Renaissance Plastic Surgery

As someone who gets migraine headaches, I can sympothize when I see patients who tell me, "I feel like an ice pick is stuck in my eye."  Therefore, the research on the use of Botox injections and surgical procedures to reduce and possibly eliminate migraine headaches has been near and dear to my heart (or at least my brain).

Migraines can be completely debilitating, lasting from hours to days. They are generally treated with medication, even narcotic pain medications. Traditionally they are thought to be related to blood vessels in the brain. However, recent evidence suggests that mechanisms outside the brain may play a significant role.

These mechanisms outside the brain are called trigger points. Many of us who have migraines understand this. They are the tender areas that seem to be the point at which the migraine starts. There are four main trigger points that have been identified. The first is the area between the eyebrows called the corrugator muscles. These are the little muscles that create the vertical wrinkles between the eyebrows. The next is the temporal area just above the sideburn. The third area is the back of the head at the base of the skull. The upper, inner nose is the last area, where the headache feels like it starts behind the eye. People with migraines can be seen putting pressure on any of these areas when they have a headache.

The first three areas have nerves that when squeezed or pressured from surrounding muscles may trigger the headache. Treatment has been targeted at these muscles by treating them with Botox to relax them. I have been doing this for 10 years. I have many patients (and myself) who regularly have Botox treatments to these areas and see a dramatic reduction in the intensity and duration of the migraine headaches.

Once the Botox is successful, we have succeeded in identifying a trigger point. Surgery can then be used to remove the part of the muscle which is causing pain. This will permanently remove the trigger point for the migraine. These treatments can result in amazing reduction in headache frequency and intensity. These surgeries are often a normal part of plastic surgery procedures that result in an improved cosmetic appearance with the added benefit of reduced migraines.

The first step to take toward fewer migraines is to keep a diary of headaches and complete a questionnaire about your headaches. This is needed to help create a plan toward a migraine free world.

Have your kids and shape back too!

Patients often come in and ask for liposuction of the abdomen to get rid of the extra skin and fat tissue that has been lovingly left to them by their children. What most women want is to have their old abdomen shape back. The way back is different for each patient. For as many different shapes of abdomens that exist, there are nearly that many ways to improve their appearance. There are also less invasive prodedures, including liposuction and modified abdominoplasties (mini or modified tummy tucks).

Abdomens often have excess fat and sometimes excess skin. There may also be stretched and loose muscle walls. Liposuction alone may be the answer for the extra fat, but after the birth of a child or two, there is often extra skin that will not improve without some skin removal.

For the smaller abdomen with some loose skin there is the smaller mini-abdominoplasty. The loose extra skin alone may be removed by the c-section area and, with a little liposuction, the entire lower abdomen can be more flat and smooth. This mini tummy tuck's incision can be smaller, like a C-section scar.

When the lower abdomen has a pooch as well as extra skin and fat then a "modified" or "hybrid" abdominoplasty may be recommended. This allows the extra skin and fat from the lower abdomen to be removed and the muscles in the lower half of the abdomen can be repaired and tightened to improve the shape. This can also be done through a smaller C-section type incision.

When the loose skin hangs or droops over the belt line area, a full tummy tuck is often required. With pregnancy, the muscles of the abdomen can stretch and bulge or tear, like a hernia. This will require more muscle repair than the modified tummy tuck can offer. This procedure will leave the entire abdomen smooth and flat. The muscles are completely repaired and the excess fat and skin are removed. With any tummy tuck procedure, some liposuction may also be used to help contour the hips to blend in with the new abdomen shape.

There are many options to improving the abdomen. The procedures must be tailored to meet your needs. The right procedures are best determined by you and your board certified plastic surgeon. So you can love having the kids and love your look too!