The skin eventually sags on most parts of the body. However, sagging skin on the neck is one of the most noticeable areas. Taut, tight, and wrinkle-free neck skin is a sign of a youthful appearance. Sagging skin can be uncomfortable and embarrassing to some people. While sagging skin is completely natural, some may wonder why it’s happening. Let’s go over the three primary reasons why sagging in the neck happens and how a neck lift can help.

Muscle Loss

Muscles have a large role to play in the appearance of your skin. Skin is very elastic and changes its appearance according to bone structure and muscles. Muscles are directly beneath the skin, and the skin often becomes tighter with larger muscles. This also applies inversely to muscle loss. Skin will appear looser with muscle loss. Muscle loss naturally occurs over time if the muscles aren’t being used or provided with nutrients. This can happen from medical conditions that affect the muscles, malnutrition,  being hospitalized or bedridden for a long period, or just a general lack of muscle use.

Sun Damage

While most people understand that the sun is not skin-friendly, it’s not common knowledge that sun damage can affect skin tightness. Skin is tight because of collagen and elastin. However, UV light can damage those fibers and cause loose skin over time. It’s best to avoid the sun and always apply sunscreen of 30 SPF or higher to prevent this.

Age

Aging is the most prominent cause of loose skin. As mentioned before, collagen and elastin cause the skin to remain healthy and tight. Human production of collagen and elastin drastically reduce as we age. This is what leads to loose skin.

How To Help a Sagging Neck

Unfortunately, age will always cause the skin to sag in some form. Thankfully, Dr. Andrew Trussler provides neck lift services as a way to get rid of sagging skin on the neck. Dr. Trussler understands that you want to look as youthful as possible and bring attention back to your face. That’s why he will assess your needs and develop a treatment plan to help you reach your skin goals. If you’re struggling with loose skin, then contact Dr. Trussler’s office at 512-450-1077 today.

The post Is Your Neck Sagging? These 3 Reasons Are Probably Why appeared first on Andrew Trussler, MD, PLLC.

Rhinoplasty is the surgical altering of the nose, often for cosmetic purposes. However, not all rhinoplasties are created equally. In fact, it’s estimated that up to 20% of patients go back to have their rhinoplasties redone or revised. That’s roughly 1 in 5 patients. With such a high rate of revision, you may begin to wonder why this happens. Let’s take a look at some reasons why someone would need a revision rhinoplasty.

Not Happy With Results 

Most of the reasons someone would get a revision rhinoplasty involve some mistake made by the surgeon or requirements by the patient. However, some people want revision rhinoplasty even if the procedure went perfectly. This is often because they simply aren’t happy with the results. They may feel that the change was too drastic or perhaps too subtle.

Scooped Profile

A scooped profile is when your nose has a scooped appearance when looking at it from the side. This normally happens when too much cartilage or bone tissue is removed while trying to make the nose appear smaller. Some people’s noses naturally have a scooped profile, but their bone structure is usually designed to support it. A scooped profile can be undesirable aesthetically and cause structural problems within the nose.

Pinched Nose

A pinched nose most commonly appears as a pinched nose tip. This can cause the nostrils to become pinched as well and deform. The nostrils often look like slits or very thin ovals with a pinched nose. This is often caused by too much cartilage being removed from the nose. This can cause breathing problems and often looks unnatural.

Picking The Right Surgeon

A successful rhinoplasty, and any cosmetic procedure, relies on having the right surgeon. Dr. Andrew Trussler is a cosmetic surgeon who provides rhinoplasty and revision rhinoplasty. Dr. Trussler believes in being real with his patients and explaining what works and what doesn’t. If a certain rhinoplasty desire would cause any deformity, then he will inform his patient and provide other options. Dr. Trussler gets it right the first time and helps patients get it right the second time with revision rhinoplasty. If you’re looking for rhinoplasty or revision rhinoplasty, then contact Dr. Trussler’s office at 512-450-1077 today.

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Many patients think that their abdominoplasty results cannot be revised or improved upon. Revision Abdominoplasty surgery can be performed and there are numerous reasons why and how they can be revised.

Abdominoplasty or tummy tucks are a very common procedure performed by plastic surgeons. There are variable types and techniques in abdominoplasty and sometimes these techniques leave patients with too high of a scar or lack of abdominal contour.

Utilization of mini-abdominoplasties and a more modern lipo-abdominoplasty can help provide a lower scar and improve the abdominal contour, though if not applied primarily the principles can be utilized in secondary abdominal revisions.

Common reasons for revision include 

1. High scar placement
2. Contour irregularity and fat deposits
3. Belly button size and position
4. Muscle laxity

High scar placement is commonly seen in patients who are more mini abdominoplasty candidates or do not have enough horizontal skin laxity to create a lower scar. In certain traditional techniques a high scar placement is normal. 

• If there is not enough horizontal laxity a small vertical scar may be used to maintain a lower abdominal scar. 

Lowering the abdominal scar can be as easy as removing skin below the abdominal scar and moving it downwards. If more movement is needed then more skin release including releasing the umbilicus and moving it down. In this scenario an umbilical reconstruction may be needed.

Fat deposits can be decreased when liposuction is primarily applied to the abdomen in a lipo-abdominopalsty. In a traditional abdominoplasty, liposuction is used sparingly and can leave central fat deposits. These can be eliminated with secondary liposuction.

This can help contour the central abdomen and waistline, and could be incorporated in a secondary revision with skin excision and scar lowering.

Umbilical position and size can be improved if needed. High central tension and deep umbilical plication sutures can help to decrease high positioning and abnormal scarring. Umbilical size can be decreased with a scar revision under local anesthesia. If a new belly button needs to be created, an umbilical reconstruction with a neo-umbilical creation can be performed.

Muscle laxity can be residual from no muscle repair being performed in the initial tummy tuck  (a skin-only abdominoplasty) to loosening of the repair in the initial healing process or recurrent laxity over time. Muscle laxity can lead to a lack of abdominal shape and contour as well as central and waistline bulging. A secondary repair can be performed through the lower incision with either primary plication of the central muscle or secondary repair without the need for removing the previously placed sutures.

Abdominoplasty revision plans need to be discussed with an in-office consultation and some of the revisions could be performed in an office-based procedure, but the majority may be better served with a two hour operative procedure. Recovery may be variable and can range between 10 days for a minor scar revision to 6 weeks for a secondary muscle repair.

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Pain

Comfort is one of the top priorities after breast lift surgery. Of course, there is bound to be a little discomfort after a surgical procedure due to tissue manipulation. However, the amount of pain that one-person experiences may be vastly different from others. One thing we have noticed among breast lift patients is that their pain level is usually quite tolerable. Strategies to improve post-operative comfort include:

• Talk to your doctor beforehand. You know your pain threshold better than anyone. Discussing your concerns with your doctor allows them to adequately prepare. Prescription pain medication may be an integral part of your initial recovery.
• Use cold compresses, but not for too long. The overuse of cold therapy is one of the easiest ways to actually worsen discomfort. Cold compresses should be applied for no longer than 20 minutes at a time, with at least 40 minutes in between applications.
• Sit and sleep at an incline between 25 and 45 degrees (or upright) to support blood flow and reduce swelling.
• Tips for Managing Scars
• Avoid smoking. Tobacco inhibits healing by blunting circulation and oxygenation.
• Eat well. Nutrients are vital to the healing process. If you don’t already, start taking a good multivitamin daily during your recovery.
• Do not tan. Exposing scar tissue to UV light can cause it to darken.
• Use a scar ointment or cream approved by your doctor.

Exercise and Bras

It can be difficult for many people to give up their beloved daily exercise routine, even for a good reason like healthy, perky breasts. However, recovery from breast lift surgery will go much more smoothly if exercise is avoided for several weeks. Your return to your usual activity level will increase steadily and you should be cleared for full activity after 6 weeks.

Unlike breast augmentation, breast lift surgery does not require you to wear a surgical bra for weeks on end. In many cases, the surgical bra that is placed right after surgery can be changed for a less compressive garment after a few days. Once you take your first shower after surgery, you may prefer to remove your surgical bra and switch to a sports bra that has wide straps and a front closure. Underwire bras should not be worn until ok’d by your surgeon.

The team in our Austin office would be happy to speak with you about breast lift surgery or any of our other services. Call (512) 450-1077 for friendly assistance.

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A belly button that has changed from an “innie” to an “outie” may be a sign of an umbilical or belly button hernia. The umbilical ring of the belly button, or umbilicus is a natural area of weakness in the abdominal wall. Overtime with vigorous activity and/or pregnancy, the umbilical ring will stretch and the area will enlarge to form a hernia.

A hernia is a full thickness defect through a tissue plane.

An umbilical hernia is a hole through the abdominal wall, through which fat and/or intestinal contents can enter into. Hernias do not go away and may enlarge through multiple pregnancies and over time. The danger of a primary hernia is that a segment of intestine gets trapped in the umbilical defect, which is called incarceration. This could lead to an injury of the intestinal segment called strangulation or blockage of the intestinal track. This only happens in moderate sized umbilical hernias and most small hernias have only pre-peritoneal fat contained in them. Pre-peritoneal fat lines the abdominal wall and is not associated with the abdominal contents.

Small umbilical hernias are a sign of abdominal wall laxity and are common in the patient who has lost weight or has had multiple pregnancies. The repair could entail repairing the umbilical hernia primarily, though with the previous stretch on the surrounding abdominal wall will thin and weaken the tissue. This general weakness called a Diastasis Recti could make the repair ineffective and limit its durability. A significant Diastasis Recti could necessitate the use of mesh to span the area of weakness in order to patch the umbilical defect.

To avoid the use of mesh and ensure a durable repair in the female patient with post-pregnancy abdominal wall laxity, a diastasis repair could be combined with an umbilical hernia repair. This will primarily repair the umbilical defect and reduce the hernia contents in combination with the repair of the entire area of central muscle laxity.

Considerations for hernia repair include discomfort at the hernia site, 6 months from delivery, an enlarging belly button, and finished having children.

The options for a repair of the umbilical or belly button hernia and the diastasis recti include:

• Umbilical Incision just under the belly button with a hernia repair with limited diastasis repair.
• Endoscopic through 2 small incisions with a hernia repair and full diastasis repair with the use of an endoscope
• Lower abdominal incision in combination with skin removal and liposuction in the form of a mini tummy tuck or full tummy tuck (abdominoplasty).

Recovery is under 10 days with resumption of cardio at 2 to 3 weeks and full lifting and core work at 6 weeks.

Andrew P. Trussler MD is a plastic surgeon in Austin Texas who has advanced training in cosmetic surgery and significant experience in abdominal aesthetics and reconstruction. He can help develop a plan to repair your umbilical hernia and strengthen your core with a diastasis recti repair with or without skin removal and liposuction.

Dr. Trussler’s Austin plastic surgery office can help guide you in recovering your abdominal shape and strength to help you look and feel your best.

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Dermal Fillers

Neurotoxins

Kybella

Lip Plumping

The post Want Some Instant Gratification? Try These Treatments On For Size! appeared first on Andrew Trussler, MD, PLLC.

• Expect smooth and glowing skin after a dermaplaning procedure without downtime
  

Dermaplaning is designed for dull and rough skin, as well as uneven skin tone and texture. It helps to remove build up of dead skin cells and has immediate results that brighten and even the skin. The skin is left smooth and soft without uneveness and dullness.
Dermaplaning safe and effective with little to no downtime. There is no discomfort and takes about 15 minutes in the office with little to no downtime. The skin is prepared with a gentle cleanser and followed by a moisturizer after the gentle dermaplaning. A sterile blade is lightly passed over the skin to removed the dead skin cells and light hairs. It should be repeated in a 6 week period and combined with skin care to avoid secondary pigment and sensitivity. The procedure should be avoided in active acne breakouts and other skin conditions such as Rosacea.
Dermaplaning can be followed with a low depth chemical peel and intense retinol treatments. The exfoliative skin treatment can help the penetration of skin care products and prepare the skin for other more invasive procedures.

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1. What is Bromelain?

It is a combination of protease enzymes, which are extracted from the fruit and stems of the pineapple.

• They have effects on blocking the body’s inflammatory effects.

2. What are the positive effects of Bromelain?

The effects of Bromelain are comparable to Non-Steroidal Anti-Inflamatory Drugs (NSAIDs) and include:

• Reduced inflammation
• Decreased swelling
• Reduced pain
• Improved healing
• Faster recovery

3. What is the effective dose of Bromelain?

The suggested dose is 500 to 1000 mg of bromelain taken on an empty stomach. The bromelain supplement needs to be enteric coated so that they do not activate in the stomach, but rather are absorbed in the intestine. They should not be taken with other medications like antibiotics because they can negatively effect their actions.

4. When should Bromelain be started after surgery?

Bromelain can be started the day of surgery and continued for one week. The daily dose can be divided into 2 for ease of use. A total of 4 days of Bromelain is effective.

5. What are the side-effects of Bromelain?

Just like any homeopathic drug, its compounding may vary in effective enzymes. An enteric form is necessary for effect. Care should be taken when combining Bromelain with other anti-inflammatory and anti-platelet medications, as the effects may be altered by Bromelain, which may lead to increased risk of bleeding, blood clots and, heart arrhythmias.

The most effective methods of improving post-surgical recovery are:

• choosing the proper plastic surgery procedure for you which includes accurate surgical technique
• maintaining proper health (operating on healthy patients with normal BMIs, good nutrition habits and proper exercise regimes)
• smoking cessation
• compliance with activity limitations
• healthy balanced diet with adequate protein supplementation for healing.

Dr. Trussler in Austin Texas encourages patients to start Bromelain 3 days prior to any operative procedure and continue 3 days after. Bromelain is provided as part of the plastic surgery pre-operative package for his cosmetic surgery patients in Austin Texas.

The post Five Facts About Bromelain: How about those (pine)apples? appeared first on Andrew Trussler, MD, PLLC.

Earrings are the most common source of traumatic injury to the ear lobe. They commonly catch on objects and clothing which can accidentally tear through the ear lobe. This leaves the ear lobe bleeding with an unsightly injury.

• Heavy earrings can cause stretching on the ear lobes, especially if worn daily for extended years.
• The ear lobe thins with age making it more common to stretch or tear the ear lobe. Ear lobe injuries can happen at any age.

The good news is there is treatment for a torn or stretched ear lobe! Dr. Trussler in Austin Texas does recommend treating the torn earlobe within 24 hours by closing the injury with stitches. This can easily be done in the office under local anesthesia. Techniques can be performed which even maintain the hole for replacement of earrings, though if the hole is not preserved, the ear lobe can be re-pierced in 6 weeks in the office.

• If treatment is not sought immediately, the earlobe is allowed to heal over a 4 week period and then the healed notch is opened and the old laceration closed.This is similarly performed in the office.
• Stretched ear lobes are typically treated the same way, though the goal is to make the ear lobe smaller and symmetric with the other side.
• Simple scar care may be recommended.

Earrings can be replaced after about 6 weeks of healing with the hole placed slightly high in the lobe so not to encourage further injuries. Dr. Trussler can evaluate and treat these injuries in his Austin, Texas plastic surgery office.

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Accidents happen and when they involve your face it usually gets your attention!

A broken nose can happen with falls, car accidents, fights and playing sports. Direct blows to the nose are the usual causes.

One good indication that you have broken your nose after one of these insults is that it bleeds(epistaxis). Other indications of a broken nose is that the nose appears: crooked, swollen and/or bruised.

If you think you have broken your nose, get evaluated by a physician, usually in an urgent care or emergency room to make sure you don’t have any other serious injuries like a neck or spine injury or other broken facial bones.

• The bleeding from the nose should be stopped with standard methods such as ice and elevation.

The nose can be palpated for appreciable broken bones and the nostrils should be evaluated for evidence of a hematoma along the septum or middle part of the nose.

• Xrays and CT scans can be helpful in visualizing where the nose is broken.

After the initial evaluation, you should be referred to a specialist who can treat a broken nose or nasal fracture, either a plastic surgeon or ENT. The broken bones and septum can be reset if they are deviated and should be done within one week of the injury. This usually requires a very short general anesthesia.

Recovery from a closed nasal fracture reduction is less than a week and any splint and tape are removed at the first follow-up visit.

• There is a greater than 85% chance that the nose can be replaced to its normal position after the nasal bone reduction.

If deviation and/or breathing problems persist after the initial accident or after the nasal fracture reduction, a definitive septorhinoplasty can be performed after 6 to 8 weeks of the injury.

Components of a Septorhinoplasty:

• Septoplasty
• Cartilage Graft Harvest
• Osteotomy
• Inferior turbinate reduction
• Internal cartilage grafting
• Cartilage supporting sutures

Dr. Trussler, a plastic surgeon with advanced rhinoplasty (nose job) experience is available to evaluate and treat your broken nose in his plastic surgery practice in Austin, Texas.

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