Call Us Now!

PHONE: (828) 526-3783 | TOLL-FREE: (877) 526-3784

209 Hospital Dr #202
Highlands, NC 28741

Facebook IconGoogle Plus IconTwitter IconRealSelf Icon


3 Not-So-Popular Signs of Aging You May Have Not Noticed

3 Not-So-Popular Signs of Aging You May Have Not Noticed

So you think you’ve escaped the dreaded signs of aging — from laugh lines to crow’s feet to unsightly forehead wrinkles.  Look at yourself in the mirror again! Here at our North Carolina plastic surgery practice, we often inform our patients to also look out for the following unexpected signs of aging that you may not have noticed!

1. Sagging breasts

Despite wearing support bras since puberty, there’s a huge chance that gravity will take its toll by the time you hit mid-life. Although breast implants are quite popular in increasing the shape and size of one’s breasts, you might also want to consider a breast lift.

2. Bat wings

Have you noticed how your arms seem to obviously wiggle when hailing a cab? The excess skin flapping around your biceps area are often referred to as bat wings or bingo wings and is one sure sign that your skin is not as tight during your younger years. We encourage an arm lift procedure to significantly improve the appearance of your arms.

3. Hands with sun spots and wrinkles

Your face may be free of the usual signs of aging but your hands may give your age away! The appearance of sun spots and wrinkles are one of the most common signs of aging in the hands. Skin care procedures such as photorejuvenation and chemical peels could make your hands look younger!

Let us help you deal with the aforementioned not-so-popular signs of aging by setting up an appointment with Dr. Buchanan! Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We are located at 209 Hospital Drive, Suite 202, Highlands, N.C. We look forward to your visit!

Everything You Need to Know About Compression Garments and Its Accessories

Here at our North Carolina plastic surgery practice, we make it a point to make your recovery period as smooth and safe as much as possible. Although healing from surgery varies from one individual to another, there are certain aids that will prove to be very helpful in your recovery, one of which include compression garments.

Compression Garment Purposes

Compression garments help reduce swelling and bruising on the operated area. Furthermore, it helps avoid blood clot formation and make sure that the body part operated on is “molded” the right way.

Every so often, compressions garments should be worn out for 24 hours during the first week post-surgery. In breast and abdominal surgeries such as a tummy tuck and liposuction, you may be required to wear it a bit longer. Lastly, compression garments also have aesthetic purposes as it could make you appear slimmer.

Compression Garment Accessories Specific to Each Surgery

  • Breast surgeries – compression bras with breathable fabric, seamless, no underwires, soft cups, and with cushioned or padded shoulder straps

  • Arm, abdominal, and leg surgeries –  varying sizes of compression garments may be needed depending on the your body’s gradual reduction in size; garments should be made of breathable fabric, no-show seams, and no hooks for long-term recovery

  • Facelift – facial bands, cushioned hats with wrap-around ties

  • Eyelid Lift –– large-framed eyeglasses with wrap-around protective coverings to shield sutures from sunlight

Quick and Safe Recovery After Your North Carolina Plastic Surgery

Let us help you figure out ways for a quick and safe recovery after your North Carolina plastic surgery. We are located at 209 Hospital Drive, Suite 202, Highlands, NC.  Call us at 828-526-3783 or fill out this contact form to schedule an initial consultation. We look forward to your visit!

Breast Augmentation (Enlargement with Implants)

One of the most frequently performed cosmetic surgery procedures worldwide can give women with small or unevenly sized breasts a fuller, better-proportioned look. Newer implants and surgery methods have improved the results and reduced the recovery time.

People choose to undergo breast enlargement for many different medical and aesthetic reasons, including achieving larger breasts and balancing asymmetric breast size. Breast enlargement may need to be combined with another procedure such as a breast lift in order to achieve the best result if gravity has also taken its toll.

To determine what is required to achieve the desired look and what size implant is needed, I believe a considerable amount of time doing an examination and consultation is necessary.  Taking more time than is standard has lowered my redo rates from around 25%, the standard for this procedure, to less than 2%.

Often, an extensive exam and discussion are the most overlooked portions of many consults for breast augmentation. Part of this evaluation process is determining the proper implant to use. A number of studies have shown that, when the implant is matched to patient measurements through a comprehensive exam and further chosen through careful discussion, the satisfaction rate goes up significantly. This is partially because the same sized implant will achieve different results in different people and even different results in the same person depending on placement of the implant. Likewise, the choice of incision should be based mainly on the implant used since the standard incisions all give equal results. As an example, the new cohesive gel Silicone implants, the so-called “Gummy Bear” implants, require a larger incision to allow positioning of the implant without risk of injury to it. (Research has demonstrated that injury from forceful insertion is one of the leading causes of late implant rupture, another cause of revision.) Location of the implant should also be made on individual patient concerns and anatomy. The newer implants now allow a choice. I generally prefer placement under the breast tissue rather than under the muscle. Positioning it above the muscle usually provides a faster recovery with less pain, prevents some displacement, especially down and outward, is ideal for those who are athletic or use their arms a lot as it does not cause the breast to move with arm movement, and may reduce the risk of deflation or rupture. Some people, those with minimal superior tissue and those wishing smooth implants, however, may fare better with submuscular implant placement. These choices then determine patient satisfaction.

My personal goal is to provide natural looking breasts that are proportional to your body, make you look great in clothes, swimwear or nothing, provide an appearance undetectable as surgically enhanced unless that is what you want, return you to normal activities as quickly as possible, usually by the next day, and do this only once. I have been able to achieve these goals using thorough evaluation, newer methods of measurement and modified surgical technique.

My method takes about two hours, a little longer than some methods, but necessary for fast recovery and minimal pain. I also prefer modern light general anesthesia (going to sleep) as an outpatient because it is, in my opinion, the safest, and you awaken faster with fewer side effects. Technique also makes a huge difference in how fast one recovers after surgery. Older techniques, though faster, stretch the tissues to make a place for the implant. This causes significant postoperative discomfort. Modifying the technique eliminates this stretch and eliminated most post procedure pain. Many people require only Tylenol® after the second day. With this type anesthesia and technique many women are back to many activities within just a few hours to a day after surgery and return to most light activities and work within one to two days. On the day after surgery, you can shower and change into a sports bra. You can return to sporting activities by 2-3 weeks. Incisions are closed with deep, dissolvable stitches and skin tapes. Though this takes longer, I believe this helps assure that the scar is as invisible as possible.

The procedure generally increases the bust line by several cup sizes, depending on each person’s desires. If there is preexisting asymmetry, use of different sized implants on each side can provide balance.

Although there are many potential problems with Breast Augmentation, when done by a well-trained surgeon in a certified facility, the risks are minimal making this an exceedingly safe operation. Taking extra time with the consultation and during surgery also results in better outcomes and higher satisfaction.

Breast Reduction Surgery brings Physical and Emotional Relief

Breast reduction reduces the size of the breasts and corrects the droop caused by the sheer weight of the breast tissue stretching the skin over time. Although everyone is different and problems vary with the size of the breasts, everyone shares two sets of problems. The weight and droop of the breasts cause physical problems. The weight causes strain on the shoulders and neck and occasionally the back. This can cause grooving of the shoulders, bony deformity of the clavicle and even nerve dysfunction in the arms. The droop can cause rashes under the breasts or irritation from the bra straps. The other problem is emotional. This can vary from poor self-esteem to severe taunting or sexual harassment. Surgical reduction and droop correction, a procedure known as Reduction Mammoplasty, generally corrects all these problems. ABC Good Morning America captured this transformation. Though the procedure is much less common than breast enlargement, almost all patients are extremely happy with the results.

Breast Reconstruction Underutilized

Pink ribbons remind most of us that October is National Breast Cancer Awareness Month. But many women know little about one part of the breast cancer experience, breast reconstruction after a mastectomy or partial mastectomy. To combat this, a national campaign has started to educate women about the options available. The kick off for this is October 17th, BRA Day (Breast Reconstruction Awareness Day).
Recent studies have shown that 7 out of 10 women undergoing some type of mastectomy are not made aware of breast reconstructive options. Thus, there are thousands and thousands of women walking around without one or both breasts, because they don’t know the options available to them. In fact, only 1 in 5 women with a mastectomy undergo reconstruction. Although some of those that do not have reconstruction do so by choice, the majority do not do so due to ignorance of their choices.

One of the most common reasons for women’s ignorance is that their doctors neglect to inform them. Some mistakenly think that reconstruction at the same time as the mastectomy can reduce the chance of cure. Others believe wrongly that recurrences of breast cancer can’t be diagnosed if reconstruction is done. Some may be practicing where there are no plastic surgeons at their hospital and, thus, assume that the cancer treatment and reconstruction cannot be coordinated. Some just may not realize that reconstruction is an option.

All of this is in spite of national legislation, the Women’s Health and Cancer Rights Act of 1998. This was intended to increase the options available to women with Breast Cancer and encourage Breast Reconstruction. It required any insurance company that pays for a mastectomy, to also cover breast reconstruction surgery. This included Medicare and Medicaid. The law further stated that the company’s clients must be told about the coverage. By doing so it defined breast reconstruction as not simply cosmetic surgery, but a medical necessity for the physical and emotional well-being of breast cancer patients. In the fourteen years since this law was enacted there has been almost no increase in breast reconstruction after mastectomy.

Why is breast Reconstruction deemed to be so important? Very simply, loss of the breast causes both mental and physical problems. From around the age of 10 the breast is synonymous with femininity and part of what defines womanhood. I am frequently told they “no longer feel attractive,” or that they were “outgoing and now have become an introvert.” Additionally, the asymmetry of weight can lead to shoulder, neck and/or back pain and difficulty sleeping. Although Dr. Buchanan has worked for years to make breast reconstruction available to women, some regional hospitals are now also recognizing this.

To correct this, there are a number of options. These can be divided into two major choices, timing and method. Timing is either immediate or delayed. With immediate reconstruction, the initial reconstructive surgery is done at the time of the mastectomy. This restores a mound (though sometimes not to the final volume) and reduces the number of surgeries and the time to complete restoration of the breast. It also prevents the skin from contracting and making any reconstruction harder. Data has shown that it does not interfere with cure of the cancer or reduce the acceptance of the new breast into the woman’s psyche. Delayed reconstruction can be anywhere from 24 hours to many years.

There are basically two reconstructive methods, use of an implant or use of one’s own tissue. Each has variations and the two can be combined. Occasionally, especially with large breasts, an implant can be placed under the tissues after the mastectomy and the reconstruction of the mound is complete. The nipple/areola is reconstructed a later time. If the remaining tissues are too tight to allow the final volume to be inserted initially, an expander (an implant containing a valve) containing a smaller volume is placed and then expanded, thus stretching the overlying skin safely to the final size. It is then exchanged for the proper sized implant.

Because the scar around the implant can contract and make the implant feel firm and some women’s desire not to have anything foreign, one’s own tissue can be used. Most commonly this is taken from the abdomen or back. Occasionally, at some specialized centers, tissue from the buttocks is used, reattaching the tissue microsurgically. When taken from the back the tissue is simply transferred from the back to the chest based on a long artery and vein. Frequently an implant is also used to reduce the scar to the back. Using the tissue from the abdomen is probably the most common and the most aesthetic, since one gets a tummy tuck at the same time as the reconstruction. This can be done by leaving the flap attached by its vasculature and just rotating it, or it can be done microsurgically. Both methods have pros and cons.

Since a true reconstruction requires the two breasts to match, and some breasts just cannot be matched by reconstruction, remodeling of the other breast to match the reconstructed one is also mandated by the 1998 law. This is very frequently required with implant reconstruction and commonly needed with tissue reconstruction.

As I said earlier, October 17th is BRA Day. For more information, go to BRADayUSA.org. The spokesperson for this effort is the singer Jewel. To further education of women about breast reconstruction, she released the single “Flower” on August 12th, and part of the proceeds goes to this effort. This song can be downloaded from iTunes.

Dr. Buchanan has extensive experience in breast reconstruction and is presently on the Breast Reconstruction Work Group of the American Society of Plastic Surgeons writing clinical practice guidelines for physicians around the country. He works year round in Highlands at the Center for Plastic Surgery.