EVOLV Medical Aesthetics

Category: Cosmetic Procedures


Even though it was over 30 years ago, I will never forget her face.

She was a young mother and school teacher with 2 small children and I was a first year plastic surgery resident.  She had a mastectomy for breast cancer and was left with a large and painful tight scar.  The implant that had been placed by my instructor under the scar was hard, unnatural and uncomfortable…..at that time in the mid 1980’s there just were not many options or choices. She looked at me and I did not know what to say to comfort her.  That was the day I decided to seek post graduate training in breast reconstruction and that young mother, with the eyes I cannot forget, changed my life forever.

This year an estimated 230,000 women in the U.S. will be diagnosed with breast cancer but less than 25% of those women will be aware of their reconstructive options before treatment.  The breast cancer experience touches not only those women but also their spouses, their children, their families and their lives for years.  The breast cancer experience involves much more than just removing a tumor or having a mastectomy, it is a journey that can involve medical and other post-operative treatments as well as impact a women’s personal life and self-confidence and relationships at every level.  In short it will someday effect all of us and someone we love.

The really exciting news is that the breast cancer experience is changing significantly for the better for a variety of reasons:

Education and Patient Awareness – public awareness and educational efforts by a number of professional     organizations have resulted in women being more informed and aware of their options.  The American Cancer Society, the American Society of Plastic Surgery, the Susan G. Komen Foundation, The Victory Center and many others are doing an incredible job of communicating useful information to patients and their families.  The best informed patients make the best choices!

Identifying Risks and Cancer Prevention – the most effective way to fight cancer is prevention.  New research on nutrition and life style as well as genetic testing to quantify risk factors have actually made a substantial difference in breast cancer incidence.  Advances in genetic mapping have made great progress and resulted in improved options and treatment outcomes for patients at risk.  Prophylactic mastectomy or removing the breast tissue to prevent cancer in high risk individuals, as popularized by actress Angelina Jolie, can reduce cancer risk by 90-95% in appropriate patients and result in excellent aesthetic outcomes.  We encourage everyone to learn more about these exciting advances in order to protect themselves and their families.

– Early Detection – After prevention, the next most effective way to impact breast cancer is early diagnosis.  Improved patient education and self-exam, consistent doctor’s visits, advances in imaging techniques such as mammography, ultrasound, MRI and other scans have resulted in earlier detection of breast cancer and breast ‘pre-cancers’ which will improve the overall patient experience and outcomes as well as reduce breast cancer morbidity.

– Improved Surgical and Reconstructive Techniques – Significant advances in biomaterials for breast implants and implantable materials (acellular dermal matrix) to help shape breast reconstruction procedures, have resulted in much more natural breast shapes as well as improved safety and less recovery.  Earlier detection and research on tumor biology have resulted in less invasive resection procedures (lumpectomy and mastectomy) and options such as sparing the breast skin and nipple in appropriate patients.  Placement of implants above the chest wall muscle (pre-pectoral reconstruction) and advances in tissue flap surgery reduce recovery time and have improved results for patients dramatically.  Our very own Dr. Peter Koltz, an associate with Dr. Barone at evolv Plastic Surgery, completed advanced training in tissue flap surgery for breast reconstruction last year and has been offering these options for patients in the Toledo area.

Post Treatment Quality of Life Improvementthe consequences of breast cancer treatment do not stop after the procedures have ended.  Many patients taking  estrogen blocking medication or other targeted chemotherapy or radiation deal with side effects such as bone and heart health, hair loss, premature skin aging, tissue dryness and laxity, post-menopausal vaginal dryness and urinary incontinence.  This often results in femininity and intimacy challenges, sexual difficulties and overall loss of self-confidence and intimacy.  New advances in clinically proven topicals, non-estrogen growth factors and other therapies can reduce symptoms and help restore confidence and vitality.  Regenerative treatments with platelet rich plasma (PRP) and other stem cell growth factors as well as collagen stimulating noninvasive technologies have given many patients much improvement in these issues and a better quality of life.

October is Breast Cancer Awareness month and October 17th is Breast Cancer Awareness Day (or ‘BRA Day’).  Please support these worthwhile programs and help bring more awareness, education and encouragement for the many women, men and their families that are dealing with this life changing issue.  We invite you to join myself, Dr. Peter Koltz and the evolv staff at Rosie’s on Wednesday, October 17th to support BRA DAY and spread the word on the improving awareness and quality of life for breast cancer patients and families.  

Yes the breast cancer experience is changing for the better and helping improve the quality of life for many.  Advances in clinical research, cancer biology, genetic testing, surgical and reconstructive option have transformed the breast cancer experience in such positive way.  The quality and safety of new reconstruction choices and postoperative treatment options can restore a patient’s self-confidence and lifestyle. As plastic surgeons we now may often hear a post reconstructive patient say, “Doctor, I sometimes forget I had a mastectomy!”

And I am forever grateful to that young mother and cancer survivor that inspired me with her courage so many years ago.

Real Skin Health Takes Work.

The mission of creating and maintaining skin that is optimally healthy, youthful, vibrant and cancer-free is a passion that all of us at evolv Plastic Surgery & Medical Aesthetics share and believe in. As summer comes to a close, it’s an excellent time to evaluate your skin health and make a personalized plan to achieve these goals for yourself. Summer is a time when many patients have had excessive sun exposure, lending itself to hyperpigmentation, fine lines, premature aging and pre-cancerous lesions (actinic keratosis). These skin issues are especially prevalent this time of year, not only in older adults but also in many younger patients.

Unfortunately, we are all inundated by companies promoting the next ‘miracle’ cream that promises to quickly and easily erase skin damage and restore youthful skin. Promotions by celebrities and very clever marketing are all around us in the media and online, convincing even well-educated consumers to buy their product with unproven promises and unrealistic expectations. The sales tactic of ‘snake oil’ in a bottle and promising more youthful and beautiful skin has always been and remains an extremely effective marketing technique. But the truth behind their marketing is that there is rarely any science or credible research to back up these claims, and the majority of consumers end up spending significant amounts of their resources for ineffective products that are cleverly packaged and promoted. There is definitely a lack of trust and credibility in the skin care and cosmetics industry.

After nearly 30 years of involvement and dedication in medical skin care and skin health, I can assure you that the advice of Dr. Obagi, “real skin health takes work,” is spot on! In order to repair, restore and rejuvenate aging or damaged skin, one must understand the physiology of healthy skin and how it is designed to function naturally and optimally. Years of research and the benefits of science and biotechnology have opened the door to many exciting possibilities in achieving and maintaining youthful and healthy skin, as well as reducing cancer risk by utilizing and respecting the natural functions of the skin. Research supports the basic principles of skin health which are the fundamental of the ZO Skin Programs:

  • Effective, but not traumatic, daily cleansing and exfoliation
  • Restoration of a normal maturation cycle through conditioning and stimulation
  • Repair of cell damage, excessive pigmentation, injury and disease
  • Protection and reduction of inflammation
  • Hydration and calming
  • Protection from ultraviolet radiation and reducing skin cancer risk

Because of the interactive nature of the skin, as well as ethnic and environmental factors, every patient’s program must be personalized to each individual’s ethnicity, lifestyle and unique skin characteristics. Obviously no single product or treatment can repair and restore skin health. A medical history, complete evaluation and understanding of the comprehensive nature of skin function and health by an experienced and knowledgeable professional are absolutely necessary for achieving youthful, healthy skin and reducing the signs of aging and risk of skin cancer.

Yes, restoring and maintaining beautiful, youthful skin takes work and commitment, but the results can be not only gratifying, but life changing for those who ‘show up’ every day for their skin workout! If you would like to find out more, please contact an evolv medical aesthetician to learn about what a difference healthy and ageless skin can make in your life.

ensoCLUB Update

We are all more than thrilled to report that after introducing evolv’s ensoCLUB subscription for personalized, aesthetic treatment plans last month, we have had more than 115 new patients subscribe as new members! At evolv, we believe that a comprehensive plan as an ensoCLUB member is the most cost effective and successful way to achieve optimal results for each patient. Be sure to inquire and find out more about the game-changing benefits available to ensoCLUB members, and come see what all the excitement is about!

The Growth of Non Surgical Aesthetics

The latest statistics are quite remarkable: last year in 2017, there were over 20 million non-surgical cosmetic procedures performed in the U.S. and nearly 16 million of that number were injectables of Botox type neuromodulators and soft tissue volume replacement (fillers).  So what could possibly explain this explosive growth?

At evolv Plastic Surgery and Medical Aesthetics, we have a long term commitment and interest in ongoing education for our staff as well as our patients.  So let’s take a look at some of the reasons driving the increased demand and popularity of injectable soft tissue fillers and Botox type neuromodulators.

More natural long lasting results

Gone are the days of simply injecting Botox to the scowl lines of the forehead (glabella) or adding filler to the nasolabial folds to rejuvenate the aging face.  The commitment to comprehensive aesthetics at evolv is a holistic appreciation of all of the parameters of the aging face and body.  Along with the fundamentals of a personalized skin health program, a number of different FDA approved injectable neuromodulators (Botox/Xeomin/Dysport) may be used for different applications and results balancing facial expressions and movement to obtain a more youthful outcome as well as to reduce migraine headache triggers.  Patients may be surprised to learn that there are over 100 medically approved therapeutic indications for current Botox type treatments!  A new Botox type injectable (DaxibotulinumtoxinA or RT002) is scheduled for release soon and has the advantage of lasting 50% longer or up to 6 months.  Combining neuromodulators and soft tissue fillers properly can result in a natural and balanced youthful appearance that can be quite cost effective and lasting.  New ‘flexible’ fillers (Galderma’s Refyne and Defyne) which create volume replacement while maintaining harmonious movement in the face resulting in a more natural result along with less swelling.

Less chance for bruising, swelling and discomfort with treatments

For many patients, the risk of bruising and prolonged swelling with traditional injection is a major concern.  This risk can be minimized by the use of cannulas for soft tissue filler placement in some areas instead of needles.  In addition, advances in bioengineering and technology have resulted in new fillers that last longer and induce significantly less swelling (Allergan’s Voluma, Vollure and Volbella and Bellotero form Merz).  evolv recently introduced the ProNox system for patients which allows them to self-administer nitrous oxide gas to reduce the perception of any discomfort during treatment.  Finally, new formulations in topical numbing or anesthetic creams are more effective in reducing any discomfort during injection and other procedures in the office.  All of the above have significantly improved the patient experience during injectable treatments at evolv.

Expanding patient base and options

Because of the improvement in products and the potential for more natural and affordable outcomes, more patients, male and female, and of all ages, are seeking treatments.  Indications as well as ‘off label’ uses of FDA fillers and neuromodulators are providing more comprehensive and natural appearing results.  A few examples are the use of Botox for migraine prevention, and the use of injectable soft tissue fillers for rejuvenation of the aging hands as well as for correcting depressions and cellulite improvement on the body and buttocks.  A new category of fillers that induce soft tissue growth from the patient’s own cells are called ‘biostimulators’ and they include Sculptra and the new exciting product Renuva which is called an ‘adipose matrix’ and triggers natural fat and tissue growth in areas of scars or depression.

The importance of safety and training

As in all areas of aesthetics, the key to achieving high patient satisfaction and safety is comprehensive and ongoing training for all providers and staff. At evolv, education and patient safety are our passion and we believe it is everyone’s responsibility to keep patients safe and happy with their overall experience.  We take this commitment seriously because, as everyone is aware, complications and unfavorable results are all too common in cosmetic treatments.  The high demand for aesthetic treatments has outpaced the number of properly trained and credentialed service providers so it is especially important for anyone interested in these treatments to carefully research and understand the experience and training credentials of any provider offering services in aesthetic care.  Complications can be very difficult and expensive to treat and correct so we encourage any interested patient to be well informed before making a decision to undergo cosmetic treatment.

The advances in biomaterials, technology and research proven new products and techniques have resulted in significant improvement and new options in non-surgical facial and body rejuvenation with injectable soft tissue filler augmentation and Botox type neuromodulators.  Safety and longevity of results, when performed by a board certified/eligible plastic surgeon or properly trained registered nurse injector, have also resulted in a tremendous increase in the popularity of these procedures.  At evolv Plastic Surgery and Medical Aesthetics, we believe in and emphasize comprehensive aesthetic programs combining these options along with a personalized skin care plan as the most effective way to achieve long lasting and natural appearing outcomes for each patient.  And finally, evolv has recently introduced the ensoClub which is a private membership program with the benefits of reduced cost, preferred bookings and more affordable customized treatment plans.  If you are interested in more information on the ensoClub program be sure to ask any of the evolv professional staff.

The Organic Approach

Whether you just received a breast cancer diagnosis or have been living cancer free from your diagnosis for years, every survivor remembers their first consult. Not only the many doctor’s consults but also with family and friends. Everyone tries to piece together all the information they are being told.  Much has changed in breast reconstruction, especially in Toledo over the past year that we want all of our patients and friends to be aware of. We like to think we take a very “organic” approach to breast reconstruction and customize the approach to every patient’s goals and personal situation. Our focus is to give you as natural of a breast as possible while causing as little disruption to your body and your life as possible. 

There are 5 new advances in breast reconstruction that we want to bring to your attention. We would welcome a discussion with anyone who may have questions about these points, which we will only touch on in this newsletter.

1. Autologous Breast Reconstruction
2. New and Improved Implants
3. Breast Sensation Following Reconstruction
4. Save the Pecs!
5. Yellow Gold!

1. Autologous Breast Reconstruction
The prefix “Auto” means “self”. Therefore, reconstruction of your breast with “self”. We think this approach personifies the “organic” breast reconstruction. While traditionally (as well as today) many breast reconstructions are performed with tissue expanders and implants, there are several operative procedures that allow the surgeon to use your own tissues (wherever you have excess, but most commonly the abdomen) to reconstruct your breast. This can take place at the time of your breast removal or even years later, even after you may have already had implants. Through the use of microvascular reconstructive surgery, tissue can be removed from one part of your body and transplanted to your breast with a quicker recovery and with less disruption of where your tissue was removed than autologous operations (TRAM) of the past.

2. New and Improved Implants
If you elect to undergo an implant-based approach to your breast reconstruction, today’s implants have drastically improved. The “organic” approach to implant-based reconstruction is based around the concept that you want your implant to be more “natural breast like” in feel and shape than the implants of the past. Additionally, today’s implants are safer than they have ever been. When the correct implant is chosen for your body there is no doubt that today’s implant breast reconstructions can come closer than ever to your “organic” breast.

3. Breast Sensation Following Reconstruction
So, you have had your breast removed…it frequently is not discussed that you will not feel your reconstructed breast again. This is important to discuss and realize going into your reconstruction. While currently it is not possible to restore sensation if you opt for an implant-based reconstruction, there have been some exciting developments with autologous (auto=self) reconstruction. At the time of transfer of your tissue from one part of your body to your breast, the nerves to your breast can be connected to your tissue that supplies sensation or feel to your abdomen to allow you to regain some sensation to your breast again. We feel like this is an exciting development worth talking about as the “organic” breast is sensate, or able to be felt!

4. Save the Pecs! 
Of Course, we all want to preserve as much of the total breast as possible but cancer removal may not allow.  However, it may be possible to save your “Pec” muscle or pectoralis major muscle at the time of your breast reconstruction. Traditionally in implant-based breast reconstruction, the chest muscle, the pectoralis major, is lifted from the chest wall and the implant is placed beneath. This is not “organic” but was previously thought to give the safest, most reliable reconstruction. However, with advances in implants and other biologic material now at our disposal, we have been able to produce implant reconstruction above the muscle, where the breast “organically” resides. This allows for less pain, a more natural look, and quicker recovery to your normal activities.

4. Yellow Gold!
Yellow Gold! While jewelry was previously a girl’s best friend, we are here to report that the new yellow gold is your own “organic” supply- FAT! With the advent of new liposuction techniques, developments in processing the fat, and injection techniques, it is now possible to deliver a much more natural looking and feeling breast reconstruction. No matter if you choose implant or autologous reconstruction, most people benefit from a touch of liposuction from one part of your body with transfer to the breast. This can happen at any point in your reconstructive journey in order to produce the most “organic” breast reconstruction.

We sincerely hope everyone is enjoying this beautiful (and HOT!) time of year and look forward to welcoming you all to the office in the near future. We greatly value our relationship with each and every one of you.

Regenerative Medicine at evolv

The Use of PRP Fat Transfer and Stem Cells in Aesthetic Rejuvenation

An exciting new area of aesthetics today is the new science of using the body’s own tissues to heal and rejuvenate. This process involves three primary components: platelet-rich plasma (PRP), fat transfer (using the patient’s own fat cells and transferring them to another area) and the enhancement of fat grafts with stem cells, which are specialized and pluripotent cell components that are isolated from fat grafts. Read on to learn more about what these techniques can do for you, as explained by Dr. Frank Barone.

regenerative medicine

Actual evolv patient – Age: 52 – Regenerative Medicine

Platelet-Rich Plasma Therapy

There are many potential benefits and applications in aesthetics for platelet-rich plasma or PRP.  PRP is a mixture of growth factors and signaling proteins called cytokines that have been shown to improve healing and rejuvenate youthfulness in the skin and tissues. “The applications of PRP are quite broad, as these are the natural growth factors harvested from the patient’s own blood and used in a variety of ways,” explained Dr. Barone.

PRP is obtained by drawing the patient’s blood and placing it into a special tube that isolates certain components. The tube is then placed in a centrifuge, which separates out the components that are not needed. Within the separated material is a layer of special growth factors and proteins along with the concentrated platelets, which is then used in skin care.

“For example, we use it with micro-needling, which is a process to stimulate the repairative functions and production of collagen in the skin,” said Dr. Barone. “And when we add PRP, we see a significant enhancement of the results of micro-needling. It can be used with the actual micro-needling process or injected into the skin after micro-needling, which has been termed the “Vampire Facelift.” PRP can also be used to reduce hair loss and stimulate new hair growth far more significantly than other non-surgical or topical medication options.

Because PRP is obtained from the patient’s own blood, it is a much more natural stimulant than other growth factors that are obtained from plants or other sources outside of the patient. PRP can be used in many ways, including being added to fat grafts to make a natural filler for an aging face, to restore loss of volume in the cheeks or sagging in the skin, and to restore the thickness of the skin and stimulate pro-growth functions. It can also be used in breast reconstruction, breast augmentation, mastectomy or fat grafts to the buttocks to enhance fat intake and healing.

Fat Transfer

Fat transfer is a process of taking the patient’s own fat cells out of an area where there is an excess, such as the abdomen, hips, flanks or legs and then using these natural living cells to repair, restore and rejuvenate. Those fat grafts are then processed, removing the unneeded components and obtaining a purified concentration of fat. “These are living fat cells and can be used as a natural filler, in the face with a facelift procedures or injections to improve volume and many other exciting applications,” explained Dr. Barone.

Fat has been shown to not only fill, but to improve the overlying skin, the production of collagen and the health of the epidermis when it’s grafted to another area. “One of the most exciting areas of fat transfer has been the enrichment of fat grafts with the patient’s own stem cells,” said Dr. Barone. “Stem cells are specialized cells obtained from the fat which have the ability to respond to many signals and actually stimulate growth, repair and rejuvenation.”

Overall, these two techniques have proved themselves as remarkable treatments within any applications. If you are interested in learning more about the exciting possibilities of regenerative medicine with PRP, fat transfer and stem cells, contact us today to schedule your consultation.

Microneedling and Infini RF

Are you unhappy with dull, uneven or sun damaged skin?  If so, evolv Plastic Surgery & Medical Aesthetics offers two treatments to address these issues. Both microneedling and Infini RF treatments can help to naturally rejuvenate your skin. Read on to learn more about these options.

What is Microneedling?

Microneedling, known as collagen induction therapy or CIT, is an aesthetic treatment that utilizes very small surgical-quality fine needles to induce a healing reaction from the body, resulting in an increased production of collagen and elastin. Microneedling stimulates the body’s own natural growth factors to improve sun-damaged skin, fine lines, acne scars as well as skin texture.

At evolv, we use automated microneedling with the Eclipse MicroPen Elite. This technology will create precision controlled micro channels in the skin, allowing the increased absorption of topical products such as growth factors and other beneficial medical skin care products. The microneedling can be adjusted to different levels of penetration, depending on the amount of damage being treated. Any part of the body including the face, neck, chest, arms, legs, abdomen and even the back can be treated with microneedling.

The Microneedling Procedure

The procedure involves cleansing the skin and often using a topical anesthetic to reduce sensation. Your evolv medical skin care professional will then apply a fine layer of gel or other topical product to the skin. The pen will be gently pressed against the skin, gliding it in various directions while the treatment is being done. This may feel like fine sandpaper and is usually not significantly uncomfortable. The procedure takes approximately 20 to 30 minutes. After the treatment, there will be some redness to the skin and healing time is generally just one to two days. Makeup can be applied at 24 hours.  Be sure to inquire about adding on the new CooLifting treatment to enhance results.

What is the Infini Treatment?

Infini RF, is a form of advanced microneedling that uses high-intensity focused radiofrequency energy along with microneedling in the various layers of the skin. This treatment can produce some very impressive results maximizing the effect of microneedling. The heat and energy produced by the radiofrequency energy will significantly improve the results of microneedling. It can help restore the skin’s youthfulness with a firming effect and result in significant improvement in texture and reduction of pores. This kind of technology is unique because the energy is delivered precisely at the level of the skin that is focused for maximal improvement.

The Infini Procedure

The procedure involves cleansing the skin and then applying a topical anesthetic cream for approximately one hour. Some patients will do this at home before the treatment. The settings are then determined after discussion with the physician and the topical gel is removed and the skin treated. It takes approximately 30 to 45 minutes to treat the entire face. Infini is safe for all skin types and can be done in any season of the year. The insulated needles will protect the surface of the skin from any kind of energy damage and reactive pigmentation. There is a very short recovery involved with Infini treatments, though the face of the skin can be red for one to two days. Makeup can be applied after 24 hours and most activities can be resumed after 28 to 48 hours.  Infini RF can also treat the neck and other areas of skin laxity. A new and exciting application of Infini is the permanent reduction in excess seating (hyperhidrosis).  Be sure to ask your evolv nurse or Dr. Barone for more information.

If you are interested in microneedling or Infini treatments in Toledo, OH, please feel free to ask your evolv licensed aesthetician or any of our nurses at our office for more information. Contact us today at 419-464-9422.

Vanquish ME vs CoolSculpting

With non-surgical body contouring devices in high demand, it’s often confusing and difficult to determine which technology is truly safe and effective. Dr. Barone explains the differences between the two most popular non-surgical body contouring methods, Vanquish ME vs CoolSculpting.

The Basics of CoolSculpting

CoolSculpting is an FDA-cleared technique for reducing excess fat by cooling the tissues, a process called cryolipolysis. During the treatment, the targeted tissue is placed in contact with paddles on the CoolSculpting device and the focal area is cooled for approximately 45-minutes to one hour.

The Basics of Vanquish ME

The Vanquish ME (‘Maximum Energy’) is also an FDA-cleared technique for fat reduction but uses a unique, focused radiofrequency energy. This energy heats targeted tissue causing destruction of excess fat cells while tightening the skin by stimulating and regenerating your body’s natural collagen production.

The Comparison

In contrast to the CoolSculpting device, Vanquish ME does not require any direct contact with the patient’s tissue and can treat a significantly larger area of the abdomen. Since there is no contact and the settings are adjustable, the energy precisely passes through the skin and heats the underlying fat.  The technology of Vanquish ME uses radiofrequency energy, the skin will be moderately warm, but the underlying fat is heated anywhere from 20 to 25 degrees higher. Additionally, keeping the skin at a lower temperature while heating the fat at a higher temperature, results in an effective destruction of the excess fat cells. The CoolSculpting device can only treat one focal area at a time, making it a longer process for optimal results in several areas of the body. Vanquish paddles allow the entire trunk of the body to be treated, including the abdomen and hips in a 45-minute session.

Although both devices are proven to reduce fat, Dr. Barone believes that Vanquish ME offers a more uniform effect because it treats a much larger area without contacting the tissues. Sometimes with CoolSculpting, there can also be a chance of fibrosis or hardening of the tissues at the edge of the treated area. Research studies have shown approximately 20 to 25% of fat reduction with CoolSculpting, and a confirmed 50 to 59% fat reduction with Vanquish ME.  Dr. Barone feels Vanquish ME is more effective with quicker results versus CoolSculpting.

Additional Information about Vanquish ME

An exciting addition to Vanquish ME is the new addition of Cellutone. Cellutone produces a unique sound wave to treated tissues allowing a more effective removal of disrupted fat and better circulation.  This addition has improved results, allowing more effective fat removal and faster improvement in body contouring.

As always, the training of the physician and technician is paramount in obtaining an effective and safe result. Call Dr. Barone’s office today to schedule your consultation for Vanquish ME today to experience the difference everyone’s been raving about! 419.720.2008

Everything You Need to Know About the Brazilian Butt Lift

Buttock augmentation or enhancement is often referred to as “Brazilian Butt Lift” and involves improving the shape of the buttocks by increasing the buttock volume, projection and contour. This can be accomplished by fat grafting or transfer, taking the patient’s own fat cells from an unwanted area where there is excess, and after processing, then transferring specific amounts to areas of the buttock to improve shape and volume which can actually result in lifting the buttock.

How is Buttock Augmentation Performed?

The options of buttock augmentation with the Brazilian Butt Lift include either using fat grafting or buttock implant, which is similar to a breast implant but a little firmer. In some situations where the buttock tissues are lax or sagging, surgical lifting of the buttock skin is sometimes added to enhance the natural contour and silhouette of the buttocks. The ancillary methods of buttock augmentation may include liposuction because shaping the excess fat around the buttocks such as in the hip or love handle area, as well as in the saddlebag or lateral thigh area, and in the thighs, can help bring out buttock contour and improve shape. This is often combined with the Brazilian Butt Lift or buttock augmentation because the fat needed for grafting is then processed and placed into the buttocks.

Why is Technique Important?

Technique is very important in buttock augmentation because fat grafting must be done carefully and precisely to maintain the viability of the delicate fat cells. Blood and other fluid are removed and the fat cells are concentrated gently. In order to improve the survival of the fat graft, PRP, or platelet-rich plasma, is used and the patient’s own blood is added. PRP contains concentrated growth factors from the blood along with platelets which are very powerful in improving the healing response and the stimulation of the fat grafts, as well as reducing swelling in the donor area of the buttocks.

What is The Recovery Period?

The recovery from buttock augmentation will depend on several factors such as the technique, including fat grafting, buttock implants, or lift of the buttock skin. Buttock augmentation surgery is typically done under general anesthesia and is always on an outpatient basis without the need for hospital admission. At our practice, evolv Plastic Surgery & Medical Aesthetics, the aesthetic surgery is always done at a fully credentialed outpatient surgery center for patient safety and consistency.

How Should I Choose a Surgeon?

Finally, when looking for a physician or a surgeon for buttock augmentation, the training, credentials and experience of the physician are typically the most important factors in obtaining the most optimal and safe result. The patient should always do their research and look at the doctor’s experience and try to find a board-certified or board-eligible aesthetic plastic surgeon, or board-eligible or board-certified plastic surgeon, that has special training in doing cosmetic procedures.

What is the Cost of Buttock Augmentation?

The cost of buttock augmentation will depend on the time of the procedure and the amount of the liposuction or other procedures that are needed to complete the augmentation. Recovery period involves wearing a compression garment for several weeks and avoiding any direct pressure on the buttocks.  Patients can resume most normal activities within several weeks.

When done by a properly trained, board-certified or eligible aesthetic plastic surgeons, buttock augmentation, whether with fat grafting or implant, has been an extremely gratifying and life-changing procedure for many patients to restore or enhance the silhouette of the body and the buttocks.  The results can be natural-appearing, long-lasting and very gratifying.

Non-Surgical, Non-Invasive Vaginal Rejuvenation with ULTRA Femme 360

As women go through their childbearing years with hormonal changes and aging, they can experience problems and frustrations in the inner and outer portions of the genitalia and vagina. Over time and after multiple childbirths, laxity of the outer tissues or the labia can occur, with loss of support and sometimes deflation of the normal fullness of the labia. Internal changes such as laxity, dryness, loss of sensation, and often, stress incontinence from the bladder are commonly experienced particularly as the woman ages.

New Vaginal Rejuvenation Technology

New technology and safe, beneficial outcomes have resulted in significant popularity for vaginal rejuvenation, particularly using non-invasive or non-surgical techniques. At evolv Plastic Surgery & Medical Aesthetics, we are excited to introduce the ULTRA Femme 360, which is a proven non-surgical and non-invasive technology that tightens and raises the labia, that can decrease the diameter of the vaginal opening or introitus in the vaginal canal, improve natural lubrication, improve sensation and even in selected patients reduce stress incontinence by improving pelvic floor tone.

The ULTRA Femme 360 utilizes a proprietary radiofrequency energy which gently heats the tissues improving blood flow to both the external genitalia as well as internally, in addition to remodeling and increasing collagen to reduce laxity and improve the youthfulness and thickness of the external and internal vaginal tissues. This technology has been proven in clinical trials to be safe and effective. In a recent study, 80% of subjects treated experienced improvement in the appearance of the labia or external genitalia, and over 60% reported improvement in sexual satisfaction. Most importantly, overall satisfaction for women after the Ultra Femme 360 treatment was greater than 90%! Other benefits seen were plumping of the labia, lifting and firming of the labia minora, tightening of the vaginal opening and vaginal canal, as well as the pelvic floor or perineum, increased sensitivity, and improved orgasm along with improvement in stress incontinence was also experienced in the study group.

How Does the ULTRA Femme 360 Work?

The ULTRA Femme 360 uses two attachments to treat the target areas, the external labia, and the internal vaginal canal. For treatment of the labia, the entire vulva area is gently heated using radiofrequency which results in stimulating collagen production and improving blood supply to rejuvenate the tissues and improve sensitivity. The focused energy from the ULTRA Femme 360 disrupts older collagen fibers to encourage the fibroblast cells to produce new collagen and improve blood supply externally and internally. To treat the internal vaginal canal, a different attachment is used, which basically benefits the entire canal surface as well as deeper tissues, unlike laser treatment that simply affects the surface. The vaginal mucosa is stimulated to produce new collagen with increased blood flow and restore the mucosa to a more youthful state.

What to Expect from ULTRA Femme 360 Treatments?

The ULTRA Femme 360 treatment is done in the office without the need for any type of sedation or anesthesia and without any downtime. Patients can opt to treat the vaginal canal, the external labia or both. Treatment of the labia and the vagina can be done consecutively during the same treatment. A water-based gel is initially applied to the skin, and the radiofrequency is delivered with the handpiece, moving gently across the area of treatment. For the internal vaginal therapy, a different adapter is applied, but there is no pain or irritation with the procedure, just a warming sensation. The treatment time is usually less than 20 or 30 minutes for both areas. For best outcomes, a series of four treatments are recommended approximately one to two weeks apart. Some improvement can be experienced immediately, while the full benefits are usually achieved by three or four weeks. Maintenance treatments are usually recommended annually.  Costs will depend on the number of areas treated, as well as the number of treatments.

What Are the Indications for Surgical Vaginal Rejuvenation?

Sometimes called female genital plastic surgery or female genital rejuvenation surgery, surgical options will involve lifting of lax tissues of the outer vaginal tissues, including the labia majora, labia minora, or the mons, or loose tissue above the vagina. Reduction in lax or sagging tissues and restoring balance to the outer vaginal labia majora and minora is done by plastic surgery techniques to remove excess tissues and reshape these structures to their preexisting or more natural state. This surgery typically requires some sedation and is done at the outpatient surgery center on an outpatient basis so that the patient can return home after the procedure. Typically, the procedure requires less than one hour, and the recovery is rapid.

What Should I Look for in a Vaginal Rejuvenation Surgeon?

The most important consideration in vaginal rejuvenation as with any aesthetic procedure are the qualifications, training, experience and credentialing of the physician. It’s important for patients to look at all these areas in selecting a physician and be sure that all questions are answered and goals are clearly defined. Optimal patient safety requires training and credentialing, as well as doing the procedure in a certified operating room and facility. Be sure to check the training certification and credentials of your physician when considering this vaginal rejuvenation as well as any aesthetic procedure.

Effective Hair Loss Treatment – Toledo

Effective Hair Loss Treatment Toledo & Prevention at evolv – State-of-the-Art

More than 75% of men and over 40% of women are affected by premature hair loss and thinning.

Studies confirm that this may have a significant impact on self-esteem, confidence and subsequently overall quality of life for individuals of all ages.  New research and technology, as well as applications of regenerative medicine, now offer multiple clinically proven options for state of the art prevention and treatment of hair loss that evolv Plastic Surgery and Medical Aesthetics is excited to introduce to our patients.

Premature hair loss and thinning is a multifactorial and complicated process, which may involve a number of interacting factors.  The most common cause of hair loss in males and females is regulated by the conversion of the hormone testosterone to dihydrotestosterone (DHT) in genetically susceptible individuals.  Other causes such as stress, illness, medical conditions, and aging may also play a contributing role.  Unfortunately, many unproven claims and false marketing promises are made that have no clinical basis or scientific evidence for efficacy or safety in preventing hair loss or restoring hair growth.

That is why all of us at evolv are particularly excited to introduce a scientifically proven, comprehensive program utilizing the fundamental principles of regenerative medicine to provide long term reversal of hair loss and to restore hair growth.  These therapeutic programs incorporate products and techniques that have been proven in clinical studies to be safe and effective in appropriate male and female patients.  Some of these concepts include:

  • The new HairMedica System of topical products and treatment proven to block the hair loss effect of the hormone DHT at the follicular level as well as stimulate growth in men and women with thinning. Scientific testing of this breakthrough system confirms the reversal of hair loss and increased growth in multiple clinical trials.
  • The use of a proprietary protocol of stem cells, fat grafts, micro needlingplatelet rich plasma (PRP), and native growth factors harvested from the patient and placed under the skin to repair, restore and regenerate aging or atrophic hair follicles in men and women.
  • A new state of the art surgical technique (Neograft) to transplant individual hair follicles to areas of complete or severe hair loss (including eyebrows) to restore the natural hair line without any visible surgical scars or prolonged downtime.

Our mission and passion at evolv are to improve the quality of life for our patients utilizing safe and proven products and services administered by a qualified and experienced professional staff.  That is why all of us at evolv are looking forward to offering these options in preventing and reducing hair loss and in hair restoration.  We believe in improving skin health for all patients and we feel these new options for hair restoration and regeneration will also benefit men and women of all ages.





Frank Barone, MD, FACS