Dr. Weinberg and Dr. Schiffer Of Mississauga Cosmetic Surgery And Laser Clinic Attended Prestigious FACE Conference

Allergan, makers of Botox and Juvederm, presented data on Botox, Juvederm and Voluma at the FACE meeting Oct 15 to 18. Botox sales have continued to rise in 2009 compared to 2008, and it is the leading muscle relaxing wrinkle treatment on the market, with growing uses in the cosmetic field , including the so called "Nefertiti" technique for restoring more definition to the jawline. Among leading Plastic Surgeons and Dermatologists the botox "brow lift" is among the most populary performed botox procedure. Allergan has submitted data from a large study showing efficacy of Botox treatment in chronic headache sufferers to the FDA and is hopeful for official approval for use in this indication. Juvederm with Lidocaine has proved to be a hugely popular hyaluronic acid filler , and experience to date by leading injectors with Voluma, a very highly viscous filler has showed it to be extremely successful at volumizing cheeks and other areas with less volume required to achieve optimal cosmetic results. Dr. Weinberg attended the Breast Augmentation portion of the conference, and enjoyed the lively discussion on challenging cases. Detailed scientific measurements can now improve the method of choosing the ideal breast implant for each patient.

Liposonix - An Exciting New non Invasive Technology To Get Rid of Unwanted Fat

In today’s appearance concsious population, the growth in both surgical and non invasive cosmetic treatments is exponential. Now in addition to things like Botox, Restylane and Juvederm, Dr. Weinberg of Mississauga Cosmetic Surgery and Laser Clinic reports the hottest trend in non surgical treatments is definitely Fat Burning Machines.  The newly introduced Liposonix Machine is the latest and most promising thing Dr. Weinberg has seen on the cosmetic horizon in quite some time. Emitting a focused high frequency ultrasound beam, it is able to target ultrasound energy at specific areas of fat at precise depths beneath the skin. No damage is done to the overlying skin, thus Liposonix is truly non - invasive. And there is no sagging of the skin after the fat has disappeared, as Liposonix promotes skin tightening over the treated area. The results are permanent!

Treatment takes about 1 hour. There is no contraindication to usual activities like work or exercise after the procedure. Thus there is very little downtime. Peak results are seen in 8 to 12 weeks after treatment. No serious or unanticipated side effects have been observed in international multicentre studies.

The areas that can be treated with Liposonix include the abdomen, hip rolls ( love handles), as well as the outer and inner thigh area. ON AVERAGE, PATIENTS TREATED IN THE LIPOSONIX STUDIES HAD A REDUCTION OF 2.8 CM ( 1.1 INCH) IN THEIR WAISTLINE, WHICH TRANSLATES INTO ONE FULL PANT OR SKIRT SIZE!  For more information on Liposonix or other options for fat reduction contact MCSC, 905-273-3045 .

Face Lifts Made Simple

Face Lift

Anyone who has ever looked in the mirror and noticed signs of aging, and has looked into the available options for facial rejuvenation will have come across a myriad of articles on facelifts. But you may have wondered, how can one make sense of all the confusing and often conflicting information? You may have seen many different terms like “ Mini Face Lift” , “Weekend Face Lift”, “Short Scar”, Long Scar”. Well read on, and we will try to demystify all of these descriptions in a simple and digestible manner.

As you may be aware, the hallmark signs of aging are often summarized as “deflation , descent and degradation”, meaning that as we age our faces lose volume, gravity takes effect, and our skin quality changes such that we develop fine lines, discoloration and crepiness to the skin. Non surgical treatments like the hyaluronic acid fillers Juvederm and Restylane, and a new product , Voluma, can temporarily restore volume. For those not yet suffering from marked skin laxity these treatments can achieve dramatic improvements when administered as part of a  "Soft Lift" , or our signature "Allure Lift". These treatments are often referred to as non surgical facelifts. but eventually when we  develop significant laxity, or looseness , particularly in the mid and lower face and neck resulting in drooping skin in the cheek, jowls, and hanging skin in the neck, this laxity cannot be sufficiently improved with injectable products, and that is the time surgical face lift becomes the one definitive way to restore a more youthful appearance.

Facelift surgery , or rhytidectomy, is achieved by lifting away the skin and tightening the underlying tissues by means of suturing ( stitching). It is the underlying connective tissue, referred to as the SMAS, or superficial musculo-aponeurotic system, that gives structure to the face, not the skin itself. Often,some skin is removed, and sometimes liposuction is done to remove fat in the jowls and neck. the skin is then redraped. In traditional facelift surgery, the neck is therefore also treated. The main incision , and therefore the scar in this case extends from the temple down to the ear, traveling either in front of or concealed within the superficial aspect of the ear, and then circles up behind the ear and down to the back of the scalp. This is a so called “long scar” facelift. The scar itself is usually well concealed within the hair, just behind the hairline, and in the creases of skin around the ear.

In Short Scar Facelifts, also called Mini Lifts, ‘S’ Lifts, or Weekend Lifts by some ,the incision extends from the temple to the front aspect of the ear, and depending on the individual’s anatomy and needs, may extend a bit behind the ear as well. The main determining factor as to whether a given patient needs a long scar or could have a short scar is whether or not they need a concomitant neck lift with their facelift. Neck bands can only be addressed with long scar facelift.

Both traditional and short scar facelifts take 2 to 5 hours and are done under general anaesthetic. The amount of bruising and downtime varies, but with Dr. Weinberg’s expertise and gentle treatment of the tissues, some patients have very little bruising and return to normal activities within days. However, it is reasonable to prepare for a 2 to 3 week recovery.

You may see references to other kinds of procedures like endoscopic facelifts, or thread lifts ( sometimes called featherlifts, or string lifts. In endoscopic facelifts small incisions are made at the corner of the mouth and within the mouth and adjacent to the ear, and an endoscopic probe is inserted, and the surgeon attempts to tighten the underlying tissues through this “keyhole”. These surgeries are not offered by many surgeons, in general because most do not believe they give the same reliable and long lasting results. As much of the procedure is done “ blind”, without directly visualizing underlying structures, there is an increased risk of damaging nerves or blood vessels. Thread lifts were achieved using string-like surgical material to hike up the underlying tissues to tighten and counteract the effects of gravity. They have been associated with short lived, not very satisfactory results, and are generally no longer offered as the “ threads” are no longer being manufactured.  There are a variety of other less invasive procedures offered by some practitioners claiming to achieve wonderful results with smaller scars and little downtime, but it is important to note that in many cases these procedures do not address underlying connective tissue structure, and rather simply “pull” the skin.These will inevitably give short lived benefits, and can often result in distortion of the anatomy, such as an upward pulling on the earlobe, which is not aesthetic.

While facelift and neck lift surgery is the only definitive way to deal with significant looseness of facial skin, for those who are not ready or willing to undergo a surgical procedure , some skin tightening of a more modest degree can also be achieved with treatments like Thermage and Fractionated Laser, available at our downtown location.

It is adviseable to seek out a board certified Plastic surgeon with a great deal of facelift experieince, such as Dr. Weinberg, when considering facelift surgery. 

If you are interested in more information on surgical Facelift, Soft Lift, Allure Lift, Thermage or fractionated Laser, visit our Website at antiwrinkle clinic .com, or call to 905-273-3045 in Mississauga, or 414-207-9090 in Toronto, and book an appointment for a consultation.

Questions in Breast Implant Surgery

"How does one decide which kind of breast implants are best  when considering Breast Augmentation?". This is a question Dr. Weinberg of Mississauga Cosmetic Surgery and Laser Clinic and The Toronto Plastic Surgery Clinic is frequently asked.  

The answer to that question is a bit complicated. The choice of implant is intimately related to the choice of surgical technique. Generally speaking, breast implants placed above the chest wall muscle tend to have a more natural look and feel. Placing the implant above the muscle is also a less major surgery with an easier and more comfortable recovery. For women with hanging breasts  (breast ptosis) , placing an implant above the muscle can also give the impression of lifting the nipple. A Gel Cohesive implant should probably be the first choice If one is going to place an implant above the muscle, as it is more likely to give a natural appearance as it is less likely to wrinkle. Gel Cohesive implants also have other advantages. The consistency of silicone gel is more similar to the texture of human fat so they feel more natural, and one can choose the shape of the implant, for eg. tear drop , as opposed to saline implants which mostly give a round appearance once implanted.

Despite all this, there is still a significant role for saline implants. For most small breasted, thin women, despite the desirability of above the muscle placement, it may not be possible to go above the muscle as there may not be enough skin and soft tissue to cover the implant. If one must therefore go below the muscle, the advantages of Gel Cohesives becomes less critical. Wrinkling and texture become less of an issue, and saline implants are more affordable. Furthermore, saline implants can be placed with a smaller incision. Finally, leakage of a saline implant is obvious as it causes deflation, while leakage of a Gel Cohesive implant can be hard to detect and may even require MRI scanning.

The good news is, with so many great choices available in type of implant ,surgical technique, as well as incision type, breast augmentation surgery can be customized to meet the goals and budget of each patient. The best way to determine what type of implant would best suit your needs is to come in for an in depth consultation with Dr. Weinberg. To view a video detailing the personal journey of 2 sisters that underwent breat implant surgery with Dr. Weinberg click HERE.

Healthy Skin and Beauty at Any Age

Everyone knows a healthy diet and exercise are good ways to stay healthy, but what about our skin? It's important to remember the Canadian Cancer Society reccomendation to wear sun screen, says Dr. Michael Weinberg of Mississauga Copsmetic Surgery and Laser Clinic. There's good science to show that good quality sunscreen with UVA and UVB protection at a high SPF prevents skin cancer .And, Dr. Weinberg points out, it prevents lines and wrinkles as well as discoloration that can make us look old. . Both La Roche Posay and Obaji make excellent suncreens, with a range of SPF up to 60. La Roche makes a convenient to use "stick", ideal for popping in a purse, Gym or beach bag, and easy to apply and reapply. Smoking is another thing that , in addition to it's other health risks, can age the skin prematurely, and Dr. weinberg advocates for his patients to seek medical help quitting smoking if they can't do it on their own. 

Dr. Weinberg and his staff find an association between how people look and how they feel. "when people look their best, they feel good too, and that is what it is all about". If years of sun exposure have already left you with sun damage, by way of dark spots, uneven pigment, and wrinkles, there are things you can do to correct those problems. Many of these treatments aren't just about looks, but promote skin health as well . For example, IPL photofacial is a laser like treatment that can eliminate dark spots and discoloration. Together with microdermabrasion and chemical peels which exfoliiate the skin, these treatment encourage collagen deposition, and help the skin stay young and healthy. 

Many people continue to suffer  from a common and  unsightly skin conditions like acne and Rosacea, assuming because they have tried over the counter treatments in the past that failed, that they just have to put up with them. Not so! Medical grade skin care products like Obaji, that can only be carried in physicians' offices because of their potency, can be very successful at treating both acne and Rosacea, particularly when combined with prescription medication. 

Mississauga Cosmetic Surgery and Laser Clinic offers these, and other cosmetic treatments, like Botox injections and so called "filler" injections, like Juvederm, Restylane, Perlane, Sculptra and fat injections, that are easy non surgical ways to stay young and vibrant looking. A recent study suggested that Botox injections actually had a mood elevating effect, possibly secondary to getting rid of those grouchy frown lines! The clinic is recognized as a centre of excellence for these treatments, and one can view before and after photos and video demonstrations on the website at www.mississaugacosmeticsurgeryclinic.com.

Tummy Tuck Surgery

Tummy Tuck is an excellent procedure for people who have had big fluctuations in weight resulting in lax stomach muscles and stubborn fat that won’t go away with exercise. In fact, exercise and further weight loss can sometimes accentuate the loose hanging skin in the tummy area. During a Tummy Tuck procedure, the loose skin and fat are removed, and what many people often don’t realize is that the tummy muscles are tightened and sewn back together. The procedure is often accompanied by liposuction to smooth out the area over the tummy and the hips. When seeking a tummy tuck , it’s important to check the credentials of your surgeon. Only board certified Plastic Surgeons, like Dr. Weinberg, are specifically trained to do Tummy Tuck surgery. Well known for superb results Dr. Weinberg was invited to demonstrate his accomplishment in Tummy Tuck and Liposuction for the popular Television series Skin Deep. His success is attributable to an experienced eye, which allows him to properly evaluate a patient’s body shape, and to achieve the maximum reduction of tummy fat and loose skin with the best belly button placement. Some patients who have an isolated outpouching of skin and fat immediately below the belly button may benefit from a mini–tuck, a procedure in which a much smaller incision made below the belly button is sufficient to allow removal of the necessary tissue to achieve a flat abdomen. This procedure takes only 45 minutes, and patients are back to work in a few days, and can resume normal exercise in 2 to 4 weeks. Dr. Weinberg’s dedication to superlative post operative care, with specialized treatments designed to promote wound healing, results in the fastest possible recovery, with the least visible, best type of scar possible given the individual's skin type. Click HERE to view a video story of a patient who underwent dramatic Tummy Tuck surgery after a 200lb weight loss. 

For more information on Tummy Tuck surgery visit HERE.

Botox and Headaches

I am often asked questions regarding the use of Botox in treatment of headache. There are a number of studies that have been done in varying types of headache sufferers. Some have looked at Botox to treat migraine, and others have looked at the use of Botox in chronic daily headaches. There has been variability in the results of these trials, and it is true that some have not shown Botox to confer a measurable benefit greater than that of placebo in a number of parameters, including frequency and severity of headahce. In contrast, some studies have shown substantial benefit , as for example a study done in 2003 did. In 271 adult migraine sufferers, 80% had some improvement in their migraine pattern. Recently, in late 2008, Allergan, the makers of Botox, announced positive results in their large study on chronic migraine patients , who were defined as individuals with headaches 15 days a month. In that study an increase in headache free days , and a decrease in headache episodes was reported.

Botox is thought to act to prevent or reduce headaches by blocking the release or action of certain neuropeptides thought to be important in pain transmission, and not due to it's muscle relaxing action.

Thus far , because of conflicting evidence, Botox is not officially approved for treatment of headaches by the FDA in the united States, nor by Health Canada. However, many believe the earlier inconclusive studies failed to show consistent benefit due to differing methods of selecting patients and due to different methods of administration and dosing of the drug. Allergan is submitting their recent study results to the FDA in the US, and it is possible official approval for this indication may be given some time in 2009 there.

Despite the lack of official Health Canada approval, many headache clinics and migraine doctors here have been using Botox to treat headache for some time, and this is perfectly legal. Ideally patients should be informed before treatment that it is an "off label" use of the medication. Many migraine specialists and patients prefer Botox to other oral medications because of the very low incidence of systemic side effects.

Most neurologists who use Botox for migraine use a protocol that involves treatment with 1 vial (100 units) of Botox injected in the forehead , over the scalp, the occipital region and sometimes into the back of the neck or shoulder area in a "follow the pain " approach. Injections are usually repeated every 3 months if benefit is reported, and is discontinued after 2 treatments if there is no improvement. 

Many, but not all, insurers will cover the cost of Botox when used to treat headache. Typically insurers do not cover the injecting fee, which is usually around $200.

See Our website for more information.