Friday, August 26, 2011

Longer Eyelashes with Latisse? Is It Safe during Pregnancy?

Longer Eyelashes with Latisse?  Is It Safe during Pregnancy?

Longer eyelashes have been the universal symbol of beauty, especially since a woman's eyes greatly affects her whole appearance.  Thicker and longer eyelashes enhance one's beauty, and it's no secret that men find women's eyes as one of the most important features of a beautiful face.  Some women would take bold steps to acquire that beautiful, luscious long eye lashes no matter how uncomfortable they may be whether it involves placement of fake eyelashes or application of eyelash extensions.

Longer Eyelashes (Photograph Courtesy of Wikimedia Commons)

What is Latisse?
Latisse, a prostaglandin analog, was previously used as an eyedrop to treat glaucoma.  The patients being treated for glaucoma with Latisse were found to have thicker and longer eyelashes.   After this discovery, several cosmetic companies started adding this prostaglandin analog to their mascaras illegally and touted them as eyelash-lengthening products.  The FDA subsequently banned these companies from the illicit use of this prescription medication in cosmetic products.   Allergan, the maker of BOTOX, received FDA approval in 2009 to manufacture Latisse as prescription medication to lengthen eyelashes.

Is Latisse Effective in Lengthening your Eyelashes?
  • Clinical studies have shown that after 16 weeks of use, there's a 25% increase in eyelash length, and 106% increase in lash fullness.
  • Improvement of eyelash length can be seen as early as 8 weeks, and may continue to improve up to 16 weeks.
Is it Safe to Use Latisse?
  • It's safe to use Latisse but there are precautions that need to be taken.
  • Latisse cannot be use when one is wearing their contact lens since one of the ingredients in Latisse (benzalkonium chloride, a preservative) may be absorbed into the contact lens.
  • Patients with glaucoma who are already undergoing prostaglandin analog treatment should take extra precaution since Latisse may bring their "eye pressure down" lower.
Is Latisse Safe During Pregnancy?
  • The use of Latisse has not been tested during pregnancy.
  • Animal studies have shown an increase in miscarriage if taken in higher doses.  
  • Studies have also shown that bimatoprost (Latisse) was also detectable in breast milk.
  • Thus, Latisse is not recommended during pregnancy and after pregnancy when one is still breast feeding. 
Side Effects of Latisse
  • Increased brown coloration of the iris of the eye may occur, especially in patients with hazel eyes.
  • Mild itching of the eyes
  • Redness of the eyelids
  • Bloodshot eyes
  • Brown discloration of the skin where the Latisse is applied.

Emmanuel De La Cruz M.D., PLLC
The Woodlands Plastic Surgeon

Tuesday, August 16, 2011

Breast Implant Placement: Above or Below the Muscle?

Where Should One Place their Breast Implants? Above or Under the Muscle?
Implant Pocket Selection

One of the most important decisions prior to a breast augmentation procedure is the selection of the breast implant pocket.  The clinical manifestations of this may not be apparent for several years since the effects of the implant on your breast tissue may occur gradually.   Sagging of the breast may inexorably worsen, especially after giving birth and with aging.

Different Breast Implant Pocket Selections

  • Total Submuscular (behind the serratus and pectoralis muscles of the chest)
  • Partial Submuscular (behind the pectoralis muscle of the chest with its origin from the ribs left intact)
  • Subglandular (above the pectoralis muscle of the chest)
  • Dual Plane (partial submuscular and partial subglandular/submammary)

Total Submuscular

  • Mostly a reconstructive technique
  • Less commonly performed for a breast augmentation
  • More painful
  • More bloody due to the dissection during surgery
  • The breast implant may have a tendency to rise superiorly
Submuscular Placement of a Breast Implant (Courtesy of Wikimedia Commons & Inamed)
Partial Submuscular (Under the Muscle)

  • Breast animation and distortion may occur when the pectoral muscles contract.
  • Lower incidence of capsular contracture.
  • Risk of double-bubble deformity of the breast.
  • More painful than a subglandular breast implant placement.
  • Decreased risk of the palpability of the implant edges 
  • Decreased risk of rippling
  • It allows for better view during mammography.
  • It's associated with a longer period of recovery, and more post-operative discomfort. 

Subglandular (Over the Muscle)
Subglandular Placement of Breast Implant (Courtesy of Wikimedia Commons & Inamed)

  • Usually reserved for patients who have a substantial breast tissue or mild degree of ptosis (sagging of the breast.)
  • May be the ideal choice for patients who are avid bodybuilders.
  • The benefits of this position is the anatomic placement of the breast implant that is not affected by contraction of your chest wall muscles.
  • A more natural appearance results with the placement of the implant subglandularly.
  • There may be an increased risk for capsular contracture
  • Implant palpability may occur when the soft tissues are very thin.  Thus, it is very important that the plastic surgeon assess the soft tissue of the breast before deciding to place the implant subglandularly.
  • Faster recovery
  • The cleavage is narrower with this technique.
  • Larger implants may be able to be placed above the muscle.
  • There’s a reduced tendency for the breast implant to ride high, and higher risk of seeing ripples (especially with saline breast implants.)

Dual-Plane Placement
Dual Plane Technique (Courtesy of Wikimedia Commons & Inamed)

  • The breast implant is partially covered by the chest wall muscle.
  • It allows for a more natural appearance while keeping the benefits of having the muscle cover the implant.
  • The implant is less palpable and less rippling is observed.
  • Pectoral muscle contraction may still occur with the dual-plane placement of the implant.
  • There’s also a reduced tendency for the breast implant to ride high, as well as reduced tendency for the implant to lateralize.
  • This technique has the benefits of both the subglandular and partial submuscular breast implant placement.
  • The technique is more complicated than the subglandular and submuscular implant placement. 

Being a fully informed patient prior to your breast augmentation procedure is critical.  Learning the advantages and disadvantages of the techniques for breast implant placement are important, and this should be discussed with your plastic surgeon. 

    Houston Breast Augmentation

    Sherrel Aston's Aesthetic Plastic Surgery 2009.
    Hidalgo DA.  Breast Augmentation: Choosing the optimal incision, implant, and pocket plane.  Plastic & Reconstructive Surgery. 2000; 105 (6): 2202-2216
    Takayanagi, et al.  Where should the implant be placed? Aesthetic Plastic Surgery. 2004; 28:83-88
    Tebbetts JB.  Dual plane breast augmentation:  Optimizing implant soft tissue relationships in a wide range of breast types. Plastic Reconstructive Surgery. 2001; 107 (5): 1255-1272

    Saturday, August 13, 2011

    Smile of the Month ~ Ethiopia

    Smile Train & Operation Smile of the Month
    Thousands of volunteers around the world donate their time and skill to help these children with cleft lip and/or palate.  Operation Smile and Smile Train have helped over two hundred thousand children all over the world.  These non-profit organization have trained medical professionals around the world enabling them to treat these children with cleft deformities in their own countries.  Lets help support Smile Train and Operation Smile.


    Emmanuel De La Cruz M.D., PLLC

    Saturday, August 6, 2011

    Teen World 2012 ~ Gabriele Marinho ( Miss Brazil )

    Congratulations to Miss Brazil !!! 2012 Teen World!
    As with the other judges, we are very proud of all the contestants of the Teen World Competition.

    Miss Brazil, Gabriele Marinho. Teen World 2012

    Emmanuel De La Cruz MD, PLLC

    Silicone Gel Breast Implant or Saline Breast Implant?