The Surgical Artist's Blog

James Koehler, MD, a Board-Certified Cosmetic Surgeon from Tulsa Surgical Arts recently wrote and article for Plastic Surgery Practice on Isolated Neck Rejuvenation and Submentoplasty. Dr. Koehler applies many of the latest facial rejuvenation techniques in his practice just as the surgeons at Southern Surgical Arts do. Carey Nease, MD, a Double Board-Certified Cosmetic Surgeon at Southern Surgical Arts uses laser technology to rejuvenate the neck and jowl area.  "Neck and jowl rejuvenation can be accomplished with laser lipolysis by removing the excess fat pads and heating of the undersurface of the skin.  The addition of the laser, when compared to tumescent liposuction, improves the outcome by generating more heat which results in more skin tightening than liposuction alone."  Dr. Nease also said laser liposuction is a quick, one-hour procedure with down time of only 3-5 days and very little pain, both during and after the procedure.  "Results can be dramatic when the right patient is selected (30's-40's).  This does not replace a full face and neck lift surgery when that is what is needed!"

At Southern Surgical Arts, Dr. Nease and Dr. Deal often combine the CO2 resurfacing laser with all face lift and facial rejuvenation procedures for enhanced results.  The CO2 laser improves skin texture, stimulates collagen and helps eliminate sun damage. The neck and jowl techniques combined with the skin resurfacing is called the Laser Face Lift. Dr. Nease is the pioneer of the Laser Face Lift and presented at the American Academy of Cosmetic Surgery's 2011 Annual Meeting in Phoenix this past January. If you are in your 30's and 40's and don't feel like you are ready for a traditional face lift, you might be a candidate for this procedure. We invite you to join us at our Chattanooga, Dalton or Calhoun office for a complimentary consultation with any of our surgeons! Call 423-266-3331 or 706-629-8622.

Below is a video testimonial of a patient who had the Lase Face Lift procedure.

Southern Surgical Arts is attending the 2011 Ladies Night Out hosted by the Chattanooga Times Free Press on Signal Mountain this Thursday, May 12 from 4:00 pm  - 9:00 pm! We invite you to attend and talk to one of our trained staff members about our services, products, Dr. Deal and Dr. Nease. Sign in at our booth and enter to win fabulous prizes:

- One area of Botox or Dysport worth $300

- Two areas of Laser Hair Removal worth $150

- One bottle of Latisse®

We look forward to seeing you there!

In the South, we start getting ready for summer in April. The heat hits, and we're ready to pack up and head to sunny beaches. And lots of weddings. Are you ready? Here are some ways Southern Surgical Arts can help you get looking your best and ready for summer:

We recently came across this post where a plastic surgeon will be presenting a new face lift technique at the Aesthetics meeting organized by the American Society for Aesthetic Plastic Surgery (ASAPS) and the Aesthetic Surgery Education and Research Foundation (ASERF). This new Face Lift, as written in the article said, "The new cosmetic surgery approach involves lifting and filling areas where fat compartments in the face have degenerated with age, as opposed to previous face lift techniques which focused on pulling the skin tight. The new technique eliminates the undesirable windswept look that has received much negative press, and replaces it with a fuller, more youthful look."

At Southern Surgical Arts, our surgeons are fellowship-trained Cosmetic Surgeons where this technique has been taught for many years. Dr. Carey Nease, Double-Board Certified Cosmetic Surgeon and the pioneer of the Laser Face Lift said, "I've been doing this for many years." So the idea that this is a new face lift technique proves that some surgeons are just catching up with what Cosmetic Surgeons have been doing for years.

Dr. Deal and Dr. Nease have been explaining the difference in face lift techniques for quite some time. In fact, each of our potential patients leave knowing that there is a difference between the Plastic Surgery Traditional Face lift, Fad Lifts, The Cosmetic Surgery Face Lift and Southern Surgical Arts' Laser Face Lift. The differences are noted as:

Traditional Plastic Face Lift
The traditional plastic face lift procedure involves significant reduction in excess skin, neck banding and wrinkles. The benefit to having a traditional face lift is that you will have very noticeable results. The downside is that the surgeons who learned this technique did not likely learn how to add the refining touches to make the patient look natural or focus on minimal scarring. Women and men no longer want to look hollow, pulled or plastic and have unsightly, visible scars, all obvious signs of surgery.

Benefits: 10-15 years younger
Downside: Scars, plastic look, long recovery (4-6 weeks), long surgery, general anesthesia

Fad Lifts
An answer to the downside of the traditional face lift came about in the 1990s with mini face lifts like LifeStyle, Feather, S-lift, MACS lift, String lifts, etc.  These fad mini face lifts were and are in demand because many patients want the benefits of looking younger but also are seeking to minimize scarring, cost and recovery. These mini face lifts are typically less expensive and can be done under conscious sedation or even local anesthesia. The problem is that very often they do not have significant or long lasting results.

Benefits: Minimal scars, short recovery, local anesthesia
Downside: Little results

The Cosmetic Face lift (at Southern Surgical Arts) does include incisions, suturing and excess skin removal, although at Southern Surgical Arts, Dr. Nease and Dr. Deal have specific expertise in minimizing scars and placing them in well-hidden areas that are difficult to find.  They also offer fat transfer and lipo-sculpting the face for a more natural, youthful appearance.  Both surgeons have been using the latest techniques and laser technology for the past 4 years at Southern Surgical Arts to provide our patients the answer to beautiful, long-lasting, natural results in facelifts. As Board-Certified Cosmetic Surgeons and an eye for artistry, they use advanced laser technology to get maximum results along with minimal scarring and quick recovery.

Benefits: 15-20 years younger, minimal scars, short recovery (10-14 days)
Downside: IV sedation anesthesia





The Laser Face lift (at Southern Surgical Arts), developed by Dr. Nease, was designed for the patient who desires facial rejuvenation but is not ready for a traditional Cosmetic Facelift with incisions and skin removal. The Laser Face lift combines Smart Liposuction, Laser Skin Resurfacing, Fat Transfer, Botox and fillers to the face, which makes a person look approximately five years younger.  Additionally, the Laser Resurfacing to the skin can be performed several times for optimal results. The Laser Facelift clinical study conducted by Dr. Nease in 2010 was presented at the annual American Academy of Cosmetic Surgery conference in Phoenix, Arizona in January 2011 and the initial results showed that more than 75% of patients were highly satisfied.

Benefits: 5-10 years younger, no scars, short recovery (5-7 days)
Downside: IV sedation anesthesia

For more information about Cosmetic Surgery Face Lifts or The Laser Face Lift at Southern Surgical Arts, please call 423-266-3331. Consultations are complimentary, and we are always happy to provide examples of the different approaches to Face Lifts so that patients can make an informed decision.

Are plastic surgeons the only group of surgeons who can perform cosmetic surgery? According to this recent article by the editor of Plastic Surgery Practice, the answer is no. He does, however, caution consumers about choosing a qualified cosmetic surgeon. The editor said "The challenge, as I started to say, is to deal with those who somehow slip through the credentialing mesh and set up shop with little more than a few weekends of training in injectables, laser-based procedures, and even full surgical procedures. This can be regulated by existing organizations who must adapt to the changes occurring all around them. I want to trust those people to implement the proper training and testing to accommodate any qualified specialist who is intent upon breaking into the aesthetic field."

At Southern Surgical Arts, we could not agree more. Again make sure that you choose a qualified cosmetic surgeon. We recently wrote an article that included what you should expect from your cosmetic surgeon:  http://southernsurgicalarts.com/index.cfm/PageID/6863?p=303

Over the last few months, we have been receiving questions about a procedure called the Smooth Tuck. It gained popularity when The Doctors featured a surgeon who developed a procedure that combined Liposuction and a Tummy Tuck. The surgeon coined the procedure as the Smooth Tuck. Although this surgeon has gained popularity for the procedure, our cosmetic surgeons at Southern Surgical Arts have been performing a Tummy Tuck with Liposuction since they began their practices. "I learned to perform Liposuction in combination with an Abdominoplasty when I was in training in Las Vegas," said Dr. Chad Deal. "The two procedures together often allow you to achieve your goals of a flat stomach and a sculpted waist-line to restore your figure. The end result takes a tummy tuck a step further by giving a woman the shape and figure she wants."



It has recently become acceptable to perform the procedures together in the past five year. Many surgeons who are not trained in the latest techniques will tell you that these two procedures cannot be done at the same time. "Surgeons who were trained before the late 90's were taught not to perform them together because of the theoretical risk of tissue injury and poor wound healing, but after performing over 400 of these procedures and observing the great results with low complication rate, I think it is absolutely the right way to go." said Dr. Carey Nease. "It does not surprise me that a catchy name has been developed to market the procedure."

As we noted in our appearance on the 3 Plus You show in Chattanooga on Friday, April 15, surgeons and practices often develop marketing terms for a procedure. Just because there is a new procedure that seems great, beware of surgeons that try to fit everyone in a box. At Southern Surgical Arts, we are  advocates of advertising and we are not suggesting that the surgeon who developed this procedure is trying to do this. "It is important to know that just because you see a new procedure on TV, does not mean that you are a candidate," said Dr. Nease.

If you are interested in the Smooth Tuck or any procedure you see in the media, please schedule a consultation with a qualified cosmetic surgeon to see if you are a candidate. Make sure, however, that the surgeon routinely performs the procedure you are interested in having -- with or without the marketed name!

According to a study conducted by researchers at the University of Texas - Austin, the answer is YES. Beauty has economic effects, which also effects happiness. Even psychologists weigh in on the study in a USA Today article. Todd Kashdan, an associate professor of psychology at George Mason University in Fairfax, Va says,  "Think about it as a gateway to getting what you want from life -- job interviews, first dates, making those initial impressions, persuading and influencing other people," he says. "Attractiveness gives that slight edge. They're getting the benefit of the doubt at first sight, and unattractive people aren't."

Does that mean you should head to our office for cosmetic Surgery? Dr. Nease and Dr. Deal agree that it should only be used to enhance your own natural beauty. "Cosmetic surgery  is not meant to transform you into a completely different looking person," said Dr. Deal. "At Southern Surgical Arts, we specialize in natural enhancements with minimal downtime and minimal scarring using the latest technology available to either turn back the hands of time or restore your figure."

Physicians from around the world joined Dr. Nease and Dr. Deal at Southern Surgical Arts for an American Academy of Cosmetic Surgery (AACS) Live Surgery Workshop on Facial Rejuvenation. There are approximately 10 of these workshops offered by the AACS in the U.S. each year. Doctors from Australia and Canada, as well as the United States joined us to learn the Facial Cosmetic Surgery techniques that help our patients discover the art of beauty. Techniques included both non-surgical and surgical techniques such as Face Lift, Liquid Face Lift (in this case, Botox®, Juvederm® and Radiesse®), Laser Resurfacing, Blepharoplasty, Fat Transfer, Facial Implants (chin and cheek) and Lip Augmentation. "I was excited to teach physicians from around the world the latest techniques for Facial Rejuvenation," said Dr. Nease.

Dr. Nease will also discuss his Laser Face Lift technique on a Web Cast hosted by Cynosure on April 6. Southern Surgical Arts, Dr. Nease and Dr. Deal are committed to staying abreast to the latest techniques available in the marketplace. Our goal is to provide our patients natural enhancements with minimal downtime and minimal scarring.

The Liquid Face Lift has received lots of media attention in the past year. The coined term, "Liquid Face Lift" is just a way to describe using fillers and other injectables to provide a patient with temporary facial rejuvenation and is a great solution for the patient who is seeking rejuvenation but is not quite ready for a Face Lift.  Many patients seek minimal downtime when considering any cosmetic procedures. Facial filler and injectables are good options for those who consider this an important factor in their decision-making process.  "A Liquid Face Lift is a procedure that can be done in the office in about 30 minutes and can make you look more youthful, refreshed and up to 5 years younger with essentially no down time.  Our patients see instant results and are happy that they have this alternative to surgery," said Dr. Nease.

According to the Liquid Face Lift Association, the Lift uses,  "dermal fillers such as Juvederm^® , Radiesse^®, Sculptra^® and Perlane^®, as well as BOTOX^®". And, something to consider when contemplating surgery is that a liquid face lift has benefits that can't be found with surgery, such as restoring natural facial contours and volume. A growing number of cosmetic surgeons are augmenting surgery with liquid face lift products to restore natural 3-dimensional contours to the face. Also, a liquid face lift is typically more subtle than surgery. An increasing number of individuals are trying liquid facelift procedures before traditional face lift procedures. At Southern Surgical Arts, our surgeons use these products on a weekly basis to provide our patients with the desired "lift." We are one of the top providers of fillers in North Georgia and Chattanooga, according to Allergan Consulting, which distributes Botox®, Juverderm® and Latisse®.

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A recent article  in Plastic Surgery Practice titled Physicians Alarmed Over Labiaplasty Demand caught our attention. The article discusses a trend in younger women having Labiaplasty, a procedure that Dr. Deal performs at Southern Surgical Arts. At our practice, we see a different age group of patients who desire the procedure. "The patients we see that desire this procedure are primarily women who have had children and desire, just like any other cosmetic procedure, to look the way they did when they were younger," Dr. Deal said. "This is often a procedure women are embarrassed to discuss -- much like Breast Augmentation was decades ago," he said.

Vaginal Rejuvenation as a whole is gaining popularity in the United States. Many women are adding it to the "Mommy Makeover" for optimal restoration of their bodies. The Vaginal Rejuvenation procedures includes vaginal tightening and labiaplasty to the minora and majora to improve function and appearance.  "When I trained in Las Vegas, it was common for women to have vaginal procedures. In the South, we are more private about these concerns but it is still gaining momentum because they see the benefits," Dr. Deal said.

Watch Dr. Deal discuss Vaginal Rejuvenation.