The Blog Has Relocated to our New Practice Website

We've relocated the blog to our new practice website. Please follow us at our new location. If there are topics you'd like to learn about please email your ideas to info@weberfacialplasticsurgery.com and we'll get to work on generating new content.

Sincerely,

Stephen Weber MD, FACS
Weber Facial Plastic Surgery, PC

We've relocated and are seeing patients at our new Lone Tree office!

Weber Facial Plastic Surgery has relocated and is open for business! Give us a call at (303) 792-2224 to schedule your next appointment.

9695 S. Yosemite Street, Suite 359
Lone Tree, CO 80124
(303) 792-2224
weberfacialplasticsurgery.com

Check out our Addy for more information and turn by turn directions to the new office.

See you soon!

Steve

Stephen Weber, M.D., F.A.C.S.

Are Blood Clots a Common Problem in Plastic Surgery Patients?

Recent media accounts regarding Hillary Clinton's blood clot have prompted several of our patients to ask what the real risk is of blood clots after Facial Plastic Surgery procedures. 

The good news is that the risk is low for healthy people without any underlying clotting conditions. There exists a perfect storm of factors referred to as Virchow's Triad. The triad includes pooling of blood in the legs, existence of a hypercoagulable state (more clotting) and injury to the inner blood vessel wall. 

Patients undergoing Facial Plastic Surgery procedures can minimize the risk by revealing any underlying blood clotting problems in themselves or family members. Further, depending upon the level of risk of blood clots (referred to as deep venous thrombosis), many maneuvers can be performed to prevent clot formation. These options include minimizing operative time, placing compressive stockings on the lower legs and using sequential compression devices to prevent pooling of blood in the legs. In more extreme cases, patients can be treated with short-term blood thinning medications to further reduce the risk. 

We are vigilant in identifying warning signs such as swelling, discomfort or pain the calf muscles following surgery. However, in our typically healthy population of patients, the risk of deep venous thrombosis is low.

Stephen Weber, MD, FACS
Lone Tree Facial Plastic Surgeon

Buyer Beware - "Illicit Botox Sparks Alert"

Illicit Botox Sparks Alert reads a recent headline in the Wall Street Journal. In the current case, physicians purchasing illicit Botox from outside the US likely received counterfeit medications. It is unclear whether the vials contain Botox and if they do whether the drug is provided at safe concentrations. 

Only MDs in the United States are allowed to purchase Botox from its manufacturer, Allergan. There are illegal arrangements where nurses, estheticians or those with even less training  obtain Botox from an absentee physician and then perform unsupervised injections. This practice is unsafe, unethical and unfortunate. This is, however, increasing in frequency as poorly trained "practitioners" or "injectors" swarm the field of cosmetic medicine and, in some tragic cases, plastic surgery.

Like many ethical issues, these practices result from financial pressure. An ethical physician would never put his or her patients at risk to make a profit. However, there are those physicians and other providers who have decided that offering cut rate injectable treatments (Botox, Dysport, Juvederm, Restylane, Perlane) is the path to a tidy sum. For very good reasons, legitimate FDA-approved drugs are not cheap (hence the higher cost of being treated by a reputable Plastic Surgeon or Dermatologist). 

When the $8 per unit Botox provider realizes that they lose money on every unit injected, there is tremendous pressure to reduce costs. This can sometimes involve overly diluting the medication such that patients receive fewer units of Botox than they paid for. Alternatively, medications can be purchased from foreign companies in India, China and Canada, to name a few. In some cases, there is no active medication in the purchased product. In other, more dangerous cases, there is excessive or non-medical grade product masquerading as an FDA-approved, safe medication. 

I am reminded of a case in which research grade Botulinum toxin was reconstituted and injected by a chiropractor. He injected himself, his (soon to be ex-) girlfriend and another couple. All four survived but wound up in the hospital for prolonged periods due to a ludicrous overdose of the drug. This type of complication is a "never event" and does not occur when Botox is purchased from its manufacturer in the US. 

The take home message is that there is an increasing number of unscrupulous providers entering the practice of cosmetic medicine. There will always be those that look to make a quick buck rather than building relationships and providing exceptional, long-term care to their patients. Warning signs include:

1. non-core physicians (those other than Facial Plastic Surgeons, Plastic Surgeons and Dermatologists) offering cosmetic services. Many among us have seen ads for injectable treatments at their internal medicine or OB-GYN office. A patient of mine was actually offered Botox by his gastroenterologist! 
2. non-physician "injectors" with no physician affiliation are suspect. To reiterate, they cannot legally buy the product they're offering to inject at bargain basement prices. Thus, you must ask where the product came from. 
3. prices that are too good to be true. In fact, they are. 

It is important to note, that fixing bad Botox is much more expensive than having it done right the first time. There is no substitute for exceptional training and experience.

If you would like to discuss Botox or other injectable treatments with a board-certified Facial Plastic Surgeon in the Denver area, schedule a consultation.

Stephen Weber, M.D., F.A.C.S.
Lone Tree, Colorado

Dr. Stephen Weber becomes Fellow of the American College of Surgeons

I am really excited to announce that I've been granted Fellow status in the American College of Surgeons. The college has a very rigorous screening process during which they extensively evaluate a candidate's education, training, professional background and competence in their area of specialization. Fellows must be board-certified in their practice specialty and embody strict ethical and professional principles in order to receive the F.A.C.S. designation. Most importantly, this distinction is one more indicator to our patients that they will be well cared for by an ethical and highly experienced Facial Plastic Surgeon.

Stephen Weber, M.D., F.A.C.S.

We've Just Rolled Out a New Website

We've just rolled out a new www.lonetreefacial.com . Please check it out and let me know what you think!

- Stephen Weber, M.D.

What can be done about my torn, stretched or "gauged" earlobes?

I am always surprised when I encounter a patient in the office who was unaware that torn, stretched or gauged earlobes can be repaired with a straight-forward office procedure.

Patient 1 - Typical stretched
ear piercing.

Heavy earrings tend to stretch the earlobe and widen the piercing. After years of wearing these baubles, women will typically present with a stretched piercing and very droopy earlobes. The stretched piercing will typically not retain small earrings and they will either fall out or point toward the floor!

Patient 2 - Torn earlobe.

Many women will at one point catch an earring on their clothing or a pillow causing the earlobe to tear. The normal healing process will frequently leave a notch in that torn earlobe that will never heal without surgery. 











Likewise, "gauging" the earlobes can result in earlobes that elongate with a large healed hole in the middle of the earlobe. The lobe will never shrink and the hole will not close properly without surgery. Of note, the popularity of earlobe repair among males has surged since the military will not allow men with gauged earlobes to enlist. In cases like these, a thirty minute office procedure enables these young men to enlist and pursue a military career.

Patient 1 - After earlobe repair.

As I've already alluded to, the only option for repair of stretched, torn or gauged earlobes are surgical in nature. However, the procedure is a quick in office procedure that can be performed in the office on the lunch hour. There is no "downtime." The edges of the torn or stretched earlobe are freshened and the tear is then meticulously closed with dissolving sutures. The gauged earlobe presents a special case since the margin of the gauged piercing is typically very delicate. Thus, gauged earlobes are slightly more complex to repair but can still be fixed with a straight-forward office procedure. 

Patient 2 - After earlobe repair.

The incisions heal very nicely and rarely objectionable. Patients with darker skin can form keloid scars but if you did not keloid from the piercing the chances are very good that you will not keloid following the repair (see Patient 2 at right). Infection is very rare after this procedure. Your new earlobe can be pierced in the office three to four weeks after the procedure.

For more information or to schedule repair of your torn, stretched or gauged earlobe call us at (303) 788-6632 or email info@lonetreefacial.com . 

What's the difference between a browlift and a blepharoplasty? Which do you need?

This is a very frequent question in my practice. Maybe my patient saw something on TV or spoke with a friend but they're convinced that they need a specific procedure to rejuvenate their face. This is incredibly common when talking about the eyes and upper face and there is alot of confusion out there.

What is a browlift?

Women tend to have refined, arched eyebrows which sit above the bony rim of the eye socket. Men, on the other hand, tend to have flat eyebrows with minimal arch and their brows tend to sit right on top of the framework of the eye socket. The browlift procedure is designed to lift and reshape the eyebrows. 

Does the browlift procedure differ in women vs. men?

The procedure is technically the same. However, I aim for a refined, arched brow in women and a flatter, less elevated brow in men to maintain the natural cues of a feminine or masculine face. One major mistake for men seeking brow or eyelid surgery is undergoing a procedure with a plastic surgeon who does not frequently operate on men. The result is often a feminized appearance that clashes with the rest of the man's masculine appearance.

What is a blepharoplasty?

Both upper and lower blepharoplasty are frequently performed. This is the most common procedure performed in my practice for women and men. 

An upper blepharoplasty is performed to remove extra skin from the upper eyelid, a small strip of muscle and occasionally a pocket of fat near the nose. This recreates the natural eyelid crease and "opens" the eyes making a person look more rested and more youthful.

Lower blepharoplasty most often involves removing fat that forms a "bag" or a bulge in the lower eyelid. This is typically performed with an incision hidden on the back of the eyelid. In patients with extra skin in the lower eyelid, a small incision is placed below the eyelashes to remove the extra skin.

So which do I need?

Drooping eyebrows AND extra upper eyelid
skin require both a blepharoplasty and browlift.

• If your eyebrows are drooping AND there is extra skin in the upper eyelid when the brow is lifted to its natural position, you need a browlift AND a blepharoplasty.

Drooping eyebrows but NO extra upper eyelid
skin require a browlift only. 

• If your eyebrows droop but there is no extra skin in the upper eyelid when the brow is lifted to its natural position, you need a browlift only. 

Eyebrows in good position but extra upper
eyelid skin require a blepharoplasty. 

• If your eyebrows are in good position but your upper eyelids are full, you need an upper blepharoplasty.

How can I learn more?

Setup a complimentary consultation with me to discuss browlift, blepharoplasty or any aspect of facial rejuvenation surgery. You can reach my office at (303) 788-6632. For your convenience, I have office hours on Wednesday evenings and Saturdays available.

Financing Offered by Weber Facial Plastic Surgery

Weber Facial Plastic Surgery has been offering our patients the convenience of CareCredit financing. This plan can be used for all cosmetic treatments as well as cosmetic surgical procedures offered in our office. It is simple to determine whether you qualify for CareCredit financing either online or via phone and we can walk you through the process following your appointment with Dr. Weber. No-interest financing for 6 months is a win-win!

From the CareCredit website:
"Many patients put off treatments and procedures because they cannot afford to pay. Doctors offer CareCredit payment plans as a convenient option to consumer credit cards, cash or checks. CareCredit allows you to pay over time often without incurring interest charges instead of a lump sum prior to treatment. Offering CareCredit removes the accounts receivable responsibilities from the doctor and allows them to focus on recommending and providing the best care to their patients."

For more information, call us at (303) 792-2224 or visit Weber Facial Plastic Surgery.

Sculptra Aesthetic Now Available at Lone Tree Facial Plastic & Cosmetic Surgery Center!

Sculptra Aesthetic is an FDA-approved injectable treatment designed to correct aging-related facial volume loss and sagging of facial tissues. I have extensive experience with Sculptra treatment and think that in the properly selected patient, the results are outstanding.

Sculptra Aesthetic is composed of poly-L-lactic acid which triggers your body to create its own new collagen, resulting in tighter and fuller facial tissues. Unlike short-term filler products, Sculptra Aesthetic treatment causes your body to lay down its own collagen resulting in long-lasting benefits. Treatment results in gradual, progressive restoration of facial volume and the facial contours associated with youth. We can restore lost volume in the temples, cheeks and lines around the mouth to create the youthful appearance of midface volume and counter the tendency of our volume to shift to the jowls and neck, both obvious signs of facial aging. 

Most of our patients require three to four treatment sessions in the office, each separated by one month. You can return to work or your daily activities the morning following each treatment. Creation of new collagen takes place gradually during the course of treatment resulting in long-lasting improvement in facial contours. The results should last two years

If you are interested in learning more about Sculptra Aesthetic, I am happy to answer your questions. I've been using this product for four years and have had great results with Sculptra Aesthetic for the treatment of aging-related facial volume loss as well as treatment of lipodystrophy. In the properly-selected patient, Sculptra Aesthetic can produce life-changing results.

Call us at (303) 788-6632 or visit Lone Tree Facial Plastic & Cosmetic Surgery Center for more information.

Before (left) and after (right) four Sculptra treatments.

Before (left) and after (right) four Sculptra treatments.

Dr. Stephen Weber Becomes Diplomate of American Board of Facial Plastic & Reconstructive Surgery

The American Board of Facial Plastic & Reconstructive Surgery recently certified me as a "Diplomate" of the  board. This connotes board certification in the highly-competitive field of Facial Plastic & Reconstructive Surgery. At Lone Tree Facial Plastic & Cosmetic Surgery Center we seek to uphold the rigorous standards of the ABFPRS and provide cutting-edge, safe, ethical care to our patients. Both Dr. Schaler and I maintain double board certification in Facial Plastic & Reconstructive Surgery and Otolaryngology and Head & Neck Surgery.

"The ABFPRS credential signifies that your surgeon:   

1. Has completed an approved residency after medical school in one of two surgical specialties focusing on facial plastic surgery (otolaryngology-head and neck surgery or plastic surgery);
2. Is double boarded, having earned prior certification in one of those specialties through the American Board of Medical Specialties or the Royal College of Physicians and Surgeons in Canada;
3. Has successfully completed a two-day examination;
4. Has submitted for peer-review an acceptable record of at least two years’ clinical experience, including operative reports of a minimum 100 facial plastic surgeries;
5. Operates in an accredited facility; and
6. Holds proper licensure and subscribes to the ABFPRS Code of Ethics."

- From the ABFPRS website (11/2/11)

Restylane now FDA-approved for in-office lip augmentation

Restylane, a hyaluronic acid dermal filler, was recently approved by the FDA for lip augmentation. We have been filling lips for years with Restylane to provide more volume, better symmetry and more definition in an "off label" fashion. However, the recent nod by the FDA should provide patients with additional comfort and confidence that Restylane can be safely used in the office for lip augmentation. Of note, this is the only hyaluronic acid filler on the market in the US that has this indication. Juvederm will still remain a great option for filling lips but does not carry this stamp of FDA approval.

Interestingly, in the study on which approval was based the most common problems following injection were bruising, swelling, redness and tenderness. However, over 80% of patients chose to be re-treated at six months suggesting that the overwhelming majority were happy with treatment. These results are consistent with what we have found at Lone Tree Facial Plastic and Cosmetic Surgery Center.

Treatments are performed in the office. The procedure requires roughly thirty minutes and is most often performed after applying a topical numbing gel. Dental blocks can also be used to increase comfort but are typically not required. A small volume goes a long way when augmenting lips so it is critically important to find an experienced injector when looking to plump your lips. Complications are highly unusual following lip augmentation.

If you're interested in further information or would like to schedule lip augmentation, give us a call at (303) 788-6632.

Medicis Press Release