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OMC Plastic Surgery

Skin Procedures

Plastic surgery is an option for people to reshape their lives. Whether it’s a reconstructive or cosmetic procedure, our team has the unique privilege of empowering our patients’ bodies, minds and spirits.

At Olmsted Medical Center, our team specializes in a variety of procedures designed to improve nearly every aspect of the body. Each procedure is described, along with expected results, which vary by patient. You also can view animations and video explanations, provided via understand.com. These are noted where available. If you need more information, please contact us.

Skin cancer: Diagnosis, removal and scar repair/reduction for the most common forms of skin cancer.

Tattoo Removal:  Removal of unwanted tattoos through various approaches.

Microdermabrasion:  Diamond Tome abrasion of outer layer of skin to improve texture, tone and quality. Used in combination with a specific skin care regimen designed especially for you.

Skin rejuvenation and resurfacing: Non-ablative method of sending light pulses into the epidermis and dermis to resurface the outer layer of the skin (1440 Fractional Laser). Other approaches include ablative skin resurfacing, volume correction and fillers, and fat transfer.

Micropigmentation: Highlighting brow lines, eyeliners and lip lines.

Hair removal: IPL (Intense Pulsed Light):  Reduces body and facial hair, excess pigment, acne, rosacea and blood vessels.

Leg veins: Clears visible spider and varicose veins (1064 Laser)

Scar and wrinkle reduction: Skin resurfacing solution for wrinkles, textural irregularities and more (2940 Fractional Ablative Laser). In some cases, skin grafting and flap surgery is involved. Botox Cosmetics™ are also used to eliminate facial and neck wrinkles.

Eyelashes: LATISSE™ for treatment of inadequate eyelashes, making them longer, thicker and darker.

 

Skin Cancer Treatment

The incidence of skin cancers is on the rise with more than a half million new cases reported every year in the United States alone. Why? One reason is that more people are spending time outdoors and many do not sufficiently protect their skin from ultraviolet rays. And because the face is usually most exposed, more than 80 percent of skin cancers appear on the face, neck or areas of the head. Persons with fair skin, freckles, or light hair may be more susceptible, as well as those who live at higher altitudes or closer to the equator. Skin cancers are also more likely to develop near moles.

A plastic surgeon is trained to diagnose and remove skin cancers, as well as repair any discoloration or scar that may be left by the original surgery. A unique aspect of your care at Olmsted Medical Center is the team approach – you will be diagnosed, have your cancer removed and the reconstructive procedure performed at the same time.

About the Procedure
Most skin cancers can be removed under a local anesthetic, usually in a doctor’s office. In cases where the cancer is larger, the incision is proportional and more tissue must be removed.

Whether a small scar is left or an area that requires reconstructive treatment, the plastic surgeon can correct your appearance, even to the point of rebuilding or reshaping body parts.

Types of Skin Cancers

Basel cell carcinoma – Slow-growing, rarely life-threatening, it seldom spreads from original surface location, but can grow deep under the skin causing bone or eye damage. Most common type of skin cancer.

Squamous cell carcinoma – Usually seen on face, lips, ears, it can spread to other locations and body parts, including the lymph system and essential organs. If left to run its course, it can be life threatening. These cancers may start as a small, pearly nodule, a series of red bumps, scaly tissue, a sore that doesn’t heal, or a patch that looks like white scar tissue.

Malignant melanoma – Most dangerous and least common form of skin cancer, but it is on the increase. Can be cured if diagnosed early, but can spread quickly throughout the body. This cancer often starts as a change in a mole or a new growth of a darker, mottled color ranging from tan to black, with ragged edges, and about the size of a pencil eraser.

Always protect yourself from the sun by wearing protective clothing and a strong sun block, not tanning lotions. And always examine your skin carefully for any changes, including your back. If you notice a change in a mole or see a new unusual growth, visit your doctor as soon as possible.

 

Tattoo Removal

Many individuals have had second thoughts about tattoos. Some people develop an allergic reaction after several years. Others seek removal for social, cultural or personal reasons. Removing tattoos always takes longer than getting them and removal is not always completely successful. Various techniques have been used over the years, including forms of dermabrasion, topical acids, cryosurgery (involving freezing the tissue), surgical removal of tissue, and removal by laser. While all of these methods can remove tattoo ink, they can leave varying amounts of scarring. Amateur tattoos are the most difficult to remove because the ink is at uneven depths in the skin.

Depending on the location and size of the tattoo, and the patient’s skin color and age, more than one removal technique may be used. In many cases, multiple treatment sessions are required.

It’s important that the patient have a full understanding of the advantages and disadvantages of the different methods of tattoo removal before any procedure.

Tattoos are surgically excised under local anesthesia in the office. Depending on the size of the tattoo and location, the procedure may need to be done in a staged process over a period of time 6 weeks apart.

 

Scar and Wrinkle Reduction

Scar Reduction
Scars, whether from an injury or a previous surgery, can never be removed completely. They can, however, be minimized so that only a portion of a scar remains, sometimes one that is so faint it will not be noticeable aside from close examination. Plastic surgery to limit scars is called scar reduction or revision. This type of procedure is not always successful, in that some scars reappear. Also, the ease in reducing a scar is dependent on the individual’s skin color or texture, their general health, the nature and location of the scar, and any corresponding scar tissue or other damage. Plastic surgeons usually advise persons with scars wait at least a year before having surgery because many scars will fade with time. The benefits of scar reduction may not be readily apparent after surgery, due to inflammation and other temporary changes caused by the procedure. Success is best assessed after a least a year. The procedure used varies greatly depending on the type of scar and its cause. Below are some major categories of scars and the techniques used.

Keloid Scars
Keloids are clusters of scar tissue that grow beyond the initial edges of a scar. They are thick, reddish or dark fibrous masses of collagen, which the body produces as part of the healing process. Initially, steroid injections will probably be used to reduce the scar without surgery. If that is unsuccessful, the scar will be surgically removed. Keloids may return. Often steroids are used in conjunction with surgery and the patient may wear a pressure bandage of some kind for as long as a year.

Hypertrophic Scars
These are sometimes confused with keloids, as they appear similar in color and texture, but hypertrophic scars don’t spread beyond the original wound site. Steroids may help here again, but if not, surgery and fine stitches can be used to reduce the scar. Steroids may be used at the site for up to two years to keep the scar from returning.

Contracture
Contractures do just what their name implies. They are scars – usually from burns or injury – that cause the skin to contract, sometimes limiting the flexibility of the area. For example, a contracture on the hand may keep someone from effectively playing the piano. Because of the area of scarring that is removed, the procedure usually involves a skin graft or skin flap. Due to previous limited mobility and the possible involvement of muscle, physical therapy may follow surgery.

Facial Scars
Here surgery with very fine stitches is common, as are attempts to disguise the reduction using natural creases and lines of the face. Again, a scar can be cut out and the skin reconnected to form a faint, less noticeable scar. Some facial scars can also be reduced by dermabrasion.

Z-plasty
Z-plasty is a procedure in which a z-shaped piece of skin is removed that includes the scar. The incision will leave a new scar, but one that is closed with fine stitches and that tends to be less visible due to the skin’s contours or natural “relaxation lines."

Skin grafting and flap surgery
Grafting and flaps are more serious techniques and are used when a scar is larger or excess skin and sometimes additional tissue or muscle is removed as well. These procedures are usually to reduce scars from injury. A graft is taken from a healthy part of the body and applied after the scar is removed. This is actually two surgeries, increasing the risk of complications and requiring a much longer healing period. Since the graft is taken from another part of the body, it is more difficult to match up textures and skin tone. Sometimes skin grafts do not “take” and another surgery is required. Flap surgery is more complex. It may include moving blood vessels, fat, and even muscles along with the skin to the new site. This procedure can be lengthy and may involve microsurgery to reattach the blood vessels.

 

Botox Cosmetics

Professionally administered injections of botulism toxin or Botox Cosmetics™ can reduce or eliminate wrinkles around the forehead, eyes, mouth and neck caused by muscles that have tightened over the years. These are the wrinkles caused by stress, muscle tension, and repetitive facial expressions. Botox Cosmetics™ actually inactivates the specific facial muscles for a time, allowing the fact to relax, eliminating the lines and wrinkles.

About the Procedure
Botox Cosmetics™ is injected at precise points in the muscle as needed. The procedure is relatively painless because of the very fine needle used and is performed in a short office visit, without anesthesia. You should be able to return to work with minimal discomfort. In those cases, applying ice to the area helps.

Botox Cosmetics™ is an appropriate treatment for frown lines, forehead creases, crow’s feet, and the bands or cords that appear in the neck, called platysmal bands. It has also shown to be effective in treating eyelid spasm, imbalance in facial muscles, spasms in eyelids or the neck, and in treating spastic muscles associated with cerebral palsy. Recent research shows that Botox Cosmetics™ may also provide relief for migraine headaches in some persons and some types of excessive sweating.

Considerations
Botox Cosmetics™ is not a treatment for age lines or for wrinkles caused by the sun. To treat those conditions, consult the surgeon for other options.

Botox Cosmetics™ treatments are not permanent. They must be repeated every three to six months or the area will return to its original appearance.

 

Hair Removal

In times past, removal of unwanted hair meant painful electrolysis, repeated use of creams or hot wax treatments. And nobody likes shaving, especially in areas where the skin is already sensitive. The Intense Pulse Light (IPL) process is gentle, safe, fast and allows a longer time between treatments. The patented method uses intense pulsed light energy in a wide beam to cover more areas at one time. That saves you time and money.

About the Procedure
There are no needles involved here and unlike traditional laser hair removal, IPL works on most skin colors without removing any pigmentation and there is less chance of scarring. It is also effective in removing pigmented hair in any location on the body. Because the process is gentle, it can be used in sensitive areas without affecting the surrounding skin.

Despite what you may have heard, removing hair doesn’t make it grow back faster or thicker. In fact, with the IPL method hair tends to return thinner and more slowly.

Considerations
Four to six treatments may be needed to achieve best results. The number of treatments necessary depends on an individual’s hair density and its growth cycle. Other factors influencing hair condition and growth are a person’s age, ethnicity, hormones, diet, metabolism and medications. The length of each treatment also depends on the size of the area involved.

Before Hair Removal using IPL

After Hair Removal using IPL

 

Skin Rejuvenation and Resurfacing

Skin care rejuvenation/resurfacing is a significant part of our comprehensive program. Skin rejuvenation can be introduced as part of preparation for a surgical procedure, as an additional treatment after surgery, or as a separate, freestanding program. The skin care program can use one or several techniques or methods depending on the patient’s skin type, previous skin care, amount of sun damage, and genetic predispositions or other existing conditions.

Microdermabrasion

This new procedure is non-surgical, non-invasive. Microdermabrasion is a means to polish the surface of the skin, getting rid of dead and flaking skin cells and leaving a soft texture. The result is a smoother appearance that makes wrinkles, age spots and blemishes far less noticeable. It also helps reduce acne scars. It’s ideal for someone who does not wish surgery or cannot tolerate chemical or laser treatments. Microdermabrasion is a successful technique that has a proven track record for years in European health centers.

Before Microdermabrasion

After Microdermabrasion

DiamondTome resurfacing
Resurfacing is a technique for removing the topmost layer of skin, leaving it supple and vibrant. The DiamondTome Wand removes this layer by gently exfoliating the skin with natural diamond chips and vacuuming the dead skin cells away. While this method is similar to particle microdermabrasion and chemical peels in its results, it does not have the adverse effects like irritation and skin reaction. Therefore, you will have no downtime after treatment.

Topical Vitamin C programs, Skinceutical, or Obagi C program
These are used for treatment for mild sun damage, pigment changes, or dynamic fine wrinkles. They can also be used to support skin care with microdermabrasion or IPL and laser skin treatments.

Retin A-based Obagi skin health rejuvenation program
This is used for severe sun damage, pore reduction, or acne treatments. Consistent use under medical supervision over a period of three to six months can produce significant improvement. Sun-induced skin changes can be reversed and skin health reestablished, generating a healthy glow.

IPL skin management
This includes rosacea treatment, acne treatment, photo rejuvenation, reduction of vascular lesions on the face, as well as hair reduction. It is often used as an integrated element of the rejuvenation program.

 

Fractional Non-Ablative Skin Resurfacing

With our “easier on the skin” fractional non-ablative process of skin resurfacing, light pulses are confined to narrow columns in the skin, allowing for a quick-healing process. The columns initiate a natural healing process that forms new, healthy tissue and improves skin appearance. Some people notice positive changes in skin appearance within a few days.

These treatments can be performed on most areas of the body, including the face, chest, arms and hands.

A series of treatments at 3-6 week intervals may be required to achieve the desired results. This procedure is less painful than CO2 ablative laser procedures and does not have an extended recovery time. Generally, the redness, warmth and swelling or tightness in the treated area typically fades within a few hours. The skin may have a pinkish tone for 5-7 days.

 

Fractional Ablative Skin Resurfacing

Using fractional ablative skin resurfacing, unsightly skin is selectively vaporized, and within a few days replaced with fresh, healthy skin – generated by the body’s lymphatic system. This is a single-treatment procedure where a powerful laser creates tiny, microscopic columns in damaged skin, which are replaced by new skin.

This advanced skin resurfacing treatment triggers a deep healing process that replaces treated areas with a fresh, glowing skin.

Fractional laser technology has made ablative skin resurfacing the preferred treatment for patients seeking deeper skin improvements, often within 2-4 days.

While the skin is healing, you are advised to stay out of the sun, avoid scrubbing and not wear makeup. For several weeks following the treatment, your skin may have a pinkish tone.

 

Volume Correction and Fillers

Juvéderm®, Juvederm Ultra and Juvederm XC are injectable fillers which the physician injects easily under the skin to smooth wrinkles or folds  particularly around the areas of the nose and mouth. The Juvederm Ultra is a robust formulation for volumizing and correcting deeper wrinkles and folds. The result of both products is a smooth and natural result which everyone will notice but no one will know. The Juvederm Ultra XC is a new product that has a numbing agent in the product itself to make injections even more comfortable for the patient during the process. (should include that this a hyluronic acid formulation)

Radiesse® is a safe, next generation cosmetic dermal filler that’s setting a new standard for the correction of facial lines and wrinkles such as nasolabial folds, giving you a natural and youthful look immediately.

Clinical studies prove that Radiesse lasts longer than the former leading filler to deliver a natural look that lasts because it stimulates your body to produce new collagen.

Radiesse treatments are typically scheduled once a year.

 

Restylane® and Perlane®

Restylane and Perlane are safe, natural cosmetic dermal fillers that restore volume and fullness and are used to correct moderate to severe facial winkles and folds like nasolabial folds. These products are made of non-animal based hyaluronic acid, a natural substance that is already present in the human body. It is completely biodegradable and compatible with the hyaluronic acid your body produces. Restylane has been used by dermatologists and plastic surgeons since 1996, and has been used in over 60 countries around the world. Perlane gel particles are larger and designed for deeper injection than Restylane.

Both products are FDA-approved.

 

Fat Transfer: A technique in which the patient’s own fat is transferred from one part of the body through liposuction and injected into a different body part. Generally the fat is taken from the abdomen, hip or thigh area. It is then put through a process in which the fat can be injected back into the nasolabial area, cheeks or lips to correct loss of volume.

The fat transfer generally lasts longer than dermal fillers. It is non-surgical and benefits can last as long as three years. And because the material used is already part of your body, there is no risk of allergic response or rejection.

Fat transfer is also beneficial for:

• Altering some facial deformities
• Correcting atrophic aging of the hands
• Post surgical and post traumatic defects
• Gluteal augmentation

About the Procedure
Fat is liposuctioned from your body, usually from the thigh or abdomen, processed to remove excess liquids and then injected at the location of the wrinkle. An anesthetic is used at both the removal and injection sites. There may be some swelling for up to 36 hours and discomfort can be treated with medication. Often, a second stage, two months later, is necessary to obtain effective, long lasting results.

Fat transfer is not permanent.

 

Overall Considerations about Fillers

Precautions before treatments may include:

• Avoid aspirin, non-steroidal anti-inflammatory medicines, St. John’s Wort, or high doses of Vitamin E prior to treatment to reduce bruising or bleeding at the injection site.
• If you have previously suffered from facial cold sores, talk to your doctor. You may be prescribed a medication to minimize recurrence.

 

LATISSE™ (Eyelashes)

LATISSE is a prescription treatment for hypotrichosis (inadequate or not enough eyelashes), used to grow eyelashes, making them longer, thicker and darker.

LATISSE is believed to affect the growth of eyelash hair growth by increasing both the length and number of hairs in the growth phase of eyelashes. The onset of effect with LATISSE is gradual, with significant improvement expected by two months of use.

LATISSE is approved by the FDA for the treatment of inadequate lashes. It is intended for use only on the upper lid.

Side effects and contradictions to using LATISSE will be discussed in your consultation.

 

Micropigmentation

Micropigmentation is used in Plastic Surgery for cosmetic procedures to highlight brow lines, eyeliners and lip lines. It is sometimes referred to as “tattooing.”

 

Leg Vein Treatment

Unsightly red and blue veins can be the result of age, heredity, stress or disease. In any case, many people wish them removed, but do not want to undergo surgical or painful procedures. Many people live with visible leg veins, which may make them embarrassed to wear shorts, skirts and swimsuits.

Intense Pulsed Light (IPL) treatments can be used to deliver a precise does of light energy with minimal risk to the skin and relatively little discomfort. Spider veins (small red, blue or purple veins appearing on the face can be treated.

In addition to the IPL, the long wave 1064 non-ablative laser is used for clearing of the medium fine spider or small varicose veins. This laser delivers concentrated energy in a specific wavelength, ideal for targeting leg veins. The light pulses heat the blood within the leg vein, causing the vessel to constrict and eventually fade from view. This treatment is generally more comfortable and effective, causing unsightly vessels to fade from view in a few treatments or less.

The choice of device will depend on the vein size, skin type, and your medical status.

About the Procedure
Light or laser energy is delivered to the exact spot through a hand piece. The energy is absorbed by the blood vessels, causing them to coagulate and eventually be absorbed by the body. After the procedure you will be asked to wear support hose to keep pressure on the veins, to keep them closed and refrain from hot baths or any vigorous activities. Bruises usually disappear after a week and a tan or brown pigmentation may remain for several weeks. Final results may not be apparent for several months.

Considerations

• Varicose veins may be a symptom of more serious vascular disorders and should be thoroughly examined by a doctor before any treatment is conducted.
• While significant improvement is usually seen in two to three treatments, more may be needed, usually in six week intervals.

 

Professional Skin Care Products

We carry a line of professional skin-care products that are not generally commercially available. Many of these products are available by prescription only.

One of our therapeutic skin care lines is plant- and vitamin- based. These products are gentle on your skins and offer the daily sun protection that we all need.

One of our team members would be happy to discuss them with you. If you become a patient, you will have access to our complete line:

Obagi
The Obagi line is one of the most recognized names globally in skin health care for prescription-strength product lines that transform skin. Skin transformation is possible with the Obagi System. Key ingrediants in the Obagi Nuderm system are prescription strength 4 percent hydroquinone, tretinoin cream and alpha hydroxyl acids.

Your face is a major part of your identity. So, facial skin care should be a major part of the skin care treatment. The Obagi System of skin care products and transforms your skin at the cellular level, so it looks younger and healthier.

The Obagi Nuderm System is ideally suited for anyone who has signs of photoaging. Photoaging signs are age spots, fine lines and wrinkles, rough skin, skin laxity, erythema, sallowness and hyperpigmentation. This system is also good for people who experiencing skin changes from hormones like melasma and acne.

ObagiC
Obagi-C contributes to healthier, refreshed, revitalized skin from cell to surface. This line promotes skin rejuvenation from the inside out using a formulation of prescription-strength 4% hydroquinone, which reduces the appearance of hyperpigmentation and age spots, combined with 10% L-ascorbic acid (Vitamin C) — the only topical antioxidant proven to stimulate collagen synthesis and protect your skin by minimizing future skin cell damage.

Obagi-C Rx Systems are ideal skin care if you have:

• Minimal fine lines
• Minimal unevenness of skin tone
• Mild hyperpigmentation and minimal age spots
• Intolerance to, or are not ready for, more aggressive anti-aging regimens
• Dry, normal, oily, or even sensitive skin

Nia
Pro-Niacin® has been clinically proven to strengthen the skin barrier through increasing the content of NAD within the skin cells and generating the growth and maturation of healthy skin cells from the inside-out through its niacin-powered barrier-building system.

This patented micronutrient delivery system brings a continuous-release from of niacin, so the skin’s barrier is restored and signs of damage are dramatically reversed, ensuring strong, better skin that’s more resilient to damage.

A stronger skin barrier improves atopic skin by providing better protection against environmental toxins, bacteria, etc. from aggravating the living skin cells beneath. A good candidate for the Nia 24 products, is someone with moderate to severe sun damage.

Skinceuticals
To maintain and improve skin health, an effective skin care regimen must contain three fundamental aims: prevent future damage, protect healthy skin, and correct previous damage. SkinCeuticals products restore youthful, radiant skin while providing protection from serious skin conditions, like skin cancer.

The SkinCeuticals research team helped pioneer the advent of cosmeceuticals with the original topical vitamin C formula that protects skin from premature signs of aging caused by environmental damage.