Tag Archives: Hawaii

What is the latest and greatest in eyelid surgery (Blepharoplasty) by Dr Schlesinger in Honolulu Hawaii

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What is the latest and greatest in eyelid surgery? Well, let’s go back and review some of the problems that occurred in the past. The first one is too much skin taken out of the upper eyelid. This one truly is not a problem if you choose the right Board Certified plastic surgeon.

http://www.mauibody.com/photo-gallery/face-gallery/eyelid-blepharoplasty-photo-gallery/

Lower eyelids have been a problem for plastic surgeons for a long time. Patients want to get rid of the bags, extra skin and wrinkling. The bags are little pouches of brown fat. However, this fat is not brown in color, but the specific biochemical makeup of this fat is the same that brown bears live off when hibernating. You have all the fat you will ever have in this area when you reach puberty. It is normally held back by a piece of tissue known as the septum orbitale and it relaxes or fails at different ages depending on your genetics. Also, smoking and drinking do not help to preserve the integrity of the septum orbitale. Once this septum weakens, the fat pushes forward and looks like little bags under the eyes.

Historically, the treatment of choice to improve the appearance of the lower eyelids was to remove skin, muscle and fat, often leading to eyelids being pulled down, the white of the sclera showing above the rim of the lower eyelid, a very unattractive look. This problem of lower eyelids being pulled down is referred to as an “entroprian”. The reason this occurs is because the lower eyelid is held up by only two ligaments, one connecting to the medial or inner side of the orbit and one connecting to the outer side of the orbit. When you take skin and muscle out from below the lower eyelid, the resulting vectors of force are all downward, and unless one creates some upward vectors, the eyelid will pull down creating an entroprian.

Finally, any attempt to remove all the fat bulge under the eyes often leads to excessive fat removal and a hollowed look which can be even less attractive than the pre-existing bulging fat. A new technique has been developed which can push the fat backwards, therefore allowing the surgeon to take less fat and eliminating that hollowed look. It also eliminates most of the wrinkles because wrinkles at rest in the lower eyelid are not from excess skin, but rather from loose muscle. This new technique takes a portion of the oblicarius oculi muscle, passing it under the lateral ligament that supports the lower eyelid, and sews it up to the covering of the orbital bone superiorally and laterally. This muscle sling not only keeps the eye from having an entroprian, but it also pushes the fat backward.

A salutary effect of this lower eyelid surgery is that it pulls up cheeks. Because the orbicularis muscle is positioned under cheek bone fat, when you pull up part of it under the lower eyelid, in effect it also pulls up the cheek. The entire procedure takes about 2.5 hours. The sutures are out in 3 days and bruising is usually very minimal.

http://liquidfacelifthawaii.com/photo-gallery/

How can this lower eyelid muscle do so many things? The answer is that the face, unlike the body muscle and skin come from the same source, ectoderm. Since fat and skin are both closely related to ectodermal muscle of the eyelids, this muscle sling, as I call it, can do a whole lot more than we were ever able to do previously in a lower eyelid blepheroplasty.

To see more of our before and afters go to one of our websites

www.MauiBody.com
www.BreastImplantCenterofHawaii.com

Or call our office at 808-597-8835

Tummy Tuck Honolulu, Hawaii by Dr Schlesinger

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Tummy Tuck in Honolulu Hawaii

The key to a great tummy tuck is a great belly button. The belly button has two blood supplies – one from the skin around it and one from the liver. There are two veins and one artery that come from the liver and go to the bottom of your belly button. This is how your mother fed you when you were inside her. In a full tummy tuck, the belly button is circumscribed (a cut is made all the way around it), and it is dropped inside to be brought out through a new opening.

Another little known fact about the belly button is that it is not a midline structure. It is usually slightly off to the right or the left. This has to be taken into consideration when your plastic surgeon creates a new belly button. I attempt to center the belly button. Many plastic surgeons try to make a very natural belly button by giving it a slight hooding. It has been my experience that this hooding rarely looks natural and takes away from the potential beautiful looks of a new belly button (neo-umbilicus). The opening to the new belly button should be neither too big nor too small since both of these choices again detract from an attractive belly button.

Technically, I use a vertical ellipse measuring 15 mm in vertical height and 8 mm in width. It is important to take all the fat off the bottom of the skin around the belly button for a distance of 20 mm. This allows the skin to indent in a very natural fashion since the belly button should have a gentle slope down to it from the tissue around, and not an abrupt step off. The scar around the neo-umbilicus should be deep inside the belly button, therefore not visible to the outside world leading to a more natural appearance. The way to do this once the surgeon has repaired the muscles of the abdominal wall, he or she should anchor the belly button at 3, 6, 9 and 12 o’clock to the fascia covering the muscles. This allows the defatted skin around the neo-umbilicus to be pulled downward leading to a hidden scar. The sutures that connect the abdominal skin to the edge of your old belly button should be below the surface, and only super glue should be used at the scar edge to prevent railroad tracking which is a dead giveaway for a tummy tuck.

A great looking belly button should be centered as much as possible, having a gentle slope down to its edge, and the scar should be hidden as much as possible inside the belly button.

The abdominoplasty incision scar should be hidden under the upper edge of one’s panty or bikini line, therefore the belly button is truly the key to a well done abdominoplasty. What is taken away during an abdominoplasty is, of course, important, but what is left after an abdominoplasty is more important. A great belly button gives you a great midriff. Feel free to visit our websites,

www.breastimplantcenterofhawaii.com
www.liquidfacelifthawaii.com

Breast Augmentation in Hawaii and Honolulu

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Breast augmentation in Hawaii and Honolulu is a permanent surgical procedure that enlarges breast size through the insertion of implants. Many women are dissatisfied with their chest size, and breast augmentation is a way to give them the volume they seek. Dr. Schlesinger offers breast augmentation in three facilities in Hawaii: Maui, Kona-Hilo, and Oahu. Patients seeking breast augmentation should find a facility with a qualified plastic surgeon who has experience in breast augmentation. Dr. Schlesinger has 29 years of experience performing plastic surgery in Hawaii, and offers free consultations to patients considering the procedure.

During your consultation, Dr. Schlesinger will answer all of your questions about the procedure, discuss any risks, and help you determine if breast augmentation is right for you in Hawaii and Honolulu.