New York City Liposuction - Abdominoplasty - Tummy Tuck Surgery

TOP PLASTIC SURGEONS PICK THE FIELD'S SHARPEST TALENTS

Steven Wallach trained at Albert Einstein in general surgery and plastic surgery, then completed a burn fellowship at Einstein and a fellowship on the West Coast with Bruce Connell, one of the fathers of American plastic surgery. He returned East to set up shop, where most of his work is face-lifts, nose jobs, and breast reduction and enhancement. One of Wallach's specialties is performing simultaneous abdominoplasties and breast augmentations.

CAN EXERCISING MY FACIAL MUSCLES PREVENT MY SKIN FROM SAGGING?

I wish. Unless you don’t eat or talk or laugh or cry – or you’ve overdone it with the BOTOX® – you’re exercising your facial muscles all day long, says Steven G. Wallach, MD, assistant clinical professor of plastic and reconstructive surgery at Albert Einstein College of Medicine in New York City. Your skin sags as you age because of multiple factors: The skin thins, connective tissue fibers under the skin stretch out, and facial fat loses volume – and as that same fat descends, it deepens the nasolabial folds around the nose and mouth, and causes jowls along the lower jawline. There are ways to prevent sagging, starting with using sunscreen every day, which helps stop the degrading effects of UVA/UVB rays…

How its done Made from botulinum toxin (yes, the same poison that causes botulism when ingested), an outpatient injection of Botox into the frown lines, crow's-feet or forehead creases paralyzes facial muscles, smoothing them out, says Steven Wallach, M.D., a New York City plastic surgeon. Sometimes a local anesthetic is used, although many patients go without it.

Pros "This is a good way to reduce wrinkling," says Wallach. In addition, there are no telltale signs of healing, the way there are with lasers. Patients see results in two days to two weeks.

"Retin-A bulks up the skin so the chemicals can penetrate as evenly and effectively as possible," says Steven Wallach, M.D., a New York City plastic surgeon who conducts pre- and postop skin-care seminars ("Basically 'Everything You Ever Wanted To Know About Plastic Surgery but Were Afraid to Ask,'" he says with a laugh") for aestheticians at leading Manhattan day spas like Frederic Fekkai Beaute de Provence and the Avon Centre.

There has been success in flattening keloids (knobby growths of scar tissue most common in people of Mediterranean or African descent) by first having the keloid sliced or frozen off, followed by a series of steroid injections - one right after surgery then three follow-up shots over the next three months (cost: depending on the extent of the scar, $1,000-$5,000 to excise it and $250 per injection). "This combination works in 70-80 percent of patients," says Steven G. Wallach, M.D., assistant clinical professor of plastic and reconstructive surgery at Albert Einstein College of Medicine in New York City.

Cellulite

'This fat can be found on all types of women, from las mas flaquitas to las mas gorditas. "It's mostly hereditary," says Steven Wallach, M.D., a plastic surgeon in New York City. What causes those popcorn-like dimples? "They occur when the conjoined fibers that hold fatty tissue between layers of skin are pulled taut or slackened, allowing tiny pockets of fat to poke through", says Dr. Wallach. "And while a healthy diet, regular exercise, and drinking plenty of water can diminish cellulite, there is no permanent cure." But, he admits, "Losing surrounding fat may reduce its appearance."

The longer-lasting solution: Liposuction

The liposuction technique (now the most popular procedure performed by plastic surgeons) entails first breaking up, then suctioning out fat cells through a small incision in the skin. Dr. Wallach recommends checking with a board-certified plastic surgeon to see whether you are a candidate. "The best patients are those of normal weight, with firm, elastic skin, and an excess of fat in particular regions," he says. Still, even surgery isn't a guaranteed, permanent solution. While your legs or hips may be slimmer and actually have less fat in them, the dimples associated with cellulite can still be noticeable. Liposuction is not recommended for people with diabetes, or significant heart or lung disease. The cost of the procedure ranges from $2,500 to $5,000.

Don't Melt the Patients' Plastic

AS IF PLASTIC SURGERY wasn't hard enough, post-op patients also had to worry about salon treatments' damaging the merchandise. Now, Dr. Steven Wallach is easing their minds along with their signs of aging, lecturing upscale salons like Frederic Fekkai and Avon in NewYork City on dealing with recently nipped, tucked and/or suctioned patients. His pointers: Don't dye the hair for three weeks to keep chemicals out of a face-lift's scalp sutures. Stylists must be cautious, too, so "no sharp combs." A facial after a nose job? "Don't touch my work!" for at least three weeks. But go for a massage a few days after lipo. "It may get rid of some of that kind of lumpy bumpy feeling."

Neck lifts can correct problems under the chin created by loose skin, excess fat or muscle tension. The approach taken will depend on the specific cause, explains Steven Wallach, M.D., a New York City plastic surgeon. For loose skin alone, an incision is made behind the ear, skin is redraped and excess removed. If isolated fat is the culprit, liposuction is done through an incision under the chin or behind the ear. A tense muscle requires an incision and then suturing on either side of the muscle or removal of a wedge of muscle to leave it less taut. The skin might redrape itself, but if not, the excess can be surgically removed. It can be done in the hospital or doctor's office; you will be sedated. Recovery time is 7 to 10 days; plan to stay at home during that period. Results last 5 to 10 years. Cost: about $2,500 for liposuction; $4,000 to $5,000 for skin or muscle surgery. Possible Risks Although rare, scarring and nerve damage that could affect your smile.

"It's safer, and it's really good for some areas, especially hip rolls, male chest, back. But with the thighs and abdomen, you can usually use classic liposuction to mechanically suck out the fat." Dr. Wallach

"Most of what was going on was people trying to limit the amount of scarring they put on the breasts. To minimize scarring, we make an incision around the areola and it's an up and down incision only. A combination breast lift and augmentation is a really hot thing." Dr. Wallach

"Patients are more in tune with what's out there. The Internet has become a very popular tool for people to canvas and obtain info on their own. Patients are savvier. They don't have consultations to gather information anymore; they are doing them to try and find a surgeon. They are well informed." Dr. Wallach

Every six months to a year a new laser comes out that improves wrinkles on the face and neck. Every meeting there is a new laser, so I am taking a wait and see attitude. If one day we can have scarless healing that would be amazing. No matter what we do, if there is an incision. there will be a scar. Hopefully, that will change." Dr. Wallach

Knowing what to expect in the E.R. can help you keep calm through an understandably trying experience. Some basics:

Plan ahead Ask your pediatrician which hospitals she can admit patients to and which one she recommends for pediatric emergencies. If you're covered by managed care, ask which hospitals are affiliated with your plan.
Review your child's medical record You'll be asked about significant illnesses or operations, allergies and immunizations.
Anticipate "controlled chaos," notes Larry Bedard, M.D., president of the American College of Emergency Physician 3. Emergency departments are busy, often noisy places.
Communicate with the nurses The triage nurse assesses whether your child needs immediate attention or can safely wait. Talk to her about special physician requests. For example, if your child needs stitches on the face, ask her to summon the plastic surgeon on call, recommends Steven Wallach, M.D., a New York City plastic surgeon.
Be realistic about squeamishness You'll be allowed to remain with your child through most procedures, but if you faint at the sight of blood, it may be better to stay in the waiting area.
Understand the E.R.'s methods Don't be alarmed by the use of restraints, for instance. Sheets, towels and boards are routinely used to minimize thrashing while a child is being examined or stitched. It may look shocking, but it's for your child's protection.

The thirties often is a time of alterations in lifestyle and body structure. More and more women are waiting until their thirties to have children. "After a woman has children, she can lose volume," explains New York City plastic surgeon Steven Wallach, M.D. Pregnancy brings weight gain and hormone changes that alter the shape of your breasts and take a toll on self-esteem. Starting at around eight weeks into pregnancy, your breasts begin to get bigger and they'll continue to grow. It's common to go up a cup size or two. As the body prepares itself in anticipation of lactation, hormones stimulate development of milk-secreting glands embedded in the fatty tissue, swelling the breasts. Among the most common breast complaints from thirtysomething women:

Problem: Drooping, sagging breasts after pregnancy
Solution: Breast lift, with or without implants

Problem: Breasts that are too small
Solution: Breast augmentation

Problem: Breasts that are too large
Solution: Breast reduction

Smooth New York, a skin care and laser center, opened this week at the offices of Manhattan plastic surgeon Steven Wallach, at 1049 Fifth Avenue. Wallach will oversee all procedures, from BOTOX® injections to Broadband Light photo-rejuvenation therapy, in addition to his specialized practice in body contouring and facelifts. With this affiliation with Smooth New York, which will provide staff nurses, Wallach can perform treatments such as microlaser peels in his office.