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“Non-Surgical Center of Excellence” for Concierge Care

November 30th, 2013 Miguel A. Delgado Jr, MD

Reception at Dr. Miguel Delgado

Reception for Dr. Miguel Delgado
Marin County, Novato CA

San Francisco, California-Always forward thinking, Dr. Delgado makes available to his patients the latest and most innovative procedures that he has determined are safe and give the best results. Not all patients desire cosmetic plastic surgery for various reasons such as: corrections are only minor, taking the time out of a busy schedule, fear of surgery and/or anesthesia, or financial limitations.

There are many non-surgical options for patients that can reduce signs of facial aging, sculpt the body, and refresh the skin. Subtle changes can increase self-confidence and one’s perspective on life. With this in mind, Dr. Delgado continues to expand procedures offered to his patients at his “Non-Surgical Center of Excellence”.

Many patients are confused as to what procedures may benefit them when they see so many treatments available that are showcased on television talk shows, the internet, and all forms of media. It is recommend that patients schedule a consultation with Dr. Delgado to discuss problem areas that patients find disturbing and with Dr. Delgado’s expertise, he can recommend the optimal treatment for the best result.

The latest procedure that Dr. Delgado has added to his practice is “CoolSculpting”. CoolSculpting is the exciting non-surgical solution to removal of those stubborn areas of fat that dieting and exercise will not eradicate. For details on this procedure see the previous blog or the section on this website.

CoolSculpting is in good company with other procedures that Dr. Delgado offers, also added this year is “ Ultherapy”   a FDA approved procedure.  Ultherapy is a non-surgical facelift that tightens the skin by ultrasound which stimulates new collagen growth. One 60 to 90 minute treatment will continue to show improvements for up to 6 months. This is the perfect treatment for patients who are not ready for a facelift but would like a little tightening, or for facelift patients that need a little touch-up.

Ultherapy Featured in New You

Ultherapy Now Offered in Marin County is
Featured in” New You”

Fat injections continue to gain popularity as an excellent filler for the face where some fat loss has occurred. Using one’s own fat loaded with stem cells has proved to be the longest lasting correction. In addition to the face, fat injections or fat grafting can correct such defects as “crater deformity” in the male chest from over resection during a gynecomastia or male breast reduction procedure. Many cosmetic surgery patients are choosing to take advantage of a service that Dr. Delgado provides through “AdiCyte”, which is a company that stores a patient’s fat for future use, known as fat banking.

According to the American Society for Aesthetic Plastic Surgery (ASAPS), non-surgical procedures have increased 356% over the last 15 years, with Botox the number one injectable every year. In 2012, Botox increased another 24%! Botox works by blocking the nerve muscles. The wrinkles will then soften and relax when the muscles can’t contract. The most popular areas treated are the glabella, (the area between the eyebrows), crow’s feet (the corners of the eyes), and the forehead.

As an expert injector, in addition to Botox, Dr. Delgado offers Dysport (similar to Botox), Restylane, Juvederm, Radiesse, Sculptra and Artefill. Each has different advantages, so it is recommended that you discuss your options in consultation with Dr. Delgado.

To complete the offerings of the “Non-Surgical Center of Excellence”, are Diolite, Photo-facial, and laser hair removal.

Diolite is a laser that treats age spots, skin tags and red vessels of the face. Photo-facial will treat brown spots, shrink pores and even out skin tone. One of the top cosmetic procedures in the United States is laser hair removal, requested by both men and women.

You can be assured that as new procedures become available, Dr. Delgado will be offering them once he is convinced that they are safe and may be of benefit to his patients and not just another marketing hype.

Consultations are offered at both the Union Square San Francisco office, and Marin County’s Novato office. Call (415) 898-4161 for a complimentary consultation for your non-surgical desires or email.

CoolSculpting Freezes the Fat Away!

October 26th, 2013 Miguel A. Delgado Jr, MD

coolsculpting_procedure

CoolSculpting Procedure
Dr. Miguel Delgado
San Francisco, CA

San Francisco, CA-According to the statistics of the American Society for Aesthetic Plastic Surgery, the two most popular cosmetic surgical procedures, are breast augmentation and liposuction. Liposuction is very popular with men looking to get rid of love handles and reduce the abdomen. Women love it for reduction of their: “saddle bags”, abdomen, thighs and more. Liposuction has been available in the United States since the early 1980’s and the popularity continues to grow.

Fat reduction is big business, which is very evident by the multiple choices of the many types of fat reducing devices available. Competition is intense for market share between manufacturers, but competition is always good in a free market society encouraging manufacturers to continue to produce more effective and higher quality devices. There have been many liposuction machines introduced, but most are just variations with small differences.

Liposuction is surgery requiring: pre-operative lab tests, surgical and operating room fees, prescription medications, compression garments and downtime for recovery. To find a way of fat reduction that does not involve surgery, has been a dream of many, for years. That dream is now a reality! Doctors from Massachusetts General Hospital in Boston noted that children who consumed many popsicles were developing dimples in their cheeks due to fat loss. Through testing, the doctors discovered that intense coldness killed fat cells, and the fat cells were then eliminated naturally by the body. Even though it is a somewhat slow process, it is permanent. This discovery led to the development of CoolSculpting. With CoolSculpting, there are not any needles, scalpels, scars or downtime.

CoolSculpting has hit the market with great reviews; the demand for the procedure shows how many patients embrace the idea of a non-surgical fat reduction option. CoolSculpting will not replace liposuction as it is not as aggressive. CoolSculpting is not meant for large areas of reduction; it is more for those difficult localized pockets of fat that diet and exercise will not remove such as: the abdomen, love handles and for some men with pseudo-gynecomastia it will reduce the fat on their chest.coolsculpting-logo

You are born with a certain amount of fat cells, if you consume more calories than your body can use, the extra calories will be stored as fat, and the cells will grow larger.  If you lose weight the cells will shrink, but they will not go away unless they are removed by liposuction or CoolSculpting. CoolSculpting only removes subcutaneous fat, fat that is attached to the skin. It does not affect visceral fat, which is deeper and surrounds the organs.

The ideal patient is within 20 to 30 pounds of ideal body weight, if you can pinch more than 2” you may want to lose weight first or consider liposuction.

For treatment, the patient arrives in comfortable clothing and lies or sits on the treatment table. Most patients read, use their laptop or take a nap. The targeted area is placed between 2 cooling plates that are held into position by a vacuum. The fat is then subjected to intense coldness, which will kill the fat cells but does not affect the blood vessels, nerves or skin. The treatment lasts for about an hour per area. Most patients claim the procedure is not painful, but they feel the initial coldness and some pressure. The side effects are minimal, and if any would include: some redness, numbness, swelling and minor bruising.

Results will not be evident right away, the destroyed fat cells can take up to 2 to 4 months to be shed by the body. Many patients state that they first start seeing results after 2 to 3 weeks when they noticed the difference in how their clothes fit. In general, one treatment will reduce an area by 20%, if a patient desires to have more removed additional treatments can be done.

Success for permanent results will be based on lifestyle changes of a healthy diet and exercise program.

To find out if CoolSculpting is for you, schedule a consultation with Dr. Delgado in either his Marin County office in Novato or his Union Square office in San Francisco. Ask about other procedures available through the “Non-Surgical Center of Excellence”such as: Ultherapy for skin tightening, Botox, fat injections, and facial fillers.

Eye Surgery: Canthopexy Versus Canthoplasty

June 16th, 2013 Miguel A. Delgado Jr, MD

This is a 66-year-old female resident of Sonoma, CA presented  for evaluation of her face. In addition to having other facial procedures, she underwent an upper and lower eyelid lift or blepharoplasty with a chemical peel of the eyelids. Note the drooping of the lower eyelids before surgery and after surgery a more youthful appearance with better lower eyelid position.

San Francisco, CA-It has been said, “The eyes are the windows to the soul”. When communicating with other people, we almost always have eye contact. Our eyes may be our most important feature. With facial aging, the eyes are usually the first to show signs with fine lines and wrinkles at the corners, commonly called “crow’s feet”. For years now Botox has been the most popular injectable for correcting “crow’s feet”, even with patients in their twenties.

According to the American Society of Plastic Surgeons, Botox and Dysport saw an increase of 8% in 2012 and eyelid surgery saw an increase of 4%. Eyelid surgery was the third most popular cosmetic surgery performed.

As we continue to age the skin starts to lose its elasticity, and along with sun exposure can result in drooping and sagging skin of the lower eyelids. The eyes may age well before the rest of the face, and may cause many to seek an eyelid lift at an early age. Whether eyelid surgery is done at an early age or along with a facelift (or both); it remains one of the most sought after procedures.

Generally we refer to eyelid surgery as blepharoplasty, which could mean upper and/or lower eyelids. For lower lid surgery specifically, there are two popular procedures, canthopexy and canthoplasty.  Often the terms are used interchangeably, but they are very different.

“Pexy” means to fixate or make secure, and “plasty” means to restore, repair or replace. With both procedures,  the goal is to strengthen the tissues at the lateral canthus, or the outer corner of the eyes, to give better support to the lower eyelids.

Canthoplasty is a surgical procedure whereby the surgeon actually cuts the canthal tendon, which holds the lower eyelid in place,  makes it tighter and may remove excess skin, as well. Then the tendon is reattached to the orbital bone. This procedure changes the shape of the eye to more of a cat-like appearance.

Canthopexy is a less invasive procedure where the tendon is not cut, but the surgeon uses sutures to tighten it and stabilize it without reconstructing it. It does ot change the shape of the eye.

These procedures can also correct ectropion. Ectropion is where the lower eyelid is gaping open; this can cause dry eyes and eye irritation that may lead to infection. This gaping of the lower eyelid can be caused by trauma or previous surgeries, inflammation, thyroid eye disease or facial nerve palsy.

For patients with ectropion and dry eyes, it is possible medical insurance will cover the corrective surgical procedure, but if it is for cosmetic purposes it will not be covered. Similar to upper eyelid surgery for the patient with redundant skin that affects vision, which is also a situation that insurance may cover. Your surgeon will be able to advise you on your possible approval for surgery with your health insurance.

Eyelid surgery can be done with local anesthesia or with IV sedation. If it is combined with other procedures such as a brow lift or facelift, then it would most likely be done under general anesthesia.

As with any surgery there are some risks involved. For canthoplasty, the junction of the upper and lower eyelids may become rounded or retracted and may result in what is known as “round eye” or “scleral show” where the lower lid is pulled down and the white part of the eye below the iris shows. If overdone, the result may be an unnatural upward slant to the eyes.

Canthopexy, on the other hand, is a much less invasive procedure and not subject to the same risks as canthoplasty. Although complications are rare with these procedures especially if you have a Board Certified Plastic Surgeon and Board Certified Anesthesiologist, the possible risks and complications  as with any surgery are; bleeding, infection, and complications with anesthesia.

This is a 62-year-old man from San Rafael, CA presented for evaluation for his eyelids. His complaints were the aged look around the eyes and the flatness around his lower eyelids. He underwent an upper and lower eyelid lift or blepharoplasty with fat injections to the mid-face region. Note the eyelid improvement and the natural appearance of the eyes.

Ultherapy – The New Non-surgical Facelift Now Available To San Francisco Patients

May 15th, 2013 Miguel A. Delgado Jr, MD

Ultherapy Ultrasonic Machine

San Francisco, California-Ultherapy is the new FDA approved ultrasound treatment that stimulates the deep structural support layers of the skin. The subcutaneous layer and the fibrous SMAS layer are heated up by ultrasound energy, which stimulates growth of new collagen over time to tone and tighten loose and sagging skin of the face and neck. This is achieved in most cases with one 60 to 90 minute office treatment. The patient has no downtime, no skin scabbing and the skin lifting results are seen over the course of 2 to 3 months, with some patients seeing continued improvement of lax skin for up to 6 months.

Ultherapy does not replace facelift surgery, but is a perfect skin tightening treatment for those Marin County patients that are not yet ready for surgery or for those who have had surgery and may need a little skin rejuvenation.

Featured on many TV shows such as 20/20, The View, Good Morning America and multiple magazine articles, Ultherapy is not a Facelift but an Uplift! To see if you are a candidate for this exciting new procedure call (415) 898-4161 for a complimentary consultation.

 

Cosmetic Procedures Increase for 3rd Year in a Row

March 15th, 2013 Miguel A. Delgado Jr, MD

The American Society of Plastic Surgeons (ASPS) has reported statistics for 2012 stating that cosmetic plastic surgery procedures performed in the United States has increased 5% since 2011. This makes three consecutive years that there has been an overall growth.

The significant rise in the plastic surgery industry is fueled by minimally-invasive procedures, where the cosmetic surgical procedures remained fairly stable. Many patients who start with the minimally-invasive procedures advance to more invasive ones as needed.

ASPS reports that the top five minimally invasive procedures were:
•    Botox and Dysport (6.1 million procedures, up 8 percent)
•    Soft tissue fillers, such as Restylane, Juvederm, Radiesse, etc. (2 million procedures, up 5 percent)
•    Chemical peel (1.1 million procedures, up 2 percent)
•    Laser hair removal (1.1 million procedures, up 4 percent)
•    Microdermabrasion (974,000 procedures, up 8 percent)
For cosmetic surgical procedures, there was an overall decrease of 2 percent, with nearly 1.6 million procedures in 2012. The top five surgical procedures were:
•    Breast augmentation (286,000 procedures, down 7 percent)
•    Nose reshaping (243,000 procedures, no change)
•    Liposuction (202,000 procedures, down 1 percent)
•    Eyelid surgery (204,000 procedures, up 4 percent)
•    Facelift (126,000 procedures, up 6 percent)
Note the large increase in eyelid surgery and facelifts, most believe this is attributed to the ongoing competition in the workforce and the high number of retiring baby boomers.
Interestingly the number one surgical procedure, breast augmentation is down 7% while male breast reduction (gynecomastia) shot up 5% for 2012.

California Governor Signs Law to Clamp Down on Medi-Spas

October 23rd, 2012 Miguel A. Delgado Jr, MD

There were 5.7 million treatments of Botox given in 2011, which is up 5% from 2010. This is an increase of 621% since 2000 according to the American Society of Plastic Surgeons (ASPS). It is not surprising that there are individuals that are trying to cash in on this phenomenon, even at the risk of the patient.

California governor, Jerry Brown, has signed a new law that will increase supervision on “medi-spas” in Marin County and all of California, that offer cosmetic treatments such as Botox and injectible fillers. The new law will increase fines on the facilities if it becomes known that there is a lack of medical supervision and some may be shut down. Some facilities or “Spas” have a doctor’s name attached to it, but it may be in name only. Should a problem occur, there would not be a trained physician to take over. These physicians will face legal action if they are only lending their name.

Recently CNN reported the story of a woman in Florida who ended up admitted to a hospital for a month, due to receiving some unknown injection to her face from a local Spa. She got a serious infection that led to 5 different surgical procedures that have left her scarred and still swollen.

ASPS encourages all patients who are considering Botox or other non-invasive treatments to be sure to see a Board Certified Plastic Surgeon who operates out of an accredited facility.

What is Cellulite? Do Cellulite Creams Work?

August 14th, 2011 Miguel A. Delgado Jr, MD

Cosmetic surgeons recognize cellulite as a condition that many San Francisco patients seek to find a cure, however the medical community does not see cellulite as a disorder but a normal condition for many women and some men.
Cellulite is a term first used in the 1920’s and became a “buzz word” when used in a Vogue magazine article in the 1960’s.  According to the Mayo Clinic 8 out of 10 women have some degree of cellulite; it does not seem to affect men very much, probably because estrogen makes fat and testosterone breaks down fat. Men with elevated estrogen have the propensity to develop gynecomastia (male breasts).
The physical cause of Cellulite is caused by fibrous cords that connect the skin to underlying muscle with fat in between. When fat cells increase they push up toward the skin and the cords are pulling down causing a dimpling effect.      
Some causes of Cellulite are:
• Hereditary
• Inactive lifestyle
• Stress
• Use of hormonal contraceptives
• Weight gain and an unhealthy diet
• Aging and the loss of skin elasticity

Many San Francisco patients come in to see Dr. Delgado with the hopes that liposuction will remove cellulite; it won’t, and in some cases can make the condition worse. Liposuction is for body sculpting not for removing fat under the surface of the skin.
What about all the creams and lotions that are advertised to remove the unwanted dimpling? Save your money, there has not been any conclusive evidence that this can cure or improve cellulite.
Endermologie uses vacuum rolling and radio waves to break up fat and help increase circulation. There have been many patients that claim they get results with this method but they have to have frequent treatments and if they stop the cellulite may return.
But due to demand, research continues and perhaps there will be a permanent cure for cellulite one day.