What's the Difference Between a Plastic and Cosmetic Surgeon?

Question:
"What's the difference between a plastic and a cosmetic surgeon?"

Answer:
The best explanation is produced by the American Academy of Cosmetic Surgery. We have reproduced this at DrYoho.com; click here to read more about plastic vs. cosmetic surgeons


Basically, cosmetic surgery is a field of beautification surgery. This includes eyelids, facelifts, breast enhancements including lifts and breast augmentation, and liposuction, among other surgeries. Plastic surgery also includes many other types of surgery, such as hand surgery and complex surgeries cooperating with other surgeons doing reconstruction work. Plastic surgeons typically work closely with other surgeons in hospitals to perform care on sick patients. Some of them also do Los Angeles / Fresno area cosmetic surgery.

If you want to read a comprehensive article about how to choose your surgeon, and understand just how the physician training and experience impacts the performance of various surgeries, refer to this chapter of my book on cosmetic surgery.

This is a pretty complex subject and you need to exercise some judgment and do your homework. Be sure to verify the credentials of your Los Angeles / Fresno area cosmetic surgeon, and research their methods to get a better idea of your options.

Fresno, CA Area Chin Liposuction Improves Sleep Apnea

We received a thank you letter from a happy patient, part of which follows. I cut out all the detail about our excellent service and so on, but the interesting thing was that the chin liposuction improved her sleep apnea. I have seen this several times, and it seems to be related to our practice of removing fat under the muscle as well as above the muscle of the under-chin area. Here it is.

"Five years ago, I was diagnosed with Sleep Apnea. Every night I was required to sleep with a C Pap machine to assist with my snoring and breathing. This was becoming very cumbersome and uncomfortable, not to mention it's a bulky piece of equipment. My job requires that I travel and carrying this machine was beyond an inconvenience, it was a nightmare. Dr.Yoho suggested that I consider having Chin Lipo to help my sleep apnea. I figured that I had nothing to loose and possibly lots to gain by having my chin done. I also decided to have full torso lipo with fat transfer to my buttocks.

On the morning of the surgery, after a few minor preparations, I met with Dr.Yoho who went over what was going to be done. We chatted for a while which made me feel comfortable and relaxed.

Since my surgery, I have not had the need to use my machine. I recently traveled out of the country for the first time after my surgery and am proud to say there was no need to travel with that extra piece of luggage. "

If you have sleep apnea it may be related to buildup of fat under the muscles of your chin. If so, you might be able to resolve this problem through a Los Angeles / Fresno area cosmetic surgery procedure. This is not a guaranteed outcome of every Fresno, CA facial liposuction procedure, but for certain patients is an added medical benefit.

Fresno Cosmetic Surgery Questions - What is the Liquid Facelift?

Question:
"What is the 'Liquid Facelift'?"

Answer:
The liquid face lift is a name for non-invasive filling of saggy parts of the maturing face. Fat loss as well as the loss of elasticity is largely responsible for the problems surgeons try to correct with a facelift. In particular, fat loss around the eyes and of the cheekbone area and upper face is responsible for allowing downward movement of the facial skin sometimes producing “jowls.” Near Los Angeles and Fresno, facelift cosmetic surgery is - in simple terms - a way to pull the skin up and trim the extra from around the ears.

However - the original facial contours were influenced very much by the original fat structure. Look at any magazine at photos of younger people: their faces are smoother, more filled out. Facelifts alone can’t produce this effect.

In order to obtain the best results with facelifts, I typically recommend a facial filler of some kind to be done along with the surgery. Fat, JUVÉDERM® Injectable Gel, Restylane® or Perlane®, or other fillers can be used. But this is up to the patient of course. Some people prefer a thinner, more mature look that a facelift alone produces. And of course nothing tightens the neck like a Fresno or Los Angeles facelift cosmetic surgery procedure.

The liquid facelift is an attempt to use the fillers alone to produce the proper effects. This is all about using larger volumes of these fillers to mimic the slightly fatter, more structurally supported faces of youth. Of course, this works best if the skin isn’t too very loose. Sun damage and natural aging processes cause problems that volume correction alone sometimes can’t completely fix.

And it’s almost always the case that the more filler you use, the better results you get. Nine syringes will obtain a great result in many cases. And our minimum is three. In order to have our patients feel confident that this is worth it, we have cut our price (in Pasadena, Visalia, Fresno areas) to $1000.00 (as of the time of this blog post) for three syringes of JUVÉDERM® Injectable Gel. If you use less than this you may get a result improving your folds around the mouth, for example, but you just can’t get the result you get using more filler.

Fat is just fantastic in some cases, but more swelling usually results and it has to be taken from somewhere on your body with a Fresno or Los Angeles, CA area liposuction procedure.
For more information on fat filling, visit my Los Angeles cosmetic surgery site or see my blog post on fat as a facial filler.

Fresno, CA Area Liposuction for Large-Volume Patients

In this post I want to comment on a post from MakeMeHeal.com, about a past patient of mine.

This is one of our Los Angeles / Fresno, CA area liposuction patients who had a large volume liposuction and who was full-figured but had VERY satisfactory result. She has posted her photos on the link. If you click through this link using the password yoho, you will find over 20 of her before-and-after photos.

These larger volume liposuctions require special care and experience, and it's my belief that they should not be performed under general anesthesia, which increases the risk of the surgery. Additionally, larger-volume procedures pose increased risks for skin problems. This patient actually had a small area of skin necrosis after her surgery, but was still extremely happy with her result. She lost weight and has a shape she is very proud of, and fits in form-fitting outfits.

meechie

Joined: 10 Dec 2006
Posts: 38

Posted: Sat Oct 25, 2008 5:10 pm Post subject: My one week pics...I am amazed
I went to DR. Yoho in Pasadena on 10/17. I had full torso lipo. I was amazed at the shape and body that he created. I never wanted to be thin, or skinny. I like the thick look. I like small waist, flat tummy, shapely, large thighs and rear...I think that is sexy. My goal is to fit into a 10-12.....I am nearly there now.

my pics are way to big but my pics are here...

http://public.fotki.com/cuteasgirl/dr-yoho/

password is yoho

Nutritional Therapy Before and After Surgery

Everyone knows that proper nutrition is important. But did you know that nutrition can influence the infection rate? And help healing of open wounds? And make any given patient respond to the stress of surgery better?

I have had many patients who have responded to my nutritional therapy, which I have used to treat complications including large open wounds lasting many months after other physician’s surgical procedures were referred to his clinic. I have cured some of these in just a few weeks using proper nutrition. One of my latest cases involved an infection from a Fresno / Los Angeles area breast augmentation procedure, that was draining - even after the implant was removed - for 8 weeks. I supplied the nutritional therapy described at the above link, and the drainage went away in 3 days and the wound closed soon thereafter.

While proper protein supplementation, vitamin C, Zinc, and other supplements are clearly helpful in some cases of surgical healing, wheat grass pills (usually 5 tablets two times a day, available at wheatgrass.com) may seem like a non-traditional idea. But in my experience they can really help in some cases.

All these therapies must of course be used with good traditional care, such as proper wound care, and possibly antibiotics if infection is demonstrated. If you are not confident that your Los Angeles or Fresno area cosmetic surgeon is offering the quality of nutrition you need, you should contact my Fresno cosmetic surgery area office in Visalia and schedule a meeting to talk with me personally.

For more information on healthy nutrition and post-surgical healing, you can also visit my cosmetic surgeon Los Angeles site, 

Fresno, CA Liposuction - What is the Brazilian Butt Lift?

Cosmetic Surgery Answers
Question:
What is the "Brazilian Butt Lift"?

The 'Brazilian Butt Lift" consists of liposuction of the areas around the buttocks, usually including the area above the butt or “sacral” area and the hips and often the outer thighs. Then, sometimes, fat is transplanted into the buttocks to make them fuller. Contrary to what is said elsewhere, the fat should be transplanted into the lower two-thirds of the buttocks, not the upper two-thirds.

There are some doctors who are spinning the fat, so as to make it denser. In my experience this does not improve the result. The bottom line is that any given butt can take only so much fat in any one operation or the transplanted fat tends to cause problems like infection. Infection is a risk anyway even if everything is done to the best possible standard, but there is no reason to worsen the risk. If you have a big butt this technique can be used to make it much bigger. If you have a small butt, the Brazilian Butt Lift can only do so much.

I have been performing this Los Angeles cosmetic surgery procedure for over a decade. Results vary with the individual, with some people getting almost all the fat to “take,” making the butt more shapely. Others, such as smokers, will have very little retention of the fat. If you are a smoker, it’s probably not worth it.

There are also Fresno cosmetic surgeons who are putting implants made of silicone into the buttocks. These implants generally go under the muscle and in my opinion often cause unnatural results, with somewhat strange bulges on top of the butt (see results at other internet sites). Fat transplant methods can be repeated if the patient wants more fullness.

Note that in some cases I can also achieve very good results to lift and shape the buttocks using Fresno, CA area liposuction alone, without transplanting fat to the area. This is because, as noted above, the areas around the butt were shaped beautifully. An additional factor is that slight weight gain, or the patient stabilizing at a similar weight as before a relatively large liposuction, can produce very nice fullness of the breasts and buttocks (whether or not the patient receives a Los Angeles breast augmentation as well), where the remaining fat tissues can grow a little. There may not be any ultimate net weight loss, but the patient sure looks a lot better, and the buttocks specifically may look much more shapely.

I have one additional note about this sort of case. It’s generally a mistake (of course there are exceptions) to liposuction the buttocks themselves. Liposuction of the area around the buttocks is best. This usually produces the most improved shape.

What Does Dr. Yoho Think About Facial Fat as a Facial Filler?

Question:
What do you Think About Using Fat as a Facial Filler?

Answer:
I have the experience of fat transplanting hundreds of patients, in faces, buttocks, and elsewhere. I think that it can be useful in certain cases, but I do have a few problems with it:

1. Sometimes it all goes away.
2. If the patient gains weight, you can end up with a patient with a really fat face.
3. If it is used underneath the lower eyelid in order to fill in the little groove here it can be a real problem because it tends to encapsulate and form a little lump that sometimes grows and sometimes has to be surgically removed through a small incision. Although the cuts in this area heal beautifully in most cases, it is still a hassle to have to remove facial fat.

I also have extensive experience using frozen fat, but after several case reports of severe infections that occurred with other physicians who were using this, I abandoned frozen facial and other frozen fat transplant approaches. This was not my preferred approach in the first place, because frozen fat is dead material, and is not ideal to create a contour that will last in the long-term.

The best fillers in my opinion as of this post are Restylane®, Radiesse®, and injectable silicone. All of these provide certain benefits and certain drawbacks which your Fresno area cosmetic surgeon can explain at the time of your consultation and which are explained at my cosmetic surgery Pasadena website.  Most notably, Radiesse frequently causes lumps when placed in the lips and so this is probably not the best use for it.

Based on my experience I feel that facial implants can often solve problems of facial sagging and work better than fillers in many cases, so when you meet with your surgeon be sure that he or she clearly explains the benefits and drawbacks of each of these options for you. See my photo gallery of cheek and chin implant before and after photos to get a better idea of the results these can achieve.

Fresno Cosmetic Surgery vs. Noninvasive Treatments - Understanding TCA Peel Procedures

The current Fresno cosmetic surgery market is filled with many advertisements for "non-invasive procedures." These procedures' results are proportional to their inconvenience and recovery time. In other words, if you have a tougher recovery, generally speaking, you will have better result. Trichloroacetic acid peeling is the perfect example of this.

This treatment can be performed in a very non-invasive way with a minimal recovery that involves just a little bit of flaking of your skin. For the right patient, this can produce color improvement and texture improvement. On the other hand, if performed in a deep fashion, trichloroacetic acid can produce a tremendous improvement in wrinkling of the whole face. Deep trichloroacetic acid peels unfortunately have a tendency to cause scarring in the area of the jaw and sometimes around the mouth. For this reason, light TCA peels and moderate TCA peels have become the standard and deep TCA peels are practiced only by a few.

At my Visalia office, serving Bakersfield, Fresno cosmetic surgery, I offer both light and moderate TCA peels with or without sedation for patients who do not want to come back repeatedly for non-invasive treatments such as FotoFacials®. These peels can produce a great deal of improvement without all of the driving back and forth and the aggravation in the expense of waiting for your non-invasive treatment to mature.

What is the American Board of Cosmetic Surgery?

Question:
What is the American Board of Cosmetic Surgery?


Answer:
The ABCS is an independent private testing organization that gives an intensive 2-day test to physicians who want to be certified or have some demonstration of their knowledge in cosmetic surgery. Cosmetic surgery is the art and science of beautification surgery. It does not include hand reconstruction, cancer surgery, or other skin surgery skills that have to do with diseases. The procedures covered include, but are not limited to, liposuction, eyelid lifts, hair transplant, facelifts, forehead lifts, resurfacing procedures of various kinds, insertion of fillers to make the face and other parts of the body fuller and more youthful looking, tummy tucks, and BOTOX® Cosmetic. The doctors are tested on emergency procedures in their office as well, and have to demonstrate good knowledge of cardiopulmonary resuscitation and knowledge of the medications and procedures used in case of emergencies of various types.

Currently, doctors testing for the American Board of Cosmetic Surgery need to have had both a surgical training program and also a fellowship (a year or 2) of specialized training in cosmetic surgery. Fresno area cosmetic surgeon Dr. Yoho was privileged to take the Cosmetic Surgery Board’s as a "grandfather," because he had performed over a thousand cosmetic surgery procedures and was considered a very competent individual to join the ranks of the board certified American Board of Cosmetic Surgery members.

This board is the only board that certifies Fresno area cosmetic surgeons purely in cosmetic surgery. The other boards are mixed boards. In other words, they certify surgeons in a whole group of other procedures including procedures to treat diseases and injuries. The plastic surgery board, the ear, nose, and throat board, and the dermatology board are examples of boards of this type, which include some information and testing about cosmetic surgery procedures, but do not concentrate exclusively on cosmetic surgery.

Note that all of the boards including the American Board of Medical Specialties are private organizations and none has any official status except as granted by medical boards and other organizing bodies. They all have their own board of directors and their own agendas to promote their membership and, in many cases, their own advertising budgets.

For a complete discussion of board certification and the American Board of Cosmetic Surgery, please see my Los Angeles cosmetic surgeon website under page "Meet Dr. Yoho" and then "Understanding Board Certification."