This year marks an end of an era for me. Hi. My name is Julie Sylvester. I am a Physician Assistant at Finishing Touch at the Plastic Surgery Group of Rochester. I began working here in August of 2001 and I began cosmetic injections one year later. Back then, it was Zyderm and Zyplast collagen. That is all I had. I trained and used it for unwanted wrinkles of the face. I used it between the brows, across the forehead and for crow’s feet and smile lines. People loved it, for a few months. Then they were back. The problem was that it took too long to start, as allergy tests were needed. And it didn’t last long enough for most, only about three to four months. Cosmoderm and Cosmoplast came next. No allergy test was needed, and it came in a smoother consistency. Hylaform and Captique began the dawn of the next generation of fillers. These were a new class of Hyaluronic acid fillers that were supposed to last longer. And they did, for the most part.
The industry kept moving forward. Next came Restylane and Juvederm. Then came Perlane and Radiesse. With each new product, came better performance than I had previously known.
I learned Perlane and Juvederm were great for nasolabial folds and lips. Radiesse was great for cheek augmentation and deep marionette lines. Botox and Dysport are unsurpassed for upper face wrinkles of the forehead, glabella and crow’s feet. Sometimes, for some people, areas of the lower face were also effectively treated this way. With all of this, I still had a few loyal collagen clients.
Then I got the Email. Collagen was discontinued. No more was to be made. A small group of my practice was disappointed and so was I, for sentimental reasons.
Collagen gave me my start. I honed my craft with you. But better performing products had now replaced you. It is the end of an era but the start of a wonderful career for me. I have enjoyed the journey so far, and anxiously await what is next…….
Julie Sylvester, RPA, C
Finishing Touch, The Plastic Surgery Group of Rochester
At some point one looks into the mirror at the face that looks back and realizes that over the course of time those familiar features have changed. Wrinkles, folds, blemishes, pigmentations and sagging skin are all characteristic of an aging face. While these features might be considered distinguished, or can be worn as the proud badge of a life full of experience and wisdom, more often it just seems like the face in the mirror has gotten old. But age isn’t what it used to be. Baby Boomers don’t seem to want to act their age. They are typically more physically active than their parents were and continue on in their careers for a longer period of time. Even in retirement this generation is typically busier, more involved and engaged in active lifestyles more than the generation that preceded it. Often, the face in the mirror just seems to look a lot older than the life it represents. While there are a number of less aggressive remedies for some of the effects of aging, a facelift is the gold standard for correcting the loose, sagging skin of the neck, jowls and cheeks that can develop with aging.
Because every face is unique, every face lift is tailored to address the variety of individual problems that may be of concern. But for the most part, a facelift involves tightening of the deep structures of the face that have become lax and then removing and tightening the overlying skin. This will smooth the contours of the face to a more youthful appearance. The surgery is performed in a hospital or ambulatory surgery setting under a general anesthetic or can be done with a local anesthetic with sedation. The incisions necessary to complete the procedure extend in front and in back of the ear, and then along the hairline behind the ear. Sometimes the scar can be limited to just the area around the sideburn and in front of the ear depending on the individual problems that need to be corrected. The procedure can take from 3 to 5 hours and afterwards patients might stay overnight or can be sent home to recover – it all depends on individual needs.
The head is bandaged afterwards with soft compressive gauze. This bandage comes off the first postoperative day. The first two days or so are uncomfortable, but not too terribly painful. Pain medication is prescribed to be used as needed, but often Tylenol or ibuprofen are enough. You can eat normally and get around the house but you probably won’t want to go out since the face and eyes are swollen and bruised and the visual effect is quite striking. After the initial 48 hours, there is only some persistent discomfort but the swelling and bruising are at their peak an won’t resolve for about 2 weeks. Drains are typically used and usually come out after 24 – 48 hours. Some of the stitches come out after 5 – 7 days and the remainder after 10 – 14 days. The results are evident within those first few weeks, but there will be some minor settling over the course of 3 months before the healing process has become complete. There are regular and frequent office visits and help is available by phone from a doctor or nurse 24 hours a day.
Reduction mammoplasty is a procedure that results in some of the most satisfied plastic surgery patients. The functional benefit from reducing the weight of a woman’s large breasts cannot be overstated. It commonly results in a dramataic reduction in back, neck, and shoulder pain and often allows a woman to lead a much more active lifestyle.
Breast reduction surgery typically lasts around 2 1/2 -3 hours and patients usually spend one night in the hospital. The most common scar pattern is an inverted T although a vertical scar technique can sometimes be used in select patients. All sutures are dissolvable and none need to be removed after surgery. The pain from the surgery is well tolerated and most women can resume most of their basic activities within a few days. Most women take off 1-2 weeks from work after the surgery. Breast size is usually reduced by a few cup sizes and the breast and nipple are lifted to result in a more youthful appearance.
Insurance approval for the procedure often depends on several factors including symptoms like back, neck and shoulder pain, rashes, and bra strap grooving and a minimum requirement for the removal of 500 grams of tissue from each breast. Pre-operative photographs must be submitted as part of the preapproval process.
Ages of breast reduction patients range from the late teens to 70’s. People with a wide variety of medical conditions are eligible and can benefit from the surgery. Anyone interested in breast reduction surgery should consult with a board certified plastic surgeon so an individualized plan can be formed.