EVOLV Medical Aesthetics

Category: Reconstructive 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.

National Cancer Survivors Day – Mary’s Story


In honor of National Cancer Survivors Day 2015, we have a very heartwarming story for each of you. We are so blessed to have such amazing patients that we can share such a personal journey with. Mary is such a joy each time she visits us and we each smile a little brighter afterwards! This is her amazing story of how she beat cancer, it didn’t beat her! Thank you for letting us share your story and we love you and are so proud of you!

~hugs to you from the entire Frank Barone MD and evolv Medical Aesthetics staff ~

maryMary’s Story

I never wanted cancer. I didn’t want the free boob job or all the attention. I didn’t want to see the expressions on my son’s faces or the sickness or the pain. I didn’t choose cancer, but cancer chose me. In turn I chose Doctor Barone.

In January 2012, three major life events happened: I moved from North Carolina to Ohio, my mother in law passed away and I found a lump in my right breast. They always tell you to listen to your body and I just knew this was not good. Two weeks later I had it biopsied and it was cancer. Here I was, away from my friends and family, home alone and the cancer chose me. My doctor was sweet, with my husband out of town he offered to have his family take me out to dinner so I wasn’t alone. Although I was thankful I didn’t feel like eating. I am the matriarch of my family. How was I going to tell my husband Doug and what would I tell my two boys. Although, grown men, they will always be my babies. I didn’t know my prognosis but how could I tell any of them that I could be dying.

I never worried about losing my breast or breasts for that matter. I cared about kicking cancer’s butt and evicting it from its home in my body. I knew one thing for certain, I did not want to die and I was not losing this battle. I began my journey with that decision. I continued it with millions of doctor’s appointments. I had a mastectomy and then, I again, listened to my body and got a second opinion on my reconstructive surgery. See, I was in a depression, I had five months of chemotherapy, a poison they drip into your body to kill the cancer. But chemo, it also makes you feel like the living dead. I began to cover up mirrors, I didn’t want to see myself. I lost self-respect because I felt my beauty was gone. Half of my womanhood was gone, I was a shell of who I was. I tried to laugh through it, I called myself the “unaboober” and would tell my sons and husbands I was fine. But the truth was, I was sick all of the time. I could not work, I could not shop, and I didn’t even want to get out of bed. Now, if you know me at all you know not shopping is like the sun not shining, I was losing who I was.

Then the journey took a turn when I met Dr. Barone and his staff. My body told me to look for a new doctor and instead I found much more. Through these warriors, I began to feel whole again, pretty again, and I felt like me again. Dr. Barone and his nurse Susie and all the other wonderful staff gave me my confidence back. They made me feel good about my looks. My new boob, my new improved cancer free boob, is incredible. My husband laid by me and held me and supported me through all of this. He told me I was beautiful when I covered mirrors and felt less than but even this great man loves the new me and thinks every woman should look like me!

There is not a day that goes by that he does not tell me how pretty I am and thanks me for taking care of myself. In this aspect, he means for me wanting to be my best me, a woman who respects herself and her body. This is not vanity this is a commitment to being happy and healthy so that we can have as many years together as possible. Dr. Barone gave me hope back into my life when I did not feel l had much left. This great doctor and his staff made me whole again. I did not choose cancer. Actually I hate cancer. But I beat cancer, cancer did not beat me. Every day I deal with the side effects of chemo, but I would take it one hundred times over to be able to hug my husband and spend time with my wonderful boys in the new and improved me.

Love to all,

Who Can You Trust?

By Frank Barone, MD, FACS

The statistics are hard to believe. An estimated 15.6 million cosmetic procedures were performed in the U.S. in 2014 and continues to increase. Nearly 56 billion (yes…billion!) dollars were spent in this country last year on beauty products and cosmetics. These staggering numbers reveal the dramatically increasing demand in our society where we all will be living and working longer as well as the human desire to feel attractive and look our best.

But who is performing these aesthetic services and procedures? Have they been appropriately trained and certified? Do you really know what exactly is in the bottle of cosmetics, skin care or health supplement product that you will be using? An alarming number of reports of complications from cosmetic surgery and aesthetic procedures or treatments along with numerous studies implicating misleading labeling, fraudulent ingredients and unsupported claims in health and skin care products are serious cause for concern.

No one can deny that clever marketing and advertising, especially with the huge impact of social media, has been an extremely powerful and effective motivator of human behavior. But is it truthful and can we trust the message and the source? Is their potential bias or conflicts of interest?

Consider the example of mass marketing in aesthetic (cosmetic) plastic surgery and aesthetic services. Lifestyle Lift, a national chain of cosmetic surgery centers headquartered in Detroit Michigan, last month closed all of its 50 cosmetic surgery centers laying off all employees. As recently as 2013, Lifestyle Lift surgeons were performing nearly 20% of all facelifts done in the U.S. Founded in Troy, Michigan in 2001 by a physician board certified in otolaryngology (ENT), Lifestyle Lift grew to nearly 80 surgery centers nationwide by spending up to $1 million per week on advertising and promotion of a ‘less expensive and less invasive’ facelift perfumed under local anesthesia. But the surprising facts are that the ‘Lifestyle Lift’ was a marketing term and not an accepted or recognized procedure in the plastic surgery literature. Lifestyle Lift ‘board certified’ surgeons were hired physicians and not board certified in plastic surgery but in other specialties and most had never completed accredited residency training in facelift and aesthetic procedures. Unfortunately most Lifestyle Lift patients never had a clue about these misleading claims. Not surprisingly a high number of complications and law suits have resulted.

These misleading marketing and unsubstantiated claims are also prevalent in the medical skin care, cosmetics and health supplement industry. In February the New York Times reported that the New York State attorney general’s office had accused four major retailers of selling fraudulent and potentially dangerous supplements. They had investigated GNC, Target, Walgreen’s and Walmart and had found that four out of five products did not contain any of the herbs on their labels and some had cheap fillers or other non-useful ingredients.
Many people do not realize that the FDA does not regulate or control the ingredients in cosmetics and supplements so there is no guarantee on product purity unless it is certified by a separate regulatory agency.

How much do you really know about the ingredients, safety or effectiveness of your sunscreen or skin care product? The Environmental Working Group (EWG), a nonprofit health research organization, recently tested 1400 over-the -counter sunscreens. Their findings? Surprisingly only 25% if the 1400 sunscreens tested actually performed or functioned to the level of sun protection claimed. Some sun screen ingredients ironically were found to be unstable in sunlight! This is an especially important report considering the epidemic increase in sun related skin cancers, particularly in young people.
What is clear is that there is a concerning and growing erosion of trust between the patient consumer and the service providers and products in the aesthetics profession. This has resulted from the increasing demand for aesthetic services and products along with the lack of appropriately trained professionals and research proven products. The highly motivated consumer is often ‘manipulated’ by misleading and unsubstantiated claims and marketing of cosmetic procedures/products promising results that are not realistic nor proven by credible research or clinical studies. Correcting unfavorable outcomes or complications, when even possible, can be expensive and disappointing for many patients.

Trust is the critical factor behind the doctor- patient relationship. Trust must be earned by consistent and clear communication, authenticity and honesty. This requires a professional and ethical responsibility to patients to only offer services that are within the scope of professional certification and training and to recommend and utilize aesthetic products that have proven efficacy and safety.

The demand for safe and effective aesthetic services and products is likely to continue to increase. At evolv Medical Aesthetics and Frank Barone MD Plastic Surgery, we believe in and have experienced the power of properly done aesthetic surgery and services as well as the use of advanced medical skin care products and treatments to improve skin health, reduce the signs of aging and ultimately to improve quality of life for many patients. We would like to encourage any patient considering cosmetic services or products to carefully check the training and qualifications of their potential service provider. Please be sure that the products that you consider purchasing and using have been proven to be effective and are made by a reputable and trusted company. Don’t be afraid to ask questions…obtaining a safe and natural appearing result these days requires that you do your homework.


5 Things to Consider Before Body Contouring Surgery After Major Weight Loss

Significant weight loss and aging often results in considerable skin and tissue laxity of the upper arms, breasts or chest, abdomen, trunk, buttocks and thighs.  This can be extremely frustrating to many patients and is not noticeably improved with exercise or diet.

Body contouring surgery is often an option for some patients to correct sagging and loose tissues and restore a youthful and balanced shape to the body.  New techniques and improved technology allows this to be done safely, on an outpatient basis and with minimal discomfort and less recovery time than in the past.

This is an extremely personal decision and we are here to help each patient with a specific and long-term plan.  When Dr. Barone is making recommendations for weight loss patients, we typically review certain fundamentals for each patient to consider:

  1. Is your weight stable?

This is an important question for a number of reasons. 1) It tells us how committed you are to maintaining your weight, especially if you will be making the investment to have these procedures, we want you to keep the weight off! 2) If you had weight loss surgery, we like to see that you’ve kept your weight stable for at least 6 months at or near your goal.  Also, we need to be sure that your nutrition is stable, and important factor for recovery.

  1. Are other medical issues resolved or controlled?

Issues like diabetes or heart disease must be well controlled or resolved before having body contouring surgery for a number of reasons.  Depending on your medical history it may be necessary to obtain clearance from other medical professionals before you may have an elective procedure. This is for your safety and also something we watch when considering your recovery.Brachioplasty Before & After

  1. Do you smoke?

Smoking can dramatically impact the body’s ability to heal and increases the risk of complications after surgery. So much so that we suggest that ALL of our surgery patients attempt to quit smoking, or at the very least quit for a period of time before surgery until most healing is complete.

  1. Are you committed to your new lifestyle?

You have worked hard to lose weight and change your life, congratulations!  As mentioned earlier, body contouring surgery is often an investment of not only financial factors but involves time off work, recovery time and is an emotional journey as well.  When considering going through these procedures, which can sometimes mean several surgeries, we urge our patients to renew the commitment they’ve made to themselves and the new lifestyle that got them where they are today.  Keep up with the diet and exercise, and ask us for help if you need resources – we would be happy to point you in the right direction.

  1. Do you have realistic expectations?

The results of body contouring procedures can be dramatic, but it is important to realize that there are of course limitations to what we can do.  There will also be scars, and Dr. Barone and our nursing staff do the best they can to prepare our patients for where they will be and what can be expected as far as recovery time.  We take every opportunity to prepare you as best we can for your surgery, but being mentally tough is important as healing can be quite a process!

We are dedicated to help all of our patients improve their lives through healthier eating, exercise and resiliency, and honored when a patient chooses us to be part of their journey!

Meet Marwa…

19 Years Later (1)…Dr. Barone’s first patient for the local chapter of Operation Smile! As a baby, Marwa had a very wide cleft lip/palate that required 2 reconstructive surgeries here in Toledo by the time she was a year old. She still comes to visit us from time to time, and is now 20 years old and studying to become a respiratory therapist. We continue to be amazed by her results and by the wonderful young woman she has become.

Permanent Makeup and the Oncology Patient

Restoring Confidence and Feeling Your Best

By Lindsay Cole, Aesthetician, Permanent Makeup Artist and Makeup Artist

Lindsay work photo 3Are you familiar with permanent makeup? Also known as permanent tattooing or cosmetic tattooing, this type of procedure can bolster confidence by not only making you look great, but feel great too! Depending upon the individual, this procedure is done for a variety of reasons and on different areas of the body; the most common areas the procedures are performed are, eyebrows, eyeliner, and lip liner. Another popular procedure is nipple/areola restoration. Having aesthetic areola re-pigmentation after finishing the breast reconstruction journey can be liberating for many women. But did you know that in order to ease the loss of eyebrows and eyelashes, permanent tattooing can also be done before or after chemotherapy or radiation? Through medical aesthetics and oncology aesthetics we have bridged the rift between cancer and beauty. Our patients are treated as a whole, so with that in mind, our goal is to ease the psychological effects of having cancer, hair loss being one of the most gut wrenching for some individuals. Wanting to look your best is healthy. When a woman looks good, she feels better about herself and radiates confidence, no matter her age or circumstance. By using permanent makeup tattoo techniques, we can help you regain a new sense of confidence by very carefully and skillfully enhancing your features to recreate the appearance of brows with our 3D brow effect, eyeliner, lash enhancing, areola restoration, camouflaging the effects of hair loss, and even blending in scars or skin discoloration; even if you are a current brave fighter or brave survivor of cancer.

Permanent makeup is increasingly being endorsed by oncologists as a way of helping patients feel more positive about the traumatic experience of chemotherapy. Over the last several years, there has been a surge of cosmetic eyebrow tattooing in patients undergoing chemotherapy and radiation, or that are about to embark on that journey. Pre-chemotherapy tattooing can capture the appearance of the patient’s natural brows in order to recreate them if chemotherapy causes hair loss.

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Permanent Eyebrow tattooing can alleviate the distress of chemotherapy by preserving the appearance of eyebrows. Patients can be treated one month before chemo drugs are administered, when their original facial hair is in place, so visible eyebrow and eyelash line can be enhanced with pigments. Some people are not bothered by their eyebrow loss, while others find it quite cumbersome. Some barely notice, while others feel their eyebrow loss gives them “the look” of being a cancer patient. For women who have lost their hair because of chemotherapy, permanent eyebrows and even eyeliner can restore self-esteem and also eliminate the need to reapply eyebrows and eyeliner every day.

Everyone responds differently to eyebrow loss during chemotherapy. It’s important that you honor yourself by coping with this side effect in the way that is best suited for you, and you alone. Don’t feel pressured to draw on eyebrows or eyeliner, because if it doesn’t bother you, go without it. Eyebrows in particular, frame the face, enhance your eyes, and may help you feel more like “you”, so if the loss or thinning of your eyebrows is distressing to you, never let anyone discredit the importance of your features and how you want to look.

Other candidates for permanent cosmetic tattooing are women who have arthritis, stroke, Parkinson’s disease, multiple sclerosis, or other conditions that cause tremors, putting on makeup can be a difficult task. Permanent makeup helps eliminate their frustration. Women with vision problems, who are blind, or who have cataracts may also be good candidates. Cosmetic tattooing also helps women who have allergies or hypersensitivity to makeup. Female athletes and other physically active women are turning to permanent cosmetics, as are business women, entertainers, models, and housewives.

Another good candidate to receive permanent tattooing are those with Alopecia (an autoimmune disease in which hair is lost from some or all areas of the body, usually from the scalp). It can be a devastating disorder and affects many men and women throughout the world. Permanent cosmetic tattooing is a remarkable solution to restore the appearance of their hair by masterfully camouflaging the effects of hair loss by blending specifically colored pigments, best suited to the individual, right into their scalp. It is confidence boosting and many clients become very emotional when they see how much their appearance is improved after the treatment

If permanent tattooing is a route you don’t want to go down, I would highly recommend consulting with an aesthetician and/or makeup artist to give you a brow lesson and teach you corrective makeup techniques to enhance your features and help camouflage the unwanted, and temporary changes in your appearance resulting from chemotherapy and radiation. It can be frustrating if you have little or no experience with makeup, let alone drawing on your eyebrows or eyeliner. When you first begin losing your eyebrows, you may want to just pencil them in. Until you lose all of your eyebrows, this can sometimes nicely disguise the loss. All you need is an eyebrow pencil or eye shadow that matches your eyebrow color. Having the help of an expert beats standing in front of the mirror for hours trying to get it just right. If permanent tattooing is a route you are seriously considering, schedule a consultation with a trusted permanent tattoo specialist and discuss your options, ask questions, and explore if you’re a good candidate.

Here at evolv Medical Aesthetics, myself and Rachel McCarthy are the permanent cosmetic tattoo artists, we are also licensed aestheticians and makeup artists. We completed our permanent tattoo training at the world renowned Beau Institute in New Jersey, under the close supervision of Rose Marie Beauchemin, pioneer in the permanent cosmetic tattooing industry and president of the Beau Institute.  The pigments we use are manufactured in the United States, using the highest quality colorants available in the industry, resulting in excellent color retention and superior results. Each shade has been designed and tested by permanent cosmetic professionals, who collectively have more than 40 years of color knowledge and experience. Pigments are different from “ink”. Ink has a tendency to migrate and create a blurred feathered affect in the skin over time. The pigments we use are made from iron oxides, which have been used in the skin for hundreds of years, making them the safest pigments. Iron oxide pigments are also MRI safe. The color pigments chosen for you will compliment your individual skin tone and are deposited into the dermis by using very careful and skilled techniques that are performed by your trained and certified permanent tattoo artist.

We would love to help you in any way with your permanent tattoo questions or needs, and urge you to contact our office to schedule your consultation or speak with a provider.