If you would like more information about the “Eye M Beautiful” procedure please contact Nancy at 303. 708.8234 or Nancy@BeautyByBuford.com

Photos are actual patients of Dr. Gregory A. Buford MD FACS.

And according to Andrews, the cost may even be slightly less than what you are used to paying in a physician’s office or medical spa for BOTOX and soft tissue fillers. So is this the wave of the future or are their concerns?  While many people see this service as a distinct advantage, there are indeed red flags. First, your home is simply not set up the same way that a medical office is. The lighting is not optimal and positioning is often substandard given the fact that most (if not all) of us simply don’t have a room designated for medical procedures.  As such, would you really like your folds softened while sitting on the couch in dim lighting?  Not me.

My prediction is that while the initial launch pricing may provide some competition to current brick and mortar establishments, it will only be a matter of time that price point readjusts to allow for travel time, fuel, etc.

And while a physician may be monitoring the injectors, what training and background does he or she actually have? The article failed to mention that.  As with any facial injectable, keep in mind that while results are only temporary, a bad result can be difficult to undo and even harder to hide.

Because this indication is not FDA approved and an advanced technique, look for an injector skilled in the use of  BOTOX and with a solid track record of experience.

A recent study by Sydney-based plastic surgeon Steven Liew, MD (see photos above) and published in Dermatology Times substantiated the role of BOTOX in softening the jawline and creating a more feminine appearance. Dr. Liew found that in his study population of 82 patients, effect was often achieved as early as two weeks and in many cases actually lasted upwards of a year.

For more information on this exciting new procedure and to schedule your complimentary consultation, please contact us at BEAUTY by BUFORD.

-One Happy Buford Patient
Denver, Colorado

The use of BOTOX Cosmetic to lift breasts has been suggested for a number of years but there has never been a good study documenting its ability to actually do so.  If you consider the factors that actually lead to ptosis (or drooping) of breasts, it makes sense that simply weakening muscle pull would provide little to no benefit.  As you age or following pregnancy and/weight gain or loss, ligaments within your breasts can tend to lengthen and lose support.  These Cooper’s ligaments are a chief contributor to loss of perkiness over time and, unfortunately, are completely unaffected by the administration of BOTOX. Even with a conventional breast lift, these ligaments are really not addressed; with surgery, the surrounding skin envelope is simply reshaped and tightened with or without addition of breast volume viz a viz placement of a breast implant.

And so given these changes, it is not conceivable that injection of BOTOX Cosmetic alone would have any significant effect on breast lifting.  And even if it did, would the slight lifting effect warrant the upfront and maintenance costs associated?

I encourage you to submit your comments and questions to drbuford@beautybybuford.com .

I look forward to hearing from you.

I respectfully disagree.

Most plastic surgeons, such as myself, recognize that a breast lift primarily addresses reshaping of the lower pole of the breast and achieves very little with respect to restoration of fullness to the upper pole. Because of this, a small implant to restore this lost volume is often added when performing a breast lift procedure in order to achieve a more uniform and more optimal reshaping of the breast as a whole. I personally feel that unless a woman has very glandular breasts (which many do not have) or has a cup size larger than a small C, that she will benefit from the addition of a small breast implant beneath the muscle to help restore upper pole fullness in conjunction with a breast lift. Without it, while the nipple position and lower pole may be optimal, the upper pole is left with the tell-tale involutional concavity reminiscent of the post-pregnancy breast.

I look forward to your comments. Please send them to us at lauren@beautybybuford.com

And so it is not surprising that fat grafting would eventually make its way to breast enhancement. Since many of us have a little extra fat here and there, surgeons put two and two together and realized that breasts could potentially be volumized simply by taking fat from another place and injecting it into a woman’s breasts. And so the media caught on and results were shown of beautiful breasts made more beautiful simply by adding fat. But its’ not that simple.

The American Society of Plastic Surgeons (ASPS) banned the use of fat grafting for cosmetic augmentation in 1987 but recently revisited its use by conducting a study to evaluate just how safe it actually is to use fat for breast augmentation. The concerns range from slight imperfections (due to local fat necrosis) to severe infections and potentially induction of breast cancer. Although plastic surgeons have used fat to reconstruct breasts after mastectomy, in this case all breast tissue is removed before the fat is actually added. And so fat, which excretes estrogen (a hormone that stimulates breast cell growth) has very little risk of stimulating breast cancer cells. But in the case of cosmetic augmentation, breast tissue obviously still remains and so there is a theoretical risk, albeit small, of increasing the risk of breast cancer. The current study, although not large (50 patients) to date has not shown an increased risk but nevertheless the risk potentially still remains.

And so the question is asked, will fat transfer ultimately replace the need for breast implants and is it a safer alternative to the saline or silicone gel implants currently being used. To best answer this, keep in mind some potential advantages and disadvantages.

· FAT IS READILY AVAILABLE

o Advantage: there is no implant cost

o Disadvantage: fat can be unpredictable and the procedure may need to be repeated to achieve long-lasting durable results whereas with an implant the volume is known

· FAT IS YOUR OWN TISSUE

o Advantage: there is no chance for rejection

o Disadvantage: numerous studies have documented the safety of breast implants and their results are predictable

· COST

o Advantage: liposuction is performed at the same time and so you are getting two procedures at the same time

o Disadvantage: most surgeons currently performing AFG for breast augmentation are charging significantly more for this procedure than for a conventional implant breast augmentation (many times the cost may run upwards of $10,000 or more!)

· THE TECHNOLOGY FOR FAT GRAFTING IS BECOMING MORE REFINED

o Advantage: better fat survival is being seen and the results are potentially more predictable than they were previously

o Disadvantages: aside from a few highly trained specialists, many plastic surgeons are not actually trained to use fat for breast augmentation and so the risk for complications can be very high. A recent study in the Journal of Plastic & Reconstructive Surgery documented just how dramatic these complications may be and warned of these dangers

And so what is the consensus? Most plastic surgeons are still very wary to fully embrace fat grafting for breast augmentation until the process is more adequately refined and until the question of breast cancer stimulation is satisfactorily answered.

If you have any questions about this interesting topic, please do not hesitate to call me or my staff. 303.708.8234. We look forward to your input.

How you look is important. But who is actually helping you look that way should also be considered. Given that, you need to know exactly what to ask your plastic surgeon to determine not only if he/she is qualified to perform your procedure but, as importantly, whether you truly feel comfortable with them. So what questions should you really ask?
In my experience, many patients are nervous about asking us about our specific skills and attributes. But keep in mind that answers to these questions may shed tremendous light on our ability to perform your procedure safely and effectively and to make the healing period as smooth as possible.

My top 5 questions include the following:

1. Are you Board Certified? If so, in what specialty?

2. How many years have you been practicing?

3. What is your favorite procedure?

4. How are you different than your competition?

5. If I was a family member, what questions would you suggest that I ask?

To dive more deeply into these questions, let’s examine why they are important:

1. Many non-core physicians have and will enter aesthetic medicine and often refer to themselves as Board Certified Cosmetic Surgeons. To achieve Board Certification in Plastic Surgery, I completed a 5 year residency in General Surgery, a 2 year Fellowship in Plastic Surgery, passed my written board exams and ultimately passed my oral board exams. By doing so, I can now say that I am Board Certified in Plastic Surgery. The same is not true of those Board Certified in “Cosmetic Surgery”. First, Cosmetic Surgery is not even an officially recognized specialty by the American Board of Medical Specialties (ABMS) and, as such, is not considered to be a true Board Certification. More importantly, it doesn’t indicate to you the patient what that physician’s true background training is actually in. This “Board Certified Cosmetic Surgeon” could actually be an Emergency Room Physician, Family Practice physician, or even Psychiatrist who decided that they suddenly want to practice Plastic Surgery. They take a few quick weekend courses and suddenly…they are a Cosmetic Surgeon. Make sure to ask about this because chances are many of them will not immediately offer this information when you first meet.

2. First let me say that there are many newer plastic surgeons who do not have a tremendous amount of experience but that are still excellent surgeons. But while they may be excellent surgeons, the attribute they lack is experience. In the first few years of my practice, I easily learned more practical knowledge than I ever gained from formal training. This is important. As a surgeon, I know the anatomy and I know how a particular procedure should be performed. But experience gives me an edge when the anatomy is not so clearcut or when the procedure doesn’t go as planned. And it provides me with subtle nuances that in many cases will produce a result that is superior to one practiced by someone less seasoned.

3. When I go to a restaurant, I often request that the chef fix his favorite meal for me because I know that his favorite meal is probably what he actually prepares the best and what he probably likes to eat. The same is true for me. I limited my surgical procedures to my 5 favorite. These are the procedures that I perform the best and the ones that I most enjoy doing.

4. How a physician differentiates themselves from the competition tells you a lot about their skills not only as a business person but, more importantly, what they identify as important to their clients. I differentiate myself from my competition with value-added services. I continually raise the bar when it comes to customer service and I only work with patients with whom I feel comfortable. If I feel uncomfortable during an initial consultation, I tell the patient just that and will not take them on as a patient. That is the only fair thing to do for both of us. If I do feel comfortable, myself and my staff will go the extra mile for that person. What is it that your plastic surgeon does differently for you?

5. This is a very important question but one that I am rarely asked. I have a family and I am obviously a Plastic Surgeon. When a family member of mine sees another physician (in any field), I recommend that they ask these basic five questions. I also suggest that they Google the physician on the internet and form an impression. Keep in mind, however, that some internet rating sites do not fairly depict a physician’s abilities or bedside manner and that a single patient (or even the physician’s competition) will often try and sabotage rankings by posting multiple low rankings of this doctor. Analyze their rankings and read the comments. If no comments are provided, discount the rankings. If the person was so upset with the service provided and feel they need to post their discontent, they should also say why they were upset so that the doctor can actually modify how he/she practices to improve the experience for future patients.

I hope these suggestions help you decide an appropriate fit for you. The decision to move forward with Plastic Surgery is an important one…but who you choose to do your Plastic Surgery is even more critical.