The Walker Plastic Surgery Blog

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Plastics in Pairs: +1s Increasingly Common During Procedures

  
  
  
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Photo credit: Josef Seibel
Call it safety in numbers. A new study from the New York Center for Facial Plastic and Laser Surgery reports that, now more than ever, patients are booking procedures in pairs. The clinic cites "moral support, shared bonding experiences, or having a loved one to go through the healing process" as the major factors that cause patients to book two by two.
The center reports that the most common procedures for women pairs are faceliits, blepharoplasty, and rhinoplasty, now being seen more and more in mother-daughter and sister-sister pairings. Female family member couplings increased 8 percent in 2013, and looks to be an even stronger this year. Also common are wife-and-husband and best friend duos.

Steady Increase in Plastic Surgery Procedures Forecast for 2014

  
  
  

dr walker procedures facelift

The American Society of Plastic Surgeons recently released its annual plastic surgery procedural statistics. The results aren’t surprising: 15.1 million cosmetic surgery procedures were performed last year, which is a 3 percent increase from 2012.

“The demand for plastic surgery remains strong, with our statistics showing increases in both cosmetic surgical and minimally-invasive procedures," said ASPS President Robert X. Murphy, MD. "Facial rejuvenation procedures were especially robust last year, with more Americans opting for facelifts, forehead lifts, eyelid surgery, fillers and peels. With new devices and products hitting the market each year, there are more options and choices available to consumers wanting to refresh their look or a little nip and tuck."

The ASPS sites new products and technological advances as reasons more and more Americans are seeking out plastic surgeons. The FDA’s approval of hyaluronic acid facial filler, which treats mid-face volume loss, is just one product that contributed to last year’s record high statistics.

Breast Aug or Breast Lift?

  
  
  

DR WALKER PROCEDURES Breast Lift

 

You’re probably familiar with both terms, but it looks like more and more women are becoming familiar with the breast lift than ever before. The American Society of Plastic Surgeons (ASPS) just realized a study indicating that since 2000, the number of women opting for a breast lift has increased 70%.

Breast augmentations are still a popular choice, and are still the most performed cosmetic surgery in women. However, breast lift procedures now outperform breast augmentations at a two-to-one ratio. Last year alone saw 90,000 breast lift procedures conducted by the organization’s member surgeons.

Who is seeking out these breast lifts? ASPS reports that women aged 30-54 years comprised a little less than 3/4s of all procedures last year. Women undergoing breast lifts sited breastfeeding, aging, and childbirth as reasons to undergo the procedure.

Are you an ideal candidate for a breast lift? Try the “pencil test:” place a pencil under your breast. If the tissue holds the pencil in place against the chest, that signifies that the breast can be fixed with a lift.

Natural Beauty Restored

  
  
  
Dr. Walker has a fantastic artistic eye when it comes to facial aesthetics. Karen, one of her patients, was an example of the amazing results Dr. Walker manages to achieve. Karen has shared her story on Fab Over Fifty, which has chosen to highlight Dr. Walker in "Uplifting News from Leading Plastic Surgeons".

“I didn’t used to have much aging in my face.  It just sort of happened in the past few years.”

Karen, 63, is a mother of three grown children, ages 40, 28, and 26, and is a retired computer programming analyst and apparel retailer.  She wanted to have her “crooked” nose straightened for a number of years. When her gynecologist referred her to Dr. Rondi Walker of Washington, DC,  Karen knew she’d found her surgeon. “I just trusted my doctor.”  Pleased with the results from the October 2012 septorhinoplasty (“basically, she rebuilt my nose),” Karen and Dr. Walker discussed a facelift at one of their follow-up appointments, when Karen noticed her jowls “just looked awful.”

Dr. Walker thought the best procedure for Karen would be a facelift, including upper and lower eyelid lifts (blepharoplasties) and fat transfer to the cheeks.  Her facelift was about three months later, in January 2013.

Where do you live?
Bethesda, MD.

Have you wanted plastic surgery for a long time?
I’d been having Botox for 10 years. The wrinkling between my eyes made me look angry!

Why did you wait so long to have the surgery if your nose had been bothering you?
Because of the expense, mainly. Even though our financial situation didn’t change that much, I talked to my husband and just decided to do it. It was just looking worse and worse the older I got. Dr. Walker did some reshaping, too. She found that maybe I had broken my nose at some point. [The surgery took 3 hours.]

What was the recovery like?
I had a cast, so I didn’t see it as it was healing. It was like a mold right on the surface. I think it was more for protection, or providing stability to the nose. It was uncomfortable because I couldn’t breathe very well.

How did you decide on a facelift after your nose surgery?
I realized that I wanted to bring some youth back into my face. I left it up to Dr. Walker, and her suggestions sounded perfect. My eyelids were drooping down over my eyelashes. This closed everything down so much and I thought it was unattractive. The jowl line needed to be lifted a bit. That’s why we decided to do that. Fat was transferred to my cheeks [from her abdomen and hip] to create definition in my face.

What was the preparation like for the facelift?
I started Arnica Montana* a week or two before both surgeries. On the days of surgery, I went to the hospital at 5:30 or 6 am. It was done under general anesthesia and took 5 hours.

*Arnica Montana is an herbal medicine to decrease bruising

Facelift, including upper and lower eyelid lifts, and fat transfer to the cheeks, by Dr. Walker


What was the recovery like for the facelift?
I had a wrap all the way around my head, and two drains behind my ears, which stayed in for several days. The wrap caused a lot of itching, so I removed it after almost a week. Although that was sooner than I was instructed, I didn’t have any problems. I also used eye drops, and kept cold, wet compresses on my eyes.

How long were you out of commission?
At least a month, but it took two months before I felt completely comfortable doing things, mainly because of the way I looked. I wasn’t in pain.

Aside from the obvious, how did the recovery from the facelift differ from your first surgery?
Psychologically, it was a completely different experience than the nose. With this, I could see the swelling and how everything was progressing.

What did you family think of your surgeries before and after?
My husband says I look as young as I did when we married almost 20 years ago. My girls had kind of a hard time with it, with their mom making any changes. My son was really worried about me going into the hospital. Now, they’re all fine with it.

Why do you want to share your plastic surgery story with other women?
I just think it’s a wonderful thing that this is available to us. I know it’s expensive and not everybody can do this, but from what I’ve seen, a lot of women try to hide plastic surgery. I just think it’s important to share it. I can’t do much about the aches and pains, but I can do something about the other parts!

How did it change you, not just physically, but mentally?
I don’t think it changed me mentally. I love it. I think my face looks more like I feel on the inside.

A note from Dr. Walker:

Nasal injuries in youth may lead to chronic nasal obstruction, breathing difficulties and nasal deformities that become more apparent with time. Difficulty with breathing is what led sixty-three year old Karen to my office for a rhinoplasty.  The complexity of her septal deviation and nasal deformity required treatment via an open rhinoplasty (where an external incision is made).  After the surgery, she could breathe easier and her nose was straight.  At her follow-up appointments, she noticed some other areas of her face that she wanted to improve.  She had a healthy attitude and was over all pleased with her looks.  However, she felt if she could restore a more youthful appearance on her face, she would feel more like her youthful inner self!

After extensive consultations following her first procedure, we agreed that she would benefit from a full meloplasty (face lift) to treat her sagging skin, particularly in the jowls.  The fat augmentation would address the loss of volume in her face.  In addition, upper and lower eyelid surgery would address those droopy eyelids we always hear about!  Just four months out of surgery, she was pleased with her results and has volunteered to speak with many of my patients about her surgical experience.  With each of my surgical patients, I tailor the surgery specifically to his or her specific anatomy, expectations, and lifestyle.

Want Fat Removal Without Downtime? Check out SmartLipo

  
  
  

Do you want to have liposuction but don’t want it to be a big deal that disrupts your life?

If your answer is “yes,” there’s a great solution for you. A cutting-edge laser liposuction procedure, SmartLipo, can help get rid of those last few pounds (e.g., “double” chins, flabby arms) without the pain, messiness, and inconvenience of traditional liposuction.

The SmartLipo Procedure and You
If you’re interested in SmartLipo, this is how the process will go:

1. You’ll have a consultation with Dr. Walker, who will let you know if you’re medically able to have the procedure and whether it’s the best option for you.

Generally, SmartLipo is the right choice for people who eat well, regularly exercise, and are within 25 pounds of their ideal body weightbut just can’t seem to get rid of a particular area of localized fat no matter how hard they try. Your doctor will also go over the cost. Typically, SmartLipo is less expensive than traditional lipo.

2. On the day of the procedure, Dr. Walker will begin by making a small incision to insert the tiny tube containing the laser. You’ll only need a local anesthesia for this, so you’ll be awake the whole time and won’t be exposed to the risks of general anesthesia, as you would be with most traditional lipo.

3. The doctor will use the laser to melt and liquefy fat, which is then removed through the incision. The laser is also used to cause blood vessels to immediately coagulate, which is why SmartLipo has far less bleeding, bruising, and swelling than traditional lipo. And best of all, the laser tightens skin to avoid the dropping rolls of loose skin that can plague traditional lipo patients.

For one localized area of fat, the entire procedure can usually be done in about an hour.

4.You go on with your life. You’ll feel some slight soreness after SmartLipo, but that’s a lot better than traditional lipo, which will make you feel like you’ve been beaten up.

And because the aftereffects are so minimal, you can get right back to your normal activities

To determine if you are good candidate for SmartLipo, contact Dr. Walker for a consultation.

RealSelf Presents The Battle Against Cellulite: Video Chat

  
  
  

For women who have ever struggled with stubborn cellulite, a free, live doctor video chat on Wednesday, October 17 will provide critical information about various procedures that help to reduce the unwanted bumps.

Hosts Dr. Grant Stevens and Dr. Michelle Spring, both plastic surgery experts and board-certified doctors at Marina Plastic Surgery in Marina Del Rey, CA, will share various procedure options, how they work, risks, average cost, satisfaction rates and more.

During the live chat, brought to you by RealSelf.com and sponsored by Cynosure, participants will get firsthand insight about the different procedures that target cellulite, including the hottest new treatment on the market, Cellulaze. The video chat takes place at 5:15 p.m. PST and participants can register at http://www.realself.com/doctalk/cellulite
                
Cellulite affects approximately 85 percent* of women in the U.S. Many are unaware that cellulite is not exclusively a fat problem; it’s a structural problem below the skin and no amount of dieting, healthy eating or exercising can get rid of it.

In addition, aging, hormones, genetics and dramatic weight changes can all play a role in the appearance of cellulite. Anybody who has questions about cellulite and the procedures that help get rid of it can ask Dr. Stevens and Dr. Spring for real-time answers during a Q&A at the end.

On RealSelf.com, Cellulaze – a minimally-invasive surgical device designed to reduce cellulite by restoring the normal structure of the skin and underlying connective tissue – gets an 84 percent “Worth It Rating” by the community and has a reported average cost of $5,500. So far in 2012, there have been more than one million searches on the topic, and curiosity continues to grow.

There are countless treatments that claim to get rid of cellulite such as creams and lotions, but these only treat cellulite superficially by working at the skin's surface and results are often inconsistent. If you have ever considered a longer lasting treatment to reduce cellulite, this is an informative session not to be missed!

To participate, attendees are encouraged to register in advance at http://www.realself.com/doctalk/cellulite for this FREE online doctor chat and get the information needed to make a confident, empowered decision. 

*Avram, MM “Cellulite: A review of physiology and treatment” Journal of Cosmetic Laser Therapy 2004; 6:181-185.

A "No Surgery Solution" for Tightening Facial and Neck Skin

  
  
  

Do you think it’s time for a facelift? How about an “uplift” instead?

A new FDA-approved procedure, Ultherapy, lifts the skin up without any cutting—or even lasers. Using ultrasound waves, Ultherapy stimulates the skin’s natural healing properties to counter the effects of time and gravity on the face and neck.

It’s well-known that as people age, one of the first visible effects of gravity is a sagging of the brows, which causes the eyes to appear smaller and tired. By lifting the skin of the brow, Ultherapy can revitalize your eyes.

Ultherapy’s effectiveness without surgery has been widely lauded­. The procedure has been the subject of reports on 20/20, The View, The Doctors, The Rachael Ray Show,and The Martha Stewart Show. It’s attracting all this attention because it works!

The Science

Ultrasound allows your doctor to see deep into your skin and direct ultrasound energy to the structural support layers.  This new technology does not disturb the skin’s surface layer, as was once necessary.

The heat of the ultrasound waves subtly agitates the skin’s underlying tissue, leading to increased collagen production. Collagen is the protein that gives skin its youthfulness, causing it to be more vibrant, toned, and tight.

Ultherapy triggers the process, but your body’s own natural healing response does the work.

The Convenience

Because Ultherapy is completely non-invasive, it’s done during an office visit of only 30 to 90 minutes. And you can pick up your normal activities as soon as you leave.

The Results

Patients will notice some immediate improvement, but building collagen and restoring “memory” to skin is much like building muscle through exercise—it takes some time. Over the course of the first two or three months, you’ll see your skin gradually lift and wrinkles disappear.

Is Ultherapy For You?

A typical patient is someone in their late 30’s to early 50’s who is concerned about wrinkles but isn’t ready for a face lift. They are usually just beginning to notice lax skin.

But some younger people are “taking the fight to gravity” by using Ultherapy to prevent wrinkling before it occurs.

If you think Ultherapy might be just the lift your skin needs, contact Dr. Walker for a consultation in the Washington, DC area.

Dr. Walker is demonstrating Ultherapy at Beauty Bash in NYC

  
  
  

Dr. Walker is thrilled to be part of The Beauty Bash on September 29, 2012 at the Metropolitan Pavilion in New York City.

The Beauty Bash is the kickoff event for the Fab over Fifty Week (FOFWeek). At Beauty Bash, you’ll gather with the smartest, savviest and strongest players in the beauty, apparel and accessories businesses to get a first-hand beat on the products, procedures and people that keep you looking good.
 
Dr. Walker will demonstrate Ultherapy and two lucky raffle winners will receive an Ultherapy treament valued at over $3,500.00.

For more information about FOF beauty bash click here. See you in NYC.

fofbeautybash

Ultherapy - a skin treatment alternative worth exploring.

  
  
  

Youthful, glowing, taut and supple skin. It is something that all women want. Unfortunately, sun damage, exposure to pollutants, gravity and, most of all, time make it increasingly difficult for a person to regain and retain this beauty ideal.

For the most part the only solution has been surgery, fillers, lasers or Botox and while there are certainly benefits that can be obtained from these procedures, there are some unfortunate downsides, such as recovery time and use of chemicals. Now there is a revolutionary and exciting alternative that is taking the world of facial rejuvenation methods into a new frontier: Ultherapy.

What is Ultherapy?

Ultherapy is a non-invasive, ultrasound procedure that causes your body's natural collagen-rebuilding process to lift and tighten your skin from the inside out.

ulthera system

There are no injections, lasers or chemicals involved and it is completely non-surgical. With the revolutionary new patented DeepSEE technology, Ultherapy is able to direct sound waves both into the skin and to the tissue underneath the skin. The 30 - 60 minute procedure works to heat the tissue which then causes your body's natural healing response to gently repair the tissue and create new collagen. The skin above the tissue is toned and tightened, essentially resulting in the same effect as a surgical procedure - without the surgery.

What are the benefits?

The result of Ultherapy is skin that is noticeably tighter, lifted and more toned. Though slight improvement is visible immediately after the procedure, patients will enjoy seeing the full benefit about two to three months after. This gradual improvement and lack of necessary downtime after the procedure helps for a very natural and subtle progression to a more youthful and improved appearance for you. Nobody will know you had any sort of cosmetic procedure. They will only know that you look fantastic!

In addition to the toning and tightening, your skin will also look and feel more supple as new collagen is created. The procedure can be applied to all problem areas of the face that need lifting, from eyelids and brows to jowls and neck.

Just imagine having the tone, smoothness and lift of your skin from your more youthful years - without having to go through surgery and recovery! As one patient happily remarked, "There was no down time and the results are very natural…Nobody knows I had anything done. They just know I look better."

Why you should choose a board certified plastic surgeon.

  
  
  

Not every doctor who claims to perform plastic and reconstructive surgeries has completed an approved residency in plastic surgery. This is because regardless of training, any licensed doctor can perform plastic surgery and call themselves a plastic surgeon.

ASPS member

Every patient who undergoes a plastic surgery procedure is risking their health and appearance. Board certified surgeons are highly trained and best able to deliver the the overall care you need to to heal quickly, minimize pain, and achieve natural looking results. Even the smallest misstep can cause catastrophic results and if your aren't 100% confident in your surgeon, you should not undergo any procedure.

It is always wisest to question a surgeon specifically, making sure that he or she is certified by the the American Board of Plastic Surgery (ABPS), not some other organization. Certified plastic surgeons have access to hospital facilities as needed, and a proven lower rate of complications. One study showed that the rate of complications at accredited and board certified plastic surgery facilities is less than one half of one percent. Certified surgeons will also be able to perform a wider range of services, such as tissue reconstruction, cosmetic surgery and microsurgery.

ABPS board certification insures that a doctor has not only graduated from an accredited medical institution, but has many additional years of training and experience, including three years of surgery, two or three of residency, and two years of professional practice. By the time a surgeon earns her certification through a series of written and oral exams before the board, she is skilled, practiced and well qualified to do his job.

Since the decision to have a plastic surgery procedure done is such an important and personal one to begin with, prospective patients should carefully consider the qualifications of any doctor before trusting themselves to him.

Dr. Walker is board certified. Learn more about her.

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Dr. Walker Featured in The Washington Post

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The Buzz hears:

Plastic surgeon Rondi Walker will chair this year’s Knock Out Abuse Against Women, the annual fundraiser that promotes awareness of domestic violence. The event is Nov. 13. Walker is a mother of three and has been on the nonprofit’s board for two decades. Cheryl Masri and Jill Sorensen founded the charity in 1993. In the past 21 years, Knock Out Abuse has raised more than $6.5 million dollars to benefit local charities.

THE BEST FACIAL ANTI-AGING SECRET: DON’T LOSE THE VOLUME

Besides excessive sun exposure and smoking the most common cause of facial aging is the gradual loss of fat in our face. Fat loss begins early in our twenties and continues throughout our lives. Not only does fat waste away, a change in the quality and quantity of the  skin’s elastin fibers and collagen results in a slow diminishing of the skin’s elasticity. Bone mass diminishes with age and facial muscles begin to atrophy. Naturally, this slow aging process alters facial structure and results in a collapsed appearance of the mid-face and cheekbones. Bone loss is most pronounced in the 70s and 80s and the majority of bone resorption occurs around the base of the nose and center of the face.


Fat loss occurs in specific facial areas that are prone to fat resorption: the cheeks and areas around the brow and eyes. The lips and temples are affected next. A quick look in the mirror will let you know if fat loss is adding years to your appearance. As you look at your face answer the following questions:


1. Has your face become square?

2. Are your cheeks sagging?

3. Do you have hallow troughs under your eyes?

4. Does your skin appear to be falling off your bones?

5. Is the area between the sides of your eyebrows and hairline sunken?

6. Are the corners of your mouth turning downward?

7. Do your lips roll in, making it difficult to apply lipstick?

8. If you get the lipstick applied does it seep into the fine lines above and below your lips?


If you have answered yes to any of the above, there is a good chance that volume loss is the source of your aged appearance.


The best ways to restore facial volume and stimulate collagen formation depends on two factors the amount of fat lost and the degree of skin laxity.


The Quick Fix


If you have minimal skin sag and facial deflation the use of hyaluronic acid fillers and collagen stimulating injectables are a fast and easy way to treat the problem. Certain facial areas may be corrected with thinner fillers such as Beletero, Juvederm or Restylane. However, larger areas with more pronounced volume loss will require a heavier filler that combines a more viscous hyaluronic acid with or without calcium hydroxyaptite such as Radiesse, Scuptura Aesthetic and Juvederm Voluma C. These fillers provide subtle improvement, results last between six to eight months.



The Natural Option: Your Own Body Fat!


Micro-liposuction is used to harvest fat cells from your hips or abdomen. The fat is washed and concentrated prior to injection. Fat transfer is a minor surgical procedure, and there are a few days of downtime but the results are well worth it.


The cost benefit proves advantageous if your condition requires multiple filler injections. Fat augmentation varies with each patient but usually lasts five to ten years, and the skin has an incredible smooth, healthy glow.


Combination Therapy


If you have loose skin and have also experienced volume loss, the best options are a face-lift or Ultherapy combined with structural fat grafting or the more viscous fillers. Utherapy is a beneficial skin tightening procedure for patients who have minimal skin laxity or cannot have surgery. A face-lift: micro, mini or standard removes excess skin. The micro face-lift requires only a small incision above the ear.. The mini and standard face-lift reposition underlying facial support structures and fat, creating a firmer look. A face-lift, in combination with fat grafting, not only tightens the skin but also fills in deep wrinkles and areas of depression. Your face is not only rejuvenated, it looks more youthful.


There are different ways to treat and restore volume loss. An individualized approach that is planned with your board certified plastic surgeon will yield the best results.

Mark Your Calendar: Knock Out Day April 1st

In honor of Dr. Walker's chairmanship of Knock Out Abuse, enjoy 20% procedures and treatements on April 1st to support efforts in fighting domestic violence.

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