Menu
Matthew C Camp, MD
Board Certified Plastic Surgeon
The periorbital region, including the lower eyelid, undergoes significant anatomical changes with age, leading to the development of perceived bags under the eyes and a haggard appearance. These changes are multifactorial and involve both intrinsic and extrinsic factors.
One key factor contributing to the development of lower eyelid bags is the thinning of facial skin and the adherence of the skin to the lower orbital rim. As individuals age, there is a gradual loss of collagen and elastin fibers in the skin, leading to decreased skin thickness and elasticity. This thinning of the skin allows the underlying orbital fat pads to become more prominent, resulting in the appearance of bags under the eyes.
Additionally, there is a loss of volume in the region of the palpebromalar junction, which refers to the area where the lower eyelid meets the cheek. This loss of volume further exacerbates the appearance of lower eyelid bags and contributes to the haggard appearance commonly associated with aging.
Recent advancements in imaging technology, such as 3D imaging, have allowed for the precise mapping of these anatomical changes in the periorbital region. This has facilitated a better understanding of the underlying mechanisms contributing to the development of lower eyelid bags.
A novel approach to addressing this cosmetic concern is the administration of subcutaneous fat to the affected area. This minimally invasive treatment involves harvesting fat from a donor site, such as the abdomen or thighs, and injecting it into the periorbital region to restore lost volume and reduce the appearance of lower eyelid bags by blending the transition from the eyelid to the cheek.
Compared to traditional treatments using hyaluronic acid fillers, the use of autologous fat has several advantages. Fat grafting provides a longer-lasting result due to the presence of viable adipocytes that can integrate with surrounding tissues. Additionally, fat grafting is associated with a lower risk of complications and allergic reactions, as the fat is derived from the patient’s own body.
Matthew C Camp, MD
Board Certified Plastic Surgeon
We see many patients in various stages of their weight loss journey. Some have already lost the weight and just need excess skin removal – hooray! Others need help to achieve the weight loss and improve their chances of having a fantastic body contouring result. We consider the many options available to lose excess weight, and guide treatment accordingly. We are often able to achieve the desired weight loss in less than 4 months. There are various current trends in weight loss treatment, including surgical weight loss, the use of GLP-1 agonists, and hormone replacement therapies.
Surgical weight loss, also known as bariatric surgery, is typically recommended for individuals who have a BMI over 40, a BMI over with associated health complications such as diabetes or sleep apnea. This type of surgery can help patients lose a significant amount of weight and lower their risk of obesity-related health conditions. However, it is important to note that the surgery also has potential risks and complications, such as blood clots, bleeding, and infection, and requires a significant commitment to a lifestyle change. This surgery is performed at a surgical center by one of our colleagues, who has many years experience in the technique.
On the other hand, the use of GLP-1 agonists, such as semaglutide, liraglutide, have also shown promising results in weight loss treatment. GLP-1 agonists are injections that mimic the actions of a natural hormone in the body that helps regulate appetite and metabolism. This reduces the “Head Hunger” of which many overweight patients complain. The phenomenon occurs when your mind thinks you are hungry, when your body does not need more calories. This type of treatment can be effective in reducing weight and improving glucose control in patients with type 2 diabetes. However, it may not be suitable for all patients, as it can cause side effects such as nausea, and may not provide the same degree of weight loss as bariatric surgery.
Lastly, hormone replacement therapies, such as testosterone and estrogen replacement, have been used in wellness and weight loss programs. Testosterone builds lean body mass, increases libido, and increases overall energy level. Human chorionic gonadotropin (HCG) is sometimes used in combination with calorie restriction for weight loss. HCG also prevents testicular atrophy due to testosterone replacement. It is important to consult with a healthcare professional before starting any hormone replacement therapy or weight loss treatment program.
When considering these weight loss treatments, a cost-benefit analysis and risk assessment should be conducted to determine the most suitable and safe option for the individual. It is important to remember that a healthy weight loss journey involves a combination of a well-balanced diet, regular physical activity, and a commitment to lifestyle changes.
Matthew C Camp, MD
Board Certified Plastic Surgeon
Breast augmentation with silicone implants has become a popular procedure among many women seeking to enhance their physical appearance and boost confidence. However, obtaining optimal results requires more than just choosing the right implant size.
One key factor is setting realistic expectations and goals prior to surgery. Patients should have a thorough understanding of the limitations and potential risks associated with the procedure. Communication between the patient and surgeon is crucial to ensure that the patient’s desires and expectations are fully understood and considered during the surgical planning stage.
Another important aspect is the three-dimensional structure of the implants and how they will interact with the breast tissue. Implants should be chosen based on a patient’s unique anatomical features and desired outcome. Proper preoperative planning is essential to assess the patient’s breast shape, size, and skin quality to determine the appropriate implant style, size, and placement.
Additionally, the position of the incision relative to the inframammary fold is crucial for optimal results. John Tebbets, a pioneer in breast augmentation surgery, developed the High Five Measurement System that uses the base diameter of the implant to determine the location of the incision. Often, the incision must be placed inferior to the fold as the fold drops in response to the implant. Understanding these principles lead to good results. Failure to understand them can lead to scar map positioning, and need for corrective surgery.
In conclusion, obtaining optimal results in breast augmentation with silicone implants requires a thorough understanding of the patient’s anatomical features and realistic expectations, as well as proper preoperative planning and a skilled surgeon. Patients should do their due diligence in selecting a qualified and experienced surgeon and discuss their desired outcome carefully before proceeding with surgery.
There are many things we take as a matter of course. One of these things is that professionals are qualified and competent to perform the services that they offer to the public. Unfortunately, this is not always clear and obvious to consumers of cosmetic surgical procedures.
Entering the field of cosmetic plastic surgery is particularly attractive to non-board certified individuals. This is dangerous, as becoming board certified in plastic surgery requires a long and arduous training track. After four years in medical school, we must complete a rigorous residency training program that lasts for at least six years, followed by extremely difficult written and oral examinations administered by the American Board of Plastic Surgery. Only after completing all of these measures can one become certified by the American Board of Plastic Surgery, and therefore eligible to be inducted into the membership of the American Society of Plastic Surgeons. By passing all of these measures, you are assured that the doctor meets the highest standards in the skilled, safe, and ethical provision of plastic surgery.
Many websites are out there that have been well designed and look very attractive. Non-plastic surgeons’ advertising is effective and sites often look just like a real plastic surgeon’s material. The clues are in the details. If the provider is described only as “board certified”, this could mean anything. There are approved board certification programs in many specialties, such as emergency medicine, pathology, psychiatry, and family medicine – none of which contain any training related to the safe provision of actual plastic surgery. There are also boards not recognized by the American Board of Medical Specialties, in areas such as “cosmetic surgery” or “dermatological surgery” or “cosmetic facial plastic surgery”. These individuals cannot get hospital operating room privileges, and as such can only perform services in their offices. The absence of hospital privileges is a red flag that the person is not qualified to perform invasive surgical techniques.
I have studied the spread of non-qualified providers in the field of plastic surgery over the past decade and published some of the very concerning results (see references below). On a weekly basis I meet patients unfortunate enough to have been treated by those who do not have the requisite training to perform effective, safe treatments. Many patients are completely blindsided by the fact that their provider was untrained and unqualified. A suboptimal result needs correction by an actual plastic surgeon. When you go to a website, look for the ASPS symbol of quality, which can only be obtained by surgeons who have met and passed the highest level of training and are Board Certified in Plastic Surgery.
In the interest of patient safety, the Medical Board of California has recently started cracking down on physicians who are promoting themselves as “board certified cosmetic surgeons”, but are not actually certified by the American Board of Plastic Surgery, which is the only plastic surgery certification board recognized by the American Board of Medical Specialties. The Medical Board of California has determined that being certified by the American Board of Cosmetic Surgery (ABCS) is not equivalent to the level of training and rigor that comes from certification by the American Board of Plastic Surgery (ABPS). This trend will likely continue as the public recognizes the adverse outcomes that can result from well meaning, but unskilled hands. The American Board of Medical Specialties runs an informational patient education website called certificationmatters.org where you can look up any physician and see what board(s) he/she is officially certified in. Dr Brian Windle and Dr Gregory Buford also have informative posts on the importance of board certification.
Cosmetic surgery is safe and beneficial; it can be very rewarding. Just make sure you have a Board Certified Plastic Surgeon as your doctor.
More Information:
American Board of Plastic Surgery (ABPS) https://www.abplasticsurgery.org/
American Society of Plastic Surgeons (ASPS) https://www.plasticsurgery.org/
American Board of Medical Specialties (ABMS) certificationmatters.org