More and more brides and grooms are getting nips and tucks before their wedding day.

Since they have already won the heart of their future husband or wife, cosmetic surgery before the wedding is something they have been thinking about for a long time. On one of the biggest days ever, they want to look and feel their best and improve their self-esteem.

Many people are concerned about how they look in pictures and realizing that these portraits will become family heirlooms, they are adding cosmetic surgery to their wedding budgets.

Here’s a list of some of the most popular procedures that are being considered and the average time prior to that big day the procedure should be done.

Injectables and Fillers

Let’s face it; no one wants wrinkles or frown lines EVER! Whether you are considering Botox to diminish those 11’s in the middle of your brows or facial fillers such as Juvederm or Voluma to plump up those cheeks or lips, allow 2-3 weeks for healing. Swelling and bruising can occur and you may need a touch up before the wedding day.

Liposuction

Dieting and exercise starts soon after the engagement for the anxious bride to be but sometimes those stubborn areas of fat still remain. Liposuction is one of the most popular cosmetic procedures chosen before the wedding day. Areas such as abdomen, hips, back, thighs, knees, calves, upper arms and necks are requested and should be done 1 month prior to the wedding. Soreness and bruising may occur. Schedule your consultation with Dr. Chad Robbins, Nashville’s Best Nip and Tuck Doctor, to see if you are a good candidate for liposuction.

Body Contouring

If you have lost a lot of weight and have excessive skin or sagging skin, you may need a tummy tuck or a body lift. And for the sagging arm fat that keeps waving when you have stopped…. an arm lift to remove excess fat and skin from your arms will allow for you to wear that sleeveless wedding dress you’ve always dreamed of! Ideally, this should be done several months in advanced so you can have the finale dress fitting after healing and swelling has gone.

Breast Augmentation

Breast Implants are popular among brides. Probably they have been thinking of this for years and after trying on a couple wedding dresses, they are now convinced and ready! Breast surgery should be done 6-8 weeks prior to the wedding day for swelling.

Skin Care

Skin care is something that should begin immediately! If you are considering a facial you may want to talk with your aesthetician about a series of them. Most likely a chemical peel will be recommended to give you that natural glow back on your face. Chemical peels help reduce fine lines and wrinkles, acne scars and pigmentation. Chemical peels should be done 2 weeks prior to your wedding day to allow the shedding of old skin and redness to calm down.

Your skin tells a story, so why wait until later in life to start caring for it. Nurture it with the right skin care products and always wear sunscreen. The benefits will last for many years!

At Robbins Plastic Surgery, we offer FREE skin care consultations. Call today to make your appointment 615-237-5552

Studies show that an average adult needs between 7.5 and 8 hours of sleep per night. But many people can function with 6 hours’ sleep, and there are also some who need 9 hours or more. The amount of sleep needed to function the next day varies from individual to individual however there’s a strong relationship between sleep and health. As your health improves, your sleep improves — and vice versa.

If You Snooze You Lose

The lack of sleep affects your health but what you may not know is what it can do to your sex life, memory, skin health and even the ability to lose weight. Lack of sleep seems to be related to an increase in hunger and appetite, and possibly to obesity. People who sleep less than six hours a day were almost 30 percent more likely to become obese than those who slept seven to nine hours.

You Look Tired

Most people have experienced sallow skin and puffy eyes after a few nights of missed sleep. But it turns out that chronic sleep loss can lead to lackluster skin, fine lines, and dark circles under the eyes and causing the comment “you look tired”. When you don’t get enough sleep, your body releases more of the stress hormone cortisol. In excess amounts, cortisol can break down skin collagen, the protein that keeps skin smooth and elastic.

At Robbins Plastic Surgery we can assist with your skin care products to help your overall skin health. We offer FREE skin consultations with our educated nurses. Call today to schedule your appointment 615-237-5552.

When you choose a doctor who is a member of the American Society of Plastic Surgeons (ASPS), you can rest assured your surgeon is qualified to perform your surgery.

Why is it so important to have a board-certified surgeon? Because legally any doctor is permitted to do any procedure — a psychiatrist could do a breast augmentation. If you use a board-certified plastic surgeon, you know he or she has completed three to five years of training in general surgery and a minimum of two to three years of training in plastic surgery, plus they have to take written and oral tests, according to Dr. Chad Robbins of Robbins Plastic Surgery. Board-certified plastic surgeons also have to do continuing medical education and take a written test every 10 years.

Reviews, Reviews, Reviews

Looking up reviews and testimonials can also help you decide on a surgeon. Most reviews will give you information based on their experience with the doctor, their surgery and care after as well as the doctor’s staff. That’s the beauty of technology today… information at your finger tips!

Consultation To Meet The Doctor

Making an appointment to meet with the doctor is very important in choosing the right surgeon for you. Be prepared. Have a list of questions to ask the doctor and his nurse. You will get a good sense of the doctor’s bedside manner as well as a sense of comfort in his abilities and knowledge.

Before and After Pictures

Visit the doctors website and view the before and after gallery. If you don’t find what you are looking for, ask the doctor or nurse if there are any pictures in the office you can view as some patients do not give consent to put their photos online but are willing to use in office only. Patient privacy is and should be a concern for you as well as the office.

If you are interested in having cosmetic surgery in the Nashville, Franklin or Clarksville TN area, please call Dr. Chad Robbins for a personal consultation today at 615-401-9454 or visit our website rsi351w1.wpengine.com

There are a lot of products to choose from, but silicone should be one of the key ingredients.

Although Mederma, an onion extract derivative active ingredient, may help keep the scar hydrated, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, sunscreen, etc)

Primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, sunscreen, etc)

bioCorneum+ works by hydrating scarred areas, helping the scar to mature through its normal collagen synthesis cycles. This improves the appearance of the scar, and bioCorneum+ has the added advantage of providing sun protection with its SPF 30 rating. Upon application, the bioCorneum+ gel forms a transparent silicone layer over your skin. This waterproof sheet of silicone breathes and flexes. bioCorneum+ gets its name from the stratum corneum, the outer layer of dead skin cells with which the gel binds to protect your healing skin from chemical, biological, and physical harm. In addition to relieving the itching and discomfort of scarred skin, bioCorneum+ has been proven to flatten, soften, and smooth scars, and to reduce discoloration. bioCorneum+ is the only patented silicone scar treatment to offer sun protection factor (SPF) 30, which helps protect healing scars from the darkening effects of sunlight.

Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.

To inquire or purchase BioCorneum+ scar cream, call Robbins Plastic Surgery at 615-401-9454

Myths & Facts about Latisse®

Latisse® is a popular prescription product that is used to increase the thickness and length of eyelashes and deepen their color. When used as directed, it doubles the thickness of eyelashes and makes them 25 percent longer. It is safe and 100 percent effective, but several myths about the product persist. Dr. Chad Robbins in Nashville, TN recommends the product and offers the following clarification.

Does Latisse® Change the Color of Blue Eyes?

When used correctly, there is no evidence that the treatment changes eye color. The active ingredient in the product was originally marketed as a treatment for glaucoma and applied directly into the eye. Delivered in this fashion, the drug did sometimes darken hazel eye colors. However, when applied to the lashes alone, this side effect has not been reported.

Will It Affect Eyesight or Cause Blindness?

The product will not cause blindness or any vision changes, even if it is accidentally applied directly into the eyes.  Latisse® is very safe and effective product.

Can It Permanently Darken the Lash Line?

A few patients have experienced some darkening of the lash line, but this is temporary and reversible upon discontinuing the product.

To see if Latisse® is right for you, visit Robbins Plastic Surgery for a professional evaluation.

Why Sun Protection Matters Every Day!

The sun is essential to good health and contributes to a sense of well-being. However, unprotected exposure to the sun’s ultraviolet (UV) rays can cause premature skin aging and skin cancer.    People of all skin colors get skin cancer. In fact, more than 3.5 million people are diagnosed each year in the United States.  Dr. Chad Robbins of Robbins Plastic Surgery recommends and personally uses EltaMD sunscreens. Listed are some facts about skin cancer and the importance of using a sunscreen everyday!

1. There are more cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colorectal.
2. UVA rays age skin cells and can damage their DNA. These rays are linked to long-term skin damage such as wrinkles, but they are also thought to play a role in some skin cancers.
3. Daily use of a broad-spectrum sunscreen decreases the risk of skin cancer and early skin aging caused by the sun when used with other sun protection measures.
4. EltaMD broad-spectrum sunscreens contain zinc oxide, a mineral compound, to protect skin against UVA and UVB rays.

Cosmetically elegant and photostable, EltaMD sunscreens are fragrance-free, sensitivity-free, paraben-free and noncomedogenic. Ask your physician or skin care professional to recommend EltaMD sunscreens that are just right for your skin type and lifestyle.

THINK ZINC FOR SERIOUS UV PROTECTION 

Zinc oxide means true broad-spectrum protection.  Zinc oxide blocks the widest spectrum of UVA and UVB rays, protecting the skin from premature aging and sunburn. Zinc is safe for even the most sensitive skin types.

UVB Rays: The Burning Rays

• Mostly affect the outer layer of the skin.
• Cause sunburns and tanning that increase the risk of skin cancer.
• Vary with time of the day and seasons.
• Are stronger in the summer.

UVA Rays: The Aging Rays

• Deeply penetrates skin layers, damaging collagen and cells.
• Causes wrinkling, loss of elasticity, and pigmentation.
• Are up to 50 times more prevalent than UVB rays.

What sun protection measures are important?

• The American Academy of Dermatology recommends use of a broad-spectrum sunscreen with SPF of 30 or higher.1
• Limit time in the sun, especially from 10 am to 2 pm
• Wear protective clothing and sunglasses

How do antioxidants benefit the skin?

Antioxidants help combat skin-aging free radicals associated with ultraviolet (UV) and infrared radiation (IR). Many EltaMD products contain antioxidants such as quercetin, ascorbyl palmitate (vitamin C ester), tocopheryl acetate (vitamin E) and thioctic acid.

To purchase your EltaMD sunscreen, call 615-401-9454 or visit rsi351w1.wpengine.com

What is the right process for applying your skin care products?

The million dollar question…..in what order do I apply my skin care products??

Sequence matters but, why?

The proper order of application allows your skin to receive the maximum benefits of each product.  Therefore, the products will illicit the full amounts of efficacy as the products work synergistically to enhance your skin results.

Another important factor to consider is the time it takes for your skin to absorb your products.  Order is important, but timing is more crucial.  The main goal is results and efficacy and in order for that to be obtained the skin has to absorb the ingredients, so allow at least a minute between each application.

So, which product goes on top of what?

A simple tip is to apply your products from thinnest to thickest or from liquid to oil. During the day most experts recommend a simple cleanser, scrub, toner, antioxidants, corrective products, skin strengthening products, eye creams and of course, sunscreen. At night, that’s when you load up on skin care actives.

Step 1: Cleanse

Step 2: Scrub (2-3 times a week)

Step 3: Oil Control or Tone

Step 4: Correct

Step 5: Stabilize/Strengthen

Step 6: Stimulate

Step 7: Protect

This order of application allows for greater absorption of ingredients, it’s very important to remember you have to support the skin before you stimulate the skin.  The best analogy I have is, “You have to build the house before you install the windows” Which means, the skin needs to complete a 6-8 week cycle of these steps, cleanse-scrub-oil control or tone-stabilize which means strengthen and always protect.  Once, that initial phase is complete then schedule a follow up to begin correction and stimulation.

My very best advice is to schedule an initial consult with one of Dr. Robbins Skin Care experts to get started on this skin care journey and remember be kind to your skin, it loves you.

In Skin Health,

Bri Adcock, LME

ZO Skin Health Representative

Inverted Nipple Repair

Inverted nipple repair is a relatively simple procedure that can be done under local anesthetic. It takes only minutes and there is no down time. Inverted nipples are not uncommon and can be reverted with an in-office procedure and a relatively straight forward recovery. I would generally recommend that you consider the procedure when your family is complete or if you know for sure that you won’t/can’t breast feed. The reason for this is that there is a chance that milk ducts will be irreversibly injured during the procedure.

If you are worried about sensation, usually patients maintain nipple sensation following repair of inverted nipples. If there is a decreased sensation at first, it typically improves over time. There is some risk of diminished sensation, but it is not common.

The repair can easily be combined with other procedures such as breast augmentation or breast lift and that would require general anesthesia.

If you are embarrassed by an inverted nipple, call our office to schedule your consultation with Dr. Robbins. During your visit you will be informed of the procedure and have all your questions answered. Call 615-237-5552 or visit rsi351w1.wpengine.com

Capsular contracture is the term used to describe scar tissue that can form around breast implants which may cause the breasts to harden, look or feel different, and may cause some discomfort from the tightening of the capsule. Capsular contracture is the most common yet unpredictable complication following breast augmentation.  Although we do not know what causes a capsular contracture to form in one woman and not in another, or why one breast may harden while the other remains completely soft and natural, there are some techniques that have reduced the risk in our patients.

(Before and After)

Capsular Contracture can be associated with the following:

• Infection
• Hematoma
• Saline Implants
• Sub glandular placement of Implants
• Radiation
• Nicotine
• Diabetes
• Collagen Vascular Disease
• Rheumatoid Arthritis
• Lupus
• Sjogren’s Disease

*Although there are no scientific studies linking nicotine and capsular contracture however there are multiple studies that show harmful effects of smoking and nicotine itself on wound healing after surgery.

No one can predict the outcome or prevent capsular contracture however there are some things to consider that are low risk- a healthy patient, sub-muscular placement of implants, using textured and form stable implants.

How is Capsular Contracture Diagnosed?

A capsular contracture is usually diagnosed on physical examination by a plastic surgeon. You may notice that one or both of your breasts are not as soft as they once were or may actually begin to harden, your breasts may begin to look or feel different, or you may experience some discomfort from the tightening of the capsule.

Dr. Robbins will examine you to determine if indeed you have a capsular contracture. The examination of each breast is classified on a Baker scale of I to IV:

Grade I: The breast is soft and normal

Grade II: The breast is less soft than normal, and the implant can be palpated

Grade III: The breast is firm, the implant can be palpated easily, and an asymmetrical distortion of shape can be appreciated

Grade IV: The breast is hard, tender, painful, and the shape distortion is pronounced or severe

Treatment for Capsular Contracture

Capsulectomy (complete removal of the scar capsule).

For those patients without significant softening, the only other effective treatment is to completely remove the scar tissue surrounding the implant. Although this does not eliminate the possibility of future scar tissue forming around the implant, it does reduce the risk of subsequent capsular contracture.

If you think you may have capsular contracture or would like more information, please visit us at rsi351w1.wpengine.com or call 615-237-5552 to schedule your appointment with Dr. Robbins.

Our options for restoring facial volume have expanded over the years with muscle relaxation via neurotoxins such as Botox, and the evolution of how fat atrophy in the face leads to stereotypical architectural changes with aging. Plastic surgeons can now add volume to refresh the face. In order to achieve a youthful but natural appearance for my patients, I use a combination of muscle balancing, skin resurfacing and tightening, as well as volume restoration. Ultimately, we will all face the battle of gravity and may require surgery to remove excess skin.

Ways to Achieve Volume

One way to restore facial volume is by using hyaluronic acids as a direct filler. Another option is a lactic acid (Sculptra), which acts as an inflammatory material inducing collagen synthesis to create a guided tissue volume additive over time. Both are easily administered in the office without any donor site pain or bruising. While these procedures are easy and safe, it takes experienced hands, eyes and judgment to achieve the best outcomes. Results can be expected to last up to two years.

Fat grafting is another source of filler material to restore volume to the face. Fat is easily harvested from the abdomen or the thighs to use in the face. The technique is a gentle form of liposuctioning, which then requires a minimal amount of processing followed by reinjection into the desired locations. In the office setting under local anesthesia, patients may not enjoy some of the pressure sensations required to obtain the fat.  The advantage of fat is that it is cheaper to obtain than manufactured materials. In most cases, there is a relatively unlimited supply. Furthermore, peripheral stem cells may direct cellular differentiation leading to improved tissue quality.

Fat vs. Fillers

Fat is certainly more technically demanding and unforgiving. For injections around the eyes to smooth the eyelid cheek junction, I prefer hyaluronic acid. When injected smoothly with appropriate application, no lumps or bumps should occur. In the lips, when I am working to recreate vertical ridges of the phyltral columns of the upper lip and “Cupid’s bow” points, as well as a nice rolled margin of the lip, I prefer hyaluronic acid because it is the consistency of caulking material and can provide shape. Fat is soft, and does not exert force on the skin in the same way as fillers. However, recent research from the University of Texas Southwestern Medical Center demonstrates excellent results of restoring large volume loss of the upper lip beyond the vermillion by placing fat cells in a broad area, making the loose skin less apparent.

With regard to the common area of deflation of the sub-malar fat pad in a non-surgical case, I prefer the highly crosslinked stiff material of Voluma, which does an excellent job of re-supporting the facial structures to a more youthful position. If I am already performing a surgical case of a face or neck lift, I often  add volume to the face prior to elevating the tissue; this is when I choose fat, because of the ease of harvest and injection under anesthesia. Some thin women may show very demarcated loss of volume in the temple area giving the face a skeletonized appearance around the eyes and making the brows seem to sag. This is an excellent indication for Sculptra.

Fat grafting is an evolving technique in plastic surgery. Every industry conference has a significant discussion about the techniques and the science behind the results, with just about every region of the body applicable to its uses, including face, breast, hand, buttock and other contour deformities. For the early stages of facial rejuvenation, which can occur in the third decade of life and beyond, much of the volume restoration is performed with off-the-shelf filler agents in an office setting due to ease and convenience.

For more information on Fat Grafting or Fillers, please call our office (615) 237-5552 to schedule a consultation to see if you are a good candidate for fat grafting.  rsi351w1.wpengine.com