Your Summer skin care checklist

With the official start to summer just around the corner, it’s time to repeat the importance of protecting your skin against damaging UVA/UVB sun exposure. Obviously, skin care is important year-round, but many of us spend more time outside during the summer (are you sick of mowing your lawn yet?).

Some people may not think of a plastic surgeon when they think of skin care, but Dr. McKee estimates that as many as 25-30% of his patients come to him for sun exposure-related skin conditions. These may include small “pre-cancers” (actinic keratoses), basal and squamous cell carninomas (two different types of skin cancer), or melanomas. Don’t take sun exposure lightly! As Dr. McKee told me and my siblings dozens of times when we were growing up, “It only takes one bad sunburn…!” That is where he would leave it, but we knew what he was saying: every sunburn increases the risk of common skin cancers and melanoma.

With that in mind, here are some great reads for your summer skin care checklist. Please share your thoughts on any of them with us in our comments.

image credit Jennifer R.S. Gordon, M.D., via New England Journal of Medicine

This image has been making the rounds lately, but what a clear illustration of the effects of sun damage on aging skin. Click on the photo or the link to read the article from ABC news.

Sunny Side Old from ABC News

The Skin Cancer Foundation Journal has an article with everything you need to know about today’s sunless tanners- GREAT information in a fun online format. I’ve been meaning to try the Tan Towel. What self tanners have you had a good (or bad!) experience with?

Fake It, Don’t Bake It- The Skin Cancer Foundation Journal

How many risk factors do you have for developing skin cancer? The Mayo Clinic provides a handy list for you. Read it and take the appropriate protective action.

Skin Cancer Risk Factors from the Mayo Clinic

Did your mom get what she really wanted?

For Mother’s Day this year, we’d like to highlight an article from the American Society of Plastic Surgeons (ASPS) about the “Mommy Makeover”. The ASPS has a great, short video featuring one woman who opted for a Mommy Makeover–watch it here. Happy Mother’s Day to all of you hardworking moms!

New Survey Shows Mom’s Unconventional Mother’s Day Wish List

For Release: 05/02/2011

ARLINGTON HEIGHTS, Ill., May 2, 2011 – What would mom get herself for Mother’s Day if she had the chance? A new survey shows that it might be a tummy tuck or breast lift.

A survey released today from the American Society of Plastic Surgeons (ASPS) shows that if cost were not an issue, 62 percent of mothers said that they would consider a “mommy makeover” that includes procedures such as a tummy tuck, breast augmentation and/or breast lift.*

According to ASPS statistics, the number of women getting “mommy makeover” procedures is on the rise. Women had nearly 112,000 tummy tucks in 2010, up 85 percent since 2000; 90,000 breast lifts, up 70 percent since 2000; and 296,000 breast augmentations, up 39 percent since 2000.

“In the last decade we’ve seen women’s attitudes about cosmetic surgery change. Today women are not afraid to admit that they love their children, but they wish their bodies looked the way they did before their first pregnancies. And they’re not afraid to acknowledge that they may need a little help beyond a healthy diet and exercise,” said ASPS President Phillip Haeck, MD.

Another trend that ASPS Member Surgeons are noticing is that the type of patient seeking “mommy makeover” plastic surgery is younger than a decade ago.

“In the past we saw a lot of women in their 50s getting these types of procedures. But today we are seeing young mothers in their 30s coming in for procedures such as tummy tucks and breast lifts. They don’t want to wait years to reestablish how they used to look. They want their pre-baby bodies back now,” said Dr. Haeck.

The promise of getting her body back is what led 38-year-old Dana Van Gray to undergo surgery for a tummy tuck and breast augmentation just one year after having her last child.

“I didn’t like my stomach. I started noticing a muffin top and I thought – why wait? I’m young, I’m healthy and I want to look good now,” Van Gray said.

“More and more patients like Dana are coming in today asking for mommy makeovers, because women now openly talk about having these procedures. It’s more accepted than it was ten years ago,” said Van Gray’s plastic surgeon, Allen Rosen, MD, an ASPS Member Surgeon in Montclair, New Jersey.

“The techniques and the technologies are to the point where we can do these procedures in an outpatient setting in a very safe and effective fashion, minimizing the amount of downtime and pain. This appeals to our patients,” said Dr. Rosen.

Van Gray says that her new and improved body not only enhanced her looks, but also her attitude.

“I feel good so I can be a better mom to my kids,” Van Gray said.

If you are considering a “mommy makeover” the ASPS has these tips:

  • Wait at least six months to one year after having your last child to undergo “mommy makeover” procedures
  • Be specific about your post-baby body goals so that your surgeon can recommend the most appropriate procedures 
  • To optimize the final outcome, if you are trying to lose weight, do so before undergoing “mommy makeover” procedures
  • Find a surgeon who is board certified in plastic surgery
  • Ask to see before and after photos of your plastic surgeon’s recent work

*For more statistics on trends in plastic surgery, visit the ASPS Report of the 2010 Plastic Surgery Statistics.

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Dr. McKee has been a member of the American Society of Plastic Surgeons for 30 years. If you are considering a tummy tuck, breast lift, breast augmentation, or liposuction, please call us at 615-868-4091 or send us a confidential email to schedule your free consultation.

A Care Credit Sweepstakes!

If you’re a Care Credit cardholder, don’t miss out on your opportunity to enter their 25 Years of Thanks sweepstakes. And if you’re not a Care Credit cardholder, it’s not too late to apply!

Winners can receive anywhere from $1000 to $25,000 dollars, but only if you use your card before May 31, 2012.

What might you consider doing with $25,000?

Care Credit is a great way to finance the surgeries you want done, especially with the 6-month and 12-month no interest payment options that Dr. McKee offers.

Call our office for more information or check out all the details at www.carecredit.com/25/

David E. McKee, M.D.

Plastic Surgery in Nashville, TN

615-868-4091

Paying for cosmetic surgery- plus a limited time offer

If you’re like many people, you’ve been considering having a cosmetic procedure done: maybe you’ve imagined what it would be like if you had a facelift, or a tummy tuck, or maybe a breast augmentation. You’ve done some online research, perhaps you’ve even gone as far as calling a few area surgeons to ask about pricing. But that’s where it stops. How would you pay for your surgery? It would take years for you to save up the money for the surgery, but you feel ready NOW. Did you know there may be an option for you to have the surgery you want now and pay for it later, interest-free?

Dr. McKee offers a financing plan for cosmetic surgeries called Care Credit. And for a limited time, Dr. McKee is adding 18-month no-interest to his financing options!

Care Credit is a medical credit card which you can use for any number of medical procedures, not just cosmetic surgery. Once you’re approved for Care Credit, you can use it over and over, any time you need help financing a medical procedure, or for medical emergencies you may not be prepared for.

Dr. McKee’s office typically offers 6- and 12-month no interest financing for cosmetic procedures through Care Credit, but just for a limited time is offering 18-month financing- that’s 18 months to pay for your cosmetic surgery, with no interest! This deal only lasts until March 31, 2012.

Visit carecredit.com to find out more about Care Credit’s services and options- you can estimate your monthly payments and even apply online. Then give our office a call at 615-868-4091 to schedule your free consultation with Dr. McKee.

How to look younger- without looking “plastic”

Dr. McKee talks about what makes a more youthful appearance, avoiding an “overdone” face, and whether TV commercial promises can live up to the hype.

What specific problems do facelifts address?

Its power is the neck and the jaw; you get some of the wrinkling out of the cheeks and pull a little of the nasal-labial fold up, but mainly its strength is the neck and the jawline. And it can rejuvenate that back to a– well, in some patients, to a look they’ve never had. There are a lot of patients that have had an area of fat under their chin that has always been there at every age, and they’ve never had a very nice flat platform. So what we do is we remove that fat and then we tighten the skin, so a lot of people end up having a neckline that they never had when they were 20. It makes a flat platform under the chin, back to a sharp drop.

We’re trying to achieve a refreshed, and certainly a younger look, but we’re not after an age-specific look. We’re not saying we’re going to take 30 years off of you, specifically, but a refreshed, rejuvenated, but still natural look. You will still look like you and not unnatural.

The “Over-done” look

I don’t think there’s any other cosmetic operations that we do that are so culturally determined as to what people think is a good result.

What that means is, patients that I see in my office complain about the celebrities they see on TV: they look over-operated on; they do not look natural.  At the same time, those people you see on TV that I and my patients would call over-operated, would be disappointed if they didn’t get that dramatic operation.

So what is off-putting for many people in our section of the country about facial rejuvenation, is they think that everybody who gets a face lift, brow lift, eyelids, are going to end up with something that is very unnatural and off-putting. That’s not the case. I don’t do the same operation that the FL and NY and CA plastic surgeons do when I do facelift and facial rejuvenation surgery. I am after a very natural result.

Now what does that mean in very specific terms? That means that I make a tight, tight neck and jawline. My opinion is that you can’t tighten the neck or the jawline too tight. It is a nice look, at every age. And if you’re 75 and have a very tight, flat platform under your chin that goes to a sharp drop, nobody complains about that, it is a very nice look at every age.

On the right: "a flat platform back to a sharp drop"

It is the cheeks that are the problem, and the eyes and the brow that are the problem when they’re over-operated. If you try to use the facelift to rejuvenate the mouth, you will get a very unnatural, wind-swept look. That’s what the celebrities have that people do not like. Their mid-face is way too tight. They try to do things, in my opinion, with the facelift that you cannot do, which is rejuvenate the nasal-labial creases a lot (those grooves just above  the mouth and the upper lip), and the area around the lips.  You cannot really rejuvenate those with a facelift. And when you try to do that, it’s not a nice look, as far as I’m concerned. It’s an over-operated, unnatural look. So we don’t do that operation. We do a face lift, which is really a neck- and jawline lift, and some cheeks, and we tighten the neck and jawline up tight, but don’t tighten the cheeks up very tight.

Healing from a facelift

A facelift is about a 3-hour operation, it’s done in the Operating Room of the hospital, you can do it under local anesthesia with sedation, or you can do it under general anesthesia, probably as safely. The patients go home the same day, or if they live out of Nashville, we have them stay in town in a hotel overnight, they return to the office the next day, get the dressing out that was put on in the operating room, and any drains that might have been used, those are removed the morning after surgery.

The patients are allowed to go home, they are allowed to shower the day after surgery, shampoo their hair, then they return to the office 5-6 days after surgery for suture removal and, the day following suture removal, they are allowed to use make up.

In terms of the amount of bruising and swelling people get, is very variable. Some people get very little, some people get a lot, pretty unpredictable. Almost everybody gets some, particularly in the neck and low neck and it settles by gravity over time.

What I tell my patients is that in 3 weeks, they are going to look good. They may look good before then, but if they have a major social engagement, like a wedding or something like that, they really need to allow three weeks.

There is very little pain associated with a facelift. If you have a lot of pain, you need to call your doctor. It is uncomfortable and your neck is certainly tight, and you may have a sore throat (it may hurt to swallow from both the tightness and if you had a general anesthetic, from the tube that was in your throat during the surgery), but other than that, very little pain.

The only scars I’ve ever had to revise are occasionally the scars in back of the ears, where you move into the hairline in back, I’ve had to revise a couple of those. Otherwise, the scars are almost imperceptible, even those that lie in front of the ears- they make thin, white lines, very hard to see.

Franchised “Thread-Lift” Procedures

We’re talking about those advertised, franchised procedures you see on TV: most of the patients who go there will end up getting a facelift, of varying qualities, but they will get a facelift. And if you look at the captions underneath the pictures they show on TV, it will always say the patient had additional neck-tightening procedure. The procedure they are advertising is some kind of thread lifting, it’s supposed to be quick and easy, with long-lasting results. That is not true. It has a high complication rate. But most of the pictures they show, whether they had threads or not, they basically had a face-lift. Now they may have had it by a surgeon who had a 2-week training course instead of being a board-certified plastic surgeon trained in face lifts, but they had a face lift of varying qualities.

Almost every plastic surgeon in the Nashville area has a patient who has come to them because they’re unhappy with the results they had at one of these franchised sites. There are no shortcuts. There is no exercise you can do to remove fat or skin. You can do all the neck and facial exercises you want, you can tighten the muscles, but it does not increase the tightness of the skin, nor does it remove fat from that site. If you burn more calories than you eat, you’ll burn fat, but your body will decide where that fat comes from, so there are no shortcuts.

If you have a lot of hanging skin in your neck, the only good way to remove that skin is through surgical incision, and the only good place to remove it is in front of the ears, and that is a facelift.

♦ ♦ ♦

Dr. McKee has over 30 years’ experience in cosmetic surgery, including facelifts. Please call us at 615-868-4091 or send us a confidential email to schedule your free consultation.

What online before and after photos don’t show you

Why doesn’t Dr. McKee post before and after photos of his patients?

I was recently on vacation and was talking with a family friend who told me that she had thought about getting her eyelids lifted. She was interested in coming to see Dr. McKee, but since she lives about 1000 miles away, that would be a difficult prospect. So I encouraged her to seek a surgeon in her area and take a look at his before & after photos. She told me “Why would I do that? Anybody can just pick out their best work and only show that.”

And she’s right. Anybody CAN do that. How do you know if you’re seeing photos that will really help you make a decision?

Dr. McKee feels similarly about having before & after photos posted online. He does take pictures of his patients before and after their procedures, but will not post them to this blog or his website. Dr. McKee’s office manager, Jeanie, says this: “He feels very strongly that the value of pre- and post-operation photos is only when they can be discussed in person (any doctor can post some good pictures… but that is not your face!)”

Dr. McKee himself says, “Without sitting down with a doctor, before and after photos don’t mean much. I do show patients pre- and post-operative photos to show the techniques that I use and that will show them a range of results.”

When you are considering cosmetic surgery, make sure that you are getting the best information possible and don’t let online photos give you a false impression of a surgeon’s skill or your potential results. Make sure your consultation is thorough and that the doctor answers all of your questions to your satisfaction.

If you are interested in having a consultation with Dr. McKee (and seeing his before and after photos), please call us at 615-868-4091.

What you may not know about your doctor’s qualifications

On Dr. McKee’s Facebook page, we recently posted a link to an article about the dangers of choosing an underqualified surgeon for cosmetic surgery. So it got me thinking: what do patients know about their surgeons’ qualifications before having surgery?

Who is looking out for you?

Who is looking out for your health and safety as a patient? Unfortunately, that answer may include fewer organizations than you think.

In my personal background, I used to work for an insurance company before coming to work for Dr. McKee. I worked in the Credentialing department, which means that I had to investigate each physician’s education and training before we would allow the doctor to participate in our network. If a doctor had insufficient training, he would not be approved and wouldn’t receive patient referrals from our insurance network.

So does that mean that if you have health insurance, any doctor you see in your network has been verified to have the right training?

Not necessarily.

Different insurance companies have different standards, so just because my former employer had fairly rigorous standards, that doesn’t mean that they all do.

And what about elective cosmetic surgery? Since your insurance company won’t be involved in helping choose the doctor, you may be starting your search from scratch.

When a doctor is licensed to practice medicine in the U.S., they’re not limited as to what procedures they can perform in their own office. If a doctor claims to be able to give you amazing results with a liposuction procedure in his office, the fact that he has a nice office, a medical license, and fancy equipment doesn’t necessarily mean he’s had adequate training in that procedure.

What does that mean for you? It means that, as a patient (or a potential patient), you need to do a little bit of homework on your doctor before agreeing to go under the knife.

Hospital Privileges: a tool patients can use

One reason some doctors may choose to perform cosmetic surgery in their offices is because they may not have the qualifications to obtain hospital privileges for those operations. What are hospital privileges? Like insurance companies, hospitals verify a doctor’s training and education to determine what procedures they will allow the doctor to perform in their hospital. However, according to Dr. McKee, “many non-American Board of Plastic Surgery cosmetic surgeons are doing procedures in their offices that they could not get privileges to do in the hospital because they are not qualified and wouldn’t be granted hospital privileges.”

In other words, if a surgeon is performing a certain procedure in his or her office, you may not know whether that surgeon would be qualified to perform that same procedure in the hospital operating room. If you’d like to know what operations your surgeon has privileges for, you can start by asking them directly. But bear in mind that while there are ways of confirming whether or not your doctor has hospital privileges (by calling the hospital or going to their website, for instance), none of them can verify the specific surgeries a doctor has privileges for.

However, hospital privileges are just one method of testing your doctors qualifications. You also need to examine the fine print when it comes to board certification.

Board Certification: all boards are not created equal

Is your doctor board-certified? By what board? The American Board of Medical Specialties (or ABMS) is the gold standard of physician training. In order to be certified by the ABMS, a doctor must undergo a specific amount of training (different for each specialty) by an accredited school, pass rigorous testing, and maintain a certain number of continuing education credits each year.

Click here to see more about Dr. McKee’s training.

Under the ABMS are 24 “member boards”- these are the boards that represent a range of different medical specialties that the ABMS has determined meet their exacting standards. When it comes to cosmetic surgery specifically, the Palo Alto Medical Foundation puts it this way, “None of the 24 ABMS approved boards includes ‘cosmetic surgery’ in their name… While some of the 24 ABMS approved boards may cover a very limited number of cosmetic surgery procedures, only the American Board of Plastic Surgery covers all cosmetic surgery procedures.”

There are dozens (if not more) organizations that are collections of doctors all practicing the same specialty that are trying to be recognized by the ABMS, but simply don’t meet their standards. Some of these organizations accept any doctor who pays their dues, without doing much in the way of verifying their training. These organizations might have a name that sounds prestigious, but be careful: the only way to really be sure a plastic surgeon has top-tier training is to choose one certified by the American Board of Plastic Surgery.

How do I know if my doctor is board certified?

Depending on your doctor’s office, you may not get much time to examine all the certificates on the wall. Luckily, the ABMS allows you to search their website for board-certified surgeons in your area.

When it comes to plastic surgeons, you can also check for membership in the American Society of Plastic Surgeons (ASPS). All of their members are certified by either the ABMS or the Royal College of Physicians and Surgeons (for doctors in Canada).

From the ASPS:

Choosing an ASPS Member Surgeon ensures that you have selected a physician who:

  • Has completed at least five years of surgical training with a minimum of two years in plastic surgery.
  • Is trained and experienced in all plastic surgery procedures, including breast, body, face and reconstruction.
  • Operates only in accredited medical facilities.
  • Adheres to a strict code of ethics.
  • Fulfills continuing medical education requirements, including standards and innovations in patient safety.
  • Is board certified by The American Board of Plastic Surgery or in Canada by the Royal College of Physicians and Surgeons of Canada®.

Your best results

Even in these enlightened times, there are still an unfortunate number of snake oil salesmen out there. Certainly, not everyone you come across is trying to take advantage of you, but for your safety, it is vital that you remain an advocate for your own health. The good news? Finding your surgeon’s qualifications can be done with just a couple of clicks.

Dr. McKee is certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons. He has 30 years’ experience in cosmetic and reconstructive surgery of all kinds. If you would like to meet with Dr. McKee for a free cosmetic surgery consultation, call us a 615-868-4091 or send us a confidential email using the form below.