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Cosmetic and reconstructive surgery is not a…
Date Recorded
July 21, 2021 Transcription
Interviewer: So maybe you're considering getting a cosmetic or a reconstructive procedure done. We've all seen the before and after photos, but it's there's sometimes a journey in between those two points, and to kind of talk us through this is Dr. Courtney Crombie. She's an Assistant Professor and plastic surgeon with University of Utah Health.
Now, Dr. Crombie, what are some of these, you know, you see in magazines, you see on advertisements, you know, the before and the after. But, you know, there's a lot more involved with the recovery, regardless of what your procedure is. Why don't you walk me through some of the things that you as a surgeon really want your patients to understand when they're first thinking about these kinds of procedures.
Dr. Crombie: So most of the time, you know, our patients come and meet with us. They'll have at least one, and sometimes multiple meetings with us prior to a given procedure. And then on the day of the procedure, once again, we meet in the morning. They'll meet their anesthesiologists, and then they'll meet with us, and usually, depending on what the procedure is, we'll do our markings and our consent forms and then off to surgery.
After the procedure, we usually see them within the first week for their first follow-up appointment, and it'll either be with the surgeon, or someone on our team to check in and make sure that they're doing okay with their pain medicines and that our surgical sites are doing okay, if there is drains involved, you know, a drain check and just to see overall how they're doing.
On my service, I usually end up seeing patients probably every one to two weeks after their procedure until the kind of the final product of our procedure is done, which may be anywhere up to six weeks later. All our checkups were following drain outputs and removing drains, checking on wounds, removing Steri-Strips, and when it is time to start doing massages on massaging of scars, we will talk you through that portion, talk about sun exposure to scar, and get you through everything to the end product.
Interviewer: So beyond say scar care, wound care, pain management, what are some other things that they also should be keeping in mind? I would assume that, you know, they're going to be out for a while, they're not going to be able to, you know, lift anything, run around with the kids. What are some of those other kind of, you know, social and psychosocial aspects of all this?
Dr. Crombie: We discuss with you your daily activities of what we start allowing you to do, from walking the dog to, you know, carrying your children, playing with your kids, riding a bike. Whatever the activities are, we're usually discussing what those things are that we think is okay to do based on what wounds you have, what muscles are lying under those wounds. So we're very involved with everything because we want you to have the very best outcome for the things that we're helping you through.
Interviewer: So a patient who, you know, they hear that it's going to be a process, right? They hear maybe they're going to hurt for a while, they might have to, you know, work through one thing or another, what is something you tell them to kind of reassure them, if this is something they really want to do?
Dr. Crombie: I remind them that there are going to be good days and bad days, and on your good days, you really need to sort of tone it down so that your bad day, you don't totally crash. And I ask them about their support system, and I encourage their significant others to help them through on, you know, to be their cheerleader, and to help them through on their bad days, and hopefully they have a good support system. We want our patients to do well. It's a reflection of us, of course, and, you know, we want the best for our patients. We want good outcomes for them. And that's why we're here. MetaDescription
Cosmetic and reconstructive surgery is not a magic overnight process. To get results, these surgical procedures take a lot of time, after-care, and money. Learn about the realities of cosmetic procedures that all patients should know when considering an operation.
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If you’re looking for cosmetic facial…
Date Recorded
June 04, 2019 Health Topics (The Scope Radio)
Health and Beauty Transcription
Announcer: Health information from experts supported by research. From University of Utah Health, this is thescoperadio.com.
Interviewer: Botox and fillers, common question, what is the difference and how can they help you? Dr. Eric Cerrati is the Director of Facial Plastic Surgery at University of Utah Health. So, first of all, are Botox and fillers the same? I would say probably not, but that's why you're here. I want to find out.
Botox vs. Fillers: What's the Difference?
Dr. Cerrati: So they're very different. Botox is a neurotoxin. And Botox, it just happens to be the trade name that everyone knows of. But actually, there's three others now that are FDA-approved, and they affect the muscles, whereas fillers are volumizing agents.
Interviewer: Okay. And how are they used differently then?
Dr. Cerrati: So, in general, Botox is used for the upper third of the face. FDA approved for three different areas, which are the horizontal forehead lines, the vertical 11s that you have between your eyes, and the smile lines outside. Obviously, there are some other off-label uses that we tend to use them for. And then, fillers are the lower two-thirds of the face. You know, I'm not a huge fan of using Botox and, you know, around the mouth or other areas, because obviously the lower two-thirds of the face is very mobile and you want to maintain that mobility.
Types of Botox
Interviewer: So kind of give us a general rundown, what are the different types of Botox and fillers? When would you use them? What do they do?
Dr. Cerrati: So Botox, in general, so it's a neurotoxin that's injected into muscles. It takes about two to three days to take effect. I usually tell patients to give it a full seven till you kind of go to the mirror and see what it does. And on average, it lasts about three to four months. After three to four months, you're right back where you started. No better, no worse.
Interviewer: Okay.
Types of Fillers
Dr. Cerrati: Fillers, on the other hand, you know, there's a whole variety of fillers that are out there. There are permanent ones, and there are, you know, hyaluronic acid ones that are dissolvable. I tend to use the dissolvable ones just for safety because, you know, it's not a benign procedure that should be taken lightly. And the different fillers, they come in different thicknesses, you know. Some are placed deeper. Some are placed more superficial. Some last a year. Some last two years.
Risks of Filler Injections
Interviewer: And when you say safety, what do you mean exactly?
Dr. Cerrati: With any filler injection, there's a risk of bruising and swelling. All hyaluronic acid fillers attract water to a certain degree, so that's how you get the swelling. They pick up red blood cells, and doing so, that's how you end up with the bruise. I don't consider those risks. I consider them known side effects. And there are certain things you can do to try to limit those side effects. Kind of the scary risk that people see and hear about online is more if the filler is injected in or around a blood vessel. That's why it's very important to go to someone who's very knowledgeable about the facial anatomy and where the filler is going and what we're trying to accomplish.
Getting Long-Lasting Results
Interviewer: The dissolvable versus non-dissolvable, so let's just take, for example, maybe under the eye. That would be a place where you might use a filler. Is the dissolvable . . . does that mean that the results don't last as long much like the Botox and the dissolvable would last longer?
Dr. Cerrati: So the filler that I tend to use around the eye will last about a year. Again, after about a year, your body dissolves it or metabolizes it, and you're back to where you started. Under the eye tends to be an area where people will swell and bruise pretty significantly. I tend to use a cannula to try to limit that, you know. And it's also a high-risk area. Given the risk associated with the under the eye fillers, I tend to favor the dissolvable fillers.
Interviewer: Yeah. It sounds like it's a little bit more complicated than just an injection of Botox here, some fillers there.
Dr. Cerrati: Exactly. And, you know, I do all of my injections myself in the office. I just think that I can give a little bit more high-quality product to the patients if I do it that way.
Facial Rejuvenation Procedures
Interviewer: And during either type of treatment, whether it's Botox or fillers, where does this happen? It happens in your office?
Dr. Cerrati: It happens in the office. Actually usually a pretty quick procedure, probably it takes anywhere from 5 to 15 minutes. And a lot of times, we can couple them together to accomplish, you know, full facial rejuvenation. That's where you start to get into things called liquid facelifts. You know, you can use Botox in the neckline to tighten the jaw line. There's a lot of different, you know, kind of off-label uses that you can really accomplish quite a bit with these two modalities.
Choosing a Qualified Surgeon
Interviewer: And it sounds like the advantage of having someone like yourself do the procedure. I mean, you're a surgeon. On the surface, it might seem like it's a little overkill. But a lot of factors involved as to what to use and safety concerns, and it's a balance of outcome versus safety. I think I'm starting to understand why I would come to someone such as yourself.
Dr. Cerrati: So I tend to believe that surgeons are going to have a more thorough knowledge of the anatomy of the face and can place the fillers in the safest way possible to give the longest-lasting result. I think when you're seeing a surgeon for a complication, it's probably not the best setting.
Interviewer: We've talked before about being comfortable with the person that is doing the procedure in the terms of when it's like a facelift, when it's a surgical procedure. These non-surgical procedures with fillers and Botox, does the same thing apply? You should be comfortable with that person?
Dr. Cerrati: Absolutely. So this is very customizable for each patient. And you can think of the surgeon as, you know, someone who's trying to sculpt or mold an image that they have in their face, of how to rejuvenate a patient's face. And so the combination of Botox and fillers and what they can accomplish is very specific to what the surgeon sees and what that patient desires. And so having that conversation before doing any of the injections is very important.
Interviewer: And there are some great surgeons to choose from here.
Dr. Cerrati: Absolutely. So we have a team of surgeons here that offer this. And obviously, Botox and fillers are widely used all across the country and all over the world. But it's very important to go to someone who's well qualified and knowledgeable.
Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with out physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com. MetaDescription
Risks and side effects of botox and fillers.
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