Wednesday, February 24, 2010

Ribbon Lift

Ribbon lift


Ribbon lift has caught the imagination of public thanks to certain celebrities like Angeline Jolie , who is rumored to have had ribbon lift done recently to restore her once chiseled jaw line. Celebrities and others who are constantly watched and captured on camera tend to start early with facelifts. They particularly seek surgery that is least invasive and gives subtle results with least downtime and scarring . Ribbon lift fits the bill perfectly.

Loss of jawline definition is one of the earliest signs of ageing and starts usually in early thirties. Overweight younger individuals in their twenties too can face this problem because of fat accumulation in lower face, upper neck and under chin. But with the onset of thirties even people with normal weight can lose the sharpness of their jawline because of the effect of gravity , loss of elasticity of skin and sagging of platysma muscle of the neck. Younger people tend to consider nonsurgical options like thermage or laser facial rejuvenation which claim to lift the face. None of the nonsurgical devices available can actually lift the sag of the muscles because muscles are too deep and outside the reach of nonsurgical methods. Plastic surgeons have constantly strived to find a solution that can actually lift the muscle with least amount of scarring or downtime, to suit the need of younger people with active lifestyle.

Ribbon lift involves placing a certain ribbon like device under the jawline between the skin and platysma mucle, to pull the skin and muscle in unison towards the ear. Ribbon , in this endotine devise is made up of absorbable material , is about one fourth of an inch wide and has hooks on the undersurface to grasp facial mucles . Ribbon is inserted through small incisions either behind earlobe or above the ear , within the hairline, where it will not be seen . Ribbon lift procedure is done under local anaesthesia . After engaging the hooks on the muscle, when ribbon is pulled towards the ear , the jawline stands out . If a lot of skin is seen bunched up , the excess skin may be removed through a short incision around the ear lobe. Procedure is quick and painless. Downtime usually is one week or less.

Ribbon lift is somewhat like older thread lift with “contour” or “happy” threads. Threadlift technique used absorbable or nonabsorbable thin barbed threads, which were inserted with needle under the skin of face and neck and pulled upwards similar to the ribbon. Multiple threads were required to hold the tissue. Since they were inserted blindly and the barbs were small and delicate results were short lasting and unpredictable. Endotine ribbon in contrast has broader and stronger grip and is placed more predictably and securely after surgical dissection. Therefore one can expect longer results with ribbon.

Who will benefit the most with Ribbon lift? Younger men and women who have minimum fat or excess skin on jawline are ideally suited to Ribbon lift. Typically people in late thirties and early forties, who shy away from conventional surgical facelift will benefit with Ribbon lift. Conventional facelift and even short scar versions involve an incision in front and behind the ear . This is a high price to pay for men and women with shorter or pulled up hairstyles and those who do not need extensive lift . Ribbon lift scars, in contrast , are smaller and well hidden. Facelift surgery involves more extensive dissection which leads to a downtime of 2-4 weeks. Ribbon lift has minimal downtime of less than one week. Of course less surgery also means lesser cost and lesser risk .

So can Ribbon replace the good old facelift completely? The answer is no. Conventional facelift and necklift is the only option when skin excess and sagging is significant. Facelift surgery results last longer 5-10 years whereas results of a ribbon lift may last much less . Ribbon is completely absorbed by body in about an years time. After that the fibrosis around the ribbon is supposed to be holding the sagging tissues for some more time. Since ribbon lift is a relatively newer technique long tem follow up is not available.

Friday, February 19, 2010

What's New in Liposuction : VASER

Popularity of liposuction for unwanted fat removal has generated demand for better technology which can make liposuction safer, painless and quicker. Patients and plastic surgeons alike have constantly seeked solutions that can make liposuction a better and more satisfying procedure. VASER is the latest technological offering in this context.


VASER has been around since 2002, when it was approved by USFDA for fat removal. And no, VASER has nothing in common with similar sounding LASER, which also has been used for liposuction. VASER stands for Vibration Amplification of Sound Energy at Resonance. Simply put it adds the benefit of ultrasound technology to the standard liposuction procedure. Ultrasound waves are sound waves at specific frequency and one commonly comes across it during ultrasound cleaning of dental plaque and while looking at the growing baby in mother’s womb. Usage of ultrasound for liposuction itself is not new. Ultrasound assisted liposuction ( UAL)was very popular in eighties. Vaser has resurrected ultrasound in liposuction. Vaser is 4th generation ultrasound assisted liposuction technology which offers more safety than earlier ultrasound technologies. Speciality of Vaser is “ liposelection” – meaning it caused damage to fat cells only without damaging other tissues.

Vaser liposuction is a surgical procedure like the good old liposuction, only technology and results differ. VASER is performed in sterile operation theatre by qualified plastic surgeon. General or local anaesthesia is used . Tumescent solution which may contain local anaesthetic is injected into the fat to be liposuctioned. Injection of tumescent solution shrinks blood vessels, provides anaesthesia and also creates safe environment for VASER by completely soaking the fat tissue.Vaser probe , which is a solid titanium rod of 3-5mm diameter is then introduced into the fatty layer through small 3-5 mm cuts in the skin. The ultrasound energy is delivered at accurate dosage at the tip of the probe, while moving the probe through fat in all layers all over the area . Ultrasound energy selectively destroys fat cell membrane and liquefies fat. Since the blood vessels, nerves and skin are resistant to lower doses of ultrasound, they are safe. Liquified fat is then vaccumed out with hollow suction metal cannulas attached to vaccume suction machine.

Depending of how much fat was removed VASER liposuction can be a same day surgery or may require hospitalization. Antibiotics and painkiller tablets are prescribed and usage of compression garments is mandatory for 1 month or more after VASER liposuction.

Tissue swelling is natural after any surgical procedure. After VASER liposuction results are seen gradually over next one month onwards as gradually swelling comes down and skin retracts. This is facilitated by wearing compression garment.

So what is the special advantage of VASER liposuction? Vaser liposuction enables larger amounts of fat removal which was hitherto unsafe due to blood loss. So one can have more fat removal, without the need for blood transfusion. Recovery after large liposuction is faster with VASER. Vaser also allows for better sculpting in tougher and fibrous areas like back and male abdomen. High definition liposculpture with VASER is gaining popularity for creating six pack abdomen look. Vaser has been used in more than 100,000 procedures all over the world and has proven to be safe.