Plastic Surgery News and Technology with Dr. Kenneth Hughes
Dr. Kenneth Hughes, Harvard-educated, Harvard-trained, board-certified plastic surgeon in Los Angeles, developed this plastic surgery education site to provide plastic surgery news and technology. Plastic surgery is ever advancing and Dr. Hughes has been at the forefront of pioneering new techniques and new technology in plastic surgery. Dr. Kenneth Benjamin Hughes also provides updates on plastic surgery procedures and the latest in technological advances in plastic surgery. This website will detail these advances and news items through a series of comprehensive and timely articles. Dr. Hughes will regularly update this page with relevant plastic surgery paradigm shifts. Dr. Kenneth Hughes was recently interviewed about shifts in plastic surgery on Marketwatch.
Dr. Kenneth Hughes Ranked Best Plastic Surgeon in Los Angeles by Top Plastic Surgeon Reviews in 2020 and 2021
Dr. Kenneth Hughes Voted Best Plastic Surgeon in Los Angeles in 2020 and again in 2021
Dr. Kenneth Hughes Honored as Top Plastic Surgeon in Los Angeles by California Magazine
Dr. Kenneth Hughes Honored as Best Plastic Surgeon in Los Angeles by California Magazine
Dr. Kenneth Hughes Has Reopened His Fully Accredited Surgery Center after the Coronavirus Lockdown
Dr. Kenneth Hughes, Los Angeles Plastic Surgeon, has reopened after the coronavirus (COVID-19) lockdown and has been performing plastic surgery procedures since May 15th, 2020. Dr. Kenneth Hughes has instituted robust COVID countermeasures that have allowed hundreds of plastic surgery patients to obtain their surgeries in Dr. Hughes’s AAAASF certified plastic surgery center without a single case of COVID transmission over hundreds of surgeries. You will not find a finder and more technologically advanced surgical center. Dr. Kenneth Hughes, Harvard-educated, Harvard-trained Plastic Surgeon in Los Angeles, has been selected Top Plastic Surgeon in Los Angeles by California Magazine.
To learn more about Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon in Los Angeles, please visit
Women’s Health Issues Including Breast Implants and Mommy Makeover Considerations
In the world of plastic surgery, women comprise the overwhelming majority of surgical patients. Therefore, all aspects of women’s health are determinants in plastic surgery options and benefits. Breast augmentation, rhinoplasty, facelift, liposuction, and butt augmentation are some of the most common procedures performed in the United States each year. One of the most common combination procedures performed in the United States and in the Los Angeles and Beverly Hills areas is often referred to as a mommy makeover.
The mommy makeover usually refers to a combination of plastic surgery procedures that are used to improve the tummy and breast areas after pregnancy. This combination may constitute a tummy tuck in which skin and fat is removed and the muscles are tightened to restore abdominal contours following pregnancy. The breast surgery typically refers to a breast augmentation surgery with breast implants to improve the breast deflation and loss of volume following pregnancy and breast feeding.
However, the mommy makeover procedure certainly does not have to be limited to the tummy tuck and breast augmentation. Patients may have different anatomic concerns, different anatomic constraints, and different goals. Therefore, the mommy makeover has really exploded to include other procedures including liposuction, arm lift, thigh lift, breast lift, Brazilian buttlift or BBL, and butt implant procedures. In addition, Bodytite and Facetite has ushered in a minimally invasive skin tightening for patients who may not have enough loose skin for the more invasive procedures.
Gummy Bear Breast Implants : The Best Breast Implants to Come to the Market in the United States?
Originally, gummy bear breast implants manufactured in the United States after FDA approval were only available in tear drop shape. This type of implant is also referred to as anatomic. Over time, companies have developed varying shapes of gummy bear breast implants with varying degrees of cohesivity. This, of course, can confuse patients but it need not be confusing. In general, gummy bear breast implants are more solid in consistency, which comes with its pros and cons. The smooth gummy bear implants may have a smaller risk for rippling. There is a possible lower risk of capsular contracture. However, if the implant pops or ruptures, it will be harder to detect. In addition, an implant that is more cohesive or solid is less pliable, requires a larger incision for placement, and can feel harder to the patient. The gummy bear implants may not be the best implants on the market, but they can be substantially more expensive than regular, cohesive silicone implants.
Breast Implant Manufacturer in the News: FDA Recall of Textured Breast Implants
As of July 24, 2019, healthcare providers should no longer use new BIOCELL textured breast implants and tissue expanders. The FDA requested that Allergan recall certain textured breast implants due to the increased risk of BIA-ALCL. The recall includes the following BIOCELL textured breast implant products: Natrelle Saline-Filled breast implants, Natrelle Silicone-Filled breast implants, Natrelle Inspira Silicone-Filled breast implants, Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled breast implants, Natrelle 133 Plus Tissue Expander and Natrelle 133 Tissue Expander with Suture Tabs (see full list below). The risk of BIA-ALCL with Allergan BIOCELL textured implants is approximately six times the risk of BIA-ALCL with textured implants from other manufacturers in the U.S.
The FDA has not recommended removal or replacement of textured breast implants or tissue expanders in asymptomatic patients. However, for patients who have concerns and would like removal of their breast implants, Dr. Kenneth Hughes in Los Angeles will be performing these breast implant removal surgeries and/or breast implant replacement surgeries.
Given the concerns generated among patients who have had the textured implants placed from other practices (Dr. Kenneth Hughes places smooth implants in the vast majority of cases), Dr. Kenneth Hughes is proud to be offering a discount for those interested in removal or removal and replacement. To learn more about this discount opportunity, please call or contact Dr. Hughes’s office in Los Angeles. Textured breast implants are less popular in the U.S. than in other countries. Macro-textured implants (like textured implants of Allergan) are less than 5% of all breast implants sold in the U.S.
Full Breast Implant Recall List below:
Natrelle Saline breast implant styles 168, 363, 468
Natrelle and McGhan 410 breast implant styles LL, LM, LF, LX, ML, MM, MF, MX, FL, FM, FF, FX
Natrelle and McGhan 410 Soft Touch breast implant styles LL, LM, LF, LX, ML, MM, MF, MX, FL, FM, FF, FX
Allergan Struggles to Find the Women Who Have Recalled Breast Implants
Allergan is making a new effort to find thousands of women who have the recalled textured breast implants that the company recalled after FDA request to recall the breast implants. Dr. Kenneth Hughes, Los Angeles Plastic Surgeon, has utilized breast implants from Mentor, Allergan, Natrelle, and Sientra at one point in his career. The implants are very similar across companies, and Dr. Hughes has used smooth implants in almost all cases except some reconstructive cases in which a textured implant may have had a therapeutic advantage at that time. Dr. Kenneth Hughes previously reported on this site in July 2019 about the FDA recall of certain textured Biocell breast implants from Allergan. Those implants were associated with BIA-ALCL, breast implant–associated anaplastic large cell lymphoma. Some of these women have died after receiving this diagnosis.
This is the latest of several actions the FDA has taken on breast implant safety. The FDA also sent a warning letter to Allergan over its failure to comply with regulatory requirements for selling its implants.
Allergan offers funds for patients to have the recalled implants removed as well as reimbursement for imaging of those implants in affected patients.
Allergan is also now facing about 48 lawsuits, including some class-action claims, relating to BIA-ALCL and its recalled implants.
Surfaces of Implants Studied by MIT Researchers as a Cause for Immune Response
MIT news office recently published the findings of MIT researchers for breast implant surfaces and the immune response. Implant surfaces influence the development of scarring, inflammation, and other complications.
A team led by MIT researchers systematically analyzed how the varying surface architecture found in these implants influences the development of adverse effects, which in rare cases can include an unusual type of lymphoma.
Silicone breast implants have been in use since the 1960s, and the earliest versions had smooth surfaces. However, with these implants, patients often experienced a complication called capsular contracture, in which scar tissue forms around the implant and squeezes it, creating pain or discomfort as well as visible deformation of the implant. These implants could also flip after implantation, requiring them to be surgically adjusted or removed.
In the late 1980s, some companies began making implants with rougher surfaces, with the hopes of reducing capsular contracture rates and making them “stick” better to the tissue and stay in place. They did this by creating a surface with peaks extending up to hundreds of microns above the surface.
However, in 2019, the FDA requested a breast implant manufacturer to recall all highly textured breast implants (about 80 microns) marketed in the United States due to risk of breast implant-associated anaplastic large cell lymphoma, a cancer of the immune system.
In a study of rabbits, the researchers found that tissue exposed to the roughest implant surfaces showed signs of increased activity from macrophages — immune cells that normally clear out foreign cells and debris.
All of the implants stimulated immune cells called T cells, but in different ways. Implants with rougher surfaces stimulated more pro-inflammatory T cell responses, while implants with the unique surface topography, including 4-micron average roughness, stimulated T cells that appear to inhibit tissue inflammation.
The researchers’ findings suggest that rougher implants rub against the surrounding tissue and cause more irritation. This may offer an explanation for why the rougher implants can lead to lymphoma: The hypothesis is that some of the texture sloughs off and gets trapped in nearby tissue, where it provokes chronic inflammation that can eventually lead to cancer.
The researchers also tested miniaturized versions of these implants in mice. They manufactured these implants using the same techniques used to manufacture the human-sized versions, and showed that more highly textured implants provoked more macrophage activity, more scar tissue formation, and higher levels of inflammatory T cells. The researchers also performed single-cell RNA sequencing of immune cells from these tissues to confirm that the cells were expressing pro-inflammatory genes.
On the other hand, implants with the unique surface architecture, including an optimized degree or “sweet spot” of surface roughness, at about 4 microns on average, and other specific characteristics, appeared to significantly reduce the amount of scarring and inflammation, compared to either the implants with higher roughness or a completely smooth surface.
The finding of a complex inflammatory and anti-inflammatory response is critically important, as is the finding that the 4-micron textured implant results in a thinner, translucent capsule than that found with smooth implants, and is the optimal formulation of a silicone breast implant to result in the least thick, least immunogenic response.
After performing their animal studies, the researchers analyzed samples from a large bank of cancer tissue samples at MD Anderson to study how human patients respond to different types of silicone breast implants.
In those samples, the researchers found evidence for the same types of immune responses that they had seen in the animal studies. Among their findings, they observed that tissue samples that had been host to highly textured implants for many years showed signs of a chronic, long-term immune response. They also found that scar tissue was thicker in patients who had more highly textured implants.
Dr. Kenneth Hughes, Los Angeles plastic surgeon, has tried to educate patients about the Allergan breast implant recall and the risks and benefits of breast implant removal surgery. Breast implant removal surgery is straightforward in the sense that breast implants are removed. However, there are a multitude of things to consider with regard to reasons for removal. As well, there may be a multitude of considerations for correction of breast shape and volume following removal of the implants.
Reasons to Remove Breast Implants
1) desire to increase or decrease the size of the breast implants
3) consideration of breast fat transfer to improve breast volume, fullness, or contours
The removal of breast implants as a stand alone procedure is a very common procedure that Dr. Kenneth Hughes has performed many times under local anesthesia. A small incision in the previous scar can be made, and the implant can be removed easily if the implant shell is intact. In more complicated cases wherein breast lift or breast fat transfer may be considered or in which total capsulectomy is to be performed, general anesthesia is a better option for patient comfort and surgeon ease.
Recovery from Breast Implant Removal Surgery
The recovery for breast implant removal is largely determined by any additional procedures that are to be performed at the same time. Breast implant removal surgery by itself is relatively painless, and the recovery is easy for most patients.
Arizona Now Requires Patients to Sign Breast Implant Consent Checklist
A recent bill passed in Arizona requires breast implant surgery patients to sign a checklist. There is really no new information and the previous breast augmentation surgery consents contain all of the information. Apparently, the simplified checklist would help outline the risks associated with implants, which have not changed. The checklist includes information about breast implant illness, complications, and details about the National Breast Implant Registry.
Arizona is the first state to pass such legislation, but those involved are pushing to get this same checklist passed in several other state legislatures. They will then leverage this support to get a bill passed at the national level. The checklist merely adds to the voluminous array of paperwork already required by government regulations.
These checklists are not a substitute for informed consent, but have been requested by patients who feel overwhelmed by the informed consent process. It is also important to understand which of these checklist items have rigorous and robust scientific backing and which items maybe should be excluded due to less rigorous evaluation.
Breast Fat Grafting: An Alternative to Breast Implants
Dr. Kenneth Hughes is sought after for breast fat grafting by patients from all over the world. This inevitably leads to jealousy of other surgeons and the shameless flagging of videos on youtube to reduce viewership of Dr. Kenneth Hughes’s excellent patient education plastic surgery videos. As a result, Dr. Hughes now provides separate copies of the videos on his websites for easier viewing rather than going through youtube and its censorship games.
Dr. Kenneth Hughes is an expert at all types of breast surgery including breast augmentation, breast augmentation revision, breast implant removal, breast fat grafting and breast fat transfer, and breast lift. During his fellowship at Harvard Medical School, Dr. Hughes performed many complicated breast augmentation revision procedures with referrals to the Beth Israel Deaconess Medical Center from all over the world. Whether a patient wants to remove or replace implants, Dr. Kenneth Hughes provides all of the possible reconstructive options to produce the best possible results for breast surgery.
In addition, breast augmentation with fat grafting alone has become a viable alternative to the more conventional breast augmentation with breast implants. There are limitations to breast fat grafting. Fat grafting can only realistically produce a 3/4 cup increase in size no matter what volume is injected. Dr. Kenneth Hughes typically injects between 240 to 360 grams per breast for the average individual. Injecting more will inevitably result in greater risk for fat necrosis or fat death and infection, without any concomitant increase in fat viability or yield. Fat grafting is particularly useful in creating better symmetry or upper pole fullness as well as camouflaging implants or reducing apparent implant separation.
Breast Fat Grafting Before and After Photos
Breast Fat Grafting Shown to Reduce Post-mastectomy Radiation Damage
Fat grafting has been utilized for decades in postmastectomy reconstruction to improve contours and fill contour defects. Many plastic surgeons realize the importance of fat grafting to improving the breast shape and contours following implant reconstruction and autologous tissue transfer. Many plastic surgeons have also seen the obvious improvements that these techniques of fat grafting have had in their own patient populations. Patients who receive post-mastectomy radiation therapy can be improved with fat injections to reduce post-radiation tissue damage.
Sixty female patients were randomly assigned to two groups, one with fat grafting and one without fat grafting. At each surgical operation, biopsies were performed in a specific breast area to evaluate adipose tissue thickness.
This study with 1 year follow-up showed tissue and visual evidence of improved tissue thickness with fat transfer to the breast envelope.
Fat Grafting to the Rescue: Restoring Facial Volume with Fat Grafting
Only a few years ago, patients who had unilateral facial atrophy or traumatic defects of the face were frequently moved to the top of the list for free flap transfer. A free tissue transfer or free flap transfer involves taking tissue with its given blood supply and moving it to another area of the body and tying into the blood supply in that area. For instance, a flap of skin, fat, and fascia with its blood vessels would be sewn into the facial blood vessels and the piece of tissue would be manipulated into the facial defect. The volume match was frequently poor and several revisions were required for optimal contour. Sometimes the scarring or the number of visible incision lines was objectionable as well.
Sometimes these free flap options are the best options, but, in many cases, fat grafting has revolutionized the thought process, the paradigm, the expectations, and the results for facial reconstruction. Fat grafting is far more versatile in creating smoother contours as it does not require a large incision to place the tissue. Fat grafts can be placed at multiple depths and in very small aliquots to create a much smoother and cosmetically pleasing appearance. In addition, the free flap transfers have issues of complete failure, require long hospital stays, and sometimes physical therapy and rehabilitation. Also the morbidity of these procedures for the patients is much greater than for fat grafting.
Remember that the donor or harvest site for fat grafting only removes fat from an area, and this liposuction can make the areas of harvest look better. In almost every case of free flap transfer, the donor site has a significant scar and can have significant deformity and morbidity as well. There is really no question that fat grafting, if done appropriately for appropriately selected candidates, can be a powerful tool to treat patients with congenital, developmental, and traumatic facial defects.
The Nonsurgical Nose Job or Nonsurgical Rhinoplasty: Is it Worth It?
What is a nose job? A nose job or rhinoplasty is a plastic surgery procedure that involves improving the appearance of the nose. What is a nonsurgical nose job? A nonsurgical nose job or nonsurgical rhinoplasty refers to the addition of filler like Juvederm or Restylane or others to the nose to alter the appearance. The indications for the nonsurgical rhinoplasty are few and limited. It is certainly not a valuable tool for making a reduction in any part of the nose, as the filler is obviously augmenting volume. Tip or bridge irregularities or asymmetries can potentially be balanced with the placement of filler. However, filler is usually temporary in nature and will have to be done again in the future.
Some patients may opt for the nonsurgical rhinoplasty as they may fear a surgery like rhinoplasty. The two variations of rhinoplasty are closed and open. While the open rhinoplasty has an external scar and has a more obvious postoperative appearance, the closed rhinoplasty involves making incisions inside the nose and produces less swelling. Patients can frequently return to work in 1 or 2 weeks, depending upon what is done. This version of the rhinoplasty can address almost any anatomical concern like a large of bulbous tip, a droopy tip, a large dorsal hump or bump, asymmetry of the bridge of tip, increased nostril size, and the list goes on and on.
Is Platelet-Rich Plasma (PRP) the Fountain of Youth?
Platelet-Rich Plasma or PRP has been touted for decades as a cure for this or that, but what does it really do? What evidence exists for its efficacy to treat certain medical conditions?
Platelet-rich plasma has been found to significantly enhance the healing process for distinct pathological conditions. Rotator cuff tears, tendon ruptures and and other soft-tissue injuries have been treated with PRP injections. PRP has also been demonstrated to improve function and reduce pain in people who have tendonitis conditions such as tennis elbow.
Dermatologists and plastic surgeons sometimes use PRP injections to treat a type of hair loss called androgenic alopecia, also known as male or female pattern baldness, which affects men and women. And some dermatologists and plastic surgeons provide PRP treatments for the face for rejuvenation.
Once platelets are in the area that’s being treated, they break down and release growth factors, which are compounds that help cells repair and renew. This is thought to trigger your body’s healing process. It can take several weeks for PRP injections to start working. For some conditions, particularly those affecting the hair or the skin, it may take up to 6 months to notice the full effects. For some conditions, including hair loss, you may need to repeat the procedure to maintain the results.
Prior to any PRP injections, you will likely need to stop taking certain medications or supplements that thin your blood like aspirin, ibuprofen, fish oil and omega-3 fatty acids, etc.
PRP doesn’t usually cause major side effects or are very limited because your body will not reject or react negatively to them. Site bruising and swelling would be the most common reactions.
Some of the key advantages of PRP injections are that they can reduce the need for anti-inflammatories or opiates in addition to providing healing for many orthopedic injuries.
Platelet Rich Plasma (PRP) for Hair Loss Treatment
Platelet rich plasma or PRP has been around for decades and has been promoted for various orthopedic conditions, skin rejuvenation, and hair regrowth. Dr. Kenneth Hughes has utilized this technology in his office for interested patients with the understanding that the literature supporting its use is not as strong as other methods for hair regrowth, such as minoxidil, finasteride, and hair transplants. Very few randomized controlled trials have been performed and most evidence has been anecdotal. Although by no means rigorous and with a small enrollment of 30 females, a prospective, randomized controlled trial of 30 females diagnosed with the most common type of hair loss received scalp injections of platelet rich plasma or saline for a total of 3 treatments over 3 months. Blinded photographic assessment indicated that 57% of PRP patients vs. 7% of saline patients improved at week 24 from baseline, which was statistically significant. Adverse reactions included swelling, redness, and bleeding after injections.
Platelet Rich Plasma or PRP for Hair Regrowth Dr. Kenneth Hughes
Preparedness Initiative to Combat the Coronavirus in Plastic Surgery Clinic
Dr. Kenneth Hughes takes many precautions to combat the coronavirus and assure that no patient contracts the coronavirus. Thus far in the United States, the Covid virus has resulted in more than two hundred thousand patient deaths, and Dr. Kenneth Hughes has assured that no patient will contract the virus from the surgery center or bring the virus into the surgery center. Any patient seen in the office is seen in a particular exam room that has surfaces that can be readily cleansed with antiviral wipes. All surfaces, door handles, drawer handles, counters, and exam room tables and chairs are vigorously disinfected after each patient encounter. Secondly, the cleaning crew is on-site every day to clean floors, bathrooms, fixtures, equipment, and even ceilings. All surgeries are scheduled apart from follow-ups or consultations so that the surgical patient is the only individual in the surgery center other than the 5 staff members. All staff members are instructed and follow these protocols as well. Masks and gloves are worn with follow-up patients. Any patients who have symptoms or coronavirus or who have been in contact with a person who had flu-like symptoms are asked to stay at home. Any nonurgent patient follow-ups are conducted over the phone or through email to minimize the influx into the office. Finally, consultations can be performed through email or through Skype to minimize exposure as well.
There are many other aspects to this system of protection against coronavirus at Hughes Plastic Surgery. However, protection against the spread of coronavirus involves maintaining clean hands and body surfaces, contact surfaces on which the coronavirus can live, and air portals through which the virus can be transmitted. Finally, his Los Angeles surgery center has an ultra-fast air filtration system, which circulates the room volume 30 times an hour. As a last measure, this same filtration system has UV lighting apparatus which kills viral particles on contact. It is important to realize that all of these components protect not only against coronavirus, but other infections as well. If a patient is looking to have surgery, this surgery center of Dr. Kenneth Hughes in Los Angeles spares no expense.
There has not been a single case of covid-19 transmission at Hughes Plastic Surgery in Los Angeles despite hundreds of procedure performed since the beginning of the pandemic.
Plastic Surgery Clinics in Korea Shut Down Amid Coronavirus Fears
As of March 2020, Dr. Kenneth Hughes is a published expert in regard to the trends in the Korean Plastic Surgery Market. The Korean plastic surgery market has always taken on a large number of plastic surgery tourists, and the recent outbreak of the coronavirus has hit the industry hard. According to the Korea Culture and Tourism Institute, there was a tourism deficit of 1.1 trillion dollars in January alone. The number of not only foreigners seeking plastic surgery but Koreans as well has plummeted in recent months. Plastic surgery insiders said they suffered about a 70% decrease in business since January. Some clinics are afraid to be stigmatized by having served a confirmed coronavirus patient, so many refuse to see foreign patients to avoid that stigma. Some of the patients have rescheduled for a later date, but, in many instances, the number of patients seen is virtually zero. In the US, plastic surgeons have closed offices for about 2 weeks now with the goal of reducing transmission of the virus and the number of patient deaths. Though Dr. Kenneth Hughes has not laid off any of his surgical staff, most offices have laid off many of the nurses, scrub technicians, aestheticians, and receptionists during this difficult time. Most offices offer virtual consultations to meet patient demand with the understanding that the surgeries will be scheduled sometime in the future. Non-cosmetic elective surgeries have largely been put on hold such as gallbladder removals, joint replacements, and other surgeries that will not substantially alter a person’s state of health for the worse.
Stopping the Spread of the Coronavirus (COVID-19)
1) Wash your hands frequently
2) Maintain social distancing
3) Avoid touching eyes, nose and mouth
4) Wear A Mask
Before putting on a mask, clean hands with soap and water. Cover mouth and nose with mask and make sure there are no gaps between your face and the mask. Avoid touching the mask while using it; if you do, clean your hands with soap and water. Replace the mask with a new one as soon as it is damp and do not re-use single-use masks. To remove the mask: remove it from behind and discard it immediately. Clean hands immediately with soap and water.
CDC Recommends Mask Wear Dr. Kenneth Hughes
CDC recommends Mask Wear and California Governor Mandates Mask Wear
The CDC has recommended cloth mask wear for anyone in public, and Dr. Kenneth Hughes asks everyone who comes into his surgery center to wear a mask as well. A significant portion of individuals with coronavirus are asymptomatic or have not demonstrated signs of infection. These people can still transmit the virus to others before showing symptoms. This means that the virus can spread between people interacting in close proximity—for example, speaking, coughing, or sneezing—even if those people are not exhibiting symptoms. Therefore, CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission. It is critical to emphasize that maintaining 6-feet social distancing remains important to slowing the spread of the virus. CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. N-95 masks are in short supply and are typically reserved for medical professionals. Face shields or eye protection or goggles can be considered to reduce the risk of transmission as well.
COVID-19 Vaccine Candidates May Be Available Before End of 2020
As of October 2020, Pfizer has developed a two dose vaccine candidate that has been estimated to be 95% effective. The company is seeking emergency approval. Pfizer estimates that it could have 50 million doses available by the end of 2020.
The real question is who will get those doses? The most vulnerable or the most connected.
Moderna’s COVID-19 vaccine will seek emergency authorization in a few weeks time as well.
UPDATE on Vaccines and Vaccination (February 2021)
At this time in February 2021, the United States has begun vaccinating frontline healthcare workers and individuals over 75. The two vaccines used are the Pfizer and Moderna Vaccines. Both require 2 doses to be administered several weeks apart.
COVID VACCINE UPDATE and Delta Variant in June 2021
While most areas have achieved vaccination of at risk adults and health care workers at high rates, many people do remain unvaccinated. Whether this is due to indifference or complacency or fear of the complications of the vaccines, the reality is that a more contagious variant can still bring significant destruction to those unvaccinated. This delta variant has increased its relative percentage in last few months and is dominating the other variants.
Paradoxical Fat Gains after Coolsculpting?
Coolsculpting is a popular cryolipolysis tool, which causes fat loss by freezing the fat. Though results are mixed, a recent article in the Aesthetic Surgery Journal studied the likelihood of developing fat growth after cryolipolysis. In certain individuals, instead of reducing fat in an area, the technology caused paradoxical fat gains, known as paradoxical adipose hyperplasia. This muticenter trial reviewed 8658 treatments in 2114 patients to determine the likelihood for developing paradoxical adipose hyperplasia. Nikolis et al determined that paradoxical adipose hyperplasia (PAH) is a rare, moderate-to-severe adverse event associated with Coolsculpting.
Findings revealed incidence rates between 0.05% and 0.39%, which are slightly higher than the manufacturer’s quoted rate of 0.025% (1 per 4000 cycles). Incidence rates at all sites were dramatically reduced by over 75% with the implementation of newer models of Coolsculpting units. Of patients who developed PAH, 55% were male and 77.8% were of European ethnic origin. The majority of cases (76.9%) were associated with older models of the Coolsculpting units.
They concluded that the development of PAH may be related to a combination of factors, including older models of the coolsculpting unit and applicators, as well as individual characteristics that predispose certain patients.
Bodytite: The Latest Technology for Minimally Invasive Skin Tightening
For decades, the field of plastic and reconstructive surgery has sought an alternative to the larger and longer scars associated with traditional excisional or skin removal surgery. While these surgeries produce dramatic results and achieve smoother contours for patients, the scars can sometimes be objectionable for patients and surgeons alike including Dr. Kenneth Hughes in Los Angeles. At the heart of cosmetic plastic surgery is the belief that as much should be achieved in contour or appearance with the least invasive approach. Various energy devices have been advocated in the past for skin tightening purposes in the hopes of providing this less invasive alternative. While heat is frequently the final common pathway to effect tightening of the tissues, the method of delivery and the efficacy as well as potential side effects incurred have not been optimized. Bodytite has been introduced to the market recently and promises something different with regard to its methodology.
Dr. Kenneth Hughes was one of the first plastic surgeons in Los Angeles to offer Bodytite technology. In the past, the energy delivery systems have been monopolar devices – one pole with dispersal of energy from that one point. This had two downsides – energy dissipation with distance and inability to focus energy to improve efficacy of treatment. Bodytite is a bipolar energy delivery device in which the energy is focused between the two poles to concentrate the effect and to effectively measure the temperature achieved. This is critical to both achieving the maximal contraction of tissues without suffering massive burns due to inability to regulate temperature. Thus, efficacy is improved and side effects are minimized, and this means better results for the patients of Dr. Kenneth Hughes in Los Angeles. Dr. Kenneth Hughes is quick to point out that Bodytite does not reproduce the tightness of an excisional procedure or that everyone is an appropriate candidate for Bodytite. Tissue contraction will not reproduce the results of excisional surgery, and patient expectations should be managed accordingly. Bodytite is also not without potential complications. Burns are still an inevitable result of a thermal device in some situations. However, Dr. Kenneth Hughes now performs hundreds of these Bodytite procedures each year on the tummies, arms, thighs, bra rolls, and other areas of skin laxity for patients from around the world. The vast majority of these patients are very happy with the improvement in skin tightness and the minimal scarring. This technology has opened up an avenue of improvement for patients who otherwise would have refused the larger scars of traditional surgery.
Answer: BodyTite will never produce the degree of tightening involved with a surgical skin removal procedure, which excises skin. Patients who fear invasive surgery, scarring, and long down time, typically opt for BodyTite to determine if the improvements are satisfactory enough to circumvent extensive excisional surgical procedures.
Question: Can BodyTite be a solution for uneven skin caused by liposuction?
Answer: Dr. Kenneth Hughes has utilized several techniques to improve uneven liposuction appearance, but it requires great precision to improve this. You need to find a plastic surgeon who does a lot of revisions. You need to realize that no one will be able to produce complete correction.
Question: How long will it take to see results after Bodytite and what is the recovery for Bodytite like?
Answer: Results can be seen immediately after one treatment and are more evident over three to six months post-treatment. Bruising and swelling can occur post-op. Sedentary activities can be resumed in two to three days and full activity with exercise within two to three weeks.
Question: Will BodyTite (without lipo) of outer thigh, buttocks and under butt help to lift droopy buttocks and smooth dimples and rolls?
Answer: BodyTite does not remove any fat, but it is capable of producing a 40% contraction in tissues. Results can be seen immediately after one treatment and are more evident over three to six months post-treatment.
Question: What are the long-term results like for BodyTite?
Answer: BodyTite is capable of producing a 40% contraction in tissues that is permanent.
J-plasma for Skin and Tissue Tightening
J-plasma, unlike Bodytite and Facetite, is a monopolar device that is used to heat the skin and underlying tissues to create tightening. Both use radiofrequency energy to create the heat, but the delivery and dispersal are different. J-plasma is supposed to cause contraction of tissue in less than a tenth of a second. Thus, this delivery requires much less effort on the part of the practitioner and reduces surgical time. The real question is does Renuvion or J plasma produce the results and the degree of contraction of Bodytite and Facetite and does it have a very small risk of burns.
Renuvion’s company website states that
The use of the Renuvion/J-Plasma device for Dermal Resurfacing in the US is considered an off-label procedure.
The use of the Renuvion/J-Plasma device for Dermal Resurfacing in any territory outside of the EU is considered an off-label procedure unless approved by the corresponding territory registration.
Risk associated with the use of Renuvion may include: unintended burns (deep or superficial), pneumothorax, scars, temporary or permanent nerve injury, pain, discomfort, gas buildup resulting in temporary and transient crepitus or pain, infection, hematoma, seroma; asymmetry and/or unacceptable cosmetic result. There may be additional risks associated with the use of other devices along with Renuvion and there may be an increased risk for patients who have undergone prior surgical or aesthetic procedures in the treatment area. As with any procedure, individual results may vary. As with all energy devices there are inherent risks associated with its use, refer to the IFU for further information.
Nonsurgical Vaginal Rejuvenation with Votiva: the Newest and Most Effective Technology
Votiva is a nonsurgical vaginal rejuvenation treatment that tightens vulvovaginal tissues and offers a number of benefits to patients. Votiva can address changes from aging and childbirth, including vulvovaginal laxity, dryness, and urinary incontinence. The recommendation from the company, InMode, for Votiva treatment is either one 30 minute session or three 10 minute sessions. The sessions are essentially painfree and do not require numbing treatments. The device itself is a wand that delivers heat through radiofrequency. Patients frequently note a warming sensation and nothing more. Dr. Kenneth Hughes has performed this procedure for patients without complications and with high satisfaction rates. There may be some soreness, and you should abstain from sexual intercourse for three days. Otherwise, you can resume daily activities immediately. Many women notice a difference, particularly a decrease in urinary incontinence or tightness, after the first treatment, but more significant changes come as cells turn over and new collagen is produced. Results continue to improve gradually over a few months. The company recommends a follow-up treatment 6 to 12 months out and then yearly, to maintain results.
Votiva treatments are a nonsurgical, pain-free way to address several symptoms at once.
There is very little downtime.
You may not see results immediately. They develop over a few months as your body responds to the treatment.
Your body continues to age and change after Votiva treatment, so you may require additional treatments.
In addition to internal tightening, the external anatomy including the labia majora and labia minora can be improved as well. The size of each can be reduced in size and tightened.
Your Votiva Questions Answered
Question: I am 62 and am considering vaginal rejuvenation. There seems to be different procedures. Would Votiva be best for this?
Answer: Inmode asserts that Votiva improves vaginal laxity, dryness, and stress incontinence. In addition, additional studies are underway for pelvic floor weakness. It is noninvasive and pain-free and only requires one 30 minute session for full benefit. It is done without any kind of anesthesia at all and there is no recovery process.
Question: How long does the Votiva procedure usually take?
Answer: A session usually lasts from 10-30 minutes. It is best that you abstain from intercourse for 72 hours following treatment and avoid hot tubs, pools, and bathtubs for 3 days following a session.
Question: Does Votiva hurt?
Answer: It is noninvasive and pain-free and only requires one 30 minute session for full benefits.
Question: What are the side effects of Votiva?
Answer: Votiva has a temperature sensor built into the hand piece which reads skin surface temperature 1000 times per second, allowing clinicians to acquire skin temperature in real time. The “cut off temperature” feature reduces RF energy automatically when the hand piece senses that the required skin temperature has been reached. Clinical evidence suggests prolonged exposure to temperature above 40°C is advantageous for optimal clinical outcomes.
Question: How much does Votiva cost?
Answer: Usually Votiva can range from $3,000 -$3,500. You will only need one time treatment to feel a difference with stress incontinence and tightening.
Question: Votiva v. Kegels
Answer: Kegels can be effective in treating several conditions (vaginal looseness, prolapse, urinary incontinence) as Votiva does. Performing Kegels daily is required for strengthening and toning the pelvic floor before results are noted anywhere from 4 – 12 weeks.
Plastic Surgery Education: “How to Select Your Plastic Surgeon” Video
As detailed in the video, review sites can be somewhat helpful. Realself has maintained the most reasonable review submission and allocation process for plastic surgeons and those procedures performed. Realself is one of the very few sites that is plastic surgery specific and values patient education for plastic surgery. However, recent attempts to help monetize the site with plastic surgeon promotion have somewhat corrupted the once transparent site. At one point, several years ago, doctors were ranked purely on the questions answered on the site and reviews garnered. Thus, the plastic surgeon with the most questions answered and the most positive reviews for a procedure would be ranked the highest for a particular procedure. Since that time, plastic surgeons can pay to be listed as an expert in a certain procedure and one up the true star in a procedure. Dr. Kenneth Hughes provides his expert analysis and routinely reviews procedure information for Realself to assure accuracy and currency as a part of Realself’s medical advisory council. Vitals and Healthgrades are two sites that tend to rank highly on google search results along with yelp.com. Vitals and Healthgrades typically record similar information about the surgeon and the nature of obtaining reviews is largely the same. There is not as much plastic surgery information available on these sites, and plastic surgeons cannot really interact with potential patients. However, there are portals for patient scheduling, which is very nice. Yelp is a review site in the simplest and most generic sense of the word with no specific attention paid to plastic surgery and no plastic surgery procedure information is provided. The reviews have been questioned as legitimate by doctors and businesses alike. Trying to evaluate the credentials and expertise of a plastic surgeon alongside reviews for mold removal and plumbing may not be the best way for a patient to find a plastic surgeon. However, it remains the largest and most influential review site for virtually everything. Doctor is a newer review site similar to vitals and healthgrades, but the site allows photos and videos of plastic surgeons to be posted as well. Doctor also has more information available for each individual plastic surgeon. However, it is not plastic surgeon specific in the doctors that are included on the site. Caredash is very similar to doctor.com with a similar layout, plastic surgeon information, and photo and video galleries. There are two newer sites beautyadvisor and cosmetictown. Beautyadvisor is similar to realself in that there is a lot of plastic surgery information present and plastic surgeons can present photos and videos. The site also has a plastic surgery forum for question and answer. In addition, they allow patients to follow plastic surgeons much like instagram. Cosmetictown provides for plastic surgeon information, articles about procedures, photos and videos, and section for surgeon reviews. Neither of these sites are as popular as realself, but they have potential to be very pure sites for patient education.
Black Market Silicone Injections in the News
Dr. Kenneth Hughes, board-certified, Harvard-trained plastic surgeon in Los Angeles, has received hundreds of inquiries from patients all over the US and throughout the world in regard to silicone and biopolymer injection removal. Many times these injections are used to augment the buttocks or hips, but they can be used to augment almost any body part including thighs, calves, lips, breasts, and others. These injections are frequently performed in larger volumes using less than sterile offerings by persons who have no medical or little medical training. It is important to realize that Dr. Kenneth Hughes does not inject these materials and most board certified plastic surgeons would not. In addition to complications such as infection, skin death, fat death (fat necrosis), inflammation, and pain in the areas injected, these injections can and have led to many patient deaths. When Dr. Kenneth Hughes sees patients in his Los Angeles surgery center for evaluation, he always explains the multitude of complications that may occur in the removal of these silicone and biopolymer substances including fluid collections, infection, inadequate removal, fat death, skin death, tissue deformities, and tissue defects. These removal surgeries can provide life-saving grace to those patients who have no other alternatives. However, the best advice Dr. Kenneth Benjamin Hughes can give is to never allow injection of foreign substances, especially in large amounts by persons with little or no surgical training.
After the materials are removed to the extent possible, there are usually defects that can range from mild to severe, depending upon the total volume of material injected, the depth of injection and surface area involved, as well as the tissue’s response to the injections and the level of tissue damage and inflammation. Dr. Kenneth Hughes has performed hundreds of these silicone removal surgeries and no two are alike. The reconstruction can consist of additional skin excision procedures or buttlifts as well as fat transfer procedures such as the Brazilian buttlift or BBL.
What is a lower facelift? A lower facelift is a surgical procedure that lifts and tightens the lower third of the face. A lower face and neck lift will improve the jowls, the jawline, and the neck and chin areas. Compared to a full facelift, it’s less invasive with smaller incisions, less scarring, and a quicker recovery. People in their late 40s and 50s who are beginning to see sagging around their mouth and jaw may be good candidates for this procedure.
Are there any alternatives to a facelift? Facetite, which is the cousin of Bodytite, can be used to treat the lower face, chin, and neck areas to cause 40% contraction of tissues. For certain patients, the results from Facetite can be quite impressive. However, Facetite will not reproduce the results of an excisional surgery like the conventional lower and face lift or rhytidectomy.
What happens during lower facelift surgery? Just before your surgery begins, you’ll be given general anesthesia or sedation, so you’ll either be fully asleep or drowsy and relaxed. Your surgeon will make incisions near the front of your ears, extending from the earlobes to the hairline. The length of the incisions and their locations will depend on your surgeon’s technique and your facial anatomy. After making the incisions, your surgeon will pull the skin and fat tissue into a newly lifted position. They may also lift and the underlying muscles, also called the superficial muscular aponeurotic system, for a SMAS facelift that produces longer-lasting results. Your surgeon will suture the tissues into their new position, trimming any excess tissue to eliminate sagging and improve your jawline definition.
What should you expect during lower facelift recovery? A lower facelift is an outpatient surgery, which means you’ll return home the same day with aftercare instructions. You’ll be groggy from the anesthesia, so make sure you have someone there to take you home. During recovery, you might also have some discomfort, redness, sensitivity, bruising, and swelling. Your surgeon may ask you to use light ice compresses to reduce swelling and refrain from vigorous exercise for one to two weeks. It is also common to experience a tightening sensation as your skin adjusts to the changes, as well as a temporary loss of sensation around the incisions. Your surgeon will monitor your recovery and remove your sutures at follow-up appointments starting a week after your surgery.
How long do lower facelift results last? Patients report seeing results within a week, as soon as the swelling starts to go down, with most of the swelling gone in about a month. A lower face and neck lift can dramatically alter neck and jawline for years.
Editor’s note from Dr. Kenneth Hughes: Dr. Kenneth Hughes performs a special type of short scar lower facelift that involves complete dissection of the face and neck that allows for maximal recruitment and improvement in contours. In addition, Dr. Kenneth Hughes has created a type of skin tethering technique, which allows for dramatic long-term improvement in the neck, jawline, and jowls.
Dr. Kenneth Hughes You Tube Video Channel Voted to Best Plastic Surgery You Tube Channels
Controversial Plastic Surgeries in the News: Rib Removal Surgery
Dr. Kenneth Hughes was interviewed in 2020 about his views on rib removal to reduce the size of the waist. Rib removal is one of those surgeries that few plastic surgeons will perform due to risk for complications. The goal of rib removal, of course, is to reduce the size of the waist. Frequently, ribs 10, 11 and 12 may be removed. “Pneumothorax, a collapsed lung, is a known risk of rib removal surgeries or rib harvest surgeries, due to the proximity of the rib to the underlying pleura,” said Dr. Kenneth Hughes, Harvard-trained, board-certified plastic surgeon in Los Angeles. Rib removal surgery is not a surgery Dr. Hughes performs nor a surgery he recommends.
Your Questions about Plastic Surgery News Answered
Q: What is air sculpt?
A: It is a marketing name for a laser liposuction. Look at before and after pictures and reviews to select your board certified plastic surgeon rather than select your surgeon based upon the name of the liposuction machine used.
Q: What is the difference between liposuction and air sculpt?
A: I would not focus on different liposuction methods or techniques but rather on your selection of surgeon.
Q: Am I a candidate for an Airsculpt lipo to get rid of my tummy?
A: Liposuction can produce a major improvement in shape. Dr. Kenneth Hughes would have to examine you to give you a better idea of what to expect about the skin. Find a liposuction expert who performs hundreds of liposuction procedures each year and has great reviews and great before and after pictures.
Q: What’s different about Airsculpt laser liposuction than other laser liposuction techniques?
Q: Was This Lip Injection Done Properly, and How Can I Reduce the Bruising?
A: Bruising is very common after having a filler injected. Give it a full 2 week for the product to settle and the bruising/swelling to heal. If the issue continues or worsens, contact your medical provider for further assistance.
Q: Is Hyaluronidase for Boletero Safe and Effective?
A: Give it a full 2-3 weeks for Belotero to settle before trying to remove this product. If you’re completely unhappy, you could have hyaluronidase injected to dissolve the area that was injected but would need a few treatments to see full result.
Q: Belotero to eye area?
A: Swelling may persist for 1 to 2 weeks or longer after filler injection. You could return the physician to have the area massaged if the product is either uneven or lumpy. Certain skin areas are more sensitive.
Q: Swelling after Belotero?
A: If you are still experiencing swelling after the Hyaluronidase, you may need another injection of Hyaluronidase. Response will be based on how much of the Belotero was injected, method of injection/placement, as well as how much Hyaluronidase was used.
Q: Discoloration after injection likely from bruising?
A: The skin of the tear trough area is very thin and has a tendency to bruise more than other areas. If the area bruises, it will be discolored. As the bruise is metabolized, it will change from purple to a more yellowish/green. The discoloration is from the extracellular blood and hemosiderin deposits under the skin (a normal occurrence with bruising).
Q: Fluid Pocket and Heavy Bruising 4 Days After Boletero Normal?
A: There is a great deal of bruising and swelling, but this can happen with an injection into that area with any product. Certain medications, activity level, along with anatomy and injection technique are all relevant.
Q: Too Soon to Inject Lips Again with Different Product?
A: You could consider another filler like Restylane or Juvederm to the lips at this time.
Q: 1.5 Weeks Ago I Had Belotero Around the Eye. Now I Have a Puffy Bag Underneath?
A: I would usually wait 2 weeks before determining if residual product exists. The residual product can be dissolved at that time.
Q: Had my Belotero Dissolved. Blue Puffy Bag is Gone, Now Very Flat. How Soon Can I Refill and Which Filler Would Be Best?
A: I would wait a couple of weeks after the filler is dissolved, and then you could try one of a couple of fillers. I use Restylane for this purpose.
Q: Am I a good candidate for CoolSculpting?
A: CoolSculpting is a noninvasive procedure that uses cryolipolysis. Targeted fatty tissue is placed between two cooling panels to freeze fat cells which are eliminated by the body’s natural cleansing process. You can return to work immediately. You may need two or more treatments to see results.
Dr. Kenneth Hughes frequently treats failed coolsculpting patients with liposuction as well as paradoxical adipose hyperplastia caused by coolsculpting.
Q: Are there less invasive/less risky alternatives to a tummy tuck for me?
A: Safety should always be the first priority when undergoing any type of surgical procedure. Whether genetic or acquired, patients who are diagnosed with thrombophilia are predisposed to excessive blood clot formation, most often in the legs (deep vein thrombosis). None of the non-invasive or less-invasive techniques would remove the loose skin and address the lax abdominal wall to give a nice, flat youthful contour to the abdomen or create a more youthful belly button and remove the c-section scars.
Q: I had my 2nd c-section 7 weeks ago along with a myomectomy. What’s the best nonsurgical option for me?
A: BodyTite is a minimally invasive procedure that shapes, tightens and lifts without a larger scar that would be necessary in excisional procedures like a tummy tuck. Bodytite will create about 40% skin contraction or improvement, but it will not reproduce the tightness of a well executed excisional procedure like a tummy tuck. Patients should not expect this type of result, and Dr. Kenneth Hughes emphasizes this to patients very clearly prior to undertaking Bodytite procedures.
BodyTite uses RF (Radio-Frequency) technology that addresses some of the shortcomings associated with traditional liposuction or surgical body lifts. Bodytite is not liposuction and should not be thought of as such. Liposuction can be combined with Bodytite for best results and frequently is used in combination.
Q: What is the differences between Liposuction and Coolsculpting in price for reduction of one area?
A: If you want a real difference in the area, find a liposuction expert and proceed.
Q: Good candidate for liposuction or non-invasive alternative for my inner knee fat?
A: Knees are a tricky area, and a physical exam will be necessary to determine if this will result in improvement based upon amount of fat and the skin laxity present. This area is more prone to contour irregularity after liposuction, and as such liposuction should be limited. You also do not want to have an issue with falling skin. Another option might be BodyTite. Bodytite provides significant skin retraction and without larger scars and long down time.
Q: Does cavitation work for moderate fat loss in problem areas?
Q: Would Embrace Scar Therapy silicone sheeting be helpful for areolar reduction incisions?
A: The application of topical silicone gel sheeting has been utilized to either limit the development of abnormal scars or treat them once they have occurred. In that the treatment has limited cost and morbidity, it is a good first line treatment for the prevention or treatment of abnormal scars.
In general, scarring is a product of genetics. Some people are good scar formers, and others are poorer scar formers. Dr. Hughes always minimizes the scars to minimize the likelihood of poor scars. There is no one best therapy for scars. Silicone sheets, Mederma, and Bicorneum are reasonable and popular options.
Q: Fractora RF or Profound RF: What is the difference between these two treatments?
A: Profound RF is a needle based energy where the energy is delivered via pins to the skin to improve skin texture, scars, wrinkles. Fractora has radiofrequency with microneedling technology combined in one. Fractora can also be combined with additional energy treatments or injectables to achieve a more extensive full face result. Amount of filler (Juvederm or Restylane) depends on the area of injection, your individual appearance at presentation, and your desired aesthetic. Visible results can be seen immediately with Fractora, but typically after two weeks the most noticeable results appear. Improvements continue up to three months after treatment.
Q: 1 day post-op. Is this normal healing for Fractora?
A: Patients experience little discomfort or side effects during healing; however, some mild reddening of the skin and some possible slight swelling can occur. It should disappear in a couple of days.
Q: Fractora Vs Microneedling?
A: Based on the information you provided you are a good candidate for Fractora. Fractora will give you immediate results with the same amount of down time as micro-needling.
Q: Is radiofrequency treatment with Fractora a solution for tear troughs?
A: The tear trough is the result of a volume deficit so you need to fill it with filler or fat.
Q: Can you get Fractora in conjunction with Votiva while on blood thinners?
A: Be sure to provide your health history to your plastic surgeon and anesthesiologist. Normal practice is to suspend the blood thinners prior to surgery and resume them after. Your hematologist will have to clear you for the procedures based upon the reason you have been prescribed the blood thinners.
Q: Is Fractora performed by a technician or a doctor?
A: Having a highly qualified/trained medical technician perform Fractora is not unusual. Dr. Kenneth Hughes prefers to perform the procedure himself for best results.
Q: Will Fractora help with all these smile lines?
A: Fractora can also be combined with additional energy treatments or injectables to achieve a more extensive full face result. Amount of filler (Juvederm or Restylane) depends on the area of injection, your individual appearance at presentation, and your desired aesthetic.
Q: Fractora for Indented Acne Scars and Hyperpigmentation?
A: Fractora bridges the gap between fractional lasers and surgical results. Clinicians can select between variable depths, densities and energy levels for results that were previously only attainable with excisional surgery.
Q: Fractora Helping Neck Wrinkles?
A: If you are looking for a non-surgical neck lift, Fractora can gradually improve the skin with practically no down time. The radio frequency improves skin texture by diminishing fine lines and wrinkles and tightening the skin by creating new collagen in the neck.
Q: Is nd yag laser hair removal effective with blond hair? If not is there any other type suitable for blondes?
A: Lasers work by detecting contrast in the pigment between your skin and hair color. Best results are achieved with lighter skinned individuals with darker, coarser hair.
Q: Can I do laser hair removal on my breast region after a vertical breast lift with saline implants?
A: Laser hair removal after breast lift with saline implants should not be a problem. Laser will not negatively or positively affect the healing of the scars. Ask your plastic surgeon when you can start shaving/waxing/plucking hairs around your breast region but a few months should be adequate.
Q: Best laser to use for hair removal?
A: Dr. Kenneth Hughes’s practice offers Diolaze, a non-invasive procedure, that requires no down time for hair removal. A diode laser beam passes through the skin towards hair follicles. The penetrating energy then heats up the hair root, which in turn prevents future hair growth. This procedure has one of the largest treatment spot sizes with a built-in skin cooling surface which makes treatment more comfortable than other devices. The number of sessions will differ depending on your hair color, hair type, body area, and skin tone. For example, each leg can be treated in about 10 minutes. Best results are noted after four to six treatments. Touch-up sessions may be needed as there is no way to rid the body of hair permanently.
Q: Time for one session of laser removal of pubic hair?
A: The number of sessions will differ depending on your hair color, hair type, body area, and skin tone, but each session would probably require 15 minutes. Best results are noted after four to six treatments. Touch-up sessions may be needed as there is no way to rid the body of hair permanently.
Q: Way to permanently remove excess hair on face, neck, and chest?
A: Dr. Kenneth Hughes offers Diolaze, a noninvasive procedure, that requires no down time for hair removal. A diode laser beam passes through the skin towards hair follicles. The penetrating energy then heats up the hair root, which in turn prevents future hair growth. This procedure has one of the largest treatment spot sizes with a built-in skin cooling surface which makes treatment more comfortable than other devices. The number of sessions will differ depending on your hair color, hair type, body area, and skin tone. Best results are noted after four to six treatments. Most commonly treated areas include: bikini, legs, arms, chest, back, shoulders, stomach, neck, chin and sideburns. Touch-up sessions may be needed as there is no way to rid the body of hair permanently.
Patients who have dealt with electrolysis, shaving, and waxing over many years are very happy with the results from Diolaze, and the fact that the treatment is virtually painless.
Q: How will I know when laser has done all it can do for my beard?
A: Laser hair removal typically takes 6 to 8 sessions. Removal works best when hair follicles are in their mature stage, however, at any given time, your hair is in various stages of growth. If you have blond or grey hair, or dark skin, you may consider another appointment to remove the remaining hairs.
If your hair removal treatment occurred two weeks ago, I would have expected the bruises to show up within a few days of the session. Because you indicate that similar bruises on your legs have occurred several times in the past for no obvious reason, I would contact your hair-removal professional and ask if others are experiencing the same side effects. If not, you might want to schedule an appointment with your PCP.
Our practice uses a completely noninvasive procedure called Diolaze which presents nearly no risks to your health other than transient swelling and redness where follicles were treated. You can return to work or other daily activities immediately following a treatment session. It removes hair from the bikini line, back, chest, legs, shoulders, chin, stomach and neck.
Q: I have an abnormal EKG. I’m very active, would laser liposuction be a safer procedure for me instead of 360 liposuction?
A: What reason did the cardiologist provide for the abnormal EKG reading? If it is not pathological, then it will not pose a threat. If your cardiologist clears you before surgery and has no reason to believe that you would suffer an anteroseptal infarct during or after the surgery, you should be reassured to proceed with the surgery. Of course, your plastic surgeon must be notified of all of the EKG results and determine the risks.
Q: Would you recommend laser liposuction for a 61 yo female who is 4′ 11 with a BMI 0f 38 for upper and bottom abdominal and waist?
A: This is very difficult to evaluate without pictures or an exam. The results depend very little on the method used and very much on the surgeon selected.
BMI is but one measure of fitness for surgery. However, many plastic surgeons prefer that the BMI be at 30 or below and a stable weight maintained for several months prior to the surgery to lower the risks of complications during and after surgery and to insure maximum results. Different board certified plastic surgeons will have different opinions and comfort levels with regard to the BMI so it is best to ask at your virtual or in-office consultation.
Q: How many non invasive body contouring treatments before you can see a difference?
A: Liposuction will create a nice result in one session and in one healing period. The subtle improvements with other noninvasive modalities yield results that do not satisfy many patients.
Q: Can I have laser Liposuction after having had traditional Liposuction?
A: Dr. Hughes would recommend a liposuction revision specialist. The type of liposuction matters little.
Q: Will Laser Liposuction remove the glandular tissue from Gynecomastia?
A: A combination approach may produce the best result, but an exam is always helpful in this.
Q: I am considering laser liposuction for my arms. Is it the right procedure for me?
A: Dr. Kenneth Hughes would have to examine you to determine if liposuction would be of benefit.
Q: How good are the results of Laser Liposuction as compared to regular Liposuction? Is down time and cost about the same?
Q: How big are Laser Liposuction incisions on the abdomen area?
A: 2 or 3 incisions (less than 5 mm each) are all that are required for liposuction of the abdomen and sides.
Q: How long can I wait before getting capsular contracture surgery?
There is no optimal time to perform a capsulectomy but you probably not want to wait for the capsular contracture to get worse or cause increased pain. If your silicone implant is leaking, remove it as soon as possible.
Q: What is the right course of action to treat my capsular contracture?
Capsular contracture is an incompletely understood entity in which many theories have been postulated but none have been substantiated. Capsular contracture can occur in even the most careful surgeon’s practice, and we do not know everything that is responsible for the occurrence of capsular contracture.
Surgical removal of the scar tissue capsule is the most effective method of capsule correction. The submuscular position is preferred for implant placement. This procedure does not eliminate the probability of the recurrence of encapsulation. In fact the recurrence rate after anterior and posterior capsulectomy is probably 30%. To reduce the rate further, form stable silicone implants or gummy bears can be used. Finally, acellular dermal matrices can reduce the risk as well.
Q: Does 2 mm fibrous capsule around breast implants mean I have a capsule contracture?
The severity of encapsulation ranges from mild, characterized by no external visible signs of distress, to extreme, which requires surgical correction. Capsular contracture is very difficult to evaluate without a physical exam. If the breasts are soft and pliable, capsular contracture is not likely. If your breast implants are feeling tighter and are looking distorted, you may be experiencing capsular contracture.
Q: 4.5 years post BA – Could this be the start of capsular contracture? And if so is there any way to stop it or slow it down?
Capsular contracture is an incompletely understood entity in which many theories have been postulated but none have been substantiated. Capsular contracture is very difficult to evaluate without a physical exam. If the breasts are soft and pliable, capsular contracture is not likely. Capsular contracture can occur in even the most careful surgeon’s practice, and we do not know everything that is responsible for the occurrence of capsular contracture. For diagnostic purposes, the sequence in the diagnosis should be mammography, ultrasound, then MRI, if necessary.
Q: Nipple piercings and capsular contracture?
Capsular contracture is an incompletely understood entity in which many theories have been postulated but none have been substantiated. The nipple piercings can be removed prior to surgery and replaced later. Replacement should be coordinated with the plastic surgeon who performs you breast augmentation.
Q: Hopefully getting surgery soon, how likely is the capsular contracture to come back? Are capsulectomies successful surgeries?
The risk of capsular contracture is less than 3% in the overall breast augmentation population. However, the recurrence rate after capsulectomy surgery is about 30%. Further measures such as dermal matrices or form stable implants can further reduce this rate.
Q: Any way to avoid or prevent capsular contracture?
Q: Would you suggest smooth silicone or textured implants after capsular contracture revision?
The more form stable implants have a lower incidence of capsular contracture as do capsulectomy procedures with the placement of acellular dermal matrices.
Q: Are gummies for reconstructive surgery? I have capsular contracture and one of the surgeons I saw wants to put gummies in me.
Dr. Kenneth Hughes would have to see you in person to make a determination about what may be the best option for you. There are many possibilities here and there is quite a variable range in price depending upon the implants chosen and the dermal matrix applied.
Q: Would you recommend to remove the implants and have the breasts lifted since the capsular contracture can happen again?
Removing breast implants will allow for the successful treatment of capsular contracture, but this may not be the best option in patients with less breast tissue or in patients who have thinned tissues due to the duration of implant placement and the size of implants placed.
Q: Capsular Contracture 9 Months Post Op on Left Breast?
There is a small risk to developing capsular contracture in the opposite breast if the implant is exchanged. However, either alternative is reasonable, particularly if you have a strong desire to get larger implants.
Q: Capsular Contracture Under Pectoralis Muscle?
If you have capsular contracture, this tends to be progressive and massage will probably not have an effect on this.
Q: Had 3 Capsular Contractures and Explant. For Revision Surgery is Alloderm/max or Strattice Better? Which Implant is Best?
The form stable implants in combination with Strattice or explantation with fat grafting would be the two options that Dr. Hughes would offer at this time.
Q: Remove and Replace Implants and Switch to Silicone Implants in Submuscular Position with Breast Lift?
It is reasonable to remove the implants and replace them with a transition to a submuscular plane. If you want to change the shape of the breasts and lift them that could be considered as well.
Q: Capsular Contracture Management for Breast Implants in the Subglandular Position?
If you have subglandular implants and capsular contracture, you should replace the implants and transition to a submuscular plane.
Q: Capsular Contracture Grade IV and Feeling Unwell?
In grade IV capsular contracture, the removal of the capsule along with removal of the implant and possibly replacement with a new implant usually does make patients feel much better from a pain standpoint.
Q: Right Side Capsular Contracture and Rupture and Left Side No Problems?
For the right sided rupture and capsular contracture, removal and replacement of the implant with anterior and posterior capsulectomy or a replaning procedure is appropriate through the same incision. There is no need to make another incision in the inframammary fold unless additional skin from the fold needs to be removed for an implant that has bottomed out. For the left side, nothing is needed if there is no implant malposition, rupture, or capsular contracture.
Q: Second Capsular Contracture Options?
If both revisions were placed above the muscle, the option of submuscular placement should be explored. The addition of the dermal matrices can be used in this, but the shift to a submuscular plane is a reasonable option.
Q: Capsular Contracture Treatment?
For the first capsular contracture, a reasonable option is to perform anterior and posterior capsulectomies with implant exchange under the muscle. One should also consider gummy bear implants or form stable silicone implants and acellular dermal matrix placement including Alloderm and Strattice options. These two approaches may be preferred in some patients if the patient has little breast tissue and the camouflage of the muscle enhances the cosmetic result.
Testimonials and Reviews for Dr. Kenneth Hughes
One Word: PHENOMENAL! Brazilian Buttlift or BBL Review
30 Aug 2018
1 month post
Dr. Hughes and his team are exceptionally caring. The office staff and nurses and anesthesiologist make each and every step easy and stress free, causing you to become extra eager in anticipation for whatever you’re considering to get done. Dr. Hughes is extremely patient, knowledgeable, actually cares to listen, and gives great attention to detail. In LA, it’s especially hard to find doctors that really care about the craft the way he does. He briefs you on pre-op obligations, surgery, and recovery will be like in a detailed step by step manner. Additionally, after surgery Hughes and his team will call and check in on you if they haven’t heard from you!! That extra step to ensure patient satisfaction is a huge plus.
I am so happy that I can say Dr. Hughes is MY surgeon. I got a BBL and I am extremely satisfied with my results. I was really concerned with how things would turn out but Dr. Hughes is such an expert that my results exceeded my expectations. I truly believe that’s everyone’s hope and dream when opting to receive plastic surgery. Thank you, Dr. Hughes!!
Amazing bbl Brazilian Buttlift Review
OMG! My BBL is the most dramatic change of my life! I have the best curves! Dr Hughes exceeded my expectations! I have been very dedicated to my maintenance. I’m still sleeping on my stomach and not sitting on it! I have not sabotaged his work!
Amazing BBL/BA Experience with Dr. Hughes!!!
12 Jun 2018
11 days post
I recently had my BBL/BA done with Dr. Hughes. I had done months of research to figure out which doctor I wanted to move forward with for my procedures – after all, this was going to be life-changing for me and I wanted to make sure I made the right decision. I decided to reach out to Dr. Hughes to ask him some questions. He is honestly the most responsive doctor that I’ve ever talked to and was very patient with his answers (I would ask him a million questions at a time via email). I ended up finding out that one of my friends also had her BBL procedure done through Dr. Hughes. She had recommended him 100% and her results were AMAZING. Talking to her and seeing her results really gave me the final confirmation that Dr. Hughes was the perfect doctor for me.
I made time to see Dr. Hughes at his office for a consultation (He is only available Monday-Thursday for consultations since he is usually performing surgeries on Fridays). Again, I asked him a million more questions, but he was very patient and understanding. To give you a background of my body type, I am more on the muscular side. I have been working out for 6 years (weight lifting and cardio) and I have broad shoulders with a square body. He made sure that I was very realistic about my results based on what I had for him to work with. At the end of the consultation, he made me feel very confident that he would be able to give me my dream body.
On the day of the surgery, his entire staff greeted me and was very warm. They made me feel extremely comfortable. The anesthesiologist took his time to meet with me prior to the surgery and asked me lots of questions – just made me feel confident that he would take good care of me (which he did!). I couldn’t have asked for a better team and doctor to be by my side for this.
I had the BBL procedure done and Dr. Hughes helped me with increasing the size of my breasts that I had a BA done before about 7 years ago. Dr. Kenneth Hughes not only did an amazing job with my BBL, he also fixed one of my breast pockets to ensure that both my of breasts were symmetrical and round as I had wanted them to be. I had no idea how many cc’s my first doctor had put into my breasts but Dr. Hughes knew exactly how much to put in there to meet my expectations based on pictures I’ve shown him and our consultation. I had lipo done in my inner thighs, arms, stomach, and back bra area. He ended up putting in 1200 cc’s into each of my buttocks and 560 cc’s into each of my breasts. HOW did he manage to do this with my muscular square shaped body – I don’t know but he is AMAZING.
I am now 11 days post surgery and I have been following all of the doctor’s instructions. I stayed in bed for 2 days straight and then went back to work 3 days post op but made sure not to move around too much at all. I am not going to lie – sleeping on my stomach and arms has got to be the most painful part of this entire process. The grossest part of this entire process is also not being able to shower for the first couple of weeks. I am also extremely swollen still from head to toe… hoping this subsides soon. I don’t even bother risking to sit on ANYTHING other than my BBL pillow – just not worth it in my opinion. I tried to sit on the BBL pillow and drive .. just not happening. I don’t know how people are able to do it. So since my surgery, I haven’t been driving and don’t plan to drive until I am able to finally sit. I wear my waist garment 24/7 except for when I am taking a bath – which is really just wiping myself down with baby wipes and cleaning everything under my buttock incision in the bathtub.
I do notice that it is shrunk substantially since the day of surgery (OBVIOUSLY) but I am praying that it doesn’t shrink too much by the time it is fully healed (4 weeks time), All in all, I am extremely happy with my experience with Dr. Hughes. He is extremely professional and will give you the results you are looking for. I couldn’t have asked for a better doctor and honestly would go to him for any future procedures. I love that he is patient, professional, and so brutally honest – which is refreshing. Don’t make the mistake of going to another doctor JUST to have Dr. Hughes fix his/her mistakes!!!
Fight Censorship, Censorship is Real in 2020
Due to numerous censorship issues with instagram, facebook, and google my business, a plastic surgeon cannot really post any buttock or breast before and after pictures anymore.
Looks like we are in for a long winter of tummy tucks and rhinoplasties.
Due to obvious censorship issues with facebook’s and instagram’s software or the result of something more sinister, it is nearly impossible to post before and after photos of butt and breast augmentation.
Breastfeeding, statues, artwork – all depicting nudity allowed on facebook and instagram, but scientific evaluation of plastic surgery before and after photos – censored. Will we as a people stand for this?
Dr. Kenneth Hughes Patient Testimonials
Much like the rest of us, I’ve been talking about getting a breast augmentation for YEARS! I finally decided it was time to actually do it and I started to really research doctors in my area. I had found one surgeon that was in Beverly Hills and had phenomenal results, but pricing was absurd. So back on the hunt I went and this is when I came across Dr. Hughes! His work amazed me to say the least. I had slightly uneven, droopy boobs and I was interested in getting large implants that were perky and full. It was really reassuring when I saw his before and after pictures of numerous patients who were very similar to my case. His website is extremely helpful and Lorena in the office was very helpful and sweet as well. I scheduled my consultation and my surgery pretty much in the same day because I was so confident he was the surgeon for me and didn’t want to miss the times he had opened. He definitely knows what he is doing. My consultation was easy and simple. He told me exactly what he suggested and answered my questions and was straight forward from the beginning! I’m two weeks post op today and I’m blown away by my results so far. I went with saline implants, 620cc’s with an under boob incision!.My surgery was seamless! The nurse (really nice looking btw) and anesthesiologist were great.