestyle changes can help the results of your liposuction last for a lifetime.

If you live in or around Naples, Fort Myers, Bonita Springs, or Estero, Florida and would like to learn more about the benefits of liposuction, please contact board-certified plastic surgeon Manuel Peña, MD to schedule an initial consultation today.

FDA Reaffirms silicone breast implant safety

2011-12-07T08:47:00.000-08:00

In recent meetings with the FDA the representatives of the Breast implant manufacturers (Innamed and Mentor) reaffirmed what the FDA knew : that silicone breast implants did not pose a health threat to consumers. They also discussed the FDA "requirement" that patients get and MRI at 3 years after implantation with slicone implants. This they felt was an unreasonable finacial burden on patients without real evidence suggesting a benefit. In fact it may be "over-read" nad cause unnecessary reoperations.

I too do not agree with this recommendation for my patients. Routine mammogrrams followed by an MRI in 6 to 10 years would have more scientific merit.

The Status of "Gummy Bear" Implants

2011-11-18T07:54:00.000-08:00

Just went to a meeting with the Vice President of sales for Allergan (breast implants) and i asked him about the status of the cohesive gel implants. i had just returned from a meeting in Prague and got to see four different manufacturers of these devices displayn their wares. They have been making them softer and now feel almost as good as the traditional silicon gel implants. He assured me (hopefully0 that FDA approval is just around the corner... probably this year. So we have to wait a little longer to add these devices to our armamentum.

Restylane approved for Lip augmentation by FDA

2011-10-20T08:14:00.000-07:00

Funny how something we have been doing for so many years is now BIG news because it just got FDA approval. We have been using Hyaluronic Acid fillers in the lips since they were originally approved for correcting the Naso Labial Folds. Since Restylane was the first Hyaluronic Acid (HA) approved it had a two year head start, however, Juvederm has captured over 70% of the market because it is a better product forthis application (LIPS). there is less bruising with this product and less tendency for tiny bumps and irregularities. The other great property about all HAs is the ability to disolve them with a simple injection if you don't like them.
In My Experience Juvederm lasts significantly longer in most individuals. We are awaiting approval of "thinner" HAs for use in finer lines such as "smokers' lines" and "crows feet". Expect 6 months or more of results with juvederm and Restylane.

Plastic surgery abroad

2011-10-10T11:38:00.000-07:00

Just returned from a meeting in Prague. What a beautiful city! The meting highlighted one of my old mentors Dr Dan Baker from NYC and several Middle Eastern Rhinoplastic surgeons performing incredible salvage operations of the most difficult nasal deformities I have seen in a long time. The return of the "Thread Lift" is looming and raising it's specter abroad.

The SILHOUETTE LIFT uses a device that employs a series of slowly dissolving upside down tiny cones fitted onto knots on a propylene suture. The cones will cause a fibrosis that will allow the tissues to use the suture and the knot as a scaffold for "long term' results. Dr Woffles Wu, with whom I had a long discussion, is a thread lift pioneer and states that it remains a good option for short (24-48) rejuvenation. He does admit that for continued results more threads will need to be added in 1-2 years. He showed several examples of long term "maintenance' facial rejuvenation using this protocol. Another surgeon from Barcelona claimed good results from his clinic using Buttocks Thread Lifts. This also used similar cone technology. With the shear weight and mobility of the gluteal area, I seriously doubt the long term efficacy, but will try to keep an open mind.
I am always interested in other methods of gluteal rejuvenation (I currently perform thr Brazilian Butt lift) and was admiring the cohesive gel Implants available elsewhere outside of the US. here only solid silicone elastomer implants can be used for buttocks augmentation. The intramuscular placement of the implants seems to be gaining popularity.
Best thing about going abroad is seeing procedures that may be available in a few years in the US and being able to ask the surgeons first hand about their experiences.

Can Liposuction Help with Loose Skin After Weight Loss?

2011-08-23T09:43:00.000-07:00

Many people work hard to lose weight: spending several hours a week at the gym, carefully watching what they eat, and doing their best to change their lifestyle. After putting so much time and effort into weight loss, it can be disheartening when you finally reach your target weight, only to notice sagging skin and stubborn fat deposits that haven’t responded to your efforts.

Depending on the amount of excess skin you have, superficial Vaser assisted liposuction can potentially tighten loose skin while it eliminates the small areas of fat that remain after weight loss. The elasticity of your skin will have a significant impact on your results. Older patients and smokers may have skin that does not respond as well to certain liposuction methods. If you need to eliminate a significant amount of loose skin, consider combining your liposuction procedure with a tummy tuck, an arm lift, or a thigh lift.

A recent non-surgical body contouring procedure called Exilis uses radio frequency (RF) waves to stimulate your skin’s collagen production, effectively tightening and firming up your skin while it naturally eliminates small areas of fat. This increasingly popular procedure is virtually painless, with no downtime or recovery period. If you have recently lost weight and are looking for ways to efficiently tighten loose skin, Exilis may be a valuable procedure for you.

If you have further questions about how to eliminate loose and sagging skin after weight loss, please contact experienced Fort Myers plastic surgeon Dr. Manuel Peña today to schedule a consultation. We can discuss your options and help you decide which treatment option is best for you. Dr. Peña serves patients in Estero, Naples, Fort Myers, and Bonita Springs, Florida.

What is the Best Age for Breast Augmentation?

2011-08-22T09:40:00.000-07:00

Choosing when to have your breast augmentation procedure performed is a very personal decision. There is no single ideal age for breast augmentation, but there may be a certain point in your life when you are most prepared for the procedure. When considering breast augmentation, take the following factors into account:

Your current lifestyle
Your current health
Your financial situation
Your life plans

According to the American Society of Plastic Surgeons, most women choose to have breast augmentation performed in their 20s and 30s. Women at this age are most often in good health, aware of how others perceive them, and mature enough to make an important decision regarding their appearance.

The question of whether to wait to have children first before Breast Augmentation is a personal one. While changes do occur to the breast during pregnancy, about half of our patients have the augmentation before the first child and are extremely pleased. Breast Augmentation should not interfere with Breast Feeding. Waiting to have surgery after childbirth often makes the individual a better candidate for a ‘Natural Look’ augmentation. It is also important to remember that breast implants do not last forever. You can expect to need additional surgery at some point in the future to either replace your implants or completely remove them.

Other than taking these essential considerations into account, there is no upper age limit for breast augmentation. As long as you are over the age of 18 and in strong metabolic health, breast augmentation can enhance your lifestyle at any age. The FDA recommends 23 years of age for Silicone Breast Augmentation although I do not agree with this.

If you have further questions about breast augmentation, please contact experienced Fort Myers cosmetic surgeon Dr. Manuel Pena today to schedule a consultation. Dr. Peña offers breast augmentation to patients in Fort Myers, Estero, Naples, and Bonita Springs, Florida.

How Long Do Exilis Results Last?

2011-08-19T15:41:00.000-07:00

As with most cosmetic procedures, the longevity of your Exilis results will depend upon your own lifestyle, and how carefully you observe good diet and exercise habits. Patients undergoing any type of body contouring procedure should commit to remaining below their original weight in order to retain their body’s new shape.

Once fat is surgically removed from a specific area of the body, it is not likely to return to that location, although weight can be regained in other areas of the body. Exilis shrinks fat deposits but does not remove the fat cells. Patients who are using Exilis as an alternative to liposuction should be able to enjoy their results for several years to come as long as they maintain a healthy lifestyle and do not gain significant weight.

If Exilis is used for facial rejuvenation, patients should not expect wrinkle reduction to be permanent. As your skin ages, new wrinkles can form, and existing wrinkles may become more pronounced. You might need further facial treatments in the future in order to maintain your results to your satisfaction.

If you have more questions about what to expect from Exilis treatments, please contact experienced Ft. Myers cosmetic surgeon Dr. Manuel Peña today to schedule an initial consultation. Dr. Peña offers Exilis treatments to patients in Estero, Naples, Bonita Springs, and Fort Myers, Florida.

What is Exilis?

2011-08-17T15:38:00.000-07:00

Exilis is a new non-invasive body contouring procedure recently approved by the FDA. Using the exclusive Energy Flow Control (EFC) system, Exilis can reduce cellulite, tighten skin, and effectively treat problem areas without using the invasive methods of traditional liposuction.

Fat cells are stored in your body in small clusters that are held together by a fibrous layer of tissue. The Exilis device works by using radio frequency (RF) waves to speed up the fat metabolism and open the pores of the fat cells. This allows fluid to leak out of the cells, the RF energy then shrinks the connective tissue around the cells. Your body then naturally eliminates the melted fat – all without the need for invasive surgery. After only a few treatments, many patients lose several inches from around their waists and enjoy tighter, firmer skin. Exilis is not effective on everyone and even successful outcomes cannot match results obtained with surgery.

Exilis can also be used as a facial rejuvenation treatment. The RF waves stimulate collagen production in your skin, helping remodel your skin cells to restore a fresh and youthful look. If you have wrinkles and sagging facial skin, Exilis can be an effective, painless treatment method that lets your youthful personality shine through.

If you would like to learn more about Exilis, please contact experienced Naples cosmetic surgeon Dr. Manuel Peña today to schedule an initial consultation. Dr. Peña offers Exilis treatments to patients in Bonita Springs, Naples, Fort Myers, and Estero, Florida.

How Permanent are Tummy Tuck Results?

2011-08-01T08:50:00.000-07:00

The results of a tummy tuck can last for years, but in order to ensure that your abdomen remains impressively firm you need to do your part to hold onto the benefits of the procedure.

A healthy diet, exercise, and regular skin care will help keep the abdominal area looking firm and toned for the long term. That said, it’s important to keep in mind that a tummy tuck, or abdominoplasty, is not intended as a weight-loss procedure.

During your tummy tuck consultation, Naples, Florida, plastic surgeon Dr. Manuel Peña will discuss recommendations for post-surgery care so you can maintain the results of your tummy tuck.

To ensure your tummy tuck success into the future, you should follow at least the same dietary and fitness standards that make you a good candidate for the procedure in the first place. It helps to be physically healthy, live an active lifestyle, be a nonsmoker, and have an emotionally healthy positive outlook with realistic expectations regarding your procedure.

Sticking to a healthy diet and exercise routine will help you remain in your ideal weight range and maintain the results of your tummy tuck for years to come.

If you would like to learn more about tummy tucks, please contact Naples, Florida, plastic surgeon Dr. Manuel Peña to schedule a consultation.

What is a Tummy Tuck?

2011-07-28T08:48:00.000-07:00

Anyone who has ever tried to lose weight by doing sit-ups or crunches knows that the abdomen is one of the toughest parts of the human body in which to reduce unwanted fat.

This is the area where most humans store their extra pounds despite all serious efforts to address diet and exercise. Women in post-pregnancy in particular have a hard time reeling in muscles that have been stretched beyond their normal limits.

The tummy tuck, or abdominoplasty, provides an effective method for toning and firming the area around the abs. The procedure does double-duty in terms of removing excess skin and fat from the area as well as tightening the stomach muscles.

Tummy tucks are not for everyone, and for this reason Naples, Florida, plastic surgeon Dr. Manuel Peña consults with prospective patients in-depth before determining whether a tummy tuck is the best solution for their goals. In order to prepare for a tummy tuck procedure, you’ll want to be within your ideal weight range (if abdominal fat is more of an issue than extra skin and loose muscles, liposuction may be more in line with what you need).

You might be a good tummy tuck candidate if you are physically healthy, lead an active life, are within 25 pounds of your ideal weight, don’t smoke and possess emotional health that allows you to have a positive outlook and realistic expectations for your tummy tuck.

Recovery from the procedure could take a few weeks to a few months, depending on a variety of factors. A tummy tuck can give you flatter abs and a smooth stomach, and while these desirable results of a tummy tuck can be sustained it also takes a genuine commitment on your part to commit to a healthy diet and regular exercise to maintain your new shape.

If you would like to learn more about tummy tucks, please contact Naples, Florida, plastic surgeon Dr. Manuel Peña to schedule a consultation.

What are Alternatives to a Facelift?

2011-07-25T08:46:00.000-07:00

If a traditional full facelift is not the best option to achieve your goals, Fort Myers plastic surgeon Dr. Manuel Peña may recommend an alternative procedure better suited to your condition and desired results.

Two popular alternate techniques include the “mid facelift” and “mini facelift.”

The mid facelift surgery targets the skin around your eyes, prominent nasal folds, and any hollowness around your upper cheeks. The mid facelift might be suited to you if you have no issues with the skin of your neck. Often, the alternative to a mid facelift is fat grafting the central cheek area, since rather than tissues sagging, here they are really “deflating.”

Sometimes called a “weekend facelift” or “S lift” the procedure called the mini facelift addresses any minor sagging on the cheeks, neck or jaw line. The procedure is often a positive solution for those in their 30s and 40s, and it offers greater affordability and reduced risk than a full facelift.

Other alternatives depending on the specifics of your condition and goals may include the browlift, eyelid surgery or nose reshaping.

A browlift deals with the skin around and between the eyebrows and the forehead. Eyelid surgery works to reduce signs of aging and promote a rejuvenated appearance around the eyes by removing excess skin, fat and muscle from both the upper and lower lids. One of the best-known forms of cosmetic surgery, nose reshaping aims to reduce or enhance the nose or correct a crooked bridge of the nose.

Additional noninvasive facial procedures include BOTOX®, facial fillers, Fraxel, or laser skin resurfacing.

If you would like to learn more about facelift alternatives, please contact Fort Myers, Florida, plastic surgeon Dr. Manuel Peña to schedule a consultation.

What is a Facelift Meant to Do?

2011-07-22T08:43:00.000-07:00

The term “facelift” can be deceiving: One word alone cannot describe every aspect of this effective facial cosmetic surgery procedure.

Fort Myers plastic surgeon Dr. Manuel Peña believes each facelift should accomplish several aesthetic goals. Facelift procedures can alter the effects of years of stress, aging and damage from the sun and environment.

Additionally, a facelift can also be combined with fat grafts to remedy a loss of volume in the area of the cheeks to restore fullness to the upper and middle of your face. A facelift can also downsize or eliminate fatty deposits, creases and sagging in the face and neck area.

Another common concern among patients considering facelifts is the lack of definition of the jawline or neck, and a facelift can provide an effective and aesthetically pleasing solution for this as well.

There are different types of facelift procedures. A consultation with Dr. Peña can help determine the procedure that’s best for your condition and desired results, from minimizing fine lines and wrinkles to treating creases and sagging skin.

Generally speaking, few cosmetic surgery treatments produce results that are as noticeable and long lasting as a facelift performed by an experienced plastic surgeon.

To learn more about your facelift options, please contact Fort Myers, Florida, plastic surgeon Dr. Manuel Peña to schedule a consultation.

How Long do Liposuction Results Last?

2011-07-18T08:40:00.000-07:00

While the body contouring technique called liposuction is used to permanently eliminate fat cells from the human body, it should not be considered a primary weight-control method. Exercise and a healthy diet can be used in conjunction with liposuction to help achieve and preserve weight loss goals and body shape.

The science behind liposuction is that humans live with a limited number of fat cells that expand and contract with weight loss and weight gain. While liposuction can target and permanently remove fat cells from various parts of the body, any fat cells that remain after the procedure have the potential for expansion. Naples, Florida, plastic surgeon Dr. Manuel Peña uses an advanced form of liposuction called “Vaser Liposuction”, which uses sound energy to “melt” away unwanted fat.

For the person who has already undergone liposuction for the hips, thighs or stomach, other areas of the body containing uninterrupted fat cells now possess a greater percentage of the individual’s body fat—along with the potential for weight gain.

During your liposuction consultation, Dr. Peña, will provide you with diet and fitness recommendations that, along with the liposuction procedure itself, will provide the foundation for maintaining the benefits of your liposuction over the long term.

Exercise and eating healthy foods need to be part of a person’s routine after liposuction to prevent weight gain and maintain the contours of the body created by the procedure. Because liposuction is not a large-volume weight-loss tool, achieving and sustaining a healthy metabolism and a wholesome diet can help maintain the body shape you have achieved through liposuction.

To learn more about liposuction and other body contouring procedures, please contact Dr. Manuel Peña to schedule a consultation.

Chasing fat around the body!

2011-05-02T10:30:00.000-07:00

A new study confirmed what I figured out 17 years ago.

http://www.cbsnews.com/8301-504763_162-20058860-10391704.html

A patient that had liposuction in one part of the body returned two years later with excess bulge somewhere else. Three years later... she was back in my office wanting it sucked out from some where else. She told me "Doc, you are chasing my fat around the body". I figured out I was. She would always return to her original weight.. so of course fat would return to the "next favorite area" or as I like to call.. the "bulge in waiting". Some times in younger women we would get lucky and this would be their breasts, but often it would go to unwanted areas that were also predisposed to get bigger as our metabolism slowed down.

What I do now is a lot of counseling and explaining how they must stay BELOW their preoperative weight if they want to prevent this from happening. I also explain that I want to take the smallest amount that will give a good shape. This will minimize the tendency to 'rebound' into unwanted areas.

Non Invasive Fat Reduction and Skin Tightening Heats Up

2011-03-19T05:31:00.000-07:00

The ways to shrink your body without surgery keep increasing. There are Ultrasounds that melt or "burst" fat, there are Lasers that let your fat escape the cells, there are machines that freeze the fat and it dies and the body gets rid of it. I felt that I had to find the best technology for this so i could offer this to my patients in a responsible way. First of all, let me tell you, YOU DO NOT GET SURGICAL RESULTS. What you do get with EXILiS is shrinking of fat deposits and a modest tightening of the skin skin.

Here is how EXCILIS works. This machine delivers energy in the form of radiofrequency waves(RF). RF is not slowed or 'impeded' much by the skin so it does not 'heat up' as it travels though it. However, when it hits the fat under the skin the heating begins. It then 'bounces back' and heats up the underside of the skin which is where thee collagen we want to tighten lives! It also travels deeper into the fat depending on the energy level used and the amount of cooling we do of the skin. We can reach down approximately one inch of fat. Now this 'heating up' of the fat increases the metabolism of the fat cell and opens up the pores of the walls allowing the fat to leak out and shrink the cells/ As the cells shrink the collagen which is in the tissue around it also shrinks due to the heating energy. This prevents the fat cell from filling up to it's original size.

OK, you know the science. Here is what i am excited to use it on: double chins, early jowls, fatty bra rolls, saggy arms (aka "batwings", knees with some fat and saggy skin, bellys with relaxed skin and fatty deposits.

We will see how many other uses I can come up with.

No Incision breast lift

2011-02-13T19:44:00.000-08:00

Just back from a meeting in Miami where I waited for a presentation of a newly approved 'hammock' breast lift that when combined with breast augmentation or even explantation could lift the breast tissue without the need for further scars. The main accomplishment itachieved appeared to be to rotate the nipple upwards and give a marginal increase in upper pole fullness. It was reminiscent of the thread lift, another static solution to mobile problems, alas! While there may be indications in certain cases, I am worried about the central skin 'puncture' that appears to be in the decolletage ares, an area that is often associated with hypertrophic scars.The possible rupture or injury to any implants in place is always a possibility

Non invasive fat reduction and skin tightening using RF (Radiofreqency)

2011-02-13T18:27:00.001-08:00

The verdict is in,the peopl want more cosmetic procedures and less surgical procedures, As Americans (and Europeans and Latin Americans and eventually Asians) age, they will seek more ways to turn back the hands of time without necessarily going "under the knife". We have seen an incredible rise in injectibles (Botulism toxin and a myriad of fillers) over the last three years while seeing a decline in invasive forms of resculpting the body and rejuvenating the face and skin.

A recent entry into the field is a Radio frequency generator that will not only tighten skin (like its predecessor Thermage) but can shrink the underwanted fat under the skin. This device is called Exilis and I had the opportunity to try nit out on several of my patients and had it tried out on myself. Although this device takes 4 treatments over 4 to 6 weeks and a period of up to three months for the collagen recruitment and final results, I was impressed by the comfort and expedient nature of the treatments.

A principal difference between Exilis and Thermage is that tje energy in Exilis was being delivered in a moving fashion allowing greater energy deliverence over a shorter period of time in a more comfortable treatment session. The energy delivered by this way can also affect the deeper fatty layers in a way Thermage could not.

Here is how it works. Radiofrequency passes through skin virtually un-impeded and has to get into the fat layer to actually start heating up the tissues. When the heat builds up in the fat it 'bounces back' and heats up and affects the deep dermis. This alters the skin collagen and is responsible for the tightening of the skin. Now, if you cool the skin using the cooling head, the Radio frequency energy can reach the 2-3 centimeter depth before reaching the appropriate temperature required to affect the fat cells in the desired manner. While the fat cells are not killed by the Exilis device, the fat cell's contents leak out and are evacuated by the body. The energy also appears to tighten the tissues around the now emptied shrunken fat cells thus giving the long term reduction of the fatty areas. I am very excited about the possibility of being able to offer a non-invasive solution to tough areas such as laxity of arms, knees, and even those tough back rolls. Post liposuction 'touch ups' will no longer require taking the patients back to the oprating room.

Radiofrequency Skin Tightening and Fat reduction

2011-02-01T13:27:00.000-08:00

I have been following RF (radiofrquency) for skin tightening for many years. About a year before Thermage was approved I became intrested in a "non-invasive" way to tighten skin. Sure we had peels and lasers.. but come on, they were not really "non- invasive". I went to a meeting in LA hoping to bring back one of these beauties (Thermage ). I was so underwhelmed that I
came back and dove into another merging technology (thread lifts) that did not pay off.

Now don't get me wrong, they were able to get some results with Thermage... but as a surgeon i was not impressed.They tinkered with the technology and it got a bit better. Now the use of a cont nous RF device that can treat the Body as well as the Face (Thermage could really only treat the face). AND... reduce fat volume...AND be painless! Sounded too good to be true coupled with the fact that the machine did not require you spend hundreds of dollars on throw away parts (Known as Consumables). Anyway I got a chance to try this technology the other day. It is the Exilis Rf generator and handpiece. Two of my patients tried it, both to shrink up loose skin. They felt it get warm then hot and told the technician when to stop. The goal was to get the skin to a temperature of about 40 -41 Centigrade and keep it there 5-10 minutes. This corresponded to about 6-10 degrees higher at the skin/fat junction where the action (shrinking and tightening) takes place. Well I had them treat my love handles... it felt fine.. like getting into a hot tub for the first time. Although results require 4 treatments spaced 1-2 weeks apart.. it was very easy to use and tolerated with minimal discomfort. Very interesting. I hear several internationally known dermatologists have had to buy a second machine because the first machine was being used constantly.

Will I get one? Thinking about it. looking into some of the other technologies that are out there before I decide.

Facial bones shrink with age.

2011-01-15T05:12:00.000-08:00

A new study reveals thatart of our natural facial aging is that our facial bones actually get smaller particularly around the eye socket and jaw line. A detailed study comparing hundreds of CT scans of facial bones of men and women at different points in their lives revealed that womwn start losing the bone volume even in their early 40s while men as much as 10=15 years later.

We have recently found out about the aging contributed by the loss of facial fat. My rejuvenation surgeries over the last ten years have all included fat grafting precisely to the areas that were identified as having bone loss. How did I figure it out before the studies? By observing the difference in appearances between a person's old photos and their current appearance. While the bone loss can be dealt with by adding implants to the facial skeleton as I often do with chin implants, other areas can be augmented by using fat as a structure mimicking the bone itself. Turns out that when fat grafts are placed close to the bone, they act and feel like bone.

Always have volume restored as a part of facial rejuvenation, or you will never really look like you did.

Prevention of the hard breast after breast augmentation

2011-01-03T10:22:00.001-08:00

Our current theory on the main cause of capsular contracture (hardening of the breasts after breast augmentation) is that of a 'Biofilm' as a causative agent. This is a low population"infection" that hangs out on the surface of the implants and secretes a mucous layer that protects the bacteria from getting destroyed by the bodies defenses. The number of bacteria is so low that it rarely leads to frank infection but still causes the body to try to protect itself by walling it off. This in effect cuases the naturally thin interface between the body and the implant to thicken and eventually tighten.

Many causes have been attributed to causing this. Among these infection, hematoma, early sun burn, leaking or ruptured implants, etc, etc. These factors do have something to do with it but the main culprit seems to be the "Biofilm". The 'no touch' insertion technique has long been touted as the best way to prevent this contamination that seems to occur as the surface of the implant comes into contact with the skin surface (even after the skin has been treated with an antiseptic scrub). Until now the ' no touch' was easier said than done especially when I was putting large implants through small incisions. This could explain the small but significant difference in the capsular contracture with saline implants compared to silicon implants. The saline implants are placed empty and have minimal contact with the skin upon placing the implant into its final resting pocket.

The addition of a triple antibiotic wash has been quite helpful in minimizing the capsular contractures.. but the real breakthrough in my practice came about 9 months ago when I began using the Keller Funnel in all my silicon breast augmentations. This is a simple sterile paper delivery system that looks like a pastry bag. Much faster placement of the implants without them coming in contact with this skin. there is much less trauma to the implant and the skin in the process! I decided not to pass the cost of this device onto my patients since eventually I would benefit from not having to treat and often re operate on these hard breasts.

Regenerative Medicine in cosmetic surgery

2010-12-17T07:22:00.000-08:00

Finally, the fruits of the federal ban on funding the fetal stem cell research has hit the big time.I remember the sexy thoughts of taking fetal stem cells from "left over fetal tissue" and creating cells that can cure all ills of the human body. Other highly advance countries have taken that road and have made some progress, however the need to use immune suppression in the individual who are treated with these cells is still a formidable problem.

In Plastic surgery we have been using stem cells from your own fat to recreate volumes (including entire breasts) lost with time, trauma, congenital absence, or surgery. The next chapter in regenerative medicine may be using the platelets (one of the parts of your blood that helps you clot and stop bleeding) and their contents to stimulate the body to regenerate tissues on their own. These so called 'growth factors' may be what is released by stem cells to create the new tissue. We will know soon. Very exciting stuff. the Vampire Lift is not a lift but a fill using your own platelet derived 'stimulants' that are mixed and processed and re injected to stimulate regrowth of your own youthful tissues.

Breast Augmentation Using Your Own Fat

2010-11-22T14:42:00.000-08:00

It is finally somewhat acceptable to use your own fat to make your breast bigger, or change the shape. For many years we have been using fat grafts to "touch up" breast reconstructions, somehow rationalizing that it was ok for those patients that already had cancer, but we could not 'confuse' the mammograms of non Cancer patients. Well , guess what' the mammographers are a lot smarter than we thought. The trained ones easily differentiate between worrisome microcalcifications and harmless fat graft induced macroclacifications.

Now, if you are a thin A cup don't expect to get to a full C in one fat grafting session, or even at all. Most fat graft augmentations can average between 180 and 280 cc (just about a cup size). But I do like to consider those patients with deformities of their breasts such as asymmetries as good candidates if they have a bit of extra fat to use for grafting. Some post augment or post lift problems can be treated with fat grafting. Lack of cleavage or fullness up top can be dealt with using this technique.

There are still limitations such as volumes and significant bruising post op. A large portion of the plastic surgery community is still skeptical although this is changing rapidly. The costs will not be less since there will be a lot more labor involved.. and this may have to be repeated if a very significant augmentation is desired. Fat grafting for breast augmentation is here and it will be an interesting evolution of techniques.

Facelift Options: Full Face Fat Grafts or Mini Facelift?

2010-08-20T09:47:00.000-07:00

If you’ve always believed facelifts were only for people of a “certain age,” you’ll be pleased to know that even subtle signs of aging can qualify you for a re-volumizing or full face fat grafting or mini facelift.

Since 1990, board-certified cosmetic surgeon Dr. Manuel Peña has used sophisticated cosmetic surgery technology to help thousands of Naples, Florida, area residents enjoy a more youthful appearance by eliminating these typical signs of aging:

• Volume loss
• Deposits of fat
• Creasing
• Wrinkling
• Sagging

Dr. Peña can help you combat the telltale effects of gravity, stress and pollution using world-class facelift procedures to achieve dramatic, lasting results. A thorough consultation with Dr. Peña can help you decide whether a mid facelift or mini facelift will give you the results you want.

Both the fat grafting and mini facelift offer a refreshed, renewed, younger facial appearance.

The mid facelift targets the eyes, nose and mouth, correcting “bags,” upper cheek hollowness, and prominent nasal folds. These problems can be dealt with more simply and sometimes with longer results with fat grafting of the cheek area and hollow below the eyes. The mid facelift is still a good solution in certain cases. Dr Peña usually performs the procedure using the endoscope amd remote incisions in the temporal areas and inside the mouth.

The mini facelift or S-lift reduces minor sagging of the cheeks, neck and jaw line. Men and women in their 30s and 40s and sometimes in the 50s who want to stave off an aging appearance while symptoms are still mild may opt for the mini facelift. Dr. Peña often uses these techniques years later after more extensive face-lift procedures to turn back the clock with a much smaller procedure.

When compared to standard facelift surgery, both the mini and full face fat grafting procedures offer less risk and stress and more affordability.

In Naples, Fort Myers, Bonita Springs, or Estero, Florida, please contact the cosmetic surgery office of Florida cosmetic surgeon, Dr. Manuel Peña to schedule your facelift consultation.

Brazilian Butt Lift

2010-08-06T07:33:00.000-07:00

Although a misnomer, the Brazilian Butt Lift it has become one of my favorite operations. The essence of this procedure is based on the visual effect of the waist getting smaller and the buttocks getting rounder. Noticed that I said "rounder" not necessarily "bigger"! This is especially true in the fact that we did not increase the lateral dimensions of the buttocks simply the posterior or projection of the superior parts. By increasing this superior and central portion of the buttocks we achieved the effect that is so pleasing to the eye in and out of clothing. This effect is accentuated by aggressively removing the fat from the waist starting from just above the buttocks and going all the way to the rib cage. This enhances the curves that we seem to want.

This effect is achieved by the use of Vaser assisted liposuction and grafting the fat obtained from the aspiration into the buttocks. Although no real lifting is performed, the effect is similar. We also placed between 200 and 400 cc per side to fill out the cheeks. The scars to obtain the fat are between 3 and 4 mm in size into place the fat about 1 mm in size. Recovery is approximately 1 to two weeks requiring some limitations of activity and wearing of compression garments for a few weeks more after that. The fat that we have grafted is yours to keep in the volume will depend on your weight as you maintained at over the next few years. There are some surgical but lives in which skin and fat is actually removed from the posterior lower back and lateral aspect of the waist, however these are much more involved both in cost and in recovery and require that a scar be left behind. I think this operation will gain in popularity is more surgeons to come familiar with the techniques of fat grafting large volumes.

If you have questions about this procedure please call my office at 239 -348 -7362 to make an appointment.

Reader's Choice Awards Naples Daily News 2010

2010-07-28T11:25:00.000-07:00

I am very thankful to all my patients who voted me the 2010 "Champion" in the Naples Daily News Reader's Choice awards in the Plastic/ Cosmetic surgery category. As always we strive to provide the best service and offer state of the art surgery and non surgical cosmetic procedures. I believe in great results mean happy patients who will in turn tell their friends. My job is to decipher the hype and cut out the BS which permeates our field. Thanks again Naples (and surrounding areas)>

IPL for Hair Removal

2010-07-20T07:20:00.000-07:00

Unwanted hair can be embarrassing and difficult to remove. Waxing and electrolysis can be painful, and depilatory creams are messy. At the cosmetic surgery office of Dr. Manuel Peña we offer an advanced hair removal technology that rivals the results of laser hair removal for beautiful, hair-free results over an extended period of time.

IPL, or Intense Pulsed Light, is a non-invasive skin treatment used for treating unwanted areas of hair growth.

One of the main benefits of IPL is its ability to deliver light wavelengths to precise hair follicles without harming surrounding tissue. IPL disrupts the cycle of hair growth by breaking up the pigment of the unwanted hair. It uses very short duration pulses of light, so that discomfort to non-targeted areas can be, and generates light energy at various frequencies, depending on the depth of the target area.

Most IPL treatments last about thirty minutes. Follow-up visits are required a few times a year.

If you have unwanted dark hair and are sick of tweezing, waxing and shaving, IPL may work for you. To find out, schedule a consultation with Dr. Peña or one of his staff. During your consultation, the physician’s assistant will talk with you about your physical and emotional health, your expectations for treatment, and the risks and benefits of IPL, so you can decide if IPL is your best solution.

In Naples, Fort Myers, Bonita Springs, or Estero, Florida, please contact the friendly cosmetic surgery office of Florida cosmetic surgeon, Dr. Pena to schedule your no-obligation consultation.

Melting Fat..let me count the ways

2010-07-13T18:40:00.000-07:00

First came cutting out the fat such as in procedures like Abdominoplasty. Then Liposuction was introduced and this revolutionized the science of fat removal. The next big step was the introduction of a wetting solution which actually made the tissues stiff or "Tumescent", making the fat easier and safer to remove. This extra fluid could contain local anesthetics such as lidocaine or bupivicane allowing the liposuction to be performed without general or regional (spinal or epidural) anesthesia.

The next big step came when ultrasound energy was used to rupture or "shake the fat cells loose" so they may be removed with less trauma to surrounding tissue but with more efficiency. This was especially important in fibrous areas such as the back and flanks. Vaser is the most advanced form of ultrasound and is what I am currently using with great results.

Lasers where the darlings of plastic surgery from 1995 to about 2000 and seem to be making another run for our attention and our pocketbooks. Almost all lasers in use today can be adapted to burn or evaporate fat. The heat they give off while doing this has been attributed to almost magical abilities to shrink overlying skin and thus avoiding skin excisions. The jury is still out on these claims and unfortunately a lot of untrained practitioners have become "experts" in the field of laser assisted liposuction over the last 12 months.

Radiofrequency assisted liposuction and also claims to offer the ability to shrink the overlying skin beyond that of other methods. Water assisted or Jet assisted liposuction claims to provide other advantages such as preserving fat cells removed to facilitate their use in fat grafts.

The most recent technologies take the fat removal to a "non-invasive " level. There are lasers you lay under and this triggers the cells to open their pores and let the fat leak out. The fat is then excreted from the body. But for how long is this effective? The methods measuring the results of this technique has been suspect at best. External freezing of fat rolls seems to hold some promise. The method damages the fat cells which promptly die and they too are excreted. The precision and subsequent scar tissue formed still bothers my scientific bones. Similarly are two current methods under development and in US clinical trials that use externally applied ultrasound energy to rupture fat cells in unwanted areas.

As a plastic surgeon who ran a weight management clinic, I know hoe much a "magic bullet" is desired by both the patients and the practitioners. My warning to the general public and to my colleagues is "if it sounds too good to be true....??????"

Tummy Tuck Costs

2010-06-01T15:01:00.000-07:00

In Naples, Florida, fun in the sun is a top priority. Beautiful beaches beckon, and residents take fitness and beauty seriously. If your beach body needs a little help to look its best, the cosmetic surgery procedure known as tummy tuck or abdominoplasty may be a good option.

The stomach area is historically problematic, easily accumulating excess fat. No matter how much you diet and exercise, you still have a tummy bulge that won’t go away. Specifically for women, pregnancy can stretch the muscles and skin in a way that exercise cannot fix. If a firm, toned abdomen is at the top of your wish list, the tummy tuck can give you a more sculpted appearance.

At the office of Dr. Manuel Peña, we often speak with patients who want to feel more confident about their appearance, but have concerns about procedure costs. While cost is a valid issue, it is only one consideration when choosing whether tummy tuck is right for you. We suggest scheduling a consultation with Dr. Peña to give you the opportunity to fully understand the procedure, the potential risks, and the results you can expect to achieve. When you are more fully informed, discussions about procedural costs make more sense.

A qualified staff member will be happy to share detailed information about financing options, including CareCredit, America's leading financing program for elective surgery procedures. Offering no-interest and extended payment plans, CareCredit has plans to fit every budget.

If you live in Naples, Fort Myers, Bonita Springs, or Estero, Florida, and want to learn more about the tummy tuck procedure, please contact Florida cosmetic surgeon, Dr. Manuel Peña for a consultation at our Naples office.

Botox at the Mall

2010-06-01T13:23:00.000-07:00

Turns everyone wants to inject Botox/Dysport/ Juvederm/ Restylane/ Sculptra, everyone who legally can. The fact that injection techniques have taken me nearly 20 years to perfect makes me cringe that you can get FDA approved cosmetic injections next to where you get your jeans. The argument is that this will make it more affordable. Yes it will but at what cost. It reminds me of my patients who choose to go to Latin America for cheaper plastic surgery. The vast majority do well... but I spend a lot of time fixing those patients that are nervous about going back once they have problems. This is not to say I have not had any complications with injectibles, Hell look at what happened to me after I injected Hydrelle into my cheeks (my blog in February). But I have the experience and resources to fix these. Can you go back to the Kiosk next to the Piercing Pagoda and expect the same experienced service?

The Cost of Breast Augmentation

2010-05-19T08:45:00.000-07:00

Cosmetic surgery has made it possible to transform virtually any part of your body. In Naples, Florida, breast augmentation surgery is a popular choice for women who are unhappy with the size, shape or fullness of their breasts. Breast augmentation adds youthful volume and contour to achieve a more feminine silhouette.

Since 1990, Dr. Manuel Peña has performed thousands of breast augmentation procedures. Renowned for exceptional artistry and surgical expertise, Dr. Peña can help you choose the right implant and recommend additional procedures, such as the breast lift, to ensure beautiful results.

A common question Dr. Peña often hears is, "How much does breast augmentation cost?" While cost is obviously an important consideration, it should not be the only factor. The best answer begins with a comprehensive consultation. After Dr. Peña performs a thorough physical evaluation and discusses expectations for your surgical outcome, a knowledgeable staff member will share information on surgical fees and payment options.

Dr. Peña and his caring professional team want to help you look your very best. If financial concerns are preventing you from having the procedures you want, we provide several financing options, including CareCredit, America's leading payment program for elective surgery procedures. CareCredit offers no-interest and extended payment plans to fit every budget.

Dr. Peña is dedicated to keeping procedural costs competitive so he can continue to offer the most innovative techniques and technologies.

If you are interested in breast augmentation in the Naples, Fort Myers, Bonita Springs, or Estero, Florida areas please contact Florida plastic surgeon Dr. Manuel Peña today to schedule your initial consultation.

A la carte facelfting

2010-05-11T10:16:00.001-07:00

Every day I see a patient that was told by another plastic surgeon that they "need"everything done even if it did not bother them. This often includes forehead, eyelids, upper and lower face, and neck as well as some volume replacement in the form of fat grafts or filler. Although I often believe that additional procedures would enhance the overall outcome of the result, I will offer to address just what bothers the patient. I will show the prospective patients what the desired procedures would look like on them and them add the rest to see if a true improvement is seen. Sometimes the person agrees with the additions and sometimes not. Regardless I am here to fulfill your wishes (as long as they are reasonable) not mine. I often perform lower face and neck lift by itself. Sometimes a full face volume replacement with fat grafts is all I do. I am being asked more and more about the limited incision facelifts such as the MACS lifs. This is a rapid recovery surgery that has withstood the test of ttime for "getting your money's worth". Limited incision neck lift are also appropriate for the younger patients that have always had a poorly defined neck.

Candidates for Tummy Tuck

2010-04-22T13:00:00.000-07:00

You may exercise and eat healthy, or diet, and still be discouraged by areas of fat that just don't seem to want to go away. Sometimes increasing the number of crunches or adding another mile to your run just will not achieve the results you want. You may want to consider the tummy tuck procedure. Most people who have undergone tummy tuck surgery are extremely pleased with the results. They get the abdomen they have always wanted, but has eluded them even with regular exercise and a proper diet.

Candidacy for Tummy Tuck

Not everyone is a candidate for tummy tuck surgery. Dr. Peña will evaluate your physical condition and speak to you at length about your cosmetic goals. He will also want to know about your general medical history. Generally, a tummy tuck candidate is:

Already leading an active lifestyle
A non-smoker
Physically healthy
Within 25 pounds of their ideal weight
Emotionally healthy
Positive with realistic expectations

A tummy tuck tightens skin and muscles in the abdominal region and can be combined with liposuction to remove abdominal fat. Dr. Peña will discuss with you how the tummy tuck procedure will benefit your specific body type.

If you believe you may be a good candidate for the tummy tuck procedure, please contact experienced Fort Myers, Florida plastic surgeon Dr. Peña for an initial consultation.

Hydrelle reaction update

2010-04-13T11:21:00.000-07:00

Finally! It appears it's all over. I had to dissolve all the material in my cheeks and there is some residual discoloration on my left cheek. I hope this goes away some day. I am going to practice what I preach and get my own fat injected into my cheeks. I hope the Stem Cells in the fat will repair some of the post inflammatory effects.

This blog has moved

2010-04-12T13:51:00.001-07:00

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Hydrelle reaction/ infection

2010-03-15T06:15:00.000-07:00

Finally getting over my reaction to Hydrelle. I have had to inject Hyalouronidase about 5 times and there is still some material left there. I will not use this stuff again!

Hydrelle reaction/ infection

2010-03-12T07:02:00.000-08:00

I am glad to be 99% better. That was a scary 3 weeks. I wish I could post my pictures but I am having problems uploading photos. I hope I can get the word out to my colleagues so this will not happen to them.

I believe using hydrelle will cause an unacceptable amount of problems and reactions.

Which Laser Treatment is Right for Me?

2010-03-11T15:20:00.000-08:00

Laser treatments can improve the look of your skin in just one session. But not all treatments are equal. Naples Laser Treatment offers different levels of treatment based upon individual needs and preferences. If you are wondering which laser treatment is right for you, the following should help explain the differences.

There are three levels of laser treatment that I offer in my Naples clinic. we use the Visia skin analysis system to evaluate your skin and the Fraxel® Laser Skin Resurfacing system for treatment.

The Fraxel® system treats skin based on three levels of care known as

Fraxel re:fine™ treatment–for prevention and maintenance
Fraxel re:store™ treatment–for mild to severe skin damage

These treatments take only a short time, often less than 30 minutes. With the re:fine™ treatment you can return to work, looking better, immediately. With the re:store™ treatment you can return to work the next day.

We use a one pass CO2 scanning laser to achieve similar results to the Fraxel repair system.

If you are ready for younger, healthier skin please contact Manuel Peña, M.D., Naples laser treatment professional in Florida.

Hydrelle Reaction personal experience

2010-03-09T12:51:00.001-08:00

6 weeks after injecting Hydrelle into my cheeks i developed swelling, redness, and firm bumps. I treated it with local antibiotics, oral and injectible steroids and dissolving enzymes called hyalouronidase. I had to drain the areas several times. I received a memo from Coapt ( the company that markets Hydrelle) about 2 weeks ago and after it started recommending it only be used in the nasolabial folds and the marionette lines. Whoops, too late for me.

I am so glad this happened to me and not to one of my patients. I am having troubles uploading photos to this Blog but they will be here soon.

Photos of My Hydrelle Reaction

2010-03-09T09:48:00.000-08:00

Here they are: scary pictures of myself Manuel M. Pena, M.D. approximately 6 weeks after I injected Hydrelle into my malar areas. About a week before these photos I had received a memo from Coapt Corp. (the marketers of Hydrelle) recommending that this material only be used in the Nasolabial folds and Oral commisures. Whoops a bit too late for me!

Infection/ Reaction to Hydrelle

2010-02-25T07:46:00.001-08:00

I tried Hydrelle in my cheeks when it first came out with excellent results. I repeated this injection about 7 weeks ago. About 12 days ago started having swelling and redness in one cheek then the other. Despite aggressive oral antibiotics , injections of Hyalouronidase, and intermittent oral and IM corticosteroids I have quite a reaction that is only now starting to turn around. I now find many similar stories o the net from several plastic surgeons around the country. With so many serious reactions to Hydrelle in such a limited time, I think this product should not/ will not last long on the market!
I am glad this happened to me rather than one of my patients that would be freaking out and rightly so. I have used Juvederm for 2 years and over 400 patients (including my own cheeks) and I have never seen anything like this.

Get the Fat OUT!

2010-02-15T16:19:00.000-08:00

Just got back from a major cosmetic surgery meeting last nite. How many ways will someone come up to 'get the fat out'. There is traditional Liposuction (hohumm), tumescent liposuction, Vaser Assisted (the ultrasound I use), six different 'Laser Assisted' liposuction devices, a water pick device (Water Jet)liposucttion. They all claim to be gentler and perhaps be better. The laser devices claim they can shrink the skin thus perhaps avoiding excisional surgery in borderline patients. These are the same claims made by the ultrasound assisted proponents originally.

Then there are the non invasive devices. Zerona a low energy laser that when applied to the body from a few inches away will cause a signal to your fat cells to open their walls and let their fat leak out. The lymphatic then gets rid of it. (but how long before they start filling up again). Not approved for 'slimming' yet.I have been following the Ultrashape.. an external ultrasound device that ruptures fat cells by concentrating external ultrasound energy beams from different directions in one area and blasting fat cells. (no FDA approval yet).Another device actually claims to freeze your fat from application OUTSIDE the body thus injuring the fat cells so that they die and are eliminated. The usual Radio frequency devices are still trying to find a home somewhere as they now claim they can 'zap' fat away.

All sounds too good to be true. Let's see which ones are around in two years.

Botox/ Dysport study 3 month results

2010-02-15T16:13:00.000-08:00

I examined and interviewed all four patients that I enrolled in my study three months ago. I also found out which side was Dysport and which side was Botox. The results were exactly the same for both the patoent and me, the examiner. So folks... stay tune to see if on lasts longer than the other.

What is the Best Age for Breast Augmentation?

2010-02-02T14:44:00.000-08:00

The actual best age for breast augmentation is, at best, unique to each person. At our Fort Myers breast augmentation clinic, I perform a thorough medical examination and review of your medical history. Many factors determine the best age for this procedure, that the standard FDA approved age minimum of 18 years, and statistically best age of less than 50 years are not universally engraved in stone.

Personal information includes having complete breast development. Results can change if breast augmentation is done when breasts are still developing. For this reason the American Society of Plastic Surgeons (ASPS) recommends 21 years as a minimum age for breast augmentation surgery. Exceptions to the age recommendations are made if there are severe breast asymmetries which can be severely crippling to young women.

Emotional maturity is another important factor that suggests waiting until you are in your mid-20s before having this surgery. What appeals to you at a young age may not seem important later. Other factors, like anticipated pregnancies, breast feeding and lifestyle need to be considered.

Women approaching age 50 need to have realistic expectations. Age-related changes affect the quality of their skin and body structure. If they have not taken excellent care of their bodies throughout life, plastic surgery will not be a miracle cure. Older bodies do not heal as well as younger ones. Age-related diseases can remain hidden yet still have a negative effect.

Please contact Fort Myers breast augmentation surgeon, Manuel Peña, M.D. for a personalized consultation about your goals for fuller or perkier breasts.

Trans Umbilical Breast Augmentation

2010-01-30T15:28:00.000-08:00

Recently, I was out with some friends and our usual waitress told us she would not be there the next couple of weeks because she was having breast surgery. When my friends volunteered that I was a plastic surgeon and had over 2000 happy breast augmentation patients in Naples, she quickly explained that she was going to a surgeon in the East coast of Florida who performed the surgery through the belly button also nown as the TUBA.

Unfortunately I have more experience fixing the results of these than I care to have. There was a surgeon here who specialized in TUBAs. He is no longer practicing and I have seen the usual lists of complications associated with this procedure. The main problem with it is the lack of precise control. Kind of like painting a corner of a room with a pole and a brush while standing outside the room! The other problem is that the natural position that the implant goes is the
subglandular (above the muscle) position. That is a whole other story. Even when the surgeons claim that they are getting it behind the muscle I have found one behind and one in front on the same patient. the third problem is the need to use saline implants even on thin patients with thin breast tissue. These cases would be better served by silicone gel implants.

The most common problem I see is that the implants drop like bombs in 2-3 years and then often require a lift!. The excuses used by TUBA advocates is that you don't have a scar in the breast and you don't alter nipple sensation. If I had bad scars from the periareolar (around the nipple) scar.. I would not have done 2000+ breast augmentations. The same goes for losing sensation of the nipple....Bull#%&@!

Let's face it, it's a gimmick.. and not a good one. In defense of the surgeon.. the young lady said he had recommended Silicone gel through a periareolar approach. He had the right idea, but he did not emphasize the importance of the right approach and implant because he did not want to lose a patient.

Questions to Ask Your Cosmetic Surgeon

2010-01-08T07:31:00.000-08:00

When you are ready to ask the critical questions about cosmetic surgery, I, Fort Myers cosmetic surgeon, Dr. Manuel Peña am prepared to answer any that you have, and many that you might not think of.

Expectations

A well-informed, well-prepared patient has realistic expectations of what results are possible for them. My growing list of satisfied patients is founded on making sure each one knows what is possible, what is not possible and what risks are involved for them, personally.

More Questions

To get that kind of information I recommend asking at least 18 specific questions of any cosmetic surgeon before you choose one to do your surgery. In the course of your conversation, you will think of more questions. Answers to your questions should tell you about that surgeon’s qualifications and not just generalized statistics. Comparing the two is helpful, but if you do not know how his outcomes line up, you really do not know anything helpful to making this all-important decision.

It is important to ask to see before and after photos of treatments done by the cosmetic surgeon you might choose. Look for the artistic details as well as you consider your impression of what you see. You will want to see photos of all types of his work along with a large number of photos of procedures you are considering. One day you may return for another type of treatment. What you want to know is that his talent is consistent in all areas of his work.

If I can answer any questions you have for a Fort Myers cosmetic surgeon, please contact Florida cosmetic surgeon, Manuel Peña, M.D., and we will schedule a personalized consultation for you.

Advances in Bariatric Surgery

2010-01-03T17:37:00.000-08:00

Bariatric or weight loss surgery is becoming a more mainstream answer to long term weight loss. As procedures become less and less invasive the use of surgery as earlier option will become a reality. Less morbidity, less recovery, and less cost is bringing a new development in the field of Weight Loss Surgery into the lime light. The so called TOGA (trans oral gastroplasty) literally sews or staples the stomach from the inside thus restricting the size and giving a person a feeling of being full quickly.

Average weight loss of 25 lbs over 3 months have been achieved. Will the stomach 'stretch out'? So far only the Gastric Bypass has withstood the test of time.

For now I will recommend old fashion behavior modification within a physician supervised program for my patients requiring significant weight loss.

Overeating during Holidays

2009-12-22T05:11:00.000-08:00

I read a great article explaining the types of food that make you feel hungry. It's no new but they explain "high Glycemic Load" concept very well. Enjoy this article:http://shine.yahoo.com/channel/health/4-reasons-you-are-quot-fake-hungry-quot-555792/

Zerona Non Invasive Fat Reduction Laser

2009-12-18T06:19:00.000-08:00

Recently attended a conference on this new technology along with Dr. John Guercio. The science is impressive but as of yet not verified in our 'gold standard' peer reviewed journals. Some of the before and after photos left a lot to be desired. One of our major concerns is how enduring will the weight loss results be over time? Aliis verbis, will this intervention be a short-term 'fix' or more permanent?
The method of fat loss is a temporary leak of fat from cells. this is quickly disposed of by the body maybe even improving the patient's lipid profile. The mechanism for the later is to be determined. The 'fat leak' seems to be generalized and not limited to the areas irradiated by the painless low wattage laser. How long will the fat loss/redistribution change remain... and what will happen if you exercise regularly and maintain a healthy diet? Stay tuned.

"Botax"

2009-12-12T06:44:00.000-08:00

In an effort to fund the national health care reform Congress thinks it has found an easy tax target. By lumping cosmetic procedures together and taxing them it has tried to dismiss these as something only the wealthy have done. Unfortunately, in my office in Naples, Florida I see a lot of hard working individuals that care about their appearance and for personal and professional reasons try to do something about it. This tax will be particularly discriminating towards women who make up about 80% of those seeking cosmetic surgical procedures or services such as Botox injections.

This tax puts cosmetic procedures on par with Tobacco and Alcohol with "sin taxes'.
Let your Senator or US Representative know how you feel!

Questions About Liposculpting

2009-12-07T15:16:00.000-08:00

Liposculpting, as done in our Naples Liposculpting clinic produces astonishing contours that are far superior to traditional liposuction. This treatment is most effective for people who are close to their optimum weight but have been unable to shape and tone areas, like small love handles or saddlebags, despite fitness and exercise efforts.

How different are liposculpting and liposuction?

Because the name liposculpting is so similar to liposuction many questions arise about the difference between the two. Both remove fat from unwanted places, but there are differences in how this is done. Liposuction manually breaks up the fat and fibrous tissue, which is then suctioned out.

At my Naples liposculpting clinic I use ultrasonic heat to liquefy the fat and fibrous tissue before suctioning it. The procedure is more precise and allows me to sculpt your new contours around your muscles, giving you a finer, more flattering result.

More Questions

Answers to questions about liposculpting, such as whether you are a good candidate for liposculpting, lifestyle changes, recovery, and risks can be found on our Naples liposculpting page.

Read through the questions and if you want to learn more or would like to schedule a consultation for liposculpting, please contact me, Manuel Peña, M.D. at our Naples, Florida clinic.

Zerona non invasive Body slimming

2009-12-01T10:44:00.000-08:00

I am very excited about an upcoming lecture that I will be attending. It concerns the noninvasive fat reducing laser technology known as Zerona. This laser has been used in the operating room to cause the fat to leak out of the fat cells for approximately 8 years. It now has been intensified by 5 and he is approved for body slimming as a noninvasive and outpatient procedure. I believe this will enhance my physician directed weight reduction program as well as my surgical treatment of localized and generalized fat disorders. More after I attend and see everything for myself.

Botox vs Dysport

2009-12-01T10:36:00.000-08:00

Finally got my study going. For patients were asked to participate in the study. All effects of Botox which they had received in the past were visibly gone. Only one individual in my office who actually mixed to two vials one of Botox in one of Dysport knew which one was which. After extensive reading and attending several conferences the Botox to Dysport ratio is approximately 1 to 3. I interviewed the patients at 3 days and a one week and 3 of the 4 seemed to indicate that the left side of either the frown line or the crows feet seemed to go away quicker than her the right side. The only dissenting vote came from a patient who felt that I had causes small bruise on the left side and the right side started working quicker. By one week both were equally effective. There were no complications such as droopy eyelids or headaches. I will see them in one month to further compare the actions and reactions of the patients. At that time I will find out which side is Dysport and which side is Botox. I will keep you informed of my findings and the significance it will have in my practice.

Choosing a Cosmetic Surgeon

2009-11-09T10:27:00.000-08:00

Choosing a cosmetic surgeon takes time and patience. I recommend that you make a list of questions designed to find out about a cosmetic surgeon’s education, training, experience, techniques and equipment that he uses. Check his board certification, license status, and disciplinary actions (if any).

More Than Just Technical Knowledge

Cosmetic surgery is as much an art as it is dependent upon knowledge and skill. Not every doctor who graduates is equal in artistic talent. Successful cosmetic surgery depends the ability of the cosmetic surgeon to create the most flattering shape in whatever part of the body he is treating.

When you are choosing a Fort Myers cosmetic surgeon please compare my results with artistic skill in mind. Ask to see before and after photos, especially of people with your body type and who have had treatment similar to the one you want to have.

I am very selective about which procedures I use for my patients. New methods come and go, but I want to make sure that my patients have treatments that I can stand behind for years to come.

When you are ready for a Fort Myers cosmetic surgeon consultation please contact me, Manuel Peña, M.D., and bring questions to help you choose your cosmetic surgeon.

What Makes a Good Candidate for Plastic Surgery?

2009-10-30T15:46:00.000-07:00

This is a common question that needs to be answered for every patient. While being a good candidate for plastic surgery is a concern that affects all of our Naples plastic surgery patients, the exact answer to that question is personal to each one. I examine each patient and consider both the general criteria as well as personal criteria.

General criteria apply to most patients. They tend to include choices that you can control:

smoking habits–tobacco toxins deteriorate skin tone and interfere with healing when taken in any amounts
alcohol and caffeine habits–deteriorate skin tone and interfere with healing when taken in excess
medications, OTC remedies, herbal supplements–many possible effects on skin, healing and interactions with anesthesia
expectations–must be realistic
lifestyle, exercise, diet, sleep patterns–keep a healthy balance
emotional stability and support –to cope with post surgery states, and both your and other people’s responses to changes
weight, body mass index (BMI)–close to normal

Personal criteria are based upon your examination, medical and social history. They can include genetic traits you cannot control:

skin characteristics
health issues such as diabetes, heart disease, immunodeficiency diseases, allergies
excess skin from prior weight loss or pregnancy
plans for future pregnancies
skin damage from sun or other causes

This is not an exhaustive list. Rather, it gives an idea what I take into consideration when making a recommendation for your best results.

If you would like to find out if you are a good candidate for plastic surgery, please contact Manuel Peña, M.D. at our Naples, Florida plastic surgery office to schedule a personal consultation.

Brazilian Butt lifts

2009-10-09T12:14:00.000-07:00

I have seen an increase in women desiring a more distinct gluteal contour. We have chosen to employ a combination of liposuction and fat grafting to the buttocks. For the liposuction i mploy the Vaser a fourth generation ultrasound device that melts the fat making the aggressive contouring ot the area oth the waist, posterior hip, and saccral area possible. This is probably at least 50-70% of the improvement in shape. The other 30-50% is a result of the fat grafts. The more excess fat you have the more volume you can graft. Typically i use from 75cc to 400ccs per side depending on the size of the patient and their desire. When I have 'limited material' to harvest my fat from, I concentrate the grafting in the superior medial edge of the newly delineated butt cheek. This area that I call the 'sausage roll' of the buttocks, is mostly responsible for giving the butt a pleasing 'hardbody' shape. recovery is fast ( a few days) but final results will take up to 3 months and require form fitting elastic compression garments.

When the skin is the problem then an excision of extra skin is necessary. We are essentially pulling up the buttocks and loose skin much like one pulls up a pair of jeans. Some times the fat that would be thrown away is 'turned down as a flap' and used to fill and shape the upper portion of the buttocks. This is the only 'Butt Implant" I like to use and it's your own tissue! Recovery for this will be measured in the weeks (a couple) and activities will be significantly restricted in the first couple of weeks.

Whichever way you go you can be proud to fill out your clothes in the way you always dreamed

Breastfeeding and Sagging Breast

2009-10-01T12:51:00.000-07:00

A recent study revealed factors other than breast feeding may contribute the most to post pregnancy sagging of the breast. Over the years I have been impressed at the spectrum of post breast feeding breast ptosis that I saw in my patients. All had assumed that breast feeding was the most damaging to the structure and appearance of the breast, however a study released in the Aesthetic Surgery Journal suggested otherwise. Advanced age, high BMI or body mass index, large pre-pregnancy breast size, and smoking all contributed to post pregnancy breast sagging to a greater degree than purely breast-feeding by itself. This information is important to allow mother to make choices based on sinus rather than hearsay and misconceptions.

Arm Lift Surgery

2009-09-30T13:05:00.000-07:00

If you have developed sagging skin in the upper arm region due to lost skin elasticity from aging or massive weight loss, then arm lift surgery might be the ideal treatment to help you achieve a more toned appearance in your upper arms.

During an arm lift, Naples plastic surgeon Dr. Manuel Peña will remove excess skin and fat from your upper arm to create a more toned appearance. It is important to understand that this procedure is ideally suited to candidates who no longer have good skin elasticity. If your skin elasticity is still good, you may benefit more from Vaser assisted liposuction.

The entire procedure can be completed within two to three hours. Dr. Peña will make an incision in your arm near the armpit along the inside of your arm. This will ensure that your scar remains hidden after the surgery is complete.

Dr. Peña uses only the most advanced body sculpting techniques to remove the excess skin and fat from your arms. When this process is complete, he will use Quill sutures to close up the incision site. Quill sutures are absorbable, so you will not have to return to get them removed. After the procedure, you will notice a reduced arm circumference and minimized sagging.

During the recovery process, your arm movements will be restricted while you heal. You will most likely miss one to two weeks of work, depending on your individual circumstances.

To find out if you are a good candidate for an arm lift, please contact our Naples plastic surgery office today to schedule your initial consultation. Dr. Peña serves patients in the Naples and Fort Meyers, Florida area.

Fat Grafts for facial volume

2009-09-28T14:07:00.000-07:00

Sculptra can be used to fill a face that is lacking volume. Unfortunately it usually takes about three or four injections over six to twelve weeks to achieve the result that has been proven to 'stick around' for up to three years. The best thing about Sculptra is that it is 'off the shelf' and can be injected when prepared the day before with just an anesthetic cream and ice. The results are gradual and may take up to a month to see. Since the volume is caused by the body reacting to it, everybody gets different volumes per injection. While this is true for fat also because of it's varied take, the desired result can be seen (with a bit extra to allow for some loss) the next day. It is a surgical procedure however and if you have more money than time Sculptra will be a good option. Oh by the way, did I mention that with your own fat cells there are stem cells that can improve the quality of your skin especially in sun damaged or acne scarred skin.

The fat is permanent once the initial three weeks are up. It is living tissue taken from areas that are programmed to grow (abdomen, hips, and thighs). There may be some gradual volume loss from the face as your natural facial fat disappears however.

More immediate 'off the shelf' options are the Hyaluronic Acids, my favorite Juvederm and a recent exciting entry Hydrelle. You see immediate (24 hour results) improvement that stays about one year and probably never returns to the original.

TecnoSurgeons versus Artist/Surgeons

2009-09-28T07:41:00.000-07:00

Many years ago I received a csll from a local middle school student wanting to know how she could become a 'laser surgeon'. I laughed and explained to her that the laser was simply one of the many tools we used to accomplish surgical goals. She sounded somewhat disappointed and i never heard from her again. Since that time I have met countless of my patients (new and established) that come in clutching a news article with some new technological advancement. I will gladly take a look and explain why I am or am not currently using that technology. Every year I attend several scientific meetings and try to bring back two procedures or technologies to my practice for evaluation. If I am still using that procedure or technology in one year I consider myself very lucky. There is a helluva lot of hype out there causing poorly trained surgeons to believe that with a magic wand they can become cosmetic surgeons. They have no artistic ability or insight and will simply let a device manufacturer train them. If they are 'well trained', they took a weekend course and took their "Board" online and passed them..

BEWARE of new technology. "All things good were once new, but all new things are not good"

Fillers and Relaxers and PTFE/silicone 'fused' implants

2009-09-25T11:26:00.000-07:00

A new system used o harvest large volumes of fat for fat grafting has been introduced. It uses a large sterile container and uses saline to 'cushion' the fat as it is collected (thus the name "Aquavage"). The design also allows ease of cleaning the fat and efficient transfer to the syringes for injection. This is especially useful in larger volume fat grafts such as to the buttocks. The new controversy seems to be if Vaser Assisted liposuction (even at a low 60%) Vaser mode damages the fat cells to a degree that makes them useless as fat grafts.
The Botulinum wars are just starting to heat up with some early competitive pricing by the Dysport camp and some original Botox disciples switching camps! The search for a product that is more effective as a topical agent is closer as the technology to deliver the purified toxin (without the proteins designed to protect in the gut) is perfected. A highly cross linked hyalouronic acid with Lidocaine in it called Hydrelle is coming on strong in the Thick Filler market. We are still waiting for Thin Fillers (for fine lines such as crow's feet and tiny smoker's lines) to make it to the US market. Sculptra has a few more indications and is certainly a good choice if no fat is available of if someone wants a product off the shelf. Too bad no one knows how much volume one is going to get per vial of Sculptra!

Another innovation is the addition PTFE (Goretex) to silicone implants to allow some incorporation or fixation to the implants. This combines the good properties of both while getting rid of the moving/ migrating silicone implant or the 'collapsing/ compressing' Goretex implants. New ideas and new technology. We'll see if they pan out.

Learning about Dysport

2009-09-18T11:49:00.000-07:00

Just got to view a detailed web presentation dealing with the science of Bolutinum Toxin type A. The few head to head studies between Botox and Dysport seem to reveal a statistically significant increase in duration of action with Dysport over Botox. Hmmmm? ok. The onset of action seems to be similar and the side effect profile is extremely similar in the larger studies. Therefore my initial hesitancy was because rumors claimed it spread more than Botox thus increasing upper eyelid drooping as a possible side effect. Turns out the numbers are the same. Hmmmm? Why haven't I tried it yet? Well I have enough of both to do my own study and frankly, researchers in this field lie on a regular basis depending on who is funding what. I will have to make my own mind.

The newer studies especially the Dysport studies show higher success with higher doses in those patients with the thicker muscles (men and women with super expressive faces). Remarkably, the complication rate did not increase with the higher dose! This however will prevent me from quoting a 'one price fits all' at least for the glabella.

Weight management update

2009-09-18T11:42:00.000-07:00

We are one month into our program. Wow, the results have been impressive. Most of the patients have exceeded their short term goals and are telling everyone about how they did it. Even two patients that went on cruises managed to lose about 1 1/2 lbs in the week. Now, that's tough! We all know that keeping it off will be the hardest part and we use every opportunity to praise the present progress and prepare them for the transition phase and eventual weaning to the Zone Diet/ way of life

Hydrelle first look and my experience

2009-09-15T05:09:00.000-07:00

Got a chance to try Hydrelle, the latest HA on the market last Friday. It is highly crosslinked (hopefully making it stick around a long time) and has the highest concentration of HA available so far in the US (making it absorb more than 50% of its volume in water thus plumping up the deepest of hollows). The last new twist is that it comes with lidocaine (the injectible anesthetic I often use to numb the areas before injecting the HA's) and this was particularly good because I tried this on myself! I have to admit there was less discomfort than with the previous materials and the swelling was noticeable for about 36 hours. This was probably from all the water being absorbed by the material. No bruising at all but a bit sore for 48 to hard touch. At 4 days I am pleased. Let's see how long it lasts.

weight management and wellness

2009-09-15T04:58:00.000-07:00

The patients who have joined our program during the initial 3 weeks have done very well in their quest to shed pounds and get healthy. All but one had elevated cholesterol and most had elevated triglycerides and ldl (bad cholesterol). Some had high blood pressure and one is a type 2 diabetic. I am exited to see their progress as we "follow all the numbers" not just their weight as we approach their goals.

The difficult part will be the transition as we wean them off the program and get them to modify the lifestyle that got them into their present condition of 'unwellness'. I am going to commit my time and my staff's time as well as all the resources we have available to make sure that the individuals that are willing to try will succeed.

Lifestyle Lift Busted

2009-09-09T14:06:00.000-07:00

Lifestyle Lift the company has been fined by the state of New York for having their employees file bogus "happy patient/customer" testimonials to boost their reputation. Well, I am not suprised. Any company that promises more than it can deliver will need tactics like this to keep the customers coming. If it sounds too good to be true it probably isn't.

I am a pretty fast surgeon and I can't do an "S-Lift" in 1 hour (that is essentislly a Lifestyle lift). I am not in a race .. my only concern is giving you the best surgical outcome with minimum risk and downtime. If you want cosmetic surgery, don't go to McDonald's, ask your physician or ask your friends and visit a plastic surgeon (board certified) who has your best interest in mind and a great reputation to maintain.

sutureless upper eyelid surgery

2009-08-31T14:42:00.000-07:00

We have been using surgical glue in plastic surgery for over 20 years. It's a form of the classic 'crazy glue' cyanoacrylic that has been purified to minimze skin irritation. A recent report I read uses only the glue to close the upper blepharoplasty incision. They used a few temporariy sutures to bring the edges together and allow the glue to make a seal and dry. They are removed at the end of the surgery. One might use this to minimze discomfort of suture removal in a sensitive area. The results were comparable to those using sutures. I can imagine the area feeling a bit stiff but might be worth the tradeoff especially if someone needs to travel before the fith day or simply cannot keep the scheduled appointments for suture removal.

Cosmetic injectible update

2009-08-28T07:34:00.000-07:00

Not only do we have the Botulism toxin war between BOTOX and DYSPORT, we now have the addition of local anesthetic to injectible hyaluronic acids. Recently approved PREVALLE SILK and HYDRELLE (for fine and deep lines and wrinkles respectively) now incorporate the local anesthetic lidocaine to minimize discomfort during injection. Other technological advancements have come in the field of transdermal delivery system. A company is close to perfecting the right combination of ingredients that would make possible the delivery of BOTULISM TOXIN through the skin in a predictable quantity. This would be exiting news for those being treated for excessive sweating (underarm and on palms) or those who just plain abhor needles and are using BOTULISM for crows feet. I will keep my finger on the pulse to differentiate between true technological advances and product hype. Stay tune.

Weight Management/ weight loss program

2009-08-20T08:44:00.000-07:00

Over the last twenty years I have been offering state of the art plastic surgery and good advice to the Southwest Florida residents, however until recently I was not able to affect their health. Many a patient came to me seeking a solution to the problem which they thought would be surgical. Their problem was that they were either overweight or downright obese and they did not need my help as a plastic surgeon but as a physician interested in their health. I recently lost 26 pounds and he has made a tremendous difference in how I feel and how I look and how others perceive my state of health. Tomorrow we will see our first patients in our clinic. My goal is not only to provide the method for them to lose weight in the incentive to keep them motivated to keep it off. My staff and I are committed to providing this service with chest as much enthusiasm as we have for our and spa services. If you know someone who has been struggling to lose weight and keep it off please have them consider a medically supervised weight management system. They can call our office and when get a medicine as possible and get them on the road to a healthier lifestyle.

Addition of Weight Management system to Our Office

2009-08-05T02:46:00.000-07:00

I am anxious to get back to Naples. We are ready to launch one more service for the Naples/ Bonita Springs/ Ft. Myers area! A total weight managemnt program based on the Zone diet and supplements as well as prescription medication (when indicated). This along with a sensible excercise program and a commited staff that will give you all the tools to get the weight off and, more importantly KEEP IT OFF! The health benefits far outweigh the improvements in your appearance. Recent reports of an 'Obesity Epidemic' which is threatening to overrun our health care system with Diabetes, Heart disease, and High blood preassure.. has been on the news worldwide.

I often see patients that need to lose weight not have surgery at that time. Now I believe I can help those individuals that truly desire an improvement in their quality of life

Uganda Cleft lip and Palate Mission Trip

2009-08-03T03:27:00.000-07:00

Sorry I have not been blogging lately. I have been gone for two weeks (one still to go). On a mission in Mbale, Uganda performing clt lip and palate surgeries on babies born with these deformties. Although I really enjoy performing the best cosmetic surgery of theface, breast, and body in the Naples, Bonita Springs, and Ft. Myers area...sometimes my heart longs to help those who cannot otherwise get help. It is "the other" type of surgery I perform. This is my eighth mission helping childen in various under-developed or third world countries. This mission is through an organization called CURE that runs many childrens hospitals in these countries. They are partners with Operation Smile/ Smile Train which you may have heard of. Thy run an excellent hospital that focuses on neurosurgical problems in children, especially post infectious hydrocephalus. Dr. John as he is affectionately called performs anicredible number of internal shunting operation using a flexible endoscope!. Truly cutting edge surgery in a top notch hosital. Several times a yer they host a plastic sugeon to perform cleft lip and palate surgery during a two week period. I even got an opportunity to repair the lip of a 23 year old man! Can you imagine growng up like this I amhonored and humbled to be able to come here and do this. I feel fortunate? for what God has given me as far as health, talent and a wonderful family. I can never expect to repay all he has chosen to give. See you back in Naples area soon

Stem Cell Facelifts

2009-07-02T07:29:00.000-07:00

Here in Naples, Florida we have been offering "stem cell face lifts" for eleven years. I just haven't called them that. What is this anyway? Recently the importance of the stem cells found in ones own fat was discovered as a rejuvenating force! Using the healing potential found in fat cell/ stem cells, the effects of facial rejuvenation with volume enhancement is improved beyond just volume restoration. The texture of the skin is improved especially in those patients with previous acne scarring and loss of elasticity due to sun exposure. The texture, thickness, and ultimately the appearance of the skin is changed for the better. Obviously the volume restoration is also the key to "looking like you did"!

Am I a Candidate for a Tummy Tuck?

2009-07-01T15:43:00.000-07:00

A tummy tuck is a body contouring procedure that results in a smoother, tighter abdomen. It is commonly sought by men and women in their 30s, 40s, and 50s who have tried diet and exercise but still have slack skin and muscle s in the abdominal area. The procedure is especially popular among women who have had one or more children but do not plan on having more, since it allows not only for the tightening of slack abdominal muscles, but also for the removal of stretch marks, since skin is removed from the abdominal region.

In general, the best candidates for tummy tucks are in good general health, are at or near their ideal weight, are non-smokers, and have realistic expectations for the procedure.

To learn more, you can read our Good Candidates for Tummy Tuck page, or schedule a personal evaluation with Naples, Florida plastic surgeon Dr. Manuel Peña today.

Am I a Candidate for Breast Augmentation?

2009-06-25T07:49:00.000-07:00

Making the decision to undergo breast augmentation is a big step and not one to be taken lightly. Many of the women who schedule consultations with Naples, Florida cosmetic surgeon, Dr. Manuel Peña, have contemplated this surgery for months or even years. But just because you have decided that you want to have larger breasts does not mean you are automatically a good candidate for this surgery. There are many factors that must be taken into consideration before having breast augmentation performed.

If you have done your research (or if you have already spoken with Dr. Peña), you know full well that breast augmentation surgery is an invasive procedure that requires a several week long recovery period. So, if you are unable to devote time to recovering from this procedure, you would not be a good candidate. This is not the type of surgery that allows you to return to work the next day.

Breast enlargement is one of the most popular procedures performed at our Naples plastic surgery center; we have been providing women with fuller, larger, and more shapely breasts since 1990. If you are in good health and have realistic expectations about what this surgery will do for you, then you will probably be a great candidate. However, if you have problems in your life and think larger breasts will make you more successful or more “liked” by other people, then you do not have the right mental attitude we are looking for in prospective patients. If you have experienced failed relationships or if you have been passed over for yet another promotion, breast augmentation will not “fix” any of that.

To learn more about what makes a good breast surgery candidate, please contact Manuel Peña, M.D. at his Naples, Florida cosmetic surgery practice today to schedule a confidential consultation.

Browlifting made Easy

2009-06-02T11:55:00.000-07:00

For many years endoscopic browlifts have been the most common way the forehead is rejuvenated. Five little incisions behind the hair line and some high tech intruments and tiny video cameras and 'Poof' you are done. Is there an 'easier way' to achieve a rejuvenated forehead?

First of all, do we know what a young forehea looks like? Are the brow really suppose to be high and the forehead expressionless? Come on you know 'that ain't right'! Let's look at your high school graduation photo.. very nice.. top of the class hmmm? Anyway, look at the poistion of the the eyebrows and the fullness of the lateral and central parts of the brows. Notice the nice pleasing arch to the brow that seems to reach its maxi mun height at the junction of the middle 1/3 and lateral 1/3 of the eye. The brow is full and there is very little skin loose below the brow. This is because the fullness takes up the skin and when your eyes are open the elastic skin accordions up. Also notice the fullness between the brows and the lack of hard lines between the brows. The distance between the brows is also limited in the 'young forehead and.Ok, we got the idea. What happens when we Lift the Brows? Brows are brought higher but what holds them there? A device that absorbs in a few months and resembles a carpet tack, is placed in a tiny hole in the skull and suspends the forehead tissues until it heals in its new elevated procedure. you can also access the frown muscles and remove them. This often results in an unnatural separation of the central part of the brows and also flattens this area.

So what do I prefer now? Much simpler procedure called a Lateral Subcutaneous Browlift has become my favorite when combined with Botox to the frown line muscles. This is a simpler procedure that is performed in a more superficial plane through small incisions in the lateral forehead hairline. The lift of the lateral aspect of the brows is achieved by pulling up on the superficial layers of the brow making this a much more efficient lift. The excess is excised and is closed to make to scar disappear as the hair growth through it. This procedure can either be done in conjunction with other surgeries or by itself under local anesthesia. There is a very quick recovery and side effects usually are limited to mild bruising around the eyes. This is in a used the endoscopic brow lift anymore, it just means that there is an easier way to achieve lifting of the lateral brow which is the main focus of the surgery in the first place.

Botox Wars

2009-05-28T06:18:00.000-07:00

Just recently the FDA announced the approval of the second Botulism type A formulation. Botox has been available for clinical use since 1972. Initially used to treat lazy eye in children and now as the number one cosmetic procedure/ product in the US. It has had no competition here for this lucrative market until now. Dysport is another Type A Botulism toxin that has been used in Europe for several years with many excellent reports from physicians. They are not as alike as they seem. Because they are processed or manufactured differently, they vary in strength per unit and their ability to spread throughout the tissues. These two properties may play an important part for its use in certain areas and circumstances. For instance, the reportedly greater diffusion of Dysport may make it a better product for controlling excessive perspiration of the armpits and hands. This however may increase the possibility of droopy eyelids when using it for frown lines. I have not used Dysport so I can't say for sure. What I can say is that I am excited to have a second product on the market and I will certainly give it a try. I am anxious to perhaps involve a series of patients and randomly use half Botox and half Dysport on each side of the face and see how fast it takes effect and how long it lasts. Any problems or nuances will be noted in the process.What I'm looking for is a good old-fashioned PRICE WAR! I hope it begins soon.

Breast Asymmetry

2009-05-25T15:40:00.000-07:00

While we all have flaws in our appearance whether it be a large nose, flat chest, pigeon toes, or crooked teeth, some flaws are a bit more embarrassing than others. Many women consider their breasts to be one of their most prominent, attractive features, so when something is “off” with their breasts, they may seek out ways to correct the problem. Thankfully, highly trained cosmetic surgeons such as Dr. Manuel Peña in Naples, Florida are able to correct our flaws through cosmetic surgery.

While many women seek to enlarge their breasts through breast augmentation, a great many women are also looking to make their breasts more symmetrical. Breast asymmetry, in which the breasts are different in size and/or shape, is a very common problem in the female population, but it’s one that can be corrected with surgery.

To know how to best correct the symmetry of your breasts, you will need to meet with Dr. Peña so he can perform a thorough examination and then make recommendations for breast correction. If you are over the age of 18 (in some cases, he may consider surgery for younger patients), in good health, and have a realistic view of what this surgery will do for you, you may be a great candidate for breast asymmetry surgery.

To learn more about how surgery can correct breast asymmetry, please contact Florida cosmetic surgeon, Dr. Manuel Peña today to schedule your consultation.

Still Waiting for "Gummy Bear Implants"

2009-05-20T20:20:00.000-07:00

For years we have been hearing about the 'Gummy Bear Implants'. They are great for this and fantastic for that and are used 70% of the time in Europe, etc, etc. Patients feel safe with these so called 'Form Stable Implants' because if they break the silicone won't leak out and wreck havoc on your body. Fact is we've known for more than ten years that silicone is not associated with any of the diseases that were attributed to it in 1993.. so why use this reason at all? Truth is that these form stable implants have a place in certain types of cases such as reconstruction and difficult constricted breast syndrome. Some of the surgeons that are using them in the U.S. study believe they are useful in certain recurring capsular contracture especially when combined with dermal collagen interposition grafts. No doubt they will be a welcome addition to our choices of implants...BUT...do think you have to wait til these are available to get an augmentation or lift with implant. The old smooth round implants will still be your best bet in over 90% of these cases. The American public will demand the choices that should be available to them ,,,,BUT...most will choose the look afforded by the implants we already have available.

Affordable plastic Surgery

2009-04-28T12:43:00.000-07:00

I just had a great seminar at my office to discuss affordable plastic surgery. Bottom line is this: people still want to have plastic surgery and I still want to do plastic surgery... so what is keeping us apart? Obviously, it's the economy and the insecurity most feel about their financial future. The key to 'coming together' is to prioritize. What really bothers you? What can be done to fix or improve this? Are there any fillers or other injectibles that can temporarily help the problem area(s) until you feel that you are in a more comfortable financial position? Can a less extensive procedure be used to improve the situation 70% of what a more extensive procedure might obtain? Can this be performed under local?

As you and your physician explore these options you will come up with a short and long term plan that will not feel like a compromise but more like a collaboration. Try it, you will like it

Saline versus Silicone

2009-04-26T21:04:00.000-07:00

It's all about the feel. Frankly they both look exactly the same. The more of your own tissue you have, the less difference there is. For instance, if you are a thin individual and you are wanting to go from a "B" to a "DD" then you may probably feel that the silicone implant feels more natural. If you have a fair amount of your own natural breast tissue and want to go up one or two sizes the difference will be much less noticeable.

The costs of saline implants run about $1000 dollars less than silicone. They both have 10 year 'part and labor' warranties (like a KIA) and lifetime implant replacement policies/ The silicone implants are lighter for the same volume but only minimally.

If you are worried about the health concerns associated with silicone implants.. forget about it.All this was resolved in 1998 when no (ZERO!) correlation was shown between silicone and all the diseases that were implicated (from Lupus to Loss of Libido). So get on the net and get informed, there is a right implant for you just waiting for its chance to get you the shape you desire.

Medical Tourism Plastic Surgery

2009-04-26T20:51:00.000-07:00

Let's face it, who doesn't want a good deal? Plastic surgery in an exotic location at half the price...hmmm, sounds real good doesn't it? However, this year alone I have seen six cases of complications of surgeries done abroad that have required my surgical intervention. These folks could have gone back to their surgeons and asked for treatment where they got their original surgery, but they were scared or too tired to keep going back. For three of these individuals the revisions (fixing the surgical problems) when you add them to the original costs of surgery, made their surgical costs greater than if they had just stayed here!. All I'm saying is that you have to consider everything when you are thinking about going out of the country for cosmetic surgery. Do your homework.. sometimes it is better and even cheaper in the long run to find a great surgeon here and have your surgery. Remember Naples, Florida is a great place to have Destination Surgery. Most physicians understand today's economy and are willing to work to keep you right here for your surgical needs.

Affordable Plastic Surgery

2009-04-18T15:32:00.000-07:00

With all the concerns about the economy in the news today, it’s probably normal to wonder if you can still afford plastic surgery. The answer is yes.

There are many options as long as you and your doctor can; list priorities, explore possibilities and accept some compromises. For example, if you are looking into facial procedures, you probably already know about BOTOX®. But what about dermal fillers like Restylane and Perlane? These are just two of several affordable dermal fillers that restore skin volume to wrinkles. While you may want a facelift, discussing other options with Dr. Peña might give you the same desired result without an economic strain.

The key is to have well defined objectives prior to coming in to the office. Though Dr. Peña will help you with many of the details, knowing what you want, as well as what you don’t want, is important. This may also help defray some of the costs in the long run. Know that while some procedures may be done together, you don’t have to have everything done at once.

Finally, Dr. Peña offers the option of financing your plastic surgery with the help of CareCredit. CareCredit has several repayment plans that are set up and tailored to your economic means.

If you have any questions about how you can afford plastic surgery or about the procedures in general, please contact Manuel Peña, MD for an initial consultation. Dr. Peña serves the areas of Naples, Fort Myers, Bonita Springs, and Estero, Florida.

Loud implants at high altitude

2009-03-28T05:56:00.000-07:00

Recently I saw a patient that had returned from a 4 day ski vacation in Colorado. She was staying at a resort at about 8000 foot elevation. shortly after arriving she noted strange noises coming from her breast any time she moved. These were quite unflattering and did not stop until she was back home at sea level. She had silicone breast implants for about two years and has had no problems before or since with them. I called several plastic surgery colleagues that practice near ski resorts and none had heard of implants making any noise 2 years after surgery!
Another curious thing. if you have experienced such an occurrence please contact me.

lovely lips follow up

2009-03-20T08:48:00.000-07:00

Here are Kelly's lips about a month after augmenting them with the solid silicone Permafil lip implants. They are very soft and feel extremely natural.permafil lip implants

Mommy Makeover

2009-03-20T08:06:00.000-07:00

Childbirth can often change your body in ways that traditional exercising and eating a proper diet may not be able to correct. In specific, the breast are often deflated and heading south as well as a tummy that has lost its muscle tone and may exhibit stretch marks. The increase in fat in the hip area can give a square appearance to the lower body.
The usual consultation starts with what ever bothers that individual the most. But be assured, they will bring up all the rest before the consultation is done. If there is no health issues then a combination surgical procedure will have several advantages. First of all the recovery is done simultaneously, minimizing overall down time. Next the cost of combining surgeries can be be significantly reduced as an incentive by the surgeon. Last but not least is the fact that once you have one procedure you will often notice the 'other areas' more in contrast to the 'up graded' areas.
Breast augmentation with and without lifts are how we deal with the breast. occasionally the breast have enough or too much volume and a lift using your own tissue as an implant is performed or even a reduction/ lift.
The tummy is evaluated for muscle tone and position as well as quality of the skin and fat deposits. Options here range from liposuction using Vaser Ultrasound Assist and a rigorous exercise program to a tummy tuck and hip liposuction. the tummy tucks come in different flavors depending on what you need. The simplest tummy tucks (abdominoplasty) deals only with excess skin and does not require muscle work. A new belly button may or may not be required. The abdominoplasty is called a 'mini' if the belly button is left alone or slid to a lower position. Muscle repositioning and waist reshaping requires a bit more recovery but often yields the most dramatic results.
"mommy makeover"

Latisse for fuller longer lashes

2009-03-13T08:00:00.000-07:00

Some great advances in cosmetic medicine have been found by accident. For instance Botox was used for many years to treat children with lazy eye. Later when used for facial spasm in adults someone said "Hey, look my wrinkles are gone where the Botox was injected!". The rest is history. Then Minoxidil was used for high blood pressure when some patients noticed hair growth... thus Rogaine. The rest is history.
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Once again patients using bimatoprost opthalmic drops for their glaucoma noticed their lashes getting thicker and longer... Thus Latisse...drops that are applied to the lashes and will result in beautiful lashes in usually 3-4 weeks. This is by prescription only and their can be some mild transient side effect.. so ask your doctor about this possibility for eyelash enhancementeyelash enhancement

2009-03-08T17:39:00.000-07:00

The question today is: "Can I afford plastic surgery?". Consider this, what other investment will you be 'wearing' 24 hours a day and enjoying every time you look in the mirror? First of all you must prioritize what bothers you most. Are there minimally invasive ways to achieve your goals? I have noticed a rise in my cosmetic medicine practice while everyone is worried about the economy. This includes Botox treatments and injections of dermal fillers such as Juvederm and Evolence. These injections can erase many lines and wrinkles in just a few minutes at a fraction of the cost of major procedures. Down time (away from work and social functions) is practically non existent!This can be accomplished in the office at a fraction of the cost of major procedures.

The most efficient way to rejuvenate a face is by restoring the volume lost by natural aging. Look at your high school graduation picture. Most striking difference between that image and what you see in the mirror is the volume. Look at the cheeks.. the brow pads above your eyelids... the lips.... the jaw line. Notice the heart shaped face you once had has changed. Yes, some elasticity has left the tissues, but primarily it has been volume loss. We lose several ccs of fat from our face every year primarily in the form of fat. One of the most natural and powerful rejuvenation surgeries I perform is full face fat grafting or 're-volumizing'. I harvest your own fat and transfer it to your face. About 70% of the transferred fat lives forever and if harvested from the areas of your bodies that are 'programmed to grow'(we all know those areas right!) ideally, the volume of your facial fat that continues to be lost will be offset by the fat from other areas that like to 'grow'. Recently the fat around your lower belly has been found to contain the highest amounts of your own stem cells. this makes them particularly hearty and able to help out the quality of surrounding tissues like your skin. The recovery is days rather than weeks and the cost is often half of traditional rejuvenation surgery.

Other options for a dramatic minimally invasive change are the medium depth chemical and laser peels. The recovey is usually about a week. But this is a a whole new topic.

2009-03-06T10:41:00.000-08:00

There are many options for lip augmentation. We have excellent fillers that last from 6 months to a bit more than a year. These are different forms of hyalouronic acid such as Juvederm and Restylane. They provide a natural feel in a simple injection form that takes 5 to 10 minutes to perform in the office. You are ready for your public in 24 to 36 hours.

Recently, implants (saline and silicone) have been introduced. Just like breast implants except the silicone is a solid gel rather than a liquid gel. As opposed to the old Goretex and Alloderm (cadaver skin), the extrusion, irregularities, and infection rate is almost nonexistent. They are permanent but can be removed rather easily. Recovery is approximately a week although most people look ok the next day. Different sizes and lengths are available to 'fill' any taste and shape of lips. This is performed under local anesthesia and takes about 30-45 minutes. Some patients take a mild sedative to relax during this quick procedure. Call our office and talk to Kelley one of our recepcionists. She had it done on February 23rd and was back at work on the 24th looking good!lip augmentation. Here she is (top two photos.. 4 days post procedure) and bottom two just before. Stay Tuned....

Welcome to our blog!

2009-03-06T09:20:00.000-08:00

Welcome to the Dr. Peña Plastic Surgery Blog