Archive for the ‘Uncategorized’ Category

How I do Liposuction

Wednesday, July 15th, 2009

Liposuction is probably done differently by every plastic surgeon who does it.

1. I make punctures to create very small holes. I do not make any cuts. I do it with a round awl (a pointed object)

2. I use a metal cannula to inject quite a lot of intravenous fluids using a special pump. The fluid contains epinephrine to make the blood vessels smaller and lessen bleeding. It also contains some xylocaine to relieve the immediate pain afterward.

3. Then I move an ultrasound emitter over the skin. The skin is covered with a lubricant like KY jelly. This also helps conduction. This process pushes the injected fluid through evenly and softens the fat.

4. I suction using special cannulae attached to large syringes. When I pull the syringe plunger it locks open and creates a vaccuum. This is how I do the suctioning. There is no machine.

5. When finished BandAids are placed over the punctures, and a support garment. There are no stitches. There is likely to be some drainage for 24 hours. This lessens bruising.

6. Recovery is quick. I like my Modesto liposuction patients to be asleep for this procedure.

Looking for your comments

Thursday, July 2nd, 2009

This blog is mainly about plastic surgery and cosmetic surgery in particular. I intend to put out articles that both inform you and stimulate you to add your own thoughts. Please ask questions. Please disagree as you feel appropriate.

I will answer you if you ask me about breast implants, breast lift, breast enhancements, breast reduction, tummy tucks of all types and also liposuction. As you know my practice is well known for excellent results in these areas.

I am fascinated by these subjects as well as all questions related to beauty and would be happy to enter into a spirited conversation with you. I will even digress to non plastic surgery subjects if you want me to. Let’s talk about the economy, weight loss, life changing situations, poltics, health care and art.

I invite you to participate.

Liposuction Abdominoplasty – a new advance in the technique for tummy tucks

Sunday, June 21st, 2009

The tummy tuck procedure has evolved and improved since the procedure was first tried in 1899. The standard technique, which has been with us for about 30 years, consists of a horizontal incision in the lower abdomen. The skin and fat is lifted up off of the muscle. The belly button is saved by cutting around it. The muscles are tightened and the skin and fat flap is brought down and trimmed off. This is still a fairly standard technique in most plastic surgery practices.

It has a couple of problems that make this method rather risky. There may be insufficient blood getting to the lower central skin after the procedure and this can result in an area of dead skin which can create a hole. This might take weeks or even months to heal up with intensive wound care. Liposuction at the same time as this technique makes this problem worse. As a result we avoided liposuction at the same time. This resulted in residual abdominal fat that would need liposuction as a second procedure. The second is that there is a large space under this flap that needs prolonged drainage tubes and often drainage fluid will accumulate there after the drains have been removed. This is called a seroma, and the fluid needs to be removed by new drains or needles.

I have been doing a better technique recently which seems to have solved these problems. Research has shown us that the blood supply for the lower abdomen comes through deep blood vessels in the upper outer portion of the abdomen. If this area is preserved then healing problems become rare or non existent. Liposuction can be done at the same time and healing still remains very good. So now we can do complete liposuction of the abdomen and then go ahead and do a modified tummy tuck to preserve these blood vessels.

The results have been amazingly good. The fat is gone. The stomach is tightened more than we could before. Healing is great. Drainage tubes come out in a week or less. Recovery is quicker. Pain is less. We use a pain pump to automatically numb the surgical area with local anesthetics for about four days. Skin numbness is less. Seromas have all but been eliminated. Return to normal activities is much quicker.

If you are extremely thin and you do not need the liposuction we can omit it and do the rest of the new and improved technique.

I have been very encouraged and excited by these results. If you are thinking about getting a tummy tuck done please make sure that you find out more about this technique first. I would be happy to schedule a consultation to tell you all about it. Please call our liposuction Modesto facility at (209) 323-2979 for an appointment.

My practice is in Stockton, but many patients come from all the surrounding areas, such as Lodi, Modesto, Manteca and Tracy and beyond.

Trinity Plaza Surgery Center has opened

Saturday, May 23rd, 2009

Dr. Silverton opened the new state-of-the-art outpatient surgery center at Trinity Plaza on Monday, May 18, 2009 by doing the first surgery cases there. Dr. Silverton operated there for three full days last week and will also be operating there on Tuesday and Wednesday this coming week (Monday is a Holiday). So far, Dr. Silverton is the only surgeon to have operated at Trinity Plaza Surgery Center.

Dr. Silverton has now closed the private outpatient surgery suite at his own office, but still continues to see patients at this same address, which is 3133 West March Lane, Suite 1040, Stockton, CA 95219.

Dr. Silverton plans to do the majority of his future cases at Trinity Plaza Surgery Center. This is a beautiful brand new facility which we have watched being constructed for more than a year. It has every conceivable modern amenity and is constructed to the very highest standards.

All of Dr. Silverton’s surgical staff have moved there too! This allowed for a seamless transition to working at the new facility because the surgical team was exactly the same as the team that had worked for many years at Dr. Silverton’s office surgery suite. This includes our Board Certified anesthesiologist, Dr. Vescera, who has now become Chief of Anesthesia at Trinity Plaza. Two surgical nurses, Lillie Thomas, RN and Laura Denton RN have also moved there and provide the same high quality of care for Dr. Silverton’s patients at the new center as they have done for years at the office surgery suite. The operating room technician, Nicole Wong, ORT and the instrument technician, Sarah Macias, have also both moved to Trinity. This unified move has made the transition extraordinarily smooth and uneventful.

Trinity Plaza Surgery Center is located on the west side of I-5 at the Eight Mile Road exit. The address is 10200 Trinity Parkway, Suite 101, Stockton, CA 95219-7249 – (8 Mile Rd. and I-5, off Trinity Parkway). The telephone number is (209) 323-3480. Trinity Plaza Surgery Center is majority owned by Lodi Memorial Hospital. Dr. Silverton is not an owner.

This is a very exciting development and will improve patient safety and comfort, and the entire patient experience. We all look forward to seeing you there.

A Competitor to BOTOX!

Sunday, May 17th, 2009

At last there is a new product that can compete with BOTOX.

Dysport is from the makers of Restylane and Perlane. It works like BOTOX, and reportedly acts quicker, is effective longer and costs less! It looks like a winner.

It has just been approved by the FDA. It is not available yet.

I will be sure to keep you informed as soon as this product is available.

Annual Meeting of the American Society for Aesthetic Plastic Surgery

Sunday, April 26th, 2009

This society will be holding its annual meeting from May 2 – 7, and Dr. Silverton will be attending. This is the premier society for cosmetic plastic surgery in the world. Membership has strict rigorous requirements. To be a member the candidate has to satisfy all the following criteria;

Must be a plastic surgeon
Must be Certified by the American Board of Plastic Surgery
Must already be a member of the American Society of Plastic Surgeons
Must concentrate the majority of their surgery on cosmetic surgery
Must maintain the highest ethical standards
Must be sponsored by two existing members
Must have completed at least 3 years of practice after certification

Only about one quarter of plastic surgeons meet these qualifications. Dr Silverton is a member. The society regularly puts on educational meetings and sponsors research in cosmetic surgery. It serves the public interest by promoting patient safety, and provides accurate and timely information of interest about cosmetic surgery to the news media. It also compiles annual statistics of cosmetic procedures done.

The Top 5 Cosmetic Surgical Procedures in 2008

Sunday, April 19th, 2009

The American Society for Aesthetic Plastic Surgery keeps a record of all cosmetic surgery statistics. According to figures recently released the top 5 procedures in 2008 were;

1. Breast Augmentation (355,671 procedures)

2. Liposuction (341,144 procedures)

3. Eyelid surgery (195,104 procedures)

4. Rhinoplasty (152,434 procedures)

5. Abdominoplasty (147,392 procedures)

Can BOTOX make you happier?

Sunday, April 5th, 2009

Psychologists have long thought that the simple act of smiling actually makes you feel better. Now scientists have reported to the British Psychological Society that if you cannot frown and put on an angry or sad expression that you might not actually feel as angry or sad.

They tested one group of patients who had recently received BOTOX for their frown muscles against another group who had not received BOTOX. The BOTOX group had less brain activity when they tried to put on an angry expression than the non treated group.

So it is probable that facial expression has an effect on mood as well as the other way around. This improvement in mood will likely only be effective while the BOTOX remains effective.

Source: http://bps-research-digest.blogspot.com/search?q=Botox

Cosmetic Surgery Statistics for 2008

Sunday, March 29th, 2009

Here are some interesting facts as reported by the American Society for Aesthetic Plastic Surgery. I am a member of this society.

From 2007-2008, there was over a 12 percent decrease in the total number of cosmetic procedures. Surgical procedures decreased by 15 percent, and nonsurgical procedures decreased by almost 12 percent.

The top five surgical cosmetic procedures in 2008 were: breast augmentation (355,671 procedures); liposuction (341,144 procedures); eyelid surgery (195,104 procedures); rhinoplasty or nose reshaping (152,434 procedures); and abdominoplasty or tummy tuck (147,392 procedures).

The top five nonsurgical cosmetic procedures in 2008 were: Botox injection (2,464,123 procedures); laser hair removal (1,280,964 procedures); hyaluronic acid (1,262,848 procedures); chemical peel (591,808 procedures); and laser skin resurfacing (570,880 procedures).

Why I prefer the peri-areola incision choice

Sunday, March 22nd, 2009

1. The scar is usually better. It is camouflaged at the brown to regular skin color junction. It hardly ever becomes keloid. I have seen the incision under the breast get keloid more often. The incision under the breast is in plain skin and therefore shows more clearly – at least until it fully matures, hopefully into an inconspicuous line.
2. Access is better. I can easily see in all directions. I can control the procedure more accurately. Sometimes if using the incision under the breast it is hard to see the very top of the breast pocket – especially if there is a prominent rib in the way. This could obscure a bleeding point. I can get a consistently safer outcome with the areola incision.
3. Less bottoming out. The support structures of the fold under the breast are not harmed with the areola incision, and the implant seems to maintain its position better. Often, if the incision is under the breast the implant might descend too low over the next year or two, perhaps because the fold itself is weakened. This gives the breast an unsatisfactory shape, with not enough breast above the nipple and too much below. The nipple might start to point upwards. This does not look good and may need surgical correction.
4. Shape is much better. It is my opinion that if the areola incision is used, the bottom of the implant rests on the breast between the nipple and the crease and is tilted slightly forward, whereas it rests directly on the fold under the breast if the incision is under the breast and the implant is more vertical in orientation. Long term shape is much better with the areola incision as the implant comes down properly as the breast ages. If the incision is under the breast the implant does not come down so readily and often starts to create a bulge in the upper breast area as the breast ages over the years and comes down with gravity. This gives the breast a long look which is not good.