Symmastia or Synmastia, or commonly referred to as breadloafing or uniboob. Symmastia occurs when two implants touch one another in the center of the chest in front of the breastbone. If the space that holds the breast implant enlarges or is overly developed in surgery one or both implants can move toward the midline and reduce or eliminate the normal cleavage.

How does symmastia occur?

This condition can occur in women who undergo submuscular breast augmentation when the muscle that is attached to the sternum detaches. It can also occur when an implant is too large, because of a tissue failure in the patient or certain chest wall deformities such as pectus excavatum.

How is symmastia corrected?

Unfortunately the only way to correct this is for a re-operation. To repair symmastia, the implants will be removed, typically through a crease incision. Dr. Vogel will remove scar tissue from the cleavage area and roll it back into the pocket. These “rolls” will give Dr. Vogel something to put sutures into and the thickness of the rolls will give strength to recreate cleavage.

After the surgery, Dr. Vogel may recommend wearing a T-Bra or Thong Bra for at least a month with a cushioned bolster to help apply pressure and keep the area stable until everything has time to heal.

Botox is a non-surgical procedure that rejuvenates facial appearance by smoothing out wrinkles of the face. Botox provides a quick and effective remedy for the facial lines and wrinkles that age, stress, worry, and environmental factors can produce, even on a younger person’s face.

The most commonly treated areas include:

•The lines around the eyes known as crow’s feet caused by squinting or smiling
•The horizontal lines across the forehead caused by raising the eyebrows
•The lines and folding of skin between the eyebrows caused by frowning

Are Botox injections safe?

Botox injections have been used safely and effectively for many years to treat ophthalmologic and neurological disorders. It is now the most commonly performed cosmetic procedure around the world, and it is also known to be the safest

Will I still be able to show facial expressions after Botox?

After treatment, the overlying skin remains smooth and unwrinkled while the untreated facial muscles contract in a normal fashion, allowing normal facial expression to be unaffected. The goal is to achieve a freshened appearance but not an expressionless face.

Is there any downtime after Botox?

Botox is a simple and safe procedure. Using a tiny needle, a small amount of Botox is injected into several locations on the face. Because the needle is so small, the discomfort is minimal. Most patients compare the sensation to a bug bite. No sedation or local anesthetic is required, and you can resume normal activities immediately. You can even drive yourself home or back to the office. Some patients experience a slight temporary bruising at the injection site. This can be covered with make-up.

What are the potential risks involved with Botox?

Temporary bruising is the most common side effect. In some cases, the Botox can migrate and cause a temporary weakness of nearby muscles. In rare cases, there can be a temporary drooping of an eyelid or asymmetry of facial expression. The risk of any side effect depends on the muscles injected. Because the effects of Botox are completely reversible, any side effects are temporary.

What results can I expect after treatment?

Botox treatments can smooth facial wrinkles to give you a more youthful appearance. The results of Botox become apparent approximately 4-5 days after treatment. However, this procedure cannot improve wrinkles due to aging and sun-damaged skin since they are unrelated to facial muscle contractions. Botox injections will not improve sagging skin or replace the need for a facelift, brow lift or eyelid surgery.

How long will the results last?

Individual results will vary, but many patient results last for up to 4 months

Line Smoothing Dermal Fillers are a fast, convenient way to enhance your natural beauty and give your face its vibrancy and youthfulness back with little or no downtime. By plumping out fine lines or volumizing lips and improving facial contouring, these non surgical treatments can improve a variety of areas.

Fillers such as Restylane (Hyaluronic Acid), Juvederm (Hyaluronic Acid), Radiesse (Hydroxyapatite), or Perlane (Hyaluronic Acid) are a fast, easy and less expensive alternative to traditional cosmetic surgery. These fillers are a great alternative for those patients not ready for a surgical procedure or who lack recovery time.

What are Restylane, Juvederm, Radiesse and Perlane used for?

These fillers are injected to instantly smooth wrinkles and folds along the side of the mouth, under the eyes, in the cheeks and are also used to create fuller lips

How long does the procedure take?

Generally treatments take 30 minutes

Is there any downtime?

After treatment the area may be red and swollen but this is temporary and should resolve in a day or two. In some cases bruising can occur but this is usually mild and can easily be covered with make-up

How long will the results last?

For most individuals results last 6-9 months but could last longer. This depends on how fast your body metabolizes the filler. The products, which are laboratory created replicas of natural body compounds, are gradually broken down and absorbed by the body, so the lines, wrinkles or lips will ultimately return to their previous appearance if no touch up treatments are performed.

Is there any anesthesia required?

The fillers are injected using a fine needle and a topical anesthetic cream. For lip enhancement, a local anaesthetic injection is usually given to remove any discomfort.

Are there any potential risks involved with the Dermal Fillers?

The greatest risk occurs when dermal fillers are injected by someone who is not properly qualified to perform injections. Very rarely, skin redness, local allergic reactions, infection, hematoma, or bruising are possible. An unsatisfactory outcome is also a potential risk and it is very important that the best procedure be matched with the patient’s goals and expectations.

Fat Grafting is the technique of moving fat from one area of the body to another to improve contour, correct defects or enhance features. As we age the underlying collagen begins to break down. A fat grafting procedure can help create more angular cheeks, healthier eyes, a stronger jaw line and fuller looking lips.

Facial Fat Grafting is a relatively new procedure that is extremely effective for filling in deep facial lines, nasolabial folds (creases that run from the nose to the corner of the mouth), and under eyes called the tear trough. Dr. Vogel performs fat grafting on many of his patients to address facial aging. Fat grafting may be done alone or in conjunction with a resurfacing procedure, such as a laser treatment, or a recontouring procedure, such as a facelift.

How is the procedure performed?

Fat is collected from a donor site, such as your abdomen, buttocks or thighs. After processing to remove excess fluids, the fat is injected in multiple thin strands into the desired area smoothing lines and wrinkles and plumping out the treated area. Slight “over-filling” is necessary since your body will absorb some of the fat.

What areas can be treated?

The most common areas for treatment are nasal labial folds (creases that run from the nose to the corner of the mouth), tear trough area (under the eyes), deep facial wrinkles, creases and furrows, sunken cheeks, skin depressions and some types of scars. This can also be used to add a fuller, more sensuous look to the lips.

How long will the fat injections last?

During the first several months, the body absorbs some of the fat. Typically 60-80% remains permanently.

Are there any side effects?

The most apparent side effect is excessive swelling which can last for about two weeks following surgery. Also, some bruising can appear. Some potential complications of fat grafting include overcorrecting (too much fat injected), under correction (the desired results are not achieved), scarring in the donor area or bleeding. Although allergic reaction is not a factor, there is still a minimal risk of infection.

What is the recovery time?

The typical recovery period for this procedure is short, with most patients returning to normal activity almost immediately.

There is very minor discomfort associated with some bruising, swelling and redness in both the donor and recipient site, which should dissipate in a few short days.

Dr. Vogel and his staff made me feel very comfortable from my very first visit. The results achieved from my surgery have been above and beyond what I could have comprehended. I feel so much better about my appearance and the whole experience was well worth all that preceded my surgery. I cannot say enough kind words about Dr. Vogel and his staff and the kindness they showed.

ALJ

Dr. Vogel has been involved in hair transplantation for many years. After seeing him and his staff performing hair transplantation, it’s apparent that he has kept pace with all the most recent advances including ultra refined grafting and the trichophytic closures.

As an experienced board certified plastic surgeon performing surgery in a beautiful state licensed facility, Dr. Vogel brings considerable surgical experience to every hair transplant surgery. He places great emphasis on state of the art surgical practices and patient safety.

While just less than half of Dr. Vogel’s plastic surgery practice is hair transplantation, his strong skills as a plastic surgeon make his donor closure in particular highly refined.

To optimize the quality of his donor closure Dr. Vogel does a “double layer closure” in which both internal and external sutures are used to close the donor area after the donor strip has been removed using a single blade. The internal suture below the surface of the skin/epidermis bring the edges of the donor area together so that the external surface suture/stitches have minimal tension or pull on them. This reduces the tension on the suture and skin and the potential for stretching and scarring.

He also performs the trichophytic closure technique to minimize the visibility of the donor strip scar. This technique enables hairs to grow up and through the thin scar in the donor area, thus covering and disguising the thin narrow scar.

He has up to seven experienced medical technicians available to assist in performing hair transplantation. This enables his clinic to provide sessions up to 3,000 grafts. However, Dr. Vogel is reluctant to remove donor strips wider than 1.5 cm in order to minimize any chance of scarring or stretching in the donor area. Thus his sessions rarely exceed 2,500 grafts.

While his session sizes are not as large as some clinics, the quality and refinement of the procedure are world class.

Dr. Vogel uses a 19 gauge needle, which makes small incisions that are approximately 0.9 mm. Given the small size of these incisions his staff has moved toward trimming tiny grafts that typically contain mostly one and two hair grafts and very few three hair grafts.

His surgery in recent years has evolved toward ever greater refinement and is now truly ultra refined.

Pat
Publisher, Hair Transplant Network/Hair Loss Learning Center
www.hairlosslearningcenter.com

I have wisely chosen to use Dr. Vogel for hair transplant procedures. I have been impressed with the professionalism and sensitivity of Dr. Vogel and his team. I am delighted with the results and have recommended several friends to Dr. Vogel as a result.

I look forward to the day when cloning will enable me to come in for more procedures…the crown!

MCB

Dr. Vogel and Staff,

I just wanted to thank you for all the wonderful kindness and caring you have shown me over the past few weeks. I have had a perfect breast augmentation experience because you really understood what I had dreamed my end results would be. I couldn’t be happier with my new breasts, and it’s all thanks to you!!

With my appreciation and gratitude,

D.O.

Dr. Vogel and Staff,

I just wanted to express how special it is to have been cared and treated for by such a great team!

You go out of your way with kindess and caring – beyond anything I have ever experienced. You take “customer experience” to new levels and I just had to let each of you know how special you are!

Thanks again,
J. T.

For more information, you can visit our new Medi-Spa section from the link on our home page.

I’m really excited about the lasting effects of Radiesse, an injectable that is best used in areas such as the nasolabial folds between your nose and mouth. My patients have been finding that it does last for up to 12 months, about 1 and ½ times as long as Restylane. However, Restylane still gives great results, especially under the eyes, smile lines and for plumping lips and those annoying tiny vertical age lines above your lips.

Juvederm is the latest injectable from the makers of BOTOX. We started using this product this year; we’re finding that its results are pretty comparable to Restylane and it lasts about as long, though it can be smoother since it’s gel-like.

BOTOX remains the most effective way to diminish or erase forehead creases and frown lines. It’s also great for crow’s feet.

Do you really need a physician to oversee your injectable?

While many salons and other non-medical settings now provide an array of injectables and Medi-spa services, they simply don’t offer the medical oversight and expertise to make sure you get the right product in the right doses, delivered by an expert. Our aesthetician and our nurses are very skilled and experienced, but having their expertise backed by a physician with years of medical training offers you an extra measure of security that your procedure will be the safest, most effective possible. Since the prices of medically-supervised centers are often comparable to those of most non-medical Medi-Spas, it usually makes sense to get the additional clinical expertise from the physician.

Currently, we offer injectables and IPL (Intense Pulsed Light) on Tuesdays, Wednesdays, Thursdays and some Saturdays.