Liposuction is the most common plastic surgery procedure done in the United States. There has been much publicity about new laser liposuction techniques which are heavily marketed. While these techniques are very exciting and promising, the technology and promotion have outpaced the development of safe effective treatment methods and the best laser technology.

Early use of the Smartlipo, possibly in incapable hands, has resulted in burns, contour deformities, and broken laser tips left in patients. While I believe in the future of laser liposuction and have incorporated laser liposuction in my practice, I am using newer technology which I believe to be much safer and more effective.

Palomar™ Medical has just introduced SLIMLIPO™ a new laser liposuction technology which may well revolutionize the way liposuction is done. The word SLIM™ stands for Selective Laser Induced Melting and what is new is the laser wavelength-920 and 920/980 nm- which selectively melts fat-3 times more than SmartLipo™and 5 times more than the 1320nm laser used in the CoolLipo™ device.

As importantly Palomar is using new patented laser fiber technology which is very sturdy and eliminates the problem of fiber breakage.

In some patients with smaller fat deposits we can melt the fat with the SLIMLIPO™ laser fiber and use no suction to remove the dissolved fat. This means less bruising, less trauma, and quick recovery.

New laser liposuction technology is revolutionizing the way liposuction is done. Benefits of the new laser liposuction technique are

· The laser selectively dissolves fat unlike standard liposuction which can destroy all tissues.

· The laser closes blood vessels=less bleeding, less bruising

· The laser tightens skin=less loose skin after liposuction

· Laser liposuction is less traumatic=quicker recovery

· The laser fiber is tiny= smaller scars

· Smaller areas done under local anesthesia

All laser liposuction machines are not equal. You need to understand the importance of the laser wavelength used to melt fat. Most laser liposuction machines on the market today use a 1064nm or 1320nm laser wavelength. Actually the best wavelength which is most highly absorbed by fat is 920nm, a wavelength patented and owned by Palomar™ Medical in Burlington, Massachusetts.

The SLIMLIPO™ Aspire™ Liposuction Unit is the first 920nm based laser liposuction and is 3 times as selectively absorbed by fat as the 1064nm lasers and 2 times more than the 1320nm-the other commercially available laser liposuction technology. It is also 5 times as selectively absorbed by blood. This means that the SLIMLIPO™ Aspire™ laser liposuction unit dissolves fat and prevents bleeding much more effectively than any other laser liposuction machine available. See the figure below for comparison of the fat melting selectivity of the various laser liposuction units available today-remember, Palomar’s new SLIMLIPO uses the 920nm laser:

For you the patient this translates into:

· Gentler more thorough fat removal

· Less bleeding, less bruising

· Quicker recovery

We also can blend in a 980nm laser wavelength with the Aspire™ which is highly absorbed by the Dermis-the deep layer of your skin which controls skin tightening. For you this translates into:

· Tighter skin after liposuction

· Less risk of revisional surgery after liposuction

I am proud to say that we helped Palomar™ develop this revolutionary new laser and we are the first to offer SLIMLIPO™ with the Aspire™ laser liposuction unit in Massachusetts and the Boston area and one of the first practices in the world to have this machine.

If you are considering laser liposuction you really need to know the facts and understand the technology. Once you do the advantages of SLIMLIPO™ with the Aspire™ system are obvious-there is nothing else like it on the market.

For more information on laser liposuction or plastic surgery in general call 978-369-4499 or visit my website.Be sure to sign up for my free email newsletter for information on the latest advances in plastic surgery and non-surgical rejuvenation procedures.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

Liposuction is the most common plastic surgery procedure done in the United States.

Palomar™ Medical has just introduced SLIMLIPO™ a new laser liposuction technology which will revolutionize the way liposuction is done. The word SLIMLIPO™ stands for Selective Laser Induced Melting and what is new is the laser wavelength-920 and 920/980 nm- which selectively melts fat-3 times more than SmartLipo™and 5 times more than the 1320nm laser used in the CoolLipo™ device.

In some patients with smaller fat deposits we can melt the fat with the tiny SLIMLIPO™ laser fiber and use no suction to remove the dissolved fat. This means less bruising, less trauma, and quick recovery.

New laser liposuction technology is revolutionizing the way liposuction is done. Benefits of the new laser liposuction technique are

· The laser selectively dissolves fat unlike standard liposuction which can destroy all tissues.

· The laser closes blood vessels=less bleeding, less bruising

· The laser tightens skin=less loose skin after liposuction

· Laser liposuction is less traumatic=quicker recovery

· The laser fiber is tiny= smaller scars

· Smaller areas done under local anesthesia

All laser liposuction machines are not equal. You need to understand the importance of the laser wavelength used to melt fat. Most laser liposuction machines on the market today use a 1064nm or 1320nm laser wavelength. Actually the best wavelength which is most highly absorbed by fat is 920nm, a wavelength patented and owned by Palomar™ Medical in Burlington, Massachusetts.

Palomar has introduced the SLIMlipo™ Aspire™ Liposuction Unit which is the first 920nm based laser liposuction and is 3 times as selectively absorbed by fat as the 1064nm lasers and 2 times more than the 1320nm-the other commercially available laser liposuction technology. It is also 5 times as selectively absorbed by blood. This means that the SLIMLIPO™ Aspire™ laser liposuction unit dissolves fat and prevents bleeding much more effectively than any other laser liposuction machine available. See the figure below for comparison of the fat melting selectivity of the various laser liposuction units available today-remember, Palomar’s new SLIMLIPO uses the 920nm laser:

For you the patient this translates into:

· Gentler more thorough fat removal

· Less bleeding, less bruising

· Quicker recovery

We also can blend in a 980nm laser wavelength with the Aspire™ which is highly absorbed by the Dermis-the deep layer of your skin which controls skin tightening. For you this translates into:

· Tighter skin after liposuction

· Less risk of revisional surgery after liposuction

I am proud to say that we helped Palomar™ develop this revolutionary new laser and are the first to offer SLIMLIPO™ with the Aspire™ laser liposuction unit in Massachusetts and the Boston area and one of the first practices in the world to have this machine.

If you are considering laser liposuction you really need to know the facts and understand the technology. Once you do the advantages of SLIMLIPO™ with the Aspire™ system are obvious-there is nothing else like it on the market.

For more information on laser liposuction or plastic surgery in general call 978-369-4499 or visit my website.Be sure to sign up for my free email newsletter for information on the latest advances in plastic surgery and non-surgical rejuvenation procedures.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

I have heard recent reports that some doctors are experimenting with removing eye bags and treating puffy eyes with laser liposuction.

My sincere and best professional medical opinion is that liposuction should not be performed around the eyes at this time. Placing a liposuction cannula into the tissue around the eye is a blind procedure, meaning the operator cannot see the structures that are being treated with the cannula. Furthermore, suctioning the delicate tissues beneath the eyelid is extremely dangerous.

In addition, using the laser liposuction technique around the eye is even more dangerous. The laser liposuction technique adds the additional risk of laser heat energy which can dissolve tissue and close blood vessels. The delicate blood vessels, muscles, and the eyeball itself are vital structures which are necessary for vision. To “blindly” place a laser fiber or suction cannula into these tissues is dangerous.

The eye muscles, blood vessels, and the globe or eyeball could all be damaged by the liposuction cannula. Suctioning with negative pressure near these delicate structures could result in very serious complications including blindness.

There have already been reported cases of blindness following injection of soft tissue fillers such as fat, Restylane®, and Radiesse® into dark circles under the eye. In my opinion using liposuction around the eye is even more dangerous.

Your eyelids are very complex, delicate, vital structures. Any invasive procedure such as an injection or surgery to treat eye bags or puffy eyes should only be performed by an experienced, board certified plastic or occuloplastic surgeon who is experienced in eyelid surgery.

I strongly advise you to avoid liposuction or laser liposuction to treat eye bags, puffy eyes, or any other condition around the eyelids.

At this point in times such procedures are experimental and dangerous.

To learn more about eyelid surgery or removal of eye bags and puffy eyes please visit my website, read Save Your Face, or call 978-369-4499.

Dr. Seckel

Concord, Massachusetts

Boston, Massachusetts

Nearly everyone over 30 years old sees wrinkles, loose skin and other signs of facial aging staring back at them in the mirror. Many would like to have a fresher younger looking face like that achieved with a face lift like below

Contact Dr Seckel

but no one wants to have a face lift or plastic surgery; everyone is looking for the non-surgical face lift.

In recent years technological advances such as Botox, and fillers like Restylane and Radiesse, and new Lasers, IPL and skin tightening machines like Thermage®, Titan®, LuxIR®, and Aluma®, have improved the plastic surgeons ability to rejuvenate the face non-surgically, but none have been able to deliver the often promised non-surgical facelift. Improvement in jowls, neck laxity, nasal labial folds and marionette lines have all required a surgical face lift. The best results of non-surgical skin tightening, the so called non-surgical facelift have achieved about a 30 % tightening of the facial skin. Dramatic results have been achieved in wrinkle removal when proper techniques have been applied, but true lifting or tightening of the facial skin, the non-surgical face lift has been modest at best

The new LaserLyte Lift™ is non-surgical face lift which promises to achieve a much more significant rejuvenation and lifting of the face. The LaserLyte Lift™ is a new non-surgical multi-modality technique in three phases which not only tightens the facial skin and subcutaneous fatty and fibrous tissue, but also removes wrinkles and other aging changes on the surface of the skin.

This new non-surgical high tech face lift or facial rejuvenation procedure is based on the theory that all of the skin layers must be treated and rejuvenated to accomplish true facial rejuvenation and is based on the principles of the 6-step non-surgical facial rejuvenation program outlined in my book Save Your Face.

The important changes in the facial skin which lead to an aged appearance occur predominantly in all facial skin layers-the epidermis or outer layer that you see in the mirror, and two deeper layers-the superficial and the deep dermis—and the deep subcutaneous fat and fibrous layers beneath the dermis.

As we age, the sun’s UV rays, and other age related factors damage all 3 layers of the skin. We see these changes in the form of wrinkles, brown spots and dry skin-changes in the Epidermis or outer layer. However the major changes causing wrinkles and sagging skin is damage to the 2 deeper layers of the dermis and the subcutaneous fat and fibrous tissue.

The result of aging changes in both layers of the dermis is the loss of collagen. Collagen plumps the skin and gives the skin its tone and elasticity. When we lose collagen from the dermis the skin loses volume and becomes wrinkled-the same way a plum turns into a prune when it loses water after drying. In addition when we lose collagen we lose elasticity, the skin does not snap back when we pull on it and release it, and the skin sags. The aging changes in the deep dermis, the subcutaneous fat and fibrous tissue cause loss of volume and elasticity which result in sagging.

The key to non-surgical facial rejuvenation or a non-surgical facelift is to remove the superficial aging changes from the superficial epidermis, restore new collagen to both the superficial and deep layers of the dermis and tighten the subcutaneous fat and fibrous tissue.

Contemporary non-surgical methods such as laser, IPL or Photo Facial, Radiofrequency (Aluma®, Thermage®), and Infrared (LuxIR®, Titan®,) energies are capable of treating the surface of the skin and the deep dermis, but do not treat the middle layer of the dermis and thus cannot achieve complete non-surgical rejuvenation or a non-surgical face-lift.

New technology has finally enabled us to treat both the middle and deep skin layers and the subcutaneous fat and fibrous layers of the skin.

This procedure is called the Laserlyte Lift™ because Laser and other forms of light (lyte) energy are used to treat all of the aged skin layers. The procedure takes time, as it requires multiple treatments scheduled several weeks apart over a time course of several months. However the results are striking-you can see them and believe them—you don’t have to try to convince yourself that they are there as you have with so many “miracle wrinkle cures” you have tried in the past.

The Laserlyte Lift™ the true laser face lift or non-surgical face lift involves three treatment protocols or phases.

Phase I begins with the important first 2 steps of the 6-step non-surgical facial rejuvenation program deep exfoliation and stimulation of new collagen growth near the surface of the skin. This phase removes wrinkles, brown spots and restores the skins shiny glow. This is the Laserlyte peel achieved with the Lux2940 ablative fractional laser. This peel is performed with a topical skin anesthetic, takes 25 minutes, and leaves you pink for 4-5 days. Some people only need one peel others may need 2 or 3. These peels are scheduled 6-8 weeks apart

Phase II begins about 6 weeks after your first ablative laser peel and is the start of your skin plumping and skin tightening regimen through stimulation of new collagen growth in the middle and deep dermal layer by the application of laser and Infrared or other energy which penetrates through the epidermis and superficial dermis to the mid and deep dermis, to restore collagen and elasticity and tighten the facial skin. I use the Lux1540 and LuxIR Skin Tightening Technology by Palomar. Treatments are spaced 4 weeks apart and at least 4 sessions are required.

The start of Phase III, deep sub dermal skin and fat tightening provides significant firming and lifting of the facial skin. The new Palomar™ Aspire™ sub dermal laser stimulation provides powerful tightening of the of the deep dermal and sub dermal layers. This maneuver also tightens and lessens the fat beneath the skin which adds to the aged facial appearance. If you only need one peel Phase 3 can begin as early as 2-3 months and be alternated with Phase 2 at 2-week intervals. If you need 3 LaserLyte Peels then Phase 3 will not begin until 5-6 months.

While the Laserlyte Lift™ , the laser face lift or true non-surgical face lift, takes time it is the only method of non-surgical facial rejuvenation to actively treat all three layers of the skin and thus the only method to achieve an effective non-surgical facelift. In fact, the Laserlyte Lift™ achieves more thorough facial rejuvenation than a surgical face lift. A surgical face lift only tightens the skin, after a facelift you have tight “old” skin. The Laserlyte Lift™ renews and rejuvenates all three skin layers, thus when you are finished your face truly looks younger as well as tighter, a true facial rejuvenation and a real non-surgical facelift, and remember, you are avoiding surgery and its dangers and discomfort. More importantly you are achieving true facial rejuvenation with wrinkle removal and new collagen, which plumps and tightens your skin to a truly youthful appearance.

As technology advances we undoubtedly will be able to achieve results is less time. However at present the Laserlyte Lift is the only method for an effective non-surgical facelift and rejuvenation of all three skin layers and it takes

For some people with very severe aging plastic surgery will be the best option, either in the form of a traditional facelift or laser resurfacing, or both.

But for the vast majority of my patients who I see daily in my practice the Laserlyte Lift™ is an excellent way to achieve true facial rejuvenation without surgery a real non-surgical face-lift, with results you can see. No face cream, diet, laser, IPL, or other technology alone can achieve as good a result.

If you start before you have severe aging changes you will likely never need to have a facelift.

You may contact me for further information, read Save Your Face, or call 978-369-4499.

Dr Seckel

Boston, Massachusetts

Concord, Masachusetts

There is much confusion regarding what people mean when they say they have dark circles under the eyes, often referred to as the tired look.

Contact Dr Seckel

There are 4 different conditions which can cause dark color beneath the eyes or under the eyelids which people call dark circles under the eyes:

1. Dark purple skin color on the lower eyelid skin
2. Brown pigment on the lower eyelid skin
3. A hollow eye appearance in which the lower eyelid is sunken in
4. A depression or deep line along the lower edge of the eyelid just above the cheek called the naso-jugal fold or tear trough deformity, the true dark circle under the eyelid and most common form of dark circle under the eyes

1. Dark Purple Color of the Lower Eyelid Skin

When the skin of the lower eyelid is a dark purple or bluish color people often say they have dark circles under the eyes. If you look closely EVERYONE has darker skin color on the lower eyelid than on the skin of the rest of the face. This is because the lower eyelid skin is the thinnest skin on the face, so thin that you can see through the skin and see the purple color of the eyelid muscle showing through the skin. This is dark purple eyelid skin color not dark circles under the eyes.

In people with thicker skin the color looks more bluish, but everyone’s lower eyelid skin is darker because of the color of the muscle beneath the thin skin. There are familial and racial differences in skin thickness and muscle color so there is great variation in the darkness of lower eyelid skin. I do not call this normal phenomena dark circles under the eyelid, rather I refer to it as a dark purple lower eyelid. The only solution for this problem is to use a cover up make up like Covermark® or Dermablend®.

2. Brown Pigment on the Lower Eyelid Skin

Sun damage to the skin, birth control pills and other medications, and the “mask of Pregnancy” and other metabolic conditions can cause the deposition of brown pigment in the lower eyelid skin. This is not called dark circles under the eyes but is called hyperpigmentation.

The treatment is the removal or correction of the underlying cause-stop the medication, sun protection etc. Once the cause is corrected there are several remedies. Skin bleaching agents such as hydroquinone and Kojic Acid can help as can microdermabrasion. The Lux2940 ablative fractional laser, a deep exfoliation technique can also be helpful.IPL also called Photo Facial can also help. A new laser, the the Lux2940 is the most up to date method for removing superficial eyelid skin pigmentation. Very goods results can be achieved with these modalities.

3. A Hollow Eye Appearnce

Some people have a very sunken in or hollow eyes appearance which some mistakenly call dark circles under the eyes. This is caused by a deficiency of the normal fat which surrounds the eyeball and plumps the lower eyelid skin. This deficiency of fat can be caused by heredity, racial factors, malnutrition, general disease, dehydration or trauma to the orbital bone which supports the eyeball.

The correction involves the treatment of the underlying disease or medical problem when there is a medical cause.

For people who have this appearance because of heredity or racial factors, the fat must be grafted into the lower eyelid to replace the deficiency. I do this by performing a blepharoplasty through an incision on the inside pink portion of the lower eyelid called the transconjunctival approach. This avoids a scar on the outside of the lower eyelid. I then harvest or take fat from an area of the body where the fat will not be missed (hip or abdomen) and transplant the fat to the lower eyelid to plump the lower eyelid.

4.The Naso-jugal Fold or Tear Trough Deformity-the True Dark Circles Under the Eyes.

The true dark circles under the eyes is a crease or depression starting at the nose and running towards the outside of the lower eyelid running at the bottom of the eyelid just above the cheek. This dark circle or depression looks dark because it is attached to the underlying bone of the rim of the orbit or eye socket, and the unattached skin of the lower eyelid above the depression is free to move and bulge and creates a shadow which gives the crease a dark color. The cheek skin below the dark circle is also free to move and bulge and is higher than the dark circle, which contributes to the shadow.

The dark circle under the eye or naso-jugal fold or tear trough gets worse or deepens as we age because the eyelid above and cheek below begin to sag with aging but the dark circle is attached to bone and cannot sag with the rest of the skin, so the lower eyelid skin hangs over more from sagging and bulging of fat, the depression deepens, the shadow gets worse and the dark circle becomes more noticeable. The dark circles under the eyes or tired look is the first thing that causes most people to seek facial rejuvenation. Usually there are eyelid wrinkles and crow’s feet and facial skin wrinkles occurring at the same time. As the eylid ages, fat pushes out on the lower eyelid causing eyelid bags.

The dark circle or naso-jugal fold or tear trough is tethered or held tight to the bony rim of the eye socket bone by a condensation of eyelid tissue called the arcus marginalis.

To correct thbags and dartk circles under the eyes I perform an eyelid rejuvenation procedure called a laser transconjunctival blepharoplasty. During the procedure I release the arcus marginalis, a condensation of eyelid tissue connected to the bone of the eye socket which frees up the dark circle or naso-jugal fold. Once the dark circle is released the dark circle skin is free to move with the lower eyelid skin and the cheek skin and the dark circle or shadow is lessened. To prevent re-attachment of the arcus marginalis and to plump up the dark circle I place a fat graft underneath the dark circle. Some surgeons place an implant called a tear trough implant under the dark circle but I usually use fat.

Correction of bags and dark circles under the eyes, also called the naso-jugal fold or tear trough deformity requires proper diagnosis. This condition needs to be differentiated from dark purple eyelid color, hyperpigmentation and hollow eyes. The correction of true dark circles under the eyes requires a blepharoplasty operation with arcus marginalis release and fat grafting or tear trough implants.

To learn more about dark circles under the eyes read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

There is much confusion regarding what people mean when they say they have dark circles under the eyes, often referred to as the tired look.

Contact Dr Seckel

There are 4 different conditions which can cause dark color beneath the eyes or under the eyelids which people call dark circles under the eyes:

1. Dark purple skin color on the lower eyelid skin
2. Brown pigment on the lower eyelid skin
3. A hollow eye appearance in which the lower eyelid is sunken in
4. A depression or deep line along the lower edge of the eyelid just above the cheek called the naso-jugal fold or tear trough deformity, the true dark circle under the eyelid and most common form of dark circle under the eyes

1. Dark Purple Color of the Lower Eyelid Skin

When the skin of the lower eyelid is a dark purple or bluish color people often say they have dark circles under the eyes. If you look closely EVERYONE has darker skin color on the lower eyelid than on the skin of the rest of the face. This is because the lower eyelid skin is the thinnest skin on the face, so thin that you can see through the skin and see the purple color of the eyelid muscle showing through the skin. This is dark purple eyelid skin color not dark circles under the eyes.

In people with thicker skin the color looks more bluish, but everyone’s lower eyelid skin is darker because of the color of the muscle beneath the thin skin. There are familial and racial differences in skin thickness and muscle color so there is great variation in the darkness of lower eyelid skin. I do not call this normal phenomena dark circles under the eyelid, rather I refer to it as a dark purple lower eyelid. The only solution for this problem is to use a cover up make up like Covermark® or Dermablend®.

2. Brown Pigment on the Lower Eyelid Skin

Sun damage to the skin, birth control pills and other medications, and the “mask of Pregnancy” and other metabolic conditions can cause the deposition of brown pigment in the lower eyelid skin. This is not called dark circles under the eyes but is called hyperpigmentation.

The treatment is the removal or correction of the underlying cause-stop the medication, sun protection etc. Once the cause is corrected there are several remedies. Skin bleaching agents such as hydroquinone and Kojic Acid can help as can microdermabrasion. The Lux2940 ablative fractional laser, a deep exfoliation technique can also be helpful.IPL also called Photo Facial can also help. A new laser, the Lux2940 is the most up to date method for removing superficial eyelid skin pigmentation. Very goods results can be achieved with these modalities.

3. A Hollow Eye Appearnce

Some people have a very sunken in or hollow eyes appearance which some mistakenly call dark circles under the eyes. This is caused by a deficiency of the normal fat which surrounds the eyeball and plumps the lower eyelid skin. This deficiency of fat can be caused by heredity, racial factors, malnutrition, general disease, dehydration or trauma to the orbital bone which supports the eyeball.

The correction involves the treatment of the underlying disease or medical problem when there is a medical cause.

For people who have this appearance because of heredity or racial factors, the fat must be grafted into the lower eyelid to replace the deficiency. I do this by performing a blepharoplasty through an incision on the inside pink portion of the lower eyelid called the transconjunctival approach. This avoids a scar on the outside of the lower eyelid. I then harvest or take fat from an area of the body where the fat will not be missed (hip or abdomen) and transplant the fat to the lower eyelid to plump the lower eyelid.

4.The Naso-jugal Fold or Tear Trough Deformity-the True Dark Circles Under the Eyes.

The true dark circles under the eyes is a crease or depression starting at the nose and running towards the outside of the lower eyelid running at the bottom of the eyelid just above the cheek. This dark circle or depression looks dark because it is attached to the underlying bone of the rim of the orbit or eye socket, and the unattached skin of the lower eyelid above the depression is free to move and bulge and creates a shadow which gives the crease a dark color. The cheek skin below the dark circle is also free to move and bulge and is higher than the dark circle, which contributes to the shadow.

The dark circle under the eye or naso-jugal fold or tear trough gets worse or deepens as we age because the eyelid above and cheek below begin to sag with aging but the dark circle is attached to bone and cannot sag with the rest of the skin, so the lower eyelid skin hangs over more from sagging and bulging of fat, the depression deepens, the shadow gets worse and the dark circle becomes more noticeable. The dark circles under the eyes or tired look is the first thing that causes most people to seek facial rejuvenation. Usually there are eyelid wrinkles and crow’s feet and facial skin wrinkles occurring at the same time. As the eylid ages, fat pushes out on the lower eyelid causing eyelid bags.

The dark circle or naso-jugal fold or tear trough is tethered or held tight to the bony rim of the eye socket bone by a condensation of eyelid tissue called the arcus marginalis.

To correct thbags and dartk circles under the eyes I perform an eyelid rejuvenation procedure called a laser transconjunctival blepharoplasty. During the procedure I release the arcus marginalis, a condensation of eyelid tissue connected to the bone of the eye socket which frees up the dark circle or naso-jugal fold. Once the dark circle is released the dark circle skin is free to move with the lower eyelid skin and the cheek skin and the dark circle or shadow is lessened. To prevent re-attachment of the arcus marginalis and to plump up the dark circle I place a fat graft underneath the dark circle. Some surgeons place an implant called a tear trough implant under the dark circle but I usually use fat.

Correction of bags and dark circles under the eyes, also called the naso-jugal fold or tear trough deformity requires proper diagnosis. This condition needs to be differentiated from dark purple eyelid color, hyperpigmentation and hollow eyes. The correction of true dark circles under the eyes requires a blepharoplasty operation with arcus marginalis release and fat grafting or tear trough implants.

To learn more about dark circles under the eyes read Save Your Face or contact me.

Dr Seckel

Boston, Massachusetts

Concord, Massachusetts

Many women today are unhappy with the scar following a c section or Caesarian Section. Often the scar contracts and causes a bulge or flap of skin on the lower abdomen which shows under a bathing suit. 

The c section or Caesarian Section scar can be removed with a tummy tuck or abdominoplasty but many women are concerned about the scar caused by the tummy tuck or abdominoplasty procedure. 

A modern mini tummy tuck called the Bikini Tummy Tuck and remove the c section scar and create a flat tummy with a minimal scar which is well hidden beneath a two piece bathing suit or “bikini” underwear.

Above-Before and After the Bikini Tummy Tuck to Remove C-section Scar

The bikini tuck works best when there is small to moderate skin excess of the lower abdomen. The bikini tuck works well to remove the C-Section scar and the flap or bulge above the C-section scar.

Many people want to have a tummy tuck but don’t want a visible scar. By placing the incision low and following the lines of your bikini, the scar is hidden by most bikinis and today’s brief underwear.

There is no scar on the “belly button” with the bikini tummy tuck.

To learn more about the tummy tuck procedure visit drseckel.com or contact me.

Be sure to sign up for my free email newsletter.

Thank you,

Dr Seckel

978-369-4499

Boston, Massachusetts

Concord, Massachusetts

Many women and men have excess skin on the lower abdomen which simply will not go away with diet and exercise. A modern tummy tuck, also called abdominoplasty is an excellent procedure to remove unwanted skin from your tummy. With modern techniques the scar can be hidden under your bikini or swimming suit using the bikini tummy tuck.

Above-Before and After the Bikini Tummy Tuck

The bikini tuck works best when there is small to moderate skin excess of the lower abdomen. The bikini tuck also works well when you have a C-Section scar.

Many people want to have a tummy tuck but don’t want a visible scar. By placing the incision low and following the lines of your bikini, the scar is hidden by most bikinis and today’s brief underwear.

There is no scar on the “belly button” with the bikini tummy tuck.

To learn more about the tummy tuck procedure visit drseckel.com or contact me.

Be sure to sign up for my free email newsletter.

Thank you,

Dr Seckel

978-369-4499

Boston, Massachusetts

Concord, Massachusetts

Laser skin treatments are used for a wide variety of skin conditions. (Contact Dr Seckel)

The most common laser skin treatment or laser skin care procedure available today is laser hair removal but there are many other types of laser skin treatments available today. Laser skin rejuvenation is rapidly becoming the most common laser skin treatments in use today. With regard to the issue of concern to you, wrinkles, fine lines, crow’s feet and facial pigment I group the laser skin care procedures under the broad category of laser skin rejuvenation.

Laser skin treatments for laser skin rejuvenation is used in several different ways to rejuvenate the face and facial skin. Broadly these laser skin care treatments can be classified as follows:

1. Laser Skin Exfoliation or Laser Skin Peel – Lasers can be used to peel or exfoliate the skin to remove dead skin and smooth wrinkles and fine lines. Once the dead skin and surface of the wrinkles are removed by the laser peel, you see new shiny skin on the surface of your face. The skin can form new cells daily and deep laser exfoliation or laser skin peel is a very effective way to stimulate the production of new facial skin cells. Laser skin care for exfoliation or laser peel usually requires some down time for redness and healing because laser skin peel is an ablative laser procedure which means the dead skin cells and wrinkles are ablated or removed so that new skin cells can grow over the facial skin, The first exfoliative laser skin care procedure was laser resurfacing, a very deep laser skin peel, but the recovery time was very long and the skin was lightened, so laser resurfacing is only done today for very deep wrinkles and acne scars. More modern laser skin care for wrinkles and fine lines involves the use of fractional laser resurfacing with de-powered lasers that do not cause as deep a laser peel. Modern laser skin care for wrinkles uses new fractional laser resurfacing using the Lux1540 and Fraxel non-ablative lasers and the newer Lux2940 fractional erbium and Fraxel Repair CO2 lasers. Exfoliative laser skin care is used for treating acne scars as well as facial aging, fine lines and wrinkles and to remove pigment.

2. Laser Stimulation of New Collagen in The Deep Skin Layer, The Dermis – A major cause of wrinkles and acne scars is loss of collagen in the deep layer of the facial skin called the dermis. Sun damage kills the collagen in the dermis of the skin and when the collagen dies the skin loses volume and shrinks and the overlying outer surface of the skin you see wrinkles. This is similar to what happens to a nice plump plum which is dried in the sun, after the plum loses its inner water volume, the skin wrinkles and you have a prune. Laser skin care also describes laser skin procedures which can stimulate the production of new collagen to replace the damaged collagen and plump up the wrinkles and even acne scars in the skin. The laser skin peels do this by irritating the skin as the laser peel is done. The irritation causes inflammation of the skin and when the skin is inflamed the skin responds by forming new collagen. The newer laser skin care techniques are very effective at stimulation of new collagen formation even in the deeper portions of the dermis and are very effective at plumping acne scars and can improve wrinkles. Examples of laser skin care techniques for new collagen production for treatment of facial skin aging and acne scars are the fractional lasers the Lux1540 by Palomar, The fraxel by Reliant technology, and the ActiveFX laser skin peel by Lumenis.

Above-Before and after Lux1540 skin plumping treatment for acne scars

3. Laser Skin Treatment of Pigment and Facial Skin Photo-damage – The aging effects of the sun, called Photo damage, are not only dry skin and wrinkles but also pigment, called brown spots, sun spots, age spots, and “liver spots”. Laser skin care procedures are very effective at removing pigment and photo-damage. The ablative laser skin care procedures such as the laser peel and laser resurfacing strip away the pigment, but only the superficial pigment. Newer Fractional laser skin care treatments go deeper and can remove deep pigment with even less recovery time than the laser resurfacing laser skin rejuvenation treatments. Microlaserpeel, and ActiveFX are the laser skin peel treatments, and the Lux1540 and Fraxel are the non-ablative fractional laser skin care treatments for pigment. Today laser skin care for pigment removal is more often done with newer IPL (Intense Pulsed Light) or photo facial treatments. IPL or photo facial uses light energy not laser energy to remove pigment, and is a more gentle treatment with no down time.

Above-Before and after Lux Green IPL treatments remove pigment for Decolletage

4. Laser Skin Tightening – Laser skin care can tighten sagging facial skin but only minimally. All of the lasers mentioned above do tighten skin a bit becau7se when they stimulate new collagen production in the skin, the new collagen is tighter and the tighter collagen tightens the skin. This effect takes months after the laser skin care treatment and is not nearly as noticeable as a face lift. Newer and more effective skin tightening treatments are possible but not with laser skin care. The more effective skin tightening treatments are done with Infrared or Radiofrequency energy with machines called LuxIR, Titan, Aluma with Faces, Refirme, and Thermage.

Before and after LuxIR Deep skin tightening of neck

5. Laser skin treatment for Broken Blood Vessels, Red Spots and Rosacea on the Face – Photo-aging and sun damage also cause broken blood vessels to appear on the face. Laser skin care can remove broken blood vessels on the face and legs. Both the 532 and 1064 Yag lasers are useful for removal of broken blood vessels. However the newer IPL and Photo-facial treatments are very effective, produce less down time and are used more frequently today. The 1064 Yag laser is the choice for larger broken blood vessels and leg veins.

Above-Before and after leg vein removal with Lux 1064 Laser

6.Laser Hair Removal – Laser hair removal is the most commonly performed laser skin care procedure done today. There are many different laser skin care treatments for laser hair removal but I prefer the diode laser-I believe it is safer for darker skin types.

Above- Before and after hair removal with the LuxRed IPL

7.Laser Tattoo Removal – Laser skin care for tattoo removal was one of the first applications of laser skin care. There are many different lasers for tattoo removal and different laser wavelengths are chosen for the specific color of the tattoo to be removed. Laser tattoo removal takes many treatments over a long period of time, but is preferable to surgery which can leave scars.

I am sure there are other laser treatments that can be classified as laser skin care but the above are the most widely available and useful laser skin care treatments available today. As you can see the applications are very different for each type of laser so it is very important that the type of laser skin care be customized to fit the facial skin problem that you are trying to correct.

The MOST IMPORTANT THING is that you seek consultation with a board certified Dermatologist or Plastic Surgeon who is knowledgeable and specializes in laser skin care. There are many doctors, spas, and medi spas and medical spas that offer laser skin care without a board certified laser specialist in house, available to evaluate you and choose the right laser treatment for your unique face and skin. This is dangerous and not good medical care. Laser skin care if not done correctly by certified medical specialists can damage your skin. The State Medical Boards and legislatures are trying to establish guidelines and licensing regulations in many states but at this time in many states anyone can buy a laser and open a spa and offer laser skin care. Protect yourself and insist on seeing a board certified doctor for evaluation and recommendation of the laser skin care procedure that is best for your unique face and skin.

For more information on laser skin care, laser skin treatments, laser peel, laser skin rejuvenation, and non-surgical facial rejuvenation read Save Your Face or contact me,

Sincerely,

Dr Seckel,

978-369-4499

Boston, Massachusetts

Concord, Massachusetts

Palpable folds beneath the breast skin are the most common complaint I hear among women who have had saline breast implant breast augmenatation.

Breast augmentation or breast enlargement with breast implants is one of the most common plastic surgery procedures. Results are usually excellent and patient satisfaction is very high.

Above: Before and after breast augmentation

Breast augmentation is also frequently done in combination with a breast lift for patients who have had sagging or breast ptosis after having children:

Above: Before and after breast lift and breast augmentation

Unfortunately a very high per cent age of Saline breast Implants do develop palpable, and occasionally visible folds after a number of years. The problem is intrinsic to the saline implant and is the most common complaint I receive. The breasts usually look excellent but patients just don’t like the feel of the saline implant especially if they feel the fold. Most commonly the fold occurs, as it has in you, at the bottom of the breast and towards the side.

Most plastic surgeons over fill the saline implants to avoid this problem but folds still do occur.

The new silicone gel breast implants are much less likely to cause folds and generally feel more natural than saline breast implants. Safety data for the new silicone gel breast implants for breast augmentation and breast enlargement is excellent and complication results are very similar for saline implants and the new generation of silicone gel implants.

Breast implant folds are felt to be more common with low profile breast implants. The low profile implants have a wider base and less projection and do have a greater tendency in my experience to cause folds.

Today I more frequently choose a moderate or medium profile implant which projects the breast more forward and has fewer tendencies to fold.

In patients who complain of folds in their saline breast implants my recommendation would be to replace the saline breast implant with a moderate profile silicone gel breast implant, possibly a bit larger to fill the space and compensate for any stretching of the skin from your previous breast implants.

My experience with the new silicone gel breast implants has been very positive. Patient satisfaction with the silicone gel breast implants has been very high and patients who have replaced their saline breast implants with the new silicone gel moderate profile breast implants have been very happy with the results.

The safety data are very similar for both the saline and new silicone gel breast implants. The one downside is that the FDA recommends follow up MRI scans to check the implant at 2 years. This is a safety feature but can be an inconvenience to you.

Typically the procedure to remove your old saline breast implants and replace them with new silicone gel breast implants is a very simple procedure with less discomfort and recovery than was experienced with the initial breast implantation or breast augmentation surgery.

Thank you for your excellent question.

If you would like to learn more about plastic surgery or breast implants please visit DrSeckel.com or contact me at 978-369-4499.

Be sure to sign up for my newsletter to learn about new developments in breast augmentation and plastic surgery.

Thank you,

Dr Seckel

978-369-4499

Concord, Massachusetts

Boston, Massachusetts